Δ 1Your Information 2General and Family 3Dependent Due Diligence 4Health Care Coverage 5Income 6Purchases, Sales, and Debt 7Retirement 8Education 9Miscellaneous 10Legacy Planning 11Review and Submit Comments This field is for validation purposes and should be left unchanged. Get Ready for Tax Season with Chatterton Begin tax season with peace of mind. By answering the following questions about tax year 2025, your tax professional can help you assess potential opportunities for tax savings, while also offering solutions for your tax situation now and in the future. Name(Required) First Last Email(Required) Phone General and Family Major Changes: Check all that apply: Retired New Job Sales of Property New Rental Property New Business Death Did your marital status change during the year? Yes No Did your address change during the year? Yes No If so, please provide your new address. Street Address City Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah U.S. Virgin Islands Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific State ZIP Code Could you be claimed as a dependent on another person’s tax return? Yes No Do you support any dependents in your household? Yes No Dependent Due Diligence You are being supplied with this questionnaire because you have indicated that you may be eligible for certain tax credits. The questionnaire is designed to assist us in qualifying you for these refundable tax credits. These are questions that we are required to ask under the Due Diligence Requirements of the new Tax Laws. For NEW CLIENTS with Dependents: Please remember to submit copies of social security cards, birth certificates and proof of residency (possibly school records or medical records showing the dependents name and YOUR address). For taxpayers claiming Head of Household filing status: Head of Household status can only be claimed by taxpayers with a qualified dependent and who are: Single and paying more than ½ cost of keeping up a home (complete worksheet below), or Married but did not live with your spouse at any time in the last 6 months of the year, or Divorced or legally separated (Please provide a copy of the Decree or Separation Agreement) If you have any questions about the questionnaire, please do not hesitate to contact our office. We will be glad to assist you. Please list the names of the dependents you are claiming on your return: Can you provide documentation, if required, to substantiate your eligibility for each credit or filing status? Yes No Have you ever been disallowed any tax credits in prior years, such as EITC/AOTC/CTC? Yes No When? Is each qualifying person for whom you are claiming the Child Tax Credit, Additional Child Tax Credit, and Credit for Other Dependents a citizen, national, or resident of the United States? Yes No Which person is not and where do they live? Yes No Do all children for whom you are claiming the CTC and/or ACTC reside with you for more than half the year? Yes No Can anyone else (such as the other parent of the child) claim any of your dependent(s) as their dependent on their tax return? Yes No Please explain why they are not claiming the child: Is there an active Form 8332, Release of Claim to Exemption for Child by Custodial Parent, or similar statement in place? Yes No Are any of your dependents over the age of 18 and disabled? Yes No Has this dependent been declared disabled by a physician? Yes No If yes, can you provide documentation? Yes No Were you unmarried or considered unmarried on the last day of the tax year? Yes No Did you provide more than half of the cost of keeping a home for the year for a qualifying person? Yes No Did any dependent file their own tax return? Yes No Did any dependent have over $4,700 in income? Yes No Health Care Coverage Did you have health insurance for you, your spouse, and all dependents for the entire year? Yes No Did you purchase health insurance through a public exchange? (CA Residents: This is Covered California) Yes No Did you contribute to a Health Savings Account? Yes No Did you receive a distribution from a Health Savings Account? Yes No Was the entire amount used for qualified medical expenses? Yes No Income Did you earn cash tips not shown on your paycheck or W-2? Yes No Did you receive any disability income or unemployment? Yes No Did you earn money or pay taxes in another country? (like wages, rent, or dividends)? Yes No Was your home rented out or used for business? Yes No Did you pay or receive any alimony in 2025? Yes No What is the amount? Date of Divorce MM slash DD slash YYYY Purchases, Sales, and Debt Did you buy, sell, or refinance your home or rental property? Yes No Did you purchase or dispose of any business assets, or convert any personal assets to business use? Yes No Did you make any energy efficient home improvements? Yes No Did you have any debts cancelled or forgiven? Yes No Did you receive any 1099 forms for sales or debt forgiveness? Yes No Retirement Did you take money out of your retirement plan (401(k), IRA, SEP, etc.)? Yes No Did you put money into a retirement plan (401(k), IRA, SEP, etc.)? Yes No Did you transfer or rollover any amount from one retirement plan to another retirement plan? Yes No Did you convert part of your traditional, SEP, or SIMPLE IRA to a Roth IRA in 2025? Yes No Did you donate any part of your Required Minimum Distribution to a charity? Yes No Education Did you receive any money from an Education Savings Account or Qualified Tuition Program (529 Plan)? Yes No Did you, your spouse, or a dependent incur any tuition expenses that are required to attend a college, university, or vocational school? Yes No Miscellaneous Did you have any bank or investment accounts outside the U.S.? Yes No Did the total value ever go over $10,000? Yes No Did you receive an inheritance or money from a trust or person in a different country? Yes No At any time during 2025, did you receive, sell, send, exchange, or otherwise acquire any financial interest in virtual currency? Yes No Have you received any notice from the IRS or state revenue department within the past year? Yes No Did you gift more than $19,000 (in money or property value) to a single person? Yes No CA Residents: Did you make any out-of-state purchases in which you did not pay CA sales tax? Yes No Legacy Planning Do you expect to receive an inheritance in the next few years? Yes No Do you have a plan to reduce taxes on your inheritance? Yes No Are you currently doing your own investing? Yes No If you were to have health or incapacity problems does your spouse have the time, desire, and ability to manage the accounts? Yes No Are you currently working with a financial advisor? Yes No Does your financial advisor consult with your tax professional? Yes No Do you have a living trust? Yes No Was it created or amended in the last 2 years? Yes No Are you currently retired? Yes No Do you plan on retiring within the next 5 years? Yes No Does the balance of all your accounts (IRA’s, 401k’s, Stocks, bonds, bank accounts, etc) total more than $500k? Yes No Review Your Submission Your Information Name Not Provided Edit Email Not Provided Edit Phone Not Provided Edit General and Family Major Changes: Check all that apply: Not Provided Edit Did your marital status change during the year? Not Provided Edit Did your address change during the year? Not Provided Edit Could you be claimed as a dependent on another person’s tax return? Not Provided Edit Do you support any dependents in your household? Not Provided Edit Health Care Coverage Did you have health insurance for you, your spouse, and all dependents for the entire year? Not Provided Edit Did you purchase health insurance through a public exchange? (CA Residents: This is Covered California) Not Provided Edit Did you contribute to a Health Savings Account? Not Provided Edit Did you receive a distribution from a Health Savings Account? Not Provided Edit Income Did you earn cash tips not shown on your paycheck or W-2? Not Provided Edit Did you receive any disability income or unemployment? Not Provided Edit Did you earn money or pay taxes in another country? (like wages, rent, or dividends)? Not Provided Edit Was your home rented out or used for business? Not Provided Edit Did you pay or receive any alimony in 2025? Not Provided Edit Purchases, Sales, and Debt Did you buy, sell, or refinance your home or rental property? Not Provided Edit Did you purchase or dispose of any business assets, or convert any personal assets to business use? Not Provided Edit Did you make any energy efficient home improvements? Not Provided Edit Did you have any debts cancelled or forgiven? Not Provided Edit Did you receive any 1099 forms for sales or debt forgiveness? Not Provided Edit Retirement Did you take money out of your retirement plan (401(k), IRA, SEP, etc.)? Not Provided Edit Did you put money into a retirement plan (401(k), IRA, SEP, etc.)? Not Provided Edit Did you transfer or rollover any amount from one retirement plan to another retirement plan? Not Provided Edit Did you convert part of your traditional, SEP, or SIMPLE IRA to a Roth IRA in 2025? Not Provided Edit Did you donate any part of your Required Minimum Distribution to a charity? Not Provided Edit Education Did you receive any money from an Education Savings Account or Qualified Tuition Program (529 Plan)? Not Provided Edit Did you, your spouse, or a dependent incur any tuition expenses that are required to attend a college, university, or vocational school? Not Provided Edit Miscellaneous Did you have any bank or investment accounts outside the U.S.? Not Provided Edit Did you receive an inheritance or money from a trust or person in a different country? Not Provided Edit At any time during 2025, did you receive, sell, send, exchange, or otherwise acquire any financial interest in virtual currency? Not Provided Edit Have you received any notice from the IRS or state revenue department within the past year? Not Provided Edit Did you gift more than $19,000 (in money or property value) to a single person? Not Provided Edit CA Residents: Did you make any out-of-state purchases in which you did not pay CA sales tax? Not Provided Edit Legacy Planning Do you expect to receive an inheritance in the next few years? Not Provided Edit Are you currently doing your own investing? Not Provided Edit Are you currently working with a financial advisor? Not Provided Edit Does your financial advisor consult with your tax professional? Not Provided Edit Do you have a living trust? Not Provided Edit Are you currently retired? Not Provided Edit Does the balance of all your accounts (IRA’s, 401k’s, Stocks, bonds, bank accounts, etc) total more than $500k? Not Provided Edit
