We're looking forward to working with you and we encourage you to call us before your appointment if you have any questions. The checklist and attached Tax Organizer are provided to assist you in gathering information for your 2018 income tax return. If you worked with us last year, prior year data is included on the organizer sections for your reference Before we can start work on your 2018 tax return we must have the signed Client Service Agreement and the organizer returned to our office. The 5 page 2018 Questionnaire portion of the organizer must be completed . If you are new to our offices, in addition to the items listed below please also include copies of your last three income tax returns. Checklist ____ Signed and dated 2018 Client Service Agreement ____ Completed 2018 Questionnaire ____ W-2 and W2G forms (wages, gambling) ____ Copy of your last 2018 paystub ( the last paycheck DATED in 2018) ____ 1099 forms (1099 INT / 1099 DIV / 1099 MISC / 1099 B ) ____ Brokerage Statements ____ K-1 Schedule(s) (income/loss from partnerships, S corporations, trusts) ____ Mortgage Interest statements (1098 forms) ____ Closing statements from any real estate purchases or sales ____1099-K forms (Merchant Card and Third Party Network Payments) ____1098 T forms (and a list of actual higher education costs paid in 2018 ) ____1095-A , 1095-B or 1095-C forms ____ Any tax notices received from the IRS or other taxing authorities 1225 North Argonne Road, Suite C Spokane Valley, Washington 99212 (509) 926-2126 www.levnotax.com
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Questionnaire portion of the organizer must be completed.
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We're looking forward to working with you and we encourage you to call us before yourappointment if you have any questions. The checklist and attached Tax Organizer areprovided to assist you in gathering information for your 2018 income tax return. If youworked with us last year, prior year data is included on the organizer sections for yourreference
Before we can start work on your 2018 tax return we must have the signed ClientService Agreement and the organizer returned to our office. The 5 page 2018 Questionnaire portion of the organizer must be completed.
If you are new to our offices, in addition to the items listed below please also includecopies of your last three income tax returns.
Checklist
____ Signed and dated 2018 Client Service Agreement
____ Completed 2018 Questionnaire
____ W-2 and W2G forms (wages, gambling)
____ Copy of your last 2018 paystub ( the last paycheck DATED in 2018)
____ 1099 forms (1099 INT / 1099 DIV / 1099 MISC / 1099 B )
____ Brokerage Statements
____ K-1 Schedule(s) (income/loss from partnerships, S corporations, trusts)
____ Mortgage Interest statements (1098 forms)
____ Closing statements from any real estate purchases or sales
____1099-K forms (Merchant Card and Third Party Network Payments)
____1098 T forms (and a list of actual higher education costs paid in 2018 )
____1095-A , 1095-B or 1095-C forms ____ Any tax notices received from the IRS or other taxing authorities
1225 North Argonne Road, Suite CSpokane Valley, Washington 99212
(509) 926-2126www.levnotax.com
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2018 QUESTIONNAIREIf you are unsure how to answer any question leave the boxes unchecked and we will contact you
during our tax preparation.
PERSONAL AND DEPENDENT INFORMATON
Yes No
Are you a U.S. Citizen?
Is your spouse a U.S. Citizen?
Did your marital status change during 2018?
Is the address shown on this organizer the correct address to use on the taxreturn?
Last year, were you or your spouse totally and permanently disabled?
Could you be claimed as a dependent on another person's tax return for 2018?
Were there any changes in dependents?
Are you the custodial parent of the dependent children listed on the return? Ifyou are NOT the custodial parent a signed 8332 FORM is usually required
Were any of your unmarried children who might be claimed as dependents 19years of age or older at the end of 2018?
Did you have any children under age 19 or full-time students under age 24 at theend of 2018, with interest and dividend income in excess of $1,050, or totalinvestment income in excess of $2,100?
Did you incur child care costs?
Did you incur adoption expenses?
MISCELLANEOUS
Yes No
Were you or your spouse a victim of identity theft?
We are required to e-file your return unless you opt out. Do you want to opt outof electronic filing? If you opt out a $25 fee will be added to your bill for paper
handling.
Do you want your completed return mailed to you? If yes, a minimum fee of$10.00 for postage & handling will be added to your bill.
Page 1NEW CLIENT 000000ORGANIZER
2018 1040 US Miscellaneous Questions
Miscellaneous Questions
MISCELLANEOUS continued
Yes No
Do you want to allocate $3 to the Presidential Election Campaign Fund? Contributing to the Campaign Fund does not affect your taxes
Does your spouse want to allocate $3 to the Presidential Election CampaignFund? Contributing to the Campaign Fund does not affect your taxes
May the IRS discuss your tax return with your preparer?
Did you have an interest in or signature or other authority over a financialaccount in a foreign country, such as a bank account, securities account, or otherfinancial account?
Did you receive a distribution from, or were you the grantor of, or transferor to, aforeign trust or did you have an interest in any foreign assets or accounts?
Did you engage the services of any household employees?
Was your home rented out or used for business?
Were you notified or audited by either the Internal Revenue Service or Statetaxing agencies?
Did you or your spouse make any gifts to an individual that total more than$15,000, or any gifts to a trust?
If you have an overpayment of taxes, do you want to APPLY your refund to2019?
If you do NOT want your refund applied to 2019, do you want to DIRECTDEPOSIT your refund? Please be sure to provide us with accurate bankinginformation for direct deposit.
INCOME
Yes No
Did you receive Alimony?
Did you receive unreported tip income of $20 or more in any month?
Did you have any U.S. Savings bond mature in 2018?
Do you like Pizza?
Page 2NEW CLIENT 000000ORGANIZER
2018 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
INCOME continued
Yes No
Did you cash any Series EE U.S. savings bonds issued after 1989 and payqualified higher education expenses for yourself, your spouse, or yourdependents?
Were you a policyholder who received payments under a long-term care (LTC)insurance contract or received any accelerated death benefits from a lifeinsurance policy?
Did you receive any disability income?
Did you have any foreign income or pay any foreign taxes?
Do you expect your 2019 income to be different from 2018?
RETIREMENT PLANS
Yes No
Did you receive a distribution from a retirement plan (401(k), IRA, SEP,SIMPLE, Qualified Plan, etc.)?
Did you make a contribution to a retirement plan (401(k), IRA, SEP, SIMPLE,Qualified Plan, etc.)?
Did you transfer or rollover any amount from one retirement plan to anotherretirement plan?
Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a RothIRA in 2018?
If you qualify, would you be interested in making a contribution to a TraditionalIRA to lower your taxes?
ADJUSTMENTS TO INCOME
Yes No
Did you make contributions to a qualified Health Savings Account?
Did you pay qualified Student Loan Interest?
Did you pay Alimony in 2018?
Page 3NEW CLIENT 000000ORGANIZER
2018 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
PURCHASES, SALES AND DEBT (Include copies of ALL closing documents and 1099forms received)
Yes No
Did you start a business or farm, purchase rental or royalty property, or acquirean interest in a partnership, S corporation, trust, or REMIC?
Did you purchase or dispose of any business assets (furniture, equipment,vehicles, real estate, etc.), or convert any personal assets to business use?
Did you buy or sell any stocks, bonds or other investment property in 2018?
Did you sell or do you plan to sell any dividend generating stocks or mutualfunds during the first 60 days of 2019?
Did you purchase, sell, or refinance your principal home or second home, or didyou take a home equity loan?
Did you make any residential energy-efficient improvements or purchasesinvolving solar, wind, geothermal or fuel cell energy sources?
Did you have any debts cancelled or forgiven or have a foreclosure of yourhome?
Does anyone owe you money which has become uncollectible?
Did you purchase or spend any cryptocurrency, such as BitCoin, Ethereum,Altcoin?
EDUCATION
Yes No
Did you receive a distribution from an Education Savings Account or a QualifiedTuition Program?
Did you, your spouse, or a dependent incur any tuition expenses that are requiredto attend a college, university, or vocational school?
Page 4NEW CLIENT 000000ORGANIZER
2018 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
ITEMIZED DEDUCTIONS
Yes No
Did you purchase any motor vehicle(s) (car, motorcycle, motor home, RV, sportutility vehicle, truck, van, or off-road vehicle) in 2018? If YES, provide copies ofpurchase papers.
Did you make significant home improvements in 2018?
Do you have a Home Equity Loan? If yes, we will require additionalinformation and we will contact you for that information during the preparationof your return
HEALTH CARE COVERAGE
Yes No
Did you receive Form(s) 1095-A, 1095-B or Form 1095-C reporting your HealthInsurance Coverage?
CONGRATULATIONSYou made it to the end! In recognition of your accomplishment and as a thank you forcompleting the 2018 Questionnaire, you are now entered into our April 16, 2019 drawingfor one of (5) Pizza Hut gift cards. Winners will be notified by mail. Good luck andthank you for choosing us for your accounting and tax needs.We are truly grateful foryour business.
Page 5NEW CLIENT 000000ORGANIZER
2018 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
ORGANIZER
2018 1040 US Tax Organizer
Taxpayer Spouse
First name and initial.......
Last name........................
Title/suffix.........................
Social security number....
Occupation......................
Date of birth (m/d/y)........
Date of death (m/d/y)......
1=blind.............................
Home phone....................
Work phone.....................
Work extension................
Cell phone........................
E-mail address................
Drivers License #.............
Drivers License State.......
Expiration Date................
Issue Date........................
Street address.............
Address Apartment number......
City...............................
State.........................
ZIP code......................
LEVNO & COMPANY1225 N ARGONNE RD STE CSPOKANE, WA 99212Telephone number: (509) 926-2126Fax number: (509) 892-6811E-mail address:[email protected]
CLIENT INFORMATION
WA
DEPENDENTS
First name........................
Last name........................
Title/suffix.........................
Date of birth (m/d/y)........
Date of death (m/d/y)......
Date of adoption (m/d/y).
Social security number....
Relationship.....................
Months lived at home......
Dependent No. Dependent No.
First name........................
Last name........................
Title/suffix.........................
Date of birth (m/d/y)........
Date of death (m/d/y)......
Date of adoption (m/d/y).
Social security number....
Relationship.....................
Months lived at home......
Dependent No. Dependent No.
This tax organizer will assist you in gathering information necessary for the preparation of your 2018 tax return.Please enter all pertinent 2018 information. If you have attached a government form for an item, check the boxand do not enter a 2018 amount.
NEW CLIENT 000000 Page 6
ORGANIZER
2018 1040 US Tax Organizer
Please enter all pertinent 2018 information. If you have attached a government form for an item,check the box and do not enter a 2018 amount.
WAGES, SALARIES AND TIPSEmployer Name: 2018 Amount 2017 Amount
INTEREST INCOME
Attach Forms W-2
Payer Name:
DIVIDEND INCOME
Attach Forms 1099-INT
Payer Name:
PENSION AND IRA INCOME
Attach Forms 1099-DIV
Payer name:
GAMBLING WINNINGS
Attach Forms 1099-R
Payer name:
Attach Forms W-2G
Total gambling losses.................................................................................
Winnings not reported on Form W-2G......................................................
OTHER GOVERNMENT FORMS - INCOMEForm 1099-B - Sales of stock (also include transaction history)..............
Form 1099-MISC - Miscellaneous income................................................
Form 1099-K - Merchant card and third party network payments..........
Form 1099-S - Sales of real estate (also include closing statements).....
Attach Forms 1099
Form 1099-G - State tax refunds............................................................... Attach Forms 1099
Taxpayer:
Form SSA-1099 - Social security benefits................................................
Form 1099-G - Unemployment compensation.........................................Attach Forms 1099
NEW CLIENT 000000 Page 7
ORGANIZER
2018 1040 US Tax Organizer
Please enter all pertinent 2018 information. If you have attached a government form for an item,check the box and do not enter a 2018 amount.
OTHER GOVERNMENT FORMS - INCOME (Continued)Spouse: 2018 Amount 2017 Amount
Form SSA-1099 - Social security benefits................................................
Form 1099-G - Unemployment compensation.........................................
Please do not complete this information if coverage is indicated on Form 1095-A, 1095-B or 1095-C.Attach the document with this organizer if you have it.