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Tax deduction recorder

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									                         Tax Deduction Recorder
Tax Year Ended                                                                       ALLEN L. KOCKLER CO.
                                                                                  PO BOX 558, NEVADA, IA 50201
                                                                                          515-382-5481
Personal Information
Taxpayer Name                                                            Taxpayer SSN #
 Spouse Name                                                               Spouse SSN#
      Address                                                             Taxpayer DOB
    City, State                                                             Spouse DOB
  Home Phone                                                            Your Occupation
                                                                     Spouse's Occupation

Dependents                               M/F         Date of Birth    Social Security #          Age         Student
         Name
         Name
         Name
         Name

Wage & Salary Income-Enclose W-2 Forms

    ~T/S~             Employer        Total Wages    Federal W/H       Social Security         Medicare     State W/H




Gambling Winnings/Losses                            Social Security Benefits Received
    ~T/S~             Amount                            ~T/S~             Amount           Less Medicare




Personal Deductions                                 Interest and Dividend Income
Doctor Expenses                                                           Interest Income
RX Expenses                                         Name of Payer                                            Amount
** Health Insurance **
Long-term Care Insurance
Dental Expenses
Nursing Home Care
Medical Mileage
State and Local Taxes
Real Estate Taxes
Personal Property Taxes
Vehicle License
Home Mortgage Interest to Banks
Home Mortgage Interest to Other                                             Dividend Income
Investment Interest                                 Name of Payer                                            Amount
Cash Contributions Given
Charitable Mileage
Non-Cash Contributions
Casualty/Theft Losses
Unreimbursed Employee Expense
Safety Deposit Box Fees
Tax Preparation Fees

** Do not include employer paid benefits **
~ T/S ~ Denotes Taxpayer or Spouse
                                  Miscellaneous Personal Expenses
                                             Tuition Paid

                             Interest Paid on Student Loans

                                                Alimony Paid

                                Teacher Educator Expenses

                                Child Care Expenses Paid         Provider 1           Provider 2

                                      Care Provider's Name

                                    Care Provider's Address

            Care Provider's Federal EIN Number or SSN

                                   Qualifying Child's Name

      Qualifying Expenses Incurred and PAID this year

                          College Savings Contributions

Business Information                                                            Expenses
Name of business:                                                                            Advertising   $
Address(if different)                                                                         Bad Debts    $
City, State                                                                             Bank Charges       $
                                                                                          Commissions      $
                   Incomes                                                       Delivery and Freight      $
                                     Sales $                                 Dues and Subscriptions        $
                                                                         Employee Benefit Programs         $
                   Returns and Allowances $                                    Gas/Oil for Equipment       $
                                                                                Insurance-not Health       $
                        Beginning Inventory $                                      Insurance - Health      $
                                                                                     Interest to Banks     $
                          Ending Inventory $                                          Interest to Other    $
                                                                               Internet Service Fees       $
                                Purchases $                                    Laundry and Cleaning        $
                                                                          Legal & Professional Fees        $
           Cost of Materials and Supplies $                                    License/Permits Fees        $
                                                                                    Lodging Expense        $
                              Cost of Labor $                              Meals and Entertainment         $
                                                                                       Office Expense      $
                                                                                     Outside Services      $
                                                                                          Parking Fees     $
                                                                          Pension/Retirement Plans         $
                                                                                    Postage Expense        $
                                                                                     Printing Expense      $
                                                                                      Rent of Property     $
                                                                         Rent or Lease of Equipment        $
                                                                       Repairs/Maintenance Expense         $
                                                                           Salaries/Wages Expense          $
                                                                                    Security Expense       $
                                                                                    Supplies Expense       $
                                                                                       Sales Tax Paid      $
                                                                                      Payroll Tax Paid     $
                                                                                Real Estate Tax Paid       $
                                                                                 Telephone Expense         $
                                                                                 Cell Phone Expense        $
                                                                                        Tools Expense      $
                                                                         Mileage for Travel Expense
                                                                                   Uniforms Expense        $
                                                                                      Utilities Expense    $

                                                               Other-Please Specify                        $
Residential Energy Tax Credits
Pesonal Energy Property Credit

Taxpayers can claim a credit for certain home improvements placed in service in 2009 and 2010. This credit for personal
energy property was also available for qualifying improvements placed in service in 2006 and 2007, but not in 2008

Allowable Credit:
* The credit is equal to 30% of the cost of                           * There are no AGI or income limits so all
    qualified energy-efficient property or improvements                  individuals can claim the credit

* The total amount of the credit that can be                          * For 2010, the credit can offset both regular tax and AMT.
   claimed in 2009 and 2010 is $1,500.


         Personal Energy Property Credit---Qualifying Property (2009)
 Credit summary: (1) credit equals 30% of cost of qualified property, (2) $1,500
                                                   Product
      Windows and Doors
                         Exterior Windows       Before 6/1/09: Must meet ENERGY STAR criteria;
 $                       and Skylights          After 6/1/09: U factor <- 0.30; SHGC 5 0.30.
                         Storm Windows          In combination with the exterior window over which it is
                                                installed; has a U-factor and SHGC of 0.30 or below;
 $                                              meets the IECC.
                         Exterior Doors         Before 6/1/09: Must meet ENERGY STAR criteria;
 $                                              After 6/1/09: U factor <- 0.30; SHGC <- 0.30
                         Storm Doors            In combination with a wood door over which it is installed;
                                                has a U-factor and SHGC of 0.30 or below; meets the
 $                                              IECC.
      Heating, Ventilation and Air Conditioning (HVAC)
                         Central A/C            Split systems: EER >—13; SEER ? 16
 $                                              Package systems: EER ? 12; SEER 14
                         Air Source Heat        Split systems: HSPF > 8.5; EER >12.5; SEER ?.15
 $                       Pumps                  Package systems: HSPF > 8; EER 12; SEER > 14
                         Natural Gas or         AFUE >— 95
 $                       Propane Furnace
 $                       Oil Furnace            AFUE 90
                         Gas, Propane, or       AFUE > 90
 $                       Oil Hot Water Boiler
                         Advanced Main Air      No more than 2% of furnace total energy use.
 $                       Circulating Fan
      Water Heaters
                         Gas, Oil, Propane      Energy factor > 0.82 or a thermal efficiency of at least
 $                       Water Heater           90%.
                         Electric Heat Pump     Same criteria as ENERGY STAR: Energy factor ? 2.0
 $                       Water Heater
      Other Property
                         Insulation             Meets 2009 IECC & Amendments. For insulation to
                                                qualify, its primary purpose must be to insulate
 $                                              (Example: insulated siding does not qualify).
                         Metal Roofs,           All ENERGY STAR qualified metal and reflective asphalt
 $                       Asphalt Roofs          shingles.
                         Biomass Stove          Stove which burns biomass fuel to heat a home or
                                                heat water. Thermal efficiency rating of at least 75% as
 $                                              measured using a lower heating value.

Residential Energy Efficient Property Credit
Taxpayers can claim a tax credit for residential energy efficient property placed in service in 2006-2016.
  The Credit is equal to 30% of the cost of the following property no limit excet fuel cells:
 *Solar energy systems (water heating and elecricity)            *Small wind energy systems
 *Fuel cells ($1,000 limit)                                      *Geothermal heat pumps
Sale of Assets                     Purchase of Assets



         Item 1                           Item 1
Description                        Description
Date Acquired                      Date Purchased
Date Sold                          Purchase Price   $
Sales Price       $
Cost              $


         Item 2                           Item 2
Description                        Description
Date Acquired                      Date Purchased
Date Sold                          Purchase Price   $
Sales Price       $
Cost              $


         Item 3                           Item 3
Description                        Description
Date Acquired                      Date Purchased
Date Sold                          Purchase Price   $
Sales Price       $
Cost              $


         Item 4                           Item 4
Description                        Description
Date Acquired                      Date Purchased
Date Sold                          Purchase Price   $
Sales Price       $
Cost              $


         Item 5                           Item 5
Description                        Description
Date Acquired                      Date Purchased
Date Sold                          Purchase Price   $
Sales Price       $
Cost              $


         Item 6                           Item 6
Description                        Description
Date Acquired                      Date Purchased
Date Sold                          Purchase Price   $
Sales Price       $
Cost              $


**** Date Sold is Imperative****
        Rental Income


                                     Property 1       Property 2       Property 3       Property 4       Property 5
          Kind of Property
       Location of Property
         # of Days Rented
# of Days of Personal Use

              Incomes
                     Rents $                      $                $                $
                  Royalities $                    $                $                $

            Expenses
                   Advertising   $                $                $                $                $
          Association Dues       $                $                $                $                $
              Auto Expense       $                $                $                $                $
         Cleaning Expense        $                $                $                $                $
               Commissions       $                $                $                $                $
                    Insurance    $                $                $                $                $
      **Interest Expense**       $                $                $                $                $
Legal & Professional Fees        $                $                $                $                $
         License & Permits       $                $                $                $                $
        Management Fees          $                $                $                $                $
Mortgage Interest to Banks       $                $                $                $                $
Mortgage Interest to Other       $                $                $                $                $
                Pest Control     $                $                $                $                $
     Remodeling Expense          $                $                $                $                $
   Repairs & Maintenance         $                $                $                $                $
                     Supplies    $                $                $                $                $
        Real Estate Taxes        $                $                $                $                $
                 Other Taxes     $                $                $                $                $
      Telephone Expense          $                $                $                $                $
        Mileage for Travel
           Utilities Expense     $                $                $                $                $
 Wages/Salaries Expense          $                $                $                $                $
     Other-Please Specify        $                $                $                $                $

      Other-Please Specify $                      $                $                $                $

        ** Do not include Mortgage Interest here**
        Farm Income for Rental or Personal
                                                 INCOMES
                   Sale of Livestock purchased for resale      $
                                          Cost of Livestock    $
             Sale of livestock, produce, grains you raised     $   Other Income-Please Specify
                                 Cooperative Distributions     $                        $
                           Agricultural Program Payments       $   Other Income-Please Specify
           Commodity Credit Corporation Loans Reported         $                        $
           Commodity Credit Corporation Loans Forfeited        $   Other Income-Please Specify
                       Crop Insurance Proceeds Received        $                        $
                                      Custom Hire Income       $
                  Federal Fuel Credit from Previous Year       $
                    State Fuel Credit from Previous Year       $
                    Cow/Calf Refund from Previous Year         $

                                              EXPENSES
                                               Advertising     $
                                            Bank Charges       $
                                      Breeding Expense         $
                                              Car & Truck      $
                                               Chemicals       $
                                      Conservation Fees        $
                                             Custom Hire       $
                                 Dues and Subscriptions        $   Other Expense-Please Specify
                            Employee Benefit Programs          $                        $
                                        Feed Purchased         $   Other Expense-Please Specify
                                     Fertilizers and Lime      $                        $
                                    Freight and Trucking       $   Other Expense-Please Specify
                                              Fuel and Oil     $                        $
              Insurance-Do not include Health Insurance        $   Other Expense-Please Specify
                        Mortgage Interest Paid to Banks        $                        $
                                      Other Interest Paid      $   Other Expense-Please Specify
                                      Internet/DTN Fees        $                        $
                                              Labor Hired      $
                           Legal and Professional Fees         $
                                       Postage Expense         $
                             Pension Plan Contributions        $
           Adminstrative and Educational Pension Costs         $
Vehicles, Machinery and Equipment Rental or Lease Cost         $
              Land, Animals, Other Rental or Lease Cost        $
                               Repairs and Maintenance         $
                           Seeds and Plants Purchased          $
                                       Security Expense        $
                              Storage and Warehousing          $
                                     Supplies Purchased        $
                                    Cell Phone Expense         $
                                     Telephone Expense         $
                                  Property Tax Expense         $
                                          Tools Expense        $   Note
                            Mileage for Travel Expense         $   Mileage for Business Usage
                                                   Utilities   $   For Sole Prop Only
                               Vehicle License Expense         $   Number of Miles
                          Veterinary and Medicine Costs        $

								
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