2022 US TAX RETURN TAX DATA QUESTIONNAIRE

Category:	Federal tax return:	State tax return:	Form 8938 & FBAR:	Form 5471 & 8858:	Form 3520 & 709:
Simple – from	£755 + VAT	£245 + VAT	£225 + VAT	£245 + VAT	£245 + VAT
Standard – from	£1,300 + VAT	£410 + VAT	£380 + VAT	£685 + VAT	£685 + VAT
Complex – from	£2,245 + VAT	£595 + VAT	£715 + VAT	£1,195 + VAT	£1,195 + VAT

This is an overview of the range of fees we charge for the preparation of US tax returns. Please note that the early provision of data in a full and concise manner will expedite the preparation of the tax return, which may make it unnecessary to file extensions, and will therefore ensure that fees are kept as low as possible.

PJD Tax are now authorised IRS E-Filers. All tax returns will be filed online where possible and all copies of tax returns will be sent electronically via email or our secure portal unless specifically requested otherwise. If you would prefer not to utilise either of these two options, please let us know when returning your questionnaire.

If you miss the e-file deadline, we will need to complete a paper submission which will incur a surcharge of £50+VAT. Our default postal service provider is 1st Class Royal Mail however, if you would like us to upgrade this service to Tracked & Signed or a different courier service provider, then the additional cost will be added to the e-file surcharge.

Electronic Filing – PJD Tax Consultants are authorised E-filers and will be filing your tax return online unless we have been instructed otherwise. Electronic filing allows for expedited processing of your return and refunds (if applicable). If your return is unable to be submitted electronically, we will contact you to explain an alternative filing procedure.

When your tax return is ready to be submitted to the IRS, Form 8879 will be provided for you to sign to grant us authority to electronically submit your tax return to the IRS on your behalf.
International Wire Transfers – Taxpayers settling their liability via wire transfer from a foreign bank account can use the IRS website.
Foreign Exchange Gains – Holders of non-US dollar denominated mortgages should be wary of the potential gains that arise when making lump-sum capital repayments. It is important to note that refinancing a loan can also be considered as a full repayment and the tax consequences can be significant. More information here.
Penalties for Form 3520 – These forms are prepared to report the existence of non-US trusts. It is important to be aware that the penalties associated with their incomplete, incorrect or late filing can be significant (at least $10,000). If you are in any way associated with a non-US trust, please complete Section 7 of the questionnaire.
Standard deduction - for 2022 is as follows:
- Single or Married Filing Separately – $12,950 (previously $12,550)
- Head of Household – $19,400 (previously $16,800)
- Married Filing Jointly – $25,900 (previously $25,100).
The standard deduction will increase by $1,400 per person if aged 65 or older ($1,750 if Single or Head of Household). If married and filing jointly a deduction of $27,300 if one spouse is 65 or over, $28,700 if both spouses are 65 or over.
Enhanced Credits for 2022 – The IRS has introduced changes to several credits and reliefs effective for 2022. Not all credits are applicable for all taxpayers:
- Child and Dependent Care Credit (Form 2441) – up to $4,000 per qualifying child or $8,000 for two or more children per qualifying person
- Child Tax Credit (Form 8812) – up to $2,000 per qualifying child with increased phaseout rates
- Earned Income Credit (Schedule EIC) – Expanded for taxpayers with no qualifying children
- Charitable Contributions – $300 ($600 for joint filers) allowable deduction for donations to qualifying US charities, even where taxpayers claim the standard deduction.

If you believe that any of the above topics may affect you, please consult your regular PJD Tax representative who will provide you with further information.

Tax return:

18 April, 2023:	Interest will be charged from this date on any tax owing.
18 April, 2023:	Filing extension may be required for US based taxpayers.
15 June, 2023:	Filing extension may be required for foreign based taxpayers.
16 October, 2023:	A letter of explanation must be filed if the tax return has still not been filed.
TBC November, 2023:	E-file deadline.
15 December, 2023:	Filing extensions will normally not be granted beyond this date.

FBAR (FinCEN Form 114):

17 April, 2023:	FBAR must be filed online (see Section 4). First deadline.
16 October, 2023:	Automatic extension granted to this date for taxpayers failing to meet April deadline.

2023 Quarterly estimated payments:

If you expect to owe Federal tax for 2023 you need to start making advanced payments as follows:

Payment period:	Due date:
1 January – 31 March, 2023	17 April, 2023
1 April – 31 May, 2023	15 June, 2023
1 June – 31 August, 2023	15 September, 2023
1 September – 31 December, 2023	15 January, 2024

Do you wish to make estimated payments towards 2023 tax liability? YesNo

If yes, please provide any change in your income levels in Section 17.

Exchange rates:

2022 Annual average exchange rates (use on tax return)	31 Dec’22 Year-end exchange rates (FBAR & 8938 only)
GBP – 0.811	GBP – 0.83
EUR – 0.951	EUR – 0.936
CHF – 0.955	CHF – 0.923
Can$ – 1.301	Can$ – 1.354
Sing$ – 1.379	Sing$ – 1.34
HK$ – 7.831	HK$ – 7.797

Taxpayer and spouse:

Please note that if you wish to file jointly with a non-resident alien spouse you must provide a valid social security number or taxpayer identification number for that spouse.

	Self:	Spouse:
Last name:
First name & initial:
Address:
Are you a politically exposed person? (more information)	YesNo	YesNo

Are your personal details the same as last year’s questionnaire?YesNo

There is no need to provide the following information if we prepared your tax return previously and your information remains unchanged.

	Self:	Spouse:
Marital status:
Date of marriage:
Email address:
Tel no (work & mobile):
Social security no:
Date of birth:
Country of citizenship:
Green card holder:
Occupation:
Type of foreign visa held:
Date of departure from US:
Date of arrival in the UK:
Date of departure from UK:
$3 to election campaign?
State driving license document ID no.

Refund:

If you would like your refund direct deposited, please provide US bank account information.

Name of bank:	Routing number:	Account number:	Checking / saving:

Dependents:

If any of your dependents independently files a Tax Return, please let us know.

Are your dependents details the same as last year’s questionnaire?YesNo

	Dependent 1:	Dependent 2:	Dependent 3:
Last name:
First name & initial:
Social security no:
Date of birth:
Gender:
Months lived with you:
Your percentage of support:
Full time student?

Miscellaneous:

Do you file UK tax returns?YesNo

If you have not done so already, please ensure that you provide copies of your most recently filed UK tax returns.

Are you a new client?YesNo

How did you hear about PJDTax?

Smart Search Agreement:

We are in the process of updating our KYC information for all new and existing clients. If you have not done so already, please sign our agreement to allow us to complete this process. You can download the document here

Have you signed the agreement?YesNo

The FBAR is filed separately to your tax return and reports the balance of your non-US financial accounts annually. You will be required to file if the combined balance of your non-US financial accounts exceeds $10,000 on any day in the tax year.

Further details about this form can be found here

Do you have a filing requirement for this form?YesNo

Would you like PJD Tax to prepare this form?YesNo

Please provide details in Section 6

As a registered BSA E-Filer, PJD Tax Consultants Ltd can file the Form on your behalf. To do this you will need to complete the Authorization “Form 114a” (which can both be found here) and return to your tax preparer.

We will not file the FBAR for you unless requested.

You can prepare and submit your own FBAR here.

PENALTIES

The penalty for failing to file an FBAR is $10,000 per account if the failure was non-wilful. If the failure to file is considered to be wilful, the penalty is the greater of $100,000 or 50% of the balance of each account per year. In severe cases, wilful violations can lead to harsh criminal sanctions of up to a $500,000 fine and ten years in prison.

You may be required to report additional information regarding any non-US financial assets you hold on Form 8938 as part of your US Federal tax return.

You need to complete a form 8938 if the following applies:

1

You are a US citizen, a green card holder or a Non-Resident alien electing to be treated as a US citizen; and

2

The value of your foreign financial assets exceeds:

Filling status:	Living inside the US:	Living outside the US:
Single	$50,000 at year end, or $75,000 during the year	$200,000 at year end, or $300,000 through the year
Married filing joint	$100,000 at year end or $150,000 during the year	$400,000 at year end, or $600,000 through the year
Married filing separate	$50,000 at year end, or $75,000 through the year	$200,000 at year end, or $300,000 through the year

More information can be found here.

Do you have a filing requirement for this form? YesNo

If so, please provide full details of your foreign financial assets in Section 6.
Please ensure that you provide details of any deferred compensation schemes.

PENALTIES

There is a potential penalty of $10,000 for failure to file Form 8938, this increases in the case of continued non-filing.

It is only necessary to complete this section if we are preparing your FBAR or you have a filing requirement for Form 8938. Please see Sections 4 & Section 5 for more details

Please tick here if you will be providing this information in a separate Excel document

Institution name:	Full street address and postcode:	Account number:	Does this account receive interest?:	Account owner, (taxpayer / spouse or joint):	Type of asset (Bank, securities, ISA, pension, etc) or signatory authority:	Date opened in 2022:	Date closed in 2022:	Max value during year:	Value at year end:	Currency:

Please specify currency where applicable.

You can download our template excel document *here* and then upload this in Section 17

Please answer the following with regards to 2022:

1 Did you gift any individual more than $16,000? *YesNo

If so, please confirm the individual’s relationship to you:

2 Did you receive a gift from a Non-US person? **YesNo

If so, please confirm the individual’s relationship to you:

3 Did you transfer money or property to a foreign trust?YesNo

4 Were you the owner of any portion of a foreign trust?YesNo

5 Did you receive a distribution from a foreign trust?YesNo

If you answered yes to any of the questions above, then you may need to file Form 3520 and / or Form 709. Please provide details in the space below and we will request further information if necessary:

* The annual gift exclusion for 2022 is $16,000 (this also includes gifts of property). Please note that gifts to a US citizen spouse are exempt from gift tax but if your spouse is a non-US person the tax-free amount is limited to $164,000 for 2022.

** If you received a gift from a non-US person that exceeded $100,000 or from a non-US corporation or Partnership that exceeded $17,339 then you will need to file Form 3520.

Were you or your spouse employed?YesNo

N.B. Please use Section 10 to provide self-employment information.

Employer details:

	Employer 1:
Employee name:
Employer name:
Employer address:
Date joined:
Date left:

Please provide copies of all payslips received in the year for all employments shown above and answer the following questions:

1 Do you have a US employment contract?YesNo

Please tick NO if your contract is with a UK or other non-US entity

2 Did you receive a W-2? (please provide a copy)YesNo

3 Did you receive a bonus?YesNo

For performance related bonuses please provide details of the period over which the bonus was earned:

4 Did you receive any Restricted Stock Awards or exercise any Stock Options?YesNo

Please provide a vesting schedule and details of when these awards / options were granted.

5 Did you work any days in the US?YesNo

If so, please complete the workday calendar in Section 18 as accurately as possible. When marking workdays, please include any weekends worked. You should also indicate for each workday if you were working in the US, the UK or another foreign country.

Tick to add another employment

Employer details:

	Employer 2:
Employee name:
Employer name:
Employer address:
Date joined:
Date left:

Please provide copies of all payslips received in the year for all employments shown above and answer the following questions:

1 Do you have a US employment contract?YesNo

Please tick NO if your contract is with a UK or other non-US entity

2 Did you receive a W-2? (please provide a copy)YesNo

3 Did you receive a bonus?YesNo

For performance related bonuses please provide details of the period over which the bonus was earned:

4 Did you receive any Restricted Stock Awards or exercise any Stock Options?YesNo

Please provide a vesting schedule and details of when these awards / options were granted.

5 Did you work any days in the US?YesNo

If so, please complete the workday calendar in Section 18 as accurately as possible. When marking workdays, please include any weekends worked. You should also indicate for each workday if you were working in the US, the UK or another foreign country.

Tick to add another employment

Employer details:

	Employer 3:
Employee name:
Employer name:
Employer address:
Date joined:
Date left:

Please provide copies of all payslips received in the year for all employments shown above and answer the following questions:

1 Do you have a US employment contract?YesNo

Please tick NO if your contract is with a UK or other non-US entity

2 Did you receive a W-2? (please provide a copy)YesNo

3 Did you receive a bonus?YesNo

For performance related bonuses please provide details of the period over which the bonus was earned:

4 Did you receive any Restricted Stock Awards or exercise any Stock Options?YesNo

Please provide a vesting schedule and details of when these awards / options were granted.

5 Did you work any days in the US?YesNo

If so, please complete the workday calendar in Section 18 as accurately as possible. When marking workdays, please include any weekends worked. You should also indicate for each workday if you were working in the US, the UK or another foreign country.

Tick to add another employment

Employer details:

	Employer 4:
Employee name:
Employer name:
Employer address:
Date joined:
Date left:

Please provide copies of all payslips received in the year for all employments shown above and answer the following questions:

1 Do you have a US employment contract?YesNo

Please tick NO if your contract is with a UK or other non-US entity

2 Did you receive a W-2? (please provide a copy)YesNo

3 Did you receive a bonus?YesNo

For performance related bonuses please provide details of the period over which the bonus was earned:

4 Did you receive any Restricted Stock Awards or exercise any Stock Options?YesNo

Please provide a vesting schedule and details of when these awards / options were granted.

5 Did you work any days in the US?YesNo

If so, please complete the workday calendar in Section 18 as accurately as possible. When marking workdays, please include any weekends worked. You should also indicate for each workday if you were working in the US, the UK or another foreign country.

Were you a member of a pension scheme?YesNo

Foreign pensions:

If you currently, or have previously participated in a non-US pension scheme please indicate by ticking the appropriate box below:

Employer scheme

Self-invested pension plan (SIPP)

Contributions:

Please supply the following information for 2022. If possible, please also provide a copy of the pension statement.

Non-US Pension plans	Pension 1:
Name of pension administrator
Account Holder
Amount of employer contributions
Amount of personal contributions (before tax relief)
Value of your pension scheme at the start of year
Value of your pension scheme at the end of year

Tick to add another pension

Non-US Pension plans	Pension 2:
Name of pension administrator
Account Holder
Amount of employer contributions
Amount of personal contributions (before tax relief)
Value of your pension scheme at the start of year
Value of your pension scheme at the end of year

Tick to add another pension

Non-US Pension plans	Pension 3:
Name of pension administrator
Account Holder
Amount of employer contributions
Amount of personal contributions (before tax relief)
Value of your pension scheme at the start of year
Value of your pension scheme at the end of year

Tick to add another pension

Non-US Pension plans	Pension 4:
Name of pension administrator
Account Holder
Amount of employer contributions
Amount of personal contributions (before tax relief)
Value of your pension scheme at the start of year
Value of your pension scheme at the end of year

Did you Contribute to an IRA or 401(k)? YesNo

US Pension plans *	Traditional self:	Traditional spouse:	ROTH self:	ROTH spouse:
IRA Contribution
% non-deductible
401K contributions
SEP IRA / KEOGH contributions

* Please provide copies of Forms 1099-R and 5498.

Pension distributions:

This also includes UK State Pensions and US Social Security.

1 Did you receive distributions from a US pension?YesNo

If yes, please provide form 1099-R for each distribution

2 Did you receive distributions from a non-US pension?YesNo

If yes, please provide details below and any relevant back-up documentation

Name of payer:	Lump sum or regular payment?:	Amount:	Tax paid:	Country:

Were you self-employed?YesNo

Please be aware that this page is not relevant if you are a Partner. Please see Section 11.

Please indicate the currency used on this page

Date self-employment started:

and ended:

Details of self-employment:

Trading name: Type of business: Business address:

Trading income:

Income received: Reimbursed expenses: Total received:

Home office:

If your office is in your home, you can deduct the amount of utilities relating to the area used exclusively for business.

Area exclusively used for business: Total area of home:

Expenses:

Rent: Utilities: Commission: Insurance: Legal fees: Office expense: Advertising: Maintenance: Travel: Entertainment: Miscellaneous: Other:

If there are any other expenses you feel may be relevant please use the continuation sheet provided detailing the type and the amount of the expenses.

Depreciation:

Please give full details of acquisitions & disposals of business property.

Description of asset:	Date acquired:	Date disposed:	Cost / Proceeds:	% Business use:

Individuals with significant interest in non-US corporations or partnerships may be required to supply further details of these foreign entities to the IRS.

Please answer the following with regards to 2022:

1 Were you a member of a non-US partnership?YesNo

Please provide details of your profit allocation

2 Did you set up a non-US company / corporation?YesNo

3 Did you set up, or become a partner, of a non-US partnership? YesNo

4 Did you acquire more than 10% of the total value / voting power of a non-US entity?YesNo

5 Did you own more than 50% of the total value / voting power of a non-US entity at any point in the tax year?YesNo

This should also include your spouse’s shareholding / voting power even if they are a non-US person

6 Have you previously made a Classification election on Form 8832 with regards to a non-US entity?YesNo

If you have answered yes to any of the above questions, please provide profit & loss accounts and balance sheets covering 2022 for the relevant non-US entity.

PENALTIES

A $10,000 penalty is imposed for each annual accounting period of each foreign entity for failure to report the activities of the foreign entity to the IRS by the due date of your tax return including extensions.

1 Did you have interest income?YesNo

If yes, please provide a Form 1099-INT or details below.

Source:	Currency:	Gross amount:	Tax withheld:	Joint? Y / N:

2 Did you have dividend income?YesNo

Please be aware that reinvested dividends are still reportable.

If yes, please provide a Form 1099-DIV or non-US brokerage statement.

Source:	Currency:	Gross amount:	Tax withheld:	Joint? Y / N:

3 Did you dispose of any assets or investments?YesNo

Please provide details below if you are not providing supporting documentation for all sales.

Description of asset:	Currency:	Purchase date:	Cost:	Sale date:	Proceeds:	Joint? Y / N:

4 Did you receive, sell, send, exchange or acquire any virtual currency?YesNo

Description of asset:	Currency:	Purchase date:	Cost:	Sale date:	Proceeds:	Joint? Y / N:

5 Did you sell a residential property?YesNo

Please indicate the currency used on this page

Address of property:

Date of sale: Date of purchase:

Gross sale proceeds: Original cost:

Dates and costs of any capital improvements: Was the property held jointly?:
Please specify other owner. Dates owned and used as main residence:

Please provide a copy of the closing statement and provide further details of any capital improvements on the continuation sheet (Section 17).

6 Did you or your spouse own any ISAs?YesNo

Income from ISAs has tax exempt status in the UK but is fully taxable on a US return. Please tick the following boxes that apply to you.

If so, please indicate which type below and provide full details:

1 Cash ISA

2 Single company / shares

3 Funds / unit trusts

7 Do you have non-US collective investments?YesNo

(Funds, Unit trusts, Income Bonds, etc). Please provide full details here.

8 Did you receive any income from US Partnerships, Estates & Trusts or S-Corporations?YesNo

If yes, please provide copies of forms K-1 for each. More information about the impact of holding non-US investments can be found here

Did you own a rental property?YesNo

Details of rental property:

Address of Property:
Property acquired:
First offered for rent:
Period available for rent:
Cost or other basis:
Currency used:

Capital improvements:	Date:	Cost:

Rental income:
Rents received from tenant for year:
Number of days rented in year:
Number of days of personal use in year:

Rental expenses:
Auto & travel:
Cleaning & maintenance:
Commissions:
Insurance:
Legal & professional fees:
Repairs – please specify:
Taxes:
Interest paid:
Utilities:
Other - please specify in Section 17

Tick to add another property

Details of rental property:

Address of Property:
Property acquired:
First offered for rent:
Period available for rent:
Cost or other basis:
Currency used:

Capital improvements:	Date:	Cost:

Rental income:
Rents received from tenant for year:
Number of days rented in year:
Number of days of personal use in year:

Rental expenses:
Auto & travel:
Cleaning & maintenance:
Commissions:
Insurance:
Legal & professional fees:
Repairs – please specify:
Taxes:
Interest paid:
Utilities:
Other - please specify in Section 17

Tick to add another property

Details of rental property:

Address of Property:
Property acquired:
First offered for rent:
Period available for rent:
Cost or other basis:
Currency used:

Capital improvements:	Date:	Cost:

Rental income:
Rents received from tenant for year:
Number of days rented in year:
Number of days of personal use in year:

Rental expenses:
Auto & travel:
Cleaning & maintenance:
Commissions:
Insurance:
Legal & professional fees:
Repairs – please specify:
Taxes:
Interest paid:
Utilities:
Other - please specify in Section 17

Tick to add another property

Details of rental property:

Address of Property:
Property acquired:
First offered for rent:
Period available for rent:
Cost or other basis:
Currency used:

Capital improvements:	Date:	Cost:

Rental income:
Rents received from tenant for year:
Number of days rented in year:
Number of days of personal use in year:

Rental expenses:
Auto & travel:
Cleaning & maintenance:
Commissions:
Insurance:
Legal & professional fees:
Repairs – please specify:
Taxes:
Interest paid:
Utilities:
Other - please specify in Section 17

Foreign Taxes:

Do you file foreign (non-US) tax returns?YesNo

Did you make any foreign tax payments in 2022?YesNo

This does not include any tax withheld on employment income. Please confirm the dates of any additional foreign tax payments in Section 17 and provide copies of any relevant tax returns filed.

Foreign housing expenses:

In addition to the Foreign Earned Income Exclusion it may be possible to deduct the cost of your foreign housing.

	Country 1:	Country 2:
Country of habitation:
City of habitation:
Habitation start date:
Habitation end date:
Currency:
Rent paid to landlord:
Utilities:
Annual council tax:
Other (please indicate):

If you arrived during 2022 please only include the expenses paid from the date of your arrival to 31st Dec.

Did you have a mortgage?YesNo

Mortgage interest & points:

Qualified residence interest is allowable in respect of loans on your home and one other property. If you have more than one loan, please indicate on the continuation sheet (Section 17) which loan relates to which property.

	Loan 1
Name of lender:
Amount of initial loan:
No. of joint borrowers and relationship to you:
Type of loan – Capital repayment or Interest only:
Date loan secured:
Balance of loan outstanding at start of year:
Balance of loan outstanding at end of year:
Total interest paid in calendar year:
Currency:

Tick to add another loan

	Loan 2
Name of lender:
Amount of initial loan:
No. of joint borrowers and relationship to you:
Type of loan – Capital repayment or Interest only:
Date loan secured:
Balance of loan outstanding at start of year:
Balance of loan outstanding at end of year:
Total interest paid in calendar year:
Currency:

1 Did you make any lump sum mortgage capital repayments?YesNo

Outside of any regular monthly payments.

2 Did you fully redeem or refinance your mortgage?YesNo

Amount paid – Loan 1:	Date of payment:

Amount paid – Loan 2:	Date of payment:

Please be aware that repayments of non-US dollar loans can generate taxable gains purely because of currency fluctuations. Please let us know if you are intending to make a capital repayment, fully redeem or refinance your mortgage. More information on this topic can be found here.

Other Itemised Deductions

Please tick the following deductions that are relevant to you and provide details.

Charitable contributions:

Only US charities, or US registered international charities are eligible. Contributions of $250 or more are only deductible if you have a receipt. If you made any non-cash contributions please attach a copy of the valuation document.

Donee or Charity:	Amount:	Cost of donation to you:	Date acquired (non-cash only):	Receipt (Y / N):

Medical expenses:

	Amount:	Reimbursement received:	Currency:
Medicine & drugs (prescription only):
Doctors, dentists, nurses, etc.:
Insurance premiums:
Other (please specify):

If any of the above amounts were paid via a HSA distribution please provide form 1099-SA.

Other interest paid:

Including investment and student loan / education related interest, but not personal interest (e.g. overdraft).

Lender or Type:	Amount:	Currency:

Taxes other than Federal Income Taxes:

	Amount:	Currency:
Real estate tax:
State tax (including estimated tax payments):
Property tax (please specify):
Other (please specify):

Please tick the following deductions that are relevant to you and provide details.

Did you make estimated tax payments towards your 2022 US tax liability?

	State:	Payment 1:	2:	3:	4:	Total:
Federal amount:
Date paid:

State amount:
Date paid:

Did you pay for any childcare services?

This includes the cost of childcare services for your dependent to enable you to work or look for work.

Amount Paid:	Name of provider:	Address of provider:	SSN (If applicable:)

Did you incur any qualifying education expenses?

If you incurred expenses for yourself, your spouse, or your dependent to enrol in or attend an eligible educational institute you may be able to take an educational credit. This does not include Private School fees.

Institution:	Amount:	Date:

Did you pay or receive any alimony payments?

Please provide details of any payments made to or amounts received from a former spouse. Please also provide the former spouse’s full name, address and social security number. Child support payments are not taxable / deductible in 2022.

Payer / Payee:	Amount paid / Received:	Tax deducted:	US / Foreign:

Did you receive a state tax refund?

Please provide copies of forms 1099-G.

State:	Amount:	Year:

Did you receive jobseekers allowance or out of work benefits?

If you were in receipt of UK jobseekers allowance please provide details below and a copy of P60.

Recipient name:	Amount paid:	UK Tax withheld:

Did you receive child benefit?

If you or your spouse were in receipt of child benefit then the amount received during the year needs to be reported on your US tax return and we will therefore require the total amount you or your spouse received in the calendar year. Please also ensure that you have entered all of your dependent’s information in Section 3.

Total amount received in 2022:

Please be aware that uploaded documents will not save to the web page. The questionnaire must be submitted in the same session.

Please use this area to upload files for submitting with this form (allowed file types: jpg, jpeg, png, gif, pdf, docx, doc, xls, xlsx, eml, msg, zip; file size limit is 35Mb for all files):

Have you included?

Payslips and / or W-2, P45, P60 1099 forms (1099-DIV, 1099-INT, 1099-B, 1099-R, 1099-G, etc.) K-1 forms Completed FBAR or spreadsheet listing accounts Details of non-US investments, including ISAs Completed work day calendar Smartsearch agreement

Please use this space to add on to any sections where you did not have enough room, or attach further pages if necessary.

You will only be required to complete this calendar if you worked any days in the US in 2022. If applicable, please complete using the key below:

Please confirm the number of days of annual leave in 2022:

	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22	23	24	25	26	27	28	29	30	31
Jan 2022	1S	2S	3M	4T	5W	6T	7F	8S	9S	10M	11T	12W	13T	14F	15S	16S	17M	18T	19W	20T	21F	22S	23S	24M	25T	26W	27T	28F	29S	30S	31M
Feb 2022	1T	2W	3T	4F	5S	6S	7M	8T	9W	10T	11F	12S	13S	14M	15T	16W	17T	18F	19S	20S	21M	22T	23W	24T	25F	26S	27S	28M
Mar 2022	1T	2W	3T	4F	5S	6S	7M	8T	9W	10T	11F	12S	13S	14M	15T	16W	17T	18F	19S	20S	21M	22T	23W	24T	25F	26S	27S	28M	29T	30W	31T
Apr 2022	1F	2S	3S	4M	5T	6W	7T	8F	9S	10S	11M	12T	13W	14T	15F	16S	17S	18M	19T	20W	21T	22F	23S	24S	25M	26T	27W	28T	29F	30S
May 2022	1S	2M	3T	4W	5T	6F	7S	8S	9M	10T	11W	12T	13F	14S	15S	16M	17T	18W	19T	20F	21S	22S	23M	24T	25W	26T	27F	28S	29S	30M	31T
Jun 2022	1W	2T	3F	4S	5S	6M	7T	8W	9T	10F	11S	12S	13M	14T	15W	16T	17F	18S	19S	20M	21T	22W	23T	24F	25S	26S	27M	28T	29W	30T
Jul 2022	1F	2S	3S	4M	5T	6W	7T	8F	9S	10S	11M	12T	13W	14T	15F	16S	17S	18M	19T	20W	21T	22F	23S	24S	25M	26T	27W	28T	29F	30S	31S
Aug 2022	1M	2T	3W	4T	5F	6S	7S	8M	9T	10W	11T	12F	13S	14S	15M	16T	17W	18T	19F	20S	21S	22M	23T	24W	25T	26F	27S	28S	29M	30T	31W
Sep 2022	1T	2F	3S	4S	5M	6T	7W	8T	9F	10S	11S	12M	13T	14W	15T	16F	17S	18S	19M	20T	21W	22T	23F	24S	25S	26M	27T	28W	29T	30F
Oct 2022	1S	2S	3M	4T	5W	6T	7F	8S	9S	10M	11T	12W	13T	14F	15S	16S	17M	18T	19W	20T	21F	22S	23S	24M	25T	26W	27T	28F	29S	30S	31M
Nov 2022	1T	2W	3T	4F	5S	6S	7M	8T	9W	10T	11F	12S	13S	14M	15T	16W	17T	18F	19S	20S	21M	22T	23W	24T	25F	26S	27S	28M	29T	30W
Dec 2022	1T	2F	3S	4S	5M	6T	7W	8T	9F	10S	11S	12M	13T	14W	15T	16F	17S	18S	19M	20T	21W	22T	23F	24S	25S	26M	27T	28W	29T	30F	31S
																											Totals

KEY: USUS business day (US) UKUK business day (UK) FOther foreign business day (F) NNon-business day (N)

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Team JM

John McLaughlin – 0203 861 2951
john@pjdtax.co.uk

Urooj Sheikh – 0203 861 2940
urooj@pjdtax.co.uk

Jelina Maharjan – 0203 8612 973
Jelina@pjdtax.co.uk

Tan Hallam – 0203 8612 975
Tan@pjdtax.co.uk

Vahini Kohulathasan – 0203 861 2971
vahini@pjdtax.co.uk

Team AJ

Andrew Jones – 0203 8612 943
andrew@pjdtax.co.uk

Thomas Cheung – 0203 8612 956
thomas@pjdtax.co.uk

Dan Phillips – 0203 861 2967
dan@pjdtax.co.uk

Kani Asian – 0203 8612 964
Kani@pjdtax.co.uk

Sruti Agarwal – 0203 8612 974
Sruti@pjdtax.co.uk

Team MP

Michèle Pizzey – 0203 8612 942
michele@pjdtax.co.uk

Daby Miranda – 0203 861 2955
daby@pjdtax.co.uk

Amy Kasemsuk – 0203 8612 952
amy@pjdtax.co.uk

Chanosan Sivaloganathan – 0203 8612 958
Chanosan@pjdtax.co.uk

Ankita Mathurvaishya – 0203 861 2940
ankita@pjdtax.co.uk

Ishika Jain – 0203 8612 959
Ishika@pjdtax.co.uk

Team PD

Paul Devonshire – 0203 8612 941
paul@pjdtax.co.uk

Bonnetta Brady – 0203 8612 945
bonnetta@pjdtax.co.uk

Dan Blythe – 0203 861 2957
danblythe@pjdtax.co.uk

Anusa Sivayoganathan – 0203 8612 961
anusa@pjdtax.co.uk

Michelle Neckles-Simpson – 0203 861 2940
michelle@pjdtax.co.uk

Elif Buyuk – 0203 861 2968
elif@pjdtax.co.uk

Ashish Shrestha – 0203 8612 973
Ashish@pjdtax.co.uk

Shirlene Tome – 0203 8612 961
Shirlene@pjdtax.co.uk

Team WW

Warwick Wilson – 0203 8612 944
warwick@pjdtax.co.uk

Omar Hussain – 0203 8612 948
omar@pjdtax.co.uk

Jack Turner – 0203 861 2962
jack@pjdtax.co.uk

Daniella Ekwedike – 0203 861 2965
daniella@pjdtax.co.uk

Anam Akhter – 0203 8621 965
anam@pjdtax.co.uk