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Missing Tax Information
Sheet
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Prepared
by: __________________
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Date:
___________________
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Name:
__________________
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Email:___________________
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Tax Year:
__________
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Home Phone:
________________________
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Work Phone:
_______________________
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Fax: __________________________
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Cell:
___________________________
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The
following information is required to complete your return:
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W-2's
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Pension/Social
Security Income
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__________________________________
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__________________________________
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__________________________________
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__________________________________
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__________________________________
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__________________________________
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Interest
Income
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Dividend
Income
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________________________
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_________
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________________________
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________
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________________________
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_________
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________________________
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________
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________________________
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_________
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________________________
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________
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K-1
Forms/Brokerage Statements:
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______________________
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__________________________
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_______________________
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______________________
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__________________________
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_______________________
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Other
Income:
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______________________
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_____________
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_________________________
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__________
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Deductions
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Medical:
____________________
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Real
Estate Taxes:
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Interest
Paid:
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______________________
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______________
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_______________________
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___________
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______________________
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______________
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_______________________
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___________
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______________________
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______________
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_______________________
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___________
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Personal
Property Tax:
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Charitable
Contributions:
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______________________
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______________
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_______________________
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___________
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______________________
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______________
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_______________________
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___________
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______________________
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______________
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_______________________
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___________
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Other
Taxes:
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Other
Deductions:
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______________________
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______________
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_______________________
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___________
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______________________
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______________
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_______________________
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___________
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______________________
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______________
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_______________________
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___________
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Other Items
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Estimated
Tax Payments:
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Date
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Amount
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Date
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Amount
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Date
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Amount
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Date
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Amount
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Federal:
______________
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____
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_______
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____
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_______
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____
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_______
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____
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_______
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State:
_______________
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____
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_______
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____
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_______
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____
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_______
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____
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_______
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Escrow
Settlement/Closing Statement For:
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______________________________________
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Dependent
Information
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Name:
_______________
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DOB: ________
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SSN:____________
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Name:
_______________
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DOB: ________
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SSN:____________
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Name:
_______________
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DOB: ________
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SSN:____________
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Schedule
C Information
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________________________________________________________
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________________________________________________________
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________________________________________________________
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________________________________________________________
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Other
Information
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________________________________________________________
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________________________________________________________
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________________________________________________________
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________________________________________________________
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________________________________________________________
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