Comprehensive Problem 5 1 John Williams (birthdate August 2, 1974) is a single taxpayer, and he lives at 1324 Forest Dr , Reno, NV 89501 His Social Security number is 555 94 9358 John's earnings and withholdings as the manager of a local casino for 2016 are reported on his Form W 2 a Employee's social security number 555 94 9358 OMB No 1545 0008 Safe, accurate, FAST Use IRS e file Visit the IRS website at www irs gov efile b Employer identification number (EIN) 31 1459656 1 Wages, tips, other compensation 194,000 00 2 Federal income tax withheld 32,000 00 c Employer's name, address, and ZIP code Lucky Ace Casino 700 N Sierra Street Reno, NV 89503 3 Social security wages 118,500 00 4 Social security tax withheld 7,347 00 5 Medicare wages and tips 194,000 00 6 Medicare tax withheld 2,813 00 7 Social security tips 8 Allocated tips d Control number 9 10 Dependent care benefits e Employee's first name and initial John Williams 1324 Forest Drive Reno, NV 89501 Last name Suff 11 Nonqualified plans 12a See instructions for box 12 C o d e 13 Statutory employee Retirement plan Third party sick pay 12b C o d e 14 Other 12c C o d e 12d C o d e f Employee's address and ZIP code 15 State NV Employer's state ID number 16 State wages, tips, etc 17 State income tax 18 Local wages, tips, etc 19 Local income tax 20 Locality name Form W 2 Wage and Tax Statement 2016 Department of the TreasuryInternal Revenue Service Copy BTo Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service John's other income includes interest on a savings account at Nevada National Bank of $13,575 John pays his ex wife, Sarah McLoughlin, $4,000 per month When their 12 year old child (in the wife's custody) reaches 18, the payments are reduced to $2,750 per month His ex wife's Social Security number is 554 44 5555 In 2016, John purchased a new car and so he kept track of his sales tax receipts during the year His actual sales tax paid is $3,560, which exceeds the estimated amount per the IRS tables During the year, John paid the following amounts (all of which can be substantiated) Credit card interest $1,760 Auto loan interest 4,300 Auto insurance 900 Property taxes on personal residence 2,640 Blue Cross health insurance premiums 2,800 Other medical expenses 790 Income tax preparation fee 900 Charitable contributions Boy Scouts 1,350 St Matthews Church 3,100 U of Nevada (Reno) Medical School 26,900 Nevada Democratic Party 250 Fund raising dinner for the Reno Auto Museum 100 (value of dinner is $25) John also received the following Form 1098 CORRECTED (if checked) RECIPIENT'S LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no Reno Bank Trust 49 Commerce Street Reno, NV 89501 Caution The amount shown may not be fully deductible by you Limits based on the loan amount and the cost and value of the secured property may apply Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person OMB No 1545 0901 2016 (Rev July 2016) Form 1098 Mortgage Interest Statement 1 Mortgage interest received from payer(s) borrower(s) $ 18,900 00 Copy B For Payer Borrower The information in boxes 1 through 9 is important tax information and is being furnished to the Internal Revenue Service If you are required to file a return, a negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6 or because you didn't report the refund of interest (box 4) or because you claimed a non deductible item RECIPIENT'S LENDER'S federal identification number 33 1234569 PAYER'S BORROWER'S taxpayer identification no 555 94 9358 2 Outstanding mortgage principal as of 1 1 2016 $ 594,400 00 3 Mortgage origination date 03 01 2001 4 Refund of overpaid interest $ 5 Mortgage insurance premiums $ PAYER'S BORROWER'S name John Williams 6 Points paid on purchase of principal residence $ Street address (including apt no ) 1324 Forest Drive 7 Is address of property securing mortgage same as PAYER'S BORROWER'S address If Yes, box is checked If No, see box 8 or 9, below City or town, state or province, country, and ZIP or foreign postal code Reno, NV 89501 10 Other 8 Address of property securing mortgage Account number (see instructions) 9 If property securing mortgage has no address, below is the description of the property Form 1098 (keep for your records) www irs gov form1098 Department of the Treasury Internal Revenue Service Click here to access the tax schedule to use for this problem Required Complete John's federal tax return for 2016 Use Form 1040, Schedule A, and Schedule B, to complete this tax return Make realistic assumptions about any missing data Enter all amounts as positive numbers If an amount box does not require an entry or the answer is zero, enter 0 If required round any dollar amount to the nearest dollar Form 1040 Department of the TreasuryInternal Revenue Service (99) U S Individual Income Tax Return 2016 OMB No 1545 0074 IRS Use Only For the year Jan 1Dec 31, 2016, or other tax year beginning , 2016, ending , 20 See separate instructions Your first name and initial John Last name Williams Your social security number 555 94 9358 If a joint return, spouse's first name and initial Last name Spouse's social security number Home address (number and street) If you have a P O box, see instructions 1324 Forest 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) Reno, NV 89501 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 Single Exemptions 6a Yes Yourself If someone can claim you as a dependent, do not check box 6a Boxes checked on 6a and 6b b No Spouse No of children on 6c who lived with you 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) Firstname Lastname did not live with you due to divorce or separation (see instructions) If more than four dependents, see instructions and check here Dependents on 6c not entered above Add numbers on lines above 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 554 44 5555 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 (2016) Form 1040 (2016) John Williams 555 94 9358 Page 2 38 Amount from line 37 (adjusted gross income) 38 Tax and Credits 39a Check if You were born before January 2, 1952, Blind Spouse was born before January 2, 1952, 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, $6,300 Married filing jointly or Qualifying widow(er), $12,600 Head of household, $9,300 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 $155,650 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 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 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 c Type Checking Savings d Account number 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 John Williams Date Your occupation Manager 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 EIN Firm's address Phone no www irs gov form1040 Form 1040 (2016) 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 2016 Attachment Sequence No 07 Name(s) shown on Form 1040 John Williams Your social security number 555 94 9358 Caution Do not include expenses reimbursed or paid by others Medical and Dental Expenses 1 Medical and dental expenses (see instructions) 1 2 Enter amount from Form 1040, line 38 2 3 Multiply line 2 by 10 (0 10) But if either you or your spouse was born before January 2, 1952, multiply line 2 by 7 5 (0 075) 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 a Income taxes, or 5 b General Sales Taxes 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 16 Gifts by cash or check If you made any gift of $250 or more, see instructions 16 17 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 21 Unreimbursed employee expensesjob travel, union dues, job education, etc Attach Form 2106 or 2106 EZ if required (See instructions ) 21 22 Tax preparation fees 22 23 Other expensesinvestment, 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 (0 02) 26 27 Subtract line 26 from line 24 If line 26 is more than line 24, enter 0 27 Other Miscellaneous Deductions 28 Otherfrom list in instructions List type and amount 28 Total Itemized Deductions 29 Is Form 1040, line 38, over $155,650 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 29 Yes Your deduction may be limited See the Itemized Deductions Worksheet in the instructions to figure the amount to enter 30 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) 2016 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 2016 Attachment Sequence No 08 Name(s) shown on return John Williams Your social security number 555 94 9358 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 1 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 1 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 4 Subtract line 3 from line 2 Enter the result here and on Form 1040A, or Form 1040, line 8a 4 Note If you received a Form 1099 DIV or substitute statement from a brokerage firm, list the firms name as the payer and enter the ordinary dividends shown on that form If line 4 is over $1,500, you must complet

Comprehensive Problem 5-1 John Williams (birthdate August 2, 1974) is a single taxpayer, and he lives at 1324 Forest Dr., Reno, NV 89501. His Social

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Total Itemized Deductions

Is Form 1040, line 38, over $155,650?

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

Comprehensive Problem 5-1

John Williams (birthdate August 2, 1974) is a single taxpayer, and he lives at 1324 Forest Dr., Reno, NV 89501. His Social Security number is 555-94-9358. John's earnings and withholdings as the manager of a local casino for 2016 are reported on his Form W-2:

a Employee's social security number 555-94-9358

OMB No. 1545-0008

Safe, accurate, FAST! Use

^IRSe ~ file

Visit the IRS website at www.irs.gov/efile

Employer identification number (EIN) 31-1459656

Wages, tips, other compensation 194,000.00

Federal income tax withheld 32,000.00

Employer's name, address, and ZIP code Lucky Ace Casino 700 N. Sierra Street Reno, NV 89503

Social security wages 118,500.00

Social security tax withheld 7,347.00

Medicare wages and tips 194,000.00

Medicare tax withheld 2,813.00

Social security tips

Allocated tips

Control number

Dependent care benefits

Employee's first name and initial John Williams 1324 Forest Drive Reno, NV 89501

Last name

Suff.

Nonqualified plans

12a

See instructions for box 12

C o d e

Statutory employee	Retirement plan	Third-party sick pay

12b

C o d e

Other

12c

C o d e

12d

C o d e

Employee's address and ZIP code

15 State NV	Employer's state ID number	16	State wages, tips, etc.	17	State income tax	18	Local wages, tips, etc.	19	Local income tax	20	Locality name

Form W-2

Wage and Tax Statement

2016

Department of the TreasuryInternal Revenue Service

Copy BTo Be Filed With Employee's FEDERAL Tax Return.

This information is being furnished to the Internal Revenue Service.

John's other income includes interest on a savings account at Nevada National Bank of $13,575.

John pays his ex-wife, Sarah McLoughlin, $4,000 per month. When their 12-year-old child (in the wife's custody) reaches 18, the payments are reduced to $2,750 per month. His ex-wife's Social Security number is 554-44-5555.

In 2016, John purchased a new car and so he kept track of his sales tax receipts during the year. His actual sales tax paid is $3,560, which exceeds the estimated amount per the IRS tables.

During the year, John paid the following amounts (all of which can be substantiated):

Credit card interest	$1,760
Auto loan interest	4,300
Auto insurance	900
Property taxes on personal residence	2,640
Blue Cross health insurance premiums	2,800
Other medical expenses	790
Income tax preparation fee	900
Charitable contributions:
Boy Scouts	1,350
St. Matthews Church	3,100
U. of Nevada (Reno) Medical School	26,900
Nevada Democratic Party	250
Fund-raising dinner for the Reno Auto Museum	100
(value of dinner is $25)

John also received the following Form 1098:

CORRECTED (if checked)

RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Reno Bank & Trust 49 Commerce Street Reno, NV 89501

*Caution: The amount shown may not be fully deductible by you. Limits based on the loan amount and the cost and value of the secured property may apply. Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person.

OMB No. 1545-0901 2016 (Rev. July 2016) Form 1098

Mortgage Interest Statement

1 Mortgage interest received from payer(s)/borrower(s)* $ 18,900.00

Copy B For Payer/Borrower The information in boxes 1 through 9 is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6; or because you didn't report the refund of interest (box 4); or because you claimed a non-deductible item.

RECIPIENT'S/LENDER'S federal identification number 33-1234569

PAYER'S/BORROWER'S taxpayer identification no. 555-94-9358

2 Outstanding mortgage principal as of 1/1/2016 $594,400.00

3 Mortgage origination date 03/01/2001

4 Refund of overpaid interest $

5 Mortgage insurance premiums $

PAYER'S/BORROWER'S name John Williams

6 Points paid on purchase of principal residence $

Street address (including apt. no.) 1324 Forest Drive

7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address?
If Yes, box is checked
If No, see box 8 or 9, below

City or town, state or province, country, and ZIP or foreign postal code Reno, NV 89501

10 Other

8 Address of property securing mortgage

Account number (see instructions)

9 If property securing mortgage has no address, below is the description of the property

Form 1098

(keep for your records)

www.irs.gov/form1098

Department of the Treasury - Internal Revenue Service

Click here to access the tax schedule to use for this problem.

Required:

Complete John's federal tax return for 2016. Use Form 1040, Schedule A, and Schedule B, to complete this tax return. Make realistic assumptions about any missing data.

Enter all amounts as positive numbers. If an amount box does not require an entry or the answer is zero, enter "0". If required round any dollar amount to the nearest dollar.

Form 1040

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

2016

OMB No. 1545-0074

IRS Use Only

For the year Jan. 1Dec. 31, 2016, or other tax year beginning

, 2016, ending

, 20

See separate instructions.

Your first name and initial John

Last name Williams

Your social security number 555-94-9358

If a joint return, spouse's first name and initial

Last name

Spouse's social security number

Home address (number and street). If you have a P.O. box, see instructions. 1324 Forest 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). Reno, NV 89501

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

Single

Exemptions	6a	Yes	Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	}	Boxes checked on 6a and 6b
b	No	Spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	No. of children on 6c who: lived with you
	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)Firstname	Lastname	did not live with you due to divorce or separation (see instructions)
If more than four dependents, see instructions and check here
					Dependents on 6c not entered above

						Add numbers on lines above
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 554-44-5555	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 (2016)

Form 1040 (2016)

John Williams

555-94-9358

Page 2

Amount from line 37 (adjusted gross income)

Tax and Credits

39a

Check if:

{

You were born before January 2, 1952, Blind. Spouse was born before January 2, 1952, Blind.

}

Total boxes checked 39a

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, $6,300

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

Head of household, $9,300

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

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

Exemptions. If line 38 is $155,650 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 credits. 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	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

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 John Williams

Date

Your occupation Manager

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

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
2016 Attachment Sequence No. 07

Name(s) shown on Form 1040 John Williams	Your social security number 555-94-9358
		Caution: Do not include expenses reimbursed or paid by others.
Medical and Dental Expenses	1	Medical and dental expenses (see instructions) . . . . . . . . . . . . . .	1
2	Enter amount from Form 1040, line 38	2
3	Multiply line 2 by 10% (0.10). But if either you or your spouse was born before January 2, 1952, multiply line 2 by 7.5% (0.075) 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
	a Income taxes, or	}	. . . . . . . . . . . . . . . . . . . . . . .	5
	b General Sales Taxes
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.	16	Gifts by cash or check. If you made any gift of $250 or more,
see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	16
17	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	21	Unreimbursed employee expensesjob travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required.
(See instructions.) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _	21
22	Tax preparation fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	22
23	Other expensesinvestment, 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% (0.02) . . . . . . . . . . . . . . . . . . . . . . . .	26
27	Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- . . . . . . . . . . . . .	27
Other Miscellaneous Deductions	28	Otherfrom list in instructions. List type and amount _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
	28

For Paperwork Reduction Act Notice, see Form 1040 instructions.

Cat. No. 17145C

Schedule A (Form 1040) 2016

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
2016 Attachment Sequence No. 08

Name(s) shown on return John Williams	Your social security number 555-94-9358
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.	1	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







	1



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
4	Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	4
	Note:If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firms name as the payer and enter the ordinary dividends shown on that form. If line 4 is over $1,500, you must complet