Low Cost Auto Insurance Lincoln Ca - PDF

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					                                                                                          2010 Taxes
                                                                                        Client Checklist
Welcome to BAKER INCOME TAX SERVICES, a Low Cost Community Based Tax Service. Please fill out as much of the following
information as possible so that we may provide you next year with our best service and your greatest possible tax benefit.
Prior Tax Return
 2009 Federal Tax Return
 2009 State Tax Return
Taxpayer Information
 Photo Identification 
 Social Security Cards/Numbers (yourself, spouse, children, etc)
Medical & Dental Payments
 Doctor_______________________________           $___________       Doctor____________________________         $____________
 Operations____________________________          $____________      Prescription Drugs__________________       $____________
 Medical/Dental Insurance________________        $____________      Long Term Care Insurance____________       $____________
 Hospital & Emergency___________________         $____________      Lab & X-Ray________________________        $____________
 Visiting Nurses/In Home Care_____________       $____________      Dental____________________________         $____________
 Dentures & Braces______________________         $____________      Glasses & Contact Lens_______________      $____________
 Hearing Aids & Batteries_________________       $____________      Orthopedic Shoes___________________        $____________
 Therapy Treatments____________________          $____________      Crutches/Canes/Braces_______________       $____________
 Wheel Chairs__________________________          $____________      Medical Miles Driven_________________      $____________
 Equipment/Supplies on Doctor’s Advice___        $____________      Other Medical Transportation__________     $____________
Contributions
 Church_______________________________           $____________      College___________________________         $____________
 United Way___________________________           $____________      March of Dimes____________________         $____________
 Red Cross_____________________________          $____________      GoodWill__________________________         $____________
 Clothing to: ___________________________        $____________      Clothing to:________________________       $____________
 Other________________________________           $____________      Other_____________________________         $____________
 Volunteer work expenses________________         $____________      Auto Miles Driven___________________       $____________
Taxes & Interest Paid
 Real Estate Tax - Residence_______________      $____________      Real Estate Tax - Other_______________     $____________
 State Income Tax_______________________         $____________      Personal Property Tax________________      $____________
 Sales Tax______________________________         $____________      New Car, Boat, RV Sales T_____________     $____________
 Home Mortgage 1st Interest_______________       $____________      Equity Line of Credit Interest__________   $____________
 Home Mortgage 2nd Interest______________        $____________      Purchase Mortgage Insurance_________       $____________
 Student Loan__________________________          $____________      Post Secondary Tuition & Fees_________     $____________
Casualty Losses
 Other________________________________ $____________  Other_____________________________ $____________


BakerTax Services                   – 980 Donaldson Ct, Lincoln CA 95648 –                   (916) 543-5244 Bus/Fax Line
                                                                                          2010 Taxes
                                                                                        Client Checklist
Child & Dependent Care
 Provider_______________________________ $____________  Provider___________________________ $____________
Miscellaneous & Unreimbursed Employee Business Expenses
 Work Tools____________________________         $____________     Sales/Entertainment_________________         $____________
 Safety Shoes & Gloves___________________       $____________     Business Travel_____________________         $____________
 Uniform Cleaning_______________________        $____________     Vehicle Use Miles (non commute)______        $____________
 Job Seeking Fees________________________       $____________     Miles Driven to 2nd Job_______________       $____________
 Tax Return Preparation__________________       $____________     Safe Deposit Box____________________         $____________
 Other________________________________          $____________     Other_____________________________           $____________
Self-Employed Business Expenses
 Advertising____________________________        $____________     Utilities/Telephone__________________        $____________
 Car & Trucking Expense__________________       $____________     Supplies___________________________          $____________
 Repairs & Maintenance__________________        $____________     Taxes & Licenses____________________         $____________
 Office Expenses________________________        $____________     Travel/Entertainment________________         $____________
 Rent or Lease Payments_________________        $____________     Meals_____________________________           $____________
 Other________________________________          $____________     Other_____________________________           $____________
 Other________________________________          $____________     Other_____________________________           $____________
Miscellaneous Questions
Y   N Please check the appropriate Y/N box and if “Yes” provide all pertinent details to the following questions:
 Any births, adoptions, marriages/divorces or deaths in your immediate family during the year?
 Are any of your unmarried children, who might be claimed as a dependent 19 years of age or older?
 Are any of your children whom you are claiming as a dependent under age 25 and going to school?
 Do you have any children under the age of 24 with interest, dividends, and/or capital gain income in excess of $950?
 Did you or your spouse “rollover” a retirement plan distribution to another plan?
 Did you or your spouse open a Roth IRA or convert an IRA into a Roth IRA?
 Did you purchase, sell or refinance your principle or second home, or obtain a home equity line of credit?
 Did you make any home energy efficiency improvements (doors/windows/heating/cooling, etc) to your home?
 Did you sell any stocks, bonds, or other investments during the year?
 Did you use your car or truck on the job other than commuting to and from work?
 Does anyone owe you money which has become uncollectible?
 Did you incur any moving expenses during the year due to a change of employment?
 Did you incur any losses because of damaged or stolen property?
 Did you make any payments for post-secondary education?
 Did you have an interest or signature authority over a bank or brokerage account in a foreign country?


BakerTax Services                   – 980 Donaldson Ct, Lincoln CA 95648 –                  (916) 543-5244 Bus/Fax Line

				
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