Thank you for your interest in our firm. In order to better serve you, please complete the form below and indicate which areas we can assist you in. Someone will be in contact with you shortly based on the information that you provide. Thank you.

TO IMPORT TO EXCEL AND EMAIL TO US: Rightclick on questionaire and select "Export to Excel"

  INCOME TAX QUESTIONAIRE      
Your 1st Name & Initial ________________________________Last Name_________________________________________
Spouse's 1st Name & Initial ________________________________Last Name_________________________________________
Present Street Address ___________________________________________________________________________________
City_____________________________________State________________________________________Zip____________________
             
HW             Social Security# Occupation          Phone# Birth Date    Date Deceased X IF
        mm-dd-yy    mm-dd-yy Blind
H ________________ _______________________ _________________ ____________ _____________ _____
W ________________ _______________________ _________________ ____________ _____________ _____
             
  DEPENDENTS          Birth Date Social Security # Relationship # Months Lived   
  Name(Include Last Name)       in Home This Year  
             
             
             
             
MEDICAL EXPENSES: (Do not include expenses paid CONTRIBUTIONS: (Please attach list even if not itemizing)  
                                      reimbursed or paid by others) Cash Contributions:                                                                                   
      Non-Cash Contributions:                                                  _____________
Medicine & Drugs                                                                           
Medical Insurance                                                                   *CAPITAL GAINS & LOSSES: RATE DECREASES*  
Total Doctor/Dentist/Hospital                                                   Please list below sales of Stocks, Real  Estate, Timber, Etc.:
Mileage to Doctor                                                                           
Hearing Aid/Dentures/Eyeglasses                                          Description of Property  Date          Date Purchase     Sales  
Other Medical List:                                                                    Acquired  Sold Price             Price  
      ___________________ ______  ______ $_______  $_______  
TAXES:          

State & Local                       //Sales Tax      $                        

Alimony Received                                                                                      
Real Estate                                                                             Alimony Paid                                                                                               

Property  Tax                                Auto Tax                          

DISASTER LOSSES (Give Details)

___________________________________________________

 Tuition Books & Fees   -attach documents)                                                                                  
      Student Name                                                                                            
INTEREST EXPENSE: (Attach or enclose statements) Freshman                                        Sophomore                                         
Home Mortgage-Bank                                                              Other                                                                                                          
Home Mortgage-Individuals                                                     Teacher Expense                                                                                       
Name of Individual                                                                          
Student Loan Interest                                                              MOVING EXPENSES:      
      # Miles Moved                                                                                            
INCOME: (Please enclose or bring statements) Cost of Moving Household Furnishings                                                     
Pensions & Annuities                                                                     
Social Security Benefits                                                          MISCELLANEOUS:     
Unemployment Compensation  Give Gross Amount (we will deduct 2400.00)                                               *IRA Retirement Account: H                                       W                                   
Interest                                                                                    Tuition and Books Paid (Attach Statements)                                                                 
Dividends                                                                                Income Tax Preparation                                                                              
      Union & Professional Dues                                                                         
ESTIMATED TAX PAYMENTS FOR 2009-STATE-FEDERAL Safety Deposit Box                                                                                     
April 15, 2009or___________________ $______$_______ Small Tools/Safety Equipment on Job                                                         
June 15, 2009 or___________________$______$_______ Required Uniforms                                                                                      
Sept 15, 2009  or__________________ $______$_______ Dues & Subscriptions                                                                                 
Jan. 15, 2010  or___________________$______$_______ Job Hunting Expense                                                                                  
      *Child Care                                                 *Deductions  Increases*          
 www.lawlerandcole.com     Name of Provider of Child Care                                                                  
             LAWLER and COLE, CPAS, LLC. Address of Provider                                                                                   
          Certified Public Accountants Social Security # of Provider                                                                      
               P.O. Box 1506  Hamilton, AL 35570 Remarks/Miscellaneous                                                                              
         Phone:(205)921-7801  Fax (205)921-9095                                                                                                                     

              Email:  jml@lawlerandcole.com  Linda@lawlerandcole.com  april@lawlerandcole.com

                                             2009       
 IRS Contact info: www.irs.gov or 800-829-1040                       Note: Under age 50 limited to to $5,000.00   
                 Age 50 and over limited to $6,000.00   

 
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