Wall Street Income Tax
[Pages:3]444 Uvalde Rd Houston TX 77015 Open All Year
Wall Street Income Tax
1215 Main St
2720 Red Bluff Rd
Pasadena TX 77506
Pasadena TX 77506
713-589-0000
Open All Year
email: info@
BASIC INFO
INCOME
Driver's License(s) or Government
Issued Identification
Social Security Card(s)/ ITIN(s) Dependents' Social Security Numbers/
ITIN(s) & Dates of Birth
Last year's Federal & State Tax Return
W-2's* Wage Statements* Self-Employment business Income &
Expenses*/ 1099-MISC*/ 1099K*
Commissions Received/Paid* Pension/ Retirement Income/1099-R* Unemployment Income/ 1099-G* Cancelled Debt Amount/ 1099-C* Social Security Income/ SSA-1099* IRA Contributions* Statements on the Sales of Stocks &
Bonds/ 1099-B*
Interest & Dividend Income/
1099-INT* & 1099-DIV*
Lottery or Gambling Winnings/ Losses
W-2G*
State Refund Amount/ 1099-G* Income & Expenses from Rental
Properties*
Alimony Paid/ Received* Income & Expense for Royalties* K-1's from Partnerships, S-Corps &
Trusts*
EXPENSE & OTHER ITEMS
HEALTHCARE
Form 1095-A (Health Insurance
Marketplace Statement)**
Form 1095-B (Health Insurance Provider
Statement)
Form 1095-C (Health Insurance
Employer Provided Coverage Statement)
Exemption Certificate Number***
Record of Purchase or Sale of
Residence*
Medical & Dental Expenses* Real Estate & Personal Property Taxes* Child Care Expenses & Provider
Information*
State or Local Taxes Paid* Estimated Taxes or Foreign Taxes Paid* Cash & Non-Cash Charitable Donations* Mortgage or Home Equity Loan Interest
Paid/1098*
Unreimbursed employment-related
Expenses*
Job-related Educational Expenses* Moving Expenses* Casualty or Theft Losses* Student Loan Interest/ 1098-E* Sales Tax Paid on Major Purchase* Educator Expenses* Tuition & Education Fees/
1098-T*
* If Applicable ** If you received health insurance from Marketplace (Exchange) *** If you were exempt from health insurance requirement by the Marketplace (Exchange)
Copyright ? 2017 Wall Street Income Tax. All Rights Reserved.
Record of Your Expenses
Medical & Dental
DR
$
DR
$
DR
$
DR
$
Operations
$
Prescription Drugs
$
Medical/Dental Insurance
$
Long-term Care Insurance
$
Hospital & Emergency $
Lab & X-Ray
$
Visiting Nurses/In-home Care$
Dental
$
Dentures & Braces
$
Glasses & Contact Lenses
$
Supplies
$
Hearing Aids & Batteries
$
Orthopedic Shoes
$
Therapy Treatments
$
Canes/Crutches/Braces $
Wheelchairs
$
On Doctor's Advice
$
Air Conditioning
$
Vaporizers
$
Thermometers & bandages $
Other
$
Medical Miles Driven
Other Medical Transportation $
Parking/ Tolls
$
Contributions/Donations
Church
$
College $
Other
$
Other
$
Value of furniture/clothing donated $
Volunteer work expenses: $
Church, Scouts, School, etc. $
Auto Miles Driven
(Out of Pocket) miles
Taxes
Real Estate Tax $
Personal Property Tax $
State Income Tax
$
Interest Paid
Home Mortgage Interest
$
2nd Mortgage/Home Equity $
Home Mortgage to Individual $
Name
Address
Points Paid at Closing
$
Investment Interest
$
miles
Casualty Losses (Must have proof of Loss)
Accident, Fire, Theft and Natural Disaster
Description of Property
(Show type, location, and date acquired) Business or Personal
Cost $
Reimbursement $
Miscellaneous and Employee Business Expenses
Uniform Cleaning
$
Work Tools
$
Union Dues
$
Safety shoes & Gloves $
Tax Return Preparation
$
Safe Deposit Box
$
Investment Expenses $
Education Expenses
$
Other
$
Employment/Job Seeking
$
Sales/Entertainment
$
Office-in-Home Expense
$
Business Travel
$
Out of Town/Temporary
$
Vehicle Use (Auto, Truck) Miles
for Work (Non-Commute) Miles
Miles Driven to 2nd Job
Year, Make & Model
miles
Higher Education Expenses Student Loan Interest $ Post-secondary, Tuition & Fees $ Bring Form 1098-T
Child Care Expenses Providers SSN/EIN Providers Name: Amount Paid to Provider $ Address:
Bring Child Care Statement Letter
Copyright ? 2017 Wall Street Income Tax. All Rights Reserved.
Self-Employed Business Expenses
Business Name: _____________________________________ EIN: ____________________
Business Address: _______________________________________________________________
Revenue $ ___________________
Advertising:
$ _________________
Commissions paid $ _________________
Contract Labor
$ _________________
Must issue 1099-Misc for Contract Labor
Insurance (not health) $ _________________
Interest:
Mortgage $ _________________
Other
$ _________________
Legal Services
$ _________________
Accounting Services $ _________________
Other Expenses:
Cost of Goods Sold: Purchases $ _________________
Labor
$ _________________
Material
$ _________________
Office Expense $ _________________
Rent/Lease:
Other
$ _________________
Property
$ _________________
Repair & Maintenance$ _________________
Supplies
$ _________________
Taxes & License $ _________________
Travel:
$ _________________
Meal & Entertain $ _________________
Utilities
$ _________________
Wages
$ _________________
$ _________________
$ _________________
$ _________________
$ _________________
1. Vehicle used in Business: Year, Make & Model ______________________________ Date Placed in Service __________
Business Miles:
Total Miles:
Written Record: ( ) YES ( ) NO
2. Vehicle used in Business: Year, Make & Model ______________________________ Date Placed in Service __________
Business Miles:
Total Miles:
Written Record: ( ) YES ( ) NO
3. Vehicle used in Business: Year, Make & Model ______________________________ Date Placed in Service __________
Business Miles:
Total Miles:
Written Record: ( ) YES ( ) NO
4. Vehicle used in Business: Year, Make & Model ______________________________ Date Placed in Service __________
Business Miles:
Total Miles:
Written Record: ( ) YES ( ) NO
1.Type of Equipment used in business________________________________________ Date Placed in Service __________ Cost (including shipping, installation, etc.) $_________________ Percentage of Business Use __________________
2.Type of Equipment used in business________________________________________ Date Placed in Service ___________ Cost (including shipping, installation, etc.) $_________________ Percentage of Business Use __________________
3.Type of Equipment used in business________________________________________ Date Placed in Service ___________ Cost (including shipping, installation, etc.) $_________________ Percentage of Business Use __________________
4.Type of Equipment used in business________________________________________ Date Placed in Service ___________ Cost (including shipping, installation, etc.) $_________________ Percentage of Business Use __________________
5.Type of Equipment used in business________________________________________ Date Placed in Service ___________ Cost (including shipping, installation, etc.) $_________________ Percentage of Business Use __________________
Business Operated from Home 1. ______________ sq. ft. Area used regularly and exclusively for business, regularly for daycare, or for storage
of inventory or product samples EXCESS OF 300 SQ FT OR 25% OF THE HOME MAY FLAG THE RETURN FOR AN AUDIT 2. ______________sq. ft. Total area of home 3. For daycare facilities not used exclusively for business use, discuss with your Preparer
Copyright ? 2017 Wall Street Income Tax. All Rights Reserved.
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