This Product Contains Sensitive Taxpayer Data Tax Return ...

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This Product Contains Sensitive Taxpayer Data

Tax Return Transcript

SSN Provided:

XXX-XX-5084

Tax Period Ending: Dec. 31, 2017

Request Date: Response Date: Tracking Number: Customer File Number:

08-09-2018 08-09-2018 100200235179 0987654321

E The following items reflect the amount as shown on the return (PR), and the amount as adjusted (PC), if

applicable. They do not show subsequent activity on the account.

SSN:

XXX-XX-5084

L SPOUSE SSN:

NAME(S) SHOWN ON RETURN: DRAK

ADDRESS:

123 DA

FILING STATUS:

Single

P FORM NUMBER:

1040

CYCLE POSTED:

20181005

RECEIVED DATE:

Jan.15, 2018

REMITTANCE:

$0.00

EXEMPTION NUMBER:

1

DEPENDENT 1 NAME CTRL:

M DEPENDENT 1 SSN:

DEPENDENT 2 NAME CTRL:

DEPENDENT 2 SSN:

DEPENDENT 3 NAME CTRL:

DEPENDENT 3 SSN:

DEPENDENT 4 NAME CTRL:

A DEPENDENT 4 SSN:

PTIN:

SPREPARER EIN:

Income

WAGES, SALARIES, TIPS, ETC: TAXABLE INTEREST INCOME: SCH B:

$13,000.00 $0.00

TAX-EXEMPT INTEREST:

$0.00

ORDINARY DIVIDEND INCOME: SCH B: QUALIFIED DIVIDENDS: REFUNDS OF STATE/LOCAL TAXES:

$0.00 $0.00 $0.00

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ALIMONY RECEIVED:

$0.00

BUSINESS INCOME OR LOSS (Schedule C):

$2,500.00

BUSINESS INCOME OR LOSS: SCH C PER COMPUTER:

$2,500.00

CAPITAL GAIN OR LOSS: (Schedule D):

$0.00

CAPITAL GAINS OR LOSS: SCH D PER COMPUTER:

$0.00

OTHER GAINS OR LOSSES (Form 4797):

$0.00

TOTAL IRA DISTRIBUTIONS:

$0.00

TAXABLE IRA DISTRIBUTIONS:

$0.00

TOTAL PENSIONS AND ANNUITIES:

$0.00

TAXABLE PENSION/ANNUITY AMOUNT: RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E): RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E) PER COMPUTER: RENT/ROYALTY INCOME/LOSS PER COMPUTER: ESTATE/TRUST INCOME/LOSS PER COMPUTER: PARTNERSHIP/S-CORP INCOME/LOSS PER COMPUTER: FARM INCOME OR LOSS (Schedule F): FARM INCOME OR LOSS (Schedule F) PER COMPUTER:

E UNEMPLOYMENT COMPENSATION:

TOTAL SOCIAL SECURITY BENEFITS: TAXABLE SOCIAL SECURITY BENEFITS: TAXABLE SOCIAL SECURITY BENEFITS PER COMPUTER:

L OTHER INCOME:

SCHEDULE EIC SE INCOME PER COMPUTER: SCHEDULE EIC EARNED INCOME PER COMPUTER: SCH EIC DISQUALIFIED INC COMPUTER: TOTAL INCOME: TOTAL INCOME PER COMPUTER:

P Adjustments to Income

EDUCATOR EXPENSES: EDUCATOR EXPENSES PER COMPUTER: RESERVIST AND OTHER BUSINESS EXPENSE: HEALTH SAVINGS ACCT DEDUCTION: HEALTH SAVINGS ACCT DEDUCTION PER COMPTR:

M MOVING EXPENSES: F3903:

SELF EMPLOYMENT TAX DEDUCTION: SELF EMPLOYMENT TAX DEDUCTION PER COMPUTER: SELF EMPLOYMENT TAX DEDUCTION VERIFIED: KEOGH/SEP CONTRIBUTION DEDUCTION:

A SELF-EMP HEALTH INS DEDUCTION:

EARLY WITHDRAWAL OF SAVINGS PENALTY: ALIMONY PAID SSN: ALIMONY PAID:

SIRA DEDUCTION:

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $2,323.00 $15,323.00 $0.00 $15,500.00 $15,500.00

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $177.00 $177.00 $0.00 $0.00 $0.00 $0.00

$0.00 $0.00

IRA DEDUCTION PER COMPUTER:

$0.00

STUDENT LOAN INTEREST DEDUCTION:

$0.00

STUDENT LOAN INTEREST DEDUCTION PER COMPUTER:

$0.00

STUDENT LOAN INTEREST DEDUCTION VERIFIED:

$0.00

TUITION AND FEES DEDUCTION:

$0.00

TUITION AND FEES DEDUCTION PER COMPUTER:

$0.00

DOMESTIC PRODUCTION ACTIVITIES DEDUCTION:

$0.00

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DOMESTIC PRODUCTION ACTIVITIES DEDUCTION PER COMPUTER: OTHER ADJUSTMENTS: ARCHER MSA DEDUCTION: ARCHER MSA DEDUCTION PER COMPUTER: TOTAL ADJUSTMENTS: TOTAL ADJUSTMENTS PER COMPUTER: ADJUSTED GROSS INCOME: ADJUSTED GROSS INCOME PER COMPUTER:

$0.00 $0.00 $0.00 $0.00 $177.00 $177.00 $15,323.00 $15,323.00

Tax and Credits

65-OR-OVER: BLIND: SPOUSE 65-OR-OVER: SPOUSE BLIND: STANDARD DEDUCTION PER COMPUTER: ADDITIONAL STANDARD DEDUCTION PER COMPUTER: TAX TABLE INCOME PER COMPUTER:

E EXEMPTION AMOUNT PER COMPUTER:

TAXABLE INCOME: TAXABLE INCOME PER COMPUTER: TOTAL POSITIVE INCOME PER COMPUTER: TENTATIVE TAX:

L TENTATIVE TAX PER COMPUTER:

FORM 8814 ADDITIONAL TAX AMOUNT: TAX ON INCOME LESS SOC SEC INCOME PER COMPUTER: FORM 6251 ALTERNATIVE MINIMUM TAX: FORM 6251 ALTERNATIVE MINIMUM TAX PER COMPUTER:

P FOREIGN TAX CREDIT:

FOREIGN TAX CREDIT PER COMPUTER: FOREIGN INCOME EXCLUSION PER COMPUTER: FOREIGN INCOME EXCLUSION TAX PER COMPUTER: EXCESS ADVANCE PREMIUM TAX CREDIT REPAYMENT AMOUNT: EXCESS ADVANCE PREMIUM TAX CREDIT REPAYMENT VERIFIED AMOUNT: CHILD & DEPENDENT CARE CREDIT:

M CHILD & DEPENDENT CARE CREDIT PER COMPUTER:

CREDIT FOR ELDERLY AND DISABLED: CREDIT FOR ELDERLY AND DISABLED PER COMPUTER: EDUCATION CREDIT: EDUCATION CREDIT PER COMPUTER:

A GROSS EDUCATION CREDIT PER COMPUTER:

RETIREMENT SAVINGS CNTRB CREDIT: RETIREMENT SAVINGS CNTRB CREDIT PER COMPUTER: PRIM RET SAV CNTRB: F8880 LN6A:

SSEC RET SAV CNTRB: F8880 LN6B:

NO NO NO NO $4,850.00 $0.00 $10,473.00 $3,100.00 $7,373.00 $7,373.00 $15,500.00 $749.00 $749.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

TOTAL RETIREMENT SAVINGS CONTRIBUTION: F8880 CMPTR:

$0.00

RESIDENTIAL ENERGY CREDIT:

$0.00

RESIDENTIAL ENERGY CREDIT PER COMPUTER:

$0.00

CHILD TAX CREDIT:

$0.00

CHILD TAX CREDIT PER COMPUTER:

$0.00

ADOPTION CREDIT: F8839:

$0.00

ADOPTION CREDIT PER COMPUTER:

$0.00

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FORM 8396 MORTGAGE CERTIFICATE CREDIT:

$0.00

FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER:

$0.00

F3800, F8801 AND OTHER CREDIT AMOUNT:

$0.00

FORM 3800 GENERAL BUSINESS CREDITS:

$0.00

FORM 3800 GENERAL BUSINESS CREDITS PER COMPUTER:

$0.00

PRIOR YR MIN TAX CREDIT: F8801:

$0.00

PRIOR YR MIN TAX CREDIT: F8801 PER COMPUTER:

$0.00

F8936 ELECTRIC MOTOR VEHICLE CREDIT AMOUNT:

$0.00

F8936 ELECTRIC MOTOR VEHICLE CREDIT PER COMPUTER:

$0.00

F8910 ALTERNATIVE MOTOR VEHICLE CREDIT AMOUNT: F8910 ALTERNATIVE MOTOR VEHICLE CREDIT PER COMPUTER: OTHER CREDITS: TOTAL CREDITS: TOTAL CREDITS PER COMPUTER: INCOME TAX AFTER CREDITS PER COMPUTER:

Other Taxes

E SE TAX:

SE TAX PER COMPUTER: SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS: SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS PER COMPUTER: TAX ON QUALIFIED PLANS F5329 (PR):

L TAX ON QUALIFIED PLANS F5329 PER COMPUTER:

IRAF TAX PER COMPUTER: TP TAX FIGURES (REDUCED BY IRAF) PER COMPUTER: IMF TOTAL TAX (REDUCED BY IRAF) PER COMPUTER: OTHER TAXES PER COMPUTER:

P UNPAID FICA ON REPORTED TIPS:

OTHER TAXES: RECAPTURE TAX: F8611: HOUSEHOLD EMPLOYMENT TAXES: HOUSEHOLD EMPLOYMENT TAXES PER COMPUTER: HEALTH CARE RESPONSIBILITY PENALTY: HEALTH CARE RESPONSIBILITY PENALTY VERIFIED:

M HEALTH COVERAGE RECAPTURE: F8885:

RECAPTURE TAXES: TOTAL ASSESSMENT PER COMPUTER: TOTAL TAX LIABILITY TP FIGURES: TOTAL TAX LIABILITY TP FIGURES PER COMPUTER:

A Payments

FEDERAL INCOME TAX WITHHELD: HEALTH CARE: INDIVIDUAL RESPONSIBILITY:

SHEALTH CARE FULL-YEAR COVERAGE INDICATOR:

$0.00 $0.00 $0.00 $0.00 $0.00 $749.00

$354.00 $354.00

$0.00 $0.00 $0.00 $0.00 $0.00 $1,103.00 $1,103.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,103.00 $1,103.00 $1,103.00

$1,000.00 $0.00 0

ESTIMATED TAX PAYMENTS:

$0.00

OTHER PAYMENT CREDIT:

$0.00

REFUNDABLE EDUCATION CREDIT:

$0.00

REFUNDABLE EDUCATION CREDIT PER COMPUTER:

$0.00

REFUNDABLE EDUCATION CREDIT VERIFIED:

$0.00

EARNED INCOME CREDIT:

$0.00

EARNED INCOME CREDIT PER COMPUTER:

$0.00

EARNED INCOME CREDIT NONTAXABLE COMBAT PAY:

$0.00

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SCHEDULE 8812 NONTAXABLE COMBAT PAY:

$0.00

EXCESS SOCIAL SECURITY & RRTA TAX WITHHELD:

$0.00

SCHEDULE 8812 TOT SS/MEDICARE WITHHELD:

$0.00

SCHEDULE 8812 ADDITIONAL CHILD TAX CREDIT:

$0.00

SCHEDULE 8812 ADDITIONAL CHILD TAX CREDIT PER COMPUTER:

$0.00

SCHEDULE 8812 ADDITIONAL CHILD TAX CREDIT VERIFIED:

$0.00

AMOUNT PAID WITH FORM 4868:

$0.00

FORM 2439 REGULATED INVESTMENT COMPANY CREDIT:

$0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS:

$0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS PER COMPUTER: HEALTH COVERAGE TX CR: F8885: PREMIUM TAX CREDIT AMOUNT: PREMIUM TAX CREDIT VERIFIED AMOUNT: PRIMARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT: SECONDARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT: FIRST TIME HOMEBUYER CREDIT REPAYMENT AMOUNT: FORM 5405 TOTAL HOMEBUYERS CREDIT REPAYMENT PER COMPUTER:

E SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER:

SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER (2): FORM 2439 AND OTHER CREDITS: TOTAL PAYMENTS:

L TOTAL PAYMENTS PER COMPUTER:

Refund or Amount Owed

AMOUNT YOU OWE: APPLIED TO NEXT YEAR'S ESTIMATED TAX: ESTIMATED TAX PENALTY:

P TAX ON INCOME LESS STATE REFUND PER COMPUTER:

BAL DUE/OVER PYMT USING TP FIG PER COMPUTER: BAL DUE/OVER PYMT USING COMPUTER FIGURES: FORM 8888 TOTAL REFUND PER COMPUTER:

Third Party Designee

THIRD PARTY DESIGNEE ID NUMBER:

M AUTHORIZATION INDICATOR:

THIRD PARTY DESIGNEE NAME:

Schedule C--Profit or Loss From Business

SOCIAL SECURITY NUMBER:

EMPLOYER ID NUMBER:

A BUSINESS NAME:

DESCRIPTION OF BUSINESS/PROFESSION: NAICS CODE: ACCT MTHD:

SFIRST TIME SCHEDULE C FILED:

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1,000.00 $1,000.00

$103.00 $0.00 $0.00 $0.00

$103.00 $103.00

$0.00

0

DRAK 000000

N

STATUTORY EMPLOYEE IND:

N

INCOME

GROSS RECEIPTS OR SALES: RETURNS AND ALLOWANCES: NET GROSS RECEIPTS: COST OF GOODS SOLD: SCHEDULE C FORM 1099 REQUIRED:

$2,700.00 $0.00 $0.00 $0.00 NONE

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SCHEDULE C FORM 1099 FILED: OTHER INCOME:

NONE $0.00

EXPENSES

CAR AND TRUCK EXPENSES:

$0.00

DEPRECIATION:

$0.00

INSURANCE (OTHER THAN HEALTH):

$0.00

MORTGAGE INTEREST:

$0.00

LEGAL AND PROFESSIONAL SERVICES:

$0.00

REPAIRS AND MAINTENANCE:

$0.00

TRAVEL: MEALS AND ENTERTAINMENT: WAGES: OTHER EXPENSES: TOTAL EXPENSES: EXP FOR BUSINESS USE OF HOME: SCH C NET PROFIT OR LOSS PER COMPUTER: AT RISK CD:

E OFFICE EXPENSE AMOUNT:

UTILITIES EXPENSE AMOUNT:

COST OF GOODS SOLD

INVENTORY AT BEGINNING OF YEAR:

L INVENTORY AT END OF YEAR:

Schedule SE--Self-Employment Tax

SSN OF SELF-EMPLOYED TAXPAYER: NET FARM PROFIT/LOSS: SCH F: CONSERVATION RESERVE PROGRAM PAYMENTS:

P NET NONFARM PROFIT/LOSS:

TOTAL SE INCOME: SE QUARTERS COVERED: TOTAL SE TAX PER COMPUTER: SE INCOME COMPUTER VERIFIED: SE INCOME PER COMPUTER:

M TOTAL NET EARNINGS PER COMPUTER:

LONG FORM ONLY

TENTATIVE CHURCH EARNINGS: TOTAL SOC SEC & RR WAGES: SE SS TAX COMPUTER: SE MEDICARE INCOME PER COMPUTER:

A SE MEDICARE TAX PER COMPUTER:

SE FARM OPTION METHOD USED: SE OPTIONAL METHOD INCOME:

$0.00 $0.00 $0.00 $0.00 $200.00 $0.00 $2,500.00

$0.00 $0.00

$0.00 $0.00

XXX-XX-5084 $0.00 $0.00

$2,500.00 $2,500.00

4 $353.12

$0.00 $2,308.00 $2,308.00

$0.00 $0.00 $286.19 $2,308.00 $66.93

0 $0.00

SForm 8863 - Education Credits (Hope and Lifetime Learning

Credits)

PART III - ALLOWABLE EDUCATION CREDITS

GROSS EDUCATION CR PER COMPUTER: TOTAL EDUCATION CREDIT AMOUNT: TOTAL EDUCATION CREDIT AMOUNT PER COMPUTER:

This Product Contains Sensitive Taxpayer Data

$0.00 $0.00 $0.00

8/9/2018

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