Individual Extension Questionnaire

1
Taxpayer Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
For your 2025 Tax Return, do you expect to OWE or receive a REFUND?* This field is required.
I expect to owe tax.
I expect to receive a refund.
4
Do you plan to make a TAX PAYMENT with your Federal or State extension?* This field is required.NOTE: Amounts are REQUIRED if you plan to make a tax payment with your extension. Tax payment calculation services are very limited in the spring filing season as we are primarily providing tax filing services. If you need a calculation in the future, please request a planning meeting in the fall/winter of the prior year.
Yes
No
5
If you plan to make a tax payment, do you know HOW MUCH do you plan to pay?
Yes
No
6
Please list your planned 2025 TAX PAYMENT amounts below:* This field is required. NOTE: Amounts are REQUIRED if you plan to make a tax payment with your extension. Tax payment calculation services are very limited in the spring filing season as we are primarily providing tax filing services. If you need a calculation in the future, please request a planning meeting in the fall/winter of the prior year.
Federal
State (Alabama)
State (Other)
Total
Payment Amount
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Payment Amount
Federal
Row 0, Column 0
State (Alabama)
Row 0, Column 1
State (Other)
Row 0, Column 2
Total
Row 0, Column 3
7
Did your MARITAL or FILING STATUS change in 2023?
No Change
Married
Divorced
Death of a Spouse/Child
Other
8
Did you have any changes in DEPENDENTS you will claim on your taxes in 2023?
No Change
Birth of a child
Adoption of a child
Child who turned 24
Child who turned 19 who IS NOT a full-time student
Dependent child who was married
50%+ support of a relative/friend that lived with you for 6 months or more
Other
9
In 2023, did YOU or YOUR SPOUSE receive any of the following INCOME? Check all that apply.In order to properly file your extension, please upload the forms listed for each box selected below to ShareFile.
Wages (Form W-2)
Interest Income (Form 1099-INT)
Dividend Income (Form 1099-DIV)
Retirement Distribution (Form 1099)
Social Security Benefits (Form SSA-1099 )
Unemployment Benefits (Forms 1099-G)
None of the Above
10
In 2023, did YOU or YOUR SPOUSE BUY and/or SELL any of the following? Check all that apply.In order to properly file your extension, please upload the forms listed for each box selected below to ShareFile.
Stocks (Form 1099-B)
Cryptocurrency or Digital Assets such as Bitcoin (Form 1099-B)
Bonds (Form 1099-B)
Investment Property (Form 1099-B)
Real Estate (Closing disclosure, formerly known as the HUD-1, and/or Forms 1099-S)
None of the Above
11
In 2023, did YOU or YOUR SPOUSE receive any BUSINESS INCOME from any of the following? Check all that apply.In order to properly file your extension, please upload the forms listed for each box selected below to ShareFile.
Partnership (Schedule K-1)
LLC (Schedule K-1)
S Corporation (Schedule K-1)
Trust (Schedule K-1)
Sole Proprietorship (Form 1099-NEC)
Rental Property (Form 1099-MISC)
Royalty Income (Form 1099-MISC)
Farm
None of the Above
12
In 2023, did YOU or YOUR SPOUSE have had any major changes to DEDUCTIONS? Check all that apply.In order to properly file your extension, please upload the forms listed for each box selected below to ShareFile.
Education Tuition and Fees (Form 1098-T)
Mortgage Interest (Form 1098)
Charitable Contributions (Statement from Non-Profit)
Real Estate Taxes (County Tax Bills)
No major changes as compared to my prior year return.
13
Please confirm the amounts below (if any) of all ESTIMATED TAX PAYMENTS that have been successfully made for tax year 2023.If you did not make any payments, please write "0" in each box.
Federal
State
First Quarter
Row 0, Column 0
Row 0, Column 1
Second Quarter
Row 1, Column 0
Row 1, Column 1
Third Quarter
Row 2, Column 0
Row 2, Column 1
Fourth Quarter
Row 3, Column 0
Row 3, Column 1
TOTAL
Row 4, Column 0
Row 4, Column 1
First Quarter
Second Quarter
Third Quarter
Fourth Quarter
TOTAL
Federal
Row 0, Column 0
State
Row 0, Column 1
Federal
Row 1, Column 0
State
Row 1, Column 1
Federal
Row 2, Column 0
State
Row 2, Column 1
Federal
Row 3, Column 0
State
Row 3, Column 1
Federal
Row 4, Column 0
State
Row 4, Column 1
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14
DON'T FORGET: If you pay quarterly estimated tax payments, your first quarter estimated tax payment will also be due April 15th*. Do you need assistance with a FIRST QUARTER estimated tax calculation?*If your due date falls on a Saturday, Sunday, or legal holiday, the due date is delayed until the next business day.
YESNO
15
We will also need the following items to prepare your extension:

Signed Engagement Letter

Deposit

If you have previously provided these items to our office, we will move forward with filing your extension.

Please click "NEXT" below to authorize and send your completed questionnaire to our office.
16
Provide signature below to authorize filing an extension* This field is required.I certify that my answers are true and complete to the best of my knowledge and authorize The Faircloth Group, P.C. to file a Tax Year 2025 Application for Extension. I understand that failure to disclose or inadequate disclosure of income or tax positions may result in the imposition of penalties and interest charges.
Should be Empty: