Tax-Aide National Tax Training Committee Workbook

Tax-Aide National Tax Training Committee Workbook

TAX YEAR 2017

National Tax Training Committee Workbook

Tax Year 2017

Greetings Tax-Aide Volunteers,

Welcome to tax year 2017. The Tax-Aide National Tax Training Committee has prepared this workbook to provide you the opportunity to practice completing tax returns similar to the ones that will typically be encountered at your tax assistance site. Since the TaxSlayer tax preparation software is continuing to evolve as we enter our second year using it, practice is again key to becoming comfortable with the software prior to the start of the tax season.

Each practice return is set up to resemble, as closely as possible, the process as it actually will happen at the site:

• The taxpayer completes their portion of Form 13614-C – Intake/Interview & Quality Review Sheet.

• The preparer then completes their portion of the Intake Sheet, adds any notes about changes or additional information from the interview and ensures that all pertinent information is included on the return. (In a real-life situation you will review the information with the taxpayer before completing the tax return.)

Exercises and quizzes are included to support the instructional process and to increase awareness of scope issues.

We welcome your suggestions and comments for improving this workbook. Please send them to us via OneSupport Submit a Request.

Thank you for all you do for the program, The National Tax Training Committee

Using the NTTC Workbook

Using the NTTC Workbook – Tax Year 2017

Notes for the Instructor

Students will need to each have a user account in Practice Lab. This will enable students to prepare returns using the practice scenarios in this publication. See Practice-Lab-Accounts-for-Training on OneSupport.

For each of the practice returns, Table 1 depicts the various Form 1040 line number issues presented by the return.

Notes for the Student

If you are participating in a volunteer training class, please follow your instructor's directions for the best use of this workbook and refer to the Completing the Returns section below.

Answers

The answers using Practice Lab 2016 will be provided to instructors through their state Training Specialists. The answers using Practice Lab 2017 will be provided in the same way shortly after the 2017 tax software is released.

Completing the Returns

As with most software, there are various ways to navigate to a particular input screen. The ultimate result is the tax form, so the comments below refer to the tax form.

When completing the problems using Practice Lab 2016, use 2016 tax law. That means that extenders are in effect. The 2017 answers will incorporate law changes that take effect in 2017.

• Complete telephone numbers with any digits that the software will accept.• Replace YC, YS and YZ with your city, your state and your zip code.• To make the training experience as realistic as possible, complete the to-be-completed-by-

Certified-Volunteer-Preparer sections of Form 13614-C for each practice return. Failure to completethe preparer sections is viewed as an error by IRS SPEC.

• When Schedule B is required, respond "no" (unless the problem indicates otherwise) to thequestions regarding financial accounts in foreign countries and distributions from, grantors of, ortransferors to a foreign trust.

• When completing Form 2106 or Schedule C, unless otherwise noted, assume: the business vehiclewas placed in service on January 1 of the tax year; the figure for “Other” mileage is 10,000 miles;written records are available; and there is another vehicle for personal use.

• The 2017 sales tax tables will likely be released in January 2018. Use 2016 sales tax tables untilyour instructor says otherwise.

• Follow your instructor's direction for completing a state income tax return.• For all training scenarios, income from Puerto Rico has not been excluded.

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Table of Contents

Table of Contents

For all returns: There should be no need to change any birth years on these returns. Gambling dates should be changed to 2016 when using 2016 software. CORE Returns

There is no itemizing on these returns, so income or sales tax is not an issue. Brent .................................................................................................... 1 Clark .................................................................................................... 7 Daniels ............................................................................................... 14 Moore ................................................................................................ 21 Quincy ............................................................................................... 28 Reed .................................................................................................. 35 Stanley ............................................................................................... 42

COMPREHENSIVE Returns Stock purchase dates on short-term sales should be changed by one year when using 2016 software. All sale dates should be changed to 2016 when using 2016 software. When itemizing on these returns use the sales tax information shown.

Archer ................................................................................................ 48 Meadows ............................................................................................ 54 Miller .................................................................................................. 63 Parsons .............................................................................................. 69 Thompson .......................................................................................... 78 Wells .................................................................................................. 88 Yale ................................................................................................... 99

SPECIALTY Returns Stock purchase dates on short-term sales should be changed by one year when using 2016 software. All sale dates should be changed to 2016 when using 2016 software. When itemizing on these returns use the sales tax information shown.

Vincent (for education benefits training) ............................................. 110 Wright (for HSA training) ................................................................... 116 Young (for Immersion/Interactive training) ......................................... 124

ACA Exercises ....................................................................................................... 156

Filing Status and Exemption Exercises .................................................................... 163

Quizzes ................................................................................................................ 167

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1040

Lin

e

Description1-5 Filing status X X X X X X X X X X X X X X X X X39a TP or SP 65 or older or blind X X X x X x6 Dependents - children X X x X X X X X X x6 Dependents - other X X X X X X X7 W-2 X X X X X X X X X X X X X X

Medicaid waiver payment X8 Interest X X X X X X X X X X X x X X X9 Dividends X X X X X X X X X X X10 Taxable state income tax refund X11 Alimony received X12 Small business (Sch C) X X X X13 Capital gain X X X X X X

Capital gain distribution X X X X X X X X XInherited property X X X XSale of man home X

15 IRA distribution X X X X X XBasis in IRA (8606) X X

16 Pension distribution X X X X X X X X XDisability pension XRRB pension X XSimplified method X X X X X X X XPSO health ins X X X

17 Rents / royalties X X19 Unemployment compensation X20 Social security benefits X X X X X X X

Social security Lump Sum X21 Other income X X X X X23 Educator expenses X X25 HSA deduction X X27 Deductible part of SE tax X X X X30 Penalty on early withdrawal X X X31 Alimony paid X X32 IRA deduction X X X X33 Student loan interest deduction X X X34 Tuition and fees36 Jury duty paid to employer X X40 Itemized deductions X X X X X X

Sales tax deduction X X X X X X46/69 Excess / add'l prem tax credit X X

48 Foreign tax credit X X X X X X X X X49 Child & dependent care credit X X X X X50 Education credit X X X X X51 Retirement savings credit X X X X52 Child tax credit X X X X X X X53 Residential energy credit X57 Self-employment tax X X X X59 Additional tax on IRA60b FTHB repayment X X61 Shared responsibility payment X

SRP exemption XFull year MEC X X X X X X X X X X X X X X X X

64 FIT withheld X X X X X X X X X X X X X X X X X65 Estimated payments X X X66a Earned income credit X X X X X X67 Additional child tax credit X X X X X X68 Refundable education credit X X X X X76 Direct deposit/savings bond X X X X X X X X X X X X X78 Amount owed/direct debit X X X

Table 1 - MatrixNTTC Workbook Tax Year 2017

ARCH

ER

BREN

T

CLAR

K

CORE COMPREHENSIVE

DANI

ELS

MEA

DOW

S

MIL

LER

MO

ORE

PARS

ONS

QUI

NCY

SPECIALTY

VINC

ENT

YOUN

G

REED

STAN

LEY

THO

MPS

ON

WEL

LS

YALE

Wrig

ht

Table 1 - Matrix - iv -

Core - Bren t

Form13614-C(October 2016)

Department of the Treasury - Internal Revenue Service OMB Number1545-1964Intake/Interview & Quality Review Sheet

You will need:• Tax Information such as Forms W-2, 1099, 1098, 1095.• Social security cards or ITIN letters for all persons on your tax return.• Picture ID (such as valid driver's license) for you and your spouse.

• Please complete pages 1-3 of this form.• You are responsible for the information on your return. Please providecomplete and accurate information.

• If you have questions, please ask the IRS-certified volunteer preparer.Volunteers are trained to provide high quality service and uphold the highest ethical standards.

To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameCHARLOTTE

Ml. Last nameBRENT

Telephone number484-555-1212

Are you a U S. citizen?0 Yes No

2. Your spouse’s first nameROBERT

Ml. Last nameBRENT

Telephone number Is your spouse a U S. citizen?0 Yes No

3. Mailing address2621 TUDOR WAY

Apt # City ZIP codeYOUR STATE YOUR ZIPState

YOUR CITY4. Your Date of Birth1/21/1964

5. Your job titleDENTAL ASSISTANT

6. Last year, were you:b. Totally and permanently disabled Yes 0 No

a. Full-time student Yes 0 Noc. Legally blind Yes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled Yes 0 No

a. Full-time studentc. Legally blind

Yes 0 NoYes 0 No

7. Your spouse’s Date of Birth 8. Your spouse’s job title12/26/1962 UNEMPLOYED10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse a. Been a victim of identity theft? Yes 0 No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information

Unmarried0 Married

(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)a. If Yes, Did you get married in 2016?b. Did you live with your spouse during any part of the last six months of 2016? 0 Yes NoDate of final decree

1. As of December 31, 2016, wereyou: Yes 0 No

Note: If using 2017 software,change question 1 dates to2017.

DivorcedLegally Separated Date of separate maintenance agreement

Year of spouse’s deathWidowed

2. List the names below of:• everyone who lived with you last year (other than your spouse)• anyone you supported but did not live with you last year

If additional space is needed check here and list on page 3

To be completed by a Certified Volunteer PreparerName (first, last) Do not enter yourname or spouse’s name below

Date of Birth(mm/dd/yy)

Relationshipto you (forexample:son,daughter,parent,none, etc)

Number ofmonthslived inyour homeiast year

US Residentof US,Canada,or Mexicolast year(yes/no)

Single orMarried asof 12/31/16(S/M;

Full-timeStudent

Totally andPermanentlyDisabled(yes/no)

Is thisperson aqualifyingchild/relativeof any otherperson?(yes/no)

Did thispersonprovidemore than50% of his/her ownsupport?(yes/no)

Did thispersonhave lessthan $4,050of income?(yes/no)

Did thetaxpayers)provide morethan 50% ofsupport forthis person?(yes/no/N/A)

Did thetaxpayer(s)pay more thanhalf the cost ofmaintaining ahome for this

Citizen(yes/no) last year

(yes/no)

person?(a) (b) (c) (d) (e) (f) (h) (>) (yes/no)(g)

ANNIE BRENT 9/16/1999 DAUGHTER 12 y y s y N

Form 13614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Core - Bre nt

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Page 2Check appropriate box for each question in each sectionYes No Unsure Part III - Income - Last Year, Did You (or Your Spouse) Receive

1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-I099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

00

0000

0000

PRIZE0Yes No Unsure Part IV - Expenses- Last Year, Did You (or Your Spouse) Pay

1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes401K (B)

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc ?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)

0X2. Contributions to a retirement account? IRA (A) Other0

0000

00

0000

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

000000000

Formll 3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

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Page 3Check appropriate box for each question in each sectionYes No Unsure Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)

1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B 0 Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

4. (B) Have an exemption granted by the Marketplace?0Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount ofadvance payments.To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.)

Name (List dependents in thesame order as in Part II)

MECEntire Year

Part Year MEC(mark months with coverage)

Exemption (mark monthsexemptions applies)

ExemptionAll YearNo MEC Notes

J F M A M J J A S O N D J F M A M J J A S O N DTaxpayerJ F M A M J J A S O N D J F M A M J J A S O N DSpouseJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependent

Part VII - Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change)Check here if you, or your spouse if filing jointly, want $3 to go to this fund n You Spouse

2. If you are due a refund, would you likea. Direct deposit0 Yes

b. To purchase U S. Savings BondsYes

3. If you have a balance due, would you like to make a payment directly from your bank account? 0 Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Seivice)

c. To split your refund between different accountsNoNo No Yes

No

Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home?6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

NONE Prefer not to answerYesYes

0 No0 No

Prefer not to answerPrefer not to answer

Additional comments


Core - Brent

Interview Notes - Brent

Charlotte has not lived with her husband since August 2017, and he will not agree to file jointly with her. His name is Robert Brent (SSN 043-xx-xxxx).

She has one daughter, Annie, for whom she provides almost all support. Robert has agreed to pay Charlotte $1,000 a month for child support until Annie graduates from high school. Last year he paid for five months. Charlotte isn’t sure if she has to claim those payments on her return.

Charlotte says that the health insurance shown on her Bond Dental W-2, Block 12b, met MEC for herself and her daughter.

Robert has already filed his tax return as Married Filing Separately and did not itemize. Neither Robert nor Charlotte itemized last year.

Charlotte won a trip to Las Vegas in a contest, valued at $8,500.

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041-XX-XXXX 042-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FDR THIS NUMBER HAS BEEN ESTABLISHED FDR

CHARLOTTE BRENT ANNIE BRENT

Fa- ax-Aide Training Purposes Only Fa- ax-Aide Training Purposes Only

a. Employee's social security number041-XX-XXXX

b. Employer identification number (EIN) 1. Wages, tips, other compensation 2. Federal income tax withheld$35,776.25 $3,475.0012-OXXXXXX

3. Social security wages 4. Social security tax withheldc. Employer’s name, address, city state and ZIP Code$38,776.25 $2,404.13BOND DENTAL ASSOCIATES

5. Medicare wages and tips 6. Medicare tax withheld$38,776.25 $562.26416 CHRISTIAN COURT

PHILADELPHIA, PA 19119-2109 7. Social security tips 8. Allocated tips

d. Control number 10. Dependant care benefits9.

e. Employee's name (first, initial, last),address, city,state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12$3,000.00CHARLOTTE BRENT D

13. Statutory Retiremer Third-partyEmployee Plan sickpay 12b.

2621 TUDOR WAY $3,750.00DD

YOUR CITY, STATE, ZIP 14. Other 12c.

12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name15. State 16. State wages, tips, etc .$35,776.25

17. State income tax$1,825.42YD 120XXXXXX

Wage and TaxStatement

Copy B - To Be Filed With Employee's FEDERAL Tax Return.This information is being furnished to the Internal Revenue Service.

2017Form

Core - Brent

CORRECTED (if checked)

Dividends andDistributions

1Total Ordinary DividendsPAYER'S name, address, city,state, ZIP code 2017$15.25PAYTON FINANCIAL BANKlb Qualified Dividends Form 1099-DIV

$5.001200 TENTH STHARTFORD, CT 06101-0054 2a Total capital gain distr.

$3.002b Unrecap. Sec. 1250 gain

Copy BFor RecipientPAYER'S Federal identification number RECIPIENTS identification number 2d Collectables (28%) gain2c Section 1202 gain

12-1XXXXXX 041-XX-XXXX3 Nondividend distributions 4Federal income tax withheldRECIPIENTS name, address,dty,state, ZIP code

CHARLOTTE BRENT This is important taxinformation and isbeing furnished to

the Internal RevenueService. If you arerequired to file a

return, a negligencepenalty or othersanction may be

imposed on you ifthis income is taxable

and the IRSdetermines that it hasnot been reported.

5 Investment expenses

2621 TUDOR WAY6 Foreign Tax Paid 7Foreign Country or US possession

YOUR CITY, STATE, ZIP8 Cash liquidation distributions 9 Noncash liquidation distribution

FATCA filingrequirment

10 Exempt-Interest dividends 11Specified private activitybond interest dividends

13 State Identification no. 14 State tax withheld12 StateAccount number (see instructions)

Form 1099-DIV

CORRECTED (if checked)Payer's RTN (optional)PAYER'S name,address, dty,state, ZIP code Interest

Income2017PAYTON FINANCIAL BANK1Interest income

Form 1099-INT$23.581200 TENTH STHARTFORD, CT 06101-0054 2Early withdrawal penalty Copy B

For RecipientPAYER'S Federal identification number RECIPIENTS identification number041-XX-XXXX

3 Interest on US Savinas Bonds and Treas. obligations$265.0012-1XXXXXX

RECIPIENTS name, address, dty,state, and ZIP code

CHARLOTTE BRENT4Federal income tax withheld This is important tax

information and isbeing furnished to the

Internal RevenueService. If you arerequired to file a


imposed on you ifthis income is

taxable and the IRSdetermines that it has

not been reported


6 ForeignTax Paid 7Foreign Country or US possession

2621 TUDOR WAY9 Speafied private activity bondinterest

8 Tax exempt interest

YOUR CITY, STATE, ZIP $250.0010 Market Discount 11Bond Premium

FATCA filingrequirment 13 Bond Premium on tax-exempt bond12

16 State Identification no14Tax-exempt and tax creditbond CUSIP no. 17 State tax withheld15 StateAccount number (see instructions)

Form 1099-INT

Core - Brent

Charlotte wants any refund to be directly deposited into her checking account. If there is a balance due, she wants that amount to be electronically withdrawn from the same account.

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CORRECTED (if checked)1RentsPAYER’S name, address, city, state. ZIP coce 2017 Miscellaneous

IncomeBLUFFTON CASINO2Royalties Form 1099-MISC

1921 CORNELL COURTDETROIT, MI 48233 3 Other Income 4Federal income tax withheld Copy B

For Recipient58,500.00PAYER'S Federal identification number RECIPIENTS identification number

041-XX-XXXX5 Fishing boat proceeds 6 Medical and health care payments

51-0XXXXXX7Nonemployee Compensation 8 Substitute payments in lieu of

dividends or interestThis is important taxinformation and isbeing furnished to




taxable and the IRSdetermines that it

has not beenreported.

RECIPIENT'S name, address, city, state, ZIP code

CHARLOTTE BRENT9 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >|_

10 Crop Insurance proceeds2621 TUDOR WAY

YOUR CITY, STATE, ZIP1211

FATCA fifingrequirment

Account number (see instructions) 13 Excess golden parachutepayments

14Gross proceeds paid to anattorneyLAS VEGAS WINNER

15a Section 409A deferrals 15b Section 409A income 16 State tax withheld 17 State/Payer's state no. 18 State income

Form 1099-MISC

CHARLOTTE BRENT2621 TUDOR WAYYOUR CITY, STATE, ZIP

1234

$PAY TO THEORDER OF

DOLLARS

Your BankBank City, State, ZIP CodeFo-: 325070760 |: 00015009924 1234

Core - Clar k






To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameJEREMY

Ml. Telephone number451-555-XXXX

Last nameCLARK

Are you a U S. citizen?0 YesA No

2. Your spouse's first nameJANICE

M.l. Last nameCLARK

Telephone number Is your spouse a U S. citizen?0 Yes NoD

3. Mailing address1129 CHARLES STREET

Apt # City StateYOUR STATE YOUR ZIP

ZIP codeYOUR CITY

4. Your Date of Birth3/13/1972

5. Your job titleTECHNICIAN

6. Last year, were you:b. Totally and permanently disabled Yes 0 No c. Legally blind

a. Full-time student Yes 0 NoYes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled Yes 0 No

a. Full-time student n Yes 0 Noc. Legally blind

7. Your spouse's Date of Birth 8. Your spouse’s job title12/12/1974 ASSISTANTMANAGER Yes 0 No10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure

a. Been a victim of identity theft? Yes 0 No b. Adopted a child? Yes No11. Have you or your spouse:Part II - Marital Status and Household Information

Unmarried0 Married







If additional space is needed check here and list on page 3To be completed by a Certified Volunteer Preparer

Name (first, last) Do not enter yourname or spouse's name below



Number ofmonthslived inyour homelast year


Single orMarried asof 12/31/16(S/M)

Full-timeStudent





Did thetaxpayer(s)pay more thanhalf the cost ofmaintaining ahome for thisperson?(yes/no)



(yes/no)

(f) (h) (i)(a) (b) (c) (d) (e) (9)SEAN CLARK 9/1/2011 SON 12 Sy y N N

THOMAS CLARK 6/8/2002 SON 12 y y s y N


Core - Clar k

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1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

000000

00

000

Yes No Unsure Part IV - Expenses- Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes

X_ 401K (B)3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)

02. Contributions to a retirement account? IRA (A) Other0

0000

000

000

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year's tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover ” on Form 1040 Schedule D?

000000000

Formli 3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Core - Clar k

Page 3Check appropriate box for each question in each sectionYes Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)No Unsure

1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B 0 Form 1095-CB3. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?03b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?0

4. (B) Have an exemption granted by the Marketplace?0Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount ofadvance payments.

To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.)


MECEntire Year





Part VII - Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change)Check here if you, or your spouse if filing jointly, want S3 to go to this fund n You Spouse

2. If you are due a refund, would you like:a. Direct deposit0 Yes

3. If you have a balance due, would you like to make a payment directly from your bank account? Yes4. Pr ovide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home?6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

b. To purchase U.S. Savings BondsYes


No


0 No0 No


Additional comments


Core - Clark

Interview Notes - Clark

Jeremy and Janice were married two years ago. Janice tells you that her Social Security card has her old name because she hasn’t notified SSA of her name change.

Jeremy says he had health insurance that meets MEC through his work for himself and his two sons. Janice did not have health insurance through her job and does not qualify for any exemptions.

(You should suggest that Janice contact SSA to correct her name to prevent delays in processing returns and to safeguard any future benefits.)

Janice was laid off from her job for a few months.

They did not itemize last year, and will not itemize this year. If there is a refund, they want a direct deposit to their checking account. If they owe, they would like to have it paid directly from the same account.

Sean was in school in the morning, but spent afternoons with a neighbor, Marie Mason, until either Jeremy or Janice picked him up after work. Marie lives at 1498 Charles St. She provided her Social Security number – 055-XX-XXXX, and a receipt for $2,475 for day care.

-10-


JEREMY A CLARK JANICE S STEPHENS

Fo- ax-Alde Training] P..-poses Only Fo- ax-Alde Training] Peposes Only


THOMAS J CLARK SEAN C CLARK

Fo- ax-Alde Training] P..-poses Only Fo- ax-Alde Training] P^ -poses Only

Core - Clark


b. Employer identification number (EIN) 2. Federal income tax withheld1. Wages, tips, other compensation$22,629.75 $1,862.7513-OXXXXXX

3. Social security wages 4. Social security tax withheld$1,473.10

c. Employer's name, address, city state and ZIP Code$23,759.75MARC TECKTRONICS

5. Medicare wages and tips 6. Medicare tax withheld$23,759.75 $344.52P O BOX 717

CHARLOTTE, N.C. 28202-0717 7. Social security tips 8. Allocated tips


e. Employee's name (first, initial, last),address, city, state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12$1,130.00JEREMY CLARK D


1129 CHARLES ST. $3,458.00DD


12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name15. State 16. State wages, tips, etc.$22,629.75

17. State income tax$520.50YS 130XXXXXX



2017Form


b. Employer identification number (EIN) 1. Wages, tips, other compensation 2. Federal income tax withheld$1,522.42$25,584.5513-1XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, city state and ZIP Code$25,584.55 $1,586.24G. K. ASSOCIATES, INC.

5. Medicare wages and tips 6. Medicare tax withheld$370.98$25,584.55313 TAYLOR

STATESVILLE, N.C. 28677 7. Social security tips 8. Allocated tips

10. Dependant care benefitsd. Control number 9.

e. Employee's name (first, initial, last),address, city, state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12

JANICE STEPHENS CLARK13. Statutory Retiremer Third-party

Employee Plan sickpay 12b.1120 CHARLES ST.YOUR CITY, STATE, ZIP 14. Other 12c.

12d.


17. State income tax$640.15YS 131XXXXXX



2017Form

Core - Clark

-12-

CORRECTED (if checked)1Unemployment compensation

PAYER'S name, address, city,state, ZIP code CertainGovernment

Payments2017$2,250.00EMPLOYMENT SECURITY COMMISSION

701W MONROE STCHARLOTTE, NC 28211

2State or local income taxrefunds, credits or offsets Form 1099-G

PAYER'S Federal identification number RECIPIENTS identification number052-XX-XXXX

. Box 2 amount is for tax year 4Federal income tax withheld Copy BFor RecipientThis is important taxinformation and is

being furnished to theInternal RevenueService. If you are

required to file a return,a negligence penalty orother sanctionmay beimposed on you if thisincome is taxable and

the IRS determines thatit has not been

reported.

$112.5013-4XXXXXX6 Taxable grants5 RTAA paymentsRECIPIENTS name, address, city, state, ZIP code

JANICE CLARK8If checked, box 2 istrade or businessincome >

7 Agriculture payments1129 CHARLES ST

9 Market qainYOUR CITY, STATE, ZIP10b State identification no 11State income tax withheld10. StateAccount number (see instructions)

Form 1099-G


Payer's RTN (optional)PAYER'S name, address, city, state,ZIP code InterestIncome2017FIRST UNITED BANK

1Interest income Form 1099-INT$85.001125 S 12TH STPHILADELPHIA, PA 19102 2Early withdrawal penalty Copy B


3 Interest on US Savinqs Bonds and Treas. obligations$120.0013-2XXXXXX

RECIPIENTS name, address, city,state, and ZIP code 4Federal income tax withheld This is important taxinformation and is

being furnished to theInternal RevenueService. If you arerequired to file a




not been reported


JANICE CLARK6 ForeignTax Paid 7Foreign Country or US possession

1129 CHARLES ST9 Specified private activity bondinterest


YOUR CITY, STATE, ZIP10 Market Discount 11Bond Premium


14Tax-exempt and tax creditbond CUSIP no. 16 State Identification no 17 State tax withheld15 StateAccount number (see instructions)

Form 1099-INT

Core - Clark



1Total Ordinary DividendsPAYER'S name, address, dty, state, ZIP code 2017$198.50ACE FINANCIAL CORPORATIONlb Qualified Dividends Form 1099-DIV

$125.50726 MAIN STCHERRYVILLE, NC 28201 2a Total capital gain distr.



13-3XXXXXX 051-XX-XXXX3 Nondividend distributions 4Federal income tax withheldRECIPIENTS name, address,dty,state, ZIP code

JEREMY A CLARK This is important taxinformation and isbeing furnished to






1129 CHARLES ST6 Foreign Tax Paid 7Foreign Country or US possession

YOUR CITY, STATE, ZIP $7.658 Cash liquidation distributions 9 Noncash liquidation distribution


10 Exempt-Interest dividends 11Speafied private activitybond interest dividends


Form 1099-DIV

JEREMY A CLARK ANDJANICE S CLARK

1234

1129 CHARLES STYOUR CITY, STATE, ZIP

=PAY TO THEORDER OF

DOLLARS

Your BankBank City, State, ZIP CodeFo-

: 325070760 |: 620150606 1234

Core - Dan iels

-14-

Form 13614-C(October 2016)





To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameJAMES

Ml. Last nameDANIELS

Telephone number218-555-XXXX

Are you a U S. citizen?0 YesC No

2. Your spouse’s first nameANNETTE

Ml. Last nameDANIELS

Telephone number Is your spouse a U S. citizen?0 YesV No

3. Mailing address1024 FOREST CIRCLE


YOUR CITY4. Your Date of Birth8/5/1959

5. Your job titleHANDYMAN

6. Last year, were you:b. Totally and permanently disabled 0 Yes No


Yes 0 NoYes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled Yes 0 No c. Legally blind

a. Full-time student n Yes 0 NoYes 0 No

7. Your spouse’s Date of Birth 8. Your spouse’s job title1/11/1961 SCHOOL COUNSELOR10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? 0 Yes No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information

Unmarried0 Married



Note: If using 2017 software,change question l dates to2017.


Year of spouse's deathWidowed



To be completed by a Certified Volunteer PreparerName (first, last) Do not enter yourname or spouse's name below






Full-timeStudent



Did thispersonprovidemore than50% of hisJher ownsupport?(yes/no)


Did thetaxpayer(s)provide morethan 50% ofsupport forthis person?(yes/no/N/A)

Did thetaxpayers)pay more thanhalf the cost ofmaintaining ahome for thisperson?(yes/no)


(yes/no)

(f) (h) (i)(a) (b) (c) (d) (e) (9)

KAREN VASQUEZ 11/6/1960 SISTER S11 y y N y

Form 13614-C (Rev. 10-2016)(Catalog Number 52121E www.irs.gov

Core - Dan iels


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds,CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

000

00

0

00000

Yes No Unsure Part IV- Expenses- Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes

401K (B)3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc ?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)


00

00

00

00

00 n

Yes No Unsure Part V - Life Events- Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover’’ on Form 1040 Schedule D?

000000000

Formil 3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Core - Dan iels

-16-

Page 3Check appropriate box for each question in each section

Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)Yes No Unsure1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?03b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?



MECEntire Year





Part VII - Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change)Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse


b To purchase U S. Savings BondsYes

c. To split your refund between different accountsYesNo

No3. If you have a balance due, would you like to make a payment directly from your bank account? 0 Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home?6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

No No

NONE Prefer not to answer0 Yes

YesNo

0 NoPrefer not to answerPrefer not to answer

Additional comments


Core - Daniels

Interview Notes Daniels

The Daniels’ e-filed return for last year was rejected because someone had already filed a return using Annette’s SSN. She has a letter from IRS showing her ID PIN as 924650.

Two years ago James, as a Mason County deputy sheriff, suffered a ‘line of duty’ injury. He was declared disabled by the department and placed on a disability pension at that time. Normal pension age for Mason County Sheriff’s Department is 60.

James and Annette had health insurance that met MEC standards through his disability benefits. Annette’s sister, who has lived with them since February, is on Medicare. Her only income is $3,800 she receives annually from an insurance settlement. Karen is totally and permanently disabled.

Since retirement, James has been doing some light handyman work for a local company. In addition to Rick’s, he received $3,752 from some customers of his own. He drove his vehicle 1,456 miles for business and 7,450 other miles. The vehicle was placed in service on January 2, 2014. They have a second vehicle and he has printed logs documenting his mileage as well as other expenses.

Advertising $520 Office supplies $20

Small tools $156 Supplies $458


JAMES CHARLES DANIELS ANNETTE VASQIJEZ DANIELS

Fo- Tax-Aide Training] P^ -poses Only Fo- Tax-Aide Training] P^ -poses Only

015-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FDR

KAREN MARIE VASQUEZ

Fo- ax-Aice Training] P^ -poses Only

Core - Daniels -18-


b. Employer identification number (EIN) 1. Wages, tips,other compensation 2. Federal income tax withheld$18,654.60 $730.0014-1XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, city state and ZIP Code$1,156.59$18,654.60DAVIS YOUNG SCHOOL DISTRICT

5. Medicare wages and tips 6. Medicare tax withheld$18,654.60 $270.494816 RIDGE AVENUE

WILMINGTON, DE 19808 7. Social security tips 8. Allocated tips


e. Employee's name (first, initial, last),address, city,state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12

ANNETTE V DANIELS13. Statutory Retiremer Third-party

Employee Plan sickpay 12b.1024 FOREST CIRCLE


12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name17. State income tax15. State 16. State wages, tips, etc.$18,654.60 $625.00YS 141XXXXXX



2017Form

CORRECTED (if checked)Payer's RTN (optional)PAYER’S name, address,city, state, ZIP code Interest

Income2017TOMPKINS FINANCIAL SERVICES1Interest income Form 1099-INT$327.65125 E MAIN ST

WILMINGTON, DE 19810 2Early withdrawal penalty Copy B


3 Interest on US Savings Bonds and Treas. obligations13-3XXXXXX

RECIPIENTS name, address, dty, state,and ZIP code 4Federal income tax withheld This is important taxinformation and is


return, a negligencepenalty or othersanctionmay be



not been reported


JAMES & ANNETTE DANEILS6 Foreign Tax Paid 7Foreign Country or US possession

1024 FOREST CIRCLE9 Specified private activity bondinterest




n14Tax-exempt and tax credit

bond CUSIP no.16 State Identification no 17State tax withheld15 StateAccount number (see instructions)

Form 1099-INT

Core - Daniels



1Total Ordinary DividendsPAYER'S name, address, city,state,ZIP code 2017$825.00TOMPKINS FINANCIAL SERVICESlb Qualified Dividends Form 1099-DIV

$650.00125 E MAIN STWILMINGTON, DE 19810 2a Total capital gain distr.



13-3XXXXXX 011-XX-XXXX3 Nondividend distributions 4Federal income tax withheldRECIPIENTS name, address, city,state, ZIP code

$32.00JAMES & ANNETTE DANIELS This is important taxinformation and isbeing furnished to






1024 FOREST CIRCLE6 Foreign Tax Paid 7Foreign Country or US possession




13 State Identification no. 14State tax withheld12 StateAccount number (see instructions)

Form 1099-DIV

CORRECTED (if checked)1RentsPAYER'S name. address,city, state. ZIP coce

RICK'S HOME CARE 2017 MiscellaneousIncome2Royalties Form 1099-MISC

14 LINDEN WAYWILMINGTON, DE 19850 4Federal income tax withheld3 Other Income Copy B

For RecipientPAYER'S Federal identification number RECIPIENTS identification number


16-OXXXXXX8 Substitute payments in lieu ofdividends or interest

7Nonemployee Compensation This is important taxinformation and isbeing furnished to






RECIPIENTS name, address, city, state, ZIP code

JAMES DANIELS $3,200.009 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >[_

10 Crop Insurance proceeds1024 FOREST CIRCLE

YOUR CITY, STATE, ZIPli 12



14 Gross proceeds paid to anattorney


Form 1099-MISC

Core - Daniels

-20-

] CORRECTED (if checked) Distributions FromPensions, Annuities,

Retirement orProfit-SharingPlans, IRAs,Insurance

Contracts, etc.

1Gross distributionPAYER'S name, address, city,state, ZIP code

2017$12,250.00MASON COUNTY PENSION FUND2a Taxable amount

Form 1099-R$12,250.00240 OLD COUNTRY RDWILMINGTON, DE 19808 2b Taxable amount

not determined. TotalDistribution Copy B

Report thisincome on your

federal taxreturn. If thisform shows

federal incometax withheld inbox 4, attachthis copy toyour return.

PAYER'S Federal identificationnumber

RECIPIENTS identificationnumber

3 Capital gain (includedin box 2a). 4Federal income tax

withheld$.0012-3XXXXXX 011-XX-XXXX

5 Employee contributions/Designated Rothcontributions orinsurance premiums

RECIPIENTS name, address, city, state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesJAMES C DANIELS

1024 FOREST CIRCLE 7.DistributionCode(s)

IRA/ 8 OtherThis information isbeing furnished to

the InternalRevenue Service

SEP/SIMPLEYOUR CITY, STATE, ZIP %3

9a Your percentage of totaldistribution

9b Total Employee Contributions

%10. Amount allocable to IRR

within 5 years11. 1st year of desig. Roth contrib. 12. State tax withheld 13. State/Payer's state no.

1235914. State Distribution

$12,250.00$.00

15. Local tax withheld 16. Name of Locality 17. Local DistributionAccount number (see instructions)

Form 1099-R

JAMES C & ANNETTE V DANIELS 1234

1024 FOREST CIRCLEYOUR CITY, STATE, ZIP

$PAY TO THEORDER OF

DOLLARS

Your BankBank City, State, ZIP CodeFo-

: 325070760 I: 987124489 1234

Core - Moo re






To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameJOANNE

Ml. Last nameMOORE


Are you a U S. citizen?0 YesS No

2. Your spouse’s first name Ml. Last name Telephone number Is your spouse a U S. citizen?Yes No

3. Mailing address200 AMBER PLACE


ZIP codeYOUR CITY


5. Your job titleNURSE



Yes 0 NoYes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled Yes No c. Legally blind

a. Full-time student n Yes NoYes No

7. Your spouse’s Date of Birth 8. Your spouse’s job title

10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? Yes 0 No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information

UnmarriedMarried

(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)a. If Yes, Did you get married in 2016?b. Did you live with your spouse during any part of the last six months of 2016? Yes NoDate of final decree

1. As of December 31, 2016, wereyou: Yes No



Year of spouse’s death0 Widowed 20152. List the names below of:

• everyone who lived with you last year (other than your spouse)• anyone you supported but did not live with you last year


To be completed by a Certified Volunteer PreparerName (first, last) Do not enter yourname or spouse's name below






Full-timeStudent



Did thispersonprovidemore than50% of his1her ownsupport?(yes/no)





(yes/no)

person?(f)(a) (b) (c) (d) (e) (9) (h) (>) (yes/no)

TERESA MOORE 5/21/2002 DAUGHTER 12 Y SY y N9/28/1999DIANA MOORE DAUGHTER 12 Y y s y N

COREY MOORE 5/15/1996 SON 12 y Sy y N

Form13614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Core - Moo re

-22-


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, I099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

00

0H0000

00000

Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes

X 401K (B)3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc ?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)


0000

00

0000

Yes No Unsure Part V - Life Events- Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover’’ on Form 1040 Schedule D?

00000000

0Formll3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Core - Moo re


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B B Form 1095-CE3. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]E3a. (A) If Yes, were advancekredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?




MECEntire Year






2. If you are due a refund, would you like;a. Direct depositE Yes


3. If you have a balance due, would you like to make a payment directly from your bank account? n Yes4. Pr ovide an email address (optional)(this email address will not be used for contacts from the Internal Revenue Service)


No No No



H No0 No


Additional comments


Core - Moore

Interview Notes – Moore

Joanne was widowed in April 2015. Her husband was a federal employee at the time of his death, having worked for 30 years with the federal government. Joanne was able to start drawing his joint/survivor annuity on January 1, 2016.

Her tax-exempt interest was exempt from state tax.

Corey is a full-time student, starting his third year last fall. His grandmother made payments for the balance of his tuition and necessary fees, directly to the university on his behalf. Corey has never been convicted of a felony. His grant is to be used only for tuition.

Joanne and her husband were never able to itemize and she doesn’t plan on it this year either. She has no mortgage on her home and she has good health insurance.

She would like any refund deposited in her checking account.

Joanne’s previous tax return shows that she has a long term loss carryover of $2,755. In 2015 they sold all of the stock they owned to help with her husband’s medical expenses.

-24-

143-XX-XXXX 144-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FOR THIS NUMBER HAS BEEN ESTABLISHED FDR

COREY ANTHONY MOORE TERESA ANGELA MOORE

For . ax-Ace raining PUpcses Only For Tax-Ace raining P^-pDses Only

141-XX-XXXX 142-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FOR THIS NUMBER HAS BEEN ESTABLISHED FDR

JOANNE SUSAN MOORE DIANA MARIE MOORE

For i ax-Ace raining PUpcses Only For Tax-Ace raining P^-pDses Only

Core - Moore


b. Employer identification number (EIN) 1. Wages, tips, other compensation 2. Federal income tax withheld$30,200.04 $1,025.7510-5XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, City,State and ZIP Code$32,200.04 1,996.40JEFFERSON MEMORIAL HOSPITAL

5. Medicare wages and tips 6. Medicare tax withheld$32,200.04 $466.90101 N MARKET ST

PHILADELPHIA, PA 19102 7. Social security tips 8. Allocated tips


e. Employee's first name and initial last namef. Employee's address and ZIP code

11. Nonqualified plans 12a. See instructions for box 12

$2,000.00D13. Statutory Retiremer Third-party

Employee Plan sickpayJOANNE S MOORE 12b.

$3,500.00DD200 AMBER PLACE

14. Other 12c.YOUR CITY, STATE, ZIP

12d.

Employer's state ID number 18. Local wages, tips,etc. 19. Local income tax 20. Locality name15. State 16. State wages, tips, etc.$30,200.04

17. State income taxYS 105XXXXXX 975.80



2017Form

CORRECTED (if checked)Payer's RTN (optional)PAYER'S name,address, city, state, ZIP code Interest

Income2017BEACON BANK & TRUST CO1Interest income

Form 1099-INT$189.22123 CHERRYVILLE AVEHARTFORD, CT 06101 2Early withdrawal penalty Copy B



RECIPIENTS name, address, city, state, and ZIP code

JOANNE MOORE4Federal income tax withheld This is important tax






not been reported


6 Foreign Tax Paid 7Foreign Country or US possession

200 AMBER PLACE9 Specified private activity bondinterest



FATCA filingrequirment 12Bond 13 Bond Premium on tax-exempt bond


Form 1099-INT

Core - Moore -26-

OMB No. 1545-0119Form: 1099R

Distribution FromPersons. AnnuitiesRetrerrent or Profit-Sharing Plans. IRA’s,

Insurance Contracts, etc.

OFFICE OF PERSONNEL MANAGEMENTRETIREMENT SERVICES PROGRAM

BY p- O. BOX 45BOYERS,PA 16017-0045

STATEMENT OF SURVIVOR ANNUITY PAIDCopy B - File with Federal tax return

PAID 2017

PAYER'S Federal Identification Recipient's ID No. (Survivor) Account number (Retirement Claim No.) 1. Gross distribution? 141-XX-XXXX CSA 2916173 $17,965.0016-5XXXXXX1«3

5. Employee Contributions/Designed ROTH Contributionsor Insurance Premiums'

2a. Taxable amount> PAID5 JOANNE SUSAN MOORE! I TO• A 4. Federal Income Tax Withheldin 200 AMBER PLACE

$.007. Distribution Code(s)4-DEATH BENEFIT

YOUR CITY, STATE, ZIPn10. State Income Tax WithheldState 1

9b. Total Employee ContributionsS'.fl 2i!i 11. State Income Tax WithheldState 2$34,250.00iL E vallIII

] CORRECTED (if checked)1Payments received forqualified tuition and relatedexpenses

FILER'S name, address, city, state,and ZIP code

OAKLAND UNIVERSITY TuitionStatement$12,900.00 2017677 OAKLAND BLVD

COLUMBUS, OH 432162 Amounts billed forqualified tuition andrelated expenses Form 1098-T

FILER'S federal identification no. STUDENTS taxpayer identification no143-XX-XXXX10-8XXXXXX 3 If this box is checked, your educational institution

has changed its reporting method for 2017. Copy BFor StudentSTUDENTS name, address, city, state,and ZIP code

4 Adjustments made for aprior year

5 Scholarships or grantsCOREY MOORE This is importanttax information

and is beingfurnished to the

Internal RevenueService. This form

maybe used tocomplete Form 8863to claim education

credits. Give it to thetax preparer or use it toprepare the tax return.

$10,000.00200 AMBER PLACEYOUR CITY, STATE, ZIP 7Checked if the amount in

box 1or 2 includesamounts for an academic

6 Adustments toscholarships or grantsfor a prior year

period begining January-i—iMarch 2018. > I—I

Service Provider/Acct No. (see instr.) 3. Checked if at least r—,half-time student [XJ

9 Checked if a graduatestudent

10 Ins. contract reimb/refund

Form 1098-T

Core - Moore

VOIDCORRECTED

> Information about Form 1095-B and its separate instructions is at www.irs.gov/forml095c.

OMB No. 1545-22511095-C Employer-Provided Health Insurance Offer and CoverageForm 2017Deps'tment of the Treasury'Entemal Revenue Service

Employee Applicable Large Employer Member (Employer)o Employer os'ivcaconmroer(E VI1 Name of Employee

JOANNE SUSAN MOORE2 Social Security Number (SSNJ

141-XX-XXXX7 Name of Employer

JEFFERSON MEMORIAL HOSPITAL 1D-5XXXXXX3 Street Address fnduding aoaorent number)

ZOO AMBER PLACE9 Sreet Address fncJudtig room or suite}1D1N MARKET ST

10 Contact fldepfione nurrcer61Q-555-XXXX

4,5.6 City or Town, Stale or Province, ZIP or Postal Code 11,12,13 City or Town, State or Province, ZIP or Posal CodePHILADELPHIA, PA 19102YOUR CITY , STATE, ZIP

Employee Offer and Coverage Plan Start Month (Enter 2-digit number): 01Feb JulJan Mar Apr May Jun Aug Sep Oct Nov DecAJ 12 Mociflis

uOUST >-rCoverage (enterreqJ red cede) 1C

15Erpoyeeiffi.reiioyTi'ZO-i

rSTJ“dTS) 555

15 Section4-WCH5=PSHa&or andOfef Re & ,;ernsfcode ifapp cable)

Covered IndividualsIf Employer provided self-insured coverage, check the box and enter the information for each individual enrolled in coverage, including the employee.I I

(c) DQB( ifSSNOP otier TIN is not

avafafete

(d) Covereda 12 Montis

(e) Montis of coverage{a} Name of covered ndivduats {bJSSNcroiher TINJan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

17 JOANNE SUSAN MOORE 141-XX-XXXX18 DIANAMARIE MOORE 142-XX-XXXX19 COREY ANTHONY MOORE 142-XX-XXXX20 TERESAANGELAMOORE 144-XX-XXXXZ1

zz

Form: 1095-C

JOANNE S. MOORE 1234

200 AMBER PLACE

YOUR CITYr STATE, ZIP=PAY TO THE

ORDER OFDOLLARS

Your BankBank Cityr Stater ZIP CodeFo-

: 325070760 1: 00140117532 1234

Core - Qu incy -28- Form 13614-C

(October 2016)Department of the Treasury - Internal Revenue Service OMB Number

1545-1964Intake/Interview & Quality Review SheetYou will need:

• Tax Information such as Forms W-2, 1099, 1098, 1095.• Social security cards or ITIN letters for all persons on your tax return.• Picture ID (such as valid driver's license) for you and your spouse.



To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameMARIE

Ml. Last nameQUINCY

Telephone number447.555.XXXX

Are you a U S. citizen?0 YesA No

2. Your spouse’s first name M.l. Last name Telephone number Is your spouse a U S. citizen?Yes No

3. Mailing address3300 BOWIE DRIVE


ZIP codeYOUR CITY

5. Your job titleDENTAL ASSISTANT


a. Full-time student Yes 0 Noc. Legally blind

4. Your Date of Birth1/21/1950 Yes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled Yes No c. Legally blind

a. Full-time student n Yes NoYes No


10. Can anyone claim you or your spouse on their tax return? Yes No Unsure11. Have you or your spouse: a. Been a victim of identity theft? Yes 0 No b. Adopted a child? Yes NoPart II - Marital Status and Household Information

0 UnmarriedMarried





Year of spouse’s death0 Widowed 20122. List the names below of:








Single orMarried asof 12/31/16(SMI)

Full-timeStudent



Did thispersonprovidemore than50% of hisJher ownsupport?(yes/no)





(yes/no)

(a) (b) (c) (d) (e) (0 (g) (h) (•)


Core - Qu incy


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? ONE2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

000000

00

000

Yes No Unsure Part IV- Expenses- Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes2. Contributions to a retirement account?3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc ?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)

0IRA (A) 401K (B) Other0

0000000000

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year's tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover’’ on Form 1040 Schedule D?

000000000


Core - Qu incy

-30-


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?



MECEntire Year





Part VII - Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change)Check here if you, or your spouse if filing jointly, want $3 to go to this fund n You Spouse



3. If you have a balance due, would you like to make a payment directly from your bank account? Yes4. Pr ovide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Seivice)


No



0 No0 No


Additional comments


Core - Quincy

Interview Notes – Quincy

Marie still works part time for a dentist, but is also receiving Social Security payments.

Marie’s husband, George, passed away in 2012. He had worked for the U.S. Government for 31 years until he started drawing his pension on October 1, 1986. His birthday was 2/25/1931.

George was informed that pensions that started between 7/2/1986 and 12/31/1986 have no limit on the exclusion, and has been excluding the proper amount every year.

Last year she owed quite a bit in income tax, so she requested to have taxes withheld from her Social Security check. She doesn’t know if she had enough, but doesn’t mind paying a little. She decided to also send in two estimated payments of $500 each. The dates were June 8 and September 8.

Her tax exempt interest was not exempt from her state tax, as it was from another state.

047-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FOR

MAIRE ANN QUINCY

For icx-Aide raining P,_ -poses Only

MARIE ANN QUINCY 1234

3300 BOWIE DRIVEYOUR CITY, STATE, ZIP

SPAY TO THEORDER OF

DOLLARS

Your BankBank City,State, ZIP CodeFor

|: 325070760 |: 124522695 1234

Core - Quincy

-32-



3. Social security wages 4. Social security tax withheldc. Employer's name, address, City,State and ZIP Code$12,240.78 758.93MEGA DENTAL ASSOCIATES

5. Medicare wages and tips 6. Medicare tax withheld$12,240.78 $177.493205 KYLE COURT

TAMPA, FL 33602 7. Social security tips 8. Allocated tips




13. Statutory Retiremer Third-partyEmployee Plan sickpay

MARIE QUINCY 12b.3300 BOWIE DRIVE


12d.


17. State income taxYS 041XXXXXX 935.00



2017Form


Payer's RTN (optional)PAYER'S name, address, city, state, ZIP code InterestIncome2017ARCHES-STARLING BANK

1Interest income Form 1099-INT$25.00P O BOX 27866HARTFORD, CT 06301-7866 2Early withdrawal penalty Copy B


3 Interest on US Savinas Bonds andTreas. obligations$75.0004-3XXXXXX

RECIPIENTS name, address, city, state, and ZIP code 4Federal income tax withheld This is important taxinformation and is





not been reported


MARIE A QUINCY 6 Foreign Tax Paid 7Foreign Country or US possession

3300 BOWIE DRIVE9 Specified private activity bondinterest




14Tax-exempt and tax creditbond CUSIP no. 16 State Identification no 17State tax withheld15 StateAccount number (see instructions)

Form 1099-INT

Core - Quincy

CORRECTED (if checked) Distributions FromPensions, Annuities,

Retirement orProfit-Sharing

Plans, IRAs,Insurance

Contracts, etc.

1Gross distributionPAYER'S name, address, dty,state, ZIP code

2017$12,000.00BOXER INVESTMENT SERVICES2a Taxable amount

Form 1099-R$12,000.00373 SW ELM AVENEW PORT RICHIE, FL 34655 2b Taxable amount

not determined.Total

Copy BReport this

income on yourfederal tax

return. If thisform shows

federal incometax withheld inbox 4,attachthis copy toyour return.

Distribution




withheld$1,200.0059-9XXXXXX 047-XX-XXXX


RECIPIENTS name, address, dty,state, ZIP code 6 Net unrealizedappreaation inemployer's securitiesMARIE A. QUINCY

3300 BOWIE DRIVE 7.DistributionCode(s)



SEP/SIMPLEYOUR CITY, STATE, ZIP %7 E




within 5 years11. 1st year of desig. Roth contrib. 12. State tax withheld 13. State/Payer's state no. 14. State Distribution

16. Name of Locality15. Local tax withheld 17. Local DistributionAccount number (see instructions)

Form 1099-R

OMB No. 1545-0119Form: 1099R

Distribution FromPersons. AnnuitiesRetrer-ent or Profit-Sharing Plans. IRA’s.



BY p- O. BOX 45BOYERS,PA 16017-0045

STATEMENT OF SURVIVOR ANNUITY PAIDCopy B - File with Federal tax return

PAID 2017

PAYER'S Federal Identification Reapient's ID No. (Survivor) Account number (Retirement Claim No.) 1. Gross distributiont 047-XX-XXXX 0472515972 $17,585.2516-5XXXXXX5n


2a. Taxable amountI PAID MARIE ANN QUINCYTO5 I* * s 4. Federal Income Tax Withheldil 3300 BOWIE DRIVEu

$.007. Distribution Code(s)4-DEATH BENEFIT

YOUR CITY, STATE, ZIPI I 10. State Income Tax WithheldState 1Hi 9b. Total Employee Contributionstt •*> *i l i 11. State Income Tax WithheldState 2$34,250.00ma i lIII

Core - Quincy

-34-

FORM SSA-1099 - SOCIAL SECURITY BENEFIT STATEMENT

2017 O PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME.

° SEE THE REVERSE FOR MORE INFORMATION.

Box 2. Beneficiary's Social SecurityBox 1. NameMARIE ANN QUINCY 047-XX-XXXX

Box 3. Benefits Paid in 2017

$12,476.59Box 4. Benefits Repaid to SSA in 2017 Box 5. Net Benefits Paid for 2017 (Box 3 minus Box 4)

$12,476.59

DESCRIPTION OF AMOUNT IN BOX 3Paid by check or direct deposit

Medicare Part B premiums deductedfrom your benefits

Medicare Prescription Drugpremiums (Part D) deducted fromyour benefits

Total Additions

Benefits for 2017

DESCRIPTION OF AMOUNT IN BOX 4

$9,937.79

$1,258.80

$280.00

$12,476.59$12,476.59

Box 6. Voluntary Federal Income Tax Withheld$1,000.00

Box 7. AddressMARIE ANN QUINCY

Benefits for 2016 3300 BOWIE DRIVEYOUR CITY, STATE, ZIPBenefits for 2015

Benefits for 2014 Box 8. Claim Number (use this number if you need to contact SSA)047-XX-XXXXA

Form SSA-1099-SM

Core - Re ed






To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameJOHN

M.l. Last nameREED


Are you a U S. citizen?0 YesJ No

2. Your spouse’s first nameELIZABETH

M.l. Last nameREED

Telephone number Is your spouse a U S. citizen?0 Yes NoA

3. Mailing address108 NPHILLIPS ST


ZIP codeYOUR CITY


5. Your job titleINSULATION INSTALLER


a. Full-time student Yes 0 Noc. Legally blind Yes 0 No


a. Full-time student n Yes 0 NoYes 0 No

7. Your spouse's Date of Birth7/14/1964

8. Your spouse’s job titleDATA INPUT


Unmarried0 Married





Year of spouse's deathWidowed








Single orMarried asof 12/31/16(SMI)

Full-timeStudent








(yes/no)

(a) (b) (c) (d) (e) (f) (g) (h) (')JACK REED 9/9/1994 SON 12 Sy y y N2/2/2015JEFFREY REED GR.SON 12 Y y s N N


Core - Re ed -36-


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? TWO2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

00

00

00000

00000

Yes No Unsure Part IV- Expenses- Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes

401K (B)3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc ?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)

0IRA (A) $2,0002. Contributions to a retirement account? Other

00

00

00

0000

Yes No Unsure Part V - Life Events- Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year's tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

000000000


Core - Re ed


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B 0 Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advanceicredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?




MECEntire Year





Part VII- Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change)Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse


b. To purchase U S. Savings BondsNo

3. If you have a balance due, would you like to make a payment directly from your bank account? n Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)

c. To split your refund between different accountsNoNo Yes Yes

No

Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home? NONE6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

Prefer not to answerYes

0 Yes0 No

NoPrefer not to answerPrefer not to answer

Additional comments


Core - Reed

Interview Notes – Reed

John and Elizabeth Reed have been coming to the same Tax-Aide site for many years. This year they have some changes.

Their son Jack and his son Jeffrey moved in with them in 2015, after Jack’s wife divorced him. They have lived with John and Elizabeth since then while Jack finishes his college education. Jack is in his third year, attending full time and has never been convicted of a felony. He has no income, but he does have a scholarship that can be used only for his tuition fees. John and Elizabeth provide total support for both Jack and Jeffrey. They also paid $2,000 for Jack’s books and fees at Harris College.

Jeffrey stays at a day care facility on the days Jack attends college so John and Elizabeth can work. Elizabeth pays the bill.

John’s employer provides insurance for the Reeds, and John was able to add Jeffrey to the policy by paying an additional amount.

John and Elizabeth have investments with Butler Investment Services. Part of the income from those investments was from tax-exempt dividends. They are not tax-exempt in their state.

-38-


JOHN JAMES REED ELIZABETH ANN REED

Fo- ax-Alde Training] P..-poses Only Fo- ax-Alde Training] Peposes Only


JACK EDWARD REED JEFFREY ALLEN REED


Core - Reed


b. Employer identification number (EIN)43-1XXXXXX

1. Wages, tips, other compensation 2. Federal income tax withheld$34,715.22 $2,276.50

3. Social security wages 4. Sodal security tax withheldc. Employer's name, address, City, State and ZIP Code$2,152.34$34,715.22KING INSULATION

5. Medicare wages and tips 6. Medicare tax withheld$34,715.22 $503.372300 EAST OLIVET

FRANKLIN, PA 16323-2267 7. Social security tips 8. Allocated tips

10. Dependant care benefitsd. Control number 9.e. Employee's first name and initial last namef. Employee's address and ZIP code


$4,650.00DD13. Statutory Retiremer Third-party

Employee Plan sickpayJOHN J. REED 12b.108 N. PHILLIPS ST.


12d.


17. State income tax1,375.10YS 4317183



2017Form



3. Social security wages 4. Social security tax withheldc. Employer's name, address.City,State and ZIP Code$17,765.40 $1,101.45CLOVER PAYROLL COMPANY, INC.

5. Medicare wages and tips 6. Medicare tax withheld$17,765.40 $257.60P O BOX 22554

PITTSBURGH, PA 15202-2554 7. Social security tips 8. Allocated tips





Employee Plan sickpayELIZABETH REED 12b.108 N PHILLIPS ST.


12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name15. State 16. State wages, tips, etc .$15,765.40

17. State income taxYS 38612456 875.75



2017Form

Core - Reed

-40-

] CORRECTED (if checked)


1Total Ordinary DividendsPAYER'S name, address, city, state, ZIP code 2017$275.20BUTLER INVESTMENT SERVICESlb Qualified Dividends Form1099-DIV

$205.002121 PEMBROOK PARKWAYPITTSBURGH, PA 15219 2a Total capital gain distr.



43-3XXXXXX 161-XX-XXXX3 Nondividend distributions 4Federal income tax withheldRECIPIENTS name, address, city,state, ZIP code

JOHN & ELIZABETH REED $14.00 This is important taxinformation and isbeing furnished to






108 N. PHILLIPS ST.6 Foreign Tax Paid 7Foreign Country or US possession




$75.00$300.0013 State Identification no. 14 State tax withheld12 State

Account number (see instructions)

Form 1099-DIV

J CORRECTED (if checked)1Payments received forqualified tuition and relatedexpenses


HARRIS COLLEGE TuitionStatement2017$11,500.00

100 COLLEGE DRIVEFRANKLIN, PA 16323

2 Amounts billed forqualified tuition andrelated expenses Form 1098-T

FILER'S federal identification no. STUDENTS taxpayer identification no43-4XXXXXX 163-XX-XXXX 3 If this box is checked, your educational institution

has changed its reportingmethod for 2017. Copy BFor StudentSTUDENTS name, address, city,state,and ZIP code


5 Scholarships or grantsJACK EDWARD REED This is importanttax information



maybe used tocomplete Form 8863to claim education


$9,500.00108 N PHILLIPS ST.YOUR CITY, STATE, ZIP 7Checked if the amount in

box 1or 2 includesamounts for an academic


period begining January -i—iMarch 2018. > I—I

Service Provider/Acct No. (see instr.) 8. Checked if at least ,—,half-time student [XJ



Form 1098-T

Lafayette Day Care775 Campbell DriveYour City,State,ZipPhone: 464-555-2222

EIN 12-4xxxxxx

January 25, 2015

Received for day care for Jeffrey ReedJanuary -December 2017: $1,875.00

Account paid in full

Core - Reed

VOIDCORRECTED

> Information about Form 1095-B and its separate instructions is at www.irs.gov/forml095c.

OMB No. 154S-22511095-C Employer-Provided Health Insurance Offer and CoverageForm 2017Depatrent of the Treasury'Internal Revenue Service

Employee Applicable Large Employer Member (Employer)1Name of EmployeeJOHN JAMES REED

2 Social Secuncy Number {SSN}161-XX-XXXX

7 Name of EmployerKING INSULATION

SEmployer osnt -'caconnur©er(E vi43-1XXXXXX

3 Street Address fnduAng apartment number)108 N. PHILLIPS ST.

9 Street Address fncltcfrig room or suue)2300 EAST OLIVET

10 Contact telephone number234-555-XXXX

4,5,6 Cty or Town, State or Province, ZIP or Postal CodeYOUR CITY. STATE. ZIP

11,12,13 C*y or Town, State or Provnce, ZIP or Postal CodeFRANKLIN. PA 16323-2267

Employee Offer and Coverage Plan Start Month (Enter 2-digit number):Feb JulJan Mar May Jun Sep Oct Nov DecApr AugAM 12 Montis

HOierofCoverage (enterreqjred code) IE

15 E~oo.ee=teqjreoConrojton(see instuckons) 5S5 1,850.00

16 5eCon4980HBa narwanaCTer =ie e*(ernercode. - ax> caoe;i

Covered IndividualsIf Employer provided self-insured coverage, check the box and enter the information for each individual enrolled in coverage, including the employee.I I

(c) DOB{ if SSNor odier TIN is not

ava aoe

(d) Coveredal 12 Montis

(e) Montis of coverage(b) SSN or other TIN(a) Name of covered ndrvtdualsJan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

17 JOHN JAMES REED m161-XX-XXXX

18 ELIZABETH ANN REED m162-XX-XXXX

19 JACK EDWARD REED m163-XX-XXXX

20 JEFFREY ALLEN REED m164-XX-XXXX

21

22

Form: 1095-C

JOHN & ELIZABETH REED108 N. PHILLIPS ST.YOUR CITYr STATE, ZIP

1234

5PAY TO THEORDER OF

DOLLARS

Your BankBank City,State, ZIP CodeFor

: 325070760 |: 150030045 1234

Core - Stan ley -42- Form13614-C

(October 2016)Department of the Treasury - Internal Revenue Service OMB Number

1545-1964Intake/Interview & Quality Review SheetYou will need:




To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)


1. Your first nameJESSICA

Ml. Last nameSTANLEY

Are you a U S. citizen?0 YesD No

2. Your spouse’s first name Ml. Last name Telephone number Is your spouse a U S. citizen?Yes No

3. Mailing address1734 HILLSDALE CIRCLE

Apt # City924 YOUR CITY

StateYOUR STATE YOUR ZIP

ZIP code


5. Your job titleREGISTERED NURSE


a. Full-time student Yes H Noc. Legally blind Yes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled Yes No

a. Full-time student Yes Noc. Legally blind

7. Your spouse’s Date of Birth 8. Your spouse’s job titleYes No

10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? Yes No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information

0 UnmarriedMarried

(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)a. If Yes, Did you get married in 2016?


b. Did you live with your spouse during any part of the last six months of 2016? Yes NoDate of final decree


0 Divorced 6/30/2013Legally Separated Date of separate maintenance agreement




usName (first, last) Do not enter yourname or spouse s name below




Residentof US,Canada,or Mexicolast year(yes/no)

Single orMarried asof 12/31/16(SM)

Full-timeStudent








(yes/no)

person?(a) (b) (c) (d) (e) (f) <h) 0) (yes/no)(g)

Form 13614-C (Rev. 10-2016)|Catalog Number 52121E www.irs.gov

Core - Stan ley

Page 2Check appropriate box for each question in each sectionYes No Unsure Part III - Income- Last Year, Did You (or Your Spouse) Receive

1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT. 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099. RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

000

00

0

0000

GAMBLING0Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay

1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes2. Contributions to a retirement account?

NoRoth IRA (B)

0YES IRA (A) 401K (B) Other0

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher s aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

00000

00000

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover’’ on Form 1040 Schedule D?

000000000

Form!l3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Core - Stan ley

-44-


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advance!credit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?



MECEntire Year







b. To purchase U.S. Savings BondsNo



Yes No


0 No0 No


Additional comments


Core - Stanley

Interview Notes – Stanley

Jessica has been divorced since 2013. Her ex-husband has been paying her alimony since then in the amount of $1,200 per month.

She received a refund of $125 from last year’s state tax return. She did not itemize last year, nor will she itemize this year. She doesn’t have the document with her, because someone told her she won’t have to claim that as income.

Jessica reports that she had gambling losses of $1,800 incurred on her trip to a casino in Reno. That amount did not include any travel, lodging or meals.

This year Jessica decided to start contributing to an IRA she had started several years ago. She wants to contribute the maximum amount for which she can get a deduction on her tax return.

Jessica inherited a little Woodward Small Tool stock from her father. He had paid $1 per share when he purchased it. On the date of his death it was valued at $10 per share. Jessica had held on to the stock since 2015 but decided to sell it this year.

Jessica made four estimated payments in a timely manner, of $550 each.


JESSICA DENISE STANLEY

Fo- aa-Akfe Training] -poses Only

JESSICA D. STANLEY 1234

1734 HILLSDALE CIRCLE, APT 924YOUR CITY, STATE, ZIP

SPAY TO THEORDER OF

DOLLARS

Your BankBank City, State, ZIP CodeFo-: 325070760 I: 42251030 1234

Core - Stanley

-46-



3. Social security wages 4. Social security tax withheldc. Employer's name, address, City, State and ZIP Code$32,561.25 $2,018.80STANFORD REGIONAL HOSPITAL

6. Medicare tax withheld5. Medicare wages and tips$32,561.25 $472.141525 SUFFOLK WAY

NEWARK, NJ 07102 7. Social security tips 8. Allocated tips



11. Nonqualified plans 12a. See instructions for box 12$4,680.00DD


JESSICA D. STANLEY 12b.1734 HILLSDALE CIRCLE, APT 924


12d.


17. State income taxYS 6410000 1,085.20



2017Form


Payer's RTN (optional)PAYER'S name, address, city, state, ZIP code InterestIncome2017LAMAR BANK

1Interest income Form 1099-INT$14.755501 TULANE AVEBALTIMORE, MD 21233 2Early withdrawal penalty Copy B


3 Interest on US Savinas Bonds and Treas. obligations64-2XXXXXX

RECIPIENTS name, address, city, state,and ZIP code 4Federal income tax withheld This is important taxinformation and is


return,a negligencepenalty or othersanction may be



not been reported


JESSICA STANLEY6 Foreign Tax Paid 7Foreign Country or US possession

1734 HILLSDALE CIRCLE, APT 9249 Specified private activity bondinterest



FATCA filingrequirment 12 Bond 13 Bond Premium on tax -exempt bond


Form 1099-INT

Core - Stanley

] CORRECTED (if checked)1. Gross winnings 2. Date wonPAYER'S name, address, city, state, and ZIP code 201706/23/2017$2,250.00BUTLER CASINO3. Type of wager 4. Federal income tax withheld

Form W2-G$225.00SLOT MACHINE2233 CLARK HIGHWAY5. Transaction 6. Race

CertainGamblingWinnings

RENO, NV 895107. Winnings from identical wagers 8. Cashier

PAYER'S Federal identification number Payer's Telephone number9. Winner's taxpayer identification no. 10. Window This information

s being furnishedto the Internal

Revenue Service

64-3XXXXXX 775-555-XXXX061-XX-XXXX

WINNER'S name, address, dty, state, and ZIP 12. SecondI.D.11. FirstI.D.JESSICA STANLEY

13. State Payer's identification no. 14. State Winnings Copy BReport this incomeon your federal taxreturn. If this form

shows federalincome

tax withheld inbox 4, attach this

copy to your return.

1734 HILLSDALE CIRCLE, APT 92415. State income tax withheld 16. Local Winnings

YOUR CITY, STATE, ZIP17. Local income tax withheld 18. Name of locality

Under penalty of perjury,Ideclare that, to the best of my knowledge and belief, the name, address, taxpayer indentification number thatIfurnishedcorrectly identify me as the recipient of this payment and any payment from identical wagers, and no other person is entitled to any part of these payments.Signature > Date >

Form W-2G

] CORRECTEDProceeds From

Broker andBarter Exchange

Transactions

Applicable Check Box on Form 8949PAYER'S name, address, dty,state, ZIP code 2017WOODWARD SMALL TOOLS CORPORATIONForm1099-B

3265 WOODWARD BLVDla Description of Property (Example 100 sh. XYZ Co.)20 SHARES WOODWARD SMALL TOOLS STOCKDETROIT, MI 48203

lb Date acquired lc Date sold or disposed12/14/201711/18/1975 Copy B

For RecipientPAYER'S Federal identification number RECIPIENTS identification number Id Proceeds le Cost or other basis$350.0044-1XXXXXX 061-XX-XXXX

If AccruedMarket Discount lg Wash sale loss disallowed

This is important taxinformation and isbeing furnished to






2Type of Gain or lossShort term gain or lossLong term gain or lossOrdinary

3If checked, basis reportedto IRSRECIPIENTS name, address, dty, state, ZIP code

JESSICA D STANLEY X

1734 HILLSDALE CIRCLE, APT 924 4Federal income tax withheld 5 If checked, noncoveredsecurity E

YOUR CITY, STATE, ZIP7If checked, loss is not alloweddue to amount in Id

6 Reported to IRSGross proceedsNet proceeds B

8 Profit or (loss) realizedin 2017 on dosed contracts

9 Unrealized profiit or (loss) onopen contracts - 12/31/2016Account number (see instructions)

CUSIP number FATCA filingrequirement

10 Unrealized profiit or (loss) onopen contracts - 12/31/2017

11Aggragate profit or (loss)on contracts

14State Name 15 State identification no. 18 State tax withheld12 Check if proceeds fromcollections

12Bartering

Form 1099-B

Comprehen sive - Archer

-48- Form 13614-C(October 2016)





To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)1. Your first nameSAIL

M.l. Last nameARCHER


Are you a U.S. citizen?0 Yes No

2. Your spouse’s first name M.l. Is your spouse a U.S. citizen?Yes

Last name Telephone numberNo

3. Mailing address2715 BISHOP ST


ZIP codeYOUR CITY




5. Your job titleMANAGER c. Legally blind

Yes NoYes No

9. Last year, was your spouse:b. Totally and permanently disabled

a. Full-time studentYes No c. Legally blind


10. Can anyone claim you or your spouse on their tax return? Yes Unsure0 No11. Have you or your spouse: a. Been a victim of identity theft? Yes 0 No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information1. As of December 31, 2016, wereyou:

0 UnmarriedMarried


Yes No






Name (first, last) Do not enter yourname or spouse’s name below






Full-timeStudentlast year(yes/no)







Citizen(yes/no)

(b) (d) (f) (b) (i)(a) (c) (e) (9)GRACE ANN ARCHER 2/12/1944 MOTHER 12 y y s N N




1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

0 100

000000

00000

Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes

IRA (A)NoRoth IRA (B)

0X2. Contributions to a retirement account? 401K (B) Other0

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher's aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

00000

0000

0Yes No Unsure Part V -Life Events - Last Year, Did You (or Your Spouse)

1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover" on Form 1040 Schedule D?

000000000

Formil3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov


-50-


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B 0 Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

4. (B) Have an exemption granted by the Marketplace?0Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income,marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount ofadvance payments.To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.)


MECEntire Year





Part VII - Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box. your tax or refund will not change)Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse





No No


0 No0 No


Additional comments


Comprehensive - Archer

Interview Notes – Archer

Gail is the manager of a restaurant. This year she paid interest on her student loan. She provides a receipt showing the amount.

Gail’s employer contributed $1,800 to her HSA account. Gail added another $1,550 herself because she received a small inheritance of $8,000 from an aunt. She took a distribution of $1,350, which she spent only on allowable medical expenses

She put $4,000 into her existing IRA in December, to count as her 2017 contribution.

Gail’s mother Grace, is widowed, lives in another state, and cannot be claimed by anyone else. Gail provides more than half of her mother’s support. Grace’s only income is her Social Security plus a small pension which pays her $220./month. She has no filing requirement. She has Medicare for her health insurance.


GAIL ARCHER GRACE ANN ARCHER

Fo- aa-Akfe Training] -poses Only Fo- aa-Akfe Training] P^ -poses Only


RECIPIENTS/LENDER'S name, address, city,state, and ZIP codePEOPLES FEDERAL BANK 2017 Student

Loan InterestStatement

P O BOX 54321SAN DIEGO, CA 92109-4321 Form1098-E

RECIPIENT'S federal identification no.10-1XXXXXX

BORROWER'S social security nunber 1Student loan interest received by lender Copy BFor Borrower$250.00021-XX-XXXX

BORROWER'S name, address, city,state and ZIP code The important taxinformation and is beingfurnished to the InternalRevenue Service. If you

are required to file areturn, a negligence

penalty or othersanction may be

imposec on you if theIRS cetermines that anunderpayment of taxresults because you

overstatec a deduction forstudent loan interest.

GAIL ARCHER

2715 BISHOP STYOUR CITY, STATE, ZIP

Account number (see instructions) 2If checked box 1does not indude loan originationfees and/or capitalized interest for loans made beforeSeptember, 12004

Form 1098-E

Comprehensive - Archer -52-


b. Employer identification number (EIN) 1. Wages, tips,other compensation 2. Federal income tax withheld$30,925.45 $2,546.5510-0XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, city state and ZIP Code$1,917.38$30,925.45SIR LOIN STEAKHOUSE

5. Medicare wages and tips 6. Medicare tax withheld$30,925.45 $448.4224 BAUER ST

SAN DIEGO, CA 92109-3504 7. Social security tips 8. Allocated tips


e. Employee's name (first, initial, last),address, city,state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12

$1,800.00GAIL ARCHER W13. Statutory Retiremer Third-party

Employee Plan sickpay 12b.2715 BISHOP ST $4,250.00DD


12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name17. State income tax15. State 16. State wages, tips, etc.$30,925.45 $375.00YS 100XXXXXX



2017Form

CORRECTED (if checked)Payer's RTN (optional)PAYER’S name, address,city, state, ZIP code Interest

Income2017PEOPLES FEDERAL BANK1Interest income Form 1099-INT$34.50P O BOX 54321

SAN DIEGO, CA 92109-4321 2Early withdrawal penalty Copy B


3 Interest on US Savings Bonds and Treas. obligations$125.0010-1XXXXXX

RECIPIENTS name, address, dty, state,and ZIP code 4Federal income tax withheld This is important taxinformation and is





not been reported


GAIL ARCHER6 Foreign Tax Paid 7Foreign Country or US possession

2715 BISHOP ST9 Specified private activity bondinterest






Form 1099-INT

Comprehensive - Archer

VOIDCORRECTED

OMB No. 1545-22511095-C Employer-Provided Health Insurance Offer and Coverage> Information about Form 1095-B and its separate instructions is at www.irs.gov/forml095c.

Form 2017Depa-tr-ent of the TreasuryInternal Revenue Service

Employee Applicable Large Employer Member (Employer)1Name of EmployeeGAIL ARCHER

2 Social Securty Number (SSN)101-XX-XXXX

7 Narre of EmployerSIR LOIN STEAKHOUSE

5Employer osm^caton number (EVi

10-QXXXXXX3 Street Address (ndwfeng apartment number)2715 BISHOP ST

S Street Address (iidudng room or suite)24 BAUER ST

10 Contact telephone number221-555-1122

4,5,6 City or Town, State or Province, ZIP or Postal CodeYOUR CITY. STATE. ZIP

11,12,13 C*y or Town, State or Province, ZIP or Postal CodeSAN DIEGO. CA 92109-3504

Employee Offer and Coverage Plan Start Month (Enter 2-digit number):JulFebJan Mar Apr May Jun Aug Sep Oct Nov DecAl 12 Months

wOftrofCcr.'eraje .;emErregjrefl coae) IB

15Employee=l«3JredConrojton

see 'tsrjccrtsiSSS 1.500.0016 Secon 49SCH5a^ -iaft>cranaOner =le e* (entercoae. - aaa cabte)

Covered IndividualsIf Employer provided self-insured coverage, check the box and enter the information for each individual enrolled in coverage, including the employee. I I

(c) DOB{ if SSNor odier TIN is not

avaiiabe

(d) Coveredal 12 Monflts

(e) Montis of coverage(a) Name of covered vitfviduafts (b) SSN or otier TINJan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

17 GAILARCHER m101-XX-XXXX 04/16/1989

18

19

20

21

22

Form: 1095-C

GAIL ARCHER2715 BISHOP STYOUR CITYr STATE, ZIP

1234

EPAY TO THEORDER OF

DOLLARS

Your BankBank City, State, ZIP CodeFor

: 325070760 |: 2531600117 1234

Comprehen sive - M

eadows

-54- Form 13614-C(October 2016)


You will need:• Tax Information such as Forms W-2, 1099, 1098, 1095.• Social security cards or ITIN letters for all persons on your tax return.• Picture ID (such as valid driver’s license) for you and your spouse.



To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year’s return)

M.l.1. Your first nameALBERT

Last nameMEADOWS


Are you a U.S. citizen?0 YesJ No

2. Your spouse’s first nameLOIS

M.l. Telephone number Is your spouse a U.S. citizen?0 Yes

Last nameMEADOWS NoC

3. Mailing address24 NORTH ST


ZIP codeYOUR CITY




5. Your job titleRETIRED Yes 0 No


a. Full-time student Yes 0 NoYes [0 No

7. Your spouse’s Date of Birth 8. Your spouse’s job title3/25/1976 TEACHER10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? Yes 0 No b. Adopted a child? n Yes 0 NoPart II - Marital Status and Household Information1. As of December 31, 2016, wereyou:

Unmarried0 Married


Yes 0 No






To be completed by a Certified Volunteer PreparerName (first , last) Do not enter yourname or spouse’s name below













Citizen(yes/no)

(b) (d) (f) (b) (i)(a) (c) (e) (9)

WARREN MEADOWS 6/21/2002 SON 12 y y s y N


Comprehen sive - M

eadows



000

0000000

00

000

Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? 0 Yes

401K (B)NoRoth IRA (B)

0IRA (A) ON W-22. Contributions to a retirement account? Other0

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

0000

00

00

00

Yes No Unsure Part V - Life Events- Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover" on Form 1040 Schedule D?

000000000

Formll3614“C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Comprehen sive - M

eadows

-56-


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?03b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?0

4. (B) Have an exemption granted by the Marketplace?Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount ofadvance payments.To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.)


MECEntire Year





Part VII - Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change )

Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse2. If you are due a refund, would you like:a. Direct depositE) Yes


3. If you have a balance due, would you like to make a payment directly from your bank account? 0 Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)


No Yes No


Prefer not to answerYesYes

No0 No


Additional comments


Comprehensive - Meadows

Interview Notes – Meadows

Albert was previously married to Eleanor Meadows (SSN 128-xx-xxxx). He pays her $400 per month in alimony.

Albert retired from AMTRAK and started drawing his pension on December 2015, after 30 years of service. His pension was set up as joint/survivor.

Albert is not eligible for retiree health insurance coverage at this time, Lois doesn’t have health insurance thru her employer, and Warren has no health insurance. Albert purchased health insurance thru the Marketplace for the entire family in December 2016.

Lois shows receipts totalling $273 for items she purchased for her students. She meets all qualifications for taking the educator expense deduction.


ALBERT JAMES MEADOWS LOIS CHRISTINE MEADOWS

Fo- sx-A'ce Training] P^ -poses Only Fo- aa-Akfe Training] P^ -poses Only


WARREN ALBERT MEADOWS

Fo- aa-Akfe Training] P^ -poses Only

Comprehensive - Meadows -58-


b. Employer identification number (EIN) 1. Wages, tips, other compensation 2. Federal income tax withheld$12,840.76 $926.0011-4XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, city state and ZIP Code$13,840.76 $858.13ELMONT ELEMENTARY SCHOOL

640 MAIN STWILMINGTON, DE 19803

5. Medicare wages and tips 6. Medicare tax withheld$13,840.76 $200.69

7. Social security tips 8. Allocated tips


e. Employee's name (first, initial, last), address, city,state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12

$1,000.00LOIS MEADOWS E13. Statutory Retiremer Third-party

Employee Plan sickpay 12b.24 NORTH STREET


12d.

Employer’s state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name15. State 16. State wages, tips, etc.$12,840.76

17. State income tax$256.00114000000



2017Form


Payer's RTN (optional)PAYER'S name, address, city, state, ZIP code InterestIncome2017MARSHLAND NATIONAL BANK

1Interest income Form 1099-INT$237.00200 MAIN STWILMINGTON, DE 19803 2Early withdrawal penalty Copy B








not been reported


ALBERT MEADOWS6 Foreign Tax Paid 7Foreign Country or US possession

24 NORTH STREET9 Specified private activity bondinterest




14Tax-exempt and tax creditbond CUSIP no. 16 State Identification no 17State tax withheld15 StateAccount number (see instructions)

Form 1099-INT




1Total Ordinary DividendsPAYER'S name, address, city, state, ZIP code 2017$232.00DELAWARE ELECTRIC105 JUDGES STWILMINGTON, DE 19803

lb Qualified Dividends Form 1099-DIV$232.00

2a Total capital gain distr. 2b Unrecap. Sec. 1250 gainCopy B

For RecipientPAYER'S Federal identification number RECIPIENTS identification number 2d Collectables (28%) gain2c Section 1202 gain

11-1XXXXXX 125-XX-XXXX3 Nondividend distributions 4Federal income tax withheldRECIPIENTS name, address, city, state, ZIP code

ALBERT J. MEADOWS This is important taxinformation and isbeing furnished to






24 NORTH ST6 Foreign Tax Paid 7Foreign Country or US possession

YOUR CITY, STATE, ZIP8 Cash liquidation distributions 9 Noncash liquidation distribution



13 State Identification no. 14State tax withheld12StateAccount number (see instructions)

Form 1099-DIV

Distributions FromPensions, Annuities,

Retirement orProfit-Sharing

Plans, IRAs,Insurance

Contracts, etc.

CORRECTED (if checked)1Gross distributionPAYER'S name,address, city, state, ZIP code

2017$3,500.00SECOND FEDERAL CREDIT UNION2a Taxable amount

Form 1099-R$3,500.00242 MOTT STWILMINGTON, DE 19802 2b Taxable amount








withheld$200.0011-3XXXXXX 125-XX-XXXX


RECIPIENTS name, address, city,state, ZIP code 6 Net unrealizedappreciation inemployer’s securitiesALBERT J. MEADOWS

24 NORTH STREET 7.DistributionCode(s)






*11. 1st year of desig. Roth contrib. 13. State/Payer's state no.113XXXXXX

10. Amount allocable to IRRwithin 5 years

12. State tax withheld 14. State Distribution$3,500.00


Form 1099-R


Albert provides a copy of his Form 8606 from last year’s tax return.

Albert shows his Form 5498 to indicate the value of his IRA at 12/31/2017 was $39,480. That is his only IRA. He shows the Form 8606 from last year’s return, to show his new total basis.

-60-

Nondeductible IRAs8606 OMBNo.1545-C074Form 1@16Information about Form 8606 and its separate instructions is at www.irs.gov/form8606.

Attach to Form 1040, Form 1040A, or Form 1040NR.Department of the TreasuryrternalRevenue Service |99)

AttachmentSequence No.48

Name.|l married, file a separate form for each spouse required to f M Form 8606.See instructions. Your social security number

125-00-2017ALBERT J MEADOWSHome address (number and street, or P.O.oox if mail is not delivered to ycjr home) Apt.no.

Fil in Your Address OnlyIf You Are Filing ThisForm by Itself and NotWith Your Tax Return

City, town o* pest office, state and ZIP code.If you have a foreign adetess, also complete the spaces below.Foreign postal codeForeign orovince/state/countyForeign country name

Nondeductible Contributions to Traditional IRAs and Distributions From Traditional, SEP, and SIMPLE IRAsComplete this part only if one or more of the fojowing apply.Parti

• You made nondeductible contributions to a traditional IRA for 2016.• You took distributions from a traditional, SEP. or SIMPLE IRA in 2016 and you made nondeductible contributions to atraditional IRA in 2016 or an earlier year.For this purpose, a distribution does not include a rolover, qualified charitablidistribution, one-time distribution to fund an HSA, conversion, recharacterization, or return of certain contributions.

• You converted part, but not al, of your traditional, SEP, and SIMPLE IRAs to Roth IRAs in 2016 (excluding any portionyou recharacterized) and you made nondeductible contributions to a traditional IRA in 2016 or an earlier year.

1 Enter your nondeductible contributions to traditional IRAs for 2016, including those made for 2016from January 1, 2017, through April 18, 2017 (see instructions)

2 Enter your total basis in traditional IRAs (see instructions)3 Add lines 1 and 2

In 2016,did you take a distributionfrom traditional, SEP, or SIMPLEIRAs,or make a Roth IRA conversion?

1103372103373

> Enter the amount from line 3 on line 14.Do not complete the rest of Part I.

> Go to line 4.4 Enter those contributions included on line 1 that were made from January 1, 2017, through Apnl 18, 20175 Subtract line 4 from line 3 .

No

Yes4

1033756 Enter the value of al your traditional, SEP, and SIMPLE IRAs as of

December 31, 2016, plus any outstanding rollovers (see instructions) . . _67 Enter your distributions from traditional, SEP, and SIMPLE IRAs in

2016.Do not include rollovers, qualified charitable distributions, a one-time distribution to fund an HSA, conversions to a Roth IRA, certainreturned contributions, or recharacterizations of traditional IRAcontributions (sec instructions)

8 Enter the net amount you converted from traditional, SEP, and SIMPLEIRAs to Roth IRAs in 2016. Do not include amounts converted that youlater recharacterized (see instructions).Also enter this amount on line 16 . 8

51502110 Divide line 5 by line 9. Enter the result as a decimal rounded to at least

3 places.If the result is 1.000 or more, enter “1.000”11 Multiply line 8 by line 10.This is the nontaxable portion of the amount

you converted to Roth IRAs. Also enter this amount on line 17 . . .12 Multiply line 7 by line 10. This is the nontaxable portion of your

distributions that you did not convert to a Roth IRA .13 Add lines 11 and 12.This is the nontaxable portion of all your distributions14 Subtract line 13 from line 3.This is your total basis in traditional IRAs for 2016 and earlier years16 Taxable amount.Subtract line 12 from line 7.If more than zero, also include this amount on Form

1040, line 15b; Form 1040A, line 11b; or Form 1040NR, line 16b.Note: You may be subject to an additional 10% tax on the amount on line 15 if you were underage 591/2 at the time of the distribution (see instructions).

48002

35007

9 Add lines 6, 7, and 8 9

0 . 2 0 110 X

11

7041270413

963314

279615

Form 8606 (20For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.QNA


PAYER'S NAME, STREET ADDRESS,CITY,STATE AND ZIP CODEUNITED STATES RAILROAD RETIREMENT BOARD844N. RUSH ST. CHICAGO,IL 60611-2092

PAYMENTS BY THERAILROAD RETIREMENT BOARD2017

3. Gross Social Security Equivalent BenefitPortion ofTier 1paid in 2017 $14,782.00

PAYER'S FEDERAL IDENTIFYING NO. 36-33146004. Social Security Equivalent BenefitPortion of Ter 1Repaid to RRB in 20171.Claim Number and Payee Code

A1250467594 COPYB -5. Net Social Security Equivalent BenefitPortion of Tier 1paid in 2017’ $14,782.00

2. Recipient's Identification Number FORRECIPIENTSRECORDS

6. Workers Compensation Offset in 2017125-XX-XXXXRecipient's Name,Address,City,State and ZIP Code

7. Social Security Equivalent BenefitPortion ofTier 1Paid for 2016ALBERT JAMES MEADOWS

8. Social Security Equivalent BenefitPortion ofTier 1Paid for 2015

THtSNlFORMATONISBEING

S-EDTOTrESTERSALREVENUESERVICE

24 NORTH ST9. Social Security Equivalent BenefitPortion ofTier 1Paid for YearsPrior to 2014YOUR CITY, STATE, ZIP

10. Federal Income Tax Withheld 11. Medicare Premium$.00

Form RRB-1099

PAYER'S NAME, STREET ADDRESS,CITY,STATE AND ZIP CODEUNITED STATES RAILROAD RETIREMENT BOARD844N. RUSH ST. CHICAGO, IL 60611-2092

ANNUITIES OR PENSIONS BY THERAILROAD RETIREMENT BOARD2017

3. Employee Contributions $38,443.00PAYER'S FEDERAL IDENTIFYING NO. 36-3314600

4. Contributory Amount Paid $21,570.001.Claim Number and Payee Code COPY B -A1250467594 5. Vested Dual Benefit

2. Recipient's Identification Number6. Supplemental Annuity

125-XX-XXXX7. Total Gross Paid $21,570.00Recipient's Name,Address,City,State and ZIP Code

8. RepaymentsALBERT JAMES MEADOWS THIS INFORMATION IS BEINGFURNISHED TO THE INTERNALREVENUE SERVICE.9. Federal Income Tax

Withheld $.0024 NORTH STLI Country 12 Medcare P-emium10. Rate ofTax

YOUR CITY, STATE, ZIP $.00Form RRB-1099-R


-62-

OMB No. 1545-22321095-A Health Insurance Marketplace StatementCORRECTED

Form

2017> Information about Form 1095-A and its separate instructionsis at www.irs.gov/ffomlQ95a.Depa-tr-ent of the Treasury

Internal Revenue Service

Recipient InformationPart l

1Marketplace Identifier 3 Policy issuer's name2Marketplace-assigned policy number12-333XXXX XXXXXX INSURER

4Recipient' name 5 Recipient's SSN125-XX-XXXX

6 Recipient's date of birth01/17/1954ALBERT JAMES MEADOWS

7Recipient' spouses's name 8 Recipient's spouse's SSN 9 Recipient's spouse's date of birth03/25/1976LOIS CHRISTINE MEADOWS 126-XX-XXXX

12 Street Address findudina apartment number)10 Policy start date01/01/2017

11Policy TerminationDate12/31/2017 24 NORTH STREET

13 City, State, Country and ZIP codeYOUR CITY. STATE. ZIP

Coverage HouseholdPart II

C. Date of BirthA Covered Individual Name B Covered Individual SSN D. Start Date E. Termination16 ALBERT 3 MEADOWS 01/17/1954 01/01/2017 12/31/2017125-XX-XXXX17 LOIS C MEADOWS 03/25/1976 01/01/2017 12/31/2017126-XX-XXXXs WARREN A MEADOWS 06/21/2002 01/01/2017 12/31/2017127-XX-XXXX

19

20

Household InformationPart III

B Monthly Premium Amount of SecondLowest Cost Silver Plan (SLCSP)

C. Monthly Advance Payment of Premium TaxMonth A Monthly Premium Amount

21January $452.58 $375.00 $85.0022February $452.58 $375.00 $85.0023March $452.58 $375.00 $85.0024 April $85.00$452.58 $375.0025 May $452.58 $375.00 $85.0026 June S452.58 $375.00 $85.0027 July $85.00$452.58 $375.0028 August $452.58 $375.00 $85.0029 September S452.58 $375.00 $85.0030 October $452.58 $85.00$375.0031November $452.58 $375.00 $85.0032December $452.58 $375.00

$4,500.00$85.00

33 Annual Totals $5,430.96 $1,020.00Form: 1095-APart III for ALBERT JAMES MEADOWS

ALBERT &. LOIS MEADOWS 1234

24 NORTH ST.

YOUR CITYr STATE, ZIP$PAY TO THE

ORDER OFDOLLARS

Your BankBank City, State, ZIP CodeFor

: 325070760 |: 5175374190 1234

Comprehen sive - M

iller






To report unethical behavior to the IRS, email us at [email protected] I- Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameJAMES

M.l. Last nameMILLER


Are you a U.S. citizen?0 YesC No

2. Your spouse’s first name M.l. Last name Telephone number Is your spouse a U.S. citizen?Yes No

3. Mailing address10250 WILDER RD


YOUR CITYa. Full-time student Yes 0 Noc. Legally blind



5. Your job titleOFFICE MANAGER Yes 0 No

9. Last year, was your spouse:b. Totally and permanently disabled n Yes No


Yes NoYes n No



Unmarried0 Married

1. As of December 31, 2016, wereyou:

(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)a. If Yes, Did you get married in 2016?b. Did you live with your spouse during any part of the last six months of 2016? Yes 0 NoDate of final decree

Yes 0 No



Year of spouse’s deathWidowed2. List the names below of:



Name (first, last) Do not enter yourname or spouse s name below













Citizen(yes/no)

(a) (b) (c) (d) (e) (f) (9) (b) (i)

JARROD MILLER 9/8/1988 SON 12 Y y s N yANTHONY MURRAY 3/9/2002 NEPHEW 12 Y y s y N

Form 13614-C (Rev.10-2016)Catalog Number 52121E www.irs.gov

Comprehen sive - M

iller

-64-

Page 2Check appropriate box for each question in each sectionYes No Unsure Part III- Income- Last Year, Did You (or Your Spouse) Receive


000

000000

00000

Yes No Unsure Part IV- Expenses- Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes2. Contributions to a retirement account?

NoRoth IRA (B)

0IRA (A) $2,000 401K (B) Other0

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher’s aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

00

0000

0000

Yes No Unsure Part V- Life Events- Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

000000

000

Form!13614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Comprehen sive - M

iller


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B 0 Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advance!credit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?



MECEntire Year





Part VII- Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If you check a box. your tax or refund will not change)Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse

2. If you are due a refund, would you like:a.Direct deposit

Yesb. To purchase U.S. Savings Bonds

Yes3. If you have a balance due, would you like to make a payment directly from your bank account? Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)

c. To split your refund between different accountsYes

0 No0 No No No


Prefer not to answer0 Yes0 Yes

NoNo


Additional comments


Comprehensive - Miller

Interview Notes - Miller

James’ wife left him in 2007 and has not lived with him since. She files her own return and informs him that she is not planning to itemize. He has not itemized previously.

His son, Jarrod is permanently disabled. He lives with his father and is supported by him. Jarrod has no earnings. James also fully supports his nephew, Anthony because Anthony’s mother is working out of the country. She will not claim him on her return

James retired after 33 years as an FBI agent. He has health insurance that meets MEC for himself and his son. Anthony is covered on his mother’s health insurance policy. James qualifies for PSO.

James recently started a job as an office manager at a large wholesale nursery company.

On 7/1/12 James started drawing his pension, which was not set up as joint/survivor.

He purchased his home in 2008 and received the $7,500 credit. He has been paying only the required minimum payment each year.

-66-

131-XX-XXXX 132-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FOR THIS NUMBER H.AS BEEN ESTABLISHED FOR

JAMES CARLTON MILLER JARROD JAMES MILLER

Fo- ax-A'rie raining P,.-poses Only Fo- ax-Aide rainingi PurposesOnly

O

133-XX-XXXXTHIS NUMBER H.AS BEEN ESTABLISHED FOR

ANTHONY MURRAY

For Tax-Aide Training Pw'poses Only




3. Social security wages 4. Social security tax withheldc. Employer's name, address, City,State and ZIP Code$12,875.25 $798.27EVERGREEN NURSERY COMPANY

5. Medicare wages and tips 6. Medicare tax withheld$12,875.25 $186.692300 W GREEN ST

CHARLOTTE, NC 28205 7. Social security tips 8. Allocated tips

10. Dependant care benefitsd. Control number 9.e. Employee's first name and initial last namef. Employee's address and ZIP code



Employee Plan sickpayJAMES C MILLER 12b.

x10250 WILDER ROAD14. Other 12c.

YOUR CITY, STATE, ZIP12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name15. State 16. State wages, bps, etc .$10,875.25

17. State income tax

YS 166XXXXXX 425.60


Copy B - To Be Filed With Employee's FEDERAL Tax Return.This informabon is being furnished to the Internal Revenue Service.

2017Form



1Total Ordinary DividendsPAYER'S name, address, city,state, ZIP code 2017$857.00FIELDS INVESTMENT COMPANYlb Qualified Dividends Form 1099-DIV

$800.002121 SPRUCE STPITTSBURGH PA 15219 2a Total capital gain distr.


Copy BFor RecipientPAYER'S Federal idenbficabon number RECIPIENTS idenbficabon number 2d Collectables (28%) gain2c Secbon 1202 gain

16-8XXXXXX 131-XX-XXXX3 Nondividend distribubons 4Federal income tax withheldRECIPIENTS name, address, city,state, ZIP code

JAMES C MILLER $25.42 This is important taxinformation and isbeing furnished to






10250 WILDER ROAD6 Foreign Tax Paid 7 Foreign Country or US possession

YOUR CITY, STATE, ZIP $9.458 Cash liquidabon distribubons 9 Noncash liquidabon distribubon


11Specified private acbvitybond interest dividends

10 Exempt-Interest dividends

13 State Idenbficabon no. 14State tax withheld12 StateAccount number (see instrucbons)

Form 1099-DIV


James may have enough to itemize and would like us to check that for him.

Medical – Doctors (Unreimbursed) ................................................... $830

Hearing aids ................................................................................ $2,200

Dentist ........................................................................................... $275

Long Term Care insurance ............................................................ $2,450

Church donations – statement from church ................................... $2,100

Salvation Army – paid by check ......................................................... $75

Salvation Army – microwave, bedroom set, clothing .......................... $480

Personal property tax (based on value) ............................................ $235

Real estate taxes ......................................................................... $1,750

Mortgage insurance premium .......................................................... $258

Mortgage interest from Form 1098 – Bankers Mortgage Co ............... 5200

Use North Carolina ZIP code 28145 for state sales tax: state rate 4.75 plus 2.25% local rate.

-68-

OMB No. 1545-0119Form: 1099R

Distribution FromPersons. AnnuitiesRetrerent or Profit-Sharing Plans. IRA's,



BY p- 0. BOX 45BOYERS, PA 16017-0045

STATEMENT OF ANNUITY PAIDCopy B - File with Federal tax return

PAID 2017

PAYER’S Federal Identification Recipient’s ID No. (Annuitant)131-XX-XXXX

Account number (Retirement Claim 1. Gross distribution

$25,864.0016-5XXXXXX CSA 45712565. Employee Contributions/Designed ROTH Contributionsor Insurance Premiums

2a. Taxable amountPAID JAMES C MILLERTO

10250 WILDER ROAD$3,275.00 4. Federal Income Tax Withheld

$1,295.007. Distribution Code(s)7-NONDISABILITY

YOUR CITY, STATE, ZIP10. State IncomeTax WithheldState 1

9b. Total Employee Contributions$49,872.00

m 5 >-o> .2o t; o11. State Income Tax WithheldState 2

l.s 2.ESS

Comprehen sive - Parsons




• If you have questions, please ask the IRS-certified volunteer preparer.You will need:


Volunteers are trained to provide high quality service and uphold the highest ethical standards.To report unethical behavior to the IRS, email us at [email protected]

Part I- Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameBEN

M.l. Last namePARSONS


Are you a U.S. citizen?0 YesA No

2. Your spouse’s first namePATRICIA

M.l. Last nameHARPER

Telephone number Is your spouse a U.S. citizen?0 Yes NoA

3. Mailing address30911LOST MEADOW


YOUR CITY6. Last year, were you:b. Totally and permanently disabled Yes 0 No




9. Last year, was your spouse:b. Totally and permanently disabled n Yes 0 No


Yes 0 NoYes 0 No

7. Your spouse’s Date of Birth 8. Your spouse’s job title10/30/1942 RETIRED10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? 0 Yes n No b. Adopted a child? Yes NoPart II - Marital Status and Household Information1. As of December 31, 2016, wereyou:

Unmarried0 Married


Yes 0 No



















Citizen(yes/no)

(b) (d) (f) (h) (i)(a) (c) <e) (9)MADISON CHAMBERS 4/5/2002 9 y y s y NGRANDCHILD


Comprehen sive - Parsons

-70-


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099. RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

0HE

H00

00

000

Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes

IRA (A)NoRoth IRA (B)

02. Contributions to a retirement account? 401K (B) Other03. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher s aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

00

0000

00

00

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much?9. (A) File a federal return last year containing a "capital loss carryover” on Form 1040 Schedule D?

000000000

Forml13614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Comprehensive - Parsons


Interview Notes – Parsons

Ben is a retired deputy sheriff. He tells you that he has supplemental health insurance that is deducted from his pension in the amount of $150 per month. He started drawing his pension January 1, 2004 and he chose the joint/survivor option.

Ben’s granddaughter Madison, moved in with them in last April and will be living with them for at least two years, while her mother is working in Italy. He provides all of her support, but Madison’s health insurance is provided by her mother’s insurance policy.

Ben thinks he may be able to itemize this year and would like to try that option.

Ben sold 200 shares of Warner Inc. stock that he had inherited from his father on October 1, 1999. The stock was worth $10 per share at the death of his father, but his father had paid $8 per share when he purchased it in 1996.

Pat has a small business designing greeting cards for a few local drug stores. Her income was below the required 1099-MISC at each store. She reports $1,500 income, with no documentation. Her expenses were only for the software needed to create the cards and supplies, totaling $945.

Last year Ben’s return was rejected because it appeared that someone had already e-filed using his Social Security number. He provides a letter he received from IRS with the PIN number he is to use his year on his return. The number is 754269.

-72-


BEN ARTHUR PARSONS PATRICIA ANN HARPER

Fo- ax-Alde Training] Pupcses Only Fo- ax-Alde Training] Peposes Only


MADISON RUTH CHAMBERS

Fo- ax-Alde Training] Peposes Only


] CORRECTED (if checked) Distributions FromPensions,Annuities,


Contracts, etc.

1Gross distributionPAYER'S name, address, city, state, ZIP code

2017$24,650.00AUBURN SHERIFF'S DEPARTMENT2a Taxable amount

Form 1099-R1HOLLOWAY ROADLEWISTON, ME 04240 2b Taxable amount










RECIPIENTS name, address, city,state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesBEN A PARSONS

$1,800.0030911 LOST MEADOWS 7.Distribution

Code(s)IRA/ 8 Other

This information isbeing furnished to





$109,420.00%10. Amount allocable to IRR



Form 1099-R



Contracts, etc.


2017$12,457.00HARRIS TRUST CO2a Taxable amount

Form 1099-R$11,782.00P O BOX 1379INDIANAPOLIS, IN 46204 2b Taxable amount










RECIPIENTS name, address, city,state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesPATRICIA A HARPER

$675.0030911 LOST MEADOW 7.Distribution

Code(s)IRA/ 8 Other









Form 1099-R


-74-


2017 O PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME.° SEE THE REVERSE FOR MORE INFORMATION.

Box 2. Beneficiary's Social SecurityBox 1. NameBEN ARTHUR PARSONS 221-XX-XXXX



$12,560.00

DESCRIPTION OF AMOUNT IN BOX 3 DESCRIPTION OF AMOUNT IN BOX 4Paid by check or direct deposit



Total Additions

Benefits for 2017

$10,871.20

$1,258.80

$430.00

$12,560.00$12,560.00

Box 6. Voluntary Federal Income Tax Withheld

Box 7. AddressBEN ARTHUR PARSONS

Benefits for 2016 30911 LOST MEADOWYOUR CITY, STATE, ZIPBenefits for 2015

Benefits for 2014 Box 8. Claim Number (use this number if you need to contact SSA)

221-XX-XXXXA

Form SSA-1099-SM



Box 2. Beneficiary's Social SecurityBox 1. NamePATRICIA ANN HARPER 222-XX-XXXX



$9,920.00




Total Additions

$8,361.20

$1,258.80

$300.00

$9,920.00$9,920.00

Box 6. Voluntary Federal Income Tax WithheldBenefits for 2017

Box 7. AddressPATRICIA ANN HARPER

Benefits for 2016 30911 LOST MEADOWYOUR CITY, STATE, ZIPBenefits for 2015


Form SSA-1099-SM


ABC Brokerage2715 Alpine LaneBoston, MA 02110

2017 TAX REPORTING STATEMENTBEN PARSONS

30911 Lost Meadow, Your City, YS ZIPAccount No. 111-227

221-XX-XXXXPayer's Fed ID Number: XX-XXXXXXX

Form 1099-DIV 2017 Dividends and DistributionsCopy B for Recipient (OMB NO . 1545-0110)

Box Amount1a Total Ordinary Dividends1b Qualified Dividends2a Total Capital Gain Distributions (Includes 2b- : . . . .2b Capital Gains that represent Unrecaptured 12!. . . .2c Capital Gains that represent Section 1202 Gail2d Capital Gains that represent Collectibles (28%3 Nondividend Distributions . . . .4 Federal Income Tax Withheld .5 Investment Expenses6 Foreign Tax Paid7 Foreign Country or U.S. Possession8 Cash Liquidation Distributions9 Non-Cash Liquidation Distributions10 Exempt-Interest Dividends11 Specified Private Activity Bond Interest Dividends12 State13 State Identification No14 State Tax Withheld

FATCA filing requirement

1,565.00875.00737.000.000.000.0018.250.000.0016.750.000.000.000.000.00

0.00

Form 1099-INT 2017 Interest IncomeCopy B for Recipient (OMB NO. 1545-0112)Box Amount

Interest IncomeEarly Withdrawal PenaltyInterest on U.S. Savings Bonds and Treas. ObligationsFederal Income Tax WithheldInvestment ExpensesForeign Tax PaidForeign Country or U.S. PossessionTax-Exempt InterestSpecified Private Activity Bond InterestMarket DiscountMarket Discount on Noncovered SecuritiesBond PremiumBond Premium on Noncovered SecuritiesBond Premium on Tax-Exempt BondTax-Exempt and Tax Credit Bond CUSIP NoStateState Identification NoState Tax WithheldFATCA filing requirement

"These amounts are not reported to the IRS.

17.2510.0020.0030.0040.0050.0060.007

232.0080.0090.00100.00 **0.00110.00 **0.0013

141516

0.0017


-76-





Summary of 2017 Proceeds From Broker and Barter Exchange TransactionsBox1d Proceeds1e Cost or Other Basis4 Federal Income Tax Withheld6 Adjustments - Wash Sales

Adjustments - Market Discount16 State Tax WithheldRegulated Futures Contracts:4 Federal Income Tax Withheld8 Profit or (Loss) Realized in 2015 on Closed Contracts9 Unrealized Profit of (Loss) on Open Contracts - 12/31/201410 Unrealized Profit of (Loss) on Open Contracts - 12/31/201511 Aggregate Profit of (Loss) on Contracts

Amount4,990.00 *

UNKNOWN **0.000.000.00 **0.00

0.000.000.000.000.00

* Gross Proceeds from each of your security transactions are reported individually to the IRS. Refer to the Form 1099-B section of this statement.** Box 1e and Box 6 contain amounts for covered securities only.





FORM 1099-B- 2017 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715

Long-term transactions for which basis is not reported to the IRSReport on Form 8949 with Box E checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 )

1a Description. 2 Long-term , 3 Basis not reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP (IRS Form 1099-B box numbers are shown below in bold type)

1f 4 Federal 14 StateIncome Tax 15 State IDWithheld Number

1b DateAcquired

1c Date Sold orDisposed

1e Cost orOther Basis

i g Gain/Loss (- 16 State TaxWithheldAction Quantity 1d Proceeds Code, if

any)Adjustments

Sale 200SH WRNER UNKNOWN 12/22/2017 4,990.00 UNKNOWN

TOTALS 4,990.00 0.00 0.00

This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanctionmay be imposed on you if this income is taxable and the IRS determines that it has not been reported.


Ben’s list of expenses

Doctor bills ........................................................................... $725

Medicare supplemental insurance for Patricia ......................... 2,075

Long Term Care insurance for Ben ........................................ 3,200

Long Term Care insurance for Patricia ................................... 2,500

Medical mileage ................................................................... 1,225 miles

Prescription drugs ................................................................ 3,742

Prescription eyeglasses (for Ben, Patricia and Madison) .......... 2,100

Church contributions (statement from church) ....................... 2,750

Church raffle ticket (didn’t win) .................................................. 25

Public Broadcasting Service (with receipt) ................................. 200

Salvation Army (donation paid by check) .................................. 100

Salvation Army (furniture - with receipt) ................................... 275

Home mortgage interest (form 1098 – Hometown Bank) ........ 2,525

Real estate taxes (paid two year’s tax in current year) ........... 3,400

Personal property tax (based on value) .................................... 270

Use NC ZIP 28145 for state sales tax. State rate of 4.75% plus 2.25% local

Comprehen sive - Thom

pson

-78- Form 13614-C(October 2016)





To report unethical behavior to the IRS, email us at [email protected] I- Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)

M.l.1. Your first nameTROY

Last nameTHOMPSON


Are you a U.S. citizen?0 YesH No

2. Your spouse’s first nameYVONNE

M.l. Last nameSMITH


Is your spouse a U.S. citizen?0 Yes NoE

3. Mailing address30911 BARD ROAD


ZIP codeYOUR CITY






a. Full-time studentYes 0 No c. Legally blind

Yes [0 No0 Yes No

7. Your spouse s Date of Birth 8. Your spouse s job title10/30/1953 RETIRED10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? Yes 0 No b. Adopted a child? n Yes 0 NoPart II - Marital Status and Household Information

Unmarried0 Married



Yes 0 No



















Citizen(yes/no)

(a) (b) (c) (d) <e) (0 (9) <b) (i)



pson


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on FormsW-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099. RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

00000

0

00

00

GAMBLING0Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay

1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes401K (B)

NoRoth IRA (B)

02. Contributions to a retirement account? IRA (A) Other03. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher's aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

00

0000

0000

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes. where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

000000000

Formll3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov


pson

-80-


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]El3a. (A) If Yes, were advanceicredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?



MECEntire Year






2. If you are due a refund, would you like:a. Direct deposit


Noc. To split your refund between different accounts

Yes0 No

0] No3. If you have a balance due, would you like to make a payment directly from your bank account? Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home?6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

Yes No

NONE Prefer not to answer0 Yes0 Yes

NoNo


Additional comments


Comprehensive - Thompson

Interview Notes - Thompson

Troy and Yvonne are retired. They may be able to itemize this year, but haven’t in the past.

Troy has full Medicare coverage. Yvonne had health insurance all of last year from her employer, but she was laid off in December and she did not take COBRA. Starting March 1, 2017, she is covered by a health insurance policy she got directly from a local company. She hopes she doesn’t have a penalty.

Yvonne was seriously injured in an accident and spent 3 months in a medical facility. She was considered chronically ill, eligible to use her qualified LTC insurance for the first time to help cover the costs

Yvonne produces a document from her ophthalmologist stating that she is legally blind.

The Thompson’s prior year return shows $2,530 Long Term Capital Loss Carryover.


TROY HAROLD THOMPSON YVONNE ELAINE SMITH

Fo- aa-Akfe Training] -poses Only Fo- aa-Akfe Training] P^ -poses Only

] CORRECTED (if checked)1. Gross winnings 2. Date won

04/25/2017PAYER'S name, address, city, state, and ZIP code 2017$1,800.00ROCKHURST CASINO

3. Type of wager 4. Federal income tax withheldForm W2-G$300.00SLOTS10411 ATHENS RD 5. Transaction 6. Race

CertainGamblingWinnings

FAIRVIEW, KY 422217. Winnings from identical wagers 8. Cashier

2718PAYER'S Federal identification number Payer's Telephone number9. Winner's taxpayer identification no. 10. Window This information


Revenue Service

63-3XXXXXX 866-555-1212622-XX-XXXX

WINNER'S name, address, dty, state, and ZIP 12. SecondI.D.CREDIT CARD

11. FirstI.D.DRIVER LICENSEYVONNE SMITH


shows federalincome



30911 BARD RD15. State income tax withheld 16. Local Winnings



Form W_2C


-82-

Distributions FromPensions,Annuities,


Contracts, etc.

CORRECTED (if checked)1Gross distributionPAYER'S name, address, city,state, ZIP code

2017$24,295.00TRI-STATE CONSTRUCTION COMPANY2a Taxable amount

Form 1099-R$22,350.00P O BOX 930FAIRVIEW, KY 42221 2b Taxable amount

not determined. TotalCopy B




Distribution






RECIPIENTS name, address, city, state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesTROY H THOMPSON

$1,945.0030911 BARD ROAD 7.Distribution

Code(s)IRA/ 8 Other









Form 1099-R



Contracts, etc.


2017$13,223.00HARRIS TRUST COMPANY2a Taxable amount

$13,223.00 Form 1099-RP O BOX 1389FAIRVIEW, KY 42221 2b Taxable amount

not determined. TotalCopy B




Distribution






RECIPIENTS name, address, city, state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesYVONNE ELAINE SMITH

30911 BARD ROAD 7.DistributionCode(s)









Form 1099-R




Box 2. Beneficiary’s Social SecurityBox 1. NameTROY HAROLD THOMPSON 621-XX-XXXX



$16,108.00




Total Additions

$13,138.00

$1,345.00

$325.00

$16,108.00$16,108.00

Box 6. Voluntary Federal Income Tax Withheld$1,300.00Benefits for 2017

Box 7. AddressTROY HAROLD THOMPSON

Benefits for 2016 30911 BARD ROADYOUR CITY, STATE, ZIPBenefits for 2015


Form SSA-1099-SM



Box 2. Beneficiary’s Social SecurityBox 1. NameYVONNE ELAINE SMITH 622-XX-XXXX



$14,960.00




Total Additions

$13,960.00

$.00

$.00

$14,960.00$14,960.00

Box 6. Voluntary Federal Income Tax Withheld$1,000.00Benefits for 2017

Box 7. AddressYVONNE ELAINE SMITH

Benefits for 2016 30911 BARD ROADYOUR CITY, STATE, ZIPBenefits for 2015


Form SSA-1099-SM


Alvin Bond Funds 2016 TAX REPORTING STATEMENT2715 Alpine Lane Troy ThompsonBoston, MA 02110 30911 Bard Road, Your City, YS ZIP

Account No. 111-227Recipient ID No. 621-XX-XXXX

Payer's Fed ID Number: 63-1XXXXXXForm 1099-DIV 2017 Dividends and DistributionsCopy B for Recipient (OMB NO. 1545-0110)Box Amount1a Total Ordinary Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,485.321b Qualified Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,352.652a Total Capital Gain Distributions (Includes 2b- 2d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.002b Capital Gains that represent Unrecaptured 1250 Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.002c Capital Gains that represent Section 1202 Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.002d Capital Gains that represent Collectibles (28%) Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.003 Nondividend Distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.754 Federal Income Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.005 Investment Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.006 Foreign Tax Paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.007 Foreign Country or U.S. Possession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.008 Cash Liquidation Distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.009 Non-Cash Liquidation Distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0010 Exempt-Interest Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0011 Specified Private Activity Bond Interest Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0012 State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 State Identification No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 State Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00

FATCA filing requirement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Form 1099-INT 2017 Interest IncomeCopy B for Recipient (OMB NO. 1545-0112)Box Amount1 Interest Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 850.002 Early Withdrawal Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.003 Interest on U.S. Savings Bonds and Treas. Obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.004 Federal Income Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.005 Investment Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.006 Foreign Tax Paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.977 Foreign Country or U.S. Possession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Tax-Exempt lnterest (Federal e only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 975.009 Specified Private Activity Bond Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00Form 1099-MISC 2015 Miscellaneous IncomeCopy B for Recipient (OMB NO. 1545-0115)Box Amount2 Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.004 Federal Income Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.008 Substitute Payments in Lieu of Dividends or Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0016 State Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0017 State Identification No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 State lncome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00

FATCA filing requirement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Summary of 2015 Original Issue DiscountBox Amount1 Original Issue Discoun . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **2 Other Periodic Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **4 Federal Income Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **5 Market Discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **#6 Acquisition Premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **#8 Original Issue Discount on U.S. Treasury Obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **

# Box 5 and Box 6 contain amounts for covered securities only.Summary of 2017 Proceeds From Broker and Barter Exchange TransactionsBox Amount1d Proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,915.43 *1e Cost or Other Basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **4 Federal Income Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.006 Adjustments - Wash Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00

Adjustments - Market Discount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 **16 State Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00Regulated Futures Contracts:4 Federal Income Tax Withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.008 Profit or (Loss) Realized in 2015 on Closed Contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.009 Unrealized Profit of (Loss) on Open Contracts - 12/31/2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0010 Unrealized Profit of (Loss) on Open Contracts - 12/31/2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0011 Aggregate Profit of (Loss) on Contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00

Page 1 of 3

** Amounts of original issue discount are individually reported to the IRS.

* Gross Proceeds from each of your security transactions are reported individually to the IRS. Refer to the Form 1099-B section of this statement. ** Box 1e and Box 6 contain amounts for covered securities only.

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Payer's Fed ID Number: 63-1XXXXXX FORM 1099-B 2017 Proceeds from Broker and Barter Exchange Transactions

Copy B for Recipient OMB NO. 1545-0715Short-term transactions for which basis is reported to the IRSReport on Form 8949 with Box A checked and/or Schedule D, Part I(This Label is a Substitute for Boxes 1a & 3 )1a Description , 2 Short-term, 3 Basis reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP (IRS Form 1099-B box numbers are shown belo w in bold type)

Action Quantity 1b Date Acquired

1c Date Sold or

Disposed

1d Proceeds

1e Cost or Other Basis

1f Code, if any

1g Adjustme

nts

Gain/Loss (-)

4 Federal Income

Tax

14 State 15 State

ID

16 State Tax

WithheldHillford Investment FundSale 16.52 09/23/2016 08/26/2017 169.36 142.58 26.78Sale 15.88 12/23/2016 08/26/2017 162.72 132.75 29.97Sale 14.35 03/23/2017 08/26/2017 147.04 128.68 18.36Sale 13.99 03/23/2017 08/26/2017 143.35 130.57 12.78Yuma Bond FundSale 175.00 10/25/2016 02/26/2017 2,368.15 2,632.75 W 226.80 -37.80Sale 150.00 03/15/2017 12/15/2017 2,286.36 2,352.45 -66.09Matte Investor Class FundSale 250.00 07/23/2017 12/05/2017 1,555.00 1,085.36 469.64Sale 100.00 07/23/2017 12/05/2017 622.00 512.74 109.26TOTALS 7,453.98 7,117.88 226.80 562.90

FORM 1099-B· 2017 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715Long-term transactions for which basis is reported to the IRSReport on Form 8949 with Box D checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 )1a Description , 2 Long-term, 3 Basis reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP (IRS Form 1099-B box numbers are shown belo w in bold type)


1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustme

nts

Gain/Loss (-)

4 Federal Income

Tax Withheld

14 State 15 State

ID Number

16 State Tax

Withheld

Hillford Investment FundSale 18.85 03/26/2011 08/26/2017 193.25 159.45 33.80Sale 17.77 06/23/2011 08/26/2017 182.13 158.36 23.77Sale 17.65 09/23/2011 08/26/2017 180.87 162.74 18.13Sale 17.52 12/23/2011 08/26/2017 179.61 156.87 22.74Sale 17.40 03/23/2012 08/26/2017 178.35 150.74 27.61Sale 17.28 06/23/2012 08/26/2017 177.09 146.35 30.74Sale 17.15 09/23/2012 08/26/2017 175.83 142.58 33.25Sale 17.03 12/23/2012 08/26/2017 174.57 139.86 34.71Sale 16.91 03/23/2013 08/26/2017 173.31 140.85 32.46Sale 16.79 06/23/2013 08/26/2017 172.05 142.65 29.40TOTALS 1,787.06 1,500.45 286.61

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Payer's Fed ID Number: 63-1XXXXXX

FORM 1099-B· 2017 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715Long-term transactions for which basis is not reported to the IRSReport on Form 8949 with Box E checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold type)1a Description, 2 Long-term, 3 Basis not reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP

Action Quantity1b Date Acquired

1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustments

Gain/Loss (-)

4 Federal Income

Tax Withheld

14 State 15 State

ID Number

16 State Tax

Withheld

Hillford Investor Class FundSale 3,842.14 05/22/2009 08/26/2017 39,381.94 36,214.99 3,166.95Sale 18.53 06/23/2009 08/26/2017 189.89 158.36 31.53Sale 18.03 09/23/2009 08/26/2017 184.76 162.74 22.02Sale 17.99 12/23/2009 08/26/2017 184.35 156.87 27.48Sale 18.35 03/23/2010 08/26/2017 188.11 150.74 37.37Sale 17.84 06/23/2010 08/26/2017 182.88 146.35 36.53Sale 17.65 09/23/2010 08/26/2017 180.93 142.58 38.35Sale 17.71 12/23/2010 08/26/2017 181.53 139.86 41.67TOTALS 40,674.39 37,272.49 3,401.90

Page 3 of 3

This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported.

-86-

] CORRECTED (if checked)1Gross Long-Term carebenefits paid

PAYER'S name, address, dty,r state, and ZIP code Long-Term Care andAccelerated Death

Benefits2017WE CARE INSURANCE CO $18,000.00

2 Accelerated Death benefits Form 1099-LTC1596 BROADWAYFAIRVIEW, KY 42221

paidCopy B

For RecipientINSURED's taxpayer identification no.

PAYER'S federal identification number28-5XXXXXX

POLICYHOLDER'S identification number622-XX-XXXX

3ReimbursedAmountixiPer r^ Diem 1—1 This is important tax


Internal RevenueService. If you are

required to file a retim,a neclicence penalty orother sanction may beimpose:on you if thisincome is taxable and

the IRS determines thatit has not been repextec.

POLICYHOLDER'S name, address, city, state, and ZIP code

YVONNE ELAINE SMITHINSURED'S name, address, city, state, ZIP

YVONNE ELAINE SMITH

30911 BARD RDYOUR CITY, STATE, ZIP 30911 BARD RD

YOUR CITY, STATE, ZIP

Account number (see instructions) 4. Qualified contract(optinal) [x]

5. (optional) Date certifiedChronically illTerminally ill

X

Form 1099-LTC


Itemizing information:

Yvonne’s health insurance .................................................. $3,200

Doctor bills ............................................................................. 723

Medical mileage .................................................................... 1210 miles

Prescription drugs ................................................................ 4,522

Prescription eyeglasses for Troy ............................................... 570

Long term care insurance for Troy ........................................ 2,850

Long term care insurance for Yvonne .................................... 2,200

Church donation (shown on statement) ................................. 2,800

Public Broadcasting, paid by check ........................................... 375

Salvation Army (furniture, good condition) ............................... 422

Home mortgage interest, from Form 1098 from First Bank ..... 4,250

County real estate tax .......................................................... 1,525

City real estate tax .................................................................. 380

Personal property tax (based on value) .................................... 320

Gambling losses ................................................................... 2,500

Use N.C. ZIP 28145 for state sales tax. State rate 4.75 - Local rate 2.25%

Comprehensive - W

ells -88- Form 13614-C

(October 2015)

Department of the Treasury - Internal Revenue Service

Intake/Interview & Quality Review SheetOMB Number

1545-1964

You will need:• Tax Information such as Forms W-2, 1099,1098, 1095.• Social security cards or ITIN letters for all persons on your tax return.• Picture ID (such as valid driver's license) for you and your spouse.

* Please complete pages 1-3 of this form.• Y o u are responsible for the information on your return. Please provide

complete and accurate information.• If you have questions,please ask the IRS-certified volunteer preparer.

Part I- Your Personal Information1. Your first nameJAMES

M.I. Last nameWELLS

Telephone number555-XXX-XXXX

Are you a U.S.citizen?0 Yes NoR

2. Your spouse’s first nameELENA

Telephone number Is your spouse a U.S. citizen?0 Yes

M.I. Last nameWELLSA No

Apt # CityYOUR CITY

State3. Mailing address3947 UNIVERSITY DRIVE

ZIP codeYOUR STATE YOUR ZIP


5. Your job titleRETIRED

6.Last year, were you:b.Totally and permanently disabled Yes 0 Mo c.Legally blind



7. Your spouse's Date of Birth 8. Your spouse's job title 9.Last year, was your spouse:b.Totally and permanently disabled 0 Yes No c.Legally blind8/16/1958 DECEASED

10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsurea.Been a victim of identity theft? Yes b.Adopted a child? Yes 0 No11. Have you or your spouse: 0 No

Part II- Marital Status and Household Information1. As of December 31, 2015, were Single

0 Married(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)

0 Yes Nob. Did you live with your spouse during any part of the last six months of 2015? 0 Yes No

Date of final decree

you: a. If Yes,Did you get married in 2015?


Year of spouse's death0 Widowed 12/15/2017

2. List the names below of:* everyone who lived with you last year (other than your spouse)•anyone you supported but did not live with you last year


Name (first,Jast)Do not enter yourname or spouse’s name below

Date of Birth(rrm/dd/yy)


Number ofmonthstved inyour homelast year


Single orMarried asof 1201/15(S/M)






Did thetaxpayers)provide morethan 50%ofsupport forthis person?(yes/no/N/A)

Did thetaxpayers)pary more thanhalf the cost ofmaintaining ahome for thisperson?(yes/no)

Citizen(yes/no)

(a) (b) (c) (d) (e) (f) (g) (h) <i>

Volunteers are trained to provide high quality service and uphold the highest ethical standards.To report unethical behavior to the IRS, email us at [email protected]


Comprehensive - W

ells


Part III- Income- Last Year, Did You (or Your Spouse) ReceiveYes No Unsure1. (B) Wages or Salary? (Form W-2) If yes,how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from; checking/savings accounts,bonds,CDs,brokerage? (Forms 1099-INT,1099-DIV)5. (B) Refund of state/local income taxes? (Form 1009-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC,cash)8. (A) Cash/check payments for anry work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks,Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B)

10. (B) Disability income? (such as payments from insurance,or workers compensation) (Forms 1099-R,W-2)11.(A) Payments from Pensions.Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation?(Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099,RRB-1099)14.(M) Income (or loss) from Rental Property?15.(B) Other income? (gambling, lottery,prizes, awards, jury duty,Sch K-1, royalties, foreign income, etc.)Specify

000

00000

00

00

00

0Part IV- Expenses-Last Year, Did You (or Your Spouse) PayYes No Unsure1. (B) Alimony or separate maintenance payments? If yes,do you have the recipient’s SSN? Yes2. Contributions to a retirement account?

NoRoth IRA(B)

0401K (B)

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses?(including health insurance premiums)6. (B) Home mortgage interest?(Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?

10.(B) For supplies used as an eligible educator such as a teacher, teacher’s aide,counselor,etc.?11.(A) Expenses related to self-employment income or any other inoome you reoeived?12. (B) Student loan interest? (Form 1098-E)

IRA(A) Other000

0000

0000

Yes No Unsure Part V- Life Events- Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA,1099-SA,W-2 with oode W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C,1099-A)3. (A) Buy,sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Inoome Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes,where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year’s tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

00000000

0Form 13614-C (Rev.10-2015)Catalog Number 52121E vww.irs.gov

Comprehensive - W

ells -90-

Pag& 3Check appropriate box for each question in each sectionYes No Unsure Part VI - Health Care Coverage - Last year, did you, your spouse,or dependents)

1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]0

3a. (A) If Yes,Receive an advanced payment from the Marketplace to help pay your monthly health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?

4. (B) Have an exemption granted by the Marketplace?0Visit http://www.heaIthcar&.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income, marital status or family size changes, to your Marketplace- Reporting changes will help to make sure you are getting the proper amount ofadvance payments.To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.)


MECEntire Year




J F M A M J J A S O N D J F M A M J J A S O N DTaxpayerJ F M A M J J A S O N D J F M A M J J A S O N DSpouseJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependent

Part VII- Additional Information and Questions Related to the Preparation of Your Return1. Presidential Election Campaign Fund (If yon check a box, your tax or refund will not change)

Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse2. If you are due a refund,would you like:

a. Direct deposit0 Yes

3. If you have a balance due, would you like to make a payment directly from your bank account?Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.4. Other than English, what language is spoken in your home? NONE5. Are you or a member of your household considered disabled? 0 Yes

b.To purchase U.S. Savings BondsYes

c.To spirt your refund between different accountsNoNo 0 No Yes

0 Yes No

Prefer not to answerPrefer not to answerNo

Additional comments


Comprehensive - Wells

Interview Notes - Wells

Tragedy struck this year at the Wells household. Elena passed away on December 15, 2017, after a long battle with cancer. Elena had applied for Social Security Disability in 2014 and received retroactive benefits in 2017.

Elena had voluntarily obtained an Identity Theft PIN – 300679.

James is hoping he can itemize this year, and brings all the necessary information.


JAMES R WELLS ELENA A WELLS

Fo- aa-Akte Training P^ -poses Only Fo- aa-Akfe Training Pupcses Only

| CORRECTED (if checked)


1Total Ordinary Dividends$35.35

PAYER'S name, address,city,state, ZIP code 2017AMERICANA FUNDSlb Qualified Dividends Form1099-DIV

$23.77P O BOX 6007INDIANAPOLIS, IN 46206-6007 2a Total capital gain distr .



59-2XXXXXX 255-XX-XXXX3 Nondividend distributions 4Federal income tax withheldRECIPIENTS name, address,city, state, ZIP code

$42.00 $.00JAMES R WELLS This is important taxinformation and isbeing furnished to






3947 UNIVERSITY DRIVE6 Foreign Tax Paid 7Foreign Country or US possession

YOUR CITY, STATE, ZIP $6.06 VARIOUS8 Cash liquidation distributions 9 Noncash liquidation distribution


11Specified private activitybond interest dividends



Form 1099-DIV


-92-


Payer's RTN (optional)PAYER'S name, address, city,state, ZIP code InterestIncome2017VANGUARD

1Interest income Form 1099-INT$1,339.00P O BOX 2600VALLEY FORGE, PA 19482-2600 2Early withdrawal penalty

$14.62Copy B



RECIPIENTS name, address,city, state, and ZIP code

JAMES R WELLS4Federal income tax withheld This is important tax






not been reported



3947 UNIVERSITY DRIVE 9 Specified private activity bondinterest


YOUR CITY, STATE, ZIP $375.00 $25.2210 Market Discount 11Bond Premium

FATCA filingrequirment 13 Bond Premium on tax -exempt bond12


12-332997-01

Form 1099-INT



Contracts, etc.


2017$116,001.75FIRST TRUST COMPANY2a Taxable amount

Form 1099-R214 W NINTH STVALLEY FORGE, PA 19482-2600 2b Taxable amount








withheld$.0059-3XXXXXX 255-XX-XXXX


RECIPIENTS name, address, city,state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesJAMES R WELLS

3947 UNIVERSITY DRIVE 7.DistributionCode(s)






%11. 1st year of desig. Roth contrib. 12. State tax withheld 13. State/Payer's state no.10. Amount allocable to IRR

within 5 years14. State Distribution


Form 1099-R


James retired from the railroad, choosing a joint/survivor annuity. He retired on 3/31/2012, and his first distribution was 4/1/2012.

Elena filed for disability benefits in 2014 and received Lump Sum Social Security benefits covering three prior years, as well as the current year.

James has received the same amount of Social Security equivalent benefits every year since 2013. They received no tax-exempt income in any prior years. Their prior year information is as follows:

2016: AGI $36,605; SS benefits $4,197

2015: AGI $36,510; SS benefits $4,166

2014: $36,390; SS benefits $4,126

PAYER'S NAME, STREET ADDRESS,CITY, STATE AND ZIP CODEUNITED STATES RAILROAD RETIREMENT BOARD844N. RUSH ST. CHICAGO,IL 60611-2092

PAYMENTS BY THERAILROAD RETIREMENT BOARD2017

3. Gross Social Security Equivalent BenefitPortion of Tier 1paid in 2017 $12,248.80

PAYER'S FEDERAL IDENTIFYING NO. 36-33146004. Social Security Equivalent BenefitPortion of Tier 1Repaid to RRB in 20171.Claim Number and Payee Code

COPYB -5. Net Social Security Equivalent BenefitPortion ofTer 1paid in 2017’ $12,248.80

2. Recipient's Identification Number FORRECIPIENTSRECORDS

6. Workers Compensation Offset in 2017255-XX-XXXXRecipient's Name, Address,City, State and ZIP Code

7. Social Security Equivalent BenefitPortion of Tier 1Paid for 2016JAMES R WELLS

8. Social Security Equivalent BenefitPortion of Tier 1Paid for 2015

THISFORMATIONisBess

TOThCNTERNALREVENUESERVICE

3947 UNIVERSITY DRIVE9. Social Security Equivalent BenefitPortion of Tier 1Paid for YearsPrior to 2014YOUR CITY, STATE, ZIP

10. Federal Income Tax Withheld 11. Medicare Premium$1,258.80

Form RRB-1099

PAYER'S NAME, STREET ADDRESS,CITY, STATE AND ZIP CODEUNITED STATES RAILROAD RETIREMENT BOARD844N. RUSH ST. CHICAGO,IL 60611-2092 2017 ANNUITIES OR PENSIONS BY THE

RAILROAD RETIREMENT BOARD

3. Employee Contributions $17,500.75PAYER'S FEDERAL IDENTIFYING NO. 36-3314600

4. Contributory Amount Paid $20,142.501.Claim Number andPayee Code COPY B -5. Vested Dual Benefit

2. Recipient's Identification Number6. Supplemental Annuity

255-XX-XXXX7. Total Gross Paid $20,142.50Recipient's Name, Address,City, State and ZIP Code

8. RepaymentsJAMES R WELLS THIS INFORMATION IS BEINGFURNISHED TO THE INTERNALREVENUE SERVICE.9. Federal Income Tax

Withheld $937.603947 UNIVERSITY DRIVELl Co-nr1/ 12 Medicare Premium10. Rate of Tax

YOUR CITY, STATE, ZIPForm RRB-1099-R


Elena withdrew $5,000 from her IRA early in the year to help with medical expenses.

-94-



Box 2. Beneficiary's Social SecurityBox 1. NameELENA A WELLS 256-XX-XXXX


$34,545.00Box 4. Benefits Repaid to SSA in Box 5. Net Benefits Paid for 2017 (Box 3 minus Box 4)

$34,545.00




Total Additions

Benefits for 2017

$30,135.20

$1,384.80

$810.00

$34,545.00$8,820.00

Box 6. Voluntary Federal Income Tax Withheld$2,215.00

Box 7. AddressELENA WELLS

Benefits for 2016 $8,820.00$8,820.00$8,085.00

3947 UNIVERSITY DRIVEYOUR CITY, STATE, ZIPBenefits for 2015

Benefits for 2014 Box 8. Claim Number (use this number if you need to contact SSA)

256-XX-XXXXA

Form SSA-1099-SM



Contracts, etc.

CORRECTED (if checked)1Gross distributionPAYER'S name, address, city, state, ZIP code

2017$5,000.00VANGUARD2a Taxable amount

Form 1099-R$5,000.00P O BOX 2600VALLEY FORGE, PA 19482-2600 2b Taxable amount

not determined.TotalDistribution Copy B






3 Capital gain (includedin box 2a). 4 Federal income tax



RECIPIENTS name,address, city, state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesELENA A WELLS

3947 UNIVERSITY DRIVE 7.DistributionCode(s)









Form 1099-R


James presents a K-1 form, but he isn’t sure if it has to be included on his tax return. He’s never received a K-1 in the past.

James inherited a PIMCO mutual fund from his uncle who died on 2/3/2011. The fund was valued at $3,593 on that day. His uncle’s basis was $1,295. James sold all of the PIMCO this year.

The Wells have carryover capital losses from their 2016 return. Their 2016 return shows that they have long term losses of $14,100 and short term losses of 2,750.

Final K-l Amended K-lSchedule K -1(Form 1065) 2C17 Partner's Share of Current Year Income,

Deductions,Credits,and Other IncomePartHI

Dep=-trent of theTreasury InternalRevenue Serves

Fo- Csknce- year 2017. or tax, 20171 Ordinary business income (loss) 15 'Creditsyear beginning

ending 202 Net rental real estate income (loss)

Partner's Share of Income,Deductions,> See ioc< of Tomi aid lesa’-Ste nstrjcGans.Credits,etc.

3 Other net rental income floss) 16 Foreign transactionsInformation About the PartnershipParti

A Partnership's employer identification number 4 Guaranteed payments59-4XXXXXX

B Partnership's name,address r city,state,and ZIP code 5 Interest income

$25.40NORTHEAST GAS PARTNERS LPP 0 BOX 85SVALLEY FORGE, PA 19482-0858

6a Ordinary dividends$94.92

6b Qualified dividendsC IRS Center where partnership filed return $75.62

7 Royalties

Check if this is a publically traded partnership (PTP)DS Net short-term capital gain floss)

Information About the PartnerPartII $112.20E Partner's identifying number 9a Net long-term capital gain floss) 17 'Alternative minimum tax (AMT) items

255-XX-XXXX $137.62F Partner's namer address,dtyr stater and ZIP code 9b Collectibles (23%) gain floss)JAMES R WELLS

9c Unrecaptured section 1250 gain3947 UNIVERSITY DRIVE

There are typically more fields in an actual K-lthan those displayed in this example. If values for items other than interest dividends, capitalgain distribution, or royalties are included within lines on a K-l, the tax return would be considered out of scope.


-96-

BETTER investmentsMember FINRA/SIPC

255-XX-XXXX Tax Year 2017 Copy B For RecipientDepartment of the Treasury - Internal Revenue Service

(keep for your records)Account Number: 1197-5498This is important tax information and is being furnished to then IRS. A negligence penaltyor other sanctionmay be imposed on you if this income is taxable and the IRS determines thatthis income is taxable and the IRS determines that it has not been reported.

Your Financial AdvisorJANET APPLETON1000 WATER VIEWWAYVALLEY FORGE, PA 19482555-236-4000

JAMES R WELLS3947 UNIVERSITY DRIVEYOUR CITY, STATE, ZIP

ID: 2BYB1099-B Page: 1of 1

IRS BOX FORM 1099-B - PROCEEDS FROM BROKER & BARTER EXCHANGES OMB #1545-0715TATAI A rAn T A \/ \/r AB Ol"l-I"7

i-jyn i ^ L-J/n I wg i t-/ r\ VJ/-VII ^ t-/ rv

DESCRIPTION QUANTITY ACQUIRED SOLD PROCEEDS OTHER BASIS (IF ANY) MENTS LOSSLAZARD FD EMERGMKT PORT 1.280 08/25/16 6/12/2017 20.80 25.80 (5.00)LAZARD FD EMERGMKT PORT 5.127 03/24/17 12/21/2017 83.35 103.36 (20.01)DODGE & COX INTSTK FD 0.713 03/24/17 12/21/2017 21.31 14.94 6.37DODGE & COX INT STK FD 11.167 08/23/17 12/21/2017 333.50 234.07 99.43DODGE & COX INT STK FD 18.082 10/20/17 12/21/2017 540.01 378.99 161.02LAZARD SPEC FUND 4.662 08/25/16 12/21/2017 75.82 49.32 W 0.75 27.25LAZARD SPEC FUND 5.491 03/24/17 12/21/2017 89.26 58.09 W 1.02 32.19LAZARD SPEC FUND 8.409 10/20/17 12/21/2017 136.70 88.97 W 5.04 52.77

1,300.75 953.54 6.81 354.02TOTAL SHORT TERM TRANSACTIONS

LONG TERMNON-COVERED TRANSACTIONSDATE DATE COST OR CODE ADJUST- GAIN OR

DESCRIPTION QUANTITY ACQUIRED SOLD PROCEEDS OTHER BASIS (IF ANY) MENTS LOSSLORD INVT FDS GROWTH 11.125 07/28/05 1/25/2017 434.15 567.89 (133.74)LORD INVT FDS GROWTH 11.230 07/28/05 2/22/2017 434.13 573.25 (139.12)LORD INVT FDS GROWTH 12.312 07/28/05 3/22/2017 434.17 528.48 (94.31)LORD INVT FDS GROWTH 12.520 03/30/06 4/25/2017 434.13 552.13 (118.00)LORD INVT FDS GROWTH 11.310 03/30/06 5/25/2017 434.19 498.77 (64.58)LORD INVT FDS GROWTH 11.370 03/30/06 6/22/2017 434.14 501.42 (67.28)LORD INVT FDS GROWTH 11.521 05/21/07 7/25/2017 434.16 533.42 (99.26)LORD INVT FDS GROWTH 10.980 05/21/07 8/25/2017 434.15 508.37 (74.22)LORD INVT FDS GROWTH 10.952 11/01/08 9/25/2017 434.22 507.08 (72.86)LORD INVT FDS GROWTH 11.310 12/01/08 10/25/2017 434.21 517.99 (83.78)LORD INVT FDS GROWTH 11.624 02/02/09 11/22/2017 434.15 514.43 (80.28)LORD INVT FDS GROWTH 11.840 05/31/09 12/20/2017 434.13 505.27 (71.14)PIMCO FDS TOTL RET INSTL 335.196 unknown 8/26/2017 3,573.50 unknown unknown

8,783.43 6,308.50 (1,098.57)TOTAL LONG TERM NON-COVERED TRANSACTIONS

LONG TERMCOVERED TRANSACTIONSDATE DATE COST OR CODE

PROCEEDS OTHER BASIS (IF ANY)ADJUST- GAIN OR

DESCRIPTION QUANTITY ACQUIRED SOLD MENTS LOSSDODGE & COX INT STK FD 249.01 06/28/12 8/26/2017 7,436.68 10,086.50 (2,649.82)LAZARD FD EMERGMKT PORT 173.407 08/01/14 8/26/2017 2,819.13 3,786.50 (967.37)

$ (3,617.19)10,255.81 13,873.00TOTAL LONG TERM COVERED TRANSACTIONS

(4,361.74)|$20,339.99 21,135.04 6.81NET CAPITAL GAINS/ LOSSES:


James thinks he can itemize his deductions this year because of medical expenses with Elena’s illness. He provides you with a list, created hastily in no particular order.

Funeral expenses ............................................................................................. $9,400

Homeowner association fees.................................................................................. 150

Hospital parking fees ............................................................................................... 50

Hospital bill (not reimbursed) .............................................................................. 5,648

Hospital lodging for 10 nights (Elena traveled out of town for treatments) ................ 460

Medical mileage ........................................................................................... 625 miles

Dental bills ........................................................................................................... 885

Teeth whitening .................................................................................................... 250

Prescriptions ...................................................................................................... 2,128

Herbal supplements and vitamins ........................................................................... 225

Cash donations (with receipts) .............................................................................. 650

(Heart Ass’n (100), Valley Elementary School (250) Cancer Ass’n (300))

Church donations (statement from church) .......................................................... 4,850

Cash given to a homeless man named Sam Jones ..................................................... 50

Doctor bills ........................................................................................................ 1,170

Home property taxes .......................................................................................... 1,755

Home mortgage interest ..................................................................................... 4,772

Mortgage Insurance Premium (house purchased in 2009) ....................................... 275

Long term care insurance for Elena ..................................................................... 2,200

Life insurance for Elena ......................................................................................... 480

Non-cash donations (with receipts)

Habitat for Humanity 125 Main Street, Your City / State / ZIP

Furniture cost $6,000, purchased 6/1/2013, donated 10/13/2017 ............... 2,500

Goodwill Industries, 15810 Indianola Drive, Your City / State / ZIP

Clothing cost $1,310, purchased various times, donated 12/26/2017 ............. 245

Vehicle registration (based on value of car) .............................................................. 90

Personal property tax ............................................................................................ 235

Car loan interest ................................................................................................ 1,458

Credit card late fee ................................................................................................. 39

Sales tax – use Salisbury, NC – ZIP 28145 – State rate 4.75% plus 2.25% local rate.


James purchased a new car in June 2017. He provides the bill of sale showing that the deductible amount of sales tax is $1,445.

-98-


RECIPIENTS/lENDER'S name, address, city, state, and ZIP code *Caution: The amount shownmay not be fully deductible by you.Limits based on the loan amountand the cost and value of thesecured property may apply. Also,you may only deduct interest tothe extent it was incurred by you,actually paid by you, and notreimbursed by another person.

MortgageInterest

Statement

FIRST TRUST BANK 2017214 NINTH STVALLEY FORGE, PA 19482-2600

Form 1098

1.Mortgage interest received from payer(s)/borrower(s) *RECIPIENT'S federal identification number66-5XXXXXX

PAYER'S social security number Copy BFor Payer/BorrowerThe information is boxes 1.2, 3. and 4 is impoTant tax

information and is beingfurnished to the Internal

Revenue Service. If you a-erequired to file a return, a

negligence penalty or othe’-sanction may be imposec onyou if the IRS determines

that an underpayment of taxres^lts beca-se youove-statec a deduction for

this mortgage inte-est or forthese points or because youdid not report this refund of

interest on your return.

255-XX-XXXX $4,772.00PAYER'S/BORROWER'S name, address,city, state, and ZIP code

JAMES R AND ELENA A WELLS2. Points paid on purchase of principal residence

3. Refund of overpaid interest3947 UNIVERSITY DRIVEYOUR CITY, STATE, ZIP

4.

Account number (see instructions) 5.

Form 1098

JAMES R AND ELENA A WELLS3947 UNIVERSITY DRIVEYOUR CITY, STATE, ZIP

1234

EPAY TO THEORDER OF

DOLLARSYour BankBank City, State, ZIP CodeFo-: 325070760 |: 54134&019 1234

Comprehen sive - Yale






To report unethical behavior to the IRS, email us at [email protected] I- Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameTHOMAS

M.l. Last nameYALE


Are you a U.S. citizen?0 YesA No

2. Your spouse’s first nameGALE

Is your spouse a U.S. citizen?0 Yes

M.l. Last nameYALE

Telephone numberNoS

3. Mailing address3421HARTFORD ST


ZIP codeYOUR CITY




5. Your job titleTUTOR Yes 0 No

Yes 0 NoYes 0 No



8. Your spouse’s job title7. Your spouse’s Date of Birth3/27/1965 TEACHER10. Can anyone claim you or your spouse on their tax return? Yes Unsure0 No

0 No b. Adopted a child? Yes 0 No11. Have you or your spouse: a. Been a victim of identity theft? YesPart II - Marital Status and Household Information

Unmarried0 Married



Yes 0 No



















Citizen(yes/no)

(a) (b) (c) (d) <e) (f) (9) (h) (i)

MELISSA YALE 5/7/2006 12 y y s y NDAUGHTER12DOUGLAS YALE 1/14/1996 SON y y s y N

RICHARD STEPHENS 9/5/1963 BROTHER 12 S N yy y



-100-


Part III - Income- Last Year, Did You (or Your Spouse) ReceiveYes No Unsure1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on FormsW-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify GAMBLING <& JURY DUTY

0000

00

00

00

00

00

0Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay

1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes2. Contributions to a retirement account?

NoRoth IRA (B)

0YES iRA (A) YES 401K (B) Other0

3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher's aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

0000000

000Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)

1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover” on Form 1040 Schedule D?

000000000

Formll3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov



1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?



MECEntire Year








3. If you have a balance due, would you like to make a payment directly from your bank account? 0 Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)


No


NONE Prefer not to answer0 Yes

YesNo

21 NoPrefer not to answerPrefer not to answer

Additional comments


Comprehensive - Yale

Interview Notes - Yale

Thomas and Gale want to file a joint return. Gale is a teacher and works part-time as a waitress. Thomas is a retired police officer and is currently self-employed as a math and science tutor. Health insurance for the whole family meets MEC.

Gale’s brother, Richard, has lived with Thomas and Gale for several years. He is totally and permanently disabled and his income consists only of $3,900 in Social Security benefits. He is unable to contribute anything to his own support. Since he has been on Social Security for 10 years, he has Medicare for his health insurance.

-102-


THOMAS ANTHONY YALE GALE STEPHENS YALE

Fo- ax-Aice Training] P^ -poses Only Fo- aa-Akfe Training] P^ -poses Only


MELISSA LOUISE YALE DOUGLAS THOMAS YALE



RICHARD ARTHUR STEPHENS

Fo- ax-Alde Training P^ -poses Only




3. Social security wages 4. Social security tax withheldc. Employer 's name, address,City,State and ZIP Code$1,426.00$23,000.00HILLSDALE SCHOOL DISTRICT

6. Medicare tax withheld5. Medicare wages and tips$23,000.00 $333.501000 W JOPLIN ST, SW

WILMINGTON, DE 19850 7. Social security tips 8. Allocated tips

d. Control number 10. Dependant care benefits9.$1,000.00


11. Nonqualified plans 12a. See instructions for box 12$2,500.00D


GALE S YALE 12b.$4,850.00DD

3421 HARTFORD ST14. Other 12c.

YOUR CITY, STATE, ZIP12d.



YS 11-178911 718.75



2017Form



3. Social security wages 4. Social security tax withheldc. Employer's name,address, City,State and ZIP Code$1,275.00 $144.15CHAFFEY FAMILY FOODS

5. Medicare wages and tips 6. Medicare tax 'withheld33.71$2,325.0012 MENLO ROAD

WILMINGTON, DE 19850 7. Social security tips 8. Allocated tips$1,050.00





GALE S YALE 12b.3421 HARTFORD ST


12d.

Employer's state ID number 18. Local wages, tips, etc. 20. Locality name19. Local income tax15. State 16. State wages, tips, etc.$2,325.00




2017Form


Thomas is self-employed as a math and science tutor. In addition to his 1099-MISC he reports cash income from various students of $1,800. The students come to his house, so he has no mileage expense. He has used business code 611000 on his past tax returns. He purchased a new computer that is used only for his tutoring business.

His expenses are as follows ...........................................................

Advertising $150

Office supplies 345

Agency fees 50

New computer 428

-104-


Payer's RTN (optional)PAYER’S name, address,city, state, ZIP code InterestIncome2017VINCENNES FEDERAL CREDIT UNION

1Interest incomeForm1099-INT$379.0015321 TYLER ST

HARTFORD, CT 06101 2Early withdrawal penalty Copy B



RECIPIENTS name, address, city, state,and ZIP code 4Federal income tax withheld This is important taxinformation and is





not been reported

5 Investment expenses$38.00THOMAS A YALE


3421 HARTFORD ST9 Specified private activity bondinterest



FATCA filingrequirment 12 Bond 13 Bond Premium on tax-exempt bond



Form 1099-INT



1Total Ordinary DividendsPAYER'S name, address, city, state, ZIP code 2017$355.76MENLO GLOBAL INClb Qualified Dividends Form1099-DIV

$305.76368 CALVIN STBANGOR, ME 04401 2a Total capital gain distr.




THOMAS A AND GALE S YALE This is important taxinformation and isbeing furnished to






3421 HARTFORD ST6 Foreign Tax Paid 7Foreign Country or US possession






Form 1099-DIV


Gale received an early distribution from her IRA in January and asks if she can avoid any of the penalty.

Thomas received his first pension check on July 1, 2013. He chose the joint/survivor annuity option. He is a retired policeman and his 1099-R shows the amount he had withheld from his checks for insurance premiums.

CORRECTED (if checked)1RentsPAYER'S name, acc-ess. city, state. ZIP code 2017 Miscellaneous

IncomeLAFAYETTE TUTOR SERVICES2Royalties Form 1099-MISC

8350 BLUEFIELD WAY, SUITE 240CONCORD, NH 03301 3 Other Income 4Federal income tax withheld Copy B



50-7XXXXXX8 Substitute payments in lieu ofdividends or interest








THOMAS A YALE $1,125.009 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >|_

10 Crop Insurance proceeds3421 HARTFORD ST

YOUR CITY, STATE, ZIPli 12

FATCA filingrequ'rment


14Gross proceeds paid to anattorney

15a Section 409A deferrals 15b Section 409A income 16 State tax withheld 17State/Payer's state no. 18 State income

Form 1099-MISC



Contracts, etc.


2017$6,000.00HASTINGS INVESTMENTS2a Taxable amount

Form 1099-R$6,000.0045 ROCKHURST WAYPROVIDENCE, RI 02904 2b Taxable amount

not determined.TotalDistribution Copy B






3 Capital gain (indudedin box 2a).

4 Federal income taxwithheld

50-8XXXXXX 512-XX-XXXX5 Employee contributions/DesignatedRothcontributions orinsurance premiums

RECIPIENTS name, address, aty, state, ZIP code 6 Net unrealizedappredation inemployer's securitiesGALE S YALE

3421 HARTFORD ST 7.DistributionCode(s)






%11. 1st year of desig. Roth contrib.10. Amount allocable to IRR

within 5 years12. State tax withheld 13. State/Payer's state no. 14. State Distribution


Form 1099-R


Gale was a federal juror for four weeks during March (20 weekdays). While serving on the jury she received $40 per day from the court. Her employer continued to pay her salary for the first two weeks of her jury service on the condition that any jury duty pay received during those 10 weekdays be surrendered to the employer, which she did.

-106-


Retirement orProfit-SharingPlans,IRAs,Insurance

Contracts, etc.

1Gross distributionPAYER'S name,address, city, state, ZIP code

2017$12,000.00BAKER COUNTY POLICE DEPARTMENT2a Taxable amount

Form 1099-R908 PIEDMONT PARKWAYCOLUMBUS, OH 43216 2b Taxable amount

not determined. TotalDistributionm Copy B


federal taxreturn.If thisform shows







RECIPIENTS name, address, city, state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesTHOMAS A YALE

$3,875.003421 HARTFORD ST 7.Distribution

Code(s)IRA/ 8 Other






$38,483.00%

11. 1st year of desig. Roth contrib.10. Amount allocable to IRRwithin 5 years

12. State tax withheld 13. State/Payer's state no. 14. State Distribution


Form 1099-R



Box 2. Beneficiary's Social SecurityBox 1. NameTHOMAS A YALE 511-XX-XXXX



$8,800.00




Total AdditionsBenefits for 2017

$7,541.20

$1,258.80

$.00

$8,800.00$8,800.00

Box 6. Voluntary Federal Income Tax Withheld

Box 7. AddressTHOMAS A YALE

Benefits for 2016 3421 HARTFORD STYOUR CITY, STATE, ZIPBenefits for 2015


Form SSA-1099-SM


Gale contributed $2,000 to her traditional IRA in December. She also paid $800 interest on a student loan needed to obtain her degree in Elementary Education.

] CORRECTED (if checked)1. Gross winnings 2. Date wonPAYER'S name, address, city, state, and ZIP code 201705/15/2017$200.00BLUFFTON CASINO3. Type of wager

BLACKJACK4. Federal income tax withheld

Form W2-G1921 CORNELL COURT

5. Transaction 6. RaceCertain

GamblingWinnings

DETROIT, MI 482337. Winnings from identical wagers 8. Cashier

PAYER'S Federal identification number Payer's Telephone number9. Winner's taxpayer identification no. 10. Window This information


Revenue Service

51-0XXXXXX 213-555-1212512-XX-XXXX

WINNER'S name, address, dty, state, and ZIP 12. SecondI.D.11. FirstI.D.GALE S YALE


shows federalincome



3421 HARTFORD ST15. State income tax withheld 16. Local Winnings



Form W_2C


The Yale’s have not itemized in the past, but they think they may be able to this year. They state that all amounts on the list they have prepared are unreimbursed.

Medical insurance (paid directly from Thomas’ pension check ................... $3,875

Medical insurance for Melissa & Douglas .................................................... 2,475

Hospital bills ............................................................................................... 275

Doctor bills ................................................................................................. 450

Dental bills for Richard ............................................................................. 1,100

Antihistamines (over the counter) ................................................................ 185

Prescription drugs ....................................................................................... 625

Life insurance premiums .............................................................................. 570

Insulin for Richard....................................................................................... 350

Vitamins for the entire family ....................................................................... 230

Federal income tax paid last year .............................................................. 1,450

Personal property tax (based on value) ........................................................ 420

Real estate taxes ..................................................................................... 1,875

Utility taxes (shown on phone, electric & gas bills) ........................................ 635

Mortgage interest (shown on Form 1098 from First Bank & Trust) .............. 8,070

Credit card interest (paid to VISA) ............................................................... 850

Interest on personal loan from their credit union .......................................... 310

Church contributions (statement from church) ........................................... 2,200

Chamber of Commerce contributions ............................................................ 125

Homeowner’s association fees ..................................................................... 550

Raffle tickets at church function (didn’t win) ................................................... 75

Union dues for Gale .................................................................................... 185

Safety deposit box (for investment records) .................................................... 75

Gambling losses ....................................................................................... 1,040

Use NC ZIP code 28145 for state sales tax: 4.75% state rate plus 2.25% local rate.

The Yale’s paid for after-school care for Melissa, so they could work.

-108-


Douglas attends Ashland University, having started his second year last fall. He has never had a conviction of a felony for possession or distribution of a controlled substance.

Phone 954-555-xxxxDana Day Care Center1648 Baylor AveYour City,State, Zip

EIN 52-Oxxxxxx

January 25, 2018

Received for after school care for Melissa YaleJanuary -December 2017: $1,500.00


CORRECTED (if checked)1Payments received forqualified tuition and relatedexpenses

FILER'S name, address, dty,state,and ZIP code

ASHLAND UNIVERSITY TuitionStatement2017$9,500.00

319 KENDALL CIRCLEMEMPHIS, TN 38101

2 Amounts billed forqualified tuition andrelated expenses Form1098-T

FILER'S federal identification no. STUDENTS taxpayer identification no52-2XXXXXX 514-XX-XXXX 3If this box is checked, your educational institution

has changed its reporting method for 2017. Copy BFor StudentSTUDENTS name, address,dty, state,and ZIP code


5 Scholarships or grantsDOUGLAS YALE This is importanttax information



maybe used tocomplete Form 8863to daim education


$3,000.003421 HARTFORD STYOUR CITY, STATE, ZIP 7Checked if the amount in

box 1or 2 indudesamounts for an academic


period begining January -]—|March 2018. > I—I

Service Provider/Acct No. (see instr.) 8. Checked if at least r—,half-time student [XJ



Form 1098-T

THOMAS A & GALE S YALE 1234

3421 HARTFORD ST

YOUR CITY, STATE, ZIP$PAY TO THE

ORDER OFDOLLARS


Specialty - V incent -110-


Department of the Treasury - Wanwi Revenue Service

Intake/Interview & Quality Review SheetOMR Number

1545-1964 0You will need:

* Tax Information such as Forms W-2, 1099,1099,1095.* Social security cards orlUIN letters for all persons on your tax return.* Picture ID (suchn valid driver 's license) for you and your spouse,

* Please complete pages 1-3 of this form,* You am responsible forth© information on your return. Please provide

compIete and accurate information.* If you have questions, please ask the IRS-certified volunteer preparer.

Volunteers are trained to provide high quality service and uphold the highest ethical standards.To report unethical behavior to the IRS, email [email protected]

Pair!I-Your Personal! Information { If you ore fifing & joint return, enter your nemes in the seme order ns test yeer’s return)1, Your first nameVAN

Ml Last nameVINCENT

Telephone rumber704-555-XXXX

Are you a U.S. Citizen?0 YesR No

2. Your spouse's first name M.l Last name Telephone number Is your Spouse a U. S. Citizen?Yes No

3. Mailing address456 OVERHILL RD

Apt # City StateYOUft STATE YOUR ZIP

ZIP codeYOUR CITY

Yes 0 NoYes 0 No


5. Your job titleASSISTANT MANAGER

6. Last year, were you:b. Totally and permanently disabled Yes 3 Ng

a. Full -time studentc. Legally blind

7. Your spouse's Date of Birth 8. Your spouses job title 9. Last year, was your spouse:b. Totally and permanently disabled Yes No


Yes NoYes No

10. Can anyone claim you or your spouse on their tax return’ n Yes H Nr:. n Unsurea. Been a victim of identity theft’ Yes No b. Adopted a child? Yes 0 No11. Have you or your spouse:

Part ll - Marital Status and Household Information1. As of December 31, 2016, were

you:0 Unmarried

Married( This includes registered domestic partnerships, civil unions, or other formal relationships understate law )

Yes Noa. If Yes, Did you get married in 2016’b. Did you live with your spouse during any part of the last six months of 2016’ Yes NoDate of final decree


0 DivorcedLegally Separated Date of separate maintenance agreementWidowed

2010

Year of spouse's death

2. List the names below of:every one who lived with you last year (other then your spouse)anyone you supported but did not live with you last year

If additional space is needed check here Eland listen page 3To be completed by a Certified Volunteer Preparer

Name first .'saf,!* Do not enter yourname or spouse -a name below

Daleof Birth Relalonaftplo you f forexample

Number ofmonrtfi -slivedinyour borne|*91 year

US Residentof US.Canada,or Mexicolass yearfresco)

SngieorMamed asof 1231/16

FiiiNimeStudentlaal yearfyes/no)

Totally andPermanentlyDaaUed(yaa/no)

lathaperaon aqualifyngdhiktireJaiveof any otherperson?fyi-S/no)

Didtnaperaonprovidemore than50% of miitoer ownsupport?

Didinaperaonhave Iessthan$4,050of income?fyestoo)

Didthetaxpayer;a)provide moretian50%ofsupport for®iia person?

Did thetaxpayer^)pay morelhanhalf the coat ofmama^ngaborne for thisperaon?

Citizen

30.0,

tfsuflmfei;panatf.

{ Of 191 m(*> «;e ;, wLARRY VINCENT 10/10/1996 SON 12 Y Y 3 Y N

Form 13614-C (Rev. 10-2016)Catalog Number 521216 www .irs .0ov

Specialt y - Vincent

Page 3Chock appropriate box f or each question In each sectionY*& No Unsure Part IK - Incom*-Last Year, Did You (or Your Spouse) Receive

1. (B) Wages or Salary? (Form W-2) If yes, how many jobs dk5 you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W* 2, 109B-T)4. (B) Interest/Dividerids from: checking/savirtgs accounts, bonds, CDs, brokerage? (Forms 1099-1 NT . 1099-DIV'i

5. (B) Refund of state/local income taxes? (Form 1G99-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A ) Gash/check payments for any work performed not reported on Forms W-2 or 1099?

9. (A ) Income (or loss ) from the sals of Stocks, Bonds or Real Estate? (Including your home) (Forms 1099-3,1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R . W-2)11 . ( A ) Payments from Pensions, Annuities, and/or IRA?* (Form 1Q99-R )12. (B) Uremptoymer>t compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-10S9, RRB-1QB9)14. (M) Income (or loss) from Rental Property?

15. (B) Other income? (gambling, lottery, prizes , awards, jury duty , Sch K-1. royalties , foreign income , etc ) Specify

H iiz

m00E0000000

Yes No Unsure Part tV Expenses- Last Year , Did You for Your Spouse) Pay1. (B) Alimony Or separate maintersanos payments? Ifyes, do you have the recipient 's SSN ? Yea

3. (B) College DT post secondary educationalexpenses for yourself, spouse or dependents? (Form1096 T)

4. (B) Unreimbursed employee business expenses9 {such as uniforms or mileage)5. (Bi Medical expenses'5 { including health insurance premiums)6. (B) Home mortgege interest? (Form 1 0S 6)7. (R) Real estate taxes for your home or personal property taxes for your vehicle9 (Form 10ft&)5. (B) Charitable contributions'?

ft. (B) Child or dapercent care expenses such as daycare?10. LB) For supplies used as aneligible educator such as a teacher, teacher's aide, counselor, etc.911 . (A) Expenses relates to self -employment income or any other income you received?12. (B) StLriert loan interest? (Farm IftftB -E)

NoRolti IRA fH)

00 2. Contributions to a retirement account 9 IRA fAi Other

0000 Li00 P0 n000

Ye* Unsure Part V - Life Events - Last Year, Did You {or Your -Spouse,'n E 1. (HSA ) Haves Health Savings Account? (Forms &49B-SA , 1099-SA, W-2 With code Win box 12)2. (A ) Have debt from a mortgage or credit cardcancelled/forgiwenby a commercial lender? (Forms 10ftft-C. 1Q99-A)3. (A ) Buy , sell or have a foreclosure of your home? (Form 1095 A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year9 Ifyes, for which tax year?b. (A ) Purchase and install energy-efficient home items? (such as winoews, furnace, insulation, etc )6. (B) Live in an area that was affected by a natural disaster9 If yes, where9

7. (A ) Reoeite the First Time Homebuyers Credit in 2008?

B. (B) Make estimated tax payments or apply last year's refund tD this year's tax? If so how much?9. (A) File afeoer &l return last year con taming a 'capital loss carryo^r" on Form 1049 Schedule D?

0i 0

000 n000 n

ronnll 3614-C ; 4ev. I0-20l&rCalitog Numtei 52131E

Specialty - Vincent -112-

zz Page 3Check appropriate box for each question in each eectionYes No Unsure Part VI - Health Care Coverage - Last yearr did you,your epoute,or dependents )

1. (B) Have health tare coverage?00 2. (B) Receiw one or more of these tonms5 (Check the box ) Form 1095-B Form 1095-C

3. (A ) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A1n n n 3a. (A) If Yes, were EKJvanceicredlt payments made to help you pay your health care payments?

3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return?4. (B) Have an exemption granted by the Marketplace^0

Visit http://www.healthcare.qovj1 or call 1-BQ0-313-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income, marital status or family size changes, to your Marketplace,Reporting changes will help to make sure you are getting the proper amount ofadvance payments.To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEG) for everyone listed on the return.)

Name (List dependents in thesame order as in Part IIj

MECEntire Year


Exempt ion (mark monthsexemptions applies]


J F M A M J J A S O N D J F M A M J J A S O N DTaxpayerJ F M A M J J A S O N D J F M A M J J A S O N DSpoutseJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependentJ F M A M J J A S O N D J F M A M J J A S O N DDependent

Part VII -Additional information and Questions Related to the Preparati on of Your Return1. Presidential Election Campaign Fund ( If you check a box, your tax or refund wiii not change)

YouCheck here if you, or your spouse if filing jointly, want $3 to goto this fund Spouse2. If you are due a refund, would you like:

a. Direct depositYes

b. To purchase U S. Savings BondsNo


0 No3. If you have a balance due, would you like to make a payment directly from your bank account?4. Provide an email address {optional} (this email address wM not he used for contacts from the Internal Revenue Service)Ma ny free tax preparation sites operate by receiving grant money.The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes,5. Other than English, what language is spoken in your home? NONE

Yes NoYes

Prefer not to answer6. Do you or any member of your household haw a disability?7. Are you or your spouse a Veteran from the U.5. Armed Forces?

YesYes

0 No0 No


Additional comments

Form 13614-C {Rev. 10-2016}Cetmog Number S2121E wwm ira gov

Specialty - Vincent

Interview Notes – Vincent

Van and his ex-wife Penny were divorced in 2010. Van has full custody and has fully supported his son Larry since the divorce. Larry is still in high school.

Both Van and Larry were covered by Van’s employer health insurance all year.

Van is in his second year of college, working half-time toward an associate degree. In addition to the $2,800 shown in box 1 of the 1098-T, Van paid $200 for books required for his classes and $500 for a used laptop that would be helpful in his classwork. Scholarships were Pell grants. Neither Van nor his son have ever had any felony convictions.

384-XX-XXXX 385-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FOR THIS NUMBER H.AS BEEN ESTABLISHED FOR

VAN R VINCENT LARRY D VINCENT

For Tax-Aide Training Pw'poses Only For Tax-Aide Training Pw'poses Only

a. Employee’s social security number384-XX-XXXX


3. Social security wages 4. Social security tax withheldc. Employer's name, address.City,State and ZIP Code$22,000.00 $1,364.00WALTON'S DEPT STORE

5. Medicare wages and tips 6. Medicare tax withheld$22,000.00 $319.00123 EAST ST.

SALISBURY, NC 28145 7. Social security tips 8. Allocated tips





VAN R VINCENT 12b.456 OVERHILL RD

14. Other 12c.YOUR CITY STATE ZIP

12d.



$1,000.00YS 208112213



2017Form

Specialty - Vincent

OPTIONAL SUPPLEMENTAL EXERCISE – VINCENT 2

After completing, confirming, and recording the results of the exercise above, remove the taxable scholarship and education expenses from the return. This time everything is the same except that Van’s son Larry is the college student – instead of Van. Instead of being a high school student, Larry is now a full-time college freshman. Larry did not have any income other than the scholarship.

-114-



LOCAL COMMUNITY COLLEGE TuitionStatement2017$2,800.00

1 COLLEGE WAYSALISBURY, NC 28145


FILER'S federal identification no. STUDENTS taxpayer identification no384-XX-XXXX20-7XXXXXX 3If this box is checked, your educational institution



5 Scholarships or grantsVAN R VINCENT This is importanttax information





$3,500.00456 OVERHILL RDYOUR CITY STATE ZIP 6 Adustments to

scholarships or grantsfor a prior year

7 Checked if the amount inbox 1or 2 indudesamounts for an academicperiod begining JanuaryH iMarch 2018. > I—I

Service Provider /Acct No. (see instr.) 8. Checked if at least r—,half-time student [XJ



Form 1098-T


FILER'S name, address, aty, state,and ZIP code

LOCAL COMMUNITY COLLEGE TuitionStatement2017$2,800.00

1 COLLEGE WAYSALISBURY, NC 28145


FILER'S federal identification no. STUDENTS taxpayer identification no20-7XX0013 385-XX-XXXX 3If this box is checked, your educational institution



5 Scholarships or grantsLARRY D VINCENT This is importanttax information





$3,500.00456 OVERHILL RDYOUR CITY STATE ZIP 6 Adustments to

scholarships or grantsfor a prior year

7 Checked if the amount inbox 1or 2 indudesamounts for an academicperiod begining JanuaryH iMarch 2018. > I—I

Service Provider /Acct No. (see instr.) 8. Checked if at least r—,half-time student [XJ



Form 1098-T

Specialty - Vincent

OPTIONAL SUPPLEMENTAL EXERCISE – VINCENT 3

Same as OPTIONAL SUPPLEMENTAL EXERCISE – VINCENT 2, except that Larry had earnings of $5,000, working part-time at Walton’s Dept Store.


b. Employer identification number (EIN) 1. Wages, tips, other compensation 2. Federal income tax withheld$.00$5,000.0020-80013XX

3. Social security wages 4. Social security tax withheldc. Employer's name, address,City,State and ZIP Code$5,000.00 310.00WALTON'S DEPT STORE

5. Medicare wages and tips 6. Medicare tax withheld$5,000.00 $72.50123 EAST ST.

SALISBURY, NC 28145 7. Social security tips 8. Allocated tips





LARRY D VINCENT 12b.456 OVERHILL RD

14. Other 12c.YOUR CITY STATE ZIP

12d.

Employer's state ID number 18. Local wages, tips,etc. 19. Local income tax 20. Locality name16. State wages, tips, etc.$5,000.00

17. State income tax15. StateYS 208112213 .00



2017Form

Specialt y - Wright

-116-






To report unethical behavior to the IRS, email us at [email protected] I- Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)1. Your first nameANDREW

M.l. Last nameWRIGHT


Are you a U.S. citizen?0 YesM No

2. Your spouse’s first nameJANE

M.l. Last nameWRIGHT

Telephone number Is your spouse a U.S. citizen?0 Yes No

3. Mailing address516 WINDGATE ROAD


ZIP codeYOUR CITY




5. Your job titleLAB TECHNICIAN c. Legally blind

Yes 0 NoYes 0 No



7. Your spouse’s Date of Birth 8. Your spouse’s job title7/1/1975 SALES REPRESENTATIVE10. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? n Yes 0 No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information1. As of December 31, 2016, wereyou:

Unmarried0 Married


Yes 0 No






Name (first, last) Do not enter yourname or spouse s name below













Citizen(yes/no)

(a) (b) (c) (d) (e) (f) (9) <b) (i)

JOHN WRIGHT 5/15/2009 SON 12 y y s y N


Special ty - Wright


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions. Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment Compensation? (Form 1099G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099. RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

000

0000000000

00

Yes No Unsure Part IV - Expenses - Last Year. Did You (or Your Spouse) Pay1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes

IRA (A) 1,158.54 401K (B)NoRoth IRA (B)

02. Contributions to a retirement account? Other03. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher's aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

000000

0000

Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy. sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes, where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year’s refund to this year's tax? If so how much?9. (A) File a federal return last year containing a “capital loss carryover" on Form 1040 Schedule D?

000000000


Specialt y - Wright

-118-

Page 3Check appropriate box for each question in each sectionYes UnsureNo Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s)

1. (B) Have health care coverage?2. (B) Receive one or more of these forms? (Check the box) Form 1095-B3. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]

3a. (A) If yes. were advance credit payments made to help you pay your health care premiums?3b. (A) If yes. Is everyone listed on your Form 1095-A being claimed on this tax return?

4. (B) Have an exemption granted by the Marketplace?

E0 Form 1095-CE

EEE0

Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance.If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, suchas, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount ofadvance payments.To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.)


MECEntire Year




J F M A M J J A S O N D J F M A M J J A S O N DTaxpayerJ F M A M J J A S O N D J F M A M J J A S O N DSpouse

Dependent J F M A M J J A S O N D J F M A M J J A S O N DJ F M A M J J A S O N D J F M A M J J A S O N DDependent

Dependent J F M A M J J A S O N D J F M A M J J A S O N DJ F M A M J J A S O N D J F M A M J J A S O N DDependent


2. If you are due a refund, would you like:a. Direct deposit


Y0Sc. To split your refund between different accounts

YesNo

No3. If you have a balance due, would you like to make a payment directly from your bank account? n Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home?

No No

Prefer not to answer6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

YesYes

NoNo


Additional comments


Specialty - Wright

Interview Notes – Wright

Andrew and Jane are married and want to file jointly.

In 2017, John had a family coverage High Deductible Health Plan at work with Dillard Technology that also covers Jane. However, his employer does not contribute to his Health Savings Account. Jane’s mother gave her $3,000 to contribute to her HSA. Therefore, Andrew believes he maxed their HSA contribution by contributing $3,750 to his HSA. Andrew and Jane both have bank statements that itemize the HSA distributions from their respective accounts at “Your Bank”. The HSA distributions match the amounts reported on the Form 1099-SA and were used for used for qualified medical expenses.

Andrew and Jane received rent for providing space on a vacant lot next to his home for house bee hives.

Andrew and Jane paid for John to attend before- and after-school care at Lafayette Day Care.


ANDREW M WRIGHT JANE WRIGHT

Fo- sx-A'ce Training] P^ -poses Only Fo- aa-Akfe Training] P^ -poses Only


JOHN WRIGHT

Fo- ax-A'ide Training] P^ -poses Only

ANDREW & JANE WRIGHT 1234

775 CAMPBELL DRIVEYOUR CITY, STATE ZIP

EPAY TO THEORDER OF

DOLLARS


Specialty - Wright -120-


b. Employer identification number (EIN) 2. Federal income tax withheld1. Wages, tips,other compensation$36,765.11 $1,268.2344-2XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address,City,State and ZIP Code$37,923.65 $2,351.27DILLARD TECHNOOGY

1134 FRIENDLY BLVD, N.W.TAMPA FL 33635





11. Nonqualified plans 12a. See instructions for box 12$1,158.54D


ANDREW WRIGHT516 WINGATE ROADYOUR CITY, STATE, ZIP

12b.$9,123.00DD

14. Other 12c.

12d.





2017Form


b. Employer identification number (EIN) 2. Federal income tax withheld1. Wages, tips,other compensation$22,465.56 $1,219.0044-3XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address,City,State and ZIP Code$22,465.56 $1,392.86REINHARDT TECHNOLOGY

5. Medicare wages and tips 6. Medicare tax withheld$22,465.56 $325.7574 LAWRENCE AVE

ST PETERSBURG, FL 33702 7. Social security tips 8. Allocated tips

d. Control number 10. Dependant care benefits9.$750.00




JANE WRIGHT 12b.516 WINDGATE ROAD


12d.





2017Form

Specialty - Wright


Payer 's RTN (optional)PAYER'S name, address, city, state,ZIP code InterestIncome2017NEWCOMB SAVINGS & LOAN

1Interest incomeForm 1099-INT$147.313265 ELON WAY

BALTIMORE, MD 21233 2 Early withdrawal penalty$15.75

Copy B


3 Interest on US Savinqs Bonds and Treas. obligations44-1XXXXXX






not been reported


ANDREW WRIGHT6 Foreign Tax Paid 7Foreign Country or US possession

516 WINDGATE RD9 Specified private activity bondinterest





Form 1099-INT

CORRECTED (if checked)1RentsPAYER'S name. address. city, state. ZIP coce 2017 Miscellaneous

Income$90.00NATURE'S HONEY

2Royalties Form 1099-MISC314 DOWN HOME TERRACEYOUR CITY, STATE, ZIP 3 Other Income 4Federal income tax withheld Copy B


445-XX-XXXX5 Fishing boat proceeds 6Medical and health care payments

44-5XXXXXX7Nonemployee Compensation 8 Substitute payments in lieu of

dividends or interestThis is important taxinformation and isbeing furnished to






RECIPIENTS name,address, city, state, ZIP code

ANDREW WRIGHT9 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >|_

10 Crop Insurance proceeds516 WINDGATE RD

YOUR CITY, STATE, ZIP1211





Form 1099-MISC

Specialty - Wright

-122-

2727 VOID CORRECTEDOMBNo. 1545-1518TRUSTEE’S name, street address, city or town, state or province, country.

ZIP or foreign postal code, and telephone number1Employee or self-employedperson’s Archer MSAcontributions made in 2017and 2018 for 2017

HSA, Archer MSA, orMedicare Advantage

MSA Information$2 Total contributions made in 2017YOUR BANK

YOUR CITY, STATE, ZIP Form 5498-SA$ $3,750.00Copy ATRUSTEE’S federal identification number PARTICIPANT'S social security number 3 Total HSA or Archer MSA contnbutions made in 2018 for 2017

$ For325-XX -XXXX 445-XX-XXXXInternal RevenueService Center

File with Form 1096.For Privacy Act and

PaperworkReduction Act

Notice, seethe 2017 GeneralInstructions for

Certain InformationReturns.

PARTICIPANT’S name 4 Rollover contributions 5 Fair market value of HSA.Archer MSA. or MA MSA

$ $ANDREW WRIGHT S7,500.000Street address (including apt. no.) 6 HSA

Archer MSA | |516 WINDGATE RDCity or town, state or province, country, and ZIP or foreign postal code MA

MSAYOUR CITY,STATE XXXXXAccount number (see instructions)

Form 5498-SA Cat. No. 38467V www.irs.gov/form5498sa )epartment of the Treasury - Internal Revenue Servicen VOID2727 CORRECTEDOMB No.1545-1518TRUSTEE’S name, street address, city or town, state or province, country.

ZIP or foreign postal code, and telephone number1Employee or self -employedperson's Archer MSAcontributions made in 2017and 2018 for 2017

HSA, Archer MSA, orMedicare Advantage

MSA Information$2 Total contributions made in 2017YOUR BANK

YOUR CITY, STATE. ZIP Form 5498-SA$ $3,000.00Copy ATRUSTEE’S federal identification number PARTICIPANT'S social security number 3 Total HSA or Archer MSA contributions made in 2018 for 2017

$ For325-XX-XXXX 446-XX-XXXXInternal RevenueService Center

PARTICIPANT'S name 4 Rollover contributions 5 Fair market value of HSA.Archer MSA.or MA MSA

$ $ File with Form 1096.For Privacy Act and

PaperworkReduction Act

Notice, seethe 2017 GeneralInstructions for

Certain InformationReturns.

JANE WRIGHT $7,000.00sStreet address (including apt. no.) 6 HSA

Archer MSA516 WINDGATE RDCity or town, state or province, country, and ZIP or foreign postal code MA

MSAYOUR CITY,STATE XXXXXAccount number (see instructions)

Form5498-SA Cat. No. 38467V www.irs.gov/form5498sa Department of the Treasury - Internal Revenue Service

^4 VOID CORRECTEDTRUSTEE'S/PAYER'S name, street address, city or town, state or province,country. ZIP or foreign postal code, and telephone number

OMB No. 1545-1517 DistributionsFrom an HSA,

Archer MSA, orMedicare Advantage

MSAYOUR BANKYOUR CITY, STATE XXXXX Form 1099-SA

Copy APAYER’S federal identification number RECIPIENT'S identification number 1 Gross distribution 2 Earnings on excess cont.ForS $325-XX-XXXX 445-XX-XXXX $550.00 Internal Revenue

Service CenterFile with Form 1096.

RECIPIENT'S name 3 Distribution code 4 FMV on date of death

$ For Privacy Actand PaperworkReduction ActNotice, see the2017 General

Instructions forCertain

InformationReturns.

ANDREW WRIGHT 15 HSA [7]Street address (including apt. no.)

Archer |—j516 WINDGATE RD MSACity or town, state or province, country, and ZIP or foreign postal code

MAMSA nYOUR CITY, STATE. ZIP


Form 1099-SA Cat. No. 38471D www.irs.gov/form1099sa Department of the Treasury - Internal Revenue Service

Specialty - Wright

B 4R 4 VOID CORRECTEDTRUSTEE'S/PAYER'S name, street address, city or town, state or province,country. ZIP or foreign postal code, and telephone number

OMB No. 1545-1517 DistributionsFrom an HSA,

Archer MSA, orMedicare Advantage

MSAYOUR BANKYOUR CITY, STATE XXXXX Form 1099-SA

Copy AFor

Internal RevenueService Center

File with Form 1096.For Privacy Actand PaperworkReduction ActNotice, see the2017 General

Instructions forCertain

InformationReturns.

PAYER'S federal identification number RECIPIENT S identification number 1 Gross distribution 2 Earnings on excess cont.$ $325-XX-XXXX 446-XX-XXXX $1,525.00

RECIPIENT S name 3 Distribution code 4 FMV on date of death

$JANE WRIGHT 15 HSA 0Street address (including apt. no.)

Archer |—j516 WINDGATE RD MSACity or town, state or province, country, and ZIP or foreign postal code

MAMSA nYOUR CITY, STATE, ZIP


Form 1099-SA Cat. No. 38471D www.irs.gov/form1099sa Department of the Treasury - Internal Revenue Service

Lafayette Day Care Center1648 Baylor AveYour City, State, Zip

Phone 841-555-xxx>EIN 20-5xxxxxx

January 25, 2018

Received for after school care for John WrightJanuary - December 2017: $1,875.00


Special ty - Young

-124-






To report unethical behavior to the IRS, email us at [email protected] I - Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)

M.l.1. Your first nameXuan

Last nameYoung


Are you a U.S. citizen?0 Yes No

2. Your spouse’s first nameYork

M.l. Last nameYoung

Telephone number Is your spouse a U.S. citizen?0 Yes No

3. Mailing address1Main

Apt # City State ZIP codeyc ys yz


a. Full-time student Yes [0 Noc. Legally blind


5. Your job titleTeacher Yes 0 No


a. Full-time studentYes No c. Legally blind

Yes NoYes No

7. Your spouse's Date of Birth 8. Your spouse's job title7/3/195010. Can anyone claim you or your spouse on their tax return? Yes 0 No Unsure11. Have you or your spouse: a. Been a victim of identity theft? Yes 0 No b. Adopted a child? Yes 0 NoPart II - Marital Status and Household Information1. As of December 31, 2016, wereyou:

UnmarriedMarried


Yes No



Year of spouse's death0 Widowed 1/5/20172. List the names below of:
















Citizen(yes/no)

(a) (b) (c) (d) (e) (f) (9) (h) (i)

Sadie Burke 3/4/1955 12 SNiece yes yes no yesCherie Cook 5/3/1997 6-daughter S11 yes yes yes noGrant Allen 7/4/2014 (3(3-son 11 Syes yes no no


Special ty - Young


1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year?2. (A) Tip Income?3. (B) Scholarships? (Forms W-2, 1098-T)4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV)5. (B) Refund of state/local income taxes? (Form 1099-G)6. (B) Alimony income or separate maintenance payments?7. (A) Self-Employment income? (Form 1099-MISC, cash)8. (A) Cash/check payments for any work performed not reported on FormsW-2 or 1099?9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S.1099-B)10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2)11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R)12. (B) Unemployment compensation? (Form 1099-G)13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099. RRB-1099)14. (M) Income (or loss) from Rental Property?15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify

00

000

0000

00

00

0Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay

1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient’s SSN? Yes2. Contributions to a retirement account? yes ??3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T)4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage)5. (B) Medical expenses? (including health insurance premiums)6. (B) Home mortgage interest? (Form 1098)7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098)8. (B) Charitable contributions?9. (B) Child or dependent care expenses such as daycare?10. (B) For supplies used as an eligible educator such as a teacher, teacher s aide, counselor, etc.?11. (A) Expenses related to self-employment income or any other income you received?12. (B) Student loan interest? (Form 1098-E)

NoRoth IRA (B)

0401K (B) ??IRA (A) yes Other0

0000000000Yes No Unsure Part V - Life Events - Last Year, Did You (or Your Spouse)

1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12)2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A)3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A)4. (B) Have Earned Income Credit (EIC) disallowed in a prior year? If yes, for which tax year?5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.)6. (B) Live in an area that was affected by a natural disaster? If yes. where?7. (A) Receive the First Time Homebuyers Credit in 2008?8. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much? federal and state9. (A) File a federal return last year containing a "capital loss carryover” on Form 1040 Schedule D?

0000

00

000

Formil3614-C (Rev. 10-2016)Catalog Number 52121E www.irs.gov

Special ty - Young

-126-


1. (B) Have health care coverage?02. (B) Receive one or more of these forms? (Check the box) Form 1095-B Form 1095-C03. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A]03a. (A) If Yes, were advancelcredit payments made to help you pay your health care payments?03b. (A) If yes. Is everyone listed on your Form 1095-A being claimed on this tax return?0



MECEntire Year









No3. If you have a balance due. would you like to make a payment directly from your bank account? 0 Yes4. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants.Your answers will be used only for statistical purposes.5. Other than English, what language is spoken in your home? none6. Do you or any member of your household have a disability?7. Are you or your spouse a Veteran from the U.S. Armed Forces?

Yes No

Prefer not to answer0 Yes0 Yes

NoNo


Additional comments


Specialty - Young

Special Note: This Young return is a very comprehensive scenario with numerous tax law areas for discussion in the class room. It contains complex comprehensive topics intended for use in Intermediate and Master volunteer training.

Interview Notes – Young

Xuan Young has returned again this year. She is a full time resident of your state and she wants to file a state return. Her husband, York, died January 5, 2017 and Xuan has some questions:

What is her best filing status for 2017?

How will she file in 2018 and beyond if Sadie continues to live with her?

York’s will provided a bequest to York’s brother for $5,000 and a donation to the American Cancer Society $5,000. Both were paid from their joint account. Xuan asks if she can get a deduction for either. (See Xuan’s list of deductions below.) Aside from this, York left everything to Xuan.

Generally, consider that York held his separate assets in his own name. If jointly owned with Xuan, consider them 50-50 owned but NOT community property assets. Plan to discuss the impact of owning the assets as community property if your state is a community property state.

Dependents

York’s granddaughter, Cherie, and great-grandson, Grant, lived with Xuan for 11 months. While Cherie was still living there, she was paid by the state to help take care of Sadie (Medicaid Waiver Payments). Cherie saved that money so she could move out, which she and Grant did late November when Cherie got a full-time job. Xuan paid for all the household costs while they lived with her. Cherie was a full-time student for the first five months.

Xuan brought you Cherie’s W-2s and asks whether she can still claim them as dependents and whether Cherie needs to file.

Specialty - Young

-128-

213-XX-XXXX 214-XX-XXXXTHIS NUMBER HAS BEEN ESTABLISHED FOR THIS NUMBER HAS BEEN ESTABLISHED FOR

CHERYL COOK GRANT ALLEN

For ax-Aide Training Purposes Only For ax-Aide Training Purposes Only


b. Employer identification number (EIN) 2. Federal income tax withheld1. Wages, tips,other compensation$4,328.28 $.0094-6XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, City,State and ZIP Code$268.35$4,328.28SOCIAL SERVICES

50 STATE STYC, YS YZ

5. Medicare wages and tips 6. Medicare tax withheld$62.76$4,328.28






CHERYL COOK1MAINYC, YS YZ

12b.

14. Other 12c.

12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name16. State wages, tips, etc.$4,328.28

17. State income tax15. StateYS 946XXX .00



2017Form

Specialty - Young

York’s niece, Sadie, is totally and permanently disabled. Sadie receives small social security disability payments and earned $5,500 at a work center (a sheltered workshop). She lived with Xuan all year, who provided more than half of her support. Xuan gives you Sadie’s W-2 so that you can prepare her return, if needed.



3. Social security wages 4. Social security tax withheldc. Employer's name, address,City,State and ZIP Code$3,518.25 $247.19MCDJOBS

64 BURGER STYC, YS YZ

5. Medicare wages and tips 6. Medicare tax withheld$57.81$3,987.00

7. Social security tips 8. Allocated tips$468.75





CHERYL COOK75 CASEY RD APT 4YC, YS YZ

12b.

14. Other 12c.

12d.

Employer's state ID number 19. Local income tax18. Local wages, tips, etc. 20. Locality name15. State 16. State wages, tips, etc.$3,987.00

17. State income tax$57.25YS 269XXXX



2017Form


SADIE BURKE

For ax-Aide Training P„-poses Only

Specialty - Young

Wage Income

York didn’t work at all in 2017 as he was too ill, though he did receive his retirement income.

-130-


b. Employer identification number (EIN) 1. Wages, tips, other compensation 2. Federal income tax withheld$5,500.00 $.0095-1XXXXXX

3. Social security wages 4. Social security tax withheldc. Employer's name, address, city state and ZIP Code$5,500.00 $341.00MILLSAP WORK CENTER

59 ASH DRIVEYC, YS YZ




e. Employee's name (first, initial, last), address, city, state and ZIP code 11. Nonqualified plans 12a. See instructions for box 12SADIE BURKE1MAINYC, YS YZ


14. Other 12c.

12d.

Employer's state ID number 18. Local wages, tips, etc. 19. Local income tax 20. Locality name15. State 16. State wages, tips, etc,

$5,500.0017. State income tax

$.00YS 951XXXX



2017Form



3. Social security wages 4. Social security tax withheld$3,132.59

c. Employer's name, address,City, State and ZIP Code$50,525.67COUNTY SCHOOL

10 ANCHOR WAYYC, YS YZ



d. Control number 10. Dependant care benefits9.$275.00685774


11. Nonqualified plans 12a. See instructions for box 12$1,200.00E


XUAN YOUNG1MAINYC, YS YZ

12b.$5,752.33DD

14. Other 12c.

12d.


17. State income taxYS 952XXX 576.16



2017Form

Specialty - Young

Investment Income

The Youngs used to own a vacation home jointly, which they sold some years ago. Xuan collected the final balloon payment on the seller-financed mortgage of $10,000. The Youngs had a small loss on the sale; so, this was not an installment sale. The purchaser was Liz Lens (SSN 219-XX-XXXX), 4216 Abby Way, Park City, UT 84098. Xuan got interest of $252.15 on the loan during 2017.

Xuan collected $500,000 on York’s life insurance policy. Xuan asks how these funds impact her tax return. The insurance company also paid her interest from the date of York’s death.

The account at Money Bags was a joint account that Xuan has now reregistered to her name alone, as she has with other accounts.


Payer's RTN (optional)PAYER'S name, address,city, state, ZIP code InterestIncome2017OBIT LIFE INSURANCE

900 HEART PASSYC, YS YZ

1Interest income Form 1099-INT$1,232.882Early withdrawal penalty Copy B


3Interest on US Savings Bonds and Treas. obligations94-4XXXXXX






not been reported




9 Specified private activity bondinterest


10 Market Discount 11Bond Premium


14Tax-exempt and tax creditbond CUSIP no.

16 State Identification no944XXX

17 State tax withheld15 StateAccount number (see instructions)YS

Form 1099-INT

I CORRECTED (if checked)

Payer's RTN (optional)PAYER'S name, address, city, state, ZIP code InterestIncome2017MONEY BAGS BANK

56 RICHES ROADYC, YS YZ

1Interest incomeForm 1099-INT$87.67

2Early withdrawal penalty$12.75

Copy B





4Federal income tax withheld This is important taxinformation and is





not been reported



9 Specified private activity bondinterest


10 Market Discount 11Bond Premium

FATCA filingrequirment 13 Bond Premium on tax -exempt bond12

14Tax-exempt and tax creditbond CUSIP no. 16 State Identification no

954XXX17State tax withheld15 StateAccount number (see instructions)

YS456456

Form 1099-INT

Specialty - Young

Neither York nor Xuan had an interest in a financial account in a foreign country and have never received distributions from, or transferred funds to, a foreign trust.

Xuan asks if she can use all the loss carryovers, even though 80% was York’s from the sale of his investments. If there is any loss carryover left, how much will Xuan be able to use. You find the following worksheet in York and Xuan's prior year return:

US Schedule D Worksheet for Capital Loss Carryovers 2016

Name: YORK YOUNG AND XUAN YOUNG SSN: 211-XX-XXXX

Capital Loss Carryovers from This Year to Next Year 1. Amount from Form 1040, line 41, or Form 1040NR, line 39 54,650 2. Loss shown on schedule D, line 21 as a positive amount. 3,000 3. Combine lines 1 and 2. If -0- or less, enter -0- 57,650 4. Smaller line 2 or line 3 3,000 5. Loss on Schedule D, Line 7 as a positive amount 7,877 6. Gain, if any, shown on Schedule D, Line 15 7. Add lines 4 and 6 3,000 8. Short-term capital loss carryover. Subtract line 7 from line 5. If -0- or

less, enter -0- 4,877

9. Loss shown on Schedule D, line 15 as a positive amount 4,456 10. Gain, if any, shown on Schedule D, line 7 0 11. Subtract line 5 from line 4. If -0- or less, enter -0- 0 12. Add lines 10 and 11 0 13. Long-term capital loss carryover. Subtract line 12 from line 9. If -0-

or less, enter -0- 4,456

-132-



1Total Ordinary Dividends$70.00

PAYER'S name, address, city, state, ZIP code 2017IL CORP73 JAMON STYC, YS YZ

lb Qualified Dividends Form1099-DIV$70.00

2a Total capital gain distr. 2b Unrecap. Sec. 1250 gainCopy B

For RecipientPAYER'S Federal identification number RECIPIENTS identification number 2d Collectables (28%) gain2c Section 1202 gain










8 Cash liquidation distributions 9 Noncash liquidation distribution





Form 1099-DIV

Specialty - Young

The broker’s statement from Lucky Dog LLC account 685-111 is York’s old account (111-227), which was his separate property. Xuan worked with Lucky Dog to transfer York’s account to her name and to update the basis information to the value on the date of York’s death (January 5, 2017). Lucky Dog has listed the pre-death buys as long term sales, even though they were owned less than 12 months – they are denoted with ** for date acquired.

Everything seems to have gone well with the transfer except the Rider shares. These were additional shares that York inherited from his Aunt Janey in 2016. On 1/29/2016, the day that Janey died, the shares were worth $1,222. She had paid $588 for them in 1999. The shares were worth $1,145 on 1/5/2017 when York died.

The tax-exempt-interest dividend was paid by a municipal bond fund (not a state-specific fund).

Lucky Dog LLC 2017 TAX REPORTING STATEMENT2715 Alpine Lane York YoungBoston, MA 02110 1 Main St, Your City, YS YZ



Form 1099-DIV 2016 Dividends and DistributionsCopy B for Recipient (OMB NO. 1545-0110)Box Amount1a Total Ordinary Dividends 15.761b Qualified Dividends 15.762a Total Capital Gain Distributions (Includes 2b- 2d) 0.002b Capital Gains that represent Unrecaptured 1250 Gain 0.002c Capital Gains that represent Section 1202 Gain 0.002d Capital Gains that represent Collectibles (28%) Gain 0.003 Nondividend Distributions 0.004 Federal Income Tax Withheld 0.005 Investment Expenses 50.006 Foreign Tax Paid 0.007 Foreign Country or U.S. Possession 0.008 Cash Liquidation Distributions 0.009 Non-Cash Liquidation Distributions 0.0010 Exempt-Interest Dividends 11.2911 Specified Private Activity Bond Interest Dividends 2.6412 State YS13 State Identification No 957XXX14 State Tax Withheld 1.57

FATCA filing requirement NO

Form 1099-INT 2016 Interest IncomeCopy B for Recipient (OMB NO. 1545-0112)Box Amount1 Interest Income 3.252 Early Withdrawal Penalty 0.003 Interest on U.S. Savings Bonds and Treas. Obligations 7.654 Federal Income Tax Withheld 0.765 Investment Expenses 0.006 Foreign Tax Paid 0.007 Foreign Country or U.S. Possession 8 Tax Exempt lnterest 0 00

-» -» 9-w

Specialty - Young

Lucky Dog LLC 2017 TAX REPORTING STATEMENT2715 Alpine Lane Xuan YoungBoston, MA 02110 1 Main St, Your City, YS YZ



Form 1099-DIV 2016 Dividends and DistributionsCopy B for Recipient (OMB NO. 1545-0110)Box Amount1a Total Ordinary Dividends 433.751b Qualified Dividends 397.262a Total Capital Gain Distributions (Includes 2b- 2d) 1,217.652b Capital Gains that represent Unrecaptured 1250 Gain 0.002c Capital Gains that represent Section 1202 Gain 0.002d Capital Gains that represent Collectibles (28%) Gain 0.003 Nondividend Distributions 0.004 Federal Income Tax Withheld 0.005 Investment Expenses 500.006 Foreign Tax Paid 27.657 Foreign Country or U.S. Possession8 Cash Liquidation Distributions 0.009 Non-Cash Liquidation Distributions 0.0010 Exempt-Interest Dividends 287.6511 Specified Private Activity Bond Interest Dividends 37.6912 State YS13 State Identification No 957XXX14 State Tax Withheld 0.00


Form 1099-INT 2016 Interest IncomeCopy B for Recipient (OMB NO. 1545-0112)Box Amount1 Interest Income 117.652 Early Withdrawal Penalty 0.003 Interest on U.S. Savings Bonds and Treas. Obligations 377.954 Federal Income Tax Withheld 32.485 Investment Expenses 0.006 Foreign Tax Paid 0.007 Foreign Country or U.S. Possession 8 Tax-Exempt lnterest 0.009 Specified Private Activity Bond Interest 0.0010 Market Discount 0.00

Market Discount on Noncovered Securities 0.00 **11 Bond Premium 0.00

Bond Premium on Noncovered Securities 0.00 **13 Bond Premium on Tax-Exempt Bond 0.0014 Tax-Exempt and Tax Credit Bond CUSIP No. 15 State YS16 State Identification No. 957XXX17 State Tax Withheld 6.55

FATCA filing requirement**These amounts are not reported to the IRS.

Page 1 of 4

-134-

Specialty - Young




Form 1099-MISC 2016 Miscellaneous IncomeCopy B for Recipient (OMB NO. 1545-0115)Box Amount2 Royalties 0.004 Federal Income Tax Withheld 0.008 Substitute Payments in Lieu of Dividends or Interest 0.0016 State Tax Withheld 0.0017 State Identification No.18 State lncome 0.00

FATCA filing requirement

Summary of 2016 Original Issue DiscountBox Amount1 Original Issue Discount for 2016 0.00 **2 Other Periodic Interest 0.00 **4 Federal Income Tax Withheld 0.00 **5 Market Discount 0.00 **6 Acquisition Premium 0.00 **8 Original Issue Discount on U.S. Treasury Obligations 0.00 **

# Box 5 and Box 6 contain amounts for covered securities only.

Summary of 2016 Proceeds From Broker and Barter Exchange TransactionsBox Amount1d Proceeds . 58,209.83 *1e Cost or Other Basis *** **4 Federal Income Tax Withheld 0.006 Adjustments - Wash Sales 2,660.00

Adjustments - Market Discount 0.00 **16 State Tax Withheld 0.00Regulated Futures Contracts:4 Federal Income Tax Withheld 0.008 Profit or (Loss) Realized in 2016 on Closed Contracts 0.009 Unrealized Profit of (Loss) on Open Contracts - 12/31/2015 0.0010 Unrealized Profit of (Loss) on Open Contracts - 12/31/2016 0.0011 Aggregate Profit of (Loss) on Contracts 0.00

*** Information not available.Page 2 of 4

** Amounts of original issue discount are individually reported to the IRS.

* Gross Proceeds from each of your security transactions are reported individually to the IRS. Refer to the Form 1099-B section of this statement.

Specialty - Young




FORM 1099-B 2016 Proceeds from Broker and Bar Lucky Dog LLCCopy B for Recipient OMB NO. 1545-0715Short-term transactions for which basis is reported to the IRSReport on Form 8949 with Box A checked and/or Schedule D, Part I(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold type)1a Description, 2 Short-term, 3 Basis reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP


1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustm'ts

Gain or Loss (-)

4 Federal Income

Tax Withheld

14 State 15 State ID

Number

16 State Tax

Withheld

Hi-Class FundSale 18.960 1/23/17 9/19/17 204.01 183.72 20.29Sale 17.250 2/23/17 9/19/17 185.61 165.60 20.01

389.62 349.32 0.00 40.30Hot Air Bond FundSale 100 10/15/17 11/17/17 11,275.00 12,527.00 -1,252.00

11,275.00 12,527.00 0.00 -1,252.00Red Balloon Investor Class FundSale 175 7/31/17 11/17/17 1,088.50 1,359.75 -271.25

1,088.50 1,359.75 0.00 -271.25TOTALS 12,753.12 14,236.07 0.00 -1,482.95

FORM 1099-B· 2016 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715Long-term transactions for which basis is reported to the IRSReport on Form 8949 with Box D checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold type)1a Description, 2 Long-term, 3 Basis reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP


1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustm'ts

Gain or Loss (-)

4 Federal Income

Tax Withheld


Number

16 State Tax

Withheld

Hi-Class FundSale 16.525 3/25/12 9/19/17 177.81 159.47 18.34Sale 15.786 6/25/12 9/19/17 169.86 152.33 17.53Sale 15.866 9/25/12 9/19/17 170.72 153.11 17.61Sale 15.975 12/24/12 9/19/17 171.89 154.16 17.73Sale 16.070 3/25/13 9/19/17 172.91 155.08 17.83Sale 16.170 6/25/13 9/19/17 173.99 156.04 17.95Sale 15.650 9/25/13 9/19/17 168.39 151.02 17.37Sale 16.250 12/27/13 9/19/17 174.85 156.81 18.04Sale 16.860 3/26/14 9/19/17 181.41 162.70 18.71Sale 17.699 6/23/14 9/19/17 190.44 170.80 19.64Sale 17.525 9/23/14 9/19/17 188.57 169.12 19.45Sale 17.225 12/23/14 9/19/17 185.34 166.22 19.12Sale 16.160 3/23/15 9/19/17 173.88 155.94 17.94Sale 17.161 6/23/15 9/19/17 184.65 165.60 19.05Sale 18.200 9/23/15 9/19/17 195.83 175.63 20.20Sale 17.037 12/23/15 9/19/17 183.32 164.41 18.91Sale 14.750 3/23/16 9/19/17 158.71 142.34 16.37Sale 20.665 6/23/16 9/19/17 222.36 199.42 22.94Sale 17.110 ** 9/19/17 184.10 165.11 18.99Sale 16.540 ** 9/19/17 177.97 159.61 18.36

3,607.00 3,234.92 0.00 372.08Hot Air Bond FundSale 135 ** 9/26/17 13,300.20 16,891.20 W 2,660.00 -931.00

13,300.20 16,891.20 2,660.00 -931.00TOTALs 16,907.20 20,126.12 2,660.00 -558.92

Page 3 of 4

-136-

Specialty - Young




FORM 1099-B· 2016 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715Long-term transactions for which basis is not reported to the IRSReport on Form 8949 with Box E checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold type)1a Description, 2 Long-term, 3 Basis not reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP


1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustm'ts

Gain or Loss (-)

4 Federal Income

Tax Withheld


Number

16 State Tax

Withheld

Hi-Class FundSale 2,343.65 5/28/09 9/19/17 25,217.70 22,616.24 2,601.46Sale 19.251 6/23/09 9/19/17 207.14 185.77 21.37Sale 18.750 9/23/09 9/19/17 201.75 180.94 20.81Sale 18.710 12/23/09 9/19/17 201.32 180.55 20.77Sale 19.077 3/23/10 9/19/17 205.27 184.09 21.18Sale 18.567 6/23/10 9/19/17 199.78 179.17 20.61Sale 18.377 9/23/10 9/19/17 197.74 177.34 20.40Sale 18.435 12/23/10 9/19/17 198.36 177.90 20.46Sale 19.077 3/23/11 9/19/17 205.27 184.09 21.18Sale 18.567 6/23/11 9/19/17 199.78 179.17 20.61Sale 18.377 9/23/11 9/19/17 197.74 177.34 20.40Sale 18.435 12/23/11 9/19/17 198.36 177.90 20.46

27,430.21 24,600.50 0.00 2,829.71Rider CorporationSale 65.000 ** 9/15/17 1,119.30 ** **

1,119.30 ** 0.00 0.00TOTAL 28,549.51 ** **

** Information not available Page 4 of 4


Specialty - Young

Sure-Trade 2016 TAX REPORTING STATEMENT135 Bond Street Xuan YoungNew Haven, CT 06405 1 Main St, Your City, YS YZ

Account No. 876858Recipient ID No. 212-XX-XXXX


Form 1099-DIV 2016 Dividends and DistributionsCopy B for Recipient (OMB NO. 1545-0110)

Box Amount1a Total Ordinary Dividends 157.671b Qualified Dividends 132.322a Total Capital Gain Distributions (Includes 2b- 2d) 0.002b Capital Gains that represent Unrecaptured 1250 Gain 0.002c Capital Gains that represent Section 1202 Gain 0.002d Capital Gains that represent Collectibles (28%) Gain 0.003 Nondividend Distributions 0.004 Federal Income Tax Withheld 0.005 Investment Expenses 0.006 Foreign Tax Paid 0.007 Foreign Country or U.S. Possession 0.008 Cash Liquidation Distributions 0.009 Non-Cash Liquidation Distributions 0.0010 Exempt-Interest Dividends 0.0011 Specified Private Activity Bond Interest Dividends 0.0012 State YS13 State Identification No. XXXXXX14 State Tax Withheld 0.00


Summary of 2016 Proceeds From Broker and Barter Exchange TransactionsBox Amount

1d Proceeds 35,331.06 *

1e Cost or Other Basis 19,127.25 **

4 Federal Income Tax Withheld 0.006 Adjustments - Wash Sales 0.00

Adjustments - Market Discount 0.00 **

16 State Tax Withheld 0.00Regulated Futures Contracts:4 Federal Income Tax Withheld 0.008 Profit or (Loss) Realized in 2016 on Closed Contracts 0.009 Unrealized Profit of (Loss) on Open Contracts - 12/31/2015 0.0010 Unrealized Profit of (Loss) on Open Contracts - 12/31/2016 0.0011 Aggregate Profit of (Loss) on Contracts 0.00

Page 1 of 2

* Gross Proceeds from each of your security transactions are reported individually to the IRS. Refer to the Form 1099-B section of this statement. ** Box 1e and Box 6 contain amounts for covered securities only.

-138-

Specialty - Young

Sure-Trade 2016 TAX REPORTING STATEMENT135 Bond Street Xuan YoungNew Haven, CT 06405 1 Main St, Your City, YS YZ

Account No. 876858

Recipient ID No. 212-XX-XXXX


FORM 1099-B 2016 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715

Short-term transactions for which basis is reported to the IRSReport on Form 8949 with Box A checked and/or Schedule D, Part I(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold t ype)

1a Description , 2 Short-term, 3 Basis reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP


1c Date Sold or

Disposed

1d Proceeds

1e Cost o r Other Basis

1f Code, if any

1g Adjustmen

ts

Gain or Loss (-)

4 Federal Income

Tax Withheld


Number

16 State Tax Withheld

Daisy LinksSale 100 11/1/16 5/26/17 12,051.00 7,613.00 4,438.00Bloomies CorpSale 150 7/15/16 3/26/17 5,698.50 6,319.50 -621.00TOTALS 17,749.50 13,932.50 3,817.00

FORM 1099-B· 2016 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715

Long-term transactions for which basis is reported to the IRSReport on Form 8949 with Box D checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold t ype)

1a Description , 2 Long-term, 3 Basis reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP


1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustmen

ts

Gain or Loss (-)

4 Federal Income

Tax Withheld


Number


Flora-4-USale 15 3/27/12 12/2/17 1,991.25 783.75 1,207.50Hoppy BrewingSale 55 9/7/13 11/25/17 4,766.85 2,901.25 1,865.60Jack's SteelSale 75 9/7/13 10/20/17 1,331.25 1,509.75 -178.50TOTALs 8,089.35 5,194.75 2,894.60

FORM 1099-B· 2016 Proceeds from Broker and Barter Exchange TransactionsCopy B for Recipient OMB NO. 1545-0715

Long-term transactions for which basis is not reported to the IRSReport on Form 8949 with Box E checked and/or Schedule D, Part II(This Label is a Substitute for Boxes 1a & 3 ) (IRS Form 1099-B box numbers are shown below in bold t ype)

1a Description , 2 Long-term, 3 Basis not reported to IRS, 6 Net Proceeds, and Stock or Other Symbol , CUSIP


1c Date Sold or

Disposed

1d Proceeds


1f Code, if any

1g Adjustmen

ts

Gain or Loss (-)

4 Federal Income

Tax Withheld


Number


Long HoldingsSale 63 ** 3/15/17 9,492.21 1,591.22 7,900.99TOTAL 9,492.21 1,591.22 7,900.99

** Information not available Page 2 of 2


Specialty - Young

K-1

Xuan provides you with the investment partnership K-1 that used to be York’s along with an attachment they gave her.

Hi Fly Ltd. February 7, 2018 Two Cent Road YC, YS YZ Dear Partner:

Pursuant Internal Revenue Code Sections 754, 734 and 743, amounts on Schedule K-1 reflect the following:

Before Adjust Adjust Reported on K-1

Box 8: -202.12 187.34 -14.78

Box 9a: 463.58 -389.27 74.31

-140-

] Final K-l Q Amended K-lSchedule K -l(Form 1065)

Depa'trent of tbeTreasury' InternalRevenue Service

2017 Partner's Share of Current Year Income,Deductions,Credits, and Other Income

Partm

For Calendar year 2017,or tax, 2017 1 Ordinary business income (loss) 15 'Creditsyear beginningending 20

2 Net rental real estate income (loss)Partner's Share of Income,Deductions,Credits, etc. > See bad*, 'arrr :eso*sCe Tstrjctions.

3 Other net rental income (loss) 16 Foreign transactionsInformation About the PartnershipParti $101.65BA Partnership's employer identification number 4 Guaranteed payments

95-9XXXXXX $65.25DB Partnership's name, address, city, state, and ZIP code 5 Interest income

$11.65HI FLY LTDTWO CENT RDYC, YS YZ

L6a Ordinary dividends

$101.656b Qualified dividends

C IRS Center where partnership filed return $97.657 • Royalties

D Q Check if this is a publically traded partnership (PTP)8 ; Net short-term capital gain (loss)

! ($14.78)Information About the PartnerPartIIE Partner's identifying number 9a ; Net long-term capital gain (loss)

j $74.3117 'Alternative minimum tax (AMT) items

212-XX-XXXXF Partner's name, address, city,state, and ZIP code 9b Collectibles (28%) gain (loss)XUAN YOUNG1MAINYC, YS YZ

9c • Unrecaptured section 1250 gain

There are typically more fields in an actual K-lthan those displayed in this example. If values for items other than interest, dividends, capitalgain distribution,or royalties are included within lines on a K-l, the tax return would be considered out of scope.

Specialty - Young

Sale of home

Xuan sold her home on November 29 to an unrelated buyer and rented it back for four months.

The closing statement shows:

Selling commissions ...................................................................... $19,560.00 Transfer taxes and fees ................................................................... $2,456.43 Credit for real estate taxes ................................................................... $29.52

She and York bought their home jointly in 2008 for $120,000, always used it as their main home and it was never used for business. The closing statement for the purchase shows the Youngs paid $1,245 in closing costs. While they owned the home, they spent money for the following:

Remodeled the kitchen before move-in ............................................... $17,200 Painted inside and out before move-in ................................................. $3,600 New carpet before move-in .................................................................... $750 Replaced dead landscape in 2010 ........................................................... $450 New windows in 2016 ($8,250 less credit $200) ................................... $8,050 New tile roof in 2016, paid in 2017 (excl. sales tax) .............................. $4,500 New furnace (excl. sales tax; see below for energy credit) .................... $1,650

Xuan also spent $3,225 in 2017 to fix up the house for sale (paint, clean, etc.).

The realtor estimated the value of the home at $630,000 on January 5, 2017.

Discuss the basis in the home before York's death.

Discuss whether Xuan's basis in the home is affected by York's death with particular attention to your state's laws.

Discuss the maximum amount of gain that Xuan could have excluded if she hadn’t sold it until 2018. What if sold in the later part of 2019.

See also First Time Home Buyers credit below.

]CORRECTED (if checked)FILER'S name, street address, city or town, state or province, country,ZIPor foreign postal code, and telephone number

REALTOR ESCROWS59 PARK LANEYC, YS YZ

1 Date of closing OMBNo. 1545-0997

11/29/2017 Proceeds From RealEstate Transactions2 Gross proceeds

$ 675,000.00 Form1099-SCopy B

For TransferorThis is important tax

information and is beingfurnished to the InternalRevenue Service. If you

are required to file areturn, a negligence

penalty or othersanction may be

imposed on you if thisitem is required to bereported and the IRSdetermines that it has

not been reported.

TRANSFEROR'S identification number

212-XX-XXXXFILER'S federal identification number

26-8XXXXXX3 Address or legs! descripton

1MAINYC, YS YZTRANSFEROR'S name

XUANYOUNG 4 Transferor recerved or will receive property or servicesas part of the consideration (if checked) . . .1Street address (including apt.no.)

1MAINCity or town, state or province, country, and ZIP or foreign postal code

5 If checked, transferor is a foreign person (nonresidentalien, foreign partnership, foreign estate, or foreigntrust)

YC. YS YZAccount or escrow number (see instructions) 6 Buyer s part of real estate tax

$ 29.52Form 1099-S ikeep for your records) wwwjrs.gov/form1099s Department of the Treasury - Internal Revenue Service

Specialty - Young

State Tax Refund

York and Xuan itemized deductions last year. Their adjusted gross income for last year was $86,033 and they had a total of $3,954 nontaxable income. Their total itemized deductions were $19,660. The amount of state income taxes deducted was $2,816. The sales tax deduction would have been almost the same at $2,812, including sales tax on the car they purchased of $1,565.

Self-Employment Income

Xuan started a small tutoring business. She meets the tutee at the student’s home or a suitable location. She got one tax form from an agency she used and kept good records.

Total fees collected, including the amount from the agency ................... $ 4,660 Commission to the agency ...................................................................... $ 209 Books ................................................................................................... $ 235 New projector (used only for tutoring) .................................................... $ 438 Business portion of her cell phone ........................................................... $ 360 Gifts to students/parents (less than $25 each) ......................................... $ 136 Coffee and business meals with current or prospective customers ............. $ 468 Supplies, business cards, etc. ...................................................................$ 62 Mileage between students .................................................................. 90 miles

She’s been using her car for this business since February 1, 2017 and drove 8,268 other miles. She also took two courses at a nearby college – see Education Benefits below.

-142-

CORRECTED (if checked)1Unemployment compensationPAYER'S name,address, city, state, ZIP code Certain

GovernmentPayments

2017{YS} TREASURY33 B AVENUEYC, YS YZ

2 State or local income taxrefunds, credits or offsets Form 1099-G

$680.00PAYER'S Federal identification number RECIPIENTS identification number

25-9XXXXXX. Box 2 amount is for tax year 4Federal income tax withheld Copy B

For RecioientThis is important taxinformation and is

being furnished to theInternal RevenueService. If you are

required to file a return,a negligence penalty orother sanction may beimposed on you if thisincome is taxable and

the IRS determines thatit has not been

reported.

212-XX-XXXX6 Taxable grants5 RTAA paymentsRECIPIENTS name, address, city, state, ZIP code


8 If checked, box 2 istrade or businessincome >

7 Agriculture payments

9 Market gain

10b State identification no 11State income tax withheld10. StateAccount number (see instructions)

Form 1099-G

Specialty - Young

Retirement Income

York was not allowed a full deduction for his contributions to his IRA in prior years. Here is his Form 8606 from their 2016 return.

] CORRECTED (if checked)1RentsPAYER'S name, acdress. city, state. ZIP code 2017 Miscellaneous

IncomeWE TEACH ANY198 F AVENUEYC, YS YZ

2Royalties Form 1099-MISC

3 Other Income 4Federal income tax withheld Copy BFor Recipient


5 Fishing boat proceeds 6 Medical and health care payments26-1XXXXXX

7Nonemployee Compensation 8 Substitute payments in lieu ofdividends or interest









$2,088.009 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >|_

10 Crop Insurance proceeds

11 12

FATCA filingrequrment




Form 1099-MISC

Nondeductible IRAs8606 OMBNo. 1545-0074Form 1(0)16Information about Form 8606 and its separate instructions is at www.irs.gov/ forw8606.

Attach to Form 1040. Form 1040A, or Form 1040NR.Department of the TreasuryInternal Revenue Service {99)

AttachmentSequence No. 4o

Name. If married, file a separate form for each spouse required to file Form 8606. See instructions.YORK YOUNG

Your social security number21!.= XX.-JCXXX

I

1 Enter your nondeductible contributions to traditional IRAs for 2016, including those made for 2016from January 1,2017. through April 18. 2017 (see instructions)Enter your total basis in traditional IFlAs (see instructions)Add lines 1and 2

112762 2

3 3 1276No >• Enter the amount from line 3 on line 14.

Do not complete the rest of Part I.> Go to line 4.

Enter those contnbutions included on line1 that were made from January 1. 2017. through Apnl 18, 2017Subtract line 4 from line 3 *Enter the value of all your traditional, SEP. and SIMPLE IRAs as ofDecember 31, 2016. plus any outstanding rollovers (see instructions) . .Enter your distnbutions from traditional, SEP, and SIMPLE IRAs in2016. Do not include rollovers, qualified charitable distributions, a one-time distribution to fund an HSA, conversions to a Roth IRA. certainreturned contributions, or recharacterizations of traditional IRAcontributions (see instructions)

In 2016, did you take a distributionfrom traditional, SEP. or SIMPLE IRAs.or make a Roth IRA conversion? Yes

4 45 S 12766

6 175487

7 35008 Enter the net amount you converted from traditional, SEP, and SIMPLE

IRAs to Roth IRAs in 2016. Do not include amounts converted that youlater recharacterized (see instructions). Also enter this amount on line 16 .

210488

9 Add lines 6. 7, and 6Divide line 5 by line 9. Enter the result as a decimal rounded to at least3 places. If the result is 1.000 or more, enter “1.000"Multiply line 8 by line 10. This is the nontaxable portion of the amountyou converted to Roth IRAs. Also enter this amount on line 17 . . .Multiply line 7 by line 10. This is the nontaxable portion of yourdistributions that you did not convert to a Roth IRAAdd lines 11 and 12. This is the nontaxable portion of all your distributionsSubtract line 13 from line 3.This is your total basis in traditional IRAs for 2016 and earlier yearsTaxable amount. Subtract line 12 from line 7. If more than zero, also include this amount on Form1040, line 15b; Form 1040A line11b: or Form 1040NR, line 16b

910

0 - 0 6 110 X

1111

1212 214

13 13 21414 14 106215

15 3286|/\4A« Vm i m^si hn c' i orv i 1O Cvf-. Inv nn «^i ir~v+ nn 1R t 4 w^\i

Specialty - Young

York started drawing his government retirement pay on February 1 of 2015 with 12 years of work credit. He recovered $981 of his cost during the first year. York selected a joint and survivor annuity, which Xuan continues to receive. Xuan confirms that the $183.33 shown in box 5 is for York’s health insurance. York was not a public safety officer.

-144-



Contracts, etc.

1Gross distributionPAYER'S name, address, city,state, ZIP code

2017$17,625.00MERRILL LYNCHONE WORLD AVEYC, YS YZ

2a Taxable amountForm 1099-R$17,625.00

2b Taxable amountnot determined. Total

Distributionm Copy BReport this

income on yourfederal tax

return. If thisform shows





withheld13-5XXXXXX 212-XX-XXXX


RECIPIENTS name, address,city, state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesXUAN YOUNG

1MAINYC, YS YZ 7.Distribution

Code(s)IRA/ 8 Other



SEP/SIMPLE

%4






Form 1099-R


Retirement orProfit-SharingPlans,IRAs,Insurance

Contracts, etc.

CORRECTED (if checked)1Gross distributionPAYER'S name, address,city, state, ZIP code

2017$1,500.00IRA BANK5 ELM STYC, YS YZ

2a Taxable amountForm 1099-R$1,500.00

2b Taxable amountnot determined.

TotalDistribution Copy B







withheld26-2XXXXXX 212-XX-XXXX


RECIPIENTS name, address,city,state, ZIP code 6 Net unrealizedappreciation inemployer's securitiesXUAN YOUNG

1MAINYC, YS YZ 7.Distribution

Code(s)IRA/ 8 Other



SEP/SIMPLE

%1




within 5 years11. 1st year of desig. Roth contrib. 13. State/Payer's state no.

262XXX14. State Distribution12. State tax withheld


Form 1099-R

Specialty - Young

OMB No. 1545-0119Form: 1099R

Distribution FromPersons. AnnuitiesRetrement or Profit-Sharing Plans. IRA’s,



BY P. O. BOX 45BOYERS, PA 16017-0045

STATEMENT OF ANNUITY PAIDCODY B - File with Federal tax return

PAID 2017

PAYER'S Federal Identification Recipient's ID No. (Annuitant)211-XX-XXXX

Account number (Retirement Claim 1. Gross distributionSl $541.6716-5XXXXXX CSA 541222942A§ 5. Employee Contributions/

Designed ROTH Contributionsor Insurance Premiums

2a. Taxable amountPAID YORK YOUNG1MAINYC, YS YZ

01 cIssi TO"8 IPc

illw^2 •"*

$183.33 4. Federal Income Tax Withheld

$54.177. Distribution Code(s)7-NONDISABILITYin2!

<n = i-m .2

10. State Income Tax Withheld

$10.83State 1

YS9b. Total Employee Contributions$27,652.00o

^ Is 11. State Income Tax WithheldState 2mi.a s.,£ £ 2

OMB No. 1S4M119Form: 1099R

Distribution FromPersons. AnnuitiesRetrement or Profit-Sharing Plans. IRA’s,



BY P- O- BOX 45BOYERS,PA 16017-0045

STATTMENT OF SURVIVOR ANNUITY PAIDCopy B - File with Federal tax return

PAID 2017

PAYER'S Federal Identification Recipient's ID No. (Survivor) Account number (Retirement Claim No.) 1. Gross distributiont 212-XX-XXXX CSA 541222942 $5,958.3316-5XXXXXX<0


2a. Taxable amountI PAID XUAN YOUNG1MAINYC, YS YZ

TO£

4. Federal Income Tax Withheld?!U a $595.837. Distribution Code(s)

4-DEATH BENEFIT2 ’10. State Income Tax WithheldState 1

$119.17YS9b. Total Employee Contributions15 11. State Income Tax WithheldState 2$27,652.00211ail111

Specialty - Young

Social Security Income

Xuan also received a $255 death benefit from the Social Security Administration.

Royalty Income

Xuan provides you with her oil & gas royalty form. This is related to their home (now sold) so she didn’t bother changing the name with the oil company.

-146-



Box 2. Beneficiary’s Social SecurityBox 1. NameYORK YOUNG 211-XX-XXXX



$1,137.50




Total AdditionsBenefits for 2017

$1,052.19

$.00

$.00

$1,137.50$1,137.50

Box 6. Voluntary Federal Income Tax Withheld$85.31

Box 7. AddressYORK YOUNG1MAINYC, YS YZBenefits for 2016

Benefits for 2015


Form SSA-1099-SM

CORRECTED (if checked)1RentsPAYER'S name, address* city, state, ZIP code 2017 Miscellaneous

IncomeGUSHER OIL9 BLACKROCK AVEYC, YS YZ

2Royalties Form1099-MISC$59.65




7Nonemployee Compensation 8 Substitute payments in lieu ofdividends or interest







RECIPIENTS name, address, city,state, ZIP code

YORK YOUNG1MAINYC, YS YZ

9 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >|_


11 12

FATCA filingrequrment




Form 1099-MISC

Specialty - Young

Other Income

Xuan served as a juror and earned $630 for her 42 days of service plus $54.39 for mileage. The school made her hand over all but 10 days’ worth of the fees.

Gambling

The W-2G reflects Xuan’s wager of $5 for the winning card. Xuan listened last year when you explained the per-session rules and kept a copious log of her wagers. In the same session that she won the above Keno prize, she played 18 other cards which lost $88. In addition, she had other net session wins of $346 and net session losses of $2,643.

CORRECTED (if checked)1RentsPAYER'S name, acc-ess. city, state. ZIP code 2017 Miscellaneous

IncomeMILLSAP COUNTY COURTJURY CLERKS OFFICECOUNTY COURT BUILDINGYC, YS YZ

2Royalties Form 1099-MISC




8 Substitute payments in lieu ofdividends or interest









$630.009 Payer made direct sales ofS5,000 or more of consumerproducts to a buyer(recipient) for resale >|_


11 12

FATCA filingrequ'rment




Form 1099-MISC

] CORRECTED (if checked)1. Gross winnings 2. Date wonPAYER'S name, address, city,state, and ZIP code 201709/16/2017$2,495.00RED HOT CASINO

65 RICHES ROADYC, YS YZ

3. Type of wager 4. Federal income tax withheldForm W2-GKENO


GamblingWinnings

7. Winnings from identical wagers 8. CashierPAYER'S Federal identification number Payer's Telephone number

9. Winner's taxpayer identification no. 10. Window This informations being furnishedto the Internal

Revenue Service

26-7XXXXXX 888-123-4567212-XX-XXXX

WINNER'S name, address, city, state, and ZIP


12. SecondI.D.11. FirstI.D.N009234

13. State Payer's identification no.YS 267XXX

14. State Winnings

$2,495.00Copy B

Report this incomeon your federal taxreturn. If this form

shows federalincome



15. State income tax withheld 16. Local Winnings

17. Local income tax withheld 18. Name of locality

Under penalty of perjury,Idedare that, to the best of my knowledge and belief, the name, address, taxpayer indentification number thatIfurnishedcorrectly identify me as the reapient of this payment and any payment from identical wagers, and no other person is entitled to any part of these payments.Signature > Date >

Form W_2C

Specialty - Young

Xuan also hit the state lottery that she plays every week.

Xuan’s gambling log shows she paid $1 for the winning ticket (so the W-2G shows the right amount, reduced for the wager) and had losing lotto tickets totaling $51 for the year. Xuan heard that the lottery winning may be tax free in your state and asks if that’s right.

Long-term Care

York's long term care insurance helped to cover part of his expenses at the rate of $180 per day for 5 days in 2017.

Educator Expenses

Xuan tells you that she paid for $668 for classroom supplies for her students. You ask how many hours she worked as an educator and she said she was full-time, well over 900 hours.

-148-

] CORRECTED (if cheeked)1. Gross winnings 2. Date wonPAYER'S name, address, city, state, and ZIP code 201710/29/2017$749.00YOUR STATE LOTTERY

87 FOLLY ROADYC, YS YZ

3. Type of wagerLOTTO

4. Federal income tax withheldForm W2-G


GamblingWinnings

7. Winnings from identical wagers 3. CashierPAYER'S Federal identification number Payer 's Telephone number

9. Winner's taxpayer identification no. 10. Window This informations being furnishedto the Internal

Revenue Service

37-5XXXXXX 800-222-2222212-XX-XXXX

WINNER'S name, address, city, state, and ZIP 12. SecondI.D.11. FirstI.D.N009234XUAN YOUNG

1MAINYC, YS YZ

13. State Payer's identification no.375XXX

14. State Winnings Copy BReport this incomeon your federal taxreturn. If this form

shows federalincome

tax withheld inbox 4,attach this


15. State income tax withheld 16. Local Winnings

17. Local income tax withheld 18. Name of locality

Under penalty of perjury,Ideclare that, to the best of my knowledge and belief, the name, address, taxpayer indentification number thatIfurnishedcorrectly identify me as the recipient of this payment and any payment from identical wagers,and no other person is entitled to any part of these payments.Signature > Date >Form W_2C

] CORRECTED (if checked)1Gross Long-Term carebenefits paid

PAYER'S name, address, dty,r state, and ZIP code Long-Term Care andAccelerated Death

Benefits2017LTC CORP

98 WELLNESS RDYC, YS YZ

$900.002 AcceleratedDeath benefits Form1099-LTCpaid

Copy BFor Recipient

INSURED's taxpayer identification no.PAYER'S federal identification number POLICYHOLDER'S identification number

211-XX-XXXX3

ReimbursedAmount® DL This s important tax


Internal RevenueService. If you a-e

required to file a return,a negligence penalty orother sanction may beimposed on you if theincome is taxable and

the IRS cetermines thatit has not been 'eponec.

95-OXXXXXX 211-XX-XXXXPOLICYHOLDER'S name, address, city, state, and ZIP code

YORK YOUNG1MAINYC, YS YZ

INSURED'S name, address, city, state, ZIPYORK YOUNG1MAINYC, YS YZ

Account number (see instructions) 4. Qualified contract(optinal)

5. (optional) Chronically ill

X Terminally illDate certified11/16/2016

Form 1099-LTC

Specialty - Young

Alimony Paid

York made one monthly payment of $300 in alimony to a previous wife. Her social security number is 215-XX-XXXX. Xuan is not obligated to continue the alimony.

IRA Contribution

Xuan made a $6,500 contribution to her traditional IRA account. She asks how much she should recharacterize to a Roth IRA to maximize her tax benefit, that is, the max that can go to the Roth without causing a tax increase.

Student Loan Interest

Xuan paid interest on a qualified student loan she incurred to obtain her teaching degree.

Itemized Deductions

Like last year, Xuan wants to itemize deductions and provides the following information: Medical insurance - supplemental policy for York ..................................... $ 100 Medical insurance for York taken from retirement pay .............................. $ 183 Medical and dental insurance for Cherie for the full year ........................ $ 2,426 Long-term care policy for York ................................................................... $ 0 Long-term care policy for Xuan ............................................................ $ 1,400 Doctor bills for York and Xuan ................................................................ $ 463 Dentist bill for Cherie.............................................................................. $ 120 Hospital bills for York ............................................................................. $ 860 Life insurance for York ........................................................................... $ 154 Funeral expenses ................................................................................. $5,600 Medical mileage ....................................................................... 428 miles total Prescription drugs (York and Xuan) ......................................................... $ 265 Insulin for Sadie (no prescription) ........................................................... $ 286 Medical equipment rental for York (doctor prescribed) ............................. $ 110 Personal property tax (based on the value of the car) .............................. $ 325 State sales tax (new roof $360 and furnace $132) ................................... $ 492 Driving ticket for texting ......................................................................... $ 225 Gambling losses .............................................................................. see above


RECIPIENTS/lENDER'S name, address, city, state, and ZIP codeFIRST CLASS CORP90ISTREETYC, YS YZ

2017 StudentLoan Interest

StatementForm1098-E

RECIPIENTS federal identification no.94-OXXXXXX

BORROWER'S social security nunber 1Student loan interest received by lender Copy BFor Borrower

This important taxinformation and is beingfurnished to the InternalRevenue Service. If you

a'e required to file areturn, a negligence

penalty or othersancton may be

imposed on you if theIRS determines that anunderpayment of taxresults because you

overstatec a deduction forstudent ban inte'est.

$2,276.35212-XX-XXXXBORROWER'S name, address, city,state and ZIP code


Account number (see instructions) 2If checked box 1does not include loan originationfees and/or capitalized interest for loans made beforeSeptember, 12004

Form 1098-E

Specialty - Young

Teachers’ Union dues ............................................................................. $ 400 Repairs to Xuan’s car.............................................................................. $ 642 Church ............................................................................................... $ 2,200 American Cancer Society (York’s will) ................................................... $ 5,000 Bequest to York’s brother (York’s will) .................................................. $ 5,000 Cash contributions to: National Public Radio, Shriners Children’s Hospital .. $ 275 Contributions to Millsap Elementary School .............................................. $ 400 Salvation Army on 11/1/2017 (67 Military Ave, YC, YS YZ) - the thrift store value of clothes (mostly York’s) and household goods; all in good used condition ........... $ 3,650

Xuan says she has receipts or canceled checks at home for all the donations. She estimates that the cost of the clothes and household goods was well over $20,000, and were purchased over many years.

The property tax shown on the form is the full amount Xuan paid. See above for the credit she got from the buyer as part of the sale ($29.52).

Note: For sales tax deduction purposes, be sure to use NC zip code 28145 and a state rate of 4.75% plus local rate of 2.25%.

Child and Dependent Care Expenses

Xuan paid the Happy Blessings Day Care Center $3,550 to watch Grant while she worked. Xuan's employer gave Xuan $275 toward the day care (see W-2). The address is 128 Magical Way, Your City, State, and ZIP Code. Their EIN is 27-0XXXXXX and phone is 213-xxx-xxxx.

-150-

CORRECTED (if checked)*Caution: The amount shownmay not be fully deductible by you.Limits based on the loan amountand the cost and value of thesecured property may apply. Also,you may only deduct interest tothe extent it was incurred by you,actually paid by you, and notreimbursed by another person.

RECIPIENTS/LENDER'S name, address, city, state, and ZIP code

HOME BANK89 EASY STYC, YS YZ

MortgageInterest

Statement2017Form 1098

1. Mortgage interest received from payer(s)/borrower(s) * Copy BFor Payer/BorrowerThe information is boxes 1.through 9 is important taxinformation and is beingfurnished to the Internal

Revenue Service. If you arerequired to file a return, a

negligence penalty or othersanction may be imposec

on you if the IRS determinesthat an underpayment of tax

results because youoverstated a deduction for

this mortgage interestor for these points, reported

in boxes 1and 6; oroeca.se you didn’t repon

the refund of interest(box 4); or beca.se youclaimed a non-deductible

item.

$2,865.00RECIPIENT'S/LENDER’S federalidentification number

94-1XXXXXX

PAYER'S/BORROWER'S taxpayeridentification number

211-XX-XXXX

2. Outstanding mortgageprincipal as if 1/1/2017

$57,315.00

3. Mortgage origination date07/25/2008

4. Refund of overpaidinterest

5. Mortgage insurancepremiums

PAYER'S/BORROWER'S name, address, city, state, and ZIP code

YORK AND XUAN YOUNG1MAINYC, YS YZ

6. Points paid on purchase of principal residence

7. Is address of property securing mortgage same asPAYER'S/BORROWER'S address?

If Yes, box is checkedIf No, see box 8 or 9 below

m8. Address of property securing mortgage

10. OtherCOUNTY PROPERTY TAX $1,324CITY PROPERTY TAX $265 9. If property securing mortgage has no address, below is

the description of the property


Form 1098

Specialty - Young

Energy Credits

In July, the furnace in Xuan’s home quit working and she replaced it with a qualified energy-efficient new gas furnace for $1,650 plus tax. She wants to know if she can get an energy credit for it or for her new tile roof ($4,500). You find the following Form 5695 in her 2016 tax return. The Youngs did not claim energy credits in years prior to 2016.

Page 2Form 5695 (2016)

Part II Nonbusiness Energy Property Credit

17a Were the qualified energy efficiency improvements or residential energy property costs for yourmain home located in theUnited States? (see instructions)Caution: If you checked the “No" box, you cannot claim the nonbusiness energy property credit.Do not complete Part II.

b Print the complete address of the main home where youmade the qualifying improvements.Caution: You can only have onemain home at a time.

1 MAIN

E Yes No17a

Number and street Unit No.

LOS ANGELES CA 90001City, State, and ZIP code

c Were any of these improvements related to the construction of this main home?Caution: If you checked the “Yes" box, you can only claim the nonbusiness energy propertycredit for qualifying improvements that were not related to the construction of the home. Do notinclude expenses related to the construction of your main home, even if the improvements weremade after youmoved into the home.

18 Lifetime limitation.Enter the amount from the Lifetime Limitation Worksheet (see instructions) . .19 Qualified energy efficiency improvements {original use must begin with you and the component must

reasonably be expected to last for at least 5 years; do not include labor costs) (see instructions).a Insulationmaterial or system specifically and primarily designed to reduce heat loss or gain of

your home that meets the prescnptive criteria established by the 2009 IECCb Exterior doors that meet or exceed the version 6.0 Energy Star program requirements . . . .c Metal or asphalt roof that meets or exceeds the Energy Star program requirements and has

appropriate pigmented coatings or cooling granules which are specifically and primarily designedto reduce the heat gain of your home

d Exterior windows and skylights that meet or exceed the version 6.0Energy Star program requirements

e Maximum amount of cost on which the credit can be figured . . . .f If you claimed window expenses on your Form 5695 prior to 2016,

enter the amount from the Window Expense Worksheet (seeinstructions); otherwise enter -0-

g Subtract line 19f from line 19e. If zero or less, enter -0-h Enter the smaller of line 19d or line19g

20 Add lines 19a,19b,19c, and 19h21 Multiply line 20 by 10% (0.10)22 Residential energy property costs (must be placed in service by you; include labor costs for onsite

preparation, assembly, and original installation) (see instructions).a Energy-efficient building property. Do not enter more than $300b Qualified natural gas. propane, or oil furnace or hot water boiler. Do not enter more than $150 . .c Advanced main air circulating fan used in a natural gas, propane, or oil furnace. Do not enter more

than $5023 Add lines 22a through 22c24 Add lines 21 and 2325 Maximum credit amount. (If you jointly occupied the home, see instructions)26 Enter the amount, if any, from line 1827 Subtract line 26 from line 25. If zero or less, stop; you cannot take the nonbusiness energy

property credit28 Enter the smaller of line 24 or line 2729 Limitation based on tax liability. Enter the amount from the Nonbusiness Energy Property Credit

Limit Worksheet (see instructions)30 Nonbusiness energy property credit. Enter the smaller of line 28 or line 29. Also indude this

amount on Form 1040, line 53; or Form 1040NR, line 50

] Yes H No17c

18

23519a19b

19c

19d 825019e $2,000

19f19g 2000

200019h20 2235

22421

22a22b

22c23

2242425 $50026

5002722428

290329

22430Form5695 (2016)

Specialty - Young

First Time Home Buyer Credit

The Youngs bought their home in 2008 and got the full $7,500 FTHBC. They’ve been repaying the minimum each year since (2010 – 2016 for a total of $3,500 – if using 2016 software, leave this amount at $3,500). Xuan recalls you telling her that York’s half would be “forgiven” and asks you to confirm that and whether it impacts the gain on the sale of her home.

Health Care Coverage

York had TRICARE retiree coverage. Xuan had health insurance through the school. Sadie had Medicare all year. Cherie had a marketplace policy that Xuan paid for all year (even though Cherie moved out in November). Cherie got her own coverage starting January 2018 with her new employer. Grant had CHIP coverage all year.

-152-

1095-A Health Insurance Marketplace Statement OMB No. 1545-2232Form

> Information about Form 1095-A and its separate instructionsis at www.irs.aov/forml095a. VOID

CORRECTED 2017Depa'tment of the TreasuryInternal Revenue Service

Recipient InformationPart l

1Marketplace Identifier 2Marketplace-assigned policy number 3 Policy issuer’s name94-5XXXXXX B453456 HEALTHY CO

4Recipient’ name 5 Recipient's SSN212-XX-XXXX

6 Recipient's date of birth01/01/1958XUAN YOUNG

8 Recipient's spouse's SSN 9 Recipient's spouse's date of birth7Recipient' spouses's name07/03/1950YORK YOUNG 211-XX-XXXX

10 Policy start date01/01/2017

11Policy Termination Date 12 Street Address findudinq apartment number)12/31/2017 1 MAIN

13 City,State, and ZIP codeYC YS YZ

Covered IndividualsPart ll

A Covered Individual Name B Covered Individual SSN C. Date of Birth D. Coverage Start Date E. Coverage Termination Date16 CHERYL COOK 05/03/1995 01/01/2017 12/31/2017213-XX-XXXX17

16

19

20

Coverage InformationPart III

Month A Monthly Enrollment Premiums B Monthly Second Lowest Cost SilverPlan (SLCSP) Premium

C. Monthly Advance Payment ofPremium Tax Credit

21January $275.00 $335.00 $96.0022February $275.00 $335.00 $96.0023 March $275.00 $335.00 $96.0024 April $275.00 $335.00 $96.0025 May $275.00 $335.00 $96.0026 June $275.00 $335.00 $96.0027 July $335.00 $96.00$275.0028 August $275.00 $335.00 $96.0029 September $275.00 $335.00 $96.0030 October $275.00 $335.00 $96.0031November $275.00 $335.00 $96.0032December $275.00 $335.00 $96.0033 Annual Totals $3,300.00 $4,020.00 $1,152.00

Form: 1095-APart III for XUAN YOUNG

Specialty - Young

Education Benefits

Cherie finished her first year at college in May, but did not continue. Cherie has never been convicted of a felony.

In addition to the amounts shown on the 1098-T form and her school account, Cherie spent $1,250 on required textbooks and $49 for needed course materials. Cherie's grants were unrestricted and could have been used for nonqualified costs, such as room and board. Xuan provided Cherie's room and board, which cost approximately $8,800 for the 11 months she lived with Xuan. Cherie also got a $650 distribution from her Education Savings Account.

Cherie is willing to report some of her scholarship as taxable if it results in a better refund for her nana. She wants to know whether declaring some of her scholarship as taxable causes her any tax.

] CORRECTED (if checked)Payments From

QualifiedEducationPrograms

(Under Sections529 and 530)

PAYER'S/TRUSTEE's name, address, city, state, and ZIP code 1Gross Distribution

2017$650.00TRUSTY BANK55 SURETY LANEYC, YS YZ

2Earnings

$27.95Form 1099-Q

PAYER'S/TRUSTEE'S federal identification no. RECIPIENTS taxpayer identification no.94-3XXXXXX

3 Basis 4Trustee-to-TrusteeTransfer

Copy BFor Recipient213-XX-XXXX


CHERYL COOK1MAINYC, YS YZ

5 Check one:* Quaiiied Tuifcxi Procram

Private or State )(

* Cloverdell ESA

6If this box is checked, therecipient is not thedesignated beneficiary [

The s impoTant taxinformation and is

being furnished to theInternal Revenue

Service. If you arerequired to file a return,a negligence penalty orother sanction may beimposec on you if thisincome is taxable and

the IRS ceterrr ines thatit has not been

reportec.

If the fair market value (FMV) is shown below, see Pub 970Tax Benefits for Education for how to figure earnings.

Account number (see instructions)23456AB

Form 1099-Q


FILER'S name, address, dty, state,and ZIP code

UR STATE U95 SMART RDYC, YS YZ

TuitionStatement2017$4,715.00


FILER'S federal identification no. STUDENTS taxpayer identification no213-XX-XXXX26-9XXXXXX 3If this box is checked, your educational institution

has changed its reportingmethod for 2017. Copy BFor StudentESTUDENTS name, address, dty, state,and ZIP code


5 Scholarships or grantsCHERYL COOK1MAINYC, YS YZ

This is importanttax information





$4,100.007Checked if the amount inbox 1or 2 indudesamounts for an academic


period begining January-i—iMarch 2018. > I—I

Service Provider/Acct No. (see instr.) 8. Checked if at least ,—,half-time student [XJ


10 Ins. contract reimb/refundnForm 1098-T

Specialty - Young

Cherie has her school account details for 2016 and 2017.

UR STATE U

95 SMART ROAD, YC, YS YZ

Issued: 01/31/2017

CHERYL COOK 1 MAIN, YC, YS YZ

Student account stmt ID: ZZ1235468

Date Posted Description Term/session Charges Credits 06/01/2016 Application Fee 50.00 06/15/2016 Tuition Third Qtr 2016 2,250.00 06/22/2016 Payment Received 2,300.00 0715/2016 Health Fee Third Qtr 2016 25.00 07/20/2016 Student Association Fee Third Qtr 2016 35.00 07/22/2016 Parking Fee Third Qtr 2016 29.00 08/01/2016 Pell Grant 2,000.00 08/10/2016 Check #987654 1,911.00 09/15/2016 Tuition Fourth Qtr 2016 2,250.00 10/01/2016 Pell Grant 2,000.00 10/08/2016 Payment Received 250.00 10/15/2016 Health Fee Fourth Qtr 2016 25.00 10/20/2016 Student Association Fee Fourth Qtr 2016 35.00 10/22/2016 Parking Fee Fourth Qtr 2016 29.00 10/25/2016 Payment Received 89.00 12/15/2016 Tuition First Qtr 2017 2,300.00 Account Balance 2,300.00

UR STATE U

95 SMART ROAD, YC, YS YZ

Issued: 01/31/2018

CHERYL COOK 1 MAIN, YC, YS YZ

Student account stmt ID: ZZ1235468

Date Posted Description Term/session Charges Credits 01/03/2017 Pell Grant 2,050.00 01/15/2017 Health Fee First Qtr 2017 25.00 01/15/2017 Student Association Fee First Qtr 2017 35.00 01/15/2017 Parking Fee First Qtr 2017 29.00 01/31/2017 Payment Received 339.00 03/15/2017 Tuition Second Qtr 2017 2,300.00 03/15/2017 Health Fee Second Qtr 2017 25.00 03/15/2017 Student Association Fee Second Qtr 2017 35.00 03/15/2017 Parking Fee Second Qtr 2017 29.00 04/03/2017 Pell Grant 2,050.00 04/15/2017 Class Change Fee 45.00 04/28/2017 Payment Received 384.00 Account Balance 0.00 0.00

-154-

'

Specialty - Young

Xuan took two professional development courses at the local college related to her teaching / tutoring. Xuan asks which education benefit is best for her expenses.

She also spent $45 to park at the college and her round trip mileage was 270 miles.

Estimated Tax Payments

During the year, Xuan made the following federal and state estimated tax payments.

DATE PAID Federal State

09/14 $ 500.00 $ 100.00

12/27 $ 500.00 $ 200.00

You see on the 2016 federal return that $3,021 was applied toward this year’s taxes.

Earned Income Credit (EIC)

Xuan asks if she qualifies for EIC.

Overpayment / Amount Owed

Xuan wants her refund deposited to her checking account. If she owes, she wants a direct debit from her checking account. She provides you a check.

Signature Line

Instruct Xuan how she should sign the 8879 authorization form - for herself and, especially, for York.

ACA Exercises

ACA Exercises

1. Abe is 19 years old and lives with his uncle who provides more than half of Abe’s support. Abe

has a part-time job while he finishes his college degree. He earns $14,000 for the year. Is Abe required to have health coverage?

2. Billy has VA coverage. His wife, Barbara is in good health and has an HSA (high-deductible) policy. Do both Billy and Barbara have MEC?

3. Carlos lost his job in January and became eligible for Medicaid in March. His application was approved in May with coverage from March 12 (the date he applied) until the end of the year. Must he pay a shared responsibility payment?

4. Sean and Sally have a child. Sean’s employer offered him family coverage which would cost 9.7% of their household income. Sally’s employer also offered family coverage that would be 8.1% of their household income. Can they take Sean’s employer’s offer, even though Sally’s employer offer would cost less?

5. Clara and Jack are married and have a child, Jessie. Jack’s employer offered him self-only coverage that would have cost 7.5% of his household income and family coverage which would have been 10% of his household income. Clara and Jessie have no other offer of coverage.

a. Can Jack buy coverage for himself through the Marketplace and get PTC?

b. Can Jack buy coverage for his family through the Marketplace and get PTC?

c. If they don’t get any MEC, are they eligible for the affordability exemption(s)?

6. Tomas, Shari and their two young children have recently immigrated to the US, and while lawfully present, are not eligible for Medicaid (even though their state expanded Medicaid coverage). Their combined income is $23,000 and Tomas and Shari believe they cannot afford health coverage. Are they eligible for an exemption from the SRP?

7. Gail and Bob are legally separated. Their child, Tommy, lives with Gail. Bob will claim Tommy as his dependent (Gail signed Form 8332). Gail provided coverage for herself and Tommy through her employer’s plan. Bob purchased a full-year policy for himself through the Marketplace.

a. Who is responsible for Tommy’s health coverage under ACA?

b. Since Bob did not provide Tommy’s health coverage, will Bob need an exemption from the shared responsibility payment with respect to Tommy?

c. In computing his premium tax credit, what is Bob’s family size?

d. Is the policy that Gail has through her employer a “shared policy” subject to allocation?

8. Carey is 25 years old, going to school full-time and earned $8,500 in a part-time job. Carey still lives with her parents who provide more than half of her support and cover her under their health policy. Who is responsible for Carey’s health insurance coverage? Does Carey need to report her health insurance coverage on her return?

-156-

ACA Exercises

9. Don did not have coverage after he lost his job in October 2016 until he got his new job in February 2017 (his coverage started on March 1, 2017). Don’s 2016 return shows he claimed the short gap exemption for November and December 2016. Can Don claim the short gap exemption for 2017? Does Don have to amend his 2016 return to pay SRP now that his gap is more than 2 months?

10. Jim and Jenn could claim Joey, their nephew, as a dependent. Joey does not have any income. If they do so, they would owe SRP because he did not have MEC. The affordability exemption does not help Jim and Jenn and they do not have a hardship. If Jim and Jenn choose to not claim Joey, would they have to pay SRP?

11. Kyle retired and is covered by Medicare Parts A, B and D. His grandson, Kerry, who is 23 years old, comes to stay with Kyle while he is going to a nearby college. Kyle provides all of Kerry’s support. Kerry’s parents’ home is in another state where Kerry still has his room. Kerry’s parents have good jobs and much more income than Kyle – so much so that they really get no tax benefit from claiming Kerry.

a. Assuming Kerry’s parents don’t claim him, can Kyle claim him as his dependent?

b. Who is responsible for Kerry’s health insurance coverage? What if Kerry has no health coverage and little or no income?

c. Whether or not Kerry is eligible for Medicaid, who would be responsible for Kerry’s health coverage if Kerry was 24 years old and had no income?

12. Larry and Lynne file jointly and claim their 18-year old child, Lisa. Lisa earned $4,320 babysitting, $25 interest income, and a short-term capital gain from her investment account of $900. Will Larry and Lynne include any of Lisa’s income as part of their household income (MAGI) for ACA purposes?

13. Maka lives and works on her recognized Indian tribe’s land. She earned $10,500 during the year but does not have health coverage. Is Maka liable for a shared responsibility payment?

14. Adda has had difficulties with the law and was in jail for the first part of the year having been released on March 10, 2016. Upon her release, she found a job and got health coverage through her employer that started June 1 and still continues. Is Adda liable for a shared responsibility payment? If so, for the whole year or for what months? How would Adda complete her return for ACA?

15. Paulo had employer-sponsored coverage until he lost his job in April. He was offered COBRA but did not take it because he thought it cost too much. While unemployed, Paulo would have been eligible for Medicaid, but failed to apply. His income for the year is $18,000 (comprised of wages and a small amount of unemployment).

a. Does Paulo need to complete the affordability worksheet with respect to the employer- offered COBRA? Would that help avoid the SRP?

b. Is Paulo entitled to any exemption for the months during which he could have had Medicaid coverage? Why or why not?

ACA Exercises

16. Pat did not have coverage at all during the year. He has a job and is not eligible for Medicaid, but would have been eligible for premium tax credits if he bought a Marketplace policy. During the year, he got behind on his utility bills and got a shut-off notice. You are preparing Pat’s return in March of the following year. Will Pat have to pay SRP? Does Pat have any options?

17. Hallie lives with her widowed mother, Marge who is 75 years old. Marge gets $15,000 of Social Security and a $5,000 survivor’s pension. Hallie earns $45,000 and pays for more than half of Marge’s support and for more than half of the cost of the household. If Hallie has no health coverage for the whole year and is not entitled to an exemption, what is the total amount of household modified adjusted gross income used to compute the shared responsibility payment?

18. Robbie was without MEC for all of 2016 through March 2017. She has coverage from April through the end of the year. Her 2016 return shows that she claimed the affordability exemption (A) for the whole year. Can Robbie claim the short gap exemption for 2017?

19. Anne was in the military until her discharge on June 25, 2017. Anne’s TRICARE also covered her son, Ethan, as her dependent. After her discharge, Anne and Ethan were without coverage until her new employer’s coverage kicked in for herself and Ethan on October 1, 2017. Anne is not married, has income of $24,000 and provides all the support for Ethan, who lived with her the whole year.

a. Is there an (easy) exemption that covers Anne and Ethan for the months before her employer coverage started? Will she owe an SRP?

b. Assuming that Ethan was eligible for CHIP for the June 26 through September 30 period, who would Anne include in the LCBP (line 1) quote in the marketplace affordability worksheet? Who would Anne include in the SLCSP (line 10) quote in the marketplace affordability worksheet?

20. Anita’s 2016 return shows she paid SRP for December. She was without MEC for January and February 2017. Is she eligible for the short gap exemption?

21. Uri and Ursa adopted a child in June 2017. This qualified them for a special enrollment period to enroll in a marketplace policy, and they signed up for a plan that covered all three of them starting July 1, 2017. They keep this coverage for the rest of the year; but before they signed up for it, Uri and Ursa were uninsured.

a. For which months do Uri and Ursa have MEC?

b. Assuming Uri and Ursa do not qualify for any exemption, how would they report the lack of coverage for themselves and for their new child?

22. Val’s husband died three years ago, after he had started to receive Social Security. Val and each of her two teenage children are receiving Social Security survivor benefits of $12,000 each. Val brings you her 1099-C for $13,000 from forgiven nonbusiness credit card debt. That is all their income and together they pay for all the costs of their support and of the household (1/3 each).

a. May Val claim the two children as dependents?

b. Who is responsible under ACA for health coverage for the children?

-158-

ACA Exercises

c. Assuming none had any health coverage and no exemption applies to them, will Val have to pay a shared responsibility payment? Will it be just for herself or will she also have to pay the SRP with respect to her children?

d. You have been asked to prepare the necessary tax returns – do the children need to file? Should they file?

23. Alex and Mike have been life partners for many years, but are not married. Alex’s employer offered him self-only coverage and a separate policy that could cover Mike, both at a nominal cost. Each of Alex and Mike’s separate income is between 200% and 400% of FPL and both are US citizens.

a. Must Alex accept his employer’s coverage for himself? For Mike’s coverage?

b. If Alex does not accept his employer’s plan and does not get other health coverage, is he entitled to an affordability exemption from the shared responsibility payment?

c. If Alex does not accept his employer’s offer for Mike’s coverage, can Mike buy coverage through the Marketplace? Is Mike eligible for APTC?

24. Dan is 60 years old, disabled, and covered by Medicare Part A. Is Dan eligible for a premium tax credit?

25. Jaime graduated from college in June. From January 1 to June 30, he was enrolled in a student health plan through his university. On September 1, Jaime started a new job that offered health coverage. He enrolled in this coverage from September 1 through December. For which months does Jaime have MEC?

26. Zoe purchased coverage through the Marketplace and was given monthly APTC of $450. Unfortunately, Zoe became ill and had to stop working. Her income fell below 100% of the FPL for the year. Since Zoe’s income is now below 100% of the FPL, can she claim any PTC?

27. Tony received medical treatments through workers’ compensation throughout 2017. In October he married Luisa. Luisa had coverage through her employer and added Tony to her policy effective October until the end of the year. For which months do Tony and Luisa have MEC?

28. Bill and Michele have been divorced for several years. They have two minor children and share custody. Their divorce grants each Bill and Michele one child’s dependency exemption deduction for income tax purposes and that is how they file their returns. Michele’s employer offers her family health coverage for herself and the two children, which Michele accepts and pays for from her paycheck.

a. Is Michele entitled to a premium tax credit?

b. Is this a shared policy for purposes of Form 8962?

ACA Exercises

29. Chris, now 64 years old, took early retirement and is collecting Social Security of $8,000 and a pension of $20,000.

a. If Chris has no health coverage for the whole year and is not entitled to an exemption, how much income will he show as MAGI to calculate his shared responsibility payment?

b. If Chris bought coverage on the exchange, how much income will he show as MAGI to calculate his premium tax credit?

30. You are completing the joint return for Andy and Sally, who purchased health coverage on the exchange and received APTC. In completing form 8962, you note that their MAGI is 301% of the FPL and the calculation shows that they have to repay a lot of APTC. Sally made an allowable contribution to her Roth IRA during 2016. Had it been a traditional IRA contribution, it would have been deductible. Can she recharacterize that contribution as made to a traditional IRA so that they can reduce their 2017 MAGI for the PTC? (Hint: Pub 590)

31. Hank has been covered under a policy he purchased through the exchange with an APTC subsidy. In late July, Hank changed employers and is covered by his new employer’s MEC plan starting September 15. Hank’s Marketplace policy was in effect through October 31. Is Henry eligible to claim PTC for the full year? If not, for which months?

32. Ellie and Matt live together but are not married. Ellie’s income is $40,000 for the year, while Matt makes $28,000. Ellie’s employer offers her affordable coverage and a stand-alone policy for Matt.

a. Since Ellie’s income is higher, is she responsible for Matt’s health coverage?

b. If Ellie takes her employer’s offer and covers herself and Matt, is Matt liable for a shared responsibility payment since he did not get his own coverage?

c. If Ellie and Matt decide to not take her employer’s offer for Matt’s coverage and he has no coverage and no other exemption, should Matt test the affordability of Ellie’s employer offer?

33. Carol’s ex-husband, Vic, purchased a policy on the exchange covering himself and their two young children and received an advance premium tax credit subsidy. Their divorce calls for each to claim one child as a dependent for income tax purposes.

a. Since Carol did not provide coverage for the child she is claiming, is she liable for a shared responsibility payment with respect to that child?

b. Is the policy that Vic bought through the exchange a shared policy subject to the allocation rules?

c. Generally, who should take the three attributes (bronze plan cost, SLCSP and APTC) shown on Form 1095-A when there is a shared policy?

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ACA Exercises

34. Sam and Shari got married during the year. Sam’s job pays him $20,000 and Shari’s income is also $20,000. They both purchased their health coverage on the exchange and received APTC of $4,000 each. Before they got married, Sam got very lucky and won $30,000 in the lottery.

a. Is the one-time lottery income part of Sam and Shari’s MAGI for Form 8962 purposes if they file a joint return?

b. Does the repayment limitation (the cap) apply to limit the amount of APTC that must be repaid if Sam and Shari file a joint return?

c. Would Sam and Shari be eligible for the alternative calculation for the year of marriage?

d. If Sam and Shari each file married filing separately, would that reduce the APTC repayment?

35. Fred purchased coverage through the exchange covering himself, his wife and their two children, whom he claims as his dependents. Fred’s wife is not lawfully present in the U.S., but he and his children were born in the U.S. and are U.S. citizens. Fred’s income is 200% of the FPL.

a. Is Fred eligible to claim any PTC?

b. If Fred is eligible to claim PTC, will his Form 8962 reflect the entire policy that covers himself, his wife and his children?

36. Alec resided in the U.S. the whole year and received his lawful status on April 24, 2017. His income level requires that he file a return. If he does not have health coverage, will he be liable for SRP for the whole year or for which months?

37. Ed and Erica were married during the year. They each had their own Marketplace policies before they got married. Once married, they switched to a single policy covering both of them through the Marketplace and received APTC. They will file a joint return.

a. Is the joint policy a Shared Policy subject to allocation?

b. In reconciling their APTC, how many Forms 8962 will Ed and Erica include in their joint tax return?

c. Assuming the policy change was effective timely, do Ed and Erica have to make a special calculation of the SLCSP for PTC purposes?

38. Teri’s son Ted is 20 years old and in college with scholarships and grants. They have decided that Ted should show $4,000 of his grants as taxable income so that the maximum American Opportunity Education credit can be claimed on Teri’s return. Ted has no other income. Teri buys health coverage for herself and Ted on the exchange and receives an APTC. Will Teri include Ted’s $4,000 of taxable grants as part of her household MAGI for Form 8962 purposes?

ACA Exercises

39. Nick and Nancy are married and are on Medicare. Their young grandson Neal came to live them two years ago, after his parents were tragically killed in an auto accident. Nick and Nancy properly claim Neal as their tax dependent. Neal is the beneficiary of a sizeable trust set up by his parents and is ineligible for Medicaid.

a. Are Nick and Nancy responsible for Neal’s health coverage under ACA?

b. In determining whether Marketplace coverage is affordable for Neal:

i. The cost of coverage for which individual(s) is included in line 1 of the marketplace affordability worksheet in the Form 8965 instructions?

ii. The SLCSP cost for which individual(s) is included in line 10 of the marketplace affordability worksheet in the Form 8965 instructions?

c. Would the answer to b(i) and b(ii) be different if Neal was eligible for, but not enrolled in, Medicaid under his state’s laws?

40. Libby brings her Form 1095-A and tells you that it is not correct. There was a mix-up with the policy. Libby called the exchange and got the correct numbers. How should you proceed in preparing Libby’s return?

a. Should you use the amounts as shown on the original Form 1095-A?

b. Should you use the amounts that Libby provided?

c. Does Libby need to get a corrected Form 1095-A before you can complete her return?

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Filing Status and Exemption Exercises


1. Steve and Lucinda had been married 30 years when Steve died in January 2017. Since then Lucinda has lived alone. She comes to your site for help with her taxes. What is her filing status?

2. Jody is 17 years old. She lives with her parents but had a summer job to make money for her college fund. She comes to your site for help with her taxes. What is her filing status?

3. Kyle and his girlfriend Haley share an apartment. They both have jobs and share the expenses. Neither has ever been married or had any children. They come to your site for help with their taxes. What is their filing status?

4. Mary and John are married with three children. They have lived together all year. What is their filing status?

5. Susie is 28 years old. In 2014, she divorced Sean and moved back home with her parents. She has a part-time job and earned about $5,000, but spends most of her money on entertainment and clothes. Her folks pay all the household bills. What is her filing status? Who claims her exemption?

6. Archie and Elaine lived together all of 2017. They married on January 1, 2018. What is their filing status for 2017?

7. Judy and Joe are married, but they didn’t live together at all in 2017. They have one child, who lives with Judy, who pays all the household expenses. What is their filing status:

a. If Joe is deployed with the army in Turkey?

b. If Joe is working in Turkey for a civilian contractor?

c. If Joe left last June without saying good-bye, and Judy doesn’t even know where he is?

d. If Joe and Judy signed a separate maintenance agreement in 2017 between themselves without court decree and are planning to divorce soon?

8. Lynn is a single mom whose only child, Luke, graduated from high school in May 2017. He got a full-time job and has paid all his own bills since then – except he still lives with his mom, who pays the rent and utilities. Overall, he paid less than half of his own support. What is Lynn’s filing status? What is Luke’s filing status? Who claims Luke’s dependency exemption?

a. Same situation as above but Luke provided more than half of his own support. What is Lynn’s filing status? Luke’s? Can Lynn claim any tax benefit for Luke?

b. Same situation as above. If Luke moved out of the house in June 2017 (but still paid less than half of his own support for the year), what is Lynn’s filing status? What is Luke’s?

9. Ted pays his ex-wife $1,000/month in child support for his two children who live with her, Laurie, 17 and Lonnie, 10. His divorce decree states he can claim an exemption for both kids in odd-numbered tax years. Since he claims the kids, can he also claim Head of Household?


10. Mary and Tom are divorced. The divorce decree doesn’t say anything about tax exemptions, but Tom pays child support for their two young children, who live with Mary. Neither has re-married. What is Mary’s filing status? What is Tom’s?

a. Same situation as above. Mary and Tom’s divorce decree won’t be final until January 2018. Tom moved out of the house in March 2017. What is Mary’s filing status? What is Tom’s?

b. Same situation as above. Mary and Tom’s divorce decree doesn’t go into effect until January 2018. Tom didn’t move out of the house until August 2017. What is Mary’s filing status? What is Tom’s?

11. Jack and Jill were married with three small children when Jack died in January 2016. Jill filed Married Filing Joint (MFJ) for TY2016.

a. What is her filing status for TY2017?

b. What is her filing status for TY2018?

c. What is her filing status for TY2019?

12. Tom and Harriet were married when Tom died in February 2017. In November 2017, she married Tom’s best friend, Dick.

a. What is Tom’s filing status for 2017?

b. What is Dick’s filing status for 2017?

c. What is Harriet’s filing status for 2017?

13. Dan and Elizabeth are married and have one son, Jake, aged 16. Jake spent eight months in juvenile detention last year.

a. Can Dan and Elizabeth claim him as a dependent?

b. Can Dan and Elizabeth claim him for EIC?

14. Maria signs a Form 8332 to let her ex-husband Max claim their daughter Missy on his tax return even though Missy lives with Maria.

a. Can Max claim the Child and Dependent Care Credit as well?

b. Can Max claim the Child Tax Credit?

c. Can Max claim the EIC with Missy as his qualifying child?

15. Tom and Shelley are married and live together with their two kids, Rachael and Rebecca. They both work and are glad to have Tom’s mother Sylvia living with them. In addition to Social Security, Sylvia has a sizable pension and pays more than half the costs of maintaining the home.

a. If it’s okay with Tom and Shelley, can Sylvia file as Head of Household (HoH)?

b. What if it is not okay with Tom and Shelley?

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16. Lynn and Les live together with Lynn’s daughter Lori, age 4. Les has a good job and pays most of the bills. Lynn works part time and made $8,000 last year. She pays for her own and Lori’s clothes, for her car and helps with the groceries.

a. What is Les’ filing status?

b. Can Les claim Lori as a dependent?

c. Can Les claim Lynn as a dependent?

d. Can Les claim EIC for Lori?

e. Can Lynn claim EIC for Lori?

f. Who can claim child tax credit for Lori?

g. Who can file as head of household?

17. Tom and Sarah are married, are not lawfully present in the United States, and do not have valid Social Security numbers. They lived together with their two children, Peter and Polly, who are lawfully present and have valid Social Security cards.

a. Can Tom and Sarah claim the children as dependents?

b. Can Tom and Sarah claim the children for Child Tax Credit?

c. Can Tom and Sarah claim the children for EIC?

d. What is their filing status?

18. Tom and Shelley are married and live together with their two kids, Rachael and Rebecca. They both work and are glad to have Tom’s mother Sandra living with them. If Sandra’s only income is Social Security, which she uses for gifts, her clothes and her car, can Tom and Shelley claim her as a dependent?

19. Marybeth lives with her father Saul in a house that Saul owns. Saul’s only income is Social Security, which he gives to Marybeth to help with household expenses. Marybeth provides all of the rest of the household income. How do you decide if Marybeth is providing more than half of Saul’s support?

20. Marissa’s sister Carol is in a residential drug rehab program, and Marissa is caring for Carol’s newborn daughter Sunny until Carol is able. Sunny has lived with Marissa since she was born in August 2017. Carol has no income and will not file a return.

a. Can Marissa claim Sunny as a dependent?

b. What is Marissa’s filing status?

21. When Susan was alive, she and her husband Charlie supported her mother and her mother’s sister in a neighboring city. They claimed both women as dependents. Now that Susan has died, Charlie continues to support them. Can he continue to claim them as dependents?


22. Andrea (25) and her children, Jane (3), Elaine (5) and Tony (7), lived with Andrea’s mother,Juliet, most of the year. Andrea’s AGI is $18,000. Juliet’s AGI is $25,000. Andrea’s husband diedthree years ago. All three children are qualifying children of both Andrea and Juliet. Whichstatement(s) are true?

a. Juliet can claim all three children as she has the higher AGI.

b. Andrea can claim all of the children as she is the parent.

c. They can reach an agreement between themselves as to who will claim each child.

23. Sonja’s husband died while he was receiving Social Security benefits. Sonja and their two childrenreceive Social Security survivor benefits of $12,000 each. Sonja has a part-time job and earned$6,000. The three pool their funds to pay for all the household costs.

a. Does Sonja need to file a return? Should she file?

b. Can Sonja claim the two children?

c. What is Sonja’s filing status?

d. Do the children need to file returns?

24. Ben (age 17) lives with his folks and works part time. He earned $8,500 so he needs to file areturn. Although his parents provide more than half of his support, they do not need to file areturn. What is Ben’s filing status? Can he claim his own personal exemption?

25. Eve supports her adopted brother Evan, age 19, who is a full-time student. Which benefit can Eveclaim with respect to Evan:

a. Dependency exemption

b. Earned income credit

c. Education credit

26. Vic and Val divorced in September. Val paid all the household costs from August to December forherself and her young daughter, Vickie. What is Val’s filing status? What is Vic’s filing status?

27. Karen and her infant, Kasey, live with Karen’s parents who have more income than Karen. Karenearned $8,600 in a part-time job. Karen has decided to let her parents claim Kasey as they willget more tax benefit than she will. Can Karen claim EIC?

28. Nancy and Debbie are sisters sharing a home with their children (two each). Each pays their share of the costs for themselves and their children. Both sisters work and have income in the EIC eligibility range. Who should claim each child? What is the most advantageous filing statuses for Nancy and Debbie?

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29. Marie, her two young children and her divorced father, Mark, all live together. Mark’s income isslightly more than Marie’s and both are within the EIC eligibility range. Marie and Mark share thehousing and other costs 50-50, and both qualify to claim the children as qualifying children.

a. What is the most advantageous filing statuses for Marie and Mark?

b. Who should claim each child?

Quizzes

Quizzes

Quizzes can be a useful tool for Instructors. They can be used to reinforce lesson material, supplement self-study and evaluate student knowledge and training effectiveness. To reinforce use of resources, Instructors should require that volunteers write down where they found the answer to the question. Some suggested uses include:

• Assign as homework before or after a lesson. Questions could be assigned to the entire class or questions could be assigned to specific volunteers to research and then brief the class at the beginning of the next day.

• Use as “sunrisers” to get the volunteers motivated at the beginning of the day. • Assign to volunteers certifying through self-study as another measure of their performance. • Use them during a lesson to reinforce the tax law and drive home the use of resources such as the

Pub 4012 and Pub 17.

QUIZ: SCOPE In scope

Out of scope

Maybe **

1. A social security pension from Germany 2. W-2 with code Q 3. Schedule K-1 4. UBER driver income 5. Form 1098-MA 6. Charitable donation of a painting appraised for $4,500 7. Moving expenses 8. Form 1099-C cancellation of car loan 9. Unreimbursed employee business expenses 10. Prior year Social Security lump sum payments 11. Form 1099-LTC 12. Form 1099-S for sale of rental property 13. Qualified adoption expenses 14. Self-employed health insurance adjustment to gross income 15. W-2 with an entry in Box 11 for a non-qualified plan 16. Loss from storm damage on Schedule A 17. 1099-R Box 7 code L1 18. Student loan interest of $3,200 19. $5,000 from renting their home for 4 days of a golf tournament 20. Taxpayer with a business making and selling jewelry at local craft fairs

** Answer “maybe” if scope may be limited.

Quizzes

QUIZ: WHO MUST FILE

1. What three factors should be checked for everyone to determine whether they must file a return?

2. If you were born on January 1, 1953 you follow the guidelines for under 65 for purposes of determining whether or not you must file a return for 2017? Yes/No

3. Kevin is 10 years old. He has income of $1,500 from a stock transaction in a trust account held by his grandmother that is reported under his SSN. Must he file a return? Yes/No

4. Philip is 17 years old and earned $1,350 in wages from his summer job (reported on a W-2). Must he file a return? Yes/No

5. Donald and Sally are 66 and 61, respectively. They had Social Security income of $24,000 and Interest and Dividend income of $500. They received a 1099-B from their broker reporting noncovered transactions with proceeds of $21,500 from stock transactions. They tell you they didn’t withdraw any money from the account as they bought other securities. Should they file a return? Yes/No

6. List five reasons a person should file a return, even though they have no taxable income.

QUIZ: WAGES

1. What will happen if the EIN on a W-2 is entered incorrectly on a return?

2. Where can you find the definition of the codes for Box 12?

3. If Box 13 is marked “Third Party Sick Pay” income in Box 1 of a W-2 is reportable but not taxable. True/False

4. Information in Box 14 on a W-2 must be reported in TaxSlayer exactly as it appears on the W-2. True/False

5. What do you do if you have multiple W-2s from the same employer?

6. What if the taxpayer tells you they have unreported tips? How would you enter them in TaxSlayer?

7. If a W-2 has a Code D in Box 12 what Form might be generated as a result and what probing questions should you ask?

8. If a W-2 has a Code DD in box 12 what does that mean? What probing questions should you ask?

QUIZ: INTEREST

1. What information is required to enter seller-financed mortgage interest in TaxSlayer?

2. The early withdrawal penalty is entered in the deductions (adjustments) section of TaxSlayer. True/False

3. If a bond is issued at a price lower than its stated redemption value, the difference is called OID, and is simply a form of interest. The issuer of the bond reports a portion of OID each year to the bondholder on Form 1099-OID and we enter it in the interest section of TaxSlayer. True/False

4. Interest on life insurance dividends is not taxable, but is reportable. True/False

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Quizzes

5. The terms tax-exempt, non-taxable and tax-free can be used interchangeably and usually mean that the interest earned is reportable but not federally taxable. True/False

6. The difference between the discounted price for savings bonds and the face value received at maturity is ___________________.

QUIZ: DIVIDENDS

1. Capital gains distributions reported on a Form 1099-DIV can only be reported in the capital gains and losses section of TaxSlayer. True/False

2. Ordinary and qualified dividends are both taxed in the same way. True/False

3. Form 1099-DIV shows $86 in Box 3 [non-dividend distributions]. Since it is not an ordinary dividend it is eligible to be treated the same as a qualified dividend. True/False

4. Is there a limit on the amount of foreign tax credit that can be claimed for an in-scope return?

5. Tax exempt dividends (1099-DIV Box 10) are not taxable and should not be entered in TaxSlayer. True/False

6. Edward claims that since his dividend was part of a reinvestment plan to purchase more shares he does not have to declare the dividend. Is his statement true or false?

7. Charlie has $9.35 in dividends from his credit union account. He did not get a document reporting the amount from his credit union. You should report the amount as qualified dividends in the dividend section of TaxSlayer. True/False

QUIZ: SELF-EMPLOYMENT BUSINESS INCOME

1. List five requirements for a taxpayer’s self-employment income to be in scope for Tax-Aide.

2. Tracey says that in addition to her full-time job, she also earned $350 baby-sitting last year. She does not have to pay self-employment tax on these earnings. True/False

3. Tom just started his own business as a painter last year. He tells you that sometimes he does house painting for only one client at a time and other times he may have two or more jobs going on the same day. He also tells you that he often makes separate trips to the paint store for supplies. He has meticulous records of all the miles he drives for his business (i.e., between home and client, between clients, and to the paint store). He is unsure what miles he is allowed to deduct. What do you tell him?

4. Bob works as an UBER driver on weekends to supplement his income. He provides you with the list of expenses below. What are the total expenses reported on his return? a. Business miles 2,500 b. Car insurance $950 c. Liability insurance purchased to protect

against his increased risk $225 d. Tolls $125 e. Gas for the car $300 f. Commissions and expenses on UBER

statement $950

g. Speeding tickets incurred while driving clients $50

h. Regular car washes $85 i. Car washes and detailing above normal

washing $75 j. Cell phone used only for UBER calls $15

per month k. Business cards $50

Quizzes

5. John is a full-time insurance agent and provides you with a W-2 which is marked as a statutory employee in Block 13. How is this income reported?

6. John has a 1099-MISC from his church with $2,750 reported in box 3 Other Income. Upon questioning about the reason for the income, he states that he does handyman tasks for the church and others regularly. How do you report this income in TaxSlayer?

7. John and Nancy are filing a joint return. Nancy supplements their family income by selling Mary Kay cosmetics. What probing questions do you ask to determine if this would be in scope?

QUIZ: CAPITAL GAINS OR LOSSES – STOCKS

1. Which form is used to report sales of stocks or mutual funds?

2. On which form of the tax return would you expect to see capital gain distributions?

3. If a taxpayer does not know the basis for stock sold, what can they do?

4. Inherited stock sold within one year is a short term transaction. True/False

5. How can you double check to make sure you have entered the stock transactions accurately?

6. Which of the following sales are in scope for Tax-Aide? a. Inherited stock b. Stock received as a gift c. No cost basis on the broker statement

d. The sale of rental property e. Sale of stock options

7. What are the steps to follow if a client has more than a few transactions and you want to enter just the totals?

8. Thomas, aged 75, has a capital loss carry forward of $78,000 and is thinking he won’t file next year as he doesn’t think he’ll be alive in 28 years to have used up his $3,000 capital loss each year. He receives $18,000 in Social security, a $9,000 pension, has more stock to sell and owns a piece of land in Georgia. Should he file a return?

9. On July 1, 2000, Fred bought 100 shares of AT&T for $44/share. The brokerage fees were $80. What is the cost basis for these shares of AT&T?

10. On December 11, 2016 Jim’s great uncle Philip died and Jim inherited 100 shares of XYZ stock. Phillip had purchased the stock for $5.00 per share in 1952. The fair market value on the date of Phillip’s death was $20.00 per share. Jim sold all the stock on December 1, 2017. He received $1,800 net proceeds and paid a $50 commission. What is the cost basis which Jim needs to report? Is the gain or loss on the sale of Jim’s stock long-term or short-term?

11. Tom and Helen received a 1099-B in their broker statement from ABC Investments. The 1099-B shows a transaction on February 1, 2017 for the sale of 100 shares of XYZ stock for $2,000 (proceeds less commissions/net) with Code D, and it also showed it was acquired on September 16, 2013 with a basis of $3,500. Tom and Helen tell you that the basis shown on the form does not reflect a $50 fee they paid when purchased. How do you enter this information in TaxSlayer?

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Quizzes

12. Tom and Helen tell you that they received a Form 1099-S showing $705,750 for the sale of their home. They purchased the home on March 3, 1954 for $3,600 and lived in it until it was sold on May 1, 2017. They have documents showing the following expenses: new fence $3,400; adding a deck $2,900; exterior painting $900; remodeled kitchen $20,600; refinished wood floors $1,100; and, annual maintenance on the heating and air conditioning system $370. Which of these expenses increase the basis on their home?

QUIZ: RETIREMENT

1. The taxpayer, a retired public safety officer (PSO), provides you a copy of his 1099-R and tells you or has a detail statement telling him health insurance premiums of $3,786 were withheld. How do you properly report this in TaxSlayer?

2. If the taxpayer is allowed to make a qualified charitable contribution from their required minimum distribution and the entire distribution amount is $4,500 while the contribution portion is $2,000; how would you handle the transaction in TaxSlayer?

3. When might the taxable amount need to be calculated on Form 1099-R? Where is it calculated when it is a pension? Where is it calculated when it is an IRA with basis?

4. The retiree died before starting to collect on his pension. It is a joint and survivor benefit policy. When using the Simplified Method, both birthdates must be used. True/False

5. If the 1099-R shows a code “3” in Box 7. What probing questions do you ask? Why? What do you do if there is an entry in box 9b on the Form 1099-R?

6. A taxpayer has an IRA 1099-R with Distribution Code 1 and tells you that he took the distribution to buy a new car, but then changed his mind and put the money back into another IRA. What probing questions do you ask and how do you enter this information in TaxSlayer? What if he took money out of two different IRAs instead of one?

7. An early distribution is not subject to the 10% early withdrawal penalty if it has one of the following codes in Box 7: 2, 3, or 4. True/False

8. A taxpayer presents a 1099-R with Distribution Code 1, what probing questions do you ask? What if the taxpayer is 70 years old?

9. The taxpayer takes a distribution from his IRA and tells you he had made non-deductible contributions in prior years. How would you enter the non-taxable portion of the current distribution into TaxSlayer?

QUIZ: OTHER INCOME

1. Walter received $20 per day for twenty days of jury duty and said that he received his full wages during that time but was required to provide his employer with all the jury duty pay he was paid after the first ten days. How do you report this on his return?

2. When asked if they had any other income during the year, John and Mary inform you that they rented their home to a group of fans for one week during the Masters Golf tournament and received $6,000 and they also paid a maid service $500 to clean the home after the group left. How do you report this on their return?

Quizzes

3. Martha provided nonmedical support services in her own home for her cousin Nancy. She received a 1099-MISC with an amount in Box 3 from a certified Medicaid provider under a Medicaid waiver program in her state. How do you report this income?

4. John has a W-2G showing that he won $3,000 at a local casino and he says he was told that he only has to report $2,000 because he had $1,000 is losses last year. What do you tell him?

5. Daniel provides a Form 1099-C for cancellation of credit card debt. What probing questions do you ask?

6. Jack provides you with a 1099-MISC with $700 reported in Box 2 Royalties. He says it is for a song that he wrote 15 years ago and he receives this every year. Where do you report this income?

7. When asked if she had any other income, Jane tells you that she did receive $10,650 from a small life insurance policy. It included $650 of accrued interest. How do you report this income?

QUIZ: ITEMIZED AND STANDARD DEDUCTIONS

1. What factors determine the Standard Deduction Amounts?

2. Harry and Sally are filing married filing jointly (MFJ). They paid the cost of keeping Sally’s father, George, in a nursing home. The entire cost of the nursing home was $18,000, of which $8,900 was for medical care. The primary reason for George being in the nursing home was for medical care. George is their dependent. How much of the nursing home costs can Harry and Sally claim as a medical expense?

3. Charles and Maria file MFJ. They paid the following bills. Which items are eligible deductions? a. Prescription drugs from Canada b. False teeth c. Medical insurance premiums deducted

from and employee’s gross pay d. Oxygen equipment and oxygen e. Nutritional supplements recommended by

their doctor to treat diabetes

f. Lodging expenses while receiving medical care

g. The cost to remove lead paint from their home

h. Vitamins and dietary supplements i. Medical marijuana prescribed by a doctor

4. Harry Windsor is 67 years old and his wife is 60 years old. They have an AGI of $40,000 and they have $4,500 of medical expenses. How much can they deduct on Schedule A?

5. Which taxes are deductible on Schedule A? a. Sales tax for the purchase or lease of a car b. Real-estate transfer taxes (or stamp taxes) c. Excise tax on gasoline, alcohol or tobacco d. State, local, and foreign real estate tax

6. Is a special assessment for a specific property eligible for the Real Estate Tax deduction? What if the special assessment is for all properties in the school district? Yes/No

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Quizzes

7. Peter has a reverse mortgage on his primary residence. He received a lump sum payment and $100 per month from the reverse mortgage lender. Interest is accruing and will be paid at some date in the future. a. Is the amount he received in a lump sum reportable as income? Yes/No b. Can he take an interest deduction for the interest which is accruing? Yes/No

8. Which of the following types of interest are within the scope of the Tax-Aide Program? a. Home mortgage interest incurred and paid by taxpayer b. Mortgage interest paid on son's mobile home while he is in college (son is sole owner of the

mobile home) c. Points paid to acquire mortgage on the purchase of taxpayer’s home d. Mortgage insurance premiums for contract that commenced December 21, 2006 e. Investment interest f. Student loan interest paid by the student’s parent

9. Jack and Jill are filing MFS. They have lived apart for two years. They each earn $55,000 per year. Jack pays half of the $6,000 mortgage interest on the house they own and Jill lives in, and all of their $4,500 property tax. Jill pays the other $3,000 mortgage interest. They have no other itemized deductions. Jack comes to your tax site and during the interview he says his wife already filed. Assuming Jill’s preparer itemized her deductions, what will Jack’s deduction be if the loan balance is $100,000? What if the loan balance is $500,000?

10. Alice and Bill are senior citizens who have itemized their deductions for many years. They have no receipts or record of their cash contributions. They tell you these contributions added up to $260. Can they deduct $260 as a cash contribution this year?

11. The amount you deduct for charitable contributions cannot be more than 50% of your AGI and may be further limited to 30% or 20% depending on the type of property and the type of organization. Any excess can be deducted in each of the next 5 years until used up. Is this in scope for AARP Tax-Aide preparers?

12. Josephine is 81 years old and made a $10,000 qualified charitable distribution from her IRA to Goodwill Industries. The distribution was made directly by the trustee of her IRA to Goodwill. How much of the $10,000 can she take as a charitable itemized deduction?

13. Liz has non-cash contributions that she wishes to claim. She has brought her receipts which show she wishes to claim amounts of $225, $350 and $450. Where should you enter the contributions? What information is required?

QUIZ: EDUCATION BENEFITS

1. List four eligibility criteria for the American Opportunity Credit.

2. Who can claim an education credit?

3. What is an eligible post-secondary education institution for purpose of an education credit?

4. Name at least three options for claiming educational expenses?

5. How do you decide which of the options is right for the taxpayer?

Quizzes

6. Last year David paid $3,000 in tuition, $500 for text books that he bought through eBay, $100 for an athletic participation fee, and $50 for safety goggles that were required for his chemistry course. Assuming he meets all eligibility requirements, how much can he claim as 1) a tuition and fees adjustment (assuming Congress extends the deduction past 2016), 2) Lifetime Learning Credit, or 3) American Opportunity Credit?

7. Grandma pays the eligible educational expenses for her grandson who is claimed on the parent’s return as a dependent. Who can claim the payment amount and where?

8. Taxpayer pays for his son’s tuition, but the son is not claimed on the taxpayer’s return. Can he claim the tuition he pays for his son as an education credit? Yes/No

9. When are scholarships and grants taxable?

QUIZ: EARNED INCOME CREDIT

1. Assume you meet all the eligibility tests to receive EIC. What are three factors that determine the amount of EIC you will receive?

2. In TaxSlayer, where is the eligibility for EIC verified?

3. Which of the following items are considered EARNED income for EIC? a. Taxable wages b. Pensions/annuities c. Worker's compensation d. Union strike benefits e. Long-term disability benefits received

prior to minimum retirement age

f. Social Security/Railroad Retirement Benefits

g. Unemployment h. Self-employment gross earnings i. Alimony j. Work release wages

4. David and Jane are divorced. Jane does not work but receives alimony and has custody of their son Michael who lives with her except for one month during the summer when he lives with his father. David provides more than half of Michael’s support and per the divorce decree claims Michael as a dependent on his return. Who should claim Michael for EIC? Why?

5. Sue, age 26, is unmarried. She and her five-year-old daughter Tracey live with Sue's mother, Doreen, 63. Sue and Doreen provide Tracey's support. Sue worked as a clerk and earned $16,000. Doreen has a part-time job and earned $8,000 to supplement her social security income. Who can claim Tracey for EIC?

6. Bob is 23 years old. Liz, his spouse, is 27 years old. They have no children, and will file Married Filing Jointly. Bob‘s wages are their only source of income. Can they claim EIC?

7. Jane is 38 years old. Jane worked as a teacher’s assistant and received $25,000. Thomas, who is single, is Jane’s 40-year-old brother. Thomas has lived with Jane in her home since 2005 as he is permanently and totally disabled. Thomas’s only income was social security disability but it provided over half of Thomas’ support. Jane and Thomas are U.S. citizens and have valid social security numbers. Is Jane eligible to receive EIC?

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D20176 (10/17)

Tax-Aide National Tax Training Committee Workbook

Documents

Transcript of Tax-Aide National Tax Training Committee Workbook