Estimate Request Form
Complete this form in its entirety to receive an estimate from Kharizmatik Tax Solutions; please note limited information will be collected on this form to protect the taxpayer's privacy should the taxpayer choose to move forward with full preparation of their tax return a full client interview will be conducted by way of our electronic "Taxpayer/Client Intake Sheet" and all supporting documents will be required at that time.
Taxpayer Personal Information
Are you a returning client?
*
Yes
No
Name of the Tax Professional who is assisting you with your return
*
What Tax Year are you filing for? (Example if the current year is 2022 you are filing for the 2021 Tax Year) Or if you are filing for a previous year including an amendment what year are you filing it for?
*
Taxpayer's Name
*
First Name
Last Name
Filing Status
*
(1) Single
(2) Married Filing Joint
(3) Married Filing Separately
(4) Head of Household
(5) Qualifying Widower
Taxpayer's age
*
Is the taxpayer blind?
*
Yes
No
Dependent of Other; can you be claimed on someone else's tax return as a dependent?
*
Yes
No
Do you have an ITIN (Individual Taxpayer Identification Number)?
*
Yes
No
How many dependents are you carrying on the return?
*
Age of the dependents you are carrying on the return
Rows
Age
Year dependent was born
Dependent #1
Dependent #2
Dependent #3
Dependent #4
Dependent #5
Dependent #6
Wages on Form W-2
If you do not have any w2 wages to report skip all questions in this section; taxpayer's w2 wages should be the only income reported below
Do you have W-2 wages to report?
*
Yes
No
Do you have 1099-R wages to report (retirement)?
*
Yes
No
W-2 or 1099-R Wages
Rows
Wages(Box 1)
Federal Withholdings(Box 2)
Additional Compensation(Boxes 12a-12d)*add them all together*
Other Compensation(Box 14)
1st W-2 or 1099-R
2nd W-2 or 1099-R
3rd W-2 or 1099-R
4th W-2 or 1099-R
If you have additional w-2 wages to report, please number each w-2 and input the information below using the same format as the chart above; separate each dollar amount by using a dash example: (#1) wages - federal withholdings - additional compensation - other compensation (#2) wages - federal withholdings - additional compensation - other compensation
Other Income
If you do not have any other income to report skip all questions in this section
Other Income
Rows
Total Amount for the Year
Interest
Dividends
Short-term gains/losses
IRA/pension distributions
Unemployment Income
Alimony Received
Social Security Benefits
Business Income
Only report self-employment income which includes sole proprietor, single member LLC, gig work and household employee income below; do not complete the questions in this section if you are needing an estimate for corporate business returns (S-Corp, C-Corp, Partnership, LLC taxed as Corp). Please note for self-employment if you operate your business out of your home you are able to right off expenses that are necessary to keep your business running.
Do you have business income to report?
*
Yes
No
Total Business Income for the year
Business Expenses
Rows
Total Amount for the Year
Advertising
Contract Labor
Commission and fees
Depletion
Employee benefit programs
Health Insurance
Insurance (other than health)
Long-Term Care Insurance
Mortgage Interest
Other Interest
Legal and professional services
Office expense
Pension and profit sharing
Rent or lease of equipment
Rent or lease of property
Repairs and maintenance
Supplies
Taxes and licenses
Travel
Meals
Utilities
Wages
Do you have multiple businesses?
*
Yes
No
Deductions
If you do not have any deductions to report skip all questions in this section
Deductions
Rows
Total Amount for the Year
Medical Expenses Paid
Real Estate Tax Paid
Mortgage Interest Paid
State, local and personal taxes paid
Cash & check charitable contributions
Noncash charitable contributions
Unreimbursed employee expenses
Adjustments/Credits
If you do not have any adjustments or credits to report skip all questions in this section
Adjustments
Rows
Total Amount for the Year
Deductible part of self-employed tax
Student loan interest paid
Retirement plan contributions
Alimony paid
Other adjustments paid
Are you eligible to participate in a work retirement plan?
*
Please Select
Yes
No
Are you or your dependent(s) attending the first four years of college?
*
Please Select
Yes
No
Credits
Rows
Total Amount for the Year
Tuition & Fees Paid
Child care expenses paid
Estimated federal taxes paid
Friendliness
Submit
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