PLEASE USE THE INFORMATION ABOVE TO FILL OUT SCHEDULE A!

Tammy Campbell 789-78-6789 32 5798 Main Street New York New York 10014 Married Filing Separately Peter Campbell 754-21-9517 34 Elizabeth Campbell 824-92-3467 6 Name SSN Age Other Street Address City State Zip Filing Status Spouse Name Spouse SSN Spouse Age Dependent Name Dependent SSN Dependent Age Dependent Name Dependent SSN Dependent Age Dependent Name Dependent Age Dependent SSN Additional tax on IRAs Business Income (QBI) Charitable Contributions by Check Credit for Childcare Expenses Education Credits Educator Expenses Eligible for Child Tax Credit Federal Income Tax Withheld Home Mortgage Interest Medical Expenses Non-Taxable Interest Ordinary Dividends Other Income Real Estate Taxes Rental Income Residential Energy Credit Self Employment Tax State Income Taxes State Sales Taxes Student Loan Interest deduction Taxable Interest Unreported Social security and Medicare Tax Wages 25,934 18,000 419 1,500 1,200 Yes 25,368 5,219 6,582 3,128 4,208 6,218 7,368 1,800 5,641 10,236 6,512 3,418 163,800 OMB No. 1545-0074 3 SCHEDULE A Itemized Deductions (Form 1040 or 1040-SR) Go to www.irs.gov/ScheduleA for instructions and the latest information. 2019 Department of the Treasury Attach to Form 1040 or 1040-SR. Attachment Internal Revenue Service (99 Caution: If you are claiming a net qualified disaster loss on Form 4684, see the instructions for line 16. Sequence No. 07 Name(s) shown on Form 1040 or 1040-SR Your social security number Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions) Dental 2 Enter amount from Form 1040 or 1040-SR, line 8b 2 Expenses 3 Multiply line 2 by 7.5% (0.075).. 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter-O- Taxes You 5 State and local taxes. Paid a State and local income taxes or general sales taxes. You may include either income taxes or general sales taxes on line 5a, but not both. If you elect to include general sales taxes instead of income taxes, check this box 5a b State and local real estate taxes (see instructions) 5b c State and local personal property taxes 5c d Add lines 5a through 5c.. 5d e Enter the smaller of line 5d or $10,000 ($5,000 if married filing separately) 5e 6 Other taxes. List type and amount 7 Add lines 5e and 6 Interest You 8 Home mortgage interest and points. If you didn't use all of your home Paid mortgage loan(s) to buy, build, or improve your home, see Caution: Your mortgage interest instructions and check this box ... deduction may be limited (see a Home mortgage interest and points reported to you on Form 1098. See instructions. instructions if limited. b Home mortgage interest not reported to you on Form 1098. See instructions if limited. If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address 8a Bd Be 9 11 8b c Points not reported to you on Form 1098. See instructions for special rules 8c d Mortgage insurance premiums (see instructions) e Add lines Ba through 8d. 9 Investment interest. Attach Form 4952 if required. See instructions 10 Add lines 8e and 9 10 Gifts to 11 Gifts by cash or check. If you made any gift of $250 or more, see Charity instructions 12 Other than by cash or check. If you made any gift of $250 or more, Caution: If you 12 made a gift and see instructions. You must attach Form 8283 if over $500. got a benelit for it. 13 Carryover from prior year 13 See instructions. 14 Add lines 11 through 13 Casualty and 15 Casualty and theft loss(es) from a federally declared disaster (other than net qualified Theft Losses disaster losses). Attach Form 4684 and enter the amount from line 18 of that form. See instructions. 15 Other 16 Other-from list in instructions. List type and amount Itemized Deductions 16 Total 17 Add the amounts in the far right column for lines 4 through 16. Also, enter this amount on Itemized Form 1040 or 1040-SR, line 9 . 17 Deductions 18 If you elect to itemize deductions even though they are less than your standard deduction, check this box For Paperwork Reduction Act Notice, see the Instructions for Forms 1040 and 1040-SR. Cat. No. 17145C Schedule A (Form 1040 or 1040-SR) 2019 14 Tammy Campbell 789-78-6789 32 5798 Main Street New York New York 10014 Married Filing Separately Peter Campbell 754-21-9517 34 Elizabeth Campbell 824-92-3467 6 Name SSN Age Other Street Address City State Zip Filing Status Spouse Name Spouse SSN Spouse Age Dependent Name Dependent SSN Dependent Age Dependent Name Dependent SSN Dependent Age Dependent Name Dependent Age Dependent SSN Additional tax on IRAs Business Income (QBI) Charitable Contributions by Check Credit for Childcare Expenses Education Credits Educator Expenses Eligible for Child Tax Credit Federal Income Tax Withheld Home Mortgage Interest Medical Expenses Non-Taxable Interest Ordinary Dividends Other Income Real Estate Taxes Rental Income Residential Energy Credit Self Employment Tax State Income Taxes State Sales Taxes Student Loan Interest deduction Taxable Interest Unreported Social security and Medicare Tax Wages 25,934 18,000 419 1,500 1,200 Yes 25,368 5,219 6,582 3,128 4,208 6,218 7,368 1,800 5,641 10,236 6,512 3,418 163,800 OMB No. 1545-0074 3 SCHEDULE A Itemized Deductions (Form 1040 or 1040-SR) Go to www.irs.gov/ScheduleA for instructions and the latest information. 2019 Department of the Treasury Attach to Form 1040 or 1040-SR. Attachment Internal Revenue Service (99 Caution: If you are claiming a net qualified disaster loss on Form 4684, see the instructions for line 16. Sequence No. 07 Name(s) shown on Form 1040 or 1040-SR Your social security number Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions) Dental 2 Enter amount from Form 1040 or 1040-SR, line 8b 2 Expenses 3 Multiply line 2 by 7.5% (0.075).. 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter-O- Taxes You 5 State and local taxes. Paid a State and local income taxes or general sales taxes. You may include either income taxes or general sales taxes on line 5a, but not both. If you elect to include general sales taxes instead of income taxes, check this box 5a b State and local real estate taxes (see instructions) 5b c State and local personal property taxes 5c d Add lines 5a through 5c.. 5d e Enter the smaller of line 5d or $10,000 ($5,000 if married filing separately) 5e 6 Other taxes. List type and amount 7 Add lines 5e and 6 Interest You 8 Home mortgage interest and points. If you didn't use all of your home Paid mortgage loan(s) to buy, build, or improve your home, see Caution: Your mortgage interest instructions and check this box ... deduction may be limited (see a Home mortgage interest and points reported to you on Form 1098. See instructions. instructions if limited. b Home mortgage interest not reported to you on Form 1098. See instructions if limited. If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address 8a Bd Be 9 11 8b c Points not reported to you on Form 1098. See instructions for special rules 8c d Mortgage insurance premiums (see instructions) e Add lines Ba through 8d. 9 Investment interest. Attach Form 4952 if required. See instructions 10 Add lines 8e and 9 10 Gifts to 11 Gifts by cash or check. If you made any gift of $250 or more, see Charity instructions 12 Other than by cash or check. If you made any gift of $250 or more, Caution: If you 12 made a gift and see instructions. You must attach Form 8283 if over $500. got a benelit for it. 13 Carryover from prior year 13 See instructions. 14 Add lines 11 through 13 Casualty and 15 Casualty and theft loss(es) from a federally declared disaster (other than net qualified Theft Losses disaster losses). Attach Form 4684 and enter the amount from line 18 of that form. See instructions. 15 Other 16 Other-from list in instructions. List type and amount Itemized Deductions 16 Total 17 Add the amounts in the far right column for lines 4 through 16. Also, enter this amount on Itemized Form 1040 or 1040-SR, line 9 . 17 Deductions 18 If you elect to itemize deductions even though they are less than your standard deduction, check this box For Paperwork Reduction Act Notice, see the Instructions for Forms 1040 and 1040-SR. Cat. No. 17145C Schedule A (Form 1040 or 1040-SR) 2019 14