2023 TAX RETURN PREPARATION CHECKLIST

Please check the applicable boxes below. Leave them blank if they do not apply to you.
 Personal Information Changes – address, email, telephone number and/or marital status.

 State Income Tax Return, Gift Tax Return or Special Tax Form – ____________________

 Refund Direct Deposited into Your Bank Account – provide bank info on page 11.
 Electronic Funds Withdrawal – If you have a balance due, we will provide you with a
payment voucher, mailing envelope and the IRS Direct Pay instructions. We do not prepare
the direct debit bank authorization form unless you check this box to instruct us to do so.

 Estimated Tax Payments – list all the payments & dates on page 12.

 Qualified Charitable Distributions from IRAs (QCD) – If you made QCDs, attach the IRA
payment confirmations and the acknowledgment letters from the charities. If you did not
donate directly from your IRAs to charities, do not check this box.

 Roth IRA Conversion – please provide Form 5498 or the conversion confirmation.

 Sale of Residence – Please provide the closing statements, home improvements & Tax Form
1099-S. See the tax organizer for Sale of Personal Residence.

 Energy Efficient Home Improvement Credit (New Roofs do not qualify. Do NOT check this
box if you replaced your roof) – Contact your contractor and obtain the applicable energy
certification. New construction, rentals and home appliances do not apply.

 Residential Clean Energy Credit– Solar water heaters must be certified. The credit does not
apply to swimming pools and hot tubs. Applies to either an existing home or a newly
constructed home.

 Clean Vehicle Credit (must be assembled in North America) – Do Not check this box for an
electric golf cart. Must provide the dealer’s certification & VIN.

Taxpayer initial _____________________ Spouse initial ________________________

Ellen Cronin Tax Services Office: 10845 N US Highway 301, Oxford, FL 34484
Mailing Address: P. O. Box 394, Oxford, FL 34484
Phone: (352)350-1951 • Fax: (352)561-2116

Page 1 of 16
 ELLEN CRONIN LLC

2023 TAX PREPARATION ENGAGEMENT UNDERSTANDING

Dear Client,

This letter is to confirm and specify the terms of our engagement with you and to clarify the nature and
extent of the services we will provide.

We will prepare your 2023 individual federal (Form 1040 or Form 1040-SR) and requested state income
return(s), including 2024 estimated tax payments from information that you will provide to us. We are under
no obligation to review the information you provide to determine whether you may have a filing obligation
with another state. If we become aware of any other filing requirement, we will tell you of the obligation and
may prepare the appropriate returns at your request.

It is your responsibility to provide all the information required for the preparation of complete and accurate
returns. You should retain all the documents, canceled checks, and other data that form the basis of income
and deductions. These may be necessary to prove the accuracy and completeness of the returns to a taxing
authority. You have the final responsibility for the income tax returns and, therefore, you should
review them carefully before you sign them.

We will furnish you with questionnaires and/or tax organizers as needed to guide you in gathering the
necessary information. Your use of such forms will assist us in keeping pertinent information from being
overlooked. You represent that the information you are supplying to us is accurate and complete to the best
of your knowledge and that you have disclosed to us all relevant facts affecting the returns. This will include
the ownership of or signature authority over any foreign bank accounts and the ownership of any other
foreign financial assets. We will not verify the information you give us; however, we may ask for additional
clarification of some information.

Our work in connection with the preparation of the tax return(s) does not include any procedures designed
to discover defalcations and/or other irregularities, should any exist. However, should we find any
irregularities or unusual items we will bring them to your attention. If, during our work, we discover
information that affects prior-year tax returns, we will make you aware of the facts. However, we cannot be
responsible for identifying all items that may affect prior-year returns. If you become aware of such
information during the year, please contact us to discuss the best resolution of the issue. We will be happy
to prepare appropriate amended returns as a separate engagement.

We will use our professional judgment to resolve questions in your favor where tax law is unclear or where
there may be conflicts between the taxing authorities’ interpretations of the law, if there is a reasonable
justification for doing so. If the IRS or a state tax agency should later contest the position taken, we assume
no liability for any such additional penalties or assessments.

Filing your returns by the due dates is your responsibility. If an extension of the time is required, any tax
due with this return must be paid with that extension. Any amounts not paid by the filing deadline
may be subject to interest and late payment penalties.

The IRS permits you to authorize us to discuss, on a limited basis, aspects of your return for one year after
the return’s due date. Your consent to such a discussion is evidenced by checking a box on the return.
Unless you tell us otherwise, we will check that box authorizing the IRS to discuss your return with us.

It is our policy to keep records related to this engagement for 3 years. However, we do not keep any of your
original records, so we will return those to you upon the completion of the engagement. When records are
returned to you, it is your responsibility to retain and protect the records for possible future use, including
potential examination by governmental or regulatory agencies.

Your return(s) may be selected for review by the taxing authorities. In the event of an audit, you may be
requested to produce documents, records, or other evidence to substantiate the items of income and
deduction shown on a tax return. Any proposed adjustments by the examining agent are subject to certain

Office: 10845 N US Hwy 301, Oxford, FL 34484 ▪ Tel: (352) 350-1951 ▪ Fax: (352) 561-2116
Mailing address: P.O. Box 394, Oxford, FL 34484

Page 2 of 16
 ELLEN CRONIN LLC
rights of appeal. In the event of a tax examination, we will be available, upon request, to represent you.
However, such additional services are not included in the fees for the preparation of the tax return(s).

Our fees for preparation of your return(s) are based upon our standard billing rates plus out-of-pocket
expenses. All invoices are due and payable upon presentation. Delinquent invoices will be subject to a
1.6% per month service charge (18% annual percentage rate) or the highest legal rate will be billed. After
60 days, collection costs including interest and reasonable attorney fees will be included in final settlement.

We have the right to withdraw from this engagement, in our discretion, if you do not provide us with any
information in a timely manner, refuse to cooperate with a reasonable request, or misrepresent any facts.
Our withdrawal will release us from any obligation to complete your return and will constitute completion of
this engagement. You agree to compensate us for our time and out-of-pocket expenses through the date
of our withdrawal.

If the foregoing correctly sets forth your understanding of our engagement, please sign this letter in the
space below and return it to our office. However, if there are other tax returns you expect us to prepare,
such as gift tax return, please inform us by noting so just below your signature at the end of this letter.

We want to express our appreciation for this opportunity to work with you.

Very truly yours,

Ellen Cronin LLC

Agreed to and Accepted by:

Taxpayer Signature _____________________________________ Date __________________

Spouse Signature _____________________________________ Date __________________

Comments or additional requests:

____________________________________________________________________________________

____________________________________________________________________________________

Client Privileged Communications

You should be aware that anything you tell us during the interview for the preparation of your tax return is confidential,
but not protected from the IRS. Privileged communications (those that are protected from the IRS authority to compel
the firm’s testimony) are limited to non-criminal tax advice on matters before the IRS or non-criminal tax proceedings
in federal courts. Although this firm considers any information you provide us as confidential, return preparation
engagements are not covered by advisor-client privilege. If you feel that the nature of any subject matter to be discussed
requires protected communications, please raise that issue so that we can discuss your possible need to consult with
an attorney for legal advice.

Office: 10845 N US Hwy 301, Oxford, FL 34484 ▪ Tel: (352) 350-1951 ▪ Fax: (352) 561-2116
Mailing address: P.O. Box 394, Oxford, FL 34484

Page 3 of 16
 ELLEN CRONIN LLC

TAX RETURN INFORMATION CONSENT FORM

Federal law requires this consent form be provided to you. Subject to certain exceptions,
the Internal Revenue Code 7216 requires that we obtain your consent to the disclosure or
use of information you provide Ellen Cronin LLC in connection with the preparation and
filing of your tax return. Ellen Cronin LLC will not use your tax return information for
any purpose other than preparing, assisting in preparing, or providing services in
connection with the preparation of your tax return unless you authorize us to do so,
except when expressly required or authorized by law, necessary to the preparation of the
tax return, or pursuant to court order.

You are not required to complete this form. If we obtain your signature on this form by
conditioning our service on your consent, your consent will not be valid. Your consent is
valid for the amount of time that you specify. If you do not specify the duration of your
consent, your consent is valid for one year.

I/We authorize Ellen Cronin LLC to use my tax return information for the purpose of
advising me by mail, email and telephone of current and enhanced tax preparation, or
services in connection with the preparation of my tax return that Ellen Cronin LLC
believes may be of interest to me.

Taxpayer Signature: _________________________________ Date: _____________

Spouse (with joint return): ____________________________ Date: _____________

E-mail address: _______________________________________________

If you believe your tax return information has been disclosed or used improperly in a
manner unauthorized by law or without your permission, you may contact the Treasury
Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484 by
email at [email protected].

Mailing address: P. O. Box 394, Oxford, FL 34484

Tel: (352)350-1951 • Fax: (352)561-2116
Page 4 of 16
 Ellen Cronin, EA MST CSA Phone: (352) 350-1951
Enrolled to practice before the IRS Fax: (352) 561-2116
Master of Science in Taxation E-mail: [email protected]
Certified Senior Advisor (CSA)®
NTPI Fellow 10845 N US Hwy 301, Oxford, FL 34484
Mailing address:
P. O. Box 394, Oxford, FL 34484

2023 Tax Organizer

This tax organizer is designed to help you gather tax information needed to prepare your personal
income tax return Form 1040 or Form 1040-SR. Please answer all questions and attach a statement
when necessary for additional information not provided in the tax organizer.

We will also need the following information:

• Qualified charitable donations made directly from your IRA (QCD).
• Six-digit Identity Protection PIN (attach the IRS letter CP01A).
• Energy efficient improvements made to your home (attach receipts & contracts).
• Gifts of more than $17,000 to any individual.
• Federal or/and state estimated taxes paid - amount and date of each payment.
• Forms W-2 for wages, salaries, and tips. All Forms 1099 for interest, dividends, retirement, mis-
cellaneous income, Social Security, state or local refunds, gambling winnings, etc.
• Brokerage statements (Form 1099-B) showing investment transactions for stocks, bonds, etc.
• Schedule K-1 showing income from partnership, S Corporations, estates and trusts.
• All Forms 1095-A, 1095-B, and/or 1095-C related to health care coverage.
• Statements supporting deductions for mortgage interest, taxes and charitable contributions.
• Virtual Currency & Non-fungible token (NFT) Transactions.
• Form 1099-S and copies of closing statements regarding the sale or purchase of real property.
• Any tax notices sent to you by the IRS or other taxing authority.
• A copy of your income tax return from last year if not prepared by this office. If we have a copy
of your last year’s return, you can simply skip the “Prior Year Information” column.

More detailed organizers such as self-employment and/or rental income & expenses are available upon
request. Please feel free to give us a call at (352) 350-1951 or email us at [email protected]
should you have any questions.

Sincerely,
Ellen Cronin LLC

Referrals are always appreciated.

Page 5 of 16
 Questions
________________________________________________________________________________
Please check the appropriate box and include all necessary details and documentation.

Yes No

Personal Information
Did your marital status change during the year? p p
If yes, explain: ______________________________________________
Did you live separately from your spouse during the last six months of the year? p p
Do you have a separate decree, instrument, or agreement and are not living in the
same household by the end of the year? p p
Did your address change from last year? p p
Can you be claimed as a dependent by another taxpayer? p p
Did you change any bank accounts, or did routing transit numbers (RTN) and/or
bank account number change for existing bank accounts that have been used
to direct deposit (or direct debit) funds from (or to) the IRS or other taxing authority
during the tax year? p p
Do you, your spouse (if applicable), and any dependents have a taxpayer
identification number (SSN, ITIN, or ATIN)? p p
Did you receive an Identity Protection PIN (IP PIN) from the IRS or have you been
a victim of identity theft? If yes, attach the IRS letter for filing returns in 2023. p p
Did you reside in or operate a business in a Federally declared disaster area? p p
The Federally declared disaster areas include victims of hurricanes, tropical storms,
floods, as well as wildfires and other disaster situations.

COVID-19 Information
Did you receive State and Local Fiscal Recovery Funds (SLFR) under a program to
support those negatively impacted by the COVID-19 pandemic for helping you with
your mortgage insurance and/or home purchases, such as funds to pay some or all
of the down payment and closing costs associated with your purchase of a home? p p
Are you a telecommuting employee that was required to "shelter in place" due to
local COVID-19 protocols while working in a state that was not your home state? p p

Dependent Information
Were there any changes in dependents from the prior year? p p
If yes, explain: ______________________________________________
Do you have any children under age 19 or a full-time student under age 24 with
unearned income in excess of $2,500? p p
Do you have dependents who must file a tax return? p p
Did you provide over half the support for any other person(s) other than your
dependent children during the year? p p
Did you pay for child care while you worked, looked for work, or while a
full-time student? p p
Is there any other person(s) who lived with you more than half the year but not
claimed by you last year? p p
Did you pay any expenses related to the adoption of a child during the year? p p
If you are divorced or separated with child(ren), do you have a divorce decree
or other form of separation agreement which establishes custodial responsibilities? p p
Did any dependents receive an Identity Protection PIN (IP PIN) from the IRS or
have they been a victim of identity theft? If yes, attach the IRS letter for use during
2023 p p

Purchases, Sales and Debt Information

Did you start a new business or purchase rental property during the year? p p

Page 6 of 16
 Did you have onwership interest in any type of business? p p
Did you sell, exchange, or purchase any assets used in your trade or business? p p
Did you acquire a new or additional interest in a partnership or S corporation? p p
Did you sell, exchange, or purchase any real estate during the year? p p
Did you purchase or sell a principal residence during the year? p p
Did you foreclose or abandon a principal residence or real property during the year? p p
Did you acquire or dispose of any stock during the year? p p
Did you take out a home equity loan this year? p p
Did you refinance a principal residence or second home this year? p p
Did you sell an existing business, rental, or other property this year? p p
Did you lend money with the understanding of repayment and this year it
became totally uncollectable? p p
Did you have any debts canceled or forgiven this year, such as a home mortgage or
student loan(s)? p p
Did you purchase a new or previously owned Clean vehicle this year that is eligible
for the new clean vehicle credit? If yes, attach the vehicle statement from the dealer. p p

Income Information
Did you have any foreign income or pay any foreign taxes during the year, directly
or indirectly, such as from investment accounts, partnerships or a foreign employer? p p
Did you receive any income from property sold prior to this year? p p
Did you receive any unemployment benefits during the year? p p
Did you receive any disability income during the year? p p
Did you receive any Medicaid waiver payments as difficulty of care during the year? p p
Did you receive tip income not reported to your employer this year? p p
Did any of your life insurance policies mature, or did you surrender any policies? p p
Did you receive any awards, prizes, hobby income, gambling or lottery winnings? p p
Did you receive any income considered to be nonemployee compensation? p p
Did you receive a Form 1099-K, 1099-MISC, 1099-NEC, or other income statement
for work done in what is commonly referred to as the "gig" economy? p p
Do you expect a large fluctuation in income, deductions, or withholding next year? p p
Did you have any sales or other exchanges of digital assets (including from an
airdrop or a hard fork, or used digital assets to pay for goods or services? p p

Retirement Information
Are you an active participant in a pension or retirement plan? p p
Did you receive any Social Security benefits during the year? p p
Did you make any withdrawals from an IRA, Roth, Keogh, SIMPLE, SEP,
401(k), or other qualified retirement plan? p p
If yes, were any withdrawals due to a Federally declared disaster? p p
If you received any qualified disaster retirement plan distributions, did you repay
any of the distributions in 2023? p p
Did you receive any lump-sum payments from a pension, profit sharing or
401(k) plan? p p
Did you make any contributions to an IRA, Roth, Keogh, SIMPLE, SEP,
401(k), or other qualified retirement plan? p p
Did you make any qualified charitable distributions (QCD) during the year? p p

Education Information
Did you, your spouse, or your dependents attend a post-secondary school
during the year, or plan to attend one in the coming year? p p
Did you have any educational expenses during the year on behalf of yourself,
your spouse, or a dependent? p p
Did anyone in your family receive a scholarship of any kind during the year? p p
If yes, were any of the scholarship funds used for expenses other than tuition,
such as room and board? p p

Page 7 of 16
 Did you make any withdrawals from an education savings or 529 Plan account? p p
If yes, were any of these withdrawals rolled over into an ABLE (Achieving a
Better Life Experience) account? p p
Did you make any contributions to an education savings or 529 Plan account? p p
Did you pay any student loan interest this year? p p
Did you cash any Series EE or I U.S. Savings bonds issued after 1989? p p
Would you like a worksheet to aid in the completion of a Free Application for
Federal Student Aid (FAFSA) with the U.S. Department of Education? p p

Health Care Information

Did you have qualifying health care coverage, such as employer-sponsored coverage
or government-sponsored coverage (i.e. Medicare/Medicaid) for your family?
"Your family" for health care coverage refers to you, your spouse if filing jointly, and
anyone you can claim as a dependent. p p
Did you enroll for lower cost Marketplace Coverage through healthcare.gov under
the Affordable Care Act? p p
Did you enroll for lower cost Marketplace Coverage through healthcare.gov under
the Affordable Care Act and share a policy with anyone who is not included in
your family? p p
Did you make any contributions to a Health savings account (HSA) or Archer MSA? p p
Did you receive any distributions from a Health savings account (HSA), Archer
MSA, or Medicare Advantage MSA this year? p p
Did you pay long-term care premiums for yourself or your family? p p
Did you make any contributions to an ABLE (Achieving a Better Life
Experience) account? p p
Did you receive any withdrawals from an ABLE (Achieving a Better Life
Experience) account? p p
If you are a business owner, did you pay health insurance premiums for your
employees this year? p p

Itemized Deduction Information

Did you incur a casualty or theft loss or any condemnation awards during the year? p p
If yes, did the loss occur in a Federally declared disaster area? p p
Did you pay out-of-pocket medical expenses (Co-pays, prescription drugs, etc.)? p p
Did you make any cash or noncash charitable contributions (clothes, furniture, etc.)? p p
If yes, please provide evidence such as a receipt from the donee organization, a
canceled check, or record of payment, to substantiate all contributions made.
Did you donate a vehicle or boat during the year?. p p
Did you pay real estate taxes for your primary home and/or second home? p p
Did you pay any mortgage interest on an existing home loan? p p
Did you incur interest expenses associated with any investment accounts you held? p p
Did you make any major purchases during the year (cars, boats, etc.)? p p
Did you make any out-of-state purchases (by telephone, internet, mail, or in person)
for which the seller did not collect state sales or use tax? p p

Miscellaneous Information
Did you make gifts of more than $17,000 to any individual? p p
Did you utilize an area of your home for business purposes? p p
Did you engage in any bartering transactions? p p
Did you retire or change jobs this year? p p
Did you incur moving costs because of a permanent change of station as a member
of the Armed Forces on active duty? p p
Did you pay any individual as a household employee during the year? p p
Did you make energy efficient improvements to your main home this year? p p
Did you receive a distribution from, or were you a grantor or transferor for a foreign
trust? p p

Page 8 of 16
 Did you have a financial interest in or signature authority over a financial account
such as a bank account, securities account, or brokerage account, located in a
foreign country? p p
Do you have any foreign financial accounts, foreign financial assets, or hold
interest in a foreign entity? p p
Are you an owner or do you control 25% of a company's ownership interest for a
company registered with a secretary of state or similar office before January 1, 2024? p p
Do you plan to become an owner or control at least 25% of a company's ownership
interests for a company registered with a secretary of state or similar office for the
first time after January 1, 2024? p p
Did you receive correspondence from the State or the IRS? p p
If yes, explain: ______________________________________________
Do you have previous years of tax returns that are either unfiled or filed with
unpaid balances due? p p
Do you want to designate $3 to the Presidential Election Campaign Fund? If you
check yes, it will not change your tax or reduce your refund. p p

Page 9 of 16
 GENERAL INFORMATION
General: 1040
Personal Information
Filing (Marital) status code (1 = Single, 2 = Married filing joint, 3 = Married filing separate, 4 = Head of household, 5 = Qualifying surviving spouse)
Mark if you were married but living apart all year Mark if your nonresident alien spouse does not have an ITIN
Taxpayer Spouse
Social security number
First name
Last name
Occupation
Designate $3.00 to the presidential election campaign fund? (1 = Yes, 2 = No, 3=Blank)
Mark if legally blind
Mark if dependent of another taxpayer
Taxpayer between 19 and 23, full-time student, with income less than 1/2 support? (Y, N)
Date of birth
Date of death
Work/daytime telephone number/ext number
Do you authorize us to discuss your return with the IRS (Y, N)
General: 1040, Contact
Present Mailing Address
Address
Apartment number
City/State postal code/Zip code
Foreign country name
Foreign phone number
Home/evening telephone number
Taxpayer email address
Spouse email address

General: 1040
Dependent Information
Care
Months expenses
in paid for
First Name Last Name Date of Birth Social Security No. Relationship home dependent

Credits: 2441
Child and Dependent Care Expenses
Provider information:
Business name
First and Last name
Street address
City, state, and zip code
Social security number OR Employer identification number
Tax Exempt or Living Abroad Foreign Care Provider (1 = TE, 2 = LAFCP)
Amount paid to care provider in 2023
Taxpayer Spouse
Employer-provided dependent care benefits that were forfeited

NOTES/QUESTIONS:

Page 10 of 16 Lite-1 GENERAL INFORMATION

 BANK & IDENTITY AUTHENTICATION
General: Bank
Direct Deposit/Electronic Funds Withdrawal Information
Per IRS Security Summit requirements, verify the name of financial institution, routing transit number, account number , and type of account
below. If you would like to have a refund direct deposited into or a balance due debited from your bank account(s), please enter information
in the fields below. Note that electronic funds will be withdrawn only from the primary account listed below.

Mark to verify all accounts listed below have been reviewed, updated as needed, and are correct.
Primary account:
Financial institution routing transit number
Name of financial institution
Your account number
Type of account (1 = Savings, 2 = Checking, 3 = IRA*)
Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account)
Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States)
Enter the maximum dollar amount, or percentage of total refund Dollar or Percent (xxx.xx)

Secondary account #1:

Financial institution routing transit number
Name of financial institution
Your account number
Type of account (1 = Savings, 2 = Checking, 3 = IRA*)
Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account)
Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States)
Enter the maximum dollar amount, or percentage of total refund Dollar or Percent (xxx.xx)

Secondary account #2:

Financial institution routing transit number
Name of financial institution
Your account number
Type of account (1 = Savings, 2 = Checking, 3 = IRA*)
Mark if married filing jointly and this is a joint account (Both taxpayer and spouse names are on the account)
Mark if financial institution is foreign based (Not located in the territorial jurisdiction of the United States)
Enter the maximum dollar amount, or percentage of total refund Dollar or Percent (xxx.xx)

*Refunds may only be direct deposited to established traditional, Roth or SEP-IRA accounts. Make sure direct deposits will be accepted by the bank or financial institution.

Electronic Filing: ID Auth

Identity Authentication

Taxpayer -
Form of identification ( 1 = Driver's license, 2 = State issued identification card, 3 = No applicable identification, 4 = Identification not provided)
Identification number
Issue date
Expiration date
Location of issuance
Document number (New York only)

Spouse -
Form of identification ( 1 = Driver's license, 2 = State issued identification card, 3 = No applicable identification, 4 = Identification not provided)
Identification number
Issue date
Expiration date
Location of issuance
Document number (New York only)

NOTES/QUESTIONS:

Page 11 of 16 Lite-6 BANK & IDENTITY AUTHENTICATION

Form ID: Est 8
Estimated Taxes

If you have an overpayment of 2023 taxes, do you want the excess:

Refunded [52]
Applied to 2024 estimated tax liability [53]
Do you expect a considerable change in your 2024 income? (Y, N) [54]
If yes, please explain any differences:
[55]
[56]
[57]
[58]
Do you expect a considerable change in your deductions for 2024? (Y, N) [59]
If yes, please explain any differences:
[60]
[61]
[62]
[63]
Do you expect a considerable change in the amount of your 2024 withholding? (Y, N) [64]
If yes, please explain any differences:
[65]
[66]
[67]
[68]
Do you expect a change in the number of dependents claimed for 2024? (Y, N) [69]
If yes, please explain any differences:
[70]
[71]
[72]
[73]
Payment method used to pay your estimated taxes (1=Electronic Federal Tax Payment System (EFTPS); 2=Direct Pay) [74]

2023 Federal Estimated Tax Payments

2022 overpayment applied to 2023 estimates [1]

Mark if you paid the calculated amounts on the dates due indicated below. Skip the remaining fields. [5]

If your estimated payments were not made on the date due or were for an amount other than the calculated amount below, please enter
the actual date and amount paid.

Date Due Date Paid if After Date Due Amount Paid Calculated Amount Method*
1st quarter payment 04/18/23 [6] [7]
2nd quarter payment 06/15/23 [8] [9]
3rd quarter payment 09/15/23 [10] [11]
4th quarter payment 01/16/24 [12] [13]
Additional payment [14] [15]

*Method of payment indicated in prior year

EFW = Electronic funds withdrawal EFTPS = Electronic Federal Tax Payment System
Voucher = Form 1040-ES estimated tax payment voucher

NOTES/QUESTIONS:

Page 12 of 16 Control Totals Form ID: Est

 W-2/1099-R/K-1/W-2G/1099-Q
Income: W2
Salary and Wages
Please provide all copies of Form W-2 that you receive.
Below is a list of the Form(s) W-2 as reported in last year's tax return. If a particular W-2 no longer applies, mark the not applicable box.
Prior Year Mark if no longer
T/S Description Information applicable

Retirement: 1099R
Pension, IRA, and Annuity Distributions
Please provide all copies of Form 1099-R that you receive.
Below is a list of the Form(s) 1099-R as reported in last year's tax return. If a particular 1099-R no longer applies, mark the not applicable box.
Prior Year Mark if no longer
T/S Description Information applicable

Income: K1, K1T

Schedules K-1
Please provide all copies of Schedule K-1 that you receive.
Below is a list of the Schedule(s) K-1 as reported in last year's tax return. If a particular K-1 no longer applies, mark the not applicable box.
Mark if no longer
T/S/J Description Form applicable

Income: W2G
Gambling Income
Please provide all copies of Form W-2G that you receive.
Below is a list of the Form(s) W-2G as reported in last year's tax return. If a particular W-2G no longer applies, mark the not applicable box.
Prior Year Mark if no longer
T/S Description Information applicable

Educate: 1099Q
Qualified Education Plan Distributions
Please provide all copies of Form 1099-Q that you receive.
Below is a list of the Form(s) 1099-Q as reported in last year's tax return. If a particular 1099-Q no longer applies, mark the not applicable box.
Prior Year Mark if no longer
T/S Description Information applicable

NOTES/QUESTIONS:

Page 13 of 16 Lite-2 W-2/1099-R/K-1/W-2G/1099-Q

 INTEREST/DIVIDENDS/CAPITAL GAINS/OTHER INCOME
Income: B1
Interest Income
Please provide all copies of Form 1099-INT or other statements reporting interest income.
Interest Prior Year
T/S/J Payer Name Income Information

Income: B3
Seller Financed Mortgage Interest

T, S, J Payer's name Payer's social security number

Payer's address, city, state, zip code
Amount received in 2023 Amount received in 2022
Income: B2
Dividend Income
Please provide copies of all Form 1099-DIV or other statements reporting dividend income.
Ordinary Qualified Prior Year
T/S/J Payer Name Dividends Dividends Information

Income: D
Sales of Stocks, Securities, and Other Investment Property
Please provide copies of all Forms 1099-B and 1099-S.
Gross Sales Price Cost or
T/S/J Description of Property Date Acquired Date Sold (Less expenses of sale) Other Basis

Income: Income
Other Income
Please provide copies of all supporting documentation.
2023 Information Prior Year Information
State and local income tax refunds

T/S Agreement Date 2023 Information Prior Year Information

Alimony received

Taxpayer Spouse Prior Year Information

Unemployment compensation
Unemployment compensation repaid
Social security benefits
Medicare premiums to be reported on Schedule A
Railroad retirement benefits
T/S/J 2023 Information Prior Year Information
Other Income:

Page 14 of 16 Lite-3 INTEREST/DIVIDENDS/CAPITAL GAINS/OTHER INCOME

 ADJUSTMENTS/EDUCATE
1040 Adj: IRA
Adjustments to Income - IRA Contributions
Please provide year end statements for each account and any Form 8606 not prepared by this office.
Taxpayer Spouse
Traditional IRA Contributions for 2023 -
If you want to contribute the maximum allowable traditional IRA contribution amount,
enter the applicable code: (1 = Deductible only, 2 = Both deductible and nondeductible)
Enter the total traditional IRA contributions made for use in 2023
Roth IRA Contributions for 2023 -
Mark if you want to contribute the maximum Roth IRA contribution
Enter the total Roth IRA contributions made for use in 2023
Educate: Educate2
Higher Education Deductions and/or Credits
Complete this section if you paid interest on a qualified student loan in 2023 for qualified higher education expenses for you,
your spouse, or a person who was your dependent when you took out the loan.
T/S Qualified student loan interest paid 2023 Information Prior Year Information

Complete this section if you paid qualified education expenses for higher education costs in 2023.
Qualified education expenses include tuition and fees required for enrollment or attendance at an eligible educational institution.
Please provide all copies of Form 1098-T.
Ed Exp Prior Year
T/S Code* Student's SSN Student's First Name Student's Last Name Qualified Expenses Information

*Education Expense Code: 1 = American opportunity credit; 2 = Lifetime learning credit; 3 = Tuition and fees deduction
The student qualifies for the American opportunity credit when enrolled at least half-time in a program leading to a degree, certificate, or
recognized credential; has not completed the first 4 years of post-secondary education; has no felony drug convictions on student's record.
1040 Adj: 3903
Job Related Moving Expenses
Complete this section if you moved to a new home due to service in the armed forces.
Description of move
Taxpayer/Spouse/Joint (T, S, J)
Mark if the move was due to service in the armed forces
Number of miles from old home to new workplace
Number of miles from old home to old workplace
Mark if move is outside United States or its possessions
Transportation and storage expenses
Travel and lodging (not including meals)
Total amount reimbursed for moving expenses

1040 Adj: OtherAdj

Other Adjustments to Income
Alimony Paid:
T/S Date* Recipient name Recipient SSN 2023 Information Prior Year Information

Street address
City, State and Zip code
*Enter the divorce/separation agreement date
Taxpayer Spouse Prior Year Information
Educator expenses:

Other adjustments:

Page 15 of 16 Lite-4 ADJUSTMENTS/EDUCATE

 ITEMIZED DEDUCTIONS
Itemized: A1
Medical and Dental Expenses
T/S/J 2023 Information Prior Year Information
Medical and dental expenses
Medical insurance premiums you paid***
Long-term care premiums you paid***
Prescription medicines and drugs
Miles driven for medical items (22 cents)
***Do not include pre-tax amounts paid by an employer-sponsored plan, amounts paid for your self-employed business, or Medicare premiums entered on Form Lite-3

Itemized: A1
Tax Expenses
T/S/J 2023 Information Prior Year Information
State/local income taxes paid
2022 state and local income taxes paid in 2023
Sales tax paid on actual expenses
Real estate taxes paid
Personal property taxes
Other taxes
Itemized: A2
Interest Expenses
T/S/J 2023 Information Prior Year Information
Home mortgage interest From Form 1098
Other home mortgage interest paid to individuals:
T/S/J Payee's Name SSN or EIN 2023 Information Prior Year Information

Address City State Zip Code

T/S/J 2023 Information Prior Year Information

Investment interest expense, other than on Sch K-1s:
Refinancing Information: Refinance #1 Refinance #2
T/S/J
Recipient/Lender name
Total points paid at time of refinance
Date of refinance
Term of new loan (in months)
Reported on Form 1098 in 2023
Itemized: A3
Charitable Contributions
T/S/J 2023 Information Prior Year Information
Contributions made by cash or check
Volunteer miles driven
Noncash items, such as: Goodwill, Salvation Army
Itemized: A3, A-St
Miscellaneous Deductions
T/S/J 2023 Information Prior Year Information
Other expenses
Gambling losses (enter only if you have gambling income)
***STATE USE ONLY - Complete the following fields only if you file a state return in AL, AR, CA, HI, MN, NY or PA
T/S/J 2023 Information Prior Year Information
Unreimbursed expenses***
Union dues, other than amounts reported on Form W-2***
Tax preparation fees***
Other expenses, subject to 2% AGI limitation***:

Safe deposit box rental***

Investment expenses, other than on Schedule(s) K-1 or Form(s) 1099-DIV/INT***
Page 16 of 16 Lite-5 ITEMIZED DEDUCTIONS