Resume

Tax Credit Data

Location:

Riverview, FL

Salary:

25.00

Posted:

November 25, 2023

Contact this candidate

Resume:

LETTER OF ENGAGEMENT

OUR RESPONSIBILITIES

Our work (whether consultation, tax return, tax plan or related product) is based on data you provide.

• We are not responsible to audit or verify the data that you give to us.

• We may ask for clarification of your data or additional information.

• We are not responsible to discover fraud or other irregularities, should any exist.

• We will work to find all the credits and deductions you are legally entitled to. YOUR RESPONSIBILITIES

• To provide all the information required for a complete and accurate finished product.

• To provide this information in a timely manner.

• To retain, with the completed work, all the documents, cancelled checks and other data that form the basis of income and deductions since you may later have to provide them to a taxing authority.

• To carefully review all work completed by our office before you sign. You have the final responsibility for anything submitted to a taxing authority.

• You are responsible not to commit fraud.

• You are responsible to let us know if you received Child Tax Credit Payments in 2021, If you did not receive your stimulus payment 1, 2, and 3 payment, 1099k Form, and Unemployment 1099 Form. PENALTIES, EXAMINATIONS AND NOTICES

The IRS and state taxing authorities impose penalties for certain offenses, including understatement of income, filing after the deadline, underpaying estimated taxes, or under withholding taxes (If you would like more information, please contact us.) They can also select any return for examination. PRIVACY POLICY

Tax preparers are bound by professional standards of confidentiality. Therefore, we have always protected your right to privacy. For current and former clients, we do not disclose any nonpublic personal information obtained in the course of our practice except as required or permitted by law, and as is necessary to properly provide our services to you. Types of Nonpublic Personal Information We Collect. We collect nonpublic personal information about you that is provided to us by you or obtained by us with your authorization.

Parties to Whom We Disclose Information. We make available information to our employees and to nonaffiliated third parties who need to know that information to assist us in providing services to you. In all such situations, we require a contractual agreement that includes procedural safeguards that protect the confidential nature of the information being shared. Protecting the Confidentiality and Security of Current and Former Client Information. We retain records relating to professional services that we provide so that we are better able to assist you with your professional needs and, in some cases, to comply with professional guidelines. In order to guard your nonpublic personal information, we maintain physical, electronic, and procedural safeguards that comply with our professional standards.

OUR FEES

We invoice for time spent, depending on schedules and forms completed and out-of-pocket expenses incurred. Our rates vary depending on the nature of the work performed. We may invoice for partially completed work that is placed on extension or remains undone. TAX DOCUMENTS

All clients are provided a copy of their tax documents at the conclusion of their tax preparation, if return is e-filed to the IRS. Tax documents are issued via email or in office only. In order to provide you with a copy of your tax documents, tax return must be e-filed and submitted to the IRS. Any additional copies of your e-filed tax documents are $50 per year.

*A retainer will be required when working on ALL tax returns and before undertaking projects for new clients. ARBITRATION

If a dispute arises out of or relates to this contract or engagement letter, or the obligations of the parties therein, and if the dispute cannot be settled through negotiation, the parties agree first to try in good faith to settle the dispute by mediation administered by the American Arbitration Association under its commercial Mediation Rules before resorting to arbitration, litigation, or some other dispute resolution procedure. AGREEMENT

The foregoing is in accordance with my (our) understanding of your engagement to provide tax and financial services and you are hereby advised that each item of revenue or expense can be substantiated by receipts, cancelled checks, or other documents. This information is true, correct, and complete to the best of my (our) knowledge. Further, it is my (our) understanding that these terms will continue to be in force for the succeeding years of our engagement. Print Taxpayer Name Date: Taxpayer Signature Date: Print Spouse’s Name (if applicable) Date: Spouse Signature (if applicable) Date: Household/Living Expense form for Self Employed

What is the amount of your rent monthly?

Monthly total: Yearly total:

What is the amount of your utility bill monthly?

Monthly total: Yearly total:

What is amount you spend on expense for you dependents? Monthly total: Yearly total:

What is the amount of your water bill monthly?

Monthly total: Yearly total:

What is the amount of your car payment monthly or transportation? Monthly total: Yearly total:

What is the amount of your car insurance monthly?

Monthly total: Yearly total:

What is the amount for groceries monthly?

Monthly total: Yearly total:

What is the amount of your cell phone monthly?

Monthly total: Yearly total:

What is the amount for Wi-Fi monthly?

Monthly total: Yearly total:

What is the amount you spend on gas (Car) monthly? Monthly total: Yearly total:

What is the amount you spend on household supplies monthly? (Laundry, cleaning supplies, etc) Monthly total: Yearly total:

What is the amount you spend on the up-kept of your home monthly? (Lawn, Garbage, maintenance, etc ) Monthly total: Yearly total:

What is the amount you spend on clothing year (Tax Payer & Dependents) ? Monthly total: Yearly total:

Monthly Household Expense Total:

Yearly Household Expense Total:

My signature below certifies that the Household/Living Expense information is accurate and true. If audited, I can supply the necessary documentation to substantiate for the information provided above. Taxpayer Print Name: Date: Taxpayer Signature: Date: Client Tax Organizer

Please provide for your appointment

− Last year's tax return (new clients only) All statements (W2’s, 1098s, 1099s, Business Income Statements)

− Name and address label (from government booklet or card) Tax Payer Verification for Filing Status (Must have)

State Issue ID Passport Marriage license Other Tax Payer Address Verification Address Verification (Must have)

Utility Bill Lease Rent Statement Bank Statement Other: Tax Payer Dependency Relationship Verification (Must have)

Birth Certificate (must have) Social Security Card (must have) Other: Tax Payer Dependent Residency Verification (Must have one)

School Records Medical Record Shot Record Government Statement Other: How do you hear about us? Please complete this Organizer before your appointment. Prior year clients should use the proforma Organizer provided. 1. Personal Information

Name Soc. Sec. No. Date of Birth Occupation Cell phone Taxpayer

Spouse

Street Address Apartment # City State ZIP

New Client or Returning client Work Phone Cell phone provider Identity Protection PIN Taxpayer Spouse Filling Status

Blind Yes No Yes No Single Married Filing Separately Disabled Yes No Yes No Head of Household Qualified Widower date of Spouse’s death: Pres. Campaign Fund Yes No Yes No Married, Filing Jointly 2. Dependents (Children & Others)

Name

(First, Last) Relationship Date of Birth

Social Security

Number

Months

Lived

With

You

Disabled

Full Time

Student

Dependent's

Gross Income

Protection

EITC Dependent Section (Relationship/Support/Residency): Dependent 1:

Name: 1. Is the dependent being claimed on your 2022, tax return your biological son or daughter? Yes No If no, explain relationship: 2. Is the dependent adopted? Yes No.

If yes, what proof can you provide? 3. Did you claim the dependent on your 2021 tax return? Yes No If no, Explain: Taxpayer Email: Taxpayer Spouse Email:

4. Did the dependent live with you more than 6 months in 2022? Yes No If yes, what months in 2022 did the dependent live with you? 5. Did the dependent live with anyone else for part of the year of 2022? Yes No If yes, what months? And with who? 6. Did you receive any support from the other biological parent in 2022? Yes No If yes, how much, and what type? 7. What is the biological parent’s first and last name? 8. What city/state is the biological parent located? 9. For which months did you receive support from the biological parent in 2022? 10. Why is the other biological parent not claiming the dependent in 2022? Explain: 11. Check the records you can provide for your dependent in 2022:

school records medical records birth certificate shot record other 12. Did you receive any additional income support in 2022 for the dependent? Gifts, Loans, Family Assistance, Credit Cards, etc. . Yes No If yes, what was is the amount you receive $ Dependent 2:

Name: 1. Is the dependent being claimed on your 2022, tax return your biological son or daughter? Yes No If no, explain relationship: 2. Is the dependent adopted? Yes No. If yes, what proof can you provide? 3. Did you claim the dependent on your 2021 tax return? Yes No If no, Explain: 4. Did the dependent live with you more than 6 months in 2022? Yes No If yes, what months in 2021 did the dependent live with you? 5. Did the dependent live with anyone else for part of the year of 2022? Yes No If yes, what months? And with who? 6. Did you receive any support from the other biological parent in 2022? Yes No If yes, how much, and what type? 7. What is the biological parent’s first and last name? 8. What city/state is the biological parent located? 9. For which months did you receive support from the biological parent in 2022? 10. Why is the other biological parent not claiming the dependent in 2022? Explain: 11. Check the records you can provide for your dependent in 2022:

Name: 1. Is the dependent being claimed on your 2022, tax return your biological son or daughter? Yes No If no, explain relationship: 2. Is the dependent adopted? Yes No. If yes, what proof can you provide? 3. Did you claim the dependent on your 2021 tax return? Yes No If no, Explain: 4. Did the dependent live with you more than 6 months in 2022? Yes No If yes, what months in 2022 did the dependent live with you? 13. If your dependent is under 13 and did not attend daycare/childcare who took care of the dependent after school while your at work? 13. If your dependent is under 13 and did not attend daycare/childcare who took care of the dependent after school while your at work? Name: (First/Last) Relationship to Tax Payer: Location: Name: (First/Last) Relationship to Tax Payer: Location: 5. Did the dependent live with anyone else for part of the year of 2022? Yes No If yes, what months? And with who? 6. Did you receive any support from the other biological parent in 2022? Yes No If yes, how much, and what type? 7. What is the biological parent’s first and last name? 8. What city/state is the biological parent located? 9. For which months did you receive support from the biological parent in 2022? 10. Why is the other biological parent not claiming the dependent in 2022? Explain: 11. Check the records you can provide for your dependent in 2022:

1. Did you receive any government assistance in 2022? Yes No 2. Did you receive Food Stamps in 2022? Yes No Amount Receive: $ For what month(s) did you receive assistance: 3. Did you receive Medicaid in 2022: Yes No

For what month(s) did you receive assistance: 4. Did you receive Housing Assistance in 2022: Yes No Amount Receive: $ For what month(s) did you receive assistance: 5. What address did you use in 2022 to claim housing assistance? Home Address: City: State: Zip: 6. Did you receive Dependent Care Assistance in 2022: Yes No Amount Receive: $ For what month(s) did you receive assistance: Additional Household Support Verification:

1. Did anyone else live in your home in 2022? Yes No If yes, please fill out the information below.

2. What is their relationship to the tax payer? 3. How many months did they stay in your home in 2022? 4. What is the amount they paid in rent or household support monthly 2022? 13. If your dependent is under 13 and did not attend daycare/childcare who took care of the dependent after school while your at work? Name: (First/Last) Relationship to Tax Payer: Location: 11.

Did you have any children under the age of

19 or 19- to 23-year-old students with

unearned income of more than $1100?

Yes No 29.

Have you or your spouse been a victim of

identity theft and given an identity theft

protection PIN by the IRS? If yes, enter the six-

digit identity protection PIN number.

Taxpayer Spouse

Yes No

12.

Did you purchase a new alternative

technology vehicle or electric vehicle?

Yes No 30.

Did you need to set up you LLC and EIN

number for your business?

Yes No

Yes No 31.

Have your tax refund ever been taken by the

IRS for owing a past due debt?

Yes No

Yes No 32. Do you have any student loans debt? Yes No 13. Did you receive stimulus 1 payment?

14. Did you receive stimulus 2 payment?

15. Did you receive stimulus 3 payment? Yes No 33. Do you have any child support debt? Yes No 16.

Did you receive child tax credit monthly

Yes No 34. Do you have any IRS debt? Yes No 17.

payments in 2022?

How much did get back on your last year tax return? 35.

Do you have any financial debt that would

prevent you from getting your tax return?

Yes No

18. Who did you file with last year? 36. Do you need to improve your credit score? Yes No 19.

Are you interested in building your

business credit?

Yes No

Please answer the following questions to determine maximum deductions 1. 20.

2. 21.

3. 22.

Were there any births, deaths, marriages,

divorces or adoptions in your immediate

family?

Did you give a gift of more than $15,000 to

one or more people?

Did you have any debts cancelled, forgiven,

or refinanced?

Yes No

23. Did you go through bankruptcy proceedings? Yes No 24. (a) If you paid rent, how much did you pay? 6.

Yes No

Yes No 25.

Yes No

8. Yes No 26. Yes No

9. Yes No 27. Yes No

10.

Are you self-employed or do you receive

hobby income?

Did you receive income from raising

animals or crops?

Did you receive rent from real estate or

other property?

Did you receive income from gravel,

timber, minerals, oil, gas, copyrights,

patents?

Did you withdraw or write checks from a

mutual fund?

Do you have a foreign bank account,

trust, or business?

Do you provide a home for or help

support anyone not listed in Section 2

above?

Did you receive any correspondence from

the IRS or State Department of Taxation?

Did you have healthcare coverage (health

insurance) for you, your spouse and

dependents during this tax season? If yes,

include Forms 1095-A, 1095-B, and 1095-C

Did you apply for an exemption through the

Marketplace/Exchange? If so, provide the

exemption certificate number.

Yes No 28.

(b) Was heat included?

Did you pay interest on a student loan for

yourself, your spouse, or your dependent

during the year?

Did you pay expenses for yourself, your

spouse, or your dependent to attend classes

beyond high school?

Did you install any energy property to your

residence such as solar water heaters,

generators or fuel cells or energy efficient

improvements such as exterior doors or

windows, insulation, heat pumps, furnaces,

central air conditioners or water heaters?

Did you own $50,000 or more in foreign

financial assets?

Yes No

Attach W-2s:

Employer

Taxpayer Spouse

Attach 1099-INT, Form 1097-BTC & broker statements Payer Amount

Tax Exempt

From Mutual Funds & Stocks - Attach 1099-DIV

Payer Ordinary

Capital

Gains

Non-

Taxable

List payers of partnership, limited partnership, S-corporation, trust, or estate income - Attach K-1

Attach 1099-S and closing statements

Property Date Acquired Cost & Imp.

Personal Residence*

Vacation Home

Land

Other

• Provide information on improvements, prior sales of home, and cost of a new residence. Also see Section 17 (Job-Related Moving).

Contributions for tax year income

Amount Date

for

Roth

Taxpayer

Spouse

Amounts withdrawn. Attach 1099-R & 5498

Plan

Trustee

Reason for

Withdrawal Reinvested?

Yes No

Attach 1099-R

Payer*

Reason for

Withdrawal Reinvested?

Yes No

10. Investments Sold

Stocks, Bonds, Mutual Funds, Gold, Silver, Partnership interest - Attach 1099-B & confirmation slips Investment Date Acquired/Sold Cost Sale Price

Mortgage interest paid (attach 1098)

Interest paid to individual for your

home (include amortization schedule)

Paid to:

Name

Address

Social Security No. Investment Interest

Premiums paid or accrued for qualified

mortgage insurance

For property damaged by storm, water, fire, accident, or stolen. Location of Property

Description of Property Other

Federally Declared

Disaster Losses

Amount of Damage

Insurance Reimbursement

Repair Costs

Federal Grants Received

Other

Church

United Way

Scouts

Telethons

University, Public TV/Radio

Heart, Lung, Cancer, etc.

Wildlife Fund

Salvation Army, Goodwill

Other

Non-Cash

Volunteer (no. of miles) @ .14

List All Other Income (including non-taxable)

Alimony Received

Child Support

Scholarship (Grants)

Unemployment Compensation (repaid)

Prizes, Bonuses, Awards

Gambling, Lottery (expenses )

Unreported Tips

Director / Executor's Fee

Commissions

Jury Duty

Worker's Compensation

Disability Income

Veteran's Pension

Payments from Prior Installment Sale

State Income Tax Refund

Other

Medical Insurance Premiums

(paid by you)

Prescription Drugs

Insulin

Glasses, Contacts

Hearing Aids, Batteries

Braces

Medical Equipment, Supplies

Nursing Care

Medical Therapy

Hospital

Doctor/Dental/Orthodontist

Mileage (no. of miles)

Personal Property Tax

Prescription Drugs

Other

17. Child & Other Dependent Care Expenses

Name of Care Provider Address

Soc. Sec. No. or

Employer ID

Amount

Paid

Also complete this section if you receive dependent care benefits from your employer.

U if you are a member of the Armed Forces on active duty and moving due to a permanent change of station due to a military order.

Date of move

Move Household Goods

Lodging During Move

Travel to New Home (no. of miles)

if Armed Forces reservist, a qualified performing artist, a fee-basis state or local government official, or an individual with a disability claiming impairment-related work expenses. Dues - Union, Professional

Books, Subscriptions, Supplies

Licenses

Tools, Equipment, Safety Equipment

Uniforms (include cleaning)

Sales Expense, Gifts

Tuition, Books (work related)

Entertainment

Office in home:

In Square

Feet

a) Total home

b) Office

c) Storage

Rent

Insurance

Utilities

Maintenance

Tax Preparation Fee

Safe Deposit Box Rental

Mutual Fund Fee

Investment Counselor

Other

Doctor/Dental/Orthodontist

Mileage (no. of miles)

Do you have written records? Yes No

Did you sell or trade in a car used for business? Yes No If yes, attach a copy of purchase agreement

Make/Year Vehicle Date purchased

Total miles (personal & business)

Business miles (not to and from work)

From first to second job

Education (one way, work to school)

Job Seeking

Other Business

Round Trip commuting distance

Gas, Oil, Lubrication

Batteries, Tires, etc.

Repairs

Wash

Insurance

Interest

Lease payments

Garage Rent

If you are not reimbursed for exact amount, give total expenses. Airfare, Train, etc.

Lodging

Meals (no. of days )

Taxi, Car Rental

Other

Reimbursement Received

Due Date Date Paid Federal State

27. Direct Deposit of Refund / or Savings Bond Purchases Would you like to have your refund(s) directly deposited into your account? Yes No

(The IRS will allow you to deposit your federal tax refund into up to three different accounts. If so, please provide the following information.) ACCOUNT 1

Owner of account Taxpayer Spouse Joint

Type of account Checking Traditional Savings Traditional IRA Roth IRA Treasury Direct Archer MSA Savings Coverdell Education Savings HSA Savings SEP IRA Name of financial institution Financial Institution Routing Transit Number (if known) Your account number Student's Name Type of Expense Amount

Alimony Paid to Social Security No. $ Student Interest Paid $

Health Savings Account Contributions $ Archer Medical Savings Acct. Contributions $ Residence:

Town Country Village School Direct City To the best of my knowledge the information enclosed in this client tax organizer is correct and includes all income, deductions, and other information necessary for the preparation of this year's income tax returns for which I have adequate records.

Taxpayer Date

Spouse

Date

BUSINESS INCOME & EXPENSE WORKSHEET YEAR NAME Federal ID # NAME OF BUSINESS ADDRESS OF BUSINESS BUSINESS ACTIVITY (Check all that apply): sales manufacturing service PRODUCT SOLD OR SERVICE PERFORMED How many months was this business in operation during the year? 12 Months OR From To How many hours during the year did you and/or your spouse devote to this business? FULL TIME OR # of hours Is any portion of your investment in this business not subject to payback by you? YES NO PROOF OF SELF EMPLOYMENT/SMALL BUSINESS QUESTIONNAIRE: 1.

Do you own a business? Yes No

Are you self-employed? Yes No

What year did your business start? Do you work from home? Yes No

Do you have a designated place in your home for business use only? Yes No How many clients do you service monthly? What type of payment method do you except? Cash Debit Credit PayPal CashApp Stripe

Venmo Square Zelle Other: 8. Do you have an LLC? Yes No If yes, what is the business name? 9. Do you have an EIN number? Yes No

10. Do you have business bank account? Yes No If yes, Which bank 11. Do you have a business website? Yes No

12. Do you have a social media present for business? Yes No 13. Do you have pictures of your business to provide proof that it exists? Yes No 14. Do you have any business licenses? Yes No

15. Do you have occupational licenses? Yes No

16. Can you provide a copy 2021 filed tax return? Yes No 17. Do you have any employees? Yes No

18. Do your employees receive a Form 1099? Yes No If yes, can you provide proof? Yes No 19. Have you ever filed Self-Employed before? Yes No If Yes, how many years? 20. Can you provide proof of income? Yes No If yes, what type? (Mark X Below)

Bank Statement

Reconstruction of Income

Receipt Book

21. Can you provide proof of expenses?

Bank Statement

Reconstruction of Income

Receipt Book

22. Do you have a home office? Yes

Summary of Income

1099 Misc. 1099k

Other:

Yes No If yes, what type? (Mark X Below)

Summary of Expenses

Record of Gross Receipts

Record of Expenses

Other:

No If yes, How many square feet is your home office? 23. Do you have a Duns number? Yes No If yes, what’s the number? 24. What month and year was your business established? 25. Do you have a logo? Yes No

26. What’s your business email? I attest that all information provided on this client info sheet is true and accurate, and is subjected to IRS review. Client Name: Client Signature: Date:

BUSINESS INCOME

GROSS SALES/RECEIPTS Include all 1099 income

for services performed

1099 – MISC. Bring in ALL 1099s received. Include

Non-Employee Amount in Gross Sales.

SALES TAX COLLECTED

If not included in above Do your records agree YES with the amount reported? NO

Did you receive $10,000.00 in actual cash from any individual at any one time—or in accumulated

amounts— during this tax year?

RETURNS / REFUNDS Amount included in Gross Sales

that was refunded to your client

OTHER INCOME Directly related to your business

Sales of Equipment, Machinery, Land, Buildings Held for Business Use Kind of Property Date Acquired Date Sold Gross Sales Price Expenses of Sale Original Cost

BUSINESS EXPENSES (cost of goods sold)

PURCHASE OF PRODUCT

& SUPPLIES FOR RESALE

Shipping cost to receive product or

F R E IGHT-IN materials, if not included in purchases Actual cost of items in purchases OTHER COSTS

PERSONAL USE used by you or your family

INVENTORY AT END OF YEAR

COST OF

LABOR

How did you arrive at inventory value?

Actual Cost Other (explain)

PURCHASE OF

MATERIAL FOR JOBS (construction or installation type)

CAR and TRUCK EXPENSES OFFICE in HOME

VEHICLE 1 VEHICLE 2

Year and Make of Vehicle

Date Purchased (month, date and year)

Ending Odometer Reading (December 31)

Beginning Odometer Reading (January 1) – –

Total Miles Driven (End Odo – Begin Odo)

Total Business Miles (do you have another vehicle?) Total Commuting Miles

Parking Fees and Tolls

License Plates

Interest

Continue below if you take actual expense (must use actual expenses if you lease) Gas, oil, lube, repairs, tires, batteries, insurance, supplies, wash, wax, etc. Lease Costs

Date Acquired Home

Total Cost

Cost Of Land

Cost Of Improvements

Sq. Footage Of Home

Sq. Footage Of Office Area

Rent Paid (If You Rent)

Interest

Taxes

Utilities/Garbage

Insurance

Repairs/Maintenance

Hours Used Per Week

Hours Worked Per Week

BUSINESS EXPENSES (continued)

ADVERTISING/PROMOTION: Ads, business cards, greeting cards, etc.

*COMMISSIONS & FEES PAID: Contract labor

EMPLOYEE BENEFITS: Health insurance, company party, mileage reimbursements, etc.

INSURANCE: Worker’s comp, business liability (do

not include auto/truck/health)

INTEREST: Mortgage (on business bldg.):

Paid to financial institution

Paid to individual

OTHER INTEREST:

(do not include auto or truck)

List life insurance loans separately

Business only credit card

*LEGAL & PROFESSIONAL: Attorney fees for business, accounting fees, bonds, permits, etc

OFFICE EXPENSE: Postage, stationery, office supplies, bank charges, pens, etc.

PENSION/PROFIT SHARING: Employees only

*RENT/LEASE: Machinery and equipment

Other business property

*REPAIRS & MAINTENANCE: Building, equipment, etc.

(do not include auto or truck)

SUPPLIES: Misc. (not included elsewhere)

Small tools

TAXES: Personal property

Licenses (not auto/truck)

Real estate of business building & land

Sales tax (if included in gross sales)

Payroll (your share Soc. Sec./Medicare)

TRAVEL (number of nights away):

City Nights out City Nights out City Nights out City Nights out City Nights out City Nights out City Nights out City Nights out EQUIPMENT PURCHASED

Item

Purchased

Date

Purchased

Business

Use %

Cost (including

sales tax)

Item Traded Additional

Cash Paid

Traded with

Related Property

Other

Information

*1099s: Amounts of $600.00 or more paid to individuals (not corporations) for rent, interest, or services rendered to you in your business, require information returns to be filed by payer. Due date of return is January 31. Nonfiling penalty can be $150 per recipient. If recipient does not furnish you with his/her Social Security Number, you are required to withhold tax on the payment(s).

Name Address Social Security # Amoun Purpose of Payment EXPENSES (AWAY FROM HOME OVERNIGHT):

Lodging

Meals & tips (keep total separate from other costs) Convention fees

Cruise ship convention/seminar

Airplane or train fares

Auto rental, taxis or bus fares

Other (incidentals, laundry, etc.)

MEALS & ENTERTAINMENT:

Sales lunches

Gifts (limited to $25 per individual or couple)

Tickets

Tickets to qualified charitable events

UTILITIES & TELEPHONE:

Electricity (business)

Natural gas/heating fuel (business)

Garbage, water, sewer (business)

Telephone (bus. line, second line, other options)

Business long distance (from home telephone)

Faxes, paging svcs, cellular svcs

WAGES: (bring your copy of W-2s/941s if they have been filed)

Wages to spouse (subject to Soc.Sec. and

Medicare tax)

Children under 18 (not subject to Soc.Sec.

and Medicare tax)

Other

OTHER EXPENSES (not listed elsewhere):

Bank charges

Courier services

Dues & publications

Education

Fuel for equipment (not auto/truck)

Laundry & cleaning

Printing & copying

Show Fees

Shipping

RECONSTRUCTION OF BUSINESS

Business Income & Expenses

Business Type: Business Name: Business Income: Corrected Income: Expense Monthly Yearly

Advertising $ $

Car & Truck $ $

Insurance $ $

Legal Professional $ $

Office Supplies $ $

Rent $ $

Repairs $ $

Business Supplies $ $

Taxes & Licenses $ $

Travel $ $

Utilities $ $

Cell Phone $ $

Fuel $ $

Other: $ $

Monthly Total: $ Year Total: $

*To calculate your corrected income: Income – (Monthly Total x 12) = Corrected Income My signature below certifies that the income and expenses were reconstructed by me and My Tax Preparer. I further certify that these calculations for the business are accurate and true. If audited, I can supply the necessary documentation to substantiate for the information provided above.

Taxpayer Print Name: Date: Taxpayer Signature: Date: SUMMARY OF INCOME & EXPENSES

SUPPLIES SUPPLIES COST

Tax

Contact this candidate