1700 Iowa Street Bellingham, WA 98229 t: (360) 671 - 1845 f: (360) 671 - 2247 office@genebellassociates.c om www.genebellassociates.com Gene R. Bell, E.A., NTPI Fellow ® , CFP ® Registered Representative Secu rities offered through Avantax Investment Services SM , Member FINRA, SIPC, Investment a dvisory services offered through Avantax Advisory Services SM , Insurance services offered through Avantax Insurance Agency SM Gene Bell & Associates is not a registered broker/dealer or registered investment advisory firm. ◊ Gene Bell & Associates is not a licensed CPA firm. Dear Valued Tax Client, Tax season is upon us again and we have enclosed our Tax Organizer Packet to help you gather your tax information. Once all of your tax information is gathered, you can mail or deliver it to our office at your convenience. We will not begin preparing your tax return until all information is made available to us, so please make your submission as complete as possible. If you would like to meet and discuss your tax return information, an appointment will be necessary; please contact our office to schedule a time that works for you. The filing dead line this year is April 15 , 20 20 To ensure your return is completed on time, we must receive your tax information by March 17 , 20 20 If we have not received your information by this date, you may be subject to additional fees and an extension may need to be filed; please refer to the enclosed engagement letter for details. If you have any questions or concerns, please do not hesitate to contact our office. Thank you for your trust and confidence in our services; we look forward to seeing you soon. Sincerely, Gene Bell & Associates Tax Packet Instructions Your tax packet includes the following items, those marked with an asterisk are required items; we cannot begin the preparation of your tax return until these items are returned to our office. *Tax Engagement Letter -- This engagement letter confirms that you are engaging our office to prepare your income tax return. You must sign and date the engagement letter every year and return it with your tax information. If you are filing a joint return, both you and your spouse must sign the engagement letter. *Questionnaire -- The questionnaire contains questions that help us determine whether or not recent tax law changes will benefit you. You must complete this questionnaire every year and return it to our office with your tax information. Consent Form -- Our firm provides services beyond tax preparation through Avantax Wealth Management SM and its affiliates (“Avantax”). Going forward, all emails sent or received by our firm are now required to be archived by Avantax. Due to IRS regulations, we must have your signed written consent on file. If you choose not to sign these consents, we will no longer be able to send you any emails regarding your tax return, including important updates or time-sensitive requests. Tax Organizer -- The tax organizer is designed to assist you in collecting and reporting information necessary for us to properly prepare your income tax return. Please complete this organizer as appropriate and include supporting documentation. Fee Schedule -- A fee schedule is included for your review. Please note that our minimum fee for a personal tax return is $400. We will continue to offer our prepayment discount this year. If you prepay $350 you will receive a $50 discount on your total tax preparation fee. If your tax preparation fee is more than $400, the remainder will be due at the time of pickup. As a reminder, your tax return will not be filed until your invoice has been paid in full and your e-file authorization form has been signed. Please remember to allow up to 4 weeks for us to prepare your tax return. We will call you when your tax return is complete and ready for you to review and sign. Page 1 of 2 Tax Return Annual Engagement Letter Between Gene Bell & Associates & _______________________________ For year ending 201 9 We are pleased to confirm our understanding of the arrangements for your income tax return(s). This letter confirms the services you have asked our firm to perform and the terms under which we have agreed to do that work. Please read this letter carefully because it is imp ortant that you understand what you can a nd cannot expect from our work and the limitation s of the services you have asked us to perform. If you have any questions or concerns, please contact our office before signing this engagement letter. This engagement letter represents the entire agreement regarding the services described herein and sup ersedes all prior negotiations, proposals, representations or agreements, written or oral, regarding these services. It shall be binding on the heirs, successors and as signs of you and us. The Internal Revenue Service imposes penalties on taxpayers, and on us as tax return preparers, for failure to observe due care in reporting for income tax returns. In order to ensure an understanding of our mutual responsibilities, we ask all clients for whom we prepare tax retur ns to confirm the following arrangements. Tax Preparer Responsibilities 1 . We will prepare your required Federal Income Tax Forms and Schedules for the year - end as stated above If you have a state filing requirement, you are responsible for providing our firm with all of the information necessary to prepare any applicable state(s) or local income tax return ( s ) as well as informing us of the applicable state(s) and/ or localities. Any other required services, forms or other actions on our part require a separate engagement lette r. In the absence of written communications from us documenting such services, our services will be limited to and governed b y the terms of this engagement letter. We will not audit, review, compile or otherwise verify the data you submit although we may a sk you to clarify some of the information. We are not responsible for tax returns prepared by other tax preparers and / or firms . We may furnish you with tax organizers and questionnaires to help you gather and organize the necessary information for us, in order to keep our fee to a minimum. 2 . We will use our professional judgment in preparing your tax return ( s ) . Whenever we are aware that a possibly applicable tax law is unclear or that there are conflicting interpretations of the law by authorities (e.g., tax agencies and courts), we will explain the possible positions that may be taken on your tax return. We will adopt whatever position you request on your tax return so long as it is consistent with the codes, regulations, and interpreta tions that have been promulgated. If the Internal Revenue Service should later contest the position taken, there may be an as sessment of additional tax plus interest and penalties. We assume no liability for any such additional penalties or assessments. Pl ease note, when a self - employed taxpayer reduces taxable income there is also a reduction in earned income reported to the Social Security Administration, which could reduce current and /or future benefits for the taxpayer and his or her dependents. You ack nowledge and agree to the current tax reduction and the potential effects on future social security benefits for you, your spouse and any dependents. Taxpayer Responsibilities 3 . A ny person subject to the jurisdiction of the United States (includes individuals, corporations, partnerships, trusts, and est ates) having a financial interest in, or signature or other authority over, bank accounts, securities, or other financial accounts having an aggregate value exceeding $10,000 in a foreign country, shall report such a relationship. Although there are some limited exceptions, filing requirements also apply to taxpayers that have direct or indirect control over a foreign or domestic enti ty with foreign financial accounts, even if the taxpayer does not have foreign account(s). Failure to disclose the required information to the U.S. Department of the Treasury may result in substantial civil and/or criminal penalties If you do not provide our firm with information regarding any interest you may have in a foreign account, we will not prepare any of the required forms and penalties may be due for which we have no responsibility. In the absence of such information being provided we will presume you do not have any foreign assets or financial interests and will not file any applicable disclosure forms without separate written authorization. 4 . If you and/or your entity have a financial interest in any foreign accounts, you are responsible for either filing Form FinCEN 114 or an extension for Form FinCEN 114 , required by the U.S. Department of the Treasury , on or before April 15 th of each tax year. T here is a 6 - month extension available only for those who also file an extensio n for their fe deral income tax r eturn. A U.S. citizen living abroad who is entitled to file his or her tax return by June 15 th rather than April 15 th will also have until June 15 th to file the Form FinCEN 114 5 . T he Internal Revenue Service, under IRC §6038 and §6046, requir es information reporting if you are an officer, director or shareholder with respect to certain foreign corporations (Form 5471); foreign - owned U.S. corporation or foreign corporation engaged in a U.S. trade or business (Form 5472); U .S. trans feror of property to a foreign corporation (Form 926) ; and, for taxable years beginning after March 18, 2010, if you hold fo reign financial assets with an aggregate valu e exceeding $50,000 (Form 8938) . These code sections de scribe the information required to be reported on the respective forms, which are due when your income tax retur n is due, including extensions. Failure to timely file may result in substantial monetary penalties. By your signature below, you accept responsibility for informing us if you believe that you fall into one of the above categories and you agree to provide us wi th the information necessary to prepare the appropriate form(s). We assume no liability for penalties associated with the failur e to file or untimely filing of any of thes e forms. 6 . It is your responsibility to maintain, in your records, the documentation necessary to support the data used in preparing y our tax return ( s ) , including but not limited to the required documents to support auto, travel, entertainment, charitable contributions , and related expenses for four years from the filing date. If you have any questions as to the type of records required, please ask us for advice in that regard. It is als o your responsibility to carefully examine an d approve your completed tax return (s) before signing and filing your tax return (s) . We are not responsible for the disallowance of doubtful deductions or inadequately supported documentation, nor for resulting taxes, penalties and interest. We will rely, without further verification, upon information you provide to us including, but not limited to: K1’s, 1099’s, 1098’s, W2’s and receipts and similar items. Other Items 7 . We must receive all information for your tax return by March 1 7 , 20 20 to ensure that it will be completed by April 1 5 , 20 20 If we receive your information after March 17 , 20 20 , and you want to file your return by April 1 5 th (i.e. no extension), you will be subject to an expedited fee from our office of an additional 30%. If we have not received all of your information by March 17 , 20 20 , we cannot guarantee that your return will be filed on time and you may be subject to lat e filing or late payment penalties from the government agencies. We do not file tax extensions for clients unless specifically requested to do so. Tax extensions are only for an extension of time to file the tax return; tax payments are still due by the du e date. If taxes are owed, we will attempt to accurately estimate these at the time of filing the exten sion; however, p enalties and interest may still be assessed. Please note the 30% expedited fee will not be assessed by our office if an extension is file d and your information is received by September 3 , 20 20 Page 2 of 2 8. Our fee does not include responding to inquires or examination by taxing authorit ies or third parties. However, we are ava ilable to represent you in these matters; our fees for such s ervices are at our standard rates and would be covered under a separate engagement letter. You agree to immediately notify us upon the receipt of any correspondence from any agency covered by thi s letter. Please do not respond to or click on any links in emails purportedly from the IRS. T he IRS never initiates correspondence via email and any such attempts are fraudulent 9 . P rivacy laws prohibit us from providing confidential information or copies of confidential information to anyone other than you without your specific, writte n authorization. Our Consent Form (available upon request) must be signed and returned before we will release your tax infor mation to anyone other than you. Upon your request, we will provide a n additional copy of your tax return(s) to you, please note that there is a fee for additional copies of tax returns, please see the current fee schedule for more information. 10 . If we are asked to disclose any privileged communication, unless we are required t o disclose the communication by law, we will not provide such disclosure until you have had an opportunity to argue that t he communication is privileged. You agree to pay any and all reasonable expenses that we incur, including legal fees, t hat are a result of attempts to protect any com munication as privileged. In addition, your confidentiality privilege can be inadvertently waived if you discuss the contents of any privileged communication with a third party, such as a lending i nstitution, a friend, or a business associate. We recommend that you contact us before releasing information to a third party. 11 . From time to time various third parties may request that we sign, for you, some verification of income, employment or tax f iling status. Because we were engaged only to prepare your i ncome tax return, without examination, review, audit or verification our insurance carriers as well as the state board of accountancy prohibit us from signing any such document and we suggest that you have them send IRS Form 4506 to the I RS to obtain such verification. 12 . It is our policy to keep records rela ted to this engagement for four years after which they are destroyed. However, we do not keep any original client records, so we will return those to you at the completion of t he services rendered und er this engagement. When records are returned to you, it is your responsibility to retain and prote ct your records for four years for possible future use, including potential examination by any government or regulatory age ncies. Prior to each tax filing se ason, we send client organizers to our clients as a convenience to assis t them with gathering their tax information. If you move, please notify us or we will send the organizer to the address we used on your prior year’s tax return. 13 In the interest of facilitating our services to you, we utilize a secure web portal. Your use of this portal mu st comply with our portal policy (available upon request) and is limited to lawful income tax related documents and/or correspondence from relevant taxi ng authorities and agencies . Your documents will be maintained and accessible solely in accordance with our portal policy for no more than 30 days. After any n otification of termination of services by either party, your information will be electronically d eleted and your secure portal will be deactivated. As owners of the portal we retain the right to limit and deny use of the portal for inappropriate purposes. While we w ill use our best efforts to keep communications secure in accordance with our obligatio ns under applicable laws and professional standards, you recognize and accept that we have no control over the un authorized interception of communications once they have been sent and consent to our use of such delivery methods during this engagement. In t he interest of maintaining service quality and timeliness, we may use a 3 rd party service provider to assist us in the use of technology to facilitate compliance with di sclosure and storage of your information. The provider has established procedures and c ontrols designed to protect client confidentiality and maintain data security. 14 Fees for our services will be at our standard rates . Please review the attached fee schedule. Our invoices are due and payable at the time of service/pick - up. Tax ret urns w ill not be filed until payment is received. Billings become delinquent if not paid within 30 days of the invoice date. If billings are not paid within 60 days of the invoice date, at our election, we may stop all work at our discretion until your accoun t i s brought current, or we may withdraw from this engagement. You acknowledge and agree that we are not required t o continue work in the event of your failure to pay on a timely basis for services rendered as required by this engagement letter. You further a cknowledge and agree that in the event we stop work or withdraw from this engagement as a result of your failure to pay on a timely basis for services rendered as required by this engagement letter, we shall not be lia ble to you for any damages that occur as a result of our ceasing to render services. Our services will conclude upon deliv ery of the completed income tax returns discussed above or upon our suspension of services or resignation from the engagement. 15 . In recognition of the relative risks and benefits of this agreement to both you, the client , and Gene Bell & Associates, the client and our firm have discussed and have agreed on the fair allocation of risk be tween them. As such, the client agrees, to th e fullest extent permitted by law, to limit the liability of Gene Bell & Associates to the client for any and all claims, losses, costs, and damages of any nature whatsoever, so that the total aggregate liabilit y of Gene Bell & Associates to the client sha ll not exceed Gene Bell & Associates’ total fee for services rendered under this agreement. Th e client and Gene Bell & Associates intend and agree that this limitation apply to any and all liability or cause o f action against Gene Bell & Associates , howeve r alleged or arising, unless otherwise prohibited by law. Both parties agree that there is a one - yea r limitation period to bring a claim against us for errors and omissions. The one - year period will begin upon the date of the tax pr eparer’s signature on th e tax return ( s ) covered by this engagement letter. Please sign and date this letter to acknowledge your agreement with and acceptance of your responsibilities and the terms of this engagemen t. I f filing a joint tax return, both parties’ signatures are req uired. It is our policy to initiate services after we receive the executed engagement letter. If any provision of this a greement is declared invalid or unenforceable, no other provision of this agreement is affected and all other provisions remain in full force and effect. We appreciate the opportunity to serve you. Sincerely, Gene Bell & Associates I have read the above terms of the engagement letter and agree with the terms of this engagement. _ __________________________ ________ ____________________________ _______ Client Signature Client Signature ___________________________ ________ ___________________________ ________ Date Date New Email Policy & Conse nt Forms As you may know, Gene Bell is affiliated with Avantax Wealth Managemen t SM and its affiliates (“Avantax”) as an independent contractor for the purpose of providing clients with financial services and products. The sec u rit ies laws and regulations require Avantax to capture, retain and supervise our electronic communications between you and our firm, regardless of the sender or recipient. Going forward, all emails received or sent by our firm are now required to be arc hiv ed by Avantax. These communications include your emails and attachments, which may contain tax return information. Avantax will protect the confidential natur e of this information by disclosing it only in response to lawful requests made by state or fed era l securities regulators, or otherwise as required by law. Due to this new policy, there are additional consent form s in your tax organizer packet. These consents are required by the IRS, and we must have them signed and on file to continue to send and re ceive email correspondence from you in regard to your tax return. We are requesting that you please sign and return th ese consent s with your tax information. Please note , if you ch o ose not to sign the se consent s , we will no longer be able to send you a ny emails regarding your tax return, including important upda tes or time - sensitive requests. If you have any questions about this new policy, or the consent form s , please do not hesitate to contact us. 1700 Iowa Street, Bellingham, WA 98229 | t: ( 360 ) 671 - 1845 | f: (360) 671 - 2247 | office@genebellassociates.com | www.genebellassociates.com Consent for Disclosure of Tax Return Information Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose your tax return information to third parties for purposes other than the preparation and filing of your tax return without your consent. If you consent t o the disclosure of your tax return information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form to engage our tax return preparation services. If we obtain your signatu re on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature. Consent I/We, __________________________________ , authorize Gene Bell & Associates to disclose my /our t ax r eturn i nformation , which includes but may not be limited to all communications with Preparer and any information Preparer derives or generates from my tax return(s) , to: (a) Avantax Investment Services SM (AIS), a registered broker - dealer ; (b) Avantax Advisory Services SM (AAS), a registered investment adviser; and (c) affiliates of those entities (collectively, “Avantax”), all of which are headquartered at 6333 N. State Highway 161, 4 th Floor, Irving, Texas 75038. I /We understand that Gene Bell & Associates is not a registered broker - dealer or a registered investment adviser I /We understand that Gene Bell is affiliated with Avantax as an independent contractor solely for the purpose of offering financial products and services Avantax does not offer, provide or supervise tax advice or tax preparation services , and any services provided by Avantax will be pursuant to a written agreement directly with the relevant Avantax entity. I/We specify the duration of this consent to be three yea rs from the date of signature, unless specified otherwise. _____________________________________________________________ Taxpayer Signature Date _____________________________________________________________ Spouse Signature Date If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1 - 800 - 366 - 4484, or by email at complaints@tigta.treas.gov 1700 Iowa Street Bellingham, WA 98229 | t: (360) 671 - 1845 | f: (360) 671 - 2247 | office@genebellassociates.com | www .genebellassociates.com Consent to Use Tax Return Information Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use your tax return information for purposes other than the preparation and filing of your tax return without your co nsent. You are not required to complete this form to engage our tax return preparation services. If we obtain your signature on this form by conditioning our tax return preparation services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year from the date of signature Consent I/We , __________________ , authorize Gene Bell & Associates to use my/our tax inform ation, for the purpose of offering the following service s, including but not limited to: financial planning, retirement planning, long - term care and life insurance, estate and gift tax planning, business consulting, individual and business tax planning , an d bookkeeping services I/We also consent to the use of my/our tax information for purposes of communicati ng with me/us via newsletter, e mail, website, phone or other means of communicating with information or data that may be of use to me/us, and at my/o ur request, for the purpose of making recommendations to me/us, for any of the purposes listed above. I/We specify the duration of this consent to be three years from the date of signature, unless specified otherwise. ____________________________________ _________________________ Taxpayer Signature Date ________________________________________________________ ___ __ Spouse Signature Date If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law o r without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1 - 800 - 366 - 4484, or by email at complaints@tigta.treas.gov 1700 Iowa Street Bellingham, WA 98229 | t: (360) 671 - 1845 | f: (360 ) 671 - 2247 | office@genebellassociates.com | www.genebellassociates.com Please review the following items and check the appropriate box as they pertain to you or your spouse for 2019. Please provide additional information as necessary. PERSONAL INFORMATION Yes No 1) Did your marital status change during the year? 2) Did your address change during the year? 3) Could you be claimed as a dependent on another person's tax return for 2019? 4) Did you receive an Identity Protection PIN (IP PIN) letter from the IRS? If so, please provide. NOTE: we cannot e-file your tax return without this PIN. DEPENDENTS 5) Were there any changes in dependents? (For newborns, please provide social security card. For an adopted or foster child, please provide social security card and court documents.) 6) Were any of your unmarried children who might be claimed as dependents 19 years of age or older at the end of 2019? 7) Did any of your dependent children have income in 2019? If so, please provide details. 8) Do your dependent children have any investment accounts (e.g. UGMA/UTMA, 529 College Plan, Trust Accounts)? If so, please provide details and current statements. HEALTH CARE 9) In 2019 did you and/or your dependents have healthcare coverage obtained on a Health Insurance Marketplace/Exchange or receive an advance of the Premium Tax Credit? If so, please provide Form(s) 1095-A. 10) Did you have a Health Savings Account (HSA) or acquire an interest in an HSA because of the death of the account holder? If so, please provide Form(s) 1099-SA and Form(s) 5498-SA. 11) Did you have a medical savings account (MSA), a Medicare + Choice MSA, or acquire an interest in an MSA or a Medicare + Choice MSA because of the death of the account holder? 12) Were you a policyholder who received payments under a long-term care (LTC) insurance contract or received any accelerated death benefits from a life insurance policy? INCOME 13) Did you or your spouse change jobs in 2019? 14) Did you receive unreported tip income of $20 or more in any month? If so, please provide details or IRS Pub 1244. 15) Did you cash any Series EE U.S. savings bonds issued after 1989 and pay qualified higher education expenses for yourself, your spouse, or your dependents? ORGANIZER 2019 1040 US Miscellaneous Questions Miscellaneous Questions Yes No 16) Did you receive any disability income? 17) Did you have any foreign income and/or pay any foreign taxes? If so, please provide foreign wage statement and foreign tax return. 18) Did you pay or receive alimony/spousal maintenance in 2019? (Do not include child support). FOREIGN ACCOUNTS 19) Did you have an interest in or signature or other authority over a financial account in a foreign country, such as a bank account, securities account, or other financial account? Please provide year end statements if combined account totals were greater than $10,000 at any time during the year. 20) Did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If so, please provide trust documents and year end bank statements. 21) Do you own any real estate outside of the U.S.? If so, please provide details. 22) Do you have financial accounts maintained by a foreign (non-U.S.) bank or financial institution that totaled more than $50,000 on the last day of the year or more than $75,000 at any time during the year ($100,000 and $150,000 respectively if married filing a joint return)? 23) Do you own any other foreign financial assets that are not held in a financial account, such as stock in foreign corporation or an interest in a foreign partnership? PURCHASES, SALES AND DEBT 24) Did you start a business or farm, purchase rental or royalty property, or acquire an interest in a partnership, S corporation, trust, or REMIC? 25) If you operate a trade or business, did you make any payments in 2019 that would require you to file Form(s) 1099? If so, did you or will you file the required Form(s) 1099? 26) Was your home rented out or used for business? If so, please provide details. 27) Did you purchase or dispose of any business assets (furniture, equipment, vehicles, real estate, etc.), or convert any personal assets to business use? If so, please provide details and any paperwork related to the transaction(s). 28) Did you buy or sell any stocks, bonds or other investment property in 2019? If so, please provide details (brokerage statements, consolidated/combined Form 1099, or Form 1099-B). 29) At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? If so, please provide details and any paperwork related to the transaction(s). 30) Have you EVER received, sold, sent, exchanged, or otherwise acquired any financial interest in any virtual currency? If so, please provide details and any paperwork related to the transaction(s). ORGANIZER 2019 1040 US Miscellaneous Questions Miscellaneous Questions (Continued) Yes No 31) Did you sell or do you plan to sell any dividend generating stocks or mutual funds during the first 60 days of 2020? 32) Did you purchase, sell, or refinance your principal home or second home, or did you take a home equity loan? If so, please bring the closing papers and any other paperwork related to the sale or refinance. 33) Did you make any residential energy-efficient improvements or purchases involving solar, wind, geothermal or fuel cell energy sources? If so, please provide details and any paperwork related to the transaction(s). 34) Did you have any debts cancelled or forgiven in 2019? If so, please provide details and any Form 1099-A or Form 1099-C. 35) Does anyone owe you money which has become uncollectible? If so, please provide all details and promissory notes. RETIREMENT PLANS 36) Did you receive a distribution from a retirement plan (401(k), IRA, SEP, SIMPLE, Qualified Plan, etc.)? 37) Did you make a contribution to a retirement plan (401(k), IRA, SEP, SIMPLE, Qualified Plan, etc.)? 38) Are you interested in making an additional retirement plan contribution to possibly lower your 2019 tax liability? 39) Did you transfer or rollover any amount from one retirement plan to another retirement plan? If so, please provide details. 40) Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a Roth IRA in 2019? If so, please provide details. EDUCATION 41) Did you receive a distribution from an Education Savings Account or a Qualified Tuition Program? If so, please provide details and Form 1099-Q. 42) Did you, your spouse, or a dependent incur any tuition expenses that were required to attend a college, university, or vocational school? If so, please provide details and Form 1098-T. ITEMIZED DEDUCTIONS 43) Did you incur a substantial loss because of damaged or stolen property, where you were not reimbursed? If so, please provide details (i.e. Insurance Paperwork, Police Report). 44) Did you work out of town for part of the year? If so, please provide details (i.e. dates, locations, and relevant expenses). 45) Are you a member of the Armed Forces of the United States on active duty who moved pursuant to a military order related to a permanent change of station? ORGANIZER 2019 1040 US Miscellaneous Questions Miscellaneous Questions (Continued) ESTIMATED TAXES Yes No 46) Did you make any estimated tax payments throughout the year? If so, please complete the Estimated Payments section of the organizer to follow. 47) Did you apply an overpayment of 2018 taxes to your 2019 estimated tax (instead of being refunded)? 48) If you have an overpayment of 2019 taxes, do you want the excess applied to your 2020 estimated tax (instead of being refunded)? MISCELLANEOUS 49) Did you pay any one household employee cash wages of $2,100 or more; withhold federal income tax at the request of any household employee; or pay total cash wages of $2,100 or more in any calendar quarter, for services such as babysitting, cleaning, cooking or gardening? If so, an appointment to discuss further is required, please contact our office to schedule a time. 50) Did you or your spouse make any gifts to an individual or trust that totaled more than $15,000? If so, please provide details. 51) Do you want to allocate $3 to the Presidential Election Campaign Fund? 52) Does your spouse want to allocate $3 to the Presidential Election Campaign Fund? 53) Were you notified or audited by either the Internal Revenue Service or any State agency? If so, please provide details. 54) Would you like to schedule a meeting to discuss any of our additional services; retirement planning, financial planning, college saving plans, life or LTC insurance? ORGANIZER 2019 1040 US Miscellaneous Questions Miscellaneous Questions (Continued) Social security number . . . Social security number . . . CLIENT INFORMATION DEPENDENTS First name and initial . . . . . Last name . . . . . . . . . . . . . . . Title/suffix . . . . . . . . . . . . . . . Social security number . . . Occupation . . . . . . . . . . . . . . Date of birth (m/d/y) . . . . . . Date of death (m/d/y) . . . . . 1=blind . . . . . . . . . . . . . . . . . . Home phone . . . . . . . . . . . . . Work phone . . . . . . . . . . . . . Work extension . . . . . . . . . . Cell phone . . . . . . . . . . . . . . . E-mail address . . . . . . . . . . . In care of . . . . . . . . . . . Street address . . . . . . Apartment number . . City . . . . . . . . . . . . . . . . State . . . . . . . . . . . . . . . ZIP code . . . . . . . . . . . First name . . . . . . . . . . . . . . . Last name . . . . . . . . . . . . . . . Title/suffix . . . . . . . . . . . . . . . Date of birth (m/d/y) . . . . . . Relationship . . . . . . . . . . . . . Months lived at home . . . . Tax Return Appointment Date: Time: Location: First name . . . . . . . . . . . . . . . Last name . . . . . . . . . . . . . . . Title/suffix . . . . . . . . . . . . . . . Date of birth (m/d/y) . . . . . . Relationship . . . . . . . . . . . . . Months lived at home . . . . Taxpayer Spouse Dependent No. Dependent No. Dependent No. Dependent No. Address 1040 US Tax Organizer Tax Organizer ORGANIZER 2019 Date of death (m/d/y) . . . . . Date of death (m/d/y) . . . . . Date of adoption (m/d/y) . . Date of adoption (m/d/y) . . Telephone number: Fax number: E-mail address: This tax organizer will assist you in gathering information necessary for the preparation of your 2019 tax return. Please enter all pertinent 2019 information. NOTE: If you claim the earned income credit, please provide proof that your child is a resident of the United States. This proof is typically in the form of: school records or statement, landlord or property management statement, health care provider statement, medical records, child care provider records, placement agency statement, social service records or statement, place of worship, Indian tribal office statement, or employer statement. NOTE: If your child is disabled, please provide one of the following forms of proof of disability: doctor statement, other health care provider statement, or social services agency or program statement. Gene Bell & Associates 1700 Iowa Street Bellingham WA 98229-4702 (360) 671-1845 (360) 671-2247 office@genebellassociates.com 1700 Iowa Street, Bellingham, WA 98229 | t: (360) 671 - 1845 | f: (360) 671 - 2247 | office@genebellassociates.com | www.genebellassociates.com Income Tax Preparation Fee Schedule Effective January 1, to December 31, 20 20 The following are the fees charged for our tax preparation services. This is a base fee schedule which can be increase d . Variance from the fee schedule is an adjustment based on the complexity of a particular return. Lack of client organization/preparedness when presen ting your tax return documents will result in an additional fee at our hourly rate of $1 9 5 Form Number Base Fee Form 1040 $225 Form 1040X $390 Schedule 1 – 6 $10 / each Schedule A $ 90 Schedule B $50 Per Item $15 Schedule C $300 Schedule C - EZ $125 Schedule D $ 55 Schedule E $125 Schedule E, pg 2 $100 Schedule SE $ 50 Schedule EIC $75 Form 114 $135 Form 461 $90 Form 2106 $75 Form 2210 $35 Form 2441 $ 75 Form 4562 $ 50 Form 4797 $ 95 Form 4868 $ 45 Form 6251 $ 200 Form 8283 $50 Form 8582 $ 65 Per Item $ 60 Form 8801 $50 Form 8824 $210 Form 8829 $ 95 Form 8863 $75 Form 8867 $ 75 Form 8949 $75 Form 8960 $75 Form 8962 $ 125 Form 8965 $ 125 Form 8995 $175 Form 8995 - A $ 250 Form 9465 $125 B usiness Type Base Fee Corporations Form 1120 $1,500 S - Corporations Form 1120 - S $1,500 Partnerships Form 1065 $1,500 Estates & Trusts Form 1041 $750 State Return Base Fee Per State $95 Child R eturn Base Fee Dependent Child $85 Non - Dependent Child * $225 ( * First Year Only) Our minimum 1040 Tax Return preparation fee for a well - organized client is $400 Tax preparation fees include reasonable email and teleph one contact throughout the year. Additional fees will be charged for in - office consultation s , extended email and telephone contact, tax agency correspondence, and audit representation at hourly rates. Copies of your tax returns are provided at the time of preparation. One electronic copy is available upon request at no charge. Additional p rinted copies are available for a fee of $3 5 per retur n .(9,1+(77,&.&3$ ̧ 6(1,257$; $&&2817 ,1*0$1$*(5 .(9,1#*(1(%(//$662&,$7(6&20 &RQWDFW2XU)LUP 2)),&(+2856 5HJXODU+RXUV 0RQGD\WKURXJK7KXUVGD\ DPWRSP (YHQLQJV)ULGD\VDQG6DWXUGD\V E\DSSRLQWPHQW 7D[6HDVRQ+RXUV 0DUFK - $SULO 0RQGD\WKURXJK)ULGD\ DPWRSP 6DWXUGD\DPWRSP (YHQLQJVE\DSSRLQWPHQW &217$&72852)),&( W - _I - ,RZD6WUHHW%HOOLQJKDP:$ RIILFH#JHQHEHOODVVRFLDWHVFRP ZZZJHQHEHOODVVRFLDWHVFRP ,RZD6WUHHW%HOOLQJKDP:$ _W - _I - _RIILFH#JHQHEHOODVVRFLDWHVFRP_ZZZJHQHEHOODVV RFLDWHVFRP $GYLVRU\5HSUHVHQWDWLYHV