TGH - W2 Upload Taxes

W2 Upload Form
Choose A Houston Tax Guys Location
Tax Payer Name

First NameLast Name

Personal Information
Full Name
Social Security Number
Date of Birth

MonthDayYear
Occupation
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
E-mail Address

Spouse Information
Full Name
Social Security Number
Date of Birth

MonthDayYear
Occupation

Marital Status
Choose Your Marital Status

MarriedSingleWidowed

Dependent Children (others)

List your dependent children and others.

	Name	Social Security Number	Date of Birth	Relationship	Dependent’s Income

Income
Wages (attach W-2s)
Name of Employer (Taxpayer)
Name of Employer (Spouse)

Interest Income (attach 1099-INT)

Interest Income (attach 1099-INT)

	Payor (bank, etc.)	Amount
Service Quality
Overall Hygiene
Responsiveness
Kindness and Helpfulness

Dividends (attach 1099-Div)

Dividends (attach 1099-Div)

	Payor (company name)	Ordinary Div.	Capital Gain	Nontaxable

Partnership, S-Corp., and Other Income (attach K-1)

Partnership, S-Corp., and Other Income (attach K-1)

	List the sources
Service Quality
Overall Hygiene
Responsiveness
Kindness and Helpfulness

Real Estate Sold (home, vacation property, bare land, etc.)

Real Estate Sold (home, vacation property, bare land, etc.)

	Payor (company name)	Ordinary Div.	Capital Gain	Nontaxable

Investments Sold (stocks, bonds, mutual funds, other)

Real Estate Sold (home, vacation property, bare land, etc.)

	Name	Cost	Date Acquired	Date Sold	Selling Price

Individual Retirement Account (IRA)

Contributions for this past year

	Amount	Roth	Regular
Taxpayer
Spouse

Withdrawals from IRA (attach 1099-R) - Reason for withdrawals:

Other Pension or Annuity Income (attach 1099-R)

Other Pension or Annuity Income (attach 1099-R)

	Payor	Reason for withdrawal

Other Income

Source

	Amount
State income tax refund
Commissions
Unreported tips
Installment sales payments received
Alimony received
Scholarships or grants
Unemployment compensation
Worker’s compensation
Disability income
Other ____________________

Expenses
Medical Expense (insurance, drugs, equipment, nursing, hospital, doctors, etc.)

Other Pension or Annuity Income (attach 1099-R)

	List type:	Amount

Did you and your family have health insurance for all twelve months of the tax year?

YesNo
If less than twelve months health coverage, please give brief reason:
Did you receive Form 1095-A, -B, or -C health insurance coverage?

YesNo

Taxes Paid (other than on W-2 wage statements)

Type of Tax

	Amount
Federal income tax estimates (Form 1040-ES)
State income tax
Real estate tax
Personal property tax
Other______________________________

Interest Paid

		Amount
Mortgage paid to:
Investment interest paid to:

Child or Other Dependent Care Expenses
Did you pay for dependent care this past year?

YesNo
Details: (Care provider, social security number, amount)

Casualty or Theft Loss
Did you have property stolen or damaged by storm, water, fire, or accident this past year?

YesNo
Details:
Charitable Contributions

Paid by cash (check)

	Organization:	Amount

Moving Expenses (job related)
Did you move this past year due to change in job locations?

YesNo
Details:
Employment Related Expenses (not reimbursed)
Did you buy tools, uniforms, licenses, or pay dues or educational expenses in relation to your work this past year?

YesNo
Details:
Investment Expenses

Item

	Amount
Item Amount
Investment interest paid
Safe deposit box rent
Tax preparation fee
Other

Upload any required and necessary files.

Upload a File

Cancelof

Signature
Should be Empty:

	YES	NO
Did you receive any notices from the IRS this past year?
Do you have a foreign bank account?
Did you pay to attend classes beyond high school?
Did you pay interest on a student loan this past year?
Did you receive any rental income from property?
Did you receive any farm income?
Do you have self-employment income or expense?
Were there any births, adoptions, or deaths in the family?

W2 Upload Form