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2023 TAX QUESTIONNAIRE & THINGS TO BRING CHECKLIST
PERSONAL INFORMATION
Did your marital status change in 2023? YES _____ No _____
Did your address change from last year? YES _____ No _____
Do we have a copy of your most recent Driver’s license? YES _____ No _____
Did your banking information change, this is for direct deposit or automatic withdrawal? YES _____ No _____
Circle and enter your preferred method of contact?
Email: __________________ Cell Phone: __________________
Home Phone: ______________________
DEPENDENT INFORMATION
Were there any changes in dependents from last year? YES _____ No _____
Did you pay childcare costs for a dependent child under age 13, or costs for caring for a disabled dependent or spouse? YES _____ No _____
PURCHASES, SALES AND DEBT INFORMATION
Did you have any debts cancelled or forgiven this year, such as a home mortgage, student loan or credit cards? Form 1099-C/1099-A YES _____ No _____
Did you acquire or dispose of any stock during the year? Form 1099-B YES _____ No _____
Did you sell, exchange, or purchase any real estate or your principal residence during the year? We will need copies of Settlement Sheets and Form 1099-S if received. YES _____ No _____
Did you purchase a new plug-in electric vehicle? Include Bill of Sale YES _____ No _____
INCOME INFORMATION
Did you receive any income from employment? Form W-2 YES _____ No _____
Did you receive any unemployment compensation? Form 1099-G YES _____ No _____
Did you receive any awards, prizes, hobby income, gambling or lottery winnings? YES _____ No _____
Do you have any interest or dividend income? Form 1099-INT/1099-DIV YES _____ No _____
Did you receive distributions from Partnerships, S-Corps or Trusts? Form K-1 YES _____ No _____
RETIREMENT INFORMATION
Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP, 401(k) or other qualified retirement plan? Form 1099-R YES _____ No _____
Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP, 401(k) or other qualified retirement plan? Form 5498 YES _____ No _____
Did you receive Social Security/Disability Benefits? Form SSA-1099 YES _____ No _____
EDUCATION INFORMATION
Did you have any educational expenses during the year on behalf of yourself, your spouse, or a dependent? Form 1098-T YES _____ No _____
Did you make any withdrawals from an education savings or 529 Plan account? Form 1099-Q YES _____ No _____
Did you make any contributions to an education savings or 529 Plan account? YES _____ No _____
Did you pay any student loan interest this year? Form 1098-E YES _____ No _____
HEALTH CARE INFORMATION
Did you enroll for lower cost Marketplace Coverage through healthcare.gov under the Affordable Care Act? If yes, attach Form 1095-A (Health Insurance Marketplace Statement) YES _____ No _____
Did you contribute to or receive a distribution from a Health Saving Account (HSA) for 2023? Form 1099-SA and/or Form 5498-SA YES _____ No _____
Did you pay long-term care premiums for yourself or family? YES _____ No _____
ITEMIZED DEDUCTION INFORMATION
Did you take out or refinance a home equity or mortgage loan? YES _____ No _____
Did you pay out-of-pocket medical expenses? YES _____ No _____
(Co-pays, prescription drugs, glasses, etc.)
Did you make any cash or noncash charitable contributions? YES _____ No _____
Did you pay real estate taxes for your primary home and/or second home? YES _____ No _____
Did you pay any mortgage interest on an existing home loan? Form 1098 YES _____ No _____
MISCELLANEOUS INFORMATION
At any time during 2023, did you receive, sell, send, exchange, or otherwise acquire any financial interest in virtual currency? (Bitcoin, Ethereum, etc.) Huge Penalties if not reported. YES _____ No _____
Did you retire or change jobs this year? YES _____ No _____
Did you make any gifts totaling more than $15,000 to any individual during 2023? YES _____ No _____
Did you make energy efficient improvements to your main home this year? YES _____ No _____
Did you receive Form 1099-MISC for any miscellaneous income received? YES _____ No _____
Did you receive Form 1099-NEC for any non-employee compensation? YES _____ No _____
Did you make Federal and or State Estimated Tax Payments (Quarterly Tax Payments) for 2023? If yes, please provide the amounts and dates of payment. YES _____ No _____
NEW CLIENTS ONLY – Please provide a copy of your 2021 and 2022 tax returns and copies of your driver's licenses