Directions Using the tax software, complete the tax return, including Form 1040 and all appropri- ate forms, schedules, or worksheets. Answer the questions following the scenario. Note: When entering Social Security numbers (SSNS) or Employer Identification Numbers (EINS), replace the Xs as directed, or with any four digits of your choice. Interview Notes Daniel, age 64 and Avery, age 53, are married. They elect to file Married Filing Jointly. Daniel is retired. He received Social Security benefits, a pension, and wages from a part-time job. Avery was a full-time elementary school teacher and paid $700 out of pocket for classroom supplies. Avery is paying off a student loan that she took out when she attended college for her bachelor's degree. Daniel and Avery have two sons, Jackson, age 19 and Matthew, age 16. Matthew lived at home the entire year. Jackson is a full-time college student in his second year of study. He is pursuing a degree in Accounting and does not have a felony drug conviction. He received a Form 1098-T for 2019. Box 2 was not filled in and Box 7 was not checked. Jackson lived in an apartment near campus during the school year and spent the summer at home with his parents. Jackson received a scholarship and the terms require that it be used to pay tuition. Daniel and Avery paid the cost of Jackson's tuition and course-related books in 2020 not covered by scholarship. They paid $90 for a parking sticker, $4,500 for a meal plan, $500 for textbooks purchased at the college bookstore, and $100 for access to an online textbook. Daniel and Avery paid more than half the cost of maintaining a home and support for Jackson and Matthew. Daniel and Avery do not have enough deductions to itemize on their federal tax return. They made a charitable contribution in the amount of $350 cash and they have a receipt for it. The Emorys made four timely estimated tax payments of $125 each for tax year 2020. The Emorys received a $2,900 Economic Impact Payment (EIP) in 2020. If Daniel and Avery receive a refund, they would like to deposit it into their checking account. Documents from County Bank show that the routing number is 111000025. Their checking account number is 11337890. 40 Basic Scenarios Form 13614-C Department of the Treasury - Internal Revenue Service OMB Number (October 2020) Intake/Interview & Quality Review Sheet 1545-1964 You will need: . Please complete pages 1-4 of this form. Tax Information such as Forms W-2, 1099, 1098, 1095. You are responsible for the information on your return. Please provide Social security cards or ITIN letters for all persons on your tax return. complete and accurate information. Picture ID (such as valid driver's license) for you and your spouse. . If you have questions, please ask the IRS-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 wi.voltax@irs.gov Part 1 - Your Personal Information (if you are filing a joint retum, enter your names in the same order as last year's return) 1. Your first name M.I. Last name DANIEL Daytime telephone number Are you a U.S. citizen? EMORY YOUR PHONE # X Yes No 2. Your spouse's first name M.I. Last name Daytime telephone number is your spouse a U.S. citizen? AVERY EMORY x Yes No 3. Mailing address Apt # City State ZIP code 645 MEADE COURT YOUR CITY YS YOUR ZIP 4. Your Date of Birth 5. Your job title 6. Last year, were you: a. a. Full-time student 0 Yes x No 7/5/1956 RETIRED b. Totally and permanently disabled Yes x No c. Legally blind Yes x No 7. Your spouse's Date of Birth 8. Your spouse's job title 9. Last year, was your spouse: a. Full-time student Yes x No 1/31/1967 TEACHER b. Totally and permanently disabled Yes x No c. Legally blind Yes x No 10. Can anyone claim you or your spouse as a dependent? Yes x No D Unsure 11. Have you, your spouse, or dependents been a victim of tax related identity theft or been issued an Identity Protection PIN? u x Yes x No Part II - Marital Status and Household Information 1. As of December 31, 2020, what D Never Married (This includes registered domestic partnerships, civil unions, or other formal relationships under state law) was your marital status? a. If Yes, Did you get married in 20207 Yes x No b. Did you live with your spouse during any part of the last six months of 2020? X Yes No O Divorced Date of final decree Legally Separated Date of separate maintenance decree D Widowed Year of spouse's death 2. List the names below of: 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 (first, last) Do not enter your Date of Birth Relationship Number of US Resident Single or Full-time Totally and is this Did this Did this Did the Did the name or spouse's name below (mm/ddyy) to you (for months Citizen of US Married as Student Permanently person a person person taxpayer(s) taxpayer(s) example: lived in (yeso) Canada, of 12/31/20 last year Disabled qualifying provide have less provide more pay more than son, your home or Mexico (S/M) (yeso) (yeso) child/relative more than than $4,300 than 50% of 0% of half the cost of daughter, last year last year of any other 50% of his/ of income? support for maintaining a parent (yeso) person? her own (yes, no, n/a) this person? home for this none, etc) (yeso) support? yeso/a) person? (a) (b) (c) (d) (0) (9) (h) (0) (yes, nora) (yeso) JACKSON EMORY 5/5/2001 SON 3 YES YES S YES NO MATTHEW EMORY 3/4/2004 SON 12 YES YES S YES NO x Married Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-2020) X D U Check appropriate box for each question in each section Yes No Unsure Part III - Income - Last Year, Did You (or Your Spouse) Receive X 1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? 2 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) A 5. (B) Refund of state/local income taxes? (Form 1099-G) 6. (6) Alimony income or separate maintenance payments? 7. (A) Self-Employment income? (Form 1099-MISC, 1099-NEC, cash) 8. (A) Cash/check 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 1099-5, 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) A 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 Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay 1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes No 2. Contributions to a retirement account? O IRA (A) 401K (B) Roth IRA (B) D Other 3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T) X 4. Any of the following? D (A) Medical & Dental (including insurance premiums) 0 (A) Mortgage Interest (Form 1098) (A) Taxes (State, Real Estate, Personal Property, Sales) X (B) 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? X 8. (B) Student loan interest? (Form 1098-E) Yes No Unsure Part V-Life Events - Last Year, Did You (or Your Spouse) 1. (A) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12) X 2. (A) Have credit card or mortgage debt cancelled/forgiven by a lender or have a home foreclosure? (Forms 1099-C, 1099-A) 3. (A) Adopt a child? 4. (B) Have Earned 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 20087 n 7. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much? $500 O 8. (A) File a federal return last year containing a "capital loss carryover' on Form 1040 Schedule D? 0 9. (A) Have health coverage through the Marketplace (Exchange)? (Provide Form 1095-A] X 10. (B) Receive an Economic Impact Payment (stimulus) in 2020? Basic Scenarios w WWWwWwwww[ Catalog Number 52121E www.lrs.gov Form 13614-C (Rev. 10-2020) Basic Scenarios Page 3 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 tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund X You 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 0 Yes X No D Yes X No 4. If you have a balance due, would you like to make a payment directly from your bank account? X Yes No 5. Did you 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 Well Not well Not at all Prefer not to answer 9. Do you or any member of your household have a disability? 0 Yes X No Prefer not to answer 10. Are you or your spouse a Veteran from the U.S. Armed Forces? D Yes X 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 X No spouse 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 X Prefer not to answer O No spouse Additional comments Gambling losses - $700 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 could happen if we do not receive it, and whether your response is voluntary, required to obtain a benefit, or mandatory. Our legal right to ask for information is 5 U.S.C. 301. We are asking for this information to assist us in contacting you relative to your interest and/or participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be furnished to others who coordinate activities and staffing at volunteer return preparation sites or outreach activities. The information may also be used to establish effective controls, send correspondence and recognize volunteers. Your response is voluntary. However, if 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 all public information requests. The OMB Control Number for this study is 1545-1964. Also, if you have any comments regarding the time estimates associated with this study or suggestion on making this process simpler, please write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR MP:T:T:SP, 1111 Constitution Ave NW, Washington, DC 20224 Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-2020) are a Employee's social security number 127-00-XXXX b Employer identification number (EIN) 35-500XXXX o Employer's name, address, and ZIP code Safe, accurate, OMB No 1545-0008 FAST! Use 1 Wages, tips, other compensation 6,500.00 3 Social security wages 6,500.00 5 Medicare wage and tipe 6,500.00 7 Social security tips Visit the IRS website at file www.ira.gov/ente 2 Federal income tax withheld 420.00 4 Social security tax withheld 403.00 6 Medicare tax withheld 94.25 8 Allocated tips RICH'S BOOK STORE 1225 OVERVIEW AVE YOUR CITY, STATE ZIP d Control number 10 Dependent care benefits . Employee's first name and initial Last name Suff. 11 Nonqualtied plans 12a See instructions for box 12 . 12b 13 By employee Rahment pla Thea iek pay DANIEL EMORY 645 MEADE COURT YOUR CITY, STATE ZIP 14 Other 12c 12d f Employee's address and ZIP code 15 State Employer's state ID number YS 35-500XXXX 18 Local wages, tips, etc. 19 Local income tax 20 Locality and 16 State wages, tips, etc. 17 State income tax 6,500.00 350.00 W-2 wage and Tax Statement 2020 Department of the Treasury-Internal Revenue Service Form Copy B-To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. a Employee's social security number 128-00-XXXX b Employer identification number (EIN) 35-600XXXX c Employer's name, address, and ZIP code SALEM ELEMENTARY SCHOOL 1270 W. 29TH ST YOUR CITY, STATE ZIP Safe, accurate, Visit the IRS website at OMB No. 1545-0008 FAST! Use e file www.is gowe 1 Wagea, tips, other compensation 2 Federal income tax withheld 30,000.00 1,525.00 3 Social security wages 4 Social security tax withheld 30,000.00 1,860.00 5 Medicare wages and tips 6 Medicare tax withheld 30,000.00 435.00 7 Social security tips 8 Allocated tips d Control number 10 Dependent care benefits . Employee's first name and initial Last name Sutt. 11 Nonqualified plans 12a See Instructions for box 12 DD 3,800.00 12b 13 arpe TOWY wake AVERY EMORY 645 MEADE COURT YOUR CITY, STATE ZIP 14 Other 12e 120 Employee's address and ZIP code 15 State Employer's state ID number YS 35-600XXXX 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 16 State wages, tips, etc. 17 State income tax 30,000.00 1,200.00 Form W-2 wage and Tax Statement 2020 Department of the Treasury - Internal Revenue Service Copy B-To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service Basic Scenarios 43 CORRECTED (if checked PAYER'S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country. ZIP or foreign postal code and phone no. Pensions, Annuities, 9,350.00 Retirement or PINE CORPORATION 2020 1809 GULF DRIVE 2a Taxable amount Profit-Sharing Plans, IRAs, Insurance YOUR CITY, STATE ZIP Ils 9,350.00 Form 1099-R Contracts, etc. 2b Taxable amount Total Copy B not determined X distribution PAYER'S TIN Report this RECIPIENT'S TIN 3 Capital gain (included 4 Federal income tax income on your in box 2) withheld federal tax return. If this 40-100XXXX 127-00-XXXX Is 1,935.00 form shows RECIPIENT'S name 5 Employee contributions 6 Net unrealized federal income Designated Roth appreciation in tax withheld in contributions or employer's securities DANIEL EMORY box 4, attach insurance premiums $ this copy to Street address including apt. no.) 7 Distribution IRA 8 Other your return. SEPY code(s) 645 MEADE COURT SIMPLE 7 $ This information is 96 being furnished to City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions the IRS. YOUR CITY, STATE ZIP distribution %$ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer's state no. 16 State distribution within 5 years Roth contrib requirement $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ Form 1099-R www.irs.gowForm1090R Department of the Treasury - Internal Revenue Service FORM SSA-1099 - SOCIAL SECURITY BENEFIT STATEMENT 2020 BETE TROVERSE FOR MORE INFORMATION PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME Box 1. Name DANIEL EMORY Box 2. Beneficiary's Social Security Number 127-00-XXXX Box 3. Benefits Paid in 2020 Box 4. Benefits Repaid to SSA in 2020 Box 5. Net Benefits for 2020 (Box 3 minus Box 4 $7,500.00 $7,500.00 DESCRIPTION OF AMOUNT IN BOX 3 DESCRIPTION OF AMOUNT IN BOX 4 Paid by check or direct deposit: $7,500 Box 6. Voluntary Federal Income Tax Withholding Box 7. Address 645 Meade Court Your City, State Zip Box B. Claim Number se enter you need to contact 884) Draft as of June 21, 2020 - Subject to change Form SSA-1009-SM 2000 DO NOT RETURN THIS FORM TO SSA OR IRS 2020 CORRECTED (if checked) RECIPIENT'S/LENDER'S name, stroat address, city or town, state or OMB No. 1545-1576 province, country, ZIP or foreign postal code, and telephone number Student FINANCIAL AID PARTNERS Loan Interest 666 LINCOLN YOUR CITY, STATE ZIP Statement Form 1098-E RECIPIENT'S TIN BORROWER'S TIN 1 Student loan interest received by lender Copy B 38-900XXXX 128-00-XXXX $ 925.00 For Borrower BORROWER'S name This is important tax AVERY EMORY information and is being furnished to the IRS. If you are required to file a Street address including apt. no.) retum, a negligence penalty or other 645 MEADE COURT sanction may be City or town, state or province, country, and ZIP or foreign postal code imposed on you if the IRS determines that an YOUR CITY, STATE ZIP underpayment of tax results because you Account number se instructions 2 if checked, box 1 does not include loan origination overstated a deduction fees and/or capitalized interest for loans made before for student loan interest. September 1, 2004 Fom 1098-E keep for your records) www.irs.gow Form 1093E Department of the Treasury - Internal Revenue Service OMB No 1545-1574 CORRECTED FILER'S name, street address, city or town, state or province, country, ZIP or 1 Payments received for foreign postal code, and telephone number qualified tuition and related expenses BUCKEYE COLLEGE $ 8,500.00 575 COLLEGE BLVD 2 YOUR CITY, STATE ZIP 2020 Tuition Statement STUDENT'S TIN 3 FILER'S employer identification no. 33-700XXXX STUDENT'S name 129-00-XXXX 4 Adjustments made for a prior year s 6 Adjustments to scholarship or grants for a prior year JACKSON EMORY Street address including apt.no) 645 MEADE COURT City or town, state or province, country, and ZIP or foreign postal code YOUR CITY, STATE ZIP Service Provider/hoct. No. (see instr.) 8 Check if at least half-time student Form 1098-T keep for your records) Form 1098-T Copy B For Student 5 Scholarships or grants This is important tax information $ 6,500.00 and is being 7 Checked if the amount furnished to the IRS. This form in box 1 includes amounts for an must be used to Academic period complete Form 3868 beginning January to claim education March 2021 credits. Give it to the 10 Ins. contract reimb./refund tax preparer or use it to prepare the tax retum. $ Department of the Treasury - Internal Revenue Service $ 9 Checked it a graduate student www.irs.gow Form1098T Buckeye College Meal Plan College Books 580 College Blvd Your City, State ZIP Buckeye College Student Housing 575 College Blvd. Your City, State ZIP Receipt: 3 Textbooks: $500 Received from: Jackson Emory $4,500 Payment for books is also on the college website. Directions Read the scenario information for Daniel and Avery Emory beginning on page 38. 11. Daniel and Avery's standard deduction is: a. $24,800 b. $26,100 C. $26,450 d. $27,400 12. What is the total amount of adjustments on the Emorys' tax return? $_ 13. Daniel and Avery's total qualified education expenses used to calculate the American opportunity credit are $2,500. a. True b. False 14. Daniel and Avery can claim the child tax credit for Matthew. a. True b. False 15. Which of the following items are included in the total payments on Daniel and Avery's tax return? a. Federal income tax withheld from Forms W-2 and 1099 b. $500 estimated tax payment c. Refundable credits d. All of the above 16. The taxable amount of Daniel's Social Security is $7,500. a. True b. False 17. Attendance at school is considered a temporary absence and those months are counted as time that Jackson lived with his parents for the earned income credit. a. True b. False Directions Using the tax software, complete the tax return, including Form 1040 and all appropri- ate forms, schedules, or worksheets. Answer the questions following the scenario. Note: When entering Social Security numbers (SSNS) or Employer Identification Numbers (EINS), replace the Xs as directed, or with any four digits of your choice. Interview Notes Daniel, age 64 and Avery, age 53, are married. They elect to file Married Filing Jointly. Daniel is retired. He received Social Security benefits, a pension, and wages from a part-time job. Avery was a full-time elementary school teacher and paid $700 out of pocket for classroom supplies. Avery is paying off a student loan that she took out when she attended college for her bachelor's degree. Daniel and Avery have two sons, Jackson, age 19 and Matthew, age 16. Matthew lived at home the entire year. Jackson is a full-time college student in his second year of study. He is pursuing a degree in Accounting and does not have a felony drug conviction. He received a Form 1098-T for 2019. Box 2 was not filled in and Box 7 was not checked. Jackson lived in an apartment near campus during the school year and spent the summer at home with his parents. Jackson received a scholarship and the terms require that it be used to pay tuition. Daniel and Avery paid the cost of Jackson's tuition and course-related books in 2020 not covered by scholarship. They paid $90 for a parking sticker, $4,500 for a meal plan, $500 for textbooks purchased at the college bookstore, and $100 for access to an online textbook. Daniel and Avery paid more than half the cost of maintaining a home and support for Jackson and Matthew. Daniel and Avery do not have enough deductions to itemize on their federal tax return. They made a charitable contribution in the amount of $350 cash and they have a receipt for it. The Emorys made four timely estimated tax payments of $125 each for tax year 2020. The Emorys received a $2,900 Economic Impact Payment (EIP) in 2020. If Daniel and Avery receive a refund, they would like to deposit it into their checking account. Documents from County Bank show that the routing number is 111000025. Their checking account number is 11337890. 40 Basic Scenarios Form 13614-C Department of the Treasury - Internal Revenue Service OMB Number (October 2020) Intake/Interview & Quality Review Sheet 1545-1964 You will need: . Please complete pages 1-4 of this form. Tax Information such as Forms W-2, 1099, 1098, 1095. You are responsible for the information on your return. Please provide Social security cards or ITIN letters for all persons on your tax return. complete and accurate information. Picture ID (such as valid driver's license) for you and your spouse. . If you have questions, please ask the IRS-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 wi.voltax@irs.gov Part 1 - Your Personal Information (if you are filing a joint retum, enter your names in the same order as last year's return) 1. Your first name M.I. Last name DANIEL Daytime telephone number Are you a U.S. citizen? EMORY YOUR PHONE # X Yes No 2. Your spouse's first name M.I. Last name Daytime telephone number is your spouse a U.S. citizen? AVERY EMORY x Yes No 3. Mailing address Apt # City State ZIP code 645 MEADE COURT YOUR CITY YS YOUR ZIP 4. Your Date of Birth 5. Your job title 6. Last year, were you: a. a. Full-time student 0 Yes x No 7/5/1956 RETIRED b. Totally and permanently disabled Yes x No c. Legally blind Yes x No 7. Your spouse's Date of Birth 8. Your spouse's job title 9. Last year, was your spouse: a. Full-time student Yes x No 1/31/1967 TEACHER b. Totally and permanently disabled Yes x No c. Legally blind Yes x No 10. Can anyone claim you or your spouse as a dependent? Yes x No D Unsure 11. Have you, your spouse, or dependents been a victim of tax related identity theft or been issued an Identity Protection PIN? u x Yes x No Part II - Marital Status and Household Information 1. As of December 31, 2020, what D Never Married (This includes registered domestic partnerships, civil unions, or other formal relationships under state law) was your marital status? a. If Yes, Did you get married in 20207 Yes x No b. Did you live with your spouse during any part of the last six months of 2020? X Yes No O Divorced Date of final decree Legally Separated Date of separate maintenance decree D Widowed Year of spouse's death 2. List the names below of: 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 (first, last) Do not enter your Date of Birth Relationship Number of US Resident Single or Full-time Totally and is this Did this Did this Did the Did the name or spouse's name below (mm/ddyy) to you (for months Citizen of US Married as Student Permanently person a person person taxpayer(s) taxpayer(s) example: lived in (yeso) Canada, of 12/31/20 last year Disabled qualifying provide have less provide more pay more than son, your home or Mexico (S/M) (yeso) (yeso) child/relative more than than $4,300 than 50% of 0% of half the cost of daughter, last year last year of any other 50% of his/ of income? support for maintaining a parent (yeso) person? her own (yes, no, n/a) this person? home for this none, etc) (yeso) support? yeso/a) person? (a) (b) (c) (d) (0) (9) (h) (0) (yes, nora) (yeso) JACKSON EMORY 5/5/2001 SON 3 YES YES S YES NO MATTHEW EMORY 3/4/2004 SON 12 YES YES S YES NO x Married Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-2020) X D U Check appropriate box for each question in each section Yes No Unsure Part III - Income - Last Year, Did You (or Your Spouse) Receive X 1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? 2 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) A 5. (B) Refund of state/local income taxes? (Form 1099-G) 6. (6) Alimony income or separate maintenance payments? 7. (A) Self-Employment income? (Form 1099-MISC, 1099-NEC, cash) 8. (A) Cash/check 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 1099-5, 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) A 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 Yes No Unsure Part IV - Expenses - Last Year, Did You (or Your Spouse) Pay 1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient's SSN? Yes No 2. Contributions to a retirement account? O IRA (A) 401K (B) Roth IRA (B) D Other 3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T) X 4. Any of the following? D (A) Medical & Dental (including insurance premiums) 0 (A) Mortgage Interest (Form 1098) (A) Taxes (State, Real Estate, Personal Property, Sales) X (B) 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? X 8. (B) Student loan interest? (Form 1098-E) Yes No Unsure Part V-Life Events - Last Year, Did You (or Your Spouse) 1. (A) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12) X 2. (A) Have credit card or mortgage debt cancelled/forgiven by a lender or have a home foreclosure? (Forms 1099-C, 1099-A) 3. (A) Adopt a child? 4. (B) Have Earned 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 20087 n 7. (B) Make estimated tax payments or apply last year's refund to this year's tax? If so how much? $500 O 8. (A) File a federal return last year containing a "capital loss carryover' on Form 1040 Schedule D? 0 9. (A) Have health coverage through the Marketplace (Exchange)? (Provide Form 1095-A] X 10. (B) Receive an Economic Impact Payment (stimulus) in 2020? Basic Scenarios w WWWwWwwww[ Catalog Number 52121E www.lrs.gov Form 13614-C (Rev. 10-2020) Basic Scenarios Page 3 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 tax or refund will not change) Check here if you, or your spouse if filing jointly, want $3 to go to this fund X You 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 0 Yes X No D Yes X No 4. If you have a balance due, would you like to make a payment directly from your bank account? X Yes No 5. Did you 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 Well Not well Not at all Prefer not to answer 9. Do you or any member of your household have a disability? 0 Yes X No Prefer not to answer 10. Are you or your spouse a Veteran from the U.S. Armed Forces? D Yes X 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 X No spouse 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 X Prefer not to answer O No spouse Additional comments Gambling losses - $700 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 could happen if we do not receive it, and whether your response is voluntary, required to obtain a benefit, or mandatory. Our legal right to ask for information is 5 U.S.C. 301. We are asking for this information to assist us in contacting you relative to your interest and/or participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be furnished to others who coordinate activities and staffing at volunteer return preparation sites or outreach activities. The information may also be used to establish effective controls, send correspondence and recognize volunteers. Your response is voluntary. However, if 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 all public information requests. The OMB Control Number for this study is 1545-1964. Also, if you have any comments regarding the time estimates associated with this study or suggestion on making this process simpler, please write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR MP:T:T:SP, 1111 Constitution Ave NW, Washington, DC 20224 Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-2020) are a Employee's social security number 127-00-XXXX b Employer identification number (EIN) 35-500XXXX o Employer's name, address, and ZIP code Safe, accurate, OMB No 1545-0008 FAST! Use 1 Wages, tips, other compensation 6,500.00 3 Social security wages 6,500.00 5 Medicare wage and tipe 6,500.00 7 Social security tips Visit the IRS website at file www.ira.gov/ente 2 Federal income tax withheld 420.00 4 Social security tax withheld 403.00 6 Medicare tax withheld 94.25 8 Allocated tips RICH'S BOOK STORE 1225 OVERVIEW AVE YOUR CITY, STATE ZIP d Control number 10 Dependent care benefits . Employee's first name and initial Last name Suff. 11 Nonqualtied plans 12a See instructions for box 12 . 12b 13 By employee Rahment pla Thea iek pay DANIEL EMORY 645 MEADE COURT YOUR CITY, STATE ZIP 14 Other 12c 12d f Employee's address and ZIP code 15 State Employer's state ID number YS 35-500XXXX 18 Local wages, tips, etc. 19 Local income tax 20 Locality and 16 State wages, tips, etc. 17 State income tax 6,500.00 350.00 W-2 wage and Tax Statement 2020 Department of the Treasury-Internal Revenue Service Form Copy B-To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. a Employee's social security number 128-00-XXXX b Employer identification number (EIN) 35-600XXXX c Employer's name, address, and ZIP code SALEM ELEMENTARY SCHOOL 1270 W. 29TH ST YOUR CITY, STATE ZIP Safe, accurate, Visit the IRS website at OMB No. 1545-0008 FAST! Use e file www.is gowe 1 Wagea, tips, other compensation 2 Federal income tax withheld 30,000.00 1,525.00 3 Social security wages 4 Social security tax withheld 30,000.00 1,860.00 5 Medicare wages and tips 6 Medicare tax withheld 30,000.00 435.00 7 Social security tips 8 Allocated tips d Control number 10 Dependent care benefits . Employee's first name and initial Last name Sutt. 11 Nonqualified plans 12a See Instructions for box 12 DD 3,800.00 12b 13 arpe TOWY wake AVERY EMORY 645 MEADE COURT YOUR CITY, STATE ZIP 14 Other 12e 120 Employee's address and ZIP code 15 State Employer's state ID number YS 35-600XXXX 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 16 State wages, tips, etc. 17 State income tax 30,000.00 1,200.00 Form W-2 wage and Tax Statement 2020 Department of the Treasury - Internal Revenue Service Copy B-To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service Basic Scenarios 43 CORRECTED (if checked PAYER'S name, street address, city or town, state or province, 1 Gross distribution OMB No. 1545-0119 Distributions From country. ZIP or foreign postal code and phone no. Pensions, Annuities, 9,350.00 Retirement or PINE CORPORATION 2020 1809 GULF DRIVE 2a Taxable amount Profit-Sharing Plans, IRAs, Insurance YOUR CITY, STATE ZIP Ils 9,350.00 Form 1099-R Contracts, etc. 2b Taxable amount Total Copy B not determined X distribution PAYER'S TIN Report this RECIPIENT'S TIN 3 Capital gain (included 4 Federal income tax income on your in box 2) withheld federal tax return. If this 40-100XXXX 127-00-XXXX Is 1,935.00 form shows RECIPIENT'S name 5 Employee contributions 6 Net unrealized federal income Designated Roth appreciation in tax withheld in contributions or employer's securities DANIEL EMORY box 4, attach insurance premiums $ this copy to Street address including apt. no.) 7 Distribution IRA 8 Other your return. SEPY code(s) 645 MEADE COURT SIMPLE 7 $ This information is 96 being furnished to City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions the IRS. YOUR CITY, STATE ZIP distribution %$ 10 Amount allocable to IRR 11 1st year of desig. 12 FATCA filing 14 State tax withheld 15 State/Payer's state no. 16 State distribution within 5 years Roth contrib requirement $ $ Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ Form 1099-R www.irs.gowForm1090R Department of the Treasury - Internal Revenue Service FORM SSA-1099 - SOCIAL SECURITY BENEFIT STATEMENT 2020 BETE TROVERSE FOR MORE INFORMATION PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME Box 1. Name DANIEL EMORY Box 2. Beneficiary's Social Security Number 127-00-XXXX Box 3. Benefits Paid in 2020 Box 4. Benefits Repaid to SSA in 2020 Box 5. Net Benefits for 2020 (Box 3 minus Box 4 $7,500.00 $7,500.00 DESCRIPTION OF AMOUNT IN BOX 3 DESCRIPTION OF AMOUNT IN BOX 4 Paid by check or direct deposit: $7,500 Box 6. Voluntary Federal Income Tax Withholding Box 7. Address 645 Meade Court Your City, State Zip Box B. Claim Number se enter you need to contact 884) Draft as of June 21, 2020 - Subject to change Form SSA-1009-SM 2000 DO NOT RETURN THIS FORM TO SSA OR IRS 2020 CORRECTED (if checked) RECIPIENT'S/LENDER'S name, stroat address, city or town, state or OMB No. 1545-1576 province, country, ZIP or foreign postal code, and telephone number Student FINANCIAL AID PARTNERS Loan Interest 666 LINCOLN YOUR CITY, STATE ZIP Statement Form 1098-E RECIPIENT'S TIN BORROWER'S TIN 1 Student loan interest received by lender Copy B 38-900XXXX 128-00-XXXX $ 925.00 For Borrower BORROWER'S name This is important tax AVERY EMORY information and is being furnished to the IRS. If you are required to file a Street address including apt. no.) retum, a negligence penalty or other 645 MEADE COURT sanction may be City or town, state or province, country, and ZIP or foreign postal code imposed on you if the IRS determines that an YOUR CITY, STATE ZIP underpayment of tax results because you Account number se instructions 2 if checked, box 1 does not include loan origination overstated a deduction fees and/or capitalized interest for loans made before for student loan interest. September 1, 2004 Fom 1098-E keep for your records) www.irs.gow Form 1093E Department of the Treasury - Internal Revenue Service OMB No 1545-1574 CORRECTED FILER'S name, street address, city or town, state or province, country, ZIP or 1 Payments received for foreign postal code, and telephone number qualified tuition and related expenses BUCKEYE COLLEGE $ 8,500.00 575 COLLEGE BLVD 2 YOUR CITY, STATE ZIP 2020 Tuition Statement STUDENT'S TIN 3 FILER'S employer identification no. 33-700XXXX STUDENT'S name 129-00-XXXX 4 Adjustments made for a prior year s 6 Adjustments to scholarship or grants for a prior year JACKSON EMORY Street address including apt.no) 645 MEADE COURT City or town, state or province, country, and ZIP or foreign postal code YOUR CITY, STATE ZIP Service Provider/hoct. No. (see instr.) 8 Check if at least half-time student Form 1098-T keep for your records) Form 1098-T Copy B For Student 5 Scholarships or grants This is important tax information $ 6,500.00 and is being 7 Checked if the amount furnished to the IRS. This form in box 1 includes amounts for an must be used to Academic period complete Form 3868 beginning January to claim education March 2021 credits. Give it to the 10 Ins. contract reimb./refund tax preparer or use it to prepare the tax retum. $ Department of the Treasury - Internal Revenue Service $ 9 Checked it a graduate student www.irs.gow Form1098T Buckeye College Meal Plan College Books 580 College Blvd Your City, State ZIP Buckeye College Student Housing 575 College Blvd. Your City, State ZIP Receipt: 3 Textbooks: $500 Received from: Jackson Emory $4,500 Payment for books is also on the college website. Directions Read the scenario information for Daniel and Avery Emory beginning on page 38. 11. Daniel and Avery's standard deduction is: a. $24,800 b. $26,100 C. $26,450 d. $27,400 12. What is the total amount of adjustments on the Emorys' tax return? $_ 13. Daniel and Avery's total qualified education expenses used to calculate the American opportunity credit are $2,500. a. True b. False 14. Daniel and Avery can claim the child tax credit for Matthew. a. True b. False 15. Which of the following items are included in the total payments on Daniel and Avery's tax return? a. Federal income tax withheld from Forms W-2 and 1099 b. $500 estimated tax payment c. Refundable credits d. All of the above 16. The taxable amount of Daniel's Social Security is $7,500. a. True b. False 17. Attendance at school is considered a temporary absence and those months are counted as time that Jackson lived with his parents for the earned income credit. a. True b. False