AO OUR CITY Department of the Treasury Service OMB Number Form 13614-C 2010 Intake/Interview & Quality Review Sheet You will need . Please complete pages 14 of this form, - Tax Information such as Forms W-2 100 100 1095 - You are responsible for the information on your return. Please provide - Social security cards or ITIN letters for persons on your tax retum complete and accurate information Picture D uchas valid driver's license for you and your spouse. . you have questions, please ask the RS certified volunteer preparer. Volunteers are trained to provide high quality service and uphold the highest ethical standards. To report unethical behavior to the IRS, email us at wl.woltairs.gov Part 1 - Your Personal Information if you are g one ou enter your names in the same order as last year's mum) 1. Your first name name Daytime slephone number Are you U S. Giron? RAMON TORREZ YOUR PHONE Yes No 2. Your spouse's name Daytime telephone number is your spouse a US citizen? Yes No 3. Mailing address ZIP code 1551 CONCORD CIRCLE YOUR ZIP 4. Your Date of Birth 5. Your 6. Last were you Fume student Yes No 11119 SELF-EMPLOYED DRIVER b. Totally and permanently disabled Yes X N .Legally blind Yes No 7. Your spouses Date of 18. Your pos itie 9. Last year was your spouse a Full-time student Yes No b. Totally and permanently disabled Yes No c. Legally blind Yes No 10. Can anyone can you or your spouse as a dependent? Yes X NO Unsure 11. Have you, your spouse, or dependents been a victim of tax related Identity theft or be issued an lonty Protection PIN? X Yes No Part II - Marital Status and Household Information (This includes registered domestic partnerships. civil unions or other formal relationships under sa w ) was your marital Status? Married af Yes, Did you get married in 2019? Yes No Did you live with your spouse during any part of the last six months of 2019? Yes No Divorced Date of final decre Legally Seed Date of separate i ncedere Widowed Year of spouse's death 2. Us the names belowo everyone who lived with you last year other than your spouse) If additional space is needed check here and list on page 3 - anyone you supported but did not live with you last year To be completed by a Certified Volunteer Preparer Name Duo Ret N U Redent Puime is the the ONDO so you can USM Perany person e r person payer ved Canada D a nge your home r ovide mere or Mexico herehe 14200 BONN of any song Form 13614-C Re 10-2014 DODDDDDDDDD PERODOXX00000000000000000000000 OXXOOXXXXXXXXXXXXXXXXXXXXXX 000000000 Check appropriate box for each question in each section Yes No Unsur Part-Income-Last Year, Did You for Your Spouse) Receive D X Wages or Scary Form W-2) yes, how many jobs did you have last year? 2. (A) Tip Income? 0 3 . (B) Scholarships? (Forms W-2, 1098-T) 4. (3) Interest Dividends from checking savings accounts, bonds, CDs, brokerage? (Forms 1000-INT, 100-DIV 5. (B) Refund of state local income taxes? (Form 1099-G) 0 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 10997 0 9 . (A) Income for oss) from the sale of Stocks, Bonds or Real Estate (including your home) forme 1090-8,1090-8) 0 10 (1) Disability income? (such as payments from insurance, or workers compensation) Forms 1000-RW-2) 0 1 1. (A) Retirement income or payments from Pensions. Annuities and or IRA? (Form 1090-R) 12.) Unemployment Compensation Form 10996) 13. () Social Security or Rafroad Retirement Benefits? (Forms SSA-1099, RRB-1099) 14. (M) Income (or loss) from Rental Property? 15. (B) Other income? (gambling lottery, prices, awards, my duty, Sch K-1, royalties, foreion income to. Specify No Unsur Part IV - Expenses - Last Year, Did You for Your Spouse) Pay (0) Almony or separate maintenance payments? If yes, do you have the recipient's SSN LY N O 2. Contributions to a retirement account? D RA (A) 401K (B) Roth IRA (6) Other 3 (6) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T) 4. (A) Any of the following? Medical & Dental (including insurance premium) Mortgage Interest (Form 1000) a Taxes (State Real Estate, Personal Property Sales) a Charitable contributions 5() Child or dependent care expenses such as daycare? 6. (B) For supplies used as an eligible educator such as a teacher teacher's side. counselor, etc.? 7. (A) Expenses related to self-employment income or any other income you received? 8. B) Student an interest? (Form 1098 E) No Unsur Party-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 Winbox 12) 2. A) Have credit card or mortgage debt cancelled forgiven by alender or have a home foreclosure? (Forma 1000-C, 1000 A) 3. (A) Adopt a child? 4. (B) Have Earned Income Credit Child Tax Credit or American Opportunity Credit disallowed in a prior year? yes, for which tax year? 5. A) Purchase and installergy efficient home items? (such as windows, fumace Insulation, etc.) 8. A) Receive the Foot Time Homebuyers Creditin 20087 7.) Make estimated tax payments or apply last year's refund to this year's tax? how much 8. AJF a federal return last year containing a capital loss carryover' on Form 1040 Schedule 8. A Mare health coverage through the Marketplace (Exchange Provide Form 10MSAL DODO ODOC Additional information and Questions Related to the Preparation of Your Return 1. Provide an amal address optional this email adres not be used for contacts from the Revenue Service 2. Presidential Election Campaign Fund (you check box your tax or refund will not change Check here you or your spouseffling jointly want to go to this fund You al Spouse 3. If you are due a refund, would you like a Direct deposit To purchase U.S. Savings Bonds To split your refund between different Yes counts No Yes No Yes No 4. If you have a balance due, would you like to make a payment directly from your bank account? Yes X No 5. Live in an arda that was declared a Federal disaster rea? Yes Noyes, where? 6. Did you or your spouse ling jointly receive a letter from the IRS? X Yes 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 wel NE O Prefer not to 8. Would you say you can read a newspaper or book in Eng ? X Very well Will Not well Not 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 US Armed Forces? Yes X NO Prefer not to answer 11. Your race? American Indian of Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White X Prefer not to answer 12. Your spouse's race? D American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White 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 Latino Prefer not to answer Additional comments The Privacy Act of 1974 da Land whether you wh a o wore Privacy Act and Paperwork Reduction Act Notice you su a s for women why we are for and now we wou what could happen n d Ourgator SUSC 301 Weg fortion to cordia ve Tax EWCARMPITS C AN DC 2014 Club 2121 13614- C 020 CORRECTED if checked) ate or province, country. DP1 Rets PAYERS Addre, y or foreign polood and honen TOP CARS RIDE SHARE 8009 PIKE CIR YOUR CITY, STATE ZIP 2019 Miscellaneous Income For 1090-MISC an income Copy B For Recipient PAYER'S TIN RECIPIENT'S Medi c are payments 38-700XXXX 227-00-XXXX RECIPIENTS nare S 225.00 Player made direct of 10 Cros RAMON TORREZ Street address including apt.no) 1551 CONCORD CIRCLE Cay or town, state or province court, und DP YOUR CITY, STATE ZIP 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 it this income is table and the IRS determines that it has not been reported Account number one FATCA in en parachute 14 Gross pro on A income Per Form 1099-MISC Kaup for your records) www.irgowo O MISC Department of the Treasury Revenue Service /uploads/2019/11/2019-IRS-Advanced-Test-and-Re-test.pdf 2019 CORRECTED (f checked) FILER S name, street address, city or town, stor province, country, ZIP FILER'S TIN or foreign postal code, and telephone no. 38-700XXXX Payment Card and TOP CARS RIDE SHARE PAYEE'S TIN Third Party 8009 PIKE CIR 227-00-XXXX ta Gross amount of payment Network YOUR CITY, STATE ZIP card/third party network Transactions transactions 29,000 Form 1090-K Tb Card Not Present 12 Marchantcategory code Copy B Check to indicate FILER IS A Check to For Payee Payment settlement entity PSE Payment Number of payment 4 Federal income tax Electronie Payment Facilitator withheld This is importa EPFYOther third party Third par information and in PAYEE'Same 5a January Sb Fabry being lumihed to $ 1,200 $ 800 h . you are RAMON TORREZ olunangan Street address including apte) 2,050 $ 2.100 santion may be June imposed on your 1551 CONCORD CIRCLE 2,000 $ 3,400 out from the Sh August transaction and the IRS determines that it Chyrownale prowince country, and P or foreign postal code $ 5,800 $ 2,800 YOUR CITY STATE ZIP September October PSE S name and phone number s $ 5,900 $ 1.200 Sk November December 700 $ 1,050 Account number nutions wat der stone March 5 April 2.100) For 1099-K www. gou For 100% Department of the re v enue Service Advanced Scenarios 32. What is the amount of Ramon's qualified business income (QBI) deduction? OA. $1,800, 20% of Ramon's net qualified business income. OB. $0 because ride share is considered a specified service business. C. $0 because Ramon does not have taxable income before the QBI deduction OD. $0 because Ramon has no qualified business income. 31. How does Ramon's self-employment tax affect his tax return? A. Ramon's self-employment tax is not reported anywhere on Form 1040. OB. A portion of the self-employment tax is deducted as a business expense on Schedule C, Profit or Loss From Business C. The self-employment tax is added to his other taxes and the full amount is deducted as an adjustment to income. D. The self-employment tax is added to his other taxes and one half of the self-employment tax is an adjustment to income. 30. What is the amount of Ramon's student loan interest deduction shown on Form 1040, Schedule 1? $ (Do not enter dollar signs, commas, periods, or decimal points in your answer.) [1] 2500 For the purpose of these scenario questions only, ignore the VITA/TCE total business expense limitation for Schedule 29. Ramon's mileage expense deduction at the standard mileage rate) for his business as a ride share driver (rounded to the nearest dollar) is $17,516, True False Back Next Skip First Skipped Question Next Skipped Question CU LA JCe .. Rainon lorez - Question 6 of 8