Tax Return Transcript
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1 Tax Return Transcript GODW Page 2 of 8 This Product Contains Sensitive Taxpayer Data Tax Return Transcript SS Provided: 432-xx-xxxx Tax Period Ending: Dec. 31, 2005 Request Date: Response Date: IRS Employee umber: HM6KB Tracking umber: The following items reflect the amount as shown on the return (PR), and the amount as adjusted (PC), if applicable. They do not show subsequent activity on the account. SS: 432-xx-xxxx SPOUSE SS: 477-xx-xxxx AME(S) SHOW O RETUR: DAMO M & MELISSA ADDRESS: 200 SAMPLE RD HOT SPRIGS, AR 33XXX FILIG STATUS: Married Filing Joint FORM UMBER: 1040 CYCLE POSTED: RECEIVED DATE: Apr.15, 2006 REMITTACE: 0.00 EXEMPTIO UMBER: 4 DEPEDET 1 AME CTRL: GODW DEPEDET 1 SS: 429-XX-XXXX DEPEDET 2 AME CTRL: GODW DEPEDET 2 SS: 432-XX-XXXX DEPEDET 3 AME CTRL: DEPEDET 3 SS: DEPEDET 4 AME CTRL: DEPEDET 4 SS: PREPARER SS: P00-59-XXXX PREPARER EI: 71-XXXXXXX Income WAGES, SALARIES, TIPS, ETC: $ 24, TAXABLE ITEREST ICOME: SCH B: $ 0.00 TAX-EXEMPT ITEREST: $ 0.00 ORDIARY DIVIDED ICOME: SCH B: $ 0.00 QUALIFIED DIVIDEDS: $ 0.00 REFUDS OF STATE/LOCAL TAXES: $ 0.00 ALIMOY RECEIVED: $ 0.00
2 Page 3 of 8 BUSIESS ICOME OR LOSS (Schedule C): $ 46, BUSIESS ICOME OR LOSS: SCH C PER COMPUTER: $ 46, CAPITAL GAI OR LOSS: (Schedule D): $ 0.00 CAPITAL GAIS OR LOSS: SCH D PER COMPUTER: $ 0.00 OTHER GAIS OR LOSSES (Form 4797): $ 0.00 TOTAL IRA DISTRIBUTIOS: $ 3, TAXABLE IRA DISTRIBUTIOS: $ 0.00 TOTAL PESIOS AD AUITIES: $ 0.00 TAXABLE PESIO/AUITY AMOUT: $ 0.00 RET/ROYALTY/PARTERSHIP/ESTATE (Schedule E): $ 0.00 RET/ROYALTY/PARTERSHIP/ESTATE (Schedule E) PER COMPUTER: $ 0.00 RET/ROYALTY ICOME/LOSS PER COMPUTER: $ 0.00 ESTATE/TRUST ICOME/LOSS PER COMPUTER: $ 0.00 PARTERSHIP/S-CORP ICOME/LOSS PER COMPUTER: $ 0.00 FARM ICOME OR LOSS (Schedule F): $ -3, FARM ICOME OR LOSS (Schedule F) PER COMPUTER: $ -3, UEMPLOYMET COMPESATIO: $ 0.00 TOTAL SOCIAL SECURITY BEEFITS: $ 0.00 TAXABLE SOCIAL SECURITY BEEFITS: $ 0.00 TAXABLE SOCIAL SECURITY BEEFITS PER COMPUTER: $ 0.00 OTHER ICOME: $ 0.00 SCHEDULE EIC SE ICOME PER COMPUTER: $ 0.00 SCHEDULE EIC EARED ICOME PER COMPUTER: $ 0.00 SCH EIC DISQUALIFIED IC COMPUTER: $ 0.00 TOTAL ICOME: $ 67, TOTAL ICOME PER COMPUTER: $ 67, Adjustments to Income EDUCATOR EXPESES: $ 0.00 EDUCATOR EXPESES PER COMPUTER: $ 0.00 RESERVIST AD OTHR BUS EXPS: $ 0.00 HEALTH SAVIGS ACCT DEDUCTIO: $ 0.00 HEALTH SAVIGS ACCT DEDUCTIO PER COMPTR: $ 0.00 MOVIG EXPESES: F3903: $ 0.00 SELF EMPLOYMET TAX DEDUCTIO: $ 3, SELF EMPLOYMET TAX DEDUCTIO PER COMPUTER: $ 3, KEOGH/SEP COTRIBUTIO DEDUCTIO: $ 0.00 SELF-EMP HEALTH IS DEDUCTIO: $ 0.00 EARLY WTHDRAWL OF SAVIGS PEALTY: $ 0.00 ALIMOY PAID SS: ALIMOY PAID: $ 0.00 IRA DEDUCTIO: $ 1, IRA DEDUCTIO PER COMPUTER: $ 1, STUDET LOA ITEREST DEDUCTIO: $ 0.00 STUDET LOA ITEREST DEDUCTIO PER COMPUTER: $ 0.00 TUITIO AD FEES DEDUCTIO: $ 0.00 TUITIO AD FEES DEDUCTIO PER COMPUTER: $ 0.00 DOMESTIC PRODUCTIO ACTIVITIES DEDUCTIO: $ 0.00 OTHER ADJUSTMETS: $ 0.00
3 Page 4 of 8 MEDICAL SAVIGS ACCT DEDUCTIO: $ 0.00 MEDICAL SAVIGS ACCT DEDUCTIO PER COMPUTER: $ 0.00 TOTAL ADJUSTMETS: $ 4, TOTAL ADJUSTMETS PER COMPUTER: $ 4, ADJUSTED GROSS ICOME: $ 63, ADJUSTED GROSS ICOME PER COMPUTER: $ 63, Tax and Credits 65-OR-OVER: BLID: SPOUSE 65-OR-OVER: SPOUSE BLID: STADARD DEDUCTIO PER COMPUTER: $ 10, ADDITIOAL STADARD DEDUCTIO PER COMPUTER: $ 0.00 TAX TABLE ICOME PER COMPUTER: $ 53, EXEMPTIO AMOUT PER COMPUTER: $ 12, TAXABLE ICOME: $ 40, TAXABLE ICOME PER COMPUTER: $ 40, TOTAL POSITIVE ICOME PER COMPUTER: $ 71, TETATIVE TAX: $ 5, TETATIVE TAX PER COMPUTER: $ 5, FORM 8814 ADDITIOAL TAX AMOUT: $ 0.00 TAX O ICOME LESS SOC SEC ICOME PER COMPUTER: $ 0.00 FORM 6251 ALTERATIVE MIIMUM TAX: $ 0.00 FORM 6251 ALTERATIVE MIIMUM TAX PER COMPUTER: $ 0.00 FOREIG TAX CREDIT: $ 0.00 FOREIG TAX CREDIT PER COMPUTER: $ 0.00 CHILD & DEPEDET CARE CREDIT: $ 0.00 CHILD & DEPEDET CARE CREDIT PER COMPUTER: $ 0.00 CREDIT FOR ELDERLY AD DISABLED: $ 0.00 CREDIT FOR ELDERLY AD DISABLED PER COMPUTER: $ 0.00 EDUCATIO CREDIT: $ 0.00 EDUCATIO CREDIT PER COMPUTER: $ 0.00 GROSS EDUCATIO CREDIT PER COMPUTER: $ 0.00 RETIREMET SAVIGS CTRB CREDIT: $ 0.00 RETIREMET SAVIGS CTRB CREDIT PER COMPUTER: $ 0.00 PRIM RET SAV CTRB: F8880 L6A: $ 0.00 SEC RET SAV CTRB: F8880 L6B: $ 0.00 TOTAL RETIREMET SAVIGS COTRIBUTIO: F8880 CMPTR: $ 0.00 CHILD TAX CREDIT: $ 2, CHILD TAX CREDIT PER COMPUTER: $ 2, ADOPTIO CREDIT: F8839: $ 0.00 ADOPTIO CREDIT PER COMPUTER: $ 0.00 DC 1ST TIME HOMEBUYERS CREDIT: $ 0.00 DC 1ST TIME HOMEBUYERS CREDIT PER COMPUTER: $ 0.00 FORM 8396 MORTGAGE CERTIFICATE CREDIT: $ 0.00 FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER: $ 0.00 F8396 AD F8859 CREDITS: $ 0.00 FORM 3800 GEERAL BUSIESS CREDITS: $ 0.00
4 Tax Return Transcript 432-XX-XXXX Page 5 of 8 FORM 3800 GEERAL BUSIESS CREDITS PER COMPUTER: $ 0.00 FORM 1040C CREDIT: $ 0.00 PRIOR YR MI TAX CREDIT: F8801: $ 0.00 PRIOR YR MI TAX CREDIT: F8801 PER COMPUTER: $ 0.00 TETATIVE EMPOWERMET ZOE CREDIT: F8844: $ 0.00 EMPOWERMET ZOE CREDIT: F8844: $ 0.00 OTHER CREDITS: $ 0.00 TOTAL CREDITS: $ 2, TOTAL CREDITS PER COMPUTER: $ 2, ICOME TAX AFTER CREDITS PER COMPUTER: $ 3, Other Taxes SE TAX: $ 6, SE TAX PER COMPUTER: $ 6, SOCIAL SECURITY AD MEDICARE TAX O UREPORTED TIPS: $ 0.00 SOCIAL SECURITY AD MEDICARE TAX O UREPORTED TIPS PER COMPUTER: $ 0.00 TAX O QUALIFIED PLAS F5329 (PR): $ 0.00 TAX O QUALIFIED PLAS F5329 PER COMPUTER: $ 0.00 IRAF TAX PER COMPUTER: $ 0.00 TP TAX FIGURES (REDUCED BY IRAF) PER COMPUTER: $ 9, IMF TOTAL TAX (REDUCED BY IRAF) PER COMPUTER: $ 9, ADVACED EARED ICOME: $ 0.00 UPAID FICA O REPORTED TIPS: $ 0.00 FORM 4970 ACCUMULATED DISTRIBUTIO OF TRUSTS: $ 0.00 RECAPTURE TAX: F8611: $ 0.00 HOUSEHOLD EMPLOYMET TAXES: $ 0.00 HOUSEHOLD EMPLOYMET TAXES PER COMPUTER: $ 0.00 RECAPTURE TAXES: $ 0.00 TOTAL ASSESSMET PER COMPUTER: $ 9, TOTAL TAX LIABILITY TP FIGURES: $ 9, TOTAL TAX LIABILITY TP FIGURES PER COMPUTER: $ 9, Payments FEDERAL ICOME TAX WITHHELD: $ 3, ESTIMATED TAX PAYMETS: $ 3, EARED ICOME CREDIT: $ 0.00 EARED ICOME CREDIT PER COMPUTER: $ 0.00 PRIOR YEAR EARED ICOME: $ 0.00 FORM 8812 PRIOR YEAR EARED ICOME CREDIT ELECT ID: FORM 8812 PRIOR YEAR EARED ICOME CREDIT: $ 0.00 OTAXABLE COMBAT PAY ELECTIO: $ 0.00 FORM 8812 OTAXABLE COMBAT PAY: $ 0.00 EXCESS SOCIAL SECURITY & RRTA TAX WITHHELD: $ 0.00 TOT SS/MEDICARE WITHHELD: F8812: $ 0.00 FORM 8812 ADDITIOAL CHILD TAX CREDIT: $ 0.00 FORM 8812 ADDITIOAL CHILD TAX CREDIT PER COMPUTER: $ 0.00 FORM 8812 ADDITIOAL CHILD TAX CREDIT VERIFIED: $ 0.00 AMOUT PAID WITH FORM 4868: $ 0.00
5 Page 6 of 8 FORM 2439 REGULATED IVESTMET COMPAY CREDIT: $ 0.00 FORM 4136 CREDIT FOR FEDERAL TAX O FUELS: $ 0.00 FORM 4136 CREDIT FOR FEDERAL TAX O FUELS PER COMPUTER: $ 0.00 HEALTH COVERAGE TX CR: F8885: $ 0.00 TOTAL PAYMETS: $ 7, TOTAL PAYMETS PER COMPUTER: $ 7, Refund or Amount Owed AMOUT YOU OWE: $ 2, APPLIED TO EXT YEAR'S ESTIMATED TAX: $ 0.00 ESTIMATED TAX PEALTY: $ 0.00 TAX O ICOME LESS STATE REFUD PER COMPUTER: $ 0.00 BAL DUE/OVER PYMT USIG TP FIG PER COMPUTER: $ 2, BAL DUE/OVER PYMT USIG COMPUTER FIGURES: $ 2, Third Party Designee THIRD PARTY DESIGEE ID UMBER: AUTHORIZATIO IDICATOR: Authorized THIRD PARTY DESIGEE AME: Schedule C--Profit or Loss From Business EMPLOYER ID UMBER: DESCRIPTIO OF BUSIESS/PROFESSIO: AICS CODE: ACCT MTHD: Cash FIRST TIME SCHEDULE C FILED: 1 STATUTORY EMPLOYEE ID: ICOME GROSS RECEIPTS OR SALES: $ 109, RETURS AD ALLOWACES: $ 0.00 COST OF GOODS SOLD: $ 15, OTHER ICOME: $ 0.00 EXPESES CAR AD TRUCK EXPESES: $ 10, DEPRECIATIO: $ 2, ISURACE (OTHER THA HEALTH): $ MORTGAGE ITEREST: $ 0.00 LEGAL AD PROFESSIOAL SERVICES: $ REPAIRS AD MAITEACE: $ 1, TRAVEL: $ 1, MEALS-AD-ETERTAIMET: $ 1, WAGES: $ 17, OTHER EXPESES: $ 1, TOTAL EXPESES: $ 48, EXP FOR BUSIESS USE OF HOME: $ 0.00 SCH C ET PROFIT OR LOSS PER COMPUTER: $ 46, AT RISK CD: COST OF GOODS SOLD
6 Page 7 of 8 IVETORY AT BEGIIG OF YEAR: $ 0.00 IVETORY AT ED OF YEAR: $ 0.00 Schedule F--Profit or Loss From Farming FARM ICOME - CASH METHOD AICS CODE: EI: COST OR OTHER BASIS OF LIVESTOCK: $ 0.00 TOTAL COOPERATIVE DISTRIBUTIOS FORM 1099-PATR: $ 0.00 TOTAL AGRICULTURAL PROGRAMS PAYMETS: $ 0.00 AGRICULTURAL PAYMETS TAXABLE AMOUT: $ 0.00 GROSS CCC LOAS FORFEITED/REPAID: $ 0.00 GROSS CROP ISURACE/DISASTER PAYMETS: $ 0.00 TAXBLE CROP ISURACE/DISASTER PAYMETS: $ 0.00 CUSTOM HIRE ICOME: $ 0.00 GROSS FARM ICOME-CASH: $ 0.00 FARM EXPESES - CASH AD ACCRUAL METHOD CUSTOM HIRE - MACHIE WORK: $ GASOLIE, FUEL, OIL DEDUCTIO: $ 0.00 MORTGAGE ITEREST: $ 0.00 REPAIRS & MAITEACE: $ SUPPLIES PURCHASED: $ TOTAL FARM EXPESES: $ 3, ET FARM PROFIT/LOSS PER COMPUTER: $ -3, AMOUTS OT AT RISK I FARM IDICATOR: All investment at risk FARM ICOME - ACCRUAL METHOD TOTAL COOPERATIVE DISTRIBUTIOS: $ 0.00 TAXABLE COOPERATIVE DISTRIBUTIO: $ 0.00 AGRICULTURAL PROGRAM PAYMETS: $ 0.00 CCC LOAS FORFEITED OR REPAID: $ 0.00 TOTAL FARM ICOME-ACCRUAL: $ 0.00 GROSS FARM ICOME-ACCRUAL: $ 0.00 Schedule SE--Self-Employment Tax SS OF SELF-EMPLOYED TAXPAYER: 432-XX-XXXX ET FARM PROFIT/LOSS: SCH F: $ -3, ET OFARM PROFIT/LOSS: $ 46, TOTAL SE ICOME: $ 42, SE QUARTERS COVERED: 4 TOTAL SE TAX PER COMPUTER: $ 6, SE ICOME PER COMPUTER: $ 39, TOTAL ET EARIGS PER COMPUTER: $ 39, LOG FORM OLY TETATIVE CHURCH EARIGS: $ 0.00 TOTAL SOC SEC & RR WAGES: $ 0.00 SE SS TAX COMPUTER: $ 4,905.06
7 Page 8 of 8 SE MEDICAL ICOME PER COMPUTER: $ 39, SE MEDICAL TAX PER COMPUTER: $ 1, SE FARM OPTIO METHOD USED: 0 SE OPTIOAL METHOD ICOME: $ 0.00 This Product Contains Sensitive Taxpayer Data
This Product Contains Sensitive Taxpayer Data
Tax Return Transcript Sample SSN Provided: 123-45-6789 Tax Period Ending: Dec. 31, 2011 This Product Contains Sensitive Taxpayer Data The following items reflect the amount as shown on the return (PR),
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