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. . . . . . Mary is 30 years old and married to Mark, age 36. Mark passed away on January 30, 2021 Mark was unemployed and had no income in 2021 due to his illness. Mary's seven-year-old daughter, Jenny, lived with her the entire year. Mary paid more than half the cost of keeping up a home and support for Mark and Jenny Mary received a distribution from her traditional IRA in January to pay for living expenses. Mary was a full-time high school teacher and earned $35.000 in wages, Mary purchased supplies for her class out of her own pocket totaling $320. Mary received a W-2G in the amount of $8,200 from the local casino. Mary paid child and dependent care expenses for Jenny while she worked. Mary elected not to receive advance child tax credit payments Mary and Mark received a $4,200 Economic Impact Payment (EIP3) in 2021. Mary, Mark, and Jenny were not medically or financially affected by the COVID-19 pandemic. Mary, Mark, and Jenny are U.S. citizens and have valid Social Security numbers. They all lived in the United States for the entire year. If Mary is entitled to a refund, she would like to deposit half into her checking account and half into her savings account. Documents from Adelphi Bank and Trust show that the routing number for both accounts is 111000025. Her checking account number is 113355779 and her savings account number is 224466880. . . . SANCIAL SECURITY ACIAL SEXURITY 620-00-XXXX Mary Rodgers Mary Rolgon 630-00-XXXX Jenny Rodgers Penye SOCIAL SECURITY 540-00-XXXX Mark Rodgers e file www.n.goulette Employee's Courty ube 620-00-XXXX b Employer identification number (EIN 38-500XXXX e Employer's name, address and ZIP code GREEN BAY SCHOOL DISTRICT 1200 LOMBARDI BLVD YOUR CITY, YOUR STATE, ZIP See accurate Visit this website OMB No 1545-000 FASTI Use 1 Wather compensation 2 Federal income tax withheld $35,000.00 $2 150.00 5 Social ecurity 4 Socioecurity fee wild $35.000.00 $2,170.00 5 More wages and & Medicare tax withheld $35,000.00 $507.50 7 Solarity to 8 Allocafe d Control number 10 Dependent are not Employee's first name and Lane S11 Noned plans 12 Sonstructions for box 12 13 120 MARY RODGERS 178 PACKER DRIVE YOUR CITY, YOUR STATE, ZIP 44 Oce 120 ad Employee's address and IP Code 15 Sale Employer's state number YS 38-500XXXX 20 locale 16 State of tot 17. a. come tu 16 Lockwoos, 19 Local income tax $35,000.00 $750.00 vom W-2 Wage and Ta\statement 2021 Det me Troevenue Service Copy B-To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service CORRECTED I checked PAYER Samro address, oly or town, prostate. Com 1 ecogs 2 Oute won and ZIP or for RIDGETOP CASINO $ $8.200.00 777 CREST ROAD > Type 4 Federal YOUR CITY, YOUR STATE, ZIP Pok $ Transaction 3/16/2021 OM No 1545-028 Form W-2G Certain Gambling Winnings January 2011 Yonday 20 21 $1,968.00 PAYERS PAYERS TO 7 C $ 30 W AR 39-600XOXX 620-00-xxx WINNERS 15 casos 12 Second bench The information is being furnished 10. the internal Revenue Service MARY RODGERS Y8987654 YS 31500XXX Sondra. 14 Swing 178 PACKER DRIVE Gyor, $ 16 YOUR CITY YOUR STATE, ZIP Copy B Report this income on your federal tax return of this form shows federal Income tax withheld in box 4 attach this copy $ 17 18 No 2021 CORRECTED checked PAYER'S name, street address, city or town, state or province, 1 Gross distribution OMB No 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, 5 4,000.00 Retirement or RILEY STATE BANK Profit-Sharing Plans, 2a Taxable amount 123 SKIP WAY IRAs, Insurance Contracts, etc. YOUR CITY, YOUR STATE, ZIP 3 4,000.00 Form 1099-R 2b Taxable amount Total Copy B not determined O distribution PAYER'S TIN Report this RECIPIENTS TIN 3 Capital gain included in 4 Federal income Tax income on your box 20) withheld federal tax return. If this 38-200XXXX 620-00-XXXX is 800.00 form shows RECIPIENT'S name 5 Employee contribution Net unrealized federal income Designated Roth appreciation in tax withheld in MARY RODGERS contributions or employer's securities Insurance premium box 4, attach S this copy to Street address including apt.no) 7 Distribution your return. 8 Other codes SER 178 PACKER DRIVE SVE us This information is City or town, state or province, country, and ZIP or foreign postal code 9 Your percentage of total bodemployee contin being furnished to the IRS YOUR CITY, YOUR STATE, ZIP distribution 10 Amount alocable to RR 11 1st year of eng 12 FATCA 14 State tax withhold within 5 years 15 Stato/Payer's state no. 16 Stute distribution Roth contro os ss Account number see instruction tof 17 Local tax withheld 18 Name of locality 13 Date of payment 19 Local distribution $ Form 1099-R www.informi Dement of Trury - Service 2021 CORRECTED RECIPIENTS/LENDER Serty of town, or OMNE$25.1576 province, country, IP or foreign postal code and telephone number MAGGIE MAE 354 LINCOLN RD YOUR CITY, YOUR STATE, ZIP Form 1098-E RECIPIENTS IN BORROWER'S TIN 1 Studentinin byder 620-00-XXXX 127-00-XXXX $750.00 BORROW'Same Student Loan Interest Statement Copy c For Recipient MARY RODGERS Sendung) 178 PACKER DRIVE Corrow, state province country and or foreign postcode YOUR CITY, YOUR STATE, ZIP Account for instruction For Privacy Act and Paperwork Reduction Act Notic, so the 2021 General Instructions for Curtain Information Heturns 2 Check box does not including the and Wealante was Form 1098-E www.fo.BE Death Service 25. Mary's gambling winnings do not have to be reported on her return. a. True b. False 26. Mary's most advantageous filing status is: a. Head of Household b. Married Filing Jointly C. Married Filing Separately d. Qualifying Widow(er) 27. Mary is subject to the additional 10% tax on early distributions. a. True b. False 18. Mary qualifies for which of the following credits? a. Child Tax Credit and Earned Income Tax Credit b. Child and Dependent Care Credit C. Retirement Savings Contribution Credit d. Both a and b 29. Mary wants to split the refund between her savings and checking accounts. How is this accomplished, if possible? a. Splitting a refund is not possible. b. Mary does not have an overpayment on her retum. This can only be accomplished if filing a paper return d. Complete Form 8888, Allocation of Refund (Including Savings Bond Purchases) 30. What amount can Mary claim as an adjustment for the supplies she purchased out of pocket? C a $0 b. $250 C. $300 d. $320 . . . . . . Mary is 30 years old and married to Mark, age 36. Mark passed away on January 30, 2021 Mark was unemployed and had no income in 2021 due to his illness. Mary's seven-year-old daughter, Jenny, lived with her the entire year. Mary paid more than half the cost of keeping up a home and support for Mark and Jenny Mary received a distribution from her traditional IRA in January to pay for living expenses. Mary was a full-time high school teacher and earned $35.000 in wages, Mary purchased supplies for her class out of her own pocket totaling $320. Mary received a W-2G in the amount of $8,200 from the local casino. Mary paid child and dependent care expenses for Jenny while she worked. Mary elected not to receive advance child tax credit payments Mary and Mark received a $4,200 Economic Impact Payment (EIP3) in 2021. Mary, Mark, and Jenny were not medically or financially affected by the COVID-19 pandemic. Mary, Mark, and Jenny are U.S. citizens and have valid Social Security numbers. They all lived in the United States for the entire year. If Mary is entitled to a refund, she would like to deposit half into her checking account and half into her savings account. Documents from Adelphi Bank and Trust show that the routing number for both accounts is 111000025. Her checking account number is 113355779 and her savings account number is 224466880. . . . SANCIAL SECURITY ACIAL SEXURITY 620-00-XXXX Mary Rodgers Mary Rolgon 630-00-XXXX Jenny Rodgers Penye SOCIAL SECURITY 540-00-XXXX Mark Rodgers e file www.n.goulette Employee's Courty ube 620-00-XXXX b Employer identification number (EIN 38-500XXXX e Employer's name, address and ZIP code GREEN BAY SCHOOL DISTRICT 1200 LOMBARDI BLVD YOUR CITY, YOUR STATE, ZIP See accurate Visit this website OMB No 1545-000 FASTI Use 1 Wather compensation 2 Federal income tax withheld $35,000.00 $2 150.00 5 Social ecurity 4 Socioecurity fee wild $35.000.00 $2,170.00 5 More wages and & Medicare tax withheld $35,000.00 $507.50 7 Solarity to 8 Allocafe d Control number 10 Dependent are not Employee's first name and Lane S11 Noned plans 12 Sonstructions for box 12 13 120 MARY RODGERS 178 PACKER DRIVE YOUR CITY, YOUR STATE, ZIP 44 Oce 120 ad Employee's address and IP Code 15 Sale Employer's state number YS 38-500XXXX 20 locale 16 State of tot 17. a. come tu 16 Lockwoos, 19 Local income tax $35,000.00 $750.00 vom W-2 Wage and Ta\statement 2021 Det me Troevenue Service Copy B-To Be Filed With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service CORRECTED I checked PAYER Samro address, oly or town, prostate. Com 1 ecogs 2 Oute won and ZIP or for RIDGETOP CASINO $ $8.200.00 777 CREST ROAD > Type 4 Federal YOUR CITY, YOUR STATE, ZIP Pok $ Transaction 3/16/2021 OM No 1545-028 Form W-2G Certain Gambling Winnings January 2011 Yonday 20 21 $1,968.00 PAYERS PAYERS TO 7 C $ 30 W AR 39-600XOXX 620-00-xxx WINNERS 15 casos 12 Second bench The information is being furnished 10. the internal Revenue Service MARY RODGERS Y8987654 YS 31500XXX Sondra. 14 Swing 178 PACKER DRIVE Gyor, $ 16 YOUR CITY YOUR STATE, ZIP Copy B Report this income on your federal tax return of this form shows federal Income tax withheld in box 4 attach this copy $ 17 18 No 2021 CORRECTED checked PAYER'S name, street address, city or town, state or province, 1 Gross distribution OMB No 1545-0119 Distributions From country, ZIP or foreign postal code, and telephone no. Pensions, Annuities, 5 4,000.00 Retirement or RILEY STATE BANK Profit-Sharing Plans, 2a Taxable amount 123 SKIP WAY IRAs, Insurance Contracts, etc. YOUR CITY, YOUR STATE, ZIP 3 4,000.00 Form 1099-R 2b Taxable amount Total Copy B not determined O distribution PAYER'S TIN Report this RECIPIENTS TIN 3 Capital gain included in 4 Federal income Tax income on your box 20) withheld federal tax return. If this 38-200XXXX 620-00-XXXX is 800.00 form shows RECIPIENT'S name 5 Employee contribution Net unrealized federal income Designated Roth appreciation in tax withheld in MARY RODGERS contributions or employer's securities Insurance premium box 4, attach S this copy to Street address including apt.no) 7 Distribution your return. 8 Other codes SER 178 PACKER DRIVE SVE us This information is City or town, state or province, country, and ZIP or foreign postal code 9 Your percentage of total bodemployee contin being furnished to the IRS YOUR CITY, YOUR STATE, ZIP distribution 10 Amount alocable to RR 11 1st year of eng 12 FATCA 14 State tax withhold within 5 years 15 Stato/Payer's state no. 16 Stute distribution Roth contro os ss Account number see instruction tof 17 Local tax withheld 18 Name of locality 13 Date of payment 19 Local distribution $ Form 1099-R www.informi Dement of Trury - Service 2021 CORRECTED RECIPIENTS/LENDER Serty of town, or OMNE$25.1576 province, country, IP or foreign postal code and telephone number MAGGIE MAE 354 LINCOLN RD YOUR CITY, YOUR STATE, ZIP Form 1098-E RECIPIENTS IN BORROWER'S TIN 1 Studentinin byder 620-00-XXXX 127-00-XXXX $750.00 BORROW'Same Student Loan Interest Statement Copy c For Recipient MARY RODGERS Sendung) 178 PACKER DRIVE Corrow, state province country and or foreign postcode YOUR CITY, YOUR STATE, ZIP Account for instruction For Privacy Act and Paperwork Reduction Act Notic, so the 2021 General Instructions for Curtain Information Heturns 2 Check box does not including the and Wealante was Form 1098-E www.fo.BE Death Service 25. Mary's gambling winnings do not have to be reported on her return. a. True b. False 26. Mary's most advantageous filing status is: a. Head of Household b. Married Filing Jointly C. Married Filing Separately d. Qualifying Widow(er) 27. Mary is subject to the additional 10% tax on early distributions. a. True b. False 18. Mary qualifies for which of the following credits? a. Child Tax Credit and Earned Income Tax Credit b. Child and Dependent Care Credit C. Retirement Savings Contribution Credit d. Both a and b 29. Mary wants to split the refund between her savings and checking accounts. How is this accomplished, if possible? a. Splitting a refund is not possible. b. Mary does not have an overpayment on her retum. This can only be accomplished if filing a paper return d. Complete Form 8888, Allocation of Refund (Including Savings Bond Purchases) 30. What amount can Mary claim as an adjustment for the supplies she purchased out of pocket? C a $0 b. $250 C. $300 d. $320