Form 1040 Gross Income Items

Ernest Nichols, age 45, is a physics professor at K-State. Ernest was divorced in 2018 from his wife, Marguerite (SSN 316-89-5489). Their 15-year-old-son, Michael (SSN 515-77-0124), is supported fully by his parents (Marguerite paid $24,000 in child support) and lives with Ernest during 2020. Ernest signed Form 8332 and presented it to Marguerite for 2020 (included in client information).

Ernest and his brother, Thomas, equally provide 60% of the support for their mother, Sharon Johnson. Her social security number is 316-20-5555. Sharon does not live with Ernest or Thomas. She has $12,000 of social security benefits and no other income. Thomas has provided a signed statement that we would include in our workpapers as part of our due diligence.

Late in 2013, Ernest inherited $1,000,000 from his grandfather. He invested $500,000 of the funds in a life annuity that began making monthly payments to Ernest of $1,300 starting on January 2, 2014. Ernest was 38 when the payments started. He invested the remaining $500,000 in the stock market.

Ernest provides the following list of items that he believes to be deductible.

Unreimbursed doctor and dentist bills	1,800
Unreimbursed prescription drugs	300
Cost of medical insurance	3,000
Personal property taxes on auto	400
Taxes owing paid with 2019 Federal tax return (paid on 4/15/20)	175
Taxes owing paid with 2019 Kansas tax return (paid on 5/15/20)	45
Cash contributions to the First Methodist church	2,400
Cash contributions to the Leukemia Society of America	400
Miscellaneous cash contributions to charities	100
Contribution of land to Habitat for Humanity on 12/31/20 (FMV = $10,000; original cost was $6,000 in 8/22/12)	?
Tax return preparation	1,000
Safe deposit box rental	30
Subscriptions to physics journals not reimbursed by employer	175

State Estimated Tax Payments
4-15-2020	200
6-15-2020	200
9-15-2020	200
12-15-2020	200

Assume that Ernest has all the needed documentation for his charitable contributions. You do not need to submit Form 8283 if you elect to itemize deductions. This form is completed by a professional appraiser, not the tax preparer, and attached to the return. We will assume that we have this form.

Required: Prepare Form 1040 and needed schedules, including Schedule A (if elect to itemize or in workpapers if do not) and Schedule B.

Prepare any other IRS forms and your own supporting schedules as needed to be submitted to the IRS with the tax return.

Prepare working papers to support any and all decisions made, including dependents and filing status.

In addition to the instructions for Schedule A, the last file in the class notes and Chapter 8 in the Murphy book will help you with the itemized deduction issues. Document decisions make in the workpapers.

History of the names used in this problem:

Ernest Nichols was president of the university from 1899 to 1909. During his tenure, the student body grew from 870 students to 2,308. While he was president, Holton Hall, Dickens Hall, Leasure Hall, Calvin Hall, and the east wing of Seaton Hall were constructed and an appropriation for Nichols Gym was obtained. Legend has it that he and his wife, Marguerite, were often seen tooling around Manhattan on their tandem bicycle, one of the first seen in this part of the country. I recall seeing a picture taken of them on Lovers Lane near where our building now exists.

This is Nichol document:

This is Form 2120

this is form 8332

a Employee's social security number Visit the IRS website at insefile www.irs.govletile b Employer identification number (EIN) Safe, accurate, OMB No 1545-0008 FAST! Use 1 Wages, tips, other compensation 96 4100.00 3 Social security wages c Employer's name, address, and ZIP code 512 - 14-1920 ol. 9996666 State of Konses 400 Jackson Topeka, KS 66601 2 Federal income tax withheld 10,000,00 4 Social Security tax withheld 6,138.00 6 Medicare tax withheld 1.435.50 8 Allocated tips 99,000.00 99, ovo. OG 5 Medicare wages and tips 7 Social Security tips d Control number 9 10 Dependent care benefits Last name Suft. 11 Nonqualified plans 12a See instructions for box 12 LEI 2000.00 13 Statutory Patient plan ployee Third-party sick pay 12b . Employee's first name and initial Ernest Nichols 5000 westues Men hatten, KS 66503 14 Other 12c HCARE 600.00 12d f Employoo's address and ZIP code 15 State Employer's state ID number KS 1.6 - Ou you 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 16 State wages, tips, etc. 17 State income tax 96.1.4.000 4,100.00 W-2 2020 Department of the Treasury - Internal Revenue Service Wage and Tax Statement Form Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Fidelity Brokerage Services PO Box 673 000 Dollas, TX 75267 512-14-1920 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) OMB No. 1545-0112 or foreign postal code, and telephone no. 2020 Interest 1 Interest income Income 147.13 $ Form 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 04-3523567 $ RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax S $ information and is Ernest Nichols being furnished 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 8 Tax-exempt interest 9 Specified private activity bond return, a negligence Sooo westview interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ imposed on you it 10 Market discount 11 Bond premium this income is Manhatten, KS 66503 taxable and the IRS determines that it has FATCA Pilings $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Band 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. $ les Form 1099-INT (keep for your records) www.irs.gov/Form 1099INT Department of the Treasury - Internal Revenue Service Manhattan Sonings & Loon 1027 Moro Manhatten, KS 66502 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) OMB No. 1545-0112 or foreign postal code, and telephone no. 2020 Interest 1 Interest income Income $ 1,930.44 Form 1099-INT 2 Early withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN is 193.04 For Recipient 3 Interest on U.S. Savings Bonds and Treas, obligations 41 - 66305 21 512-14-1920 $ RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax $ $ information and is Ernest Nichols being furnished 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 8 Tax-exempt interest 9 Specitied private activity bond return, a negligence Soo Westview interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ imposed on you if 10 Market discount 11 Bond premium 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 CUSIP no. S Manhatten, KS 66503 Form 1099-INT (keep for your records) www.irs.gov/Form 1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0110 2020 Norm Corporation 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. $ 705.00 1b Qualified dividends 231 New Yonkee Rd $ Manhatten, KS 66502 2a Total capital gain distr. $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain Dividends and Distributions Form 1099-DIV 2b Unrecap. Soc. 1250 gain $ 2d Collectibles (28%) gain For Recipient 43 - 0983456 $12-14-1920 $ RECIPIENT'S name 3 Nondividend distributions4 Federal income tax withheld $ 95.00 $ This is important tax Ernest Nichels information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ the IRS. If you are $ required to file a 7 Foreign tax paid 8 Foreign country or U.S. possession retum, a negligence Soou Westview 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 9 Cash liquidation distributions 10 Noncash liquidation distributions and the IRS $ $ determines that it has not been reported. FATCA filing 11 Exempt-interest dividends 12 Specified private activity requirement bond interest dividends $ $ Account number (see instructions) 13 State 14 State dentication no. 15 State tax withheld $ $ Form 1099-DIV (keep for your records) www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service Manhatten, KS 66503 OMB No. 1545-0110 Seaton Industries 2020 CORRECTED (if checked) PAYER'S naro, street address, city or town, state or province, country, ZIP 1a Total ordinary dividends or foreign postal code, and telephone no. $ 500.00 1b Qualified dividends 3000 s. 12th St $ 500.00 2a Total capital gain distr. $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain Dividends and Distributions New Castle, IN 47362 Form 1099-DIV 2b Unrecap. Sec. 1250 gain $ 2d Collectibles (28%) gain Copy B For Recipient 41-5636914512-14-1920 Ernest Nichols sovo Westview $ $ RECIPIENT'S name 3 Nondividend distributions 4 Federal income tax withheld S $ This is important tax information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ $ the IRS. If you are required to file a 7 Foreign tax paid & Foreign country or U.S. possession retum, 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 9 Cash liquidation distributions 10 Noncash liquidation distribution 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 Stato identification no. 15 State tax withheld $ $ Form 1099-DIV (keep for your records) www.irs.gov/Form 1099DIV Department of the Treasury - Internal Revenue Service Manhatten, KS 66503 CORRECTED (if checked) PAYER'S namne, street address, city or town, state or province, country, ZIP 1a Total ordinary dividends OMB No. 1545-0110 or foreign postal code, and telephone no. 2020 1b Qualified dividends PO Box 673 000 $ 717,36 Form 1099-DIV Dolles, TX 75267 2a Total capital gain distr. 2b Unrecap. Soc. 1250 gain $ 873.92 $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain 2d Collectibles (28%) gain fidelity Brokerage Services $ 1,622,71 Dividends and Distributions Copy B For Recipient $ 04-35 23567 512.14-1920 $ $ RECIPIENT'S name 3 Nondividend distributions 4 Federal income tax withheld $ $ Ernest Nichols 5 Section 199A dividends 6 Investment expenses Street address Including apt, no.) $ $ 7 Foreign tax paid 8 Foreign country or U.S. possession Sovo Westview City or town, state or province, country, and ZIP or foreign postal code $ 9 Cash liquidation distributions 10 Noncash liquidation distributions $ FATCA filing 11 Exempt-interest dividends 12 Specified private activity requirement bond interest dividends Is 57,12 $ Account number (see instructions) 13 State 14 Siate identification no. 15 State tax withheld $ This is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Manhatten, KS 66503 Form 1099-DIV (keep for your records) www.irs.gov/Form 1099DIV Department of the Treasury - Internal Revenue Service Capital gain distributions are toxed using using preference rates. O 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, Benefit of Death Insurance s 15,600.00 Retirement or 2020 2a Taxable amount Profit-Sharing Plans, IRAs, Insurance 1414 Reaper Blue Contracts, etc. Form 1099-R Total 2b Taxable amount Springfield, MA 01101 Copy B not determined distribution PAYER'S TIN RECIPIENT'S TIN 3 Capital gain (included 4 Federal income tax Report this in box 2a) income on your withheld federal tax 41-9875670 S12.14-1920 return. If this $ 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 Ernest Nichols insurance premiums box 4, attach $ this copy to Street address (including apt, no.) 7 Distribution your return. 8 Other SEP/ code(s) SIMPLE Sooo Westview 7 $ This information is % City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions being furnished to Monhotten, KS 66503 the IRS. 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 $ $ $ IS Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ Form 1099-R www.irs.gov/Form 1099R Department of the Treasury - Internal Revenue Service IRA % $ AA CORRECTED (if checked) RECIPIENT'S/LENDER'S name, street address, city or town, state or 'Caution: The amount shown may OMB No. 1545-1380 province, country, ZIP or foreign postal code, and telephone no. 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. Form 1098 1 Mortgage interest received from payer(s)borrower(s) Mortgage Interest Statement Konses State Bank 2020 1010 Westloop Manhatten, KS 66503 $ 6,814.33 45-2365692 512-14-1920 $ 269,451.00 9/12/18 | RECIPIENT'S/LENDER'S TIN PAYER'S/BORROWER'S TIN 2 Outstanding mortgage principal 3 Mortgage origination date PAYER'S/BORROWER'S name Ernest Nichols 4 Refund of overpaid 5 Mortgage insurance interest premiumns $ $ 6 Points paid on purchase of principal residence $ 7 If address of property securing mortgage is the same as PAYER'S/BORROWER'S address, the box is checked, or the address or description is entered in box 8. Copy B For Payer/ Borrower The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS. 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 nondeductible item. Street address (including apt. no.) Sovo Westview City or town, state or province, country, and ZIP or foreign postal code Monhatten, KS 66503 9 Number of properties securing the 10 Other mortgage See Notes Account number (see instructions) 8 Address or description of property securing mortgage (see instructions) 5000 Westview Manhatten, KS 66503 11 Mortgage acquisition date Form 1098 (Keep for your records) www.lrs.gov/Form1098 Department of the Treasury - Internal Revenue Service Box 10 Notes Reol estole taxes paid *3,410.00 Property and contents insurance paid $1,750.00 Form 2120 Multiple Support Declaration OMB No. 1545-0074 (Rev. October 2018) Attach to Form 1040. Department of the Treasury Attachment Internal Revenue Service Go to www.irs.gov/Form2120 for the latest information. Sequence No. 114 Narrols) shown on return Your social security number Ernest Nichols SI2114 |1920 During the calendar year 2020 the eligible persons listed below each paid over 10% of the support of: Sharon Nichols Name of your qualifying relative I have a signed statement from each eligible person waiving his or her right to claim this person as a dependent for any tax year that began in the above calendar year. Thomas Nichols 362 I 20 LISIS Eligible person's name Social Security number 2020 W. 17th St. Soline, KS 67401 Address (number, street, apt, no city, state, and ZIP code) Eligible person's name Social Security number Address (number, street, apt. no., city, state, and ZIP code) Eligible person's name Social Security number Address (number, street, apt. no., city, state, and ZIP code) II. Eligible person's name Social Security number Address (number, street, apt, no, city, state, and ZIP code) Instructions What's New Exemption deduction suspended. The deduction for personal exemptions is suspended for tax years 2018 through 2025 by the Tax Cuts and Jobs Act. Although taxpayers can't claim a deduction for exemptions, eligibility for the exemption remains important for determining who may claim the credit for other dependents, as well as other tax benefits. See the instructions and Pub, 501 for details. Purpose of Form Use Form 2120 to: Identify each other eligible person (see below) who paid over 10% of the support of your qualifying relative whom you are claiming as a dependent, and Indicate that you have a signed statement from each other eligible person waiving his or her right to claim that person as a dependent, An eligible person is someone who could have claimed a person as a dependent except that he or she didn't pay over half of that person's support. If there are more than four other eligible persons, attach a statement to your return with the required information Note: The rules for multiple support agreements apply to claiming an exemption for a qualifying relative and don't apply to claiming an exemption for a qualifying child. For the definitions of qualifying relative" and "qualifying child," see the instructions for your tax return and Pub. 501. Claiming a Qualifying Relative Generally, to claim a person as a qualifying relative, you must pay over half of that person's support. However, even if you didn't meet this support test, you may be able to claim him or her as a dependent if all five of the following apply. 1. You and one or more other eligible person(s) (see above) together paid over half of that person's support. 2. You paid over 10% of the support 3. No one alone paid over half of that person's support. 4. The other dependency tests are met. See Stop 4, Is Your Qualifying Relative Your Dependent in the Instructions for Form 1040. 5. Each other eligible person who paid over 10% of the support agrees not to claim that person as a dependent by giving you a signed statement. See Signed Statement on this page. Note: To find out what is included in support, see Pub. 501. Signed Statement You must have received, from each other eligible person listed above, a signed statement waiving his or her right to claim the person as a dependent for the calendar year indicated on this form. The statement must include: The calendar year the waiver applies to, The name of your qualifying relative the eligible person helped to support, and The eligible person's name, address, and social security number Don't file the signed statement with your return. But you must keep it for your records and be prepared to furnish it and any other information necessary to show that you qualify to claim the person as your dependent. Additional Information See Pub. 501 for details. Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax. You aren't required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any internal Revenue law. Generally, tax returns and return information are confidential, as required by Internal Revenue Code section 6103 The average time and expenses required to complete and file this form will vary depending on individual circumstances. For the estimated averages, soo the instructions for your income tax return If you have suggestions for making this form simpler, we would be happy to hear from you. See the instructions for your income tax return. Cat No. 11712F Form 2120 Rev. 10-2018) OMB No. 1545-0074 8332 Release/Revocation of Release of Claim Form Rev. October 2018) to Exemption for Child by Custodial Parent Attachment Department of the Treasury Attach a separate form for each child. Sequence No. 115 Internal Revenue Service Go to www.irs.gov/Form8332 for the latest information. Name of noncustodial parent Noncustodial parent's Marguerite Nichols social security number (SSN) 316-89-5489 Note: This form also applies to some tax benefits, including the child tax credit, additional child tax credit, and credit for other dependents. It doesn't apply to other tax benefits, such as the eamed income credit , dependent care credit, or head of household filing status. See the instructions and Pub. 501. Part I Release of Claim to Exemption for Current Year I agree not to claim an exemption for Michael Nichols for the tax year 20 20 Eust zweih SI2-14-1920 1/16/20 Signature of custodial parent releasing claim to exemption Custodial parent's SSN Note: If you choose not to claim an exemption for this child for future tax years, also complete Part II. Part II Release of Claim to Exemption for Future Years (If completed, see Noncustodial Parent on page 2.) I agree not to claim an exemption for for the tax year(s) (Specify. See instructions.) Name of child Date Name of child Date Signature of custodial parent releasing claim to exemption Custodial parent's SSN Part III Revocation of Release of Claim to Exemption for Future Year(s) I revoke the release of claim to an exemption for Name of child for the tax year(s) (Specify. See instructions.) Signature of custodial parent revoking the release of claim to exemption Custodial parent's SSN Date General Instructions What's New Exemption deduction suspended. The deduction for personal exemptions is suspended for tax years 2018 through 2025 by the Tax Cuts and Jobs Act. Although the exemption amount is zero, eligibility to claim an exemption may make you eligible for other tax benefits. See Pub, 501 for details Although taxpayers can't claim a deduction for exemptions, eligibility to claim an exemption for a child remains important for determining who may claim the child tax credit, the additional child tax credit, and the credit for other dependents, as well as other tax benefits. See the instructions and Pub. 501 for details Purpose of Form If you are the custodial parent, you can use this form to do the following. Release a claim to exemption for your child so that the noncustodial parent can claim an exemption for the child and claim the child tax credit, the additional child tax credit, and the credit for other dependents (if applicable). Revoke a previous release of claim to exemption for your child. Release of claim to exemption. Complete this form for sign a similar statement containing the same information required by this form) and give it to the noncustodial parent. The noncustodial parent must attach this form or similar statement to his or her tax return each year the exemption is claimed. Use Part I to release a claim to the exemption for the current year. Use Part Il if you choose to release a claim to exemption for any future year(s). Note: If the decree or agreement went into effect after 1984 and before 2009, you can attach certain pages from the decree or agreement instead of Form 8332, provided that these pages are substantially similar to Forn 8332. See Post-1984 and pre-2009 decree or agreement on page 2 Revocation of release of claim to exemption. Use Part III to revoke a previous release of claim to an exemption. The revocation will be effective no earlier than the tax year following the year in which you provide the noncustodial parent with a copy of the revocation or make a reasonable effort to provide the noncustodial parent with a copy of the revocation. Therefore, if you revoked a release on Form 8332 and provided a copy of the form to the noncustodial parent in 2018, the earliest tax year the revocation can be effective is 2019. You must attach a copy of the revocation to your tax return each year the exemption is claimed as a result of the revocation. You must also keep for your records a copy of the revocation and evidence of delivery of the notice to the noncustodial parent, or of reasonable efforts to provide actual notice. Custodial Parent and Noncustodial Parent The custodial parent is generally the parent with whom the child lived for the greater number of nights during the year. The noncustodial parent is the other parent. If the child was with each parent for an equal number of nights, the custodial parent is the parent with the higher adjusted gross income. For details and an exception for a parent who works at night, see Pub, 501. Dependent Child A dependent is either a qualifying child or a qualifying relative. See the instructions for your tax return for the definition of these terms. Generally, a child of divorced or separated parents will be a qualifying child of the custodial parent. However, if the special rule on page 2 applies, then the child will be treated as the qualifying child or qualifying For Paperwork Reduction Act Notice, see back of form. Cat, No. 13910F Form 8332 (Rev. 10-2018) a Employee's social security number Visit the IRS website at insefile www.irs.govletile b Employer identification number (EIN) Safe, accurate, OMB No 1545-0008 FAST! Use 1 Wages, tips, other compensation 96 4100.00 3 Social security wages c Employer's name, address, and ZIP code 512 - 14-1920 ol. 9996666 State of Konses 400 Jackson Topeka, KS 66601 2 Federal income tax withheld 10,000,00 4 Social Security tax withheld 6,138.00 6 Medicare tax withheld 1.435.50 8 Allocated tips 99,000.00 99, ovo. OG 5 Medicare wages and tips 7 Social Security tips d Control number 9 10 Dependent care benefits Last name Suft. 11 Nonqualified plans 12a See instructions for box 12 LEI 2000.00 13 Statutory Patient plan ployee Third-party sick pay 12b . Employee's first name and initial Ernest Nichols 5000 westues Men hatten, KS 66503 14 Other 12c HCARE 600.00 12d f Employoo's address and ZIP code 15 State Employer's state ID number KS 1.6 - Ou you 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 16 State wages, tips, etc. 17 State income tax 96.1.4.000 4,100.00 W-2 2020 Department of the Treasury - Internal Revenue Service Wage and Tax Statement Form Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Fidelity Brokerage Services PO Box 673 000 Dollas, TX 75267 512-14-1920 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) OMB No. 1545-0112 or foreign postal code, and telephone no. 2020 Interest 1 Interest income Income 147.13 $ Form 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 04-3523567 $ RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax S $ information and is Ernest Nichols being furnished 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 8 Tax-exempt interest 9 Specified private activity bond return, a negligence Sooo westview interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ imposed on you it 10 Market discount 11 Bond premium this income is Manhatten, KS 66503 taxable and the IRS determines that it has FATCA Pilings $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Band 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. $ les Form 1099-INT (keep for your records) www.irs.gov/Form 1099INT Department of the Treasury - Internal Revenue Service Manhattan Sonings & Loon 1027 Moro Manhatten, KS 66502 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) OMB No. 1545-0112 or foreign postal code, and telephone no. 2020 Interest 1 Interest income Income $ 1,930.44 Form 1099-INT 2 Early withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN is 193.04 For Recipient 3 Interest on U.S. Savings Bonds and Treas, obligations 41 - 66305 21 512-14-1920 $ RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax $ $ information and is Ernest Nichols being furnished 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 8 Tax-exempt interest 9 Specitied private activity bond return, a negligence Soo Westview interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ imposed on you if 10 Market discount 11 Bond premium 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 CUSIP no. S Manhatten, KS 66503 Form 1099-INT (keep for your records) www.irs.gov/Form 1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0110 2020 Norm Corporation 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. $ 705.00 1b Qualified dividends 231 New Yonkee Rd $ Manhatten, KS 66502 2a Total capital gain distr. $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain Dividends and Distributions Form 1099-DIV 2b Unrecap. Soc. 1250 gain $ 2d Collectibles (28%) gain For Recipient 43 - 0983456 $12-14-1920 $ RECIPIENT'S name 3 Nondividend distributions4 Federal income tax withheld $ 95.00 $ This is important tax Ernest Nichels information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ the IRS. If you are $ required to file a 7 Foreign tax paid 8 Foreign country or U.S. possession retum, a negligence Soou Westview 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 9 Cash liquidation distributions 10 Noncash liquidation distributions and the IRS $ $ determines that it has not been reported. FATCA filing 11 Exempt-interest dividends 12 Specified private activity requirement bond interest dividends $ $ Account number (see instructions) 13 State 14 State dentication no. 15 State tax withheld $ $ Form 1099-DIV (keep for your records) www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service Manhatten, KS 66503 OMB No. 1545-0110 Seaton Industries 2020 CORRECTED (if checked) PAYER'S naro, street address, city or town, state or province, country, ZIP 1a Total ordinary dividends or foreign postal code, and telephone no. $ 500.00 1b Qualified dividends 3000 s. 12th St $ 500.00 2a Total capital gain distr. $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain Dividends and Distributions New Castle, IN 47362 Form 1099-DIV 2b Unrecap. Sec. 1250 gain $ 2d Collectibles (28%) gain Copy B For Recipient 41-5636914512-14-1920 Ernest Nichols sovo Westview $ $ RECIPIENT'S name 3 Nondividend distributions 4 Federal income tax withheld S $ This is important tax information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ $ the IRS. If you are required to file a 7 Foreign tax paid & Foreign country or U.S. possession retum, 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 9 Cash liquidation distributions 10 Noncash liquidation distribution 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 Stato identification no. 15 State tax withheld $ $ Form 1099-DIV (keep for your records) www.irs.gov/Form 1099DIV Department of the Treasury - Internal Revenue Service Manhatten, KS 66503 CORRECTED (if checked) PAYER'S namne, street address, city or town, state or province, country, ZIP 1a Total ordinary dividends OMB No. 1545-0110 or foreign postal code, and telephone no. 2020 1b Qualified dividends PO Box 673 000 $ 717,36 Form 1099-DIV Dolles, TX 75267 2a Total capital gain distr. 2b Unrecap. Soc. 1250 gain $ 873.92 $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain 2d Collectibles (28%) gain fidelity Brokerage Services $ 1,622,71 Dividends and Distributions Copy B For Recipient $ 04-35 23567 512.14-1920 $ $ RECIPIENT'S name 3 Nondividend distributions 4 Federal income tax withheld $ $ Ernest Nichols 5 Section 199A dividends 6 Investment expenses Street address Including apt, no.) $ $ 7 Foreign tax paid 8 Foreign country or U.S. possession Sovo Westview City or town, state or province, country, and ZIP or foreign postal code $ 9 Cash liquidation distributions 10 Noncash liquidation distributions $ FATCA filing 11 Exempt-interest dividends 12 Specified private activity requirement bond interest dividends Is 57,12 $ Account number (see instructions) 13 State 14 Siate identification no. 15 State tax withheld $ This is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Manhatten, KS 66503 Form 1099-DIV (keep for your records) www.irs.gov/Form 1099DIV Department of the Treasury - Internal Revenue Service Capital gain distributions are toxed using using preference rates. O 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, Benefit of Death Insurance s 15,600.00 Retirement or 2020 2a Taxable amount Profit-Sharing Plans, IRAs, Insurance 1414 Reaper Blue Contracts, etc. Form 1099-R Total 2b Taxable amount Springfield, MA 01101 Copy B not determined distribution PAYER'S TIN RECIPIENT'S TIN 3 Capital gain (included 4 Federal income tax Report this in box 2a) income on your withheld federal tax 41-9875670 S12.14-1920 return. If this $ 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 Ernest Nichols insurance premiums box 4, attach $ this copy to Street address (including apt, no.) 7 Distribution your return. 8 Other SEP/ code(s) SIMPLE Sooo Westview 7 $ This information is % City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions being furnished to Monhotten, KS 66503 the IRS. 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 $ $ $ IS Account number (see instructions) 13 Date of 17 Local tax withheld 18 Name of locality 19 Local distribution payment $ $ $ Form 1099-R www.irs.gov/Form 1099R Department of the Treasury - Internal Revenue Service IRA % $ AA CORRECTED (if checked) RECIPIENT'S/LENDER'S name, street address, city or town, state or 'Caution: The amount shown may OMB No. 1545-1380 province, country, ZIP or foreign postal code, and telephone no. 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. Form 1098 1 Mortgage interest received from payer(s)borrower(s) Mortgage Interest Statement Konses State Bank 2020 1010 Westloop Manhatten, KS 66503 $ 6,814.33 45-2365692 512-14-1920 $ 269,451.00 9/12/18 | RECIPIENT'S/LENDER'S TIN PAYER'S/BORROWER'S TIN 2 Outstanding mortgage principal 3 Mortgage origination date PAYER'S/BORROWER'S name Ernest Nichols 4 Refund of overpaid 5 Mortgage insurance interest premiumns $ $ 6 Points paid on purchase of principal residence $ 7 If address of property securing mortgage is the same as PAYER'S/BORROWER'S address, the box is checked, or the address or description is entered in box 8. Copy B For Payer/ Borrower The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS. 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 nondeductible item. Street address (including apt. no.) Sovo Westview City or town, state or province, country, and ZIP or foreign postal code Monhatten, KS 66503 9 Number of properties securing the 10 Other mortgage See Notes Account number (see instructions) 8 Address or description of property securing mortgage (see instructions) 5000 Westview Manhatten, KS 66503 11 Mortgage acquisition date Form 1098 (Keep for your records) www.lrs.gov/Form1098 Department of the Treasury - Internal Revenue Service Box 10 Notes Reol estole taxes paid *3,410.00 Property and contents insurance paid $1,750.00 Form 2120 Multiple Support Declaration OMB No. 1545-0074 (Rev. October 2018) Attach to Form 1040. Department of the Treasury Attachment Internal Revenue Service Go to www.irs.gov/Form2120 for the latest information. Sequence No. 114 Narrols) shown on return Your social security number Ernest Nichols SI2114 |1920 During the calendar year 2020 the eligible persons listed below each paid over 10% of the support of: Sharon Nichols Name of your qualifying relative I have a signed statement from each eligible person waiving his or her right to claim this person as a dependent for any tax year that began in the above calendar year. Thomas Nichols 362 I 20 LISIS Eligible person's name Social Security number 2020 W. 17th St. Soline, KS 67401 Address (number, street, apt, no city, state, and ZIP code) Eligible person's name Social Security number Address (number, street, apt. no., city, state, and ZIP code) Eligible person's name Social Security number Address (number, street, apt. no., city, state, and ZIP code) II. Eligible person's name Social Security number Address (number, street, apt, no, city, state, and ZIP code) Instructions What's New Exemption deduction suspended. The deduction for personal exemptions is suspended for tax years 2018 through 2025 by the Tax Cuts and Jobs Act. Although taxpayers can't claim a deduction for exemptions, eligibility for the exemption remains important for determining who may claim the credit for other dependents, as well as other tax benefits. See the instructions and Pub, 501 for details. Purpose of Form Use Form 2120 to: Identify each other eligible person (see below) who paid over 10% of the support of your qualifying relative whom you are claiming as a dependent, and Indicate that you have a signed statement from each other eligible person waiving his or her right to claim that person as a dependent, An eligible person is someone who could have claimed a person as a dependent except that he or she didn't pay over half of that person's support. If there are more than four other eligible persons, attach a statement to your return with the required information Note: The rules for multiple support agreements apply to claiming an exemption for a qualifying relative and don't apply to claiming an exemption for a qualifying child. For the definitions of qualifying relative" and "qualifying child," see the instructions for your tax return and Pub. 501. Claiming a Qualifying Relative Generally, to claim a person as a qualifying relative, you must pay over half of that person's support. However, even if you didn't meet this support test, you may be able to claim him or her as a dependent if all five of the following apply. 1. You and one or more other eligible person(s) (see above) together paid over half of that person's support. 2. You paid over 10% of the support 3. No one alone paid over half of that person's support. 4. The other dependency tests are met. See Stop 4, Is Your Qualifying Relative Your Dependent in the Instructions for Form 1040. 5. Each other eligible person who paid over 10% of the support agrees not to claim that person as a dependent by giving you a signed statement. See Signed Statement on this page. Note: To find out what is included in support, see Pub. 501. Signed Statement You must have received, from each other eligible person listed above, a signed statement waiving his or her right to claim the person as a dependent for the calendar year indicated on this form. The statement must include: The calendar year the waiver applies to, The name of your qualifying relative the eligible person helped to support, and The eligible person's name, address, and social security number Don't file the signed statement with your return. But you must keep it for your records and be prepared to furnish it and any other information necessary to show that you qualify to claim the person as your dependent. Additional Information See Pub. 501 for details. Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax. You aren't required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any internal Revenue law. Generally, tax returns and return information are confidential, as required by Internal Revenue Code section 6103 The average time and expenses required to complete and file this form will vary depending on individual circumstances. For the estimated averages, soo the instructions for your income tax return If you have suggestions for making this form simpler, we would be happy to hear from you. See the instructions for your income tax return. Cat No. 11712F Form 2120 Rev. 10-2018) OMB No. 1545-0074 8332 Release/Revocation of Release of Claim Form Rev. October 2018) to Exemption for Child by Custodial Parent Attachment Department of the Treasury Attach a separate form for each child. Sequence No. 115 Internal Revenue Service Go to www.irs.gov/Form8332 for the latest information. Name of noncustodial parent Noncustodial parent's Marguerite Nichols social security number (SSN) 316-89-5489 Note: This form also applies to some tax benefits, including the child tax credit, additional child tax credit, and credit for other dependents. It doesn't apply to other tax benefits, such as the eamed income credit , dependent care credit, or head of household filing status. See the instructions and Pub. 501. Part I Release of Claim to Exemption for Current Year I agree not to claim an exemption for Michael Nichols for the tax year 20 20 Eust zweih SI2-14-1920 1/16/20 Signature of custodial parent releasing claim to exemption Custodial parent's SSN Note: If you choose not to claim an exemption for this child for future tax years, also complete Part II. Part II Release of Claim to Exemption for Future Years (If completed, see Noncustodial Parent on page 2.) I agree not to claim an exemption for for the tax year(s) (Specify. See instructions.) Name of child Date Name of child Date Signature of custodial parent releasing claim to exemption Custodial parent's SSN Part III Revocation of Release of Claim to Exemption for Future Year(s) I revoke the release of claim to an exemption for Name of child for the tax year(s) (Specify. See instructions.) Signature of custodial parent revoking the release of claim to exemption Custodial parent's SSN Date General Instructions What's New Exemption deduction suspended. The deduction for personal exemptions is suspended for tax years 2018 through 2025 by the Tax Cuts and Jobs Act. Although the exemption amount is zero, eligibility to claim an exemption may make you eligible for other tax benefits. See Pub, 501 for details Although taxpayers can't claim a deduction for exemptions, eligibility to claim an exemption for a child remains important for determining who may claim the child tax credit, the additional child tax credit, and the credit for other dependents, as well as other tax benefits. See the instructions and Pub. 501 for details Purpose of Form If you are the custodial parent, you can use this form to do the following. Release a claim to exemption for your child so that the noncustodial parent can claim an exemption for the child and claim the child tax credit, the additional child tax credit, and the credit for other dependents (if applicable). Revoke a previous release of claim to exemption for your child. Release of claim to exemption. Complete this form for sign a similar statement containing the same information required by this form) and give it to the noncustodial parent. The noncustodial parent must attach this form or similar statement to his or her tax return each year the exemption is claimed. Use Part I to release a claim to the exemption for the current year. Use Part Il if you choose to release a claim to exemption for any future year(s). Note: If the decree or agreement went into effect after 1984 and before 2009, you can attach certain pages from the decree or agreement instead of Form 8332, provided that these pages are substantially similar to Forn 8332. See Post-1984 and pre-2009 decree or agreement on page 2 Revocation of release of claim to exemption. Use Part III to revoke a previous release of claim to an exemption. The revocation will be effective no earlier than the tax year following the year in which you provide the noncustodial parent with a copy of the revocation or make a reasonable effort to provide the noncustodial parent with a copy of the revocation. Therefore, if you revoked a release on Form 8332 and provided a copy of the form to the noncustodial parent in 2018, the earliest tax year the revocation can be effective is 2019. You must attach a copy of the revocation to your tax return each year the exemption is claimed as a result of the revocation. You must also keep for your records a copy of the revocation and evidence of delivery of the notice to the noncustodial parent, or of reasonable efforts to provide actual notice. Custodial Parent and Noncustodial Parent The custodial parent is generally the parent with whom the child lived for the greater number of nights during the year. The noncustodial parent is the other parent. If the child was with each parent for an equal number of nights, the custodial parent is the parent with the higher adjusted gross income. For details and an exception for a parent who works at night, see Pub, 501. Dependent Child A dependent is either a qualifying child or a qualifying relative. See the instructions for your tax return for the definition of these terms. Generally, a child of divorced or separated parents will be a qualifying child of the custodial parent. However, if the special rule on page 2 applies, then the child will be treated as the qualifying child or qualifying For Paperwork Reduction Act Notice, see back of form. Cat, No. 13910F Form 8332 (Rev. 10-2018)