Bestowing Upon Ministries INC.
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Bestowing Upon Ministries INC.
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Tax Form
Part I – Your Personal information
Full Name
*
E-mail
*
Phone Number
*
Date of Birth
*
Date of Birth
Mailing Address
Job Title
Are you a U.S Citizen?
Yes
No
Were you a full time student last year?
Yes
No
Legally blind
Yes
No
Totally and permanently disabled
Yes
No
Can anyone claim you or your Spouse
Yes
No
Unsure
Have you, your spouse, or dependent been a victim of tax related identity theft or been issued Protection PIN?
Yes
No
Last Year Were Your Spouse: Full time student
Yes
No
Checkbox
Legally blind
Yes
No
Totally and permanently disabled.
Yes
No
Part II – Marital Status and Houshold Information
As Of December 31, 2023 What was your marital status?
Never Married
Married – (This includes registered domestic partnerships, civil unions, or other formal relationships under state law)
If yes did you get married in 2023?
Yes
No
Did you live with your spouse during any part if the last six months of 2023
Yes
No
Divorced
Date of Final Decree
Date of Final Decree
Legally Separated
Date of separate maintenance decree
Date of separate maintenance decree
Widowed
Date of spouse death
Date of spouse death
List the full names below of: Everyone who lived with you last year (other then your spouse) Anyone you supported but did bot live with you last year
Part III – Income – Last Year, Did you (or your spouse) Receive
Wages or Salary? (Form W-2)
Yes
No
Unsure
If yes How many Jobs
Tip Income?
Yes
No
Unsure
Scholarships? (Forms W-2, 1098-T)
Yes
No
Unsure
Interest Dividends Form: Checking/Savings accounts, bonds, Cd’s, brokerage? (Forms 1099-INT, 1099-DIV)
Yes
No
Unsure
Refund of state/local income? (forms 1099-G)
Yes
No
Unsure
Alimony Income or separate maintenance payments?
Yes
No
Unsure
Self Employment income? (1099 MISC, 1099-NEC, 1099-K, Cash, digital assets, or other property or services)
Yes
No
Unsure
Cash/checking/digital assets, or property or service for any work performed not reported on forms W-2 or 1099?
Yes
No
Unsure
Income (or loss) from the sale or exchange of stocks, bonds, digital assets or real estate? (including your home) (forms 1099-s, 1099-B)
Yes
No
Unsure
Disability Income? (Such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)
Yes
No
Unsure
Retirement Income payments form pensions, annuities, and or IRA?
Yes
No
Unsure
Unemployment Compensation? (Form 1099-G)
Yes
No
Unsure
Social Security or Railroad Retirement Benefits? Forms SSA-1099, RRB-1099)
Yes
No
Unsure
Income (or loss) form rental property?
Yes
No
Unsure
Other Income? (gambling, lottery, Prizes, awards, jury duty, digital assets, SCH K-1, Royalties foreign income, etc.)
Yes
No
Unsure
Part IV – Expenses – Last Year, Did you (or your spouse) Pay
Alimony or separate Maintenance Payments?
Yes
No
Unsure
If yes do you have the recipients's SSN:
Yes
No
Contributions or repayments to a retirement account?
Yes
No
Unsure
Like
IRA
Roth IRA
401K
Other
College or post secondary educational expenses for yourself, spouse, or dependents? (form 1098-T)
Yes
No
Unsure
Any of the following?
Yes
No
Unsure
Like
Medical and Dental (including Insurance Premiums)
Taxes (State, Real Estate, Personal Property, Sales)
Mortgage Interest (Form 1098)
Charitable Contributions
Child or dependent care expenses such as daycare?
Yes
No
Unsure
For supplies used as an eligible educator such as a teacher, teacher’s aide, Counselor, etc.?
Yes
No
Unsure
Expenses related to self-employment income or any other income you received?
Yes
No
Unsure
Student loan interest? (form 1098-E)
Yes
No
Unsure
Part V- Life Events – Last Year, Did you (or Your Spouse)
Have a Health Savings Account? (forms 5498-SA, W-2 with code W in box 12)
Yes
No
Unsure
Have Credit Card, Student loan or mortgage debt cancelled/forgiven by a lender or have a home foreclosure? (forms 1099-C, 1099-A)
Yes
No
Unsure
Adopt a Child?
Yes
No
Unsure
Have Earned income credit, child Tax Credit or American Opportunity Credit disallowed in a prior year?
Yes
No
Unsure
If yes Which Tax Year?
If yes Which Tax Year?
Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.
Yes
No
Unsure
Receive the First Time Homebuyers Credit in 2008?
Yes
No
Unsure
Make estimated tax payments or apply last year’s refund to this year’s tax?
Yes
No
Unsure
If yes how much?
File a federal return last year containing a “capital loss carryover on form 1040 Schedule D?
Yes
No
Unsure
Have Health Coverage through the marketplace (exchange)? {Provide form 1095-A]
Yes
No
Unsure
Additional information and Questions Related to the preparation of your return
Would you like to receive written communication from the IRS in a language other than English?
Yes
No
If yes , Which Language?
Presidential Election Campaign Fund (if you check a box, your tax or refund will not change)
Check here if you, your spouse if filling jointly, want $3.00 to go to this fund
You
Your Spouse
if you are due a refund, would you like | direct deposit
Yes
No
To purchase U.S Savings Bonds
Yes
No
Split your refund between different accounts
Yes
No
If you have a balance due, would you like to make a payment directly from your bank account?
Yes
No
Did you live in an area that was declared a Federal Disaster area?
Yes
No
If yes , Where?
Did you, or your spouse if filling jointly, receive a letter form the IRS?
Yes
No
Would you like information on how to vote and/or how to register to vote?
Yes
No
MANY FREE TAX PREPARATION SITES OPERATE BY RECEIVING GRANT MONEY OR OTHER FEDERAL FINANCIAL ASSISTANCE. THE DATA FROM THE FOLLOWING QUESTIONS MAY BE USED BY THIS SITE TO APPLY FOR THESE GRANTS OR TO SUPPORT CONTINUED RECEIPT OF FINANCIAL FUNDING YOUR ANSWER WILL BE USED ONLY FOR STATISTICAL PURPOSES. THESE QUESTIONS ARE OPTIONAL.
Would you say you can carry on a conversation in English, both understanding and speaking?
Very Well
Well
Not Well
Not at all
Prefer not to answer
Would you say you can read a newspaper or book in English?
Very Well
Well
Not Well
Not at all
Prefer not to answer
Do you or any member of your household have a disability?
Yes
No
Prefer Not to answer
Are you or your spouse a Veteran from the U.S. Armed Forces?
Yes
No
Prefer Not to answer
Your Race?
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Prefer Not to Answer
Your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
Prefer not to answer
Your Spouses Information
Full Name
*
E-mail
*
Phone Number
*
Date of Birth
*
Date of Birth
Mailing Address
Job Title
Spouse a U.S Citizen?
Yes
No
Notes
Your Spouse Race?
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Prefer Not to Answer
Your Spouse Ethnicity?
Hispanic or Latino
Not Hispanic or Latino
Prefer not to answer
Notes
Submit
+1-813-445-3503
jsmith@bestowingupon.org
