Mail this questionnaire, along with a deposit of $149



Dear tax client of Buck CPA llc and Buckanaugh llc, January 25, 2019

As I write this email to all of you, I happen to be on a short break in this Three-hour webinar on where we stand with regard to the new tax law (TCJA), generally, after many people with differing agendas got done messing with it. We can be assured that 2019 will bring much in the way of direction as Congress and the IRS decide how to interpret and pursue enforcement of the new laws. Of course, this all presumes that the government shut down will end early enough for the IRS to play catch-up. My understanding is that there are “numerous” new tax forms to be designed and then fit into an already unworkable system of income taxation. There will continue to be updates for many months to come. If you haven’t already become aware of this – the WHOLE of the new law “phases out” after 2025. This “gutless” action on the part of Congress – to constantly play these games with the tax code, costs Americans taxpayers countless dollars because tax-planning is virtually impossible in such a climate (will Congress really let it run out after 2025 or will they make it permanent. I hope your crystal ball is clearer than mine).

What we need to impart to you regarding this year’s tax preparation business, the IRS has adopted numerous additional fines and penalties, which they can lay on both the filer (taxpayer) and the preparer. As a result, ALL preparers are looking at more time to prepare correct returns, sometimes considerably more time, in order to make sure all IRS required “due diligence” has been applied. We will undoubtedly have more requests for information from some of you in order to satisfy the IRS’s new requirements.

Please note that we will be speaking with anyone who claims EITC (Earned Income Tax Credit) or the child tax credit. You will probably need to provide, for our files, some written proof that the child lived with you for the full year. (Examples of “proof” – school records, letter on official letterhead of clergy, social services, doctor. There are probably other types of documents that would be acceptable. The document needs to contain certain information – child’s name, name(s) of parents or guardian, child’s address and the dates during the year that the child lived with that parent or guardian).

As I have observed before, Congress once again failed “big time”, to simplify the tax code, in many respects it is very reminiscent of the 1985 “tax simplification”. It took many people several years to really understand that new law and how to apply it without violating it. Donna and I continually seek out information so that we can continue to provide you with quality, and caring tax service.

One other idea for you to consider. As you may know, I have become a very successful advocate before the IRS for taxpayers who have gotten in the IRS’s sights. More and more we find the various states aggressively pursuing delinquent taxpayers. The states frequently have no statutes on collections time limits as does the IRS. (The IRS has ten years to collect once the tax has been “assessed”.) States frequently have at least double that time and have an easy road to extend that time limit, indefinitely. (By the way, if your state audits and finds that you owe more taxes, they will notify the IRS and you will likely get a bill from the IRS, as well – this is exactly what the IRS does if their audit finds additional tax due.)

The IRS is now suffering from an exodus of experienced and capable personnel as a result we often must try to educate the very personnel who are conducting the audit or collection activity. You can imagine what quality of personnel (they probably weren’t the “A” or “B” students) we find running state departments of revenue and finance. They often have no deep understanding of the laws they are supposed to be enforcing. State income tax audits can be horrifyingly long, AND they frequently result in conclusions that the taxpayer owes significant additional taxes. This is where you either give up and pay what they say you owe, or you dig in your heals and get help from someone like me.

I have recently moved my business, my wife, myself and our three cats from Iowa, a state that has nearly 10% income tax for higher earners. Not only did I save tax dollars (Florida has no state income tax, as you may know), but I will never have to worry about an income tax audit conducted by often less than capable state employees. I recently finalized an audit by one of the Southern States (no reason to call anyone out) where the state told the taxpayer he owed well over $200K. Almost two years later we finally settled – the taxpayer got a refund of about $1500.

My recommendation, as soon as you can arrange it, move to a state that has no income tax.

Don’t hesitate to contact us if you have any questions and, please, remember us to your family and friends who may be in need of excellent tax services.

With warm regards, Tom and Donna

Welcome to Buck CPA, LLC. For your convenience and security, we’ve upgraded and added some additional features to our website. You can now upload your questionnaire and documentation directly to your ShareFile folder, instead of sending through e-mail. ShareFile is a secure online document management system, which allows you 24-7 access to a secure, shared environment. The environment is password protected on both ends, meaning you have to login to upload or download a file and so do we. You will set your password when you login the first time. Once you upload a file, we receive an email confirmation that new files have been uploaded. Online: On the documents and forms page or contact us page of our website is a link to login to ShareFile. Enter your username and password and then click upload documents to securely send us your documents. https:buckcpa.login.aspx



For your security, we are no longer storing any credit card information, and use only PayPal for these transactions.

HOW TO SUBMIT YOUR $175.00 DEPOSIT:

□ By Mail or Courier: Buck CPA, LLC

Donna Cavanaugh

830-580th Street

Storm Lake, IA 50588

Make Checks Payable to: Buckanaugh, LLC

□ Online: We are only accepting credit card payments through paypal, however, you do not need to have an account with paypal to use their system. Visit and click Tax Preparation & Planning, click Make A Payment. This will take you to paypal to process your payment securely.

We strongly recommend that everyone use ShareFile to send us their documents, instead of by e-mail or fax. Contact us if you need assistance.

DUE DILIGENCE – New IRS rules now require all tax preparers to perform additional due diligence regarding certain data reported on your tax return. As a result, we may need to contact you for additional verification on certain, specific data.

RE: EXTENSIONS

Here is what the IRS instructions have to say: CAUTION

Although you are not required to make a payment of the tax you estimate as due, Form 4868 (and form 7004) does not extend the time to pay taxes. If you do not pay the amount due by the unextended due date, you will owe interest. You may also be charged penalties. For more details, see Interest and Late Payment Penalty below. Any remittance you make with your application for extension will be treated as a payment of tax. You do not have to explain why you are asking for the extension.

Late filing penalty -5% per month up to 25%.

Late Payment Penalty - The late payment penalty is usually ½ of 1% of any tax (other than estimated tax) not paid by April 15, 2019. It is charged for each month or part of a month the tax is unpaid and goes on forever until debt is settled.

The late payment penalty will not be charged if you can show reasonable cause for not paying on time. Attach a statement to your return fully explaining the reason. Do not attach the statement to Form 4868.

You are considered to have reasonable cause for the period covered by this automatic extension if at least 85% of your actual 2018 tax liability is paid before the regular due date of your return through withholding, estimated tax payments, or payments made with Form 4868.

If you wish us to file your extension, please send a copy of any documents that show withholding - typically w-2s, 1099s (retirement income, unemployment compensation, etc.). With this information we will at least be able to show your payments on line 5 of the form 4868.

We are no longer allowed to file your extension unless we have your signed authorization (if filing jointly, both spouses must sign the authorization). Please sign and date below if you wish for us to file an extension on your behalf and return it with your documents.

_________________________________ _______________________________

Signature Date

_________________________________ _______________________________

Signature Date

One other item we wish to bring to your attention appears on the following page and that is the Audit Protection Plan we will be offering again this year. The IRS has dramatically increased the number of so-called “correspondence audits” in which they indicate that you owe additional taxes for the reasons stated in the correspondence. They are also asking for additional evidence regarding deductions and expenses. Please read about it so that you can make an informed decision. Contact us if you wish to participate.

AUDIT PROTECTION PLAN

We have often considered offering an audit protection plan. However, there was not the pressing need to make such protection available to our clients as there is today.

The IRS is doing millions more “audits” then ever in the past. While the number of face-to-face audits has not dramatically increased in recent years, the IRS now sends out correspondence audits numbering in the millions and on the increase every year. These correspondence audits can be just as financially devastating as the more complete audits most of us have feared in the past. If you do not respond to the IRS correspondence in a timely fashion, they will win by default and can begin collecting on the tax debt. The last thing you need in your life is to have the IRS as a creditor.

Under our audit protection plan, Buck, CPA llc will stand in your shoes and represent you regarding any state or federal income tax issues raised against years for which we prepared the tax returns. (If you should be audited for years not prepared by us, we would still be available to represent you, but at our usual rates for such representation.)

If you require professional help regarding an IRS audit, you should not be surprised to receive a bill for several thousands of dollars. The cost of our plan is $395.00 per year. We will represent you during the three years that a filed tax return can normally be audited by the IRS, even though you might no longer be a client when the audit occurs. This means that if you paid for the audit protection for your 2013 returns, were no longer our client after that year, but got audited in 2016 for 2013, we would still represent you for the 2013 audit.

If you have other entities for which we prepare the tax returns, we will provide audit protection for each additional entity for an additional $215.00 per year per entity.

You agree to notify us of any correspondence received from either the IRS or the state and to provide a copy of the correspondence within fifteen days of the date on the notice so that we can respond in a timely fashion. We regularly receive these notices via email or fax from our clients.

If the result of your audit is that additional taxes are owed, you need to understand that you will be responsible for payment of any tax, interest and penalties owed. However, if we are responsible for the mistake, we will pay the penalties that resulted from our error. This is an unlikely event because we are careful to make sure that you have provided us with complete information as we prepare your returns and that we have properly prepared the returns. Assuming that is true, then if you do happen to be audited, you will have the necessary evidence to convince the IRS you are not a good target for them.

Most of us understand that we cannot and, probably, should not try to insure against any and all possible problems in life. However, when it comes to something as daunting and fearsome as an IRS audit, perhaps you would like to have the peace of mind that knowing our audit protection plan is in place.

ANNUAL FILING REQUIREMENT: PLEASE SEND COPIES OF DRIVERS LICENSE OR STATE ISSUED ID’S FOR ALL FILERS (HUSBAND/WIFE IF JOINT). THESE NEED TO BE LEGIBLE COPIES AS WE NEED TO ENTER INFORMATION OFF OF THEM IN ORDER TO E-FILE.

TAX YEAR _______________

Personal Information

| |Taxpayer |Spouse |

|Last name…………………. | | |

|First name…………………. | | |

|Middle initial……………… | | |

|Social Security number…… | | |

|Occupation………………... | | |

|Date of birth………………. | | |

|Home phone………………. | | |

|Cell phone………………… | | |

|Alternate phone…………… | | |

|Work phone………………. | | |

|Fax#....................................| | |

|. | | |

|Email address……………... | | |

|Street Address…………….. | | |

|City, State, Zip……………. | | |

State Tax Information:

|County you live in……….......................................... | |

|School | |

|District.........................................................| |

|... | |

|School District Number…………………………….. | |

Contact person

|Who is filling out this questionnaire……………….. | |

|What is the best phone number to reach this person.. | |

|What is the best time to reach this person………….. | |

Filing Status: (check one)

Single Married Filing Separately

Married Filing Jointly Head of Household Possible New due diligence required.

Dependents:

|First name |M.I. |Last name |DOB |Social Security # |Relationship |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

|Did dependents live with you all year? | Yes | No |

|If no, explain: |

| |

| |

| | | |

|Did you incur child-care expenses during the year? | Yes | No |

| | |

|Child Care Expense Amount Paid………………………………………………………………….. | |

| |$ |

|Names of children provided for and cost for each child | |

|1. |

|2. |

|3. |

|4. |

|5. |

|6. |

|7. |

| |

|Name of care provider(s)………………………… | |

|Street Address of Care Provider……………………. | |

|City, State, Zip of Care Provider……………….. | |

| | |

|Social Security Number or Employer Identification Number of care | |

|provider…………………………… | |

| | |

Note: USE AN ADDITIONAL PAGE IF YOU HAD MORE THAN ONE CARE PROVIDER

New clients with children qualifying for Earned Income Tax Credit and/or Child Tax Credit will need to provide copies of social security cards and proof such as birth certificates, court-ordered guardianship or the like. Contact us if you have any questions. Possible New due diligence required.

| |Taxpayer |Spouse |

|$3 to Presidential Fund………………………………… | Yes | No | Yes | No |

|Are you permanently & totally disabled? Date………. | Yes _____________ | No | Yes _____________ | No |

|Are you legally blind……………………………….….. | Yes | No | Yes | No |

|Are you a dependent of someone (such as a parent)….. | Yes | No | Yes | No |

|If deceased this tax year provide date of death | | |

|Did you pay college tuition for yourself, a spouse or dependent……………………….…… | Yes | No |

|Name of student……………………………………………………………………………... | |

|Amount of tuition and fees paid – Attach 1098-T Forms or Statement from Institution……. | |

|Is this a qualified degree program? | Yes | No |

|Amount of student loan interest paid – Attach 1098-E | |

Did you or your spouse contribute to a retirement account during the year?

SEP, Keogh, etc. You Spouse Amount - You _________ Spouse _________

Regular IRA You Spouse Amount - You _________ Spouse _________

ROTH IRA You Spouse Amount - You _________ Spouse _________

NON-DEDUCT IRA You Spouse Amount - You _________ Spouse _________

If you have a non-deductible IRA please attach of a copy of the year-end statement.

Are you or your spouse covered by a qualified pension plan at work?

You Yes No Spouse Yes No

Income

Wages, Salaries, Tips and Other Compensation: Taxpayer Spouse

(Attach Form(s) W-2)

|Employer name…… | | |$ |$ |

|Employer name…… | | |$ |$ |

|Employer name…… | | |$ |$ |

Distributions from Pensions, Annuities, Retirement, Profit-Sharing, IRAs, etc.:

(Attach Form(s) 1099-R) Taxpayer Spouse

|Payer name………... | | |$ |$ |

|Payer name………... | | |$ |$ |

|Payer name………... | | |$ |$ |

Social Security/Railroad Benefits (Attach Form(s) SSA-1099) Taxpayer Spouse

| Social Security Benefits from Form SSA-1099…………………... |$ |$ |

| Railroad Retirement Benefits from Form RRB…………………... |$ |$ |

| Medicare B premiums withheld …………………………………. |$ |$ |

| Medicare D premiums withheld …………………………………. |$ |$ |

Miscellaneous and Independent Contractor Income (Attach Form(s) 1099-MISC):

1099-MISC Payer Name Taxpayer Spouse

| |$ |$ |

| |$ |$ |

| |$ |$ |

| |$ |$ |

Interest Income (Attach Form(s) 1099-INT):

1099-INT Payer Name Taxpayer Spouse

| |$ |$ |

| |$ |$ |

| |$ |$ |

| |$ |$ |

Dividend Income (Attach Form(s) 1099-DIV):

1099-DIV Payer Name Taxpayer Spouse

| |$ |$ |

| |$ |$ |

| |$ |$ |

| |$ |$ |

Other Forms to Attach:

|Form(s) 1099-G – Certain Government payments | |

|Schedule K-1s (Partnership, S-Corporation, Trust or Estate Income) | |

|Form(s) W-2G – Gambling or Lottery winnings | |

| | |

Other Income: Alimony, jury duty, unreported tips, disability income, prizes, awards, etc. (Enclose copy of 1099, if any.)

Explanation/Description

| |$ |

| |$ |

General Questions

|What was the sales tax rate in your locality this year……………………………………………………... | |

|Did you purchase a motor vehicle or boat during this year? If yes, attach documentation showing sales tax paid. | Yes | No |

|Did you purchase a hybrid or electric vehicle this year? If you bought a hybrid vehicle, please provide details. | Yes | No |

If yes, enter the vehicles

|Year | |Make | |Model | |Date Purchased | |

| | | | | | | | |

|Did you donate a vehicle to charity this year? | Yes | No |

|If yes, attach Form 1098C | | |

|Did your marital status change during this year? | Yes | No |

|If yes, please explain: | | |

| | | | |

|Do you have dependents who must file? If you wish us to prepare those returns, please attach W-2s, 1099s, etc. | Yes | No |

|Do you have children under age 18 (age 24 if a full-time student) with investment income greater than $1,900? | Yes | No |

|If YES, attach details. | | |

|Did you provide more than half of the support for any other person during this year? | Yes | No |

|Did you incur adoption expenses during this year? (Please provide details of expenses.) | Yes | No |

|Did you buy, sell or refinance a principal residence or other real property this year? Please furnish details, including a | Yes | No |

|closing statement. | | |

|Did you make any energy-efficient improvements to your home or purchase any energy- | Yes | No |

|saving property during this year? If YES, attach details. | | |

|Did you incur any casualty or theft losses during this year? New in 2018 only available in Presidentially declared disaster | Yes | No |

|areas. | | |

|Did you incur any non-business bad debts? | Yes | No |

|Did you incur any work-related moving expenses? New in 2018, only military personnel qualify. | Yes | No |

|Did you receive any income not included in this questionnaire? If YES, attach details. | Yes | No |

|Did you receive the $7,500 first-time home buyers credit in 2008? (If so, you are obligated to recapture $750 per | Yes | No |

|year for 10 years.) | | |

|Did a lender cancel any of your debt this year? (Attach forms 1099A or 1099C) | Yes | No |

|Did you have a household employee this year? | Yes | No |

If you answered “yes” to any of the above questions, please provide an explanation and copies of any appropriate documentation.

Payment made with extension request $_______________________ $____________________

Federal State

Did you have ANY Virtual Currency transactions during 2017? How about 2016 and 2015 or even before 2015.? If so, please include documentation on those transactions.

Call us for more information. Consequences of not making appropriate corrections for prior year lack of reporting could be VERY severe.

Foreign Bank Account Reporting

|Did you have a financial interest in or have signature control over a foreign bank account(s) this year? | Yes | No |

|If yes, what foreign country? | |

|Was the total value of all foreign accounts greater than $10,000 at any time during the year? | Yes | No |

|During the year did your receive assets (money or other) from or transfer assets to a Foreign Trust? | Yes | No |

Did you have income from a foreign source, such as interest or capital gains? Yes No

Did you receive assets (money or other) from, OR transfer assets to, a foreign individual or foreign entity of Yes No

more than $100,000?

If you held foreign assets in a USA safe deposit box and the value changed during the year, you must report the adjusted value. Please contact us in this event.

If you answered “yes” to any of the above questions, please provide an explanation and copies of any appropriate documentation.

If you paid or received any alimony, enter. New in 2018 not taxable to recipient of deductible for payor for divorce decrees granted after 2017.

|Recipient or Payee |Social Security Number |Alimony paid or received |

| | |$ |

Estimated Taxes Paid (Not Payments for Prior Year Balance Due): NOT WITHHOLDING but PAID BY YOU DIRECTLY

|Federal |State |

|Date |Amount |Date |Amount |

| |$ | |$ |

| |$ | |$ |

| |$ | |$ |

| |$ | |$ |

Electronic Filing and Direct Deposit of Refund

|Individual tax returns must be filed Electronically, in accordance with federal mandate, with a few exceptions. You |

| |

|may file Form 8944 with your tax return if you wish to file by mail. |

| |

The Internal Revenue Service is able to deposit many refunds directly into taxpayers’ accounts.

|If you receive a refund, would you like direct deposit? | Yes | No |

If yes, please attach a voided check (not a deposit slip).

What type of account is this? Checking Savings

Did you and everyone in your tax household have health insurance coverage for the entire year of 2015? Yes No

If yes, no further information is needed. If no, please see the Obamacare filing requirements on page 1. If you received a Form 1095-A, 1095-B or 1095-C please remit copies to our office. Returns that do not contain this information will not be processed.

Itemized deductions - Schedule A

If you are NOT itemizing please provide Real Estate taxes & sales tax paid on large purchases (vehicles, boats, RVs, etc.)

|Medical and Dental Expenses: New for 2019 – now ALL age groups are subject to a 10% haircut. |Amount |

|Prescription medications………………………………………………………………………. |$ |

|Health insurance premiums…………………………………………………………………… |$ |

|Doctors, dentists, etc…………………………………………………………………………... |$ |

|Hospitals, clinics, etc………………………………………………………………………….. |$ |

|Eyeglasses and contact lenses…………………………………………………………………. |$ |

|Miles driven for medical purposes…………………………………………………………….. | |

| Long-term care insurance premiums………………………………………............................. | |

|Other medical, dental, vision, etc……………………………………………………………… |$ |

The following items are subject to a $10,000 limit if married filing joint or $5,000 if married filing separately: state income tax or general sales tax, real estate tax on principal property and additional properties, and auto registration fees.

|Taxes: |Amount |

|Real estate taxes paid on principal residence………………………………………………….. |$ |

|Real estate taxes paid on additional homes or land – do not include rentals here...................... |$ |

|Auto license registration fees based on the value of the vehicle…………………..................... |$ |

|Other personal property taxes……………………………………………………….................. |$ |

Home mortgage interest paid – Attach Form(s) 1098 – Do not include Rental Property

|Lender’s Name |Primary/Additional Home/Land |Amount |

| | |$ |

| | |$ |

| | |$ |

| | |$ |

Please be aware that IRS now will be looking at two thresholds: 1) Acquisition debt of more than $1,000,000 and 2) home equity debt in excess of $100,000. By law, you cannot deduct the mortgage interest on amounts of debt exceeding these amounts (business use of home treated differently). Call with questions.

Charitable Cash Contributions:

|Organization Name: |Amount |

| |$ |

| |$ |

| |$ |

| |$ |

Be advised that the IRS now requires that you have written evidence from the donee as to the amounts donated. Cancelled checks alone are no longer adequate proof.

|Charitable Miles Driven |Total | |

|Non-cash Charitable Contributions |Total | |

If over $500, complete the following information:

|Donee……………………………… | |

|Donee Address……………………. | |

|Description of donation…………… | |

|Date acquired……………………… | |

|Date contributed…………………... | |

|Your cost………………………….. |$ |

|Value at time of donation…………. |$ |

|How you acquired the property…… | |

Note: Attach additional pages if you have more then one Donee

New 2018 law - Miscellaneous itemized deductions are no longer allowed. This will have a significant effect on employees who have been able to deduct business expenses in the past. Significantly effected would be those who have out of town expenses (truckers, pilots, etc.). We recommend that employers be challenged to adopt a qualified reimbursement plan that would make the affected employees financial whole again. Contact us for further input. Some states are still allowing miscellaneous itemized deductions, so please fill out.

| |Amount |

|Miscellaneous Deductions: (Do not include Schedule C Business Deductions) | |

|Union and professional dues…………………………………………………………………… |$ |

|Professional Subscriptions, Books, & Supplies……………………………………………….. |$ |

|Uniforms and protective clothing (including cleaning)……………………………………….. |$ |

|Job search costs………………………………………………………………………………… |$ |

|Taxpayer Educator Expenses – Teacher’s Only……………………………………………….. |$ |

|Spouse Educator Expenses – Teacher’s Only …………………………………………………. |$ |

|Tax return preparation fees……………………………………………………………………... |$ |

|Safe deposit box rental…………………………………………………………………………. |$ |

|Gambling losses (to the extent of gambling income)………………………………………….. |$ |

|Other Expenses (list)…………………………………………………………………………… |$ |

| | |

Capital Gains and Losses - Schedule D

|Did you buy or sell any stocks or bonds this year? | Yes | No |

|If yes, attach broker’s information (such as Form 1099-Bs and broker annual statements) related | | |

|to the transactions. | | |

|Name of Security |Date Acquired |Date Sold |Cost Basis |Sales Price |

| | | |$ |$ |

| | | |$ |$ |

| | | |$ |$ |

| | | |$ |$ |

| | | |$ |$ |

|Did you realize a gain or loss on property which was taken from you by destruction, theft, seizure or | Yes | No |

|condemnation? | | |

|Did you sell property or equipment on installment this year? | Yes | No |

|Did you do a “like kind” exchange of property this year? New 2018 law – Sec. 1031, like-kind exchanges apply only to real | Yes | No |

|estate transactions. | | |

If “yes” on the above three questions, please provide detail.

COST OF GOODS SOLD FOR NETWORK MARKETING ONLY

|Beginning Inventory as of 1/1 of tax year |$ |

|(should match prior year’s ending inventory – If not, please explain) | |

|Ending Inventory as of 12/31 of tax year |$ |

| | |

|Business Expenses | |

|Wholesale purchases for the year……………………………………………… |$ |

|Products used for personal use (wholesale cost) ………..……………………. |$ |

|Products used for demonstration & sample purposes (wholesale cost) .……… |$ |

|Product replacement (returned or replaced) …………………………………... |$ |

|Products used as gifts (wholesale cost) ……………………………………….. |$ |

|Products discarded (obsolete – Inventory carrying value) …..………………... |$ |

In calculating your cost of goods sold we take your inventory at the beginning of the year, add to it your cost of purchasing product this year and subtract the inventory on hand at the end of the year. Now we know how much goods you had available. Some of it was sold, some used personally (not deductible) and some used as demos, samples or replacements. If you will carefully fill in the appropriate lines above, we will be able to correctly calculate your deductible expenses.

Sole Proprietor Data - Schedule C (Please complete a separate form for each business). Possible additional due diligence required.

General Information:

|Business ownership (check one) | Taxpayer | Spouse | Joint |

|Business name……………………………………… | |

|Business address…………………………………… | |

|Principal business/profession………………………. | |

|Employer ID number………………………………. | |

|Date business began……………………………….. | |

|Income: |Amount |

|Gross receipts or sales – not reported on 1099s………………………………………….……. |$ |

|Gross receipts or sales – reported on 1099-Misc - attach all 1099s received…...……………. |$ |

| Don’t forget the new 1099-K | |

|Check if Sales Tax Is Included in Retail Sales Income | |

|Returns and allowances………………………………………………………………………... |$ |

|Other income (include federal/state gas tax credit/refund)……………………………………. |$ |

|Cost of Goods Sold – if applicable: (If a Network Marketer use page 8 for cost of goods sold) | |

|Inventory at beginning of year………………………………………………………………… |$ |

|Purchases………………………………………………………………………………………. |$ |

|Personal use items……………………………………………………………………………... |$ |

|Inventory at end of year……………………………………………………………………….. |$ |

|Expenses: |Amount |

|Advertising ……………………………………..……………………………………………. |$ |

|Car and truck expenses (see questions on page 15)………………………………………….. | |

|Commissions and fees………………………………………………………………………… |$ |

|Contract labor – 1099-Misc filing required if paid $600 or more to any one individual.…….. |$ |

|Demo products and samples…………………………………………………………………... |$ |

|Discounts (customer discounts or hostess credits, etc.)………………………………………. | |

|Employee benefits (include Medical reimbursement plans) .……………………….. |$ |

|Health Insurance………………………………………………………………………………. |$ |

| | | |

|Insurance (other than health)………………………………………………………………….. |$ |

|Interest: Mortgage (paid to banks, etc.)……………..……………………………………….. |$ |

|Interest: Other ……………………………………………………...………………………… |$ |

|Legal and professional services (include tax preparation fees)………………………………………. |$ |

|Marketing, Trade Shows & Events…………………………………………………………… |$ |

|Membership / Enrollment Fees……………………………………………………………….. |$ |

|Office expenses……………………………………………………………………………….. |$ |

|Pension and profit-sharing plans (paid by company for employee)……………….…………. |$ |

|Postage & Shipping…………………………………………………………………………… |$ |

| | Amount |

|Expenses continued: | |

|Rent or lease: |$ |

| Machinery and equipment………………………………………………………………. |$ |

| Other business property………………………………………………………………… |$ |

|Repairs and maintenance……………………………………………………………………… |$ |

|Sales Tax (if included in gross sales)………………………….……………………………… |$ |

|Supplies……………………………………………………………………………………….. |$ |

|Taxes and licenses…………………………………………………………………………….. |$ |

|Travel…………………………………………………………………………………............... |$ |

|Meals, subject to 50% limit …..……………………………………………. |$ |

|Meals and entertainment not subject to 50% limit. New law, only actual meal expenses, NOT ENTERTAINMENT, are |$ |

|allowed subsequent to 2017. | |

| |$ |

| For meal expenses, do you have records, as described below, to support expenses? Yes No |

|Note: Tax law and IRS regulations allow deductions for meals and entertainment if adequate records can be presented. Information must include: |

|Amount, Time And Place, Date, Business Purpose, Business Relationship, Brief Description Of Business Discussed |

|Utilities…………………………………………………………………………………………. |$ |

|Business Phone & Business Long Distance (first line into home is not deductible although |$ |

|business long distance is)………………………………………………………………………. | |

|Wages If you deduct employee benefits or pension/ profit sharing expenses, you must have employee(s) |$ |

|– Provide copy of W-3………………………..…………………………………………………..... | |

|Miscellaneous expenses: |$ |

| |$ |

| |$ |

| |$ |

| |$ |

| | |

|Did you buy, trade-in or sell a vehicle used for business this year? | Yes | No |

|If yes, please attach copies of the sale and purchase contracts. | | |

Purchase or Sale of Business property

|Property |Date Acquired |Date Sold |Sales Price |Cost Basis |

| | | |$ |$ |

| | | |$ |$ |

| | | |$ |$ |

| | | |$ |$ |

| | | |$ |$ |

Automobile Expenses Schedule

| |Auto # 1 |Auto # 2 |Auto # 3 |

|Business or job vehicle used in………………. | | | |

|Do you own the automobile………………….. | Yes | No | Yes | No | Yes | No |

|If leased, annual lease payment………………. |$ |$ |$ |

| Period of lease……………………………. | | | |

| Date lease began…………………………... | | | |

| Cost of vehicle when first leased…………. | | | |

|Auto Make and Model………………..……… | | | |

|Auto Year ………………………………….. | | | |

|Beginning Odometer Reading………………. | | | |

|Ending Odometer Reading……………….. | | | |

|Business miles this year per car……………… | | | |

|Mileage between two jobs……………………. | | | |

|Date first used for business…………………… | | | |

|Purchase price of auto………………………... |$ |$ |$ |

|Date purchased……………………………….. | | | |

|Date sold……………………………………… | | | |

Use additional pages if more than three vehicles were used for business.

Detailed Automobile Expenses

|Operation Expenses |Auto #1 |Auto #2 |Auto #3 |

|Gas |$ |$ |$ |

|Oil |$ |$ |$ |

|Repairs |$ |$ |$ |

|Insurance |$ |$ |$ |

|Tax/License |$ |$ |$ |

|Parking/Tolls |$ |$ |$ |

|Interest on Auto Loan |$ |$ |$ |

Home Office Questions

|How many hours per week do you spend working on your business………………………………….. | |

|Number of business hours you are in home office per week……………………………….…………. | |

|Number of business hours you are out of office per week…………………………………………….. | |

|Did you use a portion of your home as an office for the business listed above…………………………… | Yes | No |

|Is the management and administrative function of the business performed in the home office………….. | Yes | No |

|Do you meet customers in your home office……………………………………………………………… | Yes | No |

|Is the home office where money changes hands in your business………………………………………… | Yes | No |

|Was this area used regularly and exclusively for business……………………………………………….. | Yes | No |

If yes, or IF YOU STORED INVENTORY, TOOLS or DISPLAYED

PRODUCT SAMPLES in your house complete the following:

HOME OFFICE – CALCULATION OF BUSINESS PERCENTAGE USE

|Enter the total square footage of your home | |

|(include your basement or garage only if they are used for business)……………………………… | |

|Enter the total square footage of the room(s) or area that you use regularly and exclusively as an office. | |

|Enter the square footage of the footprint of the space ACTUALLY OCCUPIED by inventory or | |

|product samples that are kept in other rooms……………………………………………………… | |

|Was your home used for Child Care business? | Yes | No |

| If yes, enter the number of hours per day…………………………………………………………... | |

|Note: Add two hours for cleanup and preparation work each day open | |

| Enter the number of days per week………………………………………………………………… | |

| Enter the number of weeks this tax year……………………………………………………………. | |

|If you own (or are buying) your home, answer the following: | |

|Date you purchased your house…………………………………………………………………………... | |

|Cost when purchased……………………………………………………………………………………... |$ |

|Land value when purchased……………………………………………………………………………… |$ |

|Additions & improvements………………………………………………………………………………. |$ |

|Homeowners’ insurance…………………………………………………………………………………. |$ |

|Mortgage insurance………………………………………………………………………………………. |$ |

|Repairs and maintenance…………………………………………………………………………………. |$ |

|Annual cost of household utilities (electricity, gas, water, trash, & sewer) Do not include on Sch C…... |$ |

|If you are renting, rather than owning your home, answer the following: |Amount |

|Rent expense…………………………………………………………………………………… |$ |

|Utilities………………………………………………………………………………………… |$ |

|Renter’s Insurance…………………………………………………………………………….. |$ |

Rent and Royalties Received- (Fill in 1 sheet for each rental unit)

|Property location | |Property type | |

|Cost when purchased |$ |Land value when purchased |$ |

|Additions & improvements |$ |Year first rented | |

| | |Year purchased | |

(Include depreciation schedule for prior year unless Buck CPA did your return last year.)

Check those that apply:

Owned by spouse Owned jointly Rental property Commercial property

Active participation Material participation Royalty property Complete disposition

Other passive exceptions Some investment is not at risk

|Ownership percentage of this rental (if you own less than 100%)……………………………………….. | |

|Allocate income and expenses using ownership percentage? | Yes | No |

|Is this a vacation home property? | Yes | No |

|Number of days rented……………………………………………………………………………………. | |

|Number of days personal use……………………………………………………………………………… | |

|Number of days property owned if less than 365…………………………………………………………. | |

Did you make any payments this year that would require you to file Form 1099 (did you pay any

individual $600 or more)? Yes No

If ‘Yes,’ did you or will you file all required Forms 1099? Yes No

|Rental income…………………………………………………………………………………………….. |$ |

|Royalties from1099-MISC and K-1 Worksheets (please attach copies)…………………………………. |$ |

|Rental Expenses: |Amount |

|Advertising………………………………………………………………………………………………… |$ |

|Auto……………………………………………………………………………………………………….. |$ |

|Travel……………………………………………………………………………………………………… |$ |

|Cleaning & maintenance………………………………………………………………………………….. |$ |

|Commissions……………………………………………………………………………………………… |$ |

|Insurance………………………………………………………………………………………………….. |$ |

|Legal & professional……………………………………………………………………………………… |$ |

|Management fees…………………………………………………………………………………………. |$ |

|Mortgage interest…………………………………………………………………………………………. |$ |

|Other interest……………………………………………………………………………………………… |$ |

|Repairs……………………………………………………………………………………………………. |$ |

|Supplies…………………………………………………………………………………………………… |$ |

|Real estate taxes………………………………………………………………………………………….. |$ |

|Utilities…………………………………………………………………………………………………… |$ |

|Other expenses of rental: |$ |

|Attach additional sheet detailing other expenses, if any. | |

PLEASE BE SURE TO READ AND SIGN THE ENGAGEMENT LETTER ON THE NEXT PAGE

BOTH SPOUSES MUST SIGN IF FILING MARRIED FILING JOINTLY

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Dear Client:

We appreciate this opportunity to provide professional tax preparation and advisory services. In order to ensure an understanding of our mutual responsibilities, we ask all clients for whom we prepare income tax returns to confirm the following arrangements.

We will prepare your federal and appropriate state income tax returns from information that you furnish us. We will make no audit or other verification of the data you submit, although we may ask for clarification of some information. It is imperative that, when we request information, you respond in a timely manner.

It is your responsibility to provide us with all the information required for the preparation of complete and accurate returns. This includes copies of all documents with respect to any investments you have made. You should retain all original documents, cancelled checks and other data that supports your income and deductions for a period of a least seven years. If the records pertain to fixed assets, they should be retained for seven years after disposal. We recommend that you retain copies of tax returns indefinitely.

You have the responsibility for the accuracy of your income tax returns, therefore, you should review them carefully before you sign or authorize them for e-filing.

Our work in connection with the preparation of your income tax returns does not include any procedures designed to discover defalcations or other irregularities, should any exist. We will render such accounting and bookkeeping assistance, as we find necessary for preparation of the income tax returns, at current hourly rates for the services provided.

We will use our professional judgment in resolving questions where the tax law is unclear, or where there may be conflicts between the taxing authorities’ interpretations of the law and other supportable positions. Unless otherwise instructed by you, we will resolve such questions in your favor whenever possible.

It is possible that your return(s) may be audited by taxing authorities. In the event of such examination, we would be available to represent you. The first thing you should do if you hear from the IRS or state auditor is to contact us so that we may advise you. Billing for representation services (beyond the initial conference which will be provided at no charge) would be at our standard rates for the nature of the services provided.

Our fees for services are based upon the fee schedule published on our website, plus out-of-pocket expenses. All invoices are due and payable upon presentation.

If the foregoing fairly sets forth your understanding, please sign in the space indicated. A copy of this understanding is being provided to you for your records.

Sincerely, Tax Year(s) _________________________

Tom Buck, CPA

Donna Cavanaugh, EA

Accepted By: _______________________________________________ Date: _____________________________

Accepted By: _______________________________________________ Date: _____________________________

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NOTES:

1. Please keep a copy of this questionnaire for your records – you will need it if we call you with questions.

2. Send copies of documents only, keep your originals!

3. If this is your first year with Buck CPA, LLC please include a complete copy of last year’s federal and state(s) income tax returns, including depreciation schedules, if any.

4. If you have other tax return information, not requested on this form, please attach the information and explain it, we will contact you if we have questions.

5. Please be sure to read and sign the engagement letter at the end of this questionnaire. If married filing jointly both spouses must sign.

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