Prepare the tax returns using form 540-2EZ (California) for this problem.

Brenda Peterson is single, date of birth is March 1, 1987, and lives at 567 East Street, Pacifica, CA 94044. Her SSN is 412-34-5670. She worked the entire year for Applebee Consulting as a consultant in Pacifica. She has enclosed her form W-2 and one form 1099-INT. Brenda had qualifying health coverage for every month of 2017 and lives with her uncle without paying rent.

22222 Void b Employer identification number (EIN) 94-1234567 c Employer s name, address, and ZIP code Applebee Consulting 123 Main Street Pacifica, CA 94104 d Control number a Employee s social security number 412-34-5670 e Employee s first name and initial Brenda 567 East Street Pacifica, CA 94044 1 Employee s address and ZIP code 15 Ste Employer s state ID number CA 1234567 Last name. Peterson 16 State wages, tips, etc. 61,292.05 For Official Use Only OMB No. 1545-0008 G 1 Wages, tips, other compensation 61.292.05 Form W-2 Wage and Tax Statement 2017 Copy A For Social Security Administration - Send this entire page with Form W-3 to the Social Security Administration; photocopies are not acceptable. 3 Social security wages 61,292.05 5 Medicare wages and tips 61,292.05 7 Social security tips 9 Suff. 11 Nonqualified plans 13 Statutory employee 17 State income tax 0.00 Hatt plan 14 Other CA SDI $551.63 U Third-party sic pay IM 18 Local wages, tips, etc. Do Not Cut, Fold, or Staple Forms on This Page M YAXY 2 Federal income tax withheld 9,318.12 4 Social security tax withheld 3,800.11 ST 6 Medicare tax withheld 888.73 8 Allocated tips 10 Dependent care benefits 12a See instructions for box 12 12b 120 12d 1 19 Local income tax Department of the Treasury-Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 10134D 20 Locality name 7 + + + +7 16:39 O K 9292 VOID CORRECTED PAYER S name, street address, city or town, state or province, country, ZIP Payer s RTN (optional) or foreign postal code, and telephone no. First National Bank of Pacifica 346 Main Street Pacifica, CA 94104 PAYER S federal identification number RECIPIENT S identification number 55-7713475 RECIPIENT S name Brenda Peterson Street address (including apt. no.) 567 East Street City or town, state or province, country, and ZIP or foreign postal code Pacifica, CA 94044 Account number (see instructions) 412-34-5670 2 M 1 Interest income $837.41 2 Early withdrawal penalty IS 6 Foreign tax paid $ 3 Interest on U.S. Savings Bonds and Treas. obligations $ 4 Federal income tax withheld 5 Investment expenses $ 8 Tax-exempt interest. $ 10 Market discount. $ 2nd TIN not. 12 Tax-exempt bond CUSIP no. 0 OMB No. 1545-0112 U 2017 SAMSUNG Form 1099-INT W Interest Income Is 7 Foreign country or U.S. possession 9 Specified private activity bond interest $ 11 Bond premium Form 1099-INT Cat. No. 14410K www.irs.gov/form1099int Department of the Treasury - Internal Revenue Service Do Not Cut or Separate Forms on This Page Do Not Cut or Separate Forms on This Page Copy A For Internal Revenue Service Center ST File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2015 General Instructions for Certain Information Returns. $ 13 State 14 State identification no. 15 State tax withheld CA 8837814 +6 16:36