Personal Tax Organizer (TY 2021)

Client Status

New Client

Return Client

Are you Filing Prior Year Taxes?

Yes No

Select the Prior Year You are Filing

TY 2020

Not Listed

Prior Year(s) 1040

Add file

Please upload a file

Taxpayer's name

include suffix (Jr., Sr. III)

Date of Birth

01/01/2000

Social Security Number

555-55-5555

Taxpayer's Main Phone Number

123-45-6789

Email address

Taxpayer's Cell Phone Number

555-555-5555

Do you consent to receive text messages regarding your tax return?

Yes

Taxpayer's Occupation

Home Address

Include City, State, and Zip Code

Driver's License/ID Number

Issued State

Expiration Date

Issued Date

Do you need to file a state return?

Yes No

Which state(s)?

Required for State Taxes

What county do you live in?

Required for State Taxes

Do you have an IRS IP Pin?

Yes No

Can another taxpayer claim you (or spouse, if married) as a dependent?

Yes No

Martial Status

Single

Married

Widower

Spouse passed in the last 12 months

Will you be filing jointly? If married, your only filing option is MFJ or MFS.

Yes No

Spouse's name

include suffix (Jr., Sr. III)

Date of Birth

Spouse's Social Security Number

555-55-5555

Driver's License/ID Number

Issued State

Issued Date

Expiration Date

Phone Number

Spouse's Occupation

Spouse's Email address

Does your Spouse have a IRS IP Pin?

Yes No

Disabled?

Yes No

Spouse Disabled?

Yes No

Contribute $3 to the Presidential Campaign Fund

Yes No

Do you authorize taxing authority to discuss return with tax preparer?

Yes No

Do you have investment income $3,400 or less?

Yes No

Any time during 2021, did you (spouse, if applicable) receive, sell, exchange, or otherwise acquire any virtual currency (for example, Bitcoin)?

Yes No

Crypto Tax Documents

Add file

Please upload a file

If you were 18 years of age, or under 24 and a student, at the end of 2021, were you in foster care on or after turning 14 years of age and agree this status can be disclosed to the IRS?

Yes No

If you were 18 years of age, or under 24 and a student, at the end of 2021, were you homeless or at risk of becoming homeless and supporting yourself?

Yes No

Do you have any qualifying dependents/relatives?

Yes No

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.

Child/Relative Name

Date of Birth

Social Security Number

Number of months lived with you

Child/Relative Name

Date of Birth

Social Security Number

Number of months lived with you

Child/Relative Name

Date of Birth

Social Security Number

Number of months lived with you

Can any dependent be claimed as a dependent on another return?

No Yes

Did you provide more than half the support for these dependents?

No Yes

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”

Do you qualify for the adoption credit?

No Yes

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.

Where do the Parents live?

Did the parents of the dependent(s) work during the tax year?

Yes No

Did the dependent live with you during the tax year?

Yes No

Do you have custody documents for the Dependent?

Yes No

Do you have school documents for the dependent to prove that he or she lived with you during the tax year?

Yes No

Did you pay childcare for your Dependent(s) up to 12 years old?

Yes No

If you did not receive a child care statement Enter the Provider name, EIN/SSN, amount paid. (Receipt of payments needed)

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

Income

W-2s
1099s for dividends, Interest, and Sales
1099s for Social Security, Retirement Distributions, State Refunds, Misc.
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.
Business income and expenses
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.

Did you receive the 1st EIP stimulus?

Yes No

How Much?

Did you receive the 2nd EIP stimulus?

Yes No

How Much?

Did you receive Advance Child Tax Credit payments? Please enter the amount from Letter 6419

Yes No

How Much?

Provide IRS Notice 6419

Did you receive the 3rd Economic Impact Payment (EIP/Stimulus)? Enter the amount from IRS Notice 1444-c or 6475

Yes No

How Much?

Provide IRS Notice 1444-c or 6475

Retirement Plans attach statements for transactions &/or Form 8915-E

IRA

Spousal IRA

Roth

SEP

KEOGH

TSA

Company

N/A

Did you make any contributions?

Yes No

How Much?

Did you make any distributions? Withdraws

Yes No

How Much?

Did you take the Qualified 2020 Disaster Distributions?

Yes No

Do you have a 1098-T, Tuition for College Education?

Yes No

Did you have health insurance for all (12) twelve months?

Yes No

Did you receive health insurance through Marketplace?

Yes No

Do you have a 1098 mortgage loan interest form?

Yes No

Do you have a form 1098-E Student Loan Interest ?

Yes No

Did you sell any property or assets this year?

Yes No

Did you make any cash charitable contributions in 2021? Extend tax benefits allow for $300 per individual w/o itemized returns

Yes No

Did you make any cash charitable contributions in 2021? Extend tax benefits allow for $300 per individual w/o itemized returns

Yes No

Do you qualify for Educator's unreimbursed Classroom Expenses (max. $250)

Yes No

Expenses

$100.00

Do you owe any government agency? (ex.IRS, Child Support)

Yes No

Driver's License/State ID

Add file

Please upload a file

Social Security Cards

Add file

Please upload a file

Tax Documents (W2, 1099, 1098, Etc.)

Add file

Please upload a file

Tax Documents (W2, 1099, 1098, Etc.)

Add file

Please upload a file

Self-Employed (Sole Proprietorship) Income

Do you self-employed or business income to report?

Yes No

Who is the Business Owner?

Taxpayer Spouse

Business Legal Name

EIN

Type of Business

Business Address

Total Gross Receipts

What year did you start this business?

Which types of documents do you have to show proof of income earned.

Receipt Book

Profit & Loss Statement

1099-MISC

1099-K

Bank Statement

CRM Reports (Square, Paypal, etc.)

Profit and Loss/Income Statement

Add file

Please upload a file

Files

Add file

Please upload a file

Which accounting method did you use?

Cash

Accrual

Did you materially participate in this business in 2021?

Yes No

Did you lose the ability to work in your business due to COVID-19 in 2021? (If you were still a full-time employee and receiving leave you may not qualify)

Yes No

Did you pay Estimated Taxes related to this business?

Yes No

Do you have (W-2) Employees?

Yes No

Do you have (1099-Misc) Independent Contractors?

Yes No

Is this the first year filing this business?

Yes No

Do you use a portion of your home for business?

Yes No

Advertising

Commissions and fees

Contract Labor

Depletion

Depreciation and section 179 expense deduction

Employee benefit programs (other than on line 19)

Insurance, other than health

Interest

Legal and professional services

Office expense

Pension and profit-sharing plans

Rent or lease

Repairs and maintenance

Taxes and licenses:

Travel and meals

Utilities

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.)

Total sq. footage of the home

Total sq. footage of the part of the home used for business

Mortgage Interest

Excess Mortgage Interest

Excess Real Estate Taxes

Real Estate Taxes

Utilities

Repairs and Maintenance

Rent

Other expenses

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.

Business Miles

Commuting Miles

Other Miles

When did you place this vehicle in service?

Year/Make/Model

Business Use Percentage

Gas

Oil and Lubrication

Tires and Batteries

Garage rent/etc

Washing and polishing

Insurance

Licenses and leases

Personal property tax

Was the vehicle available for personal use?

Yes No

Did you have another vehicle available for use?

Yes No

Do you have written evidence?

Yes No

Rental Income

Do you have any rental income? That is not part of a Partnership, Multi-member LLC, or Corporation

Yes No

Did you activity participate in the rental activity during 2021?

Yes No

Did you make any payments that would require you to file Form 1099? Contractors

Yes No

Income Statement/ Profit and Loss All rental docs

Add file

Please upload a file

Address

Include City, State, Zip code

Fair Rental days

Personal days

Rents received

Royalties received

Do you have written proof and receipts? You should retain all receipts for up to 7 years.

Yes No

Do you have rental expenses?

Yes No

Advertising

Automobile/Mileage

Travel

Cleaning and maintenance

Commissions

Mortgage Insurance

Other Insurance

Legal and other professional fees

Management Fees

Mortgage Interest

Other Interest

Repair

Supplies

Real Estate Taxes

Other Taxes

Utilities

Do you or spouse (if applicable) owe any federal, state debt that would offset (take) your tax refund?

Yes No

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

As a Self-Employed business owner, did you lose the ability to work in your business due to any of the reasons listed above? (if you were still full-time employees and receiving leave you may notqualify)

Yes No Option 3

Bank Name:

Type of Account

Checking

Savings

Routing Number

Double check

Account Number

Double Check

Routing Number

Double check

Account Number

Double Check

What date would you like to have funds drafted?

Would you like audit protection? (for an additional fee of $50.00)

Yes No

Additional Services & Referral Information

How did you hear about us?

Return Client

Friend/Family

Social Media

Google

Thumbtack

Business card

Other

Referral Name

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.

Date

**/**/****

Your information will be encrypted.