TAXPAYER INFORMATION SPOUSE INFORMATION Name Initial Name Initial Last Name Last name SSN DOB SSN DOB Occupation Occupation T: Home Cell Home Cell Email Email Address City State ZIP FILING STATUS ESTIMATED TAX PAYMENTS Single Head of Household FEDERAL STATE Married Married Filing Separately Date Amount Date Amount Overpayment DEPENDENTS 1st Quarter Name 2nd Quarter DOB SSN 3rd Quarter Relationship Months Lived @ Home 4th Quarter Name DOB SSN REFUND Relationship Months @ Home Automatic Deposit Yes (attach a VOID check) No SALARIES & WAGES Attach all W-2 forms INCOME FROM BUSINESS OR PROFESSION – W-2 Employer Gross Wages GENERAL INFORMATION 1 Cash Basis Accrual Basis 1st Year 2 Principal Business/Profession 3 Business Name 4 Business Address City State ZIP OTHER INCOME INCOME INTEREST Attach Forms 1099INT Total $ Gross Receipts or Sales – DIVIDENDS Attach Forms 1099DIV Total $ Returns & Allowances – Other Income CAPITAL GAINS Attach Forms 1099B, 1099S and year-end – (if applicable) COST OF GOODS SOLD brokerage statements with purchase date and cost of each asset. Inventory @ Beginning of the year TAX REFUND Attach Forms 1099G Purchases – if you did NOT itemize last year Cost of Labor ALIMONY RECEIVED Materials & Supplies Payor Other Costs Payor’s SSN Amount Inventory @ End of the Year EXPENSES SOCIAL SECURITY BENEFITS RECEIVED Attach Forms – SSA-1099 Advertising Car & Expenses* UNEMPLOYMENT BENEFITS RECEIVED Attach Forms – 1099G Commissions Employee Benefits PENSIONS/IRA/ANNUITY DISTRIBUTIONS Attach Forms – 1099R Insurance (other than health) Health Insurance Premiums for Self* INCOME FROM PARTNERSHIPS, ESTATES, LLCS, Interest TRUSTS AND S-CORPORATIONS Attach Forms K-1 and – list any not yet received. & Professional Office Expenses
TAXPAYER INFORMATION SPOUSE INFORMATION Name Initial Name Initial Last Name Last name SSN DOB SSN DOB Occupation Occupation T: Home Cell Home Cell Email Email Address City State ZIP FILING STATUS ESTIMATED TAX PAYMENTS Single Head of Household FEDERAL STATE Married Married Filing Separately Date Amount Date Amount Overpayment DEPENDENTS 1st Quarter Name 2nd Quarter DOB SSN 3rd Quarter Relationship Months Lived @ Home 4th Quarter Name DOB SSN REFUND Relationship Months @ Home Automatic Deposit Yes (attach a VOID check) No SALARIES & WAGES – Attach all W-2 forms INCOME FROM BUSINESS OR PROFESSION W-2 Employer Gross Wages GENERAL INFORMATION 1 Cash Basis Accrual Basis 1st Year 2 Principal Business/Profession 3 Business Name 4 Business Address City State ZIP OTHER INCOME INCOME INTEREST – Attach Forms 1099INT Total $ Gross Receipts or Sales DIVIDENDS – Attach Forms 1099DIV Total $ Returns & Allowances CAPITAL GAINS – Attach Forms 1099B, 1099S and year-end brokerage statements with purchase date and cost of each asset. Other Income COST OF GOODS SOLD (if applicable) Inventory @ Beginning of the year TAX REFUND – Attach Forms 1099G Purchases if you did NOT itemize last year Cost of Labor ALIMONY RECEIVED Materials & Supplies Payor Other Costs Payor’s SSN Amount Inventory @ End of the Year SOCIAL SECURITY BENEFITS RECEIVED – Attach Forms SSA-1099 EXPENSES Advertising UNEMPLOYMENT BENEFITS RECEIVED – Attach Forms 1099G Car & Expenses* Commissions PENSIONS/IRA/ANNUITY DISTRIBUTIONS – Attach Forms 1099R Employee Benefits Insurance (other than health) INCOME FROM PARTNERSHIPS, ESTATES, LLCS, TRUSTS AND S-CORPORATIONS – Attach Forms K-1 and list any not yet received. Health Insurance Premiums for Self* Interest & Professional Office Expenses
2015-Fco-Tax-Organizer.docx