Tax Worksheet for U.S. Resident Returns

We kindly request that you complete the form below and submit all of the necessary documentation to prepare your U.S. Resident Income Tax Return. Also, a reminder that your annual Agreement Letter has been sent to you and must be signed before Larson Gross can begin tax preparation. For questions about how to sign your agreement letter, please visit our Support Resources page.

To ensure your tax return is prepared and filed by the April 15th filing deadline, please submit your documentation no later than March 15th, 2024.

We look forward to serving you!

NEW in 2023: The form below saves your data as you proceed to each step, so should you be interrupted, you can return to where you left off without losing your progress.

In addition, please be sure to keep an eye out for any small blue circle “tool tips” after questions. These tips provide additional information about supporting documents that should be uploaded at the end of the form under the “Upload Documents” section.

Tax Worksheet for US Resident

Personal Information
Dependent Information
Healthcare Information
Education Information
Employment & Business Information
Investment Information
Retirement or Severance Information
Personal Residence Information
Deductions & Credits Information
Gifting Information
Regulatory Correspondence & Foreign Information
Estimated Tax Payments Made Information
Final Questions

PERSONAL INFORMATION

First Name

Last Name

Did any of the following change during 2023 (please select all that apply):

Address

Phone Number

Email Address

Please provide new address:

Address Line 1

Address Line 2

City

State

Zip Code

Country

Please provide new phone number:

Please provide new email address:

What is your preferred method of contact?

Phone

What is your marital status?

Single

Married

Divorced

Widowed

A domestic partnership, civil union, or other state-defined relationship

Did your marital status change during 2023?

Yes

What is the date of marital status change?

Did you receive alimony during 2023?

Yes

Did you pay alimony during 2023?

Yes

Do you and your spouse want to file separate returns?

Yes

Did you pay for domestic services performed in or around your home to individuals who could be considered household employees?

Yes

DEPENDENT INFORMATION

Do you have any dependents to claim in 2023?

Yes

Are your dependent children each U.S. citizens?

Yes

Do you have any dependent children who were full time students for more than 5 months during 2023?

Yes

Was income for the year less than $4,400?

Yes

Have your dependent children lived with you for more than half of the year?

Yes

Did you ever sign form 8832 releasing the claim of an exemption for your children to another person?

Yes

Did you provide more than half of the support for each child during the year (food, lodging, clothing, education, medical, dental, recreation, transportation, etc.)?

Yes

Did your dependent children provide more than half of their own support during the year?

Yes

Were your dependent children unmarried on December 31, 2023?

Yes

Can anyone claim you or your spouse as a dependent?

Yes

Has the IRS ever disallowed a dependency exemption claim?

Yes

If you were audited, could you provide documentation to substantiate the responses provided above?

Yes

Do you have dependent children under the age of 24 with investment income greater than $1,250?

Yes

Did you make any payments for child or dependent care?

Yes

Did you adopt a child or begin adoption proceedings during 2023?

Yes

HEALTHCARE INFORMATION

Did you pay health insurance premiums during 2023?

Yes

Please provide the amount:

Did you obtain healthcare coverage through the Marketplace?

Yes

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?

Yes

Did you or your spouse have any transactions pertaining to a health savings account (HSA)?

Yes

Please list the amount contributed and upload Form 1099-SA below if any funds were distributed from the HSA:

Were distributions of funds used for qualified out-of-pocket medical expenses?

Yes

Did you or your dependents incur large medical expenses during 2023?

Yes

Please provide more detail, including amounts:

Did you or your spouse receive distributions from long-term care insurance contracts?

Yes

EDUCATION INFORMATION

Did you, your spouse, or your dependents incur any post-secondary education expenses such as tuition?

Yes

Did you or your spouse withdraw any amounts from your IRA to pay for higher education expenses?

Yes

Did you or your spouse withdraw any amounts from a Coverdell Education Savings Account or a Qualified Education Program (Section 529) plan?

Yes

Were the amounts withdrawn used for qualified tuition expenses?

Yes

Did you or your spouse pay any student loan interest?

Yes

How much?

EMPLOYMENT AND BUSINESS INFORMATION

Did you receive wage or other employment income?

Yes

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?

Yes

Did you retire or change jobs in 2023?

Yes

Did you or your spouse receive unemployment compensation in 2023?

Yes

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.

Yes

Did you start a new business in 2023?

Yes

Did you work or perform any services for compensation outside your state of residence?

Yes

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?

Yes

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 2023?

Yes

Did you sell an existing business, rental property, farm, or any existing interest (full or partial) in a partnership, LLC or corporation during 2023?

Yes

INVESTMENT INFORMATION

Do you have investment income?

Yes

Did you receive interest or dividend income?

Yes

Did you sell any stocks, mutual funds, or put/call options during 2023?

Yes

Did you have a crypto currency account during 2023?

Yes

Did you sell or exchange any crypto currency during the calendar year?

Yes

Did you sell, exchange, or purchase real estate in 2023?

Yes

Did you or your spouse engage in any rental properties?

Yes

RETIREMENT OR SEVERANCE INFORMATION

Did you or your spouse have any activity from pension, retirement accounts, or annuities?

Yes

Did you take any retirement distributions?

Yes

Did you or your spouse turn 72 and have money in an IRA or other retirement account without taking any distribution?

Yes

Did you or your spouse contribute to a traditional individual retirement account (IRA), Roth IRA, or business retirement account?

Yes

Did you or your spouse contribute to a Roth IRA?

Yes

Do you or your spouse want to contribute to an existing 2023 IRA or Roth IRA by April 15, 2024?

Yes

Did you or your spouse convert an IRA or other pension plan into a Roth IRA?

Yes

Did you or your spouse roll into a Roth IRA any distributions from a retirement plan, an annuity plan, tax shelter or deferred compensation plan?

Yes

Did you or your spouse rollover amounts from a pension or IRA account to another IRA account?

Yes

Did you or your spouse receive deferred, retirement, or severance compensation?

Yes

Please provide the date received:

PERSONAL RESIDENCE INFORMATION

Do you own your home?

Yes

Did you pay property taxes during 2023?

Yes

Please provide the amount paid:

Did you pay mortgage interest during 2023?

Yes

Are your total mortgages on your first and/or second residence greater than $750,000?

Yes

Please provide the principal balance and interest rate at the beginning and end of the year.

Did you take out a home equity loan or refinance an existing mortgage in 2023?

Yes

Please provide description of what the loan proceeds were used for:

Did you sell your personal residence?

Yes

Did you receive a 1099-S

Yes

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?

Yes

Did you or your spouse ever rent out the property?

Yes

Did you or your spouse ever use any portion of the home for business purposes?

Yes

Have you or your spouse sold a principal resident within the last two years?

Yes

DEDUCTIONS & CREDITS INFORMATION

Did you make any charitable contributions during 2023?

Yes

Please select all types of charitable contributions you made in 2023:

Contributed Cash

Contributed from your IRA as a Qualified Charitable Distribution (QCD)

Contributed Property (other than cash)

Please list all contributions made:

Did you drive your car while performing volunteer duties for a charity during 2023?

Yes

Please provide the total miles you drove in this capacity.

Did you or your spouse incur any casualty or theft losses?

Yes

Please provide details:

Did you or your spouse make any large purchases, such as motor vehicles and boats?

Yes

Please provide details:

Did you or your spouse purchase a new alternative technology vehicle, including a qualified plug-in electric drive motor vehicle?

Yes

Did you install any alternative energy equipment in your residence such as solar water heaters, solar electricity equipment or fuel cells?

Yes

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?

Yes

Please provide additional details:

Did you make any home improvements?

Yes

Please provide summary of sales tax paid:

GIFTING INFORMATION

Did you or your spouse make any gifts, including birthday, holiday, anniversary, graduation, education savings, etc., with a total (aggregate) value in excess of $17,000 to any individual?

Yes

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?

Yes

Please provide more detail:

Did you or your spouse make any contributions to a trust during the year?

Yes

Please provide more detail:

Did you or your spouse forgive any indebtedness to any individual, trust, or entity?

Yes

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?

Yes

FOREIGN INFORMATION

Did you work outside of the US or pay any foreign taxes?

Yes

At any time during 2023, 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?

Yes

Please provide details of all accounts outside of the US:

Would you like us to send you a spreadsheet to input financial account details?

Yes

Were you or your spouse a trustee or beneficiary of a foreign trust, or executor of a foreign estate?

Yes

Did you or your spouse receive from or transfer money or property to a foreign trust, or a foreign corporation?

Yes

Did you or your spouse own shares in a foreign private corporation?

Yes

Did you or your spouse receive a gift from a non-U.S. person or a bequest from a foreign estate during 2023?

Yes

ESTIMATED TAX PAYMENTS MADE INFORMATION

If you made any Estimated Tax Payments during 2023, please fill out the applicable fields below:

Federal Date Paid

Federal Amount Paid

State & Date Paid

State Amount Paid

FINAL QUESTIONS

How would you like your tax return delivered to you?

Electronic Delivery

Paper Delivery

Should any potential refund be electronically deposited into your US bank account?

Yes

Would you like any PAYMENT DUE electronically withdrawn from your US bank account?

Yes

UPLOAD DOCUMENTS

Please upload any documents necessary for properly preparing your tax return, including any of the following examples:

Any forms:

1095-A
1099-SA
1099-LTC
1099-T
1099-Q
1098-E (Student Loan Slip)
W-2
1099-MISC
1099-NEC
1099-G
2023 K-1
1099-DIV
1099-INT
1099-Conslidated
1099-B
1099-R
SSA-1099
1098
1099-S

Documentation containing the name, social security number, or employee identification number of the recipient of any child or dependent care and the amount paid.
Closing documents, purchase agreements, etc. if you started a new business, purchased a new rental property, farm or acquired any new or additional interest in any partnership, LLC, or corporation during 2023.
Closing documents, purchase agreements, etc. if you sold an existing business, rental property, farm, or any existing interest (full or partial) in a partnership, LLC or corporation during 2023.
Documentation of any sale or exchange of cryptocurrencies during 2023.
Closing statements from any real estate sold, exchanged, or purchased during 2023.
A categorized list of rental income earned and expenses paid by property address including any 1099 forms or property manager reports, if applicable.
Any receipts received from charity contributions made during 2023. If you contributed property be sure the receipts describe the items donated and their value.
A purchase statement for any new alternative technology vehicle, including a qualified plug-in electric drive motor vehicle bought during 2023.
Any notifications or correspondence received from the IRS or other taxing authority of any changes to prior year returns.
A voided check, if you would like a potential refund or payment to be automatically paid or withdrawn from your bank account.

File Upload

Choose Files

Is there anything else you would like us to know?

Questions? Please reach out to your main point of contact via email or phone or call our main office line at 360.734.4280.

PERSONAL INFORMATION

DEPENDENT INFORMATION

HEALTHCARE INFORMATION

EDUCATION INFORMATION

EMPLOYMENT AND BUSINESS INFORMATION

INVESTMENT INFORMATION

RETIREMENT OR SEVERANCE INFORMATION

PERSONAL RESIDENCE INFORMATION

DEDUCTIONS & CREDITS INFORMATION

GIFTING INFORMATION

REGULATORY CORRESPONDENCE INFORMATION

FOREIGN INFORMATION

ESTIMATED TAX PAYMENTS MADE INFORMATION

FINAL QUESTIONS

UPLOAD DOCUMENTS

Contact Information

How Can We Help?

U.S. Tax with International Component - Business

U.S. Tax with Canadian Component

U.S. Tax with International Component

CAS - Client Accounting Services Information

IT Managed Services

HR Services

Marketing Services

General Information