Docstoc

2010 US Tax Questionnaire

Document Sample
2010 US Tax Questionnaire Powered By Docstoc
					Confidential




ENGAGEMENT LETTER


This letter is to confirm and specify the terms of ExpatCPA's engagement with you and to clarify the nature and extent
of the services we will provide. We ask all clients for whom returns are prepared to read the following arrangements.
Please note that the various tabs for the tax questionnaire are located at the bottom of the screen.

Purpose, Scope and Output of the Engagement
We will prepare your federal and requested state income tax returns from information that you will furnish us. We will
not audit or otherwise verify the data you submit, although it may be necessary to ask you for clarification of some of
the information. We will furnish you with a questionnaire (following tabs) to guide you in gathering the necessary
information. Your use of such forms will assist in keeping pertinent information from being overlooked.

Please note that an expatriate tax return has all the same complexities of a domestic tax return but with the extra
complication of the foreign earned income exclusion and foreign tax credits. So once you repatriate to the United
States, if you are satisfied with our services and do not already have a CPA, then we would be happy to continue to
serve you.

Responsibilities
In conducting this engagement, information acquired by us in the course of the engagement is subject to strict
confidentiality requirements. That information will not be disclosed by us to other parties except as required or allowed
for by law, or with your express consent.

It is your responsibility to provide all the accurate and comprehensive information required for the preparation of
complete and accurate tax return. You should retain all the documents, canceled checks and other data that form the
basis of income and deductions or a period of at least seven years. These may be necessary to prove the accuracy and
completeness of the returns to a taxing authority. You have the final responsibility for the income tax returns and,
therefore, you should review them carefully before you sign them.

Our work in connection with the preparation of your income tax returns does not include any procedures designed to
discover defalcations or other irregularities, should any exist. We will render such accounting and bookkeeping
assistance as determined to be necessary for preparation of the income tax returns.

We will use professional judgment in resolving questions where the tax law is unclear, or where there may be conflicts
between the taxing authorities’ interpretations of the law and other supportable positions. Unless otherwise instructed
by you, we will resolve such questions in your favor whenever possible.

Ownership of documents
All original documents obtained from the client arising from the engagement shall remain the property of the client.
However, we reserve the right to make a reasonable number of copies of the original documents for our records. All
other documents produced by us in respect of this engagement will remain the property of the firm. The firm has a
policy of exploring a legal right of lien over any client documents in our possession in the event of a dispute.

Payment fees
Once the tax questionnaire and our credit card charge form is completed and submitted to our offices you are
authorizing us to charge 50% of the stated quote up front as a retainer fee. The reminder of the quoted balance and
any additional fees which both the tax preparer and client agreed on will be charged upon completion of your tax return
using the original credit card.

Confirmation of Terms
By submitting this tax questionnaire you are acknowledging that you have read and agree to our mutual responsibilities.
This letter will be effective for future years unless we advise you of any change.

We want to express our appreciation for this opportunity to work with you.

ExpatCPA
1 City Blvd West, Suite 870
Orange, Ca 92868
(714) 939-7670 Fax (714) 939-1032
www.expatcpa.com




ExpatCPA.com                                          Phone: (714) 939-7670                                     Fax: (714) 939-1032
Confidential




ExpatCPA.com   Phone: (714) 939-7670   Fax: (714) 939-1032
                  Confidential




accuracy and




our tax return



sponsibilities.




                  ExpatCPA.com   Phone: (714) 939-7670   Fax: (714) 939-1032
Phone: 714-939-7670
Fax: 714-939-1032

                        CREDIT CARD PAYMENT FORM
Thank you for your business!

Client Name:
Company Name (if applicable):
Address:




I authorize my credit card to be charged for the quoted fee in two payments. The first payment of
50% of the stated quote will be charged at the beginning of work as a retainer fee. The outstanding
balance will be charged upon completion of the tax return

Type of Credit Card:                                       American Express

                                                           Visa

                                                           MasterCard

Credit Card Number:

Expiration Date
                           (mm/yy)

Signature:                                                               Date:
       Confidential




     USA 2011 Expatriate Tax Questionnaire
1 General Information
      Please submit the completed questionnaire to our office along with any supporting documents or records
      you may have. If you are a new client, please also include a copy of your 2010 tax return.

                         Taxpayer                                               Spouse (if applicable)
1.01 Last Name

1.02 First name

1.03 Middle initial
                         month           day             year                   month             day               year
1.04 Date of birth
                         month           day             year                   month             day               year
1.05 Date deceased
                                                         Yes/ No                Yes/ No
1.06 Presidential election campaign contribution

1.07 US social security number

1.08 Occupation

1.09 Filing status:      Single                    Head of Household                      Married filing separately
                                                                                          (include spouse SSN on 1.7)
          Married filing jointly                   Qualifying widower                     Married to a non-US person

1.10 Dependents
            Name, Initial, Surname             Date of Birth       Social Security        Relation               Months lived
                                               month, day, year    Number                 to you                 with you in 2011




1.11 The US address you want the IRS to have on file, if any
     street name and number                    city                     state                              zip




       ExpatCPA.com                                       Page 6            Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential
1.12 Foreign street address

      Foreign city

      Foreign state or province

      Foreign postal code

      Country

1.13 Telephone                                                      E-mail address


1.14 Home State - US home state before moving abroad


1.15 US State you plan to return to after assignment abroad


1.16 When was the last year you filed a State tax return? And to which state?

                                                                                           Yes/ No
1.17 If a state tax return is required, would you like us to prepare one?
      Note: An additional charge applies                                                   Yes/ No


1.18 In the event that a tax refund is due, would you want
             a.          refund applied to the next tax year

              b.            a check mailed to you

              c.            electronically deposited into your US bank account, If so, please provide the following

                       Name of bank                                                        Checking           Savings

                       Routing Number

                       Account Number

1.19 In the event of a tax liability and assuming you qualify to e-file, would you want                           Yes/ No
     the tax liability to be withdrawn from the same account as above?




       ExpatCPA.com                                            Page 7           Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential


1.20 Were you referred by a colleagues or friend?         Yes/ No         If yes, please provide name


1.21 List properties that you own
                               Address                              Country Located          Rented         Main Home
                                                                                             Yes/No          Yes/No




      For the properties that you rent please complete the "Rental Property" tab on the bottom of the screen
                                                                                                                Yes/ No
1.22 Did you sell a house in 2011

1.23 Did you purchase a house in 2011

2 Personal Questions
                                                                                                                Yes/ No
2.01 Do you have a foreign bank account?
        If yes, did the accumulative balance(s) reach or exceed $10,000 during the tax year?
        If yes to 2.01, complete the "Foreign Bank" tab located on the bottom of the screen

2.02 Did you maintain a separate foreign residence for your family due to adverse living conditions?

2.03 During 2011, did you or your spouse earn any income in the US BEFORE moving abroad?
          If yes, provide a copy of Form W2 or 1099
2.04 During 2011, did you or your spouse earn any income in the US AFTER moving back to the US ?
          If yes, provide a copy of Form W2 or 1099

2.05 Did you elect the first time homebuyer credit on prior tax returns ($7,500 or $8,000 credit)?
     2.05a If yes to 2.05, do you still own the house?
     2.05b If yes, to 2.05, do you still live in the house?

2.06 Did you have any debt forgiven? If yes, please provide Form 1099

2.07 Did you have any foreclosures/ short-sales? If yes, please provide Form 1099




       ExpatCPA.com                                        Page 8              Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential
2.08 Did you incur any adoption expenses?

2.09 Did you own 10% or more of a foreign entity, in the beginning, during, or end of the year?

2.10 Do you along with other US individuals own 50% or greater of a foreign entity?

2.11 Do you own a foreign trust?

2.12 Did you give/receive gifts greater than $13,000? (Including gifts from non-US citizens)

2.13 If you had an interest in Specified Foreign Financial Assets* (SFFA) in 2011, please check which of the
     following best describes the total value of your SFFAs during 2011.

          a.         > $50,000 on last day of tax year or > $75,000 at any time during tax year

          b.         > $100,000 on last day of tax year or > $150,000 at any time during tax year

          c.         > $200,000 on last day of tax year or > $300,000 at any time during tax year

          d.         > $400,000 on last day of tax year or > $600,000 at any time during tax year

          e.         ≤ $50,000 at any time during tax year

      *Specified Foreign Financial Assets include any financial account maintained by a foreign financial institution; and, to the extent
      held for investment and not held in a financial account, any stock or securities issued by someone that is not a US person, any interest
      in a foreign entity, and any financial instrument or contract with an issuer or counterparty that is not a US person.
3 Foreign Information

                                                                 Taxpayer                                          Spouse
3.01 Country of citizenship
                                                                Yes/ No                                            Yes/ No
3.02 US Green Card holder

3.03 Name of country where you lived in 2011
                                                                month, day, year                                   month, day, year
3.04 Date of arrival in foreign country

3.05 Date of the departure of foreign country
     or length of time expected to stay

3.06 Family members that lived with you and their relationship to you




       ExpatCPA.com                                                   Page 9                 Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential
3.07 If you lived in multiple countries during 2011, provide the following

                               Country                    Date of arrival           Date of departure
                                                          month, day, year          month, day, year




3.08 Type of visa used to enter/exit foreign country


3.09 Do you have any limitations from your visa or employment contract that would limit your stay




       ExpatCPA.com                                       Page 10            Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential


3.10 What tax year did you last elect to claim the foreign earned income exclusion (aka $92,900 exclusion)


3.11 Did you provide a statement to the foreign government stating that you were not a resident of that country
                                                                 Yes/ No                                       Yes/ No



3.12 Days in US during 2011 Please note that a partial day spent in the US is considered a US day.
       Example: Jane left the UK on June 13th at 7pm and arrived in the US the morning of June 14th. June 13th is not considered
       a full day spent abroad, but June 14th is considered a full US day.


                    Taxpayer                                                                          Spouse
       Date arrived       Date departed                                          Date arrived            Date departed
       in the US          from the US                            Business        in the US               from the US               Business
       MM/DD/YY           MM/DD/YY                               Travel          MM/DD/YY                MM/DD/YY                  Travel




3.13 If you earned income during your business trips in the US, please provide the total income earned during your US visits




        ExpatCPA.com                                                   Page 11            Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential

4 Foreign Income Earned WHILE Living Abroad

                                            Taxpayer                                                         Spouse
4.01 Employer's Name

4.02 Employer's Foreign Address
       Foreign street address

           Foreign City

           Foreign state or province

           Foreign postal code

           Country

4.03 Employer's US address


4.04 Specify employer's entity: US entity, foreign entity, foreign affiliate of US entity, self-employed, government, other

       If self-employed please complete the "Self-Employed" tab located at the bottom of the screen

4.05 Foreign Wages Received -disclose income received between January 1, 2011 to December 31, 2011
       If Form W-2 was issued, please enclose copy or fax to our office. If you do not have Form W-2 please provide a copy
       of your last pay stub. If your employer is a foreign entity, you should request a letter detailing your pay for your records
       in the event of an audit. Also, please provide us with a copy.
                                                                       Amount             Currency                    Amount          Currency
       Foreign Earned Wages
       Bonus
       Cost of living and overseas differential
       Family
       Education
       Home Leave
       Other
       Total foreign wages received                                          0                                              0

4.06 Non-Cash Benefits Received (market value of property or facilities provided by employer)
     Meals
     Car
     Other
     Total non-cash benefits                               0                                                                0




        ExpatCPA.com                                                    Page 12                Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential


4.07 Did your employer provide living quarters, reimbursed your rent expenses, or paid your rent on your behalf
                                                         Yes/No                                Yes/No


     If YES to 4.07, please proceed. If NO to question 4.07 please skip to section 5.
4.08 Describe your living arrangement with your employer in detail




4.09 If your employer provided housing, please provide the following values. Include nonrefundable deposits paid to secure a
     lease, repairs and maintenance, furniture rental, temporary living expenses and residential parking
                                                         Amount          Currency              Amount         Currency
      Fair Market Value, if employer provided housing
      Amount paid on your behalf
      Amount reimbursed to you

4.10 Is this amount included on your total wages? (question 4.05)    Yes/No                             Yes/No

5 Out of Pocket Foreign Housing Expense

                                                                  Amount                Currency
5.01 Rent

5.02 Utilities (except telephone expense)

5.03 Repairs and maintenance

5.04 Furniture rental

5.05 Residential parking

5.06 Non-refundable deposits to secure lease

5.07 Nondeductible occupancy taxes

      Total out-of-pocket foreign housing expense                    0




       ExpatCPA.com                                      Page 13             Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential

6 Foreign Income Tax
      Do not include other taxes such as social security and health insurance               Taxpayer                   Spouse
                                                                                            Yes/ No                    Yes/ No
6.01 Does the foreign government have a tax system?
     If YES to 6.01, please continue. If NO to 6.01, skip to Section 7
6.02 Foreign income tax withheld from paycheck during the year

6.03 Foreign income tax your employer paid on your behalf

6.04 Did you file (or will you file) a foreign tax return for the 2011 tax year?
     If YES to 6.04, please proceed. If NO to 6.04, please skip to Section 7
6.05 Amount of additional income tax paid (or will pay) for 2011 tax year, if any

6.06 Amount of refund you received (or will receive) for 2011 tax year, if any

7 Other Taxable Income
                                                                   Taxpayer                           Spouse
7.01 Additional Income (For personal business and rental income, please use corresponding questionnaire (tabs located below)
                                                          Amount                                  Amount
     State income tax refund received in 2011
      (only if you deducted state taxes on Sch. A in 2010)
      Alimony received
      Farm income
      Partnership (please provide K-1)
      S Corporation (please provide K-1)
      Other Income- example: gambling winings

                                                   US income tax   State income                         US income tax      State income
                             Amount                tax withheld    tax withheld          Amount         tax withheld       tax withheld
7.02 Social Security

7.03 Unemployment




        ExpatCPA.com                                               Page 14        Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential
7.04 Interest -If you received Form 1099 disclosing interest earned, you can skip this section and provide a copy of Form 1099
         Paying Institution                             Amount                 Currency                Tax deducted            Country




7.05 Dividends -If you received Form 1099 disclosing dividends earned, you can skip this section and provide a copy of Form 1099
                                                      Ordinary              Qualified               Capital               Tax
        Paying Institution                            Dividend               Dividends              Gains                 withheld




7.06 Stock Sales -If you received Form 1099-B and a summary of your stock sales, please send copy to our office and skip this section
                                                      Sales                Date of                Original                Date of
        Stock Name                                    Proceeds             Sale                   Cost                    Purchase




        ExpatCPA.com                                               Page 15              Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential

7.07 Pension and IRA Distributions - if you received Form 1099-R disclosing this information, you can skip this section
                                           and provide a copy.
                                             Example
     Paying institution name              Bank of America
     1. Gross distribution                   $42,000
     2a. Taxable amount                      $42,000
     2b. Taxable amount not determined
         Total distribution
     3. Capital gain (included in box 2a)
     4. Federal income tax withheld           $5,256
     5. Employee cont/desig.
     6. Net unrealized appreciation
     7. Dist. Code(s)                                1.00
         IRA/SEP/SIMPLE                          X
     8. Other
     9a. Your % of total distribution
     9b. Total employee contributions
     10. State tax withheld
     11. State/Payer's state no.
     12. St. dist.
     13. Local tax withheld
     14. Name of locality
     15. Local dist.

7.08 Did you rollover the pension distribution into a qualified plan withing 60 days of distribution?
                                                Yes/ No            Yes/ No            Yes/ No               Yes/ No
                                                     yes

7.09 If yes to 7.08, specify the name of the new pension plan. Example, IRA, Roth IRA, or a new employer's 401K
                                                   IRA




       ExpatCPA.com                                        Page 16            Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential

8 Deductions

                                                                                  Taxpayer                                    Spouse
8.01 Health savings account
       *Important: Read note below


8.02 Moving Expenses **Important: Read note below
       Out of pocket
       Employer paid/reimbursed
       Total Moving Expenses                                                                     -                                             -

8.03 Self-employment SEP, SIMPLE, & qualified plans

8.04 Self-employed health insurance (premiums for you,
           your spouse, and children under the age of 27)
8.05 Penalty on early withdrawal of savings

8.06 Alimony paid
       Name of individual receiving alimony               SSN of person receiving alimony



8.07 Traditional IRA contribution

8.08 Roth IRA contribution

8.09 Student loan interest

8.10 Student tuition costs (only include tuition cost)

       Student’s required materials        (only include books, supplies,
                and equipment)

       During 2011, was this your 1st, 2nd, etc. year in school?

       During 2011, were you obtaining a bachelor’s degree or
              were you in a master’s program?

       * Different than healthcare insurance. Health savings accounts are accounts that save for future qualified medical and retiree health
       expenses. If you are unsure about the health insurance plan you have, you should ask your healthcare provider.


       ** Moving expense are only deductible if you are an employee, who worked full-time at least 39 weeks during the 12 months right after
       starting your new job. If you were self- employed, you must work full time for at least 39 weeks during the first 12 months and for a total
       of at least 78 weeks during the first 24 months after starting your new job.


8.11 State & Local Taxes Paid
     Real Estate Taxes
     Personal Property Taxes (DMV)
     Sales tax (purchase of car, boat, etc)
        ExpatCPA.com                                                        Page 17           Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential


8.12 Charitable Contributions -Only qualified organizations




        ExpatCPA.com                                          Page 18   Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential
8.13 Medical Expenses
     Premiums
     Copay (Dr., dental, optometrist)
     Prescriptions
     Other

8.14 US Tax Preparation Fee Paid in 2011

8.15 Un-reimbursed Job Expenses
           Amount        Currency      Description                                    Amount    Currency    Description




8.16 If you have a 1st & 2nd home, is the combined value of the outstanding mortgages greater than $1 million?

                                                                                                 st
8.17 Is your outstanding home equity loan balance greater than $100,000 from your 1 & 2nd house?

8.18     Home Mortgage Interest
       A Main Home - Report only interest for your main home. For rental properties use rental tab below.
         Home address
                                                       Is this a US bank?   Do you have Form 1098?
           Name of Bank                                Yes/ No              Yes/ No                    Interest Paid




           If bank is not a US bank please provide bank's foreign address



       B Second Home - Report only interest for your second home. For rental properties use rental tab below.
         Home address
                                                       Is this a US bank?   Do you have Form 1098?
           Name of Bank                                Yes/ No              Yes/ No                    Interest Paid




           If bank is not a US bank please provide bank's address




        ExpatCPA.com                                                 Page 19             Phone: (714) 939-7670 Fax: (714) 939-1032
       Confidential


                                                                                                            Yes/ No
8.19 Did you have a theft loss of $100 or more that was reported?
                                                                                                            month, day, year
      8.19a When did you discover that your property was missing ?
                                                                                                            Yes/ No
      8.19b Does a claim for reimbursement exist?
                                                                                                            Yes/ No
      8.19c Do you have a reasonable expectation of recovery?

      8.19d What was the value of the property at the time it was stolen?
      The amount of the theft needs to be 10% or greater than your adjusted gross income (AGI) in order to be deductible.


9 US Income Tax Paid -Quarterly Estimated Tax Payments
                                                                                                            Tax Paid           Name of State
9.01 Balance of prior year(s)' State tax paid in 2011

9.02 US Federal income tax quarterly payments made for the 2011 tax year
                          Date of Payment             Amount




9.03 State income tax quarterly payments made for the 2011 tax year
                           Date of Payment             Amount




       ExpatCPA.com                                                 Page 20                Phone: (714) 939-7670 Fax: (714) 939-1032
     Confidential

10 Notes
    Special information you would like us to know.




     ExpatCPA.com                                    Page 21   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 22   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 23   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 24   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 25   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 26   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 27   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 28   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 29   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 30   Phone: (714) 939-7670 Fax: (714) 939-1032
         Confidential




visits




         ExpatCPA.com   Page 31   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 32   Phone: (714) 939-7670 Fax: (714) 939-1032
         Confidential




cure a




         ExpatCPA.com   Page 33   Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential




come
hheld




        ExpatCPA.com   Page 34   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 35   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 36   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 37   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 38   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 39   Phone: (714) 939-7670 Fax: (714) 939-1032
        Confidential




State




        ExpatCPA.com   Page 40   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 41   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 42   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 43   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 44   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 45   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 46   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 47   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 48   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 49   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 50   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 51   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 52   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 53   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 54   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 55   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 56   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 57   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 58   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 59   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 60   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 61   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 62   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 63   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 64   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 65   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 66   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 67   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 68   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 69   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 70   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 71   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 72   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 73   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential



                                                   The Department of the Treasury requires that every




The Department of the Treasury requires that every US citizen or resident
with an interest in or an authority over foreign bank accounts, securities, or
other financial accounts that exceed $10,000 USD in aggregate value at
any time during the calendar year must report the account details no later than
 June 30 of the following year.

If you would like for us to prepare the appropriate forms to disclose your
foreign bank account(s), please provide the following information:
1 Foreign Bank Account Information

Name of Bank

Address of Foreign Bank


  3     Country in which account is held

  4     Number of Foreign Financial Accounts

  5     Account number

  6     Type of account              Bank               Securities          Other

  7     Joint account            Yes               No
                             (if yes, please complete a and b)
        a. How many joint owners

        b. Taxpayer Identification Number of joint owner

  8     Maximum value of account during the calendar year

  9     Do you have a financial interest over account            Yes        No
                                                                        (If no, complete a-d)
               a   Person's name or Organization Name of Account Holder




               b   Taxpayer Identification Number




               c   Address
                                              Mailing Address

                                 City              State             Zip Code
               d   Country



ExpatCPA.com                                                     Page 74                        Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential



2 Foreign Bank Account Information

Name of Bank

Address of Foreign Bank


  3     Country in which account is held

  4     Number of Foreign Financial Accounts

  5     Account number

  6     Type of account              Bank               Securities          Other

  7     Joint account            Yes               No
                             (if yes, please complete a and b)
        a. How many joint owners

        b. Taxpayer Identification Number of joint owner

  8     Maximum value of account during the calendar year

  9     Do you have a financial interest over account            Yes        No
                                                                        (If no, complete a-d)
               a   Person's name or Organization Name of Account Holder




               b   Taxpayer Identification Number




               c   Address
                                              Mailing Address

                                 City              State             Zip Code
               d   Country




ExpatCPA.com                                                     Page 75                        Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential



3 Foreign Bank Account Information

Name of Bank

Address of Foreign Bank


  3     Country in which account is held

  4     Number of Foreign Financial Accounts

  5     Account number

  6     Type of account              Bank               Securities          Other

  7     Joint account            Yes               No
                             (if yes, please complete a and b)
        a. How many joint owners

        b. Taxpayer Identification Number of joint owner

  8     Maximum value of account during the calendar year

  9     Do you have a financial interest over account            Yes        No
                                                                        (If no, complete a-d)
               a   Person's name or Organization Name of Account Holder




               b   Taxpayer Identification Number




               c   Address
                                              Mailing Address

                                 City              State             Zip Code
               d   Country

4 Foreign Bank Account Information

Name of Bank

Address of Foreign Bank


  3     Country in which account is held

  4     Number of Foreign Financial Accounts




ExpatCPA.com                                                     Page 76                        Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential



  5     Account number

  6     Type of account              Bank               Securities          Other

  7     Joint account            Yes               No
                             (if yes, please complete a and b)
        a. How many joint owners

        b. Taxpayer Identification Number of joint owner

  8     Maximum value of account during the calendar year

  9     Do you have a financial interest over account            Yes        No
                                                                        (If no, complete a-d)
               a   Person's name or Organization Name of Account Holder




               b   Taxpayer Identification Number




               c   Address
                                              Mailing Address

                                 City              State             Zip Code
               d   Country




ExpatCPA.com                                                     Page 77                        Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 78   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 79   Phone: (714) 939-7670 Fax: (714) 939-1032
                Confidential



asury requires that every




                ExpatCPA.com   Page 80   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 81   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 82   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 83   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 84   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 85   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 86   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 87   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 88   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 89   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 90   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




Rental Property Information
General

Rental Property Address

Name of occupants

Relationship of occupants to you

Purchase Information
                                              Month day, year
Purchase Date
                                              Month day, year
Date property was placed for rent
                                              Month day, year
Date property stopped being rented

                            Amount                    Currency
Cost of property
Cost of land
Closing cost
Total Cost of Property               0

If you own property with another person, provide your ownership percent

Sale Information
                                              Month day, year
Date of Sale

                                     Amount                     Currency
Sale amount
Selling cost
Other expenses associated with
sale
Accumulated depreciation taken
(provide a copy of prior year tax return)
Number of months owner lived in the property during the prior 5 years from date
of sale
Rental Income
                                     Amount                     Currency
Rental Income
Returns
Other income
Total revenue                        0

Rental Expenses
                                     Amount                     Currency
Advertising
Car and truck expenses
Cleaning and maintenance
Commissions
Insurance
Legal and professional fees
Management fees
Mortgage interest (paid to bank)
Mortgage interest (paid to person)
Repairs
Supplies
Taxes
Utilities
Supplies
Taxes and licenses
Other expenses:




Total expenses                       0




ExpatCPA.com                                                                      Page 91   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




Self-Employment
General

Name of business

Business or Profession

Business Address

                           (cash, accrual, other specify)
Accounting method:
                           (Cost, LCM, other)
Inventory method:
                           Yes/ No
First year in buisness

Business code (if known)

Income
                           Amount                           Currency
Gross Revenue
Returns and allowances
Other income

Inventory
                           Amount                           Currency
Beginning inventory
Purchases
Labor
Materials
Other cost
Ending inventory




ExpatCPA.com                                                Page 92    Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential



Business Expenses
                                    Amount   Currency
Advertising
Car and truck expenses
Commissions and fees
Contract labor
Depletion
Depreciation
Insurance (other than health)
Mortgage interest (paid to banks)
Legal and professional
Office expense
Pension and profit-sharing plans
Rent or lease
Repairs and maintenance
Supplies
Taxes and licenses
Utilities
Wages paid to employees
Travel
    Meals
    Transportation
    Hotel
Entertainment
    Meals
    Gifts
Other expenses:




ExpatCPA.com                                 Page 93    Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential



Assets
Description                       Date purchased     Amount               Currency




Vehicle

Description
                                  Month day, year
Date placed in service
                                                                      Yes/ No
Do you (or spouse) have another vehicle available for personal use?

Was your vehicle available for personal use during off-duty hours?

Do you have evidence to support your deduction?
   If "Yes," is the evidence written?

                                                     Miles
Business miles driven during 2010
Comute (to and from work) miles
Personal miles
Total miles vehicle was driven during 2010                    0

Actual Expenses                Amount                    Currency
Gasoline
Oil
Repairs
Vehicle insurance
Vehicle lease or rental

Home office

Total square footage of home

Square footage of home office

Number of months office was used as home office

                                  Amount                      Currency
Rent
Utilities(except telephone)
Improvements made home office




ExpatCPA.com                                                  Page 94                Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 95   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 96   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 97   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 98   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 99   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 100   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 101   Phone: (714) 939-7670 Fax: (714) 939-1032
Confidential




ExpatCPA.com   Page 102   Phone: (714) 939-7670 Fax: (714) 939-1032

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:8
posted:4/7/2012
language:English
pages:102