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Personal Information (David Turrentine & Associates, Inc.)

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Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 1 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Tax Year
Personal Information
Taxpayer
Spouse
Last name:
Last name (if different):
First name:
Middle initial:
First name:
Middle initial:
Social Security no. (On file? ):
Social Security no. (On file? ):
Occupation:
Occupation:
Date of birth:
Date of birth:
Email address:
Email address:
Work phone:
Ext:
Work phone:
Ext:
Cell phone:
Cell phone:
Home phone:
Home phone:
Fax number:
Fax number:
Driver’s License Information
State:
Lic. No.:
State:
Lic. No.:
Issued:
Expires:
Issued:
Expires:
Document # (NY only):
Document # (NY only):
Address:
Apt. no.
City:
State:
ZIP code:
Presidential Election Campaign Fund
Checking a box below will not change your tax or refund.
Check here if you (or your spouse if filing jointly) want $3 to go to this fund.
You Spouse
Federal Filing Status
1
Single
2
Married filing jointly
3
Married filing separately
Taxpayer did not live with spouse at any time during year
4
Head of household
If qualifying person is child but not dependent:
Child’s name:
Child’s social security number:
5
Qualifying widow(er). Year spouse died:
Are you or your spouse eligible to be claimed as a dependent on someone else’s return?
Yes No
Direct Deposit/Electronic Funds Withdrawal Information
Yes
No
Use direct deposit for any federal tax refund / state tax refund
Use electronic funds withdrawal for federal balance due
Use electronic funds withdrawal for state balance(s) due
Financial Institution Information
Check if bank
info is same
as last year
Account type:
Checking Savings
Routing number:
Account number:
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 2 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Dependents
Code*
Date of Birth
Number of
months lived
with taxpayer
in U.S.
Qualified child
and dependent
care 2021
expenses
First name
MI
Soc. Sec. number
Last name
Suffix
Relationship
* L–Dependent child who lived with taxpayer; N–Dependent child who did not live with taxpayer due to divorce or separation;
O–Other dependent; Q–Not a dependent (but is a qualifying person for the earned income credit and/or the child tax credit
and/or the credit for child and dependent care expenses).
Child and Dependent Care Expenses
(a)
Care provider’s name and
Care provider’s phone number
(b)
Address
(number, state, apt. no.,
city, state, and Zip code)
(c)
Identifying Number
(SSN or EIN)
(d)
Amount
paid
Form 1099-G – Unemployment Compensation and State Income Tax Refund(s)
Unemployment compensation and state tax refunds are reported on Form 1099-G.
State Income Tax Refunds
State
State income tax refund
Refund is for tax year:
Unemployment Compensation (provide 1099-G)
Amount Received
State
Federal Income Tax Withheld
State Income Tax Withheld
Advance Child Tax Credit
Please enter the amount of any advance Child Tax Credit Payments you received in 2021:
These payments are reported to you by the IRS on Letter 6419
L
L
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 3 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Income
Wages – Provide all copies of W-2
How many W-2 Forms do you have? (Do not enter amounts.)
Self
Spouse
Dividends and Interest Income
Provide all Forms 1099-INT and 1099-DIV which report
interest and/or dividend income.
Retirement Plan Distribution – Pensions, Annuities,
Rollovers, IRA SEP, Koeghs, Lump-Sum Distributions or
Other Retirement Plan Withdrawals
Provide all copies of Forms 1099-R received for retirement
plan distributions.
Sale of Stock (Form 1099-B)
Provide Forms 1099-B (including cost basis info)
Partnerships, Estates, Trusts and S Corporation
Provide all year-end reports and/or Schedule(s) K-1 received
for tax year 2021
Social Security Benefits (1099-SSA)
Provide Forms SSA-1099
Other Income – Provide All Forms 1099, etc.
Commissions and Fees
Tips and Gratuities not reported on
Form W-2
Bonuses and Prizes not reported on
Form W-2
Cancellation of Debt (Form 1099 C)
Jury Duty – Election Board Fees
Gambling/Lottery Earnings (Form W-2G)
Bartering Income
Other Income (Describe)
Alimony
Payer’s/Payee’s name
Social Security number
Amount received
Amount paid
What date was the divorce finalized?
2021 Estimated Tax Payments
FEDERAL
Date Paid
STATE
STATE
ID
Date Paid
Notes
Amount applied
from 2020, if any.
XXX
XXXXX
XXX
XXXXX
• If you itemize deductions on your
federal income tax return, it can be
to your advantage to pay your last
state tax estimate in December
instead of January.
• Do not include balance due from prior
year in the first estimated payment
box.
Residency
What state(s) were you a resident of during 2021?
State
Dates of Residency
to
to
Did you receive a third Economic
Impact (Stimulus) Payment in
2021?
This amount will be
reported to you by the IRS
on Letter 6475.
Please enter amount:
3
rd
Stimulus Payment
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 4 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Itemized Deductions
Note: Complete this portion only if you think your itemized deductions might exceed the
IRS standard deduction for your filing status (see below). Expenses related to self-
employment can be used in addition to the Standard Deduction.
2021 Standard Deductions
Filing Status
Married Filing Jointly
$25,100
Single or Married Filing Separately
$12,550
Head of Household
$18,800
Medical Expenses
Deductible Only If Net Cost Exceeds 7.5% of AGI
(Do not include amounts paid for or reimbursed by insurance
or health insurance premiums paid with pre-tax income.)
NOTE: If you are self-employed, don’t list health insurance
premiums here. Include in page 5.
Health Insurance Premiums
Medicare Insurance Premiums Paid (Form SSA-1099)
Long-Term Care Insurance Premiums
Dental Insurance
Dentists
Prescribed Drugs and Insulin
Hospitals, Nurses, Alcoholism Treatment, Ambulance
Doctors and Clinics
Glasses, Contact Lenses, Eye Exams
Lab Tests, Therapy, X-Ray, Anesthesiology
Prescribed Medical Equipment
Hearing Aids, Batteries & Related Equipment
Vasectomy/Tubal Ligation/Abortion Costs
Nursing or Retirement Home (medical care only)
Medical Transportation (taxi, bus, ambulance, etc.)
Medical Miles
Medical Parking
Lodging While Obtaining Medical Treatment
(Limited to $50 per night, per person)
Taxes
Real Estate Taxes
Property Tax Index Number
Property Tax Refund
Other Real Estate Taxes (second home, cabin, boat, etc.)
Personal Property Taxes
State Income Taxes Paid This Year for Prior Tax Years
New Auto or Boat Sales Taxes
Interest Paid
Primary Residence
Second Home
First Mortgage Interest
(Provide Forms 1098)
Second Mortgage
Private Mortgage Insurance (PMI)
Home Equity/Improvement Loan
Loan Points
Investment Interest Paid
Cash Contributions (Use separate sheet if needed)
Churches or Synagogues
United Campaign (Include Payroll Deductions)
Cancer or Heart
M.S./M.D./March of Dimes
Other
Out-of-Pocket Expenses for Charitable Work
Non-Cash Contributions
*Fair Market Value of Items Given to Charities
If over $500, we will need more specific details regarding the contribution
Vets/Goodwill/Salvation Army Amt*
Organization Amt*
Organization Amt*
Charitable Mileage on Auto Miles
Gambling Losses
Limited to Total Gambling Winnings
Cash Charitable Contributions in addition to the Standard Deduction
Even if you do not itemize deductions, you can still deduct from your income up to $300 as
a single filer and $600 married filing jointly for cash contributions made in 2021.
Section 529 Plan Contributions
Contributions to an Illinois Section 529 college savings plan (Bright Start, College Illinois,
Bright Directions) for 2021.
Amount:
Account Number:
Amount:
Account Number:
HSA (Health Savings Account)
Contributions made (or expected to be made) to an HSA for 2021
Amount:
Do not include contributions to a Flexible Spending Account (FSA). Do not include employer contributions reported on
Form W-2, Box 12, Code W. Please provide me with your year-end statement and any Forms 1099-SA you received
ACA Health Insurance
Yes No Did you purchase health insurance through an Affordable Care Act Exchange?
Please provide a copy of any Forms 1095-A that you received.
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 5 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Self Employed ARTIST Income/Expenses (Schedule C) See descriptions on following page.
Name of Owner
Business Activity
Business Name (if different)
Federal ID Number (if any)
Business Address (if different)
1. Do you use any part of your home for business? Yes No (If Yes, complete the Office in the Home section, page 8.)
2. How many months in business during the year?
If this will be your first year filing Schedule C (self-employed), please check here
Are you required to issue 1099s? Yes No If so, have the 1099s been issued? Yes No
Number of 1099s submitted with this worksheet
Income
Fee Income Reported on Forms 1099-MISC / 1099-NEC / 1099-K
Fee Income Not Reported on Forms 1099-MISC / 1099-NEC / 1099-K (Do not include W-2 income here)
TOTAL FEE INCOME
Common Expenses
Expense Category
Total
Amount
Expense Category
Total
Amount
Expense Category
Total
Amount
Advertising
Fees
Local Transportation
Business Insurance
Tax Preparation
Membership Dues
Postage & Shipping
Cable
Internet Service*
Office Expense
Classes
Contract Labor
Equipment Rental
Business Gifts
Software Subscriptions
Space Rental
Hair /Makeup
Streaming Services
Repairs
Liability/Equipment Insurance
Other (explain)
Supplies
Costumes
Business Meals
Trade Publications
Telephone*
Tickets for Research
Self-Employed Health Insurance
* Business amounts only
Equipment
This is anything you use in your business that has an expected life of more than one year: Computer, fax machine, cell phone,
PDA, ear prompter, musical instruments, audio and video equipment, etc. Software also goes here.
Please complete the table below. Include an additional sheet if necessary.
Item/Description
Date of Purchase
Price
% of Business Use*
* If business use percentage is over 50%, I may be able to write it all off this year.
If under 50%, the equipment must be depreciated.
$0.00
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 6 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Artist Expenses In-Town Explanation Sheet
Advertising
Anything you spend to promote yourself. Pictures, résumés,
copying costs, photographer, makeup artist, retouching
costs. On-line databases such as castnet.com
. Voice demos
and their production costs.
Postage & Shipping
List here any postage and shipping costs not included in other
categories.
Office Expense
Toner, paper, paper clips, pens and pencils, organizers, etc.
Equipment Rental
Audio and video equipment, etc.
Space Rental
Rehearsal space, studio space.
Repairs
Just as equipment is deductible; so are repairs on that
equipment. But only to the extent that the original piece of
equipment is deductible. That is, a $100 repair on a piece of
equipment that is used 50% for business is a $50 deduction.
Supplies
Sheet music, records, books, CDs, scripts, props, etc.
Business Meals
Business meals are deductible expenses if a bona fide
business discussion takes place before, during, or after the
meal or entertainment. In addition to your receipt, keep track of
this in your daily log. Jot down who you met with, where you
met, and what you talked about. Personal meals which do
not involve other people are only deductible when overnight
travel is involved.
Telephone
Include the business portion of your cellular phone service.
The monthly service charge for any land line coming into
your home is not deductible. The cell phone accessories
should be included in the equipment area of the worksheet.
Fees
Did you pay anybody for anything? To transpose music for you,
accompany you at an audition, direct you in a showcase, sub
for you on a gig? If you pay an independent contractor $600 or
more in the year, you may need to issue them a 1099 form.
Classes
This is training that improves or enhances your present job
skills, including the transportation expense of getting back and
forth to classes. (Add cab and bus fare to Local
Transportation and auto mileage to the Auto Sheet).
Gifts for Business
This deduction is limited to $25 per recipient per year. Be sure
to include opening night gifts and backstage tips.
Hair/Makeup
The general expense of year-round hair costs are personal
expenditures. These costs are not deductible. Only styling
costs directly related to your work as a performing artist are
deductible. You can certainly take off the cost of doing
something special to your hair for a show or a job or for new
headshots. Makeup costs must be for business use only –
stage, film, TV work. Include the cost of character glasses,
wigs, electrolysis, and contacts (business portion only).
Costumes
Can you deduct that new outfit you bought specifically for an
audition for an industrial? The IRS says no. You can’t deduct
clothing that is suitable for everyday street wear, whether you
wear it there or not. So, go ahead and include the clown outfit,
but not the new dress or suit. Include smocks for doing makeup,
the tux for catering jobs and opening night parties, and dance
clothes.
Trade Publications
American Theatre Magazine, Audition News, Act One
Reports, Backstage, etc.
Tickets for Research
Tickets for movies and plays can be deducted if the viewings
were for research purposes. Make sure to keep good records
related to what you saw and why it was necessary for your work.
Dance concerts and museum admissions may also sometimes
qualify for a research expense.
Streaming Services
Netflix, Hulu, etc., to the extent that they are used for research.
Local Transportation
Don’t include your auto expenses here. There is a separate
sheet for them. Local transportation related to self-employment
can be included as an expense on your Schedule C. If your
home is your principal place of business, all your transportation
related to self-employment is deductible. Don’t forget to include
transportation related to business meetings, continuing
education, research, etc. Travelling to a regular place of work is
generally considered commuting and is not deductible.
Membership Fees
Equity and
SAG/AFTRA union dues and initiation fees are no
longer deductible as they are related to W-2 income.
However, professional membership fees related to self-
employment (1099) income remain deductible. This includes
fees paid by directors, designers, or musician’s guilds or
other professional organizations.
Internet Service
The portion of your internet service that is used for business.
Cable
You may be able to deduct the percentage of your cable T.V.
bill that is used for business. (Not the portion that is
entertainment.)
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 7 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Self Employed NON-ARTIST Income/Expenses (Schedule C) Sole Proprietor
Name of Owner
Business Activity
Business Name (if different)
Federal ID Number (if any)
Business Address (if different)
1. Do you use any part of your home for business? Yes No (If Yes, complete the Office in the Home section, page 8.)
2. How many months in business during the year?
If this will be your first year filing Schedule C (self-employed), please check here
Are you required to issue 1099s? Yes No If so, have the 1099s been issued? Yes No
Number of 1099s submitted with this worksheet
Income
Fee Income Reported on Forms 1099-MISC / 1099-NEC / 1099-K
Fee Income Not Reported on Forms 1099-MISC / 1099-NEC / 1099-K (Do not include W-2 income here)
TOTAL FEE INCOME
Expenses
Advertising
Utilities (Not Home Office)
Bank Charges
Rent (Business/Not Home Office)
Commissions and Fees Paid
Repairs and Maintenance
Dues and Publications
Supplies
Insurance (Business)
Telephone (Business amount only)
Interest (Business)
Business Meals (at 100%)
Laundry and Cleaning
Business Gifts
Legal and Professional
Research
Office Supplies and Postage
Software Subscriptions
Local Transportation
Streaming Services
Licenses
Website
Contract Labor
Other (Describe):
Internet
Other:
Seminars/Classes
Other:
Self-Employed Health Insurance
Equipment
Item/Description
Date of Purchase
Price
% Business Use
$0.00
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 8 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Office in the Home
The following criteria must be met for a home office deduction:
The home office space must be used regularly and exclusively for business. Be aware that you do not have to use an entire
room as your office—a portion of a room may qualify.
If you use more than one home office during the year, split the expenses between the two. I will need you to provide me with the
number of rooms used for business and the number of rooms in your home (not including bathrooms), OR the square footage of
your office space, and the total square footage in your home. If you share your home with someone else, provide me with the
total costs for the home (not just your share).
Please provide us with the date of the move, and
any moving expenses related to the move.
Date of
Move:
Moving
Expenses:
HOME OFFICE 1
HOME OFFICE 2
Square Footage of House or Apartment (or number of rooms)
Square Footage of Office (or number of rooms)
Homeowners only: Deductible mortgage interest
Fill in these boxes
ONLY if you are
claiming an office
in your home.
Otherwise, see
page 10, Part X
Homeowners only: Real estate taxes
Homeowners only: Private Mortgage Insurance (PMI)
Renters only: Total rent paid for the year
Insurance (homeowner’s, condo owner’s, renter’s)
Repairs and maintenance
Utilities (Gas, electric, water, trash, etc. – Do not include phone or internet.)
Condo/Homeowner’s association fees
If you purchased or refinanced your home this year, please provide me with the closing (settlement) statement. Also include a
copy of any property tax bills.
Energy Credits
If you purchase an energy-efficient product or renewable energy system for your home, you may be eligible for a federal tax
credit. Examples of qualifying property include: Biomass Stoves; Heating, Ventilating and Air Conditioning; Insulation; Water
Heaters; Roofs; Windows and Doors; Geothermal Heat Pumps.
Here is a link which provides additional information regarding these energy credits:
http://www.energystar.gov/index.cfm?c=tax_credits.tx_index
Please provide me with a copy of your receipt(s) showing the products purchased and the cost. You will need to save your
receipt(s) and a copy of the Manufacturer’s Certification Statement for your records.
Education Expenses
Taxpayer
Spouse
Did you attend a college or university? Enter total cost of tuition, books, and lab fees:
Did you pay interest on a student loan? How much? Enter total amount of INTEREST ONLY:
Did you pay for educational expenses for your child(ren) to attend a public or private elementary or secondary school? Enter
Total cost of tuition, books, and lab fees: Enter The Grade level(s) for the child(ren):
Name of School
City/State
Please include any Forms 1098-T and 1098-E that you received. Also include any account statements related to your education
expenses for the year.
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 9 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Expenses Out-of-Town (Self-Employed Only)
Below are two charts for your out-of-town expenses. Travel out-of-town means when you are away from your tax home overnight
working or looking for work related to self-employment. If the primary purpose of your trip is for business, then the cost of getting
there and back is a deductible business expenses, even if you spend some time while you are there doing personal activities.
The top section below is a description of each trip. I need to know the location you were in and the number of days you were
there. Each of the columns on the bottom chart corresponds to a trip or row across the top chart.
Do not include business mileage on your own car on this page. Include all business mileage on the auto page of the worksheet.
If you received any per diem payments that were not included in the nonemployee compensation box of your 1099 form, include
these payments in the area for “Payments not included on Form 1099.” If you want me to calculate a Standard Meal Allowance to
account for your meals and incidental expenses, check the “SMA” boxes in the table below.
Employer (or Possible Employer)
City
Inclusive Dates
Number
of Days
For Office
Use Only
For Office
Use Only
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total
Air/Train/Bus travel
Lodging Expenses
Tips and Gratuities
Laundry and Dry Cleaning
Local Transportation
Auto Rental
Gasoline and Oil for Car Rental
Telephone
Other (Explain):
Total Expenses
Payments not included on Forms
1099/W-2 (per diem payments)
Meals & Incidentals or
Total Standard Meal Allowance
(Check “SMA”)
SMA
SMA
SMA
SMA
SMA
SMA
SMA
SMA
SMA
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 10 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Auto Usage
Business mileage related to self-employment can be included as an expense on your Schedule C. If your home is your
principal place of business, all of your mileage related to self-employment is deductible. Don’t forget to include mileage
related to business meetings, continuing education, research, etc. Travelling to a regular place of work is generally
considered commuting and is not deductible.
Please note that you must have written evidence, such as a paper or electronic mileage log, in order to claim a deduction for
the business use of a car.
Standard Mileage Rate
There are two ways to take this
deduction: the easy way and the hard
way. Why don’t we start with the easy
way. You keep track of your business
miles and simply multiply them by the
Standard Mileage Rate. If you ever
want to make use of the SMR for a
particular vehicle, you must use it the
first year you use the vehicle for
business. You must also own the car
or be leasing it in order to use the
Standard Mileage Deduction.
Vehicle 1.
Vehicle 2
Make and model of vehicle
Date placed in service
Business Miles for the Year
Total Commuting Miles
(back and forth to a regular job)
Total Personal Miles
Total Miles for the Year
Is The Vehicle Leased?
Yes No
Yes No
Parking & tolls FOR BUSINESS
Is another vehicle available for personal use? Yes No
Actual Expense Method
The harder way to claim an auto
usage deductible is by using the
Actual Expenses method. It’s a
more complicated process but it
can be worthwhile for some
taxpayers. Using the business and
total mileage from above, I will
determine the percentage the car is
used for business. Then we deduct
that percentage of everything it
costs you to operate the car. This
method requires more record
keeping but it can be worthwhile. If
you have the records, fill in this
table along with the above mileage
information and I will figure out the
best approach.
Vehicle 1
Vehicle 2
Cost of the vehicle
Date placed in service
Interest on car loan
Lease payments
Gas
Insurance
Auto club membership
License fees
Maintenance (oil change, tires)
Repairs
Car washes
If you purchased a new vehicle this year, please provide me with the bill of sale.
Leased Vehicles: You may use either the standard mileage or the actual expenses method. To use the actual expenses method, I will need
the fair market value of the vehicle, the total amount of your lease payments, and the mileage numbers from the top of this page.
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 11 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Rental Property Income / Expense (including Airbnb)
Date Acquired
Description of Property
Address
Number of Days
Rented During
the Year
Number of Days
You/Your Family
Resided at
Location
A
B
C
D
Income
A
B
C
D
Rents Received
Other
Expenses (List Only Rental Expenses)
A
B
C
D
Real Estate Taxes
Mortgage Interest
Other Interest
Insurance
Cleaning / Maintenance
Yard / Snow Removal
Rubbish Hauling / Trash
Supplies
Fuel
Electricity
Water / Sewer
Casual Labor
Management Fees (Commissions)
Homeowners Association Dues
Travel Expense (Detail)
Auto Travel Mileage
Telephone
Advertising
Legal & Professional
Repairs / Painting
Repairs / Plumbing
Repairs / Electrical
Repairs / Appliances
Refunds / Security Deposit
Other:
Comments / Questions
Fill out worksheet as completely as possible. Save it as your name and tax year (janedoe2021.pdf). Page 12 of 12
Email a copy to david@davidturrentine.com. Don’t forget to mail/email/fax a copy of all your tax documents.
Retirement Contributions
Did you (or will you) make a contribution to a Traditional IRA, SEP-IRA, SIMPLE IRA, or Individual 401k for last year?
Do not include salary deferrals from work reported on Forms W-2.
Taxpayer Contribution
Spouse Contribution
Traditional IRA
Roth IRA
SEP/SIMPLE/Individual 401k
Did you convert all or part of a Traditional IRA into a Roth IRA last year?
Amount converted:
The Following Items May Affect Your Tax Return
YES
NO
Are you interested in making additional contributions to a retirement plan?
Are you or your spouse eligible to participate in an employer’s retirement plan?
Did you have a retirement plan withdrawal, rollover or lump sum distribution in 2021? If so, provide Forms 1099R?
Did you incur any expenses in 2021 or prior years associated with the adoption of a child? If so, ask us about it.
Did you sell stock, securities, real estate or other property? If yes, provide all Forms 1099-B. Also provide (1) description of the
property, (2) date of purchase, (3) date of sale, (4) purchase price, (6) expenses of sale, (7) improvements or other cost/basis
and (8) closing statements for purchase and/or sale.
Did you purchase a new home or refinance your home mortgage during 2021? Please provide the settlement (closing) statement
Do you own any securities or hold any bad debts that became worthless during the year? Provide details?
Were any stock options granted to you or by your employer, or did you exercise any stock options in 2021?
Do you have income from a foreign investment, such as interest from a foreign bank account? If yes, provide details.
During 2021, did you acquire, sell, or exchange virtual currency (Bitcoin, etc.)?
Final Checklist / Items We Will Need
Your completed Personal Income Tax Organizer
All Forms W-2 (wages) and all Forms 1099 (1099-INT for interest, 1099-DIV for dividends, 1099-B for sales of securities, 1099-R for
annuities and pensions, 1099-R for IRA or other retirement plan withdrawals, 1099-G for state tax refund, SSA-1099 for Social
Security 1099-G for unemployment compensation and 1099-MISC for commissions and fees.)
Copies of returns (Schedules K-1) for partnership, joint ventures, S corporations, estates, or trusts. (In some cases, we may have
your K-1 on file.)
If you are a new client, provide a copy of last year’s tax return (Federal and State)
Electronic
Filing
If we are filing your returns electronically, we will email you a copy of your return as a PDF document. We will also
email your signature authorization forms for you to electronically sign.
IMPORTANT. Before I can transmit your returns electronically, I am required by law to
have these signed signature forms in my office.
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Personal Information (David Turrentine & Associates, Inc.)

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Completed 19 March 2022

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