John A. Kennedy, Jr., LLC

Certified Public Accountant

860.276.8025

phone

960 South Main Street, Plantsville, CT 06479

860.276.9669

fax

2004 Income Tax Organizer

Enter all relevant information in the designated areas on each page.  Feel free to add any notes or questions that might help us find ways to save you money.  If you need to include additional information, or ask additional questions, attach additional pages.

Basic Taxpayer Information

First Name

Initial

Last Name

SS#

Occupation

Date of Birth

Disabled (x)

Blind (x)

Dependent of Another (x)

Pres Elect Contrib (x)

Taxpayer

Spouse

Street Address

City, State, Zip

Telephone- home

Telephone- work

Email address

First Name

Initial

Last Name

SS#

Relationship

Date of Birth

Months

Dependent #1

Dependent #2

Dependent #3

Dependent #4

Dependent #5

Dependent #6