Tax Organizer

Tax Organizer
Name of Taxpayer
First NameLast Name
Soc. Sec. No.
Date of Birth
MonthDayYear
Date
Occupation
Work Phone Number
Please enter a valid phone number.
Name of Spouse
First NameLast Name
Soc. Sec. No. of Spouse
Date of Birth of Spouse
MonthDayYear
Date
Occupation of Spouse
Work Phone Number of Spouse
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Email
example@example.com
Please complete this Organizer before your appointment. Prior year clients should use the proforma Organizer provided.
1. Personal Information
Name Soc. Sec. No Date of Birth Occupation Work Phone
Taxpayer {nameOf} {socSec} {dateOf} {occupation} {workPhone}
Spouse {nameOf12} {socSec13} {dateOf14} {occupationOf} {workPhone16}
Street Address
{address:addr_line1} City
{address:city} State
{address:state} Zip
{address:postal} Home Phone
{homePhone}
Email
{email}
Blind (Taxpayer)
YesNo
Disabled (Taxpayer)
YesNo
Pres. Campaign Fund (Taxpayer)
YesNo
Blind (Spouse)
YesNo
Disabled (Spouse)
YesNo
Pres. Campaign Fund (Spouse)
YesNo
Civil Status
MarriedSingleWidow(er)
Date of Death
MonthDayYear
Date
Will Jointly File
YesNo
2. Dependents (Children & Others)
Dependents
Name (First, Last) Relationship Date of Birth Soc. Sec. No. Months Lived With You Disabled Full-Time Student Dependent's Gross Income ID Protection PIN
1
2
3
4
5
Please provide for your appointment
- Last year's tax return (new clients only)
- Name and address label (from government booklet or card)
- All statements (W-2s, 1098s, 1099s, etc)
Please answer the following questions to determine maximum deductions

	Yes	No
1. Are you self-employed or do you receive hobby income?
2. Did you receive income from raising animals or crops?
3, Did you receive rent from real estate or other property?
4. Did you receive income from gravel, timber, minerals, oil, gas, copyrights, patents?
5. Did you withdraw or write checks from a mutual fund?
6. Do you have a foreign bank account, trust, or business?
7. Do you provide a home for or help support anyone not listed in Section 2 above?
8. Did you receive any correspondence from the IRS or State Department of Taxation?

	Yes	No
9. Were there any births, deaths, marriages, divorces or adoptions in your immediate family?
10. Did you give a gift of more than $15,000?
11. Did you have any debts cancelled, forgiven, or refinanced?
12. Did you go through bankruptcy proceedings?

13. (a) If you paid rent, how much did you pay?

	Yes	No
13. (b) Was heat included?
14. Did you pay interest on a student loan for yourself, your spouse, or your dependent during the year?
15. Did you pay expenses for yourself, your spouse, or your dependent to attend classes beyond high school?

Yes No
16. Did you have healthcare coverage (health insurance) for you, your spouse and dependents during this tax season? If yes, include Forms 1095-A, 1095-B, and 1095-C
17. Did you apply for an exemption through the Marketplace/Exchange? If so, provide the exemption certificate number.
Yes No
18. Did you have any children under the age of 19 or 19 to 23 year old students with unearned income of more than $1100?

	Yes	No
16. Did you have healthcare coverage (health insurance) for you, your spouse and dependents during this tax season? If yes, include Forms 1095-A, 1095-B, and 1095-C

	Yes	No
18. Did you have any children under the age of 19 or 19 to 23 year old students with unearned income of more than $1100?

	Yes	No
19. Did you purchase a new alternative technology vehicle or electric vehicle?
20. Did you install any energy property to your residence such as solar water heaters, generators or fuel cells or energy efficient improvements such as exterior doors or windows, insulation, heat pumps, furnaces, central air conditioners or water heaters?
21. Did you own $50,000 or more in foreign financial assets?

22
Taxpayer Spouse
22. Have you or your spouse been a victim of identity theft and given an identity theft protection PIN by the IRS? If yes, enter the six digit identity protection PIN number.
3. Wage, Salary Income
Attach W-2s
Cancelof
wage/salary
Employer Taxpayer Spouse
1
2
3
4
5
6
7
4. Interest Income
Attach 1099-INT, Form 1097-BTC & broker statements
Cancelof
Payer Amount
1
2
3
4
Tax Exempt Amount
1
2
5. Dividend Income
Attach 1099-DIV
Cancelof
From Mutual Funds & Stocks
Payer Ordinary Capital Gains Non-Taxable
1
2
3
4
6. Partnership, Trust, Estate Income
Attach K-1
Cancelof
List payers of partnership, limited partnership, S-corporation, trust,or estate income
7. Property Sold
Attach 1099-S and closing statements
Cancelof
Property
Date Acquired Cost & Imp.
Personal Residence*
Vacation Home
Land
Other
* Provide information on improvements, prior sales of home, and cost of a new residence. Also see Section 17 (Job-Related Moving).
8. I.R.A. (Individual Retirement Acct.)
Contributions for tax year income
Amount Date Check for both
Taxpayer 63
Spouse 64
Attach 1099-R & 5498
Cancelof
Reinvested?
Plan
Trustee Reason for
Withdrawal Yes No
1
2
3
4
9. Pension, Annuity Income
Attach 1099-RPayer*
Cancelof
Reinvested?
. Reason for
Withdrawal Yes No
1
2
3
4
* Provide statements from employer or insurance company with information on cost of or contributions to plan.
Tax Payer
Yes No
Social Security Benefits
Railroad Retirement
Spouse
Yes No
Social Security Benefits
Railroad Retirement
Attach SSA 1099, RRB 1099
Cancelof
10. Investments Sold
Stocks, Bonds, Mutual Funds, Gold, Silver, Partnership interest - Attach 1099-B & confirmation slips
Investment Date Acquired/Sold Cost Sale Price
1
2
3
4
11. Other Income

	Taxpayer	Spouse
22. Have you or your spouse been a victim of identity theft and given an identity theft protection PIN by the IRS? If yes, enter the six digit identity protection PIN number.

	Amount	Date	Check for both
Taxpayer			63
Spouse			64

List All Other Income (including non-taxable)

	Amount
Alimony Received
Child Support
Scholarship (Grants)
Unemployment Compensation (repaid)
Prizes, Bonuses, Awards
Unreported Tips
Director / Executor's Fee
Commissions
Jury Duty
Disability Income
Veteran's Pension
Payments from Prior Installment Sale
State Income Tax Refund
Economic Impact Payment 1 (First Stimulus Payment)
Economic Impact Payment 2 (Second Stimulus Payment)

Gambling, Lottery (expenses)
Gambling, Lottery (income)
Other (other) income
Description Amount
Other
Other
12. Medical/Dental Expenses

medical and dental expenses

	Amount
Medical Insurance Premiums (paid by you)
Prescription Drugs
Insulin
Glasses, Contacts
Hearing Aids, Batteries
Braces
Medical Equipment, Supplies
Nursing Care
Medical Therapy
Hospital
Doctor/Dental/Orthodontist
Mileage (no. of miles)

13. Taxes Paid
13. Taxes Paid
Amount
Real Property Tax (attach bills)
Personal Property Tax
Other
Other (Amount)
14. Interest Expense
Attach 1098
Cancelof
Mortgage Interest
Amount
Mortgage interest paid
Interest paid to individual for your home (include amortization schedule
Paid To:
Details
Name
Address
Soc. Sec. No.
Investment Interest
Amount
Investment Interest
Premiums paid or accrued for qualified mortgage insurance
15. Casualty/Theft Loss
For property damaged by storm, water, fire, accident, or stolen.
Location of Property
Description of Property
casualty, theft, or loss
Other Federally Declared
Disaster Losses
Amount of Damage
Insurance Reimbursement
Repair Costs
Federal Grants Received
16. Charitable Contributions
Charitable Contributions
Amount
Church
United Way
Scouts
Telethons
University, Public TV/Radio
Heart, Lung, Cancer, etc.
Wildlife Fund
Salvation Army, Goodwill
Other
Other (Amount)
Non-Cash
Non-cash (value)
Volunteer (no. of miles @ .14)
Volunteer (value)
17. Child & Other Dependent Care Expenses
Child & Other Dependent Care Expenses
Name of Care Provider Address Soc. Sec. No. or
Employer ID Amount
Paid
1
2
3
Also complete this section if you receive dependent care benefits from your employer
18. Job-Related Moving Expenses
✓ if you are a member of the Armed Forces on active duty and moving due to a permanent change of station due to a military order
Yes
Date of Move
MonthDayYear
Date
Job-Related Moving Expenses
Value
Move Household Goods
Lodging During Move
Travel to New Home (no. of miles)
19. Employment Related Expenses That You Paid (Not self-employed)
✓ if Armed Forces reservist, a qualified performing artist, a fee-basis state or local government official, or an individual with a disability claiming impairment-related work expenses.
Yes

	Amount
Real Property Tax (attach bills)
Personal Property Tax

	Amount
Mortgage interest paid
Interest paid to individual for your home (include amortization schedule

	Details
Name
Address
Soc. Sec. No.

	Amount
Investment Interest
Premiums paid or accrued for qualified mortgage insurance

	Amount
Church
United Way
Scouts
Telethons
University, Public TV/Radio
Heart, Lung, Cancer, etc.
Wildlife Fund
Salvation Army, Goodwill

	Value
Move Household Goods
Lodging During Move
Travel to New Home (no. of miles)

Employment Related Expenses That You Paid(Not self-employed)

	Value
Dues - Union, Professional
Books, Subscriptions, Supplies
Licenses Repairs
Tools, Equipment, Safety Equipment
Uniforms (include cleaning)
Sales Expense, Gifts
Tuition, Books (work related)
Entertainment

Office in home (In Square Feet)
Total home
Office
Storage
Other employment related expenses
Value
Rent
Insurance
Utilities
Maintenance
20. Investment-Related Expenses State use only
Investment-Related Expenses State use only
Value
Tax Preparation Fee
Safe Deposit Box Rental
Mutual Fund Fee
Investment Counselor
Other
21. Business Mileage
Do you have written records?
YesNo
Did you sell or trade in a car used for business?
YesNo
If yes, attach a copy of purchase agreement
Cancelof

	Value
Rent
Insurance
Utilities
Maintenance

	Value
Tax Preparation Fee
Safe Deposit Box Rental
Mutual Fund Fee
Investment Counselor
Other

Business Mileage

	Value
Make/Year Vehicle
Date purchased
Total miles (personal & business)
Business miles (not to and from work)
From first to second job
Education (one way, work to school)
Job Seeking
Other Business
Round Trip commuting distance
Gas, Oil, Lubrication
Batteries, Tires, etc.
Repairs
Wash
Insurance
Interest
Lease payments
Garage Rent

22. Business Travel
If you are not reimbursed for exact amount, give total expenses.
Amount
Airfare, Train, etc.
Lodging
Taxi, Car Rental
Meals (no. of days)
Meals Amount
If you are not reimbursed for exact amount, give total expenses.
Amount
Other
Reimbursement Received
23. COVID-19

	Amount
Airfare, Train, etc.
Lodging
Taxi, Car Rental

	Amount
Other
Reimbursement Received

Covid-19

	Yes	No
Were you, your spouse, or a dependent diagnosed with COVID-19?
Did you experience adverse financial consequences as a result of you, your spouse, or other members of your household being quarantined, furloughed or laid off, experienced a reduction of work hours, or unable to work due to a lack of childcare?

24. Estimated Tax Paid
Estimated Tax Paid
Due Date Date Paid Federal State
1
2
3
4
25. Other Deductions
Alimony paid to
Social Sec. No.
Soc. Sec. Deductions Amount
Student Interest Paid
Archer Medical Savings Acct. Contributions
26. Education Expenses
Education Expenses
Student's Name Type of Expense Amount
1
2
3
4
5
6
27. Questions, Comments, & Other Information
Questions, Comments, & Other Information
Residence:
Town
County
Village
School District
City
28. Direct Deposit of Refund / or Savings Bond Purchases
Would you like to have your refund(s) directly deposited into your account?
YesNo
(The IRS will allow you to deposit your federal tax refund into up to three
different accounts. If so, please provide the following information.)
ACCOUNT 1
Owner of account
TaxpayerSpouseBoth
Type of account
CheckingTraditional SavingsTraditional IRARoth IRATreasury DirectArcher MSA SavingsCoverdell Education SavingsHSA SavingsSEP IRA
Name of financial institution
Financial Institution Routing Transit Number (if known)
Your account number
ACCOUNT 2
Owner of account
TaxpayerSpouseBoth
Type of account
CheckingTraditional SavingsTraditional IRARoth IRATreasury DirectArcher MSA SavingsCoverdell Education SavingsHSA SavingsSEP IRA
Name of financial institution
Financial Institution Routing Transit Number (if known)
Your account number
ACCOUNT 3
Owner of account
TaxpayerSpouseBoth
Type of account
CheckingTraditional SavingsTraditional IRARoth IRATreasury DirectArcher MSA SavingsCoverdell Education SavingsHSA SavingsSEP IRA
Name of financial institution
Financial Institution Routing Transit Number (if known)
Your account number
Would you like to purchase Series I Savings bonds with a portion of your refund? If so, please answer the following:
Amount used for bond purchases for yourself (and spouse if filing jointly).
Amount used to buy bonds for someone else (or yourself only or spouse only if filing jointly).
Bonds
Owner's name Co-owner or Beneficiary's name if applicable X if name is for a beneficiary Bond purchase Amount
1
2
3
To the best of my knowledge the information enclosed in this client tax organizer is correct and includes all income, deductions, and other information necessary for the preparation of this year's income tax returns for which I have adequate records.
Taxpayer
Clear
Date
MonthDayYear
Date
Spouse
Clear
Date
MonthDayYear
Date
Should be Empty:

Name		Soc. Sec. No	Date of Birth	Occupation	Work Phone
Taxpayer	{nameOf}	{socSec}	{dateOf}	{occupation}	{workPhone}
Spouse	{nameOf12}	{socSec13}	{dateOf14}	{occupationOf}	{workPhone16}

Street Address {address:addr_line1}	City {address:city}	State {address:state}	Zip {address:postal}	Home Phone {homePhone}
Email {email}

	Other	Federally Declared Disaster Losses
Amount of Damage
Insurance Reimbursement
Repair Costs
Federal Grants Received

	Name (First, Last)	Relationship	Date of Birth	Soc. Sec. No.	Months Lived With You	Disabled	Full-Time Student	Dependent's Gross Income	ID Protection PIN
1
2
3
4
5

	Payer	Amount
1
2
3
4

	Payer	Ordinary	Capital Gains	Non-Taxable
1
2
3
4

	Date Acquired	Cost & Imp.
Personal Residence*
Vacation Home
Land
Other