TAX BY FAX PRINTABLE WORKSHEET

PART V - ADJUSTMENTS AND CREDITS


Simply print out the form below, fill in the information and fax or mail these copies to us,
as they pertain to you. 

In 2005 did you, your spouse or both contribute to or pay any of the following?
By marking any of the following, one of our experienced tax preparers will 
contact you shortly for more information.



 Yes     No     

_____   _____ Contribute to an IRA, SEP or other retirement plan

_____   _____ Pay Alimony

_____   _____ Pay Health Insurance

_____   _____ Move your personal residence due to a job relocation

_____   _____ Incur child or disabled dependent care expenses so you could work

_____   _____ Adopt a child


		FAX:	  802-773-9381
		ADDRESS:  4 Seasons Accounting, LLC
		          Tax By Fax
			  25 Curtis Ave.
			  Rutland, VT 05701

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