Advanced Scenario 7: Mark and Barbara Matthews Directions Using the t oware complete the tax retur, including Form 1040 and all appropri- ate forms, schedules, or worksheets. Answer the questions following the scenario. Note: When entering Social Security numbers (SSN) or Employer Identification Numbers (EIN), replace the Xs as directed, or with any four digits of your choice Interview Notes Mark and Barbara are married and want to le a joint retum. Mark retired and began receiving retirement income on March 1, 2017 No distribu- tons were received prior to his retirement Mark selected a ont survivor annuity for these payments. The plan cost at annuity start date was $14.500. Mark has already recovered $1,029 of his cost in the plan. The Matthews received a $125 state income tax refund from their 2018 state tax return. The Matthews do not have enough deductions to temize for 2019 and they have never remized deductions. Mark and Barbara stated if they are entidad to a rotund, they want half of it depos ited into their checking account and the other half deposited into their savings account. The checking account number is 123456789 and the savings account number is 987654321. Both accounts are from Adephi Bank and Trust 317-00 COOK Mar Men 310-00-XOOK Barbara Matthews 13514-C Intake/Interview & Quality Review Sheet V served YOUR PHONE Daytime RED ROOSTER ROAD YOUR 2 RETIRED YY ADMIN ASST | | | - - Parti Marital Status and House information Yes Did you got me in 2018 you let you g o XY ON Lewe Year of dhe Page 3 00000000000DD DDDDDOXDXDXDDOXXOOX| Check appropriate box for each question in each section Yes No Unsure Part-Income-Last Year, Did You for Your Spouse) Receive 1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? 1 2. (A) Tip Income? 3. (B) Scholarships? (Forms W-2, 1098-T) 4. (B) Interest Dividends from checking savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV) 5. (B) Refund of state local income taxes? (Form 1099-G) 6. (B) Alimony income or separate maintenance payments? 7. (A) Self-Employment income? (Form 1099-MISC.cash) 8. (A) Cashicheck payments for any work performed not reported on Forms W-2 or 1099? 9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-8.1099-B) 10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2) 11. (A) Retirement income or payments from Pensions. Annuities, and or IRA? (Form 1099-R) 12. (B) Unemployment Compensation? (Form 10996) 13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099) 14. (M) Income (or loss) from Rental Property? 15. (B) Other income? (gambling lottery, prizes, awards. jury duty. Sch K-1, royalties, foreign income, etc.) Specify No Unsure Part IV-Expenses - Last Year, Did You (or Your Spouse) Pay 1. (B) Alimony or separate maintenance payments? yes, do you have the recipient's SSN? Yes No 2. Contributions to a retirement account? IRA (A) 401K (B) Roth IRA (B) Other 3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T) 4. (A) Any of the following? Medical & Dental (including insurance premiums) Mortgage Interest (Form 1098) Taxes (State, Real Estate, Personal Property, Sales) Charitable Contributions 5. (B) Child or dependent care expenses such as daycare? 6. (B) For supplies used as an eligible educator such as a teacher, teacher's aide, counselor, etc.? 7. (A) Expenses related to self-employment income or any other income you received? 8. (B) Student loan interest? (Form 1098-E) Unsure Part V-Life Events - Last Year, Did You for Your Spouse) 1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code w in box 12) 2. (A) Have credit card or mortgage debt cancelled forgiven by a tender or have a home foreclosure? (Forms 1099-C, 1099-A) 3. (A) Adopt a child? 4. (B) Have Eamed Income Credit Child Tax Credit or American Opportunity Credit disallowed in a prior year? If yes, for which tax year? 5. (A) Purchase and install energy efficient home items? (such as windows, furnace, insulation, etc.) 6. (A) Receive the First Time Homebuyers Credit in 2008? 7. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much? 8. (A) File a federal return last year containing a capital loss carryover' on Form 1040 Schedule D? 9. (A) Have health coverage through the Marketplace (Exchange)? [Provide Form 1095-A) 0000000000 00000 OXXOOXXXXXXXXXXXX*** 2 *xxxxxxxx 0000 0000000000000 Catalog Number 2121 www.insgow Form 13614-C Rev. 16-2019) Additional Information and Questions Related to the Preparation of Your Return 1. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service) 2. Presidential Election Campaign Fund (if you check a box, your fax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund X You X Spouse 3. If you are due a refund, would you like a Direct deposit b. To purchase U.S. Savings Bonds c. To split your refund between different accounts X Yes No Yes No X Yes No 4. If you have a balance due, would you like to make a payment directly from your bank account? Yes No 5. Live in an area that was declared a Federal disaster area? Yes x No if yes, where? 6. Did you, or your spouse if filing jointly, receive a letter from the IRS? Yes X No Many free tax preparation sites operate by receiving grant money or other federal financial assistance. The data from the following questions may be used by this site to apply for these grants or to support continued receipt of financial funding. Your answer will be used only for statistical purposes. These questions are optional 7. Would you say you can carry on a conversation in English, both understanding & speaking? X Very well Well Not well Not at all Prefer not to answer 8. Would you say you can read a newspaper or book in English? X Very well OWell Not well Not at all Prefer not to answer 9. Do you or any member of your household have a disability? Yes x No Prefer not to answer 10. Are you or your spouse a Veteran from the U.S. Armed Forces? Yes No Prefer not to answer 11. Your race? American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White X Prefer not to answer 12. Your spouse's race? American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White X Prefer not to answer 13. Your ethnicity Hispanic or Latino Not Hispanic or Latino X Prefer not to answer 14. Your spouse's ethnicity? Hispanic or Latino Not Hispanic or LatinoX Prefer not to answer Additional comments Privacy Act and Paperwork Reduction Act Notice The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for the information why we are asking for it and how it will be used. We must also tell you what could happen we do not receive it and whether your response is voluntary required to obtain a benefit o mandatory Our legal right to ask for information is SUSC 301. We are asking for this information to assists in contacting you relive to your interest and for participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be u sed to others who coordinate activities and starting volunteer return preparation sites or outreach activities. The information may also be used to establish effective control send correspondence and recognize volunteers. Your response is voluntary. However, you do not provide the requested information, the IRS may not be able to use your assistance in these programs. The paperwork Reduction Act requires that the IRS display an OMB control number on a public information requests. The OMB Control Number for study is 1545-14. Also, you have any comments regarding the timestimates associated with sudy or suggestion on making this process simple, please write to the emal Revenue Service Tax Products Coordinating Committee, SEW CAR MP T T SP, 1111 Constitution Ave NW, Washington, DC 20224 Catalog Number 52121 Form 13614.C 10.2014 CORRECTED checked y rop Grosso PAVERS 3.200.00 2019 ESSEX BANK, CUSTODIAN FOR ROTH IRA OF MARK MATTHEWS 300 MARIN STREET YOUR CITY, STATE ZIP Distributions from Pensions, A Retro Pro Sharing Plans A rance Contracts, 0.00 1099-R 2 Tabout rolled Concluded from PAVERSTIN REOPONTS TN Copy B Report this income on your federal tax retur. It form shows federal income tax withheld in box 4.attach this copy to your return 48-100XXXX REPENTS Second MARK MATTHEWS Song) 742 RED ROOSTER rown oud Proposte YOUR CITY, STATE ZIP X This formations bang ed to C per sy Account Number se c ond Date of payment N 1000-R FORM SSA-100-SOCIAL SECURITY BENEFIT STATEMENT 200RTLENEROWNIESTER ZU . T O NORMATION MARK MATTHEWS 317-00-DOCX $17.21400 151721400 BENCING MOTOR Paid by check or direct deposit $13,867.00 Medicare Part premium deducted from your benefits: 31.626.00 Total Additions: $1.721.00 Benefits for 2018 $17.214 742 Red Rooster Your City State ZIP Dat as of June 21.2019. Sub act to change DO NOT RETURN THIS FONTOSSA ONS 2019 TAX REPORTING STATEMENT ABC INVESTMENTS 256 Pima Plaza Your City YS ZIP Mark and Barbara Mathew 742 Red Rooster Road Your CyYS ZIP Account No. 111-222 Recent No 317-00 XOOX Payer's Fed ID Number: 40 200XXX Form 1099-DIV" 2019 Dividends and Distributions 1a Total Ordinary Dividends ....... ... 1b Qualified Dividends... 2a Total Capital Gain Distributions (Indudes 2-20. 2b Capital Gains that represent Unrecaptured 1250 Gain 2c Capital Gains that represent Section 1202 Gain 2d Capital Gains that represent Collectibles (28%) Gain 3 Nondividend Distributions... 4 Federal income Tax Withhaid 5 Section 190A Dividends ..... 6 Investment Expenses... 7 Foreign Tax Paid..... . B Foreign country or US. Possession... 9 Cash Liquidation Distributions ..... 10 Non-Cash Liquidation Distributions.. 11 Exempt Interest Dividends.......... 12 Specified Private Activity Bond Interest Dividends. 13 State.. 14 State Identification No.............. 15 State Tax Withheld ...... . .. .. 220 00 199 00 300.00 0.00 0.00 000 50.00 0.00 0.00 0.00 18.00 0.00 0.00 0.00 0.00 000 . . ...0.00 ... Form 1099-MISC 2019 Miscellaneous Income Copy RoperMNO. 1545-0115) 2 Royalties .. .. . .. ... .. .. .. .. .... .. 4 Federal Income Tax Withheld... B Substitute Payments in Lieu of Dividends or Interest 16 State Tax withheld 17 Stata/ Payer's State No..... 18 State Income ............0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Form 1099-INT 2019 Interest Income Copy Recent OM NO 1545-013) 1 interest Income. 2 Early Withdrawal Penalty 3 Interest on U.S. Savings Bonds and Treas. Obligatie 4 Federal income Tax Withhaid 5 Investment Expenses ...... 6 Foreign Tax Paid 7 Foreign country or US Possession. 8 Tax Exempt interest 9 Specified Private Activity Bond Interest ... 14 Tax Exempt Bond CUSIP No.......... Summary of 2019 Proceeds From Broker and Barter Exchange Transactions Sales Price of Stocks, Bords, etc... Federal Income Tax Withheld...... 0.00 000 6.300.00 0.00 met oss ocho otros prod of your torach actions are continually to the RS Reler to the Form 10998 of our on the RSS Do not registros sin aggregate Page 12 ABC INVESTMENTS 456 Pima Plaza Your C YS ZIP 2019 TAX REPORTING STATEMENT Mark and Barra Mare 742 Red Rooster Road Your CEYS ZIP Account No. 111-222 Recent NO 317,00 XXX Payer's Fed ID Number: 40 200XOOXX FORM 1099-B* 2019 Proceeds from Broker and Barter Exchange Transactions Cay e r OM NO 1545-0715 Short-term transactions for which basis is reported to the IRS Report on Form 8949 with Box A checked andior Schedule D. Part (This latesa Sumut Boxes 18 8 Description, 1d Slock or Other Symbol, CUS.P IRS Form 1000-8 box numbers are shown below in bold type) hainbatetaan to Id Pro Contorn Wherederal come Acquired Sold Lo De TWSwed Idaho Co. Common Stock Sale 02/01/2019 10/01/2019 250.000 TOTALS 489.00) 1.700.00 1.700.00 2.189.00 2.189.00 FORM 1099-B* 2019 Proceeds from Broker and Barter Exchange Transactions CopyR O MS NO. 1545-0715 Long-term transactions for which basis is not reported to the IRS Report on Form 8949 with Box E checked and/or Schedule D. Part II (This late salute Boxes & 8 Description, 1d Stock or Other Symbol, OUSP IRS Form 1095-8 box numbers are shown below in bold type) A n 1000 1d Proceeds 1e Cost of Gan/Loss) to Washe Federal core 14 15 Tax Agud os Solid Loss Draw Tax Wed State Ward lowa Co. Common Stock Sale 0915/1000 03/01/2019 200.000 TOTALS 1.700,00 2.900.00 4.800.00 4.600.00 1,700.00 This is important to information and is being furnished to the Internal Revenue Service. If you are required to featuma reggere penalty er other action may be imposed on you if this income is taxable and the RS mines that has not been reported Page 2 of 2 CORRECTED checked Adelphi Bank and Trust 8020 Yankers Blvd YOUR CITY, STATE ZIP 2019 Interest Income $ 300.00 1009 INT Copy For Recent 34-XOOOOOK 317-00-XXXX MARK MATTHEWS 742 RED ROOSTER YOUR CITY, STATE ZIP Mark and Barbara Matthews 7 Red Rooster Road Your City State 00000 PAY TO THE ORDER OF A Bank and Trust Anton S 00000 111100002511234567891236 21. What is the correct way to report the Matthews' state income tax refund A The state income tax refund is reported on Form 1040, Schedule 1. B. One half of the state income tax refund is reported on Form 1040, Schedule 1. C State income tax refunds are never reported on a federal tax return D. Since the Matthews did not itemize for 2018, the state refund is not reported on their Form 1040 22. The correct amount of taxable interest on Form 1040 is $300. True False 23. What is the net capital gain or loss reported on Form 1040? $_ (Do not enter dollar signs, commas, periods, or decimal points in your answer.) 111 24. What is the taxable portion of Mark's pension from Pine Corporation using the simplified method? A $561 B. $14,500 C. $21.971 D. $22,532 25. None of Mark's Social Security income is taxable. True False 28. The Matthews can split their refund using Form 8888, Allocation of Refund (Including Savings Bond Purchases) True False 27. What is the total federal income tax withholding reported on the Matthews' Form 1040? $ (Do not enter dollar signs, commas, periods, or decimal points in your answer.) Advanced Scenario 7: Mark and Barbara Matthews Directions Using the t oware complete the tax retur, including Form 1040 and all appropri- ate forms, schedules, or worksheets. Answer the questions following the scenario. Note: When entering Social Security numbers (SSN) or Employer Identification Numbers (EIN), replace the Xs as directed, or with any four digits of your choice Interview Notes Mark and Barbara are married and want to le a joint retum. Mark retired and began receiving retirement income on March 1, 2017 No distribu- tons were received prior to his retirement Mark selected a ont survivor annuity for these payments. The plan cost at annuity start date was $14.500. Mark has already recovered $1,029 of his cost in the plan. The Matthews received a $125 state income tax refund from their 2018 state tax return. The Matthews do not have enough deductions to temize for 2019 and they have never remized deductions. Mark and Barbara stated if they are entidad to a rotund, they want half of it depos ited into their checking account and the other half deposited into their savings account. The checking account number is 123456789 and the savings account number is 987654321. Both accounts are from Adephi Bank and Trust 317-00 COOK Mar Men 310-00-XOOK Barbara Matthews 13514-C Intake/Interview & Quality Review Sheet V served YOUR PHONE Daytime RED ROOSTER ROAD YOUR 2 RETIRED YY ADMIN ASST | | | - - Parti Marital Status and House information Yes Did you got me in 2018 you let you g o XY ON Lewe Year of dhe Page 3 00000000000DD DDDDDOXDXDXDDOXXOOX| Check appropriate box for each question in each section Yes No Unsure Part-Income-Last Year, Did You for Your Spouse) Receive 1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? 1 2. (A) Tip Income? 3. (B) Scholarships? (Forms W-2, 1098-T) 4. (B) Interest Dividends from checking savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV) 5. (B) Refund of state local income taxes? (Form 1099-G) 6. (B) Alimony income or separate maintenance payments? 7. (A) Self-Employment income? (Form 1099-MISC.cash) 8. (A) Cashicheck payments for any work performed not reported on Forms W-2 or 1099? 9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-8.1099-B) 10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2) 11. (A) Retirement income or payments from Pensions. Annuities, and or IRA? (Form 1099-R) 12. (B) Unemployment Compensation? (Form 10996) 13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099) 14. (M) Income (or loss) from Rental Property? 15. (B) Other income? (gambling lottery, prizes, awards. jury duty. Sch K-1, royalties, foreign income, etc.) Specify No Unsure Part IV-Expenses - Last Year, Did You (or Your Spouse) Pay 1. (B) Alimony or separate maintenance payments? yes, do you have the recipient's SSN? Yes No 2. Contributions to a retirement account? IRA (A) 401K (B) Roth IRA (B) Other 3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T) 4. (A) Any of the following? Medical & Dental (including insurance premiums) Mortgage Interest (Form 1098) Taxes (State, Real Estate, Personal Property, Sales) Charitable Contributions 5. (B) Child or dependent care expenses such as daycare? 6. (B) For supplies used as an eligible educator such as a teacher, teacher's aide, counselor, etc.? 7. (A) Expenses related to self-employment income or any other income you received? 8. (B) Student loan interest? (Form 1098-E) Unsure Part V-Life Events - Last Year, Did You for Your Spouse) 1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code w in box 12) 2. (A) Have credit card or mortgage debt cancelled forgiven by a tender or have a home foreclosure? (Forms 1099-C, 1099-A) 3. (A) Adopt a child? 4. (B) Have Eamed Income Credit Child Tax Credit or American Opportunity Credit disallowed in a prior year? If yes, for which tax year? 5. (A) Purchase and install energy efficient home items? (such as windows, furnace, insulation, etc.) 6. (A) Receive the First Time Homebuyers Credit in 2008? 7. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much? 8. (A) File a federal return last year containing a capital loss carryover' on Form 1040 Schedule D? 9. (A) Have health coverage through the Marketplace (Exchange)? [Provide Form 1095-A) 0000000000 00000 OXXOOXXXXXXXXXXXX*** 2 *xxxxxxxx 0000 0000000000000 Catalog Number 2121 www.insgow Form 13614-C Rev. 16-2019) Additional Information and Questions Related to the Preparation of Your Return 1. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service) 2. Presidential Election Campaign Fund (if you check a box, your fax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund X You X Spouse 3. If you are due a refund, would you like a Direct deposit b. To purchase U.S. Savings Bonds c. To split your refund between different accounts X Yes No Yes No X Yes No 4. If you have a balance due, would you like to make a payment directly from your bank account? Yes No 5. Live in an area that was declared a Federal disaster area? Yes x No if yes, where? 6. Did you, or your spouse if filing jointly, receive a letter from the IRS? Yes X No Many free tax preparation sites operate by receiving grant money or other federal financial assistance. The data from the following questions may be used by this site to apply for these grants or to support continued receipt of financial funding. Your answer will be used only for statistical purposes. These questions are optional 7. Would you say you can carry on a conversation in English, both understanding & speaking? X Very well Well Not well Not at all Prefer not to answer 8. Would you say you can read a newspaper or book in English? X Very well OWell Not well Not at all Prefer not to answer 9. Do you or any member of your household have a disability? Yes x No Prefer not to answer 10. Are you or your spouse a Veteran from the U.S. Armed Forces? Yes No Prefer not to answer 11. Your race? American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White X Prefer not to answer 12. Your spouse's race? American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White X Prefer not to answer 13. Your ethnicity Hispanic or Latino Not Hispanic or Latino X Prefer not to answer 14. Your spouse's ethnicity? Hispanic or Latino Not Hispanic or LatinoX Prefer not to answer Additional comments Privacy Act and Paperwork Reduction Act Notice The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for the information why we are asking for it and how it will be used. We must also tell you what could happen we do not receive it and whether your response is voluntary required to obtain a benefit o mandatory Our legal right to ask for information is SUSC 301. We are asking for this information to assists in contacting you relive to your interest and for participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be u sed to others who coordinate activities and starting volunteer return preparation sites or outreach activities. The information may also be used to establish effective control send correspondence and recognize volunteers. Your response is voluntary. However, you do not provide the requested information, the IRS may not be able to use your assistance in these programs. The paperwork Reduction Act requires that the IRS display an OMB control number on a public information requests. The OMB Control Number for study is 1545-14. Also, you have any comments regarding the timestimates associated with sudy or suggestion on making this process simple, please write to the emal Revenue Service Tax Products Coordinating Committee, SEW CAR MP T T SP, 1111 Constitution Ave NW, Washington, DC 20224 Catalog Number 52121 Form 13614.C 10.2014 CORRECTED checked y rop Grosso PAVERS 3.200.00 2019 ESSEX BANK, CUSTODIAN FOR ROTH IRA OF MARK MATTHEWS 300 MARIN STREET YOUR CITY, STATE ZIP Distributions from Pensions, A Retro Pro Sharing Plans A rance Contracts, 0.00 1099-R 2 Tabout rolled Concluded from PAVERSTIN REOPONTS TN Copy B Report this income on your federal tax retur. It form shows federal income tax withheld in box 4.attach this copy to your return 48-100XXXX REPENTS Second MARK MATTHEWS Song) 742 RED ROOSTER rown oud Proposte YOUR CITY, STATE ZIP X This formations bang ed to C per sy Account Number se c ond Date of payment N 1000-R FORM SSA-100-SOCIAL SECURITY BENEFIT STATEMENT 200RTLENEROWNIESTER ZU . T O NORMATION MARK MATTHEWS 317-00-DOCX $17.21400 151721400 BENCING MOTOR Paid by check or direct deposit $13,867.00 Medicare Part premium deducted from your benefits: 31.626.00 Total Additions: $1.721.00 Benefits for 2018 $17.214 742 Red Rooster Your City State ZIP Dat as of June 21.2019. Sub act to change DO NOT RETURN THIS FONTOSSA ONS 2019 TAX REPORTING STATEMENT ABC INVESTMENTS 256 Pima Plaza Your City YS ZIP Mark and Barbara Mathew 742 Red Rooster Road Your CyYS ZIP Account No. 111-222 Recent No 317-00 XOOX Payer's Fed ID Number: 40 200XXX Form 1099-DIV" 2019 Dividends and Distributions 1a Total Ordinary Dividends ....... ... 1b Qualified Dividends... 2a Total Capital Gain Distributions (Indudes 2-20. 2b Capital Gains that represent Unrecaptured 1250 Gain 2c Capital Gains that represent Section 1202 Gain 2d Capital Gains that represent Collectibles (28%) Gain 3 Nondividend Distributions... 4 Federal income Tax Withhaid 5 Section 190A Dividends ..... 6 Investment Expenses... 7 Foreign Tax Paid..... . B Foreign country or US. Possession... 9 Cash Liquidation Distributions ..... 10 Non-Cash Liquidation Distributions.. 11 Exempt Interest Dividends.......... 12 Specified Private Activity Bond Interest Dividends. 13 State.. 14 State Identification No.............. 15 State Tax Withheld ...... . .. .. 220 00 199 00 300.00 0.00 0.00 000 50.00 0.00 0.00 0.00 18.00 0.00 0.00 0.00 0.00 000 . . ...0.00 ... Form 1099-MISC 2019 Miscellaneous Income Copy RoperMNO. 1545-0115) 2 Royalties .. .. . .. ... .. .. .. .. .... .. 4 Federal Income Tax Withheld... B Substitute Payments in Lieu of Dividends or Interest 16 State Tax withheld 17 Stata/ Payer's State No..... 18 State Income ............0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Form 1099-INT 2019 Interest Income Copy Recent OM NO 1545-013) 1 interest Income. 2 Early Withdrawal Penalty 3 Interest on U.S. Savings Bonds and Treas. Obligatie 4 Federal income Tax Withhaid 5 Investment Expenses ...... 6 Foreign Tax Paid 7 Foreign country or US Possession. 8 Tax Exempt interest 9 Specified Private Activity Bond Interest ... 14 Tax Exempt Bond CUSIP No.......... Summary of 2019 Proceeds From Broker and Barter Exchange Transactions Sales Price of Stocks, Bords, etc... Federal Income Tax Withheld...... 0.00 000 6.300.00 0.00 met oss ocho otros prod of your torach actions are continually to the RS Reler to the Form 10998 of our on the RSS Do not registros sin aggregate Page 12 ABC INVESTMENTS 456 Pima Plaza Your C YS ZIP 2019 TAX REPORTING STATEMENT Mark and Barra Mare 742 Red Rooster Road Your CEYS ZIP Account No. 111-222 Recent NO 317,00 XXX Payer's Fed ID Number: 40 200XOOXX FORM 1099-B* 2019 Proceeds from Broker and Barter Exchange Transactions Cay e r OM NO 1545-0715 Short-term transactions for which basis is reported to the IRS Report on Form 8949 with Box A checked andior Schedule D. Part (This latesa Sumut Boxes 18 8 Description, 1d Slock or Other Symbol, CUS.P IRS Form 1000-8 box numbers are shown below in bold type) hainbatetaan to Id Pro Contorn Wherederal come Acquired Sold Lo De TWSwed Idaho Co. Common Stock Sale 02/01/2019 10/01/2019 250.000 TOTALS 489.00) 1.700.00 1.700.00 2.189.00 2.189.00 FORM 1099-B* 2019 Proceeds from Broker and Barter Exchange Transactions CopyR O MS NO. 1545-0715 Long-term transactions for which basis is not reported to the IRS Report on Form 8949 with Box E checked and/or Schedule D. Part II (This late salute Boxes & 8 Description, 1d Stock or Other Symbol, OUSP IRS Form 1095-8 box numbers are shown below in bold type) A n 1000 1d Proceeds 1e Cost of Gan/Loss) to Washe Federal core 14 15 Tax Agud os Solid Loss Draw Tax Wed State Ward lowa Co. Common Stock Sale 0915/1000 03/01/2019 200.000 TOTALS 1.700,00 2.900.00 4.800.00 4.600.00 1,700.00 This is important to information and is being furnished to the Internal Revenue Service. If you are required to featuma reggere penalty er other action may be imposed on you if this income is taxable and the RS mines that has not been reported Page 2 of 2 CORRECTED checked Adelphi Bank and Trust 8020 Yankers Blvd YOUR CITY, STATE ZIP 2019 Interest Income $ 300.00 1009 INT Copy For Recent 34-XOOOOOK 317-00-XXXX MARK MATTHEWS 742 RED ROOSTER YOUR CITY, STATE ZIP Mark and Barbara Matthews 7 Red Rooster Road Your City State 00000 PAY TO THE ORDER OF A Bank and Trust Anton S 00000 111100002511234567891236 21. What is the correct way to report the Matthews' state income tax refund A The state income tax refund is reported on Form 1040, Schedule 1. B. One half of the state income tax refund is reported on Form 1040, Schedule 1. C State income tax refunds are never reported on a federal tax return D. Since the Matthews did not itemize for 2018, the state refund is not reported on their Form 1040 22. The correct amount of taxable interest on Form 1040 is $300. True False 23. What is the net capital gain or loss reported on Form 1040? $_ (Do not enter dollar signs, commas, periods, or decimal points in your answer.) 111 24. What is the taxable portion of Mark's pension from Pine Corporation using the simplified method? A $561 B. $14,500 C. $21.971 D. $22,532 25. None of Mark's Social Security income is taxable. True False 28. The Matthews can split their refund using Form 8888, Allocation of Refund (Including Savings Bond Purchases) True False 27. What is the total federal income tax withholding reported on the Matthews' Form 1040? $ (Do not enter dollar signs, commas, periods, or decimal points in your answer.)
