Taxpayer Information Name: Bryan Jones Address: 1200 Main St. Green Bay, Wisconsin 12345 DOB: 5/6/1976 Filing Status: Single SSN: 500-10-2000 Occupation: Staff Accountant INCOME INFORMATION: Wages and Compensation The following information is taken from Bryan Jone's 2017 Form W-2 Wage and Tax Statement 52,000 Box 1-Wages, tips, and other compensation Box 2-Federal Withholding Box 17 - State Income Tax Withholding 8,750 1,000 Interest and Dividends Bryan has some Certificates of Deposits are Main Street bank which yielded 3,750 in interest in 2017. In addition, Bryan has interest income from municipal bonds in the amount of 1,250. Also, Bryan received $2100 in qualified dividends from Plum Electronic Co. Profit/Loss from Business Bryan has a part-time accounting services business. In 2017, his income and expenses are as f follows: Service Reveous 7,000 Office Expense Advertising Capital Gains Bryan had the following stock transactions in 2017: He sold 1,000 shares of Apex Co. for $ 12,000 on June 7, 2016, which he purchased on April 1, 2014 for 25,000. In addition, he sold 750 shares of Velocity Inc. for $10,000 on September 1, 2016, which he purchased on December 1, 2015 for $5,000. Rental Real Estate Bryan owns a rent house which he purchased on July 1, 2014. The income and expenses of the rental real estate unit for 2017 are as follows: Rental income Property taxes Depreciation Repairs and Maintenance Insurance $12,000 $1,500 $1,000 $750 $2,000 Other Transactions in 2017 1. Bryan received a gift of $4,000 from his brother. 2. Bryan paid $3,000 for the year in alimony to his ex-wife, per divorce decree. 3. Bryan had gambling winnings of $1,000 4. Bryan was the beneficiary of his mother's life insurance policy. His mother died in 2017 and he received $50,000 under this policy. 2016 Form 1040 Department of Internal Revenue Service U.S. Individual Tax Form OMB No. 1545-0074 2016, 20 For the year Jan. 1--Dec. 31,2016, or any other tax year beginning Your first name and initial Last name IRS Use Only--Do not write or staple in this space See Separate Instructions Social Security Number If a joint return, spouses first Last name Spouse Social Security Number Home address( number and street). If you have a P.O.Box, see instructions Make sure that the SSN(s) above and on line 6c are correc. City, town, or post office, state, and zip code. If you have a foreign address, also complete spaces below (see ins Presidential Election Campaign Check here if you, or your spouse if filing jointly, Foreign country name Foreign province/state/country Foreign postal code checking this box below will not change your tax refund you spouse Filing Status 1. Single 4.Head of Household (with qualifying person.) (See instructions.) If Check only one box 2.. married filing jointly the qualifying person is a child but not your dependent, enter this 3. Married filing separately. Enter spouse's SSN above child's name here and full name here. 5. Qualifying Window(er) with dependent child Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box] Boxes checked b spouse on 6a and 6b If more than four c. Dependents dependents, see (1) First name Last name (2) dependents (3) dependents (4) check if child under age 17 No. of children instructions and social security number relationship to you qualifying for tax credit see on 6c who: check here instructions. lived with you did not live with you due to divorce or separation (see instructions) Dependents on 6c not entered above d. Total number of Exemptions Claimed Add numbers on lines Income Attach Form(s) W-2 here. Also attach Forms(s) W-2 and 1099-R if tax was withheld. If you did not get a W-2, see instructions Wages, salaries, tips, etc. Attach Forms (W-2) Taxable interest. Attach Schedule B if required Tax-exempt interest. Do not include on line 8a Ordinary dividends. Attach Schedule B if required Qualified dividends Taxable refunds, credits, or offsets state or local income taxes Alimony received Business income or loss). Attach Schedule C or C-EZ Capital gain or loss). Attach Schedule D if required. If not required, check here other gains or losses). Attach Form 4797 IRA distributions 15a b Taxable amount Pensions and annuities 16a b Taxable amount Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F Unemployment compensation Social security benefits 20a b Taxable amount other income. List type and amount combine the amounts in the far right column for lines 7 through. This is your total incom H. 14-lea al--- -- 15a 20a 22 Adjusted Gross Income Educator expenses and fee-basis government. Attach Form 2106 or 2106-EZ 25 Health-savings account deduction. Attach Form 88 Moving Expenses. Attach Form 3903 Deductible part of self-employment tax. Attach Schl Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction Penalty on early withdrawal of savings Alimony paid b. Recipient IRA deduction Student loan interest deduction 34 35 Tuition and fees. Attach Form 8917 Domestic production activities deduction. Attach Form 890 35 Add lines 23 through 35 Subtract line 36 from line 22. This is your adjusted gross income. 37 OMB No. 1545-0074 SCHEDULE A (Form 1040) Internal Revenue Service 2016 Itemized Deductions Information about Schedule A and its separate instructions is at www.lrs.gov/schedule a Attach to Form 1040. Attachment Sequence No. 07 Name(s) shown on Form1040 Your social security number Medical and Dental Expenses 3 . . . . . . Taxes You Paid Caution. Do not nclude expenses reinbursed or paid by others. 1 Medical and dental expenses (see instructions)..... 2 Enter amount from Form 1040, line 38 2 3 Mutiply line 2 by 10% (-10). But if ether you or your spouse was bom before January 2, 1949, mutiply line 2 by 7.5% (075) instead A Subtract line 3 from line 1. f line 3 is more than line 1, enter-O-. . 5 State and local (check only one box): a ? Income tax or b? General sales tax 6 Real estate taxes (see instructions).. . . 7 Personal Property taxes. . . . . . . . . . 8 Other taxes List type and amount > ------------- - - ---- ---- - - - - ---- 10 Home mortgage interest and points reported to you on Form 1098 11 Home mortgage interest not reported to you on Form 1098 If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address . --- - - NO Interest You Paid Note. Your mortgage interest deduction may be Limited (see instructions Gifts to Charity if you made a gift and got a benefits for it see instructions Casualty Job Expenses and Certain Miscellaneous Deductions 12 Points not reported to you on Form 1098 See instructions for special rules . . . . . . . . . . . 13 Mortgage insurance premiums (see instructions)..... 14 Investment interest. Attach Form 4952 if required. (See instructions.) 15 Add lines 10 through 14.. 16 Gifts by cash or check. If you made any gift of $250 or more, see instructions....... . 17 Other than by cash or check. f any gift of $250 or more, see instructions. You must attach Form 8283 if over $500... 18 Carryover from prior year.... 19 Add lines 16 through 18.. ........ 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . 21 Unreimbursed employee expenses-job travel, union dues, ob education, etc Attach Form 2106 or 2106-EZ if required (see instructions) 22 Tax preparation fees ..... 23 Other expenses-investment, safe deposit box, etc. List type and amount - -- -- -- -- -- -- -- - - -- -- -- -- -- -- -- 24 Add lines 21 through 23 .......... 25 Enter amount from Form 1040, line 38 25 26 Mutiply line 25 by 2% (02)... 27 Subtract line 26 from line 24. If line 26 is more than ine 24 enter-O- Other 28 Other-from ist in instructions. List type and amount Miscellan - - ---- -- -- ---- - --- -- - - -- - cous Total 29 Is Form 1040, ine 38, over $150,000? Itemized ? No. Your deduction is not limited. Add the amounts in the far right column Deductions for ines 4 through 28. Also, enter this amount on Form 1040, line 40. ? Yes. Your deduction may be limted. See the itemized Deductions Worksheet in the instructions to figure the amount to enter 30 if you elect to tenke deductions even though they are less than your standard deduction, check here . . . . . . . . . . . . . . . . For Paperwork Reduction Act Notice, see Form 1040 instructions. Cat. No. 17145C Schedule A (Form 1040) 2016 OMB No. 1545-0074 SCHEDULE B (Form 1040A or 1040) Department of the Treasury Internal Revenue Service (99) Interest and Ordinary Dividends Attach to Form 1040A or 1040. Information about Schedule B (Form 1040A or 1040) and its instructions is at www.irs.gov/scheduleb. 2016 Attachment Sequence No. 08 Your social security number Name(s) shown on return Amount Parti 1 List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see instructions on back and list Interest this interest first. Also, show that buyer's social security number and address (See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note. If you 2 Add the amounts on line 1..... received a Form 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989 1099-INT, Form 1099-OID, or Attach Form 8815. substitute 4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form statement from 11040. line 8a 1940, he . . . . . . . a brokerage firm, list the firm's name as the payer and enter the total interest shown on that form. Note. If line 4 is over $1.500. you must complete Part III. 5 List name of payer Amount 6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040. line 9a . . . . . . . . . . . . . . . . . . . . . . Part II Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 9a.) Note. If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm's name as the payer and enter the ordinary dividends shown on that form. Note. If line 6 is over $1,500, you must complete Part III. You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a Yes No foreign account; or (c) received a distribution from, or were a grantor of, or a transferorto, a foreign trust. Part III 7a At any time during 2016, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located in a foreign Foreign country? See instructions .... Accounts If "Yes," are you required to file FinCEN Form 114, Report of Foreign Bank and Financial and Trusts Accounts (FBAR), formerly TD F 90-22.1, to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing requirements and exceptions to those requirements ............................ For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2016 (See SCHEDULED (Form 1040) Department of the Treasury Internal Rorsrus Servics (99) OMB No 545-0074 Capital Gains and Losses Attach to Form 1040 or Form 1040NR. Information about Schedule D and its separate instructions is at www.lrs.govischeduled Attachment Your social security number 2016 Namaronenretum Short-Term Capital Gains and Losses-Assets Held One Year or Less See instructions for how to figure the amounts to d e l h Gain orla Subtract Procrede Casi Adustments columne from columnd and enter on the lines below. (sales pricel Drather to gain or loss fromFomis1 0949 Partline 2.column(a) loombine the result with column () This form may be easier to complete if you round basis 1a Totals for all short-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see 1b Totals for all transactions reported on Form(s) 8949 with Box A checked ... 2 Totals for all transactions reported on Form(s) 8949 with Box B checked 3 Totals for all transactions reported on Form(s) 8949 with Box C checked ........... 4 Short-term gain from Form 6252 and short-term gain or loss) from Forms 4684, 6781, and 8824 5 Net short-term gain or loss) from partnerships, S corporations, estates, and trusts from Schedule(5) K-1 6 Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions 7 Net short-term capital gain or (loss). Combine lines 1 a through 6 in column (h). If you have any long-term capital gains or losses, go to Part Il below. Otherwise, go to Partill on the back TYWN IESLI U SUUL I S . . . . . . . . . . . . . . . . . - Long-Term Capital Gains and LossesAssets Held More Than One Year 16 Proceda (seles pricel Ih Gain or leas) Subtract Adustments columne from column(d, and o gainor loss from Form 16949.Part II line 2 columnal combine the result withcolumnal (orother basis See instructions for how to figure the amounts to enter on the lines below This form may be easier to complete if you round off cents to whole dollars. 8a Totals for all long-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see 8b Totals for all transactions reported on Form(s) 8949 with Box D checked .... 9 Totals for all transactions reporled on Form(s) 8949 with Box Echecked 10 Totals for all transactions reported on Form(s) 8949 with Box Fchecked 11 Gain from Form 4797, Part I: long-term gain from Forms 2439 and 6252, and long-term 11 gain or loss) from Forms 4684, 6781, and 8824 ....... 13 12 Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 13 Capital gain distributions. See the instructions 15 For Paperwork Reduction Act Notice, see your tax return instructions. Cat No. 1338 Schedule D [Form 10401 2016 SCHEDULE E (Form 1040) Department of the Treasury Internal Revenue Service (99) Supplemental Income and Loss (From rental real estate, royalties, partnerships, Scorporations, estates, trusts, REMICS, etc.) Attach to Form 1040, 1040NR, or Form 1041. Information about Schedule E and its separate instructions is at www.irs.gov/schedulee. OMB No. 1545-0074 2016 Attachment Sequence No. 13 Name(s) shown on return Your social security number Part Income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personal property, use Schedule C or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. Yes Yes No No A Did vou make any payments in 2016 that would reauire vou to file Form(s) 1099? (see B If "Yes, did you or will you file required Forms 1099? 1a Physical address of each property (street, city, state, ZIP code) A 1b QIV Type of Property (from list below) Fair Rental Days Personal Use Days 2 For each rental real estate property listed above, report the number of fair rental and only if you meet the requirements to file as a qualified joint venture. See instructions. B C personal use days. Check the QJV box Type of Property: 1 Single Family Residence 2 Multi-Family Residence 3 Vacation/Short-Term Rental 4 Commercial 5 Land 6 Royalties 7 Self-Rental 8 Other (describe) Income: Properties: 3 Rents received ............. 4 Royalties received ............ Expenses: 5 Advertising .............. 6 Auto and travel (see instructions) ....... 7 Cleaning and maintenance ......... 8 Commissions.............. 9 Insurance............... 10 Legal and other professional fees....... 11 Management tees 12 Mortgage interest paid to banks, etc. (see instructions) 13 Other interest. ............. 14 Repairs................ 15 Supplies ............... 16 Taxes . . . . . . . . . . . . . . . 17 Utilities .. 18 Depreciation expense or depletion....... 19 Other (list) 20 Total expenses. Add lines 5 through 19. 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties). If result is a (loss), see instructions to find out if you must file Form 6198 . . . . . . . . . . 22 Deductible rental real estate loss after limitation, if any, on Form 8582 (see instructions) ....... 18 19 20 23a 23b 23a Total of all amounts reported on line 3 for all rental properties....b Total of all amounts reported on line 4 for all royalty properties ....c Total of all amounts reported on line 12 for all properties ......d Total of all amounts reported on line 18 for all properties ......e Total of all amounts reported on line 20 for all properties ...... 23c 23d 24 Income. Add positive amounts shown on line 21. Do not include any losses ... 25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here 26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the total on line 41 on page 2. ... For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11344L Schedule E (Form 1040) 2016 Taxpayer Information Name: Bryan Jones Address: 1200 Main St. Green Bay, Wisconsin 12345 DOB: 5/6/1976 Filing Status: Single SSN: 500-10-2000 Occupation: Staff Accountant INCOME INFORMATION: Wages and Compensation The following information is taken from Bryan Jone's 2017 Form W-2 Wage and Tax Statement 52,000 Box 1-Wages, tips, and other compensation Box 2-Federal Withholding Box 17 - State Income Tax Withholding 8,750 1,000 Interest and Dividends Bryan has some Certificates of Deposits are Main Street bank which yielded 3,750 in interest in 2017. In addition, Bryan has interest income from municipal bonds in the amount of 1,250. Also, Bryan received $2100 in qualified dividends from Plum Electronic Co. Profit/Loss from Business Bryan has a part-time accounting services business. In 2017, his income and expenses are as f follows: Service Reveous 7,000 Office Expense Advertising Capital Gains Bryan had the following stock transactions in 2017: He sold 1,000 shares of Apex Co. for $ 12,000 on June 7, 2016, which he purchased on April 1, 2014 for 25,000. In addition, he sold 750 shares of Velocity Inc. for $10,000 on September 1, 2016, which he purchased on December 1, 2015 for $5,000. Rental Real Estate Bryan owns a rent house which he purchased on July 1, 2014. The income and expenses of the rental real estate unit for 2017 are as follows: Rental income Property taxes Depreciation Repairs and Maintenance Insurance $12,000 $1,500 $1,000 $750 $2,000 Other Transactions in 2017 1. Bryan received a gift of $4,000 from his brother. 2. Bryan paid $3,000 for the year in alimony to his ex-wife, per divorce decree. 3. Bryan had gambling winnings of $1,000 4. Bryan was the beneficiary of his mother's life insurance policy. His mother died in 2017 and he received $50,000 under this policy. 2016 Form 1040 Department of Internal Revenue Service U.S. Individual Tax Form OMB No. 1545-0074 2016, 20 For the year Jan. 1--Dec. 31,2016, or any other tax year beginning Your first name and initial Last name IRS Use Only--Do not write or staple in this space See Separate Instructions Social Security Number If a joint return, spouses first Last name Spouse Social Security Number Home address( number and street). If you have a P.O.Box, see instructions Make sure that the SSN(s) above and on line 6c are correc. City, town, or post office, state, and zip code. If you have a foreign address, also complete spaces below (see ins Presidential Election Campaign Check here if you, or your spouse if filing jointly, Foreign country name Foreign province/state/country Foreign postal code checking this box below will not change your tax refund you spouse Filing Status 1. Single 4.Head of Household (with qualifying person.) (See instructions.) If Check only one box 2.. married filing jointly the qualifying person is a child but not your dependent, enter this 3. Married filing separately. Enter spouse's SSN above child's name here and full name here. 5. Qualifying Window(er) with dependent child Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box] Boxes checked b spouse on 6a and 6b If more than four c. Dependents dependents, see (1) First name Last name (2) dependents (3) dependents (4) check if child under age 17 No. of children instructions and social security number relationship to you qualifying for tax credit see on 6c who: check here instructions. lived with you did not live with you due to divorce or separation (see instructions) Dependents on 6c not entered above d. Total number of Exemptions Claimed Add numbers on lines Income Attach Form(s) W-2 here. Also attach Forms(s) W-2 and 1099-R if tax was withheld. If you did not get a W-2, see instructions Wages, salaries, tips, etc. Attach Forms (W-2) Taxable interest. Attach Schedule B if required Tax-exempt interest. Do not include on line 8a Ordinary dividends. Attach Schedule B if required Qualified dividends Taxable refunds, credits, or offsets state or local income taxes Alimony received Business income or loss). Attach Schedule C or C-EZ Capital gain or loss). Attach Schedule D if required. If not required, check here other gains or losses). Attach Form 4797 IRA distributions 15a b Taxable amount Pensions and annuities 16a b Taxable amount Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F Unemployment compensation Social security benefits 20a b Taxable amount other income. List type and amount combine the amounts in the far right column for lines 7 through. This is your total incom H. 14-lea al--- -- 15a 20a 22 Adjusted Gross Income Educator expenses and fee-basis government. Attach Form 2106 or 2106-EZ 25 Health-savings account deduction. Attach Form 88 Moving Expenses. Attach Form 3903 Deductible part of self-employment tax. Attach Schl Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction Penalty on early withdrawal of savings Alimony paid b. Recipient IRA deduction Student loan interest deduction 34 35 Tuition and fees. Attach Form 8917 Domestic production activities deduction. Attach Form 890 35 Add lines 23 through 35 Subtract line 36 from line 22. This is your adjusted gross income. 37 OMB No. 1545-0074 SCHEDULE A (Form 1040) Internal Revenue Service 2016 Itemized Deductions Information about Schedule A and its separate instructions is at www.lrs.gov/schedule a Attach to Form 1040. Attachment Sequence No. 07 Name(s) shown on Form1040 Your social security number Medical and Dental Expenses 3 . . . . . . Taxes You Paid Caution. Do not nclude expenses reinbursed or paid by others. 1 Medical and dental expenses (see instructions)..... 2 Enter amount from Form 1040, line 38 2 3 Mutiply line 2 by 10% (-10). But if ether you or your spouse was bom before January 2, 1949, mutiply line 2 by 7.5% (075) instead A Subtract line 3 from line 1. f line 3 is more than line 1, enter-O-. . 5 State and local (check only one box): a ? Income tax or b? General sales tax 6 Real estate taxes (see instructions).. . . 7 Personal Property taxes. . . . . . . . . . 8 Other taxes List type and amount > ------------- - - ---- ---- - - - - ---- 10 Home mortgage interest and points reported to you on Form 1098 11 Home mortgage interest not reported to you on Form 1098 If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address . --- - - NO Interest You Paid Note. Your mortgage interest deduction may be Limited (see instructions Gifts to Charity if you made a gift and got a benefits for it see instructions Casualty Job Expenses and Certain Miscellaneous Deductions 12 Points not reported to you on Form 1098 See instructions for special rules . . . . . . . . . . . 13 Mortgage insurance premiums (see instructions)..... 14 Investment interest. Attach Form 4952 if required. (See instructions.) 15 Add lines 10 through 14.. 16 Gifts by cash or check. If you made any gift of $250 or more, see instructions....... . 17 Other than by cash or check. f any gift of $250 or more, see instructions. You must attach Form 8283 if over $500... 18 Carryover from prior year.... 19 Add lines 16 through 18.. ........ 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . 21 Unreimbursed employee expenses-job travel, union dues, ob education, etc Attach Form 2106 or 2106-EZ if required (see instructions) 22 Tax preparation fees ..... 23 Other expenses-investment, safe deposit box, etc. List type and amount - -- -- -- -- -- -- -- - - -- -- -- -- -- -- -- 24 Add lines 21 through 23 .......... 25 Enter amount from Form 1040, line 38 25 26 Mutiply line 25 by 2% (02)... 27 Subtract line 26 from line 24. If line 26 is more than ine 24 enter-O- Other 28 Other-from ist in instructions. List type and amount Miscellan - - ---- -- -- ---- - --- -- - - -- - cous Total 29 Is Form 1040, ine 38, over $150,000? Itemized ? No. Your deduction is not limited. Add the amounts in the far right column Deductions for ines 4 through 28. Also, enter this amount on Form 1040, line 40. ? Yes. Your deduction may be limted. See the itemized Deductions Worksheet in the instructions to figure the amount to enter 30 if you elect to tenke deductions even though they are less than your standard deduction, check here . . . . . . . . . . . . . . . . For Paperwork Reduction Act Notice, see Form 1040 instructions. Cat. No. 17145C Schedule A (Form 1040) 2016 OMB No. 1545-0074 SCHEDULE B (Form 1040A or 1040) Department of the Treasury Internal Revenue Service (99) Interest and Ordinary Dividends Attach to Form 1040A or 1040. Information about Schedule B (Form 1040A or 1040) and its instructions is at www.irs.gov/scheduleb. 2016 Attachment Sequence No. 08 Your social security number Name(s) shown on return Amount Parti 1 List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see instructions on back and list Interest this interest first. Also, show that buyer's social security number and address (See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note. If you 2 Add the amounts on line 1..... received a Form 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989 1099-INT, Form 1099-OID, or Attach Form 8815. substitute 4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form statement from 11040. line 8a 1940, he . . . . . . . a brokerage firm, list the firm's name as the payer and enter the total interest shown on that form. Note. If line 4 is over $1.500. you must complete Part III. 5 List name of payer Amount 6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040. line 9a . . . . . . . . . . . . . . . . . . . . . . Part II Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 9a.) Note. If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm's name as the payer and enter the ordinary dividends shown on that form. Note. If line 6 is over $1,500, you must complete Part III. You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a Yes No foreign account; or (c) received a distribution from, or were a grantor of, or a transferorto, a foreign trust. Part III 7a At any time during 2016, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located in a foreign Foreign country? See instructions .... Accounts If "Yes," are you required to file FinCEN Form 114, Report of Foreign Bank and Financial and Trusts Accounts (FBAR), formerly TD F 90-22.1, to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing requirements and exceptions to those requirements ............................ For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2016 (See SCHEDULED (Form 1040) Department of the Treasury Internal Rorsrus Servics (99) OMB No 545-0074 Capital Gains and Losses Attach to Form 1040 or Form 1040NR. Information about Schedule D and its separate instructions is at www.lrs.govischeduled Attachment Your social security number 2016 Namaronenretum Short-Term Capital Gains and Losses-Assets Held One Year or Less See instructions for how to figure the amounts to d e l h Gain orla Subtract Procrede Casi Adustments columne from columnd and enter on the lines below. (sales pricel Drather to gain or loss fromFomis1 0949 Partline 2.column(a) loombine the result with column () This form may be easier to complete if you round basis 1a Totals for all short-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see 1b Totals for all transactions reported on Form(s) 8949 with Box A checked ... 2 Totals for all transactions reported on Form(s) 8949 with Box B checked 3 Totals for all transactions reported on Form(s) 8949 with Box C checked ........... 4 Short-term gain from Form 6252 and short-term gain or loss) from Forms 4684, 6781, and 8824 5 Net short-term gain or loss) from partnerships, S corporations, estates, and trusts from Schedule(5) K-1 6 Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions 7 Net short-term capital gain or (loss). Combine lines 1 a through 6 in column (h). If you have any long-term capital gains or losses, go to Part Il below. Otherwise, go to Partill on the back TYWN IESLI U SUUL I S . . . . . . . . . . . . . . . . . - Long-Term Capital Gains and LossesAssets Held More Than One Year 16 Proceda (seles pricel Ih Gain or leas) Subtract Adustments columne from column(d, and o gainor loss from Form 16949.Part II line 2 columnal combine the result withcolumnal (orother basis See instructions for how to figure the amounts to enter on the lines below This form may be easier to complete if you round off cents to whole dollars. 8a Totals for all long-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see 8b Totals for all transactions reported on Form(s) 8949 with Box D checked .... 9 Totals for all transactions reporled on Form(s) 8949 with Box Echecked 10 Totals for all transactions reported on Form(s) 8949 with Box Fchecked 11 Gain from Form 4797, Part I: long-term gain from Forms 2439 and 6252, and long-term 11 gain or loss) from Forms 4684, 6781, and 8824 ....... 13 12 Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 13 Capital gain distributions. See the instructions 15 For Paperwork Reduction Act Notice, see your tax return instructions. Cat No. 1338 Schedule D [Form 10401 2016 SCHEDULE E (Form 1040) Department of the Treasury Internal Revenue Service (99) Supplemental Income and Loss (From rental real estate, royalties, partnerships, Scorporations, estates, trusts, REMICS, etc.) Attach to Form 1040, 1040NR, or Form 1041. Information about Schedule E and its separate instructions is at www.irs.gov/schedulee. OMB No. 1545-0074 2016 Attachment Sequence No. 13 Name(s) shown on return Your social security number Part Income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personal property, use Schedule C or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. Yes Yes No No A Did vou make any payments in 2016 that would reauire vou to file Form(s) 1099? (see B If "Yes, did you or will you file required Forms 1099? 1a Physical address of each property (street, city, state, ZIP code) A 1b QIV Type of Property (from list below) Fair Rental Days Personal Use Days 2 For each rental real estate property listed above, report the number of fair rental and only if you meet the requirements to file as a qualified joint venture. See instructions. B C personal use days. Check the QJV box Type of Property: 1 Single Family Residence 2 Multi-Family Residence 3 Vacation/Short-Term Rental 4 Commercial 5 Land 6 Royalties 7 Self-Rental 8 Other (describe) Income: Properties: 3 Rents received ............. 4 Royalties received ............ Expenses: 5 Advertising .............. 6 Auto and travel (see instructions) ....... 7 Cleaning and maintenance ......... 8 Commissions.............. 9 Insurance............... 10 Legal and other professional fees....... 11 Management tees 12 Mortgage interest paid to banks, etc. (see instructions) 13 Other interest. ............. 14 Repairs................ 15 Supplies ............... 16 Taxes . . . . . . . . . . . . . . . 17 Utilities .. 18 Depreciation expense or depletion....... 19 Other (list) 20 Total expenses. Add lines 5 through 19. 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties). If result is a (loss), see instructions to find out if you must file Form 6198 . . . . . . . . . . 22 Deductible rental real estate loss after limitation, if any, on Form 8582 (see instructions) ....... 18 19 20 23a 23b 23a Total of all amounts reported on line 3 for all rental properties....b Total of all amounts reported on line 4 for all royalty properties ....c Total of all amounts reported on line 12 for all properties ......d Total of all amounts reported on line 18 for all properties ......e Total of all amounts reported on line 20 for all properties ...... 23c 23d 24 Income. Add positive amounts shown on line 21. Do not include any losses ... 25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here 26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the total on line 41 on page 2. ... For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11344L Schedule E (Form 1040) 2016