- FACTS

All family members are US citizens and have good eyesight.

Your clients are a married couple who file a joint return:

• Josephine Burns (born 2/5/1974)
• Lorenzo Garcia (born 3/19/1976)

Neither of them wants to contribute to the Presidential Election Campaign. Neither owns, controls or manages any foreign bank accounts. Neither is a grantor or beneficiary of a foreign trust.

Attached are:

• Form W-2, reporting Josephines salary
• Form 1099-DIV, reporting dividend income received Lorenzo
• 2 Forms 1099-INT, reporting interest income received by Lorenzo
• Below is the Form. Please help me to fill in everything that needing to fill-in and checking it is the correct one

a Employee's social security number 456-42-6576 b Employer identification number (EIN) 72-4005607 c Employer's name, address, and ZIP code This information is being furnished to the Internal Revenue Service. If you OMB No. 1545-0008 are required to file a tax retum, a negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. 1 Wages, tips, other compensation 2 Federal income tax withheld $72,000 $8,600 3 Social security wages 4 Social security tax withheld $72,000 $8,928 5 Medicare wages and tips 6 Medicare tax withheld $72,000 $2,088 7 Social security tips 8 Allocated tips Proximate Ventures 3450 Melville Drive Los Angeles, CA 90038 d Control number 10 Dependent care benefits e Employee's first name and initial Last name Suff. 11 Nonqualified plans 12a See instructions for box 12 13 SETY employde grement plan THE sick phy 12b Josephine Burns 1561 Saxbury Road Glendale, CA 91020 14 Other 12c 12d f Employee's address and ZIP code 15 State Employer's state ID number 8675001 18 Local wages, tips, etc. 19 Local income tax 20 Locality name CAI 16 State wages, tips, etc. 17 State income tax $72,000 $3,100 W-2 Wage and Tax Form Statement Copy C-For EMPLOYEE'S RECORDS (See Notice to Employee on the back of copy B.) 2019 Department of the Treasury - Internal Revenue Service Safe, accurate, e-file FAST! Use 2015 OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optiona) or foreign postal code, and telephone no. State of California P.O. Box 942980 Sacramento, CA 94250 1 Interest income 2019 Interest Income For 1099-INT 2 Early withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN $ 3 Interest on U.S. Savings Bonds and Treas. obligations For Recipient 94-60001347 578-33-2345 RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This Is Important tax $ Lorenzo Garcia $ Information and is being fumished to the 6 Foreign tax paid 7 Foreign country or U.S. possession IRS. If you are Street address (including apt. no.) $ required to flle a 8 Tax-exempt interest 9 Specified private activity bond return, a negligence 1561 Saxbury Rd. interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code 4,300 $ Imposed on you if 10 Market discount 11 Bond premium Glendale, CA 91020 this Income is taxable and the IRS determines that it has FATCA filing $ $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond $ $ Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld bond CUIP no. TA-6473344 |$ Form 1099-INT (keep for your records) www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0110 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP 1a Total ordinary dividends or foreign postal code, and telephone no. Cemento Blocao (Argentina) SA $ 477 Madison Avenue, Thirty-Fifth Floor New York, NY 10022 1b Qualified dividends 3,100 2019 Dividends and Distributions 0 $ 2a Total capital gain distr. $ 2c Section 1202 gain Form 1090-DIV 2b Unrecap. Sec. 1250 gain $ 2d Collectibles (28%) gain Copy B For Recipient PAYER'S TIN RECIPIENT'S TIN 65-20004500 578-33-2345 $ RECIPIENT'S name 3 Nondividend distributions 4 Federal income tax withheld $ Lorenzo Garcia $ This is important tax information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address including apt. no.) $ the Is. If you are $ required to file a 1561 Saxbury Rd. 7 Foreign tax paid 8 Foreign country or U.S. possession return, a negligence penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ imposed on you if this income is taxable Glendale, CA 91020 9 Cash liquidation distributions 10 Noncash liquidation distributions and the IRS $ $ determines that it has FATCA filing 11 Exempt-interest dividends 12 Specified private activity not been reported. requirement bond interest dividends $ Account number (see instructions) 13 State 14 Statoidartfication na 15 State tax withheld 456-2000B $ $ Form 1099-DIV (keep for your records) www.irs.gow Form1099DIV Department of the Treasury - Internal Revenue Service OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's ATN (optional) or foreign postal code, and telephone no. Zoologica Inc. 30045 Central Avenue Scranton, PA 18515 1 Interest income 2019 Interest Income 2,700 For 1099-INT 2 Early withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN $ For Recipient 3 Interest on U.S. Savings Bonds and Treas, obligations 72-5556789 578-33-2345 $ RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This Is Important tax $ $ Information and is Lorenzo Garcia being fumished to the 6 Foreign tax paid 7 Foreign country or U.S. possession IRS. If you are Street address (including apt. no.) $ required to file a 1561 Saxbury Rd. 8 Tax-exempt interest 9 Specified private activity bond return, a negligence interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ Imposed on your 10 Market discount 11 Bond premium this Income is Glendale, CA 91020 taxable and the IRS determines that it has FATCA filing $ $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond $ $ Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld bond CUSIP no. $ ZED 48765 $ Form 1099-INT (keep for your records) www.irs.gov/Form1099|NT Department of the Treasury - Internal Revenue Service 2019 11040 Department of the Treasury - Internal Revenue Service (99) U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only-Do not write or staple in this space. Filing Status Single Married fling Jonty Married fling separately (MES) Head of household (HOH) Qualifying widowen (ow) Check only one box. If you checked the MES box, enter the name of spouse. If you checked the HOH or QW box, enter the child's name If the qualifying person is a child but not your dependent Your first name and middle initial Last name Your social securtty number Josephine Bums 4 5 6 4 26 576 If joint retum, spouse's first name and middle initial Last name Spouse's social security number Lorenzo Garcia 5 7 8!3 3 !2 3 4 5 Home address (number and street). If you have a P.O.box, see Instructions. Apt no. Presidential Election Campaign Check here you, or your spouse if filing 1561 Saxbury Road jointly, want $3 to go to this fund. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see Instructions). Checking a box below will not change your Glendale, CA, 91020 tax or refund. You Spouse Foreign country name Foreign province/state/county Foreign postal code If more than four dependents, See Instructions and here Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse Itemizes on a separate return or you were a dual-status allen Age/Blindness You were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1965 Is blind Dependents (see instructions): (2) Social security number (3) Relationship to you (4) If qualifies for see Instructions: (1) First name Last name Chlid tax credit Credit for other dependents 72000 2700 3100 2b 3b 4b 4d 5b 6 1 Wages, salaries, tips, etc. Attach Formis) W-2 2a Tax-exempt Interest. 2a 4300 b Taxable interest. Attach Sch. B if required 3a Qualified dividends 3a 0 Standard D Ordinary dividends. Attach Sch B if required Deduction for 4a IRA distributions. 4a b Taxable amount Single or Married Pensions and annuities 4C d Taxable amount fing separately. $12.200 5a Social security benefits 5a b Taxable amount Married ning 6 Jointly or Qaying Capital gain or loss). Attach Schedule D If required. If not required, check here widower) 7a $24.400 Other Income from Schedule 1. Ine 9 Head of D Add lines 1, 2, 3, 46, 40, 56, 6, and 7a. This is your total income household Ba $18.350 Adjustments to Income from Schedule 1, line 22 If you chockad b Subtractine Ba from Ine 7b. This is your adjusted gross income ary box under 9 Standa Standard deduction or itemized deductions (from Schedule A) 9 Dediction 10 Qualified business Income deduction. Attach Form 1995 or Form 1995-A 10 so Instructions 11a Add lines 9 and 10. b Taxable income. Subtract line 11a from line ab. If zero or less, enter-O- For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Cat. No. 113200 7a 7b Ba Bb 11a 11b Form 1040 2010) SCHEDULE 1 (Form 1040 or 1040-SR) Additional Income and Adjustments to Income Department of the Treasury Attach to Form 1040 or 1040-SR. Internal Revenue Service Go to www.irs.gov/Form1040 for Instructions and the latest Information. Name(s) shown on For 1040 or 1040-SR OMB No. 1545-0074 2019 Attachment Sequence No. 01 Your social security number Yes 4 9 At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? No Part 1 Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes. 1 2a Alimony received 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C. 3 4 Other gains or losses). Attach Form 4797 5 Rental real estate, royalties, partnerships, Scorporations, trusts, etc. Attach Schedule E. 5 6 Farm income or loss). Attach Schedule F 6 7 Unemployment compensation. 7 8 Other income. List type and amount 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a Part II Adjustments to Income 10 Educator expenses 10 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 11 12 Health savings account deduction. Attach Form 8889 12 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE. 14 15 Self-employed SEP, SIMPLE, and qualified plans 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid 18a b Recipient's SSN c Date of original divorce or separation agreement (see instructions) 19 IRA deduction 19 20 Student loan interest deduction 20 21 Tuition and fees. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a 22 For Paperwork Reduction Act Notice, see your tax retur Instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019 a Employee's social security number 456-42-6576 b Employer identification number (EIN) 72-4005607 c Employer's name, address, and ZIP code This information is being furnished to the Internal Revenue Service. If you OMB No. 1545-0008 are required to file a tax retum, a negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. 1 Wages, tips, other compensation 2 Federal income tax withheld $72,000 $8,600 3 Social security wages 4 Social security tax withheld $72,000 $8,928 5 Medicare wages and tips 6 Medicare tax withheld $72,000 $2,088 7 Social security tips 8 Allocated tips Proximate Ventures 3450 Melville Drive Los Angeles, CA 90038 d Control number 10 Dependent care benefits e Employee's first name and initial Last name Suff. 11 Nonqualified plans 12a See instructions for box 12 13 SETY employde grement plan THE sick phy 12b Josephine Burns 1561 Saxbury Road Glendale, CA 91020 14 Other 12c 12d f Employee's address and ZIP code 15 State Employer's state ID number 8675001 18 Local wages, tips, etc. 19 Local income tax 20 Locality name CAI 16 State wages, tips, etc. 17 State income tax $72,000 $3,100 W-2 Wage and Tax Form Statement Copy C-For EMPLOYEE'S RECORDS (See Notice to Employee on the back of copy B.) 2019 Department of the Treasury - Internal Revenue Service Safe, accurate, e-file FAST! Use 2015 OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optiona) or foreign postal code, and telephone no. State of California P.O. Box 942980 Sacramento, CA 94250 1 Interest income 2019 Interest Income For 1099-INT 2 Early withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN $ 3 Interest on U.S. Savings Bonds and Treas. obligations For Recipient 94-60001347 578-33-2345 RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This Is Important tax $ Lorenzo Garcia $ Information and is being fumished to the 6 Foreign tax paid 7 Foreign country or U.S. possession IRS. If you are Street address (including apt. no.) $ required to flle a 8 Tax-exempt interest 9 Specified private activity bond return, a negligence 1561 Saxbury Rd. interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code 4,300 $ Imposed on you if 10 Market discount 11 Bond premium Glendale, CA 91020 this Income is taxable and the IRS determines that it has FATCA filing $ $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond $ $ Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld bond CUIP no. TA-6473344 |$ Form 1099-INT (keep for your records) www.irs.gov/Form1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0110 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP 1a Total ordinary dividends or foreign postal code, and telephone no. Cemento Blocao (Argentina) SA $ 477 Madison Avenue, Thirty-Fifth Floor New York, NY 10022 1b Qualified dividends 3,100 2019 Dividends and Distributions 0 $ 2a Total capital gain distr. $ 2c Section 1202 gain Form 1090-DIV 2b Unrecap. Sec. 1250 gain $ 2d Collectibles (28%) gain Copy B For Recipient PAYER'S TIN RECIPIENT'S TIN 65-20004500 578-33-2345 $ RECIPIENT'S name 3 Nondividend distributions 4 Federal income tax withheld $ Lorenzo Garcia $ This is important tax information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address including apt. no.) $ the Is. If you are $ required to file a 1561 Saxbury Rd. 7 Foreign tax paid 8 Foreign country or U.S. possession return, a negligence penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ imposed on you if this income is taxable Glendale, CA 91020 9 Cash liquidation distributions 10 Noncash liquidation distributions and the IRS $ $ determines that it has FATCA filing 11 Exempt-interest dividends 12 Specified private activity not been reported. requirement bond interest dividends $ Account number (see instructions) 13 State 14 Statoidartfication na 15 State tax withheld 456-2000B $ $ Form 1099-DIV (keep for your records) www.irs.gow Form1099DIV Department of the Treasury - Internal Revenue Service OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's ATN (optional) or foreign postal code, and telephone no. Zoologica Inc. 30045 Central Avenue Scranton, PA 18515 1 Interest income 2019 Interest Income 2,700 For 1099-INT 2 Early withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN $ For Recipient 3 Interest on U.S. Savings Bonds and Treas, obligations 72-5556789 578-33-2345 $ RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This Is Important tax $ $ Information and is Lorenzo Garcia being fumished to the 6 Foreign tax paid 7 Foreign country or U.S. possession IRS. If you are Street address (including apt. no.) $ required to file a 1561 Saxbury Rd. 8 Tax-exempt interest 9 Specified private activity bond return, a negligence interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ Imposed on your 10 Market discount 11 Bond premium this Income is Glendale, CA 91020 taxable and the IRS determines that it has FATCA filing $ $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond $ $ Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld bond CUSIP no. $ ZED 48765 $ Form 1099-INT (keep for your records) www.irs.gov/Form1099|NT Department of the Treasury - Internal Revenue Service 2019 11040 Department of the Treasury - Internal Revenue Service (99) U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only-Do not write or staple in this space. Filing Status Single Married fling Jonty Married fling separately (MES) Head of household (HOH) Qualifying widowen (ow) Check only one box. If you checked the MES box, enter the name of spouse. If you checked the HOH or QW box, enter the child's name If the qualifying person is a child but not your dependent Your first name and middle initial Last name Your social securtty number Josephine Bums 4 5 6 4 26 576 If joint retum, spouse's first name and middle initial Last name Spouse's social security number Lorenzo Garcia 5 7 8!3 3 !2 3 4 5 Home address (number and street). If you have a P.O.box, see Instructions. Apt no. Presidential Election Campaign Check here you, or your spouse if filing 1561 Saxbury Road jointly, want $3 to go to this fund. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see Instructions). Checking a box below will not change your Glendale, CA, 91020 tax or refund. You Spouse Foreign country name Foreign province/state/county Foreign postal code If more than four dependents, See Instructions and here Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse Itemizes on a separate return or you were a dual-status allen Age/Blindness You were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1965 Is blind Dependents (see instructions): (2) Social security number (3) Relationship to you (4) If qualifies for see Instructions: (1) First name Last name Chlid tax credit Credit for other dependents 72000 2700 3100 2b 3b 4b 4d 5b 6 1 Wages, salaries, tips, etc. Attach Formis) W-2 2a Tax-exempt Interest. 2a 4300 b Taxable interest. Attach Sch. B if required 3a Qualified dividends 3a 0 Standard D Ordinary dividends. Attach Sch B if required Deduction for 4a IRA distributions. 4a b Taxable amount Single or Married Pensions and annuities 4C d Taxable amount fing separately. $12.200 5a Social security benefits 5a b Taxable amount Married ning 6 Jointly or Qaying Capital gain or loss). Attach Schedule D If required. If not required, check here widower) 7a $24.400 Other Income from Schedule 1. Ine 9 Head of D Add lines 1, 2, 3, 46, 40, 56, 6, and 7a. This is your total income household Ba $18.350 Adjustments to Income from Schedule 1, line 22 If you chockad b Subtractine Ba from Ine 7b. This is your adjusted gross income ary box under 9 Standa Standard deduction or itemized deductions (from Schedule A) 9 Dediction 10 Qualified business Income deduction. Attach Form 1995 or Form 1995-A 10 so Instructions 11a Add lines 9 and 10. b Taxable income. Subtract line 11a from line ab. If zero or less, enter-O- For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Cat. No. 113200 7a 7b Ba Bb 11a 11b Form 1040 2010) SCHEDULE 1 (Form 1040 or 1040-SR) Additional Income and Adjustments to Income Department of the Treasury Attach to Form 1040 or 1040-SR. Internal Revenue Service Go to www.irs.gov/Form1040 for Instructions and the latest Information. Name(s) shown on For 1040 or 1040-SR OMB No. 1545-0074 2019 Attachment Sequence No. 01 Your social security number Yes 4 9 At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? No Part 1 Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes. 1 2a Alimony received 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C. 3 4 Other gains or losses). Attach Form 4797 5 Rental real estate, royalties, partnerships, Scorporations, trusts, etc. Attach Schedule E. 5 6 Farm income or loss). Attach Schedule F 6 7 Unemployment compensation. 7 8 Other income. List type and amount 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a Part II Adjustments to Income 10 Educator expenses 10 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 11 12 Health savings account deduction. Attach Form 8889 12 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE. 14 15 Self-employed SEP, SIMPLE, and qualified plans 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid 18a b Recipient's SSN c Date of original divorce or separation agreement (see instructions) 19 IRA deduction 19 20 Student loan interest deduction 20 21 Tuition and fees. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a 22 For Paperwork Reduction Act Notice, see your tax retur Instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019