NJ Tests Tax Year Test # One Test Scenario. Type of account: Savings. Routing Number: Account Number:

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1 of 51 NJ Tests Tax Year 2007 Test # 1 400-00-6301 One Test Scenario Forms: NJ-1040 Notes: Direct Deposit of Refund Type of account: Savings Routing Number: 123456780 Account Number: 1221221222

NJ-1040 2013 STATE OF NEW JERSEY INCOME TAX-RESIDENT RETURN 5R For Tax Year Jan-Dec 31, 2013, Or Other Tax Year Beginning, 2013, Month Ending, 20 IMPORTANT! YOU MUST ENTER YOUR SSN(s) Fill in if application for Federal extension is enclosed or enter confirmation # Last Name, First Name and Initial (Joint filers enter first name and initial of each - Enter spouse/cu partner last name ONLY if different) For Privacy Act Notification, See Instructions FILING STATUS Spouse s/cu Partner s Social Security Number Home Address (Number and Street, incl apt # or rural route) Change of Address County/Municipality Code (See Table p 50) City, Town, Post Office State Zip Code NJ RESIDENCY STATUS DEPENDENTS 1 Single GUBERNATORIAL ELECTIONS FUND If you were a New Jersey resident for ONLY part of the taxable year, give the period of New Jersey residency: From To (Fill in only one) 2 Married/CU Couple, filing joint return 3 Married/CU Partner, filing separate return Enter Spouse s/cu Partner s Social Security Number in the boxes above 4 Head of household 5 Qualifying widow(er)/ Surviving CU Partner EXEMPTIONS / / / / Do you wish to designate $1 of your taxes for this fund? Yes No If joint return, does your spouse/cu partner wish to designate $1? Yes No 11 12a 6 7 8 Place label on form if all preprinted information is correct Otherwise, print or type your name and address M M D D Y Y M M D D Y Y 6 Regular Yourself Spouse/ CU Partner Domestic Partner 7 Age 65 or Over Yourself Spouse/CU Partner 8 Blind or Disabled Yourself Spouse/CU Partner 9 Number of your qualified dependent children 10 Number of other dependents 11 Dependents attending colleges (See instr page 16) 12 Totals (For Line 12a - Add Lines 6, 7, 8, and 11) (For Line 12b - Add Lines 9 and 10) 13 Dependent s Last Name, Dependent s Social Security Number Birth Year First Name, Middle Initial a b c d ENTER NUMBERS HERE 9 10 12b Fill in oval if dependent does not have health insurance including NJ FamilyCare/ Medicaid, Medicare, private or other (see instructions) Note: if you fill in the Yes oval(s), it will not increase your tax or reduce your refund Under the penalties of perjury, I declare that I have examined this income tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete If prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge Your Signature Date Spouse s/cu Partner s Signature (if filing jointly, BOTH must sign) Date If enclosing copy of death certificate for deceased taxpayer, fill in (See instruction page 12) Check Amount (see Line 56) If you do not need forms mailed to you next year, fill in (See instruction page 14) I authorize the Division of Taxation to discuss my return and enclosures with my preparer (below) Paid Preparer s Signature Federal Identification Number Firm s Name Federal Employer Identification Number Pay amount on Line 56 in full Write Social Security number(s) on check or money order and make payable to: STATE OF NEW JERSEY - TGI Mail your return in the envelope provided and affix the appropriate mailing label If you have an amount due on Line 56, enclose your check and NJ-1040-V payment voucher with your return and use the label for PO Box 111 If not,use the label for PO Box 555 You may also pay by e-check or credit card See instruction page 11 Division Use 1 2 3 4 5 6 7

NJ-1040 (2013) Page 2 Name(s) as shown on Form NJ-1040 14 Wages, salaries, tips, and other employee compensation (Enclose W-2) Be sure to use State wages from Box 16 of your W-2(s) See instructions 15a Taxable interest income (See instructions) (Enclose Federal Schedule B if over $1,500) 15b Tax-exempt interest income (See instructions) (Enclose Schedule) DO NOT include on Line 15a 15b 16 Dividends 17 Net profits from business (Schedule NJ-BUS-1, Part I, Line 4) (Enclose copy of Federal Schedule C, Form 1040) 18 Net gains or income from disposition of property (Schedule B, Line 4) 19a Pensions, Annuities, and IRA Withdrawals (See instruction page 21) 19b Tax-exempt Pensions and Annuities 19b 20 Distributive Share of Partnership Income (Schedule NJ-BUS-1, Part II, Line 4) (See instruction page 24) (Enclose Schedule NJK-1 or Federal Schedule K-1) 21 Net pro rata share of S Corporation Income (Schedule NJ-BUS-1, Part III, Line 4) (See instruction page 25) (Enclose Schedule NJ-K-1 or Federal Schedule K-1) 22 Net gains or income from rents, royalties, patents & copyrights (Schedule NJ-BUS-1, Part IV, Line 4) 23 Net Gambling Winnings (See instruction page 25) 24 Alimony and separate maintenance payments received 25 Other (Enclose Schedule) (See instruction page 25) 26 Total Income (Add Lines 14, 15a, and 16 through 25) 27a Pension Exclusion (See instruction page 26) 27b Other Retirement Income Exclusion (See Worksheet and instr page 26) 27c Total Exclusion Amount (Add Line 27a and Line 27b) 28 New Jersey Gross Income (Subtract Line 27c from Line 26) (See instruction page 28) 29 Total Exemption Amount (See instruction page 31 to calculate amount) (Part-Year Residents see instruction page 7) 30 Medical Expenses (See Worksheet and instruction page 28) 31 Alimony and Separate Maintenance Payments 32 Qualified Conservation Contribution 33 Health Enterprise Zone Deduction 34 Alternative Business Calculation Adjustment (Schedule NJ-BUS-2, Line 10) 35 Total Exemptions and Deductions (Add Lines 29, 30, 31, 32, 33, and 34) 36 Taxable Income (Subtract Line 35 from Line 28) If zero or less, MAKE NO ENTRY 37a Total Property Taxes Paid (See instruction page 29) 37a 37b Fill in oval if you were a New Jersey homeowner on October 1, 2013 37c Property Tax Deduction (See instruction page 33) 38 NEW JERSEY TAXABLE INCOME (Subtract Line 37c from Line 36) If zero or less, MAKE NO ENTRY 39 TAX (From Tax Table, page 52) CONTINUE TO PAGE 3 14 15a 16 17 18 19a 20 21 22 23 24 25 26 27a 27b 27c 28 29 30 31 32 33 34 35 36 37c 38 39

NJ-1040 (2013) Page 3 Name(s) as shown on Form NJ-1040 40 TAX (From Line 39, page 2) 41 Credit For Income Taxes Paid to Other Jurisdictions Enter other jurisdiction code (See instructions) 42 Balance of Tax (Subtract Line 41 from Line 40) 43 Sheltered Workshop Tax Credit 44 Balance of Tax after Credit (Subtract Line 43 from Line 42) 45 Use Tax Due on Internet, Mail-Order, or Other Out-of-State Purchases (See Worksheet and instruction page 36) If no Use Tax, enter ZERO (000) 46 Penalty for Underpayment of Estimated Tax Fill in if Form NJ-2210 is enclosed 47 Total Tax and Penalty (Add Lines 44, 45, and 46) 48 Total New Jersey Income Tax Withheld (From enclosed Forms W-2 and 1099) 49 Property Tax Credit (See instruction page 33) 50 New Jersey Estimated Tax Payments/Credit from 2012 tax return 51 New Jersey Earned Income Tax Credit (See instruction page 38) Fill in Fill in oval if you had the IRS figure your Federal Earned Income Credit only one Fill in oval if you are a CU couple claiming the NJ Earned Income Tax Credit 52 EXCESS New Jersey UI/WF/SWF Withheld (See instr page 39) (Enclose Form NJ-2450) 53 EXCESS New Jersey Disability Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 54 EXCESS New Jersey Family Leave Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 55 Total Payments/Credits (Add Lines 48 through 54) 56 If Line 55 is LESS THAN Line 47, enter AMOUNT YOU OWE 56 Fill in if paying by e-check or credit card (Remember to enter check amount on Page 1) If you owe tax, you may make a donation by entering an amount on Lines 59, 60, 61, 62, 63, and/or 64 and adding this to your payment amount 57 If Line 55 is MORE THAN Line 47, enter OVERPAYMENT Deductions from Overpayment on Line 57 which you elect to credit to: 57 58 Your 2014 tax 58 59 NJ Endangered Wildlife Fund $10 $20 Other 60 NJ Children s Trust Fund To Prevent Child Abuse $10 $20 Other 61 NJ Vietnam Veterans Memorial Fund $10 $20 Other ENTER 62 NJ Breast Cancer AMOUNT Research Fund $10 $20 Other 63 USS New Jersey OF Educational Museum Fund $10 $20 Other CONTRIBUTION 64 Other Designated Contribution $10 $20 Other (See instruction page 40) 65 Total Deductions from Overpayment (Add Lines 58 through 64) 66 REFUND (Amount to be sent to you Subtract Line 65 from Line 57) 42 43 44 45 46 47 48 50 55 65 66 SIGN YOUR RETURN ON PAGE 1 40 41 49 51 52 53 54 59 60 61 62 63 64

of 51 NEW JERSEY TEST # 2 2006 (TY06) 400-00-6302

NJ-1040 2013 STATE OF NEW JERSEY INCOME TAX-RESIDENT RETURN 5R For Tax Year Jan-Dec 31, 2013, Or Other Tax Year Beginning, 2013, Month Ending, 20 IMPORTANT! YOU MUST ENTER YOUR SSN(s) Fill in if application for Federal extension is enclosed or enter confirmation # Last Name, First Name and Initial (Joint filers enter first name and initial of each - Enter spouse/cu partner last name ONLY if different) For Privacy Act Notification, See Instructions FILING STATUS Spouse s/cu Partner s Social Security Number Home Address (Number and Street, incl apt # or rural route) Change of Address County/Municipality Code (See Table p 50) City, Town, Post Office State Zip Code NJ RESIDENCY STATUS DEPENDENTS 1 Single GUBERNATORIAL ELECTIONS FUND If you were a New Jersey resident for ONLY part of the taxable year, give the period of New Jersey residency: From To (Fill in only one) 2 Married/CU Couple, filing joint return 3 Married/CU Partner, filing separate return Enter Spouse s/cu Partner s Social Security Number in the boxes above 4 Head of household 5 Qualifying widow(er)/ Surviving CU Partner EXEMPTIONS / / / / Do you wish to designate $1 of your taxes for this fund? Yes No If joint return, does your spouse/cu partner wish to designate $1? Yes No 11 12a 6 7 8 Place label on form if all preprinted information is correct Otherwise, print or type your name and address M M D D Y Y M M D D Y Y 6 Regular Yourself Spouse/ CU Partner Domestic Partner 7 Age 65 or Over Yourself Spouse/CU Partner 8 Blind or Disabled Yourself Spouse/CU Partner 9 Number of your qualified dependent children 10 Number of other dependents 11 Dependents attending colleges (See instr page 16) 12 Totals (For Line 12a - Add Lines 6, 7, 8, and 11) (For Line 12b - Add Lines 9 and 10) 13 Dependent s Last Name, Dependent s Social Security Number Birth Year First Name, Middle Initial a b c d ENTER NUMBERS HERE 9 10 12b Fill in oval if dependent does not have health insurance including NJ FamilyCare/ Medicaid, Medicare, private or other (see instructions) Note: if you fill in the Yes oval(s), it will not increase your tax or reduce your refund Under the penalties of perjury, I declare that I have examined this income tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete If prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge Your Signature Date Spouse s/cu Partner s Signature (if filing jointly, BOTH must sign) Date If enclosing copy of death certificate for deceased taxpayer, fill in (See instruction page 12) Check Amount (see Line 56) If you do not need forms mailed to you next year, fill in (See instruction page 14) I authorize the Division of Taxation to discuss my return and enclosures with my preparer (below) Paid Preparer s Signature Federal Identification Number Firm s Name Federal Employer Identification Number Pay amount on Line 56 in full Write Social Security number(s) on check or money order and make payable to: STATE OF NEW JERSEY - TGI Mail your return in the envelope provided and affix the appropriate mailing label If you have an amount due on Line 56, enclose your check and NJ-1040-V payment voucher with your return and use the label for PO Box 111 If not,use the label for PO Box 555 You may also pay by e-check or credit card See instruction page 11 Division Use 1 2 3 4 5 6 7

NJ-1040 (2013) Page 2 Name(s) as shown on Form NJ-1040 14 Wages, salaries, tips, and other employee compensation (Enclose W-2) Be sure to use State wages from Box 16 of your W-2(s) See instructions 15a Taxable interest income (See instructions) (Enclose Federal Schedule B if over $1,500) 15b Tax-exempt interest income (See instructions) (Enclose Schedule) DO NOT include on Line 15a 15b 16 Dividends 17 Net profits from business (Schedule NJ-BUS-1, Part I, Line 4) (Enclose copy of Federal Schedule C, Form 1040) 18 Net gains or income from disposition of property (Schedule B, Line 4) 19a Pensions, Annuities, and IRA Withdrawals (See instruction page 21) 19b Tax-exempt Pensions and Annuities 19b 20 Distributive Share of Partnership Income (Schedule NJ-BUS-1, Part II, Line 4) (See instruction page 24) (Enclose Schedule NJK-1 or Federal Schedule K-1) 21 Net pro rata share of S Corporation Income (Schedule NJ-BUS-1, Part III, Line 4) (See instruction page 25) (Enclose Schedule NJ-K-1 or Federal Schedule K-1) 22 Net gains or income from rents, royalties, patents & copyrights (Schedule NJ-BUS-1, Part IV, Line 4) 23 Net Gambling Winnings (See instruction page 25) 24 Alimony and separate maintenance payments received 25 Other (Enclose Schedule) (See instruction page 25) 26 Total Income (Add Lines 14, 15a, and 16 through 25) 27a Pension Exclusion (See instruction page 26) 27b Other Retirement Income Exclusion (See Worksheet and instr page 26) 27c Total Exclusion Amount (Add Line 27a and Line 27b) 28 New Jersey Gross Income (Subtract Line 27c from Line 26) (See instruction page 28) 29 Total Exemption Amount (See instruction page 31 to calculate amount) (Part-Year Residents see instruction page 7) 30 Medical Expenses (See Worksheet and instruction page 28) 31 Alimony and Separate Maintenance Payments 32 Qualified Conservation Contribution 33 Health Enterprise Zone Deduction 34 Alternative Business Calculation Adjustment (Schedule NJ-BUS-2, Line 10) 35 Total Exemptions and Deductions (Add Lines 29, 30, 31, 32, 33, and 34) 36 Taxable Income (Subtract Line 35 from Line 28) If zero or less, MAKE NO ENTRY 37a Total Property Taxes Paid (See instruction page 29) 37a 37b Fill in oval if you were a New Jersey homeowner on October 1, 2013 37c Property Tax Deduction (See instruction page 33) 38 NEW JERSEY TAXABLE INCOME (Subtract Line 37c from Line 36) If zero or less, MAKE NO ENTRY 39 TAX (From Tax Table, page 52) CONTINUE TO PAGE 3 14 15a 16 17 18 19a 20 21 22 23 24 25 26 27a 27b 27c 28 29 30 31 32 33 34 35 36 37c 38 39

NJ-1040 (2013) Page 3 Name(s) as shown on Form NJ-1040 40 TAX (From Line 39, page 2) 41 Credit For Income Taxes Paid to Other Jurisdictions Enter other jurisdiction code (See instructions) 42 Balance of Tax (Subtract Line 41 from Line 40) 43 Sheltered Workshop Tax Credit 44 Balance of Tax after Credit (Subtract Line 43 from Line 42) 45 Use Tax Due on Internet, Mail-Order, or Other Out-of-State Purchases (See Worksheet and instruction page 36) If no Use Tax, enter ZERO (000) 46 Penalty for Underpayment of Estimated Tax Fill in if Form NJ-2210 is enclosed 47 Total Tax and Penalty (Add Lines 44, 45, and 46) 48 Total New Jersey Income Tax Withheld (From enclosed Forms W-2 and 1099) 49 Property Tax Credit (See instruction page 33) 50 New Jersey Estimated Tax Payments/Credit from 2012 tax return 51 New Jersey Earned Income Tax Credit (See instruction page 38) Fill in Fill in oval if you had the IRS figure your Federal Earned Income Credit only one Fill in oval if you are a CU couple claiming the NJ Earned Income Tax Credit 52 EXCESS New Jersey UI/WF/SWF Withheld (See instr page 39) (Enclose Form NJ-2450) 53 EXCESS New Jersey Disability Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 54 EXCESS New Jersey Family Leave Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 55 Total Payments/Credits (Add Lines 48 through 54) 56 If Line 55 is LESS THAN Line 47, enter AMOUNT YOU OWE 56 Fill in if paying by e-check or credit card (Remember to enter check amount on Page 1) If you owe tax, you may make a donation by entering an amount on Lines 59, 60, 61, 62, 63, and/or 64 and adding this to your payment amount 57 If Line 55 is MORE THAN Line 47, enter OVERPAYMENT Deductions from Overpayment on Line 57 which you elect to credit to: 57 58 Your 2014 tax 58 59 NJ Endangered Wildlife Fund $10 $20 Other 60 NJ Children s Trust Fund To Prevent Child Abuse $10 $20 Other 61 NJ Vietnam Veterans Memorial Fund $10 $20 Other ENTER 62 NJ Breast Cancer AMOUNT Research Fund $10 $20 Other 63 USS New Jersey OF Educational Museum Fund $10 $20 Other CONTRIBUTION 64 Other Designated Contribution $10 $20 Other (See instruction page 40) 65 Total Deductions from Overpayment (Add Lines 58 through 64) 66 REFUND (Amount to be sent to you Subtract Line 65 from Line 57) 42 43 44 45 46 47 48 50 55 65 66 SIGN YOUR RETURN ON PAGE 1 40 41 49 51 52 53 54 59 60 61 62 63 64

NJ-630 9-09, R-20 State of New Jersey APPLICATION FOR EXTENSION OF TIME TO FILE NEW JERSEY GROSS INCOME TAX RETURN Before completing this application for an extension of time to file Form NJ-1040, NJ-1040NR, NJ-1080C or NJ-1041 please read the instructions on both sides Form NJ-630 is an application for extension of time to file, not an extension of time to pay the tax due To be eligible for an extension you must have paid, by the original due date of your return, either through withholdings, estimated payments, or a payment made with this form, at least 80% of the tax liability computed on the New Jersey Gross Income Tax Return when filed If the 80% requirement is not met, the extension will be retroactively denied and penalty and interest charges will be imposed from the original due date of the return This application must be submitted if: 1 You are applying for a six-month extension of time to file for New Jersey gross income tax purposes but you are not applying for a federal extension; or 2 You are required to remit payment to the New Jersey Division of Taxation by the original due date of the return in order to have at least 80% of your actual tax liability (as computed on the New Jersey Gross Income Tax Return when filed) paid Form NJ-630 must be filed no later than the original due date of the return if you are requesting a six-month extension or remitting a payment NOTE: Requests for a six-month extension without a required payment or with payment by credit card/e-check of additional tax may be filed online until 12 midnight, April 15, 2008, at: http://wwwstatenjus/treasury/ taxation/ BEFORE filing Form NJ-630 be sure to: 1 Detach at perforation, 2 Fill out all requested information on the application, 3 Make your check or money order payable to STATE OF NEW JERSEY TGI, 4 Write your social security number and the tax year on your check, and 5 Mail the application with your payment to the address on the face of the application This application need not be submitted if you have paid at least 80% of your final tax liability by the original due date, and you have applied for an automatic six-month extension for federal purposes and you enclose a copy of the federal application with the final New Jersey return when filed NJ-630-M 200 Application For Extension of Time To File New Jersey Gross Income Tax Return SOCIAL SECURITY NUMBER LAST NAME, FIRST NAME AND INITIAL STREET ADDRESS MAKE YOUR CHECK PAYABLE TO STATE OF NEW JERSEY - TGI WRITE YOUR SOCIAL SECURITY # AND TAX YEAR ON YOUR CHECK CITY, STATE, ZIP CODE RETURN THIS VOUCHER WITH YOUR PAYMENT I hereby request an extension of file the return as indicated below months, until to DATE Indicate the return the extension is being requested by checking the appropriate box State of New Jersey NJ-1040NR Division of Taxation R NJ-1040 N NJ-1080C F NJ-1041 Revenue Processing Center PO Box 282 Enter amount $,, Trenton, NJ 08646-0282 of payment here: 013990000000000000000007120600000000000

1 of 51 Test 400-00-6304 Forms: NJ-1040 Notes: Direct Deposit to Checking Routing Number (RTN): 253174576 Account Number: 26543210891 Field 315030 = "1" If Field 315030 is "Blank" Direct Deposit is blocked and refund will be by paper check Use PTIN: P00000004

NJ-1040 2013 STATE OF NEW JERSEY INCOME TAX-RESIDENT RETURN 5R For Tax Year Jan-Dec 31, 2013, Or Other Tax Year Beginning, 2013, Month Ending, 20 IMPORTANT! YOU MUST ENTER YOUR SSN(s) Fill in if application for Federal extension is enclosed or enter confirmation # Last Name, First Name and Initial (Joint filers enter first name and initial of each - Enter spouse/cu partner last name ONLY if different) For Privacy Act Notification, See Instructions FILING STATUS Spouse s/cu Partner s Social Security Number Home Address (Number and Street, incl apt # or rural route) Change of Address County/Municipality Code (See Table p 50) City, Town, Post Office State Zip Code NJ RESIDENCY STATUS DEPENDENTS 1 Single GUBERNATORIAL ELECTIONS FUND If you were a New Jersey resident for ONLY part of the taxable year, give the period of New Jersey residency: From To (Fill in only one) 2 Married/CU Couple, filing joint return 3 Married/CU Partner, filing separate return Enter Spouse s/cu Partner s Social Security Number in the boxes above 4 Head of household 5 Qualifying widow(er)/ Surviving CU Partner EXEMPTIONS / / / / Do you wish to designate $1 of your taxes for this fund? Yes No If joint return, does your spouse/cu partner wish to designate $1? Yes No 11 12a 6 7 8 Place label on form if all preprinted information is correct Otherwise, print or type your name and address M M D D Y Y M M D D Y Y 6 Regular Yourself Spouse/ CU Partner Domestic Partner 7 Age 65 or Over Yourself Spouse/CU Partner 8 Blind or Disabled Yourself Spouse/CU Partner 9 Number of your qualified dependent children 10 Number of other dependents 11 Dependents attending colleges (See instr page 16) 12 Totals (For Line 12a - Add Lines 6, 7, 8, and 11) (For Line 12b - Add Lines 9 and 10) 13 Dependent s Last Name, Dependent s Social Security Number Birth Year First Name, Middle Initial a b c d ENTER NUMBERS HERE 9 10 12b Fill in oval if dependent does not have health insurance including NJ FamilyCare/ Medicaid, Medicare, private or other (see instructions) Note: if you fill in the Yes oval(s), it will not increase your tax or reduce your refund Under the penalties of perjury, I declare that I have examined this income tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete If prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge Your Signature Date Spouse s/cu Partner s Signature (if filing jointly, BOTH must sign) Date If enclosing copy of death certificate for deceased taxpayer, fill in (See instruction page 12) Check Amount (see Line 56) If you do not need forms mailed to you next year, fill in (See instruction page 14) I authorize the Division of Taxation to discuss my return and enclosures with my preparer (below) Paid Preparer s Signature Federal Identification Number Firm s Name Federal Employer Identification Number Pay amount on Line 56 in full Write Social Security number(s) on check or money order and make payable to: STATE OF NEW JERSEY - TGI Mail your return in the envelope provided and affix the appropriate mailing label If you have an amount due on Line 56, enclose your check and NJ-1040-V payment voucher with your return and use the label for PO Box 111 If not,use the label for PO Box 555 You may also pay by e-check or credit card See instruction page 11 Division Use 1 2 3 4 5 6 7

NJ-1040 (2013) Page 2 Name(s) as shown on Form NJ-1040 14 Wages, salaries, tips, and other employee compensation (Enclose W-2) Be sure to use State wages from Box 16 of your W-2(s) See instructions 15a Taxable interest income (See instructions) (Enclose Federal Schedule B if over $1,500) 15b Tax-exempt interest income (See instructions) (Enclose Schedule) DO NOT include on Line 15a 15b 16 Dividends 17 Net profits from business (Schedule NJ-BUS-1, Part I, Line 4) (Enclose copy of Federal Schedule C, Form 1040) 18 Net gains or income from disposition of property (Schedule B, Line 4) 19a Pensions, Annuities, and IRA Withdrawals (See instruction page 21) 19b Tax-exempt Pensions and Annuities 19b 20 Distributive Share of Partnership Income (Schedule NJ-BUS-1, Part II, Line 4) (See instruction page 24) (Enclose Schedule NJK-1 or Federal Schedule K-1) 21 Net pro rata share of S Corporation Income (Schedule NJ-BUS-1, Part III, Line 4) (See instruction page 25) (Enclose Schedule NJ-K-1 or Federal Schedule K-1) 22 Net gains or income from rents, royalties, patents & copyrights (Schedule NJ-BUS-1, Part IV, Line 4) 23 Net Gambling Winnings (See instruction page 25) 24 Alimony and separate maintenance payments received 25 Other (Enclose Schedule) (See instruction page 25) 26 Total Income (Add Lines 14, 15a, and 16 through 25) 27a Pension Exclusion (See instruction page 26) 27b Other Retirement Income Exclusion (See Worksheet and instr page 26) 27c Total Exclusion Amount (Add Line 27a and Line 27b) 28 New Jersey Gross Income (Subtract Line 27c from Line 26) (See instruction page 28) 29 Total Exemption Amount (See instruction page 31 to calculate amount) (Part-Year Residents see instruction page 7) 30 Medical Expenses (See Worksheet and instruction page 28) 31 Alimony and Separate Maintenance Payments 32 Qualified Conservation Contribution 33 Health Enterprise Zone Deduction 34 Alternative Business Calculation Adjustment (Schedule NJ-BUS-2, Line 10) 35 Total Exemptions and Deductions (Add Lines 29, 30, 31, 32, 33, and 34) 36 Taxable Income (Subtract Line 35 from Line 28) If zero or less, MAKE NO ENTRY 37a Total Property Taxes Paid (See instruction page 29) 37a 37b Fill in oval if you were a New Jersey homeowner on October 1, 2013 37c Property Tax Deduction (See instruction page 33) 38 NEW JERSEY TAXABLE INCOME (Subtract Line 37c from Line 36) If zero or less, MAKE NO ENTRY 39 TAX (From Tax Table, page 52) CONTINUE TO PAGE 3 14 15a 16 17 18 19a 20 21 22 23 24 25 26 27a 27b 27c 28 29 30 31 32 33 34 35 36 37c 38 39

NJ-1040 (2013) Page 3 Name(s) as shown on Form NJ-1040 40 TAX (From Line 39, page 2) 41 Credit For Income Taxes Paid to Other Jurisdictions Enter other jurisdiction code (See instructions) 42 Balance of Tax (Subtract Line 41 from Line 40) 43 Sheltered Workshop Tax Credit 44 Balance of Tax after Credit (Subtract Line 43 from Line 42) 45 Use Tax Due on Internet, Mail-Order, or Other Out-of-State Purchases (See Worksheet and instruction page 36) If no Use Tax, enter ZERO (000) 46 Penalty for Underpayment of Estimated Tax Fill in if Form NJ-2210 is enclosed 47 Total Tax and Penalty (Add Lines 44, 45, and 46) 48 Total New Jersey Income Tax Withheld (From enclosed Forms W-2 and 1099) 49 Property Tax Credit (See instruction page 33) 50 New Jersey Estimated Tax Payments/Credit from 2012 tax return 51 New Jersey Earned Income Tax Credit (See instruction page 38) Fill in Fill in oval if you had the IRS figure your Federal Earned Income Credit only one Fill in oval if you are a CU couple claiming the NJ Earned Income Tax Credit 52 EXCESS New Jersey UI/WF/SWF Withheld (See instr page 39) (Enclose Form NJ-2450) 53 EXCESS New Jersey Disability Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 54 EXCESS New Jersey Family Leave Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 55 Total Payments/Credits (Add Lines 48 through 54) 56 If Line 55 is LESS THAN Line 47, enter AMOUNT YOU OWE 56 Fill in if paying by e-check or credit card (Remember to enter check amount on Page 1) If you owe tax, you may make a donation by entering an amount on Lines 59, 60, 61, 62, 63, and/or 64 and adding this to your payment amount 57 If Line 55 is MORE THAN Line 47, enter OVERPAYMENT Deductions from Overpayment on Line 57 which you elect to credit to: 57 58 Your 2014 tax 58 59 NJ Endangered Wildlife Fund $10 $20 Other 60 NJ Children s Trust Fund To Prevent Child Abuse $10 $20 Other 61 NJ Vietnam Veterans Memorial Fund $10 $20 Other ENTER 62 NJ Breast Cancer AMOUNT Research Fund $10 $20 Other 63 USS New Jersey OF Educational Museum Fund $10 $20 Other CONTRIBUTION 64 Other Designated Contribution $10 $20 Other (See instruction page 40) 65 Total Deductions from Overpayment (Add Lines 58 through 64) 66 REFUND (Amount to be sent to you Subtract Line 65 from Line 57) 42 43 44 45 46 47 48 50 55 65 66 SIGN YOUR RETURN ON PAGE 1 40 41 49 51 52 53 54 59 60 61 62 63 64

SCHEDULES A& B (Form NJ-1040) NEW JERSEY GROSS INCOME TAX 2012 Name(s) as shown on Form NJ-1040 Schedule A CREDIT FOR INCOME OR WAGE TAXES PAID TO OTHER JURISDICTION If you are claiming a credit for income taxes paid to more than one jurisdiction, a separate Schedule A must be enclosed for each See instructions page 41 A COPY OF OTHER STATE OR POLITICAL SUBDIVISION TAX RETURN MUST BE RETAINED WITH YOUR RECORDS 1 Income actually taxed by other jurisdiction during tax year (indicate name ) (DO NOT combine the same income taxed by more than one jurisdiction) (The amount on Line 1 cannot exceed the amount shown on Line 2) 1 2 Income subject to tax by New Jersey (From Line 28, Form NJ-1040) 2 3 Maximum Allowable Credit Percentage 1 (Divide Line 2 into Line 1) 2 3 % IF YOU ARE NOT ELIGIBLE FOR A PROPERTY TAX BENEFIT ONLY COMPLETE COLUMN B COLUMN A COLUMN B 4 Taxable Income (after Exemptions and Deductions) from Line 36, Form NJ-1040 4 4 5 Property Tax Enter in Box 5a the amount from Worksheet F, and Deduction line 1 See instructions page 34 5a Property tax deduction Enter the amount from Worksheet F, line 2 See instructions page 35 5 5-0 - 6 New Jersey Taxable Income (Line 4 minus Line 5) 6 6 7 Tax on Line 6 amount (From Tax Table or Tax Rate Schedules) 7 7 8 Allowable Credit (Line 3 times Line 7) 8 8 9 Credit for Enter in Box 9a the income or wage Taxes Paid to tax paid to other jurisdiction during Other tax year on income shown on Line 1 Jurisdiction See instructions page 43 9a Credit allowed (Enter lesser of Line 8 or Box 9a) (The credit may not exceed your New Jersey tax on Line 39) 9 9 If you are not eligible for a property tax benefit, enter the amount from Line 9, Column B, on Line 41, Form NJ-1040 Make no entry on Lines 37c or 49, Form NJ-1040 If you are eligible for a property tax benefit, you must complete Worksheet I on page 44 to determine whether you receive a greater benefit by claiming a property tax deduction or taking the property tax credit Schedule B NET GAINS OR INCOME FROM DISPOSITION OF PROPERTY List the net gains or income, less net loss, derived from the sale, exchange, or other disposition of property including real or personal whether tangible or intangible 1 a Kind of property and b Date c Date sold (Mo, d Gross ecost or other basis f Gain or description acquired day, yr) sales as adjusted (loss) (Mo, day, yr) price (see instructions) (d less e) and expense of sale 2 3 Capital Gains Distributions 2 Other Net Gains 3 4 Net Gains (Add Lines 1, 2, and 3) (Enter here and on Line 18 If loss enter ZERO here and make no entry on Line 18) 4 NOTE: For tax year 2012 and after, Schedule C, Net Gains or Income From Rents, Royalties, Patents, and Copyrights, has been eliminated from this page Use Part IV of Schedule NJ-BUS-1 (Form NJ-1040) to report that income Rev 9-12

1 of 51 NJ Tests Tax Year 2007 Test # 400-00-6305 Jennifer BROWN Forms: NJ-1040 TR-1040 Notes: Direct Deposit of Refund Type of account: Checking Routing Number: 123456780 Account Number: 1112225555 Use PTIN: P00000005

NJ-1040 2013 STATE OF NEW JERSEY INCOME TAX-RESIDENT RETURN 5R For Tax Year Jan-Dec 31, 2013, Or Other Tax Year Beginning, 2013, Month Ending, 20 IMPORTANT! YOU MUST ENTER YOUR SSN(s) Fill in if application for Federal extension is enclosed or enter confirmation # Last Name, First Name and Initial (Joint filers enter first name and initial of each - Enter spouse/cu partner last name ONLY if different) For Privacy Act Notification, See Instructions FILING STATUS Spouse s/cu Partner s Social Security Number Home Address (Number and Street, incl apt # or rural route) Change of Address County/Municipality Code (See Table p 50) City, Town, Post Office State Zip Code NJ RESIDENCY STATUS DEPENDENTS 1 Single GUBERNATORIAL ELECTIONS FUND If you were a New Jersey resident for ONLY part of the taxable year, give the period of New Jersey residency: From To (Fill in only one) 2 Married/CU Couple, filing joint return 3 Married/CU Partner, filing separate return Enter Spouse s/cu Partner s Social Security Number in the boxes above 4 Head of household 5 Qualifying widow(er)/ Surviving CU Partner EXEMPTIONS / / / / Do you wish to designate $1 of your taxes for this fund? Yes No If joint return, does your spouse/cu partner wish to designate $1? Yes No 11 12a 6 7 8 Place label on form if all preprinted information is correct Otherwise, print or type your name and address M M D D Y Y M M D D Y Y 6 Regular Yourself Spouse/ CU Partner Domestic Partner 7 Age 65 or Over Yourself Spouse/CU Partner 8 Blind or Disabled Yourself Spouse/CU Partner 9 Number of your qualified dependent children 10 Number of other dependents 11 Dependents attending colleges (See instr page 16) 12 Totals (For Line 12a - Add Lines 6, 7, 8, and 11) (For Line 12b - Add Lines 9 and 10) 13 Dependent s Last Name, Dependent s Social Security Number Birth Year First Name, Middle Initial a b c d ENTER NUMBERS HERE 9 10 12b Fill in oval if dependent does not have health insurance including NJ FamilyCare/ Medicaid, Medicare, private or other (see instructions) Note: if you fill in the Yes oval(s), it will not increase your tax or reduce your refund Under the penalties of perjury, I declare that I have examined this income tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete If prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge Your Signature Date Spouse s/cu Partner s Signature (if filing jointly, BOTH must sign) Date If enclosing copy of death certificate for deceased taxpayer, fill in (See instruction page 12) Check Amount (see Line 56) If you do not need forms mailed to you next year, fill in (See instruction page 14) I authorize the Division of Taxation to discuss my return and enclosures with my preparer (below) Paid Preparer s Signature Federal Identification Number Firm s Name Federal Employer Identification Number Pay amount on Line 56 in full Write Social Security number(s) on check or money order and make payable to: STATE OF NEW JERSEY - TGI Mail your return in the envelope provided and affix the appropriate mailing label If you have an amount due on Line 56, enclose your check and NJ-1040-V payment voucher with your return and use the label for PO Box 111 If not,use the label for PO Box 555 You may also pay by e-check or credit card See instruction page 11 Division Use 1 2 3 4 5 6 7

NJ-1040 (2013) Page 2 Name(s) as shown on Form NJ-1040 14 Wages, salaries, tips, and other employee compensation (Enclose W-2) Be sure to use State wages from Box 16 of your W-2(s) See instructions 15a Taxable interest income (See instructions) (Enclose Federal Schedule B if over $1,500) 15b Tax-exempt interest income (See instructions) (Enclose Schedule) DO NOT include on Line 15a 15b 16 Dividends 17 Net profits from business (Schedule NJ-BUS-1, Part I, Line 4) (Enclose copy of Federal Schedule C, Form 1040) 18 Net gains or income from disposition of property (Schedule B, Line 4) 19a Pensions, Annuities, and IRA Withdrawals (See instruction page 21) 19b Tax-exempt Pensions and Annuities 19b 20 Distributive Share of Partnership Income (Schedule NJ-BUS-1, Part II, Line 4) (See instruction page 24) (Enclose Schedule NJK-1 or Federal Schedule K-1) 21 Net pro rata share of S Corporation Income (Schedule NJ-BUS-1, Part III, Line 4) (See instruction page 25) (Enclose Schedule NJ-K-1 or Federal Schedule K-1) 22 Net gains or income from rents, royalties, patents & copyrights (Schedule NJ-BUS-1, Part IV, Line 4) 23 Net Gambling Winnings (See instruction page 25) 24 Alimony and separate maintenance payments received 25 Other (Enclose Schedule) (See instruction page 25) 26 Total Income (Add Lines 14, 15a, and 16 through 25) 27a Pension Exclusion (See instruction page 26) 27b Other Retirement Income Exclusion (See Worksheet and instr page 26) 27c Total Exclusion Amount (Add Line 27a and Line 27b) 28 New Jersey Gross Income (Subtract Line 27c from Line 26) (See instruction page 28) 29 Total Exemption Amount (See instruction page 31 to calculate amount) (Part-Year Residents see instruction page 7) 30 Medical Expenses (See Worksheet and instruction page 28) 31 Alimony and Separate Maintenance Payments 32 Qualified Conservation Contribution 33 Health Enterprise Zone Deduction 34 Alternative Business Calculation Adjustment (Schedule NJ-BUS-2, Line 10) 35 Total Exemptions and Deductions (Add Lines 29, 30, 31, 32, 33, and 34) 36 Taxable Income (Subtract Line 35 from Line 28) If zero or less, MAKE NO ENTRY 37a Total Property Taxes Paid (See instruction page 29) 37a 37b Fill in oval if you were a New Jersey homeowner on October 1, 2013 37c Property Tax Deduction (See instruction page 33) 38 NEW JERSEY TAXABLE INCOME (Subtract Line 37c from Line 36) If zero or less, MAKE NO ENTRY 39 TAX (From Tax Table, page 52) CONTINUE TO PAGE 3 14 15a 16 17 18 19a 20 21 22 23 24 25 26 27a 27b 27c 28 29 30 31 32 33 34 35 36 37c 38 39

NJ-1040 (2013) Page 3 Name(s) as shown on Form NJ-1040 40 TAX (From Line 39, page 2) 41 Credit For Income Taxes Paid to Other Jurisdictions Enter other jurisdiction code (See instructions) 42 Balance of Tax (Subtract Line 41 from Line 40) 43 Sheltered Workshop Tax Credit 44 Balance of Tax after Credit (Subtract Line 43 from Line 42) 45 Use Tax Due on Internet, Mail-Order, or Other Out-of-State Purchases (See Worksheet and instruction page 36) If no Use Tax, enter ZERO (000) 46 Penalty for Underpayment of Estimated Tax Fill in if Form NJ-2210 is enclosed 47 Total Tax and Penalty (Add Lines 44, 45, and 46) 48 Total New Jersey Income Tax Withheld (From enclosed Forms W-2 and 1099) 49 Property Tax Credit (See instruction page 33) 50 New Jersey Estimated Tax Payments/Credit from 2012 tax return 51 New Jersey Earned Income Tax Credit (See instruction page 38) Fill in Fill in oval if you had the IRS figure your Federal Earned Income Credit only one Fill in oval if you are a CU couple claiming the NJ Earned Income Tax Credit 52 EXCESS New Jersey UI/WF/SWF Withheld (See instr page 39) (Enclose Form NJ-2450) 53 EXCESS New Jersey Disability Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 54 EXCESS New Jersey Family Leave Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 55 Total Payments/Credits (Add Lines 48 through 54) 56 If Line 55 is LESS THAN Line 47, enter AMOUNT YOU OWE 56 Fill in if paying by e-check or credit card (Remember to enter check amount on Page 1) If you owe tax, you may make a donation by entering an amount on Lines 59, 60, 61, 62, 63, and/or 64 and adding this to your payment amount 57 If Line 55 is MORE THAN Line 47, enter OVERPAYMENT Deductions from Overpayment on Line 57 which you elect to credit to: 57 58 Your 2014 tax 58 59 NJ Endangered Wildlife Fund $10 $20 Other 60 NJ Children s Trust Fund To Prevent Child Abuse $10 $20 Other 61 NJ Vietnam Veterans Memorial Fund $10 $20 Other ENTER 62 NJ Breast Cancer AMOUNT Research Fund $10 $20 Other 63 USS New Jersey OF Educational Museum Fund $10 $20 Other CONTRIBUTION 64 Other Designated Contribution $10 $20 Other (See instruction page 40) 65 Total Deductions from Overpayment (Add Lines 58 through 64) 66 REFUND (Amount to be sent to you Subtract Line 65 from Line 57) 42 43 44 45 46 47 48 50 55 65 66 SIGN YOUR RETURN ON PAGE 1 40 41 49 51 52 53 54 59 60 61 62 63 64

of 51 NJ Tests Tax Year 2007 Test # 6 400-00-6306 Lucky, Tess L FORMS NJ-1040 NJ-2450 NJ Schedule B NJ Sch REFUND To Checking RTN 253174576 Account Number 26543333333 Use PTIN: P00000006

NJ-1040 2013 STATE OF NEW JERSEY INCOME TAX-RESIDENT RETURN 5R For Tax Year Jan-Dec 31, 2013, Or Other Tax Year Beginning, 2013, Month Ending, 20 IMPORTANT! YOU MUST ENTER YOUR SSN(s) Fill in if application for Federal extension is enclosed or enter confirmation # Last Name, First Name and Initial (Joint filers enter first name and initial of each - Enter spouse/cu partner last name ONLY if different) For Privacy Act Notification, See Instructions FILING STATUS Spouse s/cu Partner s Social Security Number Home Address (Number and Street, incl apt # or rural route) Change of Address County/Municipality Code (See Table p 50) City, Town, Post Office State Zip Code NJ RESIDENCY STATUS DEPENDENTS 1 Single GUBERNATORIAL ELECTIONS FUND If you were a New Jersey resident for ONLY part of the taxable year, give the period of New Jersey residency: From To (Fill in only one) 2 Married/CU Couple, filing joint return 3 Married/CU Partner, filing separate return Enter Spouse s/cu Partner s Social Security Number in the boxes above 4 Head of household 5 Qualifying widow(er)/ Surviving CU Partner EXEMPTIONS / / / / Do you wish to designate $1 of your taxes for this fund? Yes No If joint return, does your spouse/cu partner wish to designate $1? Yes No 11 12a 6 7 8 Place label on form if all preprinted information is correct Otherwise, print or type your name and address M M D D Y Y M M D D Y Y 6 Regular Yourself Spouse/ CU Partner Domestic Partner 7 Age 65 or Over Yourself Spouse/CU Partner 8 Blind or Disabled Yourself Spouse/CU Partner 9 Number of your qualified dependent children 10 Number of other dependents 11 Dependents attending colleges (See instr page 16) 12 Totals (For Line 12a - Add Lines 6, 7, 8, and 11) (For Line 12b - Add Lines 9 and 10) 13 Dependent s Last Name, Dependent s Social Security Number Birth Year First Name, Middle Initial a b c d ENTER NUMBERS HERE 9 10 12b Fill in oval if dependent does not have health insurance including NJ FamilyCare/ Medicaid, Medicare, private or other (see instructions) Note: if you fill in the Yes oval(s), it will not increase your tax or reduce your refund Under the penalties of perjury, I declare that I have examined this income tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete If prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge Your Signature Date Spouse s/cu Partner s Signature (if filing jointly, BOTH must sign) Date If enclosing copy of death certificate for deceased taxpayer, fill in (See instruction page 12) Check Amount (see Line 56) If you do not need forms mailed to you next year, fill in (See instruction page 14) I authorize the Division of Taxation to discuss my return and enclosures with my preparer (below) Paid Preparer s Signature Federal Identification Number Firm s Name Federal Employer Identification Number Pay amount on Line 56 in full Write Social Security number(s) on check or money order and make payable to: STATE OF NEW JERSEY - TGI Mail your return in the envelope provided and affix the appropriate mailing label If you have an amount due on Line 56, enclose your check and NJ-1040-V payment voucher with your return and use the label for PO Box 111 If not,use the label for PO Box 555 You may also pay by e-check or credit card See instruction page 11 Division Use 1 2 3 4 5 6 7

NJ-1040 (2013) Page 2 Name(s) as shown on Form NJ-1040 14 Wages, salaries, tips, and other employee compensation (Enclose W-2) Be sure to use State wages from Box 16 of your W-2(s) See instructions 15a Taxable interest income (See instructions) (Enclose Federal Schedule B if over $1,500) 15b Tax-exempt interest income (See instructions) (Enclose Schedule) DO NOT include on Line 15a 15b 16 Dividends 17 Net profits from business (Schedule NJ-BUS-1, Part I, Line 4) (Enclose copy of Federal Schedule C, Form 1040) 18 Net gains or income from disposition of property (Schedule B, Line 4) 19a Pensions, Annuities, and IRA Withdrawals (See instruction page 21) 19b Tax-exempt Pensions and Annuities 19b 20 Distributive Share of Partnership Income (Schedule NJ-BUS-1, Part II, Line 4) (See instruction page 24) (Enclose Schedule NJK-1 or Federal Schedule K-1) 21 Net pro rata share of S Corporation Income (Schedule NJ-BUS-1, Part III, Line 4) (See instruction page 25) (Enclose Schedule NJ-K-1 or Federal Schedule K-1) 22 Net gains or income from rents, royalties, patents & copyrights (Schedule NJ-BUS-1, Part IV, Line 4) 23 Net Gambling Winnings (See instruction page 25) 24 Alimony and separate maintenance payments received 25 Other (Enclose Schedule) (See instruction page 25) 26 Total Income (Add Lines 14, 15a, and 16 through 25) 27a Pension Exclusion (See instruction page 26) 27b Other Retirement Income Exclusion (See Worksheet and instr page 26) 27c Total Exclusion Amount (Add Line 27a and Line 27b) 28 New Jersey Gross Income (Subtract Line 27c from Line 26) (See instruction page 28) 29 Total Exemption Amount (See instruction page 31 to calculate amount) (Part-Year Residents see instruction page 7) 30 Medical Expenses (See Worksheet and instruction page 28) 31 Alimony and Separate Maintenance Payments 32 Qualified Conservation Contribution 33 Health Enterprise Zone Deduction 34 Alternative Business Calculation Adjustment (Schedule NJ-BUS-2, Line 10) 35 Total Exemptions and Deductions (Add Lines 29, 30, 31, 32, 33, and 34) 36 Taxable Income (Subtract Line 35 from Line 28) If zero or less, MAKE NO ENTRY 37a Total Property Taxes Paid (See instruction page 29) 37a 37b Fill in oval if you were a New Jersey homeowner on October 1, 2013 37c Property Tax Deduction (See instruction page 33) 38 NEW JERSEY TAXABLE INCOME (Subtract Line 37c from Line 36) If zero or less, MAKE NO ENTRY 39 TAX (From Tax Table, page 52) CONTINUE TO PAGE 3 14 15a 16 17 18 19a 20 21 22 23 24 25 26 27a 27b 27c 28 29 30 31 32 33 34 35 36 37c 38 39

NJ-1040 (2013) Page 3 Name(s) as shown on Form NJ-1040 40 TAX (From Line 39, page 2) 41 Credit For Income Taxes Paid to Other Jurisdictions Enter other jurisdiction code (See instructions) 42 Balance of Tax (Subtract Line 41 from Line 40) 43 Sheltered Workshop Tax Credit 44 Balance of Tax after Credit (Subtract Line 43 from Line 42) 45 Use Tax Due on Internet, Mail-Order, or Other Out-of-State Purchases (See Worksheet and instruction page 36) If no Use Tax, enter ZERO (000) 46 Penalty for Underpayment of Estimated Tax Fill in if Form NJ-2210 is enclosed 47 Total Tax and Penalty (Add Lines 44, 45, and 46) 48 Total New Jersey Income Tax Withheld (From enclosed Forms W-2 and 1099) 49 Property Tax Credit (See instruction page 33) 50 New Jersey Estimated Tax Payments/Credit from 2012 tax return 51 New Jersey Earned Income Tax Credit (See instruction page 38) Fill in Fill in oval if you had the IRS figure your Federal Earned Income Credit only one Fill in oval if you are a CU couple claiming the NJ Earned Income Tax Credit 52 EXCESS New Jersey UI/WF/SWF Withheld (See instr page 39) (Enclose Form NJ-2450) 53 EXCESS New Jersey Disability Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 54 EXCESS New Jersey Family Leave Insurance Withheld (See instr page 39) (Enclose Form NJ-2450) 55 Total Payments/Credits (Add Lines 48 through 54) 56 If Line 55 is LESS THAN Line 47, enter AMOUNT YOU OWE 56 Fill in if paying by e-check or credit card (Remember to enter check amount on Page 1) If you owe tax, you may make a donation by entering an amount on Lines 59, 60, 61, 62, 63, and/or 64 and adding this to your payment amount 57 If Line 55 is MORE THAN Line 47, enter OVERPAYMENT Deductions from Overpayment on Line 57 which you elect to credit to: 57 58 Your 2014 tax 58 59 NJ Endangered Wildlife Fund $10 $20 Other 60 NJ Children s Trust Fund To Prevent Child Abuse $10 $20 Other 61 NJ Vietnam Veterans Memorial Fund $10 $20 Other ENTER 62 NJ Breast Cancer AMOUNT Research Fund $10 $20 Other 63 USS New Jersey OF Educational Museum Fund $10 $20 Other CONTRIBUTION 64 Other Designated Contribution $10 $20 Other (See instruction page 40) 65 Total Deductions from Overpayment (Add Lines 58 through 64) 66 REFUND (Amount to be sent to you Subtract Line 65 from Line 57) 42 43 44 45 46 47 48 50 55 65 66 SIGN YOUR RETURN ON PAGE 1 40 41 49 51 52 53 54 59 60 61 62 63 64

SCHEDULES A& B (Form NJ-1040) NEW JERSEY GROSS INCOME TAX 2012 Name(s) as shown on Form NJ-1040 Schedule A CREDIT FOR INCOME OR WAGE TAXES PAID TO OTHER JURISDICTION If you are claiming a credit for income taxes paid to more than one jurisdiction, a separate Schedule A must be enclosed for each See instructions page 41 A COPY OF OTHER STATE OR POLITICAL SUBDIVISION TAX RETURN MUST BE RETAINED WITH YOUR RECORDS 1 Income actually taxed by other jurisdiction during tax year (indicate name ) (DO NOT combine the same income taxed by more than one jurisdiction) (The amount on Line 1 cannot exceed the amount shown on Line 2) 1 2 Income subject to tax by New Jersey (From Line 28, Form NJ-1040) 2 3 Maximum Allowable Credit Percentage 1 (Divide Line 2 into Line 1) 2 3 % IF YOU ARE NOT ELIGIBLE FOR A PROPERTY TAX BENEFIT ONLY COMPLETE COLUMN B COLUMN A COLUMN B 4 Taxable Income (after Exemptions and Deductions) from Line 36, Form NJ-1040 4 4 5 Property Tax Enter in Box 5a the amount from Worksheet F, and Deduction line 1 See instructions page 34 5a Property tax deduction Enter the amount from Worksheet F, line 2 See instructions page 35 5 5-0 - 6 New Jersey Taxable Income (Line 4 minus Line 5) 6 6 7 Tax on Line 6 amount (From Tax Table or Tax Rate Schedules) 7 7 8 Allowable Credit (Line 3 times Line 7) 8 8 9 Credit for Enter in Box 9a the income or wage Taxes Paid to tax paid to other jurisdiction during Other tax year on income shown on Line 1 Jurisdiction See instructions page 43 9a Credit allowed (Enter lesser of Line 8 or Box 9a) (The credit may not exceed your New Jersey tax on Line 39) 9 9 If you are not eligible for a property tax benefit, enter the amount from Line 9, Column B, on Line 41, Form NJ-1040 Make no entry on Lines 37c or 49, Form NJ-1040 If you are eligible for a property tax benefit, you must complete Worksheet I on page 44 to determine whether you receive a greater benefit by claiming a property tax deduction or taking the property tax credit Schedule B NET GAINS OR INCOME FROM DISPOSITION OF PROPERTY List the net gains or income, less net loss, derived from the sale, exchange, or other disposition of property including real or personal whether tangible or intangible 1 a Kind of property and b Date c Date sold (Mo, d Gross ecost or other basis f Gain or description acquired day, yr) sales as adjusted (loss) (Mo, day, yr) price (see instructions) (d less e) and expense of sale 2 3 Capital Gains Distributions 2 Other Net Gains 3 4 Net Gains (Add Lines 1, 2, and 3) (Enter here and on Line 18 If loss enter ZERO here and make no entry on Line 18) 4 NOTE: For tax year 2012 and after, Schedule C, Net Gains or Income From Rents, Royalties, Patents, and Copyrights, has been eliminated from this page Use Part IV of Schedule NJ-BUS-1 (Form NJ-1040) to report that income Rev 9-12