2016 Tax Checklist
This form is to assist you in gathering your income tax information. Use it as a guide for information you need to provide. Please call or e-mail with any questions.
□ First, middle initial, and last names of taxpayers and dependents as written on the Social Security cards, and dates of birth for taxpayers and all dependents, especially new dependents.
□ Address (city, state, ZIP), telephone number and e-mail address.
□ Marital Status: Single ___ Married ___ Head of Household ___ Separated ___
□ Number of Dependents: ___ Did any dependents have any income? Yes ___ No ___
□ Do all dependents live with you? Yes ___ No ___
BUSINESS INCOME & EXPENSE ITEMS:
This list is not all encompassing. If you don’t see an expense listed below, ask.
Total (Gross) IncomeAdvertisingAuto: Parking &Tolls
Business Phone ExpenseCell Phone ExpenseSubcontractors
Commissions PaidInsuranceInterest Paid
General Office ExpenseRent/Lease Fees PaidLegal or Professional Fees
RepairsCleaning/MaintenanceDues & Publications
Equipment/SuppliesToolsLicense Fees/Taxes Paid
UtilitiesEducation ExpenseAssociation Dues
Bank/Credit Card FeesPostageMeals/Entertainment
Business Miles & Total Miles (A Mileage log is required)Hotel/Travel Expense
Asset Purchases (Date, amount and item)
ESTIMATED TAXES PAID:
Date of payment and amount paid for each Federal and State quarterly tax estimate.
TYPES OF INCOME AND TAX REPORTING FORMS:
□ Wages: All Forms W-2□ Income from Rentals: All 1099-MISC
□ Pensions/Retirements: 1099-R□ Business Income: All 1099-MISC & 1099-K
□ Social Security: SSA-1099□ Farm Income
□ Bank Interest: 1099-INT□ Alimony Received: Total amount
□ Dividends: 1099-DIV□ Unemployment: 1099-G
□ Commissions: 1099-MISC□ State Tax Refund: 1099-G
□ Tips and Gratuities□ Miscellaneous: Jury Duty, Gambling, Other
□ Sales of Stock, Mutual Funds: 1099-B
ADDITIONAL ITEMS FOR RENTAL PROPERTIES:
KeysCondo/PUD FeesManagement Fees
Mortgage StatementsYard WorkTermite Treatment Expense
HEALTH CARE INFORMATION:
Did you have qualifying health care coverage (employer group plan coverage or government-sponsored coverage) for every month of 2017 for you, your spouse and all members of your family as claimed on your tax return?
Did you or anyone in your family qualify for an exemption from the health care coverage mandate?
Did you acquire health care coverage through the Marketplace under the Affordable Care Act? If yes, provide Form(s) 1095-A.
If you had other healthcare insurance provide Form 1095-B or 1095-C.
Did you make any contributions to or receive distributions from a Health Savings Account, Archer MSA or Medicare Advantage MSA?
Foreign Income Matters:
Did you receive a distribution from, or were you a grantor or transferor for a foreign trust?
Did you have a financial interest in or signature authority over a financial account located in a foreign country?
Did you have any foreign financial accounts, foreign financial assets, or hold interest in a foreign entity?
DEDUCTIONS/CREDITS TO INCOME:
Self-employed Health InsuranceIRAs /Keogh/SEPsRetirement Saver’s Credit
Health Savings Account (HSA)Teacher ExpensesAdoption Expenses
Penalty on Early Withdrawal of SavingsMoving Expenses
* American Opportunity/Lifetime Learning/Student Loan Interest/Education Expenses – 1098-T Please bring a detailed billing/payment statement from the educational institution.
* Total Alimony Paid: Must have name and Social Security number of recipient, and amount paid.
* Child Care/Day Care Credit: Must have name, address, Social Security number or EIN of provider, and amount paid per child.
Mortgage Interest, Form 1098
Medical & Dental billsPrescriptionsGlasses/Contact Lenses
Out-of-pocket expensesMedical milesLab fees
Hearing AidsMedical/dental/long term care insurance
Prior year state tax paidCity/local taxReal estate tax
Personal property taxOther
Church Boy/Girl ScoutsUnited Way/CFC
March of DimesAmerican HeartEaster Seals
Salvation ArmyFoodBankPayroll deductions
Out-of-pocket Volunteer ExpensesCharitable milesOther
For donations, please provide evidence such as a receipt from the done organization, a canceled check, or record of payment to substantiate all contributions made. An itemized listing of all non-cash donations must be maintained with the receipts. List must include the Fair Market Value for each donation of non-cash items.
Did you receive an Identity Protection PIN from the Internal Revenue Service or have you been a victim of identity theft? If so, please provide the IRS letter.