Name: Tax Samaritan
Price range: $$

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Please tell us more about your tax problem:*

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Please upload any tax communications received from the IRS/State:

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Last tax year filed:*

State tax return in last tax year filed:

Did you have earned income (wages or self-employment income) while living/working in a foreign country?*

This will help us determine whether the Form 2555 to claim the foreign earned income exclusion will be needed for your return.

Select “No” if you worked directly for the U.S. government (U.S. government employees are not eligible to claim the foreign earned income exclusion for their government wages).

Select “Yes” if you worked for an employer or were self-employed and earned income performing the work while physically overseas.

Did you pay income taxes to the foreign country?*

This will help us determine whether the Form 1116 to claim the foreign tax credit may be applicable for your tax return.

Income (Including wages or distributions) from a company (not a sole proprietorship) that I own directly or indirectly?*

Type of legal entity:

Would you like us to prepare the tax return for this entity as well?*

Did you pay mortgage interest on a home you own?*

This will help us determine whether the Schedule A to claim itemized deductions, such as mortgage interest, may be needed for your return. This form is only used if the total of your itemized deductions is greater than the standard deduction based on your filing status.

As part of your engagement, we will work to identify all of your eligible itemized deductions.

Did you have any gambling winnings?*

This will help us determine whether the Schedule A to claim any gambling losses may be needed for your return.

Did you receive any interest or dividend income?*

This will help us determine whether the Schedule B to report interest and dividend income may be required for your tax return.

Self-employment income (i.e. as a consultant, independent contractor)?*

This will help us determine whether the Schedule C to report your self-employment income will be needed for your tax return.

Did you have any investment income/loss (i.e. from stock sales)?*

This will help us determine whether the Schedule D to report capital gains or losses will be needed for your tax return..

Did you have income/loss from real estate rentals or royalties?*

This will help us determine whether the Schedule E to report your passive income such rental income and losses, etc. will be needed for your tax return.

What is your gross income (from all sources including income from spouse)?*

This will help determine whether Form 1116 to reduce your US taxes resulting from your earned income in excess of the foreign earned income exclusion using taxes paid to a foreign country will be beneficial for your tax return.

Did the combined maximum balance of each of your foreign financial accounts , whether you are an owner on the account or have signing authority, directly or indirectly through one or many layers of other legal entities (such as ownership interest in a corporation), exceed $10,000 at any point in the years you are filing?*

This will help determine whether FinCen Form 114 (formerly known as TD F 90-22.1) and Form 8938 to report your foreign financial accounts and specified foreign financial assets will be required.

Do you have ownership interest of 10% or more in a foreign legal entity such as a foreign corporation, LLC, etc?*

This will help determine whether Form 5471 to report your interest/ownership in a foreign corporation will be required.

In any of the tax years to be filed, were you involved in any transactions with a foreign trust (creating one, transfers, distributions) or a participant in a foreign pension plan?*

This will help determine whether Form 3520/A to report your transactions with a foreign trust may be required.

How did you hear about us? (If you referred by a friend or family member, please enter their name below):*

Why are you looking for a new tax professional this year?

Are there any areas that you are aware of that should be discussed in your tax return but we did not address here (i.e. other income or deductions)?

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