Questionnaire: Individual Income Tax Returns

Questionnaire Individual Tax Returns

Our firm utilizes “ProSystem fx Tax” software (a CCH Wolters Kluwer application) for preparing the tax returns of our clients.  This application provides a questionnaire that can help you identify essential information to be reported on your 2015 income tax returns.

I recommend completing this form prior to submitting information to your tax preparer. This exercise can increase the likelihood of efficiently assembling the data necessary to prepare a complete return, which can improve effectiveness in tax preparation for you at a lower fee cost.

Personal Information Yes No
   Did your marital status change during 2015?
   Are you legally married?
      If Yes, do you and your spouse want to file separate returns?
      If Yes, will you file a joint federal return and be required to file single state returns?
      If No, are you in a domestic partnership, civil union, or other state-defined relation
        relationship?
   Did you address change during 2015??  If yes, please provide details.
   Can you or your spouse be claimed as a dependent by another taxpayer?
Dependents
   Were there any changes in dependents from the prior year? (Note: Include non-child
     dependents for whom you provided more than half the support)
   Did you pay for child care while you worked or looked for work?
   Do you have any children under age 18 with unearned income more than $1,000?
   Do you have any children age 18 or student children, aged 19 to 23, who did not provide
      more than half of their cost of support with earned income and that have unearned
      income of more than $1,000?
   Did you adopt a child or begin adoption proceedings during 2015?
Purchases, Sales & Debt
   Did you have any debts canceled, forgiven or refinanced during 2015?
   Did you start a new business, purchase a new rental property, farm or acquire any new
      interest in any partnership or S-Corporation during 2015?
   Did you sell an existing business, rental property, farm or any existing interest in a
      partnership or S-Corporation during 2015?
   Did you sell, exchange or purchase any real estate in 2015?  If so, please attach the
      closing statements.
   Did you withdrawal any amounts from your Individual Retirement Account (IRA) or
      Roth IRA to acquire a principal residence?
   Did you receive grants of stock options from your employer, exercise any stock options
      granted to you or dispose of any stock acquired under a qualified employee stock
      purchase plan?
   Did you pay any student loan interest in 2015?
   Are your total mortgages on your first and/or second residence greater than $1,000,000?
      If so, please provide the principal balance and interest rate at the beginning of the year
   Did you have an outstanding home equity loan at the end of 2015?  If so, please provide
      the principal balance and interest rate at the beginning and end of the year.
   Did you take out a home equity loan in 2015?
   Are you claiming a deduction for mortgage interest paid to a financial institution and
      someone else received the Form 1098?
   Did you or your mortgagee receive any mortgage assistance payments?
   Did you engage in any put option or call option transactions?  If yes, provide details.
   Did you close any open short sales during 2015?
   Did you sell any securities not reported on your Form 1099-B?
Sale of Your Home (Principal Residence)
   Did you sell your home (i.e., principal residence) in 2015?
      If Yes, did you receive Form 1099?
      If Yes, did you own and occupy the home as your principal residence for at least
      two (2) of the five (5) year period prior to the sale?
   Did you ever rent out this property?
   Did you ever use any portion of the home for business purposes?
   Have you or your spouse sold a principal residence within the last two (2) years?
   At the time of the sale, the residence was owned by:  ___Taxpayer  ___Spouse  ___Both
Itemized Deductions
   Did you contribute property (other than cash) with a fair market value greater than
      $5,000 to a charitable organization?
   Did you incur any casualty or theft losses during the year?
   Did you make any large purchases, such as motor vehicles and boats?
   Did you incur any casualty or loss attributable to a federally declared disaster?
Severance/Retirement
   Did you retire or change jobs in 2015?
   Did you receive deferred, retirement or severance compensation?
      If Yes, enter the date received (Mo/Da/Yr).  ________ (Date)
   Did you or your spouse turn age 70 ½ during the year and have money in an IRA or
      other retirement account while not taking any distribution?
Gifts
   Did you or your spouse make any gifts, including birthday, holiday, anniversary,
      graduation, etc., with a total (aggregate) value in excess of $14,000 to any individual
      during the year?
   Did you or your spouse make any gifts to a trust for any amount during the year?
   Do you or your spouse have a life insurance trust?
   Did you assist in the purchase of any asset (i.e., auto, home, etc.) for any individual
      during the year?
   Did you forgive any indebtedness to any individual, trust or entity during the year?
   Did you or your spouse make any gifts of difficult-to-value assets (such as non-publicly
      traded stock) to any person regardless of value?
Miscellaneous
   Did you or your spouse have any transactions pertaining to a medical savings
      account (MSA) during 2015?  If you received Form 1099-SA, please provide.
   Did you or your spouse have any transactions pertaining to a health savings account
      (HSA) during 2015?  If you received Form 1099-SA, please provide.
   Did you or your spouse contribute to a Roth IRA or convert an existing IRA into a
      Roth IRA?
   Did you or your spouse roll into a Roth IRA any distributions from a retirement plan, an
      annuity plan, tax shelter annuity or deferred compensation plan?
   Did you or your spouse make a qualified charitable distribution from an IRA during
      January of 2016 that was treated as though it were made in 2015?
   Did you withdrawal any amounts from your IRA to pay for higher education expenses
      incurred by you, your spouse, your children or grandchildren?
   Did you withdraw amounts from a Coverdell Education Savings Account or Qualified
      Education Program (Section 529 plan)?  If Yes, please provide Form 1099-Q.
   Did you or your dependents incur any post-secondary education expenses, such as
      tuition?
   If you or your spouse are self-employed, are you or your spouse eligible to be covered
      under an employer’s health plan at another job?  If Yes, how many months were you
      covered?    _____ (No. of Months)
   Did you move to a different home because of a change in the location of your job?
   Did you pay in excess of $1,000 in any quarter, or $1,800 during the year for domestic
      services performed in or around your home to individuals who could be considered
      household employees?
   Did you receive unreported tip income of $20 or more in any month of 2015?
   Did you or your spouse receive distributions from long-term care insurance contracts?
      If Yes, please provide Form 1099-LTC.
   Were you or your spouse a grantor or transferor for a foreign trust, have an interest in or
      a signature or other authority over a bank account, securities account or other
      financial account in a foreign country?
   Did you or your spouse own any foreign financial assets?
   Did you create or transfer money or property to a foreign trust?
   Did you purchase a new alternative technology vehicle, including a qualified plug-in
      electric drive motor vehicle in 2015?
   Did you use gasoline or special fuels for business or farm purposes (other than for a
      highway vehicle) during the year?  If Yes, provide the gallons used for off-highway
      business purposes.
   Have you received a punitive damage award or an award for damages other than for
      physical injuries or illness?
   Were you notified by the IRS or other taxing authority of changes in prior year returns?
   Did you lose your job during 2015 because of foreign competition and pay for your own
      health insurance?
   Did you install any alternative energy equipment in your residence such as solar water
      heaters, solar electricity equipment or fuel cells?
   Did you install any energy efficiency improvements, or energy property in your
      residence such as exterior doors or windows, insulation, heat pumps, furnaces, central
      air conditioners or water pumps?
   Have you been an identity theft victim and have you contacted the IRS?  If Yes, please
      furnish the 6-digit identity protection PIN issued to you by the IRS.  ______
   Did you engage in any bartering transactions?
   Did you have any work outside of the U.S. or pay any foreign taxes?
   Did you or your spouse serve in the military or were you or your spouse on active duty?
   Did you or your spouse claim a homebuyer credit for a home purchased in 2008?
   Did you have healthcare coverage (health insurance) for yourself, your spouse, and any
      dependents during 2015?

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