2018 US NON-RESIDENT TAX RETURN QUESTIONNAIRE

Category:	Federal tax return:	State tax return:
Simple – from	£395 + VAT	£145 + VAT
Standard – from	£545 + VAT	£195 + VAT
Complex – from	£695 + VAT	£295 + 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.

Please complete the questionnaire as accurately as possible. Please ensure that you indicate the currency used where possible. Please upload any supporting documentation and provide additional notes in Section 7. When complete, please click Submit in Section 8.

Tax return:

15 April, 2019:	Interest will be charged from this date on any tax owing.
15 April, 2019:	Filing extension may be required for US based taxpayers.
17 June, 2019:	Filing extension may be required for foreign based taxpayers.
15 October, 2019:	A letter of explanation must be filed if the tax return has still not been filed.
16 December, 2019:	Filing extensions will normally not be granted beyond this date.

Exchange rates:

2018 Annual average exchange rates (use on tax return)	31 Dec’18 Year-end exchange rates (FBAR & 8938 only)
GBP – 0.75 (1.333)	GBP – 0.781 (1.280)
EUR – 0.848 (1.179)	EUR – 0.872 (1.147)
CHF – 0.979 (1.021)	CHF – 0.984 (1.016)
Can$ – 1.297 (0.771)	Can$ – 1.362 (0.734)
Sing$ – 1.349 (0.741)	Sing$ – 1.361 (0.735)
HK$ – 7.838 (0.128)	HK$ – 7.832 (0.128)

Taxpayer information:

Last name:
First name & initial:
Address:

Are you a politically exposed person? (more information)YesNo

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

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

Marital status:
Email address:
Tel no (work & mobile):
Social security no:
Date of birth:
Country of birth:
Country of citizenship:
Green card holder:
Occupation:
Date of arrival in from the US:
Date of departure from the US:
Country of residence in 2018:

Refund:

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

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

Would you like an invitation to share your documentation via our secure portal?YesNo

We will send you a paper copy of the tax return to sign and submit to the tax authorities, together with a paper copy for your records.

Would you prefer to receive your personal file copy electronically?YesNo

1 Have you ever applied to be a green card holder (lawful permanent resident) of the US?YesNo

2 Were you ever a US Citizen?YesNo

3 Were you ever a green card holder?YesNo

4 What was your visa type on the last day of the tax year?

5 Have you ever changed your visa type?YesNo

Please provide details of date and nature of change:

List dates you entered and left the United States during the tax year.

NOTE: If you are a resident of Canada or Mexico & commute to work in the U.S. at frequent intervals, tick the box for Canada or Mexico and skip to question 8 in the next section.

Canada

Mexico

Date arrived:	Date departed:

Date arrived:	Date departed:

Please indicate the number of days (including vacation, non-workdays and partial days) you were present, and the days worked, in the US during:

	2016:	2017:	2018:
Days present:
Work days:

1 Did you receive any salary income from the United States during the year?YesNo

If yes, please attach a statement describing the payor, amount earned, related expenses, nature of employment. Please provide a Form W-2.

2 Did you receive any business income from the United States during the year?YesNo

If yes, please attach a statement describing the nature of the business, the income and expenses for the year, assets purchased and information about U.S. office premises and U.S. agents.

3 Did you receive any rental income from U.S. real estate?YesNo

If yes, please provide details in Section 6.

4 Did you sell any U.S. real estate during the year?YesNo

If yes, please provide full details of acquisition and sale.

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

Please provide copies of forms K-1 for each partnership.

6 Did you realise any capital gains or losses from disposal of any assets during the tax year? YesNo

This includes shares and securities, traded options and also currency transactions including offshore currency loans. If yes, please provide the cost of the initial purchase, the date of purchase, sale proceeds, and date of sale.

7 Did you receive any other income from U.S. sources? YesNo

If yes, please provide details, including payor and amount:

8 Did your spouse (if applicable) receive any U.S. income?YesNo

9 Will your spouse (if applicable) be filing a U.S. income tax return?YesNo

Other:

Please attach a list of your non-U.S. income for the year. You should note that if your worldwide income for the year exceeded US $100,000, it is necessary to provide very specific details of your income.

10 Did your income exceed US $100,000?YesNo

Provide details and amounts of any taxes withheld or paid in the U.S. during the year. Also provide details of charitable contributions, casualty or theft losses in the U.S. and any business expenses.

Did you own a rental property in 2018?YesNo

Details of rental property:

Address of Property 1:	Address of Property 2:

	Property 1:	Property 2:
Property acquired:
First offered for rent:
Period available for rent in 2018:
Cost or other basis:

Capital improvements:	Property (1 or 2):	Date:	Cost:

Rental income:	Property 1:	Property 2:
Rents received from tenant for year:
Number of days rented in year:
Number of days of personal use in year:

Rental expenses:	Property 1:	Property 2:
Auto & travel:
Cleaning & maintenance:
Commissions:
Insurance:
Legal & professional fees:
Repairs – please specify:
Taxes:
Interest paid:
Utilities:
Other - please specify in Section 7

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

Please use this are to upload files for submitting with this form (allowed file types: pdf, docx, doc, xls, xlsx, eml, msg):

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

By providing your email address below, a copy of your submission will be sent you.

We cannot proceed with the preparation of your tax return until we receive a signed copy of this questionnaire. By clicking “I Agree” below, you confirm that your electronic signature should be acknowledged as the legal equivalent of your manual signature and having read our terms and conditions, you consent to be bound by these. You are also agreeing that the information provided in the questionnaire is complete and correct to the best of your knowledge.

Printed name: Email: Date:

Please select the team containing your usual PJD Tax Representative. The teams are listed below.

Select your team:

I agree to the terms and conditions and above statement

PRIVACY NOTICE

ARE YOU A POLITICALLY EXPOSED PERSON?

TERMS & CONDITIONS

Team Leader: Andrew Jones

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

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

John McLaughlin – 0203 8612 951
john@pjdtax.co.uk

Brian Fernandes – 0203 8612 954
brian@pjdtax.co.uk

Team Leader: Michèle Pizzey

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

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

Team Leader: Paul Devonshire

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

Daniel Blythe – 0203 8612 957
daniel@pjdtax.co.uk

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

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

Team Leader: Warwick Wilson

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

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

Mohini Dhiresh – 0203 8612 962
mohini@pjdtax.co.uk