TOPTIER TAXES Self Employment

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SelfEmployment / 1099 Gig Worker Tax Questionnaire
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Full Legal Name
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SSN or ITIN
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Date of Birth
Date
Month
Day
Year
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Phone Number
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Email Address
example@example.com
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Home Address
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Filing Status:SingleMFJMFSHOHWidow(er)
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Business Name if any
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Business Start Date
Date
Month
Day
Year
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Business EIN if applicable
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Other Business Structure:Sole PropSingleMember LLC Partnership
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Type of Work Industry
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States Where Income Was Earned
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Income Information Platforms Used (check all): Uber, Lyft, DoorDash, Instacart, Amazon Flex, Airbnb, Turo, Etsy, Fiverr, Upwork, PayPal, Cash App, Stripe, Zelle, Other
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Total 1099 Income
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Cash Income Not on 1099
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Tips Received
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Did you have business expenses?YesNo Expense categories: Advertising, Phone/Internet, Supplies, Equipment, Software, Insurance, Meals, Travel, Vehicle, Other
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Estimated total expenses
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Vehicle used for business?YesNo
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Business miles driven
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Total miles driven
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Home office used exclusively?YesNo
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Home square footage
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Office square footage
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Taxes & Credits Estimated tax payments made?
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Total estimated taxes paid
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Credits/Deductions: Retirement, Health Insurance, HSA, Education, Childcare
Priorl Year Tax Return IRS or State Letters
Client Certification I certify that the information provided is true, complete, and accurate to the best of my knowledge.
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Client Signature
Clear
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Date
Date
Month
Day
Year
Should be Empty: