Enclosed is an income tax data organizer that we provide to tax clients to assist them in gathering the information necessary to prepare their individual income tax returns.

The Internal Revenue Service (IRS) matches information returns/forms with amounts reported on tax returns. A negligence penalty may be assessed when income is under reported or when deductions are overstated. Accordingly, all information returns reflecting amounts reported to the IRS are also mailed or delivered to the taxpayers in an envelope clearly marked “IMPORTANT TAX DOCUMENTS ENCLOSED” and should be submitted with this organizer.

Forms such as:

W-2 (Wages) Schedules K-1
1099-R (Retirement)

1099-INT(Interest)

(Forms 1065, 1120S, 1041)
1099-DIV (Dividends) Annual Brokerage Statements
1099-B (Brokerage Sales) 1098 – Mortgage Interest
1099-MISC (Rents, etc) Other tax information statements
1099 (any other) 8886, Reportable transactions
1098-T (Education) Form HUD-1 for Real Estate Sales/Purchases

 

Also enclosed is an engagement letter which explains the services we will provide to you. Please sign a copy of the engagement letter and return the signed copy in the enclosed envelope. Keep the other copy for your records.

To continue providing quality services on a timely basis, we urge you to collect your information as soon as possible. If information from “passthrough” entities such as partnerships, trusts, and S corporations is the only data you are missing, please send the data you have assembled and forward the missing information as soon as it is available.

The filing deadline for your income tax return was April 15, 2015. We extended your return without payment to October 15, 2015. In order to meet this filing deadline your completed tax organizer needs to be received no later than July 15, 2015. Any information received after that date may cause a delay in filing, which may involve penalties and interest for which you will be responsible.

As you know when an extension of time is required, any tax due must be paid with that extension. Any taxes not paid by the filing deadline may be subject to late payment penalties and interest.

We look forward to providing services to you.  Should you have questions regarding any items, please do not hesitate to contact _____.

If we did not prepare your prior year returns, provide a copy of federal and state returns for the three previous years. Complete pages 1 through 4 and all applicable sections.

 

Taxpayer’s Name: Yogi T. Bear SSN 111-22-3333 Occupation Cartoon bear
     
Spouse’s Name Missy T. Bear SSN  111-22-3334 Occupation Cartoon bear
Home Address: 105 Tree Top Rd, Black Moshannon, PA 16809

 

Version #7  

__________________

 

_____

 

__________

 

________________

City, Town, or Post Office County State Zip Code School District

 

Telephone Number Telephone Number (Taxpayer) Telephone Number (Spouse)
Home 814-555-1212 Office                               Office                              
Email(T) yogi21@ytb.com Fax                                   Fax                                  
Email(S)   miss32@ytb.com Cell                                   Cell                                  
  Email________________________

___________________________

Email_______________________

 

Taxpayer Date of Birth 9/25/85 Blind? Yes ____ No X
Spouse Date of Birth 5/14/86 Blind? Yes ____ No X

 

Dependent Children Who Lived With You:

Full Name SSN Relationship Birth Date
111-22-3335 Soon 7/23/15
       
       
       
       

 

Other Dependents:

 

 

 

Full Name

 

SSN

 

 

Relationship

 

 

Birth Date

Number Months

Resided in

Your Home

% Support

Furnished

By You

           
           
           

Please answer the following questions and submit details for any question answered “Yes”:

     

YES

NO

 

 1. Did any births, adoptions, marriages, divorces, or deaths occur in your family last year? If yes, provide details.

 

   

 

______

 

 

         
 2. Will the address on your current returns be different from that shown on your prior year returns? If yes, provide the new address and date moved.

 

   

 

______

 

 

         
 3. Were there any changes in dependents from the prior year? If yes, provide details.

 

   

 

______

 

 

         
 4. Are you entitled to a dependency exemption due to a divorce decree?   ______
         
 5. Did any of your dependents have income of $1,000 or more ($400 if self-employed)?    

______

         
 6. Did any of your children under age 19, age 24 if they are a full time student, have investment income over $2,000?    

______

 

  If yes, do you want to include your child’s income on your return?   ______
         
 7. Are any dependent children married and filing a joint return with their spouse?    

______

         
 8. Did any dependent child 19-23 years of age attend school full-time for less than five months during the year?    

______

 

         
 9. Did you receive income from any legal proceedings, cancellation of student loans or other indebtedness during the year? If yes, provide details.

 

   

 

______

 

         
10. Did you make any gifts during the year directly or in trust exceeding $14,000 per person?    

______

 

         
11. Did you have any interest in, or signature, or other authority over a bank, securities, or other financial account in a foreign country?    

______

 

         
12.

 

Were you the grantor, transferor or beneficiary of a foreign trust?    

______

 

         
13. Were you a resident of, or did you have income from, more than one state during the year?    

______

 

         
14. Do you wish to have $3 (or $6 on joint return) of your taxes applied to the Presidential Campaign Fund? (Current president unbearable)    

______

 

         
15. Do you wish to contribute to any state fund(s)? If yes, indicate amount(s) and which fund(s):

______________________________________________________________

______________________________________________________________

 

   

 

 

 

______

 

         
16. Do you want any overpayment of taxes applied to next year’s estimated taxes?    

______

 

         
17. Do you want any federal or state refund deposited directly into your bank account? If yes, enclose a voided check.    

______

 

  1. Do you want any balance due directly withdrawn from this same bank account on the due date?    

______

 

  2. Do you want next year’s estimated taxes withdrawn from this same bank account on the due dates?    

______

 

         
18. Do either you or your spouse have any outstanding child or spousal support payments or federal debt?    

______

 

         
19. If you owe federal or state tax upon completion of your return, are you able to pay the balance due?    

 

______

         
20. Do you expect a large fluctuation in your income, deductions or withholding next year? If yes, provide details.

 

   

 

______

 

         
21. Did you receive any distribution from an IRA or other qualified plan that was partially or totally rolled over into another IRA or qualified plan within 60 days of the distribution (Form 1099R)?    

 

______

 

         
22. If you received an IRA distribution, which you did not roll over, provide details (Form 1099R).

 

   

 

______

 

         
23. Did you “convert” IRA funds into a Roth IRA? If yes, provide details (Form 1099R).

 

   

 

______

 

         
24. Did you receive any disability payments this year?   ______  

         
25. Did you receive tip income not reported to your employer? Just Picnic baskets   ______  

         
26. Did you sell or purchase a principal residence or other real estate? If yes, provide settlement sheet (HUD-1) and Form 1099-S.    

______

 

         
27. Did you collect on any installment contract during the year? Provide details.

 

   

______

 

         
28. Did you receive tax-exempt interest or dividends not reported on Forms 1099-INT or 1099 -DIV?    

______

 

         
29. During this year, do you have any securities that became worthless or loans that became uncollectible?    

______

 

         
30. Did you receive unemployment compensation? If yes, provide Form 1099-G.   ______  

         
31. Did you receive, or pay, any Alimony during the year?  If yes, provide details.

 

  ______  

         
32. Did you have any casualty or theft losses during the year? If yes, provide details.    

______

 

         
33. Did you have foreign income, pay any foreign taxes, or file any foreign information reporting or tax return forms? Provide details.    

______

 

         
34. If there were dues paid to an association, was any portion not deductible due to political lobbying by the association or benefits received?    

______

 

         
35. Did you, or do you plan to contribute before April 15, 2015, to a traditional IRA, or Roth IRA for last calendar year?  If yes, provide details. You tell me!    

______

 

______

         
36. Did you, or do you plan to contribute before April 15, 2015 to a health savings account (HSA) for last calendar year?  If yes, provide details.    

______

 

         
37. Did you receive any distributions from an HSA?  If so, provide details.   ______  

         
38. Has the IRS, or any state or local taxing agency, notified you of changes to a prior year’s tax return? If yes, provide copies of all notices or correspondence received.    

 

______

 

         
39. Are you aware of any changes to your income, deductions and credits reported on any prior years’ returns?    

______

 

         
40. Did you purchase gasoline, oil, or special fuels, for non-highway use vehicles?   ______  

         
41. Did you purchase an energy-efficient or other new vehicle? If yes, provide purchase invoice.    

______

 

         
42. If you, or your spouse, have self-employment income, did you pay any health insurance premiums or long-term care premiums?    

______

 

         
43. Were either you or your spouse eligible to participate in an employer’s health insurance or long-term care plan?    

 

______

         
44. If you, or your spouse, have self-employment income, do you want to make a retirement plan contribution?    

______

 

         
45. Did you acquire any “qualified small business stock”?   ______  

         
46. Were you granted or did you exercise any stock options? If yes, provide details.    

______

 

         
47. Were you granted any restricted stock?  If yes, provide details.   ______  

         
48. Did you pay any household employee over age 18 wages of $1,800 or more?    

______

 

  If yes, provide copy of Form W-2 issued to each household employee.   ______  

  If yes, did you pay total wages of $1,000 or more in any calendar quarter to all household employees?    

______

 

______

         
49. Did you surrender any U.S. savings bonds?   ______  

         
50. Did you use the proceeds from Series EE U.S. savings bonds purchased after 1989 to pay for higher education expenses?    

______

 

         
51. Did you realize a gain on property which was taken from you by destruction, theft, seizure, or condemnation?    

______

 

         
52. Did you start a business?   ______  

         
53. Did you purchase rental property? If yes, provide settlement sheet (HUD-1).   ______  

         
54. Did you acquire any interests in partnerships, LLCs, S corporations, estates or trusts this year? If yes, provide Schedule K-1 that the Organization has issued to you.  

 

 

 

______

 

         
55. Do you have records to support travel, entertainment, or gift expenses? The law requires that adequate records be maintained for travel, entertainment, and gift expenses. The documenta­tion should include amount, time and place, date, business purpose, description of gift(s) (if any), and business relationship of recipient(s).    

 

 

 

 

______

         
56. Has your will or trust been updated within the last three years? If yes provide copies.    

______

 

         
57. Did you incur expenses as an elementary or secondary educator?  If so, how much?    

_____

 

         
58. Did you make any energy-efficient improvements (remodel or new construction) to your home?    

______

 

         
59. Can the Internal Revenue Service and state tax authority discuss questions about this return with the preparer?    

 

______

         
60. Did you make any large purchases or home improvements?   ______  

         
61. Did you pay real estate taxes on your principal residence?

If so, how much? $4500

 

   

 

______

 

ESTIMATED TAX PAYMENTS MADE

  FEDERAL  STATE (NAME):
  Date Paid Amount Paid Date Paid Amount Paid
  Prior year overpayment applied        
  1st Quarter        
  2nd Quarter        
  3rd Quarter        
  4th Quarter        
         

WAGES, SALARIES, AND OTHER EMPLOYEE COMPENSATION

Enclose all Forms W-2.
Fed wages $97,400

State tax withheld $2,000

Fed Tax withheld $11,000

 

PENSION, IRA, AND ANNUITY INCOME

Enclose all Forms 1099-R.  
    YES NO

 

1. Did you receive a Lump Sum distribution from your employer?   ______  

         
2. Did you “convert” a Lump Sum distribution into another plan or IRA account?   ______  

         
3. Did you transfer IRA funds to a Roth IRA this year?   ______  

         
4. Have you elected a Lump Sum treatment for any retirement distributions after 1986?  

Taxpayer

 

Spouse

   

______

 

______

 

 

SOCIAL SECURITY BENEFITS RECEIVED

Enclose all 1099 SSA Forms.

 

INTEREST INCOME – Enclose all Forms 1099-INT and statements of tax-exempt interest earned.

If not available, complete the following:

 

TSJ*

 

Name of Payor

 

Banks,

S&L, Etc.

 

U.S. Bonds,

T-Bills

 

Tax-Exempt

In-State                Out-of-State

J First Union 1920   1000  
           
           
           
           
           
           
           
           
           
           
           
           
    Early Withdrawal

Penalties

       

*T = Taxpayer  S = Spouse   J = Joint

INTEREST INCOME (Seller-Financed Mortgage)

 

Name of Payor

Social Security

Number

 

Address

 

Interest Received

       
       

 

DIVIDEND INCOME – Enclose all Forms 1099-DIV and statements of tax-exempt dividends earned.

If not available, complete the following:

 

 

TSJ*

 

 

Name of Payor

 

Ordinary

Dividends

 

Qualified

Dividends

 

Capital

Gain

 

Non

Taxable

Federal

Tax

Withheld

Foreign

Tax

Withheld

J Edwards 895 1000        
               
               
               
               
               
               
               
               
               
               
               

*T = Taxpayer  S = Spouse  J = Joint

MISCELLANEOUS INCOME – List and enclose related Forms 1099 or other forms.

  Description Amount
    State and local income tax refund(s)  
    Alimony received  
    Jury fees  
    Finder’s fees  
    Director’s fees  
    Prizes  
    Gambling winnings (W2-G)  
    Other miscellaneous income  
     
     
     


CAPITAL GAINS AND LOSSES – Enclose all Forms 1099-B (with supplemental year end brokerage statements) and 1099-S with HUD-1 closing statements). Complete the following schedule if no statements are available and provide all transaction slips for sales and purchases.

 

Description

Date

Acquired

Date

Sold

Sales

Proceeds

Cost or

Basis

 

Gain (Loss)

Disney 1/5/15 7/12/15 5000 3000 2000
IBM 12/10/13 8/10/15 4800 1800 3000
           
           
           
           
           
           
           
           

 

Enter any sales NOT reported on Forms 1099-B and 1099-S:

 

 

Description

Date

Acquired

Date

Sold

Sales

Proceeds

Cost or

Basis

 

Gain (Loss)

           
           
           
           
           
           
           
           
           
           

 

MEDICAL AND DENTAL EXPENSES (PLEASE NOTE THAT MEDICAL EXPENSES MUST EXCEED 7.5% OF ADJUSTED GROSS INCOME TO BE DEDUCTIBLE).  HEALTH INSURANCE PREMIUMS AND MEDICAL EXPENSES PAID WITH PRE-TAX DOLLARS (CAFETERIA PLANS, HEALTH SAVINGS ACCOUNTS, ETC.) ARE NOT DEDUCTIBLE.

Description Amount
  Premiums for health and accident insurance including Medicare  
  Long-term care premiums:  Taxpayer  $                                          Spouse  $

 

 

 

 

 
  Medicine and drugs (prescription only)  
  Doctors, dentists, nurses  
  Hospitals, clinics, laboratories 2350
  Eyeglasses / corrective surgery 500
  Ambulance  
  Medical supplies / equipment  
  Hearing aids  
  Lodging and meals  
  Travel  
  Mileage (number of miles)  
  Long-term care expenses  
  Payments for in-home care (complete later section on home care expenses)  
  Other  
  Insurance reimbursements received (                                       )

 

Were any of the above expenses related to cosmetic surgery? Yes_____  

 

DEDUCTIBLE TAXES

Description Amount
  State and local income tax payments made this year for prior year(s).  
  Real estate taxes:  Primary residence  
                                 Secondary residence  
                                 Other  
  Personal property or ad valorem taxes  
  Sales tax on major items (auto, boat, home improvements, etc.)  
  Other sales taxes paid (if applicable)  
  Intangible tax  
  Other taxes (itemize)  
  Foreign tax withheld (may be used as a credit)  

 

INTEREST EXPENSE

Mortgage interest (enclose Forms 1098)

Payee* Property** Amount
     
     
     
     
     

 

*Include address and social security number if payee is an individual.

**Describe the property securing the related obligation, i.e., principal residence, motor home, boat, etc.

If any mortgage or equity loan was not used to buy, build, or improve your principal or second residence, please describe how the proceeds were used.

Unamortized points on residence refinancing

Date of Refinance Loan Term   Total Points
       
       

 

Student loan interest

Payee Amount
   
   

 

Investment interest not reported on Schedules A, C, or E

Payee Investment Purpose(stocks, land , etc) Amount
     
     
     
     
     

 

Business interest not reported on Schedules C, or E

Payee Business Purpose Amount
     
     
     
     

 

CONTRIBUTIONS

 

Cash contributions, for which you have receipts, canceled checks, etc. NOTE: You need to have written acknowledgment from any charity to which you made individual donations of $250 or more during the year.

Donee Amount Donee Amount
Church 3100    
National Wildlife 1000    
       
       
       
       
       

 

 

Expenses incurred in performing volunteer work for charitable organizations:

 

  Parking fees and tolls $                                                   
  Supplies $                                                   
  Meals & entertainment $                                                   
  Other (itemize) $                                                   
  Automobile mileage ______________________    

 

Other than cash contributions (enclose receipt(s)):

  Organization name and address      
  Description of property      
  Date acquired      
  How acquired      
  Cost or basis      
  Date contributed      
  Fair market value (FMV)      
  How FMV determined      

 

For contributions over $5,000, include copy of appraisal and confirmation from charity.

 

CASUALTY OR THEFT LOSSES

 

Loss of property by theft or damage to property by fire, storm, car accident, shipwreck, flood or other “act of God”

  Property 1 Property 2 Property 3
 

Indicate type of property

  ¨ Business

¨ Personal

  ¨ Business

¨ Personal

  ¨ Business

¨ Personal

  Description of property      
  Date acquired      
  Cost      
  Date of loss      
  Description of loss      
  Was property insured? (Y/N)      
  Was insurance claim made? (Y/N)      
  Insurance proceeds      
  Fair market value before loss      
  Fair market value after loss      

Is the property in a presidentially declared disaster area?                             Yes_____     No_____

 

 


MISCELLANEOUS DEDUCTIONS

 

Description Amount
  Union dues  
  Income tax preparation fees 500
  Legal fees (provide details)  
  Safe deposit box rental (if used for storage of documents or items related to income-producing property) 25
  Small tools  
  Uniforms which are not suitable for wear outside work  
  Safety equipment and clothing  
  Professional dues  
  Business publications 150
  Unreimbursed cost of business supplies  
  Employment agency fees  
  Investment expenses 200
  Trustee fees  
  Other miscellaneous deductions – itemize  
  Documented gambling losses  

 

EMPLOYEE/SELF EMPLOYED BUSINESS EXPENSES – FORM 2106

 

Expenses incurred by:   ¨ Taxpayer  ¨ Spouse  ¨ Occupation ______________________

 

(Complete a separate schedule for each business)

 

 

Description

 

Total Expense

Incurred

Employer

Reimbursement

Reported on W-2

Employer

Reimbursement

Not on W-2

  Travel expenses while away from home:      
    Transportation costs      
    Lodging      
    Meals and entertainment      
  Business use of home (see schedule)      
  Other employee business expenses – itemize