please fill out form 1040 based on the following info.

Gross Income Ret Salary Reiver Salary Interest from City of Maryland Bond Interest from Dunder Bank $ 112,000.00 $ 187,750.00 $ 450.00 $ 230.00 $ 675.00 $ 1,885.00 $ 600.00 $ 303,140.00 Interest from Treasury Bond Dividends Gym Memberships Total Gross Income For AGI 401k Accounts Net Short Term Capital Loss $ 23,980.00 $ 1,324.00 $ 2,600.00 $ 27,904.00 Health Care Savings Account Total For AGI AGI Gross Income For AGI $ $ 303,140.00 27,904.00 275,236.00 Total AGI $ From AGI Medical Fees (unreimbursed) Prescriptions (unreimbursed) State and Local Taxes Mortgage Interest Vehical Registration Fee CPA Tax Preparations Fee $ 10,500.00 $ 1,380.00 $ 10,000.00 $ 13,478.00 $ 1,250.00 $ 2,000.00 $ 1,000.00 $ 450.00 $ 3,750.00 $ 2,500.00 $ 43,058.00 Red Cross Donation Goodwill Charities Donation Church Donation Food Bank Donation Total Itemized Deduction