Happy New Year - 2014! GUIDELINES FOR ASSEMBLING YOUR...
Transcript of Happy New Year - 2014! GUIDELINES FOR ASSEMBLING YOUR...
Happy New Year - 2014!
This Tax Organizer will assist you in collecting and reporting information necessary for us toproperly prepare your 2013 income tax return. Please complete the organizer sections as
appropriate and provide supporting documentation where necessary. Please line through anyinformation which does not apply to your 2013 tax return. Prior year data is included on theorganizer sections for your reference only. These amounts are for comparison purposes. You
do not need to change these prior year columns.
GUIDELINES FOR ASSEMBLING YOUR 2013 TAX INFORMATION
Please provide us with the following information:
-Form(s) W-2 (wages, etc.)
-Form(s) 1099 (interest, dividends, etc.)
-Schedule(s) K-1 (income/loss from partnerships, S corporations, etc.)
-Form(s) 1098 (loan balances beginning & end of year; mortgage interest statements)
-Property Tax Statements.
-New Tax Law for Sale of Securities. If you sold stock or securities through a broker, the brokerwill issue you a 1099-B.
Most of our clients have provided excellent details of their stock activities, in many casesproviding us with your own spreadsheets. Please continue to do so, but also please provide uscopies of all 1099-Bs and all other information included by the brokerage firm.
-Closing statements "FINAL"; Not the "Estimated" pertaining to real estate transactions
-All other supporting documents (schedules, checkbooks, etc.)
-Any tax notices received from the IRS or State taxing authorities.
-Foreign accounts: The reporting requirements for assets held overseas are increasing and thepenalties for failure to report them are becoming increasingly harsh. Not all foreign holdingsmust be reported. If, for example, you hold stock in a foreign company through a U.S.broker, those holdings do not have to be separately reported. However, if you hold anyother types of foreign assets, including bank accounts and securities accounts, please letus know. If you have any doubt as to whether any of your assets are foreign, pleasediscuss those assets with us.
-Use tax: California requires payment of use tax. Most such purchases are made over theinternet or by mail order from out-of-state sellers. You have the option of totaling all suchpurchases or we will use the “lookup table”. If your purchases are both over and under $1,000,you may total just the purchases that are over $1,000 and we can compute the use tax on thoseand use the lookup tables for the small purchases.
Please sign and date the Engagement Letter on the next page.
Return your completed organizer along with the information requested, and any otherinformation that you believe will be relevant to your 2013 tax.
Thank you for your help in the completion of the Tax Organizer, which will help reduce yourpreparation fee. Please contact us if you would like clarification of any item while completingit.
We may file an EXTENSION of time to complete the forms for filing your 2013 TAXRETURNS, but this will not be an extension of time to pay your estimated 2013 income taxes,if we have not received 100% of your tax information by March 1st, 2014.
We are offering a discount of 20% for each new client that gives us your name!
BUSINESS IS GREAT AND WE'RE LOOKING FOR MORE!
Sincerely,
Robert J. Hoffman & Company, CPA's, 300 Montgomery Street, Suite 730 San Francisco, CA 94104-1909 (415) 576-1040
ENGAGEMENT AGREEMENT
Thank you for the opportunity to serve you. Our Errors and Omissions insurance carrier requires us tomaintain current, signed engagement letters with our clients. Accordingly, this letter is coming to youin order to ensure a more complete understanding of the nature and extent of the services we agreeto perform, your responsibilities, and our fee arrangements. We have set forth in the followingparagraphs our understanding of these arrangements and responsibilities.
Income Tax PreparationWe will prepare your federal and state(s) income tax returns for this year and for subsequent years(including, if appropriate, estimated income tax return vouchers) from information furnished to us by you.We will continue to perform our services under the terms and conditions set forth in the EngagementAgreement in future years unless one of us notifies the other that changes are necessary. We will processyour returns through secure electronic media, outside computer service, or in house.We may utilize theservices of various third parties to assist in the preparation of your tax returns and we may make availableto them confidential information as necessary. Third parties may include accountants based locally and/oroverseas. You will be responsible for the accuracy and completeness of the information furnished to us inthe preparation of your returns. We will not audit or otherwise verify the data you submit. However, wemay ask you for clarification of some of the information or to furnish written or verbal assurance thatrecords or other evidence exists to substantiate deductions. We will furnish you with questionnaires,worksheets, or booklets upon request, and guide you in gathering the required information.
All of the information you submit to us will, to the best of your knowledge, be correct and complete, andwill include all income, deductions and other data necessary, for the preparation of your income taxreturns. Retention of the necessary documents which support data given to us is,of course, also yourresponsibility. If you have any questions about the type or duration of record retention, please ask us.
We will use our professional judgment in resolving questions of fact and in the application of pertinentlaw. Where the tax law is unclear, or where there are conflicting interpretations of the law by authorities(e.g. tax agencies and courts), we will explain all tax positions and alternative solutions. We will explainto you all the alternative solutions we have considered in arriving at a decisions on how best to categorizeand present your financial data and will advise you as to why we believe our proposed position isjustified. It is your ultimate responsibility to choose the appropriate alternative. We cannotguarantee the viability of the chosen solution or the ultimate result upon audit. Each position will be basedon facts presented by you. You will review the tax return presentation and disclosure and will evidenceyour agreement upon signing the tax return. If the Internal Revenue Service or state taxing authoritiesshould later contest the position taken, there may be an assessment of additional taxes, plus interest andpenalties. We assume no liability for such assessment. All returns are subject to certain rights ofappeal. In the event of such Government tax examination, we will be available, upon request, to representor assist you. Such additional services are not included in our fee for preparation of returns. Wewill ask for a $3,500 retainer before undertaking your audit defense.
During the normal course of our engagement, we will call to your attention matters that may affect our taxand accounting positions. However, we do not assume responsibility for discovering items whichmight provide the basis for amended returns. We will be available to answer your inquiries onspecific tax and financial matters and to consult with or assist you on financial income and estate planningmatters, including planning, to minimize income or estate taxes, to prepare income tax projections and toengage in research in connection with such matters. In any counseling with you on investments, or onpersonal, financial or tax planning, we may analyze proposed investments in terms of your financialposition and goals as well as their tax aspects. Regarding estate planning, it is customary for a marriedcouple to have the same accountant represent both of them in planning their estates. If you havedifferences of opinion as to the proper course of action, we will point out the pros and cons of thealternatives but we cannot advocate for either of your positions. Rules of professional conduct require thatwe not withhold any information obtained from one of you from the other. Lastly, if a dispute arisesbetween you so that we cannot perform the work we have undertaken, it will be necessary for us towithdraw as your joint planner and to advise one or both of you to obtain independent advise.
Business Advisory and Accounting We are available to work closely with businesses to provide a fullrange of services which may include business "start-up" planning, accounting and bookkeeping services,tax planning for closely held businesses, audit representation before the Internal Revenue Service,Franchise Tax Board, State Board of Equalization, Employment Development Department and otheragencies, payroll and pension planning. Business consultations in a variety of other areas are alsoavailable.
Fees Our fees for these services are based upon a minimum fee scale and may differ based upon thecomplexity of your tax return, billed at our standard hourly billing rates, in addition to charges forcomputer processing services, administrative service charges and any out-of-pocket costs. Out- of-pocketcosts are for items such as travel expenses, service bureau charges, and the like. Individual hourly ratescurrently range from $57 to $295 per hour. These rates vary according to the degree of responsibilityinvolved and the experience required.
We will collect fees upon completion of tax return preparation work on a "cash on delivery" basis. If weperform other work and agree to bill you on account, we will provide you with an invoice for fees andcosts incurred on a monthly basis, not exceeding every two months. You shall pay each invoice uponreceipt and cause said payment to be received by us within 30 days after invoice date. Finance charges inthe amount of 1% per month on the unpaid balance shall be assessed after 30 days. In the event thatpayment is not made on a timely basis, we will grant you an additional 30 days.
Should invoices remain unpaid for longer than 60 days, we are relieved of any further duties to you, and atour discretion cease all work on the "matter," and reserve the right to hold all work completed. Wereserve the right to bill a retainer. Firm policy also causes us to include in our charges any legal fees andcosts involving collecting outstanding balances due.
Disputes In the event of any dispute arising out of our work for you (excluding disputes over our feesand/or your payment), we and you agree to try in good faith to resolve the dispute through mediation, byselecting a neutral third party to help us reach an agreement. If we are unable to agree upon a neutralthird party to assist us, you and we agree to use the mediation services provided by the AmericanArbitration Association in San Francisco, California. If we are unable to resolve our differences throughmediation, then you and we hereby agree in advance to submit those differences to mandatory, binding,final and non-appealable arbitration in accordance with the rules of the American Arbitration Associationin San Francisco, California.
In agreeing to first mediate, then to arbitrate, you hereby acknowledge that, like us, you willingly give upthe right to have the dispute decided in a court of law before a judge or jury, as well as the right to appealthat outcome, and instead are accepting the use of mediation followed, as necessary, by bindingarbitration to insure cost-effective and timely resolution of all disputes which are subject to theseprovisions. All third party charges for mediating or arbitrating our differences shall be borne in equalshares by you and us, except that said charges shall be an element of the dispute, allocable as the partiesagree (in the case of a mediated result) or as the arbitrator determine (if arbitration is required). Feedisputes between you and us shall be subject to voluntary mediation and voluntary arbitration only. Eitherparty may, as its election, decline to submit a fee dispute to mediation and/or arbitration, in which event,either party shall be free to litigate the matter in a court of appropriate jurisdiction.
In any dispute arising out of this agreement, including any fee dispute, each side shall bear its own legalfees and associated costs, including its own expert's charges, regardless of whether the dispute ismediated, arbitrated, litigated, or subject to some other form of dispute resolution mechanism.
We appreciate the opportunity to serve you, and look forward to a continuing, mutually satisfyingrelationship. By your signature below, you agree that you have the proper records to substantiate allitems of income and deductions, including travel and entertainment expenses, that you will carefullyexamine and approve your completed tax returns before signing and mailing them to the tax authorities. If the above fairly sets forth your understanding, please sign below.
Sincerely,
Robert J. Hoffman, CPA, MS-Tax
Taxpayer Spouse Approved:
Date /___/___ Date ___/___/___.
If any of the following items pertain to you or your spouse for 2013, please check the appropriate box and provide additional information if necessary.
PERSONAL INFORMATIONYes No
Did your marital status change during the year? If yes, please explain.
Are you a Registered Domestic Partner, registered with the CaliforniaSecretary of State to allow you to file a California Joint tax return as a MarriedCouple?
If yes, you should include your partner's tax information.
Are you a Registered Domestic Partner with another State?
If yes, which State? __________________________________.
Did your address change during the year?
If yes, date of move______/______/_________Taxpayer.
If yes, date of move______/______/__________Spouse.
Jan. 1, 2013 Resident State_______________County_________.
Dec. 31, 2013 Resident State______________County_________.
Could you be claimed as a dependent on another person's tax return for 2013?
DEPENDENTSYes No
Were there any changes in dependents? If yes, please explain. Use back of sheetif needed.
Were any of your unmarried children who might be claimed as dependents19 years of age or older (24 years of age or older if Student)at the end of2013?
Did you have any children under age 19 or full-time students under age 24 at theend of 2013 with interest and dividend income in excess of $1,000, or totalinvestment income in excess of $2,000?
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions
INCOMEYes No
Did you receive unreported tip income of $20 or more in any month? If yes,please explain.
Did you cash any Series EE U.S. savings bonds issued after 1989 and payqualified higher education expenses for yourself, your spouse, or yourdependents? If yes, please explain.
Did you receive any disability income? If yes, please explain. Use back of sheetif needed.
Did you have any foreign income or pay any foreign taxes? If yes, pleaseexplain.
PURCHASES, SALES AND DEBTYes 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________?Did you Sell________?Did you Convert_______?
Did you buy or sell any stocks, bonds or other investment property in 2013?Did you Buy ___? Did you Sell ___?
If you had sales, have you included the COST basis for each sale in thisorganizer, if not, please ask your stock broker to fax the 2013 "Realized Gainand Loss Report" to us at 1-415-576-1099.
Did you purchase, sell, or refinance your principal home or second home, ordid you take a home equity loan?Purchase?_______ Principal home?________ Second home?__________Sell?___________ Principal home?________ Second home?__________Refinance?_______ Principal home?_______ Second home?__________Equity Loan?_______ Principal home?_______ Second home?__________
Did you purchase any residential energy-efficient, solar energy, wind energy,geothermal, or fuel cell property or improvements?
Have you provided us with the (1.)Final Buyers purchase escrow statement,your (2.)Final Sellers escrow statement and (3.)improvements list for yourreal estate? If not, please fax to our office at 1-415-576-1099.
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Yes NoHave you provided us, for each loan, beginning of year and end of yearbalances to determine deductibility of your mortgage interest expense?
If not, please fax to our office at 1-415-576-1099 your beginning of year andend of year loan balances for each loan.
Did you purchase a new motor vehicle in 2013? Attach the yellow "Bill OfSale."
Did you have any debts cancelled or forgiven?
If yes, have you provided us with, IRS form 1099-A "Acquisition orAbandonment of Secured Property" and/or IRS form 1099-C "Cancellation ofDebt" (if applicable) or amount of the debt---$___________________________and a description of the facts surrounding the cancellation or forgiveness. Usethe back of this page if need it
Did anyone owe you money which had become uncollectible?
If yes, have you provided us with a copy of the loan agreement. If not, pleasefax to our office at 1-415-576-1099.
Additional information needed, if not already in the Loan Agreement;
Name of debtor_______________________________________.
Amount of money that became uncollectible---$________________________.
Date the debt became uncollectable________/________/________________.
Is the debtor related to you_______________________?
Efforts you made to collect the money______________________.
Why do you believe the debt is uncollectible__________________?
RETIREMENT PLANSYes No
Did you receive a distribution from a retirement plan (401(k), IRA, SEP,SIMPLE, Qualified Plan, etc.)?
If yes, amount of distribution for 2013---$________________.
Did you make a contribution to a retirement plan (401(k), IRA, SEP, SIMPLE,Qualified Plan, etc.)?
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Yes NoDid you or your spouse make combined contributions to your 2013 401(k) plans,in excess of $17,500 if under age 50 for 2013? If yes, the amount above$17,500 should be withdrawn from your newest 401(k) plan by April 15,2014.
Did you or your spouse make combined contributions to your 2013 401(k) plans,in excess of $23,000 if age 50 by December 31, 2013 for 2013? If yes, theamount above $23,000 should be withdrawn from your newest 401(k) planby April 15, 2014.
Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a RothIRA?
If yes, please include your account statements for proper reporting of theconversion for 2013---Amount converted - $___________________.
Did you receive a distribution from a retirement plan that was subsequentlyrolled over into another retirement account within 60 days of receiving thedistribution?
If yes, please include your account statements for proper reporting of the rollover.
EDUCATIONYes No
Did you receive a distribution from an Education Savings Account or a QualifiedTuition Program?
If yes, amount of distribution---$_______________________________.
Did you, your spouse, or a dependent incur any tuition expenses that are requiredto attend a college, university, or vocational school?
If yes, amount of tuition expenses---$________________________________.
MOVING EXPENSESYes No
Did you incur unreimbursed moving expenses due to a change of employment?
Amount of your unreimbursed moving expenses (expenses in excess ofEmployer allowances)---$___________________.
Amount of your Transportation & Storage of house goods andeffects---$___________.
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Amount of your Travel & Lodging moving Old to Newhome---$_________________.
Miles from old home to new work place___________________________
Miles from old home to old work place___________________________
ITEMIZED DEDUCTIONSYes No
Did you incur a loss because of damaged or stolen property?
Date of loss______/_____/_______________.
Amount of damage or loss---$____________________.
Amount of insurance reimbursement---$______________________.
Did you temporarily work out of town for part of the year for your main job?
If yes, were any of those travel expenses unreimbursed?
Amount of your unreimbursed travel expenses---$_______________.
Did you use your car on the job (other than to and from work)?
If yes, please complete the lines below for your auto expenses, as follows;
Vehicle description_________________________.
Date you started using your car for business_____/_______/___________.
Total mileage this year_________________________________.
Business use mileage this year___________________________.
Average daily round-trip commute mileage________________.
Amount you paid for Parking fees andtolls---$_____________________________.
Amount you paid for Gasoline, lube,oil---$________________________________.
Amount you paid forRepairs---$______________________________________.
Amount you paid for Tires---$_______________________________________.
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Amount you paid forInsurance---$____________________________________.
Amount you paid for Auto Clubmembership---$___________________________.
Amount you paid for Washing,waxing---$______________________________.
Real Property Tax Paid in 2013
Main Home---$_____________.(Regular & Supplemental)
Second Home---$_____________.(Regular & Supplemental)
Other Real Property---$_____________.(Regular & Supplemental)
Personal Property Taxes Paid in 2013
Taxes Paid for your Car---New State $________. Former State $______.
Taxes Paid for your Boat---New State $________. Former State $______.
Taxes Paid for your Trailer---New State $________. Former State $_______.
Taxes Paid for your Motorcycle---New State $________. Former State$______.
CHARITABLE DONATIONS with Receipts ONLY Yes No
Did you make any CASH DONATIONS to a charities this year?
If yes, please provide the following; amount of cash donations made during 2013you have written records to substantiate the deduction, for example cancelledchecks, a receipt from the donee or other reliable written records showing thename of the donee, amount and date of the contribution. $__________.Donations above $250 must be substantiated by a written acknowledgement fromthe donee.
Did you make any NON-CASH DONATIONS to charities this year?
ESTIMATED TAXESYes No
Did you apply an overpayment of 2012 taxes to your 2013 estimated tax (insteadof being refunded)?
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Yes NoIf you have an overpayment of 2013 taxes, do you want the excess applied toyour 2014 estimated tax (instead of being refunded)?
Do you expect your 2014 taxable income and withholdings to be generally thesame as 2013?
If not, why not?
Increased income _________ deductions_________ withholdings_______?
Decreased income__________ deductions_________ withholdings_______?
MISCELLANEOUSYes No
Do you want to electronically file your tax return?
Do you want to allocate $3 to the Presidential Election Campaign Fund?
Does your spouse want to allocate $3 to the Presidential Election CampaignFund?
May the IRS discuss this return with the preparer?
Foreign Assets Disclosure*Did you have an interest in or signature or other authority over a financialaccount in a foreign country, such as a bank account, securities account, orother financial account?
*If yes, name of foreign country__________________________________.
*Jointly owned?
*Account type, (Bank) ,(Security),(Other, enter
type)___________________________.
*Number of Accounts____________________________.
*Highest Account Balance during the year$______________________________________.
*Name of Institution______________________________________________.
*Mailing address ofbranch_______________________________________________.
*Account number_______________________________________________.
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Yes No*Did you receive a distribution from, or were you the grantor of, or transferor to,a foreign trust?
Was your home rented out or used for business?
If yes, please complete the following;
Total sq. footage of home_____________. Sq. footage of rental or
business portion____________.
Amount you paid for Insurance---$________.
Amount you paid for Repairs and Maintenance---$________.
Amount you paid for Utilities---$________.
Amount you paid for Rent if renting your home---$________.
Amount you paid for Miscellaneous expenses---$________.
Did you make contributions to a health savings account (HSA) this year? Or,did you receive an HSA distribution or acquire an interest in an HSA due to thedeath of the account beneficiary? Generally for workers with high deductiblehealth insurance plans.
Did you have a medical savings account (MSA), a Medicare + Choice MSA, oracquire an interest in an MSA or a Medicare + Choice MSA because of the deathof the account holder? Or, were you a policyholder who received paymentsunder a long-term care (LTC) insurance contract or received any accelerateddeath benefits from a life insurance policy? Generally for Self-EmployedIndividuals with high deductible health insurance plans.
Did you engage the services of any household employees?
If yes, have you provided us with the payroll forms you filed?
Were you notified or audited by either the Internal Revenue Service or the Statetaxing agency?
If yes, have you provided us with the taxing agency determination letterindicating the amount of the change?
Did you or your spouse make any gifts to an individual that total more than$14,000, or any gifts to a trust?
If yes, have the appropriate forms been filed?
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
SHIPPING PROFILE
Address you prefer the finished tax returns & original documents be shipped?
________ Address on tax returns
OR
Other address _________________________________________
_________________________________________
_________________________________________
_________________________________________
ORGANIZER
2013 1040 US Miscellaneous Questions
Miscellaneous Questions (Continued)
Tax Return Appointment
Date:Telephone number: Time:Fax number: Location:E-mail address:
CLIENT INFORMATION
Filing status (table) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=married filing separate and lived with spouse. . . . . . . . . . . . . . . . . . . . . .
Year spouse died, if qualifying widow(er) (2011 or 2012) . . . . . . . . . . . . .
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. . . . . . . . . . . . . . . . . . . .
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. . . . . . . . . . . . . . . . . . . .
In care of . . . . . . . . . . . . . . . . .
Street address. . . . . . . . . . . . .
Apartment number. . . . . . . . .
City. . . . . . . . . . . . . . . . . . . . . . .
State . . . . . . . . . . . . . . . . . . . . .
ZIP code. . . . . . . . . . . . . . . . . .
Region. . . . . . . . . . . . . . . . . . . .
Postal code . . . . . . . . . . . . . . .
Country . . . . . . . . . . . . . . . . . . .
Filing Status
1 = Single2 = Married filing joint3 = Married filing separate4 = Head of household5 = Qualifying widow(er)
FilingStatus
Taxpayer
Spouse
Address
ForeignAddress
1040 US Client Information 1
Client Information
1
ORGANIZER
Series:
This tax organizer will assist you in gathering information necessary for the preparationof your 2013 tax return. Please add, change, or delete information as appropriate.
2013
Robert J. Hoffman & Company CPA's300 Montgomery Street, Suite 730San Francisco, CA 94104-1909
(415) 576-1040
(415) [email protected]
Home phone . . . . . . . . . . . . . .
Work phone . . . . . . . . . . . . . . .
Work extension. . . . . . . . . . . .
Daytime phone (table) . . . . .
Mobile phone. . . . . . . . . . . . . .
Pager number. . . . . . . . . . . . .
Fax number . . . . . . . . . . . . . . .
E-mail address . . . . . . . . . . . .
Home phone . . . . . . . . . . . . . .
Work phone . . . . . . . . . . . . . . .
Work extension. . . . . . . . . . . .
Daytime phone (table) . . . . .
Mobile phone. . . . . . . . . . . . . .
Pager number. . . . . . . . . . . . .
Fax number . . . . . . . . . . . . . . .
E-mail address . . . . . . . . . . . .
Please add, change or delete information for 2013.
CLIENT INFORMATION
TaxpayerContact
Information
SpouseContact
Information
Daytime Phone
1 = Work2 = Home3 = Mobile
1040 US Client Information (continued) 1 p2
Client Information (continued)
1 p2
ORGANIZER
Series:
2013
DEPENDENTS
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Title/suffix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number . . . . . . . . . . . . . . . . . . .
Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Months lived at home. . . . . . . . . . . . . . . . . . . . .
Type of dependent (see table) . . . . . . . . . . . .
Earned income credit (see table). . . . . . . . . .
Claimed by: 1=taxpayer, 2=spouse . . . . . . . .
Type of Dependent
1 = Child living w/taxpayer2 = Child not living w/taxpayer3 = Dependent other than child4 = Head of household only,
not a dependent5 = Earned income credit only,
not a dependent
Earned Income Credit
1 = When applicable (default)2 = Student age 19 to 233 = Disabled4 = Force5 = Suppress
Dependent Dependent
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Title/suffix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number . . . . . . . . . . . . . . . . . . .
Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Months lived at home. . . . . . . . . . . . . . . . . . . . .
Type of dependent (see table) . . . . . . . . . . . .
Earned income credit (see table). . . . . . . . . .
Claimed by: 1=taxpayer, 2=spouse . . . . . . . .
Dependent Dependent
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Title/suffix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number . . . . . . . . . . . . . . . . . . .
Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Months lived at home. . . . . . . . . . . . . . . . . . . . .
Type of dependent (see table) . . . . . . . . . . . .
Earned income credit (see table). . . . . . . . . .
Claimed by: 1=taxpayer, 2=spouse . . . . . . . .
Dependent Dependent
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Title/suffix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number . . . . . . . . . . . . . . . . . . .
Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Months lived at home. . . . . . . . . . . . . . . . . . . . .
Type of dependent (see table) . . . . . . . . . . . .
Earned income credit (see table). . . . . . . . . .
Claimed by: 1=taxpayer, 2=spouse . . . . . . . .
Dependent Dependent
1040 US Dependents 2
Dependents
2
ORGANIZER
Series:
2013
Please add, change or delete information for 2013.
NOTE: If you claim the earnedincome credit, please provideproof that your child is a res-ident of the U.S. This proof istypically in the form of:
1. School records or statement2. Landlord or property man-
agement statement3. Health care provider
statement4. Medical records5. Child care provider records6. Placement agency statement7. Social service records or
statement8. Place of worship statement9. Indian tribe office statement
10. Employer statement
NOTE: If your child is disabled,please provide one of the fol-lowing forms of proof of disa-bility:
1. Doctor statement2. Other health care provider
statement3. Social services agency or
program statement
Name of Bank Routing Number Account Number
Please enter all pertinent 2013 information.
DIRECT DEPOSIT / ELECTRONIC PAYMENT (3)
1=direct deposit of federal tax refund into bank account. . . . . . . . . . . . . . . . . .
1=electronic payment of balance due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=electronic payment of estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Percent toDeposit(xx.xx)
BANK INFORMATIONType ofAccount(Table 1)
Type ofInvest.
(Table 2)
1 Type of Account
1 = Savings2 = Checking
2 Type of Investment
1 = Checking or savings (default)2 = Taxpayer's IRA (next year limits)3 = Spouse's IRA (next year limits)4 = Health savings account (HSA)5 = Archer MSA
6 = Coverdell savings account (ESA)7 = Other8 = Taxpayer's IRA (current year limits)9 = Spouse's IRA (current year limits)
1040 US Direct Deposit & Estimates (Form 1040 ES) 3, 6
Direct Deposit & Estimates (Form 1040 ES)
3, 6
ORGANIZER
Series: 5100, 5400 (t=taxpayer, s=spouse, blank=joint)
Federal Amount Paid Date Paid TS
Overpayment applied from 2012. . . . . . . . . . .
1st quarter payment . . . . . . . . . . . . . . . . . . . . . .
2nd quarter payment. . . . . . . . . . . . . . . . . . . . . .
3rd quarter payment. . . . . . . . . . . . . . . . . . . . . .
4th quarter payment . . . . . . . . . . . . . . . . . . . . . .
Paid with extension. . . . . . . . . . . . . . . . . . . . . . .
State
Additional EstimatedTax Payments
Additional EstimatedTax Payments
Amount Paid Date Paid TS
2013
2013 ESTIMATED TAX / 1040-ES (6)
Overpayment applied from 2012. . . . . . . . . . .
1st quarter payment . . . . . . . . . . . . . . . . . . . . . .
2nd quarter payment. . . . . . . . . . . . . . . . . . . . . .
3rd quarter payment. . . . . . . . . . . . . . . . . . . . . .
4th quarter payment . . . . . . . . . . . . . . . . . . . . . .
Paid with extension. . . . . . . . . . . . . . . . . . . . . . .
2013Voucher Amount
2013Voucher Amount
Please enter all pertinent 2013 information.
APPLICATION OF 2013 OVERPAYMENT (7.1)
If you have an overpayment of 2013 taxes, do you want the excess refunded?. . or applied to 2014 estimate?. . . .
Other (please explain):
2014 ESTIMATED TAX INFORMATION
Do you expect your 2014 taxable income to be different from 2013? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If "yes" explain any differences in income, deductions, dependents, etc.:
Do you expect your 2014 withholding to be different from 2013? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If "yes" explain any differences:
Yes No
1040 US Direct Deposit & Estimates (Form 1040 ES) (cont.)
Direct Deposit & Estimates (Form 1040 ES) (cont.)
ORGANIZER
Series: 5400
7.1
7.1(t=taxpayer, s=spouse, blank=joint)
2013
(T=taxpayer, S=spouse, Blank=joint)
WAGES, SALARIES, TIPS (10)
GAMBLING WINNINGS (W-2G) (13.2)
PENSIONS, IRA DISTRIBUTIONS (13.1)
GAMBLING LOSSES & WINNINGS (NON W-2G)(13.2)
TS
Total gambling losses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Winnings not reported on Form W-2G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No. SocialSecurity(Box 4)
Name of Employer (Box c)
1=retirementplan (Box 13)
1=spouse
Wages, Tips,Other
Compensation(Box 1)
Tax Withheld
2012WagesFederal
(Box 2)Medicare(Box 6)
State(Box 17)
Local(Box 19)
No. Name of Payer
Distribution code #2
Distribution code #1
1=IRA/SEP/SIMPLE
1=spouse
GrossDistribution
(Box 1)
TaxableAmount(Box 2a)
Tax Withheld
Federal(Box 4)
State(Box 12)
Value ofall IRAs
at12/31/13
2012Distribution
No. Name of Payer 1=spouseGross Winnings
(Box 1)
Tax Withheld
Federal (Box 4) State (Box 15)
2012Winnings
1040 US Wages, Pensions, Gambling Winnings 10, 13.1, 13.2
Wages, Pensions, Gambling Winnings
10, 13.1, 13.2
ORGANIZER
Series: 11, 14, 19
2013
Please enter all pertinent 2013 amounts & attach all W-2, W-2G and 1099-R forms.Last year's amounts are provided for your reference.
2013 Amount 2012 Amount
Please enter all pertinent 2013 amounts & attach all 1099-INT, 1099-OID and 1099-DIV forms.Last year's amounts are provided for your reference.
INTEREST INCOME (11)
DIVIDEND INCOME (12)
No.Name of Payer
(also enter SSN & addressfor seller-financed mortgage)
1=taxpayer2=spouse
Banks,S&Ls, C/Us,etc. (Box 1)
Interest Income
Seller-Financed
Mtg. (Box 1)
U.S. Bonds,T-Bills(Box 3)
Tax-Exempt Interest
TotalMunicipal
Bonds
In-stateMunicipal
Bonds
EarlyWithdrawalPenalty(Box 2)
2012Interest
No. Name of Payer1=tp2=sp
Total OrdinaryDividends(Box 1a)
Dividend Income
QualifiedDividends(Box 1b)
Total CapitalGain Distrib.
(Box 2a)
U.S. Bonds(% or amt.)
TotalMunicipal
Bonds
Tax-Exempt Interest
In-stateMuni-bonds(% or amt.)
ForeignTax Paid(Box 6)
2012Dividends
1040 US Interest & Dividend Income 11, 12
Interest & Dividend Income
11, 12
ORGANIZER
Series: 12, 13
2013
Other income (1099-MISC, box 3, 8)
TAX WITHHELD (not entered elsewhere)
Federal income tax withheld. . . . . . . . . . . . . . . . . . . . . .
State income tax withheld. . . . . . . . . . . . . . . . . . . . . . . .
Local income tax withheld. . . . . . . . . . . . . . . . . . . . . . . .
Income from rental of personal property. . . . . . . . . . .
Income subject to S/E tax:
MISCELLANEOUS INCOME 2013 Amount 2012 Amount
Taxpayer Spouse Taxpayer Spouse
Social security benefits (SSA-1099, box 5) . . . . . . . .
Medicare premiums paid (SSA-1099) . . . . . . . . . . . . .
Tier 1 RR retirement benefits (RRB-1099, box 5). . .
1=lump-sum election for SS benefits. . . . . . . . . . . . . .
Alimony received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable scholarships and fellowships . . . . . . . . . . . . .
Jury duty pay. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Household employee income not on W-2. . . . . . . . . .
Excess minister's allowance. . . . . . . . . . . . . . . . . . . . . .
Alaska permanent fund dividends. . . . . . . . . . . . . . . . .
Please enter all pertinent 2013 amounts and attach all 1099-MISC, SSA-1099,and RRB-1099 forms. Last year's amounts are provided for your reference.
1040 US Miscellaneous Income 14.1
Miscellaneous Income
14.1
ORGANIZER
Series: 200
2013
STATE AND LOCAL TAX REFUNDS /UNEMPLOYMENT COMPENSATION (Form 1099-G)
2013 1099-G Amount
Please add, change or delete 2013 information as appropriate.Be sure to attach all 1099-G forms.
No.
Name of payer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Unemployment compensation:
Total received (Box 1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013 Overpayment repaid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State and local refunds:
State and local income tax refund, credit or offsets (Box 2)
1=city or local income tax refund . . . . . . . . . . . . . . . . . . . . . . . .
Tax year for box 2 if not 2012 (Box 3). . . . . . . . . . . . . . . . . . . .
Federal income tax withheld (Box 4). . . . . . . . . . . . . . . . . . . . . . . . . . .
RTAA payments (Box 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable grants:
Federal taxable amount (Box 6) . . . . . . . . . . . . . . . . . . . . . . . . .
State taxable amount, if different . . . . . . . . . . . . . . . . . . . . . . . .
Farm amounts:
Agriculture payments (Box 7). . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=agriculture payments are from conservation reserve program. . . . . . . . .
Market gain (Box 9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of farm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=box 2 is trade or business income (Box 8) . . . . . . . . . . . . . . . . . . .
State income tax withheld (Box 11). . . . . . . . . . . . . . . . . . . . . . . . . . . .
No.
1040 US State & Local Tax Refunds / Unemployment Compensation 14.2
State & Local Tax Refunds / Unemployment Compensation
14.2
ORGANIZER
Series: 15, 16
Name of payer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Unemployment compensation:
Total received (Box 1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013 Overpayment repaid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State and local refunds:
State and local income tax refund, credit or offsets (Box 2)
1=city or local income tax refund . . . . . . . . . . . . . . . . . . . . . . . .
Tax year for box 2 if not 2012 (Box 3). . . . . . . . . . . . . . . . . . . .
Federal income tax withheld (Box 4). . . . . . . . . . . . . . . . . . . . . . . . . . .
RTAA payments (Box 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable grants:
Federal taxable amount (Box 6) . . . . . . . . . . . . . . . . . . . . . . . . .
State taxable amount, if different . . . . . . . . . . . . . . . . . . . . . . . .
Farm amounts:
Agriculture payments (Box 7). . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=agriculture payments are from conservation reserve program. . . . . . . . .
Market gain (Box 9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of farm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=box 2 is trade or business income (Box 8) . . . . . . . . . . . . . . . . . . .
State income tax withheld (Box 11). . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013
ESA'S AND QTP'S (Form 1099-Q)
Name of payer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Qualified expenses:
Higher education (net of nontaxable benefits). . . . . . . . . . . . .
Elementary & secondary education (net of nontaxable benefits).
Form 1099-Q:
Gross distributions (Box 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Earnings (Box 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Basis (Box 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rollover: 1=nontaxable, 2=taxable (Box 4). . . . . . . . . . . . . . . .
Distribution type: 1=private 529, 2=state 529, 3=Coverdell ESA (Box 5). . .
ESA's only:
2013 contributions to this ESA. . . . . . . . . . . . . . . . . . . . . . . . . . .
Value of this account at 12/31/13 (plus outstanding rollovers) . . .
Basis in this ESA as of 12/31/12. . . . . . . . . . . . . . . . . . . . . . . . .
Please enter all pertinent 2013 amounts and attach all 1099-Q forms.Enter qualified education expenses below that are not entered elsewhere.
Last year's amounts are provided for your reference.
No.
No.
No.
1040 US Education Distributions (ESA's and QTP's) 14.3
Education Distributions (ESA's and QTP's)
14.3
ORGANIZER
Series: 15, 16
Name of payer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Qualified expenses:
Higher education (net of nontaxable benefits). . . . . . . . . . . . .
Elementary & secondary education (net of nontaxable benefits).
Form 1099-Q:
Gross distributions (Box 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Earnings (Box 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Basis (Box 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rollover: 1=nontaxable, 2=taxable (Box 4). . . . . . . . . . . . . . . .
Distribution type: 1=private 529, 2=state 529, 3=Coverdell ESA (Box 5). . .
ESA's only:
Name of payer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Qualified expenses:
Higher education (net of nontaxable benefits). . . . . . . . . . . . .
Elementary & secondary education (net of nontaxable benefits).
Form 1099-Q:
Gross distributions (Box 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Earnings (Box 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Basis (Box 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rollover: 1=nontaxable, 2=taxable (Box 4). . . . . . . . . . . . . . . .
Distribution type: 1=private 529, 2=state 529, 3=Coverdell ESA (Box 5). . .
ESA's only:
2013
2013 Amount 2012 Amount
2013 contributions to this ESA. . . . . . . . . . . . . . . . . . . . . . . . . . .
Value of this account at 12/31/13 (plus outstanding rollovers) . . .
Basis in this ESA as of 12/31/12. . . . . . . . . . . . . . . . . . . . . . . . .
2013 contributions to this ESA. . . . . . . . . . . . . . . . . . . . . . . . . . .
Value of this account at 12/31/13 (plus outstanding rollovers) . . .
Basis in this ESA as of 12/31/12. . . . . . . . . . . . . . . . . . . . . . . . .
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference.
GENERAL INFORMATION
Principal business/profession. . . . . . . . . . . . . . . . . . .
Principal business code. . . . . . . . . . . . . . . . . . . . . . . .
Business name, if different from Form 1040 . . . . .
Business address, if different from Form 1040 . . .
City, if different from Form 1040. . . . . . . . . . . . . . . .
Employer identification number. . . . . . . . . . . . . . . . .
Other accounting method. . . . . . . . . . . . . . . . . . . . . . .
Accounting method: 1=cash, 2=accrual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventory method: 1=cost, 2=lower cost/market, 3=other. . . . . . . . . . . . . . . . . . .
1=change of inventory method. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse, 2=joint. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=first Schedule C filed for this business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If required to file Form(s) 1099, did you or will you file all required Form(s) 1099: 1=yes, 2=no. .
1=not subject to self-employment tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=did not "materially participate". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=personal services is not a material income producing factor. . . . . . . . . . . . . .
1=investment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=minister's Schedule C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=single member limited liability company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
INCOME
Gross receipts or sales (Form 1099-MISC, box 7) . . . . . . . . . . . . . . . . . . . . . . . . . .
Returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other income:
Inventory at beginning of the year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Purchases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cost of items for personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cost of labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other costs:
Inventory at end of the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
COST OF GOODS SOLD
1040 US Business Income (Schedule C) 16
16
ORGANIZER
Series: 51
No.
State, if different from Form 1040. . . . . . . . . . . . . . .
ZIP code, if different from Form 1040 . . . . . . . . . . .
2013
2013 Amount 2012 Amount
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference.
EXPENSES
Postage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rent - vehicles, machinery, & equipment (not entered elsewhere). . . . . . . . . . .
Rent - other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - real estate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - sales tax included in gross receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - other (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Travel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total meals and entertainment in full (50%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Department of Transportation meals in full (80%). . . . . . . . . . . . . . . . . . . . . . . . . .
Uniforms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other expenses:
NOTE: If you purchased or disposed of any business assets, please complete Sheet 22.
Accounting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Answering service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bad debts from sales or service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Bank charges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Car and truck expenses (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . .
Commissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contract labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Delivery and freight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dues and subscriptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Insurance (other than health). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mortgage interest (paid to banks, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other interest (not entered elsewhere) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Janitorial. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Laundry and cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Legal and professional. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Office expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Outside services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parking and tolls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pension and profit sharing plans - contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Pension and profit sharing plans - admin. and education costs. . . . . . . . . . . . . .
1040 US Business Income (Schedule C) (cont.) 16 p2
Business Income (Schedule C) (cont.)
16 p2
ORGANIZER
Series: 51
No.2013
2013 Amount 2012 Amount
If you sold any stocks, bonds, or other investment property in 2013, please list the pertinentinformation for each sale below or provide a spreadsheet file with this information.
Be sure to attach all 1099-B forms and brokerage statements.
QuantityNo.Description of Property
(Box 8)
DateAcquired(Box 1b)
Date Sold(Box 1a)
Sales Price(gross or net)
(Box 2)
Cost or Basis(Box 3)
Expenses of Sale(if gross salesprice entered)
Federal IncomeTax Withheld(Box 4)
1040 US Capital Gains & Losses (Schedule D) 17
Capital Gains & Losses (Schedule D)
17
ORGANIZER
Series: 52
2013
Blank=basis rep.to IRS, 1=nonrec.security (Box 6)
MOVING EXPENSES (27) (If you moved because of a change in the location of your job)
1=spouse, 2=joint. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=armed forces move due to permanent change of station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miles from old home to new work place. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miles from old home to old work place. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expenses for transportation and storage of household goods and personal effects . . . . . . . . . . . . . . . . . . . . . . . .
Lodging and travel (excluding meals):
Lodging and travel (excluding automobile). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parking fees and tolls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gas and oil. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miles driven to new home. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(* owned and used property as main home for at least 2 of 5 years before sale)
SALE OF HOME (17)
Description of property (Box 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date acquired (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date sold (m/d/y) (Box 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sales price (Box 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=sale of home. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=owned and used property as main home for at least 2 of 5 years before sale. . . . . . . . . . . . . . . . . . . . . . . . . . .
1=first-time homebuyer credit was previously taken on this home. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=business use in year of sale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of days after December 31, 2008 that home was not used as principal residence. . . . . . . . . . . . . . . . . .
Adjusted BasisOriginal cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Improvements:
Adjusted basis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expenses of Sale (Commissions, advertising fees, legal fees, and loan charges paid by the seller)
Total expenses of sale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reduced Exclusion
If excl. gain from another home after May 6, 1997 & within 2 yrs. of current sale, enter date of sale (m/d/y)
1=sale due to change in health, employment or unforeseen circumstances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Days used as main home - taxpayer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Days used as main home - spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Days property owned - taxpayer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Days property owned - spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you sold your home or moved in 2013, please complete the information below.For the sale of home, please provide Form 1099-S and closing statements from
the purchase and sale of your home.
Please complete the following information if due to a change in health, place of employment, or unforeseen circumstances you either:a) Did not meet the ownership and use tests *, or b) Excluded gain on the sale of another home after May 6, 1997.
1040 US Sale of Home & Moving Expenses 17, 27
Sale of Home & Moving Expenses
17, 27
ORGANIZER
Series: 52, 500
2013
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference.
Description of property. . . . . . . . .
Street address. . . . . . . . . . . . . . . . .
Percentage of ownershipif not 100% (.xxxx). . . . . . . . . . . . . . . . . Percentage of tenant occupancyif not 100% (.xxxx). . . . . . . . . . . . . . . . .
1=nonpassive activity,2=passive royalty . . . . . . . . . . . . . . . . . .
1=single member limitedliability company . . . . . . . . . . . . . . . . . .
INCOME
Rents or royalties received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
DIRECT EXPENSES
Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Association dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Auto and travel (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cleaning and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Commissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gardening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Legal and professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Licenses and permits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Management fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mortgage interest (paid to banks, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NOTE: If you purchased or disposed of any business assets, please complete Sheet 22.
NOTE: Direct expenses are related only to the rental activity. These include rental agency fees, advertising, and office supplies.
1040 US Rental & Royalty Income (Schedule E) 18
Rental & Royalty Income (Schedule E)
18
ORGANIZER
Series: 53
No.
City. . . . . . . . . . . . . . . . . . . . . . . . . . .
State . . . . . . . . . . . . . . . . . . . . . . . . .
ZIP code. . . . . . . . . . . . . . . . . . . . . .
Type of property (see table). . . .
Other type of property. . . . . . . . . .
If required to file Form(s) 1099, did you or will you file all required Form(s) 1099: 1=yes, 2=no. . . . . . . . .
Qualified mortgage insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Excess mortgage interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other interest (not entered elsewhere) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Painting and decorating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013
2013 Amount 2012 Amount
Number of days rented. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013 Amount 2012 AmountGENERAL INFORMATION
1=spouse, 2=joint. . . . . . . . . . . . . .
1=qualified joint venture. . . . . . . .
1=did not actively participate. . .
1=real estate professional. . . . . .
1=rental other than real estate .
1=investment. . . . . . . . . . . . . . . . . .
Other:
Pest control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Plumbing and electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - real estate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - other (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Wages and salaries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Type of Property
1 = Single Family Residence2 = Multi-Family Residence3 = Vacation/Short-Term Rental4 = Commercial5 = Land6 = Royalties7 = Self-Rental
OIL AND GAS
Production type (preparer use only). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cost depletion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Percentage depletion rate or amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State cost depletion, if different (-1 if none) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State % depletion rate or amount, if different (-1 if none). . . . . . . . . . . . . . . . . . .
VACATION HOME
Number of days personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of days owned (if optional method elected). . . . . . . . . . . . . . . . . . . . . . . .
INDIRECT EXPENSES
Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Association dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Auto and travel (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cleaning and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Commissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gardening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Legal and professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Licenses and permits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Management fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mortgage interest (paid to banks, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference. The indirectexpense column should only be used for vacation homes or less than 100% tenant occupied rentals.
NOTE:Indirect expenses are related to operating or maintaining the dwelling unit.These include repairs, insurance, and utilities.
1040 US Rental & Royalty Income (Sch. E) (cont.) 18 p2
Rental & Royalty Income (Sch. E) (cont.)
18 p2
ORGANIZER
Series: 53
No.
Qualified mortgage insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Excess mortgage interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other interest (not entered elsewhere) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Painting and decorating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013
Other:
Pest control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Plumbing and electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - real estate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxes - other (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Wages and salaries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
TAXES PAID (State and local withholding and 2013 estimates are automatic.)
State income taxes - 1/13 payment on 2012 state estimate. . . . . . . . . . . . .
State income taxes - paid with 2012 state return. . . . . . . . . . . . . . . . . . . . . . .
State income taxes - paid for prior years and/or to other state. . . . . . . . . .
MEDICAL AND DENTAL EXPENSES
TS
Prescription medicines and drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Doctors, dentists and nurses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hospitals and nursing homes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Insurance premiums not entered elsewhere (excl. LT care & amts. paid w/pre-tax dollars). .
Long-term care premiums - taxpayer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Long-term care premiums - spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Insurance reimbursement (enter as a positive number). . . . . . . . . . . . . . . . .
Lodging and transportation:
Out-of-pocket expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Medical miles driven. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other medical and dental expenses:
Please enter all pertinent 2013 amounts and attach all 1098 forms.Last year's amounts are provided for your reference.
City/local income taxes - 1/13 payment on 2012 city/local estimate. . . . . .
City/local income taxes - paid with 2012 city/local extension . . . . . . . . . . . .
City/local income taxes - paid with 2012 city/local return. . . . . . . . . . . . . . . .
1040 US Itemized Deductions 25
Itemized Deductions
25
ORGANIZER
Series: 400
NOTE:Enter self-employed health insurance premiums on Sheet 24 andMedicare insurance premiums on Sheet 14.
SALES AND USE TAXES PAID
State and local sales taxes (except autos and special items) . . . . . . . . . . .
Use taxes paid on 2013 purchases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Use taxes paid with 2012 state return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sales tax on autos not included above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sales tax on boats, aircraft, other special items. . . . . . . . . . . . . . . . . . . . . . . .
OTHER TAXES PAID
Real estate taxes - property held for investment . . . . . . . . . . . . . . . . . . . . . . .
Personal property taxes (including auto fees in some states. Provide a copy of tax notice). . .
Foreign income taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Real estate taxes - principal residence:
Other taxes:
2013
2013 Amount 2012 Amount
State income taxes - paid with 2012 state return extension. . . . . . . . . . . . .
(T=taxpayer, S=spouse, Blank=joint)
Veterans' organizations, fraternal societies, nonprofit cemeteries, and certain private nonoperating foundations (30% limitation):
Contributions by cash or check:
Volunteer expenses (out-of-pocket) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of charitable miles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
INTEREST PAID
Home mortgage int. (Box 1) and points (Box 2) reported on Form 1098:
Home mortgage interest not reported on Form 1098:
Payee's name. . . . . . . . . .
Payee's SSN or FEIN. . .
Payee's street address .
Payee's city. . . . . . . . . . . .
Amount paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Points not reported on Form 1098:
Mortgage insurance premiums on post 12/31/06 contracts (Box 4). . . . .
Passive interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Certain home mortgage interest included above (6251). . . . . . . . . . . . . . . . .
CASH CONTRIBUTIONS
Churches, schools, hospitals, and other charitable organizations (50% limitation):
Contributions by cash or check:
Volunteer expenses (out-of-pocket) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of charitable miles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
TS
Investment interest (interest on margin accounts):
NOTE:Points paid on loans other than to buy, build, or improve your main home are deductible over the life of the mortgage.For these types of loans also provide the dates and lives of the loans.
NOTE:No deduction is allowed for cash or check contributions unless the donor maintains a bank record, or a written communicationfrom the donee, showing the name of the organization, contribution date(s), and contribution amount(s).
1040 US Itemized Deductions (continued) 25 p2
Itemized Deductions (continued)
25 p2
ORGANIZER
Series: 400
2013
2013 Amount 2012 Amount
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference.
Payee's state . . . . . . . . . .
Payee's ZIP code. . . . . . .
(T=taxpayer, S=spouse, Blank=joint)
Tax return preparation fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Safe deposit box rental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Investment expense:
MISCELLANEOUS DEDUCTIONS (subject to 2% AGI limit)
Union and professional dues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
50% limitation (see above):
30% limitation (see above):
30% capital gain property (gifts of capital gain property to 50% limit orgs.):
20% capital gain property (gifts of capital gain property to non-50% limit orgs.):
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference.
NONCASH CONTRIBUTIONS
TS
Other unreimbursed employee expenses (uniforms and protective clothing,professional subscriptions, employment agency fees, and certain edu. expenses):
Miscellaneous deductions (2% AGI) (certain legal and accounting fees,and custodial fees):
1040 US Itemized Deductions (continued) 25 p3
Itemized Deductions (continued)
25 p3
ORGANIZER
Series: 400
NOTE:Use Sheet 26 if total noncash contributions are over $500. No deduction is allowed for contributions of clothing and household itemsthat are not in good used condition or better. In addition, a deduction for any item with minimal monetary value may be denied.
2013
2013 Amount 2012 Amount
OTHER MISCELLANEOUS DEDUCTIONS
Estate tax, section 691(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other miscellaneous deductions:
TS
1040 US Itemized Deductions (continued) 25 p4
Itemized Deductions (continued)
25 p4
ORGANIZER
Series: 400 (T=taxpayer, S=spouse, Blank=joint)
2013
Please enter all pertinent 2013 amounts. Last year's amounts are provided for your reference.
2013 Amount 2012 Amount
Lender's name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Form (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=taxpayer, 2=spouse, blank=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Points paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total principal paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lump sum principal payment (if paid off) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Months outstanding (if not 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Home acquisition debt balance - beginning of year . . . . . . . . . . . . . . . . . . . . .
Home acquisition debt borrowed in 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Home equity debt balance - beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . .
Home equity debt borrowed in 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Grandfather debt balance - beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2.
NOTE: When completing the input section below, grandfather debt represents loans taken out prior to October 14, 1987.
LOAN INFORMATION
Fair market value of the property on the date that the last debt was secured.
Home acquisition and grandfather debt on the date that the last debt was secured . . . . . . . . . . . .
Loan #1
Lender's name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Form (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=taxpayer, 2=spouse, blank=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Points paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total principal paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lump sum principal payment (if paid off) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Months outstanding (if not 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Home acquisition debt balance - beginning of year . . . . . . . . . . . . . . . . . . . . .
Home acquisition debt borrowed in 2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Home equity debt balance - beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . .
Home equity debt borrowed in 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Grandfather debt balance - beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . .
Loan #2
If either of the following conditions below apply to you, your home mortgage interest deduction may need to belimited and the input section provided below should be completed. If neither condition applies, enter homemortgage interest amounts on organizer sheet 25 p2.
Total home equity debt exceeded $100,000 at any time during 2013 ($50,000 if married filing separate). For this purpose, home equitydebt is defined as any mortgages taken out after October 13, 1987 in which the proceeds were used for purposes other than to buy, build,or improve your home. An example of this type of mortgage is a home equity loan use to pay off credit card bills, buy a car, or pay tuition.
Total home acquisition debt exceeded $1,000,000 at any time during 2013 ($500,000 if married filing separate). For this purpose, homeacquisition debt is defined as any mortgages taken out after October 13, 1987 in which the proceeds were used to buy, build, or improveyour home.
Please enter all pertinent 2013 amounts and attach all 1098 forms.Last year's amounts are provided for your reference.
TS
1040 US Itemized Deductions (continued) 25 p5
Itemized Deductions (continued)
25 p5
ORGANIZER
Series: 400
Form
1 = Schedule A (default)2 = Business use of home3 = Schedule E
2013
2013 Amount 2012 Amount
1 How Property was Acquired
1 = Purchase2 = Gift
3 = Inheritance4 = Exchange
Name of charitable organization (donee). . . . . . . . . . . . . . . . . . . . . . .
Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property description (other than vehicle). . . . . . . . . . . . . . . . . . . . . . .
Year (yyyy). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Make and model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mileage at time of donation. . . . . . . . . . . . . . . . . . . . . . .
Date of contribution (m/d/y) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date acquired by donor (m/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How acquired by donor (Table 1 or describe). . . . . . . . . . . . . . . . . . .
Donor's cost or basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fair market value. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Method used to determine FMV (Table 2 or describe) . . . . . . . . . . .
2 Method Used to Determine FMV
1 = Appraisal2 = Thrift shop value
3 = Catalog4 = Comparable sales
For other methods, see IRS Pub. 561.
*
DONATED PROPERTY INFORMATION
If your total noncash contributions are in excess of $500 in 2013, please complete the information below foreach donee using the following guidelines:
If you contributed a motor vehicle, boat, or airplane with a claimed value of more than $500, attach Form 1098-C or other writtenacknowledgement received from the donee organization.
A deduction for contributions of clothing or other household items that are not in good used condition or better is not allowed. In addition, adeduction for any item with minimal monetary value may be denied. However, these rules do not apply to any contribution of a single item forwhich a deduction of more than $500 is claimed, if a qualified appraisal for the donated property is provided.
*
No.Vehicle
1040 US Noncash Contributions (Form 8283) 26
Noncash Contributions (Form 8283)
26
ORGANIZER
Series: 21
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ZIP code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2013
Identification number (VIN). . . . . . . . . . . . . . . . . . . . . . .
Name of charitable organization (donee). . . . . . . . . . . . . . . . . . . . . . .
Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property description (other than vehicle). . . . . . . . . . . . . . . . . . . . . . .
Year (yyyy). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Make and model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mileage at time of donation. . . . . . . . . . . . . . . . . . . . . . .
Date of contribution (m/d/y) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date acquired by donor (m/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
How acquired by donor (Table 1 or describe). . . . . . . . . . . . . . . . . . .
Donor's cost or basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fair market value. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Method used to determine FMV (Table 2 or describe) . . . . . . . . . . .
No.Vehicle
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ZIP code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Identification number (VIN). . . . . . . . . . . . . . . . . . . . . . .
HSA DISTRIBUTIONS
Total HSA distribution received (1099-SA, box 1) . .
Total unreimbursed qualified medical expenses. . . .
HSA CONTRIBUTIONS
Taxpayer Spouse Taxpayer Spouse
1=self-only coverage, 2=family coverage. . . . . . . . . .
Contributions made to date. . . . . . . . . . . . . . . . . . . . . . .
Please enter all pertinent 2013 amounts & attach all 1099-SA forms.Last year's amounts are provided for your reference.
HSA contributions you made or expect to make,except rollovers, employer contributions, andcontributions made to an employee accountthrough a cafeteria plan (1=maximum). . . . . . . . . . . .
Contributions included above that were made afteryou became eligible for Medicare. . . . . . . . . . . . . . . . .
Distributions included above that were rolled overto another HSA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1040 US Health Savings Accounts (8889) 32.1
Health Savings Accounts (8889)
32.1
ORGANIZER
Series: 2800
NOTE:Contributions to an HSA are only eligible to persons covered under a high deductible health plan. For tax year 2013, a high deductiblehealth plan is one with an annual deductible that is not less than $1,250 for self-only coverage or $2,500 for family coverage, and theannual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $6,250 for self-onlycoverage or $12,500 for family coverage.
2013
2013 Amount 2012 Amount
PERSONS OR ORGANIZATIONS PROVIDING CARE (33.2)
PERSONS AND EXPENSES QUALIFYING FOR DEPENDENT CARE CREDIT
DEPENDENT CARE EXPENSES (33.1)
Dependent care expenses incurred but not paid in 2013. . .
Employer-provided benefits forfeited in 2013. . . . . . . . . . . . . .
2012 amt:
Name of provider. . . . . . . . . . . . . . . . . . . . . . . . .
Street address . . . . . . . . . . . . . . . . . . . . . . . . . . .
City, state, ZIP code. . . . . . . . . . . . . . . . . . . . . .
Identification number (SSN or EIN) . . . . . . . .
Amount paid to care provider in 2013. . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . .
Please enter all pertinent 2013 information. Last year's amounts are provided for your reference. You must havepaid for the care of one or more dependents enabling you to work or attend school to qualify for this credit.
Taxpayer Spouse Taxpayer Spouse
No.
2012 amt:
No.
No.
No.
No.
1040 US Child and Dependent Care Expenses (Form 2441) 33.1,33.2
Child and Dependent Care Expenses (Form 2441)
33.1,33.2
ORGANIZER
Series: 31, 34
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number. . . . . . . . . . . . . . . . . . . .
1=disabled. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . .
Qualified dependent care expensesincurred and paid in 2013. . . . . . . . . . . . . . . . .
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number. . . . . . . . . . . . . . . . . . . .
1=disabled. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . .
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . .
Social security number. . . . . . . . . . . . . . . . . . . .
1=disabled. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . .
Name of provider. . . . . . . . . . . . . . . . . . . . . . . . .
Street address . . . . . . . . . . . . . . . . . . . . . . . . . . .
City, state, ZIP code. . . . . . . . . . . . . . . . . . . . . .
Identification number (SSN or EIN) . . . . . . . .
Amount paid to care provider in 2013. . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . .
2013
2013 Amount 2012 Amount
Qualified dependent care expensesincurred and paid in 2013. . . . . . . . . . . . . . . . .
Qualified dependent care expensesincurred and paid in 2013. . . . . . . . . . . . . . . . .
2012 amt:
2012 amt:
2012 amt:
Please enter all pertinent 2013 information. Last year's amounts are provided for your reference.
ELIGIBLE CHILDREN
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Identification number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=special needs child. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=foreign child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=adoption was not final in 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2012 for adoption not finalized by end of 2013. . . . .
Prior years for adoption of foreign child finalized in 2013. . . . . .
2012 and 2013 for adoption finalized in 2013 . . . . . . . .
2013 for adoption finalized before 2013. . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
QualifiedAdoptionExpensesPaid in
No.
No.
No.
1040 US Qualified Adoption Expenses (Form 8839) 37
Qualified Adoption Expenses (Form 8839)
37
ORGANIZER
Series: 35
2013
2013 Amount 2012 Amount
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Identification number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=special needs child. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=foreign child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=adoption was not final in 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2012 for adoption not finalized by end of 2013. . . . .
Prior years for adoption of foreign child finalized in 2013. . . . . .
2012 and 2013 for adoption finalized in 2013 . . . . . . . .
2013 for adoption finalized before 2013. . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
QualifiedAdoptionExpensesPaid in
First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Identification number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=special needs child. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=foreign child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=adoption was not final in 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2012 for adoption not finalized by end of 2013. . . . .
Prior years for adoption of foreign child finalized in 2013. . . . . .
2012 and 2013 for adoption finalized in 2013 . . . . . . . .
2013 for adoption finalized before 2013. . . . . . . . . . . .
1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
QualifiedAdoptionExpensesPaid in
1=born before 1996 and was disabled. . . . . . . . . . . . . . . . . . . . . . . . . .
1=born before 1996 and was disabled. . . . . . . . . . . . . . . . . . . . . . . . . .
1=born before 1996 and was disabled. . . . . . . . . . . . . . . . . . . . . . . . . .
STUDENT INFORMATION
1=taxpayer, 2=spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
First name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Last name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Social security number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of years hope credit claimed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
* Refund of qualified expenses and tax-free educational assistance received after you file your return for the year in which the expenses were paid.
Please complete the information below if you paid qualified education expenses in 2013 for you,your spouse, or your dependents enrolled in an accredited postsecondary institution.
Last year's amounts are provided for your reference.
1040 US 38
Education Credits / Tuition Deduction
38
ORGANIZER
Series: 36
Number of years American opportunity credit claimed. . . . . . . . . . . . . . . . . .
20132013 Education Credits / Tuition Deduction
2013 Amount 2012 Amount
No.
1=student was NOT entrolled at least half-time for at least one academic period that beganin 2013 at an eligible institution in a qualified program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=student completed first four years of post-secondary education before 2013. . . . . . . . . . . 1=student was convicted, before the end of 2013, of a felony for possession or distributionof a controlled substance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Street address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ZIP code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=2013 Form 1098-T was NOT received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
EDUCATIONAL INSTITUTION ATTENDED (#1)
Federal ID number from Form 1098-T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=2012 Form 1098-T received with Box 2 & 7 completed . . . . . . . . . . . . . . .
Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Street address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ZIP code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
EDUCATIONAL INSTITUTION ATTENDED (#2)
Federal ID number from Form 1098-T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Qualified tuition & fees paid in 2013 (net of refund or assistance, & not entered elsewhere) . .
Books & supplies required to be purchased from institution. . . . . . . . . . . . .
Books & supplies not entered above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amount of prior year refund or assistance * . . . . . . . . . . . . . . . . . . . . . . . . . . .
QUALIFIED EDUCATION EXPENSES
1=2013 Form 1098-T was NOT received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=2012 Form 1098-T received with Box 2 & 7 completed . . . . . . . . . . . . . . .
NOTE:Due to the change to the 1098-T question (reversing the default),we should not print the 2012 entry.
Please enter all pertinent 2013 information.
RENTER'S CREDIT
1=qualified renter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=filing separate, claiming spouse's credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=filing jointly and one spouse claimed homeowner's property tax exemption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of months in California, if part-year resident. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1040 CA Other Credits 53.013
Other Credits
53.013
ORGANIZER
Series: 301
NOTE:To qualify for the credit you must have paid rent, for at least half of the year,on property in California which was your principal residence.
2013
Please enter all pertinent 2013 information.
1=taxpayer, 2=spouse, blank=joint. . . . . . . . . . . . . . . . . . . . . . . .
Use county (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total purchases subject to use tax. . . . . . . . . . . . . . . . . . . . . . . .
Sales or use tax already paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No.
No.
No.
No.
No.
1040 CA California Use Tax
California Use Tax
ORGANIZER
Series: 4001
54.012
54.012
1=taxpayer, 2=spouse, blank=joint. . . . . . . . . . . . . . . . . . . . . . . .
Use county (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total purchases subject to use tax. . . . . . . . . . . . . . . . . . . . . . . .
Sales or use tax already paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=taxpayer, 2=spouse, blank=joint. . . . . . . . . . . . . . . . . . . . . . . .
Use county (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total purchases subject to use tax. . . . . . . . . . . . . . . . . . . . . . . .
Sales or use tax already paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=taxpayer, 2=spouse, blank=joint. . . . . . . . . . . . . . . . . . . . . . . .
Use county (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total purchases subject to use tax. . . . . . . . . . . . . . . . . . . . . . . .
Sales or use tax already paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1=taxpayer, 2=spouse, blank=joint. . . . . . . . . . . . . . . . . . . . . . . .
Use county (see table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total purchases subject to use tax. . . . . . . . . . . . . . . . . . . . . . . .
Sales or use tax already paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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1011121314151617181920212223242526272829303132
3334353637383940414243444546474849505152535455565758596061626364
6566676869707172737475767778798081828384858687888990919293949596
979899
100101102103104105106107108109110111112113114115116117118119120121122123124125126
County
= Alameda= Alpine= Amador= Butte= Calaveras= Colusa= Colusa (Williams)= Contra Costa= Contra Costa (El Cerrito)= Contra Costa (Pinole)= Contra Costa (Richmond)= Del Norte= El Dorado= El Dorado (So. Lake Tahoe)= El Dorado (Placerville)= Fresno= Fresno (Clovis)= Fresno (Reedley)= Fresno (Sanger)= Fresno (Selma)= Glenn= Humboldt= Humboldt (Trinidad)= Imperial= Impreial (Calexico)= Inyo= Kern= Kern (Delano)= Kings= Lake= Lake (Lakeport)= Lake (Clearlake)
= Lassen= Los Angeles= Los Angeles (Avalon)= Los Angeles (Inglewood)= Los Angeles (South Gate)= Madera= Marin= Marin (San Rafael)= Mariposa= Mendocino= Mendocino (Fort Bragg)= Mendocino (Ukiah)= Mendocino (Point Arena)= Mendocino (Willits)= Merced= Merced (Los Banos)= Merced (Merced)= Modoc= Mono= Mono (Mammoth Lakes)= Monterey= Monterey (Del Ray Oaks)= Monterey (Pacific Grove)= Monterey (Seaside)= Monterey (Salinas)= Monterey (Sand City)= Napa= Nevada= Nevada (Nevada City)= Nevada (Truckee)= Orange= Orange (Laguna Beach)
= Placer= Plumas= Riverside= Riverside (Cathedral City)= Sacramento= San Benito= San Benito (Hollister)= San Benito (San Juan Bautista)= San Bernardino= San Bernardino (Montclair)= San Bernardino (San Bernardino)= San Diego= San Diego (El Cajon)= San Diego (National City)= San Diego (Vista)= San Francisco= San Joaquin= San Joaquin (Manteca)= San Joaquin (Stockton)= San Luis Obispo= San Luis Obispo (Arroyo Grande)= San Luis Obispo (Grover Beach)= San Luis Obispo (Morro Bay)= San Luis Obispo (Pismo Beach)= San Luis Obispo (San Luis Obispo)= San Mateo= San Mateo (San Mateo)= Santa Barbara= Santa Clara= Santa Cruz= Santa Cruz (Capitola)= Santa Cruz (Santa Cruz)
= Santa Cruz (Scotts Valley)= Santa Cruz (Watsonville)= Shasta= Sierra= Siskiyou= Solano= Sonoma= Sonoma (Cotati)= Sonoma (Rohnert Park)= Sonoma (Santa Rosa)= Sonoma (Sebastopol)= Stanislaus= Stanislaus (Ceres)= Sutter= Tehama= Trinity= Tulare= Tulare (Dinuba)= Tulare (Farmersville)= Tulare (Porterville)= Tulare (Tulare)= Tulare (Visalia)= Tuolumne= Tuolumne (Sonora)= Ventura= Yolo= Yolo (Davis)= Yolo (West Sacramento)= Yolo (Woodland)= Yuba
2013