INSTRUCTIONS     
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1. Please use the menu on your left to navigate
2. Please fax your w2s at 1 [484] 932-7779
3. See engagement terms
4. Fill out as much information as you can, our tax professionals will do the rest.

Questions? email us at info@tax-usa.net or call us at 1 [888] 875-2668
 


Tax Year

Taxpayer and Spouse 
 
  Tax Payer Spouse
Last Name
First Name
Social Security Number
Date Of Birth
Blind ?
Over 65 by 12.31?
Filing Status

Names:
Should be entered exactly as they appear on the social security card or the IRS tax ID number notice: first, middle initial and last name.

Social security number:
If you don't have social security enter Tax ID Number.  

Contact Information

Street
Apartment
City
State
Zip Code
Home Phone Number
Work Phone Number
Email Address

Address:
Current address to which you want any refund or tax correspondence to be mailed to.
   


Children/Dependants

Name Social Security Number Date Of Birth Relationship Months Lived at Tax payer Home Day Care Expense

Months lived:
During the tax year.

Day care expense:
Does not include school tuition or overnight camps, just daycare and other caregiver expenses.

 
 
Day Care Providers
Name Address Tax ID # Expenses    
   
   
   
Employer day care expense plan      

Employer day care expense plan:
enter the amounts you have been reimbursed for by the employer's plan.

Working Visa Holders

Tax Payer Spouse

Date you have first entered the US on the current visa
Dates you have left the US this tax year
Dates you have entered the US this tax year
Visa Type
Visa Number
 
Date of arrival:
The date you first arrived to the US for relocation on the current working visa.

Visa number:
From the visa page in your passport. 
 


Wages

Tax Payer

Spouse
Employer Name
Employer Street Address
Employer City
Employer State
Employer Zip Code
Employer EIN
Wages
Federal Tax Withheld
Social Security Wages
Social Security Tax Withheld
Medicare Wages
Medicare Tax Withheld

 

Interest Income / Dividends

Bank 1  Bank 2

Bank Name

Interest Income

Interest Income From US Government
Dividend Income
Qualifying Dividend Income

 

Stock Sales

Stock 1 Stock 2 Stock 3 Stock 4
Stock Name
Number Of Stocks
Date Of  Purchase
Cost
Date Of Sale
Sale Price

Stock name:
Stock symbol or Company's name.

Cost:
(number of stocks * purchase price) - commissions.

Proceeds:
(number of stocks * purchase price) - commissions. 


Sale Of rental Property

Property Description
Date Of Purchase
Cost
Date Of Sale
Sale Price

Cost:
amount paid for the property - purchase expense.

Proceeds:
amount received for the property - sale expense
 


Rental Income

Property Description
Address
State
Property Cost  
Rental Furniture  
Date Placed In Service  
Income  
Expenses:
Mortgage Interest  
 Travel  
Management Fee  
Repairs  
Expense Type / Amount
Expense Type / Amount
Expense Type / Amount


Cost:
Amount paid for the property - purchase expense. If received as a gift or inherited enter the fair market value on the receipt date.
 
Date Placed In Service:
Date on which the property was first rented.

Business Income

Business Name
Address
State
Description  
Income  
Expenses:
Cost of Goods Sold  
Expense Type / Amount 
Expense Type / Amount
Expense Type / Amount
Expense Type / Amount
Expense Type/ Amount
Expense Type / Amount

 


Other Income

State Tax Refund
Did you itemized last year deductions?  (Check for yes)
Alimony Received  
Retirement Income
Retirement Income Payer Name
Pension Income
Unemployment Income
Unemployment  State
Unemployment Federal Tax Withheld
Unemployment State Tax Withheld
Social Security Benefit
Social Security Federal Tax
Jury Duty
Gambling Winning
Foreign Income    Employer Name & Address  
Scholarship
Check if recipient of scholarship a degree student?
Other Income
Other Income Description
 


Expenses

IRA Contributions
Roth IRA Contributions
Moving Expenses (over 50 miles)
Alimony Paid Recipient SS#
Medical Saving Account
Medical & Dental Expenses
State and Local Tax Paid
Real Estate Tax Paid
Personal Property Tax Paid
Mortgage Interest  Bank Name/ Address
Points and Fees On Principal Residence
Investment Interest
Cash Contributions
Non Cash Contributions Organization
Casualty Theft or Loss
Job Search Expenses
Business Use Of  Home
Business Travel
Tax Preparation Fees
Tuition Amount   Student (s) Name (s)
Other Expenses Amount  Description

Credit / debit card information:
(for other forms of payment submit the form with out credit card information and call us

 
1. Card:* 

2. Card Holder' Name
First Name:*
Last Name:*

3. Card Holder' Full Address:*
 Street number & name
 Suite number
 ,
 City, State & Zip Code

4. Card Number:*  

5. Card Expiration Date:* Month/ Year       

6. Payment

Due before discount see fees
Discount
Discount Code  
Due After Discount

7. Your Initials* here to confirm the payment calculated above:

8. Name:* Date:*

 

Send The Information
Enter here any comments or questions you have and click "send the information" button.

By submitting your information you agree to the following Engagement Terms:

Tax USA Inc.
11350 Random Hills Rd.
Suite 650
Fairfax, Virginia 22030
Info@tax-usa.net
Tel: 1-888-875-2668
Fax: [484] 932-7779

DEFINITIONS
The words "We" and "Our" shall mean Tax USA Inc.

GENERAL
This letter confirms our understanding of the terms and objectives of our tax services engagement and to clarify the nature and conditions of the tax services to be provided.

THE SERVICE
We will prepare the federal and state income tax returns for the current calendar year or any other calendar year up to 3 years back.

FEES
Our fees for tax services are listed on the website in the "Our Fees" section.

DELIVERY
Our tax return preparation engagement ends upon delivery of your tax returns for filing.

PRIVILEGED COMMUNICATION
Certain communications involving tax advice between you and our firm may be privileged and not subject to disclosure to the IRS.

Sincerely,
Tax USA Inc.

By checking the terms acceptance field you assert that you understand and agree to the terms of the engagements as listed above.