2016 Tax Year Workbook

Hey there, welcome to your tax prep workbook!

I'm looking forward to working together on your tax return and goals. Remember, my goal is to make tax time less stressful for you. If you need to work on this workbook over time, then do that. However, I cannot begin any work until this workbook is returned to me complete.

The information gathered in this document will be used to prepare your tax return so please make sure it is accurate. If you are confused about something, or unsure how to answer, then mark it with a question mark and we will review it together. Not all sections will apply to all people. I will alternate between instructions and information gathering pages.

In addition to this workbook you will need to gather, and submit, all tax forms you receive. You will see a checklist at the end of the workbook to guide you and you can find more resources at www.melissawhaley.com/taxclient

Welcome!

This first section will be all about your basic information and any dependents you have. Dependents are children, family members, or others that you provide more than 50%support for. For each dependent you list I will need a copy of their Social Security Card. I may request additional verification depending on credits you qualify for.

1. PERSONAL INFORMATION

Name

Street Address Apt. City or town State Zip Code County

Home Phone Mobile PhoneE-mail Address(es)

Foreign country Foreign province/state Foreign postal code

PERSONAL INFORMATION ORGANIZER

TaxpayerSpouse

SSN or ITIN Date of Birth Occupation Blind DisabledDate of Death

2. FILING STATUS

SingleMarried Filing JointMarried Filing SeparateHead of HouseholdQualifying Widow(er)

Check if parent (or someone else) can claim you as a dependent on their return.

Check if you lived apart from your spouse for all of 2016.

Year spouse died:

3. DEPENDENTS

Name Relationship Date of Birth SSN or ITIN Months LivedWith You

Disabled Full TimeStudent Gross Income

Dependent's Child CareExpenses Paid

4. MISCELLANEOUS PERSONAL INFORMATION QUESTIONS

1. Check the applicable boxes if you wish to contribute $3 to the Presidential Election campaign fund. Taxpayer Spouse

2. Were you a victim of identity theft and have you been contacted by the IRS? Yes No

If Yes, please furnish the 6-digit PIN issued to you by the IRS . . . . . . . . . . . . . . . .

3. Were you (or your spouse if filing jointly) a nonresident alien for any part of 2016? Yes No. . . . . . . . .

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4. Have you received any notices or correspondences from the IRS or state in the past 3 tax years? . . . Yes No

5. Do you have any children age 18 or under (or student under age 24) wo had unearned income or more. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes Nothan $2,100?

6. If any of your children are required to file a return, do you elect to report your child's interest anddividends on your return? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

7. Did you give a gift of more than $14,000 to one or more people? . . . . . . . . . . . . . . . Yes No

Beginning in 2014 US residents were required to obtain health insurance that meetsminimum essential coverage under the Affordable Care Act. This is typically anemployer sponsored health plan, individual plan purchased through the exchange,Medicare, Tricare, or CDHP. Below is an infographic to show what the penalties arefor not maintaining coverage.

Health Insurance Information

If you were not covered by insurance, there are certain exemptions that may reduceor eliminate the penalties. I may need to request further information to verifyinsurance, or exemption.Please complete the check sheet to verify coverage for all people listed on the taxreturn, but first one quick question:

Were you enrolled in a religious health care sharing ministry? Yes No

Source: obamacarefacts.com

ACA Health Care Organizer

Taxpayer:Spouse:Dependent:

1 Does everyone in your tax household have qualified health insurance for all 12 months of 2016? Yes No

Tax household - Includes the taxpayer, spouse (if filing joint), and any individuals claimed as a dependenton your return. It also generally includes each individual you can, but do not claim as a dependent on your return.

1a If No above, please check which months your tax household had qualified health insurance in 2016.

JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DECNAME ALL

Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:

2 Please indicate where you received your health insurance from for all members of your tax household.

Employer Government-Sponsored Marketplace Private Exchange (Individual Insurance Company)

3 Do you qualify for any exemptions from the individual shared responsibility payment (penalty)? Yes No

3a If Yes above, have you filed for any exemptions through the government-sponsored marketplace? Yes No

Taxpayer:Spouse:Dependent:

JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DECNAME ALL

Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:Dependent:

Please indicate below who qualifies for an exemption from the health care mandate and for which months.

Now let's talk about your types of income. Income can come from many differentsources so the next page breaks them down by category. This first page is just to letme know where you receive income from. Most the actual numbers I need will comefrom the source documents you send me. You will see under each sub-sectionwhich documents relate to that type of income. They are also listed on the checklistat the end of the workbook.

Income Sources

The second income page is for those who own businesses. Even if you callyourself a freelancer, you are considered to own a business in the eyes of the IRS.

Please answer the following questions first regarding your business:

Do you have a business? YES NO Do you use a separate bank account for your business? YES NODo you use accounting software or spreadsheet? YES NOHave you granted Melissa access to the accounting software? YES NO

If you use a system, please skip the income and expense section and attach yourIncome Statement or make sure I have access to your software.

If you do not use a system, I will be asking you to set up an appointment to set-upa system after tax season.

Business Owners

Own rental properties? There's a page for you as well; if you needmore let me know or attach a separate statement.

1. WAGE AND SALARY INFORMATION

INCOME ORGANIZER

Attach W-2s:Employer Name Taxpayer Spouse

Unreported tip income received: . . . . .

2. INTEREST AND DIVIDEND INCOME

Attach 1099-INT, 1099-DIV or other statementsPayer Name Taxpayer Spouse

3. RETIREMENT DISTRIBUTIONS

Attach 1099-R & 5498Payer Name Taxpayer SpouseIRA

RothIRA

Other

Did you receive social security benefits?

Did you receive railroad retirement benefits?

Attach SSA 1099 or RRB 1099 Yes No

4. SCHEDULE K-1 INCOME (1065, 1120-S AND 1041)

Attach K-1s:Payer Name Taxpayer Spouse

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5. CAPITAL GAINS AND LOSSES

Attach 1099-Bs:Payer Name Taxpayer Spouse

6. OTHER INCOME

Description AmountState income tax refundAlimony receivedUnemployment compensationGambling winningsJury payHobby incomeScholarships (grants)

Child support

7. MISCELLANEOUS INCOME QUESTIONS

1. Did you sell your home? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Did you earn any foreign income or paid any foreign taxes? . . . . . . . . . . . . . . . . . . . . . . .

3. Do you have a health savings account (HSA), Archer MSA or Medicare Advantage (MA) MSA?

Yes No

Yes No

Yes No. . . . . . . . .

4. Did you have a financial account in a foreign country (i.e. bank account, securities account, etc.)? . . . . . . . . Yes NoIf Yes, did the aggregate value of all financial accounts exceed $10,000 at any time during 2016? . . . . . . . Yes No

5. Did you have any debt forgiven (i.e. student loans, home mortgage, etc.)? . . . . . . . . . . . . . . . . . Yes No

Business, Farm and Rental and Royalty Income or Loss Organizers are on separate pages.

NOL Carryforward

Indicate the owner of this business:

So

TaxpayerBusiness Name:

Spouse Joint

Business Address:City, State, and Zip Code:Did you start or acquire this business during 2016? Yes NoAccounting Method: Cash Accrual Other (describe)

Business product or service:

Method used to value inventory: Cost Lower of cost or market Other (describe)

Income and Cost of Goods SoldGross receipts or sales

2016 Amount

Returns and allowancesOther income (enclose description)Inventory at beginning of yearPurchases less cost of items withdrawn for personal useCost of laborMaterials and suppliesOther costsInventory at end of year

ExpensesAdvertising

2016 Amount

Commissions and feesContract laborDepletionEmployee benefitsInsurance (other than health)Mortgage interestOther interestLegal and professional feesOffice expensesPension and profit sharingRent - Vehicle, machineryRent - OtherRepairs and maintenanceSupplies

Taxes and licensesTravelMeals and entertainmentUtilitiesWagesOther:

2016 Amount

Vehicle InformationVehicle description Date placed in service Cost or basisBusiness miles Commuting miles Other milesActual expenses such as gas, oil, repairs, etc Parking fees and tolls

Sales, Purchases, and Disposition of Assets in 2016Asset description

Business Use of HomeArea used exclusively for business Total area of home

YesWas the home used as a day care facility? No

Mortgage interestReal estate taxes paid

Date acquired Purchase price Sales PriceDate sold(New clients, enclose detailed listing of all depreciable assets.)

Casualty lossesRepairs and maintenanceUtilities and other expenses

Insurance

Value of land

Date home placed in service

FMV of home

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Rent

Carryover of unallowed expenses to 2016 Yes

(Schedule C)BUSINESS INCOME AND EXPENSES

No (if yes, enter amount)

Indicate the owner of this property:

So

Taxpayer

Description of property

Spouse Joint

Yes No

IncomeRents received

2016 Amount

Royalties received

ExpensesAdvertisingCleaning and maintenanceCommissionsInsuranceLegal and other professional feesManagement feesMortgage interest paid to banksOther interestRepairsSuppliesTaxesUtilities

2016 Amount

Vehicle InformationVehicle description Date placed in service Cost or basisBusiness miles Commuting miles Other miles

Actual expenses such as gas, oil, repairs, etc Parking fees and tolls

Sales, Purchases, and Disposition of Assets in 2016

Asset description Date acquired Purchase price Sales priceDate sold

(New clients, enclose detailed listing of all depreciable assets.)

Location of propertyDid you or your family use this property during the tax year for personal purposes for more

than the greater of: (a) 14 days, or (b) 10% of the total days rented at fair market value?

Yes NoDid you meet the Active Participation requirements for this property?(To meet these requirements, you must have participated in making management decisions or arranged forothers to provide services in a significant and bona fide sense. Such management decisions include approvingnew tenants, deciding on rental terms, approving repair expenditures, or other similar decisions)

Yes NoWas this property fully disposed of during 2016?

Other

Travel expenses

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(Schedule E, pg 1)

Section 481(a) adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

RENTAL AND ROYALTY INCOME AND EXPENSES

01/11/2017 10:30:07AM

Now you can get excited, because we're ready to reduce your tax bill.

Here's some things you should know about tax deductions.

Let's Deduct That

A deduction reduces your taxable income so you pay less income tax. That's

different than a tax credit, which we will cover in the next section.

There are two paths you can take with personal income deductions the Standard

Deduction and Itemized deductions.

The Standard deduction is a fixed amount based on your filing status (Single

$6300, Married Filing Joint $12,600, Head of Household $9300.)

Itemized deductions are the sum of many little deductions that can exceed the

standard deduction amount.

A few deductions are considered "above the line" which means you can deduct it

whether you use the standard or itemized deduction path. These include Student

loan interest, Educator expenses, and qualified moving expenses.

The following pages will walk you through each type of deduction. Keep in mindthat if you don't have the receipts or paperwork to prove the deduction, then wecan't claim it.

1. EDUCATION

Attach 1098-Ts, 1098-E's and 1099-Q's:Student Name

5. MISCELLANEOUS DEDUCTION QUESTIONS

1. Did you purchase an item(s) during 2016 for which you paid a large amount of sales tax? Yes No

DEDUCTIONS ORGANIZER Itemized Deduction Organizers are on separate pages.

Educational Institution Fr So Jr Sr Oth Tuition & Fees Interest PaidStudent Loan

529 PlanBooks, Supplies& Equipment

2. JOB-RELATED MOVING EXPENSES

Description Amount

LodgingGas and OilMileageOtherMiles from old home to your new workplaceMiles from old home to old workplace

3. IRA CONTRIBUTIONS

Description Amount

Contributions to a Traditional IRAContributions to a ROTH IRA

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4. OTHER DEDUCTIONS

Description Amount

Educator expensesAlimony paidHealth Savings Account contributionsArcher Medical Savings Account contributions

Rec. SSN:

Jury duty repayment to employerForeign qualified housing expensesContributions to College 529 Savings PlanOtherOtherOtherOtherOtherOther . . . . . . . . . . . . . . .

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2. Did you refinance a mortgage during 2016? Yes No. . . . . . . . . . . . . . . . . . . . . . . . . . . .

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(not including reimbursements) 2016Amount

Qualified long-term care premiumsMedicare B and D premiums from SSA-1099 and RRB-1099-RMedical/dental care insurance premiums (other than self-employed)

Medical and Dental Expenses

Doctor, dentist, and hospital feesPrescription medicines and drugsMedical aids such as eyeglasses, contact lenses, and hearing aidsTotal transportation expensesOther medical and dental expenses

Taxes Paid

State and local income taxes paid (other than withholdings and estimates)Actual state and local general sales taxes paid

Personal state/local property taxes (list type of tax paid)

Interest Paid

Home mortgage interest paid to financial institution (enclose Form 1098 or statement)

Home mortgage interest paid to individualIndividual's nameIndividual's addressIndividual's ID number

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Real estate taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Qualified mortgage insurance premiums (VA, FHA, RHS, or private)

2016Amount

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2016Amount

Investment interest expense . . . . . . .

Gifts to CharityContributions of cash or checkName of charity 2016 Amount

(If additional lines are needed, attach similar statement)

Date givenNoncash contributionsName and address of charity FMVDate given

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ITEMIZED DEDUCTIONS

Casualty and Theft Losses (for property damaged by storm, water, fire, accident, or theft)

Location of property:Description of property:

Unreimbursed Employee Business Expenses T = Taxpayer S = Spouse

Amount of damageInsurance reimbursement

Repair Costs

Federal monies received

Residential propertyBusiness property

Enclose supporting documentation of what is written here, i.e. insurance reimbursement, receipts for cost of repairs.

Cost basis of propertyFMV of property before loss

Federal Disaster

FMV of property after loss

Date of loss:

OtherOther

(If additional losses were incurred, please attach a separate sheet of paper with these details.)

Dues (related to job)Subscriptions related to your workLicenses and regulatory feesTools and supplies used in your workWork clothes, uniforms if requiredMedical exams required by your employerWork related education (books, tuition)Legal fees related to your job

*In home office:Total square footageOffice square footageOffice square footage

Vehicle descriptionDate placed in serviceCost or basis

Business milesCommuting milesOther miles

Actual expenses

Parking fees and tollsTravel expenses

Vehicle Information

T or S

Job search expenses (current occupation)

RentInsuranceUtilitiesRepairs/Maintance

*Questions relating to mortage interest, taxes, and casualty losses were asked previously

(gas, oil, repairs, etc)

Miles of vehicle

Expenses

Sales, Purchases, and Disposition of Assets in 2016

Asset description Date acquired Purchase price Sales priceDate sold(New clients, enclose detailed listing of all depreciable assets.)

T S

Investment Related Expenses

Tax preparation feesSafe deposit boxCustodial, trust admin fees

Legal fees related to producing taxable income

Fees to collect interest and dividendsTax advice not related to investment income

Gambling lossesEstate tax deductionPortfolio from Schedule K-1

OtherOtherOther

Other Misc. Deductions

Unrecovered investment in a pensionAmortizable premium on taxable bondsDisabled persons work expenses

(in respect of a decedent). . . . . . . . . . . .

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OtherOtherOther

(if any depreciable assets were sold (including the vehicle), please see worksheet below)

ITEMIZED DEDUCTIONS (continued)

Tax CreditsA tax credit reduces your tax bill and can potentially give you a refund of more thanyou paid into the tax system. The most common tax credits are child tax credit,childcare credit, residential energy credits, and earned income credit.

The following page goes over common federal tax credits. There may be additionalstate tax credits that I will ask for more information on once I have begun preparingyour return. Each state is different and I don't want to make this workbook longerthan it has to be.

The Earned Income Tax Credit, EITC or EIC, is a benefit for working people with low tomoderate income. To qualify, you must meet certain requirements and file a tax return,even if you do not owe any tax or are not required to file. EITC reduces the amount oftax you owe and may give you a refund. See the below info to see if you fall into therange for EITC.

Because of an increase in fraud on this particular credit, additional information will berequired to file the return.Please answer the following questions if you have dependents:

Can you provide additional documentation that your children live with you? YES NO (daycare statement, school records, doctor records, etc.)

Have you ever been denied Earned income credit? YES NO

Source: www.irs.gov

Attach Daycare Provider Statement(s):Care Provider Name

3. MISCELLANEOUS CREDIT QUESTIONS

1. Did you pay any expenses related to the adoption of an eligible child? Yes No

CREDITS ORGANIZER

Address NumberIdentification

Amount Paid

2. RESIDENTIAL ENERGY CREDIT

Description Amount

Solar electric propertySolar water heatingSmall wind energyGeothermal heat pump

2. Are you currently repaying the First-Time Homebuyer Credit? Yes No. . . . . . . . . . . . . . . . . . . . .

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NumberTelephone

Tax-Exempt

Fuel cell propertyInsulation materialExterior doors

Metal or asphalt roofExterior windows and skylightsElectric heat pump or central air conditionerNatural gas, propane or oil water heaterBiomass fuel stoveNatural gas, propane or oil furnace

Description Amount

Advanced main air circulating fan

1. Were the qualified improvements for your main home in the United States?2. Were any of the improvements related to the construction of this main home?

Yes NoYes No

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Do you (and your spouse) have a social security number that allows you to work and is valid?3. Yes No. . . . . . . . .

4. Were you issued a Mortgage Credit Certificate (MCC) by a state or local governmental unit or agency? Yes No. . . . . .

Final Details

This last page is to make sure I give you proper credit for any tax payments you sentin for last year and get the proper bank information for direct deposit or debitdepending on if you get a refund or owe.

You can also add any last comments or questions so I know how to better prepareyour taxes.

Do me a favor and skim back through all your answers in the workbook and makesure everything is accurate. I don't want you missing anything now, otherwise youwill be searching for the info later.

You did it! You've made it to the finish line andhopefully your brain isn't completely fried yet.

PAYMENTS AND BANKING ORGANIZERPlease complete this Organizer before your appointment.

Federal estimated payments you made

3. COMMENTS

1. Would you like to have any refunds directly deposited into your bank account? Yes No

Amount Paid

2. REFUND INFORMATION

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Date PaidApplied from 2015 federal refund . . . . . . . . . . . . . . . . . . . . . . .1st quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .2nd quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .3rd quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .4th quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State estimated payments Amount PaidDate PaidApplied from 2015 state refund . . . . . . . . . . . . . . . . . . . . . . .1st quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .2nd quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .3rd quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .4th quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State Name:

Local estimated payments Amount PaidDate PaidApplied from 2015 state refund . . . . . . . . . . . . . . . . . . . . . . .1st quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .2nd quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .3rd quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .4th quarter payment . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Locality Name:

Bank AccountOwnershipTypeBank nameRouting numberAccount number

Taxpayer Spouse JointChecking Savings

Bank AccountOwnershipTypeBank nameRouting numberAccount number

Taxpayer Spouse JointChecking Savings

Account outside the jurisdiction of the United States? Yes Account outside the jurisdiction of the United States? Yes

1. ESTIMATED TAX PAYMENTS

Affirmation

What's Next?Once this workbook is complete I will need you to upload it into the document portal.

DO NOT EMAIL THIS FORM OR ANY TAX DOCUMENTS TO ME

Email is not secure at all so please use the secure document portal I have set up toexchange all tax information.

Info, Resources and Video Walkthroughs can be found athttp://www.melissawhaley.com/taxclient

I hereby certify that I have truthfully and accurately, to the best of my knowledge and ability, provided Melissa Whaley with all information requested on this Client Organizer and that I have answered fully and truthfully to all questions and requests for information from Melissa Whaley.I understand that am legally liable for the accuracy of my own tax return and agree not to hold Melissa Whaley responsible for errors or omissions made on my return because I withheld information or failed to provide information necessary to complete my tax return accurately.

I understand that Melissa Whaley will charge a fee for the preparation of my tax return, I understand additional charges apply for amending my tax return if I provide additional income, deduction or other information after my return is filed with the IRS. If I fail to pay for any services provided to me, Melissa Whaley may use information gained while preparing my return for collection purposes

Taxpayer: Date:

Spouse: Date:

You Spouse Dependents Basic Info

Name, SSN or ITIN, and date of birth

Last Year's Return - hard copy scanned or PDF file

Estimated Taxes Paid

You Spouse Dependents Documents Received

Form W-2s - wage and tax statements

Form 1095s – includes health insurance marketplace statement (1095-A),

health coverage (1095-B) and employer-provided health insurance offer

and coverage (1095-C)

Form 1098s - includes mortgage interest (1098) and student loan interest

(1098-E)

Form 1099s - includes dividend income (1099-DIV), interest income

(1099-INT & 1099-OID), merchant card and third party network payments

(1099-K), miscellaneous income (1099-MISC), retirement plan distribution

(1099-R), sale of home or real estate (1099-S), capital gain transactions

(1099-B), distributions from an HSA, Archer MSA, or Medicare Advantage

MSA (1099-SA) and unemployment compensation (1099-G)

Form 2439s - notice to shareholder of undistributed long-term capital gains

Schedule K-1s - partnership, S Corporation and estate or trust income

You Spouse Dependents Personal Records

Child and Dependent Care Expenses

Education Expenses

Medical Expenses

Vehicle (Personal Property) Taxes Paid

What I Need to File

2016 Checklist • 1040 Individual Income Tax Return

Reminder: 2016 taxes are due April 18, 2017

What I Need to File

2016 Checklist • 1040 Individual Income Tax Return

Reminder: 2016 taxes are due April 18, 2017

You Spouse Dependents Personal Records

Child and Dependent Care Expenses

Education Expenses

Medical Expenses

Vehicle (Personal Property) Taxes Paid

Real Estate Taxes

Mortgage Interest Paid

Charitable Contributions

Business or Employee Expenses

Gambling Expenses

Investment Transactions

Retirement Contributions

Foreign Earned Income and Foreign Taxes Paid

Moving Expenses

You Spouse Dependents E-file/Print

Bank Information (Account and Routing Number for Direct

Deposit/Withdrawal)

Copy of Driver's License or State ID