Personal Tax Questionnaire

Tax Questionnaire - General Information

Thank you for taking a few minutes to provide some valuable information to help ensure this year's tax preparation is a breeze. We are very excited to be working with you, and never hesitate to reach out with any questions.

1. Please provide the following contact information:
This should be the primary contact we can communicate with most regularly

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

Who will be the primary contact (list name) for communications going forward? (This will be the person who receives the e-mail notifications from the Secure Portal as we begin to exchange information) *This question is required.

2. Did all members of the household have healthcare coverage during 2019? *This question is required.

Please describe the period for which you were/were not covered during 2019: *This question is required.

How was your healthcare coverage provided? *This question is required.

Please enter an 'other' value for this selection.

3. Have you had any communications with the IRS or any other taxing authority throughout 2019 and up until now? *This question is required.

Please describe the communications with the IRS or other taxing authorities: *This question is required.

4. Are all of your bank and brokerage accounts maintained in the United States? *This question is required.

Did the aggregate balance of your foreign accounts exceed $10,000 (USD) at any point during 2019? *This question is required.

5. Is all of your primary income derived from the United States? *This question is required.

Describe the type of income earned and in what country or countries: *This question is required.

6. At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? *This question is required.

7. Did your tax situation change from last year? *This question is required.

Which of the following information has changed from 2018? Select all that apply *This question is required.

What is your filing status for 2019? *This question is required.

Please provide the following information for the SPOUSE:

Legal First Name (Full) *This question is required.

Middle Initial

Legal Last Name *This question is required.

Date of Birth (MM/DD/YYYY) *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Occupation *This question is required.

Best Email Address to contact you (for follow-up questions, as necessary) *This question is required. This question requires a valid email address.

Best Phone Number to contact you, with area code (for follow-up questions, as necessary) *This question is required.

Valid driver's license or state-issued ID? (Yes/No) *This question is required.

In order to file as Head of Household (HOH), please ensure you meet the following criteria:

You paid for more than half of the household expenses
You must be considered unmarried for the tax year
You must have a qualifying child or dependent
- The qualifying child or dependent must have lived within your home for more than 6 months during the year
- As of the end of the tax year, the child must be under 19 if he/she is not a student, or under 24 if he/she is a full-time college student
- The child must not have paid for more than half of his/her living expenses during the tax year

In order to file as Qualifying Widow(er), please ensure you meet the following criteria:

Your spouse died in 2017 or 2018
You did not remarry before January 1, 2020
You paid more than half the cost of keeping up his home
You must have a qualifying child
- The qualifying child or dependent must have lived within your home for the entire year
- As of the end of the tax year, the child must be under 19 if he/she is not a student, or under 24 if he/she is a full-time college student
- The child must not have paid for more than half of his/her living expenses during the tax year

If you chose Married Filing Separately (MFS), will Journey Advisors & CPAs, PLLC be preparing your spouse's tax return for 2019? *This question is required.

Please share the link to this survey with your spouse (if they haven't already completed), or provide their e-mail address and we will send a link directly to them. *This question is required.

Please enter an 'other' value for this selection.

Please explain why you are unsure:

Will you be adding or removing dependents for 2019?

How many children (or others) are you adding as dependents during 2019? *This question is required.

For NEW DEPENDENT #1, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For NEW DEPENDENT #2, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For NEW DEPENDENT #3, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For NEW DEPENDENT #4, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

For NEW DEPENDENT #5, please provide the following information: *This question is required.

	First Name (Full)
	Middle Initial
	Last Name
	Relationship to Taxpayer
	Date of Birth
	# of Months in Home

Names of the dependents being removed for 2019: *This question is required.

1.
2.
3.
4.
5.

Please select all of the different forms of income received relevant to 2019 for the TAXPAYER, SPOUSE and any claimed DEPENDENTS: *This question is required.

Please select all of the different forms of expenses/deductions relevant to 2019 for the TAXPAYER, SPOUSE and any claimed DEPENDENTS: *This question is required.

Please provide the following detail the 529 plan contributions during 2019:

Space Cell	Beneficiary Name	Total Contributed	Program State
1.	1.: Beneficiary Name	1.: Total Contributed	1.: Program State
2.	2.: Beneficiary Name	2.: Total Contributed	2.: Program State
3.	3.: Beneficiary Name	3.: Total Contributed	3.: Program State
4.	4.: Beneficiary Name	4.: Total Contributed	4.: Program State
5.	5.: Beneficiary Name	5.: Total Contributed	5.: Program State

You indicated that you or someone in your household had new or terminated contractor or other self-employment activities. Please briefly describe: *This question is required.

You indicated that you or someone in your household had new or terminated rental activities. Please briefly describe: *This question is required.

You indicated that you or someone in your household had new or terminated business interests. Please briefly describe: *This question is required.

Please briefly describe the real estate activities during 2019: *This question is required.

You indicated that you or someone in your household either lived or worked in multiple states during 2019. Please briefly describe: *This question is required.

Please briefly describe any other changes in your tax situation during 2019: *This question is required.

8. Would you like to e-file or paper file your return(s)?
(There may be additional charges for paper filing) *This question is required.

9. Would you like to set up direct deposit or auto debit for any tax refund or tax due, respectively?
(Bank account number(s) will be obtained at a later date, prior to filing, and this option can be changed later) *This question is required.

Is the account checking or savings? *This question is required.

Please enter an 'other' value for this selection.

What is the name of the bank?
(Note: we will get account details later via phone or other secure message) *This question is required.

10. Any other comments, questions, or information we should know?