John Fuji (birthdate June 6, 1981) moved from California to Washington in December 2018. His earnings and income tax withholding for 2019 for his job as a manager at a Washington apple-processing plant are reported on his W-2 form (see separate tab).

John's other income includes interest on a Certificate of Deposit reported on a Form 1099-INT (see separate tab).

Also, in accordance with the January 2019 divorce decree he paid $500 per month alimony to his ex-wife (Dora Fuji, Social Security number 573-79-6075) starting with February 2019.

John received a Form 1098 that reports his mortgage interest and property taxes (see separate tab).

During 2019, John paid the following amounts (all of which can be substantiated):

John's employer offers a retirement plan, but John does not participate. Instead, he made a $4,000 contribution to a Roth IRA.

John also provides 100 percent of the support for his mother, Gala Fuji (Social Security number 323-11-4455). Gala is chronically ill and lives in an assisted living facility in Yakima. Her only income is interest of about $400 on a modest savings account. John can claim the $500 other dependent credit for Gala.

Required:

Complete John's Form 1040 and Schedule A.

• Make realistic assumptions about any missing data.
• 
  
• John has health coverage for the entire year and he does not want to make a contribution to the presidential election campaign.
• 
  
• Enter all amounts as positive numbers.
• 
  
• If an amount box does not require an entry or the answer is zero, enter "0".
• 
  
• If required round any dollar amount to the nearest dollar.

His earnings and income tax withholding for 2017 for his job as a manager at a Washington apple-processing plant are:

a Employee's social security number 571-78-5974

OMB No. 1545-0008

Safe, accurate, FAST! Use

IRS e ~ file

Visit the IRS website at www.irs.gov/efile

b

Employer identification number (EIN)
34-7654321

1

Wages, tips, other compensation
76,600.00

2

Federal income tax withheld
9,785.00

c

Employer's name, address, and ZIP code
Granny Smith Apple Co.
200 Ahtanum Rd.
Yakima, WA 98903

3

Social security wages
76,600.00

4

Social security tax withheld
4,749.20

5

Medicare wages and tips
76,600.00

6

Medicare tax withheld
1,110.70

7

Social security tips

8

Allocated tips

d

Control number

9

Verification code

10

Dependent care benefits

e

Employee's first name and initial

Last name

Suff.

11

Nonqualified plans

12a

See instructions for box 12

C
o
d
e

John Fuji
468 Bonnie Doon Ave.
Yakima, WA 98902

13

Statutory employee	Retirement plan	Third-party sick pay
☐	☐	☐

12b

C
o
d
e

14

Other

12c

C
o
d
e

12d

C
o
d
e

f

Employee's address and ZIP code

15	State	Employer's state ID number	16	State wages, tips, etc.	17	State income tax	18	Local wages, tips, etc.	19	Local income tax	20	Locality name
	WA

Form W-2 Wage and Tax Statement

2017

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.

John's other income includes interest on a Certificate of Deposit reported on a Form 1099-INT:

☐ CORRECTED (if checked)

PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Braeburn National Bank 1600 W. Nob Hill Blvd. Yakima, WA 98902			Payer's RTN (optional)		OMB No. 1545-0112 2017 Form 1099-INT				Interest Income
			1	Interest Income
			$	1,295.00
			2	Early withdrawal penalty					Copy B For Recipient This is important tax information and is being furnished to the Internal Revenue Service. 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.
			$
PAYER'S federal identification number	RECIPIENT'S identification number		3	Interest on U.S. Savings Bonds and Treas. obligations
54-9019016	571-78-974		$
RECIPIENT'S name John Fuji Street address (including apt. no.) 468 Bonnie Doon Ave City or town, state or province, country, and ZIP or foreign postal code Yakima, WA 98902			4	Federal income tax withheld	5	Investment expenses
			$	0.00	$
			6	Foreign tax paid	7	Foreign country or U.S. possession
			$
			8	Tax-exempt interest	9	Specified private activity bond interest
			$		$
			10 $	Market discount	11 $	Bond premium
		FATCA filing requirement ☐	12	Bond premium on Treasury obligations	13	Bond premium on tax-exempt bond
			$		$
Account number (see instructions)			14	Tax-exempt and tax credit bond CUSIP no.	15	State	16	State identification no.	17	State tax withheld
									$
									$

Form 1099-INT

John received the following Form 1098 that reports his mortgage interest and property taxes.

▢ CORRECTED (if checked)

RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

Braeburn National Bank
1600 W. Nob Hill Blvd.
Yakima, WA 98902

*Caution: The amount shown may 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.

OMB No. 1545-0901
2017
(Rev. July 2017)

Form 1098

Mortgage
Interest
Statement

1 Mortgage interest received from payer(s)/borrower(s)*
$ 7,780.00

Copy B
For Payer/Borrower

The information in boxes 1 through 9 is important tax information and is being furnished to the Internal Revenue Service. 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 non-deductible item.

RECIPIENT'S/LENDER'S federal identification number

54-9019016

PAYER'S/BORROWER'S taxpayer identification no.

571-78-5974

2 Outstanding mortgage principal as of 1/1/2017
$254,678.00

3 Mortgage origination date

12/1/2016

4 Refund of overpaid interest
$

5 Mortgage insurance premiums
$

PAYER'S/BORROWER'S name

John Fuji

6 Points paid on purchase of principal residence
$

Street address (including apt. no.)

468 Bonnie Doon Ave.

7 Is address of property securing mortgage same as PAYER'S/BORROWER'S address?
If "Yes," box is checked	☒
If "No," see box 8 or 9, below

City or town, state or province, country, and ZIP or foreign postal code

Yakima, WA 98902

10 Number of mortgaged properties
1

11 Other

Prop taxes $2,083

8 Address of property securing mortgage

Account number (see instructions)

9 If property securing mortgage has no address, below is the description of the property

Form 1098

(keep for your records)

www.irs.gov/form1098

Department of the Treasury - Internal Revenue Service

(keep for your records)

www.irs.gov/form1099int

Department of the Treasury - Internal Revenue Service