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income tax 27. What is the amount of Cynthias lifetime learning credit? $_______________. 1095-A 2021 Health Insurance Marketplace Statement Voo be Danach to your taxen
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1095-A 2021 Health Insurance Marketplace Statement Voo be Danach to your taxen Kayourecords CORRECTED Go to www.warm OSA formen Part Recipient Information Med M 12-3456789 987554 CYNTHIA SIMON 419-00-XOCOX 7 22411992 12/31/2021 10 01/01/2021 13 Oy 14 MMC YOUR CITY Part Il Covered individuals 159 ARCHER AVENUE Escow 71p YOUR STATE A Comida SON C.COM CYNTHIA SIMON 419-00-XOCX 2411992 01.01.2021 123/2021 18 10 20 Part Coverage Information More A Meyerwart. Mordor DOLCE CM $200 $150 $330 $330 $200 $150 $200 $330 $150 26 A $200 $330 $330 $200 26 June $200 $330 $150 $150 $150 $150 $150 $330 $200 $200 $330 $200 $200 $330 $330 $330 $330 $150 $150 $200 $150 $200 $150 52,400 $3,960 $1,800 os 2021 VOID CORRECTED RECIPENTSALENDER'Sanotas cly or to OVE NG 1545-157 province, country ZIP roposal and consume FINANCIAL AID PARTNERS 305 WASHINGTON DR YOUR CITY, YOUR STATE, ZIP Farm 1098-E T L BORROWERS TIN Student by wide 38-0600XOOXX 419-00-3000x $ 3.570.00 BORROWERS Student Loan Interest Statement Copy c For Recipient CYNTHIA SIMON Sincluding to 159 ARCHER AVENUE Olly or one or in courtyard Porn postal code YOUR CMY, YOUR STATE.ZIP American 2 Check box 1 sotud and or cand Deere Seite 1.2004 For 1098-E www.FormBE Depart of the Treasury For Pracy Act and Paper Raduction Act Nethe2021 General Instructions for Cartinformation Returns GU 2.000.00 2021 CORRECTED FLERS,Gyor EGP for food when SUFFOLK COLLEGE 10 COLLEGE AVENUE YOUR CITY, YOUR STATE, ZIP PLERS STUDENTS TIN 37-700XOOK 419-00-XDOCX rebra Tuition Statement For 1098-T Copy B For Student CYNTHIA SIMON and be 158 ARCHER AVENUE und ZIP YOUR CITY, YOUR STATE ZIP pan ng 10 @ls 1000-T ABC INVESTMENTS 456 Pima Plaza Your City, YS ZIP 2021 TAX REPORTING STATEMENT Cynthia Simon 159 Archer Avenue Your City, YS ZIP Account No. 111-222 Recipient ID No. 419-00-XXOOX Payer's Fed ID Number: 40-200XXOX FORM 1099-B" 2021 Proceeds from Broker and Barter Exchange Transactions Copy for Rent OMB NO. 1545-0715 Short-term transactions for which basis is reported to the IRS Report on Form 8949 with Box A checked and/or Schedule D. Parti (The Labells a Subtle for Besto) 8 Description, 1d Slock or Other Symbol, CUSIP (IRS Form 1099-8 box numbers are shown below in bold type) 10 DG 1 Quant 10 Proceeds To costo Gain/LOSSA) Wash 4 Federal income 14 15. Acquired disposed Sold Other Basis Los Desalowed With Sot wand lowa Co. Common Stock Sale 01/08/2021 10/30/2021 200.000 TOTALS 650.00 2.650.00 2,650.00 2,000.00 2.000.00 FORM 1099-B* 2021 Proceeds from Broker and Barter Exchange Transactions Copy for Rent OMS NO. 1545-0715 Long-term transactions for which basis is not reported to the IRS Report on Form 8949 with Box E checked and/or Schedule D. Part II (This Label as for Beste) 8 Description, 1d Stock or Other Symbol, CUSIP Action 16 te bate sold 10 Oy 1d Proceeds Te cost or Add disposed Sold Other Basis RS Form 1099-B bax numbers are shown below in bold type) ang Wash Fercome 15 Sean Lou Dalowed TWIN State Winted lowa Co. Common Stock Sale 10/12/2008 11/01/2021 200.000 TOTALS 1.400.00 3,500.00 2,500.00 2.100.00 2,100.00 This is important tax information and is being fushed to the Internal Revenue Service. If you are required to Sie a return, a nagigence penalty or other action may be imposed on you if this income in table and the IRS delines that has not been reported ABC INVESTMENTS 458 Pima Plan Your City, YS ZIP 2021 TAX REPORTING STATEMENT Cynthia Simon 150 Archer Avon Your City, YS ZIP Account No. 111-222 Recipient ID No. 419-00-XOOX Payer's Fed ID Number: 40-2003000K 150.00 75.00 300.00 0.00 0.00 0.00 0.00 Form 1099-DIV 2021 Dividends and Distributions Gegy sor OM NO 15.00 Ta Total Ordinary Dividends 1b Qualified Dividends. 20 Total Capital Gain Distribution (includes 22d) 2b Capital Gains that represent Unrecaptured 1250 Gain 2c Capital Gains that represent Section 1202 Gain 20 Capital Gains that represent Collectibles (28%) Gain 2 Nondividend Distributions 4 Federal Income Tax Withheld 5 Investment Expenses 6 Foreign country or U.S. Possession 7 Cash Liquidation Distributions 8 Non-Cash Liquidation Distributions Exempt interest Dividends 10 Specified Private Activity Bond Interest Dividends 11 State 12 Suate Identification No 13 State Tax Withheld 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Form 1099-MISC 2021 Miscellaneous Income Caos RIO NO 150 ANS 2 Royalties 4 Federal Income Tax Withheld 8 Substitute Payments in Lieu of Dividends or interest 16 Suste Tex Withheld 17 State Payer's State No. 18 State Income Form 1099-INT 2021 Interest Income PROMENO 1541 1 Interest Income 2 Early Withdrawal Perually 3 Interest on US Savings Bonds and Treas. Obligations 4 Federal Income Tax Withheld Investment Expenses Foreign Tax Paid 7 Foreign country or U.S. Posession 8 Tex- Emporal 9 Specified Private Activity Bond Interest 14 Tax Exempt Bond CUSIP No... Summary of 2021 Proceeds From Broker and Barter Exchange Transactions Sales Price of Stocks, Bonde, etc. Federal income Tax Withheld 250.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6,150.00 0.00 Page 1 2021 Nonemployee Compensation CORRECTED (if checked) PAYER'S nama, street address, city or town, state or province, country, ZIP OME No. 1545 0116 or foreign postal code and telephone na HOUSEKEEPERS HELPERS 123 TIDY WAY YOUR CITY, YOUR STATE, ZIP Form 1099-NEC PAYERS TIN RECIPIENT'S TIN 1 Noployee compensation 63-400XXXX 419-00-xcxx $ RECIPIENTS name 2 Payer made direct sales totaing 15.000 or more of consumer products to recipient for resale CYNTHIA SIMON 3 Street address including apt.no) 159 ARCHER AVENUE 4 Federal income tax with City or town, state or province, country, and ZIP or foreign postal code Is YOUR CITY, YOUR STATE, ZIP 5 Statet withheld State Payer's so Account number on instructions $ Copy B 4,000 For Recipient This importante info PS. mondta rencontre action may beingoed on you the and how en bord 7 Stat income $ Farm 1099-NEC op for your records www.ForNEC Department of the Treasury litoral Revenue Service CORRECTED PAYER Sayon Portail and women 2,000.00 2021 ESSEX BANK, CUSTODIAN FOR TRADITIONAL IRA OF CYNTHIA SIMON 300 MARIN STREET YOUR CITY. YOUR STATE, ZIP PAVERSTIN NORINTOTINE Detrons From PA Mermer Proto Sharing Plans RA Contacts 2.000,00 1000- Copy B dom Report this Pred income on you Tederal retan. this 200.00 for show federal income tax within box attach this copy to Farrum O os Thomas Lengte RE . 48.000 PONTS Spo De CYNTHIA SIMON St. 7 B 159 ARCHER AVENUE Chowdopod YOUR CITY, YOUR STATE 10 Amor CA 18 Moon of P1000- Eng 419-00 Xxx CA FATIN e-file Dwi 57-200XXX 335,000.00 $2.000.00 $35.000.00 12.170.00 ELECTRIC COMPANY 389 DAILY DRIVE YOUR CITY, STATE, ZIP $35.000.00 5597.50 CYNTHIA SIMON 158 ARCHER AVENUE YOUR CITY, YOUR STATE, ZIP YS 57-200300X $35.000.00 $750.00 ...W-2 Wage and Tax Statement 2021 Copy-To be with ERDERAL This 95 Poe Additional Information and Questions Related to the Preparation of Your Retum 1. Would you like to receive written communications from the IRS in a language other than English? Yes No If yes, which language? 2. Presidential Election Campaign Fund (you check box your tar or refund will not change! Check here you, or your spouse filing jointly, went $3 to go to this fund You Spouse 3. If you are due reund, would you like a. Direct deposit b. To purchase US Savings Bonds To spleyour refund between different accounts Yes No Yes No Yes SINO 4.If you have a balance ou would you like to make a payment directly from your bank account? Yes No 5. Did you live in an area that was declared a Federal disaster rea? Yes No If yes, where? 6. Did you or your spouse fing jointly receive a letter from the RS7 Yes 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? Very well Wel Not well Not at Preler not tower Would you say you can read a newspaper or book in English Very well Well Not weil Not at O Prefer not to answer 9. Do you or any member of your household have a disability Yes No Prefer not to answer 10. Are you or your spouse a Veteran from the US. Armed Forces? Yes No Prefer not to answer 11. Your face? American Indian or Alaska Native Asian Black or African American Native Hawn or other Pacific Islander White 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 O Prefer not to answer Ne spous 13. Your ethnicity Hispanic or Latino Not Hispanic or Latino Prefer not to answer 14. Your spouses etnicity? Hapanic or Latina Not Hispanic or Latino Prefer not ruwer No souse Additional comments Privacy Act and Paperwork Reduction Act Matice Themes that when we al forn you want to the normation weig W dewer your bed Out USG SO Wewenga concen yoyotomi Sverige. The ben kalatta, n. you. The con Oberon OM 1645-164 wysothea tario. Proscow CAMPS W DC24 GE www. Form 13614- C10-30 Page 2 ODDOC And license Check prepraebok for ench question in each section Yes No rur Part-Income-Last Year, Did You for Your Spouse) Receive DO (8) Wages or Salary? Form W2) yes, how many jobs did you have last year ED 2. (A) Tip Income? D 3. (B) Scholarships? (Fome W-2.1090-T) 4. (B) Interest Dividends from checking savings accounts, bonds, CDs, brokerage? (Form 1099-INT 1000-01) 2 5. (B) Relund of state local income taxes? (Form 1099-0) (3) Alimony income or separate maintenance payments? 7. A) Se Employment income? (Form 1000 MISC, 1000-NEC, cah, virtual currency, or other property or service 8( Cash checkvrtual currency payments, or other property or rice for any work performed not reported on Forms W-2 or 10997 9. (A) Income for oss) from the sale or exchange of Stacks. Bonds, Virtual Currency or Real Estate (including your home) (Forms 1009 5 1009 8) 10. (12) Diy income? (such as payments from insurance, or workers compensation) (Forms 1000-R, W-2) 11. (A) Retirement income or payment from Pursions. Annuities, and or IRA? (Form 1099-R) 12. (B) Unemployment Compensation Form 1096) 12. (B) Social Security or Railroad Retirement Benefits? (Foma SSA-1009, FRD-1000 14. (M) Income for oss from Rental Property? 15. () Other income gaming lottery.rs wward, y duty wsch Kroatis, foreign income, etc.) Yes No Unsur Part IV-Expenses - Last Year, Did You for Your Spouse) Pay BO (1) Almony or separate maternice payments if yes, do you have the recipients SSN? Yes NO D 2 Contributions or want to retirement account? O IRAIA) 401K (3) Roth IRAB) Other mo 2. (B) Odlage post secondary educational expenses for your spouse or dependents? (Form 1000-T) 4. Any of the following? (A) Medical & Dental (including increme) (A) Mortgage rat (Form 1000) O(A)Taxes (State Real Estate, Personal Property. Salus) DB Charitable Contribuir OB 5. (B) Child or dependent care expenses such an daycare? 6.) For supposed as an education such as a teacher, acher's side ourse 1. (A peres related to employment income of my other income you received (Slucient an interestim 1000) Yes No Unsur Part V-Life Events Last Year, Did You for Your Spouse 1. Have Health Savings Account om 549-SA 1000-SA, W-2 with code Winbox 12 2. IA Here credit card, wudention of mortgage de cancelled forgiven by ander or have a home foredre? Forma 1000-C, 1005A) 3. (A) Adegtid 4. How Eamed income Credit Card Tax Credito American Opportunity Credit lowed in a pror yea? yes, for which tax year? OB Purchase and installent home such a windows fum,mulation ate. 6 (A) Receive the time Homebuyers Creditin 2007 To Maksimales parents or last year's and to this year's how much? . A Fe federal year containing a los wover" on Form 1640 Schedule A Health coverage through the Marketplace (Exchange Provide Form 1095-.AL RO 10. Recomandi 2017 11. fecrewed Chades Ord payments F 13614- C1020 NE BOOBDOBESOH00000DBO DOBR0000000ORO 20ORORODDBODS RODAS BGSODE 1000 Form 13614-C Deperment of the Treasury Internal Revenue Service OMB Number (October 2021) 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 wl.voltax.in.gov Part 1 - Your Personal Information you are flingojoint retum, enter your names in the same order as last year retum) 1. Your first name MI Last name Best contact number Are you a US citizen? CYNTHIA SIMON YOUR PHONE Yes No 2. Your spouse's first name MI Last name Best contact number Is your spouse a US citizen Yes No 3. Maling address Apts City State ZIP code 159 ARCHER AVENUE YOUR CITY YS YOUR ZIP 4. Your Date of Birth 5. Your job title 6. Last year, were you a: Full-time student Yes No 02/241912 ELECTRICIAN b. Totally and permanently disabled Yes No Legally bind Yes No 7. Your spouse's Date of Birth 8. Your spouse's job tide 9. Last year, was your spouse a. Full-time student Yes No b. Totally and permanently disabled Yes No c Legally blind Yes No 10. Can anyone claim you or your spouse as a dependent? Yes No Unsure 11. Have you, your spouse, or dependents been a victim of tax related Identity theft or been issued an Identity Protection PIN? Yes No 12. Provide an email address loatiana (this email address will not be used for contacts from the Internal Revenue Service) Part 1 Marital Status and Household Information 1. As of December 31, 2021. what Never Married (This includes registered domestic partnerships, civil unions, or other formal relationships under statew) want your marital status? Married a. If Yes, Did you get married in 2021? Yes No b. Did you live with your spouse during any part of the last or months of 2021? Yes No Divorced Date of final decree Legally Separated Date of separate maintenance decree Widowed Year of spouse's death 2 List the names below of everyone who lived with you last year (other that 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 are create or you Date of the Ret Number of us met Fund as you for On the mothe Curen US Mantas de Pen Did the ved O Canada 12 sted your home or Me elles last year Heh ent anyther Jones Desa non her Oh le Osho po? Cata1 Foam 13614-CM10.2013 Cynthia purchased insurance for herself through the marketplace and has a Form 1095-A. If Cynthia has a refund, she would like it deposited into her checking account. Cynthia received the third Economic Impact Payment (EIP3) in the amount of $1.400 in 2021. SOCIAL SECURITY SEC 419-00-XXXX Cynthia Simon Cynthia Simon he Advanced Scenario 8: Cynthia Simon Directions Using the tax software, complete the tax return, including Form 1040 and al appropn. 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 Cynthia is an electrician, age 29, and single. Cynthia has investment income and has a consolidated broker's statement Cynthia began a cleaning service business in 2020. She was paid on Form 1099 NEC for 2021. She also received additional cash receipts of $400 not reported on the Form 1099-NEC Cynthia uses the cash method of accounting. She uses business code 561720. Cynthia has receipts for the following expenses $350 for cleaning supplies - $225 for business cards $450 for a mop, broom, and vacuum cleaner $150 for work gloves $125 for lunches $175 for work clothes suitable for everyday use Cynthia has a detailed mileage log reporting for 2021 Mileage from her home to her first client's home and mileage from her last client's home to her home - 750 miles In addition on the days Cynthia worked for multiple clients, she kept track of the mileage from the first dient's home to the second client's home in case that mileage was also deductible. She logged 450 miles (not included in the 750 miles) The total mileage on her car for tax year 2021 was 11.200 miles. Of that, 10,000 were personal miles. She placed her only vehicle, a pick-up truck in service on 3/15/2020. Cynthia will take the standard mileage rate. Cynthia took an early distribution from her IRA in April to pay off her educational expenses Cynthia is paying off her student loan from 2018 Cynthia is working towards her Master of Business Administration (MBA) degree She took a few college courses this year at an accredited college 27. What is the amount of Cynthias lifetime learning credit? $_______________.
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