Kindly help prepare form 1040.

4. During 2017, Keith and Jennifer received $550 in interest from Las Vegas municipal bonds, $1,070 interest from U.S. Treasury bonds, and $65 from their savings account at SCD Credit Union. Keith and Jennifer are joint owners of the Las Vegas city bonds and the U.S. Treasury bonds. They have a joint savings account at SCD

Credit Union.

Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 10134D

C-2 Appendix C

On January 21, 2017, Jennifer was involved in a car accident. Because the other driver was at fault, the other drivers insurance company paid Jennifer $1,350 for medical expenses relating to her injuries from the accident and $300 for emotional distress from the accident. She received payment on March 15, 2017.

Keiths father died on November 15, 2016. Keith received a $100,000 death benefit from his fathers life insurance policy on February 8, 2017.

On February 15, 2017, Keith hurt his arm on a family skiing trip in Utah and was unable to fly for two weeks. He received $4,000 for disability pay from his disability insurance policy. He received the check on March 2, 2017. Flyby Airlines paid $600 in premiums on this policy during 2017. The disability insurance policy premiums are paid for by Flyby Airlines as a fully taxable fringe benefit to Keith (the premiums paid on his behalf are included in Keiths compensation amount on his W-2).

Jennifers grandmother died on March 10, 2017, leaving Jennifer with an inheri- tance of $30,000. (She received the inheritance on May 12, 2017.) Flyby Airlines had space available on its Long Island, New York, flight and provided Keith, Jennifer, and their three children with free flights so they could attend the funeral. The value of the ticket for each passenger was $600.

On April 1, 2017, Jennifer slipped in the Small World Elementary lunchroom and injured her back. Jennifer received $1,200 in workers compensation benefits because her work-related injury caused her to miss two weeks of work. She also received a $2,645 reimbursement for medical expenses from the health insurance company. Small World Elementary pays the premiums for Jennifers health insur- ance policy as a nontaxable fringe benefit.

On May 17, 2017, Keith and Jennifer received a federal income tax refund of $975 from their 2016 federal income tax return.

On June 5, 2017, Keith and Jennifer sold their home in Henderson, Nevada, for $510,000 (net of commissions). Keith and Jennifer purchased the home 11 years ago for $470,000. On July 12, 2017, they bought a new home for $675,000.

On July 25, 2017, Keiths aunt Beatrice gave Keith $18,000 because she wanted to let everyone know that Keith is her favorite nephew.

On September 29, 2017, Jennifer won an iPad valued at $500 in a raffle at the annual fair held at Joshuas high school.

Keith and Jennifer have qualifying insurance for purposes of the the Affordable Care Act (ACA).