Neil I
Neil I. Sidi, C.P.A.
450 Seventh Avenue-Suite 2304
New York, New York 10123-2304
Phone (212) 244-1040
Fax (212) 244-1044
Email: NSidi@
TAX QUESTIONS FOR 2018 FORM 1040:
LAST NAME: _______________FIRST NAME____________MIDDLE INITIAL___
SOCIAL SECURITY NUMBER: ___-__-____ DATE OF BIRTH__/__/__
FILING STATUS: CIRCLE ONE: SINGLE MARRIED
OCCUPATION: _______________________
IF MARRIED: SPOUSE'S NAME___________________________________
IS SPOUSE A U.S.A. CITIZEN? ___YES ___NO
SPOUSE’S SOCIAL SECURITY NUMBER: ___-__-____.
SPOUSE’S DATE OF BIRTH ___/___/___
SPOUSE’S OCCUPATION: __________________
LIST ANY CHILDREN AND THEIR SOCIAL SECURITY #’S & DATE OF BIRTH:
___________________________________________________________
___________________________________________________________
1-PERMANENT RESIDENCE ADDRESS: ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
2- TELEPHONE NUMBER (WORK): __________________ SPOUSE-WORK: ___________________
HOME NUMBER: __________________
CELL NUMBER: ____________________ SPOUSE-CELL: ______________________
FAX NUMBER: ____________________
WORK EMAIL ADDRESS: _________________________________________
PERSONAL EMAIL ADDRESS: _____________________________________
SPOUSE EMAIL ADDRESS: ______________________________________
3-TAX REFUND DIRECT DEPOSIT INFORMATION: (IF JOINT RETURN MUST HAVE EACH TAXPAYER’S NAME ON THE ACCOUNT)
BANK NAME___________________
ABA NUMBER (MUST BE 9 DIGITS) _ _ _ _ _ _ _ _ _
ACCOUNT #__________________
TYPE OF ACCOUNT (“X” ONE) CHECKING: ____ SAVINGS: ____
Please confirm you and the members of your household were covered by a health insurance plan during each month of 2018. YES__________ No____
Please attach a PDF copy of your 2017 federal and state income tax returns if my office did not prepare your income tax returns.
4- MISCELLANEOUS BUSINESS EXPENSES (ONLY THOSE PAID DURING 2018):
These continue to potentially be deductible by NY State but not for federal:
>Business Publications: _______________
>Tax return preparation fees: _______________
>Business use of telephone: _______________ Blackberry/data charges: ________
>Professional association dues: _______________
>Professional licenses and registration fees: _________________
>Professional education if not required to qualify you for employment: _________
>Professional seminars/Conferences: ______________
>Job hunting expenses: ___________________
>Computer related equipment purchased: ________________
>Internet access fees for business purposes: ___________________
5> Total Cash/check contributions to U.S. charities: ____________
6>Personal property contributions to U.S. charities: ____________
(IF OVER $500 OF PROPERTY CONTRIBUTIONS PLEASE INCLUDE RECEIPTS)
7>Real estate taxes paid on primary (and secondary) residence you own: _________
(IF CO-OP PLEASE PROVIDE COPY OF THE ACCOUNTANT’S LETTER)
8>Mortgage interest or points paid on primary (and secondary) residence you own. (PLEASE PROVIDE COPIES OF FORM 1098):____________________
9- PLEASE ATTACH COPY OF SALARIED INCOME FROM WORK W-2 WAGE & TAX STATEMENT, 1099-R FORMS FOR ANY PERSION OR IRA DISTRIBUTIONS RECEIVED, AND 1099-SSA FORMS FOR ANY SOCIAL SECURITY PAYMENTS RECEIVED.
10- PLEASE ATTACH COPY OF BANK INTEREST 1099-INT, STOCK DIVIDENDS 1099-DIV, MUTUAL FUNDS FORM 1099-DIV STATEMENTS (COST BASIS FOR ANY SALES OF STOCK/MUTUAL FUNDS). ALSO LIST ANY MARGIN INTEREST PAID OR INVESTMENT ADVICE OR MANAGEMENT CHARGES PAID FOR.
11- AT ANY TIME DURING 2018, DID YOU HAVE A FINANCIAL INTEREST IN OR MAINTAIN A SIGNATURE AUTHORITY OVER A FOREIGN BANK OR SECURITIES ACCOUNT OR OTHER FOREIGN FINANCIAL ACCOUNT? YES _____ NO _____ LIST THE COUNTRIES: ____________________
IF YES, WAS THE VALUE OVER US$10,000 AT ANY TIME DURING 2018? YES _____ NO ____
IF YES, WAS THE VALUE OVER US$100,000 AT ANY TIME DURING 2018 or over US$50,000 at December 31, 2018? YES _____ NO ____
12- List the amount of moving expenses incurred in 2018 only if you moved more than 50 miles from your old home to your new workplace due to a job change:
These continue to potentially be deductible by NY State but not for federal:
- Date of the move: ____________
- Transportation expenses for the move: ______________
- Storage of household goods: ______________
- Travel expenses for the move: _____________
- Lodging expenses for the move: ____________
13- If you lived in New York City or in New Jersey during 2018, how much was the total annual rent which you paid? $_______________
14- Did you have any child care expenses for any dependent children under the age of 13 (NANNY, DAY CARE, NURSERY SCHOOL OR DAY CAMP)Yes:________ No:______
LIST NAME, ADDRESS AND TAX ID NUMBER OF PROVIDER AND AMOUNT PAID DURING 2017:
PROVIDER NAME: _______________________
ADDRESS: ____________________________________________________
TAX ID NUMBER: _______________________
AMOUNT PAID: _______________ NAME OF CHILD/CHILDREN PROVIDED FOR:_____________
(continued)
PROVIDER NAME: _______________________
ADDRESS: ____________________________________________________
TAX ID NUMBER: _______________________
AMOUNT PAID: _______________ NAME OF CHILD/CHILDREN PROVIDED FOR:_____________
15- NOTE: IF YOU BELIEVE YOUR UNREIMBURSED MEDICAL EXPENSES WILL EXCEED 7.5% (OR 2% FOR NJ RESIDENTS) OF YOUR INCOME THEN PROVIDE YOUR AGGREGATE 2017
UNREIMBURSED MEDICAL EXPENSES HERE: __________
OTHERWISE, DON’T SPEND THE TIME TO CALCULATE IT.
16- IF YOU WERE SELF EMPLOYED, AND NOT A W-2 EMPLOYEE, PLEASE LIST THE AMOUNT OF HEALTH INSURANCE _______________
17- Did you contribute to a NY 529 College Savings Plan in 2018? YES___ NO___
If yes, how much did you contribute? $__________
18- (For Connecticut residents only): Did you contribute to a CHET College Savings Plan in 2018? YES___ NO___ If yes, list the account number: __________ and how much did you contribute during 2018? $__________
19- Did you purchase a primary or secondary residence during 2018? YES___ NO___
If yes, please attach a copy of the closing statement.
20- Did you pay college or post-secondary school tuition for either yourself or any dependents during 2018? If so, please include a copy of any form 1098-T received from the college or university.
21- Did you withdraw money from a 529 College Savings Plan in 2018? YES___ NO___
If so, please include a copy of any form 1098-Q received from the 529 plan.
22- Did you withdraw money from an HSA Plan in 2018? YES___ NO___.
Did you contribute any money into an HSA Plan in 2018? YES___ NO___.
If so, please include a copy of any form 1099-SA or 5498-SA.
22- Did you make any energy efficient improvements to your primary home or purchase any solar energy efficient property for any home during 2018 or replace exterior windows, doors or heating or A/C units? IF YES, ATTACH DETAILS (DATE & AMOUNT) BY CATEGORY.
24- DID YOU MAKE ANY ESTIMATED TAX PAYMENTS FOR 2018? YES ___ NO______
IF YES, PLEASE LIST ANY ESTIMATED INCOME TAX PAYMENTS MADE FOR THE 2018 TAX YEAR TO THE US TREASURY OR STATE TAX AUTHORITIES BY AMOUNT AND BY DATE OR ATTACH COPIES OF CHECKS SENT:
TO US TREASURY:________________________________________________________________
TO STATE: (LIST NAME OF STATE): _______________________________________________
25- Did you contribute or intend to contribute by April 15, 2019 to a traditional or Roth IRA for 2018? YES____ NO____. If yes, please list the amount, the type of IRA and whether it is for the taxpayer or the spouse:
NOTE THIS DOES NOT REFER TO A 401K OR 403B PLAN THROUGH YOUR EMPLOYMENT.
26- Did you roll over a traditional IRA into a ROTH IRA during 2018? YES____ NO____. IF YES PLEASE PROVIDE A COPY OF THE 1099-R.
27- If applicable, please attach a copy of any correspondence you received during 2018 regarding your prior year federal and state income tax returns if the tax authorities made any changes to your returns as filed.
28- If you received an IRS Identity Protection Personal Identification Number on form Notice CP01A dated January 1, 2019 please provide a copy of the notice or list the six digit PIN number and specify for which taxpayer it applies to.
_ _ _ _ _ _
Note that each year the IRS reissues new IRS Identity Protection Personal Identification Numbers if you are eligible, so last year’s number would no longer be valid.
HERE IS A HELPFUL CHECKLIST OF TYPICAL SOURCE DOCUMENTS TO INCLUDE FOR PREPARATION:
W-2 FORMS
1099-R FORMS
1099-SSA FORMS
1099-G FORMS
1099-INT FORMS
1099-DIV FORMS
1099-B FORMS
REALIZED GAIN-LOSS SCHEDULE FOR SECURITY SALES
1099-MISC FORMS
1098 MORTGAGE INTEREST FORMS
1098-E STUDENT LOAN INTEREST PAID
1098-T TUITION PAID FOR YOURSELF AS WELL AS DEPENDENTS
1099-Q FOR 529 PLAN DISTRIBUTIONS FOR YOURSELF AS WELL AS DEPENDENTS
HUD-1 CLOSING STATEMENTS ON SALE/PURCHASE OF REAL PROPERTY
K-1 FORMS FROM PARTNERSHIPS AND S-CORPS
5498 FORMS FOR IRA’S OR HSA’S
1099-SA FOR HSA DISTRIBUTIONS
1) The IRS and state revenue agencies are now requiring that your driver's license information be included in the electronic filing for each taxpayer and spouse as a security checking measure. Therefore we ask that you please provide us with the following information for both you and your spouse, as applicable:
TAXPAYER SPOUSE
|Driver's license issuing state | | |
|Driver's license number | | |
|Driver's license issue date | | |
|Driver's license expiration date | | |
|NY document number (first 3 alphanumeric characters)* | | |
Alternatively, you can scan your driver's license(s) and send us a copy.
Failure to provide this information may result in a IRS letter 5071C generated by the IRS requesting verification of your identity in order to process your tax return which may delay the processing of your overpayment credit or refund.
* The NY document number is the 8 or 10 alphanumeric character string at the bottom right of the NY license or on the back if it was issued after January 28, 2014. On enhanced NY licenses issued after 1/28/2014, the document number can also begin after 'IDUSA' and is on the back of the document.
Very Important: If you have received an IRS Identity Protection Personal Identification Number for your 2018 tax return filing please provide a copy of the notice CP01A which reflects this number. Note that each year the IRS reissues new IRS Identity Protection Personal Identification Numbers if you are eligible, so last year’s number would no longer be valid.
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