Formsf1040pdfForm_1040_Department_of_the_TreasuryInternal

forms/f1040.pdf

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rm 1040 Department of the Treasury—Internal Revenue Service (99)U.S. Individual Income Tax Return 2014 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space. For the year Jan. 1–Dec. 31, 2014, or other tax year beginning , 2014, ending , 20 See separate instructions. Your first name and initial Last name Your social security number

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

▲ Make sure the SSN(s) above and on line 6c are correct.

Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Foreign country name Foreign province/state/county Foreign postal code

Presidential Election Campaign

Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse

Filing Status

Check only one box.

1 Single

2 Married filing jointly (even if only one had income)

3 Married filing separately. Enter spouse’s SSN above and full name here. ▶

4 Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this

child’s name here. ▶

5 Qualifying widow(er) with dependent child

Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . b Spouse . . . . . . . . . . . . . . . . . . . . . . . .

} c Dependents:

(1) First name Last name

(2) Dependent’s social security number

(3) Dependent’s relationship to you

(4) ✓ if child under age 17 qualifying for child tax credit

(see instructions)

If more than four dependents, see instructions and check here ▶

d Total number of exemptions claimed . . . . . . . . . . . . . . . . .

Boxes checked on 6a and 6b No. of children on 6c who: • lived with you • did not live with you due to divorce or separation (see instructions)

Dependents on 6c not entered above

Add numbers on lines above ▶

Income

Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.

If you did not get a W-2, see instructions.

7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7

8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a

b Tax-exempt interest. Do not include on line 8a . . . 8b

9 a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a

b Qualified dividends . . . . . . . . . . . 9b

10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10

11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11

12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12

13 Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶ 13

14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14

15 a IRA distributions . 15a b Taxable amount . . . 15b

16 a Pensions and annuities 16a b Taxable amount . . . 16b

17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17

18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18

19 Unemployment compensation . . . . . . . . . . . . . . . . . 19

20 a Social security benefits 20a b Taxable amount . . . 20b

21 Other income. List type and amount 21 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income ▶ 22

Adjusted Gross Income

23 Educator expenses . . . . . . . . . . . 23

24 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ 24

25 Health savings account deduction. Attach Form 8889 . 25

26 Moving expenses. Attach Form 3903 . . . . . . 26

27 Deductible part of self-employment tax. Attach Schedule SE . 27

28 Self-employed SEP, SIMPLE, and qualified plans . . 28

29 Self-employed health insurance deduction . . . . 29

30 Penalty on early withdrawal of savings . . . . . . 30

31 a Alimony paid b Recipient’s SSN ▶ 31a

32 IRA deduction . . . . . . . . . . . . . 32

33 Student loan interest deduction . . . . . . . . 33

34 Tuition and fees. Attach Form 8917 . . . . . . . 34

35 Domestic production activities deduction. Attach Form 8903 35

36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . ▶ 37

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2014)

Form 1040 (2014) Page 2

Tax and Credits

38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . 38

39a Check if:

{ You were born before January 2, 1950, Blind. Spouse was born before January 2, 1950, Blind.

} Total boxes checked ▶ 39a

b If your spouse itemizes on a separate return or you were a dual-status alien, check here ▶ 39b Standard Deduction for— • People who check any box on line 39a or 39b or who can be claimed as a dependent, see instructions. • All others: Single or Married filing separately, $6,200 Married filing jointly or Qualifying widow(er), $12,400 Head of household, $9,100

40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . 40

41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41

42 Exemptions. If line 38 is $152,525 or less, multiply $3,950 by the number on line 6d. Otherwise, see instructions 42

43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . 43

44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44

45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . 45

46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . 46

47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . ▶ 47

48 Foreign tax credit. Attach Form 1116 if required . . . . 48

49 Credit for child and dependent care expenses. Attach Form 2441 49

50 Education credits from Form 8863, line 19 . . . . . 50

51 Retirement savings contributions credit. Attach Form 8880 51

52 Child tax credit. Attach Schedule 8812, if required . . . 52

53 Residential energy credits. Attach Form 5695 . . . . 53

54 Other credits from Form: a 3800 b 8801 c 54

55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . 55

56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . ▶ 56

Other Taxes

57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . 57

58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 58

59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . 59

60 a Household employment taxes from Schedule H . . . . . . . . . . . . . . 60a

b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . 60b

61 Health care: individual responsibility (see instructions) Full-year coverage . . . . . 61

62 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 62

63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . ▶ 63

Payments 64 Federal income tax withheld from Forms W-2 and 1099 . . 64 65 2014 estimated tax payments and amount applied from 2013 return 65

If you have a qualifying child, attach Schedule EIC.

66a Earned income credit (EIC) . . . . . . . . . . 66a

b Nontaxable combat pay election 66b

67 Additional child tax credit. Attach Schedule 8812 . . . . . 67

68 American opportunity credit from Form 8863, line 8 . . . 68

69 Net premium tax credit. Attach Form 8962 . . . . . . 69

70 Amount paid with request for extension to file . . . . . 70

71 Excess social security and tier 1 RRTA tax withheld . . . . 71 72 Credit for federal tax on fuels. Attach Form 4136 . . . . 72

73 Credits from Form: a 2439 b Reserved c Reserved d 73

74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . ▶ 74

Refund

Direct deposit? See instructions.

75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 75

76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . ▶ 76a ▶

▶

b Routing number ▶ c Type: Checking Savings

d Account number

77 Amount of line 75 you want applied to your 2015 estimated tax ▶ 77 Amount You Owe

78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions ▶ 78 79 Estimated tax penalty (see instructions) . . . . . . . 79

Third Party Designee

Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No Designee’s name ▶

Phone no. ▶

Personal identification number (PIN) ▶

Sign Here Joint return? See instructions. Keep a copy for your records.

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Your signature Date Your occupation Daytime phone number

Spouse’s signature. If a joint return, both must sign. Date

▲

Spouse’s occupation If the IRS sent you an Identity Protection PIN, enter it here (see inst.)

Paid Preparer Use Only

Print/Type preparer’s name Preparer’s signature Date Check if self-employed

PTIN

Firm’s name ▶

Firm’s address ▶

Firm's EIN ▶

Phone no.

www.irs.gov/form1040 Form 1040 (2014)

Version A, Cycle 11

Internal Use Only

DRAFT AS OF

December 19, 2014

Version A, Cycle 11

Internal Use Only

DRAFT AS OF

December 19, 2014

2014 Form 1040

SE:W:CAR:MP

U.S. Individual Income Tax Return

Form

1040

Department of the Treasury—Internal Revenue Service

(99)

U.S. Individual Income Tax Return

2014

2014. Catalog Number 11320B.

OMB No. 1545-0074

O M B Number 1545-0074. For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.

IRS Use Only—Do not write or staple in this space.

See separate instructions.

▲

Make sure the SSN(s) above and on line 6c are correct.

Presidential Election Campaign

Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund.

Filing Status

Check only one box.

Single

Married filing jointly (even if only one had income)

Married filing separately. Enter spouse’s SSN above and full name here. ▶

Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child’s name here. ▶

Qualifying widow(er) with dependent child

Exemptions

Yourself. If someone can claim you as a dependent, do not check box 6a

Spouse

}

Dependents:

(1) First name Last name

(2) Dependent’s

social security number

(3) Dependent’s relationship to you

(4) ✓ if child under age 17 qualifying for child tax credit

(see instructions)

(4) Check if child under age 17 qualifying for child tax credit (see instructions).

If more than four dependents, see instructions and check here ▶

Total number of exemptions claimed

Boxes checked on 6a and 6b

No. of children on 6c who:

• lived with you

• did not live with you due to divorce or separation

(see instructions)

Dependents on 6c not entered above

Add numbers on lines above ▶

Income

Attach Form(s) W-2 here. Also attach Forms W-2G and

1099-R if tax was withheld.

If you did not

get a W-2,

see instructions.

Wages, salaries, tips, etc. Attach Form(s) W-2

Taxable interest. Attach Schedule B if required

Tax-exempt interest. Do not include on line 8a

Ordinary dividends. Attach Schedule B if required

Qualified dividends

Taxable refunds, credits, or offsets of state and local income taxes

Alimony received

Business income or (loss). Attach Schedule C or C-EZ

Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶

Other gains or (losses). Attach Form 4797

IRA distributions

15a

b Taxable amount

15b

Pensions and annuities

16a

b Taxable amount

16b

Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E

Farm income or (loss). Attach Schedule F

Unemployment compensation

Social security benefits

20a

b Taxable amount

20b

Other income. List type and amount

Combine the amounts in the far right column for lines 7 through 21. This is your total income ▶

Adjusted Gross Income

Educator expenses

Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ

Health savings account deduction. Attach Form 8889

Moving expenses. Attach Form 3903

Deductible part of self-employment tax. Attach Schedule SE

Self-employed SEP, SIMPLE, and qualified plans

Self-employed health insurance deduction

Penalty on early withdrawal of savings

Alimony paid

b Recipient’s SSN ▶

31a

IRA deduction

Student loan interest deduction

Tuition and fees. Attach Form 8917

Domestic production activities deduction. Attach Form 8903

Add lines 23 through 35

Subtract line 36 from line 22. This is your adjusted gross income ▶

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 11320B

Form 1040 (2014)

Page 2

Tax and Credits

Amount from line 37 (adjusted gross income)

Check if:

{

}

Total boxes checked ▶

39a

If your spouse itemizes on a separate return or you were a dual-status alien, check here ▶

Standard Deduction for—

• People who check any box on line 39a or 39b or who can be claimed as a dependent, see instructions.

• All others:

Single or Married filing separately, $6,200

Married filing jointly or Qualifying widow(er), $12,400

Head of household, $9,100

Itemized deductions (from Schedule A) or your standard deduction (see left margin)

Subtract line 40 from line 38

Exemptions. If line 38 is $152,525 or less, multiply $3,950 by the number on line 6d. Otherwise, see instructions

Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0-

Tax (see instructions). Check if any from:

Alternative minimum tax (see instructions). Attach Form 6251

Excess advance premium tax credit repayment. Attach Form 8962

Add lines 44, 45, and 46 ▶

Foreign tax credit. Attach Form 1116 if required

Credit for child and dependent care expenses. Attach Form 2441

Education credits from Form 8863, line 19

Retirement savings contributions credit. Attach Form 8880

Child tax credit. Attach Schedule 8812, if required

Residential energy credits. Attach Form 5695

Other credits from Form:

Add lines 48 through 54. These are your total credits

Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- ▶

Other Taxes

Self-employment tax. Attach Schedule SE

Unreported social security and Medicare tax from Form:

Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required

Household employment taxes from Schedule H

60a

First-time homebuyer credit repayment. Attach Form 5405 if required

60b

Health care: individual responsibility (see instructions)

Taxes from:

enter code(s)

Add lines 56 through 62. This is your total tax ▶

Payments

Federal income tax withheld from Forms W-2 and 1099

2014 estimated tax payments and amount applied from 2013 return

If you have a qualifying child, attach Schedule EIC.

Earned income credit (EIC)

66a

Nontaxable combat pay election

66b

Additional child tax credit. Attach Schedule 8812 .

American opportunity credit from Form 8863, line 8

Net premium tax credit. Attach Form 8962

Amount paid with request for extension to file

Excess social security and tier 1 RRTA tax withheld

Credit for federal tax on fuels. Attach Form 4136

Credits from Form:

Add lines 64, 65, 66a, and 67 through 73. These are your total payments ▶

Refund

Direct deposit? See instructions.

If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid

Amount of line 75 you want refunded to you. If Form 8888 is attached, check here ▶

76a

▶

Routing number

▶ c Type:

Account number

Amount of line 75 you want applied to your 2015 estimated tax ▶

Amount You Owe

Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions ▶

Estimated tax penalty (see instructions)

Third Party Designee

Do you want to allow another person to discuss this return with the IRS (see instructions)?

Designee’sname ▶

Phoneno. ▶

Personal identificationnumber (PIN) ▶

Sign Here

Joint return? See instructions. Keep a copy for your records.

Your signature

Date

Spouse’s signature. If a joint return, both must sign.

Date

▲

If the IRS sent you an Identity Protection PIN, enter it

here (see inst.)

Paid Preparer Use Only

Preparer’s signature

Date

Check if

self-employed

www.irs.gov/form1040

Form 1040 (2014)

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forms/f1040s8.pdf

SCHEDULE 8812 (Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Child Tax Credit ▶ Attach to Form 1040, Form 1040A, or Form 1040NR.

▶ Information about Schedule 8812 and its separate instructions is at

www.irs.gov/schedule8812.

OMB No. 1545-0074

2015 Attachment Sequence No. 47

1040A 1040

8812

◀

1040NR

Name(s) shown on return Your social security number

Part I Filers Who Have Certain Child Dependent(s) with an ITIN (Individual Taxpayer Identification Number)

▲! CAUTION

Complete this part only for each dependent who has an ITIN and for whom you are claiming the child tax credit. If your dependent is not a qualifying child for the credit, you cannot include that dependent in the calculation of this credit.

Answer the following questions for each dependent listed on Form 1040, line 6c; Form 1040A, line 6c; or Form 1040NR, line 7c, who has an ITIN (Individual Taxpayer Identification Number) and that you indicated is a qualifying child for the child tax credit by checking column (4) for that dependent.

A For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

Yes No

B For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

Yes No

C For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

Yes No

D For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

Yes No

Note: If you have more than four dependents identified with an ITIN and listed as a qualifying child for the child tax credit, see separate instructions

and check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Part II Additional Child Tax Credit Filers 1

1040 filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040, line 52).

1040A filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040A, line 35).

1040NR filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040NR, line 49).

} 1 2 Enter the amount from Form 1040, line 52; Form 1040A, line 35; or Form 1040NR, line 49 . . . . . 2 3 Subtract line 2 from line 1. If zero, stop; you cannot take this credit . . . . . . . . . . . . . 3 4a Earned income (see separate instructions) . . . . . . . . . . . 4a

b Nontaxable combat pay (see separate instructions) . . . . . . . . . . . 4b

5 Is the amount on line 4a more than $3,000? No. Leave line 5 blank and enter -0- on line 6. Yes. Subtract $3,000 from the amount on line 4a. Enter the result . . . 5

6 Multiply the amount on line 5 by 15% (.15) and enter the result . . . . . . . . . . . . . . 6 Next. Do you have three or more qualifying children?

No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part III and enter the smaller of line 3 or line 6 on line 13.

Yes. If line 6 is equal to or more than line 3, skip Part III and enter the amount from line 3 on line 13. Otherwise, go to line 7.

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 59761M Schedule 8812 (Form 1040A or 1040) 2015

If you file Form 2555 or 2555-EZ stop here, you cannot claim the additional child tax credit.

If you are required to use the worksheet in Pub. 972, enter the amount from line 8 of the Child Tax Credit Worksheet in the publication. Otherwise:

Schedule 8812 (Form 1040A or 1040) 2015 Page 2 Part III Certain Filers Who Have Three or More Qualifying Children

7 Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2, boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, see separate instructions . . . . . . 7

8 1040 filers: Enter the total of the amounts from Form 1040, lines 27 and 58, plus any taxes that you identified using code “UT” and entered on line 62.

1040A filers: Enter -0-.

1040NR filers: Enter the total of the amounts from Form 1040NR, lines 27 and 56, plus any taxes that you identified using code “UT” and entered on line 60.

} 8 9 Add lines 7 and 8 . . . . . . . . . . . . . . . . . . . 9

10 1040 filers: Enter the total of the amounts from Form 1040, lines 66a and 71.

1040A filers: Enter the total of the amount from Form 1040A, line 42a, plus any excess social security and tier 1 RRTA taxes withheld that you entered to the left of line 46 (see separate instructions).

1040NR filers: Enter the amount from Form 1040NR, line 67.

} 10 11 Subtract line 10 from line 9. If zero or less, enter -0- . . . . . . . . . . . . . . . . . 11 12 Enter the larger of line 6 or line 11 . . . . . . . . . . . . . . . . . . . . . . 12

Next, enter the smaller of line 3 or line 12 on line 13.

Part IV Additional Child Tax Credit 13 This is your additional child tax credit . . . . . . . . . . . . . . . . . . . . . 13

1040A 1040

1040NR ◀

Enter this amount on Form 1040, line 67, Form 1040A, line 43, or Form 1040NR, line 64.

Schedule 8812 (Form 1040A or 1040) 2015

Version A, Cycle 10

INTERNAL USE ONLY

DRAFT AS OF

October 7, 2015

2015 Schedule 8812 (Form 1040A or 1040)

SE:W:CAR:MP

Child Tax Credit

SCHEDULE 8812

(Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Child Tax Credit

▶ Attach to Form 1040, Form 1040A, or Form 1040NR.

▶ Information about Schedule 8812 and its separate instructions is at

www.irs.gov/schedule8812.

OMB No. 1545-0074

2015

2015. Catalog Number 59761M.

Attachment

Sequence No. 47

Attachment Sequence Number 47. For Paperwork Reduction Act Notice, see your tax return instructions.

1040A

1040

8812

◀

1040NR

Part I

Filers Who Have Certain Child Dependent(s) with an ITIN (Individual Taxpayer Identification Number)

▲

CAUTION

Complete this part only for each dependent who has an ITIN and for whom you are claiming the child tax credit.

If your dependent is not a qualifying child for the credit, you cannot include that dependent in the calculation of this credit.

For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

Note: If you have more than four dependents identified with an ITIN and listed as a qualifying child for the child tax credit, see separate instructions

and check here ▶

Part II

Additional Child Tax Credit Filers

1040 filers:

Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040, line 52).

1040A filers:

Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040A, line 35).

1040NR filers:

Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040NR, line 49).

}

Enter the amount from Form 1040, line 52; Form 1040A, line 35; or Form 1040NR, line 49

Subtract line 2 from line 1. If zero, stop; you cannot take this credit

Earned income (see separate instructions)

Nontaxable combat pay (see separate instructions)

Is the amount on line 4a more than $3,000?

Leave line 5 blank and enter -0- on line 6.

Subtract $3,000 from the amount on line 4a. Enter the result

Multiply the amount on line 5 by 15% (.15) and enter the result

Next. Do you have three or more qualifying children?

If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part III and enter the smaller of line 3 or line 6 on line 13.

If line 6 is equal to or more than line 3, skip Part III and enter the amount from line 3 on line 13. Otherwise, go to line 7.

For Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 59761M

Schedule 8812 (Form 1040A or 1040) 2015

If you file Form 2555 or 2555-EZ stop here, you cannot claim the additional child tax credit.

If you are required to use the worksheet in Pub. 972, enter the amount from line 8 of the Child Tax Credit Worksheet in the publication. Otherwise:

Schedule 8812 (Form 1040A or 1040) 2015

Page 2

Part III

Certain Filers Who Have Three or More Qualifying Children

Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2, boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, see separate instructions

1040 filers:

Enter the total of the amounts from Form 1040, lines 27 and 58, plus any taxes that you identified using code “UT” and entered on line 62.

1040A filers:

Enter -0-.

1040NR filers:

Enter the total of the amounts from Form 1040NR, lines 27 and 56, plus any taxes that you identified using code “UT” and entered on line 60.

}

Add lines 7 and 8

1040 filers:

Enter the total of the amounts from Form 1040, lines 66a and 71.

1040A filers:

Enter the total of the amount from Form 1040A, line 42a, plus any excess social security and tier 1 RRTA taxes withheld that you entered to the left of line 46 (see separate instructions).

1040NR filers:

Enter the amount from Form 1040NR, line 67.

}

Subtract line 10 from line 9. If zero or less, enter -0-

Enter the larger of line 6 or line 11

Next, enter the smaller of line 3 or line 12 on line 13.

Part IV

Additional Child Tax Credit

This is your additional child tax credit

1040A

1040

1040NR

◀

Enter this amount on

Form 1040, line 67,

Form 1040A, line 43, or

Form 1040NR, line 64.

Schedule 8812 (Form 1040A or 1040) 2015

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forms/f1040sa.pdf

SCHEDULE A (Form 1040)

Department of the Treasury Internal Revenue Service (99)

Itemized Deductions ▶ Information about Schedule A and its separate instructions is at www.irs.gov/schedulea.

▶ Attach to Form 1040.

OMB No. 1545-0074

2014 Attachment Sequence No. 07

Name(s) shown on Form 1040 Your social security number

Medical and Dental Expenses

Caution. Do not include expenses reimbursed or paid by others. 1 Medical and dental expenses (see instructions) . . . . . 1 2 Enter amount from Form 1040, line 38 2 3 Multiply line 2 by 10% (.10). But if either you or your spouse was

born before January 2, 1950, multiply line 2 by 7.5% (.075) instead 3 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . 4

Taxes You Paid

5 State and local (check only one box): a Income taxes, or b General sales taxes } . . . . . . . . . . . 5

6 Real estate taxes (see instructions) . . . . . . . . . 6 7 Personal property taxes . . . . . . . . . . . . . 7 8 Other taxes. List type and amount ▶

8 9 Add lines 5 through 8 . . . . . . . . . . . . . . . . . . . . . . 9

Interest You Paid

Note. Your mortgage interest deduction may be limited (see instructions).

10 Home mortgage interest and points reported to you on Form 1098 10 11

Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person’s name, identifying no., and address ▶

11 12

Points not reported to you on Form 1098. See instructions for special rules . . . . . . . . . . . . . . . . . 12

13 Mortgage insurance premiums (see instructions) . . . . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Add lines 10 through 14 . . . . . . . . . . . . . . . . . . . . . 15

Gifts to Charity If you made a gift and got a benefit for it, see instructions.

Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . 16

Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $500 . . . 17

18 Carryover from prior year . . . . . . . . . . . . 18 19 Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . . 19

Casualty and Theft Losses 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . . . . . . . 20 Job Expenses and Certain Miscellaneous Deductions

Unreimbursed employee expenses—job travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) ▶ 21

22 Tax preparation fees . . . . . . . . . . . . . 22 23

Other expenses—investment, safe deposit box, etc. List type and amount ▶

23 24 Add lines 21 through 23 . . . . . . . . . . . . 24 25 Enter amount from Form 1040, line 38 25 26 Multiply line 25 by 2% (.02) . . . . . . . . . . . 26 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- . . . . . . 27

Other Miscellaneous Deductions

28 Other—from list in instructions. List type and amount ▶

28 Total Itemized Deductions

Is Form 1040, line 38, over $152,525?

29 No. Your deduction is not limited. Add the amounts in the far right column for lines 4 through 28. Also, enter this amount on Form 1040, line 40. } . .Yes. Your deduction may be limited. See the Itemized Deductions Worksheet in the instructions to figure the amount to enter.

If you elect to itemize deductions even though they are less than your standard deduction, check here . . . . . . . . . . . . . . . . . . . ▶

For Paperwork Reduction Act Notice, see Form 1040 instructions. Cat. No. 17145C Schedule A (Form 1040) 2014

Version A, Cycle 4

IINTERNAL USE ONLY

DRAFT AS OF

December 11, 2014

2014 Form 1040 (Schedule A)

SE:W:CAR:MP

Itemized Deductions

SCHEDULE A (Form 1040)

Department of the Treasury Internal Revenue Service (99)

Itemized Deductions

▶ Information about Schedule A and its separate instructions is at www.irs.gov/schedulea.

▶ Attach to Form 1040.

OMB No. 1545-0074

2014

2014. Catalog Number 17145C.

Attachment

Sequence No. 07

Attachment Sequence Number 07. For Paperwork Reduction Act Notice, see Form 1040 instructions.

Medical and Dental Expenses

Caution. Do not include expenses reimbursed or paid by others.

Medical and dental expenses (see instructions)

Enter amount from Form 1040, line 38

Multiply line 2 by 10% (.10). But if either you or your spouse was born before January 2, 1950, multiply line 2 by 7.5% (.075) instead

Subtract line 3 from line 1. If line 3 is more than line 1, enter -0-

Taxes YouPaid

State and local (check only one box):

}

Real estate taxes (see instructions)

Personal property taxes

Add lines 5 through 8

InterestYou Paid

Note.Your mortgage interest deduction may be limited (see instructions).

Home mortgage interest and points reported to you on Form 1098

Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person’s name, identifying no., and address ▶

Points not reported to you on Form 1098. See instructions for special rules

Mortgage insurance premiums (see instructions)

Investment interest. Attach Form 4952 if required. (See instructions.)

Add lines 10 through 14

Gifts toCharity

If you made agift and got abenefit for it,see instructions.

Gifts by cash or check. If you made any gift of $250 or more, see instructions

Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $500

Carryover from prior year

Add lines 16 through 18

Casualty and Theft Losses

Casualty or theft loss(es). Attach Form 4684. (See instructions.)

Job Expensesand Certain Miscellaneous Deductions

Unreimbursed employee expenses—job travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) ▶

Tax preparation fees

Other expenses—investment, safe deposit box, etc. List type and amount ▶

Add lines 21 through 23

Enter amount from Form 1040, line 38

Multiply line 25 by 2% (.02)

Subtract line 26 from line 24. If line 26 is more than line 24, enter -0-

Other Miscellaneous Deductions

Total Itemized Deductions

Is Form 1040, line 38, over $152,525?

No. Your deduction is not limited. Add the amounts in the far right column

for lines 4 through 28. Also, enter this amount on Form 1040, line 40.

}

Yes. Your deduction may be limited. See the Itemized Deductions

Worksheet in the instructions to figure the amount to enter.

If you elect to itemize deductions even though they are less than your standard deduction, check here ▶

For Paperwork Reduction Act Notice, see Form 1040 instructions.

Cat. No. 17145C

Schedule A (Form 1040) 2014

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forms/f1040sb.pdf

SCHEDULE B (Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Interest and Ordinary Dividends ▶ Attach to Form 1040A or 1040.

▶ Information about Schedule B and its instructions is at www.irs.gov/scheduleb.

OMB No. 1545-0074

2015 Attachment Sequence No. 08

Name(s) shown on return Your social security number

Part I

Interest

(See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note: If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the total interest shown on that form.

List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see instructions on back and list this interest first. Also, show that buyer’s social security number and address ▶

Amount

2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . 2 3

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . 3

Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a . . . . . . . . . . . . . . . . . . . . . . ▶ 4

Note: If line 4 is over $1,500, you must complete Part III. Amount

Part II

Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 9a.)

Note: If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the ordinary dividends shown on that form.

5 List name of payer ▶

Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a . . . . . . . . . . . . . . . . . . . . . . ▶ 6

Note: If line 6 is over $1,500, you must complete Part III.

Part III Foreign Accounts and Trusts (See instructions on back.)

You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Yes No

7a At any time during 2015, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located in a foreign country? See instructions . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing requirements and exceptions to those requirements . . . . . .

b If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located ▶

8 During 2015, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If “Yes,” you may have to file Form 3520. See instructions on back . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2015

Schedule B (Form 1040A or 1040) 2015 Page 2

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

Future Developments For the latest information about developments related to Schedule B (Form 1040A or 1040) and its instructions, such as legislation enacted after they were published, go to www.irs.gov/scheduleb.

Purpose of Form Use Schedule B if any of the following applies.

• You had over $1,500 of taxable interest or ordinary dividends.

• You received interest from a seller-financed mortgage and the buyer used the property as a personal residence.

• You have accrued interest from a bond.

• You are reporting original issue discount (OID) in an amount less than the amount shown on Form 1099-OID.

• You are reducing your interest income on a bond by the amount of amortizable bond premium.

• You are claiming the exclusion of interest from series EE or I U.S. savings bonds issued after 1989.

• You received interest or ordinary dividends as a nominee.

• You had a financial interest in, or signature authority over, a financial account in a foreign country or you received a distribution from, or were a grantor of, or transferor to, a foreign trust. Part III of the schedule has questions about foreign accounts and trusts.

Specific Instructions

TIP You can list more than one payer on each entry space for lines 1 and 5, but be sure to clearly show the amount paid next to the payer's name. Add the separate amounts paid by the payers

listed on an entry space and enter the total in the “Amount” column. If you still need more space, attach separate statements that are the same size as the printed schedule. Use the same format as lines 1 and 5, but show your totals on Schedule B. Be sure to put your name and social security number (SSN) on the statements and attach them at the end of your return.

Part I. Interest Line 1. Report on line 1 all of your taxable interest. Taxable interest generally should be shown on your Forms 1099-INT, Forms 1099-OID, or substitute statements. Include interest from series EE, H, HH, and I U.S. savings bonds. Also include any accrued market discount that is includible in income. List each payer’s name and show the amount. Do not report on this line any tax-exempt interest from box 8 or box 9 of Form 1099-INT. Instead, report the amount from box 8 on line 8b of Form 1040A or 1040. If an amount is shown in box 9 of Form 1099-INT, you generally must report it on line 12 of Form 6251. See the Instructions for Form 6251 for more details. For more information on market discount and other investment income see Pub. 550.

Seller-financed mortgages. If you sold your home or other property and the buyer used the property as a personal residence, list first any interest the buyer paid you on a mortgage or other form of seller financing. Be sure to show the buyer’s name, address, and SSN. You must also let the buyer know your SSN. If you do not show the buyer’s name, address, and SSN, or let the buyer know your SSN, you may have to pay a $50 penalty.

Nominees. If you received a Form 1099-INT that includes interest you received as a nominee (that is, in your name, but the interest actually belongs to someone else), report the total on line 1. Do this even if you later distributed some or all of this income to others. Under your last entry on line 1, put a subtotal of all interest listed on line 1. Below this subtotal, enter "Nominee Distribution" and show the total interest you received as a nominee. Subtract this amount from the subtotal and enter the result on line 2.

TIP If you received interest as a nominee, you must give the actual owner a Form 1099-INT unless the owner is your spouse. You must also file a Form 1096 and a Form 1099-INT with the IRS. For

more details, see the General Instructions for Certain Information Returns and the Instructions for Forms 1099-INT and 1099-OID.

Accrued interest. When you buy bonds between interest payment dates and pay accrued interest to the seller, this interest is taxable to the seller. If you received a Form 1099 for interest as a purchaser of a bond with accrued interest, follow the rules earlier under Nominees to see how to report the accrued interest. But identify the amount to be subtracted as “Accrued Interest.”

Original issue discount (OID). If you are reporting OID in an amount less than the amount shown on Form 1099-OID, follow the rules earlier under Nominees to see how to report the OID. But identify the amount to be subtracted as “OID Adjustment.”

Amortizable bond premium. If you are reducing your interest income on a bond by the amount of amortizable bond premium, follow the rules earlier under Nominees to see how to report the interest. But identify the amount to be subtracted as “ABP Adjustment.”

Line 3. If, during 2015, you cashed series EE or I U.S. savings bonds issued after 1989 and you paid qualified higher education expenses for yourself, your spouse, or your dependents, you may be able to exclude part or all of the interest on those bonds. See Form 8815 for details.

Part II. Ordinary Dividends

TIP You may have to file Form 5471 if, in 2015, you were an officer or director of a foreign corporation. You may also have to file Form 5471 if, in 2015, you owned 10% or more of the total

(a) value of a foreign corporation’s stock, or (b) combined voting power of all classes of a foreign corporation’s stock with voting rights. For details, see Form 5471 and its instructions.

Line 5. Report on line 5 all of your ordinary dividends. This amount should be shown in box 1a of your Forms 1099-DIV or substitute statements. List each payer’s name and show the amount.

Nominees. If you received a Form 1099-DIV that includes ordinary dividends you received as a nominee (that is, in your name, but the ordinary dividends actually belong to someone else), report the total on line 5. Do this even if you later distributed some or all of this income to others. Under your last entry on line 5, put a subtotal of all ordinary dividends listed on line 5. Below this subtotal, enter “Nominee Distribution” and show the total ordinary dividends you received as a nominee. Subtract this amount from the subtotal and enter the result on line 6.

TIP If you received dividends as a nominee, you must give the actual owner a Form 1099-DIV unless the owner is your spouse. You must also file a Form 1096 and a Form 1099-DIV with the IRS. For more

details, see the General Instructions for Certain Information Returns and the Instructions for Form 1099-DIV.

Part III. Foreign Accounts and Trusts

TIP Regardless of whether you are required to file FinCEN Form 114 (FBAR), you may be required to file Form 8938, Statement of Specified Foreign Financial Assets, with your income tax

return. Failure to file Form 8938 may result in penalties and extension of the statute of limitations. See www.irs.gov/form8938 for more information.

Line 7a–Question 1. Check the “Yes” box if at any time during 2015 you had a financial interest in or signature authority over a financial account located in a foreign country. See the definitions that follow. Check the “Yes” box even if you are not required to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).

Financial account. A financial account includes, but is not limited to, a securities, brokerage, savings, demand, checking, deposit, time deposit, or other account maintained with a financial institution (or other person performing the services of a financial institution). A financial account also includes a commodity futures or options account, an insurance policy with a cash value (such as a whole life insurance policy), an annuity policy with a cash value, and shares in a mutual fund or similar pooled fund (that is, a fund that is available to the general public with a regular net asset value determination and regular redemptions).

Financial account located in a foreign country. A financial account is located in a foreign country if the account is physically located outside of the United States. For example, an account maintained with a branch of a United States bank that is physically located outside of the United States is a foreign financial account. An account maintained with a branch of a foreign bank that is physically located in the United States is not a foreign financial account.

Signature authority. Signature authority is the authority of an individual (alone or in conjunction with another individual) to control the disposition of assets held in a foreign financial account by direct communication (whether in writing or otherwise) to the bank or other financial institution that maintains the financial account. See the FinCEN Form 114 instructions for exceptions. Do not consider the exceptions relating to signature authority in answering Question 1 on line 7a.

Other definitions. For definitions of “financial interest,” “United States,” and other relevant terms, see the instructions for FinCEN Form 114.

Line 7a–Question 2. See FinCEN Form 114 and its instructions to determine whether you must file the form. Check the “Yes” box if you are required to file the form; check the “No” box if you are not required to file the form.

If you checked the “Yes” box to Question 2 on line 7a, FinCEN Form 114 must be electronically filed with the Financial Crimes Enforcement Network (FinCEN) at the following website: http://bsaefiling. fincen.treas.gov/main.html. Do not attach FinCEN Form 114 to your tax return. To be considered timely, FinCEN Form 114 must be received by June 30, 2016.

▲! CAUTION

If you are required to file FinCEN Form 114 but do not properly do so, you may have to pay a civil penalty up to $10,000. A person who willfully fails to report an account or provide account

identifying information may be subject to a civil penalty equal to the greater of $100,000 or 50 percent of the balance in the account at the time of the violation. Willful violations may also be subject to criminal penalties.

Line 7b. If you are required to file FinCEN Form 114, enter the name of the foreign country or countries in the space provided on line 7b. Attach a separate statement if you need more space.

Line 8. If you received a distribution from a foreign trust, you must provide additional information. For this purpose, a loan of cash or marketable securities generally is considered to be a distribution. See Form 3520 for details.

If you were the grantor of, or transferor to, a foreign trust that existed during 2015, you may have to file Form 3520.

Do not attach Form 3520 to Form 1040. Instead, file it at the address shown in its instructions.

If you were treated as the owner of a foreign trust under the grantor trust rules, you are also responsible for ensuring that the foreign trust files Form 3520-A. Form 3520-A is due on March 15, 2016, for a calendar year trust. See the instructions for Form 3520-A for more details.

Version A, Cycle 11

INTERNAL USE ONLY DRAFT AS OF September 21, 2015

SCHEDULE B

(Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Interest and Ordinary Dividends

▶ Attach to Form 1040A or 1040.

▶ Information about Schedule B and its instructions is at www.irs.gov/scheduleb.

Attach to Form 1040A or 1040. Information about Schedule B and its instructions is at ww.irs.gov/scheduleb.

OMB No. 1545-0074

2015

2015. Catalog Number 17146N.

Attachment

Sequence No. 08

Attachment Sequence Number 08. For Paperwork Reduction Act Notice, see your tax return instructions.

Part I

Interest

(See instructions on back and the instructions for Form 1040A, or Form 1040,

line 8a.)

Note: If you received a Form 1099-INT, Form 1099-OID, or substitute statement froma brokerage firm, list the firm’s name as thepayer and enter the total interest shown on that form.

Amount

Add the amounts on line 1

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815

Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a ▶

Note: If line 4 is over $1,500, you must complete Part III.

Amount

Part II

Ordinary Dividends

(See instructions on back and theinstructions for Form 1040A, orForm 1040,

line 9a.)

Note: If youreceived a Form1099-DIV orsubstitutestatement froma brokerage firm,list the firm’sname as thepayer and enterthe ordinarydividends shownon that form.

Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a ▶

Note: If line 6 is over $1,500, you must complete Part III.

Part III Foreign Accounts and Trusts (Seeinstructions on back.)

Yes

At any time during 2015, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located in a foreign country? See instructions

If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located ▶

During 2015, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If “Yes,” you may have to file Form 3520. See instructions on back

For Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 17146N

Schedule B (Form 1040A or 1040) 2015

Page 2

General Instructions

Section references are to the Internal Revenue Code unless otherwise noted.

Future Developments

For the latest information about developments related to Schedule B (Form 1040A or 1040) and its instructions, such as legislation enacted after they were published, go to www.irs.gov/scheduleb.

Purpose of Form

Use Schedule B if any of the following applies.

• You had over $1,500 of taxable interest or ordinary dividends.

• You received interest from a seller-financed mortgage and the buyer used the property as a personal residence.

• You have accrued interest from a bond.

• You are reporting original issue discount (OID) in an amount less than the amount shown on Form 1099-OID.

• You are reducing your interest income on a bond by the amount of amortizable bond premium.

• You are claiming the exclusion of interest from series EE or I U.S. savings bonds issued after 1989.

• You received interest or ordinary dividends as a nominee.

Specific Instructions

TIP

You can list more than one payer on each entry space for lines 1 and 5, but be sure to clearly show the amount paid next to the payer's name. Add the separate amounts paid by the payers

Part I. Interest

Line 1. Report on line 1 all of your taxable interest. Taxable interest generally should be shown on your Forms 1099-INT, Forms 1099-OID, or substitute statements. Include interest from series EE, H, HH, and I U.S. savings bonds. Also include any accrued market discount that is includible in income. List each payer’s name and show the amount. Do not report on this line any tax-exempt interest from box 8 or box 9 of Form 1099-INT. Instead, report the amount from box 8 on line 8b of Form 1040A or 1040. If an amount is shown in box 9 of Form 1099-INT, you generally must report it on line 12 of Form 6251. See the Instructions for Form 6251 for more details. For more information on market discount and other investment income see Pub. 550.

TIP

If you received interest as a nominee, you must give the actual owner a Form 1099-INT unless the owner is your spouse. You must also file a Form 1096 and a Form 1099-INT with the IRS. For

more details, see the General Instructions for Certain Information Returns and the Instructions for Forms 1099-INT and 1099-OID.

Part II. Ordinary Dividends

TIP

You may have to file Form 5471 if, in 2015, you were an officer or director of a foreign corporation. You may also have to file Form 5471 if, in 2015, you owned 10% or more of the total

(a) value of a foreign corporation’s stock, or (b) combined voting power of all classes of a foreign corporation’s stock with voting rights. For details, see Form 5471 and its instructions.

Line 5. Report on line 5 all of your ordinary dividends. This amount should be shown in box 1a of your Forms 1099-DIV or substitute statements. List each payer’s name and show the amount.

TIP

If you received dividends as a nominee, you must give the actual owner a Form 1099-DIV unless the owner is your spouse. You must also file a Form 1096 and a Form 1099-DIV with the IRS. For more

details, see the General Instructions for Certain Information Returns and the Instructions for Form 1099-DIV.

Part III. Foreign Accounts and Trusts

TIP

Regardless of whether you are required to file FinCEN Form 114 (FBAR), you may be required to file Form 8938, Statement of Specified Foreign Financial Assets, with your income tax

return. Failure to file Form 8938 may result in penalties and extension of the statute of limitations. See www.irs.gov/form8938 for more information.

Other definitions. For definitions of “financial interest,” “United States,” and other relevant terms, see the instructions for FinCEN Form 114.

If you checked the “Yes” box to Question 2 on line 7a, FinCEN Form 114 must be electronically filed with the Financial Crimes Enforcement Network (FinCEN) at the following website: http://bsaefiling.fincen.treas.gov/main.html. Do not attach FinCEN Form 114 to your tax return. To be considered timely, FinCEN Form 114 must be received by June 30, 2016.

▲

CAUTION

If you are required to file FinCEN Form 114 but do not properly do so, you may have to pay a civil penalty up to $10,000. A person who willfully fails to report an account or provide account

Line 7b. If you are required to file FinCEN Form 114, enter the name of the foreign country or countries in the space provided on line 7b. Attach a separate statement if you need more space.

If you were the grantor of, or transferor to, a foreign trust that existed during 2015, you may have to file Form 3520.

Do not attach Form 3520 to Form 1040. Instead, file it at the address shown in its instructions.

8.2.1.3144.1.471865.466429

Interest and Ordinary Dividends

SE:W:CAR:MP

2015 Form 1040A or 1040 (Schedule B)

en_US

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forms/f4684.pdf

Form 4684 Department of the Treasury Internal Revenue Service

Casualties and Thefts ▶ Information about Form 4684 and its separate instructions is at www.irs.gov/form4684.

▶ Attach to your tax return. ▶ Use a separate Form 4684 for each casualty or theft.

OMB No. 1545-0177

2015 Attachment Sequence No. 26

Name(s) shown on tax return Identifying number

SECTION A—Personal Use Property (Use this section to report casualties and thefts of property not used in a trade or business or for income-producing purposes.)

1 Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged from the same casualty or theft.

Property A

Property B

Property C

Property D Properties

A B C D 2 Cost or other basis of each property . . . . . . 2

3 Insurance or other reimbursement (whether or not you filed a claim) (see instructions) . . . . . . . . 3

Note: If line 2 is more than line 3, skip line 4.

4 Gain from casualty or theft. If line 3 is more than line 2, enter the difference here and skip lines 5 through 9 for that column. See instructions if line 3 includes insurance or other reimbursement you did not claim, or you received payment for your loss in a later tax year . . 4

5 Fair market value before casualty or theft . . . . 5

6 Fair market value after casualty or theft . . . . . 6

7 Subtract line 6 from line 5 . . . . . . . . . 7

8 Enter the smaller of line 2 or line 7 . . . . . . 8

9 Subtract line 3 from line 8. If zero or less, enter -0- . . 9

10 Casualty or theft loss. Add the amounts on line 9 in columns A through D . . . . . . . . . . . . . 10

11 Enter the smaller of line 10 or $100 . . . . . . . . . . . . . . . . . . . . . . . . 11

12 Subtract line 11 from line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Caution: Use only one Form 4684 for lines 13 through 18.

13 Add the amounts on line 12 of all Forms 4684 . . . . . . . . . . . . . . . . . . . . . 13

14 Add the amounts on line 4 of all Forms 4684. . . . . . . . . . . . . . . . . . . . . . 14

15 • If line 14 is more than line 13, enter the difference here and on Schedule D. Do not complete the rest of this section (see instructions).

• If line 14 is less than line 13, enter -0- here and go to line 16.

• If line 14 is equal to line 13, enter -0- here. Do not complete the rest of this section. } . . . . . . . 15

16 If line 14 is less than line 13, enter the difference . . . . . . . . . . . . . . . . . . . . 16

17 Enter 10% of your adjusted gross income from Form 1040, line 38, or Form 1040NR, line 37. Estates and trusts, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

18 Subtract line 17 from line 16. If zero or less, enter -0-. Also enter the result on Schedule A (Form 1040), line 20, or Form 1040NR, Schedule A, line 6. Estates and trusts, enter the result on the “Other deductions” line of your tax return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

For Paperwork Reduction Act Notice, see instructions. Cat. No. 12997O Form 4684 (2015)

Form 4684 (2015) Attachment Sequence No. 26 Page 2 Name(s) shown on tax return. Do not enter name and identifying number if shown on other side. Identifying number

SECTION B—Business and Income-Producing Property Part I Casualty or Theft Gain or Loss (Use a separate Part l for each casualty or theft.)

19 Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged from the same casualty or theft. See instructions if claiming a loss due to a Ponzi-type investment scheme and Section C is not completed. Property A

Property B

Property C

Property D Properties

A B C D 20 Cost or adjusted basis of each property . . . . . 20

21 Insurance or other reimbursement (whether or not you filed a claim). See the instructions for line 3 . . . . 21 Note: If line 20 is more than line 21, skip line 22.

22 Gain from casualty or theft. If line 21 is more than line 20, enter the difference here and on line 29 or line 34, column (c), except as provided in the instructions for line 33. Also, skip lines 23 through 27 for that column. See the instructions for line 4 if line 21 includes insurance or other reimbursement you did not claim, or you received payment for your loss in a later tax year 22

23 Fair market value before casualty or theft . . . . 23

24 Fair market value after casualty or theft . . . . . 24

25 Subtract line 24 from line 23 . . . . . . . . 25

26 Enter the smaller of line 20 or line 25 . . . . . 26

Note: If the property was totally destroyed by casualty or lost from theft, enter on line 26 the amount from line 20.

27 Subtract line 21 from line 26. If zero or less, enter -0- 27 28 Casualty or theft loss. Add the amounts on line 27. Enter the total here and on line 29 or line 34 (see instructions) 28

Part II Summary of Gains and Losses (from separate Parts l) (b) Losses from casualties or thefts

(a) Identify casualty or theft (i) Trade, business,

rental or royalty property

(ii) Income- producing and

employee property

Casualty or Theft of Property Held One Year or Less 29 ( ) ( )

( ) ( )

30 Totals. Add the amounts on line 29 . . . . . . . . . . . . 30 ( ) ( )

31 Combine line 30, columns (b)(i) and (c). Enter the net gain or (loss) here and on Form 4797, line 14. If Form 4797 is not otherwise required, see instructions . . . . . . . . . . . . . . . . . . . . . . . 31

32 Enter the amount from line 30, column (b)(ii) here. Individuals, enter the amount from income-producing property on Schedule A (Form 1040), line 28, or Form 1040NR, Schedule A, line 14, and enter the amount from property used as an employee on Schedule A (Form 1040), line 23, or Form 1040NR, Schedule A, line 9. Estates and trusts, partnerships, and S corporations, see instructions 32

Casualty or Theft of Property Held More Than One Year 33 Casualty or theft gains from Form 4797, line 32 . . . . . . . . . . . . . . . . . . . . . . . . . 33

34 ( ) ( )

( ) ( )

35 Total losses. Add amounts on line 34, columns (b)(i) and (b)(ii) . . . . . 35 ( ) ( )

36 Total gains. Add lines 33 and 34, column (c) . . . . . . . . . . . . . . . . . . . . . . 36

37 Add amounts on line 35, columns (b)(i) and (b)(ii) . . . . . . . . . . . . . . . . . . . . 37

38 If the loss on line 37 is more than the gain on line 36: a

Combine line 35, column (b)(i) and line 36, and enter the net gain or (loss) here. Partnerships (except electing large partnerships) and S corporations, see the note below. All others, enter this amount on Form 4797, line 14. If Form 4797 is not otherwise required, see instructions . . . . . . . . . . . . . . . . . . . . . 38a

Enter the amount from line 35, column (b)(ii) here. Individuals, enter the amount from income-producing property on Schedule A (Form 1040), line 28, or Form 1040NR, Schedule A, line 14, and enter the amount from property used as an employee on Schedule A (Form 1040), line 23, or Form 1040NR, Schedule A, line 9. Estates and trusts, enter on the “Other deductions” line of your tax return. Partnerships (except electing large partnerships) and S corporations, see the note below. Electing large partnerships, enter on Form 1065-B, Part II, line 11 . . . . . . . . . 38b

39 If the loss on line 37 is less than or equal to the gain on line 36, combine lines 36 and 37 and enter here. Partnerships (except electing large partnerships), see the note below. All others, enter this amount on Form 4797, line 3 . . . . 39

Note: Partnerships, enter the amount from line 38a, 38b, or line 39 on Form 1065, Schedule K, line 11. S corporations, enter the amount from line 38a or 38b on Form 1120S, Schedule K, line 10.

Form 4684 (2015)

Form 4684 (2015) Page 3 Name(s) shown on tax return Identifying number

SECTION C—Theft Loss Deduction for Ponzi-Type Investment Scheme Using the Procedures in Revenue Procedure 2009-20 (Complete this section in lieu of Appendix A in Revenue Procedure 2009-20. See instructions.) Part I Computation of Deduction

40 Initial investment . . . . . . . . . . . . . . . . . . . . . 40 41 Subsequent investments (see instructions) . . . . . . . . . . . . . 41

42 Income reported on your tax returns for tax years prior to the discovery year (see instructions) . . . . . . . . . . . . . . . . . . . . . 42

43 Add lines 40, 41, and 42 . . . . . . . . . . . . . . . . . . 43 44 Withdrawals for all years (see instructions) . . . . . . . . . . . . . 44 45 Subtract line 44 from line 43. This is your total qualified investment . . . . . . 45

46 Enter .95 (95%) if you have no potential third-party recovery. Enter .75 (75%) if you have potential third-party recovery . . . . . . . . . . . . . . . 46 .

47 Multiply line 46 by line 45 . . . . . . . . . . . . . . . . . . 47 48 Actual recovery . . . . . . . . . . . . . . . . . . . . . 48 49 Potential insurance/Securities Investor Protection Corporation (SIPC) recovery . . 49 50 Add lines 48 and 49. This is your total recovery . . . . . . . . . . . . 50

Subtract line 50 from line 47. This is your deductible theft loss. Include this amount on line 28 of Section B, Part I. Do not complete lines 19-27 for this loss. Then complete Section B, Part II . . . . . . . . . . . . . . . . . . . . . 51

Part II Required Statements and Declarations (See instructions.)

• I am claiming a theft loss deduction pursuant to Revenue Procedure 2009-20 from a specified fraudulent arrangement conducted by the following individual or entity.

Name of individual or entity

Taxpayer identification number (if known)

Address

• I have written documentation to support the amounts reported in Part I of this Section C.

• I am a qualified investor as defined in section 4.03 of Revenue Procedure 2009-20.

• If I have determined the amount of my theft loss deduction using .95 on line 46 above, I declare that I have not pursued and do not intend to pursue any potential third-party recovery, as that term is defined in section 4.10 of Revenue Procedure 2009-20.

• If I have already filed a return or amended return that does not satisfy the conditions in section 6.02 of Revenue Procedure 2009-20, I agree to all adjustments or actions that are necessary to comply with those conditions. The tax year(s) for which I filed the return(s) or amended return(s) and the date(s) on which they were filed are as follows:

Form 4684 (2015)

• I agree to comply with the conditions and agreements set forth in Revenue Procedure 2009-20 and this Section C.

Version A, Cycle 2

INTERNAL USE ONLY DRAFT AS OF August 26, 2015

2015 Form 4684

SE:W:CAR:MP

Casualties and Thefts

Form 4684

Department of the Treasury Internal Revenue Service

Casualties and Thefts

▶ Information about Form 4684 and its separate instructions is at www.irs.gov/form4684.

See separate instructions. Attach to your tax return. Use a separate Form 4684 for each casualty or theft.

▶ Attach to your tax return.

Attach to your tax return. Use a separate Form 4684 for each casualty or theft.

▶ Use a separate Form 4684 for each casualty or theft.

OMB No. 1545-0177

2015

2015. Catalog Number 12997O.

Attachment

Sequence No. 26

Attachment Sequence Number 26. For Paperwork Reduction Act Notice, see instructions.

SECTION A—Personal Use Property (Use this section to report casualties and thefts of property not used in a trade or business or for income-producing purposes.)

Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged from the same casualty or theft.

Properties

Property A.

Property B.

Property C.

Property D.

Cost or other basis of each property

Insurance or other reimbursement (whether or not you filed a claim) (see instructions)

Note: If line 2 is more than line 3, skip line 4.

Gain from casualty or theft. If line 3 is more than line 2, enter the difference here and skip lines 5 through 9 for that column. See instructions if line 3 includes insurance or other reimbursement you did not claim, or you received payment for your loss in a later tax year

Fair market value before casualty or theft

Fair market value after casualty or theft

Subtract line 6 from line 5

Enter the smaller of line 2 or line 7

Subtract line 3 from line 8. If zero or less, enter -0-

Casualty or theft loss. Add the amounts on line 9 in columns A through D

Enter the smaller of line 10 or $100

Subtract line 11 from line 10

Caution: Use only one Form 4684 for lines 13 through 18.

Add the amounts on line 12 of all Forms 4684

Add the amounts on line 4 of all Forms 4684

• If line 14 is more than line 13, enter the difference here and on Schedule D. Do not

complete the rest of this section (see instructions).

Bullet. If line 14 is more than line 13, enter the difference here and on Schedule D. Do not complete the rest of this section (see instructions).

• If line 14 is less than line 13, enter -0- here and go to line 16.

Bullet. If line 14 is less than line 13, enter zero here and go to line 16.

• If line 14 is equal to line 13, enter -0- here. Do not complete the rest of this section.

Bullet. If line 14 is equal to line 13, enter zero here. Do not complete the rest of this section.

}

If line 14 is less than line 13, enter the difference

Enter 10% of your adjusted gross income from Form 1040, line 38, or Form 1040NR, line 37. Estates and trusts, see instructions

Subtract line 17 from line 16. If zero or less, enter -0-. Also enter the result on Schedule A (Form 1040), line 20, or Form 1040NR, Schedule A, line 6. Estates and trusts, enter the result on the “Other deductions” line of your tax return

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 12997O

Form 4684 (2015)

Attachment Sequence No. 26

Page 2

SECTION B—Business and Income-Producing Property

Part I

Casualty or Theft Gain or Loss (Use a separate Part l for each casualty or theft.)

Description of properties (show type, location, and date acquired for each property). Use a separate line for each property lost or damaged

from the same casualty or theft. See instructions if claiming a loss due to a Ponzi-type investment scheme and Section C is not completed.

Properties

Property A.

Property B.

Property C.

Property D.

Cost or adjusted basis of each property

Insurance or other reimbursement (whether or not you filed a claim). See the instructions for line 3

Note: If line 20 is more than line 21, skip line 22.

Gain from casualty or theft. If line 21 is more than line 20, enter the difference here and on line 29 or line 34, column (c), except as provided in the instructions for line 33. Also, skip lines 23 through 27 for that column. See the instructions for line 4 if line 21 includes insurance or other reimbursement you did not claim, or you received payment for your loss in a later tax year

Fair market value before casualty or theft

Fair market value after casualty or theft

Subtract line 24 from line 23

Enter the smaller of line 20 or line 25

Note: If the property was totally destroyed by casualty or lost from theft, enter on line 26 the amount from line 20.

Subtract line 21 from line 26. If zero or less, enter -0-

Casualty or theft loss. Add the amounts on line 27. Enter the total here and on line 29 or line 34 (see instructions)

Part II

Summary of Gains and Losses (from separate Parts l)

(b) Losses from casualties or thefts

(a) Identify casualty or theft

(i) Trade, business, rental or royalty property

(ii) Income-

producing and employee property

Casualty or Theft of Property Held One Year or Less

(a) Identify casualty or theft.

(b) Losses from casualties or thefts. (1) Trade, business, rental or royalty property. Dollars.

(b) Losses from casualties or thefts. (1) Trade, business, rental or royalty property. Cents.

(b) Losses from casualties or thefts. (2) Income-producing and employee property. Dollars.

(b) Losses from casualties or thefts. (2) Income-producing and employee property. Cents.

Totals. Add the amounts on line 29

Combine line 30, columns (b)(i) and (c). Enter the net gain or (loss) here and on Form 4797, line 14. If Form 4797 is not otherwise required, see instructions

Enter the amount from line 30, column (b)(ii) here. Individuals, enter the amount from income-producing property on Schedule A (Form 1040), line 28, or Form 1040NR, Schedule A, line 14, and enter the amount from property used as an employee on Schedule A (Form 1040), line 23, or Form 1040NR, Schedule A, line 9. Estates and trusts, partnerships, and S corporations, see instructions

Casualty or Theft of Property Held More Than One Year

Casualty or theft gains from Form 4797, line 32

(a) Identify casualty or theft.

(b) Losses from casualties or thefts. (1) Trade, business, rental or royalty property. Dollars.

(b) Losses from casualties or thefts. (1) Trade, business, rental or royalty property. Cents.

(b) Losses from casualties or thefts. (2) Income-producing and employee property. Dollars.

(b) Losses from casualties or thefts. (2) Income-producing and employee property. Cents.

Total losses. Add amounts on line 34, columns (b)(i) and (b)(ii)

Total gains. Add lines 33 and 34, column (c)

Add amounts on line 35, columns (b)(i) and (b)(ii)

If the loss on line 37 is more than the gain on line 36:

38a

38b

If the loss on line 37 is less than or equal to the gain on line 36, combine lines 36 and 37 and enter here. Partnerships (except electing large partnerships), see the note below. All others, enter this amount on Form 4797, line 3

Note: Partnerships, enter the amount from line 38a, 38b, or line 39 on Form 1065, Schedule K, line 11. S corporations, enter the amount from line 38a or 38b on Form 1120S, Schedule K, line 10.

Form 4684 (2015)

Page 3

Part I

Computation of Deduction

Initial investment

Subsequent investments (see instructions)

Income reported on your tax returns for tax years prior to the discovery year

(see instructions)

Add lines 40, 41, and 42

Withdrawals for all years (see instructions)

Subtract line 44 from line 43. This is your total qualified investment

Enter .95 (95%) if you have no potential third-party recovery. Enter .75 (75%) if you have potential third-party recovery

Multiply line 46 by line 45

Actual recovery

Potential insurance/Securities Investor Protection Corporation (SIPC) recovery

Add lines 48 and 49. This is your total recovery

Subtract line 50 from line 47. This is your deductible theft loss. Include this amount on line 28 of Section B, Part I. Do not complete lines 19-27 for this loss. Then complete Section B, Part II

Part II

Required Statements and Declarations (See instructions.)

• I am claiming a theft loss deduction pursuant to Revenue Procedure 2009-20 from a specified fraudulent arrangement conducted by the following individual or entity.

• I have written documentation to support the amounts reported in Part I of this Section C.

Bullet. I have written documentation to support the amounts reported in Part I of this Section C.

• I am a qualified investor as defined in section 4.03 of Revenue Procedure 2009-20.

Bullet. I am a qualified investor as defined in section 4.03 of Revenue Procedure 2009-20.

Bullet. If I have determined the amount of my theft loss deduction using .95 on line 46 above, I declare that I have not pursued and do not intend to pursue any potential third-party recovery, as that term is defined in section 4.10 of Revenue Procedure 2009-20.

Bullet. If I have already filed a return or amended return that does not satisfy the conditions in section 6.02 of Revenue Procedure 2009-20, I agree to all adjustments or actions that are necessary to comply with those conditions. The tax year(s) for which I filed the return(s) or amended return(s) and the date(s) on which they were filed are as follows:

Form 4684 (2015)

• I agree to comply with the conditions and agreements set forth in Revenue Procedure 2009-20 and this Section C.

Bullet. I agree to comply with the conditions and agreements set forth in Revenue Procedure 2009-20 and this Section C.

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ACCT3410 – Fall 2015 Required Tax Return #1

“Here is a little ditty about Jack and Diane”

Directions: Please complete the required federal individual income tax return forms for Jack and Diane Diddie for the 2015 tax year. Ignore the requirement to attach the form(s) W-2 to the front page of the Form 1040. If required information is missing, use reasonable assumptions to fill in the gaps. If a 2015 form is unavailable, you may use the 2014 form but utilize all rules, thresholds, rates, percentages, etc. that are applicable to 2015 (i.e. – you must update the form where needed). You are not required to complete the state individual income tax forms. The completed return must be submitted with a tax correspondence letter to the client addressing the return, major items, etc. All Tax Return(s) are to be done individually by each student. Students may not seek nor provide any assistance to other students in completion of these returns. In addition, students may not receive assistance from outside parties (example – mommy is a tax CPA). You may utilize the book, tax code, internet, divine intervention, but you are not allowed to work with fellow students or outside parties (mom, dad, uncle cpa, etc.). The back page of every document you turn must have the following statement HANDWRITTEN, SIGNED and DATED.

I affirm under penalty of perjury and pursuant to the ETSU Honor Code, I have not received nor given any assistance to another student for this project. In addition, I affirm I have not received any assistance from outside parties or providers. Furthermore, I have not witnessed nor suspected another student of academic misconduct for this project. Last but not least, I have not discussed this project with other students or outside parties AND have not been approached to discuss this project by another student or outside parties. Printed Name: ______________________ Signature: _____________________ Date: ______

Facts: Jack (age 43) and Diane Diddie (age 43) are married and live in Lexington, Kentucky. The Diddies have two children Tito, age 15, and LaToya, age 12. The Diddies would like to file a joint tax return for the year. The following information relates to the Diddies’ tax year:

• Jack’s Social Security number is 987-45-1234 • Diane’s Social Security number is 494-37-4893 • Tito’s Social Security number is 412-32-5690 • LaToya’s Social Security number is 412-32-6940 • The Diddies’ mailing address is 95 Hickory Road, Lexington, Kentucky 40502. • Tito and LaToya are tax dependents for federal tax purposes

Jack Diddie received the following during the year:

Employer Gross Wages Federal Income Tax Withholding

State Income Tax Withholding

National Storage $66,200 $8,000 $3,750 Lexington Little League $2,710 0 0 Diane Diddie received the following during the year:

Employer Gross Wages Federal Income Tax Withholding

State Income Tax Withholding

Jensen Photography $24,500 $2,450 $1,225

ACCT3410 – Fall 2015 Required Tax Return #1

“Here is a little ditty about Jack and Diane”

All applicable and appropriate payroll taxes were withheld by Diddies’ respective employers. The Diddies also received the following during the year:

Interest income from First Kentucky Bank $130 Interest income from City of Lexington, KY Bond $450 Interest income from U.S. Treasury Bond $675 Interest income from Nevada State School Board Bond $150 Workers’ compensation payments to Jack $4,350 Disability payments received by Jack on account of injury $3,500

• National Storage paid 100% of the premiums on the policy and included the premium payments in Jack’s taxable wages

Receipt of payment by Diane as a result of a lawsuit for damages sustained in a car accident: • Medical Expenses $2,500 • Emotional Distress $12,000 • Punitive Damages $10,000

Total $24,500 Eight years ago, Diane purchased an annuity contract for $88,000. She received her first annuity payment on January 1, 2015. The annuity will pay Diane $15,000 per year for ten years (beginning with this year). The $15,000 payment was reported to Diane on Form 1099-R for the current year (box 7 contained an entry of “7” on the form). The Diddies did not own, control or manage any foreign bank accounts nor were they a grantor or beneficiary of a foreign trust during the tax year. The Diddies paid or incurred the following expenses during the year:

Dentist/Orthodontist (unreimbursed by insurance) $10,500 Doctors (unreimbursed by insurance) $ 625 Prescriptions (unreimbursed by insurance) $ 380 KY state tax payment made on 4/15/15 for 2014 liability $ 1,350 Real property taxes on residence $ 1,800 Vehicle registration fee based upon age of vehicle $ 250 Mortgage interest on principal residence $ 8,560 Interest paid on borrowed money to purchase the City of

Lexington, KY municipal bonds $ 400 Interest paid on borrowed money to purchase

U.S. Treasury bonds $ 240 Contribution to the Red Cross $ 1,000 Contribution to Senator Rick Hartley’s Re-election Campaign $ 2,500 Contribution to First Baptist Church of Kentucky $ 6,000 Fee paid to Jones & Company, CPAs for tax preparation $ 200

In addition, Jack drove 6,750 miles commuting to work and Diane drove 8,230 miles commuting to work. The Diddies have represented to you that they maintained careful logs to support their respective mileage. The Diddies drove 465 miles in total to receive medical treatment at a hospital in April.

ACCT3410 – Fall 2015 Required Tax Return #1

“Here is a little ditty about Jack and Diane”

During the year, the Diddies’ personal residence was burglarized on October 1. The theft occurred during the day while the Diddies were at work and their children were at school. The Diddies had the following personal property stolen:

Item Purchase Date Fair Value on Date of Theft

Tax Basis of Item Insurance Reimbursement

Laptop computer and Printer

09/01/2015 3,000 3,000 500

Rifle 03/01/2013 2,000 2,500 500 TV/Projector 03/01/2013 5,000 13,000 1,000

2006 Honda Pilot 07/01/2014 4,000 6,500 500 Total 14,000 25,000 2,500

The Diddies want to contribute to the Presidential Election Campaign. The Diddies would like to receive a refund (if any) of any tax they may have overpaid for the year. Their preferred method of receiving the refund is by check.

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forms/f1040.pdf

forms/f1040s8.pdf

forms/f1040sa.pdf

forms/f1040sb.pdf

forms/f4684.pdf

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