Electronic Filing Instructions for your 2011 Federal Tax Return important: Your taxes are not finished until al required steps are completed. Paul A & Amy L Str 503 Mansfield way Oswego, TL 60542 1 Balance | Your federal tax return (Form 1 due to you in the Due/ I nt of $13,975.00, Your tax lirect deposited into Refund | your account within 7 to nis accepted, The | account information you e: 232704192 Routing | Transit Number: 071923909. L I Where's My | Before you call the Internal Revenue Service with questions about Refund? | your x give them 7 to 14 days processing time fom the date | your return is acer £ then you have not received your refund, | or the amount is not what you expected, contact the Internal Revenue | Service directly at 1-800-829-4477, You can also check www.irs.gov | and select the 8 my refund?" Link L I No | No signature form is required since you signed your ret Signature | electronically Document — | Needed i L I What You I uctions (this form) Need to I return Keep I L I 2011 I sted Gross Income 3 100,828.00 Federal I Income 3 52,069.00 Tax i 1 Tax 8 4,193.00 Return i 1 Payments /Cr $18,168.00 ‘Summary I nt to be Refunded 3 13,875.00 | Effective Tax Rate 2.55% L Page 1 of 1Ha Paul and Any, We just want to thank you for using TurboTax this year! It's our goal to make your taxes easy and accurate, year after year. With TurboTax Deluxe Your Head Start On Next Year: When you come hack next year, taxes will be so easy! We'll have all your information saved and ready to transfer in to your new return ie") ask you questions about what changed since we last talked, and We'll be ready to get you the credits and deductions you deserve, no matter what life throws at you. Here's the final wrap up for your 2011 taxes Your federal refund is: $ 13,875.00 We reviewed over 350 deductions and credits so you can be sure you didn't miss a thing and that you got the maximum refund ~ guaranteed. Your Deductions and Credits Your itemized deductions for this year: $ 24,059.00 You qualified for these important credits = Education Credits - Child Tax Credit Your Guarantee of Accuracy: Breathe easy. The calculations on your return are backed with our 100% Aceuracy Guarantee = We double checked your return for errors along the way. = We helped with step-by-step guidance to get your answers on the right IRS forms — We made sure you didn't miss a deduction even if something in your lige changed, like a new job, new house - or more kids! Also included ~ We e-filed your federal returns in as few as 7 days ~ We provide the Audit Support Center free of charge, in the unlikely event you get audited free, you could get your refund Many happy returns from TurboTax.€ ossuireetteteauny-himitemasies 6 | acy $1040 Gs inciviauar income Tax Retum |2O% 4 [onan sisson |raueon-oorcere est en Fern Tau PON 27, orton Tiere @ Soe separate natactons Yaar tan an aT Taras Your sci secutty number Paul A strater 298-62-4506 any b Strater 519-84~6507 a a ER TTT TTR TPB TOE TIC ese SONG BE G03 Manseield Kay tod on ese ae tomet Bo eT la TVET ES GS ET FO TOTO Fiera Baan Conpai Oswego TL 60543 eet yrs wot y Fang ae aT PRET ae TT es in eg fee Eye Cleneme 7 Osha @ vent efhocaton wh arya pe Se aren Filing Status Bi saried fing ony even ony one had income) ‘he quaieg pron ett ot yur penn ers Ccheckerivore 2. C1 Mani ing separately. Err spouse's SSN above hig ranetor. bo and fa namo ere, ee ‘6a Ed] Yourselt.f someone can claim you as a dependent, do nat check box 6a Exemptions % El Yowse ‘@ Dependents: Torment | _e)ommers | (ze cv reanane Lassen sscalaecrynurer | reoroipta you | Sieg ci Blair H Serater 33 [5a fal W more than tour Goraay So Teeeater 3804 [Daughter a Fee Retone dependents, see 8 Dependent ne instructions and check here »C] o ‘Add umberson [re -d_Total numberof exertions claimed tines above” LS income 7 Wages, salaries, tips, ete tach Form(s) We? 7 $0, 332 fa Taxable interest, Attach Scheckle BH requires a Tax-exempt interest. Do not include on tne 82 ao ach Form(s) gq crcnary aiden. tach Schele B reque Steen Ferme Qualified dividends o» W.26 and 10 Taxable refunds, rel, or fist of state arc local income axes 10 4,153 1000-Riftex 44 Alimony received 11 was withheld. 42 Busines income or fos. Altach Schedule C or C-£Z 12 13 Capital gain toss). attach Schecule D i requied. net required, checkhere C] [a3 Nyeusidnet 44 ter ans orfsses) tach Farm 4787 “4 Sea ons, 158 WRAdstrbutions [15a b Taxable amount [as | [_ soenovek 163 Pensions and annutes b Taxable ameurt 1 2a 17 Rentalreal estate royaties, partnerships, S corporaions, trusts, ee. Attach Schedule [17 2,832. Enclose, utso 4g Farmincome or fos) Attach Schedule F 18 net stach Sry Ag Unemployment compensation 19 please ure 208 Social security berets [208 b Taxable amount 206) Form 1040. 24 Other income. List type and amount 21 22 Combine th amour in te fright cola vies Tush. iss yaureiainceme [aa [100,928 - 23 Educator expenses 23 Adjusted 24 carsin business expenses of resets, paoring aris, and Gross tee-basis government ofl, Attach Form 2108 o 210642 | 2a Income 25 Health savings account deduction. Attach Form 8889. | 25 28 Moving expenses, Aitach Form 3903 28 27 Deductible pat of set-enployment tax Attach Schedule SE. [27 28 Setremployes SEP, SIMPLE, and qualfed plans 28 29, _Selremployed heath insurance deduction 23 30 Penalty on early withdrawal of savings 30 ‘31a Almony paid Recipients SSN > ata, 32 RAdeducton 22 32° Student loan interest deduction 33 5M Tutlon and fees. tach Form 8617 [ae | [| 35. Domestic production activites deduction. Attach Form 8903 [35 36 Add ines 23 though 25 36 37 _Subtract ine 36 from ine 22, This is your adjusted gross income > [ar [700 378 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA _REVGH2aT2TIW Form 1040 (ori)Page Jax ang 38 Aron fom ne (dusted poss Beare) we [100,508 Credits 39a Check { [] You were born before January 2, 1947, 1 Blinc. | Total boxes: if 1 Spouse was bom before January 2, 1947, [] Blind. ) checked ® 39 (Standara |__b tyour spouse itemizes ona separate return or you were @dualstatus alien, check here® — 386(] Beticlon “Z" itemized deductions {rom Schecile A er your standard deduction se let mara) wo| 24,058 Peoplewno [1 Suttict ne 40 tom ine 38 wl 86868 gheckany, | 42 Exemptions. Mutiply $3,700 by the number online 6d ae 14, 800 SELS"398 or | 43. Taxable income. Sabact ne £2 om Ine 41 ne 42s more than Ine 4, ete-0- [32.088 SURES | 44 tox eestor. Cnecktery tome @ L] Form(s 8814 b [] Form 4072 © L] 82 acon [a8 5.361 Sepencent 45 Alternative minimum tax (see instructions). Attach Form 6251 45, instructions. | 4g Add lines 4 and 45. > [46 6, 961 haters | a7 orig tx cet tach Form 116 equed a BBSSang | 48 creatforcntsand dependent cee expenses. tach Ferm 2681 [4B EERE" | de ccucaton cats tom Form 8860 ne 23, a Tas Marie ting | 80. Retiemert savings corrbutons erect Atach Form 8880 [80 Bee” |e atm pe rancionn teat] PieMet | 52 Residential eneray credits. tach Form S695 52, Head of 53° Other credits rom Form: a [] 3800 » [] 8801 ¢ 53 Samah, 54 Add lines 47 through 53. These are your total credits 54 3,429 55 _Subtact no St tom ino 46 ne St is more than tne 4, eter > [as 3,522 Others Sel-employrent tx. atacn Schedule SE 6 T 57 Unreported social security and Medicare tax from Form: a[] 4137» [] 8919 57 axee 58 Additional tax on IRAs, other qualified retirement plans, ete. Attach Form $329 if reauired NO, 58 66: 58a Houtehold employment ove tom Schedule H te Fraime homebuyer red epaymen tach Form 5406 eae’ sb 0 Oihertanes Ener coce tom msiuctons ny 61 _ Add nes $5 tough 60, Ths you ttl a a1 Paymenta 62 Feceralincome tax vite fom Farms W-2 na 008 [62 wis LOMADIS 63251 estate tx poymets nd amour oped er 2010 ,eum 6B seahaes “Béa_Eamed income ered EC) ea guaieg Ty Nowauasi concatpayelecton [ab Sone C,|€8 Addtonal ch tx erect Atach For 2872 « 66 American opportunity credit from Form 8863, line 14 6 953 €7Frovime homebuyer ced tom Frm 5405, ine 10 ar 8 Arount pai wn request fr extesion le os 70 Credo federal ax o ues. tach Form 4138 70 ‘71 Credits rom Form: a []2439 b [] 8839 ¢ [])saot @ [] sas | 71 172_ Aad ines 62.62, 6, and 65 trough 7. Tese ae your total payment w]e] is,368 Refund 73 ine 72s move thanine 6, sustact ine 6 fam Ine 72. This the amour you overpaid [ 73. [ 13.875 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here > [taa 13,975 Deetdepeto PB Routing number 7/192139.0 9. meType: il Chckng C] Suings en 4 Accoun'nimber “7203-977 oralaiel2 sstuctions. 75 Amount of ine 73 you wart applied to your 2012 estimated tax> | 75 | Ll ‘Rrrount 76 Amount you owe SubtactIne 72 Fomine 61 For delle onhow to pay, we ratuctons > | 76 You Owe _77__Estinated tax senate instuctons [7 | I Third Party D2 Yeu want alow another person to discuss tis relu with ie RS (see astuctons? LI Ves ‘Complete below. EJ No Designee Dessres Prone enon iexion nine me nimerP > Sign Under paral of pray, del tal have examined is fun and acconpaning schedules and vatements, and toe bv of my krawlede ad bl Kepscn Pmaesaarain Tone baa ose Yoo ie may ener Epidemiologist fh pal TIT pe pean rane Pa a a a Preparer BPS al Cony imma > SELF PREPARED cat Fania Phan wom Tem OROSCHEDULE A Itemized Deductions 0 No, 1585-0074 (Form 1040) 5044 Oeparmen oft Tesi tach to Form > See Instructions for Schedule A (Form 1040}. ecient Beparrer te Treas Attach to Form 1040,» See Instructions for Schedule A (Form 1040), ascent g7 Name(y enn on Form 1007 ‘Your ociat security nur Paul A & Any L Strater 296-62-4906 Medical Geition. Do nt inca expenses reimbursed or pal by has and 1. Medical and dental expenses (see instructions) 1 Dental Mvoyiin2ty 75x (079) 2 lap line 2 by 7.5% ( Expenses 4 Subtractline 3 trom line 1. line Sis more than line 1, enter -0- 4 Taxes You _ 5 State and local (check only one box): Paid 2 Elincome eso | 5 4,331 b General sales taxes 6 Real estate taxes (see instructions) 6 10,363. 7 Personal property taxes 7 8 Other taxes. List ype and amount 8 9 Rad ines 8 isu ° 4,684 interest 10 Home mortgage interest and paints reported to you on Form 1088 [10] 5, 365 You Paid 11. Home mortgage interest not reported to you on Form 1088. I pald Not to the person from whom you bought the home, see instructions inte. ‘and show that person's name, identifying no., and address Your morgage me tying imeteat ace enn Secuctinmay a be imted (see 42 Points not reported to you on Form 1088. See insiructions for instructions) special rules 12| 18. Mortgage insurance premiums (see instructions) 3] 414 Investment interest. Attach Form 4952 f required. (See instructions) [14] 45 Add lines 10 through 14 45 Giftsto 16 Gifts by cash or check. Ifyou made any gift of $250 or more, Charity see instructions 16 iryoumade a 17 Other than by cash or check. If any git of $250 or more, see sit and got instructions. You must attach Form 8283 if over $500 +7| Benefit fori. 48 Canyover from prior year 8 seeinsructions. 49 Add ines 16 through 18 19 Casualty and Theft Losses 20 Casualty or theft lossfes) Attach Form 4684, (See instructions.) 20) ‘Job Expenses 21” Unreimbursed employee expenses—job travel, union dues; and Certain job education, etc. Attach Form 2106 or 2106-E2 if required Miscellaneous (See instructions.) lat Deductions 22 Tax preparation fees za 23. Other expenses—invesiment, safe deposit box, ete. List type and amount a 2s 24 Addiines 81 through 23 a 25. Enter amount ‘rom Form 1040, line 38. [25| 26 Mutiply line 25 by 2% (02) 26 27 Subtract ine 26 from line 24. it ine 26 is more than line 24, enter 27 Other 28 Other—fomlistin instructions. List ype and amount Miscellaneous Deductions Weer reenact 2s Total 29. Add the amounts in the far right column for ines 4 through 28. Also, enter this amount Itemized ‘on Form 1040, line 40 EA 24,0 Deductions 30 If you elect to itemize deductions even though they are less than your standard deduction. check here > oO For Paperwork Reduction Act Notice, see Form 1040 instructions. BAA ev ramen Tw ‘Schedule A Form 1080) 2011sched €Fom 1402011 Atachvet Sequence No. 13 Page Faso Sao BNSF TS GT HTT SOOTY ROTTS OST ar aT SST Paul A ¢ Any I 62-4 Taution, The IRS conpares arnourls reported on your tx rau With amounts shown on Schedue] KT Tncome or Loss From Partnerships and 5 Corporations Note. Iryourepor a lss rom an atiek acy fr which any amounts nota ek you must check the box in column (eon line 28 and attach Form 6198, See instructions 27 Are you reporting any loss not allowed in a prior year due to the at-risk or basis limitations, a prior year Unallowed loss from a passive activity (f that loss was not reported on Form 8582), or unveimbursed C] Yes partnership expenses? If you answered “Yes.” see instructions before completing this section. 2 to none games | gene A Th 20-5525684 oO B[The RF Team, 1 oO c oO D oO Fassia Tneoe wT TORT Napa Tone TST a Fanwion sows otaenae |B heemnes | ioc mopen | olor x 7338 758 = Ta é 5 atau : TSE b Totals 2,938 i 0° ad cums Ghana ne 7a 5 = 770 21 Add cots (and of e280 ae 22 Total partnership and 8 corporation income or ossh Combine Snes 20 and 81. Enter the result hore an inca nth aan nef blo 2 nena GENT indore or Loss From Estates and Trusts . a ooo x t Fae Eo TTSRT nga Tears BraTE Grammars oon armas aiacorses oe sco ior x + Sa Toa > Tos 38 had cotnns and othe a 3 36 Aad columns) and) line 34 a i 37 Tal entata and tat Income or (ots). Combine lines 36 and 38. Ema the rn here and ince nto talon ne 1 blow a ERIN] come or Lose From Real Eiate Warigage invsimont Conduits [REMICS) Residual Hotder 8 anne ery seauaaeeR” |izeaiehsorerm] a AMKSTS ey 35 Gori Stas and Err a rod Fre and ras eal on Tre bao 38 Summary Mon Net Tarn otal com o Tor) Far Form 35 Ato, conta Ine 3 bow ra 4 Taacon ofr Corina 12 138 ase aba mul teem es x Fom ana iets [ 7453 42 Reconcllaton of feing and fhing income. Ener your gross flvin aed thing cometepaedon Part te ine 7, Schedule (Form 1065), box 14, code B; Schedule K-1 (Form 11208), box 17, code Us and Schedule K-1 (Form 1041), ine 14, code F (see instructions) a2 | 42._‘Reconclaton fr real erate professional you wre ral esata Bryer on Feo Fo LON fama onal sue een in which you materially participated under the passive activity loss rules 43 | revonniie Taw Schedule E (Frm 1040) 20118863 Education Credits (American Opportunity and Fom ifetime Learning Credits) > See separate instructions to find out i you are eligible to take the credit > Attach to Form 1040 or Form 10404, (OMB No. 1545.0 2011 Sacer Ne, Namele snow onrourn Paul A & "Your socal secur number 296-62-4906 You cannot take both an education credit and the tution and fees deduction (see Form 8917) for the same student for the same yea ‘American Opportunity Credit Gaution: You cannot take the American opportunity credit for more than 4 tax years for the same student. 1 {@) Student's name (b) Stucent’s| (6) Quaitied | (ay Subtract $7,000 ] _(e) Mutiplythe | (colina iso, (as shown on page + social security | expenses ee | fromthe amount in | amount ircolur | enter‘ amount er of your tax return) umber (as instructions). | “column fe. z0r0. | “(dh by 2596.25) | column). there, First name shownon page | netentermore | ‘oriess, enter-0- ‘848 $2,000 tothe 28 otyourtaxretum) | than $4,000 for rout in colar leach student. 296-562-4906 28 1,528 382, 2,382 2 Tentative American opportunity eredit. Add the amounts on line 1, column (). If you are taking the lifetime learning credit for a different student, go to Part I: otherwise, go to Part II > 2,382 Lifetime Learning Credit Caution: You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year. 3 (@) Student's name (as shown on page 1 of your tax retur) (b) Student's social security | (6) Qualified ‘rumber fas shown on nage | expenses (seo First name Last name 1 of your tax return. instructons) 4 Rddthe amounts on ine &, colurnn (e), and enter the total 5 Enter the smaller of line 4 or $10,000 6 Tentative lifetime learning credit. Multiply line § by 20% (20). I you have an entry on line 2, go to Part Ill otherwise go to Part IV jperwork Reduction Act Notice, see your tax retum instuclons. BAA revouaseTW “om 8868 OTRefundable American Opportunily Credit 7 Enter the amount from line 2 7 7582 8 Enter: $180,000 if arried fling jointly; $80,000 i single, head of household, oF qualtying widower) 8 80,000 9 Enter the amount ftom Form 1040, line 38, of Forrn 10404, tine 22. Wf you are fling Form 2555, 2555-EZ, or 4563, of you are excluding income from Puerto Rico, see Pub, 970 for the amount to enter ° 00, 928 40 Subtract line 9 from line 8. If zero oF less, stop; you cannot take any education credit 10 2,072 44 Emer: $20,000 if married fling jointly; $10,000 I single, head of household, or qualifying widower) 14 20,000 42 Hline 19s: * Equal to or more than ine 11, enter 1.000 on fine 12 | + Los tha in 1, vd ne 10 by Ine 11. Enter the resut as adectalfoundedto | 12 1.000 atleast three places), 42 Multiply ine 7 by ne 12. Caution: Ifyou were under age 24 atthe end of the year and meet the conaitions on page 4 of the instructions, you eannot take the refundable American opportunity credit. Skip line 14, enter the amount from line 13 on line 15, and check this box > diss 44 Refundable American opportunity credit. Multiply line 13 by 40% (0) Enter the amount here and on Form 1040, line 68, or Form 1040A, ne 40. Then go tone 15 below 14 ‘Nonrefundable Education Credits 45. Subvact line 14 from line 13 5 416 Enter the amount from line 6, if any. I you have no entty on line 6 skip lines 17 through 22, and enter the amount from line 15 on line 6 ofthe Credit Limit Worksheet (see instructions) 16 47 Enter: $122,000 if maried filing jointly; $61,000 it single, head of ousehold, or qualtying widower) 17 48 Enter the amount from Form 1040, ine 38, or Form 10408, ine 22. I you ae fling Form 2555, 2555-EZ, or 4563, of you are excluaing income from Puerto Rico, see Pub. 970 for the amount to enter 18 49 Subtract ne 18 for ine 17. If zero o less, skip lines 20 and 21, and enter zero on ine 22 19 20 Enter: $20,000 if married fling jointy; $10,000 if single, head of household, or qualitving widower) 20 24 tine 19s: + Equal to or more than line 20, enter 1.000 on ine 21 and goto tine 22 + Less than tine 20, divide ine 19 by line 20. Enter the result as a decimal rounded to atleast three places) les 22 Mukiply ine 16 by ine 21, Enter here and on line 1 ofthe Creait Limit Worksheet (see instructions) [22] 23 Nonrefundable education eredits. Enter the amount from line 11 of the Credit Limit Worksheet {see instructions) here and on Form 1040, line 49, or Form 1040A, line 31 [23 1,429 om 8853 9017(OMB No. 1545-1008 com ODOL Passive Activity Loss Limitations Depart of he Tes, > See soparate instructions. btamalverue Serie 88 > Attach to Form 1040 or Form 1081, Frere snownon en aaa SE Paul A & Any L Strater 296-62 2011 Passive Activity Loss Caution: Complete Worksheets 1, 2, and 3 before completing Pat Rental Real Estate Activities With Active Paricipation (For the definition of active participation, see ‘Special Allowance for Rental Real Estate Activities in the instructions.) 1a Activiies with net income (enter the amount from Worksheet 1 column (a) ta Activities with net loss (enter the amount from Worksheet 1, column to) 1b | J © Prior years unallowed losses (enter the amount from Worksheet 1 column (o}) te | H d_Combine ines 1a, 1b. and te td ‘Commercial Revitalization Deductions From Rental Real Estate Activitios 2a Commercial revitalization deductions from Worksheet 2, column (a). | 2a | J b Prior year unallowed commercial revitalization deductions from Worksheet 2, column (b) 2 | H © Add lines 2a and 2b 2e | ) ‘il Other Passive Activities 8a Activities with net income (enter the amount from Worksheet 3, column (a) 3a 2,938 Activities with net loss (enter the amount from Worksheet 3, column (o) 3b | J ‘© Prior years unallowed losses (enter the amount from Worksheet 3, column (o}) ge | 4,182.) d_Combine ines 3a, 3b, and 30 3d, 1,244 @ Combine lines 1d, 2c, and 94. I this line is Zero or more, stop hee and include this form with your return: al losses are allowed, including any prior year unalowed losses entered on line te 2b, ore. Report the losses onthe forms and schedules normally used 4 -1.244 ifine 4s aloss and: © Line 1d i aloss, go to Par I + Line 2c sa loss (and line iis zero or more, skip Part land goto Part I * Line 2d aloes (and lines 1d and 2e are ero or more), skip Pats Wand land goto tne 15. Caution: ff your fing status is marred fling separately and you ved with your spouse at any time during the yer, de not complete Parti or Patil. instead, go to tine 15. Special Allowance for Rental Real Estate Activities With Active Participation Note: Enter all numbers in Part as positive amounts, See instructions for an example Enter the smaller of the loss on ine 1d or the loss on line 4 3 @ Enter $150,000. if martied fling separately, see instructions 6 7 Enter modified adjusted gross income, but notes than zero see instuctions) [7 Note: if line 7 is greater than or equal to line 6, skip lines 8 and 9, ‘enter -0- on line 10. Otherwise, go to line 8. 8 Subtract line 7 trom line 6 8 9 Mutily line & by 50% (5). Do not enter more than $25,000. If mari fling separately, see nstwuctons | 9 40 Enter the smaller of line 5 or line 9 10 3 ifline 26's alos, goto Par Il, Otherwise, go to line 15, Special Allowance for Commercial Revitalization Deductions From Rental Real Estate Activities Note: Enter ail numbers in Part las positive amounts. See the example for Pat In the instructions 11 Ener $25,000 reduced by the amount, if any, on line 10. manted fing separately, see instuctions | 11 42 Enter the loss from line 4 12 13. Reduce line 12 by the amount on tine 10, 13 14__Enter the smallest of ine 2c (treated as a positive amount), ine 11, oF ine 13 14 EEGMIY Total Losses Allowed 15. Add the income, i any, on lines 1a and Sa and enter the total [35] 16 Total losses allowed from all passive activities for 2011. Add lines 10, 14, and 15. Sot Instructions to find out how to report the losses on your tax return 16 2,938 For Paperwork Reduction Act Notice, see instructions BAA rev 206 TT “om B8B2 OTFor se2 019) rage Caution: The worksheets must be fled with your tax return. Keep a copy Tor your records Worksheet 1—For Form 8582, Lines fa, 1b, and 1c (See instructions) Current year Prior years Overall gain or loss Name of activity (a Netincome ] (B) Netioss | (@) Unalowed ain Lose {ine ta) Gine 1b) | toss (ine te) |S (oe Total. Enter on Form 8582, ines Ta, 1b, and te » Worksheet 2—For Form 8582, Lines 2a and 2b (See instructions) {@) Current year (© Prior year ie overailloxe Name of acthtty deductions (ine 22) __|unallowed deductions (ine 25)| (©) Overall Total. Enter on Form 8582, ines 2a and 2b > Worksheet S—For Form 8582, Lines Sa, 3b, and 3c (See instructions) Current year Prior years Overall gain or loss lame of activ ™ " (ej Netincome | (B)Netioss | (e) Unalowed | (a) Gain eine fine 3a) (ine 36) | oss (ine 3c) The RE Team, Tne 2, 938 182 244 Total. Enter on Form 8582, ines Sa, Sb, and 3e » 2,938 ° 4,182 Worksheet 4—Use this worksheet if an amount is shown on Form 8582, (See instructions) Form or schedule Namo city srainemamiet| ators | qynaio | ‘9)Se88l Jeotumm ts tom tobe reported on allowance |°°Unn (1 £9 {see instructions) Total » 4.00 Worksheet 5Allocation of Unallowed Losses (See instructions) Form or schedule and line number Name of activity tebe reported on (2) Loss Ratio (6) Unatiowed loss (See instructions) the AF Team, Ine Ein 28h T20a, | 100000000 12d Total > 1,244 4.00 1,244Form ase ort) Page 3 Worksheet 6—Allowed Losses (See instructions) Form or schedule and line number to Name of activity lsc reported on'fsce| @) LOSS | (b) Unallowed loss | (c) Allowed loss, instructions) he AF Team, Ine naan zea 1244 2,538 Total > 4,182 1,244 2,938 Worksheet 7—Activitios With Losses Reported on Two or More Forms or Schedules (See instructions) Namo of activity @ ® (e)Ratio | Unaliowed [1 wowed ioss Form or schedule and line number to be reported on (sot instructions): Ja Net loss pus prior year unaliowed loss ftom form or schedule. b Net income from form or schedule > Subtract ine 1b ftom tne 1a zero or ess, enter-0-P Form or schedule and line number to be reported on (soe instructions): 1a Net loss pus prior year unaliowed loss ftom form or schedule. b Net income from form or schedule > Subtract ine 1b ftom tne 1a zero or ess, enter-0-P Form or schedule and line number to be reported on (seo instructions): 1a Net loss pus prior year unaliowed loss ftom form or schedule. b Net income from form or schedule > Subtract ine 1b ftom tne 1a zero or ess, enter-0-P Total >» 4.90 Fom 85820007)Form 1098-T Tuition Statement 2011 > Keep for your records Taxpayers name Social Socutty No, Paul A @ ater 296-562-4906 Identity Student (Required): A If student is Double-click to link this 1098-T to the applicable Taxpayer or Spouse ‘Student Information Worksheet Paul B Ifstudentis Blair or Jordan Double-click to link this 1098-T to the applicable Dependent Student Information Worksheet . Filors name 1. Paymenis received for quate Western Illinois University tuiton and related expenses Stoel aadross ‘State Zip Code 2. Amounts billed for qualified tution 61455] and olated expenses. $ 12,7) Telephone no. ee 3 Mths boxis checked, your educational institution has changed its reporting method for 2011 Filer’s Federal Student's 4 Adjustments made tora | § Scholarships or grants iaentticaion number | Social Securty Number, Prior year 37-0910058 26-62-4906 8 8 3,000 Students name & Adjustments to 7 Check this box ithe amount Pau. scholarships or grants Inbox 1 or 2 includes Soot address ‘at. No. fora pr year amounts for an Mans academic period coiy Siaie Zip Code beginning January sweqo cosa | 5. March 2012 . Service Provider! Acct No | 8 Check tat last 9 Checkita graduate | 10. Ins, contract reimb.rotund haltime student » LH student 8 Reconciliation of Box 1, Payments Received for Qualified Tuition and Related Expenses ‘A Enter portion of box 1 amount net paid during 2011 B Enter portion of box 1 amount actualy paid during 2011 Reconciliation of Box 2, Amounts Billed for Qualified Tuition and Related Expenses ‘A Enter portion of box 2 amount net paid during 2011 ° B Enter portion of box 2 amount actualy paid during 2011 12,774 Reconciliation of Box 5, Veteran- or Employer-Provided Assistance Included in Box 5 Enter portion of box § amount from veteran- or tax free employer-provided assistance Enter portion of box § amount from employer-provided assistance included in income Portion of box § amount from scholarships or grants Box 5 amount includes veteran- or employer-provided educational assistance vomForm 1099-Q Payments From Qualified Education Programs 2011 (Under Sections 529 and 530) > Keep for your records Recipients name Social Socutty No. Paul 579-84-650 Designated Beneficiary and Recipient a @ 8 4 6) Someone Not Taxpayer Spouse Dependent —else.-— applicable A Who was the designated beneficiary ofthe dstrbution reported on tis form 1089-07 B Who was the recipent ofthe distibvionvopoted on is form? [] oO oO oO oO oO oO © Ifthe designated beneficiary is a dependent, double-click to link this 1099-Q to the applicable Dependent Student Information Worksheet . D Ifthe designated beneficiary is someone else, double-click to link this 1099-Q to the applicable Qualified Education Expenses Worksheet . PAYER'S/TRUSTEE'S name 1. Gross Distbution ox Up. Stroetaddoss PO Box, ‘State ZIP code 2 Earnings MA__ 02205 Telephone no. ex PAYER'S federal | RECIPIENT'S 3 Basis 4 Tustee-o-rusteo identification number | soclal seeutty number vanstor 38-6000022 59-84-6507 3 RECIPIENT'S name 5 Chock one: © Check'f he recipient Paw. + Qualieg tution Is not the designates ‘Street address (including apt no.) program beneficiary 603 Mans. Way Private City State ZIP code State x swego IL 50543) © Coverdell ESA Account number 131640615-0 Distribution Code Distribution code, if payer reported code in the box below boxes S and. . >. Qualified Tuition Program It State Qualified Tuition Program, enter state. Distributions Due to Death or Disability 1. Check box if this distribution was due to the disabiliy of the designated beneficiary | 2 Check box if this distriution was due to the death of the designated beneficiary +|ater 578-84-5507_ Page? Rollovers and Transfers 11 Was the distribution rolled over and the following conditions met? * Rolled over within 60 days ofthe distribution + 12months since a previous rollover (to the same beneficiary for a QTP). See Help 2 Yes, entire distribution was rolled over meeting above conditions seed 'b Yes, a portion of distribution was rolled over meeting above conditions. (1) Enter porton rolled over ~ «No, no portion of tne cstrbution was roled over or conaitons above nat met -[—] 2 Amount that was rolled over 3 Itarollover or transfer, checkbox lf the owner ofthe account receiving the rolioveris ‘The original designated beneficiary b A family member ofthe original designated beneficiary... - : Someone who is not a family member of the original designated beneficiary Not applicable Coverdell Education Savings Account (ESA) Return of Contribution It yes, check one: The contribution was made In 2011 and returned in 2011 The contribution was made in 2011 and retuned in 2012 (2012 1089.) The contribution was made in 2010 and retuned in 2011 Amount of return of contribution Was this distribution a return ofa contribution toa Coverdell ESA? Toves we [wa Coverdell Education Savings Account (ESA) Activity Information (a) During 2012 @ ) © As of During As of 12/81/2010 2011 1281/2011 1 Basis 2 Contrbutions a For2010 b Forz011 3 Value 4 Outstanding ralovers Coverdell Education Savings Account (ESA) Computation of Taxable Distribution For Purposes of Regular Tax For Purposes of 10% ‘Additional Tax 1. Enter the amount contributed to this ESA for 2011 2 Enter your basis of this ESA as of December 31, 2010, 3 Add lines 1 and 2. 4 Enier the total aistbutions from this ESA during 2011 : 5 Enter the amount of adjusted qualified education expenses attributable tothis ESA 6 Subtract line 5 trom line 4 7 Enter the value of this ESA as of December 31, 2011 8 Add lines 4 and 7 9 Basis fraction. Divide line 3 by Ine 8 10° Multiply ine 4 by ine 8. 11 Subtract line 10 from line 4. 12 Tax-iree traction. Divide line 5 by line 4 (but not more than 1.0). 13 Multiply ine 11 by line 12. This is the amount of tax-free earings. 14 Subtract line 13 from ine 11. This is the taxable amount to the recipient. 15 Basis as of December 31, 2011, Subtract line 10 from line 3,Paul 84-65) 07 Pages Qualified Tuition Program (QTP) Computation of Taxable Distribution For Purposes of Regular Tex For Purposes of 10% Additional Tax Enter the total distributions from this QTP during 2011, Enter the amount of adjusted qualified education expenses attributable tothis QTP Excess distributions, Subtract line 2 from line 1 Total distributed earnings from Form 1099-0 box 2 Fraction, Divide line 2 by ine 1 Multiply line 4 by tne 5, ‘Subtract line 6 from line 4, This is the taxable amount tothe recipient. 600 Distributions Not Subject to Additional 10% Tax 1. Distributions included in income 2 Distributions not subject to additonal 10% Tax 2 Paid to beneficiary on or aller the death of the designated beneficiary 'b Made because the designated beneficiary is disabled « Included in income because beneficiary received tax-ree scholarshio dd Made on account of attendance at U.S, miltary academy € Included only because qualified expenses were taken into account in determining ‘American Opportunity or lifetime learning credit { Total, Add lines 2a through 2eForm 1099-Q Payments From Qualified Education Programs 2011 (Under Sections 529 and 530) > Keep for your records Recipients name Social Socutty No. Paul 579-84-650 Designated Beneficiary and Recipient a @ 8 4 6) Someone Not Taxpayer Spouse Dependent —else.-— applicable A Who was the designated beneficiary ofthe dstrbution reported on tis form 1089-07 B Who was the recipent ofthe distibvionvopoted on is form? [] oO oO oO oO oO oO © Ifthe designated beneficiary is a dependent, double-click to link this 1099-Q to the applicable Dependent Student Information Worksheet . D Ifthe designated benetciay is someone else, double-click 0 lnk this 1099-0 tothe applicable Qualified Education Expenses Worksheet . PAYERS/TRUSTEE'S name 1 Gross Dstbuton ee Up Sweet addiess| PO Box Baie AP code 2 Eamings Boston ___MA_ 92205-5578) Telephone no ex PAYERS tederal | RECIPIENT'S 3 Basis 4 Tusteesosrustoe iserteaton number | social seuity number vanstor g8-5000022 _ |57-84-5507 400 RECIPIENT'S name 5 Check one: © Checkif the rexpent Pau + Quaties ttn isnot the designates Street address (ineluding ap no} program beneficiary 603 Mans way Private iy Sate ZIP code sae x ewego IL 50543] © Coverael ESA Account number 131640615-02 Distribution Code Distribution code, if payer reported code in the box below boxes S and. . >. Qualified Tuition Program It State Qualified Tuition Program, enter state. Distributions Due to Death or Disability 1. Check box if this distribution was due to the disabiliy of the designated beneficiary | 2 Check box if this distriution was due to the death of the designated beneficiary +|ater 578-84-5507_ Page? Rollovers and Transfers 11 Was the distribution rolled over and the following conditions met? * Rolled over within 60 days ofthe distribution + 12months since a previous rollover (to the same beneficiary for a QTP). See Help 2 Yes, entire distribution was rolled over meeting above conditions seed 'b Yes, a portion of distribution was rolled over meeting above conditions. (1) Enter porton rolled over ~ «No, no portion of tne cstrbution was roled over or conaitons above nat met -[—] 2 Amount that was rolled over 3 Itarollover or transfer, checkbox lf the owner ofthe account receiving the rolioveris ‘The original designated beneficiary b A family member ofthe original designated beneficiary... - : Someone who is not a family member of the original designated beneficiary Not applicable Coverdell Education Savings Account (ESA) Return of Contribution It yes, check one: The contribution was made In 2011 and returned in 2011 The contribution was made in 2011 and retuned in 2012 (2012 1089.) The contribution was made in 2010 and retuned in 2011 Amount of return of contribution Was this distribution a return ofa contribution toa Coverdell ESA? Toves we [wa Coverdell Education Savings Account (ESA) Activity Information (a) During 2012 @ ) © As of During As of 12/81/2010 2011 1281/2011 1 Basis 2 Contrbutions a For2010 b Forz011 3 Value 4 Outstanding ralovers Coverdell Education Savings Account (ESA) Computation of Taxable Distribution For Purposes of Regular Tax For Purposes of 10% ‘Additional Tax 1. Enter the amount contributed to this ESA for 2011 2 Enter your basis of this ESA as of December 31, 2010, 3 Add lines 1 and 2. 4 Enier the total aistbutions from this ESA during 2011 : 5 Enter the amount of adjusted qualified education expenses attributable tothis ESA 6 Subtract line 5 trom line 4 7 Enter the value of this ESA as of December 31, 2011 8 Add lines 4 and 7 9 Basis fraction. Divide line 3 by Ine 8 10° Multiply ine 4 by ine 8. 11 Subtract line 10 from line 4. 12 Tax-iree traction. Divide line 5 by line 4 (but not more than 1.0). 13 Multiply ine 11 by line 12. This is the amount of tax-free earings. 14 Subtract line 13 from ine 11. This is the taxable amount to the recipient. 15 Basis as of December 31, 2011, Subtract line 10 from line 3,Paul rater 579-84-6507_ Pages Qualified Tuition Program (QTP) Computation of Taxable Distribution For Purposes | For Purposes of of 10% Regular | Additional Tex Tax 1 Enter the total distributions from this QTP during 2011 400 400 2 Enter the amount of adjusted qualified education expenses attributable tothis QTP 400 3. Excess distributions. Subtract line 2 from line 1 4 Total distributed earnings from Form 1089-G box 2 5 Fraction. Divide line 2 by line 1 & Multiply line 4 by line 5 7 Subtract line 6 from line 4, Ths isthe taxable amount to the recipient, o. Distributions Not Subject to Additional 10% Tax 1. Distributions included in income ° 2 Distributions not subject to additonal 10% Tax 2 Paid to beneficiary on or aller the death of the designated beneficiary 'b Made because the designated beneficiary is disabled « Included in income because beneficiary received tax-ree scholarshio dd Made on account of attendance at U.S, miltary academy € Included only because qualified expenses were taken into account in determining ‘American Opportunity or lifetime learning credit { Total, Add lines 2a through 2eForm 1099-Q Payments From Qualified Education Programs 2011 (Under Sections 529 and 530) > Keep for your records Recipients name Social Socutty No. Paul 579-84-650 Designated Beneficiary and Recipient a @ 8 4 6) Someone Not Taxpayer Spouse Dependent —else.-— applicable A Who was the designated beneficiary ofthe dstrbution reported on tis form 1089-07 B Who was the recipent ofthe distibvionvopoted on is form? [] oO oO oO oO oO oO © Ifthe designated beneficiary is a dependent, double-click to link this 1099-Q to the applicable Dependent Student Information Worksheet . D Ifthe designated beneficiary is someone else, double-click to link this 1099-Q to the applicable Qualified Education Expenses Worksheet . PAYER'S/TRUSTEE'S name 1. Gross Distbution ox Up. Stroetaddoss PO Box, 926 Baie AP code 2 Eamings Boston ___MA_ 92205-5578) Telephone no ex PAYERS tederal | RECIPIENT'S 3 Basis 4 Tusteesosrustoe iserteaton number | social seuity number vanstor g8-5000022 _ |57-84-5507 RECIPIENT'S name 5 Check one: © Checkif the rexpent Pau + Quaties ttn isnot the designates Street address (ineluding ap no} program beneficiary 603 Mans way Private iy Sate ZIP code sae x ewego IL 50543] © Coverael ESA Account number 131640615-03 Distribution Code Distribution code, if payer reported code in the box below boxes S and. . >. Qualified Tuition Program It State Qualified Tuition Program, enter state. Distributions Due to Death or Disability 1. Check box if this distribution was due to the disabiliy of the designated beneficiary | 2 Check box if this distriution was due to the death of the designated beneficiary +|ater 578-84-5507_ Page? Rollovers and Transfers 11 Was the distribution rolled over and the following conditions met? * Rolled over within 60 days ofthe distribution + 12months since a previous rollover (to the same beneficiary for a QTP). See Help 2 Yes, entire distribution was rolled over meeting above conditions seed 'b Yes, a portion of distribution was rolled over meeting above conditions. (1) Enter porton rolled over ~ «No, no portion of tne cstrbution was roled over or conaitons above nat met -[—] 2 Amount that was rolled over 3 Itarollover or transfer, checkbox lf the owner ofthe account receiving the rolioveris ‘The original designated beneficiary b A family member ofthe original designated beneficiary... - : Someone who is not a family member of the original designated beneficiary Not applicable Coverdell Education Savings Account (ESA) Return of Contribution It yes, check one: The contribution was made In 2011 and returned in 2011 The contribution was made in 2011 and retuned in 2012 (2012 1089.) The contribution was made in 2010 and retuned in 2011 Amount of return of contribution Was this distribution a return ofa contribution toa Coverdell ESA? Toves we [wa Coverdell Education Savings Account (ESA) Activity Information (a) During 2012 @ ) © As of During As of 12/81/2010 2011 1281/2011 1 Basis 2 Contrbutions a For2010 b Forz011 3 Value 4 Outstanding ralovers Coverdell Education Savings Account (ESA) Computation of Taxable Distribution For Purposes of Regular Tax For Purposes of 10% ‘Additional Tax 1. Enter the amount contributed to this ESA for 2011 2 Enter your basis of this ESA as of December 31, 2010, 3 Add lines 1 and 2. 4 Enier the total aistbutions from this ESA during 2011 : 5 Enter the amount of adjusted qualified education expenses attributable tothis ESA 6 Subtract line 5 trom line 4 7 Enter the value of this ESA as of December 31, 2011 8 Add lines 4 and 7 9 Basis fraction. Divide line 3 by Ine 8 10° Multiply ine 4 by ine 8. 11 Subtract line 10 from line 4. 12 Tax-iree traction. Divide line 5 by line 4 (but not more than 1.0). 13 Multiply ine 11 by line 12. This is the amount of tax-free earings. 14 Subtract line 13 from ine 11. This is the taxable amount to the recipient. 15 Basis as of December 31, 2011, Subtract line 10 from line 3,Paul rater 579-84-6507_ Pages Qualified Tuition Program (QTP) Computation of Taxable Distribution For Purposes | For Purposes of of 10% Regular | Additional Tex Tax 1 Enter the total distributions from this QTP during 2011 1,926 2 Enter the amount of adjusted qualified education expenses attributable tothis QTP 1,926 3. Excess distributions. Subtract line 2 from line 1 0 4 Total distributed earnings from Form 1089-G box 2 408. 5 Fraction. Divide line 2 by line 1 & Multiply line 4 by line 5 7 Subtract line 6 from line 4, Ths isthe taxable amount to the recipient, o. Distributions Not Subject to Additional 10% Tax 1. Distributions included in income ° 2 Distributions not subject to additonal 10% Tax 2 Paid to beneficiary on or aller the death of the designated beneficiary 'b Made because the designated beneficiary is disabled « Included in income because beneficiary received tax-ree scholarshio dd Made on account of attendance at U.S, miltary academy € Included only because qualified expenses were taken into account in determining ‘American Opportunity or lifetime learning credit { Total, Add lines 2a through 2eForm 1099-Q Payments From Qualified Education Programs 2011 (Under Sections 529 and 530) > Keep for your records Recipients name Social Socutty No, Paul 296-562-4906 Designated Beneficiary and Recipient a @ 8 4 6) Someone Not Taxpayer Spouse Dependent —else.-— applicable ‘A Who was the designated beneficiary of the distribution reported on this form 1099-0? B_ Who was the recipient of the distribution reported on this form? oO oO oO oO oO oO oO © Ifthe designated beneficiary is a dependent, double-click to link this 1099-Q to the applicable Dependent Student Information Worksheet . D Ifthe designated beneficiary is someone else, double-click to link this 1099-Q to the applicable Qualified Education Expenses Worksheet . PAYER'S/TRUSTEE'S name 1. Gross Distbution ox Up. Stroetaddoss PO Box, ‘State ZIP code 2 Earnings MA__ 02205 Telephone no. ex PAYER'S federal | RECIPIENT'S 3 Basis 4 Tustee-o-rusteo identification number | soclal seeutty number vanstor 38-6000022 296-62-4906 RECIPIENT'S name 5 Chock one: © Check'f he recipient Paw. + Qualieg tution Is not the designates ‘Street address (including apt no.) program beneficiary 603 Mans. Way Private City State ZIP code State x swego mL 50543) © Coverdell ESA Account number 131640615-03 Distribution Code Distribution code, if payer reported code in the box below boxes S and. . >. Qualified Tuition Program It State Qualified Tuition Program, enter state. Distributions Due to Death or Disability 1. Check box if this distribution was due to the disabiliy of the designated beneficiary | 2 Check box if this distriution was due to the death of the designated beneficiary +|Paw ater 296-62-1808 Page? Rollovers and Transfers 11 Was the distribution rolled over and the following conditions met? * Rolled over within 60 days ofthe distribution + 12months since a previous rollover (to the same beneficiary for a QTP). See Help 2 Yes, entire distribution was rolled over meeting above conditions seed 'b Yes, a portion of distribution was rolled over meeting above conditions. (1) Enter porton rolled over ~ «No, no portion of tne cstrbution was roled over or conaitons above nat met -[—] 2 Amount that was rolled over 3 Itarollover or transfer, checkbox lf the owner ofthe account receiving the rolioveris ‘The original designated beneficiary b A family member ofthe original designated beneficiary... - : Someone who is not a family member of the original designated beneficiary Not applicable Coverdell Education Savings Account (ESA) Return of Contribution Was this distribution a return ofa contribution toa Coverdell ESA? Toves we [wa ityes, check one The contrbuton was made in 2011 and returned in 2011 The contrbon was mace in 2011 andfeturnedin 2012 (2012 1088-0) The contrbton was made in 2010 and turned in 2011 ‘Arwount ot retun of entiation Coverdell Education Savings Account (ESA) Activity Information @ ) © @) As of During As of During 12/81/2010 2011 1281/2011 2012 1 Basis 2 Contrbutions a For2010 b Forz011 3 Value 4 Outstanding ralovers Coverdell Education Savings Account (ESA) Computation of Taxable Distribution For Purposes | For Purposes of of 10% Regular | Addtional Tax Tax 1. Enter the amount contributed to this ESA for 2011 2 Enter your basis of this ESA as of December 31, 2010, 3 Add lines 1 and 2. 4 Enier the total aistbutions from this ESA during 2011 : 5 Enter the amount of adjusted qualified education expenses attributable tothis ESA 6 Subtract line 5 trom line 4 7 Enter the value of this ESA as of December 31, 2011 8 Add lines 4 and 7 9 Basis fraction. Divide line 3 by Ine 8 10° Multiply ine 4 by ine 8. 11 Subtract line 10 from line 4. 12 Tax-iree traction. Divide line 5 by line 4 (but not more than 1.0). 13 Multiply ine 11 by line 12. This is the amount of tax-free earings. 14 Subtract line 13 from ine 11. This is the taxable amount to the recipient. 15 Basis as of December 31, 2011, Subtract line 10 from line 3,Paul rater 296-62-4506 Page Qualified Tuition Program (QTP) Computation of Taxable Distribution For Purposes | For Purposes of of 10% Regular | Additional Tex Tax Enter the total distributions from this QTP during 2011, Enter the amount of adjusted qualified education expenses attributable tothis QTP Excess distributions, Subtract line 2 from line 1 Total distributed earnings from Form 1099-0 box 2 Fraction, Divide line 2 by ine 1 Multiply line 4 by tne 5, ‘Subtract line 6 from line 4, This is the taxable amount tothe recipient. Distributions Not Subject to Additional 10% Tax 1 2 Distributions included in income ° Distributions not subject to additional 10% Tax: 2 Paid to beneficiary on or aller the death of the designated beneficiary 'b Made because the designated beneficiary is disabled « Included in income because beneficiary received tax-ree scholarshio dd Made on account of attendance at U.S, miltary academy € Included only because qualified expenses were taken into account in determining ‘American Opportunity or lifetime learning credit { Total, Add lines 2a through 2eTax Payments Worksheet > Keep for your records 2011 Name(s) Shown on Return Paul A é Amy L Strater 28 62- Social Security Number Estimated Tax Payments for 2011 (If more than 4 payments for any state or locality, see Tax Help) Federal State Local Date Amount Date Amount 0 Date Amount 3|_oo/is/in 09/15/11 a|_or/a7yi2 01/17/12 Tot Estimated Payments ‘Tax Payments Other Than Withholding (if multiple states, see Tax Help) Federal State ID Local ‘Overpayments applied to 2011 Gredited by estates and trusts Totals Lines 1 through 7 2011 extensions ‘Taxes Withheld From: Federal 10 Forms W-2 11 Forms W2G 12 Forms 1099-R 18 Forms 1098-MISC and 1089-6 14 Schedules K-1 : 18 Forms 1098.INT, DIV and O10 16 Social Security and Railroad Benefits 17 Form 1099-8 st Loe 1Ba_Otherwithholding st Loe Other withholding st Loc © Other withholding st Loe Positive Adjustment st Loe © Negative Adjustment . . | st| | Loc 19 Total Withholding Lines 10 through 18e 20 Total Tax Payments for 2011 15,893 1,322 Prior Year Taxes Paid In 2011 (if multiple states or localities, see Tax Help) 1D Local 21 Tax paid with 2010 extensions 22 2010 estimated tax paid after 12/31/10 23 Balance due paid with 2010 return 24 Other (amended returns, installment payments, etc)‘Schedule K-1 Shareholder's Share of Income, Credits, 2011 (Form 11208) Deductions, etc. > Keep for your records Shareholders Name Social Security Number Any L Strater 519-84-650 Information About the Corporation ‘A Corporation's Employer Identification Number 20-5525684 B Corporation's Name The RF Team, 1: Address city State ZIP Code © IRS Center where corporation fled return Information About the Shareholder Shareholderis Taxpayer. .»L—] Spouse Oo _Sharehoker’s Kenting Numer E Sharehokde’s Name yt serater Address 603 Mansfield Way iy Os State ZIP Code 60543 F _Sharehole’s percentage of stock ownership for lax year % AtRisk Status (check one): Alinvestment incorporation is a-isk x Some investinent incorporation net atisk | Fates 1 Amended kt ‘Shareholder's Share of Current Year Income, Deductions, Credits, Other Items. Check Type of Activity Reported on this Schedule K-1 Business Rental Real Estate Other Rental Activities Other (investment club, etc.) 1 Ordinary business income (loss) Check if "materially" participated in the business actwvities 2 Net ental real estate income (loss) 2,938 Check if “materialy” participated in rental real estate activities Check if "actively" participated in rental real estate activites Check if rental of property to a nonpassive activity 3 Other net rental income (loss) Check if rental of property to a nonpassive activity Oo 4 Interest income. Interest income trom U.S, obligations included in box 4 5 a Ordinary dividends 5 b Qualified dividends Interest income trom U.S, obligations included in box 5. 6 Royalties Double-click to link royalties to Schedule E Worksheet .Any l. Strater 5179-84-65! Page 2 Corporation Name: the RP Team, Inc, SSS ‘Shareholder's Share of Current Year Income, Deductions, Other Items (continued) Not shor-term capital gain loss) Net long-term capital gain (loss) 'b Collectibles (28%) gain (loss) © Unrecaptured section 1250 gain Net section 1231 gain (oss) Other income (loss) Code Description Amount 11 Section 179 deduction. 12 Other deductions Code Description Amount 13 Credits & credit recapture Code Description ‘Amount 14 Foreign transactions ‘A Name of country or U.S. possession Code Description "Amount 15. Aernative minimum tax (AMT) items Code Description ‘Amount 16 Items affecting shareholder basis Code Description Amount D___ Distributions 2, 652 17 Other information Code Description ‘AmountCorporation name: L strater 579-84 550 Pages RE Team, Ine. Passive Activity Adjustment to Income or Loss — For Regular Tax Purposes Passive status Passive Activity Income (Loss) Description (a) Gain (Loss) Limited by Form 6198 it Applicable ) ‘Suspended Loss Carryover From Prior Year Enter as Negative ©) Net Income (Loss) Allowed @ Loss ‘Suspended tor Current Year Regular Tax 1 Ordinary income (loss) for Schedule E: Ordinary income (loss) pass through Section 178 expense Section 59(e)(2) expense Unreimbursed expenses Depletion expense Interest expense Total Ordinary income (loss) for Form 1040: Recoveries (bad debt, etc.) Cancellation of debt income Total Total ordinary Income (loss) Add 19, 2c. Commercial revitalization deduction: Commercial revitalization deduction Memo: Net to Sch E, Line 1g less 4a, Short-term capital gain (loss) for Sch D: Nor-portolio capital gain (loss) Installment sale Sale of assets Sale of $ corporation interest Total Long-term capital gain (loss) for Sch D: Non-portolio capital gain (loss) Installment sales Sale of assets Sale of $ corporation interest Total Section 1231 gain (loss) for Form 4797: Section 1231 gain (loss) pass through Installment sales Sale of assets, Total Ordinary gain (loss) for Form 4797: Ordinary gain (loss) pass-through Installment sales Sale of assets Sale of $ corporation interest Total Total Combine lines 8,4a,5e,60,7d 86. 2,938 2,538 2,538 2,538 2,538L strater 579-84 550 Page 4 Corporation name: The Passive Activity Adjustment to Income or Loss — Alternative Minimum Tax Purposes Passive Activity Income (Loss) Description (a) Gain (Loss) Limited by Form 6198 it Applicable ) ‘Suspended Loss Carryover From Prior Year Enter as Negative ©) Net Income (Loss) Allowed @ Loss ‘Suspended tor Current Year Ordinary income (loss) for Schedule E: Ordinary income (loss) pass through Section 178 expense Section 59(e)(2) expense Unreimbursed expenses Depletion expense Interest expense Total Ordinary income (loss) for Form 1040: Recoveries (bad debt, etc.) Cancellation of debt income Total Total ordinary Income (loss) Add 19, 2c. Commercial revitalization deduction: Commercial revitalization deduction Memo: Net to Sch, Line 1g less 4a, Short-term capital gain (loss) for Sch D: Nor-portolio capital gain (loss) Installment sale Sale of assets Sale of $ corporation interest Total Long-term capital gain (loss) for Sch D: Nor-portolio capital gain (loss) Installment sales Sale of assets Sale of $ corporation interest Total Section 1231 gain (loss) for Form 4797: Section 1231 gain (loss) pass through Installment sales Sale of assets, Total Ordinary gain (loss) for Form 4797: Ordinary gain (loss) pass-through Installment sales Sale of assets Sale of $ corporation interest Total Total Combine lines 8,4a,5e,60,7d 86. 238. 2,538 338. 2,538 2,938. 1,244Corporation Name L Strater RE Team, Tn 579-84 6507 Page § Income and Loss Reported on Schedule E, Supplemental Income or Loss Passive Income and Loss Nonpassive Income and Loss # Descriotion © (9) (hy 0 ® Loss K-1 | Income k-1 | LossK-1 | Section 179 | Income K-1 A The RF Team, Inc.| 2,938 2,938‘Schedule K-1 Shareholder's Share of Income, Credits, 2011 (Form 11208) Deductions, etc. > Keep for your records Shaeholder’s Name Social Security Number Paul A Strater 26-62-4906 Information About the Corporation ‘A Corporation's Employer Identification Number 20-5525684 B Corporation's Name The RF Team, 1: Address city State ZIP Code © IRS Center where corporation fled return Information About the Shareholder Sharehotieris Taxpayer spouse. ...+L] vont... +L] _Sharehoker’s Kenting Numer 75-62-4905 E Sharehokde’s Name 1A strater Address 603 Mansfield Way city Oem State ZIP Code 50543 F _Shareholder’s percentage of stock ownership for tax year % AtRisk Status (check one}: Alinvestment in corporation is at-tisk ara ‘Some investment in corporation not at-risk +| Fates 1 Amended kt ‘Shareholder's Share of Current Year Income, Deductions, Credits, Other Items. Check Type of Activity Reported on this Schedule K-1 Business Rental Real Estate Other Rental Activities Other (investment club, etc.) 1 Ordinary business income (loss) 2,832 Check if "materially" participated in the business actwvities 2 Net ental real estate income (loss) Check if “materialy” participated in rental real estate activities Check if "actively" participated in rental real estate activites Check if rental of property to a nonpassive activity 3 Other net rental income (loss) Check if rental of property to a nonpassive activity Oo 4 Interest income. Interest income trom U.S, obligations included in box 4 5 a Ordinary dividends 5 b Qualified dividends Interest income trom U.S, obligations included in box 5. 6 Royalties Double-click to link royalties to Schedule E Worksheet .paul AS: 4905 Page? Corporation Name: The RE Team, Inc, SOO ‘Shareholder's Share of Current Year Income, Deductions, Other Items (continued) Not shor-term capital gain loss) Net long-term capital gain (loss) 'b Collectibles (28%) gain (loss) © Unrecaptured section 1250 gain Net section 1231 gain (oss) Other income (loss) Code Description Amount 11 Section 179 deduction. 12 Other deductions Code Description Amount 13 Credits & credit recapture Code Description ‘Amount 14 Foreign transactions ‘A Name of country or U.S. possession Code Description "Amount 15. Aernative minimum tax (AMT) items Code Description ‘Amount 16 Items affecting shareholder basis Code Description Amount D___ Distributions 2,548 17 Other information Code Description ‘AmountPaul Corporation Name ihe AP Team, In Income and Loss Reported on Schedule E, Supplemental Income or Loss Passive Income and Loss Nonpassive Income and Loss # Descriotion © (9) (hy 0 0 Loss K-1 | Income k-1 | LossK-1 | Section 179 | Income K-1 B__The RF Team, Inc 2,832Form 1040 Student Loan Interest Deduction Worksheet 2011 Line33 > Keep for your records Name(s) Shown on Return Social Secutty Number Paul ater 296-562-4906 Partl Information from Form(s) 1098-E, Student Loan Interest Statement a) ) © (a) Lender's name Borrower | Borrower's social | Student loan (Taxpayer, | security number inerest Spouse) (Box 1) Taxpayer _|296~62-4906 Total student loan interest Partll_ Computation of Student Loan Interest Deduction 1. Enter the total interest you paid in 2011 on qualiied student loans 1 (see Form 1040 instructions). 2 Enler the smaller of line 1 or $2,500. 2 3 Modified AGI 3 Note: I line 3 is $75,000 or more If single, head of household, or qual'ying widow(er) or $150,000 or more if marted fling jointly, stop here, You cannot lake the deduction, 4 Enter: $60,000 i single, head of household, or qualifying widow(er); $120,000 i martied fling jointly. 4 5 Sublract ine 4 from line 3, Ifzer0 or less, enter -0- here and on line 7, skip line 6, and go onto line 8 5 6 Divide line § by $15,000 or $30,000 if married filing joint. Enter the result as a decimal (rounded to at least three places) 6 7 Multiply line 2 by line 6 7 8 Student loan interest deduction, Subtract line 7 from line 2, Enter the result here and on Form 1040, line $3, De net include this amount in figuring any other deduction on your return (such as on Schedule A, C, E, etc.) 8 Modified AGI s the amount trom Form 1040, line 22, increased by any excludable income from Puerto Rico, of of bona fide residents of American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands, and foreign earned incomeshousing exclusion, and decreased by amounts on Form 1040, ines 28 through 32 and any write-in amount next to line 36, not including the. Foreign housing deduction on ine A of the Other Adjustments to Income Smart Worksheet,Education Tuition and Fees Summary 2011 > Keep for your records Name(s) Shown on Return Your Social Securty No, Paul 296-562-4906 Part |- Qualified Education Expense Summary (a) (b) ©) (@) [OF Student's name Qualed Qualed Elected | Elected First Name mi__| Education fo: Creditor | Creditor Last Name Sul] Expenses Deduction | Deduction Social Seourly Number i it Yes No | manual | automatic 3,528. | Amer opp cr - ~Pe]-] | [I Gy 3,528. Lietme cr... »Dx 296-62-4506 37528,| Tuiton Ded. +Lx 5,376. | Total Qualified Expenses Amer Opp Cr - >| Lifetime cr. =| Tulton Ded | =| Total Qualiied Expenses Amer Opp Cr - >| Lifetime cr. =| Tulton Ded | =| Total Qualifed Expenses Total qualified expenses: Amer Opp Cr Lifetime Gr Tuli Dea Part Il - Optimize Education Expenses for the Lowest Tax Automatic 1 Launch OPTIMIZER - Check to launch Automatic Education Exoense Optimizer now Excess Contributions 2010 2011 9a Taxpayer's excess Archer MSA contributions as of 12/31, 9a b Spouse's excess Archer MSA contributions as of 12/81 b| 10.a Taxpayer's excess Coverdell ESA contributions as of 12/81... [10a b Spouse's excess Coverdell ESA contributions as of 12/31 b| ‘Wa Taxpayer's excess HSA contributions as of 12/31 11a] b Spouse's excess HSA contributions as of 12/31 b| Loss and Expense Carryovers 2010 2011 Note: Enter al entties as a positive amount ‘12a Short-term capital loss. 12a] b AMT Short-term capital loss b| 18a Long-term capital loss 134] b AMT Long-term capital loss. b| 14a Net operating loss available to carry forward 14a b AMT Net operating loss availabe to carry forward b| 18a Investment interest expense disallowed 18a b AMT Investment interest expense disallowed b| 16 Nonrecaptured net Section 1231 losses trom: | a | 2011... | 16a b | zo10. b| | 2009. . 4 | 2008. d e | 2007 e t | 2006 tFederal Carryover Worksheet page 2 2011 Paul A @ A strater 296-562-4906 Loss and Expense Carryovers (contd) 2010 2011 17 AMT Nonrecap'd net Sec 1231 losses from: | a | 2011... | 17a b | 2010. b| e | 209. e d | 2008. d e | 2007 e t | 2008. t Credit Carryovers 2010 2011 18 General business credit ree) 19 Mortgage interest credit rom: | a | 2011 194] b | 2010 b| ¢|2008. 00.2.2... |g 4 | 2008 d 20 Credit for prior year minimum tax. 20 21 District of Columbia first-time homebuyer credit. 21 22 Residential energy efficient property credit... 0s. sess se | 22 Other Carryovers 2010 2011 23 Section 179 expense deduction disallowed 2 24 Excess | Taxpayer (Form 2555, line 46) 24a] foreign bb | Taxpayer (Form 2555, line 48) b| housing | Spouse (Form 2555, ine 46) e deduction: | d | Spouse (Form 2855, line 48) d Charitable Contribution Carryovers 25 2010 Caryover ot (Other Property Capital Gain charitable contributions from: (a) 507 (b) 30% (©) 30% (a) 20% a 2010 b 2009 © 2008 4 2007 « e 2006 26 2011 Carryover of Other Property Capital Gain charitable contributions from: (a) 50% (@) 20% (e) 20% (a) 20% a 2011. b 2010 © 2009 4 2008 - e 2007 27 Amount overpaid less eared income credit 2010 State Capi I Loss Carryovers (For users not transferring from the prior year) State | Shortterm | ANTShortterm| Long-term | AMTLongterm | Capital Loss | ANT Capital Loss 1 | CapitatLoss | Capitaltess | CapitatLoss | CapitalLoss | (combined) | (combined) for State for State for State for State for State for StateELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING Taxpayer: Primary SSN: 2. Federal Return Submitted: April 17, 2012 08:17 Federal Return Acceptance Date: Your nically transmi 17/2012 The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return The Intuit Electronic Postmark documents the filing date of your income tax return, and the electronic postmark information should be kept on file with your tax return and other tax-related documentation, There are two important aspects of the Intuit Electronic Postmark: 1. THE INTUIT ELECTRONIC POSTMARK. The electronic postmark shows the date and time Intuit received the federal retum, and is deemed the filing date if the date of the electronic postmark is on or before the date prescribed for filing of the federal individual income tax return. TIMELY FILING: For your federal return to be considered filed on time, your return must be postmarked on or before midnight April 17, 2012. Intuit’s electronic postmark is issued in the Pacific Time (PT) zone. If you are rot filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark time to determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone and you electronically file your return at 9 AM on April 17, 2012, your Intuit electronic postmark will indicate April 17, 2012, 6 AM. If your federal tax retum is rejected, the IRS stil considers it fled on time if the electronic postmark is on or before April 17, 2012, and a corrected retum is submitted and accepted before April 22, 2012. If your return is submitted after April 22, 2012, a new time stamp is issued to reflect that your return was submitted after the IRS deadline and, consequently, is no longer considered to have been filed on time. It you request an automatic six-month extension, your return must be electronically postmarked by midnight October 15, 2012, If your federal tax retutn is rejected, the IRS wil still consider it fled on time if the electronic postmark is on or before October 15, 2012, and the corrected retum is submitted and accepted by October 20, 2012. 2. THE ACCEPTANCE DATE. Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return.Electronic Filing Instructions for your 2011 Illinois Tax Return important: Your taxes are not finished until all required steps are completed. Paul A & Amy L Stra 503 Mansfield way Oswego, TL 60542 Balance 1 | Your Illinois state tax 4 (Form IL-1040) shows a reg} Due/ | you in the amount of $73.00. Your tax refund should be dir Refund | deposited into your account within 7 to 14 days after your return is | accepted. The account information you enter Account Numb | 7232704192 Routing Transit Number: 071923908 L I Where's My | Before you call the Illinois Department of Revenue with ons Refund? | about your refund, give them 7 to 14 days processing time from the | date your return is accepted. If then you have not received your | refund, or the amount is not what you expected, contact the Illinois | Department of Revenue directly at 1-217-782-3236, From outside of | Illinois use 1-800-732-8866. You can also visit the Illinois | Department of Revenue web site at www.ILtax.com. L I No | No signature form is required since you signed your retur Signature i onically Document — | Needed i L I What You | Your Electronic Filing In ions (this form) Need to i copy of fe and federal returns Keep i Forns W-26, and 1099-R i other £ applicable L I 2011 I 8 00 Minois I 8 4,258.00 Tax I 3 Return | Amount to be Refun 8 ‘Summary I L Page 1 of 1febFile Individual Income Tax Return —ortorsca Ilinois Department of Revenue 2011 Form IL-1040 296-62-4806 a rat arie above he The i aa revel 4 | SA | 579-84-6507 Paul A Strater Amy b Strater 603 Mansfield way Oswego TL 60543 © Filing status (see instructions) 1 Single or head of household LX] married fling jointly C1 Marri filing separately C1 widowed D_ Check if same-sex civil union return (see instructions) C] Step 2: 1. Federal adjusted gross income from your U.S. 1040, Line 37; U.S. 1040A, Line 21; or (ite detiars oni) USS. 104082, Line 4 1 100, 928.00 << Federally tax-exempt interest and dividend income from your U.S. 1040 or 1040A, Line 8b; or US, 104082 2 oo . 3 Other addons, Attach Schedule M 3 a 3 4 Total income, Add Lines 1 tough . 4100, 32809 2 Steps: ‘Social Security benefits and certain retirement plan income E case received if included in Line 1. Attach Page 1 of federal return 5 5, 611,00 B Income & ino Income Tax overpaymentincludedin US, 1040,Line 10 1,153.00 3 7 Other subtractions. Attach Schedule M. 7 o 5 Check if Line 7 includes any amount trom Schedule 1299-c. 5 & Add Lines 5, 6, and 7. This is the total of your subtractions, 8 7,764 00 g 9 Ilinois base income, Subtract Line 8 from Line 4 9 33, 164 09 Step 4: 10 a Number of exemptions from your federal return —£ x $2,000 a 8,000.00 © exemptions © lfsomeone can caim you as a dependent, se instustons. — X $2,000 b 0 a © Check if 65 or older: [] You + [] Spouse = — X $1,000 ¢ 00 d Check iflegally blind: Fl You + [Spouse = __ X $1,000 d 00 t Exemption allowance. Add Lines a through d. 10__8, 000.00 Step: 11 Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12 1 85,164.00 niet 12. Nonresidents and part-year residents: Income ‘Check the box that applies to you during 2011 C]Nonesident Cl Part.year resident, and we the linois base income from Schedule NR. Attach Schedule NR12-—__——_—_00 Step 6: 13. Residents: Mulipy Line 11 by 5% (05) tes Nonresidents and part-year residents: Write the tax trom Schedule NR. 3 4,258.00 14 Rocapture of investment tax crits. Attach Schedule 4255. 14 a 15_ Income tax. Add Lines 13 and 14, Cannot be less than zero 15 Tato $ Step 7: 16 Income tax paid to another state while an linc resident. Scanner tach Sonedule CR 16 oo S Non" 17. Property tax and K-12 education expense credit amount from 8 Nom ole Sehedule ICR. Attach Schedule ICR ve & cre 18 Credit amount from Schedule 1299-C. Attach Schedule 1299-C. 18.00 3 19. Add Lines 16, 17, and 18. This i the total of your edits. Cannot o ‘exceed the tax amount on Line 15. 19__ 00 v 20 Tax after nonrefundable credits. Subtract Line 19 from Line 16. 204, 258.00 1040 rant R2119) ID: SWIM ev taza Tw ns Plmton ingues Fale ptnde neater uk mein apes21. Tax after nonrefundable credits trom Page 1, Line 20 2 4,258.00 Step 8: 22 Household employment tax. See instructions. 22 00 other 23 Use tax on internet, mal order, or ther out-of-state purchases from Taxes UT Worksheet or UT Table in the instructions. De natieave blank, 23 2.00 24 Total Tax. Add Lines 21, 22, and 23. 24 4,258.00 Step 8: 25. nois income Tax withheld. Attach W-2 and 1099 forms. 25 4,331.00 Payments 26 Estimated payments trom Forms IL-1040-ES and IL-505+, and including overpayment applied trom 2010 return 26 oo Refundable 27 Pass-through enily tax payments. Attach Schedule K-1-P or K--T, 27 0 Creait 28 Earned Income Credit from Schedule ICR. Attach Schedule ICR. 28 00 29 Total payments and refundable credit, Add Lines 25 through 28 29 4,231.09 Step 10: 30. Overpayment if Line 29s greater than Line 24, subtract Line 24 from Line 29. 30 73.00 Resutt 31 Underpayment. Line 24s greater than Line 29, subtract Line 29 from Line 24 31 oo Step 11:32. Late-payment penalty fr underpayment of estimated tax 32 oo Underpayment _ Sheckif at east two-thirds of your federal gross income is trom farming.) fof EstimatedTex BCheckif you or your spouse are 65 or older and permanently Penalty and tving in a nursing home. a Donations © Check if your income was not received evenly during the year and you annualized your income on Form IL-2210. Attach Form il-2210. 33. Voluntary charitable donations, Attach Schedule G. 33 0 34 Total penalty and donations. Add Lines 22 and 93 4 in Step 12: 35 If youhave an overpayment on Line 30 and this amounts greater than Refund or Line 34, subtract Line 24 fom Line 30, This is your remaining overpayment. 35 73.00 ‘AmountYou 36 Amount from Line 35 you went refunded to you 36 73.00 Owe 37 ( Complete to direct deposit your refund Routing number s[2[2 [>To X] enecking or [savings ne sbbEE oO 38 Subtract Line 26 trom Line 35. This amount wil be applied to your 2012 estimated tax. 38 0.00 39 tyou havo an underpayment on Line 31, add Lines 31 and 34. OF if you have an overpayment on Line 30 and this amounts less than Line 34 subtract Line 20 fom Line 24. This isthe amount you owe. 39 20 Step 13: Under penalties of perjury | state that | have examined tis return, and, tothe best of my knowledge, itis true, correct, and complete Sign and Pl Date Searsiratee Dae Daytime phacennbay — Yoarapouset rane One Self-Prepared Fall prepaer sanae Dae Prepwafephonenanbe Preparers FEN SSN or PTH Third Party CI Check, and complete below, ityou want to allow another person to discuss ths return with the Ilinois Department Designee of Revenue, ny Form 1089-6 Nt yar (January 2012), we wil no longer automata ral 1099-6 forms. Instead, wo ak that you gts information information from our website. Check the box if you stil want us to mail you a paper Form 1098-Gi next year. 1D:aWNenevsaasny rw [tose F121") A tines ccexrnuenr ornevewe — EAA itnors oenantnent oF revenue oor ros SonINGrELDIL e720! GALESBURG IL 61402-1040 oa ap naoo ONO A€ ossuireetteteauny-himitemasies 6 | acy $1040 Gs inciviauar income Tax Retum |2O% 4 [onan sisson |raueon-oorcere est en Fern Tau PON 27, orton Tiere @ Soe separate natactons Yaar tan an aT Taras Your sci secutty number Paul A strater 298-62-4506 any b Strater 519-84~6507 a a ER TTT TTR TPB TOE TIC ese SONG BE G03 Manseield Kay tod on ese ae tomet Bo eT la TVET ES GS ET FO TOTO Fiera Baan Conpai Oswego TL 60543 eet yrs wot y Fang ae aT PRET ae TT es in eg fee Eye Cleneme 7 Osha @ vent efhocaton wh arya pe Se aren Filing Status Bi saried fing ony even ony one had income) ‘he quaieg pron ett ot yur penn ers Ccheckerivore 2. C1 Mani ing separately. Err spouse's SSN above hig ranetor. bo and fa namo ere, ee ‘6a Ed] Yourselt.f someone can claim you as a dependent, do nat check box 6a Exemptions % El Yowse ‘@ Dependents: Torment | _e)ommers | (ze cv reanane Lassen sscalaecrynurer | reoroipta you | Sieg ci Blair H Serater 33 [5a fal W more than tour Goraay So Teeeater 3804 [Daughter a Fee Retone dependents, see 8 Dependent ne instructions and check here »C] o ‘Add umberson [re -d_Total numberof exertions claimed tines above” LS income 7 Wages, salaries, tips, ete tach Form(s) We? 7 $0, 332 fa Taxable interest, Attach Scheckle BH requires a Tax-exempt interest. Do not include on tne 82 ao ach Form(s) gq crcnary aiden. tach Schele B reque Steen Ferme Qualified dividends o» W.26 and 10 Taxable refunds, rel, or fist of state arc local income axes 10 4,153 1000-Riftex 44 Alimony received 11 was withheld. 42 Busines income or fos. Altach Schedule C or C-£Z 12 13 Capital gain toss). attach Schecule D i requied. net required, checkhere C] [a3 Nyeusidnet 44 ter ans orfsses) tach Farm 4787 “4 Sea ons, 158 WRAdstrbutions [15a b Taxable amount [as | [_ soenovek 163 Pensions and annutes b Taxable ameurt 1 2a 17 Rentalreal estate royaties, partnerships, S corporaions, trusts, ee. Attach Schedule [17 2,832. Enclose, utso 4g Farmincome or fos) Attach Schedule F 18 net stach Sry Ag Unemployment compensation 19 please ure 208 Social security berets [208 b Taxable amount 206) Form 1040. 24 Other income. List type and amount 21 22 Combine th amour in te fright cola vies Tush. iss yaureiainceme [aa [100,928 - 23 Educator expenses 23 Adjusted 24 carsin business expenses of resets, paoring aris, and Gross tee-basis government ofl, Attach Form 2108 o 210642 | 2a Income 25 Health savings account deduction. Attach Form 8889. | 25 28 Moving expenses, Aitach Form 3903 28 27 Deductible pat of set-enployment tax Attach Schedule SE. [27 28 Setremployes SEP, SIMPLE, and qualfed plans 28 29, _Selremployed heath insurance deduction 23 30 Penalty on early withdrawal of savings 30 ‘31a Almony paid Recipients SSN > ata, 32 RAdeducton 22 32° Student loan interest deduction 33 5M Tutlon and fees. tach Form 8617 [ae | [| 35. Domestic production activites deduction. Attach Form 8903 [35 36 Add ines 23 though 25 36 37 _Subtract ine 36 from ine 22, This is your adjusted gross income > [ar [700 378 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA _REVGH2aT2TIW Form 1040 (ori)Page Jax ang 38 Aron fom ne (dusted poss Beare) we [100,508 Credits 39a Check { [] You were born before January 2, 1947, 1 Blinc. | Total boxes: if 1 Spouse was bom before January 2, 1947, [] Blind. ) checked ® 39 (Standara |__b tyour spouse itemizes ona separate return or you were @dualstatus alien, check here® — 386(] Beticlon “Z" itemized deductions {rom Schecile A er your standard deduction se let mara) wo| 24,058 Peoplewno [1 Suttict ne 40 tom ine 38 wl 86868 gheckany, | 42 Exemptions. Mutiply $3,700 by the number online 6d ae 14, 800 SELS"398 or | 43. Taxable income. Sabact ne £2 om Ine 41 ne 42s more than Ine 4, ete-0- [32.088 SURES | 44 tox eestor. Cnecktery tome @ L] Form(s 8814 b [] Form 4072 © L] 82 acon [a8 5.361 Sepencent 45 Alternative minimum tax (see instructions). Attach Form 6251 45, instructions. | 4g Add lines 4 and 45. > [46 6, 961 haters | a7 orig tx cet tach Form 116 equed a BBSSang | 48 creatforcntsand dependent cee expenses. tach Ferm 2681 [4B EERE" | de ccucaton cats tom Form 8860 ne 23, a Tas Marie ting | 80. Retiemert savings corrbutons erect Atach Form 8880 [80 Bee” |e atm pe rancionn teat] PieMet | 52 Residential eneray credits. tach Form S695 52, Head of 53° Other credits rom Form: a [] 3800 » [] 8801 ¢ 53 Samah, 54 Add lines 47 through 53. These are your total credits 54 3,429 55 _Subtact no St tom ino 46 ne St is more than tne 4, eter > [as 3,522 Others Sel-employrent tx. atacn Schedule SE 6 T 57 Unreported social security and Medicare tax from Form: a[] 4137» [] 8919 57 axee 58 Additional tax on IRAs, other qualified retirement plans, ete. Attach Form $329 if reauired NO, 58 66: 58a Houtehold employment ove tom Schedule H te Fraime homebuyer red epaymen tach Form 5406 eae’ sb 0 Oihertanes Ener coce tom msiuctons ny 61 _ Add nes $5 tough 60, Ths you ttl a a1 Paymenta 62 Feceralincome tax vite fom Farms W-2 na 008 [62 wis LOMADIS 63251 estate tx poymets nd amour oped er 2010 ,eum 6B seahaes “Béa_Eamed income ered EC) ea guaieg Ty Nowauasi concatpayelecton [ab Sone C,|€8 Addtonal ch tx erect Atach For 2872 « 66 American opportunity credit from Form 8863, line 14 6 953 €7Frovime homebuyer ced tom Frm 5405, ine 10 ar 8 Arount pai wn request fr extesion le os 70 Credo federal ax o ues. tach Form 4138 70 ‘71 Credits rom Form: a []2439 b [] 8839 ¢ [])saot @ [] sas | 71 172_ Aad ines 62.62, 6, and 65 trough 7. Tese ae your total payment w]e] is,368 Refund 73 ine 72s move thanine 6, sustact ine 6 fam Ine 72. This the amour you overpaid [ 73. [ 13.875 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here > [taa 13,975 Deetdepeto PB Routing number 7/192139.0 9. meType: il Chckng C] Suings en 4 Accoun'nimber “7203-977 oralaiel2 sstuctions. 75 Amount of ine 73 you wart applied to your 2012 estimated tax> | 75 | Ll ‘Rrrount 76 Amount you owe SubtactIne 72 Fomine 61 For delle onhow to pay, we ratuctons > | 76 You Owe _77__Estinated tax senate instuctons [7 | I Third Party D2 Yeu want alow another person to discuss tis relu with ie RS (see astuctons? LI Ves ‘Complete below. EJ No Designee Dessres Prone enon iexion nine me nimerP > Sign Under paral of pray, del tal have examined is fun and acconpaning schedules and vatements, and toe bv of my krawlede ad bl Kepscn Pmaesaarain Tone baa ose Yoo ie may ener Epidemiologist fh pal TIT pe pean rane Pa a a a Preparer BPS al Cony imma > SELF PREPARED cat Fania Phan wom Tem ORO