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WETTER & CONVERTINI

Tax Organizer Part Two

OTHER_INCOME


INTEREST: Attach 1099 Forms
       Payor           Amount   
1 $
2 $
3 $
4 $


Dividends - Attach 1099 Forms
       Payor           Total      Capital  
Gain
  Ordinary  
Dividend
1 $ $ $
2 $ $ $
3 $ $ $
4 $ $ $


State Tax Refund

Amount Received$___________________

Check if you did not itemize in prior years


Capital Gains
      Description        Date 
Acquired
  Date  
Sold
  Sales  
Price
Cost or 
Basis
1     $ $
2     $ $
3     $ $
4     $ $


Pensions/IRA Distributions - Attach Form 1099 / W-2s
       Payor           Gross    
Distribution
  Taxable  
Amount
1 $ $
2 $ $


Check box if Federal or State Tax was withheld


Alimony Received

Payor________________________ Amount$___________
Payor's Social Security #_______________________________


Unemployment Received

Taxpayer Amount $________________
Spouse Amount $_________________


Social Security Received

Taxpayer Amount$_______________
Spouse Amount$_________________


Miscellaneous Income

Description:________________________________
_________________________________________
__________________________________________

DEDUCTIONS


Medical and Dental Expenses

Insurance Premiums (Net) ___________________
Doctors, Dentists, etc.______________________


Taxes Paid

State & Local Income Tax____________________
Real Estate Taxes - Residence_________________
Real Estate Taxes - Other Property______________
Auto License:
No. of Cars Fees Paid _______________________
Personal Property Taxes____________________
Other Taxes_____________________________


Interest Paid - Attach 1098 Forms

Home Mortgage Interest Paid (1st)____________________
Home Mortgage Interest Paid (2nd)____________________


Contributions - Attach Details

Contributions by Cash or Check____________________
Contributions by Other than Cash__________________


Miscellaneous Deductions

Unreimbursed Employee
Business Expenses____________________
Union /Professional Dues_______________
Investment Expense____________________
Tax Return Preparation Fees______________
Safe Deposit Box Rental_________________

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