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Please check the appropriate boxes and
provide additional information if necessary. |
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Yes |
No |
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Were there any changes in dependents?
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Did you receive or exercise any stock options?
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Do you own any stocks that became worthless during the year?
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Did you purchase, sell or refinance your home, or did you take a new home equity loan?
If so, please provide a copy of the escrow statement.
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Did you make a contribution to a retirement plan ( 401(k), IRA, SEP, SIMPLE,
Qualified Plan, etc.) ?
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Did you, your spouse, or a dependent incur any tuition expenses that are required
to attend a college, university or vocational school?
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Did you purchase any motor vehicles or boats last
year? If so, please provide
documentation containing the sales tax paid.
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Did you use your car on the job (other than to and from work) ?
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Do you expect this
year's taxable income and withholdings to be different from
last year's?
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Do you want to allocate $3 to the Presidential Election Campaign Fund?
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Did you incur moving expenses due to a change of employment?
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Did you receive any notices from either the Internal Revenue Service or the State
taxing agency? If so, please provide copies of the notices.
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Did you or your spouse make any gifts to an individual that total more than $12,000?
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Do you have a living trust?
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