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Were there any births, adoptions, marriages, divorces, or deaths in your immediate family during the year?
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Are any of your unmarried children, who might be claimed as dependents, 19 years of age or older?
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Do you have any children under age 14 with Interest and dividend income in excess of $500, or total investment income in excess of $1300?
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Are any of your unmarried children, who might be claimed as dependents, 19 years of age or older?
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Can you be claimed as a dependent on another persona's tax return?
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Did you or your spouse "rollover" a profit-share or retirement plan distribution into another plan? If yes, enter amount
$_________________,
and attach Form 1099-R.
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Did you or your spouse receive any disability income during the year? If yes, enter amount $__________________.
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Did you purchase, sell, or refinance your principal home or your second home, or make a home equity loan during the year? If yes, please bring escrow papers and other relevant information.
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Did you sell any stocks, bonds, or other investment property during the year? If yes, please list the description, date acquired, date sold, sales price, cost or basis, and expenses of sale.
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Did you pay any one household employee cash wages of $1,000 or more in prior year; withhold federal income tax during prior year at the request of any household employee; or pay total cash wages of $1,000 or more in any calendar quarter of prior year to house employees?
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Did you use your car on the job (other than to and from work)?
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Does anyone owe you money which has become uncollectible?
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Did you incur moving expenses during the year due to a change of employment?
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Did you or your spouse work out of town for part of the year?
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Did you incur a loss because of damaged or stolen property?
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Did you cash in any Series EE U.S. savings bonds issued after 1989?
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Do you have any Series E Bonds issued in 1955 or 1965?
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Do you or your spouse want to allocate $3 to the Presidential Election Campaign Fund?
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Were you audited by either the Internal Revenue Service or the State taxing agency during the year?
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Did you receive any K-1s from partnerships estates, trust, LLCs? If so, please attach.
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