James R. Kay, CPA

Helping you keep more of what you earn !

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QUESTIONNAIRE  1

Answering these questions may help us reduce your taxes, or avoid adjustments by the IRS.

When you finish, click on "Submit" at the bottom of the page.


Your Name:

Phone Number:

E-mail Address:

not required, but handy if you have one.

Yes No??

1. Did your marital status change in 2009?

Yes No??

2. Is there someone living in your home that you are not claiming as a dependent?

Yes No??

3. Do you employ a household worker?

Yes No??

4. Do you have children that depend upon you for their support?

Yes No??

5. If you have dependent children, did any of them earn interest, dividends, sell stock, or earn wages during 2009?

Yes No??

6. Do you, your spouse, or children own US Savings Bonds?

Yes No??

7. Did you buy a home in 2009?  If so, I need a copy of the settlement statement.

Yes No??

8. Did you sell a home in 2009?  If so, I need a copy of the settlement statement.

Yes No??

9. Did you move in 2009 because of a job change?

Yes No??

10. Did you move to Texas from another state in 2009?

Yes No??

11. Did you file a federal income tax return for 2008?

Yes No??

12. Did you file a state income tax return for 2008?

Yes No??

13. Did you refinance your home during 2009?

Yes No??

14. Did you refinance your home or second home in 2009?

Yes No??

15. Did you inherit any property during 2009?

Yes No??

16. Did you sell any stocks, bonds or other securities during 2009?

Yes No??

17. Were you granted any stock options during 2009?

YesNo ??

18. Did you exercise any stock options during 2009?

Yes No??

19. Did you receive any distributions from a retirement account, 401(k), IRA, etc. in 2009?

Yes No??

20. Did you make any contributions to an IRA or Roth IRA for 2009?

Yes No??

21. Are you considering making an IRA or Roth IRA contribution for 2009?

Yes No??

22. Are you self-employed?

Yes No??

23. Do you have vacation property or a second home?

Yes No??

24. Do you own a boat, trailer, cabin, etc. that has eating and sleeping facilities?

Yes No??

25. Have you loaned money to a friend or relative that has not been re-paid?

Yes No??

26. Did you purchase a vehicle, boat, motorcycle, or ATV during 2009?

Yes No??

27. Did you receive any oil and gas royalties in 2009?

Yes No??

28. Do you own any rental property?

Yes No??

29. Do you own any vacant land?

Yes No??

30. Do you work in a home office because your employer does not provide an office for you?

Yes No??

31. Did you purchase a hybrid vehicle during 2009?

Yes No??

32. Did you pay any student loan interest during 2009?

Yes No??

33. Did anyone in your household pay tuition to attend school during 2009?

Yes No??

34. Did you have a large amount of medical expenses during 2009 that were not reimbursed by insurance?

Yes No??

35. Did you make any charitable donations by cash, check, or charge during 2009?

Yes No??

36. Did you make charitable donations thru payroll deductions at work during 2009?

Yes No??

37. Did you donate any items like clothing to charity during 2009?

Yes No??

38. Did you do volunteer work for church, school, etc. during 2009?

Yes No??

39. Did you pay any adoption expenses during 2009?

Yes No??

40. Do you pay for childcare that was not reimbursed by an employer sponsored plan?

Yes No??

41. Did you pay or receive alimony in 2009?

Yes No??

42. Do you own any investments that are worthless or near worthless?

Yes No??

43. Did you receive any social security payments during 2009?

Yes No??

44. Did you receive unemployment benefits during 2009?

Yes No??

45. Do you have a foreign bank account or similar foreign financial account?

Yes No??

46. Did you have any gambling winnings during 2009?

Yes No??

47. Did you have any job hunting expenses in 2009?

Yes No??

48. Did you gift money or property to someone in excess of $12,000 during 2009?

Yes No??

49. Did you purchase building materials to make improvements on your home during 2009?

Yes No??

50. Are you or your spouse a K thru12th grade teacher, instructor, counselor, principal or aide during 2009?

Yes No??

51. Were you a National Guard reservist or Armed Forces reservists during 2009?

Yes No??

52. Did you make any quarterly estimated tax payments during 2009?

Yes No??

53. Do you have a Health Savings Account (HSA) or Medical Savings Account (MSA)?

Yes No??

54. Did you pay health insurance premiums without the help of your employer during 2009?

Yes No??

55. Did you have a significant loss of property or property value due to fire, storm, theft or other casualty during 2009?
Additional information you want to make me aware of: