2024 Tax Questionnaire
Name
First Name
Last Name
Email
example@example.com
Date
-
Month
-
Day
Year
Date
Personal Information
Did your marital status change during the year?
*
Yes
No
If your marital status changed during the year, please explain
(i.e. "Married on June 15th"
Did you live separately from your spouse during the last six months of the year?
*
Yes
No
Do you have a separate decree, instrument, or agreement and are not living in thesame household by the end of the year?
*
Yes
No
Did your address change from last year?
*
Yes
No
Can you be claimed as a dependent by another taxpayer?
*
Yes
No
Did you change any bank accounts, or did routing transit numbers (RTN) and/or bank account number change for existing bank accounts that have been used to direct deposit (or direct debit) funds from (or to) the IRS or other taxing authority during the tax year?
*
Yes
No
Do you, your spouse (if applicable), and any dependents have a taxpayer identification number (SSN, ITIN, or ATIN)?
*
Yes
No
Did you receive an Identity Protection PIN (IP PIN) from the IRS or have you beena victim of identity theft? If yes, attach the IRS letter for filing returns in 2024.
*
Yes
No
Did you reside in or operate a business in a Federally declared disaster area? The Federally declared disaster areas include victims of hurricanes, tropical storms,floods, as well as wildfires.
*
Yes
No
Covid-19 Information
Did you receive State and Local Fiscal Recovery Funds (SLFR) under a program tosupport those negatively impacted by the COVID-19 pandemic for helping you withyour mortgage insurance and/or home purchases, such as funds to pay some or allof the down payment and closing costs associated with your purchase of a home?
*
Yes
No
Are you a telecommuting employee that was required to "shelter in place" due tolocal COVID-19 protocols while working in a state that was not your home state?
*
Yes
No
Dependent Information
Were there any changes in dependents from the prior year?
*
Yes
No
If there were changes in your dependents from the prior year, please explain
Do you have any children under age 19 or a full-time student under age 24 with unearned income in excess of $2,500?
*
Yes
No
Do you have dependents who must file a tax return?
*
Yes
No
Did you provide over half the support for any other person(s) other than your dependent children during the year?
*
Yes
No
Did you pay for child care while you worked, looked for work, or while a full-time student?
*
Yes
No
Is there any other person(s) who lived with you more than half the year but not claimed by you last year?
*
Yes
No
Did you pay any expenses related to the adoption of a child during the year?
*
Yes
No
If you are divorced or separated with child(ren), do you have a divorce decree or other form of separation agreement which establishes custodial responsibilities?
*
Yes
No
Did any dependents receive an Identity Protection PIN (IP PIN) from the IRS or have they been a victim of identity theft? If yes, attach the IRS letter for use during 2022.
*
Yes
No
Upload IRS Identity Protection Pin (If Any)
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Purchases, Sales and Debt Information
Did you start a new business or purchase rental property during the year?
*
Yes
No
Did you have onwership interest in any type of business?
*
Yes
No
Did you sell, exchange, or purchase any assets used in your trade or business?
*
Yes
No
Did you acquire a new or additional interest in a partnership or S corporation?
*
Yes
No
Did you sell, exchange, or purchase any real estate during the year?
*
Yes
No
Did you purchase or sell a principal residence during the year?
*
Yes
No
Did you foreclose or abandon a principal residence or real property during the year?
*
Yes
No
Did you acquire or dispose of any stock during the year?
*
Yes
No
Did you take out a home equity loan this year?
*
Yes
No
Did you refinance a principal residence or second home this year?
*
Yes
No
Did you sell an existing business, rental, or other property this year?
*
Yes
No
Did you lend money with the understanding of repayment and this year it became totally uncollectable?
*
Yes
No
Did you have any debts canceled or forgiven this year, such as a home mortgage or student loan(s)?
*
Yes
No
Did you purchase a new or previously owned Clean vehicle this year that is eligiblefor the new clean vehicle credit? If yes, attach the vehicle statement from the dealer.
*
Yes
No
Income Information
Did you have any foreign income or pay any foreign taxes during the year, directly or indirectly, such as from investment accounts, partnerships or a foreign employer?
*
Yes
No
Did you receive any income from property sold prior to this year?
*
Yes
No
Did you receive any unemployment benefits during the year?
*
Yes
No
Did you receive any disability income during the year?
*
Yes
No
Did you receive any Medicaid waiver payments as difficulty of care during the year?
*
Yes
No
Did you receive tip income not reported to your employer this year?
*
Yes
No
Did any of your life insurance policies mature, or did you surrender any policies?
*
Yes
No
Did you receive any awards, prizes, hobby income, gambling or lottery winnings?
*
Yes
No
Did you receive any income considered to be nonemployee compensation?
*
Yes
No
Did you receive a Form 1099-K, 1099-MISC, 1099-NEC, or other income statement for work done in what is commonly referred to as the "gig" economy?
*
Yes
No
Do you expect a large fluctuation in income, deductions, or withholding next year?
*
Yes
No
Did you have any sales or other exchanges of digital assets (including from an airdrop or a hard fork, or used digital assets to pay for goods or services?
*
Yes
No
Retirement Information
Are you an active participant in a pension or retirement plan?
*
Yes
No
Did you receive any Social Security benefits during the year?
*
Yes
No
Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP,401(k), or other qualified retirement plan?
*
Yes
No
If yes, were any withdrawals due to a Federally declared disaster?
*
Yes
No
If you received any qualified disaster retirement plan distributions, did you repay any of the distributions in 2024?
*
Yes
No
Did you receive any lump-sum payments from a pension, profit sharing or401(k) plan?
*
Yes
No
Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP,401(k), or other qualified retirement plan?
*
Yes
No
Did you donate money directly from your IRA to a charity during the tax year?
*
Yes
No
Education Information
Did you, your spouse, or your dependents attend a post-secondary school during the year, or plan to attend one in the coming year?
*
Yes
No
Did you have any educational expenses during the year on behalf of yourself,your spouse, or a dependent?
*
Yes
No
Did anyone in your family receive a scholarship of any kind during the year?
*
Yes
No
If yes, were any of the scholarship funds used for expenses other than tuition,such as room and board?
*
Yes
No
Did you make any withdrawals from an education savings or 529 Plan account?
*
Yes
No
If yes, were any of these withdrawals rolled over into an ABLE (Achieving a Better Life Experience) account?
*
Yes
No
Did you make any contributions to an education savings or 529 Plan account?
*
Yes
No
Did you pay any student loan interest this year?
*
Yes
No
Did you cash any Series EE or I U.S. Savings bonds issued after 1989?
*
Yes
No
Would you like a worksheet to aid in the completion of a Free Application for Federal Student Aid (FAFSA) with the U.S. Department of Education?
*
Yes
No
Health Care Information
Did you have qualifying health care coverage, such as employer-sponsored coverage or government-sponsored coverage (i.e. Medicare/Medicaid) for your family? "Your family" for health care coverage refers to you, your spouse if filing jointly, and anyone you can claim as a dependent.
*
Yes
No
Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act?
*
Yes
No
Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act and share a policy with anyone who is not included inyour family?
*
Yes
No
Did you make any contributions to a Health savings account (HSA) or Archer MSA?
*
Yes
No
Did you receive any distributions from a Health savings account (HSA), ArcherMSA, or Medicare Advantage MSA this year?
*
Yes
No
Did you pay long-term care premiums for yourself or your family?
*
Yes
No
Did you make any contributions to an ABLE (Achieving a Better Life Experience) account?
*
Yes
No
Did you receive any withdrawals from an ABLE (Achieving a Better Life Experience) account?
*
Yes
No
If you are a business owner, did you pay health insurance premiums for your employees this year?
*
Yes
No
Itemized Deduction Information
Did you incur a casualty or theft loss or any condemnation awards during the year?
*
Yes
No
If yes, did the loss occur in a Federally declared disaster area?
*
Yes
No
Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)?
*
Yes
No
Did you make any cash or noncash charitable contributions (clothes, furniture, etc.)?
*
Yes (If yes, please provide evidence such as a receipt from the donee organization, a canceled check, or record of payment, to substantiate all contributions made.)
No
Did you donate a vehicle or boat during the year?.
*
Yes
No
Did you pay real estate taxes for your primary home and/or second home?
*
Yes
No
Did you pay any mortgage interest on an existing home loan?
*
Yes
No
Did you incur interest expenses associated with any investment accounts you held?
*
Yes
No
Did you make any major purchases during the year (cars, boats, etc.)?
*
Yes
No
Did you make any out-of-state purchases (by telephone, internet, mail, or in person)for which the seller did not collect state sales or use tax?
*
Yes
No
Miscellaneous Information
Did you make gifts of more than $17,000 to any individual?
*
Yes
No
Did you utilize an area of your home for business purposes?
*
Yes
No
Did you engage in any bartering transactions?
*
Yes
No
Did you retire or change jobs this year?
*
Yes
No
Did you incur moving costs because of a permanent change of station as a memberof the Armed Forces on active duty?
*
Yes
No
Did you pay any individual as a household employee during the year?
*
Yes
No
Did you make energy efficient improvements to your main home this year?
*
Yes
No
Did you receive a distribution from, or were you a grantor or transferor for a foreign trust?
*
Yes
No
Did you have a financial interest in or signature authority over a financial account such as a bank account, securities account, or brokerage account, located in aforeign country?
*
Yes
No
Do you have any foreign financial accounts, foreign financial assets, or hold interest in a foreign entity?
*
Yes
No
Are you an owner or do you control 25% of a company's ownership interest for acompany registered with a secretary of state or similar office before January 1, 2024?
*
Yes
No
Do you plan to become an owner or control at least 25% of a company's ownershipinterests for a company registered with a secretary of state or similar office for thefirst time after January 1, 2024?
*
Yes
No
Did you receive correspondence from the State or the IRS?
*
Yes
No
If you received correspondece from the IRS, please explain:
Do you have previous years of tax returns that are either unfiled or filed with unpaid balances due?
*
Yes
No
Do you want to designate $3 to the Presidential Election Campaign Fund? If you check yes, it will not change your tax or reduce your refund.
*
Yes
No
Due Diligence Questions - **PLEASE READ CAREFULLY**
For Child Tax Credit, Earned Income Credit, Education Tax Credit or Head of Household Filing Status.
Do you believe that you may qualify for the Child Tax Credit, the Earned Income Credit, the Education Tax Credit, or as Head of Household filing status?
*
Yes
No
Can you provide documentation to substantiate your eligibility for the credit(s) and/or Head of Household filing status and the amounts(s) of any credit(s) claimed on the return if your return was selected for an audit?
*
Yes
No
Were any credits disallowed or reduced during a previous tax year?
*
Yes
No
Can you affirm that each qualifying person for the Child Tax Credit, Additional Child Tax Credit or Other Dependent Credit is your dependent and a citizen, national, or resident of the United States?
*
Yes
No
Can you provide proof that your dependent child or children lived with you more than half of the year?
*
Yes
No
Can you provide proof that you provided more than half of the support for your dependent child or children?
*
Yes
No
Can you provide documentation to substantiate your eligibility for the credits?
*
Yes
No
Can you confirm that your dependent child or children is (are) related to you?
*
Yes
No
If you and your spouse are divorced or separated, can you provide proof that the divorce decree or court order allows you to claim the qualifying child or children?
*
Yes
No
N/A
Enter Full Name (Taxpayer)
Enter Full Name (Spouse)
Estimated Tax Payments
If you made any estimated tax payments to the IRS during the year, please list them below.
Did you make any payments to the IRS for tax year 2024?
*
Yes
No
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Other
Please enter any other notes or information you think we should know in relation to the preparation of your tax return.
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