Personal Tax Organizer (TY 2021)

Please complete and submit with supporting documentation

Please correct the errors described below.
    Please upload a file
    include suffix (Jr., Sr. III)
    Include City, State, and Zip Code
    Required for State Taxes
    Required for State Taxes
    include suffix (Jr., Sr. III)
      Please upload a file

      Qualifying Dependent(s)/Relative(s)

      In general, individuals may not be claimed as a dependent, unless:

      1) they were a U.S. citizen or a U.S. legal resident, and

      2) you provided over half of their total support in 2021, and

      3) they had gross income of less than $4,300 and was your qualifying relative, or, the individual was your child and

      a. Your child was under age 19 at the end of 2021, or

      b. Your child was under age 24 at the end of 2021 and was a student for any 5 months.

      Required for dependents over 17
      Required for dependents over 17
      Required for dependents over 17

      For parents that share joint custody of a child, a test must be performed before the child could be claimed. The taxpayer claiming the child must have the other parent's sign form 8332 (ask your tax advisor) “releasing the right to claim the child”

      If you have dependents under the age of 19 or less than 24 years old (student) and you are not the parents of the dependents, please provide the following information. If you have no Dependents, skip this section.

      If you received a child statement, please upload it, or provide the provider information.


      1. W-2s
      2. 1099s for dividends, Interest, and Sales
      3. 1099s for Social Security, Retirement Distributions, State Refunds, Misc.
      4. Income, Gambling Winnings, Distributions from Qualified Education Programs, etc. Please also make note of any taxable income where 1099s were not received, such as alimony.
      5. Business income and expenses
      6. Copy of 2021 Federal and State Income Tax Returns *New Clients (if not already provided)

      Please note: you are part of a C-Corp, S-Corp or Partnership/Multi-Member LLC Tax return you must file those returns first before you can file your personal tax return.

      Provide IRS Notice 6419
      Provide IRS Notice 1444-c or 6475
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              Self-Employed (Sole Proprietorship) Income

                Please upload a file
                  Please upload a file

                  Home Office Deduction

                  There are two methods simplified method or regular method.

                  • Simplified Method
                    • $5 per sq. ft. of the home
                    • the maximum deduction is $1500
                  • Regular Method includes:
                    • (Rent, mortgage, utilities, repairs, insurance, etc.)

                  Vehicle Expenses

                  You can use the standard mileage deduction or actual expense when deducting expenses for your vehicle.

                  • Standard mileage deductions (depreciation included)
                    • including business-related tolls and parking fees
                    • the business part of local taxes
                  • Actual Expense includes:
                    • depreciation
                    • vehicle registration fees
                    • Licenses
                    • Gas
                    • Insurance
                    • Repairs
                    • Oil
                    • Garage rent
                    • Vehicle Titles

                  You may deduct car/truck expenses for business travel,

                  • to meet clients
                  • to attend meetings and training
                  • between jobs that are business-related
                    • You cannot deduct the cost of commuting to your main job or work location. You should keep track of your travel.

                  Rental Income

                    Please upload a file
                    Include City, State, Zip code

                    If you’re not sure and have questions regarding the offset of your federal tax refund or offset of another U.S. government-issued payment, call the Treasury Offset Program Call Center at 1-800-304-3107.

                    Families First Coronavirus Response Act - Employee Paid Leave Rights
                    Qualifying reasons for leave: Under the FFCRA, an employee qualifies for paid sick time if the employee is unable to work (or unable to telework) due to a need for leave because one of the situations below applies to the employee.
                    1. Is subject to a federal, state, or local quarantine or isolation order related to Covid-19
                    2. Has been advised by a health care provider to self-quarantine related to Covid-19
                    3. Is experiencing Covid-19 symptoms and is seeking a medical diagnosis
                    4. Is caring for an individual subject to an order described in (1) or self-quarantined as described in (2)
                    5. Is caring for a child whose school or place of care is closed (or childcare provider is unavailable (for reasons related to Covid-19
                    6. Experiencing any other substantially similar condition specified by the Secretary of Health and Human Services, in consultation with the Secretaries of Labor and Treasury

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                    Funds withdrew from your account

                    Additional Services & Referral Information

                    We offer referral rewards, please let us know if you were referred by someone.

                    I acknowledge that all information provided in this form to Ethics Tax and Financial Services, LLC is true and accurate to the best of my knowledge. I understand that I am required to have any supporting documents to validate the information provided. I understand that providing false information on my tax return and reporting to the IRS or State agency is a criminal offense and is punishable by law. Ethics Tax and Financial Services, LLC, and the preparer are not liable for any error due to incorrect information provided by me. By signing below, I authorize Ethics Tax and Financial Services, LLC to file my tax return.


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