DO NOT REMOVE FROM CLASSROOM

DO NOT REMOVE FROM CLASSROOM Advanced Training Tax Year

Advanced Scenario Tax Year Interview Notes Charles and Louise Monroe are married and want to file a joint return. Their granddaughter Amber lived with them all year and her parents are not going to claim her as a dependent. Charles retired in December 2016 and began receiving monthly pension payments in June. No distributions were received before that. They selected a joint survivor annuity for these payments. Louise made a 4,000.00 contribution to her Traditional IRA in. After retirement Charles began working as a bartender at private parties. In addition to the tips his employer reported he states he received an additional 350.00 in tips not reported to his employer. Charles and Louise provide a worksheet from their prior year return showing a long-term capital loss carryover of 15,000.00. They sold their home in. The home was purchased on July 30, 2008 for 195,000.00. In 2010 they added an in-ground pool for 35,000.00. The commission to the real estate agent was 11,700.00. They brought in their closing statement which indicated they paid the following costs when they purchased their home in 2008. They lived in their home from August 2008 to February. Louise never claimed business use of home expense on her Schedule C. Legal fees 1200 Title insurance 750 Survey 425 Louise took an early distribution from her retirement plan to pay medical insurance premiums for Amber. Charles and Louise were solvent at the time the credit card debt was cancelled. Their medical expenses, mortgage interest and real estate taxes do not exceed the standard deduction for and they have no other itemized expenses. Charles and Louise were insured through his employer all year. Amber was insured through the Marketplace all year. Louise is self employed as a manicurist and provides expenses for her business. She has clients who are unable to arrange transportation to the shop where she rents her booth. Louise leaves the shop early twice a week to provide manicures and pedicures to her housebound clients who pay her with cash and checks. She also indicates tips. She started using her current vehicle a 2008 Toyota for business on March 15, 2010. Louise paid one individual 500.00 as contract labor to clean her booth. If they have a refund they would like it deposited into their checking account (2234567890) at Wells Fargo (routing 111900659). 1

671-00-2345 Charles Monroe Charles Monroe Charles DOB: 03.17.1960 657-00-1234 Louise Monroe Louise Monroe Louise s DOB: 12.12.1962 458-00-9123 Amber L. Monroe Amber L. Monroe Amber s DOB: 12.9.2001 2

Form 13614-C (October ) Intake/Interview & Quality Review Sheet Department of the Treasury - Internal Revenue Service OMB Number 1545-1964 Catalo Number 52121E AMBER MONROE (a) Name (first, last) Do not enter your name or spouse's name below 12/9/2001 (b) Date of Birth (mm/dd/yy) GRANDD Relationship to you (for example: son, daughter, parent, none, etc) (c) 12 (d) YES (e) Number of US months Citizen lived in (yes/no) your home last year 2. List the names below of: everyone who lived with.you last. year (other than.your spouse.... anyone you supported but did not live with you last year S (9) Single or Married as of 12/31/17 (S/M) www irs ov YES (f) Resident of US, Canada, or Mexico last year (yes/no) Totally and Permanently Disabled (yes/no) (i) NO Full-time Student last year (yes/no) (h) YES. Is this person a qualifying child/relative of any other person? (yes/no),, Did this person provide more than 50% of his/ her own support? (yes/no) Did the taxpayer(s) pay more than half the cost of maintaining a home for this person? (yes/no) 13614-C(Rev. 10-) Did the taxpayer(s) provide more than 50% of support for this person? (yes/no/n/a) Form Did this person have less than 4,050 of income? (yes/no) To be completed by a Certified Volunteer Preparer If additional space is needed check here and list on page 3 10. Can anyone claim you or your spouse as a dependent? Yes 0 No Unsure b. Adopted a child? Yes El No Yes 0 No 11. Have you or your spouse: a. Been a victim of identity theft? Part II Marital Status and Household Information (This includes registered domestic partnerships, civil unions, or other formal relationships under state law) 1. As of December 31,, were Never Married you: Yes 0 No El Married a. If Yes, Did you get married in? b. Did you live with your spouse during any part of the last six months of? 0 Yes No Date of final decree Divorced Legally Separated Date of separate maintenance agreement Year of spouse's death Widowed Please complete pages 1-3 of this form. You will need: You are responsible for the information on your return. Please provide Tax Information such as Forms W-2, 1099, 1098, 1095. complete and accurate information. Social security cards or ITIN letters for all persons on your tax return. If you have questions, please ask the IRS-certified volunteer preparer. Picture ID (such as valid driver's license)for you and your spouse. Volunteers are trained to provide high quality service and uphold the highest ethical standards. To report unethical behavior to the IRS, email us at wi.voltax@irs.gov Part I Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return) Telephone number Are you a U.S. citizen? 1. Your first name M.I. Last name No 121 Yes 512.555.1212 CHARLES MONROE Telephone number Is your spouse a U.S. citizen? 2. Your spouse's first name M.I. Last name No El Yes 512.555.1212 LOUISE MONROE ZIP code State Apt # City 3. Mailing address 78748 TX AUSTIN 3785 LIVE OAK DRIVE a. Full-time student Yes 13 No 6. Last year, were you: 4. Your Date of Birth 5. Your job title Yes 13 No c. Legally blind 3/1731960 RETIRED b. Totally and permanently disabled Yes El No a. Full-time student Yes 13 No 9. Last year, was your spouse: 7. Your spouse's Date of Birth 8. Your spouse's job title Yes 13 No Legally blind No c. Yes E1 12/12/1962 MANICURIST b. Totally and permanently disabled 3

Page 2 Check appropriate box for each question in each section 1 Yes No Unsure Part III Income Last Year, Did You (or Your Spouse) Receive 1. (B) Wages or Salary? (Form W-2) If yes, how many jobs did you have last year? 2. (A) Tip Income? 3. (B) Scholarships? (Forms W-2, 1098-T) 4. (B) Interest/Dividends from: checking/savings accounts, bonds, CDs, brokerage? (Forms 1099-INT, 1099-DIV) 5. (B) Refund of state/local income taxes? (Form 1099-G) 6. (B) Alimony income or separate maintenance payments? 7. (A) Self-Employment income? (Form 1099-MISC, cash) 8. (A) Cash/check payments for any work performed not reported on Forms W-2 or 1099? 9. (A) Income (or loss) from the sale of Stocks, Bonds or Real Estate? (including your home) (Forms 1099-S,1099-B) 10. (B) Disability income? (such as payments from insurance, or workers compensation) (Forms 1099-R, W-2) 11. (A) Payments from Pensions, Annuities, and/or IRA? (Form 1099-R) 12. (B) Unemployment Compensation? (Form 1099G) 13. (B) Social Security or Railroad Retirement Benefits? (Forms SSA-1099, RRB-1099) 14. (M) Income (or loss) from Rental Property? 15. (B) Other income? (gambling, lottery, prizes, awards, jury duty, Sch K-1, royalties, foreign income, etc.) Specify K-1 Yes No Unsure Part IV Expenses Last Year, Did You (or Your Spouse) Pay 1. (B) Alimony or separate maintenance payments? If yes, do you have the recipient s SSN? Yes No 2. Contributions to a retirement account? 4000 IRA (A) 401K (B) Roth IRA (B) Other 3. (B) College or post secondary educational expenses for yourself, spouse or dependents? (Form 1098-T) 4. (B) Unreimbursed employee business expenses? (such as uniforms or mileage) 5. (B) Medical expenses? (including health insurance premiums) 6. (B) Home mortgage interest? (Form 1098) 7. (B) Real estate taxes for your home or personal property taxes for your vehicle? (Form 1098) 8. (B) Charitable contributions? 9. (B) Child or dependent care expenses such as daycare? 10. (B) For supplies used as an eligible educator such as a teacher, teacher s aide, counselor, etc.? 11. (A) Expenses related to self-employment income or any other income you received? 12. (B) Student loan interest? (Form 1098-E) Yes No Unsure Part V Life Events Last Year, Did You (or Your Spouse) 1. (HSA) Have a Health Savings Account? (Forms 5498-SA, 1099-SA, W-2 with code W in box 12) 2. (A) Have debt from a mortgage or credit card cancelled/forgiven by a commercial lender? (Forms 1099-C, 1099-A) 3. (A) Buy, sell or have a foreclosure of your home? (Form 1099-A) 4. (B) Have Earned Income Credit (EIC) or other credits disallowed in a prior year? If yes, for which tax year? 5. (A) Purchase and install energy-efficient home items? (such as windows, furnace, insulation, etc.) 6. (B) Live in an area that was affected by a natural disaster? If yes, where? 7. (A) Receive the First Time Homebuyers Credit in 2008? 8. (B) Make estimated tax payments or apply last year s refund to this year s tax? If so how much? 9. (A) File a federal return last year containing a capital loss carryover on Form 1040 Schedule D? 4 Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-)

Page 3 Check appropriate box for each question in each section Yes No Unsure Part VI - Health Care Coverage - Last year, did you, your spouse, or dependent(s) Form 1095-B Form 1095-C 1. (B) Have health care coverage? 2. (B) Receive one or more of these forms? (Check the box) 3. (A) Have coverage through the Marketplace (Exchange)? [Provide Form 1095-A] 3a. (A) If yes, were advance credit payments made to help you pay your health care premiums? 3b. (A) If yes, Is everyone listed on your Form 1095-A being claimed on this tax return? 4. (B) Have an exemption granted by the Marketplace? Visit http://www.healthcare.gov/ or call 1-800-318-2596 for more information on health insurance options and assistance. If advance payments of the premium tax credit were paid on your behalf to help pay your health insurance premiums, you should report life changes, such as, income, marital status or family size changes, to your Marketplace. Reporting changes will help to make sure you are getting the proper amount of advance payments. To be Completed by a Certified Volunteer Preparer (Use Publication 4012 and check the appropriate box(es) indicating Minimum Essential Coverage (MEC) for everyone listed on the return.) Notes Exemption All Year Exemption (mark months exemptions applies) Part Year MEC (mark months with coverage) No MEC MEC Entire Year Name (List dependents in the same order as in Part II) Taxpayer X J F M A M J J A S O N D J F M A M J J A S O N D Spouse X J F M A M J J A S O N D J F M A M J J A S O N D Dependent X J F M A M J J A S O N D J F M A M J J A S O N D Dependent J F M A M J J A S O N D J F M A M J J A S O N D Dependent J F M A M J J A S O N D J F M A M J J A S O N D Dependent J F M A M J J A S O N D J F M A M J J A S O N D Part VII Additional Information and Questions Related to the Preparation of Your Return 1. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service) 2. Presidential Election Campaign Fund (If you check a box, your tax or refund will not change) Check here if you, or your spouse if filing jointly, want 3 to go to this fund You Spouse c. To split your refund between different accounts Yes No b. To purchase U.S. Savings Bonds Yes No 3. If you are due a refund, would you like: a. Direct deposit Yes No 4. If you have a balance due, would you like to make a payment directly from your bank account? Yes No 5. Have you or your spouse received any letters from the Internal Revenue Service? Yes No Many free tax preparation sites operate by receiving grant money. The data from the following questions may be used by this site to apply for these grants. Your answers will be used only for statistical purposes. 6. Other than English, what language is spoken in your home? Prefer not to answer 7. Do you or any member of your household have a disability? Yes No Prefer not to answer 8. Are you or your spouse a Veteran from the U.S. Armed Forces? Yes No Prefer not to answer 5 Additional comments Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-)

Page 4 Part VIII IRS-Certified Volunteer Quality Reviewer Section Review the tax return with the taxpayer to ensure: Taxpayer (and Spouse's) identity was verified with a photo ID. The volunteer return preparer/quality reviewer are certified to prepare/review this return and return is within scope of the program. All questions in Parts I through VI have been answered. All unsure boxes were discussed with the taxpayer and correctly marked yes or no. The information on pages one through three was correctly addressed and entered on the return. Names, SSNs, ITINs, and EINs, were verified and correctly transferred to the return. Filing status was verified and correct. Personal and Dependency Exemptions are entered correctly on the return. All Income (including income with or without source documents) checked "yes" in Part III was correctly transferred to the tax return. Adjustments to income, such as student loan interest, IRA contributions, self employment tax, were verified and are correct. Standard or Itemized Deductions are correct. All credits are correctly reported. All applicable provisions of ACA were considered for each person named on the tax return and were entered correctly. Any Shared Responsibility Payments are correct. Withholding shown on Forms W-2, 1099 and Estimated Tax Payments are correctly reported. Direct Deposit/Debit and checking/saving account numbers are correct. SIDN is correct on the return. The taxpayer(s) was advised that they are responsible for the information on their return. Certified Volunteer Preparer s name/initials (optional) Certified Volunteer Quality Reviewer s name/initials (optional) Additional Tax Preparer notes Privacy Act and Paperwork Reduction Act Notice The Privacy Act of 1974 requires that when we ask for information we tell you our legal right to ask for the information, why we are asking for it, and how it will be used. We must also tell you what could happen if we do not receive it, and whether your response is voluntary, required to obtain a benefit, or mandatory. Our legal right to ask for information is 5 U.S.C. 301. We are asking for this information to assist us in contacting you relative to your interest and/or participation in the IRS volunteer income tax preparation and outreach programs. The information you provide may be furnished to others who coordinate activities and staffing at volunteer return preparation sites or outreach activities. The information may also be used to establish effective controls, send correspondence and recognize volunteers. Your response is voluntary. However, if you do not provide the requested information, the IRS may not be able to use your assistance in these programs. 6 The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests. The OMB Control Number for this study is 1545-1964. Also, if you have any comments regarding the time estimates associated with this study or suggestion on making this process simpler, please write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, Washington, DC 20224 Catalog Number 52121E www.irs.gov Form 13614-C (Rev. 10-)

b Employer Identification Number (EIN) 74-2345601 c Employer s name, address and ZIP code RST Services PO Box 5678 Austin, TX 78704 d Employee s name, address and ZIP code Charles Monroe Austin, TX 78748 15 State Employer s state ID number 16 State wages, tips, etc CORRECTED 12a See instructions for box 12 12b 12c 12d 12e This information being provided to Internal Revenue Service Copy B To Be Filed With Employee s FEDERAL Tax Return a Employee s Social Security Number 671-00-2345 17 State income tax 18 Local wages, tips, etc. 1 Wages, tips other compensation 3,000.00 3 Social security wages 2,000.00 5 Medicare wages and tips 3,000.00 7 Social security tips 1,000.00 2 Federal income tax withheld 200.00 4 Social security tax withheld 124.00 6 Medicare tax withheld 44.00 8 Allocated tips 9 Verification code 10 Dependent care benefits 67D3-58C2-3BB9-11B3 11 Nonqualified plans 13 Statutory Retirement Plan Thirdparty Employee plan sick-pay 14 Other Interview Notes: In addition to the tips his employer reported Charles states he received an additional 350 in tips not reported to his employer. 19 Local income tax 20 Locality name. Department of the Treasury Internal Revenue Service FORM W-2 wage and Tax Statement Copy B To be filed with employee s FEDERAL tax return OMB No. 1545-0008 Form W-2 (keep for your records) www.irs.gov/formw2 Department of the Treasury Internal Revenue Service PAYER S name, street address, city or town, province or state, country, and ZIP or foreign postal code Hometown Pension Fund PO Box 7894 Austin, TX 78704 PAYER S federal identification number 74-6712345 RECIPIENT S name Louise Monroe Street address (including apt. no.) RECIPIENT S identification number 657-00-1234 City or town, province or state, country, and ZIP or foreign postal code Austin, TX 78748 10 Amount allocable to IRR within 5 years 11 1st year of desig. Roth contrib. CORRECTED (if checked) OMB No. 1545-0119 1 Gross distribution 1,020.00 2a Taxable amount 1,020.00 2b Taxable amount not determined 3 Capital gain (included in box 2a) 5 Employee contributions /Designated Roth contributions or insurance premiums 7 Distribution code(s) 1 9a Your percentage of total distribution IRA/ SEP/ SIMPLE Form 1099-R Total distribution 4 Federal income tax withheld 102.00 6 Net unrealized appreciation in employer s securities 8 Other 9b Total employee contributions % Interview Notes: Louise took an early 12 State tax withheld distribution to pay medical insurance premiums for Amber. % Distributions From Pensions, Annuities, Retirement or Profit- Sharing Plans, IRAs, Insurance Contracts, etc Copy B Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return. This information is being furnished to the Internal Revenue Service. 13 State/Payer s state no. 14 State distribution Account number (see instructions 15 Local tax withheld 16 Name of locality 17 Local distribution Form 1099-R www.irs.gov/form1099r Department of the Treasury-Internal Revenue Service 7

CORRECTED PAYER S name, street address, city or town, province or state, country, and ZIP or foreign postal code Hometown Pension Fund PO Box 7894 Austin, TX 78708 PAYER S federal identification number 74-6712345 RECIPIENT S name Charles Monroe RECIPIENT S identification number 671-00-2345 1 Gross distribution 25,895.00 2a Taxable amount 2b Taxable amount not determined 3 Capital gain (included in box 2a) 5 Employee contributions /Designated Roth contributions or insurance premiums OMB No. 1545-0119 Form 1099-R Total distribution 4 Federal income tax withheld 2,589.48 6 Net unrealized appreciation in employer s securities Distributions From Pensions, Annuities, Retirement or Profit- Sharing Plans, IRAs, Insurance Contracts, etc Copy B Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return. Street address (including apt. no.) City or town, province or state, country, and ZIP or foreign postal code Austin, TX 78748 10 Amount allocable to IRR within 5 years Account number (see instructions 11 1st year of desig. Roth contrib. 2,400.00 7 Distribution code(s) 7 IRA/ SEP/ SIMPLE 9a Your percentage of total distribution % 12 State tax withheld 8 Other 9b Total employee contributions 20,000.00 % This information is being furnished to the Internal Revenue Service. 13 State/Payer s state no. 14 State distribution 15 Local tax withheld 16 Name of locality 17 Local distribution Form 1099-R (keep for your records) www.irs.gov/1099r Department of the Treasury Internal Revenue Service Interview Notes: Charles retired in December 2016 and began receiving monthly pension payments in June. No distributions were received before annuity began. They selected a joint survivor annuity for these payments. Ages when first payment received: Charles - 57 Louise 54 Box 5 amount are usually health insurance premiums paid by the annuitant. Clarify with the client if this amount is a contribution or insurance premium. 8

PAYER S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone no. Tabitha s Salon PO Box 6542 Austin, TX 78702 PAYER S federal identification number 74-4567823 RECIPIENT S name Louise Monroe Street address (including apt. no.) RECIPIENT S identification number 657-00-1234 City or town, province or state, country, and ZIP or foreign postal code Austin, TX 78748 Account number (see instructions) 15a Section 409A deferrals 15b Section 409A income 1 Rents 2 Royalties CORRECTED 3 Other income 5 Fishing boat proceeds 7 Nonemployee compensation 14,300.00 9 Payer made direct sales of 5,000 or more of consumer products to a buyer (recipient) for resale 11 Foreign tax paid 13 Excess golden parachute payments 16 State tax withheld OMB No. 1545-0115 Form 1099-MISC 4 Federal income tax withheld 6 Medical and health care payments 8 Substitute payments in lieu of dividends or interest 10 Crop insurance proceeds 12 Foreign country or U.S. possession Miscellaneous Income Copy B For Recipient This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. 14 Gross proceeds paid to an attorney 17 State/Payer s state no. 18 State income Form 1099-MISC (keep for your records) www.irs.gov/form1099misc Department of the Treasury Internal Revenue Service PAYER S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone no. Kate s Day Spa PO Box 3016 Austin, TX 78702 PAYER S federal identification number 74-4567801 RECIPIENT S name Louise Monroe Street address (including apt. no.) RECIPIENT S identification number 657-00-1234 City or town, province or state, country, and ZIP or foreign postal code Austin, TX 78748 Account number (see instructions) 15a Section 409A deferrals 15b Section 409A income 1 Rents 2 Royalties CORRECTED 3 Other income 5 Fishing boat proceeds 7 Nonemployee compensation 2,200.00 9 Payer made direct sales of 5,000 or more of consumer products to a buyer (recipient) for resale 11 Foreign tax paid 13 Excess golden parachute payments 16 State tax withheld OMB No. 1545-0115 Form 1099-MISC 4 Federal income tax withheld 6 Medical and health care payments 8 Substitute payments in lieu of dividends or interest 10 Crop insurance proceeds 12 Foreign country or U.S. possession Miscellaneous Income Copy B For Recipient This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. 14 Gross proceeds paid to an attorney 17 State/Payer s state no. 18 State income Form 1099-MISC (keep for your records) www.irs.gov/form1099misc Department of the Treasury Internal Revenue Service 9

Are You Self-Employed? START HERE! Were you self-employed, ran your own business, or did you receive a Form 1099-MISC? If so, check the statements below that apply to you. X I paid employees. I kept an office in my home. I had more than 25,000 in business expenses. I had more than one business. I kept an inventory for my business. I need to report a business loss. If you answered YES to any of these, please stop here and bring your documents to the intake desk for review. If you answered NO to all of these, please continue by completing the worksheet below. Income and Expenses for Tax Year - Income What industry/type of work did you do? Cash and checks _2149 manicurist Form 1099-MISC _16500 Other business income _1264 Expenses Advertising 146 Overnight travel (hotel/airfare) 326 Commissions and fees Business meals Contract labor 500 Utilities (NOT household) Business liability insurance 458 Interest on business loans Business phone _427 Legal & professional services Professional education 300 Office expense/supplies Protective clothing Office or storage rent 6500 Small tools Machinery rent Other: Repairs to equipment Other: Supplies _3024 Equipment including computers Toll road fees/parking 56 Professional License/state taxes 100 Number of business miles 251 Vehicle type: Year:_2008 Make:_Toyota Model: Camry **Business miles do not include commuting miles. The standard mileage rate includes gas, oil, repairs, insurance, depreciation, etc.. Did you pay estimated taxes to the IRS last year? If yes, how much 10

ABC Investments 211 Main Street San Francisco, CA 94105 Form 1099-B Proceeds from Broker and Barter Exchange Transactions Copy B for Recipient OMB NO 1545-0715 TAX REPORTING STATEMENT Charles and Louise Monroe Austin, TX 78748 Account No. 456987 Recipient ID NO. XXX-XX-2345 Payer s Fed ID Number: 74-2345678 Short-term transactions for which basis is reported to the IRS Report on Form 8949 with Box A checked and/or Schedule D, Part I 8-Description CUSIP Number 1a Date of Sale or Exchange DEF stocks JKL stocks LMN Stock 125643 256431 564312 02/01/17 10/15/17 09/15/17 1b Date of Acquisition 09/01/16 01/22/17 06/15/17 1e Quantity Sold 250.000 100.000 100.000 2a Sales Price of Stocks, etc 1,777.00 2,523.00 1,200.00 3 Cost or Other Basis 2,875.00 1,500.00 1,000.00 Gain/Loss -1,098.00 1,023.00 200.00 TOTALS 5,500.00 5,375.00 125.00 4 Federal Income Tax Withheld Form 1099-B Proceeds from Broker and Barter Exchange Transactions Copy B for Recipient OMB NO 1545-0715 Long-term transactions for which basis is not reported to the IRS Report on Form 8949 with Box E checked and/or Schedule D, Part II 8-Description CUSIP Number 1a Date of Sale or Exchange GHI Stocks OPQ Stocks 359648 596483 02/01/17 05/01/17 1b Date of Acquisition 06/23/02 05/31/06 1e Quantity Sold 200.000 300.000 2a Sales Price of Stocks, etc 2,750.00 3,500.00 3 Cost or Other Basis 2,234.00 1,250.00 Gain/Loss 516.00 2,250.00 TOTALS 6,250.00 3,484.00 2,766.00 4 Federal Income Tax Withheld This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Interview Notes: Charles and Louise provide a worksheet from their prior year return showing a longterm capital loss carryover of 15,000.00. 11

ABC Investments Form 1099 With Account Summary Totals for your Records Tax Year Page 1 Payer s Name and Address ABC Investments 211 Main Street San Francisco, CA 94105 Federal ID Number: 74-2345678 Account Number: Dividends and Distributions Date Prepared: January 21, 2018 Recipient s Name and Address Charles & Louise Monroe Austin, TX 78748 Taxpayer ID Number: XXX-XX-2345 Form 1099-DIV Department of the Treasury-Internal Revenue Service Copy B for Recipient (OMB No. 1545-0110) Box Description Amount Total 1a Total Ordinary Dividends (includes amount shown in box 1b) 1b Qualified Dividends 2a Total Capital Gain Distribution (includes amount shown in boxes 2b, 2c, and 2d) 2b Unrecap. Sec 1250 Gain 2c Section 1202 Gain 2d Collectibles (28%) gain 3 Nondividend Distributions 4 Federal Income Tax Withheld 5 Investment Expenses 6 Foreign Tax Paid 24.00 7 Foreign country or U.S. Possession 8 Cash Liquidation Distributions 9 Noncash Liquidation Distributions 10 Exempt-interest Dividends 11 Specified Private Activity Bond Interest dividends Interest Income Form 1099-INT Department of the Treasury-Internal Revenue Service Copy B for Recipient (OMB No. 1545-0110) Box Description Total 1 Interest Income 2 Early Withdrawal Penalty 3 Interest on U.S. Savings Bonds and Treas. Obligations 4 Federal Income Tax Withheld 5 Investment Expense 6 Foreign Tax Paid 7 Foreign Country or U.S. Possession 8 Tax-exempt Interest 9 Specified Private Activity Bond Interest 10 Tax-exempt Bond CUSIP no. This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return a negligence penalty or other sanction may be imposed on you if this income is taxable and the I.R.S. determines that is has not been reported. If you should have any questions regarding information being reported on this form please call us at 1-800-XXX-XXXX. 12

FILER S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone number KLM Title PO Box 4568 Austin, TX 78704 FILER S federal identification number 74-1234560 TRANSFEROR S name Charles & Louise Monroe Street address (including apt. no.) TRANSFEROR S identification number 671-00-2345 City or Town, province or state, country, and ZIP or foreign postal code Austin, TX 78748 Account or escrow number (see instructions) CORRECTED 1 Date of closing 02/28/ 2 Gross proceeds 275,000.00 3 Address or legal description 4587 Pecan Grove Lane Austin, TX 78745 OMB No. 1545-1576 Form 1099-S 4 Transferor received or will receive property or services as part of the consideration (if checked)....... 5 Buyer s part of real estate tax Proceeds From Real Estate Transactions Copy B For Transferor This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a tax return, a negligence penalty or other sanction may be imposed on you if the IRS determines that it has not been reported. Form 1099-S (keep for your records) www.irs.gov/form1099s Department of the Treasury Internal Revenue Service Interview Notes: They sold their home in. The home was purchased on July 30, 2008 for 195,000.00. In 2010 they added an in-ground pool for 35,000.00. The commission to the real estate agent was 11,700.00. They brought in their closing statement which indicated they paid the following costs when they purchased their home in 2008. Legal fees 1200 Title insurance 750 Survey 425 They lived in their home from August 2008 to February. Louise never claimed business use of home expense on her Schedule C. 13

CORRECTED (if checked) CREDITOR S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone number National Bank PO Box 4565 Austin, TX 78701 CREDITOR S federal identification number 74-3456712 DEBTOR S name Charles Monroe Street address (including apt. no.) DEBTOR S identification number 671-00-2345 City or Town, province or state, country, and ZIP or foreign postal code Austin, TX 78748 Account number (see instructions) 4567236598752200 1 Date of identifiable event 07/15/ 2 Amount of debt discharged 500.00 3 Interest if included in box 2 4 Debt description CREDIT CARD OMB No. 1545-0901 Form 1099-C 5 If checked, the debtor was personally liable for repayment of the debt........... 6 Identifiable event code 7 Fair market value of property Cancellation of Debt Copy B For Debtor This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a tax return, a negligence penalty or other sanction may be imposed on you if taxable income results from this transaction and the IRS determines that it has not been reported. Form 1099-C (keep for your records) www.irs.gov/form 1099c Department of the Treasury Internal Revenue Service Interview Notes: Charles and Louise were solvent at the time the credit card debt was cancelled. 14

Schedule K-1 (Form 1120S) Department of the Treasury Internal Revenue Service For calendar year, or tax year beginning, ending, 20 Final K-1 Amended K-1 OMB No. 1545-0130 Part III Shareholder s Share of Current Year Income, Deductions, Credits, and Other Items 1 Ordinary business income (loss) 2 Net rental real estate income (loss) 13 Credits Shareholder s Share of Income, Deductions, Credits, etc. See back of form and separate instructions Part I Information About the Corporation A Corporation s employer identification number 74-7123456 B Corporation s name, address, city, state, and ZIP code LMN Inc. PO Box 6523 Austin, TX 78712 3 Other net rental income (loss) 4 Interest income 5a 5b Ordinary dividends Qualified dividends 6 Royalties 50 25 150 7 Net short-term capital gain (loss) 250 C IRS Center where corporation filed return 8a Net long-term capital gain (loss) Ogden (136) Part II Information About the Shareholder 8b Collectibles (28%) gain (loss) 5 14 Foreign transactions D Shareholder s identifying number 671-00-2345 E Shareholder s name, address, city, state, and ZIP code Charles J Monroe Austin, TX 78748 F Shareholder s percentage of stock Ownership for tax year..... 10 % 8c Unrecaptured section 1250 gain 9 Net section 1231 gain (loss) 10 Other income (loss) 15 Alternative minimum tax (AMT) items If the client s K-1 has entries on any lines not shown here it is out-of-scope for VITA. 11 Section 179 deduction 16 Items affecting shareholder basis 12 Other deductions A 26 17 Other information *See attached statement for additional information For Paperwork Reduction Act Notice, see Instructions for Form 1120S. www.irs.gov/form1120s Cat. No. 11520D Schedule K-1 (Form 1120S) 15

Form 1095-A Department of the Treasury Internal Revenue Service Part 1 Recipient Information Health Insurance Marketplace Statement VOID Information about Form 1095-A and it s separate instructions CORRECTED is at www.irs.gov/form1095a. 1 Marketplace identifier 2 Marketplace assigned policy number 456321879 3 Policy Issuer s name DEF Health Insurance OMB No. 1245-2232 4 Recipient s name 5 Recipient s SSN 6 Recipient s date of birth Charles Monroe XXX-XX-2345 03/17/1960 7 Recipient s spouse s name 8 Recipient s spouse s SSN 8 Recipient s spouse s date of birth 10 Policy start date 01/01/ 13 City or town Austin Part II Covered Individuals 11 Policy termination date 12/31/ 14 State or Province TX 12 Street address (including apartment no) A. Covered individual name B. Covered Individual SSN C. Covered individual date of birth 15 Country and zip or foreign postal code 78748 D. Coverage start date E. Coverage termination date 16 Amber Monroe XXX-XX-9123 12/09/2001 1/15/ 12/31/ 17 18 19 20 Part III If everyone listed on Form 1095-A is not included on Form 1040 then a shared policy allocation must be calculated and the return is out-of-scope for VITA. Coverage Information A. Monthly enrollment premiums B. Monthly second lowest cost silver Month plan (SLCSP) premium C. Monthly advance payment of premium tax credit 21 January 350 315 265 22 February 350 315 265 23 March 350 315 265 24 April 350 315 265 25 May 26 June 27 July 28 August 29 September If the SLCSP is not present on Form 1095-A the preparer must go to the Marketplace and determine the correct SLCSP to correctly reconcile advanced PTC. 30 October 31 November 32 December 33 Annual Totals 1400 1260 1060 For Privacy Act and Paperwork Reduction Act Notice, see separate instructions Cat. No. 60703Q Form 1095-A (2016) 16

Form 1095-A Department of the Treasury Internal Revenue Service Part 1 Recipient Information Health Insurance Marketplace Statement VOID Information about Form 1095-A and it s separate instructions CORRECTED is at www.irs.gov/form1095a. 1 Marketplace identifier 2 Marketplace assigned policy number 456321879 3 Policy Issuer s name DEF Health Insurance OMB No. 1245-2232 4 Recipient s name 5 Recipient s SSN 6 Recipient s date of birth Charles Monroe XXX-XX-2345 03/17/1960 7 Recipient s spouse s name 8 Recipient s spouse s SSN 8 Recipient s spouse s date of birth 10 Policy start date 01/01/ 13 City or town Austin Part II Covered Individuals 11 Policy termination date 12/31/ 14 State or Province TX 12 Street address (including apartment no) A. Covered individual name B. Covered Individual SSN C. Covered individual date of birth 15 Country and zip or foreign postal code 78748 D. Coverage start date E. Coverage termination date 16 Amber Monroe XXX-XX-9123 12/09/2001 1/15/ 12/31/ 17 18 19 20 Part III Coverage Information A. Monthly enrollment premiums B. Monthly second lowest cost silver Month plan (SLCSP) premium C. Monthly advance payment of premium tax credit 21 January 22 February 23 March 24 April 25 May 375 315 295 26 June 375 315 295 27 July 375 315 295 28 August 375 315 295 29 September 375 315 295 30 October 375 315 295 31 November 375 315 295 32 December 375 315 295 33 Annual Totals 3000 2520 2360 For Privacy Act and Paperwork Reduction Act Notice, see separate instructions Cat. No. 60703Q Form 1095-A (2016) 17

560116 Form 1095-B Department of the Treasury Internal Revenue Service Health Coverage Do not attach to your tax return. Keep for your records. Go to www.irs.gov/form1095b for instructions and the latest information. 2 Social security number (SSN) or other TIN VOID CORRECTED OMB No. 1545-2252 Part I Responsible Individual 1 Name of responsible individual 3 Date of birth (if SSN or other TIN is not available) CHARLES MONROE XXX-XX-2345 4 Street address (including apartment no.) 5 City or town 6 State or province 7 Country and ZIP or foreign postal code 3785 LIVE OAK DRIVE AUSTIN TX 78748 9 Reserved 8 Enter letter identifying Origin of the Health Coverage (see instructions for codes):... D Part II Information About Certain Employer-Sponsored Coverage (see instructions) 10 Employer name 11 Employer identification number (EIN) 12 Street address (including room or suite no.) 13 City or town 14 State or province 15 Country and ZIP or foreign postal code Part III Issuer or Other Coverage Provider (see instructions) 16 Name 17 Employer identification number (EIN) 18 Contact telephone number HPH INSURANCE 74-6782345 512.555.1212 19 Street address (including room or suite no.) 20 City or town 21 State or province 22 Country and ZIP or foreign postal code PO BOX 12603 AUSTIN TX 78701 Part IV Covered Individuals (Enter the information for each covered individual.) (a) Name of covered individual(s) (b) SSN or other TIN (c) DOB (if SSN or other TIN is not available) (d) Covered all 12 months (e) Months of coverage Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 23 CHARLES MONROE XXX-XX-2345 24 LOUISE MONROE XXX-XX-1234 25 26 27 28 For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 60704B Form 1095-B () 18

560116 Form 1095-B Department of the Treasury Internal Revenue Service Health Coverage Do not attach to your tax return. Keep for your records. Go to www.irs.gov/form1095b for instructions and the latest information. 2 Social security number (SSN) or other TIN VOID CORRECTED OMB No. 1545-2252 Part I Responsible Individual 1 Name of responsible individual 3 Date of birth (if SSN or other TIN is not available) CHARLES MONROE XXX-XX-2345 4 Street address (including apartment no.) 5 City or town 6 State or province 7 Country and ZIP or foreign postal code 3785 LIVE OAK DRIVE AUSTIN TX 78748 9 Reserved 8 Enter letter identifying Origin of the Health Coverage (see instructions for codes):... D Part II Information About Certain Employer-Sponsored Coverage (see instructions) 10 Employer name 11 Employer identification number (EIN) 12 Street address (including room or suite no.) 13 City or town 14 State or province 15 Country and ZIP or foreign postal code Part III Issuer or Other Coverage Provider (see instructions) 16 Name 17 Employer identification number (EIN) 18 Contact telephone number DEF INSURANCE 74-7823456 512.555.1212 19 Street address (including room or suite no.) 20 City or town 21 State or province 22 Country and ZIP or foreign postal code PO BOX 987 AUSTIN TX 78705 Part IV Covered Individuals (Enter the information for each covered individual.) (a) Name of covered individual(s) (b) SSN or other TIN (c) DOB (if SSN or other TIN is not available) (d) Covered all 12 months (e) Months of coverage Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 23 AMBER MONROE XXX-XX-9123 24 25 26 27 28 For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 60704B Form 1095-B () 19