Tax Preparation Checklist



Tax Preparation Checklist Personal Information (If you are returning client and no information has changed, you can leave dates of birth and social security numbers blank for security purposes)Full Name: FORMTEXT ????? Date of Birth:Click or tap to enter a date. Street Address: FORMTEXT ?????Social security number: FORMTEXT ????? Occupation: FORMTEXT ?????Phone #: FORMTEXT ????? E-mail Address: FORMTEXT ?????Were you married as of December 31, 2020? FORMCHECKBOX YES FORMCHECKBOX NOIf married, spouse’s name: FORMTEXT ?????DOB: Click or tap to enter a date. SSN: FORMTEXT ?????Occupation: FORMTEXT ?????Do you want $3 of your tax to go to the Presidential Election Fund? FORMCHECKBOX YES FORMCHECKBOX NO Does anyone claim you as a dependent? FORMCHECKBOX YES FORMCHECKBOX NODo you have any children that you may claim as a dependent? FORMCHECKBOX YES FORMCHECKBOX NOIf so, dates of birth and social security numbers (Please check the LWY box if the child lives with you.):Name: FORMTEXT ????? DOB: FORMTEXT ????? SSN FORMTEXT ????? LWY FORMCHECKBOX Name: FORMTEXT ????? DOB: FORMTEXT ????? SSN FORMTEXT ????? LWY FORMCHECKBOX Name: FORMTEXT ????? DOB: FORMTEXT ????? SSN FORMTEXT ????? LWY FORMCHECKBOX Are the children in any type of childcare? FORMCHECKBOX YES FORMCHECKBOX NOChildcare provider and amount paid: (including the provider's name, address, and Tax ID number):________________________________________________________________________Did your employer reimburse you for any of this dependent care? FORMCHECKBOX YES FORMCHECKBOX NODid anyone else (other than your spouse or children) live in your home at some point duringthe year or did you provide support to anyone who did not live with you? FORMCHECKBOX YES FORMCHECKBOX NOIncome (Please provide all forms also: W-2’s, 1099’s, etc)Did you receive income this year from work that you did as an employee? FORMCHECKBOX YES FORMCHECKBOX NO Did you receive income this year from work you did as an independent contractor? FORMCHECKBOX YES FORMCHECKBOX NO Did you receive any pension, IRA, or Social Security income? FORMCHECKBOX YES FORMCHECKBOX NO Did you receive disability or pension benefits from the Dept of Veteran’s Affairs? FORMCHECKBOX YES FORMCHECKBOX NODid you receive any savings or investment income (interest or dividends)? FORMCHECKBOX YES FORMCHECKBOX NODid you sell any investments this year? Please provide statements from your broker. FORMCHECKBOX YES FORMCHECKBOX NO Did you have your own business during the year (self-employed)? FORMCHECKBOX YES FORMCHECKBOX NO If yes, did this business provide healthcare to you or your employees? FORMCHECKBOX YES FORMCHECKBOX NODid you receive alimony from an ex-spouse? FORMCHECKBOX YES FORMCHECKBOX NO Did you collect unemployment during the year? FORMCHECKBOX YES FORMCHECKBOX NO Did you rent real estate to someone else this year? FORMCHECKBOX YES FORMCHECKBOX NODid you sell any rental real estate this year? FORMCHECKBOX YES FORMCHECKBOX NODid you have any gambling winnings this year, including prizes and awards? FORMCHECKBOX YES FORMCHECKBOX NO Did you receive an inheritance this year? FORMCHECKBOX YES FORMCHECKBOX NO Did you have any debt that was forgiven by a creditor this year? FORMCHECKBOX YES FORMCHECKBOX NODid you engage in any transaction involving virtual currency in 2020? FORMCHECKBOX YES FORMCHECKBOX NODid you receive any other income not mentioned above? FORMCHECKBOX YES FORMCHECKBOX NO If so, describe: FORMTEXT ?????DeductionsIf you paid alimony, amount paid and ex-spouse's social security number:Name: FORMTEXT ????? SSN: FORMTEXT ????? Amount Paid: FORMTEXT ?????Was this alimony agreement into before 1/1/2019? FORMCHECKBOX YES FORMCHECKBOX NOAre you an active member of the military? FORMCHECKBOX YES FORMCHECKBOX NOIf so, did you move because of an active military order? FORMCHECKBOX YES FORMCHECKBOX NO Did you, your spouse, or any of your children take any classes this year? FORMCHECKBOX YES FORMCHECKBOX NO If so, were they full-time students? FORMCHECKBOX YES FORMCHECKBOX NO (Please provide all education bills, and/or 1098-T forms)Did they receive any scholarships this year? FORMCHECKBOX YES FORMCHECKBOX NODid you invest or remove any money from a 529 educational savings plan this year? FORMCHECKBOX YES FORMCHECKBOX NO Did you or your spouse invest any money into a retirement plan this year? FORMCHECKBOX YES FORMCHECKBOX NO (Please provide all statements from your retirement plans)Itemizing DeductionsWhat is your current living situation? FORMCHECKBOX OWN FORMCHECKBOX RENT FORMCHECKBOX OTHERIf you own your home, please include 1098 from mortgage company.If your property taxes are not included in your mortgage, how much did you pay? FORMTEXT ?????Do you pay mortgage insurance (PMI) on your property? If so, how much did you pay?Do you have a home equity loan or line of credit? FORMCHECKBOX YES FORMCHECKBOX NOWhat was the money received from the loan used for? FORMTEXT ?????If you rent your home, how much is your monthly rent? FORMTEXT ????? How long did you live in this home this year? FORMTEXT ?????Did you install energy-efficient windows, insulation, a/c, furnace or water heater? FORMCHECKBOX YES FORMCHECKBOX NODid you make any donations to charity this year? FORMCHECKBOX YES FORMCHECKBOX NODid you pay any medical expenses this year that you were not reimbursed for? FORMCHECKBOX YES FORMCHECKBOX NOIf so, how much? (Please separate by Doctors, Dentists, and Pharmacy) FORMTEXT ?????Did you incur any mileage related to these visits?If yes how much: FORMTEXT ????? FORMCHECKBOX YES FORMCHECKBOX NOHow much did you pay to have your tax return prepared last year? FORMTEXT ?????Did you have more than one job this year? FORMCHECKBOX YES FORMCHECKBOX NOIf yes, which one best describes the situation? FORMCHECKBOX Change Jobs FORMCHECKBOX Second Job FORMCHECKBOX BothPrevious Year Carry Over ItemsPlease note: If you are a new client, please provide a copy of your previous year’s federal tax return.Did you claim any Homebuyer credits for the purchase of a home in 2008-2010? FORMCHECKBOX YES FORMCHECKBOX NODo you and/or your spouse still live in this house? FORMCHECKBOX YES FORMCHECKBOX NODid you sell a home in 2020? If so, was it your primary residence? FORMCHECKBOX YES FORMCHECKBOX NOWas your home foreclosed upon during the year or did you declare bankruptcy in 2020? FORMCHECKBOX YES FORMCHECKBOX NO Did you have any mortgage or other debt forgiven by the lender in 2020? (1099-C) FORMCHECKBOX YES FORMCHECKBOX NOHealth CoverageDid all individuals on your tax return (Taxpayer, Spouse, and Dependents) have healthcare coverage throughout calendar year 2020? FORMCHECKBOX YES FORMCHECKBOX NOWho provided this coverage (check all that apply)? FORMCHECKBOX Employer FORMCHECKBOX Self FORMCHECKBOX Government Healthcare Marketplace(Please provide all forms 1095-A, B, or C that you received)Please provide the name(s) and policy number(s) of the healthcare insurance provider(s)If you answered “No” to the first question, please explain who did not have coverage, for how long, and the reason that there was no coverage:Did you claim an advanced Premium Tax Credit for any of the coverage listed above? FORMCHECKBOX YES FORMCHECKBOX NOIf so, how much was paid to the Healthcare Provider on your behalf?2020 Specific Items:Did you receive payment(s) from the government because of the CARES Act (COVID-19)? FORMCHECKBOX YES FORMCHECKBOX NOPlease provide the form(s) 1444 and/or 1444-B from the IRS or provide the exact amount: FORMTEXT ?????Was any of the payment garnished or withheld? FORMCHECKBOX YES FORMCHECKBOX NODid you receive the payment for any dependents that are over age 17 as of 1/1/2020? FORMCHECKBOX YES FORMCHECKBOX NODid a member of you household note receive their payment(s)? FORMCHECKBOX YES FORMCHECKBOX NOWere your work or business hours or conditions restricted or changed because of COVID19? FORMCHECKBOX YES FORMCHECKBOX NO If so, did you collect Unemployment Benefits related to this? FORMCHECKBOX YES FORMCHECKBOX NODid you or your employer alter your dependent care reimbursement because of this? FORMCHECKBOX YES FORMCHECKBOX NODid you or your employer alter your FSA or HSA account because of this? FORMCHECKBOX YES FORMCHECKBOX NODid you or your employer choose to defer some of your 2020 payroll taxes? FORMCHECKBOX YES FORMCHECKBOX NODid you collect Family Medical Leave or Emergency Paid Sick Leave? FORMCHECKBOX YES FORMCHECKBOX NODid you receive Federal student loan payment relief in 2020 because from the CARES Act? FORMCHECKBOX YES FORMCHECKBOX NODid you have a retirement account loan out (or take one) during 2020? FORMCHECKBOX YES FORMCHECKBOX NODid you receive any foreclosure or eviction relief because of the CARES Act? FORMCHECKBOX YES FORMCHECKBOX NODid you remove any money from a retirement account for COVID-19 related expenses? FORMCHECKBOX YES FORMCHECKBOX NODid your employer provide any educational assistance to you in 2020? FORMCHECKBOX YES FORMCHECKBOX NORefund InformationDo you want your refund direct deposited? If so, please provide the routing and account number of your financial institution (If it is the same account as last year, just write SAME): Routing #: FORMTEXT ??? Account #: FORMTEXT ?????Approximately how much was your Federal refund last year? FORMTEXT ?????Approximately how much was your State refund last year? FORMTEXT ?????Please provide any other information or questions you might have that you feel is relevant to your tax situation: FORMTEXT ?????I attest that the information provided above is true and accurate to the best of my knowledge.Signature________________________________________________ Date____________________ ................
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