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Roberts Hart and Company, CPA's
2007 Income Tax Organizer
For the Year Jan 1-Dec 31, 2006, or other tax year beginning , 2006, ending , 20
Your first name & initial Last name Your Social Security Number
If a joint return, spouse's first name and initial Last name Spouse's Social Security Number
Home Address (number & street) Occupation
City, town or post office, state, and ZIP code. Spouse's Occupation
Home Phone Cell Phone Email
Existing clients indicate changes only.
Filing Status: Single Married Filing Jointly Surviving Widow(er) with Dependent Child Head of Household (1)
Married and Filing Separately Lived together during 2006? (circle one) Yes / No
In year 2006 only: Married Date Divorced date
Legally Separated Date Spouse Died Date
Spouse Name Spouse SSN
Children living with you age 18 or under, children age 19-23, attending school full time (at least 5 months
Dependents
during year), or a permanently and totally disabled child.
Name Birthdate SSN
1
2
3
4
Other Dependents: (relatives &/or members of household)
Name Relationship Birthdate SSN Gross Income # Months in your Home
1
2
Check if any of your dependent children have unearned income over $850. (i.e. interest, dividends, capital gains)
Check if you are a noncustodial parent claiming an exemption for your child because the custodial parent
released the exemption to you (Provide 8832).
(1) If you were unmarried at the end of the tax year, and you maintained a home that for more than half of the year
is the principal home of your qualifying child, you may be eligible for Head of Household filing status. If you
are married, you may be considered unmarried for this purpose if your spouse did not live in your home during
the last six months of the tax year. If maintaining the household of a parent, the parent does not need to live
with you to qualify.
All Forms W-2 (wages) and all Forms 1099 & 1098.
√ Copies of returns (Sched. K-1) for partnerships, ventures, corporations, estates or trusts.
CHECKLIST If you sold Real Estate, Stock or a Mutual Fund during the year, include 1099,
settlement statements on real estate purchase and sale, and brokerage statements.
Items your (Include the cost of securities sold.)
Tax Preparer If you bought or refinanced a home or other property this year, include a copy of
Will Need your closing statement.
Provide details and amounts of all Tips, awards, prizes, disability pay, Jury duty pay and
gambling winnings.
If you are a new client, please provide copies of previous years tax returns.
All items may be mailed or dropped off to our office.
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Roberts Hart and Company, CPA's
Part 1 Questions
yes no
1 Do you own any securities or hold any debts that became worthless during the year?
(Attach details including cost)
2 Did you exercise any stock options or were any granted to you during the tax year?
3 Did you move because of a job change? Include all costs of moving and any employer reimbursements.
4 Did you pay child care costs for a dependent child under age 13, or costs of caring for an
handicapped individual, so you could work, attend school or look for employment?
(Attach provider name, SSN, address and amounts paid)
If yes, was any amount reimbursed by your employer? Amount:
5 Did you buy a hybrid vehicle or alternative fuel source vehicle in 2006?
Type:
6 Did you buy or refinance your home in 2006? (Include settlement statements)
7 Did you have any out of pocket expenses associated with your job?
(Please complete the attached worksheet in part 7)
8 During 2006, were there any changes to federal or state returns in prior years?
9 Do you expect a substantial change in income or deductions next year?
10 Did you make gifts totaling more than $12,000 to any individual during the year?
Part 2 Sources of Income
Attach Complete Checklist
Wages Form W-2
Interest & Dividends Form 1099 Int / 1099 Div
Alimony Received $
Business Self Employed Form 1099 - Misc. Business (Part 7), Travel, meals, vehicle exp. (Part 11)
State Income Tax Refund Form 1099 - G
Rental Form 1099 - Misc. Rental (Part 9), Travel, meals, vehicle exp. (Part 11)
Sale of Property or Stock 1099-B; Brokerage Stmts Asset Sale & Transfer (Part 8)
Farm Form 1099-G; PATR Farm (Part 10), ) Travel, meals, vehicle exp. (Part 11)
Unemployment Compensation Form 1099-G
Pension / Retirement Form 1099-R
Social Security Form 1099-SSA
Other: ……………………..
Other: ……………………..
Adjustments to Income
Health Savings Account Contribution $
SEP, SIMPLE or IRA Contribution (cirlce one) TaxPayer $ Spouse $
Unreimbursed Classroom Expenses - Teachers $
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Roberts Hart and Company, CPA's
Part 3 Educational Expenses
Student's Name Education Name of Institution Type of Expense Amount Paid by Whom First 2 years
Purpose (tuition, books, Paid of college?
(degree seeking fees, student loan Yes / No
job related) interest)
Part 4 Residential Energy Effeciency Expenditures
Did you make any improvements to your principal residence during the year to increase energy efficiency such as solar energy systems, fuel cells
insulation, exterior windows, including skylights, exterior doors, metal roof coated with heat reduction pigments, qualified electric heat pump
water heater, geothermal heat pump, central air conditioning or natural gas, propane or oil water heaters? To qualify for the energy tax credit, the
manufacturer must certify that the property meets the IRS requirements to claim the credit (ENERGY STAR label, IECC, etc).
Description of Improvement/Expenditure Date Placed in Service Amount
Part 5 2006 Estimated Tax Payments 1
Federal Date paid State Date Paid Notes
Amount applied from 2005
refund, if any 1 Do not include withholding from
First Quarter 2 Forms W-2 or 1099 in estimated
Second Quarter tax payments shown here.
Third Quarter 2 Do not include balance due from
Fouth Quarter prior year in the First Quarter
Total 2006 Estimates reporting.
Part 6 Tax Refund - Direct Deposit Information
If you ar expecting a refund, complete the following chart for direct deposit. Otherwise, a refund check will be mailed to your address
on the tax return. (Tax refunds may also be directly deposited to your IRA, Health Savings Account, or Education Savings Accout)
Type of Account Routing Number Account # Percent of
(checking or Savings) (Nine Digits) Refund
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Roberts Hart and Company, CPA's
Part 7 Business Income & Expenses EIN
Business Activity/Product
Business Name
Total Income $
Inventory - Beg. of Year $ End of Year $
Purchases $
Expenses
For business property or equipment purchases or sales, provide separate schedule listing date, price/cost, description, etc.
Do you qualify for business use of home? yes no
Business use area (sq ft) _____________________ Total area of home (sq ft)
Business Use of
Use Correct Column Self Employed
Home (100%)
Advertising XXXXX Business Use of Home Deduction. If an area of
Association Dues the home is used regularly and exclusively for business
Car/Truck Expenses see vehicle exp. Worksheet a deduction for a portion of mortgage interest, taxes,
Bank Charges XXXXX insurance, utilities and depreciation may be allowed.
Business Phone/Long Distance Calls XXXXX If business use of the home is established, a mileage
Commissions, Fees Paid XXXXX deduction for travel between home and other job
Contract labor XXXXX locations may be allowed. Special rules apply for
Employee Benefit Program XXXXX inventory storage and daycare.
General Office Supplies Expense XXXXX
Insurance (not health) Equipment / Improvements
Insurance (Health) XXXXX Items expected to last more than one year.
Interest - Mortgage (Form 1098) Provide a separate listing. Do not duplicate in above
Interest - Other Interest XXXXX expense categories. Include description, date
Legal & Other Professional Fees XXXXX purchased and cost. Provide actual receipts if
Postage & Freight XXXXX available.
Professional Dues & Publications XXXXX
Rent Paid - vehicle, machine, equip.
Rent Paid - Other business property
Repairs & Maintenance
Supplies (include small hand tools) XXXXX
Taxes - Real Estate
Taxes - Other
Utilities: Electric_______ Heat_____
Water, Sewer, Trash __________
Other_______ Total________
Wages XXXXX
Other
Other
Other
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Roberts Hart and Company, CPA's
Part 8 Asset Sale & Transfer
For sales of stock & other securities, include Form 1099-B's, Brokerage Statements for sale and cost of items sold.
For sales of real estate, include closing settlement statements for purchase and sale of property.
List all other sales of personal or investment property in the schedules below.
Asset #1 Asset #2
Description of Property
Date Acquired
Initial Purchase Price
Date Sold
Sales Price
Improvements
Sales Expenses
Installment Sale Y/N
Asset #3 Asset #4
Description of Property
Date Acquired
Initial Purchase Price
Date Sold
Sales Price
Improvements
Sales Expenses
Installment Sale Y/N
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Roberts Hart and Company, CPA's
Part 9 Rental Income & Expense
1 List the type and location of each Rental Real Estate Property: 2 For each rental real estate property Yes No
listed on line 1, did you or your family use
A A
it during the tax year for personal
purposes for more than the greater of:
B B
++ 14 days or
++ 10% of the total days rented
C C
at fair rental value?
Income Properties
A B C
3 Rents Received 3 3 3
Expenses
4 Advertising 4 4 4
5 Auto & Travel 5 5 5
(see vehicle exp. worksheet)
6 Cleaning & maintenance 6 6 6
7 Commissions 7 7 7
8 Insurance 8 8 8
9 Legal & other professional fees 9 9 9
10 Management fees 10 10 10
11 Mortgage Interest paid to banks, etc. 11 11 11
12 Other Interest 12 12 12
13 Repairs 13 13 13
14 Supplies 14 14 14
15 Taxes 15 15 15
16 Utilities 16 16 16
17 Other 17 17 17
18 Other 18 18 18
19 Other 19 19 19
20 Other 20 20 20
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Roberts Hart and Company, CPA's
Part 10 Farm Income & Expense Employer ID # (EIN) -
Principal Product
Accounting method: (circle one) Cash or Accrual
Did you "materially participate" in the operation of this business during 2006? (circle one) Yes No
Part A Farm Income - Cash Method; complete parts A & B (Accrual complete parts B & C)
1 Sales of livestock and other items you bought for resale ……………………………………………… 1
2 Cost of livestock and other items reported on line 1 ………………………………………………. 2
3 Subtract line 2 from 1 …………………………………………………………….. 3
4 Sales of livestock, produce, grains, and other products you raised 4
5 Cooperative distributions (Form 1099-PATR) 5 Taxable Amount ……….
6 Agricultural Program payments …………. 6 Taxable Amount ………
a CCC Loans reported under election 6
7 Crop Insurance proceeds 7
a Amount received in 2006 ………… 7a Taxable Amount …………
8 Custom hire (machine work) income 8
9 Other income 9
Part B Farm Expenses - Cash & Accrual Method
Do not include personal or living expenses such as taxes, insurance or repairs to your home.
10 Car & Truck Expenses: complete vehicle expense sheet 20 Rent or lease …………………….
11 Chemicals …………………… a Vehicles, machinery, and equipment ……….
12 Custom hire (machine work) b Other ………………………………….
13 Feed ……………………… 21 Repairs and maintenance ……….
14 Fertilizers and lime …….… 22 Seeds and plants …………………….
15 Freight and Trucking ………… 23 Storage and warehousing ……….
16 Gas, fuel, oil …………………….. 24 Supplies ………………………………….
17 Insurance (not health) ……….. 25 Taxes ………………………………….
18 Interest: Mortgage ……….. 26 Utilities ………………………………….
a Interest: Other ……….. 27 Veterinary, breeding and medicine
19 Labor hired ……….. 28 Other expenses …………………….
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Roberts Hart and Company, CPA's
This worksheet is for taxpayers who are self-employed or have job related expenses
Part 11 Employee, Self Employed, Business, Farm & Rental
Travel, Meals & Entertainment Expenses
Number of days away from
Self Employed
home: ( ) Employee Rentals
Travel fares & Tips Were you reimbursed for any of
Meals & Entertainment these expenses? (circle one) Yes / No
Lodging If yes, is the reimbursement included
Telecommunications in your Form W-2? (circle one) Yes / No
Cleaning / Laundry
Other
Other
Other
Vehicle Expenses
Vehicle #1 #2
1) Total miles driven this year
2) Mileage breakdown of Business
(1) above Commuting
Personal
3) Description of Vehicle
4) Date vehicle was first
used for business
5) Cost of Vehicle (attach receipt) $ $
or Lease Payments = $ $
6) Interest Paid on Vehicle Loan
7) Parking and Tolls
8) Gas, Oil Changes
9) Repairs, Maint, Car Wash
10)Tires & Supplies
11) Insurance
12) Permits & Licenses
13) Other
14) Other
Questions for All Taxpayers Claiming Vehicle Expenses
1) Do you have proof to support your deduction? Yes No
If so, is the evidence written? Yes No
2) Do you have another vehicle available for your personal use? Yes No
3) Do you have an employer provided vehicle that is available Yes No
for personal use?
4) Were you reimbursed for any of the auto expenses listed above? Yes No
If so, is the reimbursement included in your Form W-2? Yes No
Vehicle Expenses - Do you qualify?
⌂Travel expenses between home and a temporary work location within your metropolitan area are NOT
deductible unless one of two tests are met:
(1) you have one or more regular work locations away from your home, or
(2) you qualify for a business use of home deduction
⌂A work location is considered temporary if employment is expected to last and actually does last for
for one year or less. Commuting expenses for going between the taxpayer's home and a temporary
work location outside the metropolitan area where the taxpayer lives and normally works are deductible.
⌂ There are two methods to determine the deduction for vehicles used for business:
(1) Actual Expenses
(2) Standard Mileage Rate (per mile)
If you use the Standard Mileage Rate, then ignore lines 7-12 above.
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Roberts Hart and Company, CPA's
Part 12 Itemized Deductions (Round all figures to nearest dollar)
Complete Part 13 only if you think your total itemized deductions might
Note:
exceed the IRS standard deduction for your filing status. Miscelaneous
2006 Standard Deduction Add for Deductible only if total exceeds 2% of AGI
Standard Blind &/or
Filing Status Ded. Over 65 Unreimbursed employee expenses:
Married Filing Jointly $10,300 + $1,000 Union Dues ………………………
Single ……………. 5150 1250 Tools & supplies ………….
Head of Household 7550 1250 Special Uniforms / Safety Equip…….
Married Filing Separately 5150 1000 Professional Dues/Subscriptions……
Medical Expenses Job related education ………….
Deductible only if net costs exceeds 7.5% of Adjusted Gross Income (AGI)
Do not include amounts of paid for or reimbursed by your Job Seeking Expenses in Same Field
Note:
insurance or health premiums paid with pre-tax income. …………
Travel/Air Fare/Lodging
Health Insurance Premiums; Include after Meals ……………………..
tax amounts paid or withheld at work Employment Agency Fees
Vison / Dental Insurance Resume ………………………
Prescription Drugs Other ………………………
Doctors / Clinics / Hospitals Total …………………………………..
Dentists / Orthodontists
Nursing / Long Term Care Facility Tax Prep, Financial Planning/Consultation Fees
Medical Miles Incurred: Investment Expenses …………………….
________ Miles @ $0.18 Gambling Losses Limited to Gambling Winnings
Parking Other ………………………………….
Taxes Other ………………………………….
Income Tax Paid in 2006 for Prior Tax Years Other ………………………………….
Sales Tax Paid for Major Purchases
Real Estate Taxes (if not included on Form 1098)
Other Notes:
Interest Paid
Primary Second Home,
Provide Form 1098 Residence Cabin
First Mortgage Interest
Seller Financed Mortgage
Name: SSN:
Address:
Investment Interest Paid
Contributions
Cash: Include payroll deductions
Church / Synagogue
Idaho Schools
Other:
Other:
Noncash:
*Fair Market Value of items given to Charities.
If over $500, provide documentation
Charity 1
Charity 2
If a vehicle, boat or airplane donation over
$500, Provide Form 1098-C
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