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YOUR GROSS INCOME IS LESS THAN 500K.
YOU HAVE LESS THAN 4 DEPENDENTS.
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If you do not select the tax year, it is assumed to be current tax year, 2023.

Your First Name:*
 Your Last Name:*
 Email:*
 Spouse First Name:
 Spouse Last Name:
 City:*
 State:*
Filing Status:
Form W-2 Box 1(Wages):*
 Unemployment Compensation:*
 Form W-2 Federal income tax withheld:
 Form 1099 Federal income tax withheld:
 What was your state refund in 2022?
 IRA Distribution:
 IRA Taxable Income:
 Pension Gross Distribution:
 Pension Taxable Income:
 Soc. Sec. Distribution:
 Soc. Sec. Taxable Income:
Interest Income:
Who Paid the Interest?
 Corporation's Gross Receipts:
Returns/Allowances:
Advertising:
 Car Expense:
Commission:
 Personal Insurance:
Legal:
Office Expense:
Car, Equip., Machine Rental:
Other Property Rental:
Equipment Repairs:
 Supplies:
 Sale Tax:
 Personal Property Taxes:
 State / Local Taxes:
Self Employment Taxes:
Real Estate Taxes:
Travel:
 Meals:
 Utility:
 Business Wages:
Business Miles: 		Cash Gift:
 Mortgage Interest:
Home Business Insurance:
Home Business Rent:
 Home Business Repair/Maint.:
 Home Business Utility:
 Job Education Expense:
 Union Dues:
 Bank/Convenience Fee:
 Gambling Losses:
Tax Preparation:
 Medical Expense:

DEPENDENTS
 Did Dependent #1 live with you > 1/2 of the year?
Is Dependent #1 Under 17 Years Old?
 Dependent #1 Name:
Dependent #1 Relationship to You:
 Dependent #1 Type of Credit:
Did Dependent #2 live with you > 1/2 of the year?
Is Dependent #2 Under 17 Years Old?
 Dependent #2 Name:
Dependent #2 Relationship to You:
 Dependent #2 Type of Credit:
 Did Dependent #3 live with you > 1/2 of the year?
Is Dependent #1 Under 17 Years Old?
Dependent #3 Name:
Dependent #3 Relationship to You:
 Dependent #3 Type of Credit:
 Did Dependent #4 live with you > 1/2 of the year?
Is Dependent #1 Under 17 Years Old?
 Dependent #4 Name:
Dependent #4 Relationship to You:
 Dependent #4 Type of Credit:

Company Type:
Date of Incorporation: Month Day Year
Made Payments Require Form 1099?
Were Form 1099 Filed?
Your Job Title:
 Spouse Job Title:
Product/Service:
Business Activity:
Business Code:

EXPENSE NAMES

 COSTS

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Work Area:

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