Dear Taxpayer:
You are invited to use this organizer to help you organize your tax information and aid your memory of what happened in 2023 (and make sure you don't miss any important deductions).
DON'T WORRY ABOUT WHERE THE INFORMATION GOES. If you don't know where to put some information, just attach the relevant documents. This form is a memory aid and an organizational tool for your convenience.
Write in any questions you have, too!
TAXPAYER INFORMATION
First Name: ______________________ Initial _______
Last Name_____________________________
Social Security # _____________________________
Occupation__________________________________
Date of Birth ________________________
Street Address __________________________________
City________________ State_________ Zip____________
Home Telephone ______________________________
Work Telephone______________________________
E-mail address______________________________
SPOUSE INFORMATION
First Name:___________________ Initial_______
Last Name_____________________________
Social Security # _____________________________
Occupation__________________________________
Date of Birth ________________________
Street Address __________________________________
City________________ State_________ Zip____________
Home Telephone ______________________________
Work Telephone______________________________
E-mail address______________________________
FILING STATUS (Circle one)
Single
Married
Head of Household
Married Filing Separate
SALARIES AND WAGES (List W-2's below and attach)
TAXPAYER
Employer #1 _____________________________
Employer #2 _____________________________
Employer #3 _____________________________
SPOUSE
Employer #1 _____________________________
Employer #2 _____________________________
Employer #3 _____________________________
DEPENDENTS
Name_______________________________________
Date of Birth_________________
Social Security #________________________
Relationship _____________________________
Months Lived at Home_________________
Name_______________________________________
Date of Birth_________________
Social Security #________________________
Relationship _____________________________
Months Lived at Home_________________
Name_______________________________________
Date of Birth_________________
Social Security #________________________
Relationship _____________________________
Months Lived at Home_________________
Name_______________________________________
Date of Birth_________________
Social Security #________________________
Relationship _____________________________
Months Lived at Home_________________
OTHER INCOME
INTEREST: List payor and attach 1099 Forms
Payor #1______________________________
Payor #2______________________________
Payor #3______________________________
Payor #4______________________________
DIVIDENDS - Attach 1099 Forms
Payor #1______________________________
Payor #2______________________________
Payor #3______________________________
Payor #4______________________________
State Tax Refund
Amount Received $___________________
CAPITAL GAINS
Property Sold::
Description__________________________________________
Date Acquired_______________________________
Date Sold___________________________________
Sales Price__________________________________
Cost or Basis________________________________
If there are more, attach list
Attach all 1099 B or S forms for property sold
PENSIONS/ IRA DISTRIBUTIONS
Attach Form 1099 / W-2s
Payor_____________________________
Payor_____________________________
Was Federal or State Income Tax withheld?
___________________________________
ALIMONY RECEIVED
Payor________________________ Amount $___________
Payor's Social Security #_______________________________
UNEMPLOYMENT RECEIVED
Taxpayer Amount $________________
Spouse Amount $_________________
SOCIAL SECURITY RECEIVED
Taxpayer Amount $_______________
Spouse Amount $_________________
MISCELLANEOUS INCOME
Description:________________________________
_________________________________________
__________________________________________
DEDUCTIONS
Medical and Dental Expenses
Insurance Premiums (Net) ___________________
Doctors, Dentists, etc.______________________
TAXES PAID
State & Local Income Tax____________________
Real Estate Taxes - Residence_________________
Real Estate Taxes - Other Property______________
Auto License:
No. of Cars Fees Paid _______________________
Personal Property Taxes____________________
Other Taxes_____________________________
INTEREST PAID - Attach 1098 Forms
Home Mortgage Interest Paid (1st)____________________
Home Mortgage Interest Paid (2nd)____________________
CONTRIBUTIONS - Attach Details
Contributions by Cash or Check____________________
Contributions by Other than Cash__________________
MISCELLANEOUS DEDUCTIONS
Unreimbursed Employee
Business Expenses____________________
Union /Professional Dues_______________
Investment Expense____________________
Tax Return Preparation Fees______________
Safe Deposit Box Rental_________________
BUSINESS INCOME
General Information:
Cash basis?
Accrual Basis?
First Year?
Taxpayer's business?
Spouse's business?
Principal Bus./Profession__________________________
Business Name__________________________________
Business Address________________________________
City, State, Zip__________________________________
Other Accounting Method___________________________
Income
Gross Receipts or Sales $___________________________
Returns and Allowances $___________________________
Other Income $___________________________________
Cost of Goods Sold - If Applicable
Inventory at Beginning of the Year $___________________________
Inventory at End of the Year $___________________________
Purchases $____________________________
Cost of Items for Personal Use $_______________________
Cost of Labor $_________________________
Materials and Supplies $__________________
Other Costs $___________________________
Expenses
Advertising $_____________________________
Car and Truck Expenses * $___________________
Commissions $____________________________
Employee Benefit Programs $_________________
Insurance (other than health) $________________
Health Insurance
Premiums for Self* $_______________________
Mortgage Interest
(paid to banks, etc.) $_______________________
Other Interest $___________________________
Legal and Professional $_____________________
Office Expense $___________________________
Pension and Profit Sharing Plans $_________________
Rent - Vehicles, Machinery, and Equipment $___________________________
Rent - Other Business Property $______________
Repairs $_________________________________
Supplies $_______________________________
Taxes - Real Estate $______________________
Taxes - Other $___________________________
Travel $________________________________
Total Meals and Entertainment $_______________________
Utilities $______________________________
Wages $________________________________
* Attach detailed schedule
Did you dispose of any business assets (including real estate)?
Yes
No
If yes, attach detailed schedule.
Did you have a home office during the year?
Yes
No
Rent $____________________ Utilities $________________
Insurance $________________ Janitorial $_______________
Misc._________________ % of exclusive business use_______
RENTAL INCOME & EXPENSES
Check if property was purchased/converted to rental in 2023 ___
Property Address
1. ___________________________________________
2. ___________________________________________
3. ___________________________________________
ADJUSTMENTS TO INCOME
Alimony Paid
Payee___________________ Amount $_____________
Payee's Social Security #__________________________
IRA Deduction___________________________
Keogh/SEP Deduction_____________________
Penalty on Early Withdrawal of Savings____________________
ESTIMATED TAX PAYMENTS
04.15.23_______________
06.15.23_______________
09.15.23_______________
01.15.24_______________
If any of the following items pertain to you or your spouse for the year 2023, please indicate if applicable and include all pertinent details.
YES or NO
Were there any births, adoptions, marriages, divorces, or deaths in your immediate family during the year?
Are any of your unmarried children, who might be claimed as dependents, 19 years of age or older?
Do you have any children under age 14 with interest and dividend income?
Are any of your unmarried children, who might be claimed as dependents, 19 years of age or older?
Can you be claimed as a dependent on another persona's tax return?
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.
Did you or your spouse receive any disability income during the year? If yes, enter amount $__________________.
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.
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.
Did you pay any one household employee cash wages in 2023?
Did you use your car on the job (other than to and from work)?
Does anyone owe you money which has become uncollectible?
Did you incur moving expenses during the year due to a change of employment?
Did you or your spouse work out of town for part of the year?
Did you incur a loss because of damaged or stolen property?
Did you have an interest in or signature over a bank or brokerage account in a foreign country, or were you a grantor of or transferor to a foreign trust?
Were you audited by either the Internal Revenue Service or the State taxing agency during the year?
Did you receive any forms 1099-K in 2023?
Did you receive any K-1's from S corporations, partnerships estates, trusts, or LLC's? If so, please attach.
Did you buy an electric car in 2023? (please provide purchase invoice).
USE THIS SPACE TO LIST ANY QUESTIONS YOU MAY HAVE:
______________________________________
______________________________________
______________________________________
______________________________________
PLEASE PROVIDE PRIOR YEAR'S TAX RETURNS
Once you have completed the organizer form, call David C. Belzer at 206.288-5575 for an appointment, promptly scheduled to your convenience.
Or, if you prefer, you can email the completed form to David C. Belzer at davebelzer@gmail.com.
Or you can mail the completed form to: David C. Belzer, 506 - 2nd Ave, Suite 1400, Seattle, WA 98104. Your return will be promptly prepared and delivered to you by your choice of delivery.
Thank you for the opportunity to be of service.
Sincerely,
David C. Belzer
David C. Belzer