Академический Документы
Профессиональный Документы
Культура Документы
$122,850
$0
$122,850
$35,465
$15,600
$71,785
$10,800
$9,874
$0
$926
1040
Form
Your Name:
Spouse Name:
Street, No:
City,ST,ZIP:
Bruce
Byrd
Alice
Byrd
473 Revere Ave
Lowell
Not
For
Filing
2013
to
OMB No.1545-0074
Jr
111-11-1111
123-45-6789
Make sure
SSNs correct
MA 01850
Presidential
Elec Campaign
Filing
1
Status
2
Check
one
box.
Spouse name
6a
tions
b
Spouse . .
c Dependents:
Last Name
(1) First
John
Byrd
Byrd
Sam
here
Exemp-
If > 4
dependents,
check
(3) Relationship
(2) SSN
123-45-6786 Son
123-45-6787 Parent
Attach
copy B
6a+6b 2
# Children
# Lived w/
you . . . 1
Apart div . . . .
#
Other . 1
Income
(4)
Crdt
7
8a
b
9a
b
0
0
120,100
120,100
Wages, etc . . . . . . .
7
Taxable interest income. (Sch B if required) . . . . . . . . . . . . . . . . . 8a
0
Tax-exempt interest . . . . . . . . . . . . . . . . . . . . 8b
Ordinary dividends . . . . . . . . . . . . . . . . . . .
9a
0
Qual divs . . . . . . . . . . .
9b
MINI-WORKSHEET FOR LINE 10, TAXABLE REFUNDS
OF STATE AND LOCAL INCOME TAXES
Note: This mini-worksheet requires certain information
from your 2012 income tax return. If you did not create
this tax return using last year's tax data, complete the
Last Year's Data Worksheet before continuing.
a. Sum of "special case" amounts from Forms
1099-G (based on Pub. 525) . . . . . . . . . . . . . . . . . .a.
(If so, see IRS Pub. 525 and enter your taxable
refunds manually on line 10.)
b. Amount of refunds (up to diff betw deds):
Refunds received (Form 1099-G) . . . . . . . . . . . .
i.
Check to use amount on line i . . . . . . . . . . . . . . . . . . . . . . . . . . .
Check to calculate limit on taxable amt . . . . . . . . . . . . . . . . . . . .
Limitation on Taxable Amount
H&R Block load last year users who calculated (but
did not use) sales tax deduction in 2012:
Sales tax you could have
1.
deducted in 2012 . . . . . . . . . . . . . . . . . . . .
Line 1 comes from the Last Year's Data Worksheet.
We blank out lines 2 - 9 if line 1 is calculated.
Others:
2. 2012 number of exemptions . . . . . . . . . . . . . .
3. 2012 adjusted gross income . . . . . . . . . . . . . .
4. 2012 nontaxable income . . . . . . . . . . . . . . . . .
120,100
2,750
0
Not
For
Filing
5.
6.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
of W-2,
W-2G, &
1099-R
here.
10
11
12
13
14
22
Adjusted 23
24
0
0
0
0
0
0
0
122,850
25
26
27
28
a.
b.
c.
d.
e.
f.
g.
29
30
25
26
27
28
Not
For
Filing
0
0
0
0
0
0
0
0
Not
For
Filing
32
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
Income
32
33
34
35
36
Lns 23 - 35 . . . . . . . . . .
36
37
37
122,850
33
34
35
KIA
END OF PAGE 1
Form 1040 (2013)
Page 2
Byrd
SSN:
Page 2
111-11-1111
Tax and
38
Credits
39a
Blind . . .
Blind
122,850
39a 0
40
40
35,465
41
87,385
15,600
71,785
45
44
45
9,874
0
46
46
9,874
44
Not
For
Filing
a.
b.
c.
d.
47
48
49
50
51
52
53
54
Other
Taxes
55
56
57
58
59a
b
60
61
69
70
0
0
0
0
54
9,874
c.
d.
65
66
67
68
9,874
0
0
0
0
0
b.
62
63
64a
b
47
48
49
50
51
Not
For
Filing
a.
Payments
61
0
10,800
0
10,800
10,800
0
0
0
0
Refund
Direct
deposit?
See
instr.
Amount
71
Credits from:
8885 d
c
72
2439
Reserved
71
0
72
10,800
73
926
Not
For
Filing
926
No
SCHEDULE A
(Form 1040)
Bruce
ITEMIZED DEDUCTIONS
2013*07
OMB No. 1545-0074
SSN: 111-11-1111
Byrd
Note: If you and your spouse paid expenses jointly and are filing separate
returns for 2013, see IRS Publication 504 to figure the portion of joint
expenses that you can claim as itemized deductions.
CAUTION: Don't include medical expenses reimbursed or paid by others.
If you are a retired public safety officer, do not include premiums
you paid to the extent they were paid for with a tax-free distribution
from your retirement plan.
MINI-WORKSHEET FOR LINE 1,
MEDICAL EXPENSES
(MILEAGE AND TRANSPORTATION)
a. Miles driven for medical purposes:
Miles driven between 1/1 and 12/31 . . . . . . . . . . . .
i.
Deductible amount . . . . . . . . . . . . . . . . . . . . . . . . .
ii.
b. Other transportation and lodging for
treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c. Total medical mileage and transportation.
Line a.ii + line b. Include on line 1 . . . . . . . . . . . . . . . . . . . . .
MINI-WORKSHEET FOR LINE 1,
MEDICAL EXPENSES
(OTHER THAN MILEAGE AND TRANSPORTATION)
a. Self-employed health ins premium (from 1040) . . . . . . . . . . .
b. Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c. Doctors, dentists, and other care providers . . . . . . . . . . . . . .
d. Prescriptions and insulin . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e. Tests and lab fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f. Hospitalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g. Medical aids and devices . . . . . . . . . . . . . . . . . . . . . . . . . . . .
h. Other eligible expenses not previously
entered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i. Total. Include on line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
MEDICAL
1.
AND
2.
4,500
4,000
900
3,500
8,500
21,400
21,400
122,850
3.
EXPENSES 4.
a.
b.
c.
a.
b.
c.
9,115
6,050
900
6,950
Not
For
Filing
4
Number of exemptions . . . . . . . . . . . . .
122,850
Adjusted gross income . . . . . . . . . . . . .
Tax-exempt interest,
nontaxable social security and
0
railroad retirement benefits . . . . . . . . . .
Other nontaxable income (not
iv.
including rollovers) . . . . . . . . . . . . . . . .
122,850
Total available income . . . . . . . . . . . . .
v.
States of residence:
vi.
(1) State at year-end . . . . . . . . . . MA
Locality . . . .
State general sales tax rate . . . . . . . . 6.2500 %
CA and NV: Enter your combined
state and local general sales
tax rate on the following line.
Local general sales tax rate . . . . . . . .
%
(2) Other state . . . . . . . . . . . . . . .
Dates of residence in other state:
From 01/01/2013 to
Locality . . . .
State general sales tax rate . . . . . . . .
%
CA and NV: Enter your combined
state and local general sales
tax rate on the following line.
Local general sales tax rate . . . . . . . .
%
900
d. Total from tables . . . . . . . . . . . . . . . . . . . . . . . . .
e. Larger of line b. or line d . . . . . . . . . . . . . . . . . . . . . . . . . . .
f. Total sales tax for deduction
(line a + line e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Not
For
Filing
i.
ii.
iii.
TAXES
YOU
5.
6.
6,950
State and local . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Income taxes, or
a.
General sales taxes
b.
MINI-WORKSHEET FOR LINE 6,
REAL ESTATE TAXES
a. Property tax from Rentals and Royalties Wksht . . . . . . . . . .
b. Property tax from Forms 8829 for Sch C . . . . . . . . . . . . . . . .
c. Property tax from Forms 1098 . . . . . . . . . . . . . . . . . . . . . . . .
d. Other real estate taxes you paid:
Amount #1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i.
Amount #2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii.
Amount #3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii.
e. Total real estate taxes (a+b+c+d) for line 6 . . . . . . . . . . . . . .
Real estate taxes . . . . . . . . . . . . . . . . . . . . . . . . . . .
a.
b.
c.
d.
e.
PAID
7.
900
900
0
0
0
5,000
5,000
5,000
0
0
9.
8
Sum of lines 5 through 8. Total taxes . . . . . . . . . . . . . . . . . . . . . .
0
0
9
11,950
a.
b.
c.
d.
e.
f.
YOU
0
0
0
0
0
0
8,800
0
0
0
8,800
PAID
Mtg. interest
deduction may
be limited.
11
a.
b.
c.
d.
e.
12.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
13.
8,800
0
0
0
0
0
0
0
0
0
0
0
122,850
100,000
23,000
1.000
0
0
0
Not
For
Filing
Not
For
Filing
GIFTS
TO
14.
15.
16.
17.
CHARITY 18.
19.
CASUALTY
AND LOSS 20.
22.
8,800
5,250
350
0
Carryover from prior year . . . . . . . . . . . . . . . . . . . . . 18
Sum of lines 16 - 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Note: The amount on line 19 above comes from
line 4 of Part VI of our Charitable Donations
Worksheet.
5,600
JOB
21.
EXPENSES
1,075
1,075
a.
b.
c.
d.
e.
f.
g.
h.
i.
1,075
0
0
23.
Other (describe):
24.
25.
26.
27.
0
23
1,075
Sum of lines 21 to 23 . . . . . . . . . . . . . . . . . . . . . . . . 24
122,850
Amount from 1040, line 38 . . . . . . . . 25
2,457
2% of the amount on line 25 . . . . . . . . . . . . . . . . . . 26
Line 24 - line 26 (but not less than zero) . . . . . . . . . . . . . . . . . . . . 27
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
OTHER
28.
MISC.
DEDUCTIONS
0
0
0
0
28
29.
Not
For
Filing
35,465
Not
For
Filing
SCHEDULE B
INTEREST AND ORDINARY DIVIDENDS
(Form 1040A or 1040)
Bruce
Byrd
Note: Enter your data for this form on the Interest Income Worksheet
(1099-INT/OID) and the 1099-DIV Worksheet.
Caution: If you override our calculations on this form, amounts from the
worksheets will not be totalled properly on your return.
PART I
Not
For
Filing
2013*08
OMB No. 1545-0074
SSN: 111-11-1111
2,750
PART II
2
3
2,750
2,750
2,750
AMOUNT OF
ORDINARY
DIVIDENDS
Not
For
Filing
7a. At any time during 2013, did you have a financial interest in or
signature authority over a financial account, such as a bank
account, securities account, or brokerage account located in a
foreign country? See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," are you required to file FinCEN Form 114, Report of
Foreign Bank and Financial Accounts (FBAR), formerly
TD F 90-22.1 to report that financial interest or signature
authority? See FinCEN Form 114 and its instructions for filing
requirements and exceptions to those requirements . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. If you are required to file FinCEN Form 114, enter the name of
the foreign country where the financial account is located.
Country code . . . . . . . . . . . .
Name of country . . . . . . . . . .
During 2013, did you have ownership or authority over foreign
financial assets worth $50,000 or more? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note: If you check Yes, you must file Form 8938 with your return.
8.
KIA
FORM 2106
(Form 1040)
Your name
Bruce
Byrd
2013*129
OMB No. 1545-0074
Occupation
manager
Self, or
Soc Sec No
111-11-1111
Spouse.
2.
3.
4.
5.
6.
Column A
Column B
0
Vehicle expense, from line 22 or 29 . . . . . . . . . . . . . . . . . . . . . . .1
MINI-WORKSHEET FOR LINE 2,
PARKING FEES, TOLLS, LOCAL TRAINS, ETC.
Do not include expenses that involved overnight travel or
commuting to and from work.
a. Parking fees, local trains, buses, etc . . . . . . . . . . . . . . . . . .
Note: Enter on line a above parking fees,
tolls, etc., not entered on the Vehicle
Worksheet. Don't include commuting expenses.
b. Business tolls, parking from Vehicle Wksht . . . . . . . . . . . . .
c. Total. To line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Parking fees, tolls, local trains, buses, etc . . . . . . . . . . . . . . . . . .2
Travel expense while away from home overnight . . . . . . . . . . . . .3
Note: Line 3 is for expenses while away from home overnight, e.g., hotel,
car rental, airplane. Do NOT include meals & entertainment on line 3 or 4.
MINI-WORKSHEET FOR LINE 4,
OTHER BUSINESS EXPENSES
a. Depreciation expenses (e.g., computer) . . . . . . . . . . . . . . .
Note: Depreciation expenses carry from the Depreciation
Worksheet for Form 2106, if line 1 of that worksheet
is set for this copy of Form 2106.
b. Education expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note: DO NOT INCLUDE any tuition and fees you
deducted on Form 1040, line 34, (Tuition and fees
adjustment), any education expenses you deducted on Form
1040, line 23 (Educator expenses adjustment), or any
education expenses being used to claim an education
credit on Form 8863.
c. Expenses of seeking a job . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Expenses of special clothing . . . . . . . . . . . . . . . . . . . . . . . .
e. Use of home as an employee (use Form 8829) . . . . . . . . . .
Note: The amount that carries from Form 8829 is the
difference between line 35 of Form 8829 and line 14
of Form 8829. You should deduct any home mortgage
interest and real estate taxes on the appropriate
lines on Schedule A. You should deduct any casualty
or theft losses directly on Form 4684.
f. Nondeductible job expenses . . . . . . . . . . . . . .
g. Other (dues, publications, bus. gifts, etc.) . . . . . . . . . . . . . .
h. Total. To line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Business expenses not included on lines 1 to 3 . . . . . . . . . . . . . .4
Meal & entertainment expenses. See IRS instrucs . . . . . . . . . . . 5
Total expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
In Column A, add lines 1 through 4. In Column B, enter the
amount from line 5.
0
0
0
400
400
400
400
Note: If you were not reimbursed for any expenses in Step 1, skip line 7
and enter the amount from line 6 on line 8.
Step 2
Not
For
Filing
Step 3
Not
For
Filing
0
400
8a. Line 6 - line 7 (column A) . . . . . . . . . .
Note: If line 7 is greater than line 6 in Column
A (i.e., if line 8a is negative), we carry (via
the "Worksheet for Wages Not on a W-2") the amount
to Form 1040, above line 7, as other wage income.
8.
400
400
400
(CONT'D) PAGE 2
2013*54
FORM 2106
Bruce
(CONT'D) PAGE 2
Byrd
SSN:
2013*54
111-11-1111
Vehicle
Vehicle
Y
Y
Y
N
N
N
Note: Enter all your car information on the Vehicle Worksheet, whether
you use standard mileage or actual expenses.
Note: For more information about vehicles, see "Explain This Form" for
Form 2106.
Check to complete lines 22 using the standard mileage method . . . . . . . . . . . . . . . . . . . . . . . . . .
22. Multiply line 13 by 56.5 cents (.565) and enter the result here
and on line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section C
- Actual Expenses.
(a)
Vehicle 1
(a)
(b)
Vehicle 2
0
0
0
0
0
0
0
0
Vehicle 1
Note: Depreciation can only be claimed for a vehicle you own. Data
carries here from the Vehicle Worksheet.
Note: Use Section D only if you own the vehicle and are completing
Section C for the vehicle.
30. Cost or other basis . . . . . . . . . .30
31. 2013 Sec. 179 deduction
and special allowance . . . . . . . 31
Note: Line 31, Sec 179 and special allowance applies only if car was
placed in service in 2013. See IRS instructions.
32. Ln 30 * ln 14 (see inst if
claiming Sec 179 deduction
or special allowance) . . . . . . . . 32
33. Deprec. method and % . . . . . . 33
Note: For the calculations on line 32 and line 37 of Form 2106, we
generally use a percentage that is equal to business miles divided
by total miles (i.e., line 13/line 12).
Note: The description of method and percentage appearing on line 33
are prescribed by the IRS. The amount on line 34 carries from the
Vehicle Worksheet (and might not equal line 32 * line 33).
34. Deprec. amt (ln 32*33) . . . . . . .34
35. Lines 31 + 34 . . . . . . . . . . . . . .35
36. Luxury car limit . . . . . . . . . . . . .36
(b)
Vehicle 2
Not
For
Filing
Not
For
Filing
Not
For
Filing
FORM 2106
(Form 1040)
Your name
Alice
Byrd
2013*129
OMB No. 1545-0074
Occupation
manager
Self, or
Soc Sec No
123-45-6789
Spouse.
2.
3.
4.
5.
6.
Column A
Column B
0
Vehicle expense, from line 22 or 29 . . . . . . . . . . . . . . . . . . . . . . .1
MINI-WORKSHEET FOR LINE 2,
PARKING FEES, TOLLS, LOCAL TRAINS, ETC.
Do not include expenses that involved overnight travel or
commuting to and from work.
a. Parking fees, local trains, buses, etc . . . . . . . . . . . . . . . . . .
Note: Enter on line a above parking fees,
tolls, etc., not entered on the Vehicle
Worksheet. Don't include commuting expenses.
b. Business tolls, parking from Vehicle Wksht . . . . . . . . . . . . .
c. Total. To line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Parking fees, tolls, local trains, buses, etc . . . . . . . . . . . . . . . . . .2
Travel expense while away from home overnight . . . . . . . . . . . . .3
Note: Line 3 is for expenses while away from home overnight, e.g., hotel,
car rental, airplane. Do NOT include meals & entertainment on line 3 or 4.
MINI-WORKSHEET FOR LINE 4,
OTHER BUSINESS EXPENSES
a. Depreciation expenses (e.g., computer) . . . . . . . . . . . . . . .
Note: Depreciation expenses carry from the Depreciation
Worksheet for Form 2106, if line 1 of that worksheet
is set for this copy of Form 2106.
b. Education expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note: DO NOT INCLUDE any tuition and fees you
deducted on Form 1040, line 34, (Tuition and fees
adjustment), any education expenses you deducted on Form
1040, line 23 (Educator expenses adjustment), or any
education expenses being used to claim an education
credit on Form 8863.
c. Expenses of seeking a job . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Expenses of special clothing . . . . . . . . . . . . . . . . . . . . . . . .
e. Use of home as an employee (use Form 8829) . . . . . . . . . .
Note: The amount that carries from Form 8829 is the
difference between line 35 of Form 8829 and line 14
of Form 8829. You should deduct any home mortgage
interest and real estate taxes on the appropriate
lines on Schedule A. You should deduct any casualty
or theft losses directly on Form 4684.
f. Nondeductible job expenses . . . . . . . . . . . . . .
g. Other (dues, publications, bus. gifts, etc.) . . . . . . . . . . . . . .
h. Total. To line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Business expenses not included on lines 1 to 3 . . . . . . . . . . . . . .4
Meal & entertainment expenses. See IRS instrucs . . . . . . . . . . . 5
Total expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
In Column A, add lines 1 through 4. In Column B, enter the
amount from line 5.
0
0
675
0
0
675
675
675
Note: If you were not reimbursed for any expenses in Step 1, skip line 7
and enter the amount from line 6 on line 8.
Step 2
Not
For
Filing
Step 3
Not
For
Filing
0
675
8a. Line 6 - line 7 (column A) . . . . . . . . . .
Note: If line 7 is greater than line 6 in Column
A (i.e., if line 8a is negative), we carry (via
the "Worksheet for Wages Not on a W-2") the amount
to Form 1040, above line 7, as other wage income.
8.
675
675
675
(CONT'D) PAGE 2
2013*54
FORM 2106
Alice
(CONT'D) PAGE 2
Byrd
SSN:
2013*54
123-45-6789
Vehicle
Vehicle
Y
Y
Y
N
N
N
Note: Enter all your car information on the Vehicle Worksheet, whether
you use standard mileage or actual expenses.
Note: For more information about vehicles, see "Explain This Form" for
Form 2106.
Check to complete lines 22 using the standard mileage method . . . . . . . . . . . . . . . . . . . . . . . . . .
22. Multiply line 13 by 56.5 cents (.565) and enter the result here
and on line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section C
- Actual Expenses.
(a)
Vehicle 1
(a)
(b)
Vehicle 2
0
0
0
0
0
0
0
0
Vehicle 1
Note: Depreciation can only be claimed for a vehicle you own. Data
carries here from the Vehicle Worksheet.
Note: Use Section D only if you own the vehicle and are completing
Section C for the vehicle.
30. Cost or other basis . . . . . . . . . .30
31. 2013 Sec. 179 deduction
and special allowance . . . . . . . 31
Note: Line 31, Sec 179 and special allowance applies only if car was
placed in service in 2013. See IRS instructions.
32. Ln 30 * ln 14 (see inst if
claiming Sec 179 deduction
or special allowance) . . . . . . . . 32
33. Deprec. method and % . . . . . . 33
Note: For the calculations on line 32 and line 37 of Form 2106, we
generally use a percentage that is equal to business miles divided
by total miles (i.e., line 13/line 12).
Note: The description of method and percentage appearing on line 33
are prescribed by the IRS. The amount on line 34 carries from the
Vehicle Worksheet (and might not equal line 32 * line 33).
34. Deprec. amt (ln 32*33) . . . . . . .34
35. Lines 31 + 34 . . . . . . . . . . . . . .35
36. Luxury car limit . . . . . . . . . . . . .36
(b)
Vehicle 2
Not
For
Filing
Not
For
Filing
Not
For
Filing
SUPPORTING FORMS
SSN: 111-11-1111
BACKGROUND
2013
, MA 01850
Foreign country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foreign province/state/county . . . . . . . . . . . . . . . . . . . . .
Foreign postal code . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Your telephone number (daytime) . . . . . . . . . . . .
I live outside the U.S. and Puerto Rico and my main place of work is
outside the U.S. and Puerto Rico, or I'm in military or naval service
outside the U.S. and Puerto Rico.
Check here if you received a letter from the IRS with an
identity protection personal identification number (IP PIN).
IP PIN's are uncommon. They are sent to certain taxpayers
taxpayers who have had a problem with identity theft.
Taxpayer 6-digit IP PIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Spouse 6-digit IP PIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. GENERAL INFORMATION
Yours
Your spouse's
123-45-6789
Social Security number . . . . . . . . . .111-11-1111
09/21/1966
Date of birth (MM/DD/YYYY) . . . . . 06/27/1964
"X" if legally blind . . . . . . . . . . . . . . .
Enter "X" if disabled . . . . . . . . . . . . .
manager
Occupation . . . . . . . . . . . . . . . . . . .manager
"X" if you want $3 to go to
Pres. Elec. Campaign Fund . . . . . . .
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
a.
b.
c.
d.
e.
f.
Primary taxpayer
Spouse
Not
For
Filing
(CONT'D) PAGE 2
2013
Not
For
Filing
BACKGROUND
Bruce
(CONT'D) PAGE 2
Byrd
SSN:
2013
111-11-1111
0
Total estimated tax payments . . . . . . . . . . . .
If
you
and
your
spouse
each
filed
separate
extensions
but are
Note:
now filing a joint return, or if you jointly filed an extension but
are now filing separate returns, see the IRS instructions to
Form 4868 and adjust the amount on line b. accordingly.
b. Amount paid with Form 4868 (for October returns) . . . . . . . . . . . . . . . . . . . . . . . . .
MINI-WORKSHEET FOR LINE 5c
0
a. Withholding from imported Form 1099-B's . . . . . . . . .
b. Withholding from other Form 1099-B's . . . . . . . . . . . .
0
c. Total withholding on Form 1099-B . . . . . . . . . . . . . . . .
c. Withholding on Form 1099-B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Withholding on Form 1099-PATR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. PAYING YOUR TAXES BY CREDIT CARD
a. Confirmation number, if taxes are being paid by credit card.
b. Amount charged to credit card (not including convenience
fee), if taxes are being paid by credit card . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. REFUND INFORMATION
Direct Deposit
Would you like to speed your refund by having the IRS deposit it directly
into your account at a bank or other financial institution in the
United States? If so, fill in the following regarding the
account and place an X here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1a. Routing Transit Number ("RTN") . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Depositor Account Number ("DAN") . . . . . . . . . . . . . . . . . . . . . . . .
Note: Here is a sample of the numbers you might find at the bottom
of a check, with "RTN," "DAN," and check number identified.
RTN:
DAN:
Check number:
123404567
123-4567
0101
c. Type of account:
Checking
Savings
Not
For
Filing
d.
2a.
b.
c.
d.
3a.
b.
c.
d.
Not
For
Filing
(CONT'D) PAGE 3
2013
BACKGROUND
Bruce
(CONT'D) PAGE 3
Byrd
SSN:
2013
111-11-1111
Not
For
Filing
DEPENDENTS
Bruce
2013
SSN:111-11-1111
Date of Birth
02/07/1993
ITIN
Type of Dependent
Child Lived with You
Time Lived With You
Lived With When Not at College
No
No
Not
For
Filing
Not
For
Filing
No
Not
For
Filing
No
Not
For
Filing
DEPENDENTS
Bruce
2013
SSN:111-11-1111
Date of Birth
03/06/1937
ITIN
Type of Dependent
Other
Time Lived With You
Did Not Live With
No
No
Not
For
Filing
Not
For
Filing
No
Not
For
Filing
No
Not
For
Filing
Byrd
2013
SSN:
111-11-1111
Use this Worksheet to enter information from your 2012 tax return for use in
our calculations.
2012 Form 1040, 1040A or 1040EZ
1a Filing status:
Single
Married filing joint return
Married filing separate return
Head of household
Qualifying widow(er)
Spouse's Social Security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you and your spouse filed separate returns last year, check the box
if your spouse itemized deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b Form filed:
Eligible for:
2
3
Form 1040
Filed:
Form 1040
Form 1040A
Form 1040A
Form 1040EZ
Form 1040EZ
Number of exemptions (1040 line 6, 1040A line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of additional deductions (1040 line 39a, 1040A line 23a) . . . . . . . . . . . . . . . . . . . . . . . .
Note: Your entry on line 2 must be between 0 and 4.
2012 Schedule D
15 Used Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16 Line 6 of Qualified Dividends and Capital Gain Tax Worksheet or
line 13 of Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17 Line 19 of Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Line 10 of Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19 Line 7 of Qualified Dividends and Capital Gain Tax Worksheet or
line 14 of Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note: Enter the amounts on lines 20 and 21 as positive numbers.
Yes
No
SSN:
2013
111-11-1111
Line 46 (yours) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Line 48 (yours) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Line 46 (spouse's) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Line 48 (spouse's) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Not
For
Filing
SSN:
2013
111-11-1111
Not
For
Filing
Not
For
Filing
FORM 1099-INT/OID
INTEREST INCOME WORKSHEET
Use this form to report interest you received, even if it wasn't reported
on a Form 1099-INT/1099-OID.
2013
FORM 1099-INT
Box 1 -
Interest income:
Box 2 -
Box 3 -
Box 4 -
Box 7 -
Tax-exempt interest:
MINI-WORKSHEET FOR LINE 8
a. Portion of this interest item that's exempt from state
tax in the state for which you'll be filing a state tax
return as a full-year resident
Box 8 -
Box 9 -
Box 10 -
Box 11 -
State(s):
Box 12 -
Box 13 -
$
$
FORM 1099-OID
Box 1 -
$
$
Box 2 -
Box 3 -
Box 4 -
Box 5 -
Box 6 -
Box 8 -
Box 9 -
Investment expenses:
Box 10 -
State(s):
2,750
Not
For
Filing
Box 11 -
Box 12 -
$
$
Not
For
Filing
Byrd
2013
SSN:
Yourself
Your spouse
111-11-1111
Both of you
No
Description of Property . . . . . . . . . . . . . . . . . . . . . .
Name of lender/bank/co-op . . . . . . . . . . . . . . . . . . . . .
Did you receive a Form 1098 for this mortgage? . . . . . . . . . . . . . . . . . . . . . . . . Yes
Did you pay this interest to a financial institution? . . . . . . . . . . . . . . . . . . . . . . . .Yes
A.
No
No
B.
1.
2.
3.
8,800
No
Not
For
Filing
4.
5.
C.
1.
2.
Not
For
Filing
Byrd
2013
SSN:
111-11-1111
ALLOCATIONS
Complete this section if you had a home office on the mortgaged property
or you rented out any portion of the mortgaged property.
Exception: Do not make any entries in this section if this loan did not
benefit the home (e.g., a home equity loan used to pay off credit card
bills, to buy a car, or to pay tuition costs).
Exception: Do not make any entries in this section for a home office
(farming or non-farming) for which you're claiming the safe harbor
deduction, or for rental property you used as a home but that you
rented for less than 15 days.
Exception: If you used your home office for only a portion of 2013,
enter allocations in the Interview, not here.
Destination
Copy #
Description
Form 8829
Rental Wkst
Schedule F
END OF PAGE 2
Not
For
Filing
Byrd
2013
SSN: 111-11-1111
EXPLANATORY STATEMENT
Not
For
Filing
CHARITABLE
Bruce
2013
SSN:111-11-1111
Note: In this part, we ask for information about cash or money donations. If
you need to make more entries than we provide on line 1a below, you may group
several of your donations on one line so that they fit in the table. If
you have to group several donations on one line, be sure that all of them
are the same type (e.g., donations subject to 30% limit).
1a.
Name of Charity
Type
Amount
250
5,000
4.
5.
From K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mileage for charitable purposes
a. From DeductionPro . . . . . . . . . . . . . . . . .
b. Other than from DeductionPro . . . . . . . .
c. Total miles . . . . . . . . . . . . . . . . . . . . . . . .
Line 3c * 14 cents per mile . . . . . . . . . . . . . . .
Parking fees, tolls, and other
out-of-pocket expenses for
charitable purposes
a. From DeductionPro . . . . . . . . . . . . . . . . .
1b
(b)
Subject to
30% Limit
0
5,250
(c)
Total
0
0
0
0
0
Not
For
Filing
b.
c.
6.
5,250
Not
For
Filing
PART II
Not
For
Filing
350
PART III
Regular
50%
Capital Gain
30%
30%
0
END OF PAGE 3
20%
Not
For
Filing
PART IV
Not
For
Filing
Note: In this part, we apply IRS limits to the amounts you've entered and
calculate the amount of your charitable deduction for the current year and
the amount of your carryover to next year.
Charitable Donations
5,600
Current-year donations subject to 50% limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Carryover donations subject to 50% limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Current-year donations subject to 30% limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Carryover donations subject to 30% limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
Current-year capital gain donations subject to 30% limit . . . . . . . . . . . . . . . . . . . .
0
Carryover capital gain donations subject to 30% limit . . . . . . . . . . . . . . . . . . . . . .
0
Current-year capital gain donations subject to 20% limit . . . . . . . . . . . . . . . . . . . .
0
Carryover capital gain donations subject to 20% limit . . . . . . . . . . . . . . . . . . . . . .
Deduction
Carryover
in 2013
to 2014
2013 Donations Subject to 50% Limit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
122,850
61,425
5,600
0
55,825
0
0
55,825
5,600
36,855
55,825
0
0
55,825
36,855
0
0
55,825
0
0
55,825
36,855
0
0
55,825
36,855
36,855
24,570
0
0
55,825
Not
For
Filing
36,855
36,855
24,570
5,600
43.
44.
END OF PAGE 4
PART V
Carryover of charitable
donations from:
a. 2013 . . . . . . . . . . . . . . . . . . .
b. 2012 . . . . . . . . . . . . . . . . . . .
c. 2011 . . . . . . . . . . . . . . . . . . .
d. 2000 . . . . . . . . . . . . . . . . . . .
e. 2009 . . . . . . . . . . . . . . . . . . .
Totals . . . . . . . . . . . . . . . . . .
f.
PART VI
Regular
50%
30%
0
Capital Gain
30%
0
20%
0
1.
2.
3.
4.
1
2
3
4
5,250
350
0
5,600
5.
Not
For
Filing
Byrd
2013
SSN:111-11-1111
Note: On this worksheet, we gather information about certain state and local
tax payments, including estimated tax payments and other tax payments made
during 2013. This worksheet does not gather information about state and
local taxes withheld; we collect information about those taxes on other forms
(e.g., Form W-2).
Note: The information from this worksheet carries to the mini-worksheet above
line 5 of Schedule A and also to our state programs.
PART I
STATE ESTIMATED TAX PAYMENTS FOR 2013
Note: In this part, we ask for information about state estimated tax payments
for 2013. If the payment was made in 2012, it will not carry to Schedule A,
but it will carry to our state programs. If the payment was made in 2013,
then it will carry to Schedule A. We'll also carry a payment made in 2013
to our state programs unless the payment was a fourth-quarter payment for
2012 (as indicated by an "X" in the "fourth quarter" column below). Payments
made after 2013 don't carry to Schedule A but do carry to our state programs.
1. Date
(MM/DD/YYYY)
Amount
State
Abbrev.
PART II
LOCAL ESTIMATED TAX PAYMENTS FOR 2013
Note: In this part, we ask for information about local estimated tax payments
for 2013. If the payment was made in 2012, it will not carry to Schedule A.
If the payment was made in 2013, then it will carry to Schedule A. Payments
made after 2013 don't carry to Schedule A. Our state programs don't carry
information on local estimated tax payments.
3. Date
(MM/DD/YYYY)
Amount
Locality
5. Description
Amount
State
Not
For
Filing
Not
For
Filing
Abbrev.
PART IV
7. Description
Amount
Locality
Not
For
Filing
9. Description
state income tax
Amount
900
State
Abbrev.
MA
10
900
12
900
PART VI
11. Description
Amount
Locality
SUMMARY
NON-W2 WAGES
Bruce
1
2
3
4
5
You
Wages received as a household employee . . . . . . . . . . . . . . . . . . . . .
Unreported tip income and allocated tips (Form 4137) . . . . . . . . . . . . .
Taxable dependent care benefits (Form 2441) . . . . . . . . . . . . . . . . . . .
Taxable employer-provided adoption benefits . . . . . . . . . . . . . . . . . . .
Taxable scholarship and fellowship grants . . . . . . . . . . . . . . . . . . . . . .
2013
111-11-1111
SSN:
Spouse
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Not
For
Filing
2013
111-11-1111
Basic Information
Salvation Army
Choose charity name:
Salvation Army
Charity if not listed:
2. Charity address:
615 Slaters Lane
Street address
Alexandria
City
VA
State
22313
Zip
Foreign address
Clothing
3. Description of property:
4. Date of donation:
5. Miles driven to drop off items:
We'll multiply your miles by $.14 and add this amount to your
charitable deduction for mileage on Schedule A.
Note: See the help panel on the right for assistance on completing
line 6.
1.
350
Value of property:
Thrift shop value
Method used to determine fair market value:
Enter the method used to determine fair market value
(if choice is not included in list above):
8. Motor vehicle, boat, or airplane:
Vehicle year:
(YYYY)
Vehicle identification number (VIN):
Note: See the help panel on the right for assistance on completing
line 9. If you don't designate a type, we'll treat the donation as
a donation subject to the 50% limit (type "1").
6.
7.
9. Property type:
10. DeductionPro
Use DeductionPro values for this donation
Not available in Basic version.
Use the interview to access the DeductionPro valuation feature
B.
3.
C.
2.
Not
For
Filing
3.
4.
D.
Not
For
Filing
Foreign address
For tangible property, enter the place where the property
is located or kept:
Name of any person, other than the donee organization, having actual
possession of the property:
2.
3.
No
2013
Kind of property:
If tangible property was donated, give a brief summary of the
overall physical condition at the time of the gift:
8.
F.
SSN:
2013
111-11-1111
Not
For
Filing
Not
For
Filing
FORM 1098-C
Is this 1098-C for:
Yourself
Your spouse
DONOR's id no.
1 Date of contribution
2c Model
3 Vehicle or other id no
4a
4b Date of sale
5a
Donee certifies that vehicle will not be transferred for money, other
property, or services before completion of material improvements or
significant intervening use
5b
Yes
No
Under the law, the donor may not claim a deduction of more than $500 for
this vehicle if this box is checked . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FORM W-2
2013
1. Wages, etc.
62,100
2. Fed Tax WH
6,300
6. Med. Tax WH
900
8. Alloc. tips
d. Control Number
9.
11. Nonqual
plans
Employer State
Tax ID #
13. Statutory
employee . . .
Retirement
plan . . . . . . .
Third party
sick pay . . . .
16. State
17. State
18. Local 19. Local
Wages
Tax
Wages
Tax
62,100
3,100
Other Amt.
20. Locality
Name
Not
For
Filing
Not
For
Filing
FORM W-2
2013
1. Wages, etc.
58,000
Name2:
Street: 433 Broad St
Lowell
City:
01850
State: MA
ZIP:
Check if foreign address.
Note: See help panel for special
data entry instructions.
2. Fed Tax WH
4,500
5. Med. Wages
58,000
6. Med. Tax WH
841
8. Alloc. tips
d. Control Number
9.
11. Nonqual
plans
Employer State
Tax ID #
13. Statutory
employee . . .
Retirement
plan . . . . . . .
Third party
sick pay . . . .
16. State
17. State
18. Local 19. Local
Wages
Tax
Wages
Tax
58,000
2,950
Other Amt.
20. Locality
Name
Not
For
Filing
Not
For
Filing