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Send Friend (23) FDFRNDOL-1WV 1. Send a friend to us. We'll thank you both with cash! 5 for you. 1 to your friend! Easy-to-follow instructions: 1. Give one of the forms below to a friend and make copies to refer more friends.* 2. Have your friend go online to hrblock.com/friend to prepare his taxes, or have him fill out the form and bring it to a participating H&R Block office. 3. For each friend you refer who files his taxes through H&R Block, we'll send both of you a check. Thanks for choosing H&R Block and referring your friends. Act today and get paid! *You are eligible to receive 5 for each new client you refer to H&R Block, when that person purchases online tax preparation services from H&R Block between 1/1/24 and 4/15/24. Limit five referrals per person and limit one referral award per federal tax return. Offer valid only for new H&R Block referrals who are US residents that prepare their taxes at hrblock.com/friend or at participating H&R Block offices in the United States. Offer is not valid for office clients when referred client files taxes prior to or on the same day as the client making the referral. Any referred client who used H&R Block tax preparation services for the prior year tax return or who is filing an amended return is ineligible. For office referrals, the certificate must be presented to H&R Block prior to completion of initial tax preparation interview. H&R Block associates are not eligible to receive referrals. Allow approximately 8 weeks for delivery of check. This offer may not be combined with any other gift or referral offer. Offer expires 4/15/24. Do It Yourself 1. Visit hrblock.com/friend. 2. Choose your online tax program. 3. File your taxes through hrblock.com/friend or at your local H&R Block office and get paid! Please mail 5 to: R WYATT & S LOVE 86 CRESC APT 2A JOHNSTON IA 5131 Do your taxes online with H&R Block. As a new online client you'll get 1! Your friend who gave you this form will get 5! Your Tax Pro: Or have H&R Block prepare your taxes for you. Visit hrblock.com/friend for details and office locations, or call 1-8-HRBLOCK. FILL IN YOUR INFORMATION BELOW. (Please print.) Last Name Address First MI Client ID C26F763243B44318BA4D9989A9356DF City State Zip Code For office use: For office use: District ID Office ID Tax Pro ID District ID Office ID Tax Pro ID *You are eligible to receive 5 for each new client you refer to H&R Block, when that person purchases online tax preparation services from H&R Block between 1/1/24 and 4/15/24. Limit five referrals per person and limit one referral award per federal tax return. Offer valid only for new H&R Block referrals who are US residents that prepare their taxes at hrblock.com/friend or at participating H&R Block offices in the United States. Offer is not valid for office clients when referred client files taxes prior to or on the same day as the client making the referral. Any referred client who used H&R Block tax preparation services for the prior year tax return or who is filing an amended return is ineligible. For office referrals, the certificate must be presented to H&R Block prior to completion of initial tax preparation interview. H&R Block associates are not eligible to receive referrals. Allow approximately 8 weeks for delivery of check. This offer may not be combined with any other gift or referral offer. Offer expires 4/15/24. Do It Yourself 1. Visit hrblock.com/friend. 2. Choose your online tax program. 3. File your taxes through hrblock.com/friend or at your local H&R Block office and get paid! Please mail 5 to: Your Tax Pro: R WYATT & S LOVE 86 CRESC APT 2A JOHNSTON IA 5131 Do your taxes online with H&R Block. As a new online client you'll get 1! Your friend who gave you this form will get 5! Or have H&R Block prepare your taxes for you. Visit hrblock.com/friend for details and office locations, or call 1-8-HRBLOCK. FILL IN YOUR INFORMATION BELOW. (Please print.) Last Name Address First MI Client ID C26F763243B44318BA4D9989A9356DF City State Zip Code For office use: For office use: District ID Office ID Tax Pro ID District ID Office ID Tax Pro ID *You are eligible to receive 5 for each new client you refer to H&R Block, when that person purchases online tax preparation services from H&R Block between 1/1/24 and 4/15/24. Limit five referrals per person and limit one referral award per federal tax return. Offer valid only for new H&R Block referrals who are US residents that prepare their taxes at hrblock.com/friend or at participating H&R Block offices in the United States. Offer is not valid for office clients when referred client files taxes prior to or on the same day as the client making the referral. Any referred client who used H&R Block tax preparation services for the prior year tax return or who is filing an amended return is ineligible. For office referrals, the certificate must be presented to H&R Block prior to completion of initial tax preparation interview. H&R Block associates are not eligible to receive referrals. Allow approximately 8 weeks for delivery of check. This offer may not be combined with any other gift or referral offer. Offer expires 4/15/24.

Advantage (23) FDADVICE-1WV 1. prepared for: RICHARD S. WYATT STACEY L. LOVE date prepared: 2/2/24 Today's Savings Taking advantage of the Saver's Credit this year saved you 7 in taxes. Claiming the child tax credit for you this year helped you reduce your federal taxes by 1,. By participating in a qualified retirement plan through your employer, we calculated that you saved 15 in taxes this year because you funded the plan with pretax dollars. Filing, Refund and Balance Due Information Tax Return e-file / Mail To Federal See the Filing Checklist for mailing instructions. Refund / (Balance Due) Summary 1,751. Refund/(Bal Due) 1,751. Iowa See the Filing Checklist for mailing instructions. 86. Refund/(Bal Due) 86.

Advantage (23) FDADVICE-2WV 1. Looking Ahead - Opportunities and Advice IRA Rollover: When you leave an employer, it's important to preserve the retirement savings you accumulated while employed there. Check with your former employer to find out whether you'll have to take a mandatory withdrawal by a certain date. If so, you'll need to roll over those funds into a new retirement plan to avoid paying taxes and penalties to the IRS. Roth IRA Contributions: Consider opening a Roth IRA. You can contribute up to 3, each year. Unlike a traditional IRA, contributions aren't deductible, but you can withdraw your contributions at any time without paying taxes or penalties (although the earnings will be taxed). And after five years, you can withdraw your earnings -- free from taxes and penalties -- if you use the money to buy a first home or you're over 59 1/2. Saving for Education: Education Savings Accounts (ESAs) allow you to save for elementary, secondary, or post-secondary education expenses. Section 529 plans, on the other hand, can only be used to pay higher education costs. But they can offer immediate state tax savings. Both plans allow tax-free withdrawals for qualified education expenses and can be started for as little as 25 a month. Getting Your Refund All Year: Congratulations! You're getting a big refund. You're pleased because you can use the money. Uncle Sam is pleased, too, because you've loaned him all that money interest-free for 12 months. If you'd rather get more in each paycheck, adjust your withholding so that you get a smaller refund at tax time but more money every payday. Fill out a new Form W-4 to give to your employer. Keep Track of Your Charitable Contributions: Even though you didn't itemize your deductions this year-and might not next year-it could pay to keep track of your cash and non-cash contributions to charity. That's because Congress is considering a new tax rule that will let every taxpayer take a tax deduction for charitable donations-even if you don't itemize your deductions. If that does become law, you'll be glad you kept track of what you gave to charity. Emergency Cash Reserves: You should have at least 9 days worth of net income set aside to pay for unexpected expenses. save 26 each month, at the end of two years you will have saved your 9 days worth, 4,936. If you Start Saving Now: The sooner you start saving, the more time you'll have for your nest egg to grow. If you set aside just 5 each month at an interest rate of 4%, you would have nearly 3,4 after five years. Keep doing this for 25 years, and you'll have nearly 26,. Put the same money aside in a tax-deferred account such as an IRA, and you'll get even more bang for your bucks. Borrowing from Your 41(k): If your employer permits it, you can borrow up to 5% of the value of your 41(k) account tax-free if you repay the loan within 5 years. You can take longer to repay the loan if you use it to buy a principal residence. Employers who permit this-and it's up to the employer-will usually set up a payroll withdrawal plan to repay the loan. But beware: if you leave that employer before you pay the loan off, the IRS will tax and penalize the outstanding balance. For more information about tax, mortgage and financial services call 1-8-HRBLOCK or visit hrblock.com.

Client Sum (23) FDBASUM-1WV 1. 23 Tax Return Summary Federal Year over Year Comparison INCOME Year 23 Year 22 Wages, salaries, tips 39,82 Total income 39,82 Change() 39,82 39,82 ADJUSTED GROSS INCOME Total income less total adjustments 39,82 39,82 TAABLE INCOME Standard deductions 9,5 9,5 Exemptions 9,15 9,15 Taxable income 21,152 21,152 TA COMPUTATION Income tax 2,476 2,476 Tax before credits 2,476 2,476 CREDITS Retirement savings contribution 7 7 Child tax credit 1, 1, Total credits 1,7 1,7 Tax after credits 1,46 1,46 OTHER TAES Total tax 1,46 1,46 PAYMENTS Federal withholding 3,157 3,157 Total payments 3,157 3,157 REFUND Overpayment Refund due 1,751 1,751 1,751 1,751 OTHER COMPUTATIONS Alternative minimum taxable income Marginal tax bracket Effective tax bracket Filing status 39,82 15% 4% Married Filing Jointly 39,82 For more information about tax, mortgage and financial services call 1-8-HRBLOCK or visit hrblock.com.

Client Sum (23) FDBASUM-2WV 1. Client Services Name Date of Birth RICHARD S. WYATT July 28, 1978 STACEY L. LOVE September 9, 1983 EMMA WYATT November 27, 23 SSN 481-8-5573 482-6-892 483-33-9733 Relationship SELF N/A SPOUSE N/A DAUGHTER 12 Number of Months Supported For more information about tax, mortgage and financial services call 1-8-HRBLOCK or visit hrblock.com.

8453OL(D) (23) FD8453OD-1WV 1. Declaration Control Number (DCN) 3 Perjury Statement - knowledge and belief, it is true, correct, and complete. I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send my return/form to IRS and to receive the following information from IRS: 1) acknowledgment of receipt or reason for rejection of transmission; 2) refund offset; 3) reason for any delay in processing or refund; and, 4) date of any refund. - Under penalties of perjury, I declare that I have examined this return, including any accompanying statements and schedules and, to the best of my Consent to Disclosure RICHARD S. WYATT STACEY L. LOVE Tax Return Signature/Consent to Disclosure On-Line Self Select PIN without Direct Debit I am signing this Tax Return and Electronic Funds Withdrawal Consent, if applicable, by entering my Self Select PIN below. Taxpayer's PIN: Taxpayer's Date of Birth: Taxpayer's Prior Year Adjusted Gross Income: Spouse's PIN: Spouse's Date of Birth: Spouse's Prior Year Adjusted Gross Income: 9831 7/28/1978 4,544 9832 9/9/1983 4,544 Date: 2/2/24 Rev 8/15/22

8453D (23) IA8453D-1WV 12 Name: RICHARD S WYATT & STACEY L LOVE SSN: 481-8-5573 Iowa Direct Deposit Information Name of financial institution(s) Routing Transit Number (RTN) Depositor Account Number (DAN) Type of Account 27373848 123483 Checking

personalized tax filing advice for: RICHARD S WYATT STACEY L LOVE This checklist has been customized for you based on the method you're using to file your 23 tax return. The statements below are designed to help guide you through the steps you will take to file your return. filing checklist for your 23 federal tax return Prepared On: 2/2/24 Return Prepared: 14A quick summary Gross Income Adjusted Gross Income Total Deductions Total Taxable Income 39,82 39,82 18,65 21,152 Total Tax Total Payments Refund Amount Amount You Owe 1,46 3,157 1,751 to file your 23 federal tax return, simply follow these instructions STEP 1 - Once your e-filed return has been accepted, you will receive an e-mail STEP 2 - Keep a copy Print a copy of the return for your records. Please attach a copy of each W-2, W-2G, 199G and 199R to your return. NOTE: Since you are filing your return electronically and you chose to use an electronic signature, you do not mail your return. For more information about tax, mortgage and financial services call 1-8-HRBLOCK or visit hrblock.com

14A (23) FD14A-1WV 18 Form 14A Label (See page 19.) Use the IRS label. Otherwise, please print or type. Presidential Election Campaign (See page 2.) Filing Status Check only one box. Exemptions If more than six dependents, see page 21. 1 2 3 Department of the Treasury - Internal Revenue Service U.S. Individual Income Tax Return RICHARD S WYATT STACEY L LOVE 86 CRESCENT CHASE JOHNSTON, IA 5131 6a b c Note. Checking "Yes" will not change your tax or reduce your refund. Do you, or your spouse if filing a joint return, want 3 to go to this fund? Single Married filing jointly (even if only one had income) Married filing separately. Enter spouse's SSN above & full name below. Yourself. Spouse Dependents: (1) First name If your parent (or someone else) can claim you as a dependent on his or her tax return, do not check box 6a. Last name APT. 2A (99) IRS Use Only - Do not write or staple in this space. (2) Dependent's social security number 481-8-5573 482-6-892 Important! If the qualifying person is a child but not your dependent, enter this child's name here. (3) Dependent's relationship to you (4) if qual. child for child tax cr. (see pg 23) EMMA WYATT 483-33-9733DAUGHTER 4 5 23 OMB No. 1545-85 Your social security number Spouse's social security number You must enter your SSN(s) above. You Yes No Spouse Head of household (with qualifying person). (See page 2.) Qualifying widow(er) with dependent child (See page 21.) No. of boxes checked on 6a and 6b No. of children on 6c who: lived with you Yes did not live with you due to divorce or separation (see page 23) Dependents on 6c not entered above No 2 1 d Total number of exemptions claimed. Add numbers on lines above 3 Income 7 Wages, salaries, tips, etc. 7 39,82. Attach Form(s) W-2 here. Also attach Form(s) 199-R if tax was withheld. If you did not get a W-2, see page 24. Enclose, but do not attach, any payment. 8a b 9a b 1a b 11a 12a 13 14a Taxable interest. Attach Schedule 1 if required. Tax- exempt interest. Do not include on line 8a. 8b Ordinary dividends. Attach Schedule 1 if required. Qualified dividends (see page 25.) 9b Capital gain distributions (see page 25). Post-May 5 capital gain distributions (see page 25). 1b IRA 11b Taxable amount distributions. 11a (see page 25). Pensions and 12b Taxable amount annuities. 12a (see page 26). Unemployment compensation and Alaska Permanent Fund dividends. Social security 14b Taxable amount benefits. 14a (see page 28). 8a 9a 1a 11b 12b 13 14b Adjusted gross income 15 16 17 18 19 2 Add lines 7 through 14b (far right column). This is your total income. Educator expenses (see page 28). IRA deduction (see page 28). Student loan interest deduction (see page 31). Tuition and fees deduction (see page 31). Add lines 16 through 19. These are your total adjustments. 16 17 18 19 15 2 39,82. 21 Subtract line 2 from line 15. This is your adjusted gross income. KBA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 57. 21 39,82. Form 14A (23)

14A (23) FD14A-2WV 18 Form 14A (23) Tax, credits, and payments Standard Deduction for People who checked any box on line 23a or 23b or who can be claimed as a dependent, see page 32. All others: Single or Married filing separately, 4,75 Married filing jointly or Qualifying widow(er), 9,5 Head of household, 7, If you have a qualifying child, attach Schedule EIC. Refund Direct deposit? See page 5 and fill in 45b, 45c, and 45d. Amount you owe Third party designee Sign here Joint return? See page 2. Keep a copy for your records. Paid preparer's use only RICHARD S WYATT & STACEY L LOVE 22 23a 24 25 26 27 28 29 3 31 32 33 34 35 36 37 38 39 4 41 42 43 44 46 47 48 b 45a Enter the amount from line 21 (adjusted gross income). Check if: If you are married filing separately and your spouse itemizes deductions, see page 32 and check here Enter your standard deduction (see left margin). Subtract line 26 from line 25. If line 26 is more than line 25, enter --. Attach Schedule 2. Schedule 3. Retirement savings contributions credit. Attach Child tax credit (see page 37). Adoption credit. Attach Form 8839. Add lines 29 through 34. These are your total credits. Subtract line 35 from line 28. If line 35 is more than line 28, enter --. Advance earned income credit payments from Form(s) W-2. Add lines 36 and 37. This is your total tax. Federal income tax withheld from Forms W-2 and 199. 23 estimated tax payments and amount applied from 22 return. Earned income credit (EIC). Designee's name 27373848 123483 Phone no. TECHNICAL BARISTA 7. 1,. 3,157. 481-8-5573 Page 2 39,82. Personal ID 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 the taxpayer) is based on all information of which the preparer has any knowledge. Preparer's signature Firm's name (or yours if self-employed), address, and ZIP code Spouse was born before January 2, 1939, Subtract line 24 from line 22. If line 24 is more than line 22, enter --. This is your taxable income. Tax, including any alternative minimum tax (see page 33). Date Date Blind Multiply 3,5 by the total number of exemptions claimed on line 6d. Credit for child and dependent care expenses. Credit for the elderly or the disabled. Attach Education credits. Attach Form 8863. Form 888. Additional child tax credit. Attach Form 8812. Add lines 39 through 42. These are your total payments. If line 43 is more than line 38, subtract line 38 from line 43. This is the amount you overpaid. Amount of line 44 you want refunded to you. b Routing number d Account number Amount of line 44 you want applied to your 24 estimated tax. Amount you owe. Subtract line 43 from line 38. For details on how to pay, see page 51. Your signature You were born before January 2, 1939, Estimated tax penalty (see page 52). Spouse's signature. If a joint return, both must sign. c Type: Date Blind Do you want to allow another person to discuss this return with the IRS (see page 52)? For Info Only-Do not file For Info Only-Do not file 29 3 31 32 33 34 39 4 41 42 Checking 46 48 Total boxes checked Your occupation 23a 23b Savings Spouse's occupation Check if self-employed EIN 22 24 25 26 27 28 35 36 37 38 43 44 45a 47 Yes. Complete the following. Phone no. 9,5. 3,32. 9,15. 21,152. 2,476. 1,7. 1,46. 1,46. 3,157. 1,751. 1,751. Daytime phone number Preparer's SSN or PTIN No Form 14A (23)

888 (23) FD888-1WV 1. Form 888 Credit for Qualified Retirement Savings Contributions OMB No. 1545-185 Department of the Treasury Internal Revenue Service Name(s) shown on return Attach to Form 14 or Form 14A. See instructions on page 2. Attachment Sequence No. 129 Your social security number RICHARD S WYATT & STACEY L LOVE 481-8-5573 1 2 3 4 5 You cannot take this credit if either of the following applies. The amount on Form 14, line 35, or Form 14A, line 22, is more than 25, (37,5 if head of household; 5, if married filing jointly). The person(s) who made the qualified contribution or elective deferral (a) was born after January 1,1986. (b) is claimed as a dependent on someone else's 23 tax return, or (c) was a student (see instructions). Traditional and Roth IRA contributions for 23. Do not include rollover contributions Elective deferrals to a 41(k) or other qualified employer plan, voluntary employee contributions, and 51(c)(18)(D) plan contributions for 23 (see instructions) Add lines 1 and 2 Certain distributions received after 2 and before the due date (including extensions) of your 23 tax return (see instructions). If married filing jointly, include both spouses' amounts in both columns. See instructions for an exception Subtract line 4 from line 3. If zero or less, enter -- 1 2 3 4 5 (a) You 7 7 7 (b) Your spouse 6 In each column, enter the smaller of line 5 or 2, 6 7 7 Add the amounts on line 6. If zero, stop; you cannot take this credit 7 7 8 Enter the amount from Form 14, line 35*, or Form 14A, line 22 8 39,82 9 Enter the applicable decimal amount shown below: If line 8 is - And your filing status is - Over - Married Head of Single, Married filing But not filing jointly household separately, or over- Enter on line 9 - Qualifying widow(er) --- 15, 15, 16,25 22,5 24,375 25, 3, 32,5 37,5 5, 16,25 22,5 24,375 25, 3, 32,5 37,5 5, ---.2..2...2..... 9 Note: If line 9 is zero, stop; you cannot take this credit. 1 11 12 13 14 Multiply line 7 by line 9 Enter the amount from Form 14, line 43, or Form 14A, line 28 11 Enter the total of your credits from Form 14, lines 44 through 47, or Form 14A, lines 29 through 31 12 Subtract line 12 from line 11. If zero, stop; you cannot take the credit Credit for qualified retirement savings contributions. Enter the smaller of line 1 or line 13 here and on Form 14, line 48, or Form 14A, line 32 2,476 1 13 14 7 2,476 7 KBA *See Pub. 59 for the amount to enter if you are filing Form 2555, 2555-EZ, or 4563 or you are excluding income from Puerto Rico. For Paperwork Reduction Act Notice, see page 2 of form. Form 888 (23)

personalized tax filing advice for: RICHARD S WYATT STACEY L LOVE This checklist has been customized for you based on the method you're using to file your 23 tax return. The statements below are designed to help guide you through the steps you will take to file your return. filing checklist for your 23 tax return Prepared On: 2/2/24 Return Prepared: IA Form IA 14 quick summary Gross Income Adjusted Gross Income Total Deductions Total Taxable Income 39,82 3,83 33,41 Total Tax Total Payments Refund Amount Amount You Owe 1,682 1,768 86 to file your 23 tax return, simply follow these instructions PLEASE PROCEED TO THE NET STEP This step does not apply to you and your tax return. Step 1 - PLEASE PROCEED TO THE NET STEP This step does not apply to you and your tax return. Step 2 - PLEASE PROCEED TO THE NET STEP This step does not apply to you and your tax return. Step 3 - PLEASE PROCEED TO THE NET STEP This step does not apply to you and your tax return. Step 4 - KEEP A COPY Click the Main Menu and Step 3: File and Print to print your return. Attach your copy of each W-2, W-2G, 199R or 199G with withholding. Step 5 - For more information about tax, mortgage and financial services call 1-8-HRBLOCK or visit hrblock.com

IA14 2 H E R E or fiscal year beginning Last name A. Spouse's last name B. SPOUSE (IF filing status 3) 1. Wages, salaries, tips, etc. 2. Taxable interest income. If more than 1,5, complete Sch. B 3. Ordinary dividend income. If more than 1,5, complete Sch. B 4. Alimony received 23. Iowa capital gains deduction 24. Other adjustments 25. Total adjustments. ADD lines 16-24 26. NET INCOME. SUBTRACT line 25 from line 15 Federal income tax refund received in 23 27. (Include the Advance Child Tax Credit.) 28. Self-employment/household employment taxes 29. Addition for Federal taxes. ADD lines 27 and 28 31. Federal tax withheld 23 and ending STEP 1: Fill in all spaces. You MUST fill in your Social Security Number. Spouse's first name/middle initial Current mailing address (number and street, apartment, lot or suite number) or PO Box 1 3 4 5 6 WYATT City, State, ZIP JOHNSTON IA 5131 STEP 2 Filing Status: Mark one box only. Single: Were you claimed as a dependent on another person's Iowa return? Married filing a joint return. (Two-income families may benefit by using status 3 or 4) Married filing separately on this combined return. Spouse use column B. Married filing separate returns. Spouse's name: 3. Total. ADD lines 26 and 29 32. Federal estimated tax payments made in 23 33. Additional Federal tax paid in 23 for 22 and prior years 34. Deduction for Federal taxes. ADD lines 31, 32, and 33 EMMA 1. 2. 3. 4. Are your name, your spouse's name, if applicable, and your address the same as on last year's return? Head of household with qualifying person. If qualifying person is not claimed as a dependent on this return, enter the person's name and SSN below. Qualifying widow(er) with dependent child. Name: d. Enter first names of dependents here: a. Personal Credit: Enter 1 Your first name/middle initial b. Enter 1 if 65 or older and/or 1 if blind c. Dependents: Enter 1 for each dependent d. Enter first names of dependents here: 5. Business income/(loss) from Federal Sch. C or C-EZ Figure your Federal tax addition and deduc- tion 6. Capital gain/(loss) from Federal Schedule D 6. S T 7. Other gains/(losses) from Federal form 4797 7. A P 8. Taxable IRA distributions 8. L E 9. Taxable pensions and annuities 9. W 1. Rents, royalties, partnerships, estates, etc. 1. - 2 11. Farm income/(loss) from Federal Schedule F 11. S P A Y M 12. Unemployment compensation 13. Taxable Social Security benefits 14. Other income, gambling income,bonus depreciation adjustment 12. 13. 14. E 15. GROSS INCOME. ADD lines 1-14 N T STEP 5 16. Payments to an IRA, KEOGH or SEP 16. A N 17. One-half of self-employment tax 17. D Figure your 18. Health insurance deduction 18. V O adjust- 19. Penalty on early withdrawal of savings 19. U ments C 2. Alimony paid 2. H to E income 21. Pension/retirement income exclusion 21. R 22. Moving expense deduction from Federal form 393 22. 35. BALANCE. SUBTRACT line 34 from line 3. Enter here and on line 36, page 2 14 (23) IA14-1WV 16 5. 23. 24. 27. 28. 31. 32. 33. YES SSN: SSN: B. Spouse/Status 3 Social Security Number Social Security Number a. Personal Credit: Enter 1 (Enter 2 if filing joint or head of household) STEP 3 YOU Exemptions (and spouse IF b. Enter 1 for each spouse who is 65 or older and/or 1 for each spouse who is blind filing jointly) c. Dependents: Enter 1 for each dependent STEP 4 Figure your gross income STEP 6 23 Iowa Individual Income Tax Long Form 86 CRESCENT CHASE APT 2A RICHARD S 481-8-5573 LOVE STACEY L 482-6-892 NO YES A. You or Joint NO 39,82 15. 25. 26. 586 29. 3. 3,157 34. 35. Your Occupation TECHNICAL Spouse's Occupation BARISTA Income: 2x 4 = 8 x 2 = 1x 4 = 4 12 x x x Residence on 12/31/3 County No. e. TOTAL 4 2 4 e. TOTAL B. Spouse/Status 3 = = = Sch. Dist No. 77 3231 School District Name JOHNSTON A. You or Joint 41-1a (8/2/3) 39,82 39,82 586 4,388 3,157 37,231 LO3

RICHARD S WYATT & STACEY L LOVE 481-8-5573 IA 14 23, page 2 B. Spouse/Status 3 A. You or Joint B. Spouse/Status 3 A. You or Joint STEP 7 36. BALANCE. From page 1, line 35 36. 37,231 Figure your taxable income STEP 8 Figure your tax, credits and checkoff contribu- tions STEP 9 Figure your credits 37. Total itemized deductions from Federal Schedule A 37. Taxpayers with bonus depreciation must use Iowa Schedule A 38. 39. 4. Iowa income tax if included in line 5 of Federal Schedule A BALANCE: Subtract line 38 from line 37 or enter the amount of itemized deductions from the Iowa Schedule A Other deductions 41. Deduction. Check one box. 42. TAABLE INCOME. SUBTRACT line 41 from line 36 43. Tax from tables or alternate tax 44. Iowa lump-sum tax. 25% of Federal tax from form 4972 45. Iowa minimum tax. Attach IA 6251 46. Total tax. ADD lines 43, 44 and 45 47. Total exemption credit amount(s) from Step 3, side 1 48. Iowa earned income credit: 6% (.65) of Federal credit 49. Tuition and textbook credit 5. Total credits. ADD lines 47, 48 and 49 51. BALANCE. SUBTRACT line 5 from line 46. If less than zero, enter zero 52. Credit for nonresident or part-year resident. Attach IA 126 and Federal return 53. BALANCE. SUBTRACT line 52 from 51. If less than or equal to zero, enter zero 54. Other Iowa credits 55. BALANCE. SUBTRACT line 54 from line 53 56. School district surtax/ems surtax. (take percentage from table, multiply by line 55) 57. Total Tax. ADD lines 55 and 56 58. Total tax before contributions. ADD Columns A & B on line 57 and enter here 59. Contributions. Contributions will reduce your refund or add to the amount you owe. Amounts must be in whole dollars. Fish/Wildlife 59a: 6. TOTAL TA AND CONTRIBUTIONS. ADD lines 58 and 59 61. Iowa income tax withheld 62. Estimate and voucher payments made for tax year 23 63. Out-of-state tax credit. Attach IA 13 64. Motor vehicle fuel tax credit. Attach IA 4136 65. Child and dependent care credit 66. Other refundable credits 71. Amount of line 69 to be applied to your 24 estimated tax 1,768 69. If line 68 is more than line 6, SUBTRACT line 6 from line 68. This is the amount you overpaid 7. Amount of line 69 to be REFUNDED REFUND Mail return to Iowa Income Tax - Refund Processing, Hoover State Office Bldg, Des Moines IA 5319-12 72. If line 68 is less than line 6, SUBTRACT line 68 from line 6. This is the AMOUNT OF TA YOU OWE 73. Penalty for underpayment of estimated tax. From IA 221 or IA 221F. 74. Penalty and interest I (We), the undersigned, declare under penalty of perjury that I (we) have examined this return, including all accompanying schedules and statements, and, to the best of my (our) knowledge and belief, it is a true, correct, and complete return. Declaration of preparer (other than taxpayer) is based on all information of which the preparer has any knowledge. Your Signature 61. 62. 63. 64. 65. 66. Check if annualized income method is used Preparer's Signature 1,82 12 1,682 1,682 1,682 1,682 1,682 1,682 75. TOTAL AMOUNT DUE. ADD lines 72, 73 and 74, and enter here PAY THIS AMOUNT 75. E- pay by credit card or by transfer from your bank account. Go to www.state.ia.us/tax. This is a secure site. To pay by mail: Iowa Income Tax - Document Processing, PO Box 9187, Des Moines IA 536-9187. Make check payable to TREASURER, STATE OF IOWA. 1 to Campaign Fund State Fair 59b: 74a. Penalty 74b. Interest ADD Enter total 74. 1 to Campaign Fund 38. 39. 4. Itemized. Add lines 39 and 4. 67. TOTAL. ADD lines 61-66 67. STEP 1 68. TOTAL CREDITS. ADD columns A and B on line 67 and enter here Figure your refund or amount you owe 43. 44. 45. 47. 48. 49. 71. Keep Iowa Beautiful 59c: Date Standard. 1. Yes No 41. 42. 46. 5. 51. 52. 53. 54. 55. 56. 57. ADD Enter total Complete lines 37-4 ONLY if you itemize. STEP 11 POLITICAL CHECKOFF. This checkoff does not increase STEP 12 STEP 13 the amount of tax you owe or decrease your refund. NET YEAR, COW- CALF REFUND Attach IA 132. SPOUSE YOURSELF Would you like to receive a booklet? This Do NOT use these amounts to increase your 1 to Democratic Party 1 to Democratic Party option is not available to electronic filers. overpayment (line 69) or reduce the amount 1 to Republican Party 1 to Republican Party you owe (line 72). STEP 14 PLEASE SIGN HERE For Info Only For Info Only Spouse: SIGN HERE Verify your Social Spouse's Signature Date Address Security Number(s) Recheck your math (515) 276-4943 Attach all W-2s Daytime Telephone Number Daytime Telephone Number This return is due April 3, 24. 14 (23) IA14-2WV 16 1,82 12 1,768 You: 68. 69. 7. 72. 73. 58. 59. 6. 3,83 33,41 1,768 86 86 Date Identification Number 41-1b (9/12/3)

Name(s) Child Tax Credit Worksheet - 23 RICHARD S WYATT 481-8-5573 SSN 1. Number of qualifying children: 1 x 1,. Enter the result. 1 1, 2. 3. Enter the amount, if any, of your advance child tax credit (before offset). 2 Is line 1 less than line 2? Yes. You cannot take this credit, If line 2 is more than line 1, you do not have to pay back the difference. No. Subtract line 2 from line 1. 3 1, 4. 5. Enter the amount from Form 14, line 35, or Form 14A, line 22. 14 filers: Enter the total of any - Exclusion of income from Puerto Rico, and amounts from Form 2555, lines 43 and 48; Form 2555-EZ, line 18; and Form 4563, line 15. 14A filers: Enter - -. 4 5 39,82 6. 7. Add lines 4 and 5. Enter the total. Enter the amount shown below for the taxpayer's filing status. 6 39,82 8. Married filing jointly - 11, Single, head of household, or qualifying widow(er) - 75, Married filing separately - 55, Is the amount on line 6 more than the amount on line 7? No. Yes. Leave line 8 blank. Enter - - on line 9. Subtract line 7 from line 6. If the result is not a multiple of 1,, increase it to the next multiple of 1, (for example, increase 425 to 1,, increase 1,25 to 2,, etc.) 7 8 11, 9. 1. Multiply the amount on line 8 by 5% (). Enter the result. Is the amount on line 3 more than the amount on line 9? No. Do not complete this worksheet. No child tax credit is allowed. No additional child tax credit allowed. Yes. Subtract line 9 from line 3. Enter the result. Go to line 11. 9 1 1, 11. 12. Enter the amount from Form 14, line 43, or Form 14A, line 28. Add the amounts from - Form 14: or Form 14A: Line 44 Line 45 Line 46 Line 29 Line 3 + + Line 47 Line 31 + Line 48 Line 32 + 7 11 2,476 13. Enter the total. Is the taxpayer claiming any of the following credits? Adoption credit, Form 8839 Mortgage interest credit, Form 8396 District of Columbia first-time homebuyer credit, Form 8859 No. Enter the amount from line 12. Yes. Complete the Line 13 worksheet to figure the amount to enter here. 12 7 13 7 14. 15. Subtract line 13 from line 11. Enter the result. Is the amount on line 1 of this worksheet more than the amount on line 14? No. Yes. Enter the amount from line 1. Enter the amount from line 14. See the NOTE below. Enter this amount on Form 14, line 49, or Form 14A, line 33. Note: The taxpayer may be able to take the additional child tax credit on Form 14, line 65, or Form 14A, line 42, only if the "Yes" box on line 15 is checked. First, complete Form 14 through line 64, or Form 14A through line 41. Then, use Form 8812 to figure any additional child tax credit. WS CTC (23) FDCTC-1WV 1. 14 15 2,46 1,