Tax Preparation Information

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Tax Preparation Information Sheet

Please Fill Out This Form Completely. Fields with a * are mandatory.

Taxpayer Information

Spouse Information

S.S. #

First Name*:

First Name:

Last Name*:

Last Name:

D.O.B.:

Telephone:

Mailing Address:

(if different)

Zip Code

City, State:

E-Mail*:

Dependent Information:

First Name:

Last Name:

D.O.B.:

Age:

SSN

Relationship

Clergy:

Books:

Equipment:

Conferences:

Office supplies:

Home Maintenance:

Furlough Funds:

Housing Allowance:

Furlough Meals:

Housing:

Furlough Hotels:

Medical Expenses:

Printing/Newsletter:

Property Taxes:

Postage/Shipping

Reserve Funds:

Taxes Paid US Federal:

Retirement Fund:

Taxes Paid Foreign:

Telephone:

Travel Expenses:

Tithe/Charity:

Total

Tuition:

Utilities

General Helpful Information:

How many W-2’s ?

How many 1099’s (R, Misc., etc.)

How many 1098’s (mortgage interest)

Do you have an approved 4361 SS Exemption Form? Yes or no

How many days were you in the USA?

     Please enter any addition information of a message below: