Tax Organizer
Please complete this Organizer before your appointment. Prior year clients should use the proforma Organizer provided.
| Name | Soc. Sec. No | Date of Birth | Occupation | Work Phone | |
| Taxpayer | Stephen Donovan | 65675757656 | Thursday, March 18, 1976 | Manager | (432) 432-4324 |
| Spouse | Geraldine Scott | 6757656757657 | Wednesday, March 26, 1986 | Lawyer | (768) 678-6876 |
| Street Address 3562 Monroe Avenue | City Tampa | State Florida | Zip 33602 | Home Phone (465) 465-4564 |
| Email stephen@example.com | ||||
| Taxpayer | Spouse |
| 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 |
|---|---|---|---|---|---|---|---|---|
| Andew Parker | Son | 10/2/2001 | 12323432 | 300 | No | No | 10000 | 12321 |
| - | - | - | - | - | - | - | - | - |
| - | - | - | - | - | - | - | - | - |
| - | - | - | - | - | - | - | - | - |
| - | - | - | - | - | - | - | - | - |
Please provide for your appointment
- Last year's tax return (new clients only) - All statements (W-2s, 1098s, 1099s, etc)
- Name and address label (from government booklet or card)
Please answer the following questions to determine maximum deductions
| 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? | - |
| 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? |
| 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 | |
|---|---|---|
| 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? |
| 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 | - |
| 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? | - |
|---|
| 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. | no | no |
| Employer | Taxpayer | Spouse |
|---|---|---|
| 500 | - | |
| - | - | |
| - | - | |
| - | - | |
| - | - | |
| - | - | |
| - | - |
| Payer | Ordinary | Capital Gains | Non-Taxable |
|---|---|---|---|
| ghj | 699 | 100 | 499 |
| - | - | - | - |
| - | - | - | - |
| - | - | - | - |
| Payer | Amount |
|---|---|
| 5000 | - |
| 500 | - |
| 59 | - |
| 500 | - |
| Tax Exempt | Amount |
|---|---|
| 100 | - |
| 166 | - |
| Property | Date Acquired | Cost & Imp. |
| Personal Residence* | 9/1/2020 | 1000 |
|---|---|---|
| Vacation Home | 8/2/2020 | 1000 |
| Land | 6/4/2020 | 1000 |
| Other | 8/22/2020 | 1000 |
* Provide information on improvements, prior sales of home, and cost of a new residence. Also see Section 17 (Job-Related Moving).
| Amount | Date | Check for both | |
|---|---|---|---|
| Taxpayer | 4000 | 2/21/2020 | |
| Spouse | 199 | 1/1/2021 |
| . | Reason for Withdrawal | Yes | No |
|---|---|---|---|
| 90000 | Moving to another investment | - | |
| - | - | - | - |
| - | - | - | - |
| - | - | - | - |
| Plan Trustee | Reason for Withdrawal | Yes | No |
|---|---|---|---|
| 1000 | Moving to another investment | ||
| 2000 | Moving to another investment | ||
| 200 | Moving to another investment | ||
| 2000 | Moving to another investment |
* Provide statements from employer or insurance company with information on cost of or contributions to plan.
Did you receive:
| Social Security Benefits | Yes |
|---|---|
| Railroad Retirement | No |
| Yes |
| No |
| Investment | Date Acquired/Sold | Cost | Sale Price |
|---|---|---|---|
| test | 2/21/2020 | 100 | 10000 |
| test | 11/21/2020 | 100 | 10000 |
| test | 12/21/2020 | 100 | 10000 |
| test | 12/22/2020 | 1000 | 10000 |
| Alimony Received | 1000 |
|---|---|
| Child Support | 1000 |
| Scholarship (Grants) | 1000 |
| Unemployment Compensation (repaid) | 1000 |
| Prizes, Bonuses, Awards | |
| Unreported Tips | 1000 |
| Director / Executor's Fee | |
| Commissions | 1000 |
| Jury Duty | 1000 |
| Disability Income | |
| Veteran's Pension | |
| Payments from Prior Installment Sale | 1000 |
| State Income Tax Refund | 1000 |
| Economic Impact Payment 1 (First Stimulus Payment) | 1000 |
| Economic Impact Payment 2 (Second Stimulus Payment) | 1000 |
| Mortgage interest paid | 332 |
|---|---|
| Interest paid to individual for your home (include amortization schedule | 23423 |
| Name | Michelle David |
|---|---|
| Address | 1 rainbow street, florida |
| Soc. Sec. No. |
| Investment Interest | 455 |
|---|---|
| Premiums paid or accrued for qualified mortgage insurance | 66 |
For property damaged by storm, water, fire, accident, or stolen.
Gambling, Lottery (expenses: 299)
| Other | personal property auction | 30000 |
|---|---|---|
| Other |
| Other | Federally Declared Disaster Losses | |
|---|---|---|
| Amount of Damage | 200 | 3000 |
| Insurance Reimbursement | 100 | |
| Repair Costs | ||
| Federal Grants Received |
| Medical Insurance Premiums (paid by you) | 299 |
|---|---|
| Prescription Drugs | 300 |
| Insulin | 400 |
| Glasses, Contacts | 400 |
| Hearing Aids, Batteries | |
| Braces | |
| Medical Equipment, Supplies | |
| Nursing Care | |
| Medical Therapy | |
| Hospital | 444 |
| Doctor/Dental/Orthodontist | |
| Mileage (no. of miles) |
| Amount | |
|---|---|
| Church | 1000 |
| United Way | 1000 |
| Scouts | |
| Telethons | |
| University, Public TV/Radio | 200 |
| Heart, Lung, Cancer, etc. | 300 |
| Wildlife Fund | 100 |
| Salvation Army, Goodwill | 100 |
| Real Property Tax (attach bills) | 363 |
|---|---|
| Personal Property Tax | 369 |
Also complete this section if you receive dependent care benefits from your employer
| Rent | 2323 |
|---|---|
| Insurance | 23 |
| Utilities | 88 |
| Maintenance | 39 |
| Move Household Goods | 1000 |
|---|---|
| Lodging During Move | 200 |
| Travel to New Home (no. of miles) | 100 |
| Tax Preparation Fee | 49 |
|---|---|
| Safe Deposit Box Rental | 23 |
| Mutual Fund Fee | 23 |
| Investment Counselor | 232 |
| Other | 23 |
| Dues - Union, Professional | 19 |
|---|---|
| Books, Subscriptions, Supplies | 393 |
| Licenses Repairs | 33323 |
| Tools, Equipment, Safety Equipment | 333 |
| Uniforms (include cleaning) | 4434 |
| Sales Expense, Gifts | 324 |
| Tuition, Books (work related) | 33 |
| Entertainment | 23 |
Office in home (In Square Feet)
| Due Date | Date Paid | Federal | State |
|---|---|---|---|
| 04/20/2020 | 3000 | 100 | 300 |
| - | - | - | - |
| - | - | - | - |
| - | - | - | - |
| Make/Year Vehicle | 2001 |
|---|---|
| Date purchased | 2002 |
| Total miles (personal & business) | 30000 |
| Business miles (not to and from work) | 1000 |
| From first to second job | 300 |
| Education (one way, work to school) | 3030 |
| Job Seeking | 300 |
| Other Business | 100 |
| Round Trip commuting distance | 400 |
| Gas, Oil, Lubrication | 400 |
| Batteries, Tires, etc. | 100 |
| Repairs | 300 |
| Wash | 50 |
| Insurance | 1000 |
| Interest | 10 |
| Lease payments | 399 |
| Garage Rent |
| Student's Name | Type of Expense | Amount |
|---|---|---|
| Jonathan Mitchel | School Fees | 1000 |
| - | - | |
| - | - | - |
| - | - | - |
| - | - | - |
| - | - | - |
| Airfare, Train, etc. | 100 |
|---|---|
| Lodging | 30 |
| Taxi, Car Rental | 100 |
| Other | 399 |
|---|---|
| Reimbursement Received | 30 |
| Were you, your spouse, or a dependent diagnosed with COVID-19? | No |
|---|---|
| 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? | No |
Residence:
(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
ACCOUNT 2
ACCOUNT 3
Would you like to purchase Series I Savings bonds with a portion of your refund? If so, please answer the following:
| Owner's name | Co-owner or Beneficiary's name if applicable | X if name is for a beneficiary | Bond purchase Amount |
|---|---|---|---|
| Noni Chan | - | - | 40000 |
| - | - | - | - |
| - | - | - | - |
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.
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