Required information [The following information applies to the questions displayed below] Ken is 63 years old and unmarried. He retired at age 55 when he sold his business, Understock.com. Though Ken is retired, he is still very active, Ken reported the following financial information this year. Assume Ken files as a single taxpayer. a. Ken won $1,500 in an illegal game of poker (the game was played in Utah, where gambling is illegal). b. Ken sold 1,300 shares of stock for $32 a share. He inherited the stock two years ago. His tax basis (or investment) in the stock was $31 per share. c. Ken received $28,000 from an annuity he purchased eight years ago. He purchased the annuity, to be paid annually for 20 years, for $235,200. d. Ken received $13,750 in disability benefits for the year. He purchased the disability insurance policy last year. e. Ken decided to go back to school to learn about European history. He recelved a $800 cash scholarship to attend, He used $450 to pay for his books and tuition, and he applied the rest toward his new car payment. f. Ken's son, Mike, instructed his employer to make half of his final paycheck of the year payable to Ken as a gift from Mike to Ken. Keb received the check on December 30 in the amount of $1,550. 9. Ken received a $760 refund of the $3,900 in state income taxes his employer withheld from his pay last year. Ken claimed $12,900 in itemized deductions last year (the standard deduction for a single filer was $12,550 ). h. Ken received $33,000 of interest from corporate bonds and money market accounts. 2. Complete page 1 of Form 1040 through line 9 and Schedule 1 for Ken. umbers) EXACTLY as they appear in any given information or Problem Statement. Use 2022 tax rules regardless of year on tax orm. Ken does not wish to contribute to the Presidential Election Campaign fund and did not have any virtual currency ransactions or interests. Social security numbers: en: 111223333 1040 for a single taxpayer. Form 1040 Page 1. If joint retum, spouse's first name and midide intia! 1) Required information Required information 1040PG1 Schedule 1 Form 1040 Schedule 1. SCHEDULE 1 (Form 1040) Additional Income and Adjustments to Income OMB No. 1545-0074 2021 Department of the Treasury Attach to Form 1040, 1040-SR, or 1040-NR. internal Revenue Service Go to www.irs.gov/Form1040 for instructions and the latest Attachment Sequence No. 01 Name(s) shown on Form 1040, 10s0-SR, or 1040-NR information. Additional Income Part 1 Taxable refunds, credita, or offsets of state and local income taxps 2a Alimony recolved b Date of onginal divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C Other gains or (iosses). Attach Form 4797 5. Rental real estate, royaltes, partnenhips, S corporatons, Iruste, etc. Attach Scheduie E 6. Farm income of (joss). Atach Schedule F 7 Unemployment compensation 8. Other income a. Net operating loss b Gambling Income c Cancetation of debt d Forelgn eamed income exclusiorttom Form 2555 Taxable Heaith Savings Acoount distibution Your social secunty number Prev 1 of 1 Next (1) Virchingnior uninvisation! Required information b Gambling income c Cancellation of debt d Foreign eamed income exclusion from Form 2555 Taxable Health Savings Account distribution Altska Permanent Fund dividends Jury duty pay Prizes and awards Activity not engaged in for profit income Stock options Income from the rental of personal property if you engaged in the rental for profit but were not in the business of renting such property Olympic and Paraympic medals and USOC prize money (see instructions) Section 951(a) inclusion (see instructions) Section 951 A(a ) inclusion (see instructions) Section 461 (1) excess business loss adjustment p. Taxable distributions from an ABLE account (see instructions) 2 Other income. List type and amount 9 Total other income: Add lines Ba through 8z 10 Part II Combine lines 1 through 7 and 9 . Enter here and on Form 1040, 1040-SR, or 1040NR; line 8 Adjustments to Income 11 Educator expenses 12 Certain business expenses of reseryists, performing artsts, and fee-basis government otficials. Attach Form 13 Health savings account deductionnAttach Form 8889 14 Moving expenses for members of the Armed Forces: Attach Form 3903 Required information 9 10 Part II 11 12 13 14 15 16 17 18 19a bs e 26 21 22 23 24 a b c. d) 6 6 1 Contribitions to section 501(c)(18(D) pension plans Total other inceme. Add lines Ba through Bz. Combine lines 1 through 7 and 9 . Enter here and on Form 1040. 1040-SF, or 1040NR, line 8 Adjustments to Income Educator expenses Certain business expenses of reservists, performing artists, and foe-basis government officiais. Altach Form 2105 Health savings account deduction. Adtach Forms B8s9 Moving experses for members of the Armed Forees. Attach Form 3903 Deductole part of seif-employment tax Attach Schedule SE Self-employed SER, SIMPLE, and qualined plans Self-employed heath insurance deduction Penalty on early withdrawal of savings Almeny paid Reciplents 55N Date of original divorce or separation agreement (bee instructons) IRA dedvation Stugent ioan interest deduction Reserved for future use Archar MSA deductan Cther adystments: Jury auly pay (see instructions) Deductiblo empenses relased so income reported on ihe ex trem The rental of personal property engaged in for profit Nontaxable amount of the value of Cympic and Paralympic medals and USOC prize money reported on ine Af. Reforestatian amortization and expensos Repayment of aypplemiental unekfiloyment banefits under the. Trade A ct of 1974 Centributions to section 501(c)(18(D) pension plan \begin{tabular}{|l|r|} \hline 9 & 0 \\ \hline 10 & 0 \\ \hline \end{tabular} \begin{tabular}{|c|c|} \hline 11 & \\ \hline 12 & \\ \hline 13 & \\ \hline 14 & \\ \hline 15 & \\ \hline 16 & \\ \hline 17 & \\ \hline 18 & \\ \hline 19a & \\ \hline \end{tabular} Required information 21 Student ioan interest deduction 22. Reserved for future use 23 Archer MSA deduction 24 Other ad, ustments: a Jury duty pay (see instructions) b Deductble expenses related to income reported on line 8k from the rental of personal property engaged in for profit c Nontaxable amount of the value of Olympic and Paralympic medals and USOC prize money reported on line Bi d Reforestation amortization and oxpenses Repayment of supplemental unemployment benefits under the Trade Act of 1974 Contributions to section 501(c)(18)(D) pension plans g. Contributions by cartain chaplains to section 403 (b) plans h Attomey fees and court costs for actions involving cortain unlawful discrimination claims (see instructions) Attomey fees and court costs you paid in connection with an award from the IRS for intormation you provided that holped the IRS detect tax law violations Housing doduction from Form 2555 Excess deductions of section 67(e) expenses ftom Schedule K-1 (Form 1041) Other adjustments. Lit type and amount 25 Total other adjustments. Add lines 24a through 24Z 26 Add lnes 11 through 23 and 25 . These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, Ine 10, or Form 1040-NR, Ine 10a For Paperwork Reduction Act Notice, see your tax return. instructions. Cat No, 71479F Schedule 1 (Form 1040) 2021 OFFICIAL U.S. TAX FORM. IT IS NOT THE OFFICIAL FORM ITSELF. DO NOT USE THIS FORM FOR TAX FILINGS OR FOR ANY PURPOSE OTHER THAN EDUCATIONAL. 2022 MeGraw-Hill Education. 1040PG1 serieduln 1