Supplemental Information Sheet
Tax Year : 20
Are you a member of a
Taxpayer Social Security Number
Taxpayer Name Per Social Security Card
Spouse Social Security Number
Spouse Name Per Social Security Card
Can you be claimed as a dependent
Dependents do not take
on another persons return?
your own exemption
Name of Person Who can Claim You
Social Security # (if known )
Did you or your spouse
a. Receive the Alaska PFD?
c. Receive commercial fishing income?
e. Receive a Form 1099-MISC?
b. Have the Alaska PFD taken away?
d. Receive a native/corporation dividend?
If Yes, what was done to earn this income?
If Yes, please list the corporation:
To claim Head of Household filing status you must be either Single or Married Filing a Separate return and have lived apart from your spouse for the last six months of the year. You must have a
qualifying dependent. Only one person in the home can be Head of Household. Ask your preparer for details.
If you are single or MFS and qualify, did you pay more than half the cost of keeping up the home for yourself and a qualifying dependent?
List all dependents. You may be able to claim a dependent as a qualifying child or as a qualifying relative. You may be able to claim a person that is not related to you if the person lived with you
for the entire year and made less than the personal exemption amount and you provided for more than half of their support. You may be able to claim your child that is over 18. Make sure that the
person that you claim as a dependent does not claim themself on their own return. Ask your preparer and check out the dependency brochure.
Dependents Full Name
Is the Dependent a
Did this person have income
Must match Social Security card
member of a
other than the PFD,
Social Security Number
such as Wages, Self
(List youngest to oldest)
dividends, Social Security, etc?
Do not enter your name or your
spouses name below.
Were any of the dependents married as of December 31
or can anyone else claim the dependents on their tax return?
Preparer Complete Grey Area
Does anyone else live in the home?
If you are due a refund would you like direct deposit?
If yes, Bank
Checking or Savings
TAXPAYER SPREADSHEET FISHING QUESTIONS (TAX PREPARERS COMPLETE GREY AREA)
Form 1099 MISC
1. Do you or your spouse own a commercial fishing Limited Entry Permit issued by the State of Alaska? These permits may be issued
for salmon, herring, crab or other types of finfish or shellfish. Please answer Yes or No.
If YES, then stop; if NO then go to questions 2.
2. Do you or your spouse own IFQ shares (Individual Fishing Quota)? Please answer Yes or No.
If YES, then stop; if NO then go to questions 3.
3. Are you or your spouse a commercial fishing captain or crewmember? Please answer Yes or No.
Preparers: The individual total should not be more than 1. The combined total should not be more that 2.
Preparers: use the combined totals to complete the Taxpayer Spreadsheet.