Tax Organizer

Please complete this Organizer before your appointment. Prior year clients should use the proforma Organizer provided.

1. Personal Information

Name

Soc. Sec. No

Date of Birth

Occupation

Work Phone

Taxpayer

Stephen Donovan

65675757656

Thursday, March 18, 1976

Manager

(432) 432-4324

Spouse

Geraldine Scott

6757656757657

Wednesday, March 26, 1986

Lawyer

(768) 678-6876

Street Address
3562 Monroe Avenue

City
Tampa

State
Florida

Zip
33602

Home Phone
(465) 465-4564

Email
stephen@example.com

Will Jointly File

Yes

Civil Status

Married

Single

Widow(er)

Taxpayer

Spouse

Blind

Yes

Yes

Yes

Disabled

Yes

Date of Spouse's Death

02/03/2021

Yes

Pres. Campaign Fund

Yes

2. Dependents (Children & Others)

Name (First, Last)	Relationship	Date of Birth	Soc. Sec. No.	Months Lived With You	Disabled	Full-Time Student	Dependent's Gross Income	ID Protection PIN
Andew Parker	Son	10/2/2001	12323432	300	No	No	10000	12321
-	-	-	-	-	-	-	-	-
-	-	-	-	-	-	-	-	-
-	-	-	-	-	-	-	-	-
-	-	-	-	-	-	-	-	-

Please provide for your appointment
- Last year's tax return (new clients only) - All statements (W-2s, 1098s, 1099s, etc)
- Name and address label (from government booklet or card)

Please answer the following questions to determine maximum deductions

	Yes	No
9. Were there any births, deaths, marriages, divorces or adoptions in your immediate family?		-
10. Did you give a gift of more than $15,000?		-
11. Did you have any debts cancelled, forgiven, or refinanced?		-
12. Did you go through bankruptcy proceedings?		-

	Yes	No
1. Are you self-employed or do you receive hobby income?
2. Did you receive income from raising animals or crops?
3, Did you receive rent from real estate or other property?
4. Did you receive income from gravel, timber, minerals, oil, gas, copyrights, patents?
5. Did you withdraw or write checks from a mutual fund?
6. Do you have a foreign bank account, trust, or business?
7. Do you provide a home for or help support anyone not listed in Section 2 above?
8. Did you receive any correspondence from the IRS or State Department of Taxation?

13. (b) Was heat included?		-
14. Did you pay interest on a student loan for yourself, your spouse, or your dependent during the year?		-
15. Did you pay expenses for yourself, your spouse, or your dependent to attend classes beyond high school?		-

	Yes	No
19. Did you purchase a new alternative technology vehicle or electric vehicle?
20. Did you install any energy property to your residence such as solar water heaters, generators or fuel cells or energy efficient improvements such as exterior doors or windows, insulation, heat pumps, furnaces, central air conditioners or water heaters?
21. Did you own $50,000 or more in foreign financial assets?

	Yes	No
16. Did you have healthcare coverage (health insurance) for you, your spouse and dependents during this tax season? If yes, include Forms 1095-A, 1095-B, and 1095-C		-

18. Did you have any children under the age of 19 or 19 to 23 year old students with unearned income of more than $1100?		-

3. Wage, Salary Income

	Taxpayer	Spouse
22. Have you or your spouse been a victim of identity theft and given an identity theft protection PIN by the IRS? If yes, enter the six digit identity protection PIN number.	no	no

Attach W-2s of Employer

pdf

EN-USDJPY-20170131-M.pdf

pdf

Employer	Taxpayer	Spouse
500		-
-		-
-		-
-		-
-		-
-		-
-		-

5. Dividend Income

Attach 1099-DIV

pdf

47_EN-GBPUSD-20170131-M_1620.pdf

pdf

Payer	Ordinary	Capital Gains	Non-Taxable
ghj	699	100	499
-	-	-	-
-	-	-	-
-	-	-	-

4. Interest Income

Attach 1099-INT, Form 1097-BTC & broker statements

piggy-bank-1270926_640.jpg

Payer	Amount
5000	-
500	-
59	-
500	-

6. Partnership, Trust, Estate Income

Attach K-1

pdf

EN-GBPUSD-20170131-M.pdf

pdf

List payers of partnership, limited partnership, S-corporation, trust,or estate income

none

Tax Exempt	Amount
100	-
166	-

7. Property Sold

Property

Date Acquired

Cost & Imp.

Personal Residence*	9/1/2020	1000
Vacation Home	8/2/2020	1000
Land	6/4/2020	1000
Other	8/22/2020	1000

* Provide information on improvements, prior sales of home, and cost of a new residence. Also see Section 17 (Job-Related Moving).

Attach 1099-R & 5498

pdf

EN-USDJPY-20170131-A.pdf

pdf

9. Pension, Annuity Income

8. I.R.A. (Individual Retirement Acct.)

Contributions for tax year income

	Amount	Date	Check for both
Taxpayer	4000	2/21/2020
Spouse	199	1/1/2021

Reinvested?

.	Reason for Withdrawal	Yes	No
90000	Moving to another investment		-
-	-	-	-
-	-	-	-
-	-	-	-

Attach 1099-S and closing statements

pdf

EN-USDJPY-20170207-A.pdf

pdf

Amounts withdrawn

Plan Trustee	Reason for Withdrawal	Yes	No
1000	Moving to another investment
2000	Moving to another investment
200	Moving to another investment
2000	Moving to another investment

* Provide statements from employer or insurance company with information on cost of or contributions to plan.

Did you receive:

Tax Payer

Social Security Benefits	Yes
Railroad Retirement	No

Spouse

Yes

10. Investments Sold

Stocks, Bonds, Mutual Funds, Gold, Silver, Partnership interest - Attach 1099-B & confirmation slips

Investment	Date Acquired/Sold	Cost	Sale Price
test	2/21/2020	100	10000
test	11/21/2020	100	10000
test	12/21/2020	100	10000
test	12/22/2020	1000	10000

13. Taxes Paid (cont.)

11. Other Income

14. Interest Expense

List All Other Income (including non-taxable)

Alimony Received	1000
Child Support	1000
Scholarship (Grants)	1000
Unemployment Compensation (repaid)	1000
Prizes, Bonuses, Awards
Unreported Tips	1000
Director / Executor's Fee
Commissions	1000
Jury Duty	1000
Disability Income
Veteran's Pension
Payments from Prior Installment Sale	1000
State Income Tax Refund	1000
Economic Impact Payment 1 (First Stimulus Payment)	1000
Economic Impact Payment 2 (Second Stimulus Payment)	1000

Mortgage interest paid	332
Interest paid to individual for your home (include amortization schedule	23423

Paid To:

Name	Michelle David
Address	1 rainbow street, florida
Soc. Sec. No.

Investment Interest	455
Premiums paid or accrued for qualified mortgage insurance	66

15. Casualty/Theft Loss

For property damaged by storm, water, fire, accident, or stolen.

Location of Property

203 Gordon Street, Sun City, California

Description of Property

a 500 square feet, 2 storey 4 bedroom house, with 5 car garage

Gambling, Lottery (expenses: 299)

30000

Other	personal property auction	30000
Other

	Other	Federally Declared Disaster Losses
Amount of Damage	200	3000
Insurance Reimbursement		100
Repair Costs
Federal Grants Received

12. Medical/Dental Expenses

medical and dental expenses

Medical Insurance Premiums (paid by you)	299
Prescription Drugs	300
Insulin	400
Glasses, Contacts	400
Hearing Aids, Batteries
Braces
Medical Equipment, Supplies
Nursing Care
Medical Therapy
Hospital	444
Doctor/Dental/Orthodontist
Mileage (no. of miles)

16. Charitable Contributions

	Amount
Church	1000
United Way	1000
Scouts
Telethons
University, Public TV/Radio	200
Heart, Lung, Cancer, etc.	300
Wildlife Fund	100
Salvation Army, Goodwill	100

13. Taxes Paid

Real Property Tax (attach bills)	363
Personal Property Tax	369

16. Charitable Contributions

$4.20

Volunteer (no. of miles @ .14)

17. Child & Other Dependent Care Expenses

Also complete this section if you receive dependent care benefits from your employer

18. Job-Related Moving Expenses

19. Employment Related Expenses That You Paid (Not self-employed) (cont.)

✓ if you are a member of the Armed Forces on active duty and moving due to a permanent change of station due to a military order

Yes

Rent	2323
Insurance	23
Utilities	88
Maintenance	39

Date of Move

Thursday, April 8, 2021

Move Household Goods	1000
Lodging During Move	200
Travel to New Home (no. of miles)	100

20. Investment-Related Expenses State use only

Tax Preparation Fee	49
Safe Deposit Box Rental	23
Mutual Fund Fee	23
Investment Counselor	232
Other	23

19. Employment Related Expenses That You Paid (Not self-employed)

Dues - Union, Professional	19
Books, Subscriptions, Supplies	393
Licenses Repairs	33323
Tools, Equipment, Safety Equipment	333
Uniforms (include cleaning)	4434
Sales Expense, Gifts	324
Tuition, Books (work related)	33
Entertainment	23

21. Business Mileage

Do you have written records?

Yes

Did you sell or trade in a car used for business?

Yes

Office in home (In Square Feet)

Total home

300

Office

Storage

232

24. Estimated Tax Paid

21. Business Mileage

Due Date	Date Paid	Federal	State
04/20/2020	3000	100	300
-	-	-	-
-	-	-	-
-	-	-	-

Make/Year Vehicle	2001
Date purchased	2002
Total miles (personal & business)	30000
Business miles (not to and from work)	1000
From first to second job	300
Education (one way, work to school)	3030
Job Seeking	300
Other Business	100
Round Trip commuting distance	400
Gas, Oil, Lubrication	400
Batteries, Tires, etc.	100
Repairs	300
Wash	50
Insurance	1000
Interest	10
Lease payments	399
Garage Rent

25. Other Deductions

Alimony paid to

Andrea Mitchel

Social Sec. No.

239239

26. Education Expenses

Student's Name	Type of Expense	Amount
Jonathan Mitchel	School Fees	1000
	-	-
-	-	-
-	-	-
-	-	-
-	-	-

22. Business Travel

If you are not reimbursed for exact amount, give total expenses.

Airfare, Train, etc.	100
Lodging	30
Taxi, Car Rental	100

Meals (no. of days)

199

27. Questions, Comments, & Other Information

No additional information.

Other	399
Reimbursement Received	30

23. COVID-19

Were you, your spouse, or a dependent diagnosed with COVID-19?	No
Did you experience adverse financial consequences as a result of you, your spouse, or other members of your household being quarantined, furloughed or laid off, experienced a reduction of work hours, or unable to work due to a lack of childcare?	No

Residence:

Town

Gelderland

County

Swimsun

Village

Goldsun

School District

Animal District

City

South City

28. Direct Deposit of Refund / or Savings Bond Purchases

Would you like to have your refund(s) directly deposited into your account?

Yes

(The IRS will allow you to deposit your federal tax refund into up to three
different accounts. If so, please provide the following information.)

ACCOUNT 1

Owner of account

Taxpayer

Spouse

Both

Type of account

Checking

Traditional Savings

Traditional IRA

Roth IRA

Treasury Direct

Archer MSA Savings

Coverdell Education Savings

HSA Savings

SEP IRA

Name of financial institution

Industrial Bank

Financial Institution Routing Transit Number (if known)

303

Your account number

2309409

ACCOUNT 2

Owner of account

Taxpayer

Spouse

Both

Type of account

Checking

Traditional Savings

Traditional IRA

Roth IRA

Treasury Direct

Archer MSA Savings

Coverdell Education Savings

HSA Savings

SEP IRA

Name of financial institution

General Bank of California

Financial Institution Routing Transit Number (if known)

444

Your account number

292039

ACCOUNT 3

Owner of account

Taxpayer

Spouse

Both

Type of account

Checking

Traditional Savings

Traditional IRA

Roth IRA

Treasury Direct

Archer MSA Savings

Coverdell Education Savings

HSA Savings

SEP IRA

Name of financial institution

Metropolis Bank

Financial Institution Routing Transit Number (if known)

Your account number

23902309203

Would you like to purchase Series I Savings bonds with a portion of your refund? If so, please answer the following:

Amount used for bond purchases for yourself (and spouse if filing jointly).

499

Amount used to buy bonds for someone else (or yourself only or spouse only if filing jointly).

299

Owner's name	Co-owner or Beneficiary's name if applicable	X if name is for a beneficiary	Bond purchase Amount
Noni Chan	-	-	40000
-	-	-	-
-	-	-	-

To the best of my knowledge the information enclosed in this client tax organizer is correct and includes all income, deductions, and other information necessary for the preparation of this year's income tax returns for which I have adequate records.

Taxpayer