Income Tax Organizer - Section One

This five-section income tax organizer will help you to both organize your tax information and ensure that you don't overlook any deductions to which you're entitled. Please feel free to print out this organizer and use it whether you do your own tax return or use the services of our firm.

Taxpayer Information for Tax Year ____________________

First Name ____________________________________________ Initial _______

Last Name_____________________________________________

Social Security # _______________________________________

Occupation____________________________________________

Date of Birth ________________________

Street Address ______________________________________________________

City___________________________________ State_________ Zip____________

Home Telephone _____________________________

Mobile Telephone _____________________________

Email Address _______________________________

Work Telephone______________________________

Spouse Information

First Name ____________________________________________ Initial _______

Last Name_____________________________________________

Social Security # _______________________________________

Occupation____________________________________________

Date of Birth ________________________

Street Address ______________________________________________________

City___________________________________ State_________ Zip____________

Home Telephone _____________________________

Work Telephone______________________________

Filing Status

Single Married
Head of Household Married Filing Separate

Salaries and Wages

W-2  Gross Income  Federal Withholding     FICA    
1 $ $ $
2 $ $ $
3 $ $ $
4 $ $ $
5 $ $ $

 

W-2    Medical    State Withholding     SDI    
1 $ $ $
2 $ $ $
3 $ $ $
4 $ $ $
5 $ $ $

Electronic Filing

Would you like electronic filing?

Yes No
Automatic deposit?
Yes
(attached a VOIDed check)
No

Dependents

1. Name ________________________________________________________

Date of Birth_________________

Social Security #________________________

Relationship _____________________________

Months lived at home this tax year _________________

2. Name ________________________________________________________

Date of Birth_________________

Social Security #________________________

Relationship _____________________________

Months lived at home this tax year _________________

3. Name ________________________________________________________

Date of Birth_________________

Social Security #________________________

Relationship _____________________________

Months lived at home this tax year _________________

4. Name ________________________________________________________

Date of Birth_________________

Social Security #________________________

Relationship _____________________________

Months lived at home this tax year _________________


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Hickman & Associates, CPAs, P.C.
Certified Public Accountants
Mailing Address: P.O. Box 305140
Nashville, TN 37230
Street Address: 2451 Atrium Way
Nashville, TN 37214

(615) 391-2930 • Fax: (615) 316-5416
E-mail: kevin@kehcpa.biz

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