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Name: Jane Doe SSN: 4 4 4 - 4 4 - 4 4 4 4 Address: 5 5 5 Any Street, Anytown, CA 9 0
Name: Jane Doe
SSN:
Address: Any Street, Anytown, CA
Marital Status: Separated Living apart
Minor Children: lives with exhusband
Elections: Standard deduction never itemized
Summary:
Jane Doe DOE was an employee at ABC, Inc. benefit details below After being injured on the job, DOE
received three monthly payments from an disability policy benefit details below At the start of the tax year,
DOE sold her residence for $Payer # DOE bought the house she sold for $ and lived in the
house for years prior to the sale. During the tax year, DOE received $ in workers compensation
payments. By the end of the tax year, DOE had substantial gambling debts that exceed her total assets. Realizing
the her debt of $ was uncollectable, the casino Payer # forgave DOE's gambling debt and issued her a
Form During the tax year, DOE received the following:
$ in winnings from slot machines; and
$ from a state income tax refund;.
With regard to DOE's job at ABC, Inc., DOE received wages of $ for time she worked. In addition to her
salary, DOE received the following employee benefits from ABC, Inc.:
Employer paid health care of $;
$ in sick pay benefits;
$ in vacation benefits; and
Employer paid group term life insurance with $ in coverage.
Question
When completing Form which entries are correct?
X in Box A; d $; e $; h $
X in Box C; d $; e $; h $
X in Box F; d $; e $; f H; g$; h $
X in Box F; d $; e $; f i; g$; h $
Question
When completing Schedule D which entry is correct?
Line h $
Line h $
Line h $
Line d $
Question
When completing Schedule which entries are correct?
$; a $; and $
$; b $; and $
$; b $; c $; and $
$; b $; c $; z; and $
Question
What is DOE's total income on Form
$
$
$
$
Question
What is DOE's taxable income?
$
$
$
$
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