the 2019 tax organizer will assist you in collecting and ... · 6. investment, legal and tax...

12531 High Bluff Drive, Ste. 110, San Diego, CA 92130 | Main: 858.668.0776 | Fax: 858.668.3016

Advisory services offered through Premier Wealth Advisors (PWA), a registered investment adviser. Securities and additional advisory services offered through Independent Financial Group, LLC (IFG),

a registered broker‐dealer and Investment adviser, member FINRA and SIPC. IFG and PWA are unaffiliated.

The 2019 Tax Organizer will assist you in collecting and reporting information necessary for us to properly prepare your 2019 income tax return. Please complete the organizer sections as appropriate and provide supporting documentation where necessary. Please provide us with a copy of your 2018 Federal and State tax returns and the following additional information/documents:

Income

1. Wage Statements: W-2s or last paycheck stub. 2. Retirement/Pension Income: 1099-Rs, and Social Security Statements SSA-1099. 3. Interest & Dividend Statements: 1099-INT, 1099-DIV, 1099-B from banks, credit unions,

mortgage companies, brokerage firms, stocks, insurance companies, etc. 4. State Tax refund: 1099-G. 5. K-1s from partnerships, corporations, etc. 6. Rental Property or Small Business Income and Expense statement. 7. Gambling Winnings: W-2Gs. 8. Health Savings Account Statements: 1099-SA and 5498-SA. 9. Court-ordered alimony received. 10. Any other document stating that it is income being reported to IRS.

Deductions

1. Medical Expenses: Insurance costs, un-reimbursed Rx, doctor, hospital and dental bills. 2. Estimated income tax payments. 3. Personal Property Taxes: County property tax bills, vehicle registrations, etc. 4. Mortgage Interest Statements: 1098s, closing statement from refinances, home purchases,

improvement loans, equity lines of credit. 5. Charitable Contributions: Cash or Non-Cash (Salvation Army, Goodwill, etc.) 6. Investment, legal and tax preparation fees; employee business expenses: uniforms, tools,

educational costs, mileage, etc. (state only). Thank you for completing the Tax Organizer. We look forward to working with you. Please contact us if you need further assistance. Sincerely, Premier Wealth Advisors

12531 High Bluff Drive, Ste. 110, San Diego, CA 92130 | Main: 858.668.0776 | Fax: 858.668.3016

Advisory services offered through Premier Wealth Advisors (PWA), a registered investment adviser. Securities and additional advisory services offered through Independent Financial Group, LLC (IFG),

a registered broker‐dealer and Investment adviser, member FINRA and SIPC. IFG and PWA are unaffiliated.

This letter is to confirm the arrangements with respect to the services we will render as your tax preparer. You are engaging Premier Wealth Advisors to prepare your original 2019 federal and state individual income tax returns and all related tax forms for the year ending December 31, 2019. We will use our judgment in resolving questions where the tax law is unclear or, where there may be conflicts between the taxing authorities' interpretation of the law and what seem to be other supportable positions. We will discuss any “gray areas” with you, including potential penalties, prior to completingyour return. We reserve the right to refuse to sign and/or submit returns with positions that we consider to be frivolous or that lack a reasonable basis. Under IRS regulations, you are responsible for keeping records of your business expenses, travel, entertainment, gifts and of the business and personal use of any property (i.e., automobile) used by you. We rely on information you provide to us, we do not audit or independently verify the information supplied by you. By signing this engagement letter you confirm that you are aware of the documentation requirements and that you have maintained sufficient records and other corroborative evidence to support the deductions claimed on your return. We will make reasonable inquiries if the information provided by you appears incomplete, inaccurate or contrary to other factual matters. Our fees will be computed at our standard rates. Your invoice is due and payable upon presentation. If invoices are not paid on a timely basis, we will not perform any additional work until your account is current. Unless specifically instructed by you in writing, your returns will be e-filed upon receipt of your signed e-file authorization form(s). You agree to promptly inform us of any communications you receive from any federal or state taxing authority. Additional fees will apply for responding to tax authority inquiries, preparation of audits or amended returns. We are not responsible for IRS disallowance of doubtful deductions, deductions unsupported by adequate documentation or for resulting taxes, interest or penalties. We are not responsible for penalties resulting from underpayment of taxes, late filing or failure to file. If you receive a penalty due to our error, we will reimburse you for the penalty, but not for additional taxes owed. Your personal information is handled in strict confidentiality. You acknowledge that we maintain copies of your source documents and returns as required by regulations. You expressly give us consent to access your personal tax data online from government sources, such as MyFTB account (CA taxpayers). Premier Wealth Advisors is a registered investment advisor offering financial planning and advisory services. Ari Crandall, Joe LeBlanc, and Su-Yen Kuhn are registered representatives of and offer securities through Independent Financial Group, LLC (IFG), a registered broker-dealer, member FINRA and SIPC. Fees for these services are separate from the tax preparation fee and will be contracted and disclosed as appropriate. You consent to the use of your personal tax information for securities and planning purposes. You are under no obligation to purchase securities or planning services. Your personal information will not be released to any third party for marketing purposes. If any dispute arises among the parties, we agree first to try in good faith to settle the disputes by mediation administered by the American Arbitration Association (AAA) under its Commercial Mediation Procedures. Any unresolved disputes shall then be decided by final and binding arbitration in accordance with the Commercial Arbitration Rules of the AAA. Fees charged by any mediators, arbitrators or the AAA shall be shared equally by all parties. The foregoing is the complete agreement between us. Any modification must be acknowledged in writing and signed by both parties. We look forward to working with you. Client Signature:________________________ Client Signature:__________________________ Date:____________ PWA Signature: ________________________ Date:____________

If any of the following items pertain to you or your spouse for 2019, please check the appropriate box and provide additional information if necessary.

Yes No

Did you receive an IP PIN (ID Protection PIN) from the IRS for 2019?

Did your marital status change during the year?

Did you pay or receive alimony? Do not include child support.

Did your address change during the year?

Did you incur moving expenses due to military PCS orders?

Are you or your spouse a K-12 teacher?

Were there any changes in dependents?

Did you pay child care costs for a dependent child under the age of 13, orcosts of caring for a disabled dependent or spouse so you could work,attend school or look for a job?

Did you pay any individual $2,100 or more to perform household servicesduring the year, such as babysitter, caregiver, housekeeper, cook orgardener?

Did you receive unreported tip income of $20 or more in any month?

Did you receive any unemployment or disability income?

Did you receive any gambling income (W-2G)?

Did you operate a home-based business or have self-employment(1099-Misc) income?

Was your home or a portion of your home rented out (VRBO, Air BnB,etc.) or used for business?

Did you sell any personal property on E-Bay or other online auction sites?

Did you buy or sell any stocks, bonds or other investment property?

Did you buy, sell, or refinance your principal home or second home, ordid you take a home equity loan?

Did you purchase and install a solar energy system at your house orbusiness?

Did you have any debts canceled or reduced (including credit cards),property repossessed or foreclosed upon or did you file for bankruptcy?

ORGANIZER

2019 1040 US Miscellaneous Questions

Miscellaneous Questions

Did you receive a distribution from a retirement plan (401(k), IRA, etc.)?

Did you make a contribution to a retirement plan (IRA, Roth IRA,Solo-401k, etc.)

Did you transfer or rollover any amount from one retirement plan toanother retirement plan?

Did you convert part or all of your traditional IRA/401k to a Roth IRA/401kin 2019?

Did you, your spouse, or a dependent incur any tuition expenses that arerequired to attend a college, university, or vocational school?

Did you have health insurance coverage for yourself and all dependentsof your family all 12 months of last year? Please provide a copy of Form1095-B or 1095-C.

Did you (or your spouse) receive health coverage from CoveredCalifornia, COBRA or Advanced Premium Tax Credit assistance for anymonth during 2019? Please attached a copy of Form 1095-A (HealthInsurance Marketplace Statement).

Did you incur a loss for damaged property due to a Federally-declareddisaster?

Did you use your car on the job (other than to and from work) includingUBER or LYFT driving?

Did you have an interest in or signature or other authority over a financialaccount in a foreign country, such as a bank or securities account at anytime in 2019?

Do you own any income producing assets outside of the US (rentalhouse, farm land, etc.)?

Were you notified or audited by either the Internal Revenue Service orthe State taxing agency?

Did you purchase, mine, own, exchange or sell any virtual currency(Bitcoin, cryptocurrency, altcoin, etc.) in 2019?

Did you purchase out-of-state items by phone, internet, mail or in-personwhere the seller did not collect California sales or use tax?

Do you want to electronically file your tax return?

May the IRS discuss your tax return with your preparer?

Did your bank account information change in the last year?

ORGANIZER

2019 1040 US Miscellaneous Questions

Miscellaneous Questions (Continued)

Social security number . . .


CLIENT INFORMATION

DEPENDENTS

First name and initial. . . . .

Last name. . . . . . . . . . . . . . .

Title/suffix. . . . . . . . . . . . . . .


Occupation . . . . . . . . . . . . . .

Date of birth (m/d/y). . . . . .

Date of death (m/d/y). . . . .

1=blind. . . . . . . . . . . . . . . . . .

Home phone. . . . . . . . . . . . .

Work phone . . . . . . . . . . . . .

Work extension . . . . . . . . . .

Cell phone. . . . . . . . . . . . . . .

E-mail address. . . . . . . . . . .

In care of. . . . . . . . . . .

Street address. . . . . .

Apartment number. .

City. . . . . . . . . . . . . . . .

State. . . . . . . . . . . . . . .

ZIP code . . . . . . . . . . .

First name. . . . . . . . . . . . . . .

Last name. . . . . . . . . . . . . . .

Title/suffix. . . . . . . . . . . . . . .


Relationship . . . . . . . . . . . . .

Months lived at home . . . .

Tax Return Appointment

Date:Time:Location:

First name. . . . . . . . . . . . . . .

Last name. . . . . . . . . . . . . . .

Title/suffix . . . . . . . . . . . . . . .


Relationship . . . . . . . . . . . . .

Months lived at home . . . .

Taxpayer Spouse

Dependent No. Dependent No.

Dependent No. Dependent No.

Address

1040 US Tax Organizer

Tax Organizer

ORGANIZER

2019



Date of adoption (m/d/y). .

Date of adoption (m/d/y). .

Telephone number:Fax number:E-mail address:

This tax organizer will assist you in gathering information necessary for the preparationof your 2019 tax return. Please enter all pertinent 2019 information.

NOTE: If you claim the earned income credit, please provide proof that your child is a resident of the United States. This proof is typically in the formof: school records or statement, landlord or property management statement, health care provider statement, medical records, child care providerrecords, placement agency statement, social service records or statement, place of worship, Indian tribal office statement, or employer statement.

NOTE: If your child is disabled, please provide one of the following forms of proof of disability: doctor statement, other health care provider statement,or social services agency or program statement.

PREMIER WEALTH ADVISORS, Inc.12531 High Bluff Drive #110SAN DIEGO CA 92130

858-668-0776

858-668-3016

Attach Forms 1099

WAGES, SALARIES AND TIPSEmployer name:

INTEREST INCOMEPayer name:

DIVIDEND INCOMEPayer name:

PENSIONS, IRA AND GAMBLING INCOMEPayer name:

Winnings not reported on W-2G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total gambling losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

OTHER GOVERNMENT FORMS - INCOMEForm 1099-B - Sales of stock (also include transaction history). . . . . .

Form 1099-MISC - Miscellaneous income . . . . . . . . . . . . . . . . . . . . . . . . . . Attach Forms 1099

Form 1099-S - Sales of real estate (also include closing statements)

Form 1099-G - State tax refunds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Attach Forms 1099Taxpayer:

Form SSA-1099 - Social security benefits. . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-G - Unemployment compensation. . . . . . . . . . . . . . . . . . . . . . .

Spouse:

Form SSA-1099 - Social security benefits. . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-G - Unemployment compensation. . . . . . . . . . . . . . . . . . . . . . .

Please enter all pertinent 2019 information. If you have attacheda government form for an item, check the box and do not enter a 2019 amount.

Attach Forms W-2

Attach Forms 1099-INT

Attach Forms 1099-DIV

Attach Forms1099-R & W-2G

Attach Forms 1099


Tax Organizer

ORGANIZER

Form 1099-K - Merchant card and third party network payments. . . . .

2019

2019 Amount 2018 Amount

Form 1099-Q (529 Plan). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-QA/5498-QA (ABLE Accounts). . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-Q (529 Plan). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-QA/5498-QA (ABLE Accounts). . . . . . . . . . . . . . . . . . . . . . . . . .

RETIREMENT PLAN CONTRIBUTIONSTaxpayer: Traditional IRA contributions (1=maximum). . . . . . . . . . . . . . . . . . . . .

Roth IRA contributions (1=maximum) . . . . . . . . . . . . . . . . . . . . . . . . . .

Self-employed, SEP, SIMPLE, & qualified plan contributions (1=maximum). . . . . .

Spouse: Traditional IRA contributions (1=maximum). . . . . . . . . . . . . . . . . . . . .

Roth IRA contributions (1=maximum) . . . . . . . . . . . . . . . . . . . . . . . . . .

Self-employed, SEP, SIMPLE, & qualified plan contributions (1=maximum). . . . . .

MEDICAL AND DENTAL EXPENSESPrescription medicines and drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Doctors, dentists and nurses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hospitals and nursing homes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Long-term care premiums - taxpayer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Long-term care premiums - spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance reimbursement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Out-of-pocket lodging and transportation expenses. . . . . . . . . . . . . . . . . . . . . . .

Number of medical miles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other:

OTHER GOVERNMENT FORMS - DEDUCTIONSForm 1098-E - Student loan interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1098-T - Tuition and related expenses . . . . . . . . . . . . . . . . . . . . . . . . . Attach Forms 1098

ADJUSTMENTS TO INCOMETaxpayer:

Self-employed health insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . .

Educator expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other adjustments to income:

Alimony paid - Recipient name & SSN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Spouse:

Self-employed health insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . .

Educator expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other adjustments to income:

Alimony paid - Recipient name & SSN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

TAXES PAIDState income taxes - 1/19 payment on 2018 state estimate. . . . . . . . . . . . . . .


Tax Organizer

ORGANIZER

2019


Attach Forms 1095

AFFORDABLE CARE ACTForm 1095-A - Health Insurance Marketplace Statement. . . . . . . . . . . . . .

Form 1095-B - Health Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1095-C - Employer-Provided Health Insurance Offer and Coverage. . . . . .

MISCELLANEOUS INCOMETaxpayer: Alimony received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Spouse: Alimony received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other:

CASH CONTRIBUTIONS

Volunteer expenses (out-of-pocket). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of charitable miles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

INTEREST PAIDHome mortgage interest and points paid:

Home mortgage interest not on Form 1098 (include name, SSN, & address of payee):

Points not reported on Form 1098:

Mortgage insurance premiums on post 12/31/06 contracts . . . . . . . . . . . . . . . .

Investment interest (interest on margin accounts):

Passive interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NONCASH CONTRIBUTIONS

MISCELLANEOUS DEDUCTIONSUnion and professional dues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tax return preparation fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Safe deposit box rental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Investment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Estate tax, section 691(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unreimbursed employee expenses:

Other:

TAXES PAID (continued)

Personal property taxes (including automobile fees in some states) . . . Attach Tax Notice

City/local income taxes - paid with 2018 city/local extension . . . . . . . . . . . . . .

City/local income taxes - paid with 2018 city/local return. . . . . . . . . . . . . . . . . .

State and local sales taxes (except autos and special items) . . . . . . . . . . . . .

Use taxes paid on 2019 purchases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Use taxes paid on 2018 state return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sales tax on autos not included above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sales taxes paid on boats, aircraft, and other special items. . . . . . . . . . . . . . .

Real estate taxes - principal residence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Real estate taxes - property held for investment . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign income taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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).

NOTE: No deduction is allowed for contributions of clothing and household items that are not in good used condition or better, in addition,a deduction for any item with minimal monetary value may be denied.

Attach Forms 1098


Tax Organizer

ORGANIZER

2019


City/local income taxes - 1/19 payment on 2018 city/local estimate. . . . . . . .

State income taxes - paid with 2018 state extension . . . . . . . . . . . . . . . . . . . . .

State income taxes - paid with 2018 state return. . . . . . . . . . . . . . . . . . . . . . . . .

State income taxes - paid for prior years and/or to other states. . . . . . . . . . .

Please enter all pertinent 2019 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 . . . . . . . . . . .

2019


1=trader in financial instruments or commodities. . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign region. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


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 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.2019



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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2019


Number of days rented. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2019 Amount 2018 AmountGENERAL INFORMATION

1=spouse, 2=joint. . . . . . . . . . . . . .

1=qualified joint venture. . . . . . . .

1=did not actively participate. . .

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

1=rental other than real estate .

1=real estate professional. . . . . .

BUSINESS USE OF HOME

Form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of form (e.g., enter 2 for Schedule C number 2) . . . . . . . . . . . . . . . . . . .

Business use area (square footage). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total area of home (square footage) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total hours facility used (for daycare facilities only) . . . . . . . . . . . . . . . . . . . . . . . .

Total hours available (if not 8,760). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

% (.xx) or amount of gross income from home if not 100% (-1 if none). . . . . .

% (.xx) or amount of expenses from home if not 100% (-1 if none) . . . . . . . . .

INDIRECT EXPENSES

Mortgage interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Real estate taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Casualty losses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Other indirect expenses:

DIRECT EXPENSES

Mortgage interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Real estate taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Casualty losses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Excess casualty losses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Allowable casualty losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other direct expenses:

NOTE: Indirect expenses are for keeping up and running your entire home.They benefit both the business and personal parts of your home.

NOTE: Direct expenses benefit only the business part of your home. They includepainting or repairs made to specific areas or rooms used for business.


1040 US Business Use of Home (Form 8829) 29

Business Use of Home (Form 8829)

29

ORGANIZER

Series: 22

No.2019

Please enter 2019 indirect expenses in full. Nonbusiness portion will carry to Schedule A.Business percentage will be applied to indirect expenses only.

Area of home included above used exclusively for daycare business, if any (sq ft) . . . . . . . . . . . .

Excess real estate taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess real estate taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


VEHICLE 2

Description of vehicle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date placed in service (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total mileage (for the tax year). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Business mileage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Commuting mileage (for the tax year). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average daily round-trip commute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of months of business use if changed from 100% personal use . . . . .

Parking fees and tolls (business portion only). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Actual expenses:

Gasoline, lube, oil. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Auto license (other than personal property taxes) . . . . . . . . . . . . . . . . . . . . . .

Personal property taxes (based on car's value). . . . . . . . . . . . . . . . . . . . . . . . .

Interest (car loan) (for Schedule C, E and F). . . . . . . . . . . . . . . . . . . . . . . . . . .

Vehicle rent or lease payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Inclusion amount (enter as positive). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Value of employer-provided vehicle on Form W-2 (2106). . . . . . . . . . . . . . . .

VEHICLE INFORMATION

1=vehicle used primarily by more than 5% owner . . . . . . . . . . . . . . . . . . . . . . . . . .

1=vehicle is available for off-duty personal use . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=no other vehicle is available for personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=no evidence to support your deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=no written evidence to support your deduction. . . . . . . . . . . . . . . . . . . . . . . . . . .

VEHICLE 1

Description of vehicle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date placed in service (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total mileage (for the tax year). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Business mileage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Commuting mileage (for the tax year). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average daily round-trip commute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of months of business use if changed from 100% personal use . . . . .

Parking fees and tolls (business portion only). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Actual expenses:

Gasoline, lube, oil. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Auto license (other than personal property taxes) . . . . . . . . . . . . . . . . . . . . . .

Personal property taxes (based on car's value). . . . . . . . . . . . . . . . . . . . . . . . .

Interest (car loan) (for Schedule C, E & F). . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Vehicle rent or lease payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Inclusion amount (enter as positive). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Value of employer-provided vehicle on Form W-2 (2106). . . . . . . . . . . . . . . .

1040 US Vehicle Expenses (Form 2106) (cont.) 30 p2

Vehicle Expenses (Form 2106) (cont.)

30 p2

ORGANIZER

Series: 64

No.2019


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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Condition and mileage . . . . . . . . . . . . . . . . . . . . . . . . . . .

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 2019, 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2019

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Condition and mileage . . . . . . . . . . . . . . . . . . . . . . . . . . .

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). . . . . . . . . . . . . . . . . . . . . . .

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 2019. . .

Employer-provided benefits forfeited in 2019. . . . . . . . . . . . . .

2018 amt:

Name of provider. . . . . . . . . . . . . . . . . . . . . . . . .

Street address . . . . . . . . . . . . . . . . . . . . . . . . . . .

City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Identification number (SSN or EIN) . . . . . . . .

Amount paid to care provider in 2019. . . . . .

1=spouse, 2=joint . . . . . . . . . . . . . . . . . . . . . . . .

Please enter all pertinent 2019 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.

2018 amt:

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 2019. . . . . . . . . . . . . . . . .

2019


Title or suffix. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2018 amt:

No.

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 2019. . . . . . . . . . . . . . . . .

Title or suffix. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ZIP code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign country . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign postal code. . . . . . . . . . . . . . . . . . . . . . .

Foreign region. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Please furnish any additional information or supporting details not provided elsewhere in this tax organizer.

1040 US Additional Information

Additional Information

ORGANIZER

Series:

2019

the 2019 tax organizer will assist you in collecting and ... · 6. investment, legal and tax...

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