2014 turbotaxreturn (1)

Form

1040A 2014U.S. Individual Income Tax ReturnDepartment of the Treasury—Internal Revenue Service

IRS Use Only—Do not write or staple in this space. (99)

OMB No. 1545-0074Your first name and initial Last name

Your social security number

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Make sure the SSN(s) above and on line 6c are correct.

Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Foreign country name Foreign province/state/county Foreign postal code

Presidential Election Campaign

Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse

Filing status Check only one box.

1 Single2 Married filing jointly (even if only one had income)3 Married filing separately. Enter spouse’s SSN above and

full name here.

4 Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child’s name here.

5 Qualifying widow(er) with dependent child (see instructions)

Exemptions

If more than six dependents, see instructions.

6a Yourself. If someone can claim you as a dependent, do not check box 6a.

b Spouse}

c Dependents:

(1) First name Last name

(2) Dependent’s social security number

(3) Dependent’s

relationship to you

(4) if child under age 17 qualifying for child tax credit (see

instructions)

d Total number of exemptions claimed.

Boxes checked on 6a and 6b

No. of children

on 6c who:

• lived with

you

• did not live with you due to

divorce or separation (see

instructions)

Dependents

on 6c not

entered above

Add numbers

on lines

above

Income Attach Form(s) W-2 here. Also attach Form(s) 1099-R if tax was withheld. If you did not get a W-2, see instructions.

7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7

8a Taxable interest. Attach Schedule B if required. 8ab Tax-exempt interest. Do not include on line 8a. 8b

Ordinary dividends. Attach Schedule B if required. 9ab Qualified dividends (see instructions). 9b

10 Capital gain distributions (see instructions). 1011 a IRA

distributions. 11a11b Taxable amount

(see instructions). 11b12 a Pensions and

annuities. 12a12b Taxable amount

(see instructions). 12b

13 Unemployment compensation and Alaska Permanent Fund dividends. 1314 a Social security

benefits. 14a14b Taxable amount

(see instructions). 14b

15 Add lines 7 through 14b (far right column). This is your total income. 15Adjusted gross income

16 Educator expenses (see instructions). 1617 IRA deduction (see instructions). 1718 Student loan interest deduction (see instructions). 18

19 Tuition and fees. Attach Form 8917. 1920 Add lines 16 through 19. These are your total adjustments. 20

21 Subtract line 20 from line 15. This is your adjusted gross income. 21For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040A (2014)

1

2

Law

256 W Franklin St 2

1

10,779.

10,779.

6,779.

4,000.4,000.

Kendra E Kineg 198-76-4256 Daughter

Elizabeth M 205 48 9337

Womelsdorf PA 19567

BAA REV 01/20/15 Intuit.cg.cfp.sp

Form 1040A (2014) Page 2

Tax, credits,

and

payments

22 Enter the amount from line 21 (adjusted gross income). 2223 a Check

if: { You were born before January 2, 1950, BlindSpouse was born before January 2, 1950, Blind }Total boxes

checked 23ab If you are married filing separately and your spouse itemizes

deductions, check here 23bStandard Deduction for—

• People who check any box on line 23a or 23b or who can be claimed as a dependent, see instructions. • All others: Single or Married filing separately, $6,200 Married filing jointly or Qualifying widow(er), $12,400 Head of household, $9,100

24 Enter your standard deduction. 2425 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 2526 Exemptions. Multiply $3,950 by the number on line 6d. 2627 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.

This is your taxable income. 2728 Tax, including any alternative minimum tax (see instructions). 2829 Excess advance premium tax credit repayment. Attach

Form 8962. 2930 Add lines 28 and 29. 3031 Credit for child and dependent care expenses. Attach

Form 2441. 3132 Credit for the elderly or the disabled. Attach

Schedule R. 3233 Education credits from Form 8863, line 19. 3334 Retirement savings contributions credit. Attach Form 8880. 3435 Child tax credit. Attach Schedule 8812, if required. 3536 Add lines 31 through 35. These are your total credits. 3637 Subtract line 36 from line 30. If line 36 is more than line 30, enter -0-. 3738 Health care: individual responsibility (see instructions). Full-year coverage 3839 Add line 37 and line 38. This is your total tax. 3940 Federal income tax withheld from Forms W-2 and 1099. 4041 2014 estimated tax payments and amount applied

from 2013 return. 41If you have a qualifying child, attach Schedule EIC.

42a Earned income credit (EIC). 42ab Nontaxable combat pay election. 42b

43 Additional child tax credit. Attach Schedule 8812. 4344 American opportunity credit from Form 8863, line 8. 4445 Net premium tax credit. Attach Form 8962. 4546 Add lines 40, 41, 42a, 43, 44, and 45. These are your total payments. 46

Refund Direct deposit? See instructions and fill in 48b, 48c, and 48d or Form 8888.

47 If line 46 is more than line 39, subtract line 39 from line 46. This is the amount you overpaid. 47

48a Amount of line 47 you want refunded to you. If Form 8888 is attached, check here 48a

b Routing number

c Type: Checking Savings

d Account number

49 Amount of line 47 you want applied to your 2015 estimated tax. 49

Amount you owe

50 Amount you owe. Subtract line 46 from line 39. For details on how to pay, see instructions. 50

51 Estimated tax penalty (see instructions). 51

Third party

designee

Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete the following. No

Designee’s name

Phone no.

Personal identification number (PIN)

Sign here Joint return? See instructions. Keep a copy for your records.

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.

Your signature Date Your occupation Daytime phone number

Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protection PIN, enter it here (see inst.)

Paid

preparer

use only

Print/type preparer's name Preparer’s signature DateCheck if self-employed

PTIN

Firm's name

Firm's address

Firm's EIN

Phone no.

Form 1040A (2014)

Self-Prepared

0.

0.0.

0.

0.

0.

9 8 6 0 3 2 0 9 5 2

9,100.

7,900.

customer service (510)589-4255

6,779.

670.

3,975.

3,975.3,975.

3,305.

0 3 1 3 0 2 9 5 5

REV 01/20/15 Intuit.cg.cfp.sp

SCHEDULE EIC (Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Earned Income CreditQualifying Child Information

Complete and attach to Form 1040A or 1040 only if you have a qualifying child.

1040A . . . . . . . . . .

1040

EIC

OMB No. 1545-0074

2014Attachment Sequence No. 43 Information about Schedule EIC (Form 1040A or 1040) and its instructions is at www.irs.gov/scheduleeic.

Name(s) shown on return Your social security number

Before you begin: • See the instructions for Form 1040A, lines 42a and 42b, or Form 1040, lines 66a and 66b, to make sure that (a) you can take the EIC, and (b) you have a qualifying child.

• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card. Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s social security card is not correct, call the Social Security Administration at 1-800-772-1213.

!CAUTION

• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details.

• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

Qualifying Child Information Child 1 Child 2 Child 3

1 Child’s name If you have more than three qualifying children, you have to list only three to get the maximum credit.

First name Last name First name Last name First name Last name

2 Child’s SSN

The child must have an SSN as defined in the instructions for Form 1040A, lines 42a and 42b, or Form 1040, lines 66a and 66b,unless the child was born and died in 2014. If your child was born and died in 2014 and did not have an SSN, enter “Died” on this line and attach a copy of the child’s birth certificate, death certificate, or hospital medical records.

3 Child’s year of birth Year

If born after 1995 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5.

Year If born after 1995 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5.

Year If born after 1995 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5.

4 a Was the child under age 24 at the end of 2014, a student, and younger than you (or your spouse, if filing jointly)?

Yes.

Go to line 5.

No.

Go to line 4b.

Yes.

Go to line 5.

No.

Go to line 4b.

Yes.

Go to line 5.

No.

Go to line 4b.

b Was the child permanently and totally disabled during any part of 2014?

Yes.Go to line 5.

No.The child is not a qualifying child.

Yes.Go to line 5.


Yes.Go to line 5.


5 Child’s relationship to you (for example, son, daughter, grandchild, niece, nephew, foster child, etc.)

6 Number of months child lived with you in the United States during 2014

• If the child lived with you for more than half of 2014 but less than 7 months, enter “7.”

• If the child was born or died in 2014 and your home was the child’s home for more than half the time he or she was alive during 2014, enter “12.”

months Do not enter more than 12 months.



For Paperwork Reduction Act Notice, see your tax return instructions.

Schedule EIC (Form 1040A or 1040) 2014

Elizabeth M Law 205-48-9337

Kendra E Kineg

198-76-4256

1 9 9 6

Daughter

12


Form 8917Department of the Treasury Internal Revenue Service

Tuition and Fees Deduction Attach to Form 1040 or Form 1040A.

Information about Form 8917 and its instructions is at www.irs.gov/form8917.

OMB No. 1545-0074

2014Attachment Sequence No. 60

Name(s) shown on return Your social security number

!CAUTION

You cannot take both an education credit from Form 8863 and the tuition and fees deduction from this form for the same student for the same tax year.

Before you begin: To see if you qualify for this deduction, see Who Can Take the Deduction in the instructions below.

If you file Form 1040, figure any write-in adjustments to be entered on the dotted line next to Form 1040, line 36. See the 2014 Form 1040 instructions for line 36.

1 (a) Student’s name (as shown on page 1 of your tax return)

First name Last name

(b) Student’s social security

number (as shown on page

1 of your tax return)

(c) Adjusted qualified

expenses (see

instructions)

2 Add the amounts on line 1, column (c), and enter the total . . . . . . . . . . . . . 2

3 Enter the amount from Form 1040, line 22, or Form 1040A, line 15 3

4 Enter the total from either:

• Form 1040, lines 23 through 33, plus any write-in adjustments entered on the dotted line next to Form 1040, line 36, or

• Form 1040A, lines 16 through 18. . . . . . . . . . . 4

5 Subtract line 4 from line 3.* If the result is more than $80,000 ($160,000 if married filing jointly), stop; you cannot take the deduction for tuition and fees . . . . . . . . . . . . . 5

*If you are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from Puerto Rico, see Effect of the Amount of Your Income on the Amount of Your Deduction in Pub. 970, chapter 6, to figure the amount to enter on line 5.

6 Tuition and fees deduction. Is the amount on line 5 more than $65,000 ($130,000 if married filing jointly)?

Yes. Enter the smaller of line 2, or $2,000.

No. Enter the smaller of line 2, or $4,000.

Also enter this amount on Form 1040, line 34, or Form 1040A, line 19.

} . . . . . . . . . . . . . . 6

For Paperwork Reduction Act Notice, see your tax return instructions. Form 8917 (2014)

10,779.

Elizabeth M Law 205-48-9337

10,779.

4,000.

4,427.

Elizabeth M Law 205-48-9337 4,427.


PA-40 - 2014Pennsylvania Income Tax Return

ENTER ONE LETTER OR NUMBER IN EACH BOX (06-14)

Extension.

1a Gross Compensation. Do not include exempt income, such as combat zone pay and qualifying retirement benefits. See the instructions.

1b Unreimbursed Employee Business Expenses.1c Net Compensation. Subtract Line 1b from Line 1a.

2 Interest Income. Complete PA Schedule A if required.3 Dividend and Capital Gains Distributions Income. Complete PA Schedule B if required.4 Net Income or Loss from the Operation of a Business, Profession or Farm.

5 Net Gain or Loss from the Sale, Exchange or Disposition of Property.6 Net Income or Loss from Rents, Royalties, Patents or Copyrights.7 Estate or Trust Income. Complete and submit PA Schedule J.8 Gambling and Lottery Winnings. Complete and submit PA Schedule T.9 Total PA Taxable Income. Add only the positive income amounts from Lines 1c,

2, 3, 4, 5, 6, 7 and 8. DO NOT ADD any losses reported on Lines 4, 5 or 6.

10 Other Deductions. Enter the appropriate code for the type of deduction. See the instructions for additional information.

11 Adjusted PA Taxable Income. Subtract Line 10 from Line 9.

Amended Return.

Farmers.

Taxpayer Date of Death

Deceased

Spouse Date of Death

School District Name ________________________

1a

1b1c

234

56789

10

11

Single, Married/Filing Jointly,

Married/Filing Separately, Final Return

Occupation

Occupation

Residency Status.

PA Resident/Nonresident/Part-Year Resident

from to

Page 1 of 2

EC FCOFFICIAL USE ONLY

0N

0

0

00

N

N

N

10779

010779

10779

10779

205489337

LAW

ELIZABETH M

APT 2

256 W FRANKLIN ST

WOMELSDORF PA 19567

CUSTOMER S

N N

R

S

N

510-589-4255 06110

1400115224

CONRAD WEISER

000

1555 REV 12/19/14 INTUIT.CG.CFP.SP

1400115224

Tax Forgiveness Credit. Submit PA Schedule SP.19a Filing Status: 01 Unmarried or Separated 02 Married 03 Deceased19b Dependents, Part B, Line 2, PA Schedule SP20 Total Eligibility Income from Part C, Line 11, PA Schedule SP.21 Tax Forgiveness Credit from Part D, Line 16, PA Schedule SP.

22 Resident Credit. Submit your PA Schedule(s) G-L and/or RK-1.23 Total Other Credits. Submit your PA Schedule OC.24 TOTAL PAYMENTS and CREDITS. Add Lines 13, 18, 21, 22 and 23.25 USE TAX. Due on internet, mail order or out-of-state purchases. See instructions.26 TAX DUE. If the total of Line 12 and Line 25 is more than line 24, enter the difference here.27 Penalties and Interest. See the instructions. Enter Code:

If including form REV-1630/REV-1630A, mark the box.

28 TOTAL PAYMENT DUE. See the instructions.29 OVERPAYMENT. If Line 24 is more than the total of Line 12, Line 25 and Line 27, enter

the difference here.The total of Lines 30 through 36 must equal Line 29.

30 Refund – Amount of Line 29 you want as a check mailed to you. REFUND31 Credit – Amount of Line 29 you want as a credit to your 2015 estimated account.

32 Refund donation line. Enter the organization code and donation amount. See instructions.33 Refund donation line. Enter the organization code and donation amount. See instructions.34 Refund donation line. Enter the organization code and donation amount. See instructions.35 Refund donation line. Enter the organization code and donation amount. See instructions.36 Refund donation line. Enter the organization code and donation amount. See instructions.

Your Signature Spouse’s Signature, if filing jointly

Preparer’s Name and Telephone Number Date

PA-40 - 2014

Page 2 of 2

Social Security Number

Name(s)

13

1415161718

19a19b2021

222324252627

2829

3031

3233343536

12 PA Tax Liability. Multiply Line 11 by 3.07 percent (0.0307).13 Total PA Tax Withheld. See the instructions.

14 Credit from your 2013 PA Income Tax return. 15 2014 Estimated Installment Payments. REV-459B included.16 2014 Extension Payment.17 Nonresident Tax Withheld from your PA Schedule(s) NRK-1. (Nonresidents only)18 Total Estimated Payments and Credits. Add Lines 14, 15, 16 and 17.

12

E-File Opt Out

Firm FEIN

Preparer’s PTIN

Signature(s). Under penalties of perjury, I (we) declare that I (we) have examined this return, including all

accompanying schedules and statements, and to the best of my (our) belief, they are true, correct, and complete.

N

SELF-PREPARED

N

N

0

0101

ELIZABETH M LAW205489337

0

331

00

0

662

331

10779331

331

3310

1555 REV 12/19/14 INTUIT.CG.CFP.SP

1400215230

0

00

00

0

1400215230 1400215230

OFFICIAL USE ONLY

PA SCHEDULE W-2SWage Statement Summary

2014PA-40 Schedule W-2S(07-14)(I)

Use this schedule to list and calculate your total PA-taxable compensation and PA tax withheld from all sources.Part A Instructions: List each federal Form W-2 for you and your spouse, if married, received from your employer(s). In the first column enter T for the taxpayer’s SocialSecurity Number that appears first on the PA tax return and enter S for the second or spouse SSN. From the Forms W-2, enter each employer’s federal identification num-ber. Enter the amounts from the Forms W-2 in each column. IMPORTANT: You do not have to submit a copy of your Form W-2 if you earned all your income inPennsylvania and your employer reported your PA wages correctly and withheld the correct amount of PA income tax. You must submit a copy of your Form W-2 in cer-tain circumstances. See the PA Schedule W-2S instructions for a list of when a copy of a W-2 is required.Part B Instructions: List each source of income received during the taxable year on a form or statement other than a federal Form W-2. Enter each payer’s name. Listthe payment type that most closely describes the source of your non-employee compensation. Enter the amount of other compensation that you earned. If the form orstatement does not have separately stated amounts, enter the amount shown in both federal and PA columns.IMPORTANT: You must submit a copy of each form and statement that you list in Part B, whether or not the payer withheld any PA income tax and regardless ofwhether or not the income was taxable in PA. CAUTION: The federal and Pennsylvania (state) wages may be different in Part A and Part B.

If you need more space, you may photocopy this schedule or make your own schedules in this format.

Part A - Federal Forms W-2 SEE THE INSTRUCTIONS FOR WHEN TO SUBMIT FORM(S) W-2

T/S Employer’s identification number from Box bFederal wages Medicare wages PA compensation PA income tax

from Box 1 from Box 5 from Box 16 withheld from Box 17

Total Part A- Add the Pennsylvania columns

Part B - Miscellaneous and Non-employee Compensation from federal Forms 1099-R, 1099-MISC and other statements

YOU MUST SUBMIT COPIES OF EACH FORM OR STATEMENT LISTED IN THIS PART

A. B. C. D. E. F. G. H.T/S Type Payer name 1099R code Total federal amount Adjusted plan basis PA compensation PA tax withheld

Total Part B - Add the Pennsylvania columns

TOTAL - Add the totals from Parts A and B

Enter the TOTALS on your PA tax return on: Line 1a Line 13

Payment type: A. Executor fee B. Jury duty pay C. Director’s fee D. Expert witness fee

E. Honorarium F. Covenant not to compete G. Damages or settlement for lost wages, other than personal injury

H. Other nonemployee compensation. Describe:

I. Distribution from employer sponsored retirement, pension or qualified deferred compensation plan

J. Distribution from IRA (Traditional or Roth) K. Distribution from Life Insurance, Annuity or Endowment Contracts

L. Distribution from Charitable Gift Annuities

Name shown first on the PA-40 (if filing jointly) Social Security Number (shown first)

Summary of PA-Taxable Employee, Non-employee and Miscellaneous Compensation

10,779 331

10,779 331

ELIZABETH M LAW 205-48-9337

T 22-3606734 9,251 9,251 9,251 284T 45-2403263 1,231 1,231 1,231 38T 20-0360283 297 297 297 9

1401910029

1555

1401910029 REV 09/16/14 INTUIT.CG.CFP.SP 1401910029

PA SCHEDULE SPSpecial Tax Forgiveness

PA-40 Schedule SP (07-14)(I) 2014 OFFICIAL USE ONLY

1. Unmarried - use Column A to calculate your Eligibility Income. Fill in the Unmarried oval on Line 19a of your PA-40. Fill in the oval that describes your situation:

a. Single. Unmarried/divorced on Dec. 31, 2014

b. Single and claimed as a dependent on another person’s PA Schedule SP. Enter the other person’s:

2. Separated – use Column A to calculate your Eligibility Income.Fill in this oval only if (a) you are separated pursuant to a written agreement or (b) you were married, but separated and lived apart for the last six months of the year. Fill in the Unmarried oval on Line 19a of your PA-40.

3. Married - Fill in the Married oval on Line 19a of your PA-40. Enter your spouse’s name and SSN above. Fill in the oval that describes your situation:a. Married and claiming Tax Forgiveness together with my spouse. Use Column A to calculate Eligibility Income.

b. Married and filing separate PA tax returns. Certification. Fill in this oval certifying that you and your spouse are submitting the sameinformation on each PA Schedule SP. Use Columns B and C to calculate your Eligibility Income.

c. Married with a spouse who is a dependent on another person’s PA Schedule SP or federal income tax return. Use Columns B and C to calculateEligibility Income. Enter the other person’s:

d. Separated and lived apart from my spouse but for less than the last six months of the year. Use Columns B and C to calculate Eligibility Income.Enter your spouse’s name and SSN above.

4. Deceased - use Column A to calculate your Eligibility Income.Fill in the Deceased oval on Line 19a of the PA-40. You must annualize the decedent’s income (see the instructions) and briefly describe your method:

1. Dependent’s Name Age

2.

Relationship Social Security No.

2. Number of dependent children.Enter on Line 19b of your PA-40. . . . . . . .

Part C. Eligibility Income.

Married taxpayers filing jointly use Column A and Eligibility Income Married taxpayers filing separately, and taxpayers separated but not for the lastTable 2. Single filers, qualifying separated filers, and if filing for six months of the year use Columns B and C, and Eligibility Income Table 2.a decedent use Column A and Eligibility Income Table 1.

Column A The Eligibility Income Tables are on page 36 of the PA-40 booklet.Married Filing Separately

Unmarried or Married Column B Column CFiling Jointly Taxpayer Spouse

1. PA taxable income from Line 9 of your PA-40 1.

2. Nontaxable interest, dividends and gains and/or annualized income 2.

3. Alimony 3.

4. Insurance proceeds and inheritances 4.

5. Gifts, awards and prizes 5.

6. Nonresident income – part-year residents and nonresidents 6.

7. Nontaxable military income – Do not include combat pay 7.

8. Gain excluded from the sale of a residence 8.

9. Nontaxable educational assistance 9.

10. Cash received for personal purposes from outside your home 10.

11. ÁTotal Eligibility Income for Column A

Total Eligibility Income for Columns B and C – add Lines 1 through 10 for each spouse and enter the total Ë 11.

Part D. Calculating your Tax Forgiveness Credit

12. PA Tax Liability from your PA-40, Line 12 (if amended return, see instructions) 12.

13. Less Resident Credit from your PA-40, Line 22 13.

14. Net PA Tax Liability. Subtract Line 13 from Line 12 14.

15. Percentage of Tax Forgiveness entered as a decimal from the Eligibility Income Table 15.using your dependents from Part B and your Total Eligibility Income from Line 11

16. Tax Forgiveness Credit. Multiply Line 14 by the decimal on Line 15. 16.Enter on your PA-40, Line 21.

Part A. Filing Status for Tax Forgiveness.

Part B. Dependent Children. Provide all the information for each dependent child. If more than four dependent children, submit additional sheets in this format.

IMPORTANT: Only claim the child or children that youclaimed as your dependent(s) on your 2014 FederalIncome Tax return.

Name of taxpayer claiming Tax Forgiveness (if filing a PA-40 jointly, enter the name shown first) Social Security Number (shown first)

Spouse’s Name (even if filing separately) Spouse’s Social Security Number

Eligibility Questions

1. Are you a dependent on another taxpayer’s (parent, guardian, step-parent, etc.) federal tax return? Yes No

2. If you answered “Yes” above, does the taxpayer on whose return you are a dependent qualify for tax forgiveness? Yes No

IMPORTANT: If you answered “No” to Question 1, please proceed with completing Schedule SP. If you answered “Yes to Question 1, you must also have answered“Yes” to Question 2 to be eligible for tax forgiveness and complete Line 1b. or Line 3c. from Part A below.

SSN: Name:

SSN: Name:

ELIZABETH M LAW 205-48-9337

X

1

10,779

10,779

3310

331

1.00

331

0

000

00

00

0

KENDRA E KINEG 18DAUGHTER 198-76-4256

1401110026

0 00 00 00 00 00 00 00 00 00 0

0

000

0

1555REV 09/03/14 INTUIT.CG.CFP.SP

Documents

2014 turbotaxreturn (1)