Client Questionnaire

First and last name of the person completing this questionnaire.*
What is your email address?*
Yes - please include a voided check with your informationNo

General Questions
SingleMarried filing jointlyMarried filing separatelyHead of household – generally you must be unmarried at the end of the year and provide housing and support to a dependent. Please see below.
Please click here for more information

Head of Household

General Questions
YesNo

General Questions
Please enter your new address.*

General Questions
YesNo

General Questions
Please list your driver's license number. Many states are now requiring this information in order to electronically file.*
Please list the expiration date of your driver's license.*
Please list your spouse's (if applicable) driver's license number.
Please list the expiration date of your spouse's driver's license.

Contributions to Charitable Organizations
YesNo, if not, you are not allowed a tax deduction

IRA's
YesNo
YesNo

IRA's
How much did you or will you contribute to an IRA for 2022?*
What is the approximate date of the contribution you have made or will make before April 15, 2023?*

MonthDayYear
Date
How much did your spouse contribute or how much will your spouse contribute to an IRA for 2022?
What is the approximate date of the contribution your spouse made or will make before April 15, 2023?

MonthDayYear
Date

IRA's
Yes - Please provide documentation showing the amount on 12-31-22.No

Home Deductions
YesNo
Click here for an example

Closing Disclosure Example
YesNo

Foreign Questions
YesNo

Foreign Questions
Yes - Please provide a statement showing the name and address of the institution and the highest amount held in the account during the year.No

Foreign Questions
YesNo

Foreign Questions
Please provide all relevant information about the foreign distribution.*

Digital Assets
YesNo

Digital Assets
Please provide all relevant information

Digital Assets
YesNo

Digital Assets
Please provide all relevant information

Gifts to Individuals
YesNo

Gifts to Individuals
Name of the person who received the gift.*
Relationship to the person who received the gift (i.e., son, daughter, grandchild)*
Address of the person receiving the gift.*
Date of the gift.*

MonthDayYear
Date
Amount of the gift.*

Dependent Questions
YesNo

Dependents
YesNo

State Questions
Full year Arizona residentFull year Florida residentFull year Minnesota residentFull year resident of another statePart year resident in multiple states

Minnesota
YesNo
Click here for more information

Qualifying Education Expenses

Minnesota
Please list dependent 1's name, grade, and education expense amount. The deduction is limited to $1,625 for dependents K-6 and $2,500 for dependents 7-12.*
Please list dependent 2's name, grade, and education expense amount. The deduction is limited to $1,625 for dependents K-6 and $2,500 for dependents 7-12.
Please list dependent 3's name, grade, and education expense amount. The deduction is limited to $1,625 for dependents K-6 and $2,500 for dependents 7-12.
Please list dependent 4's name, grade, and education expense amount. The deduction is limited to $1,625 for dependents K-6 and $2,500 for dependents 7-12.

Minnesota
YesNo

Minnesota
Please list dependent 1's name, the financial institution holding the funds, the account number, the amount contributed and/or withdrawn from this account.*
Please list dependent 2's name, the financial institution holding the funds, the account number, the amount contributed and/or withdrawn from this account.
Please list dependent 3's name, the financial institution holding the funds, the account number, the amount contributed and/or withdrawn from this account.
Please list dependent 4's name, the financial institution holding the funds, the account number, the amount contributed and/or withdrawn from this account.

Minnesota
Yes - Please provide form 1098-ENo

Minnesota
What was the total amount of loans you originally borrowed?*
What were your total loan payments in 2022 (principal and interest)?*
What was the total amount of loans your spouse originally borrowed?
What were your spouses total loan payments in 2022 (principal and interest)?

Minnesota
YesNo

Minnesota
Please list the name of the company, policy number and the amount contributed for you. If you previously provided the name of the company and policy number, enter "on file" for this information.*
Please list the name of the company, policy number and the amount contributed for your spouse (if any). If you previously provided the name of the company and policy number, enter "on file" for this information.

Minnesota
YesNo

Please list the amount you (or your spouse received)*

Arizona
YesNo

Arizona
Please list the total amount contributed to all 529 College Savings Plan.*

Arizona
YesNo
Click the links for more information. Hint: After opening the link, use Ctrl+F on your keyboard to bring up a search box and type the name of the school or charity to see if your donation qualifies.

Qualifying Charitable Organizations

Public School List

Private School Tuition

Arizona
Please list the code, name, amount and the date you contributed to the qualifying organization 1. Or please provide the forms that have this information on it to us. Arizona requires all of the information in order to claim it on your return.*
Please list the code, name, amount and the date you contributed to the qualifying organization 2. Or please provide the forms that have this information on it to us. Arizona requires all of the information in order to claim it on your return
Please list the code, name, amount and the date you contributed to the qualifying organization 3. Or please provide the forms that have this information on it to us. Arizona requires all of the information in order to claim it on your return
Please list the code, name, amount and the date you contributed to the qualifying organization 4. Or please provide the forms that have this information on it to us. Arizona requires all of the information in order to claim it on your return

Florida
YesNo

Florida
Please list what you purchased and the sales tax amount.*

Residency
Please list the state you lived in.*

Residency
Name of State 1.*
Date residency began in State 1.*

MonthDayYear
Date
Date residency ended in State 1*

MonthDayYear
Date
Name of State 2.*
Date residency began in State 2.*

MonthDayYear
Date
Date residency ended in State 2.*

MonthDayYear
Date
Name of State 3.
Date residency began in State 3.

MonthDayYear
Date
Date residency ended in State 3.

MonthDayYear
Date

2023 Information
Other than your Mayo salary, do you expect any changes in your tax situation for 2023?*
Should be Empty:

General Questions

General Questions

General Questions

General Questions

General Questions

General Questions

Contributions to Charitable Organizations

IRA's

IRA's

IRA's

Home Deductions

Foreign Questions

Foreign Questions

Foreign Questions

Foreign Questions

Digital Assets

Digital Assets

Digital Assets

Digital Assets

Gifts to Individuals

Gifts to Individuals

Dependent Questions

Dependent Questions

Dependents

Dependent Questions

Head of Household

State Questions

Minnesota

Minnesota

Minnesota

Minnesota

Minnesota

Minnesota

Minnesota

Minnesota

Minnesota

Arizona

Arizona

Arizona

Arizona

Florida

Florida

Residency

Residency

2023 Information