5 Starr Tax Professionals

1804-A Barataria Blvd Marrero LA 70072

504-345-2354

www.5starrtaxpros.com

Thank you for allowing us to prepare your tax return. It is very important you provide ALL Information requested in this form to help our certified staff in completing your return. If to have any questions, please ask, You will need your:

Tax information such as Forms W-2, 1099, 1098
Social security cards or ITIN letters for you and all persons on your tax return.
Proof of identity (government issued photo ID such as driver's license, state ID or other photo ID).

Street Address

#Apt

CityState / Province

Postal / Zip Code

Please enter a valid phone number.

SingleHohQualifying Widow

List below the name of everyone who lived in your home and outside your home that you supported during the last tax year. If additional space is required, please check here and use an additional page for additional information.

	Yes	No
Have correct identification been provided? (Photo copies made)
Do all names on return match SS cards provided?
By your state's definition, are you LEGALLY married?
If yes, did your spouse live in your home through July or until December?
Did you/spouse receive military pay?
Can anyone claim you/spouse as a dependent?
Did you/spouse live with someone with a higher adjusted gross income?
Are you renting a room and can provide a rental agreement?
Dependent/Qualifying Children
Have you verified birthday information entered on the return?
Did you/spouse provide over 50% of total support per ea. Dependent?
Does your dependent have a valid SS#?
-Under 19 and lived in the taxpayer's home more than one half of the
-Under 19 and foster child of taxpayer and lived in home for full year
-Under 19 and younger than you or your spouse
-Full time student age 19-24
-Totally disabled and can provide proof
*Are you claiming a brother, sister, niece, nephew, grandchild, or parent?
Did the parents of the dependent also live in the household?

	Type
-If no, what is the reason for the absence?
-If yes, did they financially contribute to the household?
-If yes, is your adjusted gross income higher than that of the parents?
How many months have the dependent lived in your household?
Can anyone else claim this dependent? Y/N

I understand the above questions and have answered them to the best of my abilities.

	AMOUNTS
Advertising
Bad Debts
Commissions Paid
Fees Paid
Depletion
Depreciation/Section 179
Insurance (other then health)
Mortgage Interest
Other Interest Payments
Licenses
Professional Services
Legal Services
Office Expenses
Phones
Business Line
Cellular
Pager
Rent
Vehicle
Machinery
Equipment
Other Business Rent
Supplies
Taxes
Real Estate
Personal Property
Employee
Other
Travel
Meals/Entertainment
(enter total, 50% deductable)
Wages
Pension and Profit Sharing

	AMOUNTS
Cost of Goods Sold
Beginning Inventory
Purchases
Personal Use Total
Other Costs
Ending Inventory
Equipment Purchased or Sold (List)
Car Expenses
Mileage
Business
Commuting
Other
Actual Expenses
Gas
Oil
Tires
Repairs
Tolls/Parking

Tax preparers are not allowed to give you any totals for your expenses toward your business. By signing this form, you agree that the information that has been provided by you, is true.

What information do you have to support your expenses? Ex; receipts, bank statements, etc.

5 Starr Tax Professionals

1804-A Barataria Blvd Marrero LA 70072

Part 1: Your Personal Information

Filling status

Part 2: Dependent Information

Part 3: Bank Information

Part 4: Questionnaire

EITC Questionnaire

5 STARR TAX PROFESSIONALS

Tax Preparer Notes