Jose and Dora Hernandez are married filing jointly They are 50 and 45 years old, respectively Their address is 32010 Lake Street, Atlanta, GA 30294 Additional information about Mr and Mrs Hernandez is as follows Social security numbers Jose 412 34 5670 Dora 412 34 5671 Date of birth 4 23 1966 Date of birth 7 12 1971 W 2 for Jose shows these amounts W 2 for Dora shows these amounts Wages (box 1) $ 45,800 00 Wages (box 1) $ 31,000 00 Federal W H (box 2) $ 6,160 00 Federal W H (box 2) $ 3,650 00 Social security wages (box 3) $ 45,800 00 Social security wages (box 3) $ 31,000 00 Social security W H (box 4) $ 2,839 60 Social security W H (box 4) $ 1,922 00 Medicare wages (box 5) $ 45,800 00 Medicare wages (box 5) $ 31,000 00 Medicare W H (box 6) $ 664 10 Medicare W H (box 6) $ 449 50 Form 1099 INT for Jose and Dora shows this amount Box 1 $300 00 from City Bank Dependent Daughter Adela is 5 years old Her date of birth is 3 15 2011 Her social security number is 412 34 5672 Jose is a store manager, and Dora is a receptionist Prepare the tax return for Mr and Mrs Hernandez using the appropriate form They are entitled to a $1,000 child tax credit (this credit is discussed in Chapter 9) For now, enter the credit on the appropriate line of the form Both Jose and Dora want to contribute to the presidential election campaign Mr and Mrs Hernandez had qualifying health care coverage at all times during the tax year (List the names of the taxpayers in the order in which they appear in the problem Input all the values as positive numbers ) Use the appropriate Tax Tables Page 1 of Form 1040A Use provided information and follow instructions on form Form 1040A U S Individual Income Tax Return (99) 2016 IRS Use Only Do not write in this space Your first name and initial Last name Your social security number (Enter as xxx xx xxxx) Jose Hernandez 412 34 5670 If a joint return, spouse's first name and initial Last name Spouse's social security number (Enter as xxx xx xxxx) Dora Hernandez 412 34 5671 Home address (number and street) If you have a P O box, see instructions Apt no Make sure the SSN(s) above and on line 6c are correct 32010 Lake Street City, town or post office, state, and ZIP code If you have a foreign address, also complete spaces below Presidential Election Campaign Atlanta, GA 30294 Check here if you, or your spouse if filing jointly, want $3 to go to this fund Checking a box below will not change your tax or refund Foreign country name Foreign province Foreign postal code Youcheckbox unchecked1 of 1 Spousecheckbox unchecked1 of 1 Filing Status 1 Single radio button unchecked1 of 5 4 Head of household (with qualifying person) If the qualifying person is a child but not your radio button unchecked2 of 5 Check only one box 2 Married filing jointly radio button checked3 of 5 dependent, enter this child's name here 3 Married filing radio button unchecked4 of 5 5 Qualifying widow(er) with dependent child radio button unchecked5 of 5 separately Exemptions 6a Yourself checkbox checked1 of 1 Boxes checked on 6a and 6b b Spouse checkbox checked1 of 1 No of children on 6c who c Dependents (2) Dependent's social security number (Enter as xxx xx xxxx) (3) Dependent's relationship to you (4) X if child under age 17 qualifying for child tax credit Lived with you (1) First name Last name Did not live with you If more than four dependents, see instructions Adela Hernandez 412 34 5672 Daughter checkbox checked1 of 1 Dependents on 6c not entered above checkbox unchecked1 of 1 checkbox unchecked1 of 1 checkbox unchecked1 of 1 Add numbers on lines above d Total number of exemptions claimed 0 Income 7 Wages, salaries, tips, etc Attach Form(s) W 2 7 8a Taxable interest Attach Schedule B if required 8a Attach Form(s) W 2 here Also attach Forms W 2G and 1099 R if tax was withheld b Tax exempt interest Do not include on line 8a 8b 9a Ordinary dividends Attach Schedule B if required 9a b Qualified Dividends 9b 10 Capital gain distributions (see instructions) 10 11a IRA distributions 11a 11b Taxable amount (see instructions) 11b 12a Pensions and 12a 12b Taxable amount (see instructions) 12b Annuities 13 Unemployment compensation and Alaska Permanent Fund dividends 13 14a Social security 14a 14b Taxable amount (see instructions) 14b benefits 15 Add lines 7 through 14b (far right column) This is your total income 15 0 Adjusted Gross Income 16 Educator expenses (see instructions) 16 17 IRA deduction (see instructions) 17 18 Student loan interest deduction (see instructions) 18 19 Tuition and fees Attach Form 8917 19 20 Add lines 16 through 19 These are your total adjustments 20 0 21 Subtract line 20 from line 15 This is your adjusted gross income 21 0 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions Cat No 11327A Form 1040A (2016) UYA Page 2 of Form 1040A Some information does not carry over from Page 1 Form 1040 (2016) Jose Hernandez Dora Hernandez 412 34 5670 Page 2 Tax, credits, and payments 22 Amount from line 21 (adjusted gross income) 22 0 23a Check if You were born before Jan 2, 1952checkbox unchecked1 of 2 Total boxes checked 23a Spouse was born before Jan 2, 1952checkbox unchecked1 of 2 b If your spouse itemizes on a separate return or you were a dual status alien, check here 23b checkbox unchecked1 of 1 Standard deduction for 24 Enter your standard deduction 24 25 Subtract line 24 from line 22 If line 24 is more than line 22, enter 0 25 0 26 Exemptions Multiply $4,050 by the number on line 6d 26 Single or Married filing separately, $6,300 27 Subtract line 26 from line 25 If line 26 is more than line 25, enter 0 This is your taxable income 27 0 28 Tax, including any alternative minimum tax (see instructions) 28 29 Excess advance premium tax credit repayment Attach Form 8962 29 Married filing jointly or Qualifying widow(er), $12,600 30 Add lines 28 and 29 30 0 31 Credit for child and dependent care expenses Attach Form 2441 31 32 Credit for the elderly or the disabled Attach Schedule R 32 Head of household, $9,300 33 Education credits from Form 8863, line 19 33 34 Retirement savings contributions credit Attach Form 8880 34 35 Child tax credit Attach Schedule 8812, if required 35 36 Add lines 31 through 35 These are your total credits 36 0 37 Subtract line 36 from line 30 If line 36 is more than line 30, enter 0 37 0 If you have a qualifying child, attach schedule EIC 38 Health care individual responsibility (see instructions) Full year coverage checkbox unchecked1 of 1 38 39 Add line 37 and line 38 This is your total tax 39 0 40 Federal income tax withheld from Forms W 2 and 1099 40 41 2016 estimated tax payments and amount applied from 2015 return 41 42a Earned income credit (EIC) 42a b Nontaxable combat pay election 42b 43 Additional child tax credit Attach Schedule 8812 43 44 American opportunity credit from Form 8863, line 8 44 45 Net premium tax credit Attach Form 8962 45 46 Add lines 40, 41, 42a, 43, 44, and 45 These are your total payments 46 0 Refund 47 If line 46 is more than line 39, subtract line 39 from line 46 This is the amount you overpaid 47 0 48a Amount of line 47 you want refunded to you If Form 8888 is attached, check here checkbox unchecked1 of 1 48a 0 Direct deposit See instructions and fill in 48b, 48c, and 48d or Form 8888 b Routing number c Type Checkingcheckbox unchecked1 of 1 d Account number Savingscheckbox unchecked1 of 1 49 Amount of line 47 you want applied to your 2017 estimated tax 49 Amount You Owe 50 Amount you owe Subtract line 46 from line 39 For details on how to pay, see instructions 50 51 Estimated tax penalty (see instructions) 51 Third party Do you want to allow another person to discuss this return with the IRS (see instructions) Designee Designee's Phone Personal identification name no number (PIN) Sign Here Under penalties or perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and accurately list all amounts and sources of income I recieved during the tax year Declaration of preparer (other than the taxpayer) is based on all information of which the preparer has any knowledge Joint return See instructions Your signature Date Your occupation Daytime phone number Keep a copy for your records Spouse's signature If a joint return, both must sign Date Spouse's occupation If the IRS sent you an ID Protection PIN, enter it here (see inst ) Paid preparer use only Print type preparer's name Preparer's signature Date Self employed PTIN Firm's name Firm's EIN Firm's address Phone no UYA Form 1040A (2016)

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Jose and Dora Hernandez are married filing jointly. They are 50 and 45 years old, respectively. Their address is 32010 Lake Street, Atlanta, GA 30294.

Jose and Dora Hernandez are married filing jointly. They are 50 and 45 years old, respectively. Their address is 32010 Lake Street, Atlanta, GA 30294. Additional information about Mr. and Mrs. Hernandez is as follows:

Social security numbers:
Jose: 412-34-5670				Dora: 412-34-5671
Date of birth: 4/23/1966				Date of birth: 7/12/1971
W-2 for Jose shows these amounts:				W-2 for Dora shows these amounts:
Wages (box 1)	=	$	45,800.00	Wages (box 1)	=	$	31,000.00
Federal W/H (box 2)	=	$	6,160.00	Federal W/H (box 2)	=	$	3,650.00
Social security wages (box 3)	=	$	45,800.00	Social security wages (box 3)	=	$	31,000.00
Social security W/H (box 4)	=	$	2,839.60	Social security W/H (box 4)	=	$	1,922.00
Medicare wages (box 5)	=	$	45,800.00	Medicare wages (box 5)	=	$	31,000.00
Medicare W/H (box 6)	=	$	664.10	Medicare W/H (box 6)	=	$	449.50

Form 1099-INT for Jose and Dora shows this amount:

Box 1 = $300.00 from City Bank.

Dependent: Daughter Adela is 5 years old. Her date of birth is 3/15/2011. Her social security number is 412-34-5672.

Jose is a store manager, and Dora is a receptionist.

Prepare the tax return for Mr. and Mrs. Hernandez using the appropriate form. They are entitled to a $1,000 child tax credit (this credit is discussed in Chapter 9). For now, enter the credit on the appropriate line of the form. Both Jose and Dora want to contribute to the presidential election campaign. Mr. and Mrs. Hernandez had qualifying health care coverage at all times during the tax year. (List the names of the taxpayers in the order in which they appear in the problem. Input all the values as positive numbers.)

Use the appropriate Tax Tables.

Page 1 of Form 1040A. Use provided information and follow instructions on form.

Form 1040A - U.S. Individual Income Tax Return			(99)	2016		IRS Use Only - Do not write in this space.
Your first name and initial			Last name			Your social security number (Enter as xxx-xx-xxxx)
Jose			Hernandez			412-34-5670
If a joint return, spouse's first name and initial			Last name			Spouse's social security number (Enter as xxx-xx-xxxx)
Dora			Hernandez			412-34-5671
Home address (number and street). If you have a P.O. box, see instructions.					Apt. no.	? Make sure the SSN(s) above and on line 6c are correct.
32010 Lake Street						? Make sure the SSN(s) above and on line 6c are correct.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below.						Presidential Election Campaign
Atlanta, GA 30294						Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund.
Foreign country name			Foreign province		Foreign postal code

						Youcheckbox unchecked1 of 1	Spousecheckbox unchecked1 of 1
Filing Status	1 Single	radio button unchecked1 of 5	4 Head of household (with qualifying person). If the qualifying person is a child but not your				radio button unchecked2 of 5
Check only one box.	2 Married filing jointly	radio button checked3 of 5	dependent, enter this child's name here. ?				radio button unchecked2 of 5
Check only one box.	3 Married filing	radio button unchecked4 of 5	5 Qualifying widow(er) with dependent child				radio button unchecked5 of 5
	separately
Exemptions	6a Yourself	checkbox checked1 of 1			Boxes checked on 6a and 6b
	b Spouse	checkbox checked1 of 1			No. of children on 6c who:
	c Dependents:		(2) Dependent's social security number (Enter as xxx-xx-xxxx)	(3) Dependent's relationship to you	(4) X if child under age 17 qualifying for child tax credit.	? Lived with you
	(1) First name	Last name		(3) Dependent's relationship to you		? Did not live with you
If more than four dependents, see instructions.	Adela	Hernandez	412-34-5672	Daughter	checkbox checked1 of 1	Dependents on 6c not entered above
					checkbox unchecked1 of 1	Dependents on 6c not entered above
					checkbox unchecked1 of 1
					checkbox unchecked1 of 1	Add numbers on lines above ?
	d Total number of exemptions claimed					Add numbers on lines above ?	0
Income	7 Wages, salaries, tips, etc. Attach Form(s) W-2					7
	8a Taxable interest. Attach Schedule B if required					8a
Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.	b Tax-exempt interest. Do not include on line 8a			8b
	9a Ordinary dividends. Attach Schedule B if required					9a
	b Qualified Dividends			9b
	10 Capital gain distributions (see instructions).					10
	11a IRA distributions	11a		11b Taxable amount (see instructions).		11b
	12a Pensions and	12a		12b Taxable amount (see instructions).		12b
	Annuities
	13 Unemployment compensation and Alaska Permanent Fund dividends.					13
	14a Social security	14a		14b Taxable amount (see instructions).		14b
	benefits
	15 Add lines 7 through 14b (far right column). This is your total income ?					15	0
Adjusted Gross Income	16 Educator expenses (see instructions).			16
Adjusted Gross Income	17 IRA deduction (see instructions).			17
	18 Student loan interest deduction (see instructions).			18
	19 Tuition and fees. Attach Form 8917.			19
	20 Add lines 16 through 19. These are your total adjustments.					20	0
	21 Subtract line 20 from line 15. This is your adjusted gross income.					21	0
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.						Cat. No. 11327A	Form 1040A (2016)
UYA

Page 2 of Form 1040A. Some information does not carry over from Page 1

Form 1040 (2016)	Jose	Hernandez	Dora	Hernandez	412-34-5670		Page 2
Tax, credits, and payments	22 Amount from line 21 (adjusted gross income)					22	0
	23a Check if:	You were born before Jan. 2, 1952checkbox unchecked1 of 2		Total boxes checked	?23a
		Spouse was born before Jan. 2, 1952checkbox unchecked1 of 2
	b If your spouse itemizes on a separate return or you were a dual-status alien, check here				?23b	checkbox unchecked1 of 1
Standard deduction for-	24 Enter your standard deduction.					24
	25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-.					25	0
	26 Exemptions. Multiply $4,050 by the number on line 6d.					26
? Single or Married filing separately, $6,300	27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-. This is your taxable income.					? 27	0
	28 Tax, including any alternative minimum tax (see instructions).				28
	29 Excess advance premium tax credit repayment. Attach Form 8962				29
? Married filing jointly or Qualifying widow(er), $12,600	30 Add lines 28 and 29					30	0
	31 Credit for child and dependent care expenses. Attach Form 2441				31
	32 Credit for the elderly or the disabled. Attach Schedule R				32
? Head of household, $9,300	33 Education credits from Form 8863, line 19				33
	34 Retirement savings contributions credit. Attach Form 8880				34
	35 Child tax credit. Attach Schedule 8812, if required				35
	36 Add lines 31 through 35. These are your total credits					36	0
	37 Subtract line 36 from line 30. If line 36 is more than line 30, enter -0-					37	0
If you have a qualifying child, attach schedule EIC	38 Health care: individual responsibility (see instructions)			Full-year coverage	checkbox unchecked1 of 1	38
	39 Add line 37 and line 38. This is your total tax					39	0
	40 Federal income tax withheld from Forms W-2 and 1099.				40
	41 2016 estimated tax payments and amount applied from 2015 return				41
	42a Earned income credit (EIC)				42a
	b Nontaxable combat pay election			42b
	43 Additional child tax credit. Attach Schedule 8812				43
	44 American opportunity credit from Form 8863, line 8				44
	45 Net premium tax credit. Attach Form 8962				45
	46 Add lines 40, 41, 42a, 43, 44, and 45. These are your total payments				?	46	0
Refund	47 If line 46 is more than line 39, subtract line 39 from line 46. This is the amount you overpaid					47	0
	48a Amount of line 47 you want refunded to you. If Form 8888 is attached, check here ?				checkbox unchecked1 of 1	48a	0
Direct deposit? See instructions and fill in 48b, 48c, and 48d or Form 8888.	?b Routing number			? c Type:	Checkingcheckbox unchecked1 of 1
	?d Account number				Savingscheckbox unchecked1 of 1
	49 Amount of line 47 you want applied to your 2017 estimated tax.				49
Amount You Owe	50 Amount you owe. Subtract line 46 from line 39. For details on how to pay, see instructions. ?					50
	51 Estimated tax penalty (see instructions)				51
Third party	Do you want to allow another person to discuss this return with the IRS (see instructions)?
Designee	Designee's			Phone		Personal identification
	name ?			no. ?		number (PIN) ?
Sign Here	Under penalties or perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and accurately list all amounts and sources of income I recieved during the tax year. Declaration of preparer (other than the taxpayer) is based on all information of which the preparer has any knowledge.
Joint return? See instructions.
	Your signature		Date	Your occupation		Daytime phone number
Keep a copy for your records.
	Spouse's signature. If a joint return, both must sign		Date	Spouse's occupation		If the IRS sent you an ID Protection PIN, enter it
						here (see inst.)
Paid preparer use only	Print/type preparer's name		Preparer's signature		Date	Self-employed?	PTIN

	Firm's name ?					Firm's EIN ?
	Firm's address ?					Phone no.

UYA						Form 1040A (2016)