Using the information below, complete a 2020 tax return for Raphael and Michelle Yustis.
The taxpayers have not received a notice from the IRS or any state or local taxing authority within the last year, outside of notices regarding the Economic Impact Payments.
The taxpayers did not provide a driver's license or state identification.
Introduction
You remember from last year that Raphael was in the military in 2019, so you ask if he was still in the military for 2020.
Taxpayer Information
| Taxpayer name: | Raphael R. Yustis |
| Taxpayer SSN: | 562-00-7540 |
| Taxpayer DOB: | May 30, 1972 |
| Occupation: | Military IT specialist |
| | |
| Spouse name: | Michelle P. Yustis |
| Spouse SSN: | 562-00-1081 |
| Spouse DOB: | July 15, 1973 |
| Occupation: | Pastoral minister |
| | |
| Address: | 1110 Wormwood Avenue |
| | Your City, YS XXXXX |
| Preferred phone: | (XXX) 555-1014; Type: Cell; OK to call; FCC: Yes; Best Time: Morning |
| Spouse phone: | (XXX) 555-2014; Type: Cell; OK to call; FCC: Yes; Best Time: Afternoon |
| Taxpayer email: | rryustis@net.net |
| Spouse email: | mpyustis@net.net |
| Health Insurance | |
| Did everyone in the household have health insurance in 2020? | Yes |
| Total months covered through a state exchange or federal marketplace: | 0 |
| Total months covered through another plan: | 12 |
| Was a Form 1095-A issued? | No |
| The taxpayers did not provide a Form 1095-B or Form 1095-C, but stated they had qualifying health care coverage through their employer all year. |
Raphael and Michelle are married and wish to file a joint return. Their SSNs are valid for work in the U.S. and were received before the original filing due date of the return (including extensions). Both are U.S. citizens. No one may claim either of them as a dependent. Neither are students. The taxpayers do not wish to designate $3 to the Presidential Election Campaign Fund. Raphael is not blind or disabled. Michelle is considered blind, but she is able to participate in substantial gainful activity.
You've undoubtedly heard this phrase before, but you may not know why it matters here. The designations blind and disabled have specific definitions for Social Security Administration (SSA) and IRS purposes. Click each hyperlink if you'd like to know more.
The Yustises did not suffer any casualty losses during the current tax year. They did not receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency. They do not have a financial interest in or signature authority over a foreign account and did not receive a distribution from, nor were they the grantors of or transferor to, a foreign trust. The IRS has not issued any Identity Protection ID Numbers for their return.
Neither Raphael nor Michelle received any unemployment income. They made $480 in cash charitable contributions.
CARES Act Information
The taxpayers did not receive qualified sick and/or family leave credits. They do not qualify for the Health Coverage Tax Credit. They did receive a recovery rebate/Economic Impact Payment of $2,400.
Consolidated Appropriations Act (2021) Information
They also received the second recovery rebate/Economic Impact Payment in the amount of $1,200.
Household Information
The Yustises rented their home until February 1, 2020. They purchased a home when Raphael was relocated to a new permanent military position. More information on this is provided later in this case study.
Additional Information
Michelle was injured in a car accident in 2016, which resulted in significant loss to her eyesight and mobility. She has been legally blind since 2017. She received a personal injury settlement in 2018, which helped to pay for necessary medical attention through the years. Finding great strength in her faith during this difficult recovery, Michelle decided to pursue pastoral ministry to help women in similar situations. After the Yustises moved, Michelle reduced her work to only making trips for lectures once or twice a month.
On February 1, 2020, Raphael and Michelle moved from Former City to Your City, when Raphael was assigned to a new permanent duty station by the military. Former City and Your City are both in Your State. Raphael and Michelle paid $3,662 to have their household furnishings and personal possessions moved from Former City to Your City. Raphael was reimbursed $1,500 of the moving expenses by the military. The Yustises drove both of the cars they own 102 miles for the move. The distance from their old home to the new workplace is 112 miles. The distance from their old home in Former City is six miles from Raphael's old workplace. Raphael began work at the new location on February 3, 2020.
The closing on the new home at 1110 Wormwood Avenue took place on February 3, 2020. The closing documents show that the Yustises reimbursed the seller $1,500 in real estate taxes (not included in their Form 1098) and had an origination fee (points paid) of $3,200.
Remember
Michelle would like to start contributing as much as she is allowed to a traditional IRA to qualify for the deduction. If there is a remaining amount not deductible for the traditional IRA, then she would like to contribute this amount up to the maximum to a Roth IRA. She is covered under her husband's retirement plan from the military. All contributions will be made before the filing deadline.
Clergy Income & Expenses
All of Michelle's income is represented in the documents she brought in. There was no carryforward of prior-year negative qualified business income. Michelle's income was impacted more significantly by their move than by COVID-19 mandates and lockdowns. She did not miss work due to concerns of major illness.
She had the following expenses>>:
| Supplies related to self-employment income | $230 |
| Mileage related to Form W-2 income | 237 miles |
| Travel expenses related to self-employment income: | 2,047 miles $412 $745 |
What about housing?
Yes, we spent quite a bit of time discussing parsonage or rental allowance. Chapter 5 gave you an opportunity to express those tax concepts. However, even though the spouse in our scenario did not receive nor require that benefit, there is still an important entry to make in BlockWorks. BlockWorks will be looking for a number on the Clergy Information page. In order to close the loop and let the system know you didn't forget to make an entry, input a negative of (-1) in the Housing allowance received box.
Other Income
Raphael and Michelle received a state refund of $27 during 2020 for taxes paid in 2019. They did not itemize their deductions in 2019 because they were renting a home and did not have enough deductions to exceed the standard deduction.
Toward the end of 2019, Raphael decided to become a 5% partner of a company his friend owns. Raphael was hesitant, but he did want to diversify his efforts. All Raphael knows is that his friend operates an oil company. He waited to receive his 2020 Schedule K-1 to judge the company's performance, which he was not happy with, and will probably liquidate his remaining portion in 2021.
Itemized Deductions
Raphael and Michelle are interested in knowing if they can itemize for 2020, with the purchase of the new home as well as their medical expenses.
In addition to their mortgage interest incurred in their acquisition mortgage on the new home, real estate taxes paid at closing and on Form-1098, as well as other deductible expenses related to the home acquisition, they also paid the following expenses in 2020:
| Church contributions by cash/check | $480 |
| Personal property tax, assessed on vehicle value | $642 |
| Doctor bills for Michelle | $1,023 |
| Guide dog "Sparky" | $5,000 |
| Veterinarian bills for Sparky | $968 |
| Food and grooming fees for Sparky | $471 |
| Tax preparation fee | $250 |
The Yustises decided to purchase a guide dog in 2020 for Michelle to help her get around more independently. The dog's name is Sparky. The cost for purchasing the guide dog was $5,000. The Yustises have receipts for all expenses they are claiming as itemized deductions. If they itemize their deductions, Raphael and Michelle would prefer to claim the deduction for state income tax rather than state sales tax.
2019 Earned Income
The taxpayer(s) had earned income of $73,975 in 2019.
Information Documents
Raphael and Michelle brought in two Forms W-2, one Form SSA-1099, one Form 1098, one Form 1099-G, one Form 1099-NEC, one Form 1099-INT*, one Form 1099-DIV, and one Form K-1 (1065). They had no other income.
Clergy Information (Not for Church Employee Income) Click this link to go to the Schedule SE Schedule SE Housing Method #1 - Taxpayer and/or spouse may use either method, but not both. Fair Rental Value of Parsonage Provided by Church Taxpayer Spouse 3a Fair rental value of parsonage provided by church b Utility allowance, if any. b c Actual expenses for utilities... Housing Method #2 - Taxpayer and/or spouse may use either method, but not both. Parsonage or Rental Allowance 4a Housing allowance received (including any utility allowances)... 4a -1 Housing allowance received while retired (not included in F1099R).. b Utility allowance, if separate... Utility allowance received while retired (not included a Employee's social security number 562-00-1081 b Employer identification number (EIN) 09-5620801 c Employer's name, address, and ZIP code FAITH CHURCH 655 NORTH AVENUE YOUR CITY, YS XXXXX Safe, accurate, Visit the IRS website at en file www.insgevalle OMB No. 1545-0008 FASTI Use 1 Wagos, tips, other compensation 2 Federal income tax withhold 1,800.00 3 Social security wages 4 Social security tax withheld 0.00 5 Medicare wagos and tips 6 Medicare tax withheld 0.00 7 Social security tips 8 Allocated tips d Control number 9 10 Dependent care benefits Suff. 11 Nonqualified plans 12a See Instructions for box 12 . Employee's first name and initial Last name MICHELLE YUSTIS 1110 WORMWOOD AVENUE YOUR CITY, YS XXXXX 13 theory Non see Thay 120 14 Other 12c 12d 1 Employee's address and ZIP code 15 State Employer's state ID number YS S09-5620801 18 Local wages, tips, etc. 19 Local income tax 20 Locally more 16 Stato wages, tips, etc. 17 State income tax 1,800.00 2020 Department of the Treasury-Intemal Revenue Service Form W-2 Wage and Tax Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Form W-2 Wage and Tax Statement 2020 OMB No. 0000-0000 Control number Employer identification number 09-5620602 Employer's name, address and ZIP Code Employee's SSN 562-00-7540 DFAS 7 Social security tips 8899 EAST 56TH STREET YOUR CITY, YS XXXXX 8 Allocated tips Employee's first name, middle innal, last name, suffix RAPHAEL YUSTIS D $ 3,000.00 Employee's Address and ZIP Code DD $ 16,524.00 120 P $ 1,500.00 1110 WORMWOOD AVENUE YOUR CITY, YS XXXXX 15 State Employer's State ID number State wages, tips etc 17 State income tax Local wages, tipset YS 095620602G $ 68,254.00 $ 3,119.00 Department of the Treasury - Internal Revenue Service COPY B to Be Filed With Employee's FEDERAL Tax Return 1 Wages, lipsother compensation 2 Federal income tax weheld $ 68,254.00 $ 5,460.00 3 Social security wages Social security tax withheld $ 71,254.00 $ 4,417.75 15 Medicare wages and tips 6 Medicare tax withheld $ 71,254.00 $ 1,033.18 10 Dependent care benefits 111 Nonqualfed plans 120 14 Other 13 Statutory Employee 120 Retirement Plan 12d Third-party sick pay 19 Local income tax 20 Locality name FORM SSA-1099 - SOCIAL SECURITY BENEFIT STATEMENT 2020 PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME. SEE THE REVERSE FOR MORE INFORMATION. Box 1. Name Box 2. Beneficiary's Social Security Number MICHELLE P. YUSTIS 562-00-1081 Box 3. Rignets Paid in 2020 Box 4. Benefits Repaid to SSA in 2020 Box 5. Net Benefits for 2020/Box 3 minus Box 1) $ 11,239.43 $ 11,239.43 DESCRIPTION OF AMOUNT IN BOX 3 DESCRIPTION OF AMOUNT IN BOX 4 Box 6. Voluntary Federal Income Tax Withholding $ Box 7. Address 1110 WORMWOOD AVENUE YOUR CITY, YS XXXXX Box 8. Claim Number (se this number if you need to contact SSA) 562-00-XXXX-HA Form SSA-1099-SM (1-2020) DO NOT RETURN THIS FORM TO SSA OR IRS CORRECTED (if checked) PAYERS name, street address, city or town, state or province, country, ZP Payer's RTN (optional) OMB No 1545-0112 or foreign postal code, and elephone ne SECURE SAVINGS FEDERAL BANK 2020 Interest 1 Interest income 9400 COMMERCE WAY Income YOUR CITY, YS XXXXX $ 894.63 Form 1099-INT 2 Early withdrawal peraty Copy B PAYER'S TIN RECIPIENTS TIN 1$ For Recipient 3 Interest on U.S. Savings Bonds and Trees obligations 09-5620803 562-00-7540 $ RECIPIENTS name Federal income tax withheld investment expenses This is important tax information and is RAPHAEL YUSTIS being tumished to the Foreign tax paid 7 Foreign county or U.S. RS. If you are Street address including pt.no required to files Tax-exempt for 1110 WORMWOOD AVENUE return, a negligence Specified private activity bord interest penalty or other City or town, state or province, country, and ZIP or foreign postal code sanction may be $ imposed on you 10 Market discount 11 Bond premium YOUR CITY, YS XXXXX this income is taxable and the IRS determines that it has FATCA fings $ not been reported requirement 13 odporino Tresury aligators 13 Bord remontu.com bord $ Account number se instructions) 14 Tax-exempt and tax credit 15 State 16 State identication no. 17 State tax withheld bond CUSP 10 99887766 YS For 1099-INT keep for your records) www.insgow Form1000NT Department of the Treasury - Internal Revenue Service *35% of the Box 8 Tax-Exempt Interest is from Your State $ 47.00 OMB No 1545-0110 2020 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP la Total ordinary dividends or foreign postal code, and telephone no. 695.33 $ CENTURY MUTUAL FUNDS 1b Qualified dividends 100 EAST KENYON WAY 695.33 YOUR CITY, YS XXXXX $ (XXX) 555-9524 2a Total capital gain distr. $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain Dividends and Distributions Form 1099-DIV 2b Unrecap. Soc. 1250 gain $ 2d Collectibles (28%) gain Copy B For Recipient 09-5620802 562-00-7540 RECIPIENT'S name 3 Nondividend distributions - Federal income tax withheld RAPHAEL YUSTIS This is important tax $ $ information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ $ the IRS. If you are required to file a 1110 WORMWOOD AVE 7 Foreign tax paid 8 Foreign country or US. possession return, a negligence penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ imposed on you if this income is taxable YOUR CITY, YS XXXXX Cash liquidation distributions 10 Noncash liquidation distribution and the IRS $ $ determines that it has FATCA fiing 11 Exempt-interest dividends 12 Specified private activity not been reported. requirement bond interest dividends $ Account number (see instructions) 13 State 14 Sete identification no 15 State tax withheld YS $ GR113355 $ Form 1099-DIV (keep for your records) www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service Certain Government Payments $ 27.00 CORRECTED (if checked) PAYER'S name, street address, city or town, state or provinco, country, ZIP 1 Unemployment compensation OMB No. 1545-0120 or foreign postal code, and telephone no. YOUR STATE DEPT. OF REVENUE $ 2020 1256 MAIN STREET 2 State or local income tax refunds, credits, or offsets YOUR CITY, YS XXXXX Form 1099-G PAYER'S TIN RECIPIENT'S TIN 3 Box 2 amount is for tax year Federal income tax withheld 09-5620805 562-00-7540 2019 $ RECIPIENT'S name 5 RTAA payments 6 Tatable grants RAPHAEL YUSTIS $ $ 7 Agriculture payments 8 If checked, box 2 is Street address (ncluding apt. no.) trade or business $ income 1110 WORMWOOD AVENUE 9 Market gain City or town, state or province, country, and ZIP or foreign postal code $ YOUR CITY, YS XXXXX 10 State 10 State identification no " State income tax witheid Account number (see instructions) YS $ Copy B For Recipient This is important tax information and is being furnished to the IRS. If you are required to file a retum, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Form 1099-G (keep for your records) www.lrs.gov/Form 10996 Department of the Treasury - Internal Revenue Service Limits based on the loan amount Mortgage Interest Statement CORRECTED (if checked) RECIPIENT'S/LENDER'S name, street address, city or town, state or 'Caution: The amount shown may OMB No. 1545-1380 province, country, ZIP or foreign postal code, and telephone no. not be fully deductible by you. and the cost and value of the 2020 MORTGAGE LENDERS secured property may apply. Also, you may only deduct interest to the 1203 COLUMBIA PARKWAY excent it was incurred by you, actualy paid by you, and not YOUR CITY, YS XXXXX reimbursed by another person. Form 1098 (XXX) 555-5242 1 Mortgage interest received from payer(s)borrowers) $ 8,433.00 RECIPIENT SALENDER'S TIN PAYERS/BORROWER'S TIN 2 Outstanding mortgage 3 Mortgage origination date principal $ 295,000.00 02/03/2020 09-5620807 562-00-7540 4 Refund of overpaid 5 Mortgage Insurance interest premiums PAYER'S/BORROWER'S name $ $ 2,125.00 RAPHAEL YUSTIS 6 Points paid on purchase of principal residence $ Street address (including apt. no.) 7 If address of property securing mortgage is the same as PAYER'S/BORROWER'S address, the box is checked, or 1110 WORMWOOD AVENUE the address or description is entered in box 8. City or town, state or province, country, and ZIP or foreign postal code 8 Address or description of property securing mortgage (see instructions) YOUR CITY, YS XXXXX 9 Number of properties securing the 10 Other mortgage RE TAX $3,423 Account number (see instructions) 2014098 Copy B For Payer/ Borrower The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS. If you are required to file a retum, a negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6 or because you didn't report the refund of interest (box 4), or because you claimed a nondeductible item. 11 Mortgage acquisition date 02/03/2020 Form 1098 (Keep for your records) www.irs.gov/Form 1098 Department of the Treasury - Internal Revenue Service Nonemployee Compensation CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP OMB No 1545-0116 or foreign postal code, and telephone no. ONE TRUTH FAMILY OF CHURCHES 2020 1517 EPHATA STREET YOUR CITY, YS XXXXX Form 1099-NEC (XXX) 555-5007 1 Nonemployee compensation $ 1,500.00 RECIPIENT'S TIN 09-5620806 562-00-1081 Copy B For Recipient PAYER'S TIN RECIPIENT'S name MICHELLE YUSTIS Street address (including apt. no.) 4 Federal income tax withheld 1110 WORMWOOD AVENUE $ City or town, state or province, country, and ZIP or foreign postal code YOUR CITY, YS XXXXX FATCA filing requirement This is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Account number (see instructions) State/Payer's state no. 7 State income $ 5 State tax withheld $ $ www.irs.gov/Form1099NEC wil Form 1099-NEC (keep for your records) Department of the Treasury - Internal Revenue Service 15 Credits 5 D 651119 Final K-1 Amended K-1 OMB No 1545-0123 Schedule K-1 2020 Part III Partner's Share of Current Year Income, (Form 1065) Deductions, Credits, and Other Items Department of the Treasury 1 Ordinary business income loss Internal Revenue Service For calendar year 2020, or tax year -5,404 beginning 2020 ending 2 Net rental real estate income foss) Partner's Share of Income, Deductions, 3 Other net rental income foss) Credits, etc. 16 Foreign transactions See separate instructions. Part 1 Information About the Partnership 4a Guaranteed payments for services A Partnership's employer identification number 09-5620804 4b Guaranteed payments for capital B Partnership's name, address, city, state, and ZIP code LUBE N TUBE HOLDINGS 46 Total guaranteed payments 13 OIL CAN BLVD, YOUR CITY, YS XXXXX Interest income IRS Center where partnership filed rotun OGDEN 13 Check if this is a publicly traded partnership PTP 6a Ordinary dividends Part II Information About the Partner E Partner's SSN OF TIN (Do not use TIN of a disregarded entity. See instructions.) Qualified dividends 562-00-7540 F Name, address, city, state, and ZIP code for partner entered in E. See instructions 6c Dividend equivalents 17 Alternative minimum tax (AMT) items RAPHAEL YUSTIS 1110 WORMWOOD AVENUE, YOUR CITY, YS XXXXX 7 Royalties 547 General partner or LLC Limited partner or other LLC Not short-term capital gain (los) morbor manager member 30 Domestic partner Foreign partner 9a Net long-term capital gain foss) 18 Tax-exempt income and H2 If the partner is a disregarded entity (DE), enter the partner's: 2,163 nondeductible expenses Name 9b Collectibles (28%) gain 11 What type of entity is this partner? INDIVIDUAL PASSIVE If this partner is a retirement plan (RA SEP/Keogh/etc.), check here 9c Unrecaptured section 1250 gain Partner's share of profit, loss, and capital (see instructions) Beginning Ending 10 Net section 1231 gain foon Profit 19 Distributions Loss 11 Other Income foss) Capital 5% Check it decrease is due to sale or exchange of partnership interest Other information 12 Section 179 deduction Partner's share of abilities: Beginning Ending 8 O OD H1 TIN 12 J 5 % 5 % 5% 5 % 5 % 20 K 12 Section 179 deduction 13 Other deductions * Partner's share of abilities: Beginning Ending Nonrecourse Qualified nonrecourse financing Recourse Check this box if tom includes liability amounts from lower tier partnerships. Partner's Capital Account Analysis $ $ L 14 Set-employment earnings for) 7125 $ - 2651 Beginning capital account Capital contributed during the year $ Current year net income foss) Other increase decrease) (attach explanation $ Withdrawals & distributions $ Ending capital account 21 More than one activity for at-risk purpose 22 More than one activity for passive activity purposes "See attached statement for additional information. 4474 M Yes X No Did the partner contribute property with a built-in gain or loss? If "Yes,"attach statement. See instructions Partner's Share of Net Unrecognized Section 704(c) Gain or (Loss) Beginning Ending For Paperwork Reduction Act Notice, see Instructions for Form 1065 www.rs.gov/Form 1065 For IRS Use Only N Cat. No. 11394R Schedule K-1 (Form 1065) 2020 Clergy Information (Not for Church Employee Income) Click this link to go to the Schedule SE Schedule SE Housing Method #1 - Taxpayer and/or spouse may use either method, but not both. Fair Rental Value of Parsonage Provided by Church Taxpayer Spouse 3a Fair rental value of parsonage provided by church b Utility allowance, if any. b c Actual expenses for utilities... Housing Method #2 - Taxpayer and/or spouse may use either method, but not both. Parsonage or Rental Allowance 4a Housing allowance received (including any utility allowances)... 4a -1 Housing allowance received while retired (not included in F1099R).. b Utility allowance, if separate... Utility allowance received while retired (not included a Employee's social security number 562-00-1081 b Employer identification number (EIN) 09-5620801 c Employer's name, address, and ZIP code FAITH CHURCH 655 NORTH AVENUE YOUR CITY, YS XXXXX Safe, accurate, Visit the IRS website at en file www.insgevalle OMB No. 1545-0008 FASTI Use 1 Wagos, tips, other compensation 2 Federal income tax withhold 1,800.00 3 Social security wages 4 Social security tax withheld 0.00 5 Medicare wagos and tips 6 Medicare tax withheld 0.00 7 Social security tips 8 Allocated tips d Control number 9 10 Dependent care benefits Suff. 11 Nonqualified plans 12a See Instructions for box 12 . Employee's first name and initial Last name MICHELLE YUSTIS 1110 WORMWOOD AVENUE YOUR CITY, YS XXXXX 13 theory Non see Thay 120 14 Other 12c 12d 1 Employee's address and ZIP code 15 State Employer's state ID number YS S09-5620801 18 Local wages, tips, etc. 19 Local income tax 20 Locally more 16 Stato wages, tips, etc. 17 State income tax 1,800.00 2020 Department of the Treasury-Intemal Revenue Service Form W-2 Wage and Tax Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Form W-2 Wage and Tax Statement 2020 OMB No. 0000-0000 Control number Employer identification number 09-5620602 Employer's name, address and ZIP Code Employee's SSN 562-00-7540 DFAS 7 Social security tips 8899 EAST 56TH STREET YOUR CITY, YS XXXXX 8 Allocated tips Employee's first name, middle innal, last name, suffix RAPHAEL YUSTIS D $ 3,000.00 Employee's Address and ZIP Code DD $ 16,524.00 120 P $ 1,500.00 1110 WORMWOOD AVENUE YOUR CITY, YS XXXXX 15 State Employer's State ID number State wages, tips etc 17 State income tax Local wages, tipset YS 095620602G $ 68,254.00 $ 3,119.00 Department of the Treasury - Internal Revenue Service COPY B to Be Filed With Employee's FEDERAL Tax Return 1 Wages, lipsother compensation 2 Federal income tax weheld $ 68,254.00 $ 5,460.00 3 Social security wages Social security tax withheld $ 71,254.00 $ 4,417.75 15 Medicare wages and tips 6 Medicare tax withheld $ 71,254.00 $ 1,033.18 10 Dependent care benefits 111 Nonqualfed plans 120 14 Other 13 Statutory Employee 120 Retirement Plan 12d Third-party sick pay 19 Local income tax 20 Locality name FORM SSA-1099 - SOCIAL SECURITY BENEFIT STATEMENT 2020 PART OF YOUR SOCIAL SECURITY BENEFITS SHOWN IN BOX 5 MAY BE TAXABLE INCOME. SEE THE REVERSE FOR MORE INFORMATION. Box 1. Name Box 2. Beneficiary's Social Security Number MICHELLE P. YUSTIS 562-00-1081 Box 3. Rignets Paid in 2020 Box 4. Benefits Repaid to SSA in 2020 Box 5. Net Benefits for 2020/Box 3 minus Box 1) $ 11,239.43 $ 11,239.43 DESCRIPTION OF AMOUNT IN BOX 3 DESCRIPTION OF AMOUNT IN BOX 4 Box 6. Voluntary Federal Income Tax Withholding $ Box 7. Address 1110 WORMWOOD AVENUE YOUR CITY, YS XXXXX Box 8. Claim Number (se this number if you need to contact SSA) 562-00-XXXX-HA Form SSA-1099-SM (1-2020) DO NOT RETURN THIS FORM TO SSA OR IRS CORRECTED (if checked) PAYERS name, street address, city or town, state or province, country, ZP Payer's RTN (optional) OMB No 1545-0112 or foreign postal code, and elephone ne SECURE SAVINGS FEDERAL BANK 2020 Interest 1 Interest income 9400 COMMERCE WAY Income YOUR CITY, YS XXXXX $ 894.63 Form 1099-INT 2 Early withdrawal peraty Copy B PAYER'S TIN RECIPIENTS TIN 1$ For Recipient 3 Interest on U.S. Savings Bonds and Trees obligations 09-5620803 562-00-7540 $ RECIPIENTS name Federal income tax withheld investment expenses This is important tax information and is RAPHAEL YUSTIS being tumished to the Foreign tax paid 7 Foreign county or U.S. RS. If you are Street address including pt.no required to files Tax-exempt for 1110 WORMWOOD AVENUE return, a negligence Specified private activity bord interest penalty or other City or town, state or province, country, and ZIP or foreign postal code sanction may be $ imposed on you 10 Market discount 11 Bond premium YOUR CITY, YS XXXXX this income is taxable and the IRS determines that it has FATCA fings $ not been reported requirement 13 odporino Tresury aligators 13 Bord remontu.com bord $ Account number se instructions) 14 Tax-exempt and tax credit 15 State 16 State identication no. 17 State tax withheld bond CUSP 10 99887766 YS For 1099-INT keep for your records) www.insgow Form1000NT Department of the Treasury - Internal Revenue Service *35% of the Box 8 Tax-Exempt Interest is from Your State $ 47.00 OMB No 1545-0110 2020 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP la Total ordinary dividends or foreign postal code, and telephone no. 695.33 $ CENTURY MUTUAL FUNDS 1b Qualified dividends 100 EAST KENYON WAY 695.33 YOUR CITY, YS XXXXX $ (XXX) 555-9524 2a Total capital gain distr. $ PAYER'S TIN RECIPIENT'S TIN 2c Section 1202 gain Dividends and Distributions Form 1099-DIV 2b Unrecap. Soc. 1250 gain $ 2d Collectibles (28%) gain Copy B For Recipient 09-5620802 562-00-7540 RECIPIENT'S name 3 Nondividend distributions - Federal income tax withheld RAPHAEL YUSTIS This is important tax $ $ information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ $ the IRS. If you are required to file a 1110 WORMWOOD AVE 7 Foreign tax paid 8 Foreign country or US. possession return, a negligence penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ imposed on you if this income is taxable YOUR CITY, YS XXXXX Cash liquidation distributions 10 Noncash liquidation distribution and the IRS $ $ determines that it has FATCA fiing 11 Exempt-interest dividends 12 Specified private activity not been reported. requirement bond interest dividends $ Account number (see instructions) 13 State 14 Sete identification no 15 State tax withheld YS $ GR113355 $ Form 1099-DIV (keep for your records) www.irs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service Certain Government Payments $ 27.00 CORRECTED (if checked) PAYER'S name, street address, city or town, state or provinco, country, ZIP 1 Unemployment compensation OMB No. 1545-0120 or foreign postal code, and telephone no. YOUR STATE DEPT. OF REVENUE $ 2020 1256 MAIN STREET 2 State or local income tax refunds, credits, or offsets YOUR CITY, YS XXXXX Form 1099-G PAYER'S TIN RECIPIENT'S TIN 3 Box 2 amount is for tax year Federal income tax withheld 09-5620805 562-00-7540 2019 $ RECIPIENT'S name 5 RTAA payments 6 Tatable grants RAPHAEL YUSTIS $ $ 7 Agriculture payments 8 If checked, box 2 is Street address (ncluding apt. no.) trade or business $ income 1110 WORMWOOD AVENUE 9 Market gain City or town, state or province, country, and ZIP or foreign postal code $ YOUR CITY, YS XXXXX 10 State 10 State identification no " State income tax witheid Account number (see instructions) YS $ Copy B For Recipient This is important tax information and is being furnished to the IRS. If you are required to file a retum, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Form 1099-G (keep for your records) www.lrs.gov/Form 10996 Department of the Treasury - Internal Revenue Service Limits based on the loan amount Mortgage Interest Statement CORRECTED (if checked) RECIPIENT'S/LENDER'S name, street address, city or town, state or 'Caution: The amount shown may OMB No. 1545-1380 province, country, ZIP or foreign postal code, and telephone no. not be fully deductible by you. and the cost and value of the 2020 MORTGAGE LENDERS secured property may apply. Also, you may only deduct interest to the 1203 COLUMBIA PARKWAY excent it was incurred by you, actualy paid by you, and not YOUR CITY, YS XXXXX reimbursed by another person. Form 1098 (XXX) 555-5242 1 Mortgage interest received from payer(s)borrowers) $ 8,433.00 RECIPIENT SALENDER'S TIN PAYERS/BORROWER'S TIN 2 Outstanding mortgage 3 Mortgage origination date principal $ 295,000.00 02/03/2020 09-5620807 562-00-7540 4 Refund of overpaid 5 Mortgage Insurance interest premiums PAYER'S/BORROWER'S name $ $ 2,125.00 RAPHAEL YUSTIS 6 Points paid on purchase of principal residence $ Street address (including apt. no.) 7 If address of property securing mortgage is the same as PAYER'S/BORROWER'S address, the box is checked, or 1110 WORMWOOD AVENUE the address or description is entered in box 8. City or town, state or province, country, and ZIP or foreign postal code 8 Address or description of property securing mortgage (see instructions) YOUR CITY, YS XXXXX 9 Number of properties securing the 10 Other mortgage RE TAX $3,423 Account number (see instructions) 2014098 Copy B For Payer/ Borrower The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS. If you are required to file a retum, a negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6 or because you didn't report the refund of interest (box 4), or because you claimed a nondeductible item. 11 Mortgage acquisition date 02/03/2020 Form 1098 (Keep for your records) www.irs.gov/Form 1098 Department of the Treasury - Internal Revenue Service Nonemployee Compensation CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP OMB No 1545-0116 or foreign postal code, and telephone no. ONE TRUTH FAMILY OF CHURCHES 2020 1517 EPHATA STREET YOUR CITY, YS XXXXX Form 1099-NEC (XXX) 555-5007 1 Nonemployee compensation $ 1,500.00 RECIPIENT'S TIN 09-5620806 562-00-1081 Copy B For Recipient PAYER'S TIN RECIPIENT'S name MICHELLE YUSTIS Street address (including apt. no.) 4 Federal income tax withheld 1110 WORMWOOD AVENUE $ City or town, state or province, country, and ZIP or foreign postal code YOUR CITY, YS XXXXX FATCA filing requirement This is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Account number (see instructions) State/Payer's state no. 7 State income $ 5 State tax withheld $ $ www.irs.gov/Form1099NEC wil Form 1099-NEC (keep for your records) Department of the Treasury - Internal Revenue Service 15 Credits 5 D 651119 Final K-1 Amended K-1 OMB No 1545-0123 Schedule K-1 2020 Part III Partner's Share of Current Year Income, (Form 1065) Deductions, Credits, and Other Items Department of the Treasury 1 Ordinary business income loss Internal Revenue Service For calendar year 2020, or tax year -5,404 beginning 2020 ending 2 Net rental real estate income foss) Partner's Share of Income, Deductions, 3 Other net rental income foss) Credits, etc. 16 Foreign transactions See separate instructions. Part 1 Information About the Partnership 4a Guaranteed payments for services A Partnership's employer identification number 09-5620804 4b Guaranteed payments for capital B Partnership's name, address, city, state, and ZIP code LUBE N TUBE HOLDINGS 46 Total guaranteed payments 13 OIL CAN BLVD, YOUR CITY, YS XXXXX Interest income IRS Center where partnership filed rotun OGDEN 13 Check if this is a publicly traded partnership PTP 6a Ordinary dividends Part II Information About the Partner E Partner's SSN OF TIN (Do not use TIN of a disregarded entity. See instructions.) Qualified dividends 562-00-7540 F Name, address, city, state, and ZIP code for partner entered in E. See instructions 6c Dividend equivalents 17 Alternative minimum tax (AMT) items RAPHAEL YUSTIS 1110 WORMWOOD AVENUE, YOUR CITY, YS XXXXX 7 Royalties 547 General partner or LLC Limited partner or other LLC Not short-term capital gain (los) morbor manager member 30 Domestic partner Foreign partner 9a Net long-term capital gain foss) 18 Tax-exempt income and H2 If the partner is a disregarded entity (DE), enter the partner's: 2,163 nondeductible expenses Name 9b Collectibles (28%) gain 11 What type of entity is this partner? INDIVIDUAL PASSIVE If this partner is a retirement plan (RA SEP/Keogh/etc.), check here 9c Unrecaptured section 1250 gain Partner's share of profit, loss, and capital (see instructions) Beginning Ending 10 Net section 1231 gain foon Profit 19 Distributions Loss 11 Other Income foss) Capital 5% Check it decrease is due to sale or exchange of partnership interest Other information 12 Section 179 deduction Partner's share of abilities: Beginning Ending 8 O OD H1 TIN 12 J 5 % 5 % 5% 5 % 5 % 20 K 12 Section 179 deduction 13 Other deductions * Partner's share of abilities: Beginning Ending Nonrecourse Qualified nonrecourse financing Recourse Check this box if tom includes liability amounts from lower tier partnerships. Partner's Capital Account Analysis $ $ L 14 Set-employment earnings for) 7125 $ - 2651 Beginning capital account Capital contributed during the year $ Current year net income foss) Other increase decrease) (attach explanation $ Withdrawals & distributions $ Ending capital account 21 More than one activity for at-risk purpose 22 More than one activity for passive activity purposes "See attached statement for additional information. 4474 M Yes X No Did the partner contribute property with a built-in gain or loss? If "Yes,"attach statement. See instructions Partner's Share of Net Unrecognized Section 704(c) Gain or (Loss) Beginning Ending For Paperwork Reduction Act Notice, see Instructions for Form 1065 www.rs.gov/Form 1065 For IRS Use Only N Cat. No. 11394R Schedule K-1 (Form 1065) 2020
