Tax Organizer Template For 2015
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1
2FILLING THIS OUT - HELPS US HELP YOU.
SCH F - FARM INCOME & EXPENSES
Appointment Date
FARM EXPENSES continued
Amount
Federal ID No. (If applicable)
_______________
Thank you for
BROWN, BROWN AND ASSOCIATES, P.C.
Other (land, animals, etc.)
your referrals.
PRODUCE & STOCK SALES - Raised on Farm
Certified Public Accountants
Repairs and maintenance
Appointment Time
TAX ORGANIZER for 2015
Kind
Amount
Seeds and plants purchased
_______________
Cattle
Storage and warehousing
CLARKSVILLE
SPRINGFIELD
GOODLETTSVILLE
KNOXVILLE
SEVIERVILLE
Brood Cows / Bull / Animals - Sold 2 yrs or older
Supplies purchased
309 Poston Street
728 South Main
Gatewest Building
4505 Greenway Drive
109 Parkway, Suite 1
Total Cattle
Clarksville, TN 37040
Springfield, TN 37172
515 Rivergate Parkway
Knoxville, TN 37918
Sevierville, TN 37862
Taxes
Phone 931-647-2486
Phone 615-384-8431
1st Floor, Suite 115
Phone 865-673-9798
Phone 865-428-2824
Hogs
Water, Electric, Tel, Cell Phone
Fax 931-552-3284
Fax 615-384-7271
Goodlettsville, TN 37072
Fax 865-524-1509
Fax 865-428-8880
Tobacco
Ervin: brbrasso@bellsouth.net
Phone 615-227-0622
Duane: bbasheena@bellsouth.net
Office Exp., Postage
Fax 615-851-9962
Claudetta: cpacsm@bellsouth.net
Ellen:
Soybeans
Veterinary, breeding and medicine
Tim: tewingcpa@bellsouth.net
Teresa:
Ervin Cell 615-415-6037
Other Grains
brbrasso@bellsouth.net
Jessica: bbajessica@bellsouth.net
Tina:
Dues & Subscriptions
Nikki: bbanikki@bellsouth.net
Mary Cell 615-415-6040
Patronage Dividends - 1099 PATR
Safety Deposit Box
Rebecca: bbarebecca@att.net
Agriculture Program Payments
Legal, Accounting, Tax Prep.
Filing Status:
Single
Joint
Head of Household
Married - Filing Separately
❑
❑
❑
❑
Crop Insurance Proceeds
Other expenses (specify)
YOUR PERSONAL INFORMATION
Custom hire (machine work) income
TOTAL
Other income, including fuel tax credit or refund
Name
SS#
Birthdate
/
/
Occupation
Work #
Spouse’s Name
SS#
Birthdate
/
/
Occupation
Work #
Address
FARMERS FUEL TAX CREDIT
(Gas or Diesel Purchased at Service Station but used in Tractor, or off road)
TOTAL
Number of gallons of gasoline used
Dependents Full Name
Dependents SS#
Relationship
Birthdate
Number of gallons of diesel used
Sale of Livestock you bought for resale
Number of gallons of oil used
Livestock Type
Date Bought
Cost
Selling Amount
ESTIMATED TAXES
Have Qualifying Health Insurance Coverage
Yes / No
QUESTIONS
Overpayment:
April 15, 2015
Have 1095- A, B, C
Yes / No
June 15, 2015
If no, specify if you have Non-Qualifying Insurance or None
Sept 15, 2015
skype address
Jan 15, 2016
TOTAL
INCLUSIONS
e-mail address
Total Paid for this Year
I have included with this form: (please check)
EQUIPMENT PURCHASED
Amount
❑ W2’s
WAGES AND SALARIES
DIVIDEND INCOME - 1099 DIV
❑ 1098T
Please make sure all W-2s are enclosed
❑ 1099’s
Employer
Amount
Payor
Amount
❑ 1099’s MISC
❑ 1099 K
BROOD STOCK PURCHASED
Amount
❑ 1095 A
❑ 1095 B
❑ 1095 C
RETIREMENTS & ANNUITIES
Please make sure all 1099R’s are enclosed.
❑ Purchase & Selling agreements for real estate, stocks, etc.
Payor
Amount
TAX EXEMPT INTEREST INCOME
NOTICE: “You are required by law to keep records that will enable you to
Amount
prepare a complete and accurate Income tax return. Although the law does
not require any special form of records, you must retain all receipts, cancelled
checks, and other evidence to prove amounts claimed as deductions. You
must keep your records for as long as their contents may be material in
INTEREST INCOME - 1099 INT
administering any Internal Revenue Law.”
OTHER INCOME
Amount
Commissions
Please refer your friends and neighbors to us.
Bonuses & Prizes
THANK YOU - WE CARE
Alimony received
Total
State Tax refund
Penalty on early withdrawals
Unemployment Compensation
INDIVIDUAL RETIREMENT ACCOUNT - IRA
Gambling / Lottery
Payments made for current year - Regular
Husband’s Social Security / Railroad Retirement
Wife Social Security / Railroad Retirement
Payments made for current year - Roth
Have Pension Plan?
Yes ❑
No ❑
Other (List)
Individual ❑
Spouse ❑
CANCELLATION OF DEBT / 1099C
Amount
Credit Cards or Other
Mortgages
SALES OF PROPERTY, STOCK, EQUIPMENT OR TIMBER
List below any buildings, land and/or equipment sold, 1099B/1099S
Date Purchased
Purchase Price
Date Sold
Sales
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