PERSONAL INFORMATION
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Social Security Number |
Relationship |
Date of Birth |
Self |
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Spouse |
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Dependent |
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Dependent |
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Dependent |
Childcare Costs
[ ] Cancelled checks or invoices
[ ] Provider's name ____________________________
[ ] Provider's address ________________________________________________
[ ] Provider's tax ID or social security number ______________________________
Educational Costs
[ ] Tuition bills or cancelled checks for post-high school education
Adoption Costs
[ ] Social Security number or I.D. number of adopted child __________________
[ ] Receipts or cancelled checks for:
[ ] Legal fees
[ ] Transportation
[ ] Other costs
INCOME INFORMATION
Income from Jobs
[ ] W-2 forms for all employers for whom you and your spouse worked.
Investment Income
[ ] Interest income - Form 1099-INT
[ ] Dividend income - Form 1099-DIV
[ ] Proceeds from the sale of stocks, bonds, etc. - Form 1099-B
[ ] Confirmation slips or brokers' statements for all stocks, etc. that you sold.
[ ] Schedule(s) K-1 (Form 1065) from investments in partnerships
[ ] Income from foreign investments – Amount of foreign taxes paid (you can find this on the brokers' statement) ___
[ ] Income from stock option exercises and sales:
[ ] Stock option agreement (showing type of options you received)
[ ] Stock option statement showing exercise prices of options
[ ] Form 1099-B for proceeds from stock sale
[ ] Sale of employee stock purchase plan shares:
[ ] Form 1099-B for proceeds from stock sale
[ ] Stock price on grant date ______________
[ ] Stock price on purchase date ___________
[ ] If stock sale occurred before qualifying period begins, Form W-2 showing "compensation income" from a disqualifying disposition
Income from State and Local Income Tax Refunds
[ ] Form 1099-G from state or local governments
[ ] State income tax return from the previous year.
[ ] City income tax return from the previous year, if any
Alimony
[ ] Bank statements or record of deposits
Unemployment Income
[ ] Form 1099-G from your state unemployment agency, OR
[ ] Unemployment check stubs and deposit records
Business or Farming Income
[ ] Books/accounting records for your business, OR:
[ ] Invoices or billings
[ ] Bank statements
[ ] Cancelled checks for expenses
[ ] Payroll records
In addition you need:
[ ] Invoices for major machinery, equipment, furniture, etc. purchases
[ ] Logs or other records listing vehicle mileage
[ ] Inventory records, if your business maintains an inventory of goods or materials
If you Use your Home for Business
[ ] Square footage of your home office area _______________
[ ] Total square footage of your home _____________________
[ ] Total rent paid, if home is rented _____________________
[ ] Mortgage interest reported on Form 1098 _______________
[ ] Property tax payments from assessor's bill, cancelled checks, or impound records ________________
[ ] Homeowner's insurance premium payments _______________
[ ] Invoices for repairs and maintenance on your house
[ ] Utility bills
IRA/Pension Distributions
[ ] Form 1099-R for payments from IRA or retirement plans
[ ] Account summary form for the year for your IRA accounts, OR
[ ] Deposit receipts and contribution records
[ ] If you received a distribution from an IRA account – The most-recently filed Form 8606, if you made contributions to IRAs that weren't deductible on your return
Rental Property Income
[ ] Profit and loss statements from your property manager, OR
[ ] Checkbook or cancelled checks for expenses
[ ] Form 1099-Misc or other records for rental income paid to you
[ ] Mortgage interest reported on Form 1098
[ ] Property tax payments from assessor's bill, cancelled checks, or impound records
[ ] Record of suspended rental losses from prior years (usually shown on last year's return)
Social Security Benefits
[ ] Form SSA-1099
Income from Sales of Property
If the property was sold:Miscellaneous Income
[ ] Jury duty pay records
[ ] Form(s) W-2G for gambling and lottery winnings
[ ] Receipts for all gambling purchases
[ ] Form 1099-MISC for prizes and awards you received
[ ] Form 1099-MSA for distributions from medical savings accounts
[ ] Scholarship records (if you used the money for anything other than tuition, books, and supplies)
[ ] Director's fees receipts if you received money for serving on a corporate board of directors
ADJUSTMENTS
IRA Contributions
[ ] Year-end account summary or bank statements
Student Loan Interest
[ ] Form 1098-E showing interest paid, OR
[ ] Loan statements
Medical Savings Account Contributions
[ ] Account statements OR
[ ] Cancelled checks
Moving Expenses
[ ] Invoices from moving companies, OR
[ ] Cancelled checks AND
[ ] Paycheck stub for moving expense reimbursements
Self-employed Health Insurance
[ ] Insurance premium bills, OR
[ ] Cancelled checks
Keogh & SEP Pension Plans
[ ] Year-end account summary, OR
[ ] Cancelled checks
Alimony
[ ] Cancelled checks
Educator Expenses
[ ] Cancelled checks for expenses paid for classroom supplies, etc.
ITEMIZED DEDUCTIONS
Medical and Dental Expenses
[ ] Medical bills or cancelled checks
[ ] Form SSA-1099 for Medicare premiums paid from your social security benefits
[ ] Year-end pay stub if premiums were paid through your wages (only if the deductions were after-tax)
[ ] Mileage records for trips to the doctor, clinics, etc.
Taxes
Interest You Paid
Points:
[ ] Form 1098 if you purchased a home
[ ] Your last year tax return if you refinanced in prior year
Interest paid on investment loans:
[ ] Brokers' statements showing margin interest paid
[ ] Loan statements for loans taken out to purchase investments
Charitable Donations
Cash donations:
[ ] Charity bills, receipts, or cancelled checks
[ ] Records of the mileage incurred for charitable purposes (Scouts, etc.)
Donations of Property:
[ ] Receipts from charitable agency
[ ] Estimated value of property given _____________
[ ] Appraisal fees for expensive donations ____________
Other charitable donations:
[ ] Prior years' tax returns if you have unused charitable contributions (carryovers) from earlier years
[ ] Year-end paycheck stub if donations were paid through your wages
Casualty and Theft Losses
[ ] Description of property damaged or stolen
[ ] Receipts or cancelled checks showing cost of property
[ ] Insurance policy and insurance reports showing reimbursement
[ ] Appraisal fees if applicable _______________
Job Expenses
[ ] Reimbursement check stubs or reports from your employer
[ ] Job travel information:
[ ] Invoices, receipts, or ticket stubs for transportation
[ ] Mileage records per vehicle used
[ ] Hotel bills
[ ] Restaurant tickets showing name and address of establishment
[ ] Parking fee receipts
[ ] Union dues – Paycheck stub for automatic withdrawals
[ ] Gifts to clients, etc. – Receipts showing date, cost, description
[ ] Supplies – Receipts or bills
[ ] Property purchased for use in your work – Invoices, receipts
[ ] Uniform and special clothing costs – Bills or paycheck stubs showing deductions
[ ] Seminar fees – Receipts or invoices
[ ] Professional publications and books – Receipts or invoices
[ ] Receipts for small tools and supplies you purchased
[ ] Job search expenses:
[ ] Long-distance call bills
[ ] Resume costs (printing, mailing, resume service, etc.)
[ ] Transportation bills and mileage records
[ ] Employment agency fees
[ ] Career counseling costs
[ ] Job-related educational expenses:
[ ] Tuition, fee, and book receipts for education that maintains or improves your present skills
[ ] Transportation receipts
[ ] Lodging receipts if you take classes away from home
Other Miscellaneous Deductions
[ ] Tax return preparation fees – Invoices or cancelled checks
[ ] Cost of tax return preparation software and books – Receipts or cancelled checks
[ ] Safe deposit box rental fees from bank invoice or statement _______
[ ] IRA custodial fees (if paid from a non-IRA account) ________
[ ] Payroll records for office workers managing your investments
[ ] Investment advice costs: invoices or bills
INFORMATION ON HOUSEHOLD EMPLOYEES
[ ] Wages paid ________________
[ ] Employee's social security number ________________
TAX PAYMENTS
[ ] Quarterly estimated tax payments – Records showing the date paid and amount
[ ] If you applied a tax overpayment from the previous year – your 2001 income tax return
[ ] If you filed for an extension for last tax return – Cancelled checks for payments you made with the extension
DIRECT DEPOSIT INFORMATION
If you want your refund deposited directly into your bank account, you need your:
[ ] Routing number from the lower left side of one of your checks (usually the first nine digits): ________________________
[ ] Bank account number from the bottom of check or on bank statement:
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