WETTER
& CONVERTINI
Tax Organizer Part Two
INTEREST: Attach 1099 Forms
| Payor | Amount |
|---|---|
| 1 | $ |
| 2 | $ |
| 3 | $ |
| 4 | $ |
Dividends - Attach 1099 Forms
| Payor | Total | Capital Gain |
Ordinary Dividend |
|---|---|---|---|
| 1 | $ | $ | $ |
| 2 | $ | $ | $ |
| 3 | $ | $ | $ |
| 4 | $ | $ | $ |
State Tax Refund
Amount Received$___________________
Check if you did not itemize
in prior years
Capital Gains
| Description | Date Acquired |
Date Sold |
Sales Price |
Cost or Basis |
|---|---|---|---|---|
| 1 | $ | $ | ||
| 2 | $ | $ | ||
| 3 | $ | $ | ||
| 4 | $ | $ |
Pensions/IRA Distributions - Attach Form 1099 / W-2s
| Payor | Gross
Distribution |
Taxable Amount |
|---|---|---|
| 1 | $ | $ |
| 2 | $ | $ |
Check box if Federal or State
Tax was withheld
Alimony Received
Payor________________________ Amount$___________
Payor's Social Security #_______________________________
Unemployment Received
Taxpayer Amount $________________
Spouse Amount $_________________
Social Security Received
Taxpayer Amount$_______________
Spouse Amount$_________________
Miscellaneous Income
Description:________________________________
_________________________________________
__________________________________________
Medical and Dental Expenses
Insurance Premiums (Net) ___________________
Doctors, Dentists, etc.______________________
Taxes Paid
State & Local Income Tax____________________
Real Estate Taxes - Residence_________________
Real Estate Taxes - Other Property______________
Auto License:
No. of Cars Fees Paid _______________________
Personal Property Taxes____________________
Other Taxes_____________________________
Interest Paid - Attach 1098 Forms
Home Mortgage Interest Paid (1st)____________________
Home Mortgage Interest Paid (2nd)____________________
Contributions - Attach Details
Contributions by Cash or Check____________________
Contributions by Other than Cash__________________
Miscellaneous Deductions
Unreimbursed Employee
Business Expenses____________________
Union /Professional Dues_______________
Investment Expense____________________
Tax Return Preparation Fees______________
Safe Deposit Box Rental_________________
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