Information Needed to do Tax Projections
Date Fee $50-$100 - Please allow 5 business days for completion. Advisor Name:
Investments Being Moved
Name
Company
Account #
Origination Date
Initial Premium
# of Shares
Account Value
Penalty
Surrender Amount
Qualified
Non-Qualified
Roth
Cost Basis
Investment Type
(Moving to) Qualified
(Moving to) Non-Qualified or Roth conversion
None
Taxes Withheld when moved Percentage:

Select an option:

Client Spouse
Personal: Name
Birth Dates of Client
Is anyone blind?
Number of dependents
Income: Annual Social Security Benefit
Pension/Annuity income
IRA income
Wages
Interest income
Dividend income
Capital Gain/Loss (Sch D)
Other Income:
Rental/Royalties Sch E
Sch C - Business
Deductions: Medical
Long term care Insurance
Real Estate Taxes
Mortgage Interest
Charitable Contributions
What kind of care do they receive?
Cost?


Please supply previous year or 2 tax returns

*Minimum of 1 tax return required* PDFs only (.pdf) 5MB is the file size limit

Tax Form 1 *Required*

Tax Form 2 (optional)

Description of Reason for the Tax Plan