Individual Income Tax Information Worksheet

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INDIVIDUAL INCOME TAX INFORMATION FOR 20
1.
GENERAL INFORMATION
Name
Date of Birth
Soc Sec #
Spouse
Date of Birth
Soc Sec #
Taxpayer Occupation
Spouse’s Occupation
Address
City
State
Zip Code
County
Home Phone
Work
Cell
Work
Cell
E-mail Address (to contact for additional information)
Indicate Filing Status
Single
Married Filing
Married Filing
Head of
Joint
Separately
Household
2. DEPENDENT INFORMATION
Months
Date
Social
Lived
Student
Name
of Birth
Security #
Relationship
at Home Yes/No
No
No
No
No
No
3. ESTIMATED TAX PAYMENTS - (Bring copies of your cancelled checks.)
Federal
State
April 15, 2015
June 15, 2015
September 15, 2015
December 31, 2015
January 15, 2016
2014 overpayment applied to 2015
4. WAGES & COMPENSATION (Bring in all W-2 and 1099 forms)
5. INTEREST & DIVIDEND INCOME (Bring in all 1099 forms)
Name of Payer
Amount
Name of Payer
Amount
6. TAX-EXEMPT INTEREST
Name of Payer
Amount
Name of Payer
Amount

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