First Name required
Last Name required
Spouse First Name
Spouse Last Name
Address 1 required
Address 2
City required
State required
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
ZIP Code required
Work Telephone
Home Telephone required
E-Mail Address required
Filing Status
Married
Married, Filing Separate
Single
Head of Household
Number of Dependent Children
Number of Other Dependents
Did you ever live in more than one state during the year?
Yes
Other State:
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
How many months?
Do you own your own primary residence?
Yes
Do you own a secondary residence?
Yes
Do you have a self-employed business you operate?
If so, how many?
Are you a partner in a business or investment?
If so, how many?
Are you a stockholder in an "S" corporation?
If so, how many?
Are you a member in an LLC?
If so, how many?
Do you own rental properties?
If so, how many?
How many W-2's do you have?
Approximate W-2 income
$
Interest Income
Do you have Interest Income?
Yes
How many Interest Income Accounts do you have?
Approximate Interest income
$
Dividend Income
Do you have Dividend Income?
Yes
How many Dividend Income Accounts do you have?
Approximate Dividend income
$
Capital Gains
Did you sell any investments this year?
Yes
How many sales this year?
Approximate gain or loss
$
Do you have pension income?
Yes
Do you recieve Social Security income?
Yes
Do you make Roth or IRA income?
Yes
Do you have undergraduate college students?
Yes
Do you have childcare expenses?
Yes
Do you usually owe tax with your return?
Yes
Do you make tax estimates?
Yes
Do you take a deduction for Home Office?
Yes
How many charities do you contribute to?
Do you make non-cash contributions of more than $500
Yes
Do you have unreimbursed employee expenses
Yes
Do you use your car on the job?
Yes
Do you have any Business, Rental, or other assets you deprecate?
If so, how many?
Did you sell any business or rental assets?
If so, how many?
Please explain any other income or deduction that was not listed above or affects the above results.
Additional Comments: