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Green Card and Filing Income Tax

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					                                                                                                              For Office Use Only:
  James Maertin, C.P.A.                                                                                           ACT:        LY

  2006 EXPATRIATE TAX QUESTIONNAIRE
  Important: Make sure this questionnaire was saved to your computer before filling it out!

General Information
                        TAXPAYER                                                                  SPOUSE
                                                                               You must complete these fields if married as of Dec. 31, 2006

       First Name:                                                               First Name:
      Middle Initial:                                                           Middle Initial:
       Last Name:                                                                Last Name:
  Social Security #:                                                            SSN or ITIN:
      Date of Birth:                                                            Date of Birth:
         Employer:                                                                 Employer:
       Occupation:                                                               Occupation:

       U.S. Citizen:                                                            U.S. Citizen:
  U.S. Green Card:                                                         U.S. Green Card:
  Other Citizenship:                                                       Other Citizenship:
                                                                                                  (if spouse if a US nonresident alien,
  Telephone:                                                                                      please read note to the side)
               Work
              Mobile
              Home

  Email Addresses                                                     ← I will send email to you at this address


  Referred By:
  (new clients)

  Current Address: (street, city, postal code, country)                                                From (mm/dd/yy)           To (mm/dd/yy)
                                                                                                                                 Present

  Mailing Address for IRS correspondence, if different (i.e., PO Box, work address, etc.).



  Complete if you lived at any other location during 2006.
  Taxpayer (T), Spouse (S), Joint (J)
  T/S/J Address                                                                                        From (mm/dd/yy)           To (mm/dd/yy)



  DEPENDENTS                                 Date of Birth           Social Security #                                    Green Card holder or
  First Name, Initial, Last Name               (mm/dd/yy)                 (required)         Relationship to You          US Citizen? (yes or no)




  ELECTRONIC FILING: I will set your return up for electronic filing unless there is a reason why it cannot be e-filed
  (e.g., your spouse does not have an ITIN or SSN number).

  DIRECT DEPOSIT
  Name of US Bank
                             Checking        Savings

  Routing Number                                             (9-digit number on the bottom left of a check)
  Account Number

  ELECTRONIC FUNDS WITHDRAWAL (only if e-filing)
  If there is a tax balance due, do you want the funds withdrawn from your bank account on April 16?                       Yes         No
U.S. Source Income

    Generally, I do not need you to fill out U.S. source income amounts on the questionnaire as I can get them directly from the
    tax documents that you have received from the payers. Please scan & email or fax me all such forms.

    Please check which U.S. tax forms you [and/or your spouse] received, and then e-mail or fax me a copy:
                           Wages (Form W-2)
                           Interest (1099-INT)
                        Dividends (1099-DIV)
                  Sales of Securities (1099-B)  (please also complete Trades tab)
          Miscellaneous Income (1099-MISC)      (please also complete Self-Employment tab)
                      Tax Overpayment (1099-G)
         Unemployment Compensation (1099-G)
             Partnership/S-Corp/Trust (Sch. K-1)
               Retirement Distributions (1099-R)
        Foreigner's U.S. Source Income (1042-S)
                   Mortgage Interest (Form 1098)
                  Student Loan Interest (1098-E)
                  Tuition Expense (Form 1098-T)
            2005 Tax Returns (New Clients Only)

Trades / Self-Employment / Rental Property

    For these items, whether U.S. or foreign source, please click on the link to provide additional information:

                        Trades/Sales of Securities
                                Self-Employment
                                   Rental Income

Foreign Source Income & Employment
    Employers during 2006:
    Taxpayer (T), Spouse (S)                                                                                               Where worked
    T/S    Employer:                        Occupation                    From                     To                      (state or country)
    T      0                                0                                                           Present



    Taxpayers are required to report all worldwide income. Please use the Currency Converter below.
Taxpayer (T), Spouse (S), Joint (J)
          Type of Income:                                Currency        Gross Income        Income Converted    Gross Tax Paid      Tax Converted
T/S/J      (wages, interest, etc.)   Name of Payer       (euro, etc.)   (foreign currency)    to US Dollars*    (foreign currency)    to US Dollars*
    T                          0




                                                                        Foreign Currency         US Dollar
                                                           2006             Amount              Conversion
                    EMU MEMBERS             Euro           1.2563                                 0.00
                    UNITED KINGDOM          Pound          1.8434                                 0.00
                    ARGENTINA               Peso           0.3273                                 0.00
                    AUSTRALIA               Dollar         0.7535                                 0.00
                    CHINA                   Yuan           7.9723                                 0.00
                    CZECH REPUBLIC          Koruna        0.04441                                 0.00
                    ESTONIA                 Kroon         0.08027                                 0.00
                    HONG KONG               Dollar         7.7681                                 0.00
                    INDIA                   Rupee         45.1900                                 0.00
                    JAPAN                   Yen          116.3100                                 0.00
                    NEW ZEALAND             Dollar         0.6492                                 0.00
                    POLAND                  Zloty         0.32300                                 0.00
`                   SAUDI ARABIA            Riyal         0.26670                                 0.00
                SINGAPORE                  Dollar          1.58820                               0.00
                SWEDEN                     Krona           7.37180                               0.00
                SWITZERLAND                Franc           1.25320                               0.00                    `
                THAILAND                   Baht           37.87600                               0.00
                UKRAINE                    Hryvnia         0.20610                               0.00

      See also http://www.oanda.com/convert/classic (to get an average exchange, click on FXHistory)

Information for Foreign Earned Income Exclusion
  Foreign Address during 2006                                                                           From (mm/dd/yy)            To (mm/dd/yy)
  0                                                                                                            0                   Present

  TAXPAYER                                                                           SPOUSE

  Principal Foreign Employer during 2006:                                            Principal Foreign Employer during 2006:
  Employer's Name:                                                                   Employer's Name:
  0
  Employer's US Address (if any):                                                    Employer's US Address (if any):


  Employer's Foreign Address:                                                        Employer's Foreign Address:



  Type of Company:                                                                   Type of Company:
          Foreign Entity                                                                     Foreign Entity
          U.S. Company                                                                       U.S. Company
          Self                                                                               Self
          Foreign Affiliate of a U.S. Company                                                Foreign Affiliate of a U.S. Company
          Other (specify)                                                                    Other (specify)

  Date you moved outside the U.S.:                                              Date you moved outside the U.S.:

  Living Quarters Abroad:
             Purchased home
             Rented house or apartment
             Rented room
             Quarters furnished by Employer                                                                Foreign Currency          US Dollar
                                                                                                               Amount               Conversion
        If renting, what were your total housing costs for the year (while working abroad)?
             *(Include rent, utilities (except phone), insurance, parking, repairs, furniture rental)

  Are you required to pay income taxes in the foreign country in which you reside?                              Yes           No



  Dates of trips to the U.S. during 2006:
               Date Entered US         Date Left US     # of Business
  T/S/J         (mm/dd/yy)             (mm/dd/yy)       Days in US      Full        US
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -1          1
                                                                        -9          9      356   Number of full days in foreign countries



  What type of visa do you hold in the foreign country?
  Taxpayer:                                                                  Spouse:
  If your visa limits your length of stay or employment, what are the conditions?
  Taxpayer:                                                      Spouse:

                                                                               No
   Did you maintain a home in the United States?          Yes       No
       If yes, was it rented out?    Yes      No
       If rented out:
       1 Names of Occupants
       2 Occupants relationship to you
       3 Please complete the      Rental Property worksheet


Expenses
   Note: Avoid using round numbers ending with "00" because they raise a red flag to the IRS. For example, if your expense
   is $595, don't report it as $600.

   IRA CONTRIBUTIONS:                     TAXPAYER        SPOUSE
         IRA Traditional              $               $                 Tax Year 2006, maximum contribution is $4,000 per
         IRA Roth                     $               $                 person (to age 49), and $5,000 (age 50 and older).

   Charitable Donations to Qualified U.S. Charities
                                     TAXPAYER        SPOUSE             JOINT
   Cash, Checks, or Credit Cards   $               $                $
   Noncash (i.e., goods)           $               $                $

   Please enter amount in U.S. dollars. You may use the currency converter above.
   Schedule A Expenses:              TAXPAYER      SPOUSE        JOINT
       Real Estate Taxes*          $             $             $                *(This can be for a foreign residence)
       Mortgage Interest*          $             $             $
       Last Year's Tax Prep Fee    $             $             $
       Margin Interest             $             $             $
       Job Search Costs            $             $

   University Education
      Tuition and Fees                $               $

   Student Loan Interest Paid:        $               $

Foreign Accounts

   If you had more than $10,000 in a foreign account at any time during 2006, please provide the account information below.
   Such information is required to be reported to the Treasury Department. There are possible penalties for noncompliance.

Taxpayer (T), Spouse (S), Joint (J)
T/S/J         Type of Account:                       Maximum Value of Account:             Account Number:
                 Bank                                   Under $10,000
                 Security                               $10,000-$99,999                    Name of Financial Institution
                 Other                                  $100,000-$1,000,000
                                                        Over $1,000,000                    Country in which account is held:


T/S/J         Type of Account:                       Maximum Value of Account:             Account Number:
                 Bank                                   Under $10,000
                 Security                               $10,000-$99,999                    Name of Financial Institution
                 Other                                  $100,000-$1,000,000
                                                        Over $1,000,000                    Country in which account is held:


T/S/J         Type of Account:                       Maximum Value of Account:             Account Number:
                 Bank                                   Under $10,000
                 Security                               $10,000-$99,999                    Name of Financial Institution
                 Other                                  $100,000-$1,000,000
                                                        Over $1,000,000                    Country in which account is held:


T/S/J         Type of Account:                       Maximum Value of Account:             Account Number:
                 Bank                                   Under $10,000
                 Security                               $10,000-$99,999                    Name of Financial Institution
                 Other                                  $100,000-$1,000,000
                                                        Over $1,000,000                    Country in which account is held:
Special Situations

  New Clients: Did you file a tax return last year?       Yes      No
     If yes, I will need a copy of your 2005 federal and state returns. Please don't send prior tax year W-2's,etc.

  If any of these apply, please provide additional information:
  * You received a notice in 2006 of a tax adjustment or audit, or settled an audit.
  * You gave a gift of more than $11,000 to any one donee during 2006.
  * You paid alimony or received alimony.
  * You had income not otherwise indicated on the questionnaire
  Note: If you mailed in quarterly estimated tax payments, please enter them on the self-employment tab.

  If you have other situations or questions, list them here, call, or send me an email:
  Note: To start a new line, press ALT-ENTER.




      PLEASE SAVE THIS QUESTIONNAIRE, THEN SEND IT TO ME AS AN E-MAIL ATTACHMENT

  Thank you for completing the questionnaire. Since I only keep electronic files, please send your U.S. tax
  documents to me by e-mail (e.g., .pdf or .jpg) or by fax (see numbers below). If you mail me any documents,
  please keep the originals and send me photocopies, unstapled, since I will be scanning and then shredding
  them. If you are a new client, I'll also need a copy of your 2005 tax returns, if filed. Please do not send me
  expense receipts; I only need the totals for each type of expense which you should have already entered on the
  questionnaire. I will start preparing your tax return upon receipt of all information.
                   Reminder: Your tax return cannot be filed without your signature.

                                                   James Maertin, C.P.A.
                                                 Tel: 212-541-5523
                E-Fax Numbers: 212-937-3731 (New York); 01.53.0134.52 (Paris); 0207-681-1305 (London)
                                              james@jamedance.com
                                               www.jamesdance.com
            2006 Capital Gains and Losses (Schedule D)
Name:
SSN:        000-00-0000

SHORT TERM Capital Gains and Losses - Assets Held One Year or Less
Part I, Line 1

Number of                                  Date       Date       Sales     Cost
 Shares           Name of Security       Acquired     Sold       Price     Basis   Gain/Loss
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                      $0      $0        $0

LONG TERM Capital Gains and Losses - Assets Held More Than One Year
Part II, Line 8

Number of                                  Date       Date       Sales     Cost
 Shares           Name of Security       Acquired     Sold       Price     Basis   Gain/Loss
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                                       0.00
                                                                      $0      $0        $0
                               2006 Self-Employment Information
         Taxpayer:                                                                Spouse:

Type of Business/Profession:


    (please be specific, e.g., if consultant, in what field?)

Social Security
   Were you covered by social security in a foreign country on your self-employment income?
      Taxpayer:      Yes       No                                           Spouse:       Yes                      No


Self-Employment Income
                          TAXPAYER                                                                SPOUSE
                          Amount (USD)                                                            Amount (USD)
                      $                                                                       $

Currency Converter
                                                                                 Foreign Currency     US Dollar
                                                                      2006           Amount           Conversion
                          EMU MEMBERS                      Euro        1.2563                           0.00
                          UNITED KINGDOM                   Pound       1.8434                           0.00
                          ARGENTINA                        Peso        0.3273                           0.00
                          AUSTRALIA                        Dollar      0.7535                           0.00
                          BRAZIL                           Real        2.1738                           0.00
                          CANADA                           Dollar      1.1340                           0.00
                          CHINA                            Yuan        7.9723                           0.00
                          CZECH REPUBLIC                   Koruna     0.04441                           0.00
                          ESTONIA                          Kroon      0.08027                           0.00
                          HONG KONG                        Dollar      7.7681                           0.00
                          INDIA                            Rupee      45.1900                           0.00
                          JAPAN                            Yen       116.3100                           0.00
                          MEXICO                           Peso       10.9060                           0.00
                          POLAND                           Zloty         0.323                          0.00

                 See also http://www.oanda.com/convert/classic (to get an average exchange, click on FXHistory)

Self Employment Expenses
                          TAXPAYER                                                                SPOUSE
                                                      Amount (USD)                                                           Amount (USD)
                          Advertising             $                                                     Advertising      $
                  Health Insurance                $                                             Health Insurance         $
                   Other Insurance                $                                              Other Insurance         $
 Last Year's Tax Preparation Fee                  $                              Last Year's Tax Preparation Fee         $
    Other Legal/Professional Fees                 $                                         Computer Equipment           $
              Computer Equipment                  $                               Other Legal/Professional Fees          $
                    Office Supplies               $                                               Office Supplies        $
        Office Rent (other than home)             $                                    Office Rent (other than home)     $
                               Repairs            $                                                          Repairs     $
       Supplies (other than office)               $                                   Supplies (other than office)       $
                  Travel & Lodging                $                                             Travel & Lodging         $
            Meals & Entertainment                 $                                       Meals & Entertainment          $
                            Research              $                                                       Research       $
                           Telephone              $                                                      Telephone       $
                               Internet           $                                                          Internet    $
                       Dues & Fees                $                                                  Dues & Fees         $
           Client Gifts (limit $25 each)          $                                      Client Gifts (limit $25 each)   $
            Education & Seminars                  $                                        Education & Seminars          $
                              Postage             $                                                         Postage      $
              Local Transportation                $                                          Local Transportation        $
                Trade Publications                $                                           Trade Publications         $
    LIST OTHER SELF-EMPLOYMENT BUSINESS EXPENSES:
    Description                   Amount                                        Description                              Amount
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $
                                $                                                                                    $

Self-Employed Retirement Plan (Keogh and SEP)

    If you've already contributed to a SEP or Keogh:
    2006 SEP contribution           $                                           2006 SEP contribution                $
    2006 Keogh contribution         $                                           2006 Keogh contribution              $

    If not, do you want me to calculate your maximum 2006 SEP contribution?
    Taxpayer:       Yes     No                                  Spouse:                          Yes        No


Home Office

Note: Although home office is a common and legitimate expense, claiming the expenses slightly increases your chance of audit.
                     Yes        No                                                               Yes        No
If you lived at more than one location during the year, please complete expenses separately:
                      TAXPAYER                                                               SPOUSE
   Location 1: Address                                                     Location 1: Address
   0                                                                       0
   Dates worked: From                    to                                Dates worked: From                    to
                Total area of home (sq. ft.)                                            Total area of home (sq. ft.)
Area used exclusively for business (sq. ft.)                            Area used exclusively for business (sq. ft.)
   Rent $           X      months = $                 0                    Rent $           X      months = $                   0
Utilities $         X      months = $                 0                 Utilities $         X      months = $                   0
    Repairs and maintenance expense $                                       Repairs and maintenance expense $
         Home insurance (total for year) $                                       Home insurance (total for year) $

    Location 2: (If you moved during the year)                             Location 2: (If you moved during the year)

   Dates worked: From                    to                                Dates worked: From                    to
                Total area of home (sq. ft.)                                            Total area of home (sq. ft.)
Area used exclusively for business (sq. ft.)                            Area used exclusively for business (sq. ft.)
   Rent $           X      months = $                 0                    Rent $           X      months = $                   0
Utilities $         X      months = $                 0                 Utilities $         X      months = $                   0
    Repairs and maintenance expense $                                       Repairs and maintenance expense $
         Home insurance (total for year) $                                       Home insurance (total for year) $

    Note: List furniture purchase and other expenses related to the home office under self-employment expenses.
Vehicle Expenses

List only vehicle expenses that apply to self-employment (see Employee Expenses tab for W-2 related vehicle use)

Note: If you used more than one vehicle during the year, please I will need the expenses listed separately
for each vehicle.

    Vehicle 1:                                                       Vehicle 2:
Year, make and model                                             Year, make and model
    Dates used:       From                 to                        Dates used:       From                 to
           Total miles (personal + business)                                Total miles (personal + business)
                       Total business miles                                             Total business miles
Is another vehicle available for personal use:        Yes   No   Is another vehicle available for personal use:        Yes   No
                     Is your vehicle leased?          Yes   No                        Is your vehicle leased?          Yes   No
      If owned, purchase price of vehicle $                            If owned, purchase price of vehicle $
                           Date of purchase                                                 Date of purchase
                                      Tolls $                                                          Tolls $
                                   Parking $                                                        Parking $

If you want me to calculate actual expenses, which
may be more than standard mileage:

List total expenses incurred between the dates below:                List total expenses incurred between the dates below:
(I will calculate the business percentage)                           (I will calculate the business percentage)
                        From        1/0/00 to    1/0/00                                  From        1/0/00 to    1/0/00
                                 Gas & oil $                                                      Gas & oil $
                             Repairs/tires $                                                  Repairs/tires $
                         Lease payments $                                                  Lease payments $
                           Auto Insurance $                                                 Auto Insurance $
                              Garage rent $                                                    Garage rent $
                         Auto Club (AAA) $                                                 Auto Club (AAA) $

Estimated Tax Payments
                TAXPAYER                                                         SPOUSE

FEDERAL PAYMENTS               Date paid if                      FEDERAL PAYMENTS               Date paid if
 QTR     Due Date           later than due date       Amount      QTR     Due Date           later than due date       Amount
   1     04/15/06                                 $                 1     04/15/06                                 $
   2     06/15/06                                 $                 2     06/15/06                                 $
   3     09/15/06                                 $                 3     09/15/06                                 $
   4     01/15/07                                 $                 4     01/15/07                                 $

STATE:                                                           STATE:
   1        04/15/06                              $                 1        04/15/06                              $
   2        06/15/06                              $                 2        06/15/06                              $
   3        09/15/06                              $                 3        09/15/06                              $
   4        01/15/07                              $                 4        01/15/07                              $

Locality:                                                        Locality:
  1         04/15/06                              $                1         04/15/06                              $
  2         06/15/06                              $                2         06/15/06                              $
  3         09/15/06                              $                3         09/15/06                              $
  4         01/15/07                              $                4         01/15/07                              $
                            2006 Rental Property Worksheet

General Information:

  Taxpayer:                                                            Spouse:

  If married, is the house owned jointly?   Yes              No      → If not, who is the owner?     Taxpayer      Spouse
  Do you [and spouse] own 100% of the property?                Yes     No → If not, list ownership percentage

  Address of property:

  Date property was placed in service (made available for rent). This can be a past year:

  Date, if any, property was no longer available for rent:

                                                         Yes          No
  Is the entire property available for rental use?                         → If not, percentage rented out

Rental Income and Expenses

  Rental income for the entire tax year:             $

  Rental Expenses:                        Amount
                      Advertising     $                                                          Currency Converter:
                           Travel     $
         Cleaning & maintenance       $                                                          EMU MEMBERS           Euro
                   Commissions        $                   Rental amount (if not fully rented)    UNITED KINGDOM        Pound
                       Insurance      $                        0%          $           0         ARGENTINA             Peso
        Legal & professional fees     $                                                          AUSTRALIA             Dollar
               Management fees        $                                                          BRAZIL                Real
                Mortgage interest     $                        0%          $           0         CANADA                Dollar
                Real estate taxes     $                        0%          $           0         CHINA                 Yuan
                          Repairs     $                                                          CZECH REPUBLIC        Koruna
                         Supplies     $                                                          ESTONIA               Kroon
                  Water & sewer       $                        0%          $           0         HONG KONG             Dollar
                Garbage removal       $                        0%          $           0         INDIA                 Rupee
  Description                                                                                    JAPAN                 Yen
                                      $                                                          MEXICO                Peso
                                      $                                                          POLAND                Zloty
                                      $

  List any capital improvements made to the property during the tax year:
  These are improvements made to your home that add to its value, prolong its useful life, or adapt it to new uses.
  (Examples include replacements or additions such as roof, carpet, boiler, rooms, patio, driveway,
  central air, windows, etc.)

  Type of Improvement                     Cost            Date
                                      $
                                      $
                                      $
                                      $
                                      $
Cost Basis of Property

      Adjusted Basis of Property:
       $                        Purchase Price of Property
       $                        Settlement Costs (abstract fees, legal fees, recording fees, surveys, transfer taxes, title insurance)
       $                        Capital Improvements made to property before it was made available for rent:

        $            0              = TOTAL ADJUSTED BASIS

            (Note: If you converted a personal property to a rental property, your basis is the lesser of the fair market
            value or the adjusted basis of the property).

      Value of land in price of property:
       $                          (Note: Land is not a depreciable asset)


      For more information, see        IRS Publication 527: Residential Rental Property

				
DOCUMENT INFO
Description: Green Card and Filing Income Tax document sample