COVER PAGE Filing Checklist For 28 Tax Return Filed On Standard Forms Prepared on: 1/13/29 12:55:49 am Return: C:\Documents and Settings\Owner.gateway\My Documents\TaxCut\Donna Harp 28 Tax Return.T8 To file your 28 tax return, simply follow these instructions: Step 1 - Sign and date the return If your return is signed by a representative for you, you must have a power of attorney attached that specifically authorizes the representative to sign your return. To do this, you can use Form 2848, Power of Attorney and Declaration of Representative. Step 2 - Assemble the return These forms should be assembled behind Form 14 --U.S. Individual Income Tax Return - Schedule D - Form 393 - Form 14-V Staple these documents to the front of the first page of the return: Form W-2: Wage and Tax Statement 1st (Farah Movie, Inc) 2nd (Ocala Production, Inc) Step 3 - Pay the balance due on your taxes Make your check or money order for $5156 payable to the "United States Treasury". Don't send cash. Write the following on your check or money order: - "28 Form 14" - Your name and address - Your daytime phone number - Your Social Security Number On the right side of the check or money order write the dollar amount of the payment, like this: $5156.. Don't staple or otherwise attach the payment to the return. Instead, just place it loose in the envelope with the return. Step 4 - Mail the return Mail the return to this address: Department of the Treasury Internal Revenue Service Center [Please enter your state on Background Worksheet.] We recommend that you use one of these IRS-approved methods to send your return. Retain the proof of mailing to avoid a late filing penalty: - U.S. Postal Service certified mail. - DHL Same Day Service, Next Day 1:3 am, Next Day 12: pm, Next Day 3: pm, or 2nd Day Service. - FedEx Priority Overnight, Standard Overnight, 2Day, International Priority, or International First. - United Parcel Service Next Day Air, Next Day Air Saver, 2nd Day Air, 2nd Day Air A.M., Worldwide Express Plus, or Worldwide Express. Step 5 - Keep a copy Print a second copy of the return for your records. We recommend that you also print and retain these supporting forms, which don't need to be sent to the IRS: - - Background Worksheet - - Home Mortgage Interest Worksheet - - Sale of Home Worksheet 28 Tax Return Information. Keep this for your records. Here is some additional information about your 28 return. Keep this information with your records. You will need your 28 AGI to electronically sign your return next year.
Total (Gross) Income $196, Adjusted Gross Income 193,28 Taxable Income 184,157 Total Federal Tax 33,67 Total Payments 28, Penalties 89 Refund Amount Amount You Owe $5,156 * Your long-term capital gains and qualifying dividends are taxed at a lower rate than your other income. As a result, your total federal tax is less than the tax shown on the IRS's Tax Table.
F or m Department of the Treasury Internal Revenue Service 14 U.S. Individual Income Tax Return 28 Label (See instructions.) Use the IRS label. Otherwise, please print or type. Presidential Election Campaign Filing Status Check only one box. Exemptions If more than four dependents, see instructions. Income Attach Form(s) W-2 here. Also attach Forms W-2G and 199-R if tax was withheld. If you did not get a W-2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 14-V. Adjusted Gross Income KIA L A B EL H E R E (99) IRS Use Only Do not write or staple in this space. For the year Jan. 1 Dec. 31, 28, or other tax year beginning, 28, ending, 2 OMB No. 1545-74 Your first name and initial Last name Your social security number 1 2 3 City, town or post office, state, and ZIP code. If you have a foreign address, see instructions. 6a If a joint return, spouse's first name and initial Last name Spouse's social security number Home address (number and street). If you have a P.O. box, see instructions. b c Single Married filing jointly (even if only one had income) Married filing separately. Enter spouse's SSN above and full name here. Qualifying widow(er) with dependent child (see instructions) X Yourself. If someone can claim you as a dependent, do not check box 6a....... Boxes checked 1 on 6a and 6b Spouse........................................... No. of children on 6c who: Dependents: (1) First name Last name 4 5 (2) Dependent's social security number Apt. no. (3) Dependent's relationship to you (4) X if qualifying child for child tax credit (see instr.) You must enter your SSN(s) above. Checking a box below will not change your tax or refund Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see instructions) You Spouse X Head of household (with qualifying person). (See instr.) If the qualifying person is a child but not your dependent, enter this child's name here. d Total number of exemptions claimed............................... 7 Wages, salaries, tips, etc. Attach Form(s) W-2.......................... 7 8a Taxable interest. Attach Schedule B if required.......................... 8a b Tax-exempt interest. Do not include on line 8a.............. 8b 9a Ordinary dividends. Attach Schedule B if required......................... 9a b Qualified dividends (see instructions)................... 9b 1 11 12 13 14 Taxable refunds, credits, or offsets of state and local income taxes (see instructions)....... Alimony received.......................................... 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 4797............................. 1 11 12 13 14 15a IRA distributions 15a b Taxable amount (see inst.) 15b 16a Pensions and annuities....... 16a b Taxable amount (see inst.) 16b 17 18 19 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E..... Farm income or (loss). Attach Schedule F............................. Unemployment compensation................................... 17 18 19 2a Social security benefits...... 2a b Taxable amount (see inst.) 2b 21 22 Other income. List type and amount (see instructions) _ Add the amounts in the far right column for lines 7 through 21. This is your total income.... 21 22 23 Educator expenses (see instructions)................... 23 24 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 216 or 216-EZ....... 24 25 Health savings account deduction. Attach Form 8889........... 25 26 Moving expenses. Attach Form 393................... 26 2,72 27 One-half of self-employment tax. Attach Schedule SE........... 27 28 Self-employed SEP, SIMPLE, and qualified plans............. 28 29 Self-employed health insurance deduction (see instructions)....... 29 3 Penalty on early withdrawal of savings................... 3 31a Alimony paid b Recipient's SSN 31a 32 IRA deduction (see instructions)...................... 32 33 Student loan interest deduction (see instructions)............. 33 34 Tuition and fees deduction. Attach Form 8917............... 34 35 Domestic production activities deduction. Attach Form 893....... 35 36 Add lines 23 through 31a and 32 through 35............................ 36 37 Subtract line 36 from line 22. This is your adjusted gross income................ 37 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. 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 1 1, 96, 196, 2,72 193,28 Form 14 (28)
Form 14 (28) Tax and Credits Standard Deduction for People who checked any box on line 39a, 39b, or 39c or who can be claimed as a dependent, see instructions All others: Single or Married filing separately, $5,45 Married filing jointly or Qualifying widow(er), $1,9 Head of household, $8, Other Taxes Payments If you have a qualifying child, attach Schedule EIC. Refund Direct deposit? See instructions and fill in 73b, 73c, and 73d, or Form 8888. Amount You Owe Third Party Designee Sign Here Joint return? See instructions. Keep a copy for your records. Paid Preparer's Use Only KIA 38 Amount from line 37 (adjusted gross income)............................ 39a Check You were born before January 2, 1944, Blind. Total boxes if: Spouse was born before January 2, 1944, Blind. checked 39a b If your spouse itemizes on a separate return, or you were a dual-status alien, see instructions and check here 39b c Check if standard deduction includes real estate taxes or disaster loss (see instructions) 39c X 4 Itemized deductions (from Schedule A) or your standard deduction (see left margin)...... 41 Subtract line 4 from line 38..................................... 42 If line 38 is over $119,975, or you provided housing to a Midwestern displaced individual, see instructions. Otherwise, multiply $3,5 by the total number of exemptions claimed on line 6d... 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter --....... 43 44 Tax (see instructions). Check if any tax is from: a Form(s) 8814 b Form 4972................... 45 Alternative minimum tax (see instructions). Attach Form 6251................... 46 Add lines 44 and 45....................................... 47 Foreign tax credit. Attach Form 1116 if required............. 47 48 Credit for child and dependent care expenses. Attach Form 2441.... 48 49 Credit for the elderly or the disabled. Attach Schedule R......... 49 5 Education credits. Attach Form 8863.................. 51 Retirement savings contributions credit. Attach Form 888....... 52 Child tax credit (see instructions). Attach Form 891 if required..... 53 Credits from Form: a 8396 b 8839 54 Other credits from Form: a Form 38 b Form 881 c 55 Add lines 47 through 54. These are your total credits......... 56 Subtract line 55 from line 46. If line 55 is more than line 46, enter --.. 57 Self-employment tax. Attach Schedule SE............................. 58 Unreported social security and Medicare tax from Form: 59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required..... 6 Additional taxes: 61 Add lines 56 through 6. This is your total tax......................... 62 Federal income tax withheld from Forms W-2 and 199......... 62 28, 63 28 estimated tax payments and amount applied from 27 return.. 63 64a Earned income credit (EIC)...................... 64a b Nontaxable combat pay election..... 64b 65 Excess social security and tier 1 RRTA tax withheld (see instructions).. 65 66 Additional child tax credit. Attach Form 8812.............. 66 67 Amount paid with request for extension to file (see instructions)..... 67 68 Credits from Form: a 2439 b 4136 c 881 d 8885 68 69 First-time homebuyer credit. Attach Form 545............. 69 7 Recovery rebate credit (see worksheet in the instructions)....... 7 71 Add lines 62 through 7. These are your total payments.................... 72 If line 71 is more than line 61, subtract line 61 from line 71. This is the amount you overpaid... 73a Amount of line 72 you want refunded to you. If Form 8888 is attached, check here.... b Routing number XXXXXXXXX c Type: Checking Savings d Account number XXXXXXXXXXXXXXXXX 74 Amount of line 72 you want applied to your 29 estimated tax 74 75 Amount you owe. Subtract line 71 from line 61. For details on how to pay, see the instructions 76 Estimated tax penalty (see instructions)................. 76 Do you want to allow another person to discuss this return with the IRS (see instructions)? Designee's name 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. Your signature Date Your occupation Daytime phone number Spouse's signature. If a joint return, both must sign. Preparer's signature Firm's name (or yours if self-employed), address, and ZIP code Date c 5695 Phone no. Spouse's occupation Date 5 51 52 53 54 a 4137 b 8919........ a AEIC payments b Household employment taxes. Attach Schedule H Check if self-employed 89 EIN 38 4 41 42 44 45 46 55 56 57 58 59 6 61 71 72 73a 75 Yes. Complete the following Personal indentification number (PIN) Preparer's SSN or PTIN Phone no. Page 2 193,28 5,95 187,33 3,173 184,157 33,67 33,67 33,67 33,67 28, 5,156 X No Form 14 (28)
SCHEDULE D (Form 14) Department of the Treasury Internal Revenue Service (99) Name(s) shown on return Capital Gains and Losses OMB No. 1545-74 28 Attach to Form 14 or Form 14NR. See instructions for Schedule D (Form 14). Attachment Use Schedule D-1 to list additional transactions for lines 1 and 8. Sequence No. 12 Your social security number Part I Short-Term Capital Gains and Losses Assets Held One Year or Less 1 (a) Description of property (Example: 1 sh. XYZ Co.) (b) Date acquired (Mo., day, yr.) (c) Date sold (Mo. day, yr.) (d) Sales price (see the instructions) (e) Cost or other basis (see the instructions) (f) Gain or (loss) Subtract (e) from (d) 2 Enter your short-term totals, if any, from Schedule D-1, line 2............................... 2 3 Total short-term sales price amounts. Add lines 1 and 2 in column (d)............................ 3 4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824... 5 Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1.............................................. 6 Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions.................................. 4 5 6 ( ) 7 Net short-term capital gain or (loss). Combine lines 1 through 6 in column (f)............. Part II 8 CA Long-Term Capital Gains and Losses Assets Held More Than One Year (a) Description of property (Example: 1 sh. XYZ Co.) (b) Date acquired (Mo., day, yr.) (c) Date sold (Mo. day, yr.) (d) Sales price (see the instructions) (e) Cost or other basis (see the instructions) 7 (f) Gain or (loss) Subtract (e) from (d) 3/23/87 8/1/8 5, 154, 346, SECTION 121 3/23/87 8/1/8 25, -25, 9 Enter your long-term totals, if any, from Schedule D-1, line 9............................... 1 Total long-term sales price amounts. Add lines 8 and 9 in 1 5, column (d)............................ 11 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 8824................................. 12 Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1.............................................. 13 Capital gain distributions. See the instructions.............................. 13 14 Long-term capital loss carryover. Enter the amount, if any, from line 13 of your Capital Loss Carryover Worksheet in the instructions................................. 14 ( ) 15 Net long-term capital gain or (loss). Combine lines 8 through 14 in column (f). Then go to Part III on page 2............................................. 15 96, KIA For Paperwork Reduction Act Notice, see Form 14 or Form 14NR instructions. Schedule D (Form 14) 28 9 11 12
Schedule D (Form 14) 28 Page 2 Part III Summary 16 Combine lines 7 and 15 and enter the result.............................. 16 96, If line 16 is: A gain, enter the amount from line 16 on Form 14, line 13, or Form 14NR, line 14. Then go to line 17 below. A loss, skip lines 17 through 2 below. Then go to line 21. Also be sure to complete line 22. Zero, skip lines 17 through 21 below and enter -- on Form 14, line 13, or Form 14NR, line 14. Then go to line 22. 17 Are lines 15 and 16 both gains? X Yes. Go to line 18. No. Skip lines 18 through 21, and go to line 22. 18 Enter the amount, if any, from line 7 of the 28% Rate Gain Worksheet in the instructions............................................... 18 19 Enter the amount, if any, from line 18 of the Unrecaptured Section 125 Gain Worksheet in the instructions............................................. 19 2 Are lines 18 and 19 both zero or blank? X Yes. Complete Form 14 through line 43, or Form 14NR through line 4. Then complete the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions for Form 14 (or in the Instructions for Form 14NR). Do not complete lines 21 and 22 below. No. Complete Form 14 through line 43, or Form 14NR through line 4. Then 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 14, line 13, or Form 14NR, line 14, the smaller of: The loss on line 16 or......................... ($3,), or if married filing separately, ($1,5) 21 ( ) Note. When figuring which amount is smaller, treat both amounts as positive numbers. 22 Do you have qualified dividends on Form 14, line 9b, or Form 14NR, line 1b? Yes. Complete Form 14 through line 43, or Form 14NR through line 4. Then complete the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions for Form 14 (or in the Instructions for Form 14NR). No. Complete the rest of Form 14 or Form 14NR. KIA Schedule D (Form 14) 28
Form 393 Department of the Treasury Internal Revenue Service (99) Name(s) shown on return Before you begin: Moving Expenses Attach to Form 14 or Form 14NR. OMB No. 1545-74 28 Attachment Sequence No. Your social security number V See the Distance Test and Time Test in the instructions to find out if you can deduct your moving expenses. V See Members of the Armed Forces in the instructions, if applicable. 62 1 Transportation and storage of household goods and personal effects (see instructions)...... 2 Travel (including lodging) from your old home to your new home (see instructions). Do not include the cost of meals........................................... 3 Add lines 1 and 2........................................... 1 2 3 2,35 37 2,72 4 Enter the total amount your employer paid you for the expenses listed on lines 1 and 2 that is not included in box 1 of your Form W-2 (wages). This amount should be shown in box 12 of your Form W-2 with code P................................ 4 5 Is line 3 more than line 4? No. You cannot deduct your moving expenses. If line 3 is less than line 4, subtract line 3 from line 4 and include the result on Form 14, line 7, or Form 14NR, line 8. X Yes. Subtract line 4 from line 3. Enter the result here and on Form 14, line 26, or Form 14NR, line 26. This is your moving expense deduction............. 5 2,72 KIA For Paperwork Reduction Act Notice, see instructions. Form 393 (28)
Form Detach _ Here and Mail _ With Your _ Payment _ and Return 14-V (28) _ Department of the Treasury Internal Revenue Service 28 Use this voucher when making a payment with Form 14. Do not staple this voucher or your payment to Form 14. Make your check or money order payable to the "United States Treasury." Write your social security number (SSN) on your check or money order. 123-45-6789 Form 14-V Payment Voucher Amount you are paying by check or money order KIA 117 5,156 Donna Harp 123456789 JP HARP 3 2812 61