2014 TaxReturn
2014 TaxReturn
2014 TaxReturn
Important: Your taxes are not finished until all required steps are completed.
An N Vu
13605 58th Ave N
Plymouth, MN 55446
|
Balance | Your federal tax return (Form 1040) shows a balance due of $1,181.00.
Due/ |
Refund | Your return shows you have elected to pay your balance due of
| $1,181.00 by Direct Debit using the following information:
| - Amount Withdrawn: $1,181.00
| - Account Number: 152302509137
| - Routing Transit Number: 081000210
| - Date of Withdrawal: 04/03/2015
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your federal return
Keep |
|
______________________________________________________________________________________
|
2014 | Adjusted Gross Income $ 175,910.00
Federal | Taxable Income $ 157,620.00
Tax | Total Tax $ 37,299.00
Return | Total Payments/Credits $ 36,118.00
Summary | Payment Due $ 1,181.00
| Effective Tax Rate 21.20%
|
______________________________________________________________________________________
|
Estimated | Estimated Payments for 2015 - Do not mail these vouchers with your
Payments to | 2014 income tax return. The estimated vouchers displayed below are
Make for Next | used to prepay your 2015 income taxes that will be filed next year.
Year's Return | If you expect to owe more than $1,000 in 2015, you may incur
| underpayment penalties if you do not make these four estimated tax
| payments. This printout includes your estimated tax vouchers for your
| federal estimated taxes (Form 1040-ES).
|
| Mail payments according to the schedule below:
|
| Voucher Number Due Date Amount
| 1 04/15/2015 $ 1,228.00
| 2 06/15/2015 $ 1,228.00
| 3 09/15/2015 $ 1,228.00
| 4 01/15/2016 $ 1,228.00
|
| Include a separate check or money order for each payment, payable to
| "United States Treasury". Write your social security number and "Form
| 1040-ES" on each check.
|
| Mail payments to:
| Internal Revenue Service
| P.O. Box 802502
| Cincinnati, OH 45280-2502
|
______________________________________________________________________________________
Page 1 of 1
Hi An,
We just want to thank you for using TurboTax this year! It's our goal to make
your taxes easy and accurate, year after year.
We reviewed over 350 deductions and credits so you can be sure you
didn't miss a thing and that you got the maximum refund - guaranteed.
Your Deductions and Credits:
Also included:
- We provide the Audit Support Center free of charge, in the unlikely
event you get audited.
For the year Jan. 1–Dec. 31, 2014, or other tax year beginning , 2014, ending , 20 See separate instructions.
Your first name and initial Last name Your social security number
An N Vu 327-02-4303
If a joint return, spouse’s first name and initial Last name Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above
c
and on line 6c are correct.
13605 58th Ave N
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign
Plymouth MN 55446 Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign country name Foreign province/state/county Foreign postal code
a box below will not change your tax or
refund. You Spouse
Exemptions 6a
b
Yourself. If someone can claim you as a dependent, do not check box 6a .
Spouse . . . . . . . . . . . . . . . . . . . .
.
.
.
.
.
.
.
.
} Boxes checked
on 6a and 6b
No. of children
1
c Dependents: (2) Dependent’s (3) Dependent’s (4) if child under age 17 on 6c who:
social security number relationship to you qualifying for child tax credit • lived with you
(1) First name Last name (see instructions) • did not live with
you due to divorce
or separation
If more than four (see instructions)
dependents, see Dependents on 6c
instructions and not entered above
check here a Add numbers on
d Total number of exemptions claimed . . . . . . . . . . . . . . . . . lines above a 1
7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7 174,979.
Income
8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a 852.
b Tax-exempt interest. Do not include on line 8a . . . 8b
Attach Form(s)
W-2 here. Also
9a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a 79.
attach Forms b Qualified dividends . . . . . . . . . . . 9b 79.
W-2G and 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10
1099-R if tax 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11
was withheld.
12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12
13 Capital gain or (loss). Attach Schedule D if required. If not required, check here a 13
If you did not 14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14
get a W-2,
see instructions. 15a IRA distributions . 15a b Taxable amount . . . 15b
16a Pensions and annuities 16a b Taxable amount . . . 16b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . 19
20a Social security benefits 20a b Taxable amount . . . 20b
21 Other income. List type and amount 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income a 22 175,910.
23 Educator expenses . . . . . . . . . . . 23
Adjusted 24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24
Income 25 Health savings account deduction. Attach Form 8889 . 25
26 Moving expenses. Attach Form 3903 . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE . 27
28 Self-employed SEP, SIMPLE, and qualified plans . . 28
29 Self-employed health insurance deduction . . . . 29
30 Penalty on early withdrawal of savings . . . . . . 30
31a Alimony paid b Recipient’s SSN a 31a
32 IRA deduction . . . . . . . . . . . . . 32
33 Student loan interest deduction . . . . . . . . 33
34 Tuition and fees. Attach Form 8917 . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903 35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . a 37 175,910.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA REV 03/10/15 TTO Form 1040 (2014)
Form 1040 (2014) Page 2
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . 38 175,910.
Tax and
Credits
39a Check
if:
{ You were born before January 2, 1950,
Spouse was born before January 2, 1950,
Blind.
Blind.
} Total boxes
checked a 39a
b If your spouse itemizes on a separate return or you were a dual-status alien, check here a 39b
Standard 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . 40 14,340.
Deduction 161,570.
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41
• People who 42 Exemptions. If line 38 is $152,525 or less, multiply $3,950 by the number on line 6d. Otherwise, see instructions 42 3,950.
check any
box on line 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . 43 157,620.
39a or 39b or 44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44 37,299.
who can be
claimed as a 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . 45
dependent,
see 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . 46
instructions. 47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . a 47 37,299.
• All others:
48 Foreign tax credit. Attach Form 1116 if required . . . . 48
Single or
Married filing 49 Credit for child and dependent care expenses. Attach Form 2441 49
separately,
$6,200 50 Education credits from Form 8863, line 19 . . . . . 50
Married filing 51 Retirement savings contributions credit. Attach Form 8880 51
jointly or
Qualifying 52 Child tax credit. Attach Schedule 8812, if required . . . 52
widow(er), 53 Residential energy credits. Attach Form 5695 . . . . 53
$12,400
Head of 54 Other credits from Form: a 3800 b 8801 c 54
household, 55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . 55
$9,100
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . a 56 37,299.
57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . 57
Other 58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 58
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . 59
Taxes 60a Household employment taxes from Schedule H . . . . . . . . . . . . . . 60a
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . 60b
61 Health care: individual responsibility (see instructions) Full-year coverage . . . . . 61
62 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 62
63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . a 63 37,299.
Payments 64 Federal income tax withheld from Forms W-2 and 1099 . . 64 36,118.
65 2014 estimated tax payments and amount applied from 2013 return 65
If you have a
66a Earned income credit (EIC) . . . . . . . . . . 66a
qualifying
child, attach b Nontaxable combat pay election 66b
Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 . . . . . 67
68 American opportunity credit from Form 8863, line 8 . . . 68
69 Net premium tax credit. Attach Form 8962 . . . . . . 69
70 Amount paid with request for extension to file . . . . . 70
71 Excess social security and tier 1 RRTA tax withheld . 71. . .
72 Credit for federal tax on fuels. Attach Form 4136 . 72. . .
73 Credits from Form: a 2439 b Reserved c Reserved d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . a 74 36,118.
Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 75
76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . a 76a
a bRouting number X X X X X X X X X a c Type: Checking Savings
Direct deposit?
See a dAccount number X X X X X X X X X X X X X X X X X
instructions.
77 Amount of line 75 you want applied to your 2015 estimated tax a 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions a 78 1,181.
You Owe 79 Estimated tax penalty (see instructions) . . . . . . . 79
Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No
Designee’s Phone Personal identification
Designee name a no. a number (PIN) a
Sign 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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation Daytime phone number
F
An N Vu 327-02-4303
Caution. Do not include expenses reimbursed or paid by others.
Medical 1 Medical and dental expenses (see instructions) . . . . . 1
and 2 Enter amount from Form 1040, line 38 2
Dental 3 Multiply line 2 by 10% (.10). But if either you or your spouse was
Expenses born before January 2, 1950, multiply line 2 by 7.5% (.075) instead 3
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . 4
Taxes You 5 State and local (check only one box):
Paid a
b
Income taxes, or
General sales taxes } . . . . . . . . . . . 5 10,471.
}
Itemized No. Your deduction is not limited. Add the amounts in the far right column
Deductions for lines 4 through 28. Also, enter this amount on Form 1040, line 40. . . 29 14,340.
Yes. Your deduction may be limited. See the Itemized Deductions
Worksheet in the instructions to figure the amount to enter.
30 If you elect to itemize deductions even though they are less than your standard
deduction, check here . . . . . . . . . . . . . . . . . . . a
For Paperwork Reduction Act Notice, see Form 1040 instructions. BAA REV 12/30/14 TTO Schedule A (Form 1040) 2014
Tax History Report 2014
G Keep for your records
Adjustments to income
Interest expense 8. 0.
Contributions
Miscellaneous
deductions
Other Itemized
Deductions
Total itemized/
standard deduction 6,100. 14,340.
Total credits
Other taxes
Applied to next
year’s estimated tax
Refund
Preparation fee
Federal law requires this consent form be provided to you. Unless authorized by law we cannot use
your tax return information for purposes other than the preparation and filing of your tax return
without your consent.
You are not required to complete this form to engage our tax return preparation services.
If we obtain your signature on this form by conditioning our tax return preparation services
on your consent, your consent will not be valid. Your consent is valid for the amount of time
that you specify. If you do not specify the duration of your consent, your consent is valid for one year
from the date of signature.
If you are requesting use of personal information from a joint return, you are representing that we
have consent for both parties on the return.
If you believe your tax return information has been disclosed or used improperly in a manner
unauthorized by law or without your permission, you may contact the Treasury Inspector General for
Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at [email protected].
Sign this agreement by entering your name and the date below.
an vu
First Name Last Name
03/29/2015
Date
SBIA1001.SCR 11/11/14
Form 1095-OTH Health Insurance Coverage 2014
Health Insurance Coverage for Individuals - This form may be used to report health insurance coverage information
for each individual whose health coverage is NOT reported on a Form 1095-A. If reporting an individual’s periods of
coverage from Form 1095-B or Form 1095-C, that individual’s health coverage information should not be reported below.
Check the box to populate the Name, SSN, and DOB for everyone listed on the return below.
Note: Checking this box again will repopulate the information below and overwrite existing entries.
Covered Individual:
a. Name of covered individual(s) Covered all
b. SSN c. DOB 12 months Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
17 An
327-02-4303 09/24/84 X X X X X X X X X X X X
18
19
20
21
22
Form 1040 Qualified Dividends and Capital Gain Tax Worksheet 2014
Line 44 G Keep for your records
Estimated Tax Payments for 2014 (If more than 4 payments for any state or locality, see Tax Help)
Tot Estimated
Payments
2013 State and Local Income Tax Information (See Tax Help)
a 2013
b 2012
c 2011
d 2010
e 2009
a 2014
b 2013
c 2012
d 2011
e 2010
2013 State Capital Loss Carryovers (For users not transferring from the prior year)
State Short-term AMT Short-term Long-term AMT Long-term Capital Loss AMT Capital Loss
ID Capital Loss Capital Loss Capital Loss Capital Loss (combined) (combined)
for State for State for State for State for State for State
Electronic Filing Instructions for your 2014 Minnesota Tax Return
Important: Your taxes are not finished until all required steps are completed.
An N Vu
13605 58th Ave N
Plymouth, MN 55446
|
Balance | Your Minnesota state tax return (Form M1) shows a balance due of
Due/ | $2,142.00.
Refund |
| Your return shows you have elected to pay your balance due of
| $2,142.00 by Direct Debit using the following information:
| - Amount Withdrawn: $2,142.00
| - Account Number: 152302509137
| - Routing Transit Number: 081000210
| - Date of Withdrawal: 04/03/2015
|
| To inquire about the status of your Direct Debit call the Minnesota
| Department of Revenue directly at 6512977865.
|
______________________________________________________________________________________
|
No | No signature form is required since you signed your return
Signature | electronically.
Document |
Needed |
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your state and federal returns
Keep |
|
______________________________________________________________________________________
|
2014 | Taxable Income $ 165,760.00
Minnesota | Total Tax $ 12,208.00
Tax | Total Payments/Credits $ 10,066.00
Return | Payment Due $ 2,142.00
Summary |
|
______________________________________________________________________________________
Page 1 of 1
M1 2014 Individual Income Tax 1411
PLYMOUTH MN 55446
2014 Federal
Filing Status (1) Single (2) Married filing joint (3) Married
filing separate:
(place an X in (4) Head
of Enter spouse’s name and
one oval box): household (5) Qualifying widow(er) Social Security number here
State Elections Campaign Fund Political Party and Code Number:
If you want $5 to go to help candidates for state of- Republican . . . . . . . . . . . 11 Grassroots . . . . . . . . . . . 14
fices pay campaign expenses, you may each enter
the code number for the party of your choice. This
Democratic Farmer-Labor 12 Libertarian . . . . . . . . . . . 16
will not increase your tax or reduce your refund. Independent . . . . . . . . . . 13 General Campaign Fund 99
From Your Federal Return (for line references see instructions), enter the amount of:
A Wages, salaries, tips, etc.: B IRA, Pensions and annuities: C Unemployment: D Federal adjusted gross income:
174979 0 0 175910
Do not send W-2s. Enclose Schedule M1W to
4 Add lines 1 through 3 (if a negative number, place an X in the oval box) . . . . . . . . . . . . 4 165760
6 Other subtractions, such as net interest or mutual fund dividends from U.S. bonds
or K-12 education expenses (see instructions; enclose Schedule M1M) . . . . . . . . . . . 6
8 Minnesota taxable income. Subtract line 7 from line 4. If zero or less, leave blank. . . . . 8 165760
19 Subtract line 18 from line 15 (if result is zero or less, leave blank) . . . . . . . . . . . . . . . . . . . . 19 12208
20 Nongame Wildlife Fund contribution (see instructions, page 15)
This will reduce your refund or increase amount owed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Checking Savings
35 Amount from line 30 you want applied to your 2015 estimated tax . . . . . . . . . . . . . . . . . . . 35
I declare that this return is correct and complete to the best of my knowledge and belief. Paid preparer: You must sign below.
Your signature Date Paid preparer’s signature Date
SELF-PREPARED
Spouse’s signature (if filing jointly) Taxpayer’s daytime phone Preparer’s daytime phone
7632225381
Include a copy of your 2014 federal return and schedules.
Mail to: Minnesota Individual Income Tax I authorize the Minnesota Department of
St. Paul, MN 55145-0010 Revenue to discuss this return with my I do not want my paid preparer
To check on the status of your refund, visit www.revenue.state.mn.us paid preparer or the third-party designee to file my return electronically.
indicated on my federal return.
REV 10/31/14 TTO 1555
201431
Schedule M1W, Minnesota Income Tax Withheld 2014
Sequence #2
Complete this schedule to report Minnesota income tax withheld. Include this schedule when you file your return.
AN N VU 327024303
If you received a W-2, 1099, W-2G, Schedule KPI, KS or KF that shows Minnesota income tax was withheld, complete this
schedule to determine line 22 of Form M1. List only the forms that report Minnesota income tax withheld. Round dollar
amounts to the nearest whole dollar. You must include this schedule when you file your return. DO NOT send in your W-2,
1099 or W-2G forms; keep them with your tax records. All instructions are included on this schedule.
1 Minnesota wages and tax withheld from W-2s, other than from W-2G. If you have more than five W-2s, complete line 5 on the back.
A B—Box 13 C—Box 15 D—Box 16 E—Box 17
If the W-2 is for: If Retirement Plan Employer’s 7-digit Minnesota State wages, tips, etc. Minnesota tax withheld
• you, enter 1 box is checked, state tax ID number (round to nearest whole dollar) (round to nearest whole dollar)
• spouse, enter 2 mark an X below.
Total Minnesota tax withheld from all W-2 forms (add amounts in line 1, column E) . . . . . . . . . . . . . 1 10066
2 Minnesota tax withheld from 1099 and W-2G forms. If you have more than four forms, complete line 6 on the back.
A B C D
If the 1099 or W-2G is for: Payer’s 7-digit Minnesota state tax ID Income amount (see the table on Minnesota tax withheld
• you, enter 1 number (if unknown, contact the payer) the back for amounts to include) (round to nearest whole dollar)
• spouse, enter 2
Subtotal for additional 1099 and W-2G forms (from line 6 on the back) . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Minnesota tax withheld from all 1099 and W-2G forms (add amounts in line 2, column D) . . . 2
For the year Jan. 1–Dec. 31, 2014, or other tax year beginning , 2014, ending , 20 See separate instructions.
Your first name and initial Last name Your social security number
An N Vu 327-02-4303
If a joint return, spouse’s first name and initial Last name Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above
c
and on line 6c are correct.
13605 58th Ave N
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign
Plymouth MN 55446 Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign country name Foreign province/state/county Foreign postal code
a box below will not change your tax or
refund. You Spouse
Exemptions 6a
b
Yourself. If someone can claim you as a dependent, do not check box 6a .
Spouse . . . . . . . . . . . . . . . . . . . .
.
.
.
.
.
.
.
.
} Boxes checked
on 6a and 6b
No. of children
1
c Dependents: (2) Dependent’s (3) Dependent’s (4) if child under age 17 on 6c who:
social security number relationship to you qualifying for child tax credit • lived with you
(1) First name Last name (see instructions) • did not live with
you due to divorce
or separation
If more than four (see instructions)
dependents, see Dependents on 6c
instructions and not entered above
check here a Add numbers on
d Total number of exemptions claimed . . . . . . . . . . . . . . . . . lines above a 1
7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7 174,979.
Income
8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a 852.
b Tax-exempt interest. Do not include on line 8a . . . 8b
Attach Form(s)
W-2 here. Also
9a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a 79.
attach Forms b Qualified dividends . . . . . . . . . . . 9b 79.
W-2G and 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10
1099-R if tax 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11
was withheld.
12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12
13 Capital gain or (loss). Attach Schedule D if required. If not required, check here a 13
If you did not 14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14
get a W-2,
see instructions. 15a IRA distributions . 15a b Taxable amount . . . 15b
16a Pensions and annuities 16a b Taxable amount . . . 16b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . 19
20a Social security benefits 20a b Taxable amount . . . 20b
21 Other income. List type and amount 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income a 22 175,910.
23 Educator expenses . . . . . . . . . . . 23
Adjusted 24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24
Income 25 Health savings account deduction. Attach Form 8889 . 25
26 Moving expenses. Attach Form 3903 . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE . 27
28 Self-employed SEP, SIMPLE, and qualified plans . . 28
29 Self-employed health insurance deduction . . . . 29
30 Penalty on early withdrawal of savings . . . . . . 30
31a Alimony paid b Recipient’s SSN a 31a
32 IRA deduction . . . . . . . . . . . . . 32
33 Student loan interest deduction . . . . . . . . 33
34 Tuition and fees. Attach Form 8917 . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903 35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . a 37 175,910.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA REV 03/10/15 TTO Form 1040 (2014)
Form 1040 (2014) Page 2
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . 38 175,910.
Tax and
Credits
39a Check
if:
{ You were born before January 2, 1950,
Spouse was born before January 2, 1950,
Blind.
Blind.
} Total boxes
checked a 39a
b If your spouse itemizes on a separate return or you were a dual-status alien, check here a 39b
Standard 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . 40 14,340.
Deduction 161,570.
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41
• People who 42 Exemptions. If line 38 is $152,525 or less, multiply $3,950 by the number on line 6d. Otherwise, see instructions 42 3,950.
check any
box on line 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . 43 157,620.
39a or 39b or 44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44 37,299.
who can be
claimed as a 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . 45
dependent,
see 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . 46
instructions. 47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . a 47 37,299.
• All others:
48 Foreign tax credit. Attach Form 1116 if required . . . . 48
Single or
Married filing 49 Credit for child and dependent care expenses. Attach Form 2441 49
separately,
$6,200 50 Education credits from Form 8863, line 19 . . . . . 50
Married filing 51 Retirement savings contributions credit. Attach Form 8880 51
jointly or
Qualifying 52 Child tax credit. Attach Schedule 8812, if required . . . 52
widow(er), 53 Residential energy credits. Attach Form 5695 . . . . 53
$12,400
Head of 54 Other credits from Form: a 3800 b 8801 c 54
household, 55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . 55
$9,100
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . a 56 37,299.
57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . 57
Other 58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 58
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . 59
Taxes 60a Household employment taxes from Schedule H . . . . . . . . . . . . . . 60a
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . 60b
61 Health care: individual responsibility (see instructions) Full-year coverage . . . . . 61
62 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 62
63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . a 63 37,299.
Payments 64 Federal income tax withheld from Forms W-2 and 1099 . . 64 36,118.
65 2014 estimated tax payments and amount applied from 2013 return 65
If you have a
66a Earned income credit (EIC) . . . . . . . . . . 66a
qualifying
child, attach b Nontaxable combat pay election 66b
Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 . . . . . 67
68 American opportunity credit from Form 8863, line 8 . . . 68
69 Net premium tax credit. Attach Form 8962 . . . . . . 69
70 Amount paid with request for extension to file . . . . . 70
71 Excess social security and tier 1 RRTA tax withheld . 71. . .
72 Credit for federal tax on fuels. Attach Form 4136 . 72. . .
73 Credits from Form: a 2439 b Reserved c Reserved d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . a 74 36,118.
Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 75
76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . a 76a
a bRouting number X X X X X X X X X a c Type: Checking Savings
Direct deposit?
See a dAccount number X X X X X X X X X X X X X X X X X
instructions.
77 Amount of line 75 you want applied to your 2015 estimated tax a 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions a 78 1,181.
You Owe 79 Estimated tax penalty (see instructions) . . . . . . . 79
Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No
Designee’s Phone Personal identification
Designee name a no. a number (PIN) a
Sign 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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation Daytime phone number
F
An N Vu 327-02-4303
Caution. Do not include expenses reimbursed or paid by others.
Medical 1 Medical and dental expenses (see instructions) . . . . . 1
and 2 Enter amount from Form 1040, line 38 2
Dental 3 Multiply line 2 by 10% (.10). But if either you or your spouse was
Expenses born before January 2, 1950, multiply line 2 by 7.5% (.075) instead 3
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . 4
Taxes You 5 State and local (check only one box):
Paid a
b
Income taxes, or
General sales taxes } . . . . . . . . . . . 5 10,471.
}
Itemized No. Your deduction is not limited. Add the amounts in the far right column
Deductions for lines 4 through 28. Also, enter this amount on Form 1040, line 40. . . 29 14,340.
Yes. Your deduction may be limited. See the Itemized Deductions
Worksheet in the instructions to figure the amount to enter.
30 If you elect to itemize deductions even though they are less than your standard
deduction, check here . . . . . . . . . . . . . . . . . . . a
For Paperwork Reduction Act Notice, see Form 1040 instructions. BAA REV 12/30/14 TTO Schedule A (Form 1040) 2014
Tax History Report 2014
G Keep for your records
Adjustments to income
Interest expense 8. 0.
Contributions
Miscellaneous
deductions
Other Itemized
Deductions
Total itemized/
standard deduction 6,100. 14,340.
Total credits
Other taxes
Applied to next
year’s estimated tax
Refund
Preparation fee