Tax Problem 1 Hi Class, I am providing some instructions for the Tax Problem 1 here We are looking more at completing the 1040 return than tax law Based on this fact, I am providing some additional information on the data you are given You only use line 1 and line 2 for the two w 2 tax documents for the total wages and total federal taxes withheld respectively You use line 4 for obtaining interest income Taxpayers do not include municipal bond interest on federal tax returns Though, they do include the other interest income For line 13, you include the $500 income on the return For line 14, you check a particular box when taxpayers have insurance for the full year You do not use any of the information from 5 through 12 for the federal tax return They are not included on the return as they are not taxable items Given the above, you want to fully complete the front and back of the 1040 return You do not require any other schedules I will grade the assignment based on your full completion with reductions proportional for parts missed or not fully completed This includes any checked boxes required and information required for a complete an accurate return Individual Tax Return Problem 1Facts Tax Problem 1 Hi Class, I am providing some instructions for the Tax Problem 1 here We are looking more at completing the 1040 return than tax law Based on this fact, I am providing some additional information on the data you are given You only use line 1 and line 2 for the two w 2 tax documents for the total wages and total federal taxes withheld respectively You use line 4 for obtaining interest income Taxpayers do not include municipal bond interest on federal tax returns Though, they do include the other interest income For line 13, you include the $500 income on the return For line 14, you check a particular box when taxpayers have insurance for the full year You do not use any of the information from 5 through 12 for the federal tax return They are not included on the return as they are not taxable items Given the above, you want to fully complete the front and back of the 1040 return You do not require any other schedules I will grade the assignment based on your full completion with reductions proportional for parts missed or not fully completed This includes any checked boxes required and information required for a complete an accurate return Keith Hamilton is employed as an airline pilot for Flyby Airlines in Las Vegas, Nevada Jennifer is employed as a teacher's assistant at Small World Elementary School, in Henderson, Nevada Keith and Jennifer live in a home they purchased this year Keith and Jennifer have three children who lived with them all year, Joshua (17), Danielle (14), and Sara (10) Keith and Jennifer provided the following personal information Keith and Jennifer do not want to contribute to the presidential election campaign Keith and Jennifer do not claim itemized deductions Keith and Jennifer live at 3678 Blue Sky Drive, Henderson, Nevada 89052 Keith's birthday is 10 12 1970 and his Social Security number is 535 22 4466 Jennifer's birthday is 7 16 1973 and her Social Security number is 535 44 2255 Joshua's birthday is 6 30 1998 and his Social Security number is 454 54 5454 Danielle's birthday is 8 12 2001 and her Social Security number is 343 43 4343 Sara's birthday is 5 13 2005 and her Social Security number is 2 3 2 32 3232 P age C 1 Keith received the following Form W 2 for 2015 from Flyby Airlines 22222 I Vold 535 22 4466 For Official Use Only II 0MB No 1646 0008 b Employer ldenllflcatlon number (EINJ 91 0001002 1 Wages Ups olhet compensation 163,645 00 2 Federal Income tax withheld 31,000 00 c Employer's name, address and ZIP code Flyby Airlines 375 West Flight Blvd Las Veg as, NV 89119 3 Social secunty wages $118,500 00 4 Social security tax withheld 7,347 00 5 Medicare wages and tips 178 ,645 00 6 Medicare tax withheld 2,590 35 7 Social secur,ty lips 8 Allocated tips d Control number 9 10 Dependent care benefits e Emp loy ee's first name andnI i t ia l lLastname ISu tt 11 Nanqual,fied plans , ,,, 12a See 1nstructlons tor box 12 j D I 15,000 Keith Hamilton 3678 Blue Sky Drive Henderson, NV 89052 f Emp k yee1s address and ZIP code 13 Tlllrd pvty cq,i ay D D 12b I 14 Other 12c I I 12d i I 15 Slate Employer 's state ID number N V i 9 8 7 6 5 4 3 2 1 I 16 State wages , Ups etc 1 6 3 , 6 4 5 0 0 17 State Income 1a e 0 0 0 18 Locol wages, ps, eic 19 Local inc ome tax 20 l ocahtynama 0 I a Employee 's social securrty number Fann 2015 W 2 Wage and Tax Statement Copy A For Social Security Administration Send this entire page with Form W 3 to the Social Secu rity Adm inistra tion photocopies are not acceptable Department of the Treasury Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate lnstru c Jons Cal No 10134D Do Not Cut, Fold, or Staple Forms on This Page Jennifer received the following Form W 2 for 2015 from Small World Elementary School b Employe, identifica tion number (EIN) 91 0001003 1 Wages tips other compensa1ion 36,825 00 2 Federal income tax withheld 5,524 00 c Employer's name, address, and ZIP code Small World Elementary School 3 Social security wages 39,925 00 4 Social secll'ity l ax withheld 2,469 15 Form 2015 W 2 Wage and Tax Statement Copy A For Social Security Administration Send thisentire page with Form W 3 to the Social Security Administration photocopies are not acceptable Department of the Treas ury Internal Revenue Service For Priv acy Act and Paperw ork Reduction Act Notice, see the separate instruct ions Cat No 10134D Do Not Cut, Fold, or Staple Forms on This Page During 2015, Keith and Jennifer received $550 in interest from Las Vegas municipal bonds, $1,070 interest from U S Treasury bonds, and $65 from their savings account at SCD Credit Union Keith and Jennifer are joint owners of the Las Vegas city bonds and the U S Treasury bonds They have a joint savings account at SCD Credit Union On January 21, 2015, Jennifer was involved in a car accident Page C 2 Because the other driver was at fault, the other driver's insurance company paid Jennifer $1,350 for medical expenses relating to her injuries from the accident and $300 for emotional distress from the accident She received payment on March 15, 2015 Keith's father died on November 15, 2014 Keith received a $100,000 death benefit from his father's life insurance policy on February 8, 2015 On February 15, 2015, Keith hurt his arm on a family skiing trip in Utah and was unable to fly for two weeks He received $4,000 for disability pay from his disability insurance policy He received the check on March 2, 2015 Flyby Airlines paid $600 in premiums on this policy during 2015 The disability insurance policy premiums are paid for by Flyby Airlines as a fully taxable fringe benefit to Keith (the premiums paid on his behalf are included in Keith's compensation amount on his W 2) Jennifer's grandmother died on March 10, 2015, leaving Jennifer with an inheritance of $30,000 (She received the inheritance on May 12, 2015 ) Flyby Airlines had space available on its Long Island, New York, flight and provided Keith, Jennifer, and their three children with free flights so they could attend the funeral The value of the ticket for each passenger was $600 On April 1, 2015, Jennifer slipped in the Small World Elementary lunchroom and injured her back Jennifer received $1,200 in worker's compensation benefits because her work related injury caused her to miss two weeks of work She also received a $2,645 reimbursement for medical expenses from the health insurance company Small World Elementary pays the premiums for Jennifer's health insurance policy as a nontaxable fringe benefit LO On May 17, 2015, Keith and Jennifer received a federal income tax refund of $975 from their 2014 federal income tax return On June 5, 2015, Keith and Jennifer sold their home in Henderson, Nevada, for $510,000 (net of commissions) Keith and Jennifer purchased the home 11 years ago for $470,000 On July 12, 2015, they bought a new home for $675,000 On July 25, 2015, Keith's aunt Beatrice gave Keith $18,000 because she wanted to let everyone know that Keith is her favorite nephew On September 29, 2015, Jennifer won an iPad valued at $500 in a raffle at the annual fair held at Joshua's high school KeithandJenniferhavequalifyinginsuranceforpurposesofthetheAffordableCareAct(ACA) Tax Problem 1 Hi Class, I am providing some instructions for the Tax Problem 1 here We are looking more at completing the 1040 return than tax law Based on this fact, I am providing some additional information on the data you are given You only use line 1 and line 2 for the two w 2 tax documents for the total wages and total federal taxes withheld respectively You use line 4 for obtaining interest income Taxpayers do not include municipal bond interest on federal tax returns Though, they do include the other interest income For line 13, you include the $500 income on the return For line 14, you check a particular box when taxpayers have insurance for the full year You do not use any of the information from 5 through 12 for the federal tax return They are not included on the return as they are not taxable items Given the above, you want to fully complete the front and back of the 1040 return You do not require any other schedules I will grade the assignment based on your full completion with reductions proportional for parts missed or not fully completed This includes any checked boxes required and information required for a complete an accurate return Individual Tax Return Problem 1 Facts Keith Hamilton is employed as an airline pilot for Flyby Airlines in Las Vegas, Nevada Jennifer is employed as a teacher's assistant at Small World Elementary School, in Henderson, Nevada Keith and Jennifer live in a home they purchased this year Keith and Jennifer have three children who lived with them all year, Joshua (17), Danielle (14), and Sara (10) Keith and Jennifer provided the following personal information Keith and Jennifer do not want to contribute to the presidential election campaign 1 Keith and Jennifer do not claim itemized deductions Keith and Jennifer live at 3678 Blue Sky Drive, Henderson, Nevada 89052 Keith's birthday is 10 12 1970 and his Social Security number is 535 22 4466 Jennifer's birthday is 7 16 1973 and her Social Security number is 535 44 2255 Joshua's birthday is 6 30 1998 and his Social Security number is 454 54 5454 Danielle's birthday is 8 12 2001 and her Social Security number is 343 43 4343 Sara's birthday is 5 13 2005 and her Social Security number is 232 32 3232 1 Page C 2 Keith received the following Form W 2 for 2015 from Flyby Airlines 22222 I Vold 0 I a Employee 's social securrty number 535 22 4466 For Official Use Only II 0MB No 1646 0008 b Employer ldenllflcatlon number (EINJ 1 Wages Ups olhet compensation 91 0001002 163,645 00 c Employer's name, address and ZIP code 7,347 00 6 Medicare tax withheld 2,590 35 178 ,645 00 7 Social secur,ty lips 8 Allocated tips 10 Dependent care benefits 9 l Lastname I 12a See 1nstructlons tor box 12 11 Nanqual,fied plans Su tt , ,,, 13 D Tlllrd pvty cq,i ay 14 Other D jD 12b I 12c 12d i f Emp k yee1 s address and ZIP code 15 Slate N V i Employer 's state ID number 9 87 6 5 4 32 1 Social security tax withheld $118,500 00 Keith Hamilton 3678 Blue Sky Drive Henderson, NV 89052 4 5 Medicare wages and tips d Control number Emp loy ee's first name andnI i t ia l 31,000 00 3 Social secunty wages Flyby Airlines 375 West Flight Blvd Las Veg as, NV 89119 e 2 Federal Income tax withheld 16 State wages , Ups etc 1 6 3,6 4 17 State Income 1a e 0 0 5 00 0 W 2 Wage and Tax Statement 2015 Fann A For Social Security Administration Send this entire page with Copy Form W 3 to the Social Secu rity Adm inistra tion photocopies are not acceptable 18 Locol wages, ps, eic I 15,000 I I I 19 Local inc ome tax 20 l ocahtynama Department of the Treasury Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate lnstru c Jons Cal No 10134D Do Not Cut, Fold, or Staple Forms on This Page 3 Jennifer received the following Form W 2 for 2015 from Small World Elementary School b Employe, identifica tion number (EIN) 1 Wages tips other compensa1ion 91 0001003 36,825 00 a EmployBB's social security number c Employer's name, address, and ZIP code For Offic ial Use Only , 222 I Void World 22 Small 535 44 2255 0MB School No 1545 0008 Elementary 333 Tiny Tot 0 Lane d Control Henderson, number NV 89053 I 3 Social security wages 39,925 00 2 Federal income tax withheld 5,524 00 4 Social secll'ity l ax withheld 2,469 15 6 Med tax and t tips8 withheld 7 wages Social security ips 577 46 9 10 Dependent 39,925 00 Allocated tips care benefits Nonqualifie 12a See 5 Medicare 1 1 dplans 1 1 , 3 Ie I 00 D 12b12 12 I c' 14 Last name L Su ff 1 i2 other d f Employ88 s address 16 State wages etc 17 Sta le inoome tax18 Local wages, and ZIP code Jennifer Hamilton tips etc 19 Local name 15NV Stile I 123456789 3 6 , 8 2 I 5 0 3678 Blue Sky Employer's state ID Drive Henderson, NV number IB I 89052 0 0 0 0 I e Emp loy ee 's fir tn ame and initial ,y D D instructions 3,0for box R tips , M lr C income tax20 LocaDty 9fflW t I W 2 Wage and Tax Statement 2015 Department of the Treas ury Internal Revenue Service Form A For Social Security Administration Send thisentire page with Copy Form W 3 to the Social Security Administration photocopies are not acceptable For Priv acy Act and Paperw ork Reduction Act Notice, see the separate instruct ions Cat No 10134D Do Not Cut, Fold, or Staple Forms on This Page 4 During 2015, Keith and Jennifer received $550 in interest from Las Vegas municipal bonds, $1,070 interest from U S Treasury bonds, and $65 from their savings account at SCD Credit Union Keith and Jennifer are joint owners of the Las Vegas city bonds and the U S Treasury bonds They have a joint savings account at SCD Credit Union Page C 2 5 On January 21, 2015, Jennifer was involved in a car accident Because the other driver was at fault, the other driver's insurance company paid Jennifer $1,350 for medical expenses relating to her injuries from the accident and $300 for emotional distress from the accident She received payment on March 15, 2015 6 Keith's father died on November 15, 2014 Keith received a $100,000 death benefit from his father's life insurance policy on February 8, 2015 7 On February 15, 2015, Keith hurt his arm on a family skiing trip in Utah and was unable to fly for two weeks He received $4,000 for disability pay from his disability insurance policy He received the check on March 2, 2015 Flyby Airlines paid $600 in premiums on this policy during 2015 The disability insurance policy premiums are paid for by Flyby Airlines as a fully taxable fringe benefit to Keith (the premiums paid on his behalf are included in Keith's compensation amount on his W 2) 8 Jennifer's grandmother died on March 10, 2015, leaving Jennifer with an inheritance of $30,000 (She received the inheritance on May 12, 2015 ) Flyby Airlines had space available on its Long Island, New York, flight and provided Keith, Jennifer, and their three children with free flights so they could attend the funeral The value of the ticket for each passenger was $600 9 On April 1, 2015, Jennifer slipped in the Small World Elementary lunchroom and injured her back Jennifer received $1,200 in worker's compensation benefits because her work related injury caused her to miss two weeks of work She also received a $2,645 reimbursement for medical expenses from the health insurance company Small World Elementary pays the premiums for Jennifer's health insurance policy as a nontaxable fringe benefit LO On May 17, 2015, Keith and Jennifer received a federal income tax refund of $975 from their 2014 federal income tax return 11 On June 5, 2015, Keith and Jennifer sold their home in Henderson, Nevada, for $510,000 (net of commissions) Keith and Jennifer purchased the home 11 years ago for $470,000 On July 12, 2015, they bought a new home for $675,000 12 On July 25, 2015, Keith's aunt Beatrice gave Keith $18,000 because she wanted to let everyone know that Keith is her favorite nephew 13 On September 29, 2015, Jennifer won an iPad valued at $500 in a raffle at the annual fair held at Joshua's high school 14 Keith and Jennifer have qualifying insurance for purposes of the the Affordable Care Act (ACA) Page C 3

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Tax Problem 1 Hi Class, I am providing some instructions for the Tax Problem 1 here. We are looking more at completing the 1040 return

Tax Problem 1 Hi Class,

I am providing some instructions for the Tax Problem 1 here. We are looking more at completing the 1040 return than tax law. Based on this fact, I am providing some additional information on the data you are given.

You only use line 1 and line 2 for the two w-2 tax documents for the total wages and total federal taxes withheld respectively.

You use line 4 for obtaining interest income. Taxpayers do not include municipal bond interest on federal tax returns. Though, they do include the other interest income.

For line 13, you include the $500 income on the return.

For line 14, you check a particular box when taxpayers have insurance for the full year.

You do not use any of the information from 5 through 12 for the federal tax return. They are not included on the return as they are not taxable items.

Given the above, you want to fully complete the front and back of the 1040 return. You do not require any other schedules. I will grade the assignment based on your full completion with reductions proportional for parts missed or not fully completed. This includes any checked boxes required and information required for a complete an accurate return

Individual Tax Return Problem 1Facts:

Tax Problem 1 Hi Class,

You only use line 1 and line 2 for the two w-2 tax documents for the total wages and total federal taxes withheld respectively.

You use line 4 for obtaining interest income. Taxpayers do not include municipal bond interest on federal tax returns. Though, they do include the other interest income.

For line 13, you include the $500 income on the return.

For line 14, you check a particular box when taxpayers have insurance for the full year.

You do not use any of the information from 5 through 12 for the federal tax return. They are not included on the return as they are not taxable items.

Keith Hamilton is employed as an airline pilot for Flyby Airlines in Las Vegas, Nevada. Jennifer is employed as a teacher's assistant at Small World Elementary School, in Henderson, Nevada. Keith and Jennifer live in a home they purchased this year. Keith and Jennifer have three children who lived with them all year, Joshua (17), Danielle (14), and Sara (10). Keith and Jennifer provided the following personal information:
Keith and Jennifer do not want to contribute to the presidential election campaign.
Keith and Jennifer do not claim itemized deductions.
Keith and Jennifer live at 3678 Blue Sky Drive, Henderson, Nevada 89052.
Keith's birthday is 10/12/1970 and his Social Security number is 535- 22-4466.
Jennifer's birthday is 7/16/1973 and her Social Security number is 535-44-2255.
Joshua's birthday is 6/30/1998 and his Social Security number is 454-54-5454.
Danielle's birthday is 8/12/2001 and her Social Security number is 343-43-4343.
Sara's birthday is 5/13/2005 and her Social Security number is 232- 32-3232. Page C-1

Keith received the following Form W-2 for 2015 from Flyby Airlines.

22222 I Vold 535-22-4466

For Official Use Only II>

0MB No. 1646-0008

b Employer ldenllflcatlon number (EINJ

91-0001002

1 Wages. Ups. olhet compensation

163,645.00

2 Federal Income tax withheld

31,000 .00

c Employer's name, address. and ZIP code

Flyby Airlines

375 West Flight Blvd. Las Veg as, NV 89119

3 Social secunty wages

$118,500.00

4 Social security tax withheld

7,347.00

5 Medicare wages and tips

178 ,645.00

6 Medicare tax withheld

2,590.35

7 Social secur,ty lips

8 Allocated tips

d Control number

10 Dependent care benefits

e Emp loy ee's first name andnI i t ia l - lLastname- - ISu .tt

Nanqual,fied plans

_..,..,,,

12a See 1nstructlons tor box 12

j D I 15,000

Keith Hamilton

3678 Blue Sky Drive Henderson, NV 89052

f Emp k>yee1s address and ZIP code

Tlllrd-pvty

cq,i ay

D D

12b

! I

14 Other

12c

I I

12d

i I

15 Slate Employer 's state ID number

---N--V--i- -----9--8-7--6--5--4--3-2--1-----------------------

16 State wages , Ups. etc .

------1--6--3-,-6--4--5--.-0-0--------

17 State Income 1a>e

---------0--.-0--0-----------

18 Locol wages, ps, eic.

----------------------------

19 Local inc ome tax

----------------

20 l.ocahtynama

-----

0 I a Employee 's social securrty number

Fann 2015

W- 2 Wage and Tax Statement

Copy A For Social Security Administration - Send this entire page with

Form W-3 to the Social Secu rity Adm inistra tion: photocopies are not acceptable .

Department of the Treasury-Internal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate lnstru c!Jons.

Cal. No. 10134D

Do Not Cut, Fold, or Staple Forms on This Page

Jennifer received the following Form W-2 for 2015 from Small World Elementary School.

b Employe, identifica tion number (EIN)

91-0001003

1 Wages. tips. other compensa1ion

36,825.00

2 Federal income tax withheld

5,524.00

c Employer's name, address, and ZIP code

Small World Elementary School

3 Social security wages

39,925.00

4 Social secll'ity l ax withheld

2,469.15

Form 2015

W- 2 Wage and Tax Statement

Copy A For Social Security Administration - Send thisentire page with

Form W-3 to the Social Security Administration ; photocopies are not acceptable.

Department of the Treas ury- Internal Revenue Service

For Priv acy Act and Paperw ork Reduction Act Notice, see the separate instruct ions.

Cat. No. 10134D

Do Not Cut, Fold, or Staple Forms on This Page

During 2015, Keith and Jennifer received $550 in interest from Las Vegas municipal bonds, $1,070 interest from U.S. Treasury bonds, and

$65 from their savings account at SCD Credit Union. Keith and Jennifer are joint owners of the Las Vegas city bonds and the U.S. Treasury bonds. They have a joint savings account at SCD Credit

Union.

On January 21, 2015, Jennifer was involved in a car accident.

Page C-2

Because the other driver was at fault, the other driver's insurance company paid Jennifer $1,350 for medical expenses relating to her injuries from the accident and $300 for emotional distress from the accident. She received payment on March 15, 2015.

Keith's father died on November 15, 2014. Keith received a $100,000

death benefit from his father's life insurance policy on February 8,

2015.

On February 15, 2015, Keith hurt his arm on a family skiing trip in Utah and was unable to fly for two weeks. He received $4,000 for disability pay from his disability insurance policy. He received the check on March 2, 2015. Flyby Airlines paid $600 in premiums on this policy during 2015. The disability insurance policy premiums are paid for by Flyby Airlines as a fully taxable fringe benefit to Keith (the premiums paid on his behalf are included in Keith's compensation amount on his W-2).
Jennifer's grandmother died on March 10, 2015, leaving Jennifer with an inheritance of $30,000. (She received the inheritance on May 12, 2015.) Flyby Airlines had space available on its Long Island, New York, flight and provided Keith, Jennifer, and their three children with free flights so they could attend the funeral. The value of the ticket for each passenger was $600.
On April 1, 2015, Jennifer slipped in the Small World Elementary lunchroom and injured her back. Jennifer received $1,200 in worker's compensation benefits because her work-related injury caused her to miss two weeks of work. She also received a $2,645 reimbursement for medical expenses from the health insurance company. Small World Elementary pays the premiums for Jennifer's health insurance policy as a nontaxable fringe benefit.

LO. On May 17, 2015, Keith and Jennifer received a federal income tax refund of $975 from their 2014 federal income tax return.

On June 5, 2015, Keith and Jennifer sold their home in Henderson, Nevada, for $510,000 (net of commissions). Keith and Jennifer purchased the home 11 years ago for $470,000. On July 12, 2015, they bought a new home for $675,000.
On July 25, 2015, Keith's aunt Beatrice gave Keith $18,000 because she wanted to let everyone know that Keith is her favorite nephew.

On September 29, 2015, Jennifer won an iPad valued at $500 in a raffle at the annual fair held at Joshua's high school.
KeithandJenniferhavequalifyinginsuranceforpurposesofthetheAffordableCareAct(ACA).

Tax Problem 1 Hi Class, I am providing some instructions for the Tax Problem 1 here. We are looking more at completing the 1040 return than tax law. Based on this fact, I am providing some additional information on the data you are given. You only use line 1 and line 2 for the two w-2 tax documents for the total wages and total federal taxes withheld respectively. You use line 4 for obtaining interest income. Taxpayers do not include municipal bond interest on federal tax returns. Though, they do include the other interest income. For line 13, you include the $500 income on the return. For line 14, you check a particular box when taxpayers have insurance for the full year. You do not use any of the information from 5 through 12 for the federal tax return. They are not included on the return as they are not taxable items. Given the above, you want to fully complete the front and back of the 1040 return. You do not require any other schedules. I will grade the assignment based on your full completion with reductions proportional for parts missed or not fully completed. This includes any checked boxes required and information required for a complete an accurate return Individual Tax Return Problem 1 Facts: Keith Hamilton is employed as an airline pilot for Flyby Airlines in Las Vegas, Nevada. Jennifer is employed as a teacher's assistant at Small World Elementary School, in Henderson, Nevada. Keith and Jennifer live in a home they purchased this year. Keith and Jennifer have three children who lived with them all year, Joshua (17), Danielle (14), and Sara (10). Keith and Jennifer provided the following personal information: Keith and Jennifer do not want to contribute to the presidential election campaign. 1. Keith and Jennifer do not claim itemized deductions. Keith and Jennifer live at 3678 Blue Sky Drive, Henderson, Nevada 89052. Keith's birthday is 10/12/1970 and his Social Security number is 535- 22-4466. Jennifer's birthday is 7/16/1973 and her Social Security number is 535-44-2255. Joshua's birthday is 6/30/1998 and his Social Security number is 454-54-5454. Danielle's birthday is 8/12/2001 and her Social Security number is 343-43-4343. Sara's birthday is 5/13/2005 and her Social Security number is 232- 32-3232. 1 Page C- 2. Keith received the following Form W-2 for 2015 from Flyby Airlines. 22222 I Vold 0 I a Employee 's social securrty number 535-22-4466 For Official Use Only II> 0MB No. 1646-0008 b Employer ldenllflcatlon number (EINJ 1 Wages. Ups. olhet compensation 91-0001002 163,645.00 c Employer's name, address. and ZIP code 7,347.00 6 Medicare tax withheld 2,590.35 178 ,645.00 7 Social secur,ty lips 8 Allocated tips 10 Dependent care benefits 9 l Lastname- - I 12a See 1nstructlons tor box 12 11 Nanqual,fied plans Su .tt _..,..,,, 13 D Tlllrd-pvty cq,i ay 14 Other D jD 12b ! I 12c 12d i f Emp k>yee1 s address and ZIP code 15 Slate N V i Employer 's state ID number 9 87 6 5 4 32 --- -- -- - ----- -- - -- -- -- -- - -1 ----------------------- Social security tax withheld $118,500.00 Keith Hamilton 3678 Blue Sky Drive Henderson, NV 89052 . 4 5 Medicare wages and tips d Control number Emp loy ee's first name andnI i t ia l - 31,000 .00 3 Social secunty wages Flyby Airlines 375 West Flight Blvd. Las Veg as, NV 89119 e 2 Federal Income tax withheld 16 State wages , Ups. etc . 1 6 3,6 4 17 State Income 1a>e 0 .0 ------ -- -- - - -- -- --------- -- - -5 .00 0 -- - - ------------------ W- 2 Wage and Tax Statement 2015 Fann A For Social Security Administration - Send this entire page with Copy Form W-3 to the Social Secu rity Adm inistra tion: photocopies are not acceptable . 18 Locol wages, ps, eic. I 15,000 I I I 19 Local inc ome tax ---------------------------- ---------------- 20 l.ocahtynama ----- Department of the Treasury-Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate lnstru c!Jons. Cal. No. 10134D Do Not Cut, Fold, or Staple Forms on This Page 3. Jennifer received the following Form W-2 for 2015 from Small World Elementary School. b Employe, identifica tion number (EIN) 1 Wages. tips. other compensa1ion 91-0001003 36,825.00 a EmployBB's social security number c Employer's name, address, and ZIP code For Offic ial Use Only .,. 222 I Void World 22 Small 535-44-2255 0MB School No. 1545-0008 Elementary 333 Tiny Tot 0 Lane d Control Henderson, number NV 89053 I 3 Social security wages 39,925.00 2 Federal income tax withheld 5,524.00 4 Social secll'ity l ax withheld 2,469.15 6 Med tax and t tips8 withheld 7 wages Social security ips 577.46 9 10 Dependent 39,925.00 Allocated tips care benefits Nonqualifie 12a See 5 Medicare 1 1 dplans 1 1 ;;;;;,; 3 .. Ie I 00 . D 12b12 12 I c' 14 Last name. L Su .ff 1 .. i2 other d f Employ88"s address ; 16 State wages. etc. 17 Sta.le ..inoome tax18 Local wages, and ZIP code Jennifer Hamilton tips. etc. 19 Local name 15NV Stile. I...._123456789 .................... ----3--6-,-8--2-I 5--.-0-3678 Blue Sky Employer's state ID Drive Henderson, NV number IB I 89052 0------- ------0--.-0--0-----------I ---------------------------- ------------------------- --------------. e Emp loy ee 's fir.>tn ame and initial ,y D D instructions 3,0for box R tips , M lr C income tax20 LocaDty 9fflW!t I W- 2 Wage and Tax Statement 2015 Department of the Treas ury- Internal Revenue Service Form A For Social Security Administration - Send thisentire page with Copy Form W-3 to the Social Security Administration ; photocopies are not acceptable. For Priv acy Act and Paperw ork Reduction Act Notice, see the separate instruct ions. Cat. No. 10134D Do Not Cut, Fold, or Staple Forms on This Page 4. During 2015, Keith and Jennifer received $550 in interest from Las Vegas municipal bonds, $1,070 interest from U.S. Treasury bonds, and $65 from their savings account at SCD Credit Union. Keith and Jennifer are joint owners of the Las Vegas city bonds and the U.S. Treasury bonds. They have a joint savings account at SCD Credit Union. Page C-2 5. On January 21, 2015, Jennifer was involved in a car accident. Because the other driver was at fault, the other driver's insurance company paid Jennifer $1,350 for medical expenses relating to her injuries from the accident and $300 for emotional distress from the accident. She received payment on March 15, 2015. 6. Keith's father died on November 15, 2014. Keith received a $100,000 death benefit from his father's life insurance policy on February 8, 2015. 7. On February 15, 2015, Keith hurt his arm on a family skiing trip in Utah and was unable to fly for two weeks. He received $4,000 for disability pay from his disability insurance policy. He received the check on March 2, 2015. Flyby Airlines paid $600 in premiums on this policy during 2015. The disability insurance policy premiums are paid for by Flyby Airlines as a fully taxable fringe benefit to Keith (the premiums paid on his behalf are included in Keith's compensation amount on his W-2). 8. Jennifer's grandmother died on March 10, 2015, leaving Jennifer with an inheritance of $30,000. (She received the inheritance on May 12, 2015.) Flyby Airlines had space available on its Long Island, New York, flight and provided Keith, Jennifer, and their three children with free flights so they could attend the funeral. The value of the ticket for each passenger was $600. 9. On April 1, 2015, Jennifer slipped in the Small World Elementary lunchroom and injured her back. Jennifer received $1,200 in worker's compensation benefits because her work-related injury caused her to miss two weeks of work. She also received a $2,645 reimbursement for medical expenses from the health insurance company. Small World Elementary pays the premiums for Jennifer's health insurance policy as a nontaxable fringe benefit. LO. On May 17, 2015, Keith and Jennifer received a federal income tax refund of $975 from their 2014 federal income tax return. 11. On June 5, 2015, Keith and Jennifer sold their home in Henderson, Nevada, for $510,000 (net of commissions). Keith and Jennifer purchased the home 11 years ago for $470,000. On July 12, 2015, they bought a new home for $675,000. 12. On July 25, 2015, Keith's aunt Beatrice gave Keith $18,000 because she wanted to let everyone know that Keith is her favorite nephew. 13. On September 29, 2015, Jennifer won an iPad valued at $500 in a raffle at the annual fair held at Joshua's high school. 14. Keith and Jennifer have qualifying insurance for purposes of the the Affordable Care Act (ACA). Page C-3