It will help you in preparing the material needed for your income tax preparation.
Please fill in your tax summaries on the following pages and bring them to our appointment, mail them or email them to us.
Please note that not all the pages in this organizer may apply to you.
Should you have any questions don't hesitate to call.
To download the questionnaire as Word document please click here.
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DATE______________ TAX YEAR______________ |
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P E R S O N A L I N F O R M A T I O N |
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LAST NAME__________________________ FIRST NAME____________________________ SOCIAL SECURITY_________________________________ OCCUPATION______________________________________ BIRTH DATE_______________________________________ SPOUSE'S LAST NAME_____________________ FIRST NAME_______________________ SOCIAL SECURITY_________________________________ OCCUPATION______________________________________ BIRTH DATE _______________________________________ ADDRESS____________________________________________________________________ _____________________________________________________________________________ TELEPHONE - HOME____________________________ CELL_________________________ FAX____________________ WORK___________________ EXTENSION_________________ E-MAIL_______________________________________________________________________ DIRECT DEPOSIT OF REFUNDS
_____________________________________________________________________________ DEPENDENTS
_____________________________________________________________________________ ADDRESS IN ISRAEL__________________________________________________________ EMPLOYER ISRAEL___________________________________________________________ OTHER INFORMATION_________________________________________________________ |
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I N C O M E - ENCLOSE ALL W-2'S & 1099'S |
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WAGES EMPLOYER - SELF____________________________________________________________
_____________________________________________________________________________ EMPLOYER - SPOUSE_________________________________________________________
_____________________________________________________________________________ PENSIONS
_____________________________________________________________________________ _____________________________________________________________________________ INTEREST INCOME
_____________________________________________________________________________ _____________________________________________________________________________ DIVIDEND INCOME
_____________________________________________________________________________ ____________________________________________________________________________ OTHER INCOME STATE REFUND FROM LAST YEAR_____________________________________________ UNEMPLOYMENT COMPENSATION_____________________________________________ ROYALTIES___________________________ OTHER________________________________ |
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| A D J U S T M E N T S |
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| MOVING EXPENSES DISTANCE FROM PREVIOUS RESIDENCE TO NEW PLACE OF EMPLOYMENT ________________________________ DISTANCE FROM PREVIOUS RESIDENCE TO OLD PLACE OD EMPLOYMENT ________________________________ TRAVEL EXPENSES _____________________________________________________________________________ TRANSPORTATION OF HOUSEHOLD GOODS _____________________________________________________________________________ INDIVIDUAL RETIREMENT ACCOUNTS SELF - $ _________________ SPOUSE - $ ______________ EDUCATION TAX CREDIT - EDUCATION EXPENSES - HUSBAND_________________________________ WIFE______________________________ CHILD HIGHER EDUCATION_____________________________________________________ MASSACHUSETTS, MICHIGAN & NEW JERSY RESIDENTS RENT PAID DURING THE YEAR__________________________________ LANDLORD’S NAME___________________________________________ LANDLORD’S ADDRESS________________________________________ |
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| I T E M I Z E D D E D U C T I O N S | |||||||||||||||||||||||
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MEDICAL DOCTORS____________________________ HOSPITALS_____________________________ PRESCRIPTIONS______________________ GLASSES__________ LENSES_____________ HEARING AIDS_______________________ LABS & X-RAYS__________________________ MEDICAL INSURANCE _________________________________________________________ MEDICAL TRAVEL____________________ MEDICAL MILEAGE______________________ TAXES STATE & LOCAL INCOME TAXES____________ REAL ESTATE TAX_________________ AUTO LICENSES___________________________ OTHER TAXES_____________________ INTEREST EXPENSE HOME MORTGAGE INTERST___________________________________________________ INVESTMENT INTEREST_______________________________________________________ CONTRIBUTIONS CASH_______________________________ NONCASH_______________________________ _____________________________________________________________________________ VOLUNTARY EXPENSES AND MILEAGE ________________________________________ MISCELLANEOUS EXPENSES UNION & PROFESSIONAL DUES __________ PROFESSIONAL LITERATURE __________ CONVENTION COSTS____________________ PROFESSIONAL SUPPLIES_____________ OFFICE SERVICES______________________ PROFESSIONAL EDUCATION____________ TAX PREPARATION FEE_______________________________________________________ OTHER ______________________________________________________________________ |
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| T E M P O R A R Y A S S I G N M E N T - | |||||||||||||||||||||||
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FOR ASSIGNMENTS THAT LAST LESS THAN ONE YEAR AUTOMOBILE EXPENSES - TYPE OF CAR 1._________________ 2.__________________ PURCHASE DATE_______________________ PURCHASE PRICE_____________________ SALE DATE____________________________ SELLING PRICE________________________ TOTAL MILES FOR YEAR________________________________ BUSINESS MILES_______________________________________ CAR RENTALS / LEASES________________________________ OTHER AUTO EXPENSES______________________________________________________ _____________________________________________________________________________ PARKING & PUBLIC TRANSPORTATION__________________________________________ TRAVEL - AIRFARES_________________________ OTHERS_________________________ RENT___________________________________________________ HOTELS________________________________________________ UTILITIES____________________________ TELEPHONE_____________________________ HOUSE CLEANING__________________ LAUNDRY & DRY CLEANING_________________ HOUSEHOLD EQUIPMENT________________________ OTHER_______________________ MEALS ALLOWANCE ACCORDING TO IRS TABLES_______________________________ |
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| I N C O M E F R O M S E L F E M P L O Y M E N T | |||||||||||||||||||||||
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GROSS RECEIPTS / SALES_______________________ OTHER INCOME_________________________________ COST OF GOODS SOLD__________________________ COST OF LABOR________________________________ MATERIALS & SUUPLIES_________________________ EXPENSES ADVERTISING____________________________ REPAIRS____________________________ BANK CHARGES_________________________ SUPPLIES___________________________ CAR EXPENSES _________________________ FREIGHT____________________________ DUES & PUBLICATIONS___________________ LAUNDRY & CLEANIG_________________ INSURANCE_____________________________ TOOLS______________________________ INTEREST_______________________________ EQUIPMENT_________________________ LEGAL & PROFESSIONAL_________________ RENT_______________________________ TRAVEL_________________________________ UTILITIES____________________________ MEALS & ENTERTAINMENT_______________ WAGES & SALARIES_________________ OFFICE_________________________________ OTHER_______________________________ EDUCATION_____________________________ PRINTING____________________________ POSTAGE_______________________________ OTHER______________________________ BUSINESS PROPERTY & EQUIPMENT
_____________________________________________________________________________ _____________________________________________________________________________ |
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| R E N T A L I N C O M E A N D E X P E N S E S | |||||||||||||||||||||||
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DESCRIPTION OF PROPERTY___________________________________________________ ADDRESS____________________________________________________________________ I N C O M E RENTS RECEIVED_____________________________________________________________ E X P E N S E S ADVERTISING__________________ ASSOCIATION DUES___________________________ AUTO & TRAVEL_______________ CLEANING & MAINTENANCE____________________ INSURANCE____________________ LEGAL & PROFESSIONAL______________________ MANAGEMENT FEES___________ MORTGAGE INTEREST_________________________ PROPERTY TAXES______________ REPAIRS_____________________________________ SUPPLIES______________________ TELEPHONE__________________________________ UTILITIES______________________ OTHER_______________________________________ DATE PROPERTY WAS ACQUIRED______________________________________________ COST OF PROPERTY__________________________________________________________ VALUE OF PROPERTY FOR DEPRECIATION______________________________________ VALUE OF FURNITURE & APPLIANCES FOR DEPRECIATION_______________________ |
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| S A L E OF S E C U R I T I E S | |||||||||||||||||||||||
_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ |
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| C H I L D A N D D E P E N D E N T C A R E | |||||||||||||||||||||||
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DID YOU PARTICIPATE IN AN EMPLOYER PROVIDED DEPENDENT CARE BENEFIT NAME OF CHILD UNDER 13 FOR WHICH EXPENSES WERE INCURRED 1.______________________________________ 2.___________________________________ 3.______________________________________ 4.___________________________________
1.____________________________________________________________________________ _____________________________________________________________________________ 2.____________________________________________________________________________ _____________________________________________________________________________ 3.____________________________________________________________________________ _____________________________________________________________________________ |
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| F O R E I G N I N C O M E - U.S CITIZENS & GREEN CARD HOLDERS ONLY | |||||||||||||||||||||||
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EMPLOYER IN ISRAEL_________________________________________________________ ADDRESS____________________________________________________________________ INCOME______________________________________________________________________ INCOME TAX WITHHELD_______________________________________________________ OTHER TAXES WITHHELD______________________________________________________ |
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| G E N E R A L I N F O R M A T I O N | |||||||||||||||||||||||
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U.S. CITIZEN_________________________ GREEN CARD____________________________ PURPOSE OF VISIT TO U.S._____________________________________________________ _____________________________________________________________________________ TYPE OF VISA ________________ VISA NUMBER__________________________________ DATES ENTERED & LEFT DURING YEAR_________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ NUMBER OF DAYS IN THE U.S. - CURRENT YEAR__________________ PREVIOUS YEAR___________ YEAR BEFORE PREVIOUS____________ DID YOU FILE A U.S. TAX RETURN PREVIOUSLY WHAT YEAR__________ WHAT FORM____________ IRS OFFICE____________________ ARRIVAL IN UNITED STATES___________________________________________________ EXPECTED RETURN TO ISRAEL________________________________________________ OTHER INFORMATION_________________________________________________________ _____________________________________________________________________________ |
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