Filing Instructions. Amount to be refunded to you...$ 5,056

Transcription

1 Prepared for: Filing Instructions Prepared by: Stephen M. & Jaime M. Weinress Accounting Specialists, Inc. Po Box P.O. Box 1040 Steamboat Springs, CO Nederland, CO U.S. INDIVIDUAL INCOME TAX RETURN Amount to be refunded to you...$ 5,056 This return has been prepared for electronic filing and the practitioner PIN program has been elected. Please sign and return Form 887 to our office. We will then transmit your return electronically to the IRS. Do not mail the paper copy of the return to the IRS. If after three weeks you have not received your refund, you may contact the IRS at Your refund will be deposited directly into your account ending in 177. Refer to Form 1040 on the Direct Deposit/Debit Report for complete account information COLORADO INCOME TAX RETURN Amount to be refunded to you...$ 517 This return has been prepared for electronic filing. If you wish to have it transmitted electronically to the CDOR, please sign, date, and return Form DR 8453 to our office. We will then submit your electronic return to the CDOR. Your refund will be deposited directly into your account ending in 177. Refer to Form 104 on the Direct Deposit/Debit Report for complete account information

2 Form () 1040 U.S. Individual Income Tax Return 2016 OMB No and full name here. 5 Qualifying widow(er) with dependent child Boxes checked 6a Yourself. If someone can claim you as a dependent, do not check box 6a ~~~~~~~~~~~~~~~~ on 6a and 6b b X Spouse No. of children (4) if child on 6c who: (2) Dependent's social (3) Dependent's u c Dependents: relationship to under age 17 security number (1) First name Last name qualifying for child you tax credit Educator expenses ~~~~~~~~~~~~~~~~~~~~~~~ Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ ~~~~~~~~~~~~~~~~~ IRS Use Only - Do not write or staple in this space. For the year Jan. 1-Dec. 31, 2016, or other tax year beginning, 2016, ending, 20 See separate instructions. Your first name and initial Last name Your social security number STEPHEN M. WEINRESS If a joint return, spouse's first name and initial Last name Spouse's social security number JAIME M. WEINRESS " " Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above PO BOX ; and on line 6c are correct. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below. Presidential Election Campaign STEAMBOAT SPRINGS, CO Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below Foreign country name Foreign province/state/county Foreign postal code will not change your tax or refund. You Spouse 1 Single 4 Head of household (with qualifying person). If the qualifying Filing Status 2 X Married filing jointly (even if only one had income) person is a child but not your dependent, enter this child's 3 Check only Married filing separately. Enter spouse's SSN above name here. one box. Exemptions X 2 If more than four dependents, see instructions and check here d Total number of exemptions claimed 7 Wages, salaries, tips, etc. Attach Form(s) W-2 ~~~~~~~~~~~~~~~~~~~~~~~~~~ STMT 1 7 Income 8a Taxable interest. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~~ 8a b Tax-exempt interest. Do not include on line 8a ~~~~~~~~~~~ 8b Attach Form(s) W-2 here. Also a Ordinary dividends. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~ a attach Forms b Qualified dividends ~~~~~~~~~~~~~~~~~~~~~~~ b W-2G and 10 Taxable refunds, credits, or offsets of state and local income taxes~~~~~~~~~~~~~~~~~~ R if tax was withheld. 11 Alimony received ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11 If you did not get a W-2, see instructions. Adjusted Gross Income LHA a 16a a 21 Social security benefits ~~~~ 20a b Taxable amount ~~~~~~ 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income a CAMDEN WEINRESS SON X WESLEY WEINRESS SON X Business income or (loss). Attach Schedule C or C-EZ ~~~~~~~~~~~~~~~~~~~~~~~ Capital gain or (loss). Attach Schedule D if required. If not required, check here ~~~~~~~ Other gains or (losses). Attach Form 477 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ IRA distributions ~~~~~~~ 15a b Taxable amount ~~~~~~ Pensions and annuities ~~~~ 16a b Taxable amount ~~~~~~ Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F Alimony paid b Recipient's SSN Subtract line 36 from line 22. This is your adjusted gross income For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions a ~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unemployment compensation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other income. List type and amount Health savings account deduction. Attach Form 888 ~~~~~~~~ Moving expenses. Attach Form 303 ~~~~~~~~~~~~~~~ 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 ~~~~~~~~~~~~~~~ IRA deduction Student loan interest deduction!! ~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~ Tuition and fees. Attach Form 817 ~~~~~~~~~~~~~~~~ Domestic production activities deduction. Attach Form 803 ~~~~~ Add lines 23 through 35 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b 16b b pmob " " lived with you did not live with you due to divorce or separation (see instructions) Dependents on 6c not entered above Add numbers on lines above ,0. 4,5. 1,726. 3, ,08. Form 1040 (2016)

3 Form 1040 (2016) STEPHEN M. & JAIME M. WEINRESS Tax and 38 Amount from line 37 (adjusted gross income) 38 Credits 3a Check You were born before January 2, 152, Blind. Total boxes Standard Deduction for - if: Spouse checked 3a rqs was born before January 2, 152, Blind. pmo ~ People who b If your spouse itemizes on a separate return or you were a dual-status alien, check here ~~ 3b check any box on line 3a or 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ~~~~~~~~~~~ 40 3b orwho can be claimed as a 41 Subtract line 40 from line 38 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 41 dependent, see instructions. 42 Exemptions. If line 38 is $155,650 or less, multiply $4,050 by the number on line 6d. Otherwise, see inst. ~~ Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- ~~~~~~~~~~~ 44 Tax. Check if any from: a Form(s) 8814 b Form 472 c ~~~~~ 45 Alternative minimum tax. Attach Form 6251 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All others: 46 Excess advance premium tax credit repayment. Attach Form 862 ~~~~~~~~~~~~~~~~~~~~ Single or Married filing 47 Add lines 44, 45, and 46 separately, $6,3 48 Foreign tax credit. Attach Form 1116 if required ~~~~~~~~~~~~~ 48 Married filing jointly or Qualifying widow(er), $12,6 Head of household, $,3 Other Taxes If you have a qualifying child, attach Schedule EIC. Direct deposit? See instructions. Joint return? See instructions. Keep a copy for your records Residential energy credits. Attach Form 565 ~~~~~~~~~~~~~~ 53 Other credits from Form: a 38 b 8801 c 54 Add lines 48 through 54. These are your total credits~~~~~~~~~~~~~~~~~~~~~~~~~~ 55 Self-employment tax. Attach Schedule SE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unreported social security and Medicare tax from Form: a 4137 b 81 ~~~~~~~~~~~ b Nontaxable combat pay election ~~~~~ 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid~~~~~~~~~ 76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here Routing Account b number c Type: X Checking Savings d number 77 Amount of line 75 you want applied to your 2017 estimated tax Credit for child and dependent care expenses. Attach Form 2441 ~~~~~~ Education credits from Form 8863, line 1 ~~~~~~~~~~~~~~~ Retirement savings contributions credit. Attach Form 8880 ~~~~~~~~ Child tax credit. Attach Schedule 8812, if required ~~~~~~~~~~~~ Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 532 if required ~~~~~~~~~~ 60a Household employment taxes from Schedule H ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b First-time homebuyer credit repayment. Attach Form 5405 if required ~~~~~~~~~~~~~~~~~~~ 61 Health care: Individual responsibility (see instructions) Full-year coverage X ~~~~~~~~~~~ 62 Taxes from: a Form 85 b Form 860 c Inst.; enter code(s) 63 Add lines 56 through 62. This is your total tax Payments 64 Federal income tax withheld from Forms W-2 and 10 ~~~~~~~~~~ 64 3, estimated tax payments and amount applied from 2015 return ~~~~ 65 66a Earned income credit (EIC) 66a 2,374. Refund Amount You Owe Third Party Designee Sign Here Paid Preparer Use Only = Additional child tax credit. Attach Schedule 8812 ~~~~~~~~~~~~ American opportunity credit from Form 8863, line 8 ~~~~~~~~~~~ Net premium tax credit. Attach Form 862 ~~~~~~~~~~~~~~~ Amount paid with request for extension to file ~~~~~~~~~~~~~~ Excess social security and tier 1 RRTA tax withheld Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No Designee's Phone Personal identification name no. number (PIN) 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 accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Date Your occupation Daytime phone number Spouse's signature. If a joint return, both must sign. Date Spouse's occupation If the IRS sent you an Identity Protection PIN, enter it here Print/Type preparer's name Preparer's signature Date Check self-employed Firm's name Firm's EIN P.O. BOX 1040 " Phone no. Firm's address 66b ~~~~~~~~~~~ Credit for federal tax on fuels. Attach Form 4136 ~~~~~~~~~~~~~ 72 Credits from Form: a 243 b Reserved c 8885 d 73 Add lines 64, 65, 66a, and 67 through 73. These are your total payments 74 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions ~~~~~~~ 78 Estimated tax penalty (see instructions) , ,081. 4,0. if a 60b a MICHAEL J MASSA P33877 ACCOUNTING SPECIALISTS, INC NEDERLAND, CO PTIN Page 2 38,08. 12,6. 26, ,2. 10,108. 1,013. 1,013. 1, ,62.,056. 5,056.

4 SCHEDULE C (Form 1040) Department of the Treasury Internal Revenue Service () Name of proprietor Profit or Loss From Business (Sole Proprietorship) Information about Schedule C and its separate instructions is at Attach to Form 1040, 1040NR, or 1041; partnerships generally must file Form OMB No Attachment Sequence No. Social security number (SSN) 0 STEPHEN M. WEINRESS A Principal business or profession, including product or service (see instructions) B Enter code from instructions METAL FABRICATION 8120 C Business name. If no separate business name, leave blank. D Employer ID number (EIN), (see instr.) E Business address (including suite or room no.) City, town or post office, state, and ZIP code F Accounting method: (1) X Cash (2) Accrual (3) Other (specify) G Did you "materially participate" in the operation of this business during 2016? If "No," see instructions for limit on losses ~~~~~~~~~ X Yes No H If you started or acquired this business during 2016, check here ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I Did you make any payments in 2016 that would require you to file Form(s) 10? (see instructions) ~~~~~~~~~~~~~~~~ Yes X No J If "Yes," did you or will you file required Forms 10? 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 4,5. 2 Returns and allowances ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 3 Subtract line 2 from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 4, Gross income. Add lines 5 and 6 Part II Expenses. Enter expenses for business use of your home only on line Advertising~~~~~~~~~~~~ Car and truck expenses Office expense~~~~~~~~~~~~~~ Pension and profit-sharing plans ~~~~~~ (see instructions) ~~~~~~~~~ 20 Rent or lease (see instructions): 10 Commissions and fees ~~~~~~ 10 a Vehicles, machinery, and equipment ~~~~ 12 Depletion ~~~~~~~~~~~~ Repairs and maintenance ~~~~~~~~~ 13 Depreciation and section than on line 1) ~~~~~~~~~~ 14 b Deductible meals and 15 Insurance (other than health) ~~~~ 15 entertainment (see instructions) ~~~~~~ 16 Interest: 25 Utilities ~~~~~~~~~~~~~~~~~ a Mortgage (paid to banks, etc.) ~~~ 16a 26 Wages (less employment credits) ~~~~~ b Other ~~~~~~~~~~~~~~ 16b 27 a Other expenses (from line 48) ~~~~~~~ 17 Legal and professional services 17 b Reserved for future use Total expenses before expenses for business use of home. Add lines 8 through 27a ~~~~~~~~~~~~~~~~~ 28 Tentative profit or (loss). Subtract line 28 from line 7 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 Simplified method filers only: enter the total square footage of: (a) your home: 31 Net profit or (loss). Subtract line 30 from line Cost of goods sold (from line 42) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross profit. Subtract line 4 from line 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) ~~~~~~~~~~~~~~~ 11 Contract labor (see instructions) ~~ 11 b Other business property ~~~~~~~~~ LHA expense deduction (not included in Part III) (see instructions) ~~~~~ Employee benefit programs (other 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 32. If you checked 32a, enter the loss 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 the line 31 instructions). Estates and trusts, enter on Form 1041, line 3. If you checked 32b, you must attach Form 618. Your loss may be limited. 23 Supplies (not included in Part III) Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 882 unless using the simplified method (see instructions). and (b) the part of your home used for business: Use the Simplified Method Worksheet in the instructions to figure the amount to enter on line 30 B B B B If you have a loss, check the box that describes your investment in this activity (see instructions). ~~~~~ Taxes and licenses ~~~~~~~~~~~~ 24 Travel, meals, and entertainment: a Travel ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ a 20b a 24b a 27b a 32b All investment is at risk. Some investment is not at risk. For Paperwork Reduction Act Notice, see the separate instructions. Schedule C (Form 1040) p mo pn mno 4,5. 4, ,5. 4,5.

5 Schedule E (Form 1040) 2016 Attachment Sequence No. 13 Page 2 Name(s) shown on return. Do not enter name and social security number if shown on page 1. Your social security number STEPHEN M. & JAIME M. WEINRESS 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 column (e) on line 28 and attach Form 618. See instructions. 27 Are you reporting any loss not allowed in a prior year due to the at-risk, excess farm loss, 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 Pfor (c) Check (d) Employer (e) Check if partnership; S if foreign any amount is for S corporation partnership identification number not at risk A STORM MOUNTAIN METAL INC S B C D A B C D 2a b (f) Passive loss allowed (attach Form 8582 if required) (g) Passive income from Schedule K-1 (h) Nonpassive loss from Schedule K-1 Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the 33 (a) Name A B A B Totals ~~~~~ Totals ~~~~~ Add columns (g) and (j) of line 2a Passive Income and Loss Add columns (f), (h), and (i) of line 2b (c) Passive deduction or loss allowed (attach Form 8582 if required) Passive Income and Loss (d) Passive income from Schedule K-1 Nonpassive Income and Loss ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ result here and include in the total on line 41 below Part III Income or Loss From Estates and Trusts (i) Section 17 expense (j) Nonpassive income deduction from Form 4562 from Schedule K-1 28, , ,762. (e) Deduction or loss from Schedule K (b) Employer identification number Nonpassive Income and Loss 48, ,488. ( 28,762. ) 1,726. (f) Other income from Schedule K-1 34a b Totals ~~~~~~~~ Totals ~~~~~~~~ 35 Add columns (d) and (f) of line 34a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add columns (c) and (e) of line 34b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 36 ( ) 37 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 37 Part IV Income or Loss From Real Estate Mortgage Investment Conduits (REMICs) - Residual Holder 38 (a) Name (b) Employer (c) Excess inclusion from (d) Taxable income (net (e) Income from Schedules Q, line 2c identification number loss) from Schedules Q, (see instructions) Schedules Q, line 3b line 1b 3 Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below 3 Part V Summary 40 Net farm rental income or (loss) from Form Also, complete line 42 below ~~~~~~~~~~~~~~~~~~~~~ Total income or (loss). Combine lines 26, 32, 37, 3, and 40. Enter the result here and on Form 1040, line 17, or Form 1040NR, line 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 V; and Schedule K-1 (Form 1041), box 14, code F (see instructions) Reconciliation for real estate professionals. If you were a real estate professional (see instructions), 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 43 Schedule E (Form 1040) ,726.

6 OMB No SCHEDULE SE (Form 1040) Self-Employment Tax Department of the Treasury Information about Schedule SE and its separate instructions is at Attachment Internal Revenue Service () Attach to Form 1040 or Form 1040NR. Sequence No. 17 Name of person with self-employment income (as shown on Form 1040 or Form 1040NR) Social security number of person with self-employment STEPHEN M. WEINRESS income 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. " " No Did you receive wages or tips in 2016? Are you a minister, member of a religious order, or Christian Was the total of your wages and tips subject to social security Yes Science practitioner who received IRS approval not to be taxed Yes or railroad retirement (tier 1) tax plus your net earnings from on earnings from these sources, but you owe self-employment self-employment more than $118,5? tax on other earnings? No No < < Are you using one of the optional methods to figure your net Yes Did you receive tips subject to social security or Medicare Yes earnings (see instructions)? tax that you didn't report to your employer? No Did you receive church employee income (see instructions) Yes No Did you report any wages on Form 81, Uncollected Social Yes reported on Form W-2 of $ or more? Security and Medicare Tax on Wages? No < < You may use Short Schedule SE below You must use Long Schedule SE on page 2 Section A-Short Schedule SE. Caution. Read above to see if you can use Short Schedule SE. 1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve 2 3 (Form 1065), box 14, code A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code Z ~~ 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, 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 STMT ~~~~~ 2 Combine lines 1a, 1b, and 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4 Multiply line 3 by 2.35% (0.235). If less than $4, you don't owe self-employment tax; don't file this schedule unless you have an amount on line 1b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Note. If line 4 is less than $4 due to Conservation Reserve Program payments on line 1b, see instructions. 5 Self-employment tax. If the amount on line 4 is: $118,5 or less, multiply line 4 by 15.3% (0.153). Enter the result here and on Form 1040, line 57, or Form 1040NR, line 55 More than $118,5, multiply line 4 by 2.% (0.02). Then, add $14,64 to the result. Enter the total here and on Form 1040, line 57, or Form 1040NR, line 55 ~~~~~~~~~~~~~~~~~~~ 6 Deduction for one-half of self-employment tax. LHA B B Multiply line 5 by 50% (0.50). Enter the result here and on < < < < Form 1040, line 27, or Form 1040NR, line 27 6 No < : For Paperwork Reduction Act Notice, see your tax return instructions. Schedule SE (Form 1040) 2016 Yes a 1b ,5. 4,5. 4,

7 SCHEDULE 8812 (Form 1040A or 1040) Attach to Form 1040, Form 1040A, or Form 1040NR. OMB No Information about Schedule 8812 and its separate instructions is at Department of the Treasury Attachment Internal Revenue Service () Sequence No. 47 Name(s) shown on return Your social security number STEPHEN M. & JAIME M. WEINRESS Part I Filers Who Have Certain Child Dependent(s) with an ITIN (Individual Taxpayer Identification Number) CAUTION A! Complete this part only for each dependent who has an ITIN and for whom you are claiming the child tax credit. If your dependent is not a qualifying child for the credit, you cannot include that dependent in the calculation of this credit. Answer the following questions for each dependent listed on Form 1040, line 6c; Form 1040A, line 6c; or Form 1040NR, line 7c, who has an ITIN (Individual Taxpayer Identification Number) and that you indicated is a qualifying child for the child tax credit by checking column (4) for that dependent. For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions. Yes No Child Tax Credit 2016 B C D presence test? See separate instructions. Yes No presence test? See separate instructions. Yes No presence test? See separate instructions. Yes No Note: If you have more than four dependents identified with an ITIN and listed as a qualifying child for the child tax credit, see separate instructions and check here ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 If you file Form 2555 or 2555-EZ stop here; you cannot claim the additional child tax credit. If you are required to use the worksheet in Pub. 72, enter the amount from line 8 of the Child Tax 1040 filers: 1040A filers: 1040NR filers: 2 Enter the amount from Form 1040, line 52; Form 1040A, line 35; or Form 1040NR, line 4 ~~~~~~~~~~ 2 3 Subtract line 2 from line 1. If zero, stop here; you cannot claim this credit 3 4a Earned income (see separate instructions) ~~~~~~~~~~~~~~~~~ 4a 1,182. b For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial Part II Credit Worksheet in the publication. Otherwise: 4b 5 Is the amount on line 4a more than $3,0? No. Leave line 5 blank and enter -0- on line 6. X Yes. Subtract $3,0 from the amount on line 4a. Enter the result ~~ 5 16, Multiply the amount on line 5 by 15% (0.15) and enter the result ~~~~~~~~~~~~~~~~~~~~~~~ 6 LHA Additional Child Tax Credit Filers Next. Do you have three or more qualifying children? X No. If line 6 is zero, stop here; you cannot claim this credit. Otherwise, skip Part III and enter the Yes. Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040, line 52). Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040A, line 35). Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040NR, line 4). Nontaxable combat pay (see separate instructions) ~~~~~~~~~~~~~~~~ smaller of line 3 or line 6 on line 13. If line 6 is equal to or more than line 3, skip Part III and enter the amount from line 3 on line 13. Otherwise, go to line 7. For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 8812 (Form 1040A or 1040) 2016 p n m n o 1 2,0. 1, ,

8 Schedule 8812 (Form 1040A or 1040) 2016 Part III Certain Filers Who Have Three or More Qualifying Children filers: Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2, boxes 4 and 6. If married filing jointly, include your spouse's amounts with yours. If your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, see separate instructions ~~~~~~~~ 1040A filers: 1040NR filers: Enter the total of the amounts from Form 1040NR, lines 27 and 56, plus any taxes that you identified using code "UT" and entered on line filers: 1040A filers: Enter the total of the amounts from Form 1040, lines 27 and 58, plus any taxes that you identified using code "UT" and entered on line 62. Enter -0-. Add lines 7 and 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the total of the amounts from Form 1040, lines 66a and 71. Enter the total of the amount from Form 1040A, line 42a, plus any excess social security and tier I RRTA taxes withheld that you entered to the left of line 46 (see separate instructions). 1040NR filers: Enter the amount from Form 1040NR, line Subtract line 10 from line. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the larger of line 6 or line 11~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 12 Next, enter the smaller of line 3 or line 12 on line Page 2 Part IV Additional Child Tax Credit 13 This is your additional child tax credit ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter this amount on Form 1040, line 67, Form 1040A, line 43, or Form 1040NR, line 64. p n m n o p n m n o Schedule 8812 (Form 1040A or 1040)

9 862 Premium Tax Credit (PTC) 2016 OMB No Form Attach to Form 1040, 1040A, or 1040NR. Department of the Treasury Attachment Internal Revenue Service Information about Form 862 and its separate instructions is at Sequence No. 73 Name shown on your return Your social security number STEPHEN M. WEINRESS You cannot claim the PTC if your filing status is married filing separately unless you qualify for an exception. If you qualify, check the box. Part I Annual and Monthly Contribution Amount 1 Tax family size. Enter the number of exemptions from Form 1040 or Form 1040A, line 6d, or Form 1040NR, ln 7d 2a Modified AGI. Enter your b Enter the total of your dependents' modified AGI (see instructions) 2a 38,08. modified AGI (see instructions) ~~ 2b Household income. Add the amounts on lines 2a and 2b ~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 38,08. Federal poverty line. Enter the federal poverty line amount from Table 1-1, 1-2, or 1-3 (see instructions.) Check the appropriate box for the federal poverty table used. a Alaska b Hawaii c X Other 48 states and DC 4 24,250. Household income as a percentage of federal poverty line (see instructions) ~~~~~~~~~~~~~~~~~ % for how to report your excess advance PTC repayment amount. 7 Applicable Figure. Using your line 5 percentage, locate your "applicable figure" on the table in the instructions a Annual contribution amount. Multiply ln 3 by b Monthly contribution amount. Divide line 8a ln 7. Round to nearest whole dollar amount 8a 1,766. by 12. Round to nearest whole dollar amount 8b 147. Part II Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit Are you allocating policy amounts with another taxpayer or do you want to use the alternative calculation for year of marriage (see instructions)? Yes. Skip to Part IV, Allocation of Policy Amounts, or Part V, Alternative Calculation for Year of Marriage. X No. Continue to line See the instructions to determine if you can use line 11 or must complete lines 12 through 23. X Yes. Continue to line 11. Compute your annual PTC. Then skip lines No. Continue to lines Compute and continue to line 24. your monthly PTC and continue to line 24. (a) Annual enrollment (b) Annual applicable (c) Annual (d) Annual maximum (e) Annual premium (f) Annual advance Annual premiums (Form(s) SLCSP premium contribution premium assistance tax credit allowed payment of PTC Calculation 105-A, line 33A) (Form(s) 105-A, amount (subtract (c) from (b), (smaller of (a) or (d)) (Form(s) 105-A, line 33B) (line 8a) if zero or less, enter -0-) line 33C) 11 Annual Totals 11, ,511. 1,766.,745.,745. 6,664. (a) Monthly enrollment (b) Monthly (c) Monthly (d) Monthly maximum (e) Monthly premium (f) Monthly advance premiums (Form(s) applicable SLCSP contribution amount premium assistance tax credit allowed payment of PTC Monthly (amount from line 8b Calculation 105-A, lines 21-32, premium (Form(s) (subtract (c) from (smaller of (a) or (d)) (Form(s) 105-A, column A) 105-A, lines 21-32, or alternative marriage (b), if zero or lines 21-32, column B) monthly calculation) less, enter -0-) column C) greater than line 24, leave this line blank and continue to line 27 Part III Repayment of Excess Advance Payment of the Premium Tax Credit 27 Excess advance payment of PTC. If line 25 is greater than line 24, subtract line 24 from line 25. Enter the difference here ~~ 28 2 Did you enter 401% on line 5? (See instructions if you entered less than 1%.) X No. Continue to line 7. Yes. You are not eligible to take the PTC. If advance payment of the PTC was made, see the instructions January February March April May June July August September October November December Total premium tax credit. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total here ~~ Advance payment of PTC. Enter the amount from line 11(f) or add lines 12(f) through 23(f) and enter the total here ~~ Net premium tax credit. If line 24 is greater than line 25, subtract line 25 from line 24. Enter the difference here and on Form 1040, line 6; Form 1040A, line 45; or Form 1040NR, line 65. If line 24 equals line 25, enter zero. Stop here. If line 25 is Repayment limitation (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Excess advance premium tax credit repayment. Enter the smaller of line 27 or line 28 here and on Form 1040, line 46; Form 1040A, line 2; or Form 1040NR, line 44 LHA For Paperwork Reduction Act Notice, see your tax return instructions. Form 862 (2016) ,745. 6,664. 3,081.

10 Form 862 (2016) STEPHEN M. WEINRESS Page 2 Part IV Allocation of Policy Amounts Complete the following information for up to four shared policy allocations. See instructions for allocation details. Allocation 1 30 (a) Policy Number (Form 105-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month Allocation percentage applied to monthly amounts (e) Premium Percentage (f) SLCSP Percentage (g) Advance Payment of the PTC Percentage Allocation 2 31 (a) Policy Number (Form 105-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month Allocation percentage applied to monthly amounts (e) Premium Percentage (f) SLCSP Percentage (g) Advance Payment of the PTC Percentage Allocation 3 32 (a) Policy Number (Form 105-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month Allocation percentage applied to monthly amounts Allocation 4 (e) Premium Percentage (f) SLCSP Percentage (g) Advance Payment of the PTC Percentage 33 (a) Policy Number (Form 105-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month Allocation percentage (e) Premium Percentage (f) SLCSP Percentage (g) Advance Payment of the PTC applied to monthly Percentage amounts 34 Have you completed all policy amount allocations? Yes. Multiply the amounts on Form 105-A by the allocation percentages entered by policy. Add all allocated policy amounts and nonallocated policy amounts from Forms 105-A, if any, to compute a combined total for each month. Enter the combined total for each month on lines 12-23, columns (a), (b), and (f). Compute the amounts for lines 12-23, columns (c)-(e), and continue to line 24. No. See the instructions to report additional policy amount allocations. Part V Alternative Calculation for Year of Marriage Complete line(s) 35 and/or 36 to elect the alternative calculation for year of marriage. For eligibility to make the election, see the instructions for line. To complete line(s) 35 and/or 36 and compute the amounts for lines 12-23, see the instructions for this Part V. 35 Alternative entries (a) Alternative family size (b) Alternative monthly (c) Alternative start month (d) Alternative stop month for your SSN contribution amount 36 Alternative entries for your spouse's SSN (a) Alternative family size (b) Alternative monthly (c) Alternative start month (d) Alternative stop month contribution amount Form 862 (2016)

11 Shared Responsibility Payment To Figure Your Shared Responsibility Payment Follow Steps 1 through 5 next. Complete Worksheet A or Worksheet B if you are directed to them as you complete Steps 1 through 5. Complete the Shared Responsibility Payment Worksheet as directed by Steps 1 through 5 or Worksheets A and B. Step 1 All Filers 1. Can someone claim you as a dependent? Yes. Stop. You do not owe a shared responsibility payment. Do not check the box on line 6a of Form 1040 or Form 1040A. If you file Form 1040EZ, check the box on line 5 X No. Continue to line 2 2. Did you, and everyone else in your tax household (see Tax household under Definitions, earlier) have qualifying health coverage for every month of 2016*? X Yes. Stop. You do not owe a shared responsibility payment. Check the Full-year coverage box on Form 1040, line 61; Form 1040A, line 38; or Form 1040EZ, line 11 No. Continue to line 3 *You can check the Full-year coverage box if you had or adopted a child during the year, or a member of your tax household died during the year, as long as that person had qualifying health care coverage for every month he or she was a member of your tax household. 3. Did you or anyone else in your tax household have qualifying health coverage or qualify for a coverage exemption for any month in Yes. Stop. Claim any coverage exemption you qualify for on Form 865. Skip question 4; go to Worksheet A No. Continue to line 4 Step 2 Flat Dollar Amount 1. Multiply $65 by the number of people in your tax household who were at least 18 years old.*~~~~~~~~~~~~~~~~ 1 2. Multiply $ by the number of people in your tax household who were under age 18 ~~~~~~~~~~~~~~~~~~ ? 4. Did you, or anyone else in your tax household turn 18 during 2016? Yes. Go to Worksheet A No. Go to Step 2 *For purposes of figuring the shared responsibility payment, an individual is considered under age 18 for an entire month if he or she didn't turn 18 before the first day of the month. An individual turns 18 on the anniversary of the day the individual was born. Add lines 1 and 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Enter the smaller of line 3 or $2,085 here and on line 1 of the Shared Responsibility Payment Worksheet. Go to Step 3~~~~ Step 3 Household Income 1. Enter the amount from Form 1040, line 38; Form 1040A, line 21; or Form 1040EZ, line 4 ~~~~~~~~~~~~~~~~~~~ 1 2. Did you receive any tax-exempt interest? No. Continue to line 3 Yes. Enter the amount from Form 1040, line 8b; Form 1040A, line 8b; or the amount entered in the space to the left of Form 1040EZ, line 2 ~~~~~~~ 3. Did you attach Form 2555 or Form 2555-EZ? Yes. Enter the amount from Form 2555, lines 45 and 50; or Form 2555-EZ, line 18 ~~~~~~~~~~~~~~~~~~ No. Continue to line 4 4. Did you claim any dependents? Yes. Continue to line 5 No. Stop. Add lines 1 through 3. This is your household income. Enter the result on Step 4, line 1 5. Were any of the dependents you claimed required to file a return? Yes. Complete questions 1 through 3 for each dependent with a filing requirement for whom you did not attach Form Enter the total here ~~~~~ No. Add lines 1 through 3. This is your household income. Enter the result on Step 4, line 1 6. Did you attach Form 8814? Yes. Continue to line 7 No. Stop. Add lines 1, 2, 3, and 5. This is your household income. Enter the result on Step 4, line 1 7. Is Form 8814, line 4 more than $1,050? Yes. Add the amount from Form 8814, line 1b and the smaller of Form 8814, line 4 or 5 ~~~~~~~~~~~~~~~ No. Enter -0-. Continue to line 8 8. Add lines 1, 2, 3, 5, and 7. This is your household income. Enter the result on Step 4, line 1 ~~~~~~~~~~~~~~~~

12 Shared Responsibility Payment continued Step 4 Percentage Income Amount 1. Enter your household income from Step 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 2. Were you or your spouse (if filing jointly) born before January 2, 152? Yes. Skip question 3. Find your filing threshold on the Filing Thresholds for Most People chart and enter it both here and on line 4. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ No. Go to question Enter the amount listed below for your filing status. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Single - $10,350 Head of household - $13,350 Married filing jointly - $20,7 Married filing separately - $4,050 Qualifying widow(er) with dependent child - $16, Enter the amount from line 2 or 3. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4 5. Subtract line 4 from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Is the amount on line 5 zero or less? Yes. Stop. You do not owe a shared responsibility payment. Complete Form 865 by checking the box on line 7. No. Continue to line Multiply line 5 by 2.5% (0.025). This is your percentage income amount ~~~~~~~~~~~~~~~~~~~~~~~~~~ 8. Were you required to complete Worksheet A? Yes. Go to Worksheet B. Then continue to Step 5 No. Enter the amount from line 7 above on line 2 of the Shared Responsibility Payment Worksheet and complete line 3 of that worksheet. Then continue to step 5. Step 5 National Average Bronze Plan Premium 1. Were you required to complete Worksheet A? Yes. Continue to line 2 No. Skip question 2; Go to question Multiply $223* by the number on Worksheet A, line 8. Enter the result here and on line 4 of the Shared Responsibility Payment Worksheet. Skip question 3 and complete line 5 of the Shared Responsibility Payment Worksheet ~~~~~~~~ 2 *$223 is the 2016 national average premium for a bronze level health plan available through the Marketplace for one individual for one month. 3. Enter on line 4 of the Shared Responsibility Payment Worksheet, the amount below that corresponds to the total number of people in your tax household. Then complete line 5 of the Shared Responsibility Payment Worksheet. 1 person - $2,676 2 people - $5,352 3 people - $8,028 4 people - $10,704 5 or more people - $13, Shared Responsibility Payment Worksheet Use this worksheet if you are referred here from the Shared Responsibility Payment flowchart or from Worksheet A or B. If everyone in your tax household had either minimum essential coverage or a coverage exemption for every month during 2016, stop here. You do not owe a shared responsibility payment. Complete Step 1 1. Enter the flat dollar amount. (From Step 2, question 4 or Worksheet A, line 7) ~~~~~~~~~~~~~~~~~ 1 Complete Step 3 2. Enter the percentage income amount. (From Step 4, question 7 or Worksheet B, line 14) ~~~~~~~~~~~~ 2 3. Enter the larger of line 1 or line 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 Complete Step 5 4. Enter the National Average Bronze Plan Premium (From Step 5, question 2 or 3) ~~~~~~~~~~~~~~~~ 4 5. Enter the smaller of line 3 or line 4 here and on Form 1040, line 61; Form 1040A, line 38; or Form 1040EZ, line 11. This is your shared responsibility payment ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

13 Form 4562 Depreciation and Amortization (Including Information on Listed Property) SUMMARY OMB No Attach to your tax return. Department of the Treasury Attachment Internal Revenue Service () Information about Form 4562 and its separate instructions is at Sequence No. 17 Name(s) shown on return Business or activity to which this form relates Identifying number STEPHEN M. & JAIME M. WEINRESS ALL BUSINESS ACTIVITIES Part I Election To Expense Certain Property Under Section 17 Note: If you have any listed property, complete Part V before you complete Part I. 1 Maximum amount (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 5,0. 2 Total cost of section 17 property placed in service (see instructions) ~~~~~~~~~~~~~~~~~~~~~ Threshold cost of section 17 property before reduction in limitation ~~~~~~~~~~~~~~~~~~~~~~ 3 2,010,0. 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~ Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions 5 5,0. 6 (a) Description of property (b) Cost (business use only) (c) Elected cost TOTAL ALLOWABLE PASS-THROUGH SECTION 17 EXPENSE 28, Tentative deduction. Enter the smaller of line 5 or line 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13 Carryover of disallowed deduction to Add lines and 10, less line Note: Don't use Part II or Part III below for listed property. Instead, use Part V. Part II Special Depreciation Allowance and Other Depreciation (Don't include listed property. ) Listed property. Enter the amount from line 2 ~~~~~~~~~~~~~~~~~~~ Total elected cost of section 17 property. Add amounts in column (c), lines 6 and 7 ~~~~~~~~~~~~~~ Carryover of disallowed deduction from line 13 of your 2015 Form 4562 ~~~~~~~~~~~~~~~~~~~~ Business income limitation. Enter the smaller of business income (not less than zero) or line 5 Section 17 expense deduction. Add lines and 10, but don't enter more than line Other depreciation (including ACRS) Part III MACRS Depreciation (Don't include listed property. ) (See instructions.) Section A 17 MACRS deductions for assets placed in service in tax years beginning before 2016 ~~~~~~~~~~~~~~ If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here J Section B - Assets Placed in Service During 2016 Tax Year Using the General Depreciation System (b) Month and (c) Basis for depreciation (a) Classification of property year placed (business/investment use (d) Recovery (e) Convention (f) Method (g) Depreciation deduction in service only - see instructions) period 7 ~~~~~~~~~ Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Property subject to section 168(f)(1) election ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ , , ,88. 28,762. 1a b c d e f g h i 20a b Residential rental property / 27.5 yrs. MM S/L / 27.5 yrs. MM S/L Nonresidential real property / 3 yrs. MM S/L / MM S/L Section C - Assets Placed in Service During 2016 Tax Year Using the Alternative Depreciation System c 40-year Part IV Summary (See instructions.) 21 Listed property. Enter amount from line 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ year property 5-year property 7-year property 10-year property 15-year property 20-year property 25-year property 25 yrs. S/L Class life 12-year Total. Add amounts from line 12, lines 14 through 17, lines 1 and 20 in column (g), and line 21. / For Paperwork Reduction Act Notice, see separate instructions. 12 yrs. 40 yrs. MM Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instr. For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs LHA 23 S/L S/L S/L 22 Form 4562 (2016)

14 STEPHEN M. & JAIME M. WEINRESS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 1040 WAGES RECEIVED AND TAXES WITHHELD STATEMENT 1 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} FEDERAL STATE CITY T AMOUNT TAX TAX SDI FICA MEDICARE S EMPLOYER'S NAME PAID WITHHELD WITHHELD TAX W/H TAX TAX - }}}}}}}}}}}}}}} }}}}}}}}}} }}}}}}}}}} }}}}}}}}} }}}}}}} }}}}}}} }}}}}}} T STORM MOUNTAIN METAL INC 15,0. 3, }}}}}}}}}} }}}}}}}}}} }}}}}}}}} }}}}}}} }}}}}}} }}}}}}} TOTALS 15,0. 3, ~~~~~~~~~~ ~~~~~~~~~~ ~~~~~~~~~ ~~~~~~~ ~~~~~~~ ~~~~~~~ STATEMENT(S) 1

15 STEPHEN M. & JAIME M. WEINRESS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SCHEDULE SE NON-FARM INCOME STATEMENT 2 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} METAL FABRICATION 4,5. }}}}}}}}}}}}}} TOTAL TO SCHEDULE SE, LINE 2 4,5. ~~~~~~~~~~~~~~ STATEMENT(S) 2

16 STEPHEN M. & JAIME M. WEINRESS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 6251 DEPRECIATION ON ASSETS PLACED IN SERVICE AFTER 186 STATEMENT 3 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} FROM K-1 - STORM MOUNTAIN METAL INC -1,61. }}}}}}}}}}}}}} TOTAL TO FORM 6251, LINE 18-1,61. ~~~~~~~~~~~~~~ STATEMENT(S) 3

17 STEPHEN M. & JAIME M. WEINRESS }}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 4562 PART I - BUSINESS INCOME STATEMENT 4 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} INCOME TYPE AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} WAGES 15,0. SCHEDULE C 4,5. S CORPORATIONS 48,488. }}}}}}}}}}}}}} TOTAL BUSINESS INCOME USED IN FORM 4562, LINE 11 67,88. ~~~~~~~~~~~~~~ STATEMENT(S) 4

18 Departmental Use Only FORM 104 (08/26/16) COLORADO DEPARTMENT OF REVENUE X Full-Year 2016 (13) Colorado Individual Income Tax Form 104 Part-Year or Nonresident (or resident, part-year, non-resident combination) Mark if Abroad on due date - see instructions Your Last Name Your First Name Middle Initial WEINRESS STEPHEN M Date of Birth (MM/DD/YYYY) SSN 07/10/ Deceased Enter the following information from your current State of Issue Last 4 characters of ID number Date of Issuance driver license or state identification card. If Joint, Spouse's Last Name Spouse's First Name Middle Initial WEINRESS JAIME M Date of Birth (MM/DD/YYYY) Spouse's SSN 08/24/ Deceased Enter the following information from your State of Issue Last 4 characters of ID number Date of Issuance spouse's current driver license or state identification card. Mailing Address Phone Number PO BOX City State ZIP Code Foreign Country (if applicable) STEAMBOAT SPRINGS CO Enter Federal Taxable Income from your federal income tax form: 1040EZ line 6, 1040A line 27, 1040 line 43 Staple W-2s and 10s with CO withholding here. ß 1 Round To The Next Dollar 10,108 Additions to Federal Taxable Income 2. State Addback, enter the state income tax deduction from your federal form 1040 schedule A, line 5 (see instructions) 2 3. Explain: Other Additions, explain (see instructions) 3 4. Subtotal, add lines 1 through , Subtractions from DR 0104AD Schedule, line Colorado Taxable Income, line 4 minus line ,108

19 FORM 104 (08/26/16) COLORADO DEPARTMENT OF REVENUE Name SSN STEPHEN M. WEINRESS Tax, Prepayments and Credits: full-year residents go to Form 104CR and part-year and nonresidents go to Form 104PN 7. Colorado Tax from tax table or Form 104PN line Alternative Minimum Tax from Form 104AMT 8. Recapture of prior year credits Subtotal, add lines 7 through Nonrefundable Credits from Form 104CR line 3, cannot exceed the sum of lines 7 and 8 Total Nonrefundable Enterprise Zone credits used - as calculated, or from DR 1366 line Other Prepayments: 104BEP DR 0108 DR Net Income Tax, add lines 11 and 12. Then subtract that sum from line 10. Use Tax reported on DR 0104US schedule line 7 Net Colorado Tax, add lines 13 and 14 CO Income Tax Withheld from W-2s and 10s Prior-year Estimated Tax Carryforward Estimated Tax Payments, enter the sum of the quarterly payments remitted for this tax year Extension Payment remitted with form 158-I Gross Conservation Easement Credit from DR 1305G line Innovative Motor Vehicle Credit from form DR Refundable Credits from Form 104CR line Subtotal, add lines 16 through 23 Federal Adjusted Gross Income from your federal income tax form: 1040EZ line 4; 1040A line 21; 1040 line , Overpayment, if line 24 is greater than 15 then subtract line 15 from line Estimated Tax Credit Carry Forward to 2017 first quarter, if any Voluntary Contributions elected on DR 0104CH schedule line Subtotal, add lines 27 and Refund, subtract line 2 from line 26 (see instructions)

20 FORM 104 (08/26/16) COLORADO DEPARTMENT OF REVENUE Name SSN STEPHEN M. WEINRESS Direct Deposit Routing Number Type: X Checking Savings CollegeInvest 52 Account Number For questions regarding CollegeInvest direct deposit or to open an account call or visit CollegeInvest.org 31. Net Tax Due, subtract line 24 from line 15, then add line Delinquent Payment Penalty (see instructions) Delinquent Payment Interest (see instructions) Estimated Tax Penalty (see instructions) Amount You Owe, add lines 31 through 34 The State may convert your check to a one time electronic banking transaction. Your bank account may be debited as early as the same day received by the State. If converted, your check will not be returned. If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account electronically. Third Party Designee Do you want to allow another person to discuss this return and any other information related to this return with the Colorado Department of Revenue? Designee's Name No Phone Number Sign Below Under penalties of perjury, I declare that to the best of my knowledge and belief, this return is true, correct and complete. Your Signature Date (MM/DD/YY) Yes. Complete the following: Spouse Signature. If joint return, BOTH must sign. Date (MM/DD/YY) Paid Preparer's Name Paid Preparer's Phone MICHAEL J MASSA Paid Preparer's Address City State ZIP P.O. BOX 1040 NEDERLAND CO New For This Year: If you are filing this return with a check or payment, please mail the return to: COLORADO DEPARTMENT OF REVENUE Denver, CO If you are filing this return without a check or payment, please mail the return to: COLORADO DEPARTMENT OF REVENUE Denver, CO

21 Departmental Use Only FORM 104CR (11/18/16) COLORADO DEPARTMENT OF REVENUE Form 104CR Individual Credit Schedule 2016 Taxpayer's Last Name First Name Middle Initial SSN Be sure to submit the required supporting documentation as indicated for each credit. Most e-file software and tax preparers have the ability to submit this schedule and attachments electronically. However, Revenue Online can also be used to file your return and attachments electronically. Otherwise, attach all required documents to your paper return. If you received any of these credits from a pass-through entity, be sure to provide the entity's name and account number and your ownership percentage where required. If credits were passed through from multiple entities, attach to your return a written statement that includes all relevant information. Dollar amounts shall be rounded to the nearest whole dollar. Calculate percentages to the second decimal place. 1. Child Care Expenses Credit from Form DR WEINRESS STEPHEN M Use this schedule to calculate your income tax credits. For best results, visit TaxColorado.com to research eligibility requirements and other information about these credits before following the line-by-line instructions contained below. Part I - Refundable Credits Earned Income Tax Credit - full or part-year Colorado residents who claim the federal EITC are allowed an earned income tax credit against their income tax. Complete the table for each qualifying child. Enter the amount of Earned Income calculated for your federal return The federal EITC you claimed Qualifying Child's Last Name Qualifying Child's First Name Year of Birth SSN 2 3 1,182 2,374 WEINRESS WESLEY WEINRESS CAMDEN COEITC, multiply line 3 by 10% (.1) Part-year residents only, multiply line 4 by the percentage on line 34 of Form 104PN (If the percentage exceeds 1%, use 1% ) Business Personal Property Credit: Use the worksheet in the DR 0104 book instructions to calculate, submit copy of assessor's statement Refundable Renewable Energy Tax Credit from line 88 of Form DR Total Refundable Credits, add lines 1, 4 (or 5), 6, and 7. Enter the sum on line 23 of Form

22 FORM 104CR (11/18/16) COLORADO DEPARTMENT OF REVENUE Name SSN STEPHEN M. WEINRESS Part II - Credit for Tax Paid to Another State Colorado nonresidents do not qualify for this credit. Part-year residents generally do not qualify for this credit. If you have income or losses from two or more states, you must separately calculate lines 10 through 16 for each state. If you do not file electronically, you must submit Form 104CR for each state. Then, enter "Combined" on line and complete lines 10 through 16 to disclose the combined total for each line. A summary schedule is not acceptable Submit a copy of the tax return for each other state when claiming this credit. The portion of the return submitted must include the adjusted gross income calculation, any disallowed federal deductions by that state, and the tax calculation for the other state Name of other state: Total of lines 7 and 8 Form 104 Modified Colorado adjusted gross income from sources in the other state Total modified Colorado adjusted gross income Amount on line 11 divided by amount on line 12 Amount on line 10 multiplied by the percentage on line 13 Tax liability to the other state Allowable credit, the smaller of lines 14 or 15 Part III - Other Credits The following credits can be carried forward to subsequent tax years if your current tax liability is less than the sum of your credits. Visit TaxColorado.com for limitations that are specific to each credit. To report this properly, use the first column to report the total credit that is available (the amount generated this year plus any prior-year carryforward). Then, use the second column to report the amount you are using this year to offset your tax liability. The difference should be reported on line 40, which is your subsequent carryforward amount. Plastic recycling investment credit, submit required receipts Plastic recycling net expenditures amount (fill below): Available Credit Credit Used Column (A) Column (B) 18. Colorado Minimum Tax Credit 2016 Federal Minimum Tax Credit (fill below): Historic Property Preservation credit, submit verification or a copy of the federal credit calculation Child Care Center Investment credit, submit a copy of your facility license and a list of depreciable tangible personal property