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Minister’s Income Tax Organizer Compliments of (Right click to print.) larrygiles@mindspring.com |
FOR TAX YEAR
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Your Name |
S.S. No - - |
Birthdate / / |
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Spouses Name |
S.S. No. - - |
Birthdate / / |
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Mailing Address |
Home Phone Number ( ) -- |
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Work Phone Number ( ) -- |
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DEPENDENTS
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NAME |
S.S. NO. |
D.O.B. |
NAME |
S.S. NO. |
D.O.B. |
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Was there anyone else that you have contributed support for last year in the U.S., Canada or Mexico?
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NAME |
S.S. NO. |
RELATIONSHIP |
MONTHS LIVED IN YOUR HOME |
INCOME OF PERSON |
PERCENTAGE OF TOTAL SUPPORT |
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$ |
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$ |
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CHILD OR DEPENDENT CARE
Did you hire a baby-sitter last year?
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NAME OF
SITTER |
S.S. NO. |
ADDRESS |
AMT. PD. |
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$ |
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$ |
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$ |
If your sitter is an adult & works in your home you are required to file W-2 forms by January 31. If you want us to prepare
these forms contact us right away.
ESTIMATED TAXES
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DID YOU PREPAY YOUR FEDERAL
& STATE TAXES BY ESTIMATED TAXES? |
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CREDIT FROM PRIOR YEAR’S VOUCHER PAYMENTS |
FIRST QUARTER (APRIL 15) |
SECOND QUARTER (JUNE 15) |
THIRD QUARTER (SEPT. 15) |
FOURTH QUARTER (JAN. 15) |
TOTAL FOR YEAR |
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Federal $ |
$ |
$ |
$ |
$ |
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State $ |
$ |
$ |
$ |
$ |
$ |
FOR PASTORS & CERTAIN RELIGIOUS WORKERS
Most Ministers need to attach a separate page for
additional information.
PASTORIAL & PROFESSIONAL INCOME
Please Attach all 1099’s
Church Salary $____________________ Does your church assist you in non-taxable compensation?
Bonuses $____________________ If yes, list_________________________________________
Special Services $____________________ Car Payments $____________________
Other Pastorial Incomes $____________________ Car Insurance $____________________
Nature & Source $____________________ House Payments $____________________
Non-Taxable (Free Love Offerings & Gifts) $____________________ Rent Payments $____________________
PROFESSIONAL
EXPENSES
AUTO
EXPENSE PARSONAGE
EXPENSES
Total Miles Driven $____________________ Do You Own? $____________________
Total Professional Miles $____________________ Do you Rent? $____________________
Or Professional Percentage $____________________ Rent $____________________
Car License Fees & Tolls $____________________ Mortgage Interest $____________________
Car Interest $____________________ Property Taxes $____________________ Car Sales Tax $____________________ Gas $____________________
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OPTIONAL
AUTO EXPENSE |
(USE AMOUNTS SPENT) |
Electricity |
$____________________ |
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Gas Expense |
$____________________ |
Water & Sewer |
$____________________ |
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Oil & Lubrication |
$____________________ |
Garbage |
$____________________ |
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Filters |
$____________________ |
Gardening, Yardwork |
$____________________ |
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Auto Club |
$____________________ |
Cleaning |
$____________________ |
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Towing & Auto Rentals |
$____________________ |
Insurance |
$____________________ |
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Washing & Waxing |
$____________________ |
Pest Control |
$____________________ |
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Car Care Products |
$____________________ |
Repairs (list) |
$____________________ |
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Tires |
$____________________ |
Carpentry |
$____________________ |
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Batteries |
$____________________ |
Decorating |
$____________________ |
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Belts & Antifreeze |
$____________________ |
Electrical |
$____________________ |
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Shocks |
$____________________ |
Furnace |
$____________________ |
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Upholstry |
$____________________ |
Air Conditioning |
$____________________ |
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Sound Equipment |
$____________________ |
Filters |
$____________________ |
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Tune-ups |
$____________________ |
Painting Inside |
$____________________ |
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Other Engine Repairs |
$____________________ |
Painting Outside |
$____________________ |
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Other Auto Repairs |
$____________________ |
Plumbing |
$____________________ |
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Insurance |
$____________________ |
Roofing |
$____________________ |
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Lease Payments |
$____________________ |
Carpet |
$____________________ |
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Accident Repairs |
$____________________ |
Carpet Cleaning |
$____________________ |
PROFESSIONAL TRAVEL & ENTERTAINMENT
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PARSONAGE EXPENSE (CONTINUED FROM PAGE 2) |
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Plane Fares* |
_________________________ |
Food |
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Bus & Trains* |
_________________________ |
Households |
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Taxi Fares* |
_________________________ |
Cleaning Supplies |
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Motels & Hotels* |
_________________________ |
Furniture Purchased |
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Out of Town Meals* |
_________________________ |
Appliance Purchased |
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Tips* |
_________________________ |
Appliance Repaired |
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Entertaining Meals Out* |
_________________________ |
Additions |
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Entertaining In Home* |
_________________________ |
Remodeling |
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(Keep receipts & diary for 3 years) |
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Assesments |
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Sound & Video Items |
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House Sitting / Child Care |
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PROFESSIONAL CONTINUING EDUCATION (Not to become a minister) |
What is the fair rental value of your home? |
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Tuition |
_________________________ |
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Books |
_________________________ |
OTHER CAPITAL ITEMS
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School & Study Supplies |
_________________________ |
Did you buy a new or used car? |
_________________________ |
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Transportation Expense |
_________________________ |
If so, how much did it cost? |
_________________________ |
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Meals |
_________________________ |
Did you buy any new equipment? |
_________________________ |
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Lodging |
_________________________ |
Item______________________ |
Cost______________________ |
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Educational Trip Expense |
_________________________ |
Item______________________ |
Cost______________________ |
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Educational Activity Expense |
_________________________ |
Item______________________ |
Cost______________________ |
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Did you buy any expensive sets |
Item______________________ |
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OTHER BUSINESS CONSIDERATIONS Did you minister to a small starting church whose total bank accounts |
of books or music?___________ |
Cost______________________ |
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average less than $5,000? |
_________________________ |
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If so how much did you contribute back to the church? ___________________________ |
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PROFESSIONAL EXPENSES
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Accounting |
_________________________ |
Postage |
_________________________ |
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Advertising |
_________________________ |
Office Rent |
_________________________ |
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Bank Charges |
_________________________ |
Equipment Rent |
_________________________ |
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Casual Labor |
_________________________ |
Office & Equipment Repairs |
_________________________ |
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Commissions |
_________________________ |
Supplies |
_________________________ |
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Dues & Professional Societies |
_________________________ |
License & Professional Fees |
_________________________ |
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Insurance (office or professional) |
_________________________ |
Office Utilities |
_________________________ |
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Interest (professional) |
_________________________ |
Office Telephone |
_________________________ |
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Clerical Uniforms |
_________________________ |
Parsonage Telephone |
_________________________ |
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Laundry & Cleaning |
_________________________ |
Less Personal Long Distance |
_________________________ |
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Legal Fees |
_________________________ |
General Expense |
_________________________ |
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Office Supplies |
_________________________ |
Religious Books |
_________________________ |
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Periodicals |
_________________________ |
Sermon Material |
_________________________ |
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Bibles |
_________________________ |
Miscellaneous Expense |
_________________________ |
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Other (list)_________________ |
_________________________ |
Other (list)_________________ |
_________________________ |
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Other (list)_________________ |
_________________________ |
Other (list)_________________ |
_________________________ |
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PASTOR'S INFORMATION
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Have you excluded yourself from Social Security?________________ If you have been a minister for 2 years or less, do you wish to exclude yourself from Social Security?__________________ |
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Does your spouse work in the ministry?__________________________ Please include all church & ministrial activities including bookkeeping, answering phones, organ playing, babysitting & entertaining |
If so, approximately how many hours a week?___________________ |
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Does your spouse draw a salary from your church?_______________ |
If so, how much last year? |
__________________________ |
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INCOME
Wages, Salaries, Tips, Etc. (Attach W-2s)
Interest income from Seller-Financed Mortgages & Individuals:
Interests from Banks & Financial Institutions (Attach 1099s)
Include all that have your Social Security number on them.
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NAME |
AMOUNT |
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NAME |
AMOUNT |
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_________________________ |
$________________ |
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_________________________ |
$________________ |
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_________________________ |
$________________ |
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_________________________ |
$________________ |
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Did you sell or turn in any U.S. Savings Bonds? |
YES |
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NO |
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If yes, Please list information:___________________________________________________________________________
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Nontaxable Interest: (Attach Information) |
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Did you have any foreign bank accounts? |
YES |
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NO |
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If yes, Please
explain__________________________________________________________________________________
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Did you have any penalties on
Early Withdrawal of Savings Certificates? |
YES |
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NO |
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If yes, list or attach
information__________________________________________________________________________
Dividends: (Attach 1099s)
Capital Gain Distributions: (Attach 1099s)
Nontaxable Distributions: (Attach 1099s)
Exclusions of Reinvested Dividends from Public Utility: Attach Information.
Pensions: (Attach 1099s)
Did you contribute to your pension plan?__________ If yes, have you already recovered your contribution?__________
Did you have any Rollovers?__________If yes, attach 1099 Distribution & Rollover papers.
Alimony: How much did you receive? $_______________
OTHER INCOME
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Estate & Trusts |
$___________________ |
(Attach K-1s) |
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Jury Duty |
$___________________ |
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S-Corporations |
$___________________ |
(Attach K-1s) |
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Other |
$___________________ |
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Partnerships |
$___________________ |
(Attach K-1s) |
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Other |
$___________________ |
Did you have any tips?__________ If yes, did you report your tips to your employer?__________ If not reported, how much did
you receive? $________________.
Prizes & Awards $_______________ State Tax Refund $_______________ Unemployment Compensation $_______________
Lump Sum Distributions $_______________ (Attach 1099s)
Gains & Losses
from Sale of Property, Stock, Etc.
|
Description |
Date Bought |
Date Sold |
Sale Price |
Cost & Expense |
Gain or Loss |
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_______________________________ |
___/___/___ |
___/___/___ |
$___________ |
$___________ |
$__________ |
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_______________________________ |
___/___/___ |
___/___/___ |
$___________ |
$___________ |
$__________ |
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_______________________________ |
___/___/___ |
___/___/___ |
$___________ |
$___________ |
$__________ |
SALE OF RESIDENCE - Please send or bring escrows of purchase & sale of new house. Also list improvements on old house.
DID YOU HAVE ANY
OTHER INCOME FROM ANY OTHER SOURCE?
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Source |
_____________________________________ |
Amount |
$_______________ |
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Source |
_____________________________________ |
Amount |
$_______________ |
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Source |
_____________________________________ |
Amount |
$_______________ |
SOCIAL SECURITY
How much did you receive? $_______________ How much did your spouse receive?_______________ (Attach 1099s)
If you paid any individuals or Partnership $600.00 or more for rent or services, you are required to file 1099s prior to
February 28th. If you want us to prepare these please contact us right away.
FARM INCOME - If you had any Farm Income, Farm Expenses, attach or bring in the information.
BUSINESS INCOME / BUSINESS EXPENSES (FOR
SELF EMPLOYED)
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What is the main business activity?________________________________________________________________________________________________ |
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Business Name_____________________________________________________________________________________ |
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Business Address____________________________________________________________________________________ |
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How much is your gross business income ?_____________ (Attach 1099s) |
How much did you spend on:
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Merchandise |
$________________ |
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Real Estate Taxes |
$________________ |
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Costs of Goods |
$________________ |
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Other Taxes & Licenses |
$________________ |
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Materials & Supplies |
$________________ |
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Travel (no meals) |
$________________ |
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Advertising |
$________________ |
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Meals & Entertainment |
$________________ |
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Bad Debts |
$________________ |
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Utilities & Telephone |
$________________ |
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Car & Truck Expense |
$________________ |
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Wages & Salaries |
$________________ |
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Commissions |
$________________ |
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Bank Service Charges |
$________________ |
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Insurance (other than health) |
$________________ |
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Tools |
$________________ |
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Mortgage Interest |
$________________ |
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Uniforms |
$________________ |
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Other Interest Paid |
$________________ |
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Safety Items |
$________________ |
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Legal & Professional Fees |
$________________ |
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Freight & Shipping |
$________________ |
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Office Expenses |
$________________ |
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Dues & Publications |
$________________ |
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Rent on Business Property |
$________________ |
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Laundry & Cleaning |
$________________ |
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Equipment Rentals |
$________________ |
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(other) |
$________________ |
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Repairs |
$________________ |
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(other) |
$________________ |
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Supplies |
$________________ |
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(other) |
$________________ |
INCOME FROM PROPERTY RENTAL
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RENTAL 1 |
RENTAL 2 |
RENTAL 3 |
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Rents Received (Attach all 1099s) |
$__________________ |
$__________________ |
$__________________ |
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Advertising Costs |
$__________________ |
$__________________ |
$__________________ |
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Association Dues |
$__________________ |
$__________________ |
$__________________ |
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Auto & Travel |
$__________________ |
$__________________ |
$__________________ |
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Cleaning & Maintenance |
$__________________ |
$__________________ |
$__________________ |
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Commissions |
$__________________ |
$__________________ |
$__________________ |
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Gardening |
$__________________ |
$__________________ |
$__________________ |
|
Insurance |
$__________________ |
$__________________ |
$__________________ |
|
Legal & Professional Fees |
$__________________ |
$__________________ |
$__________________ |
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Licenses & Permits |
$__________________ |
$__________________ |
$__________________ |
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Management Fees |
$__________________ |
$__________________ |
$__________________ |
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Miscellaneous |
$__________________ |
$__________________ |
$__________________ |
|
Mortgage Interest |
$__________________ |
$__________________ |
$__________________ |
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Other Interest Paid |
$__________________ |
$__________________ |
$__________________ |
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Painting & Decorating |
$__________________ |
$__________________ |
$__________________ |
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Painting Equipment ( brushes, ladders, etc. ) |
$__________________ |
$__________________ |
$__________________ |
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Pest Control |
$__________________ |
$__________________ |
$__________________ |
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Plumbing & Electrical |
$__________________ |
$__________________ |
$__________________ |
|
Repairs |
$__________________ |
$__________________ |
$__________________ |
|
Supplies |
$__________________ |
$__________________ |
$__________________ |
|
Cleaning Supplies |
$__________________ |
$__________________ |
$__________________ |
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Tools |
$__________________ |
$__________________ |
$__________________ |
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Taxes |
$__________________ |
$__________________ |
$__________________ |
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Telephone |
$__________________ |
$__________________ |
$__________________ |
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Utilities |
$__________________ |
$__________________ |
$__________________ |
|
Wages & Salaries |
$__________________ |
$__________________ |
$__________________ |
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Other (list) |
$__________________ |
$__________________ |
$__________________ |
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Other (list) |
$__________________ |
$__________________ |
$__________________ |
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Other (list) |
$__________________ |
$__________________ |
$__________________ |
RENTAL INCOME (continued)
What type of property is the rental? (i.e. four bedroom house, warehouse, trailer park, etc.)
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RENTAL 1________________________ |
RENTAL 2________________________ |
RENTAL 3________________________ |
When did you purchase your rental property? (Mm/Yy)
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RENTAL 1................_______/_______ |
RENTAL 2................_______/_______ |
RENTAL 3 ...............________/_______ |
How much did the rental property cost you?
|
RENTAL 1 $______________________ |
RENTAL 2 $______________________ |
RENTAL 3 _______________________ |
Did you have any Farm Rental Income? __________ If yes, attach information.
Did you have any Royalties? __________If yes, attach information & 1099s.
PERSONAL ITEMIZED DEDUCTIONS
MEDICAL
How much did you spend on:
|
Medicines |
$_____________________ |
Drugs |
$_____________________ |
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NAME |
Amount Paid After Insurance Reimbursement |
NAME |
Amount Paid After Insurance Reimbursements |
|
Doctors:______________________________ |
$_____________ |
Specialists:_________________________ |
$_____________ |
|
____________________________________ |
$_____________ |
_________________________________ |
$_____________ |
|
____________________________________ |
$_____________ |
_________________________________ |
$_____________ |
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Dentists: _____________________________ |
$_____________ |
Chiropractors:______________________ |
$_____________ |
|
____________________________________ |
$_____________ |
_________________________________ |
$_____________ |
|
____________________________________ |
$_____________ |
__________________________________ |
$_____________ |
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Orthodontists: _________________________ |
$_____________ |
Clinics:____________________________ |
$_____________ |
|
____________________________________ |
$_____________ |
_________________________________ |
$_____________ |
|
____________________________________ |
$_____________ |
_________________________________ |
$_____________ |
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Practitioners:__________________________ |
$_____________ |
Hospitals:__________________________ |
$_____________ |
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____________________________________ |
$_____________ |
_________________________________ |
$_____________ |
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Transportation & Lodging________ |
$_____________ |
Insurance Premiums |
$_____________ |
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Prenatal Care |
$__________________ |
Postnatal |
$__________________ |
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Eyeglasses |
$__________________ |
Hearing Aids |
$__________________ |
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X-Rays |
$__________________ |
Lab Fees |
$__________________ |
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Medical Lodging |
$__________________ |
Bandages |
$__________________ |
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Therapy Equipment |
$__________________ |
Crutches |
$__________________ |
|
Medical Supplies & Appliances |
$__________________ |
Diabetic Expense |
$__________________ |
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Prosthesis Expense |
$__________________ |
Therapy Pool |
$__________________ |
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Required Air Conditioning Expense |
$__________________ |
Electrical Expense |
$__________________ |
|
Repairs & Filters |
$__________________ |
Medicare |
$__________________ |
TAXES
Did you pay State Taxes last year? __________________________________ How much? $________________________
Did you pay State Taxes last year for prior years _______________________ How much? $________________________
|
Auto License Fee |
$___________________ |
Auto Sales Tax |
$___________________ |
|
Real Estate Taxes |
$___________________ |
Property Taxes |
$___________________ |
|
Irrigation Taxes |
$___________________ |
Personal Property Taxes |
$___________________ |
|
Boat Taxes |
$___________________ |
Other Taxes |
$___________________ |
Did you buy any cars, boats, motorcycles, R.V.s, trailers, mobile homes, airplanes, etc.?_______________ (Attach Information.)
DEDUCTIONS
(CONTINUED)
INTEREST: (Attach all 1099s)
|
1ST HOME |
NAME |
AMOUNT |
2ND HOME |
NAME |
AMOUNT |
|
Mortgages.................. |
_______________ |
$_____________ |
Mortgages.................. |
_____________ |
$______________ |
|
2nd Home Mortgage.. |
_______________ |
$_____________ |
2nd Home Mortgage... |
_____________ |
$______________ |
|
Late Charges.............. |
_______________ |
$_____________ |
F.H.A. Charges |
_____________ |
$______________ |
|
Mortgage Insurance... |
_______________ |
$_____________ |
Real Estate Loan Fees (Points) ______________ |
_____________ |
$______________ |
CONTRIBUTIONS
How much money did you give to:
|
Churches |
$__________________ |
|
Payroll Deductions |
$__________________ |
|
Missions |
$__________________ |
|
Youth Programs |
$__________________ |
|
Evangelists |
$__________________ |
|
Muscular Dystrophy |
$__________________ |
|
Bazaar |
$__________________ |
|
Salvation Army |
$__________________ |
|
Public Schools |
$__________________ |
|
County Fairs |
$__________________ |
|
Jaycees |
$__________________ |
|
Boy - Girl Scouts |
$__________________ |
|
Heart Fund |
$__________________ |
|
Xmas / Easter Seals |
$__________________ |
|
Cancer Fund |
$__________________ |
|
United Way |
$__________________ |
Did you donate any non - cash items such as food or used clothing? ____________________________________________________
Miscellaneous
|
Union Dues |
$__________________ |
|
Spouse Dues |
$__________________ |
|
Tax Preparer Fee |
$__________________ |
|
Audit Fees |
$__________________ |
|
Extension Fees |
$__________________ |
|
Business Dues |
$__________________ |
|
Books & Publications |
$__________________ |
|
Safety Items |
$__________________ |
|
Fire Retardant Clothing |
$__________________ |
|
Safety Boots |
$__________________ |
|
Protective Eye Wear |
$__________________ |
|
Mosquito Spray |
$__________________ |
|
Gloves |
$__________________ |
|
Work Watch |
$__________________ |
|
Tools |
$__________________ |
|
Flashlights |
$__________________ |
|
Batteries |
$__________________ |
|
Water Jugs |
$__________________ |
|
Uniforms |
$__________________ |
|
Telephone for Business |
$__________________ |
|
Cleaning |
$__________________ |
|
Protective Headgear |
$__________________ |
|
Investment Expense |
$__________________ |
|
Sales & Promo Costume |
$__________________ |
|
Adoption Expense |
$__________________ |
|
Safety Deposit Box |
$__________________ |
|
Record Keeping Costs |
$__________________ |
|
Safety Glasses |
$__________________ |
|
Other ( list ) |
$__________________ |
|
Other ( list ) |
$__________________ |
EDUCATION EXPENSE
|
Name of Institution |
___________________ |
|
Dates Attended |
___________________ |
|
Education Purpose |
___________________ |
|
Tuition Expense |
$__________________ |
|
Travel Expense |
$__________________ |
|
Supplies Expense |
$__________________ |
EMPLOYEE BUSINESS EXPENSE
Did you use your auto on the job to run errands, chase parts, carry job tools or other wise use your auto for your employer?
Please include Job Hunting. Please explain : ______________________________________________________________________
How many miles did you drive for the year ? ________________ How many miles did you drive for business ? ________________
Did you purchase an auto last year ? ________________ Please enclose purchase papers.
What kind of auto do you have ? Make ______________ Model _________________ Year_________________
|
Auto License Fee |
$__________________ |
|
Auto Sales Tax |
$__________________ |
|
Auto Interest |
$__________________ |
|
Parking & Tolls |
$__________________ |
OPTIONAL
|
Oil & Lubrication |
$__________________ |
|
Auto Club |
$__________________ |
|
Washing & Polishing |
$__________________ |
|
Tires, Batteries, Etc. |
$__________________ |
|
Repairs |
$__________________ |
|
Insurance |
$__________________ |
|
Fuel |
$__________________ |
|
Other ( list ) |
$__________________ |
TRAVEL &
EXPENSES OTHER THAN AUTO
|
Plane & Rail Fares |
$__________________ |
|
Bus Fares |
$__________________ |
|
Taxi & Public Transit |
$__________________ |
|
Car Rentals |
$__________________ |
|
Lodging |
$__________________ |
|
Meals |
$__________________ |
|
Telephone, Fax, Postage |
$__________________ |
|
Tips & Baggage Charge |
$__________________ |
|
Laundry & Cleaning |
$__________________ |
|
Other ( list ) |
$__________________ |
SALES EXPENSE
|
Lunches, Dinners, Etc. |
$__________________ |
|
Show & Event Tickets |
$__________________ |
|
Organization Dues |
$__________________ |
|
Gifts |
$__________________ |
|
Stationary & Postage |
$__________________ |
|
Basic Phone |
$__________________ |
|
Other ( list ) |
$__________________ |
|
Long Distance Phone |
$__________________ |
|
|
|
|
|
|
|
|
|
|
|
|
Did you make any modifications to your home for the handicapped ? Please Describe :_____________________________________
Cost of modifications $______________________________
Transportation Cost $__________ Storage Cost $________ Travel & Lodging $___________
How much were you reimbursed that was not included in your wages? $___________
Did you or your spouse contribute to an IRA or KEOGH ? $_____________________________
Do you or your spouse have a retirement plan at work ? ________________________________
Did you pay alimony ? _________ How much ? ____________________________________
Recipients Last Name & S. S. # ___________________________________________________
DECLARATION :
I have provided the
information on this form to the best of my knowledge and hereby declare it is
complete and ready for the preparation of my/our income tax returns. Where business deductions shown, I
acknowledge having spent these amounts and have kept a log or diary of such activities, pursuant to section 274(a) and can fully substantiate such
deductions.
__________________________________________ __________________________________________
SIGNATURE (must be signed) DATE