Test Scenario 3 (NACTP Test 8) Oklahoma Forms: 511, 511CR, 538-S. Taxpayer: Baby Sitter 222 Nursery Lane Oklahoma City, OK SSN:

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1 Test Scenario (NACTP Test 8) Oklahoma Forms:, CR, 8-S Taxpayer: Bay Sitter Nursery Lane Oklahoma City, OK 0 SSN: Dependent: John Doe SSN: Modification to Federal return: W: Oklahoma withholding of $.00. Adjust your charitale contriutions y $.00 Additional Information: Use the Federal AGI to compute Use Tax. For Form 8-S - Taxpayer did not receive TY0 EIC in FY0 Taxpayer s home was destroyed in the May 0, 0 tornado. Taxpayer prepared form 6 in 0. Final Result: Refund equals $9.00 (Form, line 8)

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3 NACTP Test 8 Single taxpayer worked part time and ran a daycare out of her home; she is a widow with child Forms: 00, W (), Schedule A, Schedule C, Schedule EIC, Schedule SE,, 6, 88, 88, 889, 886 Taxpayer: Bay Sitter Nursery Lane Tillamook, OR 9 SSN: DOB: 0//96 Filing Status: Qualifying Widow(er) Spouse DOD 06/0/0 Dependent: John Doe SSN DOB 0/9/00 Daycare Provider for John: Tiny Tots Child Care Lane Tillamook, OR 9 EIN: Amount paid: $

4 Page: Name(s) DEPRECIATION WORKSHEET - ALL METHODS BABY SITTER SSN / EIN If the usiness- use percentage of an asset is expected to change from year to year, use a separate worksheet for that asset, recomputing the columns D through O each year. In states where depreciation is computed different than federal, use a separate worksheet for state depreciation. When more than eight assets are eing depreciated, use as many worksheets as necessary. A S S E T 6 8 Asset Description/Location Manner/ Date Acquired (Purchased, gift, inherited, etc.) * Enter asis adjustment for clean- fuel vehicle deduction or electric vehicle credit in column B. Date Placed in Service, if different System (M ACRS, ACRS, etc.) & Class/ Lif e A. B. C. D. E. Cost or Other Basis Land/ Salvage or other adj.* In the section elow, use the top row for each asset to compute depreciation for regular tax purposes, and the shaded row elow it to compute depreciation for AMT purposes. In column O, enter the tax year at the top and the asset's recovery year elow (st, nd, etc.). Find the percentage from the appropriate tale. To continue depreciation after the third year, another row or use additional copies of this worksheet as overflow worksheets. Enter in Column M any depreciation claimed on prior years' worksheets. AM T AM T AM T AM T AM T 6 AM T AM T 8 AM T L I S T E D Business or Activity: SCH C BABY SITTER CHILD CARE S Suform: 889 F. Sec. 9 Deduction DEPRECIATION G. H. I. J. K. L. M. (E- F)** Special*** Depreciation Allowance, if any (col. G x percentage) T y N p u e c HOME H U0/0/00/0/0MACRS N Depreciale Amount (G- H) Recovery Period Method and Convention Prior Depreciation Claimed Date of Disposition Rec. Year: Year % Depr. Qualified Basis (A- B) Business Use % N. Depreciation Computation ** Reduce the result y any investment credit asis adjustment efore entering the figure in column G. *** An additional allowance of: 0% for qualified assets placed in service in the New York Lierty Zone after Septemer, 00 and efore January, 00, or for other qualified assets placed in service after Septemer, 00 and efore January, 00, or 0% for assets placed in service after May, 00 and efore Septemer 9, 00 or 00% after Septemer 8, 00 and efore January, 0. See special rules that apply to certain disaster areas. * System calculated prior depreciation WS Deprec (0) FDWS9- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc * MM 9*. 08 (I x %) Year: Rec. Year % Depr. (I x %) Year: Rec. Year % Business Basis (C x D) Depr. (I x %)

5 Form Filing Status Check only one ox. Exemptions If more than four dependents, see inst and check here Income Attach Form(s) W- here. Also attach Forms W- G and 099- R if tax was withheld. If you did not get a W-, see instructions. Single Married filing jointly (even if only one had income) Married filing separately. Enter spouse's SSN aove & f ull name h ere. H ead of h ouseh old (w ith qualif ying person). (See instructions.) If th e qualif ying person is a ch ild ut not your dependent, enter th is Qualifying widow(er) with dependent child B oxes checked 6a Yourself. If someone can claim you as a dependent, do not check ox 6a on 6a and 6 Spouse. of ch ildren on 6c w h o: c Dependents: () D ependent's () D ependent's () if qual. ch ild< f or lived with you social security numer relationsh ip to you ch ild tax cr. () First name Last name (see inst) did not live w ith you due to divorce JOHN DOE SON or separation (see inst) d 8a 9a 0 a 6a 8 9 0a Adjusted Gross Income D epartment of th e Treasury - Internal Revenue Service 00 U.S. Individual Income Tax Return OM B For th e year J an. - D ec., 0, or oth er tax year eginning BABY SITTER NURSERY LANE TILLAMOOK, OR 9 Foreign country name Total numer of exemptions claimed Wages, salaries, tips, etc. Attach Form(s) W- Taxale interest. Attach Schedule B if required Tax- exempt interest. Do not include on line 8a Ordinary dividends. Attach Schedule B if required Taxale refunds, credits, or offsets of state and local income taxes Alimony received Business income or (loss). Attach Schedule C or C- EZ Attach Sch edule D if required. Capital gain or (loss). If not required, check here Other gains or (losses). Attach Form 9 IRA distriutions Pensions and annuities Taxale amt Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F Unemployment compensation Social security enefits a 6a 0a Other income. List type and amount 8 Taxale amt Taxale amount Comine the amounts in the far right column for lines through. This is your total income a 6 ch ild's name h ere. Qualified dividends Educator expenses Certain usiness expenses of reservists, performing artists, and fee- asis government officials. Attach Form 06 or 06- EZ Health savings account deduction. Attach Form 8889 Moving expenses. Attach Form 90 6 Deductile part of self- employment tax. Attach Schedule SE 9. Self- employed SEP, SIMPLE, and qualified plans Self- employed health insurance deduction Penalty on early withdrawal of savings Alimony paid IRA deduction Recipient's SSN Student loan interest deduction Tuition and fees. Attach Form 89 8a D ependents on 6c not entered aove Add numers on lines aove Domestic production activities deduction. Attach Form 890 Add lines through 6 9. Sutract line 6 from line. This is your adjusted gross income KBA For Disclosure, Privacy Act, and Paperwork Reduction Act tice, see separate instructions. Form 00 (0) 00 (0) FD00- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc..-. (99), 0, ending, 0 Foreign province/ state/ county Foreign postal code a IRS Use Only - D o not w rite or staple in th is space. See separate instructions. Your social security numer Spouse's social security numer M ake sure th e SSN(s) aove and on line 6c are correct. Presidential Election Campaign Ch eck h ere if you, or your spouse if f iling jointly, w ant $ to go to th is f und. Ch ecking a ox elow w ill not ch ange your tax or ref und. You Spouse 9a,00.,096. 6,96.,.

6 Form 00 (0) Tax and Credits Standard Deduction for - People who check any ox on line 9a or 9 or who can e claimed as a dependent, see instr. Other Taxes Payments If you have a qualifying child, attach Schedule EIC. Refund Direct deposit? See instructions. Amount 8 9a Amount from line (adjusted gross income) Check Exemptions. If line 8 is $0,000 or less, multiply $,900 y th e numer on line 6d. Oth erw ise, see instructions Taxale income. Sutract line from line. If line is more than line, enter - 0- Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 9 if required Household employment taxes from Schedule H Form 9 0 Credit for federal tax on fuels. Attach Form 6 Re- Credits f rom Form: a 9 served c 888 d Blind. Blind. If your spouse itemizes on a separate return or you were a dual- status alien, check here Sutract line 0 from line 8 You were orn efore January, 99, Spouse was orn efore January, 99, Itemized deductions (from Schedule A) or your standard deduction (see left margin) Alternative minimum tax (see instructions). Attach Form 6 Add lines and Foreign tax credit. Attach Form 6 if required Credit for child and dependent care expenses. Attach Form 8. 0 Retirement savings contriutions credit. Attach Form Child tax credit. Attach Schedule 88, if required Residential energy credit. Attach Form 69 Oth er credits f rom Form: a c Add ln through. These are your total credits 6 Sutract line from line 6. If line is more than line 6, enter - 0- Self- employment tax. Attach Schedule SE Unreported social security and Medicare tax from Form: 8 9a a d Federal income tax withheld from Forms W- and estimated tax payments and amount applied from 0 return Earned income credit (EIC) Additional child tax credit. Attach Schedule 88 Amount paid with request for extension to file Add lines 6, 6, 6a, and 6 through. These are your total payments If line is more than line 6, sutract line 6 from line. This is the amount you overpaid Amount of line you want refunded to you. If Form 8888 is attached, check here Routing numer Account numer Amount of line you want applied to your 0 estimated tax a c Type: Checking Savings 6 Amount you owe. Sutract line from line 6. For details on how to pay, see instructions 6 You Owe Estimated tax penalty (see instructions) Third Party Designee Sign Here All others: Single or M arried filing separately, $6,00 M arried filing jointly or Qualif ying w idow (er), $,00 Head of h ouseh old, $8,90 Joint return? See instructions. Keep a copy for your records. Paid Preparer Use Only BABY SITTER 6 6 a if: Do you want to allow another person to discuss this return with the IRS (see instructions)?. Complete elow. Designee's name Phone no. Personal ID numer (PIN) Under penalties of perjury, I declare th at I h ave examined th is return and accompanying sch edules and statements, and to th e est of my know ledge and elief, th ey are true, correct, and complete. D eclaration of preparer (oth er th an taxpayer) is ased on all inf ormation of w h ich preparer h as any know ledge. Your signature Date Your occupation Daytime phone numer Spouse's signature. If a joint return, oth must sign. Date Spouse's occupation Print/Type preparer's name Preparer's signature Date Check if PTIN KATHLEEN PERRY 09/0/0 self- employed P Firm's name HRB TA GROUP INC Firm's EIN -880 Firm's address Tax. Check if any from: a Education credits from Form 886, line 9 ntaxale comat pay election 6 American opportunity credit from Form 886, line 8 Reserved Form(s) 88 First- time homeuyer credit repayment. Attach Form 0 if required enter Taxes from: a Form 899 Form 8960 c Instructions; code(s) Add lines through 60. This is your total tax Excess social security and tier RRTA tax withheld For Info Only-Do not file For Info Only-Do not file DUBLIN, OH 0 00 (0) FD00- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc..-. c 68 Total oxes checked 9a 9,00.,099.,000. Phone no Page 8, a DAYCARE PROVIDR 8 9a a,0.,6.,900., ,80.,80.,99.,9.,9. If th e IRS sent you an ID Protection PIN, enter it h ere (see inst.) (6) 69-8 Form 00 (0)

7 SCHEDULE A (Form 00) D epartment of th e Treasury Internal Revenue Service (99) Name(s) shown on Form 00 Taxes You Paid Interest 0 You Paid Gifts to Charity Other Miscellaneous Deductions Medical and dental expenses (see instructions) Multiply line y 0% (.0). But if either you or your spouse was State and local (check only one ox): 6 Real estate taxes (see instructions) 6 Home mortgage interest and points reported to you on Form 098 Casualty or theft loss(es). Attach Form 68. (See instructions.) Enter amount from Form 00, line 8 Multiply line y % (.0) Sutract line 6 from line. If line 6 is more than line, enter - 0- Other - from list in instructions. List type and amount,.. Your deduction is not limited. Add the amounts in the far right column for lines through 8. Also, enter this amount on Form 00, line 0. OMB Information aout Schedule A and its separate instructions is at Attach ment Attach to Form 00. Sequence.0 Your social security numer Caution. Do not include expenses reimursed or paid y others. Jo Expenses Unreimursed employee expenses - jo travel, union dues, jo education, and Certain etc. Attach Form 06 or 06- EZ if required. Miscellaneous (See inst.) Deductions Tax preparation fees Total Itemized Deductions Sutract line from line. If line is more than line, enter - 0- Personal property taxes 8 Other taxes. List type and amount 8 te. person's name, identifying no., and address Your mortgage interest deduction may Points not reported to you on Form 098. See instructions for special rules e limited (see Mortgage insurance premiums (see instructions) instructions). Investment interest. Attach Form 9 if required. (See instructions.) 6 Gifts y cash or check. If you made any gift of $0 or more, see instructions 6 0 Add lines through 6 Enter amount from Form 00, line 8 9 Add lines through 8 Itemized Deductions BABY SITTER Medical and Dental Expenses If you made a Other than y cash or check. If any gift of $0 or more, see gift and got a instructions. You must attach Form 88 if over $00 enefit for it, 8 Carryover from prior year see instructions. 9 Add lines 6 through 8 Casualty and Theft Losses Add lines 0 through 8 9 orn efore January, 99, multiply line y.% (.0) instead a Income taxes, or General sales taxes Home mortgage interest not reported to you on Form 098. If paid to the person from whom you ought the home, see instructions and show that CHURCH,. Other expenses - investment, safe deposit ox, etc. List type and amount Is Form 00, line 8, over $0,000?. Your deduction may e limited. See the Itemized Deductions Worksheet in the instructions to figure the amount to enter. 0 If you elect to itemize deductions even though they are less than your standard deduction, check here KBA For Paperwork Reduction Act tice, see Form 00 instructions. Schedule A (Form 00) Sch A (0) FDA- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc ,.,00.,.,., ,.,. 6,8. 0.,0.

8 SCHEDULE C (Form 00) D epartment of th e Treasury Internal Revenue Service (99) Name of proprietor A C E F G H Principal usiness or profession, including product or service (see instructions) Business name. If no separate usiness name, leave lank. Business address (including suite or room no.) City, town or post office, state, and ZIP code Accounting method: () Cash Part I Part II () Accrual () (Sole Proprietorship) Other (specify) Did you "materially participate" in the operation of this usiness during 0? If "," see instructions for limit on losses Returns and allowances Sutract line from line Cost of goods sold (from line ) Gross profit. Sutract line from line 6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) 6 Gross income. Add lines and 6 8 Advertising 8 9 Car and truck expenses (see instructions) 0 Commissions and fees 0 Depletion Depreciation and section 9 expense deduction (not included in Part III) (see inst) Employee enefit programs (other than on line 9) Insurance (other than health) 6 a If you started or acquired this usiness during 0, check here Interest: Mortgage (paid to anks, etc.) Other Income 9 6a 6 Legal and professional services Profit or Loss From Business OMB Social security numer (SSN) BABY SITTER I CHILD CARE SERVICES : DAY CARE BABY SITTER J If "," did you or will you file required Forms 099? Expenses Contract laor (see instructions) NURSERY LANE TILLAMOOK, OR 9 Enter code from instructions Employer ID numer (EIN), (see instr.). 8 Office expense (see instructions) 8 6. Vehicles, machinery, and equipment B D 60 9 Pension and profit- sharing plans 9 0 Rent or lease (see instructions): Other usiness property Repairs and maintenance Supplies (not included in Part III) Taxes and licenses a a Travel, meals, and entertainment: Travel Total expenses efore expenses for usiness use of home. Add lines 8 through a Tentative profit or (loss). Sutract line 8 from line Net profit or (loss). Sutract line 0 from line 9. Deductile meals and entertainment (see instructions) Other expenses (from line 8) (If you checked the ox on line, see instructions). Estates and trusts, enter on Form 0, line. If a loss, you must go to line. For information on Schedule C and its instructions, go to Attach to Form 00, 00NR, or 0; partnerships generally must file Form 06. 0a 0 a Utilities 6 Wages (less employment credits) 6 a a Attachment Sequence. Did you make any payments in 0 that would require you to file Form(s) 099? (see instructions) Gross receipts or sales. See instructions for line and check the ox if this income was reported to you on Form W- and the "Statutory employee" ox on that form was checked If a profit, enter on oth Form 00, line (or Form 00NR, line ) and on Schedule SE, line. If you have a loss, check the ox that descries your investment in this activity (see instructions). If you checked a, enter the loss on oth Form 00, line, (or Form 00NR, line ) and on Schedule SE, line. (If you checked the ox on line, see the line instructions). Estates and trusts, enter on Form 0, line. If you checked, you must attach Form 698. Your loss may e limited. KBA For Paperwork Reduction Act tice, see the separate instructions. Enter expenses for usiness use of your home only on line 0. Reserved for future use Expenses for usiness use of your home. Do not report these expenses elsewhere. Attach Form 889 unless using the simplified method (see instructions). Simplified method filers only: enter the total square footage of: (a) your home: and () the part of your home used for usiness: Method Worksheet in the instructions to figure the amount to enter on line Sch C (0) FDC- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc..9-. ATTACHMENT. Use the Simplified a 09,000.,000.,000.,000. 6,00. 6,8. 0,9.,.,096. All investment is at risk. Some investment is not at risk. Schedule C (Form 00) 0

9 SCHEDULE SE (Form 00) Self- Employment Tax Information aout Schedule SE and its separate instructions is at D epartment of th e Treasury Internal Revenue Service (99) Attach to Form 00 or Form 00NR. Name of person with self- employment income (as shown on Form 00 or Form 00NR) Social security numer of person with self- employment income OMB Attachment Sequence. BABY SITTER Before you egin: To determine if you must file Schedule SE, see the instructions. May I Use Short Schedule SE or Must I Use Long Schedule SE? te. Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SE in the instructions. Did you receive wages or tips in 0? Are you a minister, memer of a religious order, or Christian Science practitioner who received IRS approval not to e taxed on earnings from these sources, ut you owe selfemployment tax on other earnings? Was the total of your wages and tips suject to social security or railroad retirement (tier ) tax plus your net earnings from self- employment more than $,000? Are you using one of the optional methods to figure your net earnings (see instructions)? Did you receive tips suject to social security or Medicare tax that you did not report to your employer? Did you receive church employee income (see instructions) reported on Form W- of $08.8 or more? Did you report any wages on Form 899, Uncollected Social Security and Medicare Tax on Wages? You may use Short Schedule SE elow You must use Long Schedule SE on page Section A - Short Schedule SE. Caution. Read aove to see if you can use Short Schedule SE. a Net farm profit or (loss) from Schedule F, line, and farm partnerships, Schedule K- (Form 06), ox, code A Net profit or (loss) from Schedule C, line ; Schedule C- EZ, line ; Schedule K- (Form 06), ox, code A (other than farming); and Schedule K- (Form 06- B), ox 9, code J. Ministers and memers of religious orders, see Comine lines a,, and If you received social security retirement or disaility enefits, enter the amount of Conservation Reserve Program payments included on Schedule F, line, or listed on Schedule K- (Form 06), ox 0, code Z instructions for types of income to report on this line. See instructions for other income to report Multiply line y 9.% (.9). If less than $00, you do not owe self- employment tax; do not file this schedule unless you have an amount on line te. If line is less than $00 due to Conservation Reserve Program payments on line, see instructions. Self- employment tax. If the amount on line is: $,000 or less, multiply line y.% (.). Enter the result here and on Form 00, line, or Form 00NR, line More than $,000, multiply line y.9% (.09). Then, add $,08 to the result. Enter the total here and on Form 00, line, or Form 00NR, line 6 Deduction for one- half of self- employment tax. Multiply line y 0% (.0). Enter the result here and on Form 00, line, or Form 00NR, line 6 9. KBA For Paperwork Reduction Act tice, see your tax return instructions. Schedule SE (Form 00) 0 a 0. ( ),096.,096.,09., Sch SE (0) FDSE- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc.

10 OMB Form Attach to Form 00, Form 00A, or Form 00NR. Information aout Form and its separate instructions is at D epartment of th e Treasury Attachment Internal Revenue Service (99) Sequence. Name(s) shown on return Your social security numer BABY SITTER Part I Persons or Organizations Who Provided the Care - You must complete this part. (If you have more than two care providers, see the instructions.) (a) Care provider's name Child and Dependent Care Expenses () Address (numer, street, apt. no., city, state, and ZIP code) (c) Identifying numer (SSN or EIN) (d) Amount paid (see instructions) CHILD CARE LANE TINY TOTS TILLAMOOK OR 9-6,000. Did you receive dependent care enefits? Complete only Part II elow. Complete Part III on page next. Caution. If the care was provided in your home, you may owe employment taxes. If you do, you cannot file Form 00A. For details, see the instructions for Form 00, line 60a, or Form 00NR, line 9a. Part II Credit for Child and Dependent Care Expenses Information aout your qualifying person(s). If you have more than two qualifying persons, see the instructions. First (a) Qualifying person's name Last () Qualifying person's social security numer (c) Qualified expenses you incurred and paid in 0 f or th e person listed in column (a) JOHN DOE , Add the amounts in column (c) of line. Do not enter more than $,000 for one qualifying person or $6,000 for two or more persons. If you completed Part III, enter the amount from line Enter your earned income. See instructions If married filing jointly, enter your spouse's earned income (if you or your spouse was a student or was disaled, see the instructions); all others, enter the amount from line Enter the smallest of line,, or Enter the amount from Form 00, line 8; Form 00A, line ; or Form 00NR, line Enter on line 8 the decimal amount shown elow that applies to the amount on line If line is: Over $0,000,000 9,000,000,000,000,000 Multiply line 6 y the decimal amount on line 8. If you paid 0 expenses in 0, see the instructions But not over Decimal amount is,000.,000. 9,000.,000.,000.,000.0, ,000.8 Tax liaility limit. Enter the amount from the Credit Limit Worksheet in the instructions If line is: Over $9,000,000,000,000,000 9,000,000,000 Credit for child and dependent care expenses. Enter the smaller of line 9 or line 0 here and on Form 00, line 9; Form 00A, line ; or Form 00NR, line KBA For Paperwork Reduction Act tice, see your tax return instructions. But not over,000.,000.6,000.,000. 9,000.,000.,. Decimal amount is,000. limit ,000.,.,., Form (0) (0) FD- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc..-.

11 SCHEDULE EIC (Form 00A or 00) D epartment of th e Treasury Internal Revenue Service (99) Name(s) shown on return Before you egin: Earned Income Credit Qualifying Child Information OMB Complete and attach to Form 00A or 00 only if you have a qualifying child. Attachment Information aout Schedule EIC (Form 00A or 00) and its instructions is at Sequence. Your social security numer BABY SITTER See the instructions for Form 00A, lines a and, or Form 00, lines 66a and 66, to make sure that (a) you can take the EIC, and () you have a qualifying child. Be sure the child's name on line and social security numer (SSN) on line 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 If you take the EIC even though you are not eligile, you may not e allowed to take the credit for up to 0 years. See separate 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 Child Child Child's name If you have more than three qualifying children, you have to list only three to get the maximum credit. Child's SSN The child must have an SSN as defined in the instructions for Form 00A, lines a and, or Form 00, lines 66a and 66, unless the child was orn and died in 0. If your child was orn and died in 0 and did not have an SSN, enter "Died" on this line and attach a copy of the child's irth certificate, death certificate, or hospital Child's year of irth a medical records. Was the child under age at the end of 0, a student, and younger than you (or your spouse, if filing jointly)? JOHN DOE First name Last name Year If orn after 99 and the child is younger than you (or your spouse, if filing jointly), skip lines a and ; go to line.. First name. Last name Year If orn after 99 and the child is younger than you (or your spouse, if filing jointly), skip lines a and ; go to line.. Go to Go to line. Go to Go to line. line. line. First name Last name Year If orn after 99 and the child is younger than you (or your spouse, if filing jointly), skip lines a and ; go to line... Go to Go to line. line. Was the child permanently and totally disaled during any part of 0? Child's relationship to you (for example, son, daughter, grandchild, niece, nephew, foster child, etc.) 6 Numer of months child lived with you in the United States during 0 If the child lived with you for more than half of 0 ut less than months, enter "." SON.. months If the child was orn or died in 0 and your home was the child's home for more than Do not enter more than half the time he or she was months. alive during 0, enter "." KBA.. Go to The child is not a Go to The child is not a Go to line. qualifying child. line. qualifying child. line. For Paperwork Reduction Act tice, see your tax return instructions. 00- Sch EIC (0) FDEIC- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc. months Do not enter more than months... The child is not a qualifying child. months Do not enter more than months. Schedule EIC (Form 00A or 00) 0

12 Schedule 88 (Form 00A or 00) D epartment of th e Treasury Internal Revenue Service (99) Name(s) shown on return Child Tax Credit Attach to Form 00, Form 00A, or Form 00NR. Information aout Schedule 88 and its separate instructions is at OMB Attachment Sequence. Your social security numer BABY SITTER Part I Filers Who Have Certain Child Dependent(s) with an ITIN (Individual Taxpayer Identification Numer) Complete this part only for each dependent who has an ITIN and for whom you are claiming the child tax credit. If your dependent does not qualify for the credit, you cannot include that dependent in the calculation of this credit. Answer the following questions for each dependent listed on Form 00, line 6c; Form 00A, line 6c; or Form 00NR, line c, who has an ITIN (Individual Taxpayer Identification Numer) and that you indicated qualified for the child tax credit y checking column () for that dependent. A For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the sustantial presence test? See separate instructions. B C D For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the sustantial presence test? See separate instructions. For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the sustantial presence test? See separate instructions. For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the sustantial presence test? See separate instructions. te. If you have more than four dependents identified with an ITIN and listed as a qualifying child for the child tax credit, see the instructions and check here Part II Additional Child Tax Credit Filers 00 filers: 00A filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 00, line ). Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 00A, line )., NR filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 00NR, line 8). If you used Pu. 9, enter the amount from line 8 of the Child Tax Credit Worksheet in the pulication. Enter the amount from Form 00, line ; Form 00A, line ; or Form 00NR, line 8 Sutract line from line. If zero, stop; you cannot take this credit a Earned income (see separate instructions) a ntaxale comat pay (see separate instructions) Is the amount on line a more than $,000?.. 6 Multiply the amount on line y % (.) and enter the result 6 Next. Do you have three or more qualifying children?.. Leave line lank and enter - 0- on line 6. Sutract $,000 from the amount on line a. Enter the result If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part III and enter the smaller of line or line 6 on line. If line 6 is equal to or more than line, skip Part III and enter the amount from line on line. Otherwise, go to line. KBA For Paperwork Reduction Act tice, see your tax return instructions.,.,. 0.,000.,6. Schedule 88 (Form 00A or 00) 0 88 (0) FD88- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc..-.

13 Schedule 88 (Form 00A or 00) 0 Part III Withheld social security, Medicare, and Additional Medicare taxes from Forms(s) W-, oxes and 6. If married filing jointly, include your spouse's amounts with yours. If your employer withheld or you paid Additional Medicare Tax or tier RRTA taxes, see separate instructions 8 00 filers: Enter the total of the amounts from Form 00, lines and, plus any taxes that you identified using code "UT" and entered on line A filers: 00NR filers: 9 Add lines and 8 BABY SITTER Certain Filers Who Have Three or More Qualifying Children Enter Enter the total of the amounts from Form 00NR, lines and, plus any taxes that you identified using code "UT" and entered on line filers: Enter the total of the amounts from Form 00, lines 6a and A filers: Enter the total of the amount from Form 00A, line 0 8a, plus any excess social security and tier RRTA taxes withheld that you entered to the left of line (see separate instructions). 00NR filers: Enter the amount from Form 00NR, line 6. Sutract line 0 from line 9. If zero or less, enter - 0- Enter the larger of line 6 or line Next, enter the smaller of line or line on line. Part IV Additional Child Tax Credit Page,000. This is your additional child tax credit Enter this amount on Form 00, line 6, Form 00A, line 9, or... Form NR, line Schedule 88 (Form 00A or 00) 0 88 (0) FD88- (DRAFT FORM) Form Sof tw are Copyrigh t H RB Tax Group, Inc..-.

14 Form (Rev. D ecemer 0) Attach to your tax return if you claimed a total deduction D epartment of th e Treasury of over $00 for all contriuted property. Internal Revenue Service Information aout Form 88 and its separate instructions is at Name(s) shown on your income tax return te. Figure the amount of your contriution deduction efore completing this form. See your tax return instructions. Section A. Donated Property of $,000 or Less and Pulicly Traded Securities - List in this section only items (or groups of similar items) for which you claimed a deduction of $,000 or less. Also, list pulicly traded securities even if the deduction is more than $,000 (see instructions). Part I A B 88 ncash Charitale Contriutions OMB (a) Name and address of the donee organization Identifying numer BABY SITTER Information on Donated Property - If you need more space, attach a statement. MY CHARITY CHARITY ROW TILLAMOOK OR 9 () If donated property is a vehicle (see instrs), check the ox. Also enter the vehicle identification numer (unless Form 098- C is attached) Attachment Sequence. (c) Description of donated property (For a vehicle, enter the year, make, model, and mileage. For securities, enter the company name and the numer of shares.) CLOTHING HOUSEHOLD ITEMS C D E te. (d) Date of the (e) Date acquired (f) How acquired (g) Donor's cost (h) Fair market (i) Method used to determine contriution y donor (mo., yr.) y donor or adjusted asis value (see instr.) the fair market value A 09//0VARIOUS PURCHASED,00.,600.THRIFT STORE VALUE B C D E Part II Partial Interests and Restricted Use Property- Complete lines a through e if you gave less than a c If the amount you claimed as a deduction for an item is $00 or less, you do not have to complete columns (e), (f), and (g). an entire interest in a property listed in Part I. Complete lines a through c if conditions were placed on a contriution listed in Part I; also attach the required statement (see instructions). Enter the letter from Part I that identifies the property for which you gave less than an entire interest If Part II applies to more than one property, attach a separate statement. Total amount claimed as a deduction for the property listed in Part I: Name and address of each organization to which any such contriution was made in a prior year (complete only if different from the donee organization aove): Name of charitale organization (donee) () () For this tax year For any prior tax years Address (numer, street, and room or suite no.) City or town, state, and ZIP code d e For tangile property, enter the place where the property is located or kept Name of any person, other than the donee organization, having actual possession of the property a Is there a restriction, either temporary or permanent, on the donee's right to use or dispose of the donated property? Did you give to anyone (other than the donee organization or another organization participating with the donee organization in cooperative fundraising) the right to the income from the donated property or to the possession of the property, including the right to vote donated securities, to acquire the property y purchase or otherwise, or to designate the person having such income, possession, or right to acquire? c Is there a restriction limiting the donated property for a particular use? KBA For Paperwork Reduction Act tice, see separate instructions. 88 (0) FD88- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc. Form 88 (Rev. - 0)

15 Form 889 Expenses for Business Use of Your Home OMB File only with Schedule C (Form 00). Use a separate Form 889 for each home you used for usiness during the year. D epartment of th e Treasury Internal Revenue Service (99) Information aout Form 889 and its separate instructions is at Attach ment Sequence. 6 Name(s) of proprietor(s) Your social security numer BABY SITTER Part I Part of Your Home Used for Business Part II Part III Part IV Area used regularly and exclusively for usiness, regularly for daycare, or for storage of Total area of home Divide line y line. Enter the result as a percentage % For daycare facilities not used exclusively for usiness, go to line. All others go to line. Multiply days used for daycare during year y hours used per day Total hours availale for use during the year (6 days x hours) (see instructions) 6 Divide line y line. Enter the result as a decimal amount 6 8 Carryover of prior year excess casualty losses and depreciation (see instructions),0 hr. 8,60 hr. 0.6 Business percentage. For daycare facilities not used exclusively for usiness, multiply line 6 y line (enter the result as a percentage). All others, enter the amount from line % Enter the amount from Schedule C, line 9, plus any gain derived from the usiness use of your home, minus any loss from the trade or usiness not derived from the usiness use of your home (see instructions) 9 Casualty losses (see instructions) inventory or product samples (see instructions) See instructions for columns (a) and () efore completing lines 9-. Deductile mortgage interest (see instructions) Real estate taxes (see instructions) Add lines 9, 0, and Multiply line, column () y line Add line, column (a) and line Sutract line from line 8. If zero or less, enter - 0- Excess mortgage interest (see instructions) Insurance Rent Repairs and maintenance Utilities Figure Your Allowale Deduction Other expenses (see instructions) Add lines 6 through Multiply line, column () y line Carryover of prior year operating expenses (see instructions) Add line, column (a), line, and line Allowale operating expenses. Enter the smaller of line or line Limit on excess casualty losses and depreciation. Sutract line 6 from line Excess casualty losses (see instructions) Depreciation of your home from line elow (a) Direct expenses Add lines 8 through 0 Allowale excess casualty losses and depreciation. Enter the smaller of line or line Add lines, 6, and Casualty loss portion, if any, from lines and. Carry amount to Form 68 (see instructions) Allowale expenses for usiness use of your home. Sutract line from line. Enter here and on Schedule C, line 0. If your home was used for more than one usiness, see instructions Depreciation of Your Home () Indirect expenses 6 Enter the smaller of your home's adjusted asis or its fair market value (see instructions) Value of land included on line Basis of uilding. Sutract line from line Business asis of uilding. Multiply line 8 y line 9 8,9. 0 Depreciation percentage (see instructions) 0.6% Depreciation allowale (see instructions). Multiply line 9 y line 0. Enter here and on line 9 aove Carryover of Unallowed Expenses to 0 Operating expenses. Sutract line 6 from line. If less than zero, enter Excess casualty losses and depreciation. Sutract line from line. If less than zero, enter - 0- KBA For Paperwork Reduction Act tice, see your tax return instructions. Form 889 (0) 889 (0) FD889- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc ,00, SEE ATTACHED COMPUTATION 6,0.,00. 8,0.,90. 0.,000.,0.,.,08. 0,9.,90. 6,.,.,.,0.,08.,08.,.,. 89,000. 0,000. 9,000.,

16 Form D epartment of th e Treasury Internal Revenue Service Part I 886 Taxpayer name(s) shown on return BABY SITTER All Taxpayers Paid Preparer's Earned Income Credit Checklist To e completed y preparer and filed with Form 00, 00A, or 00EZ. Information aout Form 886 and its separate instructions is at For the definitions of Qualifying Child and Earned Income, see Pu. 96. OMB Attach ment Sequence. Taxpayer's social security numer Enter preparer's name and PTIN KATHLEEN PERRY P Is the taxpayer's filing status married filing separately? If you checked "" on line, stop; the taxpayer cannot take the EIC. Otherwise, continue. Does the taxpayer (and the taxpayer's spouse if filing jointly) have a social security numer (SSN) that allows him or her to work and is valid for EIC purposes? See the instructions efore answering If you checked "" on line, stop; the taxpayer cannot take the EIC. Otherwise, continue. Is the taxpayer (or the taxpayer's spouse if filing jointly) filing Form or - EZ (relating to the exclusion of foreign earned income)? If you checked "" on line, stop; the taxpayer cannot take the EIC. Otherwise, continue. a Was the taxpayer (or the taxpayer's spouse) a nonresident alien for any part of 0? If you checked "" on line a, go to line. Otherwise, skip line and go to line 6. Is the taxpayer's filing status married filing jointly? If you checked "" on line a and "" on line, stop; the taxpayer cannot take the EIC. Otherwise, continue. 6 Is the taxpayer's investment income more than $,0? See the instructions efore answering If you checked "" on line 6, stop; the taxpayer cannot take the EIC. Otherwise, continue. Could the taxpayer e a qualifying child of another person for 0? If the taxpayer's filing status is married filing jointly, check "." Otherwise, see Rule 0 (Rule if the taxpayer does not have a qualifying child) in Pu. 96 efore answering If you checked "" on line, stop; the taxpayer cannot take the EIC. Otherwise, go to Part II or Part III, whichever applies. KBA For Paperwork Reduction Act tice, see separate instructions. Form 886 (0) Information provided y: BABY SITTER Information provided in person. Date information provided: 08/6/0 886 (0) FD886- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc.

17 Form 886 (0) Part II a c BABY SITTER Taxpayers With a Child Caution. If there is more than one child, complete lines 8 through for one child efore going to the next column. Child's name Is the child the taxpayer's son, daughter, stepchild, foster child, rother, sister, steprother, stepsister, half rother, half sister, or a descendant of any of them? Was the child unmarried at the end of 0? If the child was married at the end of 0, see the instructions efore answering Did the child live with the taxpayer in the United States for over half of 0? See the instructions efore answering Was the child (at the end of 0) - Under age 9 and younger than the taxpayer (or the taxpayer's spouse, if the taxpayer files jointly), Under age, a student (defined in the instructions), and younger than the taxpayer (or the taxpayer's spouse, if the taxpayer files jointly), or Any age and permanently and totally disaled? If you checked "" on lines 9, 0,, and, the child is the taxpayer's qualifying child; go to line a. If you checked "" on line 9, 0,, or, the child is not the taxpayer's qualifying child; see the instructions for line. Do you or the taxpayer know of another person who could check "" on lines 9, 0,, and for the child? (If the only other person is the taxpayer's spouse, see the instructions efore answering.) If you checked "" on line a, go to line. Otherwise, go to line. Enter the child's relationship to the other person(s) Under the tiereaker rules, is the child treated as the taxpayer's qualifying child? See the instructions efore answering If you checked "" on line c, go to line. If you checked "," the taxpayer cannot take the EIC ased on this child and cannot take the EIC for taxpayers who do not have a qualifying child. If there is more than one child, see the te at the ottom of this page. If you checked "Don't know," explain to the taxpayer that, under the tiereaker rules, the taxpayer's EIC and other tax enefits may e disallowed. Then, if the taxpayer wants to take the EIC ased on this child, complete lines and. If not, and there are no other qualifying children, the taxpayer cannot take the EIC, including the EIC for taxpayers without a qualifying child; do not complete Part III. If there is more than one child, see the te at the ottom of this page. Does the qualifying child have an SSN that allows him or her to work or is valid for EIC purposes? See the instructions efore answering If you checked "" on line, the taxpayer cannot take the EIC ased on this child and cannot take the EIC availale to taxpayers without a qualifying child. If there is more than one child, see the te at the ottom of this page. If you checked "" on line, continue. Child Child JOHN DOE Don't know Don't know Child Don't know Page Are the taxpayer's earned income and adjusted gross income each less than the limit that applies to the taxpayer for 0? See instructions If you checked "" on line, stop; the taxpayer cannot take the EIC. If you checked "" on line, the taxpayer can take the EIC. Complete Schedule EIC and attach it to the taxpayer's return. If there are two or three qualifying children with valid SSNs, list them on Schedule EIC in the same order as they are listed here. If the taxpayer's EIC was reduced or disallowed for a year after 996, see Pu. 96 to see if Form 886 must e filed. Go to line 0. te. If there is more than one child, complete lines 8 through for the other child(ren) (ut for no more than three qualifying children). Form 886 (0) 886 (0) FD886- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc.

18 Part III BABY SITTER Taxpayers Without a Qualifying Child Form 886 (0) Page 6 Was the taxpayer's main home, and the main home of the taxpayer's spouse if filing jointly, in the United States for more than half the year? (Military personnel on extended active duty outside the United States are considered to e living in the United States during that duty period.) See the instructions efore answering If you checked "" on line 6, stop; the taxpayer cannot take the EIC. Otherwise, continue. Was the taxpayer, or the taxpayer's spouse if filing jointly, at least age ut under age 6 at the end of 0? See the instructions efore answering If you checked "" on line, stop; the taxpayer cannot take the EIC. Otherwise, continue. 8 Is the taxpayer eligile to e claimed as a dependent on anyone else's federal income tax return for 0? If the taxpayer's filing status is married filing jointly, check "" If you checked "" on line 8, stop; the taxpayer cannot take the EIC. Otherwise, continue. 9 Are the taxpayer's earned income and adjusted gross income each less than the limit that applies to the taxpayer for 0? See instructions If you checked "" on line 9, stop; the taxpayer cannot take the EIC. If you checked "" on line 9, the taxpayer can take the EIC. If the taxpayer's EIC was reduced or disallowed for a year after 996, see Pu. 96 to find out if Form 886 must e filed. Go to line 0. Part IV Due Diligence Requirements 0 Did you complete Form 886 ased on current information provided y the taxpayer or reasonaly otained y you? Did you complete the EIC worksheet found in the Form 00, 00A, or 00EZ instructions (or your own worksheet that provides the same information as the 00, 00A, or 00EZ worksheet)? If any qualifying child was not the taxpayer's son or daughter, do you know or did you ask why the parents were not claiming the child? If the answer to question a is "" (indicating that the child lived for more than half the year with someone else who could claim the child for the EIC), did you explain the tiereaker rules and possile consequences of another person claiming your client's qualifying child? Does not apply Does not apply Did you ask this taxpayer any additional questions that are necessary to meet your knowledge requirement? See the instructions efore answering To comply with the EIC knowledge requirement, you must not know or have reason to know that any information you used to determine the taxpayer's eligiility for, and the amount of, the EIC is incorrect. You may not ignore the implications of information furnished to you or known y you, and you must make reasonale inquiries if the information furnished to you appears to e incorrect, inconsistent, or incomplete. At the time you make these inquiries, you must document in your files the inquiries you made and the taxpayer's responses. Did you document (a) the taxpayer's answer to question (if applicale), () whether you explained the tiereaker rules to the taxpayer and any additional information you got from the taxpayer as a result, and (c) any additional questions you asked and the taxpayer's answers? Does not apply Does not apply You have complied with all the due diligence requirements if you:. Completed the actions descried on lines 0 and and checked "" on those lines,. Completed the actions descried on lines,,, and (if they apply) and checked "" (or "Does not apply") on those lines,. Sumit Form 886 in the manner required, and. Keep all five of the following records for years from the latest of the dates specified in the instructions under Document Retention: a. Form 886,. The EIC worksheet(s) or your own worksheet(s), c. Copies of any taxpayer documents you relied on to determine eligiility for or amount of EIC, d. A record of how, when, and from whom the information used to prepare the form and worksheet(s) was otained, and e. A record of any additional questions you asked and your client's answers. You have not complied with all the due diligence requirements if you checked "" on line 0,,,,, or. You may have to pay a $00 penalty for each failure to comply. Form 886 (0) 886 (0) FD886- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc.

19 BABY SITTER Documents Provided to You Form 886 (0) Page Part V 6 Identify elow any document that the taxpayer provided to you and that you relied on to determine the taxpayer's EIC eligiility. Check all that apply. Keep a copy of any documents you relied on. See the instructions efore answering. If there is no qualifying child, check ox a. If there is no disaled child, check ox o. a c d e f g h o p q r qualifying child School records or statement Landlord or property management statement Health care provider statement Medical records Child care provider records Placement agency statement Social service records or statement disaled child Doctor statement Other health care provider statement Social services agency or program statement Residency of Qualifying Child(ren) i Disaility of Qualifying Child(ren) j k l m n s t u Place of worship statement Indian trial official statement Employer statement Other (specify) SEE ATTACHMENT Did not rely on any documents, ut made notes in file Did not rely on any documents Other (specify) Did not rely on any documents, ut made notes in file Did not rely on any documents If a Schedule C is included with this return, identify elow the information that the taxpayer provided to you and that you relied on to prepare the Schedule C. Check all that apply. Keep a copy of any documents you relied on. See the instructions efore answering. If there is no Schedule C, check ox a. a c d e f g Schedule C Business license Forms 099 Records of gross receipts provided y taxpayer Taxpayer summary of income Records of expenses provided y taxpayer Taxpayer summary of expenses Documents or Other Information h i j k l Bank statements Reconstruction of income and expenses Other (specify) SEE ATTACHMENT Did not rely on any documents, ut made notes in file Did not rely on any documents Form 886 (0) 886 (0) FD886- V. Form Sof tw are Copyrigh t H RB Tax Group, Inc.

20 Supporting Schedules 0 Name: BABY SITTER SSN: Schedule A Line - Gifts y Other Than Cash or Check Description Amount FORM 88, Total,600 SCHEDULE C - BABY SITTER LINE - GROSS RECEIPTS OR SALES Description Amount COUNTY 099MISC, TOTAL,000 FORM NURSERY LANE TILLAMOOK OR 9 LINE - SPECIAL COMPUTATION FOR CERTAIN DAYCARE FACILITIES TOTAL AREA OF HOME...,00. AREA USED ECLUSIVELY FOR DAYCARE AREA USED PARTLY FOR DAYCARE...,000. DIVIDE LINE BY LINE... 0.%. DIVIDE LINE BY LINE....8% 6. MULTIPLY DAYS USED FOR DAYCARE DURING YEAR BY HOURS USED PER DAY...,0. TOTAL HOURS AVAILABLE FOR USE DURING THE YEAR... 8,60 8. DIVIDE LINE 6 BY LINE. ENTER THE RESULT AS A DECIMAL MULTIPLY LINE BY LINE % 0. ADD LINE AND LINE % Form 886, Page Line 6 - Residency of Qualifying Child(ren) Other (specify) NEIGHBOR AFFIDAVITS Form 886, Page Line - Documents or Other Information Other (specify) TITLE PROVIDER FOR COUNTY RECEIVED 099MISC