Tax Worksheet for US Resident Did any of the following change during 2022 (please select all that apply): Please provide new address: Country Select Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belau Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda São Tomé and Príncipe Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (Dutch part) Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) United States (US) United States (US) Minor Outlying Islands United States (US) Virgin Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe What is your preferred method of contact? Did your marital status change during 2022? Did you receive alimony during 2022? Did you pay alimony during 2022? Do you and your spouse want to file separate returns? Are you in a domestic partnership, civil union, or other state-define relationship? Do you have any dependents to claim in 2022? Please provide full names and SSN of each dependent: Are your dependents U.S. citizens? Have your dependents lived with you for more than half of the year? Did any of your dependents provide more than 50% of their own support during the year (including amounts spent for food, lodging, clothing, education, medical, dental, recreation, transportation, and other necessities)? Did you make any payments for child or dependent care? Did any of your children file a joint return with their spouse? Do you have any dependents other than children under the age of 24? Has the IRS ever disallowed your Child Tax Credit or Other Dependent Credit? Do you have dependent children under the age of 24 with investment income greater than $1,150? Do you have any children who were full time students for more than 5 months during 2022? Was income for the year less than $4,400? Have you or your spouse ever signed form 8832 releasing the claim of an exemption for any of your children? Can anyone claim you or your spouse as dependents? Has the IRS ever disallowed a dependency exemption claim? If you were audited, could you provide documentation to substantiate the responses provided above? Did you adopt a child or begin adoption proceedings during 2022? Please provide more detail: Did you pay health insurance premiums during 2022? Did you obtain healthcare coverage through the Marketplace? Did you receive Form 1095-A for someone claimed as a dependent on another taxpayer's return or who is filing their own return and is not claimed on another taxpayer's return? Did you or your spouse have any transactions pertaining to a health savings account (HSA)? Did you or your dependents incur large medical expenses during 2022? Please provide more detail: Did you or your spouse receive distributions from long-term care insurance contracts? Did you, your spouse, or your dependents incur any post-secondary education expenses such as tuition? Did you or your spouse withdraw any amounts from your IRA to pay for higher education expenses? Did you or your spouse withdraw any amounts from a Coverdell Education Savings Account or a Qualified Education Program (Section 529) plan? Were the amounts withdrawn used for qualified tuition expenses? Did you or your spouse pay any student loan interest?
EMPLOYMENT AND BUSINESS INFORMATION
Did you receive wage or other employment income? Did you receive grants of stock options from your employer, exercise any stock options granted to you or dispose of any stock acquired under a qualified employee stock purchase plan? Did you retire or change jobs in 2022? Did you or your spouse receive unemployment compensation in 2022? Are you self-employed, work as an independent contractor, or as a farmer? If so, please attach a categorized list of income earned and expenses paid and include any 1099 forms you received that report income. Did you work or perform any services for compensation outside your state of residence? Were you or your spouse a partner in any partnership, member in any LLC, a stockholder in a U.S. S-Corporation, or receive a distribution from a U.S. trust/estate? Did you start a new business, purchase a new rental property, farm or acquire any new or additional interest in any partnership, LLC, or corporation during 2022? Did you sell an existing business, rental property, farm, or any existing interest (full or partial) in a partnership, LLC or corporation during 2022? Do you have investment income? Did you receive interest or dividend income? Did you sell any stocks, mutual funds, or put/call options during 2022? Did you have a crypto currency account during 2022? Did you sell or exchange any crypto currency during the calendar year? Did you sell, exchange, or purchase real estate in 2022? Did you or your spouse engage in any rental properties? If you were a Washington State resident in 2022, do you expect to have more than $250,000 in non-real estate long term gains in 2022?
RETIREMENT OR SEVERANCE INFORMATION
Did you have any activity from pension, retirement accounts, or annuities? Did you take any retirement distributions? Did you or your spouse contribute to a traditional individual retirement account (IRA), Roth IRA, or business retirement account? Did you or your spouse convert an IRA or other pension plan into a Roth IRA? Did you or your spouse rollover amounts from a pension or IRA account to another IRA account? Did you or your spouse receive social security benefits?
PERSONAL RESIDENCE INFORMATION
Did you pay property taxes during 2022? Did you pay mortgage interest during 2022? Are your total mortgages on your first and/or second residence greater than $750,000? Did you take out a home equity loan or refinance an existing mortgage in 2022? Please provide description of what the loan proceeds were used for: Did you sell your personal residence? Did you or your spouse own and occupy the home as your principal residence for at least two years of the five-year period prior to the sale? Did you or your spouse ever rent out the property? Did you or your spouse ever use any portion of the home for business purposes? Have you or your spouse sold a principal resident within the last two years?
DEDUCTIONS & CREDITS INFORMATION
Did you make any charitable contributions during 2022? Please select all types of charitable contributions you made in 2022: Please list all contributions made: Did you drive your car while performing volunteer duties for a charity during 2022? Did you or your spouse incur any casualty or theft losses? Did you or your spouse make any large purchases, such as motor vehicles and boats? Did you or your spouse purchase a new alternative technology vehicle, including a qualified plug-in electric drive motor vehicle? Did you install any alternative energy equipment in your residence such as solar water heaters, solar electricity equipment or fuel cells? Please provide additional details: Did you install any alternative energy equipment in your residence such as exterior doors or windows, insulation, heat pumps, furnaces, central air conditioners or water heaters? Please provide additional details: Did you make any home improvements? Please provide summary of sales tax paid: Did you or your spouse make any gifts, including birthday, holiday, anniversary, graduation, education savings, etc., with a total (aggregate) value in excess of $16,000 to any individual? Please provide more detail: Did you or your spouse make any gifts of difficult-to-value assets (such as non-publicly traded stock) to any person regardless of value? Please provide more detail: Did you or your spouse make any contributions to a trust during the year? Please provide more detail: Did you or your spouse forgive any indebtedness to any individual, trust, or entity? Please provide more detail:
REGULATORY CORRESPONDENCE INFORMATION
Were you notified by the IRS or other taxing authority of any changes to prior year returns or receive any other correspondence? Did you work outside of the US or pay any foreign taxes? At any time during 2022, did you or your spouse have an interest in or signature authority over a bank account, securities account, or other financial account in a foreign contry? Please provide details of all accounts outside of the US: Would you like us to send you a spreadsheet to input financial account details? Were you or your spouse a trustee or beneficiary of a foreign trust, or executor of a foreign estate? Did you or your spouse receive from or transfer money or property to a foreign trust, or a foreign corporation? Did you or your spouse own shares in a foreign private corporation? Did you or your spouse receive a gift from a non-U.S. person or a bequest from a foreign estate during 2022?
ESTIMATED TAX PAYMENTS MADE INFORMATION
If you made any Estimated Tax Payments during 2022, please fill out the applicable fields below:
How would you like your tax return delivered to you? Should any potential refund be electronically deposited into your US bank account? Would you like any PAYMENT DUE electronically withdrawn from your US bank account? Please upload any additional documents necessary for properly preparing your tax return: Is there anything else you would like us to know? Submit Form