Tax Preparation Information Form

TAX PREPARATION INFORMATION FORM * Print this form, fill it out and bring it with you when you visit Joche And Associates. This is a two page form so be certain to print and fill out both pages*

You will need:

a) valid Picture I.D.

b) Copies of all W-2, 1099 Forms and proof of other income received by you and your spouse.

c) Social Security Card or Tax identification Number (TIN) card (i.e. ITIN card or Letter, etc) for you, your spouse and any others shown on the tax return.

YOUR INFORMATION:
First Name ____________________________________M.I. ___Last Name ________________________	Social Security # /ITIN
SPOUSE INFORMATION:	_________________
First Name ____________________________________M.I. ___Last Name _________________________	Social Security #/ITIN
ADDRESS:	_________________
Street, Apt, _______________________City, State, Zip Code ________________________________________

TELEPHONE NUMBERS:		OCCUPATION AND NUMBER OF JOBS:
YOUR	SPOUSE
Business ________________________	Business_________________________	Your_______________________
Home __________________________	Home ___________________________	Spouse_____________________
Cell____________________________	Cell_____________________________

Taxpayer's Birthdate ________________________Spouse's Birthdate ____________________________________

MARITAL STATUS
Were you legally married as of December 31st?	YES NO
If so, were you living with your spouse as of December 31st?	YES NO
Did your spouse die within the last 2 years? if yes, date of death	YES NO
Can someone else claim you or your spouse as a dependent on their tax return?	YES NO

FAMILY/DEPENDANT INFORMATION- Do not include yourself or your spouse.

Please list all persons who lived in your home and anyone living outside your home that you supported during the tax year.

NAME	DATE OF BIRTH	SOCIAL SECURITY NUMBER	RELATIONSHIP	Months person lived with you in 2005	Did you provide more than 50% support for this person in 2005
_______________________	_______________	________________________	_______________	_______________	_______________
_______________________	_______________	_______________________	_______________	_______________	_______________
_______________________	_______________	_______________________	_______________	_______________	_______________
_______________________	_______________	_______________________	_______________	_______________	_______________
If you have additional dependents, please include them in the "Comments" field below

Did you or your spouse have income during the tax year that was not reported on a W2....	YES NO	Did you or anyone in your family pay student loan interest?........	YES NO
Did you receive Social Security payments during the tax year?...........................	YES NO	Did you own your own home during the tax?.........	YES NO
Did you receive unemployment payments during the tax year? ......................	YES NO	Have you ever had Earned Income Credit disallowed by the IRS?......	YES NO
Did you pay for childcare during the tax year that allowed you to work?.........	YES NO	Do you want to use Direct Deposit to a savings or checking account?........	YES NO
If yes, did you bring the address and tax identification number for the provider?.........	YES NO	If so, did you bring the account number and the routing number of the financial institution?.........	YES NO
Did you or anyone in your family attend college or vocational school during the tax year?............	YES NO	Did you bring a copy of your prior year's tax return?.....	YES NO

Please indicate below whether we may use the information contained on this form to assist in resolving problems in the event return processing problems occur. By signing this document and indicating your agreement below, you will allow us to retain this form so that general information such as employer/taxpayer address, identification numbers, birth dates and names can be verified if return processing problems occur.The information retained will not be shared with any unauthorized persons and will not be sold, given away, or used for commercial purposes. This information will be properly disposed of when no longer needed and retained no longer than December 31 of the current tax year.
Can we retain the information on this Form to improve/help with the processing of your tax return? YES NO

_______________________________	__________________________________________
Your signature	Spouse signature
If you are not filing your return electronically (i.e. you will mail your return), after your tax return has been completed, attach this completed form to your copy of your tax return.
I understand that this is a free service by volunteers. I will be patient and treat volunteers with courtesy and respect. I agree to provide all information necessary to complete an accurate tax return. I have reviewed the information contained in this document and agree that all the information is complete and correct.

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