Client Tax Organizer

Referred by:
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Preferred Tax Preparer:
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January 1 - December 31, 20
Client Tax Organizer

Jordan & Associates, LLC "Tax Angels"
Verification and Signature:
To the best of my knowledge the enclosed information is true and correct and includes all income, deductions, and other information necessary for the preparation of this year’s income tax return for which I have adequate records to prove such if needed by a Taxing Authority such as the IRS and any State Revenue Agency.
Taxpayer Signature*

Clear
Date:*

MonthDayYear
Date
Spouse Signature

Clear
Date:

MonthDayYear
Date
1. Personal Information
Filing Status

Single (if you and your child(ren) are living with someone else or you live at your own residence and don't have any dependents)Head of Household (if you have dependent(s) and are responsible for paying more than 50% of taking care of your home)Married Filing Jointly (if you are married and will file this tax return with your spouse)Married Filing Separately (i.e. you and your spouse are still living in the same home but are in the process of divorcing, EIC and a few other credits/tax breaks are not allowed)Qualifying Widower (if you have dependent(s) and your spouse has passed within the last 2 years)
If your Filing Status is Qualifying Widower, please enter your Spouse Date of Death:

MonthDayYear
Date
Taxpayer Name:*

First NameTaxpayer Last Name
Middle Initial
Taxpayer Middle Initial
Social Security #:*
Date of Birth:*

MonthDayYear
Spouse Name:

First NameSpouse Last Name
Middle Initial
Spouse Middle Initial
Social Security #:
Date of Birth:

MonthDayYear
Address

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone:
Taxpayer
Work Phone:
Taxpayer
Cell Phone:
Taxpayer
Email:
Taxpayer (example@example.com)
Home Phone:
Spouse
Work Phone:
Spouse
Cell Phone:
Spouse
Email:
Spouse (example@example.com)
Occupation:
Taxpayer
Occupation:
Spouse
ID Information:
Driver’s License/State I.D. #:*
Taxpayer
Issuing State:*
Taxpayer
Issue Date:*

MonthDayYear
Taxpayer
Expiration Date:*

MonthDayYear
Taxpayer
Driver’s License/State I.D. #:
Spouse
Issuing State:
Spouse
Issue Date:

MonthDayYear
Spouse
Expiration Date:

MonthDayYear
Spouse
Taxpayer Initials*
Spouse Initials
Taxpayer Blind

YesNo
Taxpayer Disabled

YesNo
Spouse Blind

YesNo
Spouse Disabled

YesNo

	Taxpayer	Spouse
Blind
Disabled

Add to mailing list

YesNo

Please answer the following questions to determine maximum deductions:

	Yes	No
1. Are you Self-Employed or do you receive hobby income?
2. Were there any births, deaths, marriages, divorces, or adoptions in your household?
3. Did you receive income from raising animals or crops?
4. Did you give a gift of more than $15,000 to one or more persons?
5. Did you have any debts cancelled, forgiven, or refinanced?
6. Did you receive income from gravel, timber, minerals, oil, gas, copyrights, and/or patents?
7. Did you go through bankruptcy?
8. Did you receive rent from real estate or other property?
9. Did you withdraw or write checks from a mutual fund?
10. Did you pay rent or mortgage?
a. If so, are you Head of your Household?
11. Do you have a foreign bank account, trust, or business?
12. Did you pay interest on a student loan for yourself, spouse, or your dependent during the year?
13. Do you provide a home for and/or help support anyone not listed in Section 2 below?
14. Did you pay expenses for yourself, your spouse, or your dependent to attend classes beyond high school?
15. Did you receive any correspondence from the IRS or State Department of Taxation?
16. Did you have any children under the age of 19 or 19-23 year old students that had unearned income of more than $950?
17. Did you purchase a new alternative technology vehicle or electric vehicle?
18. Did you own $50,000 of more in foreign assets?
19. Did you install any energy property to your residence such as solar water heaters, generators, etc... or make improvements such as exterior doors or windows, insulation, heat pumps, furnaces, central air conditioners, or water heaters?
20. Did you withdraw and/or borrow from your retirement Account?

2. Dependents (Children & Others); List in order from youngest to oldest. (Please Provide Social Security Cards or SSA printouts)

	Exact name on Social Security Card	Relationship	D.O.B.	S.S.N.	Months Lived with you	Disabled	Full-Time Student	Gross Income (if any)
Dependent 1
Dependent 2
Dependent 3
Dependent 4
Dependent 5

Taxpayer Initials*
Spouse Initials

3. Estimated Taxes Paid (not taxes withheld from earnings)

	Date Paid	Federal	State
First Quarter
Second Quarter
Third Quarter
Fourth Quarter

4. Refund Options (Please Check One):

Refund Advance (1-48 hours for an Advance o n your refund; remaining refund will be available within 7-21 days; fees may apply and will be disclosed to you)Refund Transfer Check (7-21 days; Check printed at our office; fees withheld from Refund)Refund Transfer Direct Deposit (7-21 days; Refund Direct Deposited into your bank account; fees withheld from Refund)Refund Transfer Prepaid Debit Card (7-21 days; Refund Direct Deposited onto Prepaid Card; fees withheld from Refund; Prepaid Card will be provided upon you signing your tax return)IRS Direct Deposit (7-21 days; Refund Directed Deposited by the IRS; no fees are withheld but tax preparation fees are due upfront prior to signing and receiving a copy of your tax return)IRS Check (6-8 weeks; Refund Check mailed to you by the IRS; no fees are withheld but tax preparation fees are due upfront prior to signing and receiving a copy of your tax return)
Taxpayer Initials*
Spouse Initials
If any form of direct deposit is chosen, please complete the following
Bank Name
Banking Routing Number (9-Digit Number)
Account Number
Type a question

CheckingSavingsOther
Account Type
Please enter whole numbers only (no cents).

5. Interest Income (Please provide 1099-INTs & brokerage statements.)

	Payer	T/S/J	Bank or Credit Union	U.S. Bonds/T Bills	Federal Tax Withheld	Municipal or Tax-Exempt
Payer 1
Payer 2
Payer 3
Payer 4

6. Dividend Income from Mutual Funds and Stocks (Please provide 1099-DIVs for each item listed below.)

	Payer	T/S/J	Total ordinary Dividends (Box 1a)	Qualified Dividends (Box 1b)	Capital Gain Distribution (Box 2a)	Federal Tax Withheld
Payer 1
Payer 2
Payer 3
Payer 4

7. Other Income (Please list all other income).Payer/Source

	Payer/Source	Taxpayer	Spouse	Federal Tax Withheld
Alimony Received
Prizes, Bonuses, Awards
Jury Duty
Social Security Benefits (Taxable Income)
Medicare Premiums Withheld
Unemployment Compensation Received
Unemployment Compensation Repaid
Gambling, Lottery
Worker's Compensation
Other Income
Other Income

Taxpayer Initials*
Spouse Initials
8. Medical / Dental / Vision Expenses

To be deducted, medical expenses must exceed 7.5% of your adjusted gross income, and then only the amount that exceeds a 7.5% floor is deductible. Example: Your AGI is $40,000 for the year; your medical expenses must exceed $3,000. State deductible limits/requirments may differ from Federal, depending on your state.
8.1. Acupuncture/Chiropractic
8.2. Lodging for Away-From-Home Medical Purposes
8.3. Ambulance/Paramedics
8.4. Long-Term Care Insurance – Taxpayer
8.5. Medical Miles (for Taxpayer, Spouse, & Dependents, include all miles for medical, dental, vision, and medicinal purposes)
8.6. Long-Term Care Insurance – Spouse
8.7. Braces
8.8. Medical Equipment, Supplies
8.9. Medical, Dental, & Vision Doctor Visit Payments (discretionary cosmetic surgery is not deductible)
8.10. Medical Insurance Premiums (paid by you)
8.11. Medical, Dental, & Vision Deductibles (discretionary cosmetic surgery is not deductible)
8.12. Medical, Dental, & Vision Deductibles (discretionary cosmetic surgery is not deductible)
8.13. Handicapped Modification to Home
8.14. Nursing Homes, Nursing Care
8.15. Handicap Placard/Tag:
8.16. Parking Fees for Medical Purposes
8.17. Hearing Aid and/or Batteries
8.18. Prescription Drugs
8.19. Insulin
8.20. Psychotherapy, Psychological Counseling
8.21. Lab Fees & X-Rays
8.22. Insurance Reimbursement
8.23. Hospital
8.24. Other:
Amount of other expenses
Type of other medical expenses from # 8.24:
List the type of other expenses included in the amount on line 24.
9. Home Mortgage Interest
IF YOU HAVE PURCHASED, SOLD OR REFINANCED YOUR HOME THIS YEAR, IF POSSIBLEPLEASE PROVIDE YOUR ESCROW PAPERS.
Mortgage Company:
Amount Paid
Mortgage Company:
Amount Paid:
Mortgage Company:
Amount Paid:
Home Equity Loan:
Amount Paid:
Seller Financed Mortgage (Enter the Seller Name):
Seller Social Security # or Tax I.D. #:
Seller Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount Paid:
Taxpayer Initials*
Spouse Initials
10. Taxes Paid
Real Estate Taxes:
Auto License Fees (Specialty vehicle license fee portion only):
Property taxes on investment property:
Personal property tax – car, boat, etc.:
State Income Tax (that you paid directly to the state yourself):
Sales Tax:
Other Taxes:
Type of other taxes
List the other taxes you paid
Other Taxes:
Type of other taxes
List the other taxes you paid
11. Alimony Paid

(Do not include amount paid for child support. Child support is not deductible.)
Name

First NameLast Name
Social Security Number
Amount Paid
12. Charitable Contributions
Cash Contributions
Church/Tithes
Payroll Deduction
United Way
Cancer Society
Red Cross
Scouts
Other (please list):
Other (please list):
Other (please list):
Volunteer (no. of miles)

Non-Cash Charitable Contributions

	Donee Name	Description of Property	Fair Market Value
Donee 1
Donee 2
Donee 3

Taxpayer Initials*
Spouse Initials
13. Miscellaneous Itemized Deductions

As of 2018, unreimbursed employee expenses are no longer deductible for federal tax purposes, however, please complete this section as certain states, such as Alabama, still allow said deductions.

	Taxpayer	Spouse
Telephone
Cell Phone
Credential Renewal & Transcripts
Continuing Education Courses
Internet
Job Seeking Expense
Professional Dues (CTA, NEA, etc...)
Professional Subscriptions
Safety Deposit Box
Safety Equipment
Tax Return Preparation Fee
Teaching Aids & Supplies
Uniforms & Laundry
Union Dues
Work Tools
Other (Please list):

14. Education Expenses

College or Other Continuing Education Expenses (Provide 1098-T or other supporting documentation)

	Student’s Name	Type of Expense	Year of School	Amount
Student 1
Student 2
Student 3
Student 4
Student 5
Student 6

15. Child & Dependent Care Expenses

Care must enable you to work &/or look for work or attend school FULL TIME. (Care must be for a child under age 13 or a dependent who is physically or mentally incapable of self-care.)

	Provider Name	Address City, State, Zip	Phone	Provider SSN or EIN	Amount Paid	Child’s Name
Provider 1
Provider 2
Provider 3
Provider 4
Provider 5

*If childcare is for more than one child or dependent, please indicate how much was paid for each child or dependent.
Taxpayer Initials*
Spouse Initials
16. Student Loan Interest Paid

(Please provide 1098-E or other supporting documentation)

	Taxpayer	Spouse	Dependent
Interest Amount Paid

Tax returns that require payment upfront will not be filed until payment is received in full. Thank you
Taxpayer Signature*

Clear
Date:

MonthDayYear
Date
Spouse Signature

Clear
Date:

MonthDayYear
Date
Select how you would like to receive your copy of your tax return:

EmailedUpload to Your Client Portal AccountPaper Copy
Sign and date here to confirm receipt of your tax return documents:

(the signature below is to be completed once tax return preparation is completed and tax return documents received)
Signature

Clear
Date:

MonthDayYear
Date
Taxpayer Initials

Clear
Spouse Initials

Clear
Please upload a picture ID (Driver's License, State ID, Passport, etc...) and Social Security Cards for you and/or your dependents. *

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Please upload your W-2's and/or any and all tax documents you have received from any employers, banks, IRS and/or State Notices, etc... *

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Should be Empty:

Client Tax Organizer

Verification and Signature:

1. Personal Information

ID Information:

8. Medical / Dental / Vision Expenses

9. Home Mortgage Interest

10. Taxes Paid

12. Charitable Contributions

Cash Contributions

13. Miscellaneous Itemized Deductions

14. Education Expenses

15. Child & Dependent Care Expenses

16. Student Loan Interest Paid