Alfred E Old and Beulah A Crane, each age 42, married on September 7, 2014 Alfred and Beulah will file a joint return for 2016 Alfred's Social Security number is 111 11 1112 Beulah's Social Security number is 123 45 6789, and she adopted Old as her married name They live at 211 Brickstone Drive, Atlanta, GA 30304 Alfred was divorced from Sarah Old in March 2014 Under the divorce agreement, Alfred is to pay Sarah $1,250 per month for the next 10 years or until Sarah's death, whichever occurs first Alfred pays Sarah $15,000 in 2016 In addition, in January 2016, Alfred pays Sarah $50,000, which is designated as being for her share of the marital property Also, Alfred is responsible for all prior years' income taxes Sarah's Social Security number is 123 45 6788 Alfred's salary for 2016 is $150,000, and his employer, Cherry, Inc (Federal I D No 98 7654321), provides him with group term life insurance equal to twice his annual salary His employer withheld $24,900 for Federal income taxes and $8,000 for state income taxes The proper amounts were withheld for FICA taxes Beulah recently graduated from law school and is employed by Legal Aid Society, Inc (Federal I D No 11 1111111), as a public defender She receives a salary of $40,000 in 2016 Her employer withheld $7,500 for Federal income taxes and $2,400 for state income taxes The proper amounts were withheld for FICA taxes Beulah has $2,500 in qualified dividends on Yellow Corporation stock she inherited Alfred and Beulah receive a $1,900 refund on their 2015 state income taxes They itemized deductions on their 2015 Federal income tax return (total of $15,000) Alfred and Beulah pay $4,500 interest and $1,450 property taxes on their personal residence in 2016 Their charitable contributions total $2,400 (all to their church) They paid sales taxes of $1,400, for which they maintain the receipts Both spouses had health insurance for all months of 2016 and do not want to contribute to the Presidential Election Campaign Required Compute the Olds' net tax payable (or refund due) for 2016 Use Form 1040 and Schedule A, Schedule B and the Qualified Dividends and Capital Gain Tax Worksheet to complete this tax return It may be necessary to complete the tax schedules before completing Form 1040 Enter all amounts as positive numbers If an amount box does not require an entry or the answer is zero, enter 0 Make realistic assumptions about any missing data When computing the tax liability, do not round your immediate calculations If required round your final answers to the nearest dollar Use the 2016 Tax Rate Schedule provided Do not use the Tax Tables Complete Form 1040 for the Olds Form 1040 Department of the TreasuryInternal Revenue Service (99) U S Individual Income Tax Return 2016 OMB No 1545 0074 IRS Use OnlyDo not write or staple in this space For the year Jan 1Dec 31, 2016, or other tax year beginning ,2016, ending ,20 See separate instructions Your first name and initial ALFRED E Last name OLD Your social security number 111 11 1112 If a joint return, spouse's first name and initial BEULAH A Last name OLD Spouse's social security number 123 45 6789 Home address (number and street) If you have a P O box, see instructions 211 BRICKSTONE DRIVE Apt no Make sure the SSN(s) above and on line 6c are correct City, town or post office, state, and ZIP code If you have a foreign address, also complete spaces below (see instructions) ATLANTA, GA 30304 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 Foreign country name Foreign province state country Foreign postal code Filing status Exemptions 6a Yourself If someone can claim you as a dependent, do not check box 6a 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 b Spouse If more than four dependents, see instructions and check here c Dependents (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) (1) First name Last name d Total number of exemptions claimed 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 9a 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 15a IRA distributions 15a b Taxable amount 15b 16a 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 20a 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 31a Alimony paid b Recipient's SSN 123 45 6788 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 KIA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions Form 1040 (2016) Form 1040 (2016) ALFRED E OLD 111 11 1112 Page 2 Tax and Credits 38 Amount from line 37 (adjusted gross income) 38 39a Check if You were born before January 2, 1951, Blind Spouse was born before January 2, 1951, Blind Total boxes checked 39a 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, $6,300 Married filing jointly or Qualifying widow(er), $12,600 Head of household, $9,250 b If your spouse itemizes on a separate return or you were a dual status alien, check here 39b 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 $154,950 or less, multiply $4,050 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 credit 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 60a 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 If you have a qualifying child, attach Schedule EIC 65 2016 estimated tax payments and amount applied from 2015 return 65 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 8885 d 73 74 Add lines 64, 65, 66a, and 67 through 73 These are your total payments 74 Refund 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 Direct deposit See instructions b Routing number X X X X X X X X X c Type Checking Savings d Account number X X X X X X X X X X X X X X X X 77 Amount of line 75 you want applied to your 2017 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 EXECUTIVE Daytime phone number Spouse's signature If a joint return, both must sign Date Spouse's occupation ATTORNEY 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 EIN Firm's address Phone no KIA www irs gov form1040 Form 1040 (2016) 2016 Tax Rate Schedules Single Schedule X If taxable income is of the amount over Head of household Schedule Z If taxable income is amount over The tax is over 13250 50,400 130,150 210,800 413,350 441,000 0 $ 9,275 10 9,275 37,650 $ 1,325 00 15 6,897 50 25 26,835 00 28 49,417 0033 116,258 50 35 125,936 0039 6 13,250 50,400 130,150 210,800 413,350 441,000 37,650 $ 927 50 15 5,183 75 25 18,558 75 28 46,278 75 33 119,934 75 35 9,275 37,650 91,150 190,150 413,350 120,529 75 39 6 415,050 50,400 130,150 210,800 190,150 190,150 413,350 415,050 Married filing separately Schedule Y 2 Married filing jointly or Qualifying widow(er) Schedule Y 1 If taxable income is If taxable income is amount amount over The tax is The tax is over over $9,275 37,650 75,950 115,725 206,675 233475 0 18,550 10 $ $1,855 00 15 10,367 50 25 29,51 7 50 28 51,791 50 33 111,818 50 35 130,578 50 39 6 9,275 37,650 75,950 115,725 206,675 233,475 18,550 75,300 18,550 75,300 151,900 231450 413,350 466,950 75,300 151,900 $ 927 50 15 5,183 75 25 14,758 75 28 25,895 7533 55,909 25 35 9,275 37,650 75,950 115,725 206,675 65,289 2539 6 233,475 413350 466,950 466,950

The Answer is in the image, click to view ...

Answered step by step

Verified Expert Solution

Link Copied!

Question

1 Approved Answer

Posted on Jul 30, 2024

Alfred E. Old and Beulah A. Crane, each age 42, married on September 7, 2014. Alfred and Beulah will file a joint return for 2016.

Alfred E. Old and Beulah A. Crane, each age 42, married on September 7, 2014. Alfred and Beulah will file a joint return for 2016. Alfred's Social Security number is 111-11-1112. Beulah's Social Security number is 123-45-6789, and she adopted "Old" as her married name. They live at 211 Brickstone Drive, Atlanta, GA 30304.

Alfred was divorced from Sarah Old in March 2014. Under the divorce agreement, Alfred is to pay Sarah $1,250 per month for the next 10 years or until Sarah's death, whichever occurs first. Alfred pays Sarah $15,000 in 2016. In addition, in January 2016, Alfred pays Sarah $50,000, which is designated as being for her share of the marital property. Also, Alfred is responsible for all prior years' income taxes. Sarah's Social Security number is 123-45-6788.

Alfred's salary for 2016 is $150,000, and his employer, Cherry, Inc. (Federal I.D. No. 98-7654321), provides him with group term life insurance equal to twice his annual salary. His employer withheld $24,900 for Federal income taxes and $8,000 for state income taxes. The proper amounts were withheld for FICA taxes.

Beulah recently graduated from law school and is employed by Legal Aid Society, Inc. (Federal I.D. No. 11-1111111), as a public defender. She receives a salary of $40,000 in 2016. Her employer withheld $7,500 for Federal income taxes and $2,400 for state income taxes. The proper amounts were withheld for FICA taxes.

Beulah has $2,500 in qualified dividends on Yellow Corporation stock she inherited. Alfred and Beulah receive a $1,900 refund on their 2015 state income taxes. They itemized deductions on their 2015 Federal income tax return (total of $15,000). Alfred and Beulah pay $4,500 interest and $1,450 property taxes on their personal residence in 2016. Their charitable contributions total $2,400 (all to their church). They paid sales taxes of $1,400, for which they maintain the receipts. Both spouses had health insurance for all months of 2016 and do not want to contribute to the Presidential Election Campaign.

Required:

Compute the Olds' net tax payable (or refund due) for 2016. Use Form 1040 and Schedule A, Schedule B and the Qualified Dividends and Capital Gain Tax Worksheet to complete this tax return.

It may be necessary to complete the tax schedules before completing Form 1040.

Enter all amounts as positive numbers.

If an amount box does not require an entry or the answer is zero, enter "0".

Make realistic assumptions about any missing data.

When computing the tax liability, do not round your immediate calculations. If required round your final answers to the nearest dollar.

Use the 2016 Tax Rate Schedule provided. Do not use the Tax Tables.

image text in transcribed

Complete Form 1040 for the Olds.

Form 1040

Department of the TreasuryInternal Revenue Service (99) U.S. Individual Income Tax Return

2016

OMB No. 1545-0074

IRS Use OnlyDo not write or staple in this space.

For the year Jan. 1Dec. 31, 2016, or other tax year beginning	,2016, ending	,20	See separate instructions.
Your first name and initial ALFRED E	Last name OLD		Your social security number 111-11-1112
If a joint return, spouse's first name and initial BEULAH A	Last name OLD		Spouse's social security number 123-45-6789
Home address (number and street). If you have a P.O. box, see instructions. 211 BRICKSTONE DRIVE		Apt. no.	Make sure the SSN(s) above and on line 6c are correct.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). ATLANTA, GA - 30304			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
Foreign country name	Foreign province/state/country	Foreign postal code

Filing status

Exemptions

Yourself.

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

}

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

Spouse

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Dependents:

(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)

(1) First name

Last name

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

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15a

IRA distributions . . . . . . .

15a

Taxable amount . . . .

15b

16a

Pensions and annuities . .

16a

Taxable amount . . . .

16b

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

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

Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20a

Social security benefits . . . .

20a

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 . . . . . . . . . . . . . . .

31a

Alimony paid b Recipient's SSN

123-45-6788

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 . . . . . . . . . . . . .

KIA

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

Form 1040 (2016)

Form 1040 (2016)

ALFRED

E OLD

111-11-1112

Page 2

Tax and Credits

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

39a

Check if:

{

You were born before January 2, 1951, Blind. Spouse was born before January 2, 1951, Blind.

}

Total boxes checked 39a

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, $6,300

Married filing jointly or Qualifying widow(er), $12,600

Head of household, $9,250

If your spouse itemizes on a separate return or you were a dual-status alien, check here 39b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

Exemptions. If line 38 is $154,950 or less, multiply $4,050 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: a Form(s) 8814 b Form 4972 c ___

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 credit. Attach Form 5695 . . . . . . . . . . . . . . .

Other credits from Form: a 3800 b 8801 c

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: a 4137 b 8919 . . . . . . . . .

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

60a

Household employment taxes from Schedule H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

60a

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

60b

Health care: individual responsibility (see instructions)

Full-year coverage

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

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

Payments

Federal income tax withheld from Forms W-2 and 1099 . . . . . .

If you have a qualifying child, attach Schedule EIC.

2016 estimated tax payments and amount applied from 2015 return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

66a

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: a 2439 b Reserved c 8885 d

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

Refund

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

76a

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

76a

Direct deposit? See instructions.

Routing number

c Type: Checking Savings

Account number

Amount of line 75 you want applied to your 2017 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)? 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 EXECUTIVE

Daytime phone number

Spouse's signature. If a joint return, bothmust sign.

Date

Spouse's occupation ATTORNEY

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 EIN
		Firm's address			Phone no.
KIA	www.irs.gov/form1040				Form 1040 (2016)

2016 Tax Rate Schedules Single-Schedule X If taxable income is of the amount over_ Head of household-Schedule Z If taxable income is: amount over_ The tax is: over_ 13250 50,400 130,150 210,800 413,350 441,000 0 $ 9,275 10% 9,275 37,650 $ 1,325.00+15% 6,897.50 + 25% 26,835.00 28% 49,417.0033% 116,258.50 + 35% 125,936.0039.6% 13,250 50,400 130,150 210,800 413,350 441,000 37,650 $ 927.50 + 15% 5,183.75 25% 18,558.75 + 28% 46,278.75 33% 119,934.75 + 35% 9,275 37,650 91,150 190,150 413,350 120,529.75 39.6% 415,050 50,400 130,150 210,800 190,150 190,150 413,350 415,050 Married filing separately-Schedule Y-2 Married filing jointly or Qualifying widow(er)- Schedule Y-1 If taxable income is: If taxable income is: amount amount over_ The tax is: The tax is: over_ over_ $9,275 37,650 75,950 115,725 206,675 233475 0 18,550 ..10% $ $1,855.00 + 15% 10,367.50 + 25% 29,51 7.50 28% 51,791.50 + 33% 111,818.50 35% 130,578.50 + 39.6% 9,275 37,650 75,950 115,725 206,675 233,475 18,550 75,300 18,550 75,300 151,900 231450 413,350 466,950 75,300 151,900 $ 927.50 + 15% 5,183.75 25% 14,758.75 + 28% 25,895.7533% 55,909.25 + 35% 9,275 37,650 75,950 115,725 206,675 65,289.2539.6% 233,475 413350 466,950 466,950