Tax Organizer

1
Reminder... Please complete this Organizer before your appointment.

Once again, remember to add ALL necessary information, but do NOT include information that does not pertain to you. (Please simply skip any questions that do not pertain to you.)

Prior year clients should use the organizer provided.

New clients should use the organizer provided, but you should also have a copy of prior years' tax returns.

Please feel free to use our tax expert within the organizer, Chandra Jenkins, if you have questions.

Thank you!
2
Name of Taxpayer* This field is required.
First Name
Middle Name
Last Name
Suffix
3
Filing Status* This field is required.
Single
Head of Household
Married Filing Jointly
Married Filing Separately
Widow(er)
4
Date of Birth of Taxpayer* This field is required.
Date
Month
Day
Year
5
Soc. Sec. No. of Taxpayer* This field is required.Please have proof of your ID for me to view during the consultation.
6
Phone Number of Taxpayer* This field is required.
Please enter a valid phone number.
7
Email of Taxpayer* This field is required.
example@example.com
8
Occupation of Taxpayer* This field is required.
If you do not have an occupation, type "none."
9
Name of Spouse
First Name
Last Name
10
Date of Birth of Spouse
Date
Month
Day
Year
11
Soc. Sec. No. of SpouseI will need to speak with the spouse to verify identity and validate permission to file. Please have proof of your ID for me to view during the consultation.
12
Phone Number of Spouse
Please enter a valid phone number.
13
Occupation of Spouse
14
Address
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
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
United States
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
15
1. Personal Information
16
Blind (Taxpayer)
Yes
No
17
Disabled (Taxpayer)
Yes
No
18
Pres. Campaign Fund (Taxpayer)
Yes
No
19
Blind (Spouse)
Yes
No
20
Disabled (Spouse)
Yes
No
21
Pres. Campaign Fund (Spouse)
Yes
No
22
Date of Death (Spouse of Qualifying Dependent)
Date
Month
Day
Year
23
2. Dependents (Children & Others)
24
Dependents
Name (First, Last)
Relationship
Date of Birth
Soc. Sec. No.
Months Lived With You
Disabled
Full-Time Student
Dependent's Gross Income
ID Protection PIN
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Yes
No
Row 0, Column 5
Yes
No
Row 0, Column 6
Row 0, Column 7
Row 0, Column 8
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Yes
No
Row 1, Column 5
Yes
No
Row 1, Column 6
Row 1, Column 7
Row 1, Column 8
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Yes
No
Row 2, Column 5
Yes
No
Row 2, Column 6
Row 2, Column 7
Row 2, Column 8
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
Yes
No
Row 3, Column 5
Yes
No
Row 3, Column 6
Row 3, Column 7
Row 3, Column 8
5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Row 4, Column 4
Yes
No
Row 4, Column 5
Yes
No
Row 4, Column 6
Row 4, Column 7
Row 4, Column 8
1
2
3
4
5
Name (First, Last)
Row 0, Column 0
Relationship
Row 0, Column 1
Date of Birth
Row 0, Column 2
Soc. Sec. No.
Row 0, Column 3
Months Lived With You
Row 0, Column 4
Disabled
Yes
No
Row 0, Column 5
Full-Time Student
Yes
No
Row 0, Column 6
Dependent's Gross Income
Row 0, Column 7
ID Protection PIN
Row 0, Column 8
Name (First, Last)
Row 1, Column 0
Relationship
Row 1, Column 1
Date of Birth
Row 1, Column 2
Soc. Sec. No.
Row 1, Column 3
Months Lived With You
Row 1, Column 4
Disabled
Yes
No
Row 1, Column 5
Full-Time Student
Yes
No
Row 1, Column 6
Dependent's Gross Income
Row 1, Column 7
ID Protection PIN
Row 1, Column 8
Name (First, Last)
Row 2, Column 0
Relationship
Row 2, Column 1
Date of Birth
Row 2, Column 2
Soc. Sec. No.
Row 2, Column 3
Months Lived With You
Row 2, Column 4
Disabled
Yes
No
Row 2, Column 5
Full-Time Student
Yes
No
Row 2, Column 6
Dependent's Gross Income
Row 2, Column 7
ID Protection PIN
Row 2, Column 8
Name (First, Last)
Row 3, Column 0
Relationship
Row 3, Column 1
Date of Birth
Row 3, Column 2
Soc. Sec. No.
Row 3, Column 3
Months Lived With You
Row 3, Column 4
Disabled
Yes
No
Row 3, Column 5
Full-Time Student
Yes
No
Row 3, Column 6
Dependent's Gross Income
Row 3, Column 7
ID Protection PIN
Row 3, Column 8
Name (First, Last)
Row 4, Column 0
Relationship
Row 4, Column 1
Date of Birth
Row 4, Column 2
Soc. Sec. No.
Row 4, Column 3
Months Lived With You
Row 4, Column 4
Disabled
Yes
No
Row 4, Column 5
Full-Time Student
Yes
No
Row 4, Column 6
Dependent's Gross Income
Row 4, Column 7
ID Protection PIN
Row 4, Column 8
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25
Please provide for your appointment
- Last year's tax return (new clients only).
- Name and address label (from government booklet or card).
- All statements (W-2s, 1098s, 1099s, etc).

Please answer the following questions to determine maximum deductions.
26
Gathering Information
Yes
No
1. Are you self-employed or do you receive hobby income?
Row 0, Column 0
Row 0, Column 1
2. Did you receive income from raising animals or crops?
Row 1, Column 0
Row 1, Column 1
3, Did you receive rent from real estate or other property?
Row 2, Column 0
Row 2, Column 1
4. Did you receive income from gravel, timber, minerals, oil, gas, copyrights, patents?
Row 3, Column 0
Row 3, Column 1
5. Did you withdraw or write checks from a mutual fund?
Row 4, Column 0
Row 4, Column 1
6. Do you have a foreign bank account, trust, or business?
Row 5, Column 0
Row 5, Column 1
7. Do you provide a home for or help support anyone not listed in Section 2 above?
Row 6, Column 0
Row 6, Column 1
8. Did you receive any correspondence from the IRS or State Department of Taxation?
Row 7, Column 0
Row 7, Column 1
1. Are you self-employed or do you receive hobby income?
2. Did you receive income from raising animals or crops?
3, Did you receive rent from real estate or other property?
4. Did you receive income from gravel, timber, minerals, oil, gas, copyrights, patents?
5. Did you withdraw or write checks from a mutual fund?
6. Do you have a foreign bank account, trust, or business?
7. Do you provide a home for or help support anyone not listed in Section 2 above?
8. Did you receive any correspondence from the IRS or State Department of Taxation?
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
Yes
Row 2, Column 0
No
Row 2, Column 1
Yes
Row 3, Column 0
No
Row 3, Column 1
Yes
Row 4, Column 0
No
Row 4, Column 1
Yes
Row 5, Column 0
No
Row 5, Column 1
Yes
Row 6, Column 0
No
Row 6, Column 1
Yes
Row 7, Column 0
No
Row 7, Column 1
1 of 8
27
Gathering Information (Continued)
Yes
No
9. Were there any births, deaths, marriages, divorces or adoptions in your immediate family?
Row 0, Column 0
Row 0, Column 1
10. Did you give a gift of more than $15,000?
Row 1, Column 0
Row 1, Column 1
11. Did you have any debts cancelled, forgiven, or refinanced?
Row 2, Column 0
Row 2, Column 1
12. Did you go through bankruptcy proceedings?
Row 3, Column 0
Row 3, Column 1
9. Were there any births, deaths, marriages, divorces or adoptions in your immediate family?
10. Did you give a gift of more than $15,000?
11. Did you have any debts cancelled, forgiven, or refinanced?
12. Did you go through bankruptcy proceedings?
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
Yes
Row 2, Column 0
No
Row 2, Column 1
Yes
Row 3, Column 0
No
Row 3, Column 1
1 of 4
28
13. (a) If you paid rent, how much did you pay?
29
More Information
Yes
No
13. (b) Was heat included?
Row 0, Column 0
Row 0, Column 1
14. Did you pay interest on a student loan for yourself, your spouse, or your dependent during the year?
Row 1, Column 0
Row 1, Column 1
15. Did you pay expenses for yourself, your spouse, or your dependent to attend classes beyond high school?
Row 2, Column 0
Row 2, Column 1
13. (b) Was heat included?
14. Did you pay interest on a student loan for yourself, your spouse, or your dependent during the year?
15. Did you pay expenses for yourself, your spouse, or your dependent to attend classes beyond high school?
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
Yes
Row 2, Column 0
No
Row 2, Column 1
1 of 3
30
Healthcare Coverage Information
Yes
No
16. Did you have healthcare coverage (health insurance) for you, your spouse and dependents during this tax season? If yes, include Forms 1095-A, 1095-B, and 1095-C
Row 0, Column 0
Row 0, Column 1
16. Did you have healthcare coverage (health insurance) for you, your spouse and dependents during this tax season? If yes, include Forms 1095-A, 1095-B, and 1095-C
Yes
Row 0, Column 0
No
Row 0, Column 1
31
17. Did you apply for an exemption through the Marketplace/Exchange? If so, provide the exemption certificate number.
32
Unearned Income Question
Yes
No
18. Did you have any children under the age of 18 or 19 to 24 year old students with unearned income of more than $2600?
Row 0, Column 0
Row 0, Column 1
18. Did you have any children under the age of 18 or 19 to 24 year old students with unearned income of more than $2600?
Yes
Row 0, Column 0
No
Row 0, Column 1
33
More InformationIf you choose not to respond, the assumed answer will be "no."
Yes
No
19. Did you purchase a new alternative technology vehicle or electric vehicle?
Row 0, Column 0
Row 0, Column 1
20. Did you install any energy property to your residence such as solar water heaters, generators or fuel cells or energy efficient improvements such as exterior doors or windows, insulation, heat pumps, furnaces, central air conditioners or water heaters?
Row 1, Column 0
Row 1, Column 1
21. Did you own $50,000 or more in foreign financial assets?
Row 2, Column 0
Row 2, Column 1
19. Did you purchase a new alternative technology vehicle or electric vehicle?
20. Did you install any energy property to your residence such as solar water heaters, generators or fuel cells or energy efficient improvements such as exterior doors or windows, insulation, heat pumps, furnaces, central air conditioners or water heaters?
21. Did you own $50,000 or more in foreign financial assets?
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
Yes
Row 2, Column 0
No
Row 2, Column 1
1 of 3
34
Identity Theft Question
Taxpayer
Spouse
22. Have you or your spouse been a victim of identity theft and given an identity theft protection PIN by the IRS? If yes, enter the six digit identity protection PIN number. 
Row 0, Column 0
Row 0, Column 1
22. Have you or your spouse been a victim of identity theft and given an identity theft protection PIN by the IRS? If yes, enter the six digit identity protection PIN number. 
Taxpayer
Row 0, Column 0
Spouse
Row 0, Column 1
35
3. Wage, Salary Income
36
Attach W-2s
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
37
Wage/Salary
Employer and Amount
Taxpayer
Spouse
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
6
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
7
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
1
2
3
4
5
6
7
Employer and Amount
Row 0, Column 0
Taxpayer
Row 0, Column 1
Spouse
Row 0, Column 2
Employer and Amount
Row 1, Column 0
Taxpayer
Row 1, Column 1
Spouse
Row 1, Column 2
Employer and Amount
Row 2, Column 0
Taxpayer
Row 2, Column 1
Spouse
Row 2, Column 2
Employer and Amount
Row 3, Column 0
Taxpayer
Row 3, Column 1
Spouse
Row 3, Column 2
Employer and Amount
Row 4, Column 0
Taxpayer
Row 4, Column 1
Spouse
Row 4, Column 2
Employer and Amount
Row 5, Column 0
Taxpayer
Row 5, Column 1
Spouse
Row 5, Column 2
Employer and Amount
Row 6, Column 0
Taxpayer
Row 6, Column 1
Spouse
Row 6, Column 2
1 of 7
38
4. Interest Income
39
Attach 1099-INT, Form 1097-BTC & Broker Statements
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
40
Specific Information from 1099-INT o5 1097 BTC and Broker Statements
Payer
Amount
1
Row 0, Column 0
Row 0, Column 1
2
Row 1, Column 0
Row 1, Column 1
3
Row 2, Column 0
Row 2, Column 1
4
Row 3, Column 0
Row 3, Column 1
1
2
3
4
Payer
Row 0, Column 0
Amount
Row 0, Column 1
Payer
Row 1, Column 0
Amount
Row 1, Column 1
Payer
Row 2, Column 0
Amount
Row 2, Column 1
Payer
Row 3, Column 0
Amount
Row 3, Column 1
1 of 4
41
Continued
Tax Exempt
Amount
1
Row 0, Column 0
Row 0, Column 1
2
Row 1, Column 0
Row 1, Column 1
1
2
Tax Exempt
Row 0, Column 0
Amount
Row 0, Column 1
Tax Exempt
Row 1, Column 0
Amount
Row 1, Column 1
1 of 2
42
5. Dividend Income
43
Attach 1099-DIV
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
44
From Mutual Funds & Stocks
Payer
Ordinary
Capital Gains
Non-Taxable
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
1
2
3
4
Payer
Row 0, Column 0
Ordinary
Row 0, Column 1
Capital Gains
Row 0, Column 2
Non-Taxable
Row 0, Column 3
Payer
Row 1, Column 0
Ordinary
Row 1, Column 1
Capital Gains
Row 1, Column 2
Non-Taxable
Row 1, Column 3
Payer
Row 2, Column 0
Ordinary
Row 2, Column 1
Capital Gains
Row 2, Column 2
Non-Taxable
Row 2, Column 3
Payer
Row 3, Column 0
Ordinary
Row 3, Column 1
Capital Gains
Row 3, Column 2
Non-Taxable
Row 3, Column 3
1 of 4
45
6. Partnership, Trust, Estate Income
46
Attach K-1
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
47
List Payers of Partnership, Limited Partnership, S-Corporation, Trust, or Estate Income
48
7. Property Sold
49
Attach 1099-S and Closing Statements
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
50
Property
Date Acquired
Cost & Imp.
Personal Residence*
Row 0, Column 0
Row 0, Column 1
Vacation Home
Row 1, Column 0
Row 1, Column 1
Land
Row 2, Column 0
Row 2, Column 1
Other
Row 3, Column 0
Row 3, Column 1
Personal Residence*
Vacation Home
Land
Other
Date Acquired
Row 0, Column 0
Cost & Imp.
Row 0, Column 1
Date Acquired
Row 1, Column 0
Cost & Imp.
Row 1, Column 1
Date Acquired
Row 2, Column 0
Cost & Imp.
Row 2, Column 1
Date Acquired
Row 3, Column 0
Cost & Imp.
Row 3, Column 1
1 of 4
51
* Provide information on improvements, prior sales of home, and cost of a new residence. Also see Section 17 (Job-Related Moving).
52
8. I.R.A. (Individual Retirement Acct.)
53
Contributions for Tax Year Income
Amount
Date
Check for both
Taxpayer
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Spouse
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Taxpayer
Spouse
Amount
Row 0, Column 0
Date
Row 0, Column 1
Check for both
Row 0, Column 2
Amount
Row 1, Column 0
Date
Row 1, Column 1
Check for both
Row 1, Column 2
1 of 2
54
Attach 1099-R & 5498
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
55
Reinvested?
Plan Trustee
Reason For Withdrawal
Yes
No
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
1
2
3
4
Plan Trustee
Row 0, Column 0
Reason For Withdrawal
Row 0, Column 1
Yes
Row 0, Column 2
No
Row 0, Column 3
Plan Trustee
Row 1, Column 0
Reason For Withdrawal
Row 1, Column 1
Yes
Row 1, Column 2
No
Row 1, Column 3
Plan Trustee
Row 2, Column 0
Reason For Withdrawal
Row 2, Column 1
Yes
Row 2, Column 2
No
Row 2, Column 3
Plan Trustee
Row 3, Column 0
Reason For Withdrawal
Row 3, Column 1
Yes
Row 3, Column 2
No
Row 3, Column 3
1 of 4
56
9. Pension, Annuity Income
57
Attach 1099-RPayer*
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
58
Reinvested?
Plan Trustee
Reason for Withdrawal
Yes
No
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
1
2
3
4
Plan Trustee
Row 0, Column 0
Reason for Withdrawal
Row 0, Column 1
Yes
Row 0, Column 2
No
Row 0, Column 3
Plan Trustee
Row 1, Column 0
Reason for Withdrawal
Row 1, Column 1
Yes
Row 1, Column 2
No
Row 1, Column 3
Plan Trustee
Row 2, Column 0
Reason for Withdrawal
Row 2, Column 1
Yes
Row 2, Column 2
No
Row 2, Column 3
Plan Trustee
Row 3, Column 0
Reason for Withdrawal
Row 3, Column 1
Yes
Row 3, Column 2
No
Row 3, Column 3
1 of 4
59
* Provide statements from employer or insurance company with information on cost of or contributions to plan.
60
Tax Payer Retirement Information
Yes
No
Social Security Benefits
Row 0, Column 0
Row 0, Column 1
Railroad Retirement
Row 1, Column 0
Row 1, Column 1
Social Security Benefits
Railroad Retirement
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
1 of 2
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Spouse Retirement Information
Yes
No
Social Security Benefits
Row 0, Column 0
Row 0, Column 1
Railroad Retirement
Row 1, Column 0
Row 1, Column 1
Social Security Benefits
Railroad Retirement
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
1 of 2
62
Attach SSA 1099, RRB 1099
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Select files to upload
Max. file size: 10.6MB
Cancelof
63
10. Investments Sold
64
Stocks, Bonds, Mutual Funds, Gold, Silver, Partnership Interest - Attach 1099-B & Confirmation Slips
Investment
Date Acquired/Sold
Cost
Sale Price
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
1
2
3
4
Investment
Row 0, Column 0
Date Acquired/Sold
Row 0, Column 1
Cost
Row 0, Column 2
Sale Price
Row 0, Column 3
Investment
Row 1, Column 0
Date Acquired/Sold
Row 1, Column 1
Cost
Row 1, Column 2
Sale Price
Row 1, Column 3
Investment
Row 2, Column 0
Date Acquired/Sold
Row 2, Column 1
Cost
Row 2, Column 2
Sale Price
Row 2, Column 3
Investment
Row 3, Column 0
Date Acquired/Sold
Row 3, Column 1
Cost
Row 3, Column 2
Sale Price
Row 3, Column 3
1 of 4
65
11. Other Income
66
List All Other Income (Including Non-Taxable)
Amount
Alimony Received
Row 0, Column 0
Child Support
Row 1, Column 0
Scholarship (Grants)
Row 2, Column 0
Unemployment Compensation (repaid)
Row 3, Column 0
Prizes, Bonuses, Awards
Row 4, Column 0
Unreported Tips
Row 5, Column 0
Director / Executor's Fee
Row 6, Column 0
Commissions
Row 7, Column 0
Jury Duty
Row 8, Column 0
Disability Income
Row 9, Column 0
Veteran's Pension
Row 10, Column 0
Payments from Prior Installment Sale
Row 11, Column 0
State Income Tax Refund
Row 12, Column 0
Economic Impact Payment 1 (First Stimulus Payment)
Row 13, Column 0
Economic Impact Payment 2 (Second Stimulus Payment)
Row 14, Column 0
Alimony Received
Child Support
Scholarship (Grants)
Unemployment Compensation (repaid)
Prizes, Bonuses, Awards
Unreported Tips
Director / Executor's Fee
Commissions
Jury Duty
Disability Income
Veteran's Pension
Payments from Prior Installment Sale
State Income Tax Refund
Economic Impact Payment 1 (First Stimulus Payment)
Economic Impact Payment 2 (Second Stimulus Payment)
Amount
Row 0, Column 0
Amount
Row 1, Column 0
Amount
Row 2, Column 0
Amount
Row 3, Column 0
Amount
Row 4, Column 0
Amount
Row 5, Column 0
Amount
Row 6, Column 0
Amount
Row 7, Column 0
Amount
Row 8, Column 0
Amount
Row 9, Column 0
Amount
Row 10, Column 0
Amount
Row 11, Column 0
Amount
Row 12, Column 0
Amount
Row 13, Column 0
Amount
Row 14, Column 0
1 of 15
67
Gambling, Lottery (Expenses)
68
Gambling, Lottery (Income)
69
Other Income
Description
Amount
Other
Row 0, Column 0
Row 0, Column 1
Other
Row 1, Column 0
Row 1, Column 1
Other
Other
Description
Row 0, Column 0
Amount
Row 0, Column 1
Description
Row 1, Column 0
Amount
Row 1, Column 1
1 of 2
70
12. Medical/Dental Expenses
71
Medical and Dental Expenses
Amount
Medical Insurance Premiums (paid by you)
Row 0, Column 0
Prescription Drugs
Row 1, Column 0
Insulin
Row 2, Column 0
Glasses, Contacts
Row 3, Column 0
Hearing Aids, Batteries
Row 4, Column 0
Braces
Row 5, Column 0
Medical Equipment, Supplies
Row 6, Column 0
Nursing Care
Row 7, Column 0
Medical Therapy
Row 8, Column 0
Hospital
Row 9, Column 0
Doctor/Dental/Orthodontist
Row 10, Column 0
Mileage (no. of miles)
Row 11, Column 0
Medical Insurance Premiums (paid by you)
Prescription Drugs
Insulin
Glasses, Contacts
Hearing Aids, Batteries
Braces
Medical Equipment, Supplies
Nursing Care
Medical Therapy
Hospital
Doctor/Dental/Orthodontist
Mileage (no. of miles)
Amount
Row 0, Column 0
Amount
Row 1, Column 0
Amount
Row 2, Column 0
Amount
Row 3, Column 0
Amount
Row 4, Column 0
Amount
Row 5, Column 0
Amount
Row 6, Column 0
Amount
Row 7, Column 0
Amount
Row 8, Column 0
Amount
Row 9, Column 0
Amount
Row 10, Column 0
Amount
Row 11, Column 0
1 of 12
72
13. Taxes Paid
73
Taxes Paid
Amount
Real Property Tax (attach bills)
Row 0, Column 0
Personal Property Tax
Row 1, Column 0
Real Property Tax (attach bills)
Personal Property Tax
Amount
Row 0, Column 0
Amount
Row 1, Column 0
1 of 2
74
Other
75
Other (Amount)
76
14. Interest Expense
77
Attach 1098
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Cancelof
78
Mortgage Interest
Amount
Mortgage interest paid
Row 0, Column 0
Interest paid to individual for your home (include amortization schedule
Row 1, Column 0
Mortgage interest paid
Interest paid to individual for your home (include amortization schedule
Amount
Row 0, Column 0
Amount
Row 1, Column 0
1 of 2
79
Paid To:
Details
Name
Row 0, Column 0
Address
Row 1, Column 0
Soc. Sec. No.
Row 2, Column 0
Name
Address
Soc. Sec. No.
Details
Row 0, Column 0
Details
Row 1, Column 0
Details
Row 2, Column 0
1 of 3
80
Investment Interest
Amount
Investment Interest
Row 0, Column 0
Premiums paid or accrued for qualified mortgage insurance
Row 1, Column 0
Investment Interest
Premiums paid or accrued for qualified mortgage insurance
Amount
Row 0, Column 0
Amount
Row 1, Column 0
1 of 2
81
15. Casualty/Theft Loss
82
For property damaged by storm, water, fire, accident, or stolen.
83
Location of Property
84
Description of Property
85
Casualty, Theft, or Loss
Other
Federally Declared Disaster Losses
Amount of Damage
Row 0, Column 0
Row 0, Column 1
Insurance Reimbursement
Row 1, Column 0
Row 1, Column 1
Repair Costs
Row 2, Column 0
Row 2, Column 1
Federal Grants Received
Row 3, Column 0
Row 3, Column 1
Amount of Damage
Insurance Reimbursement
Repair Costs
Federal Grants Received
Other
Row 0, Column 0
Federally Declared Disaster Losses
Row 0, Column 1
Other
Row 1, Column 0
Federally Declared Disaster Losses
Row 1, Column 1
Other
Row 2, Column 0
Federally Declared Disaster Losses
Row 2, Column 1
Other
Row 3, Column 0
Federally Declared Disaster Losses
Row 3, Column 1
1 of 4
86
16. Charitable Contributions
87
Charitable Contributions
Amount
Church
Row 0, Column 0
United Way
Row 1, Column 0
Scouts
Row 2, Column 0
Telethons
Row 3, Column 0
University, Public TV/Radio
Row 4, Column 0
Heart, Lung, Cancer, etc.
Row 5, Column 0
Wildlife Fund
Row 6, Column 0
Salvation Army, Goodwill
Row 7, Column 0
Church
United Way
Scouts
Telethons
University, Public TV/Radio
Heart, Lung, Cancer, etc.
Wildlife Fund
Salvation Army, Goodwill
Amount
Row 0, Column 0
Amount
Row 1, Column 0
Amount
Row 2, Column 0
Amount
Row 3, Column 0
Amount
Row 4, Column 0
Amount
Row 5, Column 0
Amount
Row 6, Column 0
Amount
Row 7, Column 0
1 of 8
88
Other
89
Other (Amount)
90
Non-Cash
91
Non-Cash Value
92
Volunteer (No. of Miles @ $0.14)
93
Volunteer (Value)
94
17. Child & Other Dependent Care Expenses
95
Also complete this section if you receive dependent care benefits from your employer
96
Child & Other Dependent Care Expenses
Name of Care Provider
Address
Soc. Sec. No. or Employer ID
Amount Paid
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
1
2
3
Name of Care Provider
Row 0, Column 0
Address
Row 0, Column 1
Soc. Sec. No. or Employer ID
Row 0, Column 2
Amount Paid
Row 0, Column 3
Name of Care Provider
Row 1, Column 0
Address
Row 1, Column 1
Soc. Sec. No. or Employer ID
Row 1, Column 2
Amount Paid
Row 1, Column 3
Name of Care Provider
Row 2, Column 0
Address
Row 2, Column 1
Soc. Sec. No. or Employer ID
Row 2, Column 2
Amount Paid
Row 2, Column 3
1 of 3
97
18. Job-Related Moving Expenses
98
✓ if you are a member of the Armed Forces on active duty and moving due to a permanent change of station due to a military order
Yes
99
Date of Move
Date
Month
Day
Year
100
Job-Related Moving Expenses
Value
Move Household Goods
Row 0, Column 0
Lodging During Move
Row 1, Column 0
Travel to New Home (no. of miles)
Row 2, Column 0
Move Household Goods
Lodging During Move
Travel to New Home (no. of miles)
Value
Row 0, Column 0
Value
Row 1, Column 0
Value
Row 2, Column 0
1 of 3
101
19. Employment Related Expenses That You Paid (Not self-employed)
102
✓ Are you an Armed Forces reservist, a qualified performing artist, a fee-basis state or local government official, or an individual with a disability claiming impairment-related work expenses?
Yes
103
Employment Related Expenses That You Paid(Not Self-Employed)
Value
Dues - Union, Professional
Row 0, Column 0
Books, Subscriptions, Supplies
Row 1, Column 0
Licenses Repairs
Row 2, Column 0
Tools, Equipment, Safety Equipment
Row 3, Column 0
Uniforms (include cleaning)
Row 4, Column 0
Sales Expense, Gifts
Row 5, Column 0
Tuition, Books (work related)
Row 6, Column 0
Entertainment
Row 7, Column 0
Dues - Union, Professional
Books, Subscriptions, Supplies
Licenses Repairs
Tools, Equipment, Safety Equipment
Uniforms (include cleaning)
Sales Expense, Gifts
Tuition, Books (work related)
Entertainment
Value
Row 0, Column 0
Value
Row 1, Column 0
Value
Row 2, Column 0
Value
Row 3, Column 0
Value
Row 4, Column 0
Value
Row 5, Column 0
Value
Row 6, Column 0
Value
Row 7, Column 0
1 of 8
104
Do You Have A Home Office?

Tell us about your home office. For spacial consideration, please total square feet.
105
Total Home Square FootageWhat is the total square footage of your home?
106
Home Office Square FootageWhat is the square footage of the space in your home that is specifically designated for your business (and not shared with personal activities)?
107
Storage Square FootageIs there a portion of your home that is designated as the storage space for your business?
108
Other Employment Related Expenses
Value
Rent
Row 0, Column 0
Insurance
Row 1, Column 0
Utilities
Row 2, Column 0
Maintenance
Row 3, Column 0
Rent
Insurance
Utilities
Maintenance
Value
Row 0, Column 0
Value
Row 1, Column 0
Value
Row 2, Column 0
Value
Row 3, Column 0
1 of 4
109
20. Investment-Related Expenses State use only
110
Investment-Related Expenses Please upload a copy of your Profit/Loss Statement for each business that you run.
Value
Tax Preparation Fee
Row 0, Column 0
Safe Deposit Box Rental
Row 1, Column 0
Mutual Fund Fee
Row 2, Column 0
Investment Counselor
Row 3, Column 0
Other
Row 4, Column 0
Tax Preparation Fee
Safe Deposit Box Rental
Mutual Fund Fee
Investment Counselor
Other
Value
Row 0, Column 0
Value
Row 1, Column 0
Value
Row 2, Column 0
Value
Row 3, Column 0
Value
Row 4, Column 0
1 of 5
111
21. Business Mileage
112
Do you have written records?
Yes
No
113
Did you sell or trade in a car used for business?
Yes
No
114
If yes, attach a copy of purchase agreement
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115
Business Mileage
Value
Make/Year Vehicle
Row 0, Column 0
Date purchased
Row 1, Column 0
Total miles (personal & business)
Row 2, Column 0
Business miles (not to and from work)
Row 3, Column 0
From first to second job
Row 4, Column 0
Education (one way, work to school)
Row 5, Column 0
Job Seeking
Row 6, Column 0
Other Business
Row 7, Column 0
Round Trip commuting distance
Row 8, Column 0
Gas, Oil, Lubrication
Row 9, Column 0
Batteries, Tires, etc.
Row 10, Column 0
Repairs
Row 11, Column 0
Wash
Row 12, Column 0
Insurance
Row 13, Column 0
Interest
Row 14, Column 0
Lease payments
Row 15, Column 0
Garage Rent
Row 16, Column 0
Make/Year Vehicle
Date purchased
Total miles (personal & business)
Business miles (not to and from work)
From first to second job
Education (one way, work to school)
Job Seeking
Other Business
Round Trip commuting distance
Gas, Oil, Lubrication
Batteries, Tires, etc.
Repairs
Wash
Insurance
Interest
Lease payments
Garage Rent
Value
Row 0, Column 0
Value
Row 1, Column 0
Value
Row 2, Column 0
Value
Row 3, Column 0
Value
Row 4, Column 0
Value
Row 5, Column 0
Value
Row 6, Column 0
Value
Row 7, Column 0
Value
Row 8, Column 0
Value
Row 9, Column 0
Value
Row 10, Column 0
Value
Row 11, Column 0
Value
Row 12, Column 0
Value
Row 13, Column 0
Value
Row 14, Column 0
Value
Row 15, Column 0
Value
Row 16, Column 0
1 of 17
116
22. Business Travel
117
If you are not reimbursed for exact amount, give total expenses.
Amount
Airfare, Train, etc.
Row 0, Column 0
Lodging
Row 1, Column 0
Taxi, Car Rental
Row 2, Column 0
Airfare, Train, etc.
Lodging
Taxi, Car Rental
Amount
Row 0, Column 0
Amount
Row 1, Column 0
Amount
Row 2, Column 0
1 of 3
118
Meals (no. of days)
119
Meals Amount
120
If you are not reimbursed for exact amount, give total expenses.
Amount
Other
Row 0, Column 0
Reimbursement Received
Row 1, Column 0
Other
Reimbursement Received
Amount
Row 0, Column 0
Amount
Row 1, Column 0
1 of 2
121
23. COVID-19
122
Covid-19
Yes
No
Were you, your spouse, or a dependent diagnosed with COVID-19?
Row 0, Column 0
Row 0, Column 1
Did you experience adverse financial consequences as a result of you, your spouse, or other members of your household being quarantined, furloughed or laid off, experienced a reduction of work hours, or unable to work due to a lack of childcare?
Row 1, Column 0
Row 1, Column 1
Were you, your spouse, or a dependent diagnosed with COVID-19?
Did you experience adverse financial consequences as a result of you, your spouse, or other members of your household being quarantined, furloughed or laid off, experienced a reduction of work hours, or unable to work due to a lack of childcare?
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
1 of 2
123
24. Estimated Tax Paid
124
Estimated Tax Paid
Due Date
Date Paid
Federal
State
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
1
2
3
4
Due Date
Row 0, Column 0
Date Paid
Row 0, Column 1
Federal
Row 0, Column 2
State
Row 0, Column 3
Due Date
Row 1, Column 0
Date Paid
Row 1, Column 1
Federal
Row 1, Column 2
State
Row 1, Column 3
Due Date
Row 2, Column 0
Date Paid
Row 2, Column 1
Federal
Row 2, Column 2
State
Row 2, Column 3
Due Date
Row 3, Column 0
Date Paid
Row 3, Column 1
Federal
Row 3, Column 2
State
Row 3, Column 3
1 of 4
125
25. Other Deductions
126
Alimony Paid To
127
Social Sec. No.
128
Soc. Sec. Deductions Amount
129
Student Interest Paid
130
Archer Medical Savings Acct. Contributions
131
26. Education Expenses
132
Education Expenses
Student's Name
Type of Expense
Amount
1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
6
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
1
2
3
4
5
6
Student's Name
Row 0, Column 0
Type of Expense
Row 0, Column 1
Amount
Row 0, Column 2
Student's Name
Row 1, Column 0
Type of Expense
Row 1, Column 1
Amount
Row 1, Column 2
Student's Name
Row 2, Column 0
Type of Expense
Row 2, Column 1
Amount
Row 2, Column 2
Student's Name
Row 3, Column 0
Type of Expense
Row 3, Column 1
Amount
Row 3, Column 2
Student's Name
Row 4, Column 0
Type of Expense
Row 4, Column 1
Amount
Row 4, Column 2
Student's Name
Row 5, Column 0
Type of Expense
Row 5, Column 1
Amount
Row 5, Column 2
1 of 6
133
27. Questions, Comments, & Other Information
134
Questions, Comments, & Other Information
135
Residence:
136
Town
137
County
138
Village
139
School District
140
City
141
28. Direct Deposit of Refund / or Savings Bond Purchases
142
Would you like to have your refund(s) directly deposited into your account?
Yes
No
143
(The following information will be used for the IRS to deposit any federal tax refund that you may be due. Please make sure to give accurate information.)
144
Owner of Account
Taxpayer
Spouse
Both
145
Type of Account
Checking
Traditional Savings
146
Name of Financial Institution
147
Financial Institution Routing Transit Number
148
Your Account Number
149
To the best of my knowledge the information enclosed in this client tax organizer is correct and includes all income, deductions, and other information necessary for the preparation of this year's income tax returns for which I have adequate records.
150
Taxpayer's Signature
Clear
151
Date
Date
Month
Day
Year
152
Spouse's Signature
Clear
153
Date
Date
Month
Day
Year
Should be Empty: