Client Name:

Send Results to: Mike Verville Brad Wallace Jason Neumann Reed Lamoreaux Jeff Jones Jared Draney Dustin Wheeler David McAllister Brigg Owens Brian Donnelly

Please answer the following questions that pertain to you or your spouse for 2007 and provide additional information if necessary.

1. Did your marital status change during the year?
   Yes. (Please explain in box below)
   No.
   Explanation:



2. Did your address change during the year?
   Yes. (Please provide your new address in the box below)
   No.
   New Address:



3. Could you be claimed as a dependent on another person's tax return for 2007?
   Yes. (Please explain in box below)
   No
   Explanation:



4. Were there any changes in dependents?
   Yes. (For new dependents, provide the full name, date of birth, relationship, and social security number in box below)
   No
   Explanation:



5. Were any of your unmarried children who might be claimed as dependents 19 years of age or older at the end of 2007?
   Yes. (Please explain in box below)
   No.
   Explanation:



6. Did you have any children under age 18 on January 1, 2008 with interest and dividend income in excess of $850, or total investment income in excess of $1,700?
   Yes. (Please explain in box below)
   No.
   Explanation:



7. Did you receive unreported tip income of $20 or more in any month?
   Yes. (Please explain in box below)
   No.
   Explanation:



8. Did you cash any Series EE U.S. savings bonds issued after 1989 and pay qualified higher education expenses for yourself, your spouse, or your dependents?
   Yes. (Please explain in box below)
   No.
   Explanation:



9. Did you receive any disability income?
   Yes. (Please explain in box below)
   No.
   Explanation:



10. Did you have any foreign income or pay any foreign taxes?
    Yes. (Please explain in box below)
    No.
    Explanation:



11. Did you start a business or farm, purchase rental or royalty property, or acquire an interest in a partnership, S corporation, trust, or REMIC?
    Yes. (Please explain in box below)
    No.
    Explanation:



12. Did you purchase or dispose of any business assets (furniture, equipment, vehicles, real estate, etc.), or convert any personal assets to business use?
    Yes. (Please explain in box below)
    No.
    Explanation:



13. Did you buy or sell any stocks, bonds or other investment property in 2007?
    Yes. (Please explain in box below)
    No.
    Explanation:



14. Did you purchase, sell, or refinance your principal home or second home, or did you take a home equity loan?
    Yes. (Please explain in box below and provide closing statements)
    No.
    Explanation:



15. Did you add any energy efficient improvements (insulation systems, exterior windows and doors, metal roofs) to your home in 2007?
    Yes. (Please explain in box below)
    No.
    Explanation:



16. Did you purchase a new hybrid vehicle in 2007?
    Yes. (Please explain in box below)
    No.
    Explanation:



17. Did you have any debts cancelled or forgiven?
    Yes. (Please explain in box below)
    No.
    Explanation:



18. Did anyone owe you money which had become uncollectible?
    Yes. (Please explain in box below)
    No.
    Explanation:



19. Did you receive a distribution from a retirement plan (401(k), IRA, SEP, SIMPLE, Qualified Plan, etc.)?
    Yes. (Please explain in box below)
    No.
    Explanation:



20. Did you make a contribution to a retirement plan (401(k), IRA, SEP, SIMPLE, Qualified Plan, etc.)?
    Yes. (Please explain in box below, and provide the plan type and amount)
    No.
    Explanation:



21. Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a Roth IRA?
    Yes. (Please explain in box below)
    No.
    Explanation:



22. Did you receive a distribution from an Education Savings Account or Qualified Tuition Program?
    Yes. (Please explain in box below)
    No.
    Explanation:



23. Did you, your spouse, or a dependent incur any tuition expenses that are required to attend a college, university, or vocational school?
    Yes. (Please explain in box below)
    No.
    Explanation:



24. Did you incur a loss because of damaged or stolen property?
    Yes. (Please explain in box below)
    No.
    Explanation:



25. Did you work out of town for part of the year?
    Yes. (Please explain in box below)
    No.
    Explanation:



26. Did you use your car on the job (other than to and from work)?
    Yes. (Please explain in box below, specify the vehicle, and provide the total mileage and business mileage)
    No.
    Explanation:



27. Did you apply an overpayment of 2006 taxes to your 2007 estimated tax (instead of being refunded)?
    Yes. (Please explain in box below)
    No.
    Explanation:



28. If you have an overpayment of 2007 taxes, do you want the excess applied to your 2008 estimated tax (instead of being refunded)?
    Yes.
    No.
    


29. Do you expect your 2008 taxable income and withholdings to be different from 2007?
    Yes. (Please explain in box below)
    No.
    Explanation:



30. Do you want to electronically file your tax return?
    Yes.
    No.
    


31. Do you want to allocate $3 to the Presidential Election Campaign Fund?
    Yes.
    No.
    


32. Does your spouse want to allocate $3 to the Presidential Election Campaign Fund?
    Yes.
    No.
    


33. May the IRS discuss your tax return with your tax preparer?
    Yes.
    No.
    


34. Did you have an interest in or signature or other authority over a financial account in a foreign country, such as a bank account, securities account, or other financial account?
    Yes. (Please explain in box below)
    No.
    Explanation:



35. Did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust?
    Yes. (Please explain in box below)
    No.
    Explanation:



36. Was your home rented out or used for business?
    Yes. (Please explain in box below)
    No.
    Explanation:



37. Did you (or someone on your behalf, including your employer) make contributions to a health savings account (HSA) this year? Or, did you receive a HSA distribution or acquire an interest in an HSA due to the death of the account beneficiary?
    Yes. (Please explain in box below)
    No.
    Explanation:



38. Did you have a medical savings account (MSA), a Medicare Advantage MSA, or acquire an interest in an MSA or a Medicare Advantage MSA because of the death of the account holder? Or, were you a policyholder who received payments under a long-term care (LTC) insurance contract or received any accelerated death benefits from a life insurance policy?
    Yes. (Please explain in box below)
    No.
    Explanation:



39. Did you incur moving expenses due to a change of employment?
    Yes. (Please explain in box below)
    No.
    Explanation:



40. Did you engage the services of any household employees?
    Yes. (Please explain in box below)
    No.
    Explanation:



41. Were you notified or audited by either the Internal Revenue Service or the State taxing agency?
    Yes. (Please explain in box below)
    No.
    Explanation:



42. Did you or your spouse make any gifts to an individual that total more than $12,000, or any gifts to a trust?
    Yes. (Please explain in box below)
    No.
    Explanation:


Additional Comments: