SCHEDULE A (Form 14) Name(s) shown on Form 14 Itemized Deductions Attach to Form 14. See Instructions for Schedule A (Form 14). Medical Caution. Do not include expenses reimbursed or paid by others. and 1 Medical and dental expenses (see instructions)... 1 1,44 Dental 2 Enter amount from Form 14, line 3 2 3,25 Expenses 3 Multiply line 2 by 7.5% (.75)... 3 6,246 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter --... 4 Taxes You 5 State and local (check only one box): Paid a Income taxes, or... 5 2,3 b General sales taxes 6 Real estate taxes (see instructions)... 6 1,35 7 New motor vehicle taxes from line of the worksheet on Interest You Paid page 2 (for certain vehicles purchased in 29). Skip this line if you checked box 5b... Other taxes. List type and amount 9 Add lines 5 through... 9 1 Home mortgage interest and points reported to you on Form 19. 1 1,5 Home mortgage interest not reported to you on Form 19. If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address Note. Your mortgage interest 12 Points not reported to you on Form 19. See instructions for deduction may special rules... 12 be limited (see 13 Mortgage insurance premiums (see instructions)... 13 instructions). 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Add lines 1 through 14... 15 Gifts to 16 Gifts by cash or check. If you made any gift of $25 or more, Charity see instructions... 16 55 17 Other than by cash or check. If any gift of $25 or more, see If you made a gift and got a instructions. You must attach Form 23 if over $5... 17 benefit for it, 1 Carryover from prior year... 1 see instructions. 19 Add lines 16 through 1... 19 Casualty and Theft Losses 2 Casualty or theft loss(es). Attach Form 464. (See instructions.)... 2 Job Expenses and Certain Unreimbursed employee expenses - job travel, union dues, job education, etc. Attach Form 6 or 6-EZ if required. (See Miscellaneous instructions.) Deductions 22 Tax preparation fees... 22 25 23 Other expenses - investment, safe deposit box, etc. List type and amount 23 24 Add lines through 23... 24 25 25 Enter amount from Form 14, line 3 25 3,25 26 Multiply line 25 by 2% (.2)... 26 1,666 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter --... 27 Other Miscellaneous 2 Other - from list in instructions. List type and amount Deductions 2 7 OMB No. 1545-74 Total 29 Add the amounts in the far right column for lines 4 through 2. Also, enter this amount Itemized on Form 14, line 4... 29 14,7 Deductions 3 If you elect to itemize deductions even though they are less than your standard deduction, check here... For Paperwork Reduction Act Notice, see Form 14 instructions. EEA Schedule A (Form 14) 7 3,65 1,5 55
SCHEDULE B (Form 14A or 14) Part I Interest (See instructions for Form 14A, or Form 14, line a.) Interest and Ordinary Dividends Attach to Form 14A or 14. See instructions. OMB No. 1545-74 1 List name of payer. If any interest is from a seller-financed mortgage and the Amount buyer used the property as a personal residence, see instructions and list this interest first. Also, show that buyer's social security number and address BANK OF AMERICA 5,5 Note. If you received a Form 199-INT, Form 199-OID, or substitute statement from a brokerage firm, list the firm's name as the payer and enter the total interest shown on that form. 1 Part II Ordinary Dividends 2 Add the amounts on line 1... 2 3 Excludable interest on series EE and I U.S. savings bonds issued after 199. Attach Form 15... 3 4 Subtract line 3 from line 2. Enter the result here and on Form 14A, or Form 14, line a... 4 Note. If line 4 is over $1,5, you must complete Part III. 5 List name of payer Amount 5,5 5,5 ARIZONA PUBLIC SERVICE 3,6 (See instructions for Form 14A, or Form 14, line 9a.) Note. If you received a Form 199-DIV or substitute statement from a brokerage firm, list the firm's name as the payer and enter the ordinary dividends shown on that form. Part III Foreign Accounts and Trusts (See instructions) 6 Add the amounts on line 5. Enter the total here and on Form 14A, or Form 14, line 9a... Note. If line 6 is over $1,5, you must complete Part III. You must complete this part if you (a) had over $1,5 of taxable interest or ordinary dividends; (b) had a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. 7a b At any time during, did you have an interest in or a signature or other authority over a financial account in a foreign country, such as a bank account, securities account, or other financial account? See instructions for exceptions and filing requirements for Form TD F 9-22.1 If "Yes," enter the name of the foreign country During, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If "Yes," you may have to file Form 352. See instructions... For Paperwork Reduction Act Notice, see your tax return instructions. EEA Schedule B (Form 14A or 14) 5 6 3,6 Yes No
OMB No. 1545-74 SCHEDULE D Capital Gains and Losses (Form 14) Attach to Form 14 or Form 14NR. See Instructions for Schedule D (Form 14). Use Schedule D-1 to list additional transactions for lines 1 and. 12 Part I 1 Short-Term Capital Gains and Losses - Assets Held One Year or Less (a) Description of property (b) Date acquired (c) Date sold (d) Sales price (e) Cost or other basis (f) Gain or (loss) (see page D-7 of (see page D-7 of (Example: 1 sh. YZ Co.) (Yr., mo., day) (Yr., mo., day) Subtract (e) from (d) the instructions) the instructions) GREEN CO 6 3 4, 4,5 (5) BLUE CO 312 922 6, 5,2 2 3 Enter your short-term totals, if any, from Schedule D-1, line 2... Total short-term sales price amounts. Add lines 1 and 2 in column (d)... 2 3 1, 4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 464, 671, and 24... 4 5 Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1... 5 6 Short-term capital loss carryover. Enter the amount, if any, from line 1 of your Capital Loss Carryover Worksheet on page D-7 of the instructions... 6 ( ) 7 Net short-term capital gain or (loss). Combine lines 1 through 6 in column (f)... 7 Part II Long-Term Capital Gains and Losses - Assets Held More Than One Year 3 (a) Description of property (b) Date acquired (c) Date sold (d) Sales price (e) Cost or other basis (f) Gain or (loss) (see page D-7 of (see page D-7 of (Example: 1 sh. YZ Co.) (Yr., mo., day) (Yr., mo., day) Subtract (e) from (d) the instructions) the instructions) RED CO 2322 15 6, 2,5 3,5 WHITE CO 22512 5, 5, 3, BLACK CO 22915 1 6, 7, (1,) 9 1 12 Enter your long-term totals, if any, from Schedule D-1, line 9... 9 Total long-term sales price amounts. Add lines and 9 in column (d)... 1 2, Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 464, 671, and 24... Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1... 12 13 Capital gain distributions. See page D-2 of the instructions... 13 14 Long-term capital loss carryover. Enter the amount, if any, from line 15 of your Capital Loss Carryover Worksheet on page D-7 of the instructions... 14 ( ) 15 Net long-term capital gain or (loss). Combine lines through 14 in column (f). Then go to Part III on page 2... 15 5,5 For Paperwork Reduction Act Notice, see your tax return instructions. EEA Schedule D (Form 14)
Schedule D (Form 14) Page 2 Part III Summary 16 Combine lines 7 and 15 and enter the result... 16 5, 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. If line 16 is a loss, skip lines 17 through 2 below. Then go to line. Also be sure to complete line 22. If line 16 is zero, skip lines 17 through 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? Yes. Go to line 1. No. Skip lines 1 through, and go to line 22. 1 Enter the amount, if any, from line 7 of the 2% Rate Gain Worksheet on page D- of the instructions... 1 19 Enter the amount, if any, from line 1 of the Unrecaptured Section 125 Gain Worksheet on page D-9 of the instructions... 19 2 Are lines 1 and 19 both zero or blank? Yes. Complete Form 14 through line 43, or Form 14NR through line 41. Then complete the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions for Form 14, line 44 (or in the Instructions for Form 14NR, line 42). Do not complete lines and 22 below. No. Complete Form 14 through line 43, or Form 14NR through line 41. Then complete the Schedule D Tax Worksheet on page D-1 of the instructions. Do not complete lines and 22 below. 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) 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 41. Then complete the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions for Form 14, line 44 (or in the Instructions for Form 14NR, line 42). No. Complete the rest of Form 14 or Form 14NR. EEA Schedule D (Form 14)
SCHEDULE M (Form 14A or 14) Attach to Form 14A or 14. Making Work Pay Credit See separate instructions. OMB No. 1545-74 166 CAUTION! To take the making work pay credit, you must include your social security number (if filing a joint return, the number of either you or your spouse) on your tax return. A social security number does not include an identification number issued by the IRS. Only the Social Security Administration issues social security numbers. CAUTION! You cannot take the making work pay credit if you can be claimed as someone else's dependent or if you are a nonresident alien. Important: Check the "No" box on line 1a and see the instructions if: (a) You have a net loss from a business, (b) You received a taxable scholarship or fellowship grant not reported on a Form W-2, (c) Your wages include pay for work performed while an inmate in a penal institution, (d) You received a pension or annuity from a nonqualified deferred compensation plan or a nongovernmental section 457 plan, or (e) You are filing Form 2555 or 2555-EZ. 1a Do you (& your spouse if filing jointly) have wages of more than $6,451 ($12,93 if married filing jointly)? Yes. Skip lines 1a through 3. Enter $4 ($ if married filing jointly) on line 4 and go to line 5. No. Enter your earned income (see instructions)... 1a b Nontaxable combat pay included on line 1a (see instructions)... 1b 2 Multiply line 1a by 6.2% (.62)... 2 3 Enter $4 ($ if married filing jointly)... 3 4 Enter the smaller of line 2 or line 3 (unless you checked "Yes" on line 1a)... 4 4 5 Enter the amount from Form 14, line 3*, or Form 14A, line 22... 5 6 Enter $75, ($15, if married filing jointly)... 6 3,25 75, 7 Is the amount on line 5 more than the amount on line 6? No. Skip line. Enter the amount from line 4 on line 9 below. Yes. Subtract line 6 from line 5... 7,25 Multiply line 7 by 2% (.2)... 9 Subtract line from line 4. If zero or less, enter --... 9 166 234 1 Did you (or your spouse, if filing jointly) receive an economic recovery payment in? You may have received this payment in if you did not receive an economic recovery payment in 29 but you received social security benefits, supplemental security income, railroad retirement benefits, or veterans disability compensation or pension benefits in November 2, December 2, or January 29 (see instructions). No. Yes. Enter -- on line 1 and go to line. Enter the total of the payments you (and your spouse, if filing jointly) received in. Do not enter more than $25 ($5 if married filing jointly)... 1 Making work pay credit. Subtract line 1 from line 9. If zero or less, enter --. Enter the result here and on Form 14, line 63; or Form 14A, line 4... 234 *If you are filing Form 2555, 2555-EZ, or 4563 or you are excluding income from Puerto Rico, see instructions. For Paperwork Reduction Act Notice, see your tax return instructions. EEA Schedule M (Form 14A or 14)