Questionnaire for 2022 Tax Return
Your Name
First Name
Last Name
Did you or spouse receive any unemployment income? (Need 1099G)
Yes
No
Did you receive retirement or Social Security benefits? (Need Statement from SSA-1099/1099-R)
Yes
No
Do you have Medicare? (Social Security health insurance)
Yes
No
Do you have a secondary/supplement insurance you pay out of pocket?
Yes
No
Annual Amount
Do you have Long Term Health Care policy?
Yes
No
Name(s)
Cost (per individual)
Did you purchase insurance through Market Place? (Need to provide 1095-A)
Yes
No
Do you purchase health insurance out of pocket?
Yes
No
Amount
Have you received any of the following 1099's: (Copies Needed)
1099-R
Yes
No
1099-DIV
Yes
No
1099-INT
Yes
No
Did you have a self employed business?
Yes
No
Have you filed a Schedule C, E or F in previous tax year?
Yes
No
Did you use a credit card processor for business? (You should receive a 1099-K)
Yes
No
Did you have any gambling winnings/losses? (If yes, please include W2G's and loss documentation)
Yes
No
Did you have any Electronic/Virtual Digital Currency transactions? (Need documentation)
Yes
No
Did you sell any stocks, bonds, mutual funds or other assets? (Need to 1099)
Yes
No
Did you make any contributions (outside of payroll) to any IRA in 2022?
Yes
No
Whose name is it in?
First Name
Last Name
Is it a Traditional or Roth?
Please Select
Traditional
Roth
Amount of contribution (per individual)
Did anyone else make any contributions (outside of payroll) to any IRA in 2022?
Yes
No
Whose name is it in?
First Name
Last Name
Is it a Traditional or Roth?
Please Select
Traditional
Roth
Amount of contribution (per individual)
Do you qualify for educator expense? (300 Fed- 500 Iowa)
Yes
No
Amount claiming
Did you make any cash donations?
Yes
No
Amount
Did you make any NON Cash donations?
Yes
No
Value
Did you take early with drawl or distributions from 401K and or Roll over a 401K? (Need 1099-R)
Yes
No
Do you have Mortgage Interest? (Need 1099-INT)
Yes
No
Do you have Real estate/Property Tax to deduct? **Will need to provide documentation OR $ amount **If you live in ILLINOIS and pay property tax we will need your property ID #
Yes
No
Dollar Amount
Property # (Illinois Only)
Did you purchase any Residential Energy property? (Need proof of Energy Star Certification & Receipt)
Yes
No
Did you pay for daycare/child care expense? (Need Name, SS/EIN, Address of provider & Amount, Amount paid for each child)
Yes
No
Were any of your dependents, you or your spouse in college in 2022?
Yes
No
Did you pay college tuition/expenses for yourself or dependent in 2022? (Need Provide a 1098-T & Receipts)
Yes
No
Have you taken American Opportunity or Lifetime Learning Education Credit on previous tax returns? (Need years taken-(per student)
Yes
No
Years Taken (Per Student)
Did you contribute/withdraw money from an educational IRA or 529 plan? (Need contribution letter/ 1098-Q)
Yes
No
Did you pay interest on college loans? (Need 1098-E to report interest deduction)
Yes
No
Did you have any debt cancelled/forgiven (credit card, etc) or a mortgage principle reduction? (Need 1099-C)
Yes
No
IA residents -License Registration: (Need payment amount & documents if available)
Yes
No
Did you pay Registration fees/tuition for your dependents, grades K-12? Need amount paid for each student
Yes
No
Did you contribute money to HSA account (Health Savings Account)? (Need 5498-SA and/or 1099-SA)
Yes
No
Did you operate any Rental Property during tax year?
Yes
No
Did you sell your primary home in 2022? (Need a copy of the closing statement for sale and NEW purchase)
Yes
No
How long did you live there?
Did you sell a second home or vacation home in 2022?
Yes
No
Have you moved to a different school district? (Need new school district **Iowa residents only)
Yes
No
Have you moved to a different state during 2022? (Need specific date)
Yes
No
Are you a member/beneficiary of an S-Corp, Partnership, Estate, Trust, Etc? Include all K-1
Yes
No
Did you make any Estimated Quarterly payments for this tax year to Federal and/or State?
Yes
No
Federal
Date (Payment 1)
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Month
/
Day
Year
Date
Amount Paid
Date (Payment 2)
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Month
/
Day
Year
Date
Amount Paid
Date (Payment 3)
/
Month
/
Day
Year
Date
Amount Paid
Date (Payment 4)
/
Month
/
Day
Year
Date
Amount Paid
State
Date (Payment 1)
/
Month
/
Day
Year
Date
Amount Paid
Date (Payment 2)
/
Month
/
Day
Year
Date
Amount Paid
Date (Payment 3)
/
Month
/
Day
Year
Date
Amount Paid
Date (Payment 4)
/
Month
/
Day
Year
Date
Amount Paid
Do you require a Federal Identity PIN # to file your taxes? (Should receive a new Pin Letter each year)
Yes
No
Are you a Volunteer Fire Fighter/EMS? (Letter Required)
Yes
No
Do you want a Paper Copy or Emailed Copy of your Tax Return?
Paper
Email
Do you want to receive our monthly Email Tax Tip Newsletter?
Yes
No
**We will need Documentation if claiming dependents other than your own children.
**We will need Legal Documents if you are acting as Power of Attorney for someone.
Please include documents needed for filing:
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