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General Information The Use any Fictitious name and SSN and assumes Occupations Office Manager Song: Use any Fictitious name and SSN and assume age under Soccupation is High School Teacher Filing Status MAI Address: Use any Fictitious addrest Dependents Assume 2 children living with taxpayers, Use any fictious cames and assume one child is over 17 and one child is under 17 Income Information Salary-Assume combined salaries of taxpayer and one to be S, Federal Income Tax Withholding 8.312 and S/NYC Income Tax WhiteSUS Interest Income - This should be equal to last four digital of your social security number Unemployment.compensation: $11,000 Gambling Winnings $1,000 Other Expenses and Politie Deductions: Out of Pocket Educators for the co-$1,200 Student interest - $1,500 for each spouse for a total of 1,000 BA contributions Fach pouse contributed maximum a towed to var at their separate a's and they do not have a retirement plan at work Metical Expenses Health Insurance $6.000 Doctor, Dentists $1.000 Prescriptions $ 250 . Over the counter medicine S 500 Gym membership $ 800 Medical Miles 75 Continued on next Personal Property Toes Real Estate Taxes $1.000 $ 5.000 Mortgage Interest $10,000 Credit card interest $3,000 Investment interest $4.500 Charity . Cash contributions $3,656 Clothing $ 456 Stock in BM-Value $10,000, Costas 54.000 Other Unrembursed employee expenses $2.500 Gambling losses $1.500 31040 U.S. Individual Income Tax Return 2020 N N. 14.07.com Fling Status Single Married fingjay Maried fing separately FS Head of hethod CH wing widowe CM Check only you checked the box, enter the name of your SOUSE. you checked the HOH Crow box, enter the child's name the quallying person a child but not your dependent Your name and middel Your social security mer in firmame and ident Spouse's social security number Monet resumber and you here PO, Bor, ciers A. Presidentitetin Campaign Check here if you, you Cay. Towar post office you have to address to completam below Dosting, want to go to the hund. Checking a Do teow we change Foreign country Foreign procedury Forude your ord Alany time during 2020, did you receive all send exchange or others squire any financial interest in any virtual currency? Yes No Standard someone can claim you as a dependent Your use as a dependent Deduction Southern arte em youtus Agobinds You Were bombersy2.1056 Arbind Spouse was bombatore devery 2.180 a bind Dependents estruction Roland Vestir more Od torradt Coro depende than our dependent se instructions and check here 1 Wages, salaries, tos, etc. Altach For W-2 1 2 Tarpinterest Schw Tablet 3e Qualified dividends 3 b Ontrary dividends 40 4 IRA distributions b Tebe mount 4 sa Pensions and are Ba Texable amount Standard 6 Bell curly bir Temont Deduction to Capital gain or loss. Attach Schedule Dried not required, check here 7 aviador # Other Income from Schedule, . Ads in 1, 7, th. th. th.7 and 8. This is your total income - wider 10 Adjustments to income Quality a From Schedule 1, Ine 22 widow 04.800 Charitable contributions if you are the standard deduction See Instructions 106 - Hotel Ads in 10 and 106. These we your totalements to come 10 $1,650 11 Subtractine 100 from Ines. This is your adjusted gross income 11 you! 12 Standard deduction or antad deductions from Schedule 12 any benne 13 Quadfled bushese income deduction. Attach Form 2005 Form 106-A 13 Dedicto * Addie 12 and 13 14 15 Taxable income. Sublatine 14 tromfine 11. zero ressenter For Door, Play Act and Paperwork Redwon Ast in parte hatrons Pre 1040 ABLE E AA Page 2 Form 104020200 16 Tax (see instructions). Check it any from Format 108814 24972 3D 16 17 Amount from Schedule 2. Iine 3 17 18 Add lines 16 and 17. 18 19 Child tax credit or credit for other dependents 19 20 Amount from Schedule 3. line 7 20 21 Add lines 19 and 20. 21 22 Subtract line 21 from line 18. If zero or less enter- 22 23 Other taxes, including self-employment tax, from Schedule 2 Ine 10 23 24 Add lines 22 and 23. This is your total tax 24 25 Federal income tax withheld from: Formis) W-2 250 b Forms 1000 25 Other forms (see instructional 25c dAdd lines 25a through 250 2 you have 26 2020 estimated tax payments and amount applied from 2019 return Outlying ch37 Eamed income credit (EC) SEK 27 you have 28 Additional child tax credit. Attach Schedule 8812 28 more 29 American opportunity credit from Form 8863, Ine 8 29 Intructions 30 Recovery rebate credit, See Instructions 30 31 Amount from Schedule 3, Ine 13 31 32 Add fines 27 through 31. These are your total other payments and refundable credits 32 33 Add lines 250, 25, and 32. These are your total payments 33 Refund 34 If ine 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpald 34 3Sa Amount of line 34 you want refunded to you. I Form 8888 is attached, check here 35a Direct deposit? > Routing number Sentrictions Account number Type Checking Savings 36 Amount of line 34 you want applied to your 2021 estimated tax. 38 Amount 37 Subtractine 33 from line 24. This is the amount you owe now You Owe For details on Note: Schedule Hand Schedule Se flers, line 37 may not represent all of the taxes you owe for how to pay, 2020. See Schedule 3, Ine 12, and its instructions for details Instructions 38 Estimated taxpay Constructions) Third Party Do you want to allow another person to discuss this retum with the RS? See Designee instructions Yes. Complete below. No Designer's Phone Personal identification combl. Sign Under penalties of perjuy. I decore That I have examined this tum and accompanying schedule and statements, and to the best of my knowledge and balet, they are correct and complete. Declaration of properer other than taxpayer is based on all information of which preparer has any knowledge Here Your signature Date Your socupation the sent you an identity Protection Poster here Join turn se) See Instructor Spouse's signature. Wartom, both mustig Date Spouse's cupation thesent your spouse an Kep a copy for cerity Protection Renter the your record Phone no Email address Preparer's name Paid Preparer's signature Date PTIN Check in Osemployed Preparer Use Only Firm's address Fim's EIN Go to www.in.govi Farm 1040 for instructions and the latest Information For 1040 Attachment 3 5 8 9 SCHEDULE 1 OMB No. 1545-0074 (Form 1040) Additional Income and Adjustments to Income 2020 Department of the Treasury Attach to Form 1040 1040-SR, or 1040-NR. Internal Revenue Service Go to www.irs.gov/Form 1040 for instructions and the latest information Sune No. 01 Name(s) shown on Form 1040,1040-SR, or 1040-NR Your social security number Part Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes. 1 2a Alimony received ... 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C 4 Other gains or losses). Attach Form 4797 ... 4 5 Rental real estate, royalties, partnerships, corporations, trusts, etc. Attach Schedule E 6 Farm income or (loss). Attach Schedule F 6 7 Unemployment compensation. 7 8 Other income. List type and amount 9 Combine lines through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR. line 8 Part II Adjustments to Income 10 Educator expenses. 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 12 Health savings account deduction. Attach Form 8889 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE 15 Self-employed SEP, SIMPLE, and qualified plans 16 Self-employed health insurance deduction 16 17 Penalty on earty withdrawal of savings 17 18a Alimony paid. 18a b Recipient's SSN c Date of original divorce or separation agreement (see instructions) 19 IRA deduction 20 Student loan interest deduction 20 21 Tuition and fees deduction. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 1040-SR, or 1040-NR, line 10a 22 For Paperwork Reduction Act Notice, see your tax return instructions. Cat No. 71475F Schedule 1 Form 1046 2020 10 11 12 14 15 19 SCHEDULE A Itemized Deductions OMB. 543-0374 Fann 1040 1040 Go to www.is.goviSchedule for instructions and the latest information Pencary 2008 Attach to Form 1040 or 1040-SR. 2019 Do Att Daniel Caution you recting and qualified disaster Form 40. The run for ine 16 Be N 07 Manel Form 1000 100-GR Your social security number Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions Dental 2 Enter amount from Form 1040 or 1040 Sine 21 Expenses 3 Multiply line 2 by 2.5% 0.079 3 4 Subtractin from Ina 1. I 3 is more than in 1. enter- Taxes You 5 State and locales. Paid a State and local income taxes or general sales tea. You may include either income taxes or general sales taxes on line 5s, but not both. It you feel to include gallos tres instead of income to check this box DS State and local rette taxe free instructions c State and local personal property dAddiness through Enter the smaller of line 5d or $10.000 (55.000 married filing separately 6 Other taxes List type and amount 38E SO 7 Add fines 5 and 6 Interest & Home mortgage interest and points. If you didn't use all of your home You Paid mortgage loaned to buy, build, or improve your home. see Castro instructions and check this box ducho say a Home more interest and points reported to you on Form 1098 mortgage More See instructions med Home mortgage interest not reported to you on Form 100. See instructions if limited. I paid to the person from whom you bought the home to tractions and show that person's name, identifying no. and address ab Points not reported to you on Form 1098. See instructions for special Bc d Mortono insurance premium se instruction 8d Add lines Bathrough Bd Be 9 Investment interest. Attach Form 4952ed. See instructions 9 10 Add ins Be and Gifts to 11 Gifts by cash or check. If you made any of $250 or more Charity instructions 11 Canyou 12 Other than by cash or check if you made any gift of $250 or more mietin offor see instructions. You must attach Form 8283 over $500. 12 13 Carryover from prior your 13 14 Add in 11though 13 14 Casualty and 15 Casualty and the loss from a federally declared disaster other than not qualified Theft Losses disaster loss. Attach Form 4684 and enter the amount from ine 18 of that fom. See Instructions 15 Other 16 Other-from list in instructions. List type and amount Itomized Deductions Total 17 Add the amounts in the far right column for in 4 Ovough 16. Also enter this amount on Itemized For 104 or 1040-SR, in 17 Deductions 18 if you clect to termice deductions even though they are than your standard deduction check this box For Paperwork Reduction Act Notice, see the bestrations for Forms 1040 and 101-SR. Cat. 40 Schedule Arm1040 1040-GROOT SCHEDULEB Form 1040 Det there Interest and Ordinary Dividends Go to www.ra.gov/Scheduster Instruction and the information Attach to Form 1046 1010 R. 2020 Anadmer Segre 08 Amount 1 List name of payer. If any interest is from a sile-financed mortgage and the buyer used the property as a personal residence, see the instructions and this Interest first. Also, show that buyer's social security number and address Part 1 Interest See Instructions and the Instructions for Forms 1043 and 1040-SR, in ) Nate you received a Form 1000 INT.Form 1099-01D, wat statement from a brokerage list the firme name as the peyer and enter the totalitare shown on 2 Add the amounts on Ine 1 2 3 Excludable interest on series EE and U.S. savings bonds issued after 1909 Attach Farm 8815 3 4 Subtract line 3 from Ine 2. Enter the result here and on Form 1040 1040-SR line 20 Note: Ifine 4 is over $1.500, you must complete Patil Amount Part 11 5 Uome of payer Ordinary Dividends See instructions and the instructions for Forma 1040 and 1040-SR, the Notes If you reolved a Fom 1090-DIV botte statement from a brokerage is the firm's mes payer and en the way duidend row . Add the amounts on line 5. Enter the total are and on Form 1000 1540-SR on that com. line 3 Note: If line is over $1,500, you must complete Part Part III You must complete this part if you had over $1.500 of taxable interest of ordinary dividends hada Yes No foreign account of received a distribution from or were a gratar of, or a transfer to a foreign trust Foreign To At any time during 2020, did you have a financial interest in or signature authority over a financial Accounts account such as a bank account, securities account or brokerage account located in a foreign and Trusts country See Instructions Caution "Yes" are you required to file FinCEN Form 114, Report of Foreign Bark and Financial required. fature Accounts (FBAR, to report that financial interest or signature authorty See PCEN Form 114 to VICEN and its instructions for filing requirements and exceptions to those requirements. Form 114 may result in you se required to file FNCEN Form 114, enter the name of the foreign country where the subst Snancial account is located pensee & During 2020, did you receive a distrbution from, or were you the grantor of, or transferorto, instructions foreign ? Yes, you may have to fie Form 3520. See instructions For Paperwork Reduction Act Notice, see your tax retum intrins. Schedule Form 1049 2030 Aachent Saree No. 03 1 3 SCHEDULE 3 OMN. 1545-0074 (Form 1040) Additional Credits and Payments 2020 Department of the Treasury Attach to Form 1040,1040-SR, or 1040-NR. Intemal venue Service Go to www.ira.gov/Form 10:40 for instructions and the latest Information Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number Part 1 Nonrefundable Credits 1 Foreign tax credit. Attach Form 1116 if required 2 Credit for child and dependent care expenses. Attach Form 2441 2 3 Education credits from Form 8863, line 19..... 4 Retirement savings contributions credit. Attach Form 8880 4 5 Residential energy credits. Attach Form 5695 5 6 Other credits from Form: a 3800 8801 co 6 7 Add lines 1 through 6. Enter here and on Form 1040, 1040-SR, or 1040-NR, Iine 20 7 Part II Other Payments and Refundable Credits 8 Net premium tax credit. Attach Form 8962. 8 9 Amount paid with request for extension to file (see instructions) 10 Excess social security and tier 1 RATA tax withheld 10 11 Credit for federal tax on fuels. Attach Form 4136 11 12 Other payments or refundable credits: a Form 2439 b Qualified sick and family leave credits from Schedule(s) Hand Form(s) 7202 12b c Health coverage tax credit from Form 8885 d Other: 120 Deferral for certain Schedule H or SE filers (see instructions) 12e Add lines 12a through 12e 121 13 Add lines 8 through 121. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 31 13 For Paperwork Reduction Act Notion, see your tax return Instructions Cat No. 714100 Schedule Form 10402020 9 12a 12c General Information The Use any Fictitious name and SSN and assumes Occupations Office Manager Song: Use any Fictitious name and SSN and assume age under Soccupation is High School Teacher Filing Status MAI Address: Use any Fictitious addrest Dependents Assume 2 children living with taxpayers, Use any fictious cames and assume one child is over 17 and one child is under 17 Income Information Salary-Assume combined salaries of taxpayer and one to be S, Federal Income Tax Withholding 8.312 and S/NYC Income Tax WhiteSUS Interest Income - This should be equal to last four digital of your social security number Unemployment.compensation: $11,000 Gambling Winnings $1,000 Other Expenses and Politie Deductions: Out of Pocket Educators for the co-$1,200 Student interest - $1,500 for each spouse for a total of 1,000 BA contributions Fach pouse contributed maximum a towed to var at their separate a's and they do not have a retirement plan at work Metical Expenses Health Insurance $6.000 Doctor, Dentists $1.000 Prescriptions $ 250 . Over the counter medicine S 500 Gym membership $ 800 Medical Miles 75 Continued on next Personal Property Toes Real Estate Taxes $1.000 $ 5.000 Mortgage Interest $10,000 Credit card interest $3,000 Investment interest $4.500 Charity . Cash contributions $3,656 Clothing $ 456 Stock in BM-Value $10,000, Costas 54.000 Other Unrembursed employee expenses $2.500 Gambling losses $1.500 31040 U.S. Individual Income Tax Return 2020 N N. 14.07.com Fling Status Single Married fingjay Maried fing separately FS Head of hethod CH wing widowe CM Check only you checked the box, enter the name of your SOUSE. you checked the HOH Crow box, enter the child's name the quallying person a child but not your dependent Your name and middel Your social security mer in firmame and ident Spouse's social security number Monet resumber and you here PO, Bor, ciers A. Presidentitetin Campaign Check here if you, you Cay. Towar post office you have to address to completam below Dosting, want to go to the hund. Checking a Do teow we change Foreign country Foreign procedury Forude your ord Alany time during 2020, did you receive all send exchange or others squire any financial interest in any virtual currency? Yes No Standard someone can claim you as a dependent Your use as a dependent Deduction Southern arte em youtus Agobinds You Were bombersy2.1056 Arbind Spouse was bombatore devery 2.180 a bind Dependents estruction Roland Vestir more Od torradt Coro depende than our dependent se instructions and check here 1 Wages, salaries, tos, etc. Altach For W-2 1 2 Tarpinterest Schw Tablet 3e Qualified dividends 3 b Ontrary dividends 40 4 IRA distributions b Tebe mount 4 sa Pensions and are Ba Texable amount Standard 6 Bell curly bir Temont Deduction to Capital gain or loss. Attach Schedule Dried not required, check here 7 aviador # Other Income from Schedule, . Ads in 1, 7, th. th. th.7 and 8. This is your total income - wider 10 Adjustments to income Quality a From Schedule 1, Ine 22 widow 04.800 Charitable contributions if you are the standard deduction See Instructions 106 - Hotel Ads in 10 and 106. These we your totalements to come 10 $1,650 11 Subtractine 100 from Ines. This is your adjusted gross income 11 you! 12 Standard deduction or antad deductions from Schedule 12 any benne 13 Quadfled bushese income deduction. Attach Form 2005 Form 106-A 13 Dedicto * Addie 12 and 13 14 15 Taxable income. Sublatine 14 tromfine 11. zero ressenter For Door, Play Act and Paperwork Redwon Ast in parte hatrons Pre 1040 ABLE E AA Page 2 Form 104020200 16 Tax (see instructions). Check it any from Format 108814 24972 3D 16 17 Amount from Schedule 2. Iine 3 17 18 Add lines 16 and 17. 18 19 Child tax credit or credit for other dependents 19 20 Amount from Schedule 3. line 7 20 21 Add lines 19 and 20. 21 22 Subtract line 21 from line 18. If zero or less enter- 22 23 Other taxes, including self-employment tax, from Schedule 2 Ine 10 23 24 Add lines 22 and 23. This is your total tax 24 25 Federal income tax withheld from: Formis) W-2 250 b Forms 1000 25 Other forms (see instructional 25c dAdd lines 25a through 250 2 you have 26 2020 estimated tax payments and amount applied from 2019 return Outlying ch37 Eamed income credit (EC) SEK 27 you have 28 Additional child tax credit. Attach Schedule 8812 28 more 29 American opportunity credit from Form 8863, Ine 8 29 Intructions 30 Recovery rebate credit, See Instructions 30 31 Amount from Schedule 3, Ine 13 31 32 Add fines 27 through 31. These are your total other payments and refundable credits 32 33 Add lines 250, 25, and 32. These are your total payments 33 Refund 34 If ine 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpald 34 3Sa Amount of line 34 you want refunded to you. I Form 8888 is attached, check here 35a Direct deposit? > Routing number Sentrictions Account number Type Checking Savings 36 Amount of line 34 you want applied to your 2021 estimated tax. 38 Amount 37 Subtractine 33 from line 24. This is the amount you owe now You Owe For details on Note: Schedule Hand Schedule Se flers, line 37 may not represent all of the taxes you owe for how to pay, 2020. See Schedule 3, Ine 12, and its instructions for details Instructions 38 Estimated taxpay Constructions) Third Party Do you want to allow another person to discuss this retum with the RS? See Designee instructions Yes. Complete below. No Designer's Phone Personal identification combl. Sign Under penalties of perjuy. I decore That I have examined this tum and accompanying schedule and statements, and to the best of my knowledge and balet, they are correct and complete. Declaration of properer other than taxpayer is based on all information of which preparer has any knowledge Here Your signature Date Your socupation the sent you an identity Protection Poster here Join turn se) See Instructor Spouse's signature. Wartom, both mustig Date Spouse's cupation thesent your spouse an Kep a copy for cerity Protection Renter the your record Phone no Email address Preparer's name Paid Preparer's signature Date PTIN Check in Osemployed Preparer Use Only Firm's address Fim's EIN Go to www.in.govi Farm 1040 for instructions and the latest Information For 1040 Attachment 3 5 8 9 SCHEDULE 1 OMB No. 1545-0074 (Form 1040) Additional Income and Adjustments to Income 2020 Department of the Treasury Attach to Form 1040 1040-SR, or 1040-NR. Internal Revenue Service Go to www.irs.gov/Form 1040 for instructions and the latest information Sune No. 01 Name(s) shown on Form 1040,1040-SR, or 1040-NR Your social security number Part Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes. 1 2a Alimony received ... 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C 4 Other gains or losses). Attach Form 4797 ... 4 5 Rental real estate, royalties, partnerships, corporations, trusts, etc. Attach Schedule E 6 Farm income or (loss). Attach Schedule F 6 7 Unemployment compensation. 7 8 Other income. List type and amount 9 Combine lines through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR. line 8 Part II Adjustments to Income 10 Educator expenses. 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 12 Health savings account deduction. Attach Form 8889 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE 15 Self-employed SEP, SIMPLE, and qualified plans 16 Self-employed health insurance deduction 16 17 Penalty on earty withdrawal of savings 17 18a Alimony paid. 18a b Recipient's SSN c Date of original divorce or separation agreement (see instructions) 19 IRA deduction 20 Student loan interest deduction 20 21 Tuition and fees deduction. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 1040-SR, or 1040-NR, line 10a 22 For Paperwork Reduction Act Notice, see your tax return instructions. Cat No. 71475F Schedule 1 Form 1046 2020 10 11 12 14 15 19 SCHEDULE A Itemized Deductions OMB. 543-0374 Fann 1040 1040 Go to www.is.goviSchedule for instructions and the latest information Pencary 2008 Attach to Form 1040 or 1040-SR. 2019 Do Att Daniel Caution you recting and qualified disaster Form 40. The run for ine 16 Be N 07 Manel Form 1000 100-GR Your social security number Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions Dental 2 Enter amount from Form 1040 or 1040 Sine 21 Expenses 3 Multiply line 2 by 2.5% 0.079 3 4 Subtractin from Ina 1. I 3 is more than in 1. enter- Taxes You 5 State and locales. Paid a State and local income taxes or general sales tea. You may include either income taxes or general sales taxes on line 5s, but not both. It you feel to include gallos tres instead of income to check this box DS State and local rette taxe free instructions c State and local personal property dAddiness through Enter the smaller of line 5d or $10.000 (55.000 married filing separately 6 Other taxes List type and amount 38E SO 7 Add fines 5 and 6 Interest & Home mortgage interest and points. If you didn't use all of your home You Paid mortgage loaned to buy, build, or improve your home. see Castro instructions and check this box ducho say a Home more interest and points reported to you on Form 1098 mortgage More See instructions med Home mortgage interest not reported to you on Form 100. See instructions if limited. I paid to the person from whom you bought the home to tractions and show that person's name, identifying no. and address ab Points not reported to you on Form 1098. See instructions for special Bc d Mortono insurance premium se instruction 8d Add lines Bathrough Bd Be 9 Investment interest. Attach Form 4952ed. See instructions 9 10 Add ins Be and Gifts to 11 Gifts by cash or check. If you made any of $250 or more Charity instructions 11 Canyou 12 Other than by cash or check if you made any gift of $250 or more mietin offor see instructions. You must attach Form 8283 over $500. 12 13 Carryover from prior your 13 14 Add in 11though 13 14 Casualty and 15 Casualty and the loss from a federally declared disaster other than not qualified Theft Losses disaster loss. Attach Form 4684 and enter the amount from ine 18 of that fom. See Instructions 15 Other 16 Other-from list in instructions. List type and amount Itomized Deductions Total 17 Add the amounts in the far right column for in 4 Ovough 16. Also enter this amount on Itemized For 104 or 1040-SR, in 17 Deductions 18 if you clect to termice deductions even though they are than your standard deduction check this box For Paperwork Reduction Act Notice, see the bestrations for Forms 1040 and 101-SR. Cat. 40 Schedule Arm1040 1040-GROOT SCHEDULEB Form 1040 Det there Interest and Ordinary Dividends Go to www.ra.gov/Scheduster Instruction and the information Attach to Form 1046 1010 R. 2020 Anadmer Segre 08 Amount 1 List name of payer. If any interest is from a sile-financed mortgage and the buyer used the property as a personal residence, see the instructions and this Interest first. Also, show that buyer's social security number and address Part 1 Interest See Instructions and the Instructions for Forms 1043 and 1040-SR, in ) Nate you received a Form 1000 INT.Form 1099-01D, wat statement from a brokerage list the firme name as the peyer and enter the totalitare shown on 2 Add the amounts on Ine 1 2 3 Excludable interest on series EE and U.S. savings bonds issued after 1909 Attach Farm 8815 3 4 Subtract line 3 from Ine 2. Enter the result here and on Form 1040 1040-SR line 20 Note: Ifine 4 is over $1.500, you must complete Patil Amount Part 11 5 Uome of payer Ordinary Dividends See instructions and the instructions for Forma 1040 and 1040-SR, the Notes If you reolved a Fom 1090-DIV botte statement from a brokerage is the firm's mes payer and en the way duidend row . Add the amounts on line 5. Enter the total are and on Form 1000 1540-SR on that com. line 3 Note: If line is over $1,500, you must complete Part Part III You must complete this part if you had over $1.500 of taxable interest of ordinary dividends hada Yes No foreign account of received a distribution from or were a gratar of, or a transfer to a foreign trust Foreign To At any time during 2020, did you have a financial interest in or signature authority over a financial Accounts account such as a bank account, securities account or brokerage account located in a foreign and Trusts country See Instructions Caution "Yes" are you required to file FinCEN Form 114, Report of Foreign Bark and Financial required. fature Accounts (FBAR, to report that financial interest or signature authorty See PCEN Form 114 to VICEN and its instructions for filing requirements and exceptions to those requirements. Form 114 may result in you se required to file FNCEN Form 114, enter the name of the foreign country where the subst Snancial account is located pensee & During 2020, did you receive a distrbution from, or were you the grantor of, or transferorto, instructions foreign ? Yes, you may have to fie Form 3520. See instructions For Paperwork Reduction Act Notice, see your tax retum intrins. Schedule Form 1049 2030 Aachent Saree No. 03 1 3 SCHEDULE 3 OMN. 1545-0074 (Form 1040) Additional Credits and Payments 2020 Department of the Treasury Attach to Form 1040,1040-SR, or 1040-NR. Intemal venue Service Go to www.ira.gov/Form 10:40 for instructions and the latest Information Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number Part 1 Nonrefundable Credits 1 Foreign tax credit. Attach Form 1116 if required 2 Credit for child and dependent care expenses. Attach Form 2441 2 3 Education credits from Form 8863, line 19..... 4 Retirement savings contributions credit. Attach Form 8880 4 5 Residential energy credits. Attach Form 5695 5 6 Other credits from Form: a 3800 8801 co 6 7 Add lines 1 through 6. Enter here and on Form 1040, 1040-SR, or 1040-NR, Iine 20 7 Part II Other Payments and Refundable Credits 8 Net premium tax credit. Attach Form 8962. 8 9 Amount paid with request for extension to file (see instructions) 10 Excess social security and tier 1 RATA tax withheld 10 11 Credit for federal tax on fuels. Attach Form 4136 11 12 Other payments or refundable credits: a Form 2439 b Qualified sick and family leave credits from Schedule(s) Hand Form(s) 7202 12b c Health coverage tax credit from Form 8885 d Other: 120 Deferral for certain Schedule H or SE filers (see instructions) 12e Add lines 12a through 12e 121 13 Add lines 8 through 121. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 31 13 For Paperwork Reduction Act Notion, see your tax return Instructions Cat No. 714100 Schedule Form 10402020 9 12a 12c