2020 Tax Questionnaire

Name(s):   

  

If married who is in charge of the taxes?:


Best Phone Number:  

  

Preferred Email:

*Read Carefully*

Engagement Letter Acknowledgement:

The link below will take you to our 2021 Engagement Letter for Income Tax Preparation. Please review and confirm your understanding of the Terms & Conditions set forth. By clicking the check box below, “YES, I agree to the Terms & Conditions outlined in the 2021 Engagement Letter for Income Tax Preparation”, you have accepted and confirmed your understanding of our tax preparation engagement for the 2021 Tax Year.

If you click “NO, I don’t agree”, you do not need to continue completing the Tax Questionnaire, we will remove you from our tax preparation list.

https://annehollidaycpa.com/1040engagementletter.html

YES I agree.

NO I don’t agree. Please remove me from your tax preparation list.

Tax Return(s) Delivery Method:

Would you prefer secure electronic delivery of your completed tax return package INSTEAD of paper copies being mailed?

  • By indicating “YES”, we will securely email you the completed tax return package for your review. The tax return package will include your Instruction Letter, Tax Preparation Invoice, Tax Return(s), Estimated Payments if required, and your original documents/data used to prepare the return(s). Your original tax documents will NOT be returned to you by US mail, we will safely/securely destroy the documents once we save an electronic copy for our files. We will email the tax return package to the email address you indicated as the preferred email listed above.
  • By indicating “NO”, we will mail you the completed tax return package via US Mail including the original tax documents that were provided to us.

Please select an option below:

YES Securely email me the tax return package to review.

NO Send the tax return package by US mail.

Tax Data Submission:

Would you like to submit your tax data to us electronically via a secure portal?

  •  If you check, “YES”, we will send you a secure link with instructions on how to upload your data.
  •  Other data delivery options: Mail, fax, or use our secure drop box located outside the office to deliver your tax data. Please note the office is not currently open to the public.

YES please send me a link.

NO

Appointment with Anne:

Do you have tax, financial, or planning issues that you need to discuss? We can schedule a call or Zoom meeting. Please indicate the preferred day of the week and time in the comment box below.

YES I need an appointment with Anne.

NO I’m all set for now.

For any “YES” answers, please provide the applicable supporting documents when you submit your 2021 tax information.

VIRTUAL CURRENCY:

1. Did you have any sales or exchanges of virtual currency? If, YES, please provide documentation of the transactions with your tax data, and in the comment box below, list ALL of the Crypto currency exchange(s) you utilize. (Ex. Coinbase, Kraken, Binance.)

YES

 

NO

2. Did you use virtual currencies to pay for goods and/or services? If, YES, please provide documentation of the transactions with your tax data.

YES

NO

3. Are you holding virtual currencies as an investment? If, YES, please provide documentation of the transactions with your tax data.

YES

NO

ECONOMIC IMPACT PAYMENT #3 (EIP #3)

The third round of Economic Impact Payments are reconciled on the 2021 tax return. EIP #3 was issued in March, 2021.  We will need the EXACT amount of the payment received. If you do not have the exact amount, you’ll need to setup/log into your online IRS Taxpayer Account to get the exact dollar amount of EIP #3.  

IRS website: https://www.irs.gov/payments/view-your-tax-account

YES I have the amount of EIP #3 now and I’ll enter the amount received in the comment box below.

NO I do not have this information available right now, I will provide it with my tax data.

FAMILY INFORMATION:

1. Did your marital status change during the year?  If, YES, provide the date of marriage/divorce/death in the comment box.

YES

 NO

2. Did your mailing address change from last year? If, YES, please indicate your new mailing address in the comment box.

YES

NO

3. Did you change the bank account used to direct deposit funds from the IRS or another taxing authority? If, YES, please provided a voided check with your tax data.

YES

NO

4. Did your child (who you list as a dependent on your tax return) file their own tax return(s)? If, YES, please provide a copy of their tax return(s) with your tax data.

YES

NO

5. Do you have any child under the age of 19 with income from interest, dividends, stock sales or capital gains in excess of $2,200? If, YES, please include their Consolidated 1099 with your tax data.

YES

NO

6. Did you (or your spouse) renew your Driver’s License in 2021? If YES, please provide a legible copy of the front of the new license with your tax data. If this is the first year, we are preparing your tax return(s) please include a copy of your Drivers’ License.

YES

NO

7. Did you receive an Identity Theft PIN from the IRS? If YES, provide the IRS letter with the six-digit PIN number with your tax data.

YES

NO

8. Would you like to designate $3 to the Presidential Election Campaign Fund? This will not change your tax liability or reduce your refund.

YES

NO

9. Have your dependents changed? (Birth/adoption, death, got their own job, or moved back into your home) If YES, provide detail in the comment box below.

YES

 

NO

INCOME INFORMATION

1. Did you sell any real estate? If YES, provide the Settlement Statement given to you at closing with your tax data.

YES

NO

2. Did you make any withdrawals from a qualified retirement plan? If YES, provide Form 1099-R with your tax data.

YES

NO

3. Did you receive any Social Security benefits? If YES, provide Form SSA-1099 with your tax data.

YES

NO

4. Did you receive any unemployment? If YES, provide Form 1099-G with your tax data.

YES

NO

5. Did you receive any awards, prizes, hobby income, gambling, or lottery winnings? If YES, provide Form W-2G and/or Form 1099-MISC or any other details, with your tax data.

YES

NO

6. Did you have any debts cancelled or forgiven? If YES, provide Form 1099-C with your tax data.

YES

NO

TAX CREDITS:

1. Did you receive Advanced Payments of the Child Tax Credit? If YES, please provide the exact dates and amounts of payments received with your tax data. If you do not have the exact amount, you’ll need to setup/log into your online IRS Taxpayer Account to get the exact dollar amount.

IRS website: https://www.irs.gov/payments/view-your-tax-account

YES

NO

2. Did you pay for childcare while you worked, or looked for work? If YES, please provide the name, address, Employer ID number, and cost per child, per provider with your tax data.

YES

NO

3. Did you have any educational expenses during the year for yourself, your spouse, or your dependents? If YES, provide Form 1098-T with your tax data.

YES

NO

4. If you are self-employed, were you impacted by COVID during the period January 1, 2021 through March 31, 2021 by any of the following? Please check all that apply.

YES  Subject to quarantine or had COVID symptoms, indicate number of days impacted in the comment box. [when this box is checked, can a comment box open]

YES  You cared for an individual required to quarantine or that had COVID. Indicate number of days impacted in the comment box. [when this box is checked, can a comment box open]

YES  Your child’s school was closed, and you missed work to care for the child. Indicate number of days impacted in the comment box. [when this box is checked, can a comment box open]

Not Applicable

DEDUCTIONS:

1. Did you make any contributions to an IRA, ROTH, SIMPLE, SEP or 401(k)? If YES, please indicate the type of plan you contributed to and the amount of the 2021 contribution made in the comment box below.

YES

NO

2.  Would you like us to calculate your 2021 maximum allowable IRA or retirement plan contribution for you?

YES, please indicate your preference in the comment box below.

NO [if NO, skip question 4 of this section]

3. You have answered, “YES”, to question 3 – maximum allowed retirement plan contribution. Do you need us to       check with you before we prepare the retirement with that maximum contribution?

YES, email me to approve maximum contribution prior to proceeding with tax preparation.

NO, email necessary, I’ll make the maximum contribution you calculate for use on my/our tax return.

4. Did you make any contribution or withdrawals to a Health Savings Account (HSA)? If YES, provide Form 1099-SA and/or Form 5498-SA with your tax data.

YES

NO

5. Did you pay Student Loan interest? If YES, provide Form 1098-E with your tax data.

YES

NO

ITEMIZED DEDUCTION INFORMATION:

1. Did you have out-of-pocket medical expenses, including premiums, greater that 7.5% of your income?

YES

NO

2. Did you or your spouse pay Long Term Care Premiums? If YES, provide the amount you paid for each policy with your tax data.

YES

NO

3. Did you make any non-cash contributions? (ex. clothing, furniture, books) valued greater than $500? If YES, provide the organization name, address, date and value of the items donated with your tax data. All donation receipts must include value, regardless of the amount.

YES

NO

4. Real Estate: Did you take out a Home Equity loan? If “YES”, provide the Settlement Statement with your tax data.

YES

NO

5. Real Estate: Did you refinance a principal residence or second home? If “YES”, provide the Settlement Statement with your tax data.

YES

NO

PAYMENTS:

1. Did you make Federal (IRS) Estimated Payments for 2021? If YES, provide the dates and amounts of each payment in the comment box below or with your tax data. Include any payments that were made in 2022 for 2021 if applicable.

YES  (Payment date and amount paid in box below)

  

NO

2. Did you make State Estimated Payments for the 2021 Tax Year? If YES, provide the dates and amounts of each payment in the comment box below or with your tax data. Include any payments that were made in 2022 if applicable.

YES  (Payment date and amount paid ion box below)

 

NO

MISCELLANEOUS:

1. Were you and your spouse (and applicable dependents) covered with health insurance purchased through the Marketplace (aka “The Healthcare Exchange”)?

YES, provide Form 1095A with your tax data.

NO

If you live in Massachusetts, provide Form 1095 MA-HC with your tax data.

2. Do you have your Legacy Planning documents in place? (ex. Will, Living Will, Power of Attorney, Advanced Directives, Trust).

YES – Legacy Planning documents are in place.

NO – Legacy Planning documents are NOT in place, currently, but intend to address this in 2022.

HELP – I need help creating/drafting documents

3. Did you pay any individual $2,300 or more as a household employee (ex. Nanny, tutor, housekeeper, aide, etc...)?

YES

NO

4. Do you have any foreign financial assets, other than those held in mutual funds? If YES, provide the year-end statement, and highest balance during 2021, for each account with your tax data.

YES

NO

5. Did you make any gift(s) to an individual that totaled more than $15,000 per person in 2021? If YES, we will contact you to gather additional information.

YES

NO

6. Were you notified by mail, or audited, by either the IRS or State taxing agency? If YES, provide the correspondence with your tax data. If we assisted with the correspondence or audit, you do NOT need to provide another copy of the notice.

YES

NO

7. Please use the comment box below to indicate any questions, comments, or notes about any subject matter. It is tax season…...comic relief is always appreciated!! AND random prizes will be awarded!



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