Garibay Tax Services
Income Tax Organizer
| Tax Year
|
|||||
| Name | First, M.I. | Last | SSN# | Occupation | Birth Date |
| Taxpayer: | |||||
| Spouse: | |||||
| Home Tel: | ( ) | ||||
| Cell Phone: | ( ) | ||||
| Work Tel: | ( ) ext. | ||||
| Fax Tel: | ( ) | ||||
| E-mail: (required) | |||||
| Dependents | 1 | 2 | 3 | 4 | 5 |
| Name | |||||
| Date of Birth | |||||
| Social Security # | |||||
| Relationship | |||||
| Months Lived with you | |||||
| Other Income | ||||
| Refund of State | $ | |||
| Other Income Sources (list): | Amount | |||
| $ | ||||
| $ | ||||
| $ | ||||
| Alimony Recipient | SSN# | Alimony Paid | ||
| $ | ||||
| Taxpayer | Spouse | |||
| Payment to an IRA | $ | $ | ||
| Payment to KEOGH | $ | $ | ||
| Amount withdrawn from your IRA/KEOGH/401(K) during any part of this year | ||||
| Taxpayer | Spouse | |||
| $ | $ | |||
| Interest Income Source (i.e., Bank, Broker, etc.) |
Amount | |||
| $ | ||||
| $ | ||||
| $ | ||||
| $ | ||||
| Dividend Source | Gross Amount | Capital Gain | Non-Taxable Amount | |
| $ | $ | $ | ||
| $ | $ | $ | ||
| $ | $ | $ | ||
| $ | $ | $ | ||
| $ | $ | $ | ||
| Sales of Stocks | ||||
| Name | Date of Purchase | Date of Sale | Sale Price | Purchase Price |
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| Medical and Dental | |
| Medicines, Insulin, Doctors, Insurance, etc. | $ |
| Taxes | |
| State and Local Income Tax (other than W-2) | $ |
| Real Estate taxes | $ |
| Personal Property tax | $ |
| Interest Expense | |
| Home Mortgage (name of lender): | $ |
| Points paid to purchase of residence | $ |
| Contributions (Donations), Name: | $ |
| Contributions (Donations), Name: | $ |
| Contributions (Donations), Name: | $ |
| Contributions (Donations), Name: | $ |
| Tax preparation | $ |
| Moving Expenses | ||||
| Travel | Meals | Hotels | Shipping | |
| $ | $ | $ | $ | |
| Temporary Away from Home Expenses | ||||
| Rent | Utilities | Insurance | Meals/Food | |
| $ | $ | $ | $ | |
| Set Up Costs (furniture, appliances, household items, etc.): | $ | |||
| Car Expenses | |||
| How many cars do you own? | |||
| Date of Purchase | Price $ | ||
| Gasoline | Parking | Insurance | Repairs |
| $ | $ | $ | $ |
| Mileage to/from work | Total Mileage | ||
| Employee Business Expense | |||
| Business Travel: | Destination | Number of Days | Airline Ticket |
| $ | |||
| $ | |||
| $ | |||
| $ | |||
| Other: | Books & Dues | Food & Lodging | Other |
| $ | $ | $ | |
| Business Income & Expenses (for Self-employed) | |||
| Business Name | |||
| Proprietor | |||
| Business Address | |||
| Business Activity and Product | |||
| Employer ID# | |||
| Gross receipts or sales | $ | ||
| Expense List | |||
| Advertising | $ | Bank service charges | $ |
| Car and truck expenses | $ | Dues and publications | $ |
| Insurance | $ | Laundry and cleaning | $ |
| Legal and professional services | $ | Office expenses | $ |
| Rent on machinery and equipment | $ | Repairs | $ |
| Supplies | $ | Taxes | $ |
| Tools | $ | Travel | $ |
| Meals and entertainment | $ | Utilities and telephone | $ |
| Other Expenses (list) |
| $ |
| $ |
| $ |
| Child Care Expenses | ||||
| Expenses incurred and paid | $ | |||
| Care Providers: | ||||
| Care Provider Name | Address | SSN | Amount | Name of Child |
| $ | ||||
| $ | ||||
| $ | ||||
| $ | ||||
| Student(s) in Family | |||
| Name | Tuition | Year of Study | Books |
| $ | $ | ||
| $ | $ | ||
| $ | $ | ||
| $ | $ | ||
| Rental Property | |||
| Cost of Property | $ | Cost of Household Items | $ |
| Rent Received | $ | Insurance | $ |
| Management Fee | $ | Mortgage Interest | $ |
| Repairs | $ | Real Estate Taxes | $ |
| Travel | $ | Association Fee | $ |
| Gardening | $ | Other | $ |
|
|
|||
| Notes and Comments: |