PLEASE USE THIS INFORMATION TO FILL OUT:

1) Individual return: form 1040 2019

2) Itemized Deductions: form 1040 Schedule A 2019

3) Additional Income and Adjustment to income: form 1040 schedule 1

4) Additional Taxes: form 1040 schedule 2

5) Additional Credits and Payments: form 1040 schedule 3

Please fill out the form even if there is no number matched with the form. Thank you!

Name SSN 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 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 2019 Department of the Treasury - Internal Revenue Service (99) OMB No. 1545-0074 IRS Use Only-Do not write or staple in this space. Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widower) (W) Check only one box. If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child's name if the qualifying person is a child but not your dependent. Your first name and middle initial Last name Your social security number If joint return, spouse's first name and middle initial Last name Spouse's social security number Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your tax or refund. You Spouse Foreign country name Foreign province/state/county Foreign postal code If more than four dependents, see instructions and here Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse itemizes on a separate return or you were a dual-status alien Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Dependents (see instructions): (2) Social security number (3) Relationship to you (4) Vif qualifies for (see instructions): (1) First name Last name Credit for other dependents Is blind Child tax credit 1 2a 2b 3b 4b 4d 5b 6 ] 7a 1 Wages, salaries, tips, etc. Attach Form(s) W-2 2a Tax-exempt interest b Taxable interest. Attach Sch. Bif required 3a Qualified dividends. 3a Standard b Ordinary dividends. Attach Sch. B if required Deduction for 4a IRA distributions. 4a b Taxable amount Single or Married 4c Pensions and annuities filing separately, d Taxable amount $12,200 5a Social security benefits. 5a b Taxable amount Married filing 6 jointly or Qualifying Capital gain or (loss). Attach Schedule D if required. If not required, check here widower) 7a Other income from Schedule 1, line 9 $24,400 Head of Add lines 1, 2, 3, 4b, 4d, 56, 6, and 7a. This is your total income household $18,350 8a Adjustments to income from Schedule 1, line 22 If you checked b Subtract line 8a from line 7b. This is your adjusted gross income any box under Standard 9 Standard deduction or itemized deductions (from Schedule A) 9 Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10 see instructions. 11a Add lines 9 and 10 b Taxable income. Subtract line 11a from line 85. If zero or less, enter-O- For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 113208 b 7b 8 8b 11a 11b Form 1040 (2019) Page 2 14 Form 1040 (2019) 12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a b Add Schedule 2 line 3, and line 12a and enter the total 12b 13a Child tax credit or credit for other dependents. 13a b Add Schedule 3, line 7, and line 13a and enter the total 13b 14 Subtract line 13b from line 12b. If zero or less, enter-O- 15 Other taxes, including self-employment tax, from Schedule 2, line 10 15 16 Add lines 14 and 15. This is your total tax . 16 17 Federal income tax withheld from Forms W-2 and 1099 17 18 . If you have a Other payments and refundable credits: qualifying child, Earned income credit (EIC). 18a attach Sch. EIC. If you have b Additional child tax credit. Attach Schedule 8812 18b nontaxable c American opportunity credit from Form 8863, line 8 18C combat pay, see instructions. d Schedule 3, line 14 18d e Add lines 18a through 18d. These are your total other payments and refundable credits 18e 19 Add lines 17 and 18e. These are your total payments 19 20 Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here 21a Direct deposit? Routing number Type: Checking Savings See instructions. Account number 22 Amount of line 20 you want applied to your 2020 estimated tax . Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions 23 You Owe 24 Estimated tax penalty (see instructions). 24 Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below. Designee No (Other than Designee's Phone Personal identification paid preparer) name no. number (PIN) Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge Here Your signature Date Your occupation If the IRS sent you an Identity Protection PIN, enter it here Joint return? (see inst.) See instructions. Spouse's signature. If a joint retur, both must sign. Date Spouse's occupation If the IRS sent your spouse an Keep a copy for Identity Protection PIN, enter it here your records. (see inst.) Phone no. Email address Preparer's name Preparer's signature Date PTIN Check if. Paid 3rd Party Designee Preparer Firm's name Phone no. Self-employed Use Only Firm's address Firm's EIN Go to www.irs.gov/Form 1040 for instructions and the latest information. Form 1040 (2019) 22 SCHEDULE A Itemized Deductions OMB No. 1545-0074 (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 4 Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions) 1 Dental 2 Enter amount from Form 1040 or 1040-SR, line 8b 2 Expenses 3 Multiply line 2 by 7.5% (0.075). 3 . 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 O 5a b State and local real estate taxes (see instructions) 5b c State and local personal property taxes 5c dAdd 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 6 7 Add lines 5e and 6 Interest You 8 Home mortgage interest and points. If you didn't use all of your home mortgage loan(s) to buy, build, or improve your home, see Caution: Your instructions and check this box mortgage interest deduction may be a Home mortgage interest and points reported to you on Form 1098. See limited (see instructions if limited instructions) 8 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. 7 Paid 8b c Points not reported to you on Form 1098. See instructions for special rules 8 d Mortgage insurance premiums (see instructions) 8d e Add lines Ba through 8d 8e 9 Investment interest. Attach Form 4952 if required. See instructions 9 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 11 12 Other than by cash or check. If you made any gift of $250 or more, Caution: If you made a gift and see instructions. You must attach Form 8283 if over $500. 12 got a benefit for it, 13 Carryover from prior year 13 see instructions. 14 Add lines 11 through 13. 14 Casualty and 15 Casualty and theft lossles) 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 SCHEDULE 1 (Form 1040 or 1040-SR) Additional Income and Adjustments to Income Department of the Treasury Attach to Form 1040 or 1040-SR. Internal Revenue Service Go to www.irs.gov/Form 1040 for instructions and the latest information. Name(s) shown on Form 1040 or 1040-SR OMB No. 1545-0074 2019 Attachment Sequence No. 01 Your social security number 1 3 6 9 At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? . Yes No Part Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes 2a Alimony received 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C. 4 Other gains or losses). Attach Form 4797. 4 5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. 5 6 Farm income or loss). Attach Schedule F 7 Unemployment compensation 7 8 Other income. List type and amount 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a Part II Adjustments to Income 10 Educator expenses 10 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 .. 11 12 Health savings account deduction. Attach Form 8889 12 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE 14 15 Self-employed SEP, SIMPLE, and qualified plans. 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid. 18a b Recipient's SSN C Date of original divorce or separation agreement (see instructions) IRA deduction 19 20 Student loan interest deduction 20 21 Tuition and fees. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a 22 For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019 19 SCHEDULE 2 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 or 1040-SR Additional Taxes Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No. 1545-0074 2019 Attachment Sequence No. 02 Your social security number N| O Part 1 Tax 1 Alternative minimum tax. Attach Form 6251 1 2 Excess advance premium tax credit repayment. Attach Form 8962 3 Add lines 1 and 2. Enter here and include on Form 1040 or 1040-SR, line 12b Part II Other Taxes 4 Self-employment tax. Attach Schedule SE. 4 5 Unreported social security and Medicare tax from Form: a 4137 b 8919 5 6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored accounts. Attach Form 5329 if required... 7a Household employment taxes. Attach Schedule H 7a b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if required 7b Taxes from: a Form 8959 b Form 8960 c Instructions, enter code(s) 8 9 Section 965 net tax liability installment from Form 965-A 10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form 1040 or 1040-SR, line 15 10 For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 2 (Form 1040 or 1040-SR) 2019 6 8 9 Cat. No. 71478U SCHEDULE 2 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 or 1040-SR Additional Taxes Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No. 1545-0074 2019 Attachment Sequence No. 02 Your social security number N| O Part 1 Tax 1 Alternative minimum tax. Attach Form 6251 1 2 Excess advance premium tax credit repayment. Attach Form 8962 3 Add lines 1 and 2. Enter here and include on Form 1040 or 1040-SR, line 12b Part II Other Taxes 4 Self-employment tax. Attach Schedule SE. 4 5 Unreported social security and Medicare tax from Form: a 4137 b 8919 5 6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored accounts. Attach Form 5329 if required... 7a Household employment taxes. Attach Schedule H 7a b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if required 7b Taxes from: a Form 8959 b Form 8960 c Instructions, enter code(s) 8 9 Section 965 net tax liability installment from Form 965-A 10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form 1040 or 1040-SR, line 15 10 For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 2 (Form 1040 or 1040-SR) 2019 6 8 9 Cat. No. 71478U SCHEDULE 3 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 or 1040-SR Additional Credits and Payments Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No 1545-0074 2019 Attachment Sequence No. 03 Your social security number OWN = 7 Part| Nonrefundable Credits 1 Foreign tax credit. Attach Form 1116 if required 2 Credit for child and dependent care expenses. Attach Form 2441 3 Education credits from Form 8863, line 19 4 Retirement savings contributions credit. Attach Form 8880 5 Residential energy credits. Attach Form 5695 6 Other credits from Form: a 3800 b 8801 7 Add lines 1 through 6. Enter here and include on Form 1040 or 1040-SR, line 13b Part II Other Payments and Refundable Credits 8 2019 estimated tax payments and amount applied from 2018 retum 9 Net premium tax credit. Attach Form 8962 10 Amount paid with request for extension to file (see instructions) 11 Excess social security and tier 1 RRTA tax withheld . 12 Credit for federal tax on fuels. Attach Form 4136 13 Credits from Form: a 2439 b Reserved c 8885 14 Add lines 8 through 13. Enter here and on Form 1040 or 1040-SR, line 18d For Paperwork Reduction Act Notice, see your tax return instructions. 8 9 10 11 12 13 14 Schedule 3 (Form 1040 or 1040-SR) 2019 Cat. No. 71480G Name SSN 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 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 2019 Department of the Treasury - Internal Revenue Service (99) OMB No. 1545-0074 IRS Use Only-Do not write or staple in this space. Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widower) (W) Check only one box. If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child's name if the qualifying person is a child but not your dependent. Your first name and middle initial Last name Your social security number If joint return, spouse's first name and middle initial Last name Spouse's social security number Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your tax or refund. You Spouse Foreign country name Foreign province/state/county Foreign postal code If more than four dependents, see instructions and here Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse itemizes on a separate return or you were a dual-status alien Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Dependents (see instructions): (2) Social security number (3) Relationship to you (4) Vif qualifies for (see instructions): (1) First name Last name Credit for other dependents Is blind Child tax credit 1 2a 2b 3b 4b 4d 5b 6 ] 7a 1 Wages, salaries, tips, etc. Attach Form(s) W-2 2a Tax-exempt interest b Taxable interest. Attach Sch. Bif required 3a Qualified dividends. 3a Standard b Ordinary dividends. Attach Sch. B if required Deduction for 4a IRA distributions. 4a b Taxable amount Single or Married 4c Pensions and annuities filing separately, d Taxable amount $12,200 5a Social security benefits. 5a b Taxable amount Married filing 6 jointly or Qualifying Capital gain or (loss). Attach Schedule D if required. If not required, check here widower) 7a Other income from Schedule 1, line 9 $24,400 Head of Add lines 1, 2, 3, 4b, 4d, 56, 6, and 7a. This is your total income household $18,350 8a Adjustments to income from Schedule 1, line 22 If you checked b Subtract line 8a from line 7b. This is your adjusted gross income any box under Standard 9 Standard deduction or itemized deductions (from Schedule A) 9 Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10 see instructions. 11a Add lines 9 and 10 b Taxable income. Subtract line 11a from line 85. If zero or less, enter-O- For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 113208 b 7b 8 8b 11a 11b Form 1040 (2019) Page 2 14 Form 1040 (2019) 12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a b Add Schedule 2 line 3, and line 12a and enter the total 12b 13a Child tax credit or credit for other dependents. 13a b Add Schedule 3, line 7, and line 13a and enter the total 13b 14 Subtract line 13b from line 12b. If zero or less, enter-O- 15 Other taxes, including self-employment tax, from Schedule 2, line 10 15 16 Add lines 14 and 15. This is your total tax . 16 17 Federal income tax withheld from Forms W-2 and 1099 17 18 . If you have a Other payments and refundable credits: qualifying child, Earned income credit (EIC). 18a attach Sch. EIC. If you have b Additional child tax credit. Attach Schedule 8812 18b nontaxable c American opportunity credit from Form 8863, line 8 18C combat pay, see instructions. d Schedule 3, line 14 18d e Add lines 18a through 18d. These are your total other payments and refundable credits 18e 19 Add lines 17 and 18e. These are your total payments 19 20 Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here 21a Direct deposit? Routing number Type: Checking Savings See instructions. Account number 22 Amount of line 20 you want applied to your 2020 estimated tax . Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions 23 You Owe 24 Estimated tax penalty (see instructions). 24 Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below. Designee No (Other than Designee's Phone Personal identification paid preparer) name no. number (PIN) Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge Here Your signature Date Your occupation If the IRS sent you an Identity Protection PIN, enter it here Joint return? (see inst.) See instructions. Spouse's signature. If a joint retur, both must sign. Date Spouse's occupation If the IRS sent your spouse an Keep a copy for Identity Protection PIN, enter it here your records. (see inst.) Phone no. Email address Preparer's name Preparer's signature Date PTIN Check if. Paid 3rd Party Designee Preparer Firm's name Phone no. Self-employed Use Only Firm's address Firm's EIN Go to www.irs.gov/Form 1040 for instructions and the latest information. Form 1040 (2019) 22 SCHEDULE A Itemized Deductions OMB No. 1545-0074 (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 4 Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions) 1 Dental 2 Enter amount from Form 1040 or 1040-SR, line 8b 2 Expenses 3 Multiply line 2 by 7.5% (0.075). 3 . 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 O 5a b State and local real estate taxes (see instructions) 5b c State and local personal property taxes 5c dAdd 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 6 7 Add lines 5e and 6 Interest You 8 Home mortgage interest and points. If you didn't use all of your home mortgage loan(s) to buy, build, or improve your home, see Caution: Your instructions and check this box mortgage interest deduction may be a Home mortgage interest and points reported to you on Form 1098. See limited (see instructions if limited instructions) 8 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. 7 Paid 8b c Points not reported to you on Form 1098. See instructions for special rules 8 d Mortgage insurance premiums (see instructions) 8d e Add lines Ba through 8d 8e 9 Investment interest. Attach Form 4952 if required. See instructions 9 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 11 12 Other than by cash or check. If you made any gift of $250 or more, Caution: If you made a gift and see instructions. You must attach Form 8283 if over $500. 12 got a benefit for it, 13 Carryover from prior year 13 see instructions. 14 Add lines 11 through 13. 14 Casualty and 15 Casualty and theft lossles) 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 SCHEDULE 1 (Form 1040 or 1040-SR) Additional Income and Adjustments to Income Department of the Treasury Attach to Form 1040 or 1040-SR. Internal Revenue Service Go to www.irs.gov/Form 1040 for instructions and the latest information. Name(s) shown on Form 1040 or 1040-SR OMB No. 1545-0074 2019 Attachment Sequence No. 01 Your social security number 1 3 6 9 At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? . Yes No Part Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes 2a Alimony received 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C. 4 Other gains or losses). Attach Form 4797. 4 5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. 5 6 Farm income or loss). Attach Schedule F 7 Unemployment compensation 7 8 Other income. List type and amount 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a Part II Adjustments to Income 10 Educator expenses 10 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 .. 11 12 Health savings account deduction. Attach Form 8889 12 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE 14 15 Self-employed SEP, SIMPLE, and qualified plans. 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid. 18a b Recipient's SSN C Date of original divorce or separation agreement (see instructions) IRA deduction 19 20 Student loan interest deduction 20 21 Tuition and fees. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a 22 For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019 19 SCHEDULE 2 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 or 1040-SR Additional Taxes Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No. 1545-0074 2019 Attachment Sequence No. 02 Your social security number N| O Part 1 Tax 1 Alternative minimum tax. Attach Form 6251 1 2 Excess advance premium tax credit repayment. Attach Form 8962 3 Add lines 1 and 2. Enter here and include on Form 1040 or 1040-SR, line 12b Part II Other Taxes 4 Self-employment tax. Attach Schedule SE. 4 5 Unreported social security and Medicare tax from Form: a 4137 b 8919 5 6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored accounts. Attach Form 5329 if required... 7a Household employment taxes. Attach Schedule H 7a b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if required 7b Taxes from: a Form 8959 b Form 8960 c Instructions, enter code(s) 8 9 Section 965 net tax liability installment from Form 965-A 10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form 1040 or 1040-SR, line 15 10 For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 2 (Form 1040 or 1040-SR) 2019 6 8 9 Cat. No. 71478U SCHEDULE 2 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 or 1040-SR Additional Taxes Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No. 1545-0074 2019 Attachment Sequence No. 02 Your social security number N| O Part 1 Tax 1 Alternative minimum tax. Attach Form 6251 1 2 Excess advance premium tax credit repayment. Attach Form 8962 3 Add lines 1 and 2. Enter here and include on Form 1040 or 1040-SR, line 12b Part II Other Taxes 4 Self-employment tax. Attach Schedule SE. 4 5 Unreported social security and Medicare tax from Form: a 4137 b 8919 5 6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored accounts. Attach Form 5329 if required... 7a Household employment taxes. Attach Schedule H 7a b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if required 7b Taxes from: a Form 8959 b Form 8960 c Instructions, enter code(s) 8 9 Section 965 net tax liability installment from Form 965-A 10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form 1040 or 1040-SR, line 15 10 For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 2 (Form 1040 or 1040-SR) 2019 6 8 9 Cat. No. 71478U SCHEDULE 3 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Name(s) shown on Form 1040 or 1040-SR Additional Credits and Payments Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No 1545-0074 2019 Attachment Sequence No. 03 Your social security number OWN = 7 Part| Nonrefundable Credits 1 Foreign tax credit. Attach Form 1116 if required 2 Credit for child and dependent care expenses. Attach Form 2441 3 Education credits from Form 8863, line 19 4 Retirement savings contributions credit. Attach Form 8880 5 Residential energy credits. Attach Form 5695 6 Other credits from Form: a 3800 b 8801 7 Add lines 1 through 6. Enter here and include on Form 1040 or 1040-SR, line 13b Part II Other Payments and Refundable Credits 8 2019 estimated tax payments and amount applied from 2018 retum 9 Net premium tax credit. Attach Form 8962 10 Amount paid with request for extension to file (see instructions) 11 Excess social security and tier 1 RRTA tax withheld . 12 Credit for federal tax on fuels. Attach Form 4136 13 Credits from Form: a 2439 b Reserved c 8885 14 Add lines 8 through 13. Enter here and on Form 1040 or 1040-SR, line 18d For Paperwork Reduction Act Notice, see your tax return instructions. 8 9 10 11 12 13 14 Schedule 3 (Form 1040 or 1040-SR) 2019 Cat. No. 71480G