Trucker Tax Service

2023 Company Driver Tax Organizer

W2 Employees Only

Trucker Tax Service

2117 Traders Crossing, Fort Wayne, IN 46845

info@truckertaxservice.com - 888.799.1099 - www.truckertaxservice.com

Text 260-203-3390

This is the part of the process that is critical to insuring your taxes are completed properly and in a timely manner. Although it may look a little overwhelming, we promise the more thoroughly you complete the following pages, the easier, faster, and more successful the process will be. Remember, missing out on a sizeable refund or paying out additional tax dollars you don’t actually owe, depends upon how you fill out this form. Take the time to be thorough and complete.

Today's Date

MonthDayYear

Referred by:*

Full Name*

First NameLast Name

Phone Number*

E-mail*

Did you move last year?

YesNo

If so, enter move date

Date

Please enter new address. If no change, leave blank.

Street Address

Street Address Line 2

CityState

Zip CodeCountry

County of Residence

School District - Ohio Only

Social Security Number

Birthdate

Marital Status as of 12/31 of tax year

SingleMarried Filing JointlyMarried Filing SeparatelyHead of household (must have a qualifying dependent living with you)

If married, provide spouse information

	First and Last Name	Social Security #	Birth Date
Spouse

Exemptions and Dependents

	First and Last Name	Social Security #	Birth Date	Relationship	Months Living w/taxpayer
1st Person
2nd Person
3rd Person
4th Person
5th Person

Taxpayer Drivers License #

Issue Date

Expiration Date

State of Issue

Spouse Drivers License #

Issue Date

Expiration Date

State of Issue

Did you receive any unemployment compensation in the tax year? Include copy of your 1099-G

YesNo

Did you receive any additional misc income (gambling, jury duty, prizes) (Include Form)?

YesNo

Did you receive distributions from pensions or your retirement fund? (Include the 1099-R)

YesNo

Did you sell any stocks or investments in this tax year? Include copies of your year-end brokerage tax statement.

YesNo

Did you or your spouse receive any social security benefits? (Include copies of your 1099-SSA)

YesNo

Did you pay or receive alimony (not child support)?

NoPaidReceived

Amount Paid or Received

Spouse's name

Spouse's SS#

If you are a partner or shareholder in any entity please include the K-1.

Did you or your spouse pay any student loan interest? (Include copy of the 1098-E)

YesNo

Did you pay tuition for you or a dependent in this tax year? (Include copy of the 1098-T)

YesNo

Did you make a contribution to a Traditional IRA?

YesNo

If yes, enter amount

Did you or anyone in your family purchase marketplace health insurance? If yes, you must provide us with a copy of your 1095A (B or C) form. +++++++++++

YesNo

Amount of unreimbursed medical bill payments.

Amount, if any, of health insurance premiums paid by you.

Amount of sales tax on any large purchases in tax year

Amount of vehicle registration paid in tax year for your personal auto?

Did you own a home? If yes, include the mortgage interest statement.

YesNo

Amount of any real estate taxes for your home.

Did you donate any cash or goods to charity? If so, fill out what the item was, to whom it was donated, and what was the dollar value:

	Description	To Whom	Dollar Value
Item One
Item Two
Item Three
Item Four
Item Five
Item Six

What did you pay for tax preparation services in last tax year?

Amount of any child care expenses in tax year

Full Name of Child Care Provider

Provider's SS# or EIN

Provider Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Did you receive a child tax credit this tax year?

YesNo

If so, how much? Include the IRS letter 6419, Child Tax Credit Reconciliation

Enter dollar amount

Did you buy a new home in this tax year? If yes, please include the settlement statement.

YesNo

Did you rent a home or apartment in this tax year? (May pertain to your state tax return)

YesNo

If yes, amount of rent

Name of Landlord

Address of Landlord

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Did you pay federal estimates this past tax year?

YesNo

If yes, fill in the following:

	Date	Amount
1
2
3
4

Did you pay state estimates this past tax year?

YesNo

If yes, fill in the following:

	Date	Amount
1
2
3
4

If you would like your tax refund direct deposited into your bank account, please provide the following:

Client Name

Bank Name

Routing NumberAccount Number

Type of Account - Checking/Savings, etc.

Upon completion of the tax return, a copy will be sent to your current email address. The e-file signature forms will also be forwarded to you. When we receive the e-file authorization forms, we will e-file the tax return(s).

Address if different than the tax return

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

THE INFORMATION CONTAINED HEREIN IS, TO THE BEST OF MY KNOWLEDGE, CORRECT AND COMPLETE. I UNDERSTAND THAT TRUCKER TAX SERVICE, INC. WILL NOT COMPILE MY TAX RETURN UNTIL THIS FORM IS COMPLETED, SIGNED, AND RETURNED WITH ALL MY TAX DOCUMENTS AND INCOME STATEMENTS. THERE ARE NO EXCEPTIONS TO THIS POLICY.*

I agree

Client Agreement Signature

Date

2023 Engagement Letter

Dear Client:
We would like to thank you for this opportunity to work with you. This letter is to confirm and specify terms of our engagement. In order to ensure an understanding of our mutual responsibilities, we ask all clients for whom returns are prepared to confirm the following arrangements.

We will prepare your 2023 federal and state income tax returns from information you furnish to us. We will not audit or otherwise verify the data you submit, although it may be necessary to ask your clarification of the information. We will furnish you with questionnaires and worksheets to guide you in gathering the necessary information. Your use of such forms will assist in keeping pertinent information from being overlooked.

The standard tax preparation fee is strictly for tax return(s) preparation. If we need to organize individual receipts, or provide any extra service, this will be charged at our normal billing rate per hour or charged by task.

It is your responsibility to provide all the information required for the preparation of complete and accurate
returns. You should retain all the documents, and other data that form the basis of income and deductions.

Trucker Tax Service, Inc. may, at its option, for any reason, automatically file for an extension on behalf of Client to extend the tax return filing deadline. If Client has not provided all documentation necessary by April 1st for the preceding tax year, Trucker Tax Service, Inc. will most likely file an extension on behalf of Client.

Your returns may be selected for review by the taxing authorities. Any proposed adjustments by the examining agent are subject to certain rights of appeal. In the event of such government tax examination or audit, we will be available upon request to represent you. You may be charged for time and expenses incurred.

Upon your understanding and agreement of this engagement letter, please sign below.

Very truly yours,

Jim O'Donnell

James K. O’Donnell
Trucker Tax Service, Inc.

I agree with the terms of the above Engagement Letter

Please Choose One of The Following Options for Payment

Tax Preparation Full Payment $250.00

If you are a resident of the following states AR, CA, IA, MN, or NY, we may be able to itemize deductions at the state level. Let us know if you are interested and we will look into for you.

Tax Prep Full Payment for Ohio Residents Only$300.00

This increase is to cover the additional complexities of the State of Ohio tax return

Tax Prep Remaining Payment After Extension $150.00

If you have paid us $100 for an extension, then you only owe us $150

Tax Prep Remaining Payment after Extension for Ohio Residents$200.00

If you have paid us $100 for an extension, then you only owe us $200

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

To send this information to us, press the "Submit" button below. As soon as you see the "Thank You" page Trucker Tax Service will have received all your information. Press print before "Submit" if you would like a printed copy.

MAKE SURE YOU ALSO SEND copies of the following tax information pertaining to you, to the address below:

First time clients must send a copy of your previous year's tax returns
W2s
SS4 showing your EIN
Loan Documents
Pension/IRA or investment documents
Insurance form 1095 which you have received from the marketplace
Any correspondence marked "Important Tax Documents"

Please email copies of the appropriate documents to:
dstixrood@truckertaxservice.com or Fax to 888-750-7557

For questions: Call 888-799-1099 Ext 200 or Text 260-203-3390

Profile Information

Personal Tax Information

Payment