The following is information and items you will want to gather in preparation to file your tax return for 2010:

Tax Return Preparation Information and Checklist

Taxpayer Name _____________________________________________Spouse _____________________________________________

Taxpayer SSN________-______-____________                              Spouse SSN ________-______-____________

Taxpayer Birthdate __________________________________                      Spouse Birthdate __________________________________

Taxpayer Occupation ______________________________________ Spouse Occupation ________________________________

Address _____________________________________________________________________City ___________________Zip____________

Phone (H) _________________________________(W) ______________________________(C)___________________________________

Email  __________________________________

Marital Status _________________________

Children/Dependents:

1.      ___________________________________________________ SSN ________-______-____________ Birthdate ____/____/______

2.      ___________________________________________________ SSN ________-______-____________ Birthdate ____/____/______

3.      ___________________________________________________ SSN ________-______-____________ Birthdate ____/____/______

4.      ___________________________________________________ SSN ________-______-____________ Birthdate ____/____/______

5.      ___________________________________________________ SSN ________-______-____________ Birthdate ____/____/______

6.      ___________________________________________________ SSN ________-______-____________ Birthdate ____/____/______

Please answer all of the following questions:

Yes      No

Did you have any changes in your filing status or number of dependents in 2010?

Did you purchase/sell/refinance your personal residence in 2010?

Did you pay any tuition, fees, or other education expenses for anyone in your household?

Did you or your spouse receive any Unemployment Income, Jury Duty pay or Combat pay?

Did you receive any notices from the IRS or State? State tax refund notice? $_____________

Did you or your spouse receive any Social Security or disability benefits?

Did you pay or receive Alimony, and If so, how much $_______________________________.

Does anyone owe you money which has become uncollectible?

Did you or your spouse purchase, participate in or rollover a retirement plan or IRA?

Did you have any debt that was forgiven, reduced, or negotiated?

Did you receive any money or tips that need to be reported?

Other than commuting, did you use your vehicle for work purposes or travel out of town?

Did you pay anyone more than $1,700 for housekeeping, babysitting, or yard care?

Did you have any financial interest or work in another country during the year?

Did you make any gifts totaling $13,000 or more to any individual during the year?

Did you start, sell or dispose of a business or purchase rental property?