TH3 2022 TAX QUESTIONNAIRE

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Did your marital status change this year?
YESNO
4
Did your address change this year?
YESNO
5
New Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Could you be claimed as a dependent on another person's tax return for 2022?
YESNO
7
Were there any changes to dependents this past year?Any children born or anyone additional this past year you could claim as a dependent?
YESNO
8
Did you have any children under age 19 or full-time students under age 24 at the end of 2022, with interest and dividend income in excess of $1,100, or total investment income in excess of $2,200?
YESNO
9
Did you receive IRS document Form 1095-A, B, or C (Health Insurance Marketplace Statement)?
YESNO
10
Did you and your dependents have health care coverage for the full year?
YESNO
11
Did you start a business or farm, purchase rental or royalty property, or acquire an interest in a partnership, S corporation, trust, or REMIC?
YESNO
12
Did you buy or sell any stocks, bonds or other investment property in 2022?
YESNO
13
Did you purchase, sell, or refinance your principal home or second home, or did you take a home equity loan?
YESNO
14
Did you make any residential energy-efficient improvements or purchases involving solar, wind, geothermal or fuel cell energy sources?
YESNO
15
Did you receive a distribution (money paid out) from a retirement plan (40l(k), IRA, SEP, SIMPLE, Qualified Plan, etc.)?
YESNO
16
Did you make a contribution (money paid in) to a retirement plan (401(k), IRA, SEP, SIMPLE, Qualified Plan, etc.)?
YESNO
17
Did you personally contribute (money in) to an HSA (Health Savings Account) in 2022?Did you contribute directly outside of your employer or company
YESNO
18
Did you take any HSA (Health Savings Account) distributions (money out) for qualified medical expenses in 2022?
YESNO
19
Did you transfer or rollover any amount from one retirement plan to another retirement plan?
YESNO
20
Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a Roth IRA in 2022?
YESNO
21
Did you make contributions to a 529 Plan? A 529 plan is a tax-advantaged account that can be used to pay for qualified education costs, including college, K-12, and apprenticeship programs
YESNO
22
Did you receive a distribution (money out) from an Education Savings Account or a Qualified Tuition Program?
YESNO
23
Did you, your spouse, or a dependent incur any tuition expenses that are required to attend a college, university, or vocational school?
YESNO
24
Did you engage the services of any household employees?
YESNO
25
Were you notified or audited by either the Internal Revenue Service or the State taxing agency?
YESNO
26
Did you or your spouse make any gifts to an individual that total more than $16,000, or any gifts to a trust?
YESNO
27
Did your bank account information change within the last twelve months?
YESNO
28
Did you have an interest in or signature or other authority over a financial account in a foreign country, such as a bank account, securities account, or other financial account?
YESNO
29
Did you receive, sell, send, exchange or otherwise acquire any financial interest in virtual/crypto currency?
YESNO
30
Would you like a pdf copy of your Tax Organizer?The tax organizer takes the data from last year's return and will let you know what to include in the tax documents you send us based on last year. We'll add a pdf copy of your tax organizer into Sharefile to view or download and print. This is only available for previous year tax clients as the information is pulled from your prior year return in our system.
YESNO
31
How would you like to get us your 2022 tax documents?To submit digitally, we will create a Sharefile folder for your tax documents and you will be able to upload them securely. We'll send you the link when the folder has been created.
Digitally, please create a Sharefile folder to upload my tax documents
Drop off at the TH3 Office
Mail to the TH3 Office
Schedule a meeting
32
Please list any questions or other helpful information related to your 2022 personal taxes.
Should be Empty: