Individual Tax Organizer

3501 Black Horse Pike Suite 530 #1013
Turnersville, NJ 08082
(609) 227-3674
info@antoniagoodwater.com
www.antoniagoodwater.com
REFERRALS ARE ALWAYS APPRECIATED
If you know someone who would like a tax appointment, please
have them call our office. Do not be concerned that your business,
personal or financial matters will be discussed with clients whom
you refer. All client information is treated in the utmost confidence.
Tax Organizer
Tax Year (Please complete one organizer for each year you need to file)
Have you received any notice from the IRS or state revenue department within the past year? If yes, provide a copy.

Name

First NameLast Name
Date of Birth

MonthDayYear
Date
SSN
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Select all that apply:

Rows	Paid To	Address & Phone Number	Provider's SSN or Employer ID # MANDATORY unless it is an exempt organization (EO). If EO, check box.
Child or Dependent Care Expenses Information

For EIP:

If you didn't get an Economic Impact Payment or got less than the full amounts, you may be eligible to claim the Recovery Rebate Credit when your 2021 tax return is filed.

Did you receive any of the following? Select all that apply
Advanced Child Credit (IRS Letter 6419) Amount Received:
Please compare the amount on the letter 6419 to the amount you received in your bank account to confirm that the amount on your 6419 letter is correct.

Rows	Amount Received	No EIP Received
EIP 1 (2020)
EIP 2 (2020)
EIP 3 (2021)

Only complete this section if you itemize your deductions.

Please fill-up the information within the current year only.

General Expenses

Rows	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long Term Care Premiums
Prescription Drugs and Medications
Home Mortgage
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Tax Preparation Fees
Investment Expenses

Total Expenses

Driver's License/State Identification

Rows	DL Information
DL Number
DL Issue State
DL Issue Date
DL Expires

Rows	DL Information Spouse
DL Number
DL Issue State
DL Issue Date
DL Expires

REFUND DIRECT DEPOSIT Complete this section to have your refund automatically deposited into your bank account. Doing so will speed up the refund and eliminate the danger of a check being lost or stolen. Direct deposit can be allocated to up to 3 separate accounts. Entries for only one account are provided below. If you wish to make multiple deposits, please provide the additional account information and how you wish to allocate the refund.

Rows	Banking Information
Bank Name
Bank Routing Number (9 Digits)
Bank Account Number
Type of Account (Checking or Savings)
Paper Check

Tax Related Documents to upload:

Other
File Upload

Cancelof
Additional comments

- I confirmed that all information I entered here is accurate and true.
- I allow Antonia Goodwater Bookkeeping to capture my sensitive data like personal ID, government ID, social security number (SSN), and other information.
- I have read the terms and conditions and privacy policy of Antonia Goodwater Bookkeeping.
- By signing below, you acknowledge that you have read and understood your responsibilities and our responsibilities in doing this tax return.
Date Signed

MonthDayYear
Date
Taxpayer Signature
Date Signed

MonthDayYear
Date
Spouse Signature
Should be Empty:

Rows	Yes/No	Employer	Spouse Ins	Exchange/ Marketplace	Direct with Insurer	Medicare	Medicaid
Taxpayer
Spouse
Dependent 1
Dependent 2
Dependent 3

Rows	Name	SSN	Date of Birth	Relationship
Dependent 1
Dependent 2
Dependent 3

3501 Black Horse Pike Suite 530 #1013Turnersville, NJ 08082(609) 227-3674info@antoniagoodwater.comwww.antoniagoodwater.com

Tax Organizer

3501 Black Horse Pike Suite 530 #1013
Turnersville, NJ 08082
(609) 227-3674
info@antoniagoodwater.com
www.antoniagoodwater.com