JOSEPH COHEN If a joint return, spouse's first name and initial Last name Spouse's social security number

Transcription

1 Department of the Treasury ' Internal Revenue Service (99) Form 1040 U.S. Individual Income Tax Return 2012 OMB No IRS Use Only ' Do not write or staple in this space. For the year Jan 1 - Dec 31, 2012, or other tax year beginning, 2012, ending, 20 See separate instructions. Your first name and initial Last name Your social security number JOSEPH COHEN If a joint return, spouse's first name and initial Last name Spouse's social security number DIANA COHEN Home address (number and street). If you have a P.O. box, see instructions. 85 NORTH MAPLE DRIVE City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below. PLEASANTVILLE, NJ Apartment no. Foreign country name Foreign province/state/county Foreign postal code J Make sure the SSN(s) above and on line 6c are correct. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund? Checking a box below will not change your tax or refund. X You X Spouse 1 Single 4 Head of household (with qualifying person). (See Filing Status instructions.) If the qualifying person is a child 2 X Married filing jointly (even if only one had income) but not your dependent, enter this child's 3 Married filing separately. Enter spouse's SSN above & full name here.. G Check only one box. name here... G. 5 Qualifying widow(er) with dependent child Boxes checked Exemptions 6a X Yourself. If someone can claim you as a dependent, do not check box 6a on 6a and 6b... 2 b X Spouse No. of children on 6c who: (2) Dependent's (3) Dependent's (4) b if c Dependents: child under? lived social security relationship age 17 with you number to you qualifying for child tax cr? did not (1) First name Last name (see instrs) live with you due to divorce REBECCA COHEN DAUGHTER or separation If more than four (see instrs).... dependents, see ALAN COHEN SON X Dependents on 6c not instructions and DAVID COHEN SON X entered above.. check here... G Add numbers on lines d Total number of exemptions claimed above G 5 Income 7 Wages, salaries, tips, etc. Attach Form(s) W ,325. 8a Taxable interest. Attach Schedule B if required a 1,07 b Tax-exempt interest. Do not include on line 8a b 20 9a Ordinary dividends. Attach Schedule B if required Attach Form(s) 9a 6,255. W-2 here. Also b Qualified dividends b 4,255. attach Forms 10 Taxable refunds, credits, or offsets of state and local income taxes W-2G and 1099-R if tax was withheld. 11 Alimony received Business income or (loss). Attach Schedule C or C-EZ ,261. If you did not 13 Capital gain or (loss). Att Sch D if reqd. If not reqd, ck here G 13-3,00 get a W-2, see instructions. 14 Other gains or (losses). Attach Form a IRA distributions a b Taxable amount b 16a Pensions and annuities a b Taxable amount b 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. 17 Enclose, but do 18 Farm income or (loss). Attach Schedule F not attach, any 19 Unemployment compensation payment. Also, 20a Social security benefits a b Taxable amount please use 20b Form 1040-V. 21 Other income Combine the amounts in the far right column for lines 7 through 21. This is your total income G ,311. Adjusted 23 Educator expenses Certain business expenses of reservists, performing artists, and fee-basis Gross government officials. Attach Form 2106 or 2106-EZ Income 25 Health savings account deduction. Attach Form Moving expenses. Attach Form Deductible part of self-employment tax. Attach Schedule SE , Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction Penalty on early withdrawal of savings a Alimony paid b Recipient's SSN.... G 31a 32 IRA deduction Student loan interest deduction Tuition and fees. Attach Form Domestic production activities deduction. Attach Form Add lines 23 through , Subtract line 36 from line 22. This is your adjusted gross income G ,114. BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. FDIA0112L 01/11/13 Form 1040 (2012)

2 Form 1040 (2012) JOSEPH AND DIANA COHEN Page 2 Tax and 38 Amount from line 37 (adjusted gross income) ,114. Credits 39 a Check You were born before January 2, 1948, Blind. Total boxes if: X Spouse was born before January 2, 1948, Blind. checked. G 39a 1 Standard b If your spouse itemizes on a separate return or you were a dual-status alien, check here G 39b Deduction 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ,60 for ' 41 Subtract line 40 from line ,514.? People who check any box 42 Exemptions. Multiply $3,800 by the number on line 6d ,00 on line 39a or 43 Taxable income. Subtract line 42 from line b or who can If line 42 is more than line 41, enter ,514. be claimed as a 44 Tax (see instrs). Check if any from: a Form(s) 8814 c 962 election dependent, see b Form instructions , Alternative minimum tax. Attach Form ? All others: Add lines 44 and Single or G 46 24,326. Married filing 47 Foreign tax credit. Attach Form 1116 if required separately, 48 Credit for child and dependent care expenses. Attach Form $5, Education credits from Form 8863, line Married filing jointly or 50 Retirement savings contributions credit. Attach Form Qualifying 51 Child tax credit. Attach Schedule 8812, if required widow(er), 52 Residential energy credits. Attach Form $11, Head of 53 Other crs from Form: a 3800 b 8801 c 53 household, 54 Add lines 47 through 53. These are your total credits $8, Subtract line 54 from line 46. If line 54 is more than line 46, enter G 55 24,126. Other 56 Self-employment tax. Attach Schedule SE ,559. Taxes 57 Unreported social security and Medicare tax from Form: a 4137 b Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required a Household employment taxes from Schedule H a b First-time homebuyer credit repayment. Attach Form 5405 if required b 60 Other taxes. Enter code(s) from instructions Add lines 55-6 This is your total tax G 61 29,685. Payments 62 Federal income tax withheld from Forms W-2 and ,23 If you have a estimated tax payments and amount applied from 2011 return qualifying 64a Earned income credit (EIC) a child, attach b Nontaxable combat pay election..... G Schedule EIC. 64b 65 Additional child tax credit. Attach Schedule American opportunity credit from Form 8863, line Reserved Amount paid with request for extension to file Excess social security and tier 1 RRTA tax withheld ,68 70 Credit for federal tax on fuels. Attach Form Credits from Form: a 2439 b Reserved c 8801 d Add lns 62, 63, 64a, & These are your total pmts G 72 29,91 Refund 73 If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here.. G 74a 225. G b Routing number XXXXXXXXXX G c Type: Checking Savings Direct deposit? G d Account number XXXXXXXXXXXXXXXXXXXXXXXX See instructions. 75 Amount of line 73 you want applied to your 2013 estimated tax G 75 Amount 76 Amount you owe. Subtract line 72 from line 61. For details on how to pay see instructions G 76 You Owe 77 Estimated tax penalty Third Party Designee Sign Do you want to allow another person to discuss this return with the IRS? Yes. Complete below. X No Designee's Phone Personal identification name no. number (PIN) G G G Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Your signature Date Your occupation Daytime phone number Joint return? See instructions. Keep a copy for your records. Paid Preparer Use Only A A Spouse's signature. If a joint return, both must sign. Date Spouse's occupation Print/Type preparer's name Preparer's signature Date Check if PTIN Firm's name Firm's address G G SELF-PREPARED FDIA0112L 01/11/13 VICE PRESIDENT OF CONSULTANT self-employed Firm's EIN Phone no. G If the IRS sent you an Identity Protection PIN, enter it here (see instrs) Form 1040 (2012)

3 SCHEDULE A (Form 1040) Itemized Deductions G Information about Schedule A and its separate instructions is at G Attach to Form 104 OMB No Department of the Treasury Attachment Internal Revenue Service (99) Sequence No. 07 Name(s) shown on Form 1040 Your social security number JOSEPH AND DIANA COHEN Medical Caution. Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses ,60 Dental Expenses 2 Enter amount from Form 1040, line , Multiply line 2 by 7.5% (.075) , Subtract line 3 from line 1. If line 3 is more than line 1, enter Taxes You 5 State and local (check only one box): Paid a X Income taxes, or 5 13, b General sales taxes 6 Real estate taxes , Personal property taxes ,25 8 Other taxes. List type and amount G 8 9 Add lines 5 through Interest 10 Home mtg interest and points reported to you on Form You Paid 11 Home mortgage interest not reported to you on Form If paid to the person 10 12,55 from whom you bought the home, see instructions and show that person's name, 22,175. Note. Your mortgage interest deduction may be limited (see instructions). identifying number, and address G 12 Points not reported to you on Form See instrs for spcl rules Mortgage insurance premiums Investment interest. Attach Form 4952 if required. (See instrs.) Add lines 10 through Gifts to 16 Gifts by cash or check. If you made any gift of $250 or Charity more, see instrs If you made a 17 Other than by cash or check. If any gift of $250 or gift and got a more, see instructions. You must attach Form 8283 if benefit for it, over $ see instructions. 18 Carryover from prior year Add lines 16 through Casualty and Theft Losses 20 Casualty or theft loss(es). Attach Form (See instructions.) Job Expenses and Certain Miscellaneous Deductions Other Miscellaneous Deductions Total Itemized Deductions 21 Unreimbursed employee expenses ' job travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) G 22 Tax preparation fees Other expenses ' investment, safe deposit box, etc. List type and amount G 24 Add lines 21 through Enter amount from Form 1040, line Multiply line 25 by 2% (.02) Subtract line 26 from line 24. If line 26 is more than line 24, enter Other ' from list in instructions. List type and amount G 29 Add the amounts in the far right column for lines 4 through 28. Also, enter this amount on Form 1040, line If you elect to itemize deductions even though they are less than your standard deduction, check here G , ,15 19, ,60 BAA For Paperwork Reduction Act Notice, see Form 1040 instructions. FDIA0301L 01/10/13 Schedule A (Form 1040) 2012

4 SCHEDULE B Interest and Ordinary Dividends (Form 1040A or 1040) 2012 Department of the Treasury G Attach to Form 1040A or 104 Attachment Internal Revenue Service (99) G Information about Schedule B (Form 1040A or 1040) and its instructions is at Sequence No. 08 Name(s) shown on return OMB No Your social security number JOSEPH AND DIANA COHEN List name of payer. If any interest is from a seller-financed mortgage and the buyer used Amount Part I the property as a personal residence, see the instructions and list this interest first. Also, Interest show that buyer's social security number and address G (See FIRST BANK OF NEW JERSEY 32 instructions for GENERAL MILLS 40 Form 1040A, or Form 1040, line US TREASURY 35 8a.) Note. If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a brokerage firm, list the firm's name as the payer and enter the total interest shown on that form. 1 Part II Ordinary Dividends (See instructions for Form 1040A, or Form 1040, line 9a.) 2 Add the amounts on line Excludable interest on series EE and I U.S. savings bonds issued after Attach Form Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a G 4 Note. If line 4 is over $1,500, you must complete Part III. 1,07 Amount 5 List name of payer G 3M 35 ABBOTT LABS 275. CARDINAL HEALTH 425. CHINA FUND 2,00 COOPER TIRE 20 KELLOGG COMPANY 20 MICROSOFT 75 PEPSICO 225. PROCTER & GAMBLE 19 RIO TINTO 1,50 UNION PACIFIC 14 Note. If you received 5 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. 1,07 Part III Foreign Accounts and Trusts (See instructions.) 6 6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a G 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 foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. 7 a At any time during 2012, 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 country? See instructions If 'Yes,' are you required to file Form TD F to report that financial interest or signature authority? See Form TD F and its instructions for filing requirements and exceptions to those requirements b If you are required to file Form TD F , enter the name of the foreign country where the financial 6,255. account is located G 8 During 2012, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If 'Yes,' you may have to file Form 352 See instructions X BAA For Paperwork Reduction Act Notice, see your tax return instructions. FDIA0401L 07/26/12 Schedule B (Form 1040A or 1040) 2012 Yes No X

5 SCHEDULE C (Form 1040) Profit or Loss From Business (Sole Proprietorship) GFor information on Schedule C and its instructions, go to (99) GAttach to Form 1040, 1040NR, or 1041; partnerships generally must file Form OMB No Department of the Treasury Attachment Internal Revenue Service Sequence No. 09 Name of proprietor Social security number (SSN) DIANA COHEN A Principal business or profession, including product or service B CONSULTING G C Business name. If no separate business name, leave blank. D Enter code from instructions Employer ID number (EIN), (see instrs) E Business address (including suite or room no.) G City, town or post office, state, and ZIP code F Accounting method: (1) X Cash (2) Accrual (3) Other (specify) G G Did you 'materially participate' in the operation of this business during 2012? If 'No,' see instructions for limit on losses. X Yes No H If you started or acquired this business during 2012, check here G I Did you make any payments in 2012 that would require you to file Form(s) 1099? Yes X No J If 'Yes,' did you or will you file all required Forms 1099? Yes No Part I Income 1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on Form W-2 and the 'Statutory employee' box on that form was checked G 1 2 Returns and allowances Subtract line 2 from line Cost of goods sold (from line 42) Gross profit. Subtract line 4 from line Other income, including federal and state gasoline or fuel tax credit or refund Gross income. Add lines 5 and G 7 Part II Expenses. Enter expenses for business use of your home only on line 3 8 Advertising Office expense Car and truck expenses 19 Pension and profit-sharing plans Rent or lease : 10 Commissions and fees a Vehicles, machinery, and equipment a 11 Contract labor b Other business property b 12 Depletion Repairs and maintenance Depreciation and section 22 Supplies (not included in Part III) expense deduction 23 Taxes and licenses (not included in Part III) Travel, meals, and entertainment: 14 Employee benefit programs a Travel a (other than on line b Deductible meals and entertainment 15 Insurance (other than health) b 16 Interest: 25 Utilities a Mortgage (paid to banks, etc) a 26 Wages (less employment credits) b Other b 27 a Other expenses (from line 48) a 17 Legal & professional services b Reserved for future use b 28 Total expenses before expenses for business use of home. Add lines 8 through 27a G Tentative profit or (loss). Subtract line 28 from line Expenses for business use of your home. Attach Form Do not report such expenses elsewhere Net profit or (loss). Subtract line 30 from line 29.? If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2. If you checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3.? If a loss, you must go to line If you have a loss, check the box that describes your investment in this activity.? If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and on All investment is Schedule SE, line 2. (If you checked the box on line 1, see the instructions for line 31). Estates and 32a at risk. trusts, enter on Form 1041, line 3. Some investment? If you checked 32b, you must attach Form Your loss may be limited. 32b is not at risk. BAA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule C (Form 1040) 2012 FDIZ0112L 01/03/ ,25 44,25 44,25 44,25 4, , , ,224.

6 Schedule C (Form 1040) 2012 DIANA COHEN Page 2 Part III Cost of Goods Sold 33 Method(s) used to value closing inventory: a Cost b Lower of cost or market c Other (attach explanation) Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If 'Yes,' attach explanation Inventory at beginning of year. If different from last year's closing inventory, attach explanation Yes No 36 Purchases less cost of items withdrawn for personal use Cost of labor. Do not include any amounts paid to yourself Materials and supplies Other costs Add lines 35 through Inventory at end of year Cost of goods sold. Subtract line 41 from line 4 Enter the result here and on line Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must file Form When did you place your vehicle in service for business purposes? (month, day, year) G 1/01/ Of the total number of miles you drove your vehicle during 2012, enter the number of miles you used your vehicle for: a Business 290 b Commuting c Other 10, Was your vehicle available for personal use during off-duty hours? Yes X No 46 Do you (or your spouse) have another vehicle available for personal use? X Yes No 47a Do you have evidence to support your deduction? X Yes No b If 'Yes,' is the evidence written? X Yes No Part V Other Expenses. List below business expenses not included on lines 8-26 or line 3 48 Total other expenses. Enter here and on line 27a Schedule C (Form 1040) 2012 FDIZ0112L 01/03/13

7 SCHEDULE C (Form 1040) Profit or Loss From Business (Sole Proprietorship) GFor information on Schedule C and its instructions, go to (99) GAttach to Form 1040, 1040NR, or 1041; partnerships generally must file Form OMB No Department of the Treasury Attachment Internal Revenue Service Sequence No. 09 Name of proprietor Social security number (SSN) DIANA COHEN A Principal business or profession, including product or service B BOARD OF DIRECTORS G C Business name. If no separate business name, leave blank. D Enter code from instructions Employer ID number (EIN), (see instrs) E Business address (including suite or room no.) G City, town or post office, state, and ZIP code F Accounting method: (1) X Cash (2) Accrual (3) Other (specify) G G Did you 'materially participate' in the operation of this business during 2012? If 'No,' see instructions for limit on losses. X Yes No H If you started or acquired this business during 2012, check here G I Did you make any payments in 2012 that would require you to file Form(s) 1099? Yes X No J If 'Yes,' did you or will you file all required Forms 1099? Yes No Part I Income 1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on Form W-2 and the 'Statutory employee' box on that form was checked G 1 2 Returns and allowances Subtract line 2 from line Cost of goods sold (from line 42) Gross profit. Subtract line 4 from line Other income, including federal and state gasoline or fuel tax credit or refund Gross income. Add lines 5 and G 7 Part II Expenses. Enter expenses for business use of your home only on line 3 8 Advertising Office expense Car and truck expenses 19 Pension and profit-sharing plans Rent or lease : 10 Commissions and fees a Vehicles, machinery, and equipment a 11 Contract labor b Other business property b 12 Depletion Repairs and maintenance Depreciation and section 22 Supplies (not included in Part III) expense deduction 23 Taxes and licenses (not included in Part III) Travel, meals, and entertainment: 14 Employee benefit programs a Travel a (other than on line b Deductible meals and entertainment 15 Insurance (other than health) b 16 Interest: 25 Utilities a Mortgage (paid to banks, etc) a 26 Wages (less employment credits) b Other b 27 a Other expenses (from line 48) a 17 Legal & professional services b Reserved for future use b 28 Total expenses before expenses for business use of home. Add lines 8 through 27a G Tentative profit or (loss). Subtract line 28 from line Expenses for business use of your home. Attach Form Do not report such expenses elsewhere Net profit or (loss). Subtract line 30 from line 29.? If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2. If you checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3.? If a loss, you must go to line If you have a loss, check the box that describes your investment in this activity.? If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and on All investment is Schedule SE, line 2. (If you checked the box on line 1, see the instructions for line 31). Estates and 32a at risk. trusts, enter on Form 1041, line 3. Some investment? If you checked 32b, you must attach Form Your loss may be limited. 32b is not at risk. BAA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule C (Form 1040) 2012 FDIZ0112L 01/03/ ,50 6,50 6,50 6, ,037. 6,037.

8 Schedule C (Form 1040) 2012 DIANA COHEN Page 2 Part III Cost of Goods Sold 33 Method(s) used to value closing inventory: a Cost b Lower of cost or market c Other (attach explanation) Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If 'Yes,' attach explanation Inventory at beginning of year. If different from last year's closing inventory, attach explanation Yes No 36 Purchases less cost of items withdrawn for personal use Cost of labor. Do not include any amounts paid to yourself Materials and supplies Other costs Add lines 35 through Inventory at end of year Cost of goods sold. Subtract line 41 from line 4 Enter the result here and on line Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must file Form When did you place your vehicle in service for business purposes? (month, day, year) G 1/01/ Of the total number of miles you drove your vehicle during 2012, enter the number of miles you used your vehicle for: a Business 315 b Commuting c Other 10, Was your vehicle available for personal use during off-duty hours? Yes X No 46 Do you (or your spouse) have another vehicle available for personal use? X Yes No 47a Do you have evidence to support your deduction? X Yes No b If 'Yes,' is the evidence written? X Yes No Part V Other Expenses. List below business expenses not included on lines 8-26 or line 3 48 Total other expenses. Enter here and on line 27a Schedule C (Form 1040) 2012 FDIZ0112L 01/03/13

9 SCHEDULE D (Form 1040) OMB No Capital Gains and Losses G Attach to Form 1040 or Form 1040NR G Information about Schedule D and its separate instructions is at Attachment G Use Form 8949 to list your transactions for lines 1, 2, 3, 8, 9, and 1 Department of the Treasury Internal Revenue Service (99) Sequence No. 12 Name(s) shown on return Part I Short-Term Capital Gains and Losses ' Assets Held One Year or Less Your social security number JOSEPH AND DIANA COHEN Complete Form 8949 before completing line 1, 2, (d) Proceeds (sales (e) Cost or other basis (g) Adjustments to (h) Gain or (loss) or 3. This form may be easier to complete if you price) from Form(s) from Form(s) 8949, gain or loss from Subtract column (e) from round off cents to whole dollars. 8949, Part I, line 2, Part I, line 2, Form(s) 8949, Part I, column (d) and combine column (d) column (e) line 2, column (g) the result with column (g) Short-term totals from all Forms 8949 with 1 box A checked in Part I Short-term totals from all Forms 8949 with box B checked in Part I Short-term totals from all Forms 8949 with box C checked in Part I ,35 26,00 1,35 4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions Net short-term capital gain or (loss). Combine lines 1 through 6 in column (h). If you have any long-term capital gain or losses, go to Part II below. Otherwise, go to Part III on page Part II Long-Term Capital Gains and Losses ' Assets Held More Than One Year 1,35 Complete Form 8949 before completing line 8, 9, (d) Proceeds (sales (e) Cost or other basis (g) Adjustments to (h) Gain or (loss) or 1 This form may be easier to complete if you price) from Form(s) from Form(s) 8949, gain or loss from Subtract column (e) from round off cents to whole dollars. 8949, Part II, line 4, Part II, line 4, Form(s) 8949, Part II, column (d) and combine column (d) column (e) line 4, column (g) the result with column (g) 8 Long-term totals from all Forms 8949 with box A checked in Part II ,35 77,75-1,40 9 Long-term totals from all Forms 8949 with box B checked in Part II Long-term totals from all Forms 8949 with box C checked in Part II Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 4684, 6781, and Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K Capital gain distributions. See instrs Long-term capital loss carryover. Enter the amount, if any, from line 13 of your Capital Loss Carryover Worksheet in the instructions ,00 15 Net long-term capital gain or (loss). Combine lines 8 through 14 in column (h). Then go to Part III on page BAA For Paperwork Reduction Act Notice, see your tax return instructions ,40 Schedule D (Form 1040) 2012 FDIA0612L 12/31/12

10 Schedule D (Form 1040) 2012 JOSEPH AND DIANA COHEN Page 2 Part III Summary 16 Combine lines 7 and 15 and enter the result ? If line 16 is a gain, enter the amount from line 16 on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 17 below.? If line 16 is a loss, skip lines 17 through 20 below. Then go to line 21. Also be sure to complete line 22.? If line 16 is zero, skip lines 17 through 21 below and enter -0- on Form 1040, line 13, or Form 1040NR, line 14. Then to go line ,05 17 Are lines 15 and 16 both gains? Yes. Go to line 18. No. Skip lines 18 through 21, and go to line Enter the amount, if any, from line 7 of the 28% Rate Gain Worksheet in the instructions G Enter the amount, if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet in the instructions G Are lines 18 and 19 both zero or blank? Yes. Complete the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44 (or in the instructions for Form 1040NR, line 42). Do not complete lines 21 and 22 below. No. Complete the Schedule D Tax Worksheet in the instructions. Do not complete lines 21 and 22 below. 21 If line 16 is a loss, enter here and on Form 1040, line 13, or Form 1040NR, line 14, the smaller of:? The loss on line 16 or? ($3,000), or if married filing separately, ($1,500) ,00 Note. When figuring which amount is smaller, treat both amounts as positive numbers. 22 Do you have qualified dividends on Form 1040, line 9b, or Form 1040NR, line 10b? X Yes. Complete the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44 (or in the instructions for Form 1040NR, line 42). No. Complete the rest of Form 1040 or Form 1040NR. Schedule D (Form 1040) 2012 FDIA0612L 12/31/12

11 Form 8949 Department of the Treasury Internal Revenue Service Name(s) shown on return Sales and Other Dispositions of Capital Assets G Information about Form 8949 and its separate instructions is at G File with your Schedule D to list your transactions for lines 1, 2, 3, 8, 9, and 10 of Schedule D. OMB No Attachment Sequence No. 12A SSN or taxpayer identification no. JOSEPH AND DIANA COHEN Most brokers issue their own substitute statement instead of using Form 1099-B. They also may provide basis information (usually your cost) to you on the statement even if it is not reported to the IRS. Before you check Box A, B, or C below, determine whether you received any statement(s) and, if so, the transactions for which basis was reported to the IRS. Brokers are required to report basis to the IRS for most stock you bought in 2011 or later. Part I Short-Term. Transactions involving capital assets you held one year or less are short term. For longterm transactions, see page 2. You must check Box A, B, or C below. Check only one box. If more than one box applies for your short-term transactions, complete a separate Form 8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need. X (A) Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (B) Short-term transactions reported on Form(s) 1099-B showing basis was not reported to the IRS (C) Short-term transactions not reported to you on Form 1099-B 1 (a) (b) (c) (d) (e) Description of property (Example: 100 shares XYZ Co) Date acquired (Mo, day, yr) Date sold or disposed (Mo, day, yr) Proceeds (sales price) Adjustment, if any, to gain or loss. If you enter an amount in column (g), Cost or other basis. enter a code in column (f). Gain or (loss). Subtract column See the Note below See the separate instructions. (e) from column and see Column (e) in the separate (f) (g) (d) and combine instructions Code(s) from Amount of the result with instructions adjustment column (g) (h) 2000 MICROSOFT 5/01/12 7/01/12 22,50 21,00 1,50 50 COOPER TIRE 6/28/12 10/14/12 2,10 2, UNION PACIFIC 9/05/11 1/07/12 2,75 3, Totals. Add the amounts in columns (d), (e), (g), and (h) (subtract negative amounts). Enter each total here and include on your Schedule D, line 1 (if Box A above is checked), line 2 (if Box B above is checked), or line 3 (if Box C above is checked) G 27,35 26,00 1,35 Note. If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment. BAA For Paperwork Reduction Act Notice, see your tax return instructions. FDIA9212L 12/31/12 Form 8949 (2012)

12 Form 8949 (2012) Attachment Sequence No. 12A Page 2 Name(s) shown on return. (Name and SSN or taxpayer identification no. not required if shown on other side.) SSN or taxpayer identification no. JOSEPH AND DIANA COHEN Most brokers issue their own substitute statement instead of using Form 1099-B. They also may provide basis information (usually your cost) to you on the statement even if it is not reported to the IRS. Before you check Box A, B, or C below, determine whether you received any statement(s) and, if so, the transactions for which basis was reported to the IRS. Brokers are required to report basis to the IRS for most stock you bought in 2011 or later. Part II Long-Term. Transactions involving capital assets you held more than one year are long term. For short-term transactions, see page 1. You must check Box A, B, or C below. Check only one box. If more than one box applies for your long-term transactions, complete a separate Form 8949, page 2, for each applicable box. If you have more long-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need. X (A) Long-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (B) Long-term transactions reported on Form(s) 1099-B showing basis was not reported to the IRS (C) Long-term transactions not reported to you on Form 1099-B 3 (a) (b) (c) (d) (e) Description of property (Example: 100 shares XYZ Co) Date acquired (Mo, day, yr) Date sold or disposed (Mo, day, yr) Proceeds (sales price) Cost or other basis. See the Note below and see Column (e) in the separate instructions Adjustment, if any, to gain or loss. If you enter an amount in column (g), enter a code in column (f). See the separate instructions. (h) Gain or (loss). Subtract column (e) from column (f) (g) (d) and combine Code(s) from Amount of the result with instructions adjustment column (g) 75 APPLE INC 3/08/10 4/15/12 28,75 33,75-5, COOPER TIRE 1/12/09 10/14/12 12,60 9,00 3, CARDINAL HEALTH 10/10/96 9/03/12 35,00 35,00 4 Totals. Add the amounts in columns (d), (e), (g), and (h) (subtract negative amounts). Enter each total here and include on your Schedule D, line 8 (if Box A above is checked), line 9 (if Box B above is checked), or line 10 (if Box C above is checked) G 76,35 77,75-1,40 Note. If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment. FDIA9212L 12/31/12 Form 8949 (2012)

13 Schedule E (Form 1040) 2012 Page 2 Name(s) shown on return. Do not enter name and social security number if shown on Page 1. Your social security number JOSEPH AND DIANA COHEN Caution: The IRS compares amounts reported on your tax return with amounts shown on Schedule(s) K-1. Part II Income or Loss From Partnerships and S Corporations Note. If you report a loss from an at-risk activity for which any amount is not at risk, you must check the box in column (e) on line 28 and attach Form See instructions. 27 Are you reporting any loss not allowed in a prior year due to the at-risk or basis limitations, a prior year unallowed loss from a passive activity (if that loss was not reported on Form 8582), or unreimbursed partnership expenses?..... Yes X No If you answered 'Yes,' see instructions before completing this section. 28 (a) Name (b) Enter P for (c) Check if partnership; S (d) Employer (e) Check if foreign identification any amount for S partnership corporation number is not at risk ABRIGHT IDEAS BNATURAL SUNSHINE INC C S S D A B C Passive Income and Loss Nonpassive Income and Loss (f) Passive loss allowed (g) Passive income (h) Nonpassive loss (i) Section 179 (j) Nonpassive expense deduction income from (attach Form 8582 if required) from Schedule K-1 from Schedule K-1 from Form 4562 Schedule K-1 15,00 15,00 D 29 a Totals ,00 b Totals ,00 30 Add columns (g) and (j) of line 29a Add columns (f), (h), and (i) of line 29b SEE STATEMENT Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the result here and include in the total on line 41 below Part III Income or Loss From Estates and Trusts 33 (a) Name A B A B Passive Income and Loss 32 (b) Employer ID no. Nonpassive Income and Loss (c) Passive deduction or loss allowed (d) Passive income (e) Deduction or loss (f) Other income (attach Form 8582 if required) from Schedule K-1 from Schedule K-1 from Schedule K-1 34 a Totals b Totals Add columns (d) and (f) of line 34a Add columns (c) and (e) of line 34b Total estate and trust income or (loss). Combine lines 35 and 36. Enter the result here and include in the total on line 41 below Part IV Income or Loss From Real Estate Mortgage Investment Conduits (REMICs) ' Residual Holder (b) Employer (c) Excess inclusion from (d) Taxable income 38 (a) Name (e) Income from identification number Schedules Q, line 2c (net loss) from Schedules Q, line 3b Schedules Q, line 1b 39 Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below Part V Summary 40 Net farm rental income or (loss) from Form Also, complete line 42 below ,00-15,00 41 Total income or (loss). Combine lines 26, 32, 37, 39, and 4 Enter the result here and on Form 1040, line 17, or Form 1040NR, line G Reconciliation of farming and fishing income. Enter your gross farming and fishing income reported on Form 4835, line 7; Schedule K-1 (Form 1065), box 14, code B; Schedule K-1 (Form 1120S), box 17, code U; and Schedule K-1 (Form 1041), box 14, code F Reconciliation for real estate professionals. If you were a real estate professional, enter the net income or (loss) you reported anywhere on Form 1040 or Form 1040NR from all rental real estate activities in which you materially participated under the passive activity loss rules BAA FDIZ2302L 12/28/12 Schedule E (Form 1040) 2012

14 SCHEDULE SE OMB No (Form 1040) Self-Employment Tax 2012 G Information about Schedule SE and its separate instructions is at Department of the Treasury Attachment Internal Revenue Service (99) G Attach to Form 1040 or Form 1040NR. Sequence No. 17 Name of person with self-employment income (as shown on Form 1040) Social security number of person DIANA COHEN with self-employment income G Before you begin: To determine if you must file Schedule SE, see the instructions. May I Use Short Schedule SE or Must I Use Long Schedule SE? Note. Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SE, in the instructions. Did you receive wages or tips in 2012? No I I I Are you a minister, member of a religious order, or Yes Yes Christian Science practitioner who received IRS approval Was the total of your wages and tips subject to social not to be taxed on earnings from these sources, but you security or railroad retirement (tier 1) tax plus your net owe self-employment tax on other earnings? earnings from self-employment more than $110,100? Yes I No Are you using one of the optional methods to figure your net earnings? Yes I Did you receive tips subject to social security or Medicare tax that you did not report to your employer? No Yes I No Did you receive church employee income reported on Form W-2 of $ or more? I No Yes No Did you report any wages on Form 8919, Uncollected Yes Social Security and Medicare Tax on Wages? H You may use Short Schedule SE below You must use Long Schedule SE on page 2 I No I Section A ' Short Schedule SE. Caution. Read above to see if you can use Short Schedule SE. 1 a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065), box 14, code A If you received social security retirement or disability benefits, enter the amount of Conservation Reserve b Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code Y Net profit or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K-1 (Form 1065), box 14, code A (other than farming); and Schedule K-1 (Form 1065-B), box 9, code J1. Ministers and members of religious orders, see instructions for types of income to report on this line. See instructions for other income to report a 1 b 2 45, Combine lines 1a, 1b, and , Multiply line 3 by 92.35% (.9235). If less than $400, you do not owe self-employment tax; do not file this schedule unless you have an amount on line 1b G Note. If line 4 is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions. 4 41, Self-employment tax. If the amount on line 4 is:?$110,100 or less, multiply line 4 by 13.3% (.133). Enter the result here and on Form 1040, line 56, or Form 1040NR, line 54.?More than $110,100, multiply line 4 by 2.9% (.029). Then, add $11,4540 to the result. Enter the total here and on Form 1040, line 56, or Form 1040NR, line Deduction for employer-equivalent portion of self-employment tax. If the amount on line 5 is:?$14, or less, multiply line 5 by 57.51% (.5751) 5,559.?More than $14,643.30, multiply line 5 by 50% (.50) and add $1,100 to the result. Enter the result here and on Form 1040, line 27 or Form 1040NR, line BAA For Paperwork Reduction Act Notice, see your tax return instructions. FDIA1101L 08/15/12 3,197. Schedule SE (Form 1040) 2012