2002 INCOME TAX CHECK LIST

2007 Income Tax Checklist

Complete & Mail to: The Tax Shoppe, 155 Lake St., Ramsey, NJ 07446, or to FAX: 201-327-4930

201-327-4965

Personal Information ►Have there been any name changes? If yes, indicate the changes:______________________


Your Name (as shown on Social Security Card)		Social Security #		Date of Birth*	Occupation

Spouse’s Name (as shown on Social Security Card)		Social Security #		Date of Birth*	Occupation

Address				City		State	Zip Code

Home Phone #	Work Phone #		Cell Phone #	E-mail

* Date of birth is important as there are additional benefits based on age.

NJ RESIDENTS ONLY: IF YOU’RE A RENTER, PLEASE INDICATE MONTHLY RENT PD:________

PLEASE INDICATE HOW WE SHOULD HANDLE YOUR RETURN

We will E-file your return (IT’S FREE!) unless you say NO. Do NOT E-file my return____________

Do you want a paper copy of your return or a CD?________________

Direct Deposit? ____YES _____No ►Bank Routing #_____________________ & Acct #___________________

Get your refund as quick as 7 days (Routing # is a 9-digit number printed on the bottom of your check followed by your acct #)

with NO additional cost to you. ►Is this a checking______or savings_______ account? (check one)

I AUTHORIZE YOUR OFFICE TO COLLECT YOUR FEE OUT OF MY REFUND___________________________

AUTHORIZED SIGNATURE

I AUTHORIZE YOUR OFFICE TO COLLECT YOUR FEE OUT OF MY ACCOUNT___________________________

DATE TO WITHDRAW FUNDS_________ (Provide Account info above) AUTHORIZED SIGNATURE

_____________________________________________________________________________________________

_____E-file IMMEDIATELY ______CALL ME first with results before e-filing. NOTE: This may mean a

after return is done. ‘OR’ delay in your refund if we can’t get in touch with you immediately.

PAYING YOUR TAX PREPARATION FEE

We require payment prior to E-filing your return.

We accept cash, checks, Split Refund, E-Checks or Credit Cards. For Credit Card payment: fill out the information below; OR call us with your information; OR go to http://www.the-tax-shoppe.com/ and click the “Make a Payment” link.

OR for Split Refund or E-Check, see above section.

Type of Card (circle one)

VISA / MC /AMEX / Discover

Address the card bill is sent if other than home address:

Card Number

Name as it appears on Card

Expiration Date (mo/yr)

Dependents (If additional dependents, list on a separate page)

Name (as shown on Social Security Card)	Date of Birth*	Relationship	Social Security #	College Student? Y/N	College Tuition cost	Child Care? Y/N

* Date of birth is important as there are additional benefits based on age.

Child Care Information (Child must be under 13 years old)

Child’s Name(s)

Amount Paid

Name of Provider

EIN or SS #

Address

Income (Please enclose your W-2s, Form 1099’s or the $ amts, etc.) CHECK OFF the types of income you have.

W-2s	K-1 Forms	Self Employed**	Farm Income**
Form 1099-DIV	IRA Withdrwl	Unemployment	Gambling Winnings
Form 1099-INT	Rental Income*	Social Security	State Tax Refund
Form 1099-MISC	Alimony received	Pensions	Misc. Income

See below * Expenses for Rental ** Expenses for Self-Employed

Capital Gains & Losses (list add’l stock transactions on a separate page)

Name of Security	# of Shares	Date Purchased	Cost	Date Sold		Amount Received
					07
					07

Major Deductions (Roth IRAs are not deductible)

IRA Contributions	Keogh	Simple Plans	Gambling Losses (Cannot exceed winnings)
	SEP
Moving Expenses (Job related only) Must be 50 miles	Student Loan Interest	Alimony Paid
			amount	SS# of recipient

Itemized Deductions (please indicate amounts)

Doctors/co pay	Eye Care (Incl. Glasses)	Unreimbursed Expenses
Dental	CHARITY: Cash	Job Hunting Expenses
Prescriptions	Check	Tools/Safety Equipment
Health Insurance

City

Date of Birth*

Relationship

Social Security #

Self Employed**

Rental Income*

Alimony received

SS# of recipient