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Find and prepare PDF versions of the following IRS forms and Schedules, if applicable: Form 1 0 9 9 - S , Form 1 0
Find and prepare PDF versions of the following IRS forms and Schedules, if applicable:
Form S Form C and Form ;
Schedule and Schedule D; and
Form page only
Taxpayer Jane Doe has the following personal information:
Name: Jane Doe
SSN:
Address: Any Street, Anytown, CA
Marital Status: Separated Living apart
Minor Children: lives with exhusband
Elections: Standard deduction never itemized
Summary:
Jane Doe DOE was an employee at ABC, Inc. benefit details below After being injured on the job, DOE received three monthly
payments from a disability policy benefit details below At the start of the tax year, DOE sold her residence for $Payer
# DOE bought the house she sold for $ and lived in the house for years prior to the sale. During the tax year, DOE
received $ in workers compensation payments. By the end of the tax year, DOE had substantial gambling debts that exceed
her total assets. Realizing her debt of $ was uncollectable, the casino Payer # forgave DOE's gambling debt and issued her a
Form During the tax year, DOE received the following:
$ in winnings from slot machines; and
$ from a state income tax refund;
With regard to DOE's job at ABC, Inc., DOE received wages of $ for time she worked. In addition to her salary, DOE received
the following employee benefits from ABC, Inc.:
Employer paid health care of $;
$ in sick pay benefits;
$ in vacation benefits; and
Employer paid group term life insurance with $ in coverage.
With regard to DOE's disability policy, DOE receives $ per month. DOE purchased the private disability policy with her own
funds.
Payer #: Anytown Escrow, Inc.
EIN:
Address: Corp. Blvd Ste Anytown, CA
Payer #: The House Always Wins, LLC
EIN:
Address: Casino Blvd Anytown, CA
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