Fillable ETS-TA-Submission-V1.2 ETS TA Submission V1.2

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ETS-TA-Submission-V1.2 ETS TA Submission V1.2

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Instructions for Tax Review
222 Pacific Coast Highway,10th Floor El Segundo, CA 90245
1. Please attach a completed Tax Assesment Application and submit to info@ubos.pro
2. Please submit (1) the completed Tax Assesment Application and (2) a copy of prior tax returns,
both business and personal to the link: https://taxlawofficeofjaykim.sharefile.com/share/filedrop
3. If you need additional directions on how to fill out this form or directions on how to upload
your documents for review, please go to our YouTube Channel at
https://www.youtube.com/c/UBOSTaxPlanning
www.UBOS.pro/ets
Tax Assessment Application
ENTREPRENEUR
TAX SOLUTIONS
POWERED BY
UBOS
Name
Phone Number
Email
Mailing Address
We will contact you periodically to provide you updates on the status of your Tax Assess-
ment Application. Upon approval, you will get a confirmation email letting you know
that we are accepting your case, and the contact information for your dedicated UBOS
Case Coordinator.
Referred By
222 Pacific Coast Highway,10th Floor El Segundo, CA 90245
Tax Assessment
Application
www.UBOS.pro/ets
Please tell us about yourself.
Saving for college
How much is the total area (sqft) of your home?
What is the business area?
Do you rent or have a mortgage?
What is the annual amount?
How much is your property tax?
Utilities:
Cell Phone:
Water, Gas, Electricity
TV, Internet, Home Phone
Data subscriptions ex: Dropbox, Google Cloud:
Accounting/Bookeeping:
Errors & Omissions Insurance:
Seminars/Trainings:
Family
Home Office: Business Expenses:
Status* First Name Last Name DOB Nicotine User
Y / N
Y / N
Y / N
Y / N
Y / N
Y / N
Paying college tuition
Rent your home
Own your home
Own business entity
*Status: T= Taxpayer S=Spouse C=Child D=Other Dependent
Monthly health insurance premium
Monthly out-of-pocket expenses
Do you own a home office?
Do you or your dependents have any medical conditions?
If so, what _______________, monthly expense ________________
If so, what _______________, monthly expense ________________
Do you or your dependents visit a physical therapist, chiropractor or acupuncture?
If so, what _______________, monthly expense ________________
Health Related Expenses:
How much is your home insurance?
Do you or your dependents get routine eye or dental check up?
Do you or your dependents visit psychologist, psychiatrist or therapist?
If so, what _______________, monthly expense ________________
Have you or your dependents had to travel outside of the state/country for any medical procedures?
If so, what _______________, travel expense ________________
ENTREPRENEUR
TAX SOLUTIONS
POWERED BY
UBOS
1. Are you or your spouse self employed?
If yes, do you pay over $4,000 federal tax in Form 1040?
2. Are an employee?
If yes, are you insterested in becoming an independent
contractor?
First, let's make sure you're eligible to apply for Tax Assessment.
If you checked any of the boxes above, you may qualify for a Free Assessment.
3. Do you own real estate property?
Example: condo, house or commercial building.
4. Do you have Qualified Retirement Plans such as IRAs, 401(k), etc.?
If yes, are you interested in converting those plans into tax-free
plans such as Roth IRAs?
Please tell us about your personal finance.
Monthly Expenses
Monthly Income
Combined Gross: __________________
Net: __________________
Discretionary: _________________
Assets
Fixed Expenses Market Value of Home
Mortgage/Rent Stocks or Mutual Funds
Property Insurance
Property Tax
Savings Account
Auto Payments
Checking Account
Auto Maintenance/Gas
Retirement Plan
Auto Insurance
Life Insurance
Previous Year Tax Refund
Health Insurance
Others
Food
Utilities(House) : Gas, Electric, Water, TV, Phone, Internet
$0
Cellular Phone :
Liabilities
Mortgage
Flexible Expenses
Property Tax
Personal Ex
penses
Auto Loan
Fitness, S
ports, Travel
Credit Card
Savings
Others Equity Loan
Credit Card Payment
Charity
Misc.
Savings IRA Cash Value Life Ins.
Checking Pension 529
Mutual Fund/Stock
403(b)
Health Insurance Provider :
Monthly Premium :
Life Insurance Provider : Death Benefit : Benefit Period
Husband Monthly Premium : Insured :
Date Issued :
Life Insurance Provider :
Benefit Period
Wife Monthly Premium : Insured :
Date Issued :
Disability Insurance Provider : Monthly Benefits Benefit Period
Monthly Premium :
Will Trust
Expecting any Lump Sum or Inheritance in the near future?
Purchased Value
Purchased
Year
Market
Value
Mortgage
Balance
Property Tax Property Ins. Other
Purchased Value
Punchased
Year
Market
Value
Mortgage
Balance
Property Tax Property Ins.
Other
Total Rental Income - (Mortgage Payment + Property Tax + Property Insurance) =
Mortgage Payment
List of Rental Properties
Income/m
Tax Now Ta
x Later Tax Advantaged
Current Residence
Mortgage Payment Income/m
Life Insurance Cash Value
Cash
401(k) Roth IRA
222 Pacific Coast Highway,10th Floor El Segundo, CA 90245
Death Benefit :
www.UBOS.pro/ets
ENTREPRENEUR
TAX SOLUTIONS
POWERED BY
UBOS
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ETS-TA-Submission-V1.2 ETS TA Submission V1.2

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Completed 7 May 2020

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