KEEPS ACCOUNTING SOLUTIONS - Tax Preparation Questionnaire

Tax Preparation Questionnaire

Keeps Bookkeeping & Accounting Solutions
Please read carefully and complete the tax questionnaire below. This form should take between 10-30 minutes to complete. Please don't hesitate to contact us with any questions or concerns. Thank you for choosing Keeps Solutions!
Filing Status

SingleHead of HouseholdMarried Filing SeparateMarried Filing JointQualifying Widower

Enter your dependents here.

Do you, your spouse, and your dependent(s) have health insurance within 12 months during the tax year? If yes, complete below as applicable.

General Tax Related Questions
Do you wish to donate $3 to the Presidential Election Campaign?

YesNo
Did you receive a federal tax refund last year?

YesNo
Did you change your state residency during the tax year?

YesNo
At any time during the tax year, did you (a) receive (as a reward or payment for property or services); or (b) sell, exchange, gift, or otherwise dispose of a digital asset (or a financial interest in a digital asset)?*

YesNo
Did you open a pre-tax retirement account for the first time during the tax year?

YesNo
Are you contributing to a 401(k) or other pre-tax retirement account?

YesNo
Did you withdraw funds from your 401(k) or pre-tax retirement account this year?

YesNo
Do you own a rental property (residential or commercial)?

YesNoI own more than one rental property.
Property is owned by:

TaxpayerSpouse
Percentage ownership if not 100%.
Enter percentage less than 100 (e.g., 75%)

Do you require assistance preparing and filing other return(s) besides Federal? Please make selections, as needed.

State returnSchoolLocalRITACountry returns
If an additional return is selected above, please describe below.
State, locality, school, etc.

	Days
Number of days rented
Number of days used personally

If you would like your tax refund (if any) deposited into your bank, please complete below.

	Account Type (checking or savings)	Account Number	Routing Number
1

Credits
Child and Dependent Care - number of qualifying individuals.
Please enter number of individuals that qualify.

If payments were made to an individual, were the services performed in your home?
Type: Yes or No
Tuition & Fees paid for higher education.
(American Opportunity & Lifetime Learning Credits)
Expenses incurred in connection with adoption.
Please indicate if "special needs" child.
Do you have a child under the age of 18 as of December 31 of the tax year who has earned an income (interest, dividends, etc.) of more than $1,150? If yes, please attach details below.

YesNo
Foreign Tax Credits? If yes, enter total amount.
Round to nearest dollar.

Estimated Tax Payments made during the tax year.

Do you have energy star rated improvements to your home?

WindowsDoorsFurnaceOther
Are you currently renting?

YesNo
What is your total rent payment for the tax year?
Base Rent Only.
When did you move into this rental unit?

MonthDayYear
Date
Do you own a home?

YesNo
Did you purchase this home during the tax year?

YesNo
When did you purchase this home?

MonthDayYear
Date
Do you have documents that show you paid for property taxes? This applies to real estate tax and other property tax.

Yes - I have all documents.No - I don't have any documentation.I have some documentation.
Did you pay tax on a vehicle this year?

YesNo
Did you use a vehicle for business purposes during the tax year?

YesNo
Did you pay mortgage interest this year?

YesNo
Did you pay real estate tax this year?

YesNo
Did you have casualty and theft losses during the tax year? If yes, please attach details below.

YesNo

Income
Did you sell any stock during the tax year? If yes, please attach related forms below.

YesNo
Did you receive interest from a "Seller Financed" mortgage?

YesNo
Did you exercise any stock options during the tax year? If yes, please attach detail below.

YesNo
Are any of the below applicable? Please attach forms and schedules below.

Rental incomeRoyalty incomeSole ProprietorshipPartnershipsS CorporationsEstates / Trusts
Are any of the below applicable? Please attach forms and schedules below.

PensionsIRA DistributionsAnnuitiesRollovers
Unemployment compensation received. Please attach forms and schedules below.
Round to nearest dollar.
Social Security Benefits received. Please attach annual statement below.
Round to nearest dollar.
State/Local Tax Refunds received.
Round to nearest dollar.
Federal Tax Refunds received.
Round to nearest dollar.

Wages and Salaries (attach forms below).

Interest Income (attach 1099 forms below).

Dividend Income (attach 1099 forms below).

Other Income (attach forms below).

Capital Gains and Losses (attach forms below).

Other Gains and Losses (include details of dispositions of any business/rental/farm assets - attach forms below).

General Expenses

	Amount
Medical Expenses
Dental Expenses
Insurance Premiums paid
Long-Term Care Premiums
Prescription Drugs and Medications
Home Mortgage Interest (paid to financial institutions or individuals)
Investment Interest
Cash Contributions
Non-Cash Contributions
Unreimbursed Business Expenses
Union Dues
Investment Expenses
Real Estate Taxes Paid
Student Loan Interest Paid
Other Taxes Paid (e.g. vehicle, other personal property)
Rental Property Expenses

Total Expenses
Additional comments
Please upload all applicable tax forms and documents.

EX: 1099s, W-2s, Business Income and Expenses, Mortgage Interest, Rental Income and Expenses, etc.
Cancelof

Acknowledgment & Signature
- I confirm that all information I entered above is accurate and true to the best of my knowledge.
- I allow Keeps Accounting Solutions to capture my sensitive data like personal id, government id, social security number (SSN), and other information for purposes of preparing and filing my tax return.
- I have read and understand the terms and conditions and privacy policy of Keeps Accounting Solutions provided in the engagement letter.
- By signing below, I acknowledge that I have read and understand Keeps Accounting Solutions responsibilities and my responsibilities in preparing and filing the tax return(s).
Date Signed*

MonthDayYear
Date
Taxpayer Signature*

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Date Signed*

MonthDayYear
Date
Spouse Signature*

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