Pierce (age 40, DOB: 9/18/79, SSN 219-00-1440), and Sharon Canon (age 36, DOB: 12/25/83, SSN 289-00-2222) are married and have lived together at 1210 Pinkerton Drive, Your City, Your State - Your Zip, for several years. Their twin daughters, Mia (age 6, DOB: 8/23/2013, SSN 369- 00-5478) and Maya (age 6, DOB: 8/23/2013, SSN 369-00-5479) lived with them all year. Pierce and Sharon want to designate $3 of their taxes for the Presidential Campaign Fund. The family was covered by health insurance for the entire year. Pierce is a dentist, and Sharon is a stay-at-home mom. Their 1099s and W-2s follow. They had the following expenses: Supplemental RX/vision insurance St. Francis Hospital Eyeglasses Dr. Middleton Dr. DeHart $3,600 2,950 300 1,254 2,053 Mortgage interest Real estate taxes Personal property tax Church donations Breast cancer charity $14,536 3,285 1,385 5,900 1,000 The Canons gave children's clothes and men's suits to the Salvation Army (6100 Midlothian Turnpike, Your City. Your State - Your Zip). The items were purchased on various dates for $4,600. The clothing was donated on November 25". The consignment value of the clothing was $945. They donated two new laptops to the Children's Miracle Network (8795 Loving Avenue, Your City, Your State - Your Zip) on March 200. The cost of the laptops were $2,700, and they were purchased the same day they were donated to CMN. They itemized last year and received a state refund of $26 a Employee's social security number 219-00-1440 b Employer identification number (EIN) 63-2125332 c Employer's name, address, and ZIP code Healthy Smiles PO Box 658 Your City, Your State - Your ZIP Safe, accurate, Visit the IRS website at OMB No 1545-0008 FASTIUS e file www.is.gov/elle 1 Wagas, tips, other compensation 2 Federal income tax withheld 164900.00 23500.00 3 Social Security wages 4 Social security tax withhold 128400.00 7960.80 5 Medicare wages and tips 6 Medicare tax withheld 179400.00 2601.30 7 Social security tips 8 Alocated tips 9 10 Dependent care benefits d Control number Last name Suff 11 Nonqualified plans 12a See instructions for bok 12 . Employee's first name and initial Pierce D Canon 14500.00 12b sick pay 1210 Pinkerton Drive Your City, Your State - Your ZIP 13 Statutory Retirement Third party employee plan X 14 Other 12c 12d 1 Employee's address and ZIP code 15 State Employer's state ID number YS 548995232 16 State wages, fips, etc. 17 State income tax 164900.00 11543.00 18 Local wages, tips, etc. 19 Local income tax 20 Locally name Department of the Treasury - Internal Revenue Service Form W-2 20XX Wage and Tax Statement Copy B.To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the internal Revenue Service Carter's Investments 9299 Abernathy Drive, Suite C The Gresham Office Park Your City, Your State - Your Zip Broker: Matt Harper 800-555-5555 Account number: 698-85242253 Account owner: Pierce Canon 1210 Pinkerton Drive Your City. Your State - Your Zip Social Security Number: 219-00-1440 Form 1099-B Transaction Trade Date Not Covered Shares Sold Price/Share Proceeds Less Commissions SOLD X 01/13/2019 500 shares of Global $20 $10,000.00 Transaction Trade Date Shares Sold Price/Share Cost plus Commissions PURCHASE 10/19/2010 $15 500 shares of Global $7,500.00 Total long-term gains or losses for noncovered securities $2,500.00 OMB No. 1545 0112 CORRECTED (if checked) PAYER'S name, street Address, cly or town, state or province, country, ZIP Payer's RTN (optional) or foreign postal code, and telephone no The Big Bank 1 Interest income 9210 E. 21" Street Your City. Your State - Your ZIP $ 2385.00 2 Exty withdrawal penalty 20XX Form 1099-INT Interest Income PAYER S federal sentication number RECIPIENTS Identification number Copy B 54-2311721 219-00-1440 3 Interest on US Sawngt bonds and Trom, obligatora For Recipient RECIPIENT'S name Pierce and Sharon Canon 4 Federal come tax withheld investment expenses Foreign taxpat $ 7 Foreign country U.S. Possession Street Address including apt no) 1210 Pinkerton Drive Tax exempterest Specified private activity Bond interest Cly or town, state or province, country and ZP of foreign postal code Your City. Your State - Your ZIP This is important fax information and is being furnished to the Internal Revenue Service you are required to file return a negligence penalty or other sanction may be imposed on your this income is taxable and the IRS determines that it has not been reported $ 11 Bond premium 10 Market Ducourt FATCA fing requrement 12 lord pruum on Treurgation $ 14 Tax-exempt and tax credit bond CUSSP no 13 Bond pummontaremont $ 15 S 16 Studentilation Account number is instruction 17 wined Form 1099-INT keep for your records) www.its gov/form 1099int Department of the Treasury -- Internal Revenue Service CORRECTED (if checked) PAYER'S nama street address, oly or town, or provins, county, ZP 1a Tot ordinary dividends or foreign postcode and telephone no $ 256.00 AT&T 1b Qualified dividends OMB No 1545-0110 20XX Dividends and Distributions 2 Call Lane Your City. Your State - Your ZIP $ 2a Total capital gain distr $ 2c Section 1202 gain Form 1099-DIV 26 Unrecap. Soc. 1250 gain $ 2d Collectibles (289) gain Copy B PAYER'S Federal identification number RECIPIENTS Identification number For Recipient 54-1658682 219-00-1440 3 Nondividend distributions RECIPIENTS name Pierce and Sharon Canon Street address (including apt no.) 1210 Pinkerton Drive 6 Fornign tax paid City or town, state or province, county, and ZIP or foreign postal code Your City. Your State - Your ZIP $ 8 Cath liquidation distributions $ 10 Exempt-interest dividends $ This is important 4 Federal income tax withheld information and is being furnished to 5 Investment expenses the Internal Revenue Service. If you are 7 Fomign country or US possession required to a retum a negligence penalty or other sanction may be imposed on you if 9 Noncash liquidation distributions this income is able $ and the IRS 11 Specfed private activity determines that it has not been reported bond interest dividends $ 14 State tax withheld $ $ Department of the Treasury - Internal Revenue Service FATCA Sing requirement Account number (see instructions) $ 12 State 13 State identification no. Form 1099-DIV (keep for your records) www.irs/form1099div CORRECTED (if checked) PAYER dress your own site or provin, County, F Ta To ordinary a riportate and phone $ 751.10 The Mutual Fund 1b nied dividende OMB No 1505-0110 20XX Dividends and Distributions 1010 19h Street Your City. Your State - Your ZIP $ 2a Toptan Form 1099-DIV 2b Unrecap Sec 1250 g $ a Collected (205) gain Copy B For Recipient $ Federal income tax withheld This portar normation and bonged to PAYERS Federal identifionumber RECIPENTS confiation unter 2c Section 1202 54-1659982 219.00-1440 $ RECIPIENTS Nondividerdirbutions Pierce and Sharon Canon $ Sre (induting Apt.no) 1210 Pinkerton Drive Foreign tax paid Cty or own state or province, county, and Performin postal code $ Your City. Your State - Your ZIP 8 Cash liquidation dirbutions FATCASing 10 Exemptinterest dividende Sinvestment expenses 7 Foreign country US. 9 Norcash liquidationibus $ 11 Spoofed prve dvy bond interest vidende na regione patyrordion may be imposed on you this one is the and the RS be Amour (enstructions 13 Store $ 14 Swed $ $ Form 1099-DIV (keep for your records) www.is/orm 1099div Department of the Treasury - Internal Revenue Service OMB No 1545 0110 20XX Dividends and Distributions CORRECTED (if checked) PAYER'Same street stress or owner province courty ZP 1a Twordinary and og outcode and phone no $ 256.00 AT&T 1b Quifed videos 2 Call Lane $ Your City. Your State - Your ZIP 2 capital and $ PAYERS FOR RECENT Sectionner 2 din 1202 54-1658682 219-00-1440 $ REOPENTS Novided buone Perce and Sharon Canon Form 1099-DIV 2 Unca: Sec 1250 Copy B 2d Cofectos gan For Recipient bong Answer the following question based on the tax return you prepared for Pierce and Sharon Canon: Select the Adjusted Gross Income (AGI): A) $168,292 CB) $169,811 CC) $170,818 CD) $164,900