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TAX DEDUCTION LOCATOR
& IRS TROUBLE MINIMIZER
YOUR TAX APPOINTMENT
Please complete and sign this organizer prior to your appointment.
Please call to schedule your appointment. Try to call early before
the calendar is booked up.
Please mail the completed organizer along with the requested
information to this ofce prior to your appointment.
Please mail the completed organizer along with the requested
information to this ofce so the return can be prepared by
correspondence.
Your tax appointment is scheduled for:
Day:
Date:
Time:
Please notify this ofce promptly if you are unable to keep this appointment.
REFERRALS ARE ALWAYS
APPRECIATED
If you know someone who would like a tax appointment, please
have them call this ofce. Do not be concerned that your business,
personal or nancial matters will be discussed with clients whom
you refer. All client information is treated in the utmost condence.
Before proceeding, please take a moment to review the purpose of
the SPECIAL MARKERS used throughout this organizer.
Your tax information from the prior year is
automatically transferred to this year’s tax return.
Therefore, not all taxpayer data and contact info
needs to be recorded. The marker signies that
returning clients need only enter data in that section
if it has changed since the prior year or if there is new
information.
This marker notes areas where the IRS can match the
entry on their computer and incomplete or incorrect
information can trigger government correspondence
or, worse yet, an ofce audit. Pay particular attention
to sections or individual entries with this symbol.
This ag symbol denotes areas where a deduction
or item of income is to be treated differently when
computing the alternative minimum tax (AMT). The
AMT is another way of computing your tax liability,
which applies more restrictive limits on certain
deductions and preference income. If higher than the
regular tax, the AMT applies.
This marker indicates payments that may require the
issuance of a 1099 if the annual amount paid to an
individual is $600 or more. Failure to le 1099s can
lead to a loss of the tax deduction for that expense
and failure to timely le the forms with the IRS and
furnish copies to payees can result in substantial
penalties.
SAVE TIME - READ THIS
FIRST
This organizer is designed to assist and remind you of information
that is needed to prepare your tax return. The goal is not to overlook
anything so you can maximize your legal deductions, comply with
government reporting requirements, and avoid problems with the
IRS after the return is led.
Taxes are complicated and the rules change constantly. This
organizer was designed specically for the 2018 tax year and
certain items may not apply to other years. Although care has been
taken to accommodate most taxpayers’ needs, please note questions
that are related to issues not included here under Questions You
May Have” in Section D6.
Section Categories
To help you collect your information quickly, this organizer is
organized into four general areas. Information required from:
everyone Sections A1 A13 (Pages 2 & 3)
those who itemize their deductions Sections B1 B11 (Pages
4 & 5)
those with business or rental income Sections C1 C7 (Pages
6 & 7)
everyone Health Care reporting Section D1 (page 8)
those who have relocated, sold their home, made home energy
improvements or have debt relief income Sections D2 D5
(Page 8)
The instructions provided in the header of each section will help
you determine if you are required to complete the information in
that section.
1099
IF YOU ARE A NEW CLIENT, BE SURE TO PROVIDE A COPY OF
LAST YEAR’S TAX RETURN.
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A - TAXPAYER INFORMATION
The information on this page is required for every taxpayer. Please review each section on this page and report items that are applicable to you, your
spouse or dependents.
2
A3 - STATUS CHANGES FOR 2018
Check any that apply and enter the effective date.
Married / / Moved / /
Separated / / Home Sold / /
Divorced / / Spouse Deceased / /
Retired / / Dependent Deceased / /
Coverdell Education Account Contribution
Coverdell Education Account Distribution (provide 1099-Q)
Qualied Tuition Plan (Sec. 529) Distribution (provide 1099-Q)
Student Loan Interest paid (provide 1098-E)
HSA Distributions (provide 1099-SA)
Adoption Expenses
Special needs child
CAUTION Review the following questions carefully. There are severe penalties associated with failing
to report an interest in or signature authority over a foreign bank account. Please call our attention to any
dealings related to foreign accounts and inheritances.
CHECK ALL THAT APPLY.
You or your spouse have signature authority or are named as a co-owner on a bank
account in a foreign country even if the funds are not yours.
You received an inheritance from someone in a foreign country.
You or your spouse have a foreign bank account (over $10,000 at any time in 2018)
You or your spouse received a distribution from, or were the grantor, or transferor to, a
foreign trust
At any time during the year you or your spouse held an interest in a foreign nancial
asset
You have been denied Earned Income Credit by the IRS
You’ve been re-certied for the Earned Income, Child Tax, or American Opportunity
Credit
You bought, sold, or gifted real estate in 2018. If you have, please call in advance to
discuss what documents are needed.
You made a gift of money or property to any individual in excess of $15,000 ($30,000
for joint gifts by a married couple)
You employ household workers
You sold jewelry, gold, coins, or other precious metals during the year
Filer
Spouse
You wish to contribute to the Presidential campaign fund
A8 - SPECIAL QUESTIONS & INFO
A2 - ADDRESS
Returning clients can skip this section except for changes.
Street Apt/Unit No
City
State Zip
Home Phone Number

Payment & Due Date Date Paid Federal State
Applied from Last Year’s Refund
First Quarter (April 17, 2018) / /
Second Quarter (June 15, 2018) / /
Third Quarter (Sept. 17, 2018) / /
Fourth Quarter (Jan. 15, 2019) / /
A4 - ESTIMATED TAXES PAID
This ofce cannot assume that all estimated taxes were paid as originally scheduled or
on time. Therefore, please enter the amounts and dates of payment or provide proof of
payments. Incorrect amounts will result in IRS or state correspondence after the return is
led.
You Spouse
W-2 Wages Please provide W-2 Forms (retain copy “C” for your records)
Partnership, Trust or S-Corporation K-1s (provide complete K-1 copies)
Were you the beneciary of an inheritance? If so, please verify with
executor or trustee if you will be receiving a K-1.
Yes Yes
State Tax Refund (provide 1099-G)
Social Security or RR (provide SSA-1099 or RRB-1099)
Pension Income (provide all 1099-Rs)
Alimony Received (IRS matches with alimony paid)
Alimony Paid (provide name and SSN below)
Paid to: SSN:
Tips (not included in W-2s)
Unemployment Compensation (provide 1099-G)
Gambling Winnings (provide W-2Gs)
A6 - INCOME & ADJUSTMENTS
You Spouse
Retirement plan with your employer?
Yes Yes
Did you or your spouse convert a traditional IRA into a Roth IRA during
2018?
Yes Yes
Traditional IRA, Keogh & SEP Plans
Contributions
Withdrawals (1099-R)
(1)
Rollovers
(2)(3)
Basis (Total of your prior year non-deductible contributions)
Roth IRA
Contributions
Withdrawals (1099-R)
(1)
Rollovers
(2)(3)
(1) Show reason if under age 59- (2) Must be reported even if not taxable unless directly “transferred”
(3) Rollovers from Traditional to a Roth IRA may be taxable.
A7 - IRA & SE PLANS
A1 - TAXPAYER INFORMATION
Returning clients: enter rst and last name of ler and any changes only.
Filer Name
(Must Match SS Admin)
Social Security No. Birth Date / /
Occupation
Legally Blind
Contact Phone Day Evening
Email Address
Spouse Name
(Must Match SS Admin)
Social Security No Birth Date / /
Occupation
Legally Blind
Contact Phone Day Evening
Email Address

Bank Name
Bank Routing Number (Exactly 9 Digits)
Account Number (include hyphens - omit spaces & special characters 17 digits max)
Account Type Checking Savings Allocation: %
A5 - REFUND DIRECT DEPOSIT
Complete this section to have your refund automatically deposited into your bank account.
Doing so will speed up the refund and eliminate the danger of a check being lost or
stolen. Direct deposit can be allocated to up to 3 separate accounts. Entries for only one
account are provided below. If you wish to make multiple deposits, please provide the
additional account information and how you wish to allocate the refund.
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A - TAXPAYER INFORMATION
The information on this page is required for every taxpayer. Please review each section on this page and report items that are applicable to you, your
spouse or dependents.
3
A13 - CHILD OR DEPENDENT CARE EXPENSES
Care must enable you to work (or search for work) or attend school FULL-TIME. Care must be for a child under age 13 or an individual who is physically or mentally incapable of self
care. If you are a student, also see section C4. IRS matches employer provided care benets and income reporting of care provider.
Employer provides dependent care services
Provider's SSN or Employer ID #
MANDATORY unless it is an exempt
organization (EO). If EO, check box.
Payments MUST BE Allocated by Child/Dependent
Paid To Address & Phone Number
Child/Depnd.'s Name: Child/Depnd.'s Name: Child/Depnd.'s Name:
A9 - DEPENDENTS
Returning clients need only enter rst names and any changes. Enter all the information for new dependents.
First Name
Last Name
(If Different)
Social Security Number
(Mandatory)
S, D, F, M, G,
Other or HOH*
Months in Home
(Your Home)
Birth Date
If over the age of 18
Income Student
/ /
Yes
/ /
Yes
/ /
Yes
* Enter S-Son, D-Daughter, F-Father, M-Mother, G-Grandchild, or enter other relationship. Enter HOH for non-dependent Head of Household qualiers.
A10 - INTEREST INCOME
IRS matches payer and amount. Always use the payer name listed on 1099 even if not the original source.
Name of Payer
Please provide all forms 1099INT and 1099OID
(Entries are not needed when 1099s are provided)
Banks, Credit Union,
Corp Bonds, Seller
Financed Mortgages,
etc.
Direct U.S. Obligations
Saving Bonds, T-Bills, etc.
(State Tax-Free)
Home State Municipal Bonds
(Generally Tax-Free)
Other State
(Federal Tax-Free)
Seller Financed Mortgages
Note: Seller nanced mortgages require the name, SSN and address of the payer.
Payer Name: SSN: Address:
Forfeited Interest (early withdrawal
penalty)
Federal Tax Witholding on Interest &
Dividends
Caution: All interest must be reported even if tax-free!
A11 - DIVIDEND INCOME
IRS matches payer and amount. Always use payer name listed on 1099 even if not the original source. Some institutions use substitute 1099s and caution must be used in separating
the various types of dividends. Please bring broker statements.
Name of Payer
Please provide all forms 1099DIV
(Entries are not needed when 1099s are provided)
Foreign
Taxes Paid
Ordinary
Dividends
Qualied
Dividends
(1)
Capital Gains
199A
Dividends
Source U.S.
Obligations
(2)
Taxable to
State Only
Non-Taxable
State &
Federal
(1) Qualied dividends receive special tax treatment and are included in the Ordinary Dividends” total. (2) Includes income from savings bonds, T-Bills, etc., which are state tax-free.
A12 - INVESTMENT SALES
IRS matches gross proceeds from sales using the 1099-B. All transactions must be reported even if there is no prot. If broker provides a summary of transactions, bring it and skip
this section. For home sales, see Section D2.
Description
(Please provide all forms 1099-B and any gain/loss statements provided by broker)
Inherited? Date Acquired Date Sold Selling Price Cost or Other Basis
Prot
(Memo Only)
Yes
/ / / /
Yes
/ / / /
Yes
/ / / /
(1) The basis from which gain is determined may not be the original cost and must account for stock splits, reverse splits, mergers, reinvested dividends, wash sales, etc.
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4
B - ITEMIZED DEDUCTIONS
Taxpayers may choose between itemized or standard deductions. This page and the adjoining page are for recording your expenses, which are needed when
itemizing your deductions. If you are certain that you cannot itemize your deductions for either federal or state, you can skip this page and the next one
except for B10.
CAUTION: If you are married and ling separately and either you or your spouse itemize your deductions, then the other spouse must also itemize their
deductions. The law does not allow one to itemize and the other to take the standard deduction.
If ling married separate and your spouse is itemizing deductions.
Brokerage Margin Accounts
Vacant Land
Other:
Other:
B2 - INVESTMENT INTEREST
Interest paid on loans to acquire investments. This interest is only allowable to the extent
of net investment income.
INSURANCE PREMIUMS for Medical, Dental, Vision & Hospital
(1)
Medicare Insurance Premiums (Not payroll tax)
Long-Term Care Insurance
Filer
Spouse
Doctors, Dentists
(2)
(No discretionary cosmetic surgery)
Acupuncture & Chiropractic Care
Hospital
(3)
Prescription Drugs (No over-the-counter drugs except insulin)
Nursing Care
Check if in-home care
Eye Exam, Glasses, Contact Lenses, Contact Lens Solution
Hearing Aids & Batteries
Ambulance & Paramedics
Auto Travel
(To and from medical treatment)
Parking & tolls (For medical treatment)
Taxi, Shuttle, Air Fare, Etc. (To reach medical treatment)
Lodging (For medical treatment) No. of days:
Telephone (Medical-related toll charges only)
Therapy & Special Schooling
(4)
Supplies & Equipment
Handicapped Placard
Handicapped Home Modications
Rentals
(crutches, wheelchair, walker, oxygen equipment, etc.)
Other:
Other:
(1) Include only amounts you paid.
(2) Includes Christian Science practitioner and psychological counseling.
(3) Includes nursing homes for individuals medically incapable of self care. Also includes
hospital or nursing home meals.
(4) Includes physical therapy and psychotherapy; special schooling for physically or mentally
handicapped.
B1 - MEDICAL EXPENSES
Although for Federal purposes medical expenses for 2018 are only deductible to the
extent they exceed 7.5% of your adjusted gross income (AGI) for the year, some states,
such as Arizona, do not have that limitation. If your state has a lower or no limitation
be sure to list your medical expenses. Do NOT list expenses reimbursed by insurance or
expenses and premiums paid with pre-tax funds or HSA distributions.
Real Estate Primary Residence
Do not
include
interest and
penalties
Real Estate 2nd Home
Real Estate Investment Property (Land, etc.)
CAUTION Some tax bills include non-deductible special services. Please provide copies of the tax bills.
Vehicle License Fees (Tax portion only): (1) (2) (3)
Personal Property Tax
(Boat, plane, etc.)
Sales Tax – Receipted (Leave blank for standard amount)
Sales Tax Cars, Boats, Home, Etc. (Do not include above)
Income Taxes Paid to Another State State:
City, County, Local Taxes (not listed in another category)
Other:
State Income Tax Paid During 2018 (please provide proof of payment)
Do not include taxes withheld; they are automatic from the source documents.
Balance Due
2017 Return
Other Year’s Tax
Or Adjustment
Extension Payment
2017 Return
2017 4th Qtr. Estimate
Paid Jan. 2018
B3 - TAXES PAID
Do not list any taxes associated with a business or rental activity. Taxes are not
deductible for AMT purposes.
B4 - HOME MORTGAGE INTEREST
Enter only interest on loans secured by your primary residence and designated second
residence. This deduction is limited, for federal, to interest paid on $1 million ($750,000 for
debts incurred after 12/15/2017) of home acquisition debt on your primary or designated
second residence. The debt limit applies separately to each co-owner who is not your
spouse. Equity debt interest is not federally deductible for years 2018 thru 2025 unless loan
funds were used to make home improvements. Some states allow a deduction for interest
paid on up to $100,000 of equity debt. The IRS computer veries the interest paid on home
mortgages.
CAUTION –If no 1098 received, check "Paid To" box and
enter payee's name. If paid to a person from whom you bought
the home and no 1098 received, also complete Box A below.
2nd
Home
Equity
Loan
Amount
Provide Form
1098
Paid To:
Paid To:
Paid To:
Paid To:
CAUTION If Form 1098 was issued using a co-owner’s SSN, enter that individual’s name, address & SSN
Box
A
Name:
SSN:
Address:
If your home or 2nd home is a qualied motor home, boat, etc., list the name of the payee here:
CHECK ALL THAT APPLY.
Has the original home loan ever been renanced?
Did you renance any of these loans this year? (If so, provide escrow closing statements)
Have you exceeded the $100,000 (applies for some states) equity debt limit?
Does the total of all your home loan balances exceed $1 million ($750,000 for post-
12/15/2017 loans)?

miles
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5
B - ITEMIZED DEDUCTIONS
House of Worship
Payroll Deduction
Filer
Spouse
Other:
Other:
Other:
B5 - CASH CHARITABLE CONTRIBUTIONS
All cash contributions MUST be documented with either a bank record or written
verication from the charity. Personal benets must be excluded from the donation.
Gambling Losses (Only to the extent of gambling winnings)
Impairment (Handicapped) Related Work Expenses
Unrecovered Pension Basis (Deceased taxpayer)
B7 - OTHER DEDUCTIONS
The expenses listed in this section are part of the miscellaneous” itemized deductions but
are listed separately because they are not subject to the 2% of AGI limit.
The loss was in a presidentially declared disaster area
The loss was from theft or embezzlement
The loss was the result of a Ponzi scheme
Casualty Description:
Date of Casualty / /
Insurance Reimbursement
Property Damaged or provide a list in the same format
Description of
Property
Date
Acquired
Original Cost
or Other Basis
Fair Market Value
Before Casualty After Casualty
/ /
/ /
/ /
B8 - CASUALTY LOSSES
For years 2018 thru 2025 personal casualty losses are not deductible for federal (some
states may allow personal casualty losses) unless incurred in a presidentially declared
disaster area. Generally, to be deducted for federal, casualty losses must be incurred in
a federally declared disaster area and, after insurance reimbursement must exceed 10%
of your adjusted gross income (AGI) and then only the amount that exceeds the 10% is
deductible.
Clothing & Household Items
Automobile Travel
miles
Volunteer Expenses - Explain:
Vehicle Donation (Provide Form 1098-C)
Other:
Other:
B6 - NON-CASH CONTRIBUTIONS
Household and clothing items must be in good or better condition. Items of minimal value
such as underclothing are not counted. A written receipt is required for donations of $250
or more. An itemized list should be included with your return if the total exceeds $500.
Deductions are limited to the lesser of your cost or the fair market value (FMV) for each
item contributed.
Investment Expenses DIRECTLY connected with the production of TAXABLE INCOME ONLY! Do not
include purchase or sales costs. Include interest in Section B2.
Investment Advisory Fees
Safe Deposit Box Fees
Legal & Accounting (Related to investments)
Other:
B10 - INVESTMENT EXPENSES
For years 2018 thru 2025 investment expenses are not deductible for federal purposes.
But are still allowed in some states.
Description of Property Date Acquired Cost
/ /
/ /
/ /
B11 - ITEMS WITH A USEFUL LIFE OF ONE
YEAR OR MORE
Equipment, tools, computers, etc., purchased this year and used in business having a
useful life of more than one year must be treated differently for tax purposes.
B9 - MISCELLANEOUS
The expenses listed in this section and section B10 are not deductible for federal in
2018 thru 2025. Some states allow them only to the extent they exceed 2% of your AGI.
DO NOT enter self-employed business expenses here. Instead
list them in Section C7
Employee Business Expenses
Don’t include amounts that COULD BE or were reimbursed by your employer. List
all travel expenses including out-of-town meals, hotel, air fare, etc., in section C2.
You Spouse
Name: Name:
Auto Travel See Section C1
Business Gifts Limited to $25 per recipient per year.
Must be ordinary and necessary.
Continuing Education See Section C4
Employment Seeking & Resume Fees
Entertainment & Meals (Enter 100% of expense)
Alimony Received (IRS matches with alimony paid)
Equipment Include individual items with a useful life of one year or more in
Section B11.
Insurance Malpractice, E&O, Etc.
Occupational Licenses, Fees, Credentials, Etc.
Publications & Journals (Not general interest publications)
Telephone (Business calls only)
Tools Include individual items with a useful life of one year or more in Section
B11.
Supplies
Uniform Purchases (Not including street wear)
Uniform Cleaning
Union & Professional Dues
Other:
Other Miscellaneous Deductions
Attorney Fees (To protect or produce taxable income only)
IRA or SE Plan Fees Paid By You (Not deducted from the plan)
Tax Preparation & Consulting Fees
Credit/Debit Card Fees to Make Tax Payments
Other:
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6
C - BUSINESS EXPENSES
These expenses are primarily deductible on business schedules. Prior to 2018 employees could also deduct the expenses as an itemized deduction. However,
for 2018 thru 2025 the deductions are not allowed as an itemized deduction for employees on the federal return but may be deductible on some state returns.
This section MUST be completed for every vehicle that is used for
business whether or not you use the actual expense or standard
mileage rate." IF THIS IS THE FIRST YEAR OF BUSINESS USE FOR
THE VEHICLE, PROVIDE A COPY OF THE PURCHASE OR LEASE
CONTRACT.
Vehicle
#1
Vehicle
#2
You You
Spouse Spouse
Enter vehicle make, model and year
The vehicle is provided (owned) by your employer
Amount of reimbursement provided by the employer
Reimbursement is included in W-2 (Box 1) wages
This vehicle is available for personal use
You have another vehicle for personal use
You have written evidence to support your deduction
Parking Expenses (do not include at place of employment) & Tolls
TOTAL MILES DRIVEN THIS YEAR
Include all mileage personal, commuting and business
miles miles
For employer
miles miles
Between First & Second Job
miles miles
From Job to School (for job-related education)
miles miles
Rental
miles miles
Self-Employed Business
miles miles
Temporary Job Sites
miles miles
Other (i.e. investment, tax prep, union or professional meetings -
Provide detail)
miles miles
Average Round-Trip Distance to Work Required
miles miles
Total Commuting Miles for the Year Required
miles miles
Vehicle Operating Expenses This information is only required if you are using the actual expense
method, or if you used the actual method the rst year the vehicle was placed in service.
Fuel
Maintenance, Tires, Batteries and Repairs
Insurance (Do Not Duplicate Elsewhere)
Vehicle Licenses (Do Not Duplicate Elsewhere)
Lease Payments
Loan Interest (Self-employed only)
Taxes (Do Not Duplicate Elsewhere)
Wash & Wax
BUSINESS EXPENSE DOCUMENTATION
Business expenses must be based on a log and/or other receipts and records. Receipts are
required for expenditures of $75 or more and for all lodging expenses. The records should
document: the business purpose, date and time, place and amount. Business meals must be
ordinary and necessary to carry on the trade or business, not be lavish or extravagant, and
be provided to a current or potential business customer or client, with the taxpayer or an
employee present. For federal no deduction allowed for entertainment expenses for2018
thru 2025. You must record the name and business relationship of each person for whom a
meal is provided. You may not deduct these expenses unless documented.
C1 - VEHICLE OPERATING EXPENSES
DO NOT complete this section or the Business Vehicle Expense section if your vehicle is
used only for commuting to work and for personal travel.
Business Miles
You Spouse
Check if expenses incurred as an employee (Section B9)
Check if expenses incurred for a self-employed business (Section C7)
Airfare
Auto Rental, Bus, Shuttle, Taxi, Train, Etc.
Meals (Including tips)
Lodging (Meals must be separated and included in the line above)
Laundry
Bellman, Skycap, Etc.
Other:
C2 - AWAY FROM HOME
EXPENSES
Ofce is for:
Filer Spouse
If both, provide separate set of data for both
Self-Employed Business
Date of use began:
/ /
Area (sq ft) of:
Entire Home:
Ft
2
Ofce Area:
Ft
2
Business Storage:
Ft
2
If Day Care Center, Days per Week Used: Hours Per Day:
Expenses
(Entire Home)
Rent
(1)
Utilities Insurance
Repairs
(2)
Maintenance
Management
Condo Fees
Expenses
(Ofce Portion Only)
Repairs Maintenance Other
(1) If you own your home leave this entry blank. If this is the rst time to claim this ofce, provide the home
purchase settlement closing statement, property tax statement and list of improvements to the ofce. (2)
Roof, outside painting included, not lawn care or pool maintenance.
C3 - HOME OFFICE EXPENSES
To qualify, a “home ofce must be used exclusively and on a regular basis (a) as your
principal place of business, or (b) by patients, clients, or customers in meeting and dealing
with you in a normal course of business. A home ofce will qualify as your principal
place of business if: 1) You use it exclusively and regularly for the administrative or
management activities of your trade or business, and 2) You have no other xed location
where you conduct substantial administrative or management activities of your trade or
business. A federal home ofce deduction is not allowed by employees for 2018 thru 2025.
Enter 100% of home taxes and mortgage interest in Sections B3 & B4.
C4 - EDUCATION EXPENSES
CAUTION: These expenses may qualify for tax credits and deductions and are used to
justify certain exclusions and tax or penalty-free distributions. Expenses must be segregated
by student. Use a different column for each student in the family. Please provide forms 1098-
T and/or 1099-Q if applicable. Form 1098-T is mandatory to claim credit.
Student #1 Name:
Taxpayer Spouse Dependent
Student #2 Name:
Taxpayer Spouse Dependent
Student #3 Name:
Taxpayer Spouse Dependent
For Tuition Credit Student #1 Student #2 Student #3
Full-Time Student? If yes, check box
Post-Secondary Tuition First Four Years
Post-Secondary Tuition After Four Years
Enrollment Fees & Course Materials
For Job Related Continuing Education
(No federal deduction for employees for 2018-2025.)
Tuition & Fees
Seminar Fees, Etc.
Books & Supplies
Travel Expenses List in Sections C1 and/or C2
For Education Plans
Certain expenses, although not deductible, must be reported to justify tax-free
distributions from Coverdell Accounts, Qualied Tuition (Sec. 529) Plans and Savings Bond Exclusions. If you
did not have distributions from one of those, you can skip the entries below.
Tuition K 12th Grade (Coverdell, 529 plan)
Tuition Post Secondary
Books & Supplies
(not 529 plan for Grades K-12)
Room & Board (not 529 plan for Grades K-12)
Property
Number
R or C
(1)
Address or Description
Rental Income
(Provide any 1099-Ks)
Percent Ownership
(if not 100%)
IF A VACATION HOME
# of Days
Personally Used
Number of Rental
Days
#1
#2
Expenses Property #1 Property #2 Expenses Property #1 Property #2
Advertising Taxes – Property
Cleaning & Maintenance Taxes – Payroll
(Do not include amounts withheld from employees)
Commissions Utilities (electric, gas, water, garbage collection, etc.)
Insurance Wages (W-2) (Generally the amount from line 1 of the 2018 form W-3)
Legal & Professional Fees Condo or Homeowner Association (HOA) Dues
Management Fees Telephone
(toll calls only)
Mortgage Interest Paid to Banks
Improvements & Replacements
These include cost of furnishings, appliances, drapes and major repairs.
Enter these expenses in Section C6.
Other Interest
For short-term rentals, including when tenants are secured
using online services such as HomeAway, Airbnb and VRBO,
enter the average number of days of rental use.
Repairs
Supplies, Hardware, Etc.
(1) R for Residential, C for Commercial
C5 - REAL ESTATE RENTAL INCOME & EXPENSES
For property purchased or converted to rental use this year, provide purchase documents and property tax statement. List business vehicle expenses and travel expenses under
"Rental Mileage”, Section C1. Enter equipment rental business activities in Section C7 below. Copy this page if you have more than two rental activities or purchased more than four
business assets or property improvements.
Business
Number
F or S
(1)
Self-Employed Health
Insurance Cost
Business Name
Employer ID Number
(If Applicable)
Gross
Income
(2)
Returns &
Allowances
Beginning
Inventory
Additions to Inventory (If other than
purchases provide additional detail)
Ending
Inventory
#1
#2
Expenses
Business
#1
Business
#2 Expenses
Business #1 Business
#2
Advertising Legal & Professional
Commissions and Fees Licenses
(list multi-year licenses & permits under other”)
Contract Labor Ofce Expense
Dues & Publications Pension Plan Fees
Business Meals
(100%) Rent – Equipment
Employee Benet Programs Rent Other
Employee Health Benet Plans Repairs
Equipment
with useful life of less than
one year
Supplies
Equipment Other Enter these expenses in Section C6. Taxes – Payroll
(Do not include amounts withheld from employees)
Freight Taxes – Sales
Gifts
(Limited to $25 per person) Taxes – Property
Insurance
(Not Health) Telephone
Interest – Mortgage (other than home)
Utilities
Interest Other
Wages (W-2)
(Generally the amount from line 1 of the 2018 form W-3)
Internet Service Other Expenses
Lease Improvements
Home Ofce
(Enter information at C3 and check box indicating which
business the home ofce is associated with)
(1) F for Filer, S for Spouse (2) Enter the total gross income including cash and credit card payments. Please provide all Forms 1099-K received from all merchant card and third party payers.
C7 - SELF-EMPLOYED BUSINESS
List business vehicle expenses and travel expenses in Sections C1 and C2. Enter home ofce expenses in Section C3. Copy this page if you have more than two business activities.
7
C - RENTAL & BUSINESS INCOME
This marker indicates payments that may require the issuance of a 1099 if the annual amount you paid to an individual is $600 or
more. Failure to issue 1099s could lead to the loss of the deduction for that expense and/or monetary penalties.
1099
1099
1099
1099
1099
1099
1099
1099
1099
1099
C6 - BUSINESS PURCHASES AND IMPROVEMENTS
Date
Purchased
Description
Used For
Cost
Rental # Business #
/ /
/ /
Date
Purchased
Description
Used For
Cost
Rental # Business #
/ /
/ /
8
D - HEALTH CARE, RELOCATION, HOME SALE,
DEBT RELIEF, ENERGY CREDITS
D1 - HEALTH INSURANCE
IRS requires that you report, on your tax return, certain information related to your health care coverage.
CHECK ALL THAT APPLY.
You had health care coverage with a government Marketplace (Exchange) during 2018. If so provide the Form 1095-A issued by the Marketplace. In some family situations you may
have more than one 1095-A.
You are claiming someone on your return who was included on another taxpayer’s policy with a Marketplace. If so, you will also need a copy of that taxpayer’s 1095-A.
A dependent led a return for 2018. Provide a copy of the return.
You had compliant health insurance through an employer plan, private policy or with a government plan and provide Form 1095-B, 1095-C or other proof of insurance document.
Complete the information below if you or any individual included in your “tax family” did NOT have insurance coverage for any month of 2018. Check for months NOT insured.
Name Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec
You were issued a hardship exemption by the Marketplace (Exchange). Provide all applicable exemption certicate numbers issued for each member of your family.
D2 - HOME SALE
If you sold your home, abandoned it, or lost it to foreclosure, the disposition may need to be
reported. If you received a 1099-S, it is very important that you provide it. If you abandoned
the home or lost it to foreclosure, see Section D5.
CHECK ALL THAT APPLY
Address of Home Sold
Date Purchased / /
Purchase Price
You deferred gain from a home sale made prior to 5/7/1997. If so, please provide the
Form 2119 for the year of sale.
Improvements to Home Sold (not maintenance)
Date of Sale
(Please bring FINAL closing
escrow statement. This
document will have the
information needed for
these entries.)
/ /
Sales Price
Sales Expenses
You owned and used the home as your primary residence for two of the prior ve years
(counting back from the sale date)
Your spouse (if married) owned and used the home as his/her primary residence for
two of the prior ve years
If owned and used less than two years, give reason for sale:
If the home was ever used for business (such as a rental, home ofce or day care
center)
Any of the business use in the prior question was before 5/7/97
The home was acquired by tax-deferred (Sec 1031) exchange after 10/22/04
You (and spouse if married) have excluded gain from the sale of a prior residence
within two years of the date of sale of this residence
The home was inherited (including from a deceased spouse)
The home was not used as your primary residence for any period after 2008
You previously claimed the new or long time resident homeowner credit
D3 - HOME ENERGY CREDITS
Enter only items certied by the manufacturer to meet Government energy standards.
You installed solar electric generation or solar water heating property that meets
Government energy standards for your main or a second home within the U.S.
Installed on primary residence. Provide description of energy property and cost.
D6 - QUESTIONS YOU MAY HAVE
D5 - DEBT RELIEF & FORECLOSURE
If you had debt totally or partially forgiven, you may be required to report debt relief income.
This includes real estate mortgages, credit card debt, vehicle loans, etc. Debts discharged
in bankruptcy are not included. Please call the ofce in advance to discuss what additional
documentation may be required.
CHECK ALL THAT APPLY
You had any amount of credit card debt forgiven and provide a copy of the 1099-C you
received from the nancial institution
You abandoned your home and provide a copy of the 1099-A and/or the 1099-C
you received from the nancial institution (also complete Section D2 home sale
information)
Your home was foreclosed upon or you sold it under a short sale” agreement with the
lender and provide a copy of the 1099-A and/or the 1099-C you
Check if employer reimbursed any amount of moving expense or home sale assistance
and provide the reimbursement statement from the employer (Form 3903 or a
substitute statement)
A - Miles from Old Residence to New Job
miles
B - Miles from Old Residence to Old Job
miles
A minus B if less than 50 miles, stop: no deduction allowed
miles
Commercial Mover
Temporary Storage
(up to 30 days)
Truck Rental
Lodging en route
(no
meals)
Trailer Rental Highway Tolls
Rental Fuel Costs Airfare
# of owned vehicles driven
to new home
Auto Travel
miles
Boxes/Tape/Supplies Other:
D4 - MOVING DEDUCTIONS
For federal for years 2018 - 2025, allowed only for active duty members of the Armed
Forces who move pursuant to a military order. To qualify for a moving expenses deduction,
the distance to the new job from the old home must be at least 50 miles farther than to
the old job from the old home.
D7 - SIGNATURE
To the best of my knowledge, all the information contained within this document is true, correct and complete.
/ / / /
Filer Signature Date Spouse Signature Date