2B. David Fleming is a single taxpayer living at 169 Trendie Street, Apartment 6B, La Jolla, CA 92037. His Social Security number is 865-68-9635 and his birthdate is September 18, 1976. David was employed as a delivery person for a local pizza restaurant. David's W-2 showed the following: Employee's social security numbe b Employer identification number (EIN) 23-4567321 Employer's name, adds, and ZIP code Calfomia Pizza Cafe 231 Foodie Street La Jolla, CA 92037 865-68-9635 OMB No. 1546 0008 Safe, accurate FAST! Use e-file Wages per competion 23,750.00 3 Social security 23,750.00 5 Medicare wages and 23,750.00 7 Social security 9 Vat the IRS web www.i.gov 2 Fadwal income tax withheld 1,250.00 4 Socially lax withheld 1472.50 6 Medicare tax withheld 344.38 8 Allocated 10 Dependent care benefits Cumber Employee's first name and inta Last name Sut. 11 Nongplan 12 See instructions for box 12 David Fleming 169 Trendie Street, Apt 6B 13 y 13b La Jolla, CA 92037 Employee's address and 2P code 16 Sa CA Employer's state number D4567221 14 Other 12c 120 16 State wages, tipe, etc 17 State income tax 23,750.00 375.00 18 Local wages, tips, etc 19 Local Income tax 20 Locally Form W-2 Wage and Tax Statement Copy B-To Be Filled With Employee's FEDERAL Tax Return This information is being fumished to the Internal Revenue Service 2021 Department of the Treasury-Internal Revenue Service David's only other source of income during the year was a prize he won appearing on a game show. The game show sent David home with a Form 1099-MISC: PAYER'S name sreet address, city or town, state or province, country, P or foreign postal code, and telephone no. Price is Accurate Studios, Inc. Studio 44 Studio City, CA 91604 PAYERS TIN 1 Rents CORRECTED of checked OMB No. 1545-0115 $ Miscellaneous 2 Royales $ 3Other income $ 10,000.00 Fishing boat proceeds 2021 Farm 1099-MISC 4 Federal income tax withheld $ 2,400.00 Income Copy B For Recipient 21-8675309 RECIPIENTS TIN 865-68-9635 $ RECIPIENT'S name David Fleming Street address including apt no) 169 Trendie Street, #6B 7 Payer made direct sales of $5,000 or more of consumer products to a buye Crop Insurance proceeds Subate payment in leu of dividends or 10 Gross proceeds paid to an affor $ City or town, state or province, country, and ZP or foreign postal code 11 Fish purchased for resale 12 Section 400Adela La Jolla, CA 92037 $ FATCA ing requirement Account number (see instructional Form 1099-MISC koop for your records) $ 13 Excess golden parachute payments $ 15 State lax withheld $ 200.00 www.irs.gov/Form1000MISC 14 Nonguaifed deferred compensation $ This is important tax Information and is being furnished to the IRS. If you are required to file a retum, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that t has not been reported. 16 State/Payer's stale no 17 State income Department of the Treasury-Internal Revenue Service cash payment of $500 to a charity after winning big at the game show and a $1,400 He has no other adjustments to income or deductible expenses except for a single EIP received in 2021. Unfortunately, David's employer did not provide health care to its employees but David signed up for coverage through his state's health care The exchange sent him a Form 1095-A as shown on Page 7-65. exchange. Required: Complete David's federal tax return for 2021. Use Form 1040, Schedule 1, Schedule 2, and Form 8962. Make realistic assumptions about any missing data