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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

SQUARE FOOTAGE OF HOME WORK AREA

Work Area:

Total Area:

ASSETS

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Ending:

LIABILITIES

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