Gilbert is an elementary school teacher at a public school. Gilbert and Tara are married and choose to file Married Filing Jointly on their 2021 tax return. • Gilbert worked a total of 1,280 hours in 2021. During the school year, he spent $500 on unreimbursed classroom expenses. • Tara retired in 2018 and began receiving her pension on October 1st of that year. She explains that this is a joint and survivor annuity. She has already recovered $1,013 of the cost of the plan. • Gilbert settled with his credit card company on an outstanding bill and brought the Form 1099-C to the site. They aren’t sure how it will impact their tax return for tax year 2021. The Washingtons determined that they were solvent as of the date of the canceled debt. • Tara won $3,000 gambling at a casino and had additional lottery winnings of $150. Tara has documented casino losses of $1,500. • Their son, Chandler, is in his second year of college pursuing a bachelor’s degree in Logistics at a qualified educational institution. He received a scholarship and the terms require that it be used to pay tuition. Box 2 was not filled in and Box 7 was not checked on his Form 1098-T for the previous tax year. The Washingtons provided Form 1098-T and an account statement from the college that included additional expenses. The Washingtons paid $450 for books required for Chandler’s courses. This information is also included on the College statement of account. • Chandler does not have a felony drug conviction. • The Washington’s received the third Economic Impact Payment (EIP3) in the amount of $4,200 in 2021. • They are all U.S. citizens with valid Social Security numbers. 1. What is the total amount of other income reported on the Washingtons' Form 1040, Schedule 1 ? Which of the following credits are the Washingtons’ eligible to claim on their tax return? A. Child tax credit B. Credit for other dependents C. Child and dependent care credit D. None of the above
Gilbert is an elementary school teacher at a public school. Gilbert and Tara are married and choose to file Married Filing Jointly on their 2021 tax return. • Gilbert worked a total of 1,280 hours in 2021. During the school year, he spent $500 on unreimbursed classroom expenses. • Tara retired in 2018 and began receiving her pension on October 1st of that year. She explains that this is a joint and survivor annuity. She has already recovered $1,013 of the cost of the plan. • Gilbert settled with his credit card company on an outstanding bill and brought the Form 1099-C to the site. They aren’t sure how it will impact their tax return for tax year 2021. The Washingtons determined that they were solvent as of the date of the canceled debt. • Tara won $3,000 gambling at a casino and had additional lottery winnings of $150. Tara has documented casino losses of $1,500. • Their son, Chandler, is in his second year of college pursuing a bachelor’s degree in Logistics at a qualified educational institution. He received a scholarship and the terms require that it be used to pay tuition. Box 2 was not filled in and Box 7 was not checked on his Form 1098-T for the previous tax year. The Washingtons provided Form 1098-T and an account statement from the college that included additional expenses. The Washingtons paid $450 for books required for Chandler’s courses. This information is also included on the College statement of account. • Chandler does not have a felony drug conviction. • The Washington’s received the third Economic Impact Payment (EIP3) in the amount of $4,200 in 2021. • They are all U.S. citizens with valid Social Security numbers. 1. What is the total amount of other income reported on the Washingtons' Form 1040, Schedule 1 ? Which of the following credits are the Washingtons’ eligible to claim on their tax return? A. Child tax credit B. Credit for other dependents C. Child and dependent care credit D. None of the above
Gilbert is an elementary school teacher at a public school. Gilbert and Tara are married and choose to file Married Filing Jointly on their 2021 tax return. • Gilbert worked a total of 1,280 hours in 2021. During the school year, he spent $500 on unreimbursed classroom expenses. • Tara retired in 2018 and began receiving her pension on October 1st of that year. She explains that this is a joint and survivor annuity. She has already recovered $1,013 of the cost of the plan. • Gilbert settled with his credit card company on an outstanding bill and brought the Form 1099-C to the site. They aren’t sure how it will impact their tax return for tax year 2021. The Washingtons determined that they were solvent as of the date of the canceled debt. • Tara won $3,000 gambling at a casino and had additional lottery winnings of $150. Tara has documented casino losses of $1,500. • Their son, Chandler, is in his second year of college pursuing a bachelor’s degree in Logistics at a qualified educational institution. He received a scholarship and the terms require that it be used to pay tuition. Box 2 was not filled in and Box 7 was not checked on his Form 1098-T for the previous tax year. The Washingtons provided Form 1098-T and an account statement from the college that included additional expenses. The Washingtons paid $450 for books required for Chandler’s courses. This information is also included on the College statement of account. • Chandler does not have a felony drug conviction. • The Washington’s received the third Economic Impact Payment (EIP3) in the amount of $4,200 in 2021. • They are all U.S. citizens with valid Social Security numbers. 1. What is the total amount of other income reported on the Washingtons' Form 1040, Schedule 1 ? Which of the following credits are the Washingtons’ eligible to claim on their tax return? A. Child tax credit B. Credit for other dependents C. Child and dependent care credit D. None of the above
Gilbert is an elementary school teacher at a public school. Gilbert and Tara are married and choose to file Married Filing Jointly on their 2021 tax return. • Gilbert worked a total of 1,280 hours in 2021. During the school year, he spent $500 on unreimbursed classroom expenses. • Tara retired in 2018 and began receiving her pension on October 1st of that year. She explains that this is a joint and survivor annuity. She has already recovered $1,013 of the cost of the plan. • Gilbert settled with his credit card company on an outstanding bill and brought the Form 1099-C to the site. They aren’t sure how it will impact their tax return for tax year 2021. The Washingtons determined that they were solvent as of the date of the canceled debt. • Tara won $3,000 gambling at a casino and had additional lottery winnings of $150. Tara has documented casino losses of $1,500. • Their son, Chandler, is in his second year of college pursuing a bachelor’s degree in Logistics at a qualified educational institution. He received a scholarship and the terms require that it be used to pay tuition. Box 2 was not filled in and Box 7 was not checked on his Form 1098-T for the previous tax year. The Washingtons provided Form 1098-T and an account statement from the college that included additional expenses. The Washingtons paid $450 for books required for Chandler’s courses. This information is also included on the College statement of account. • Chandler does not have a felony drug conviction. • The Washington’s received the third Economic Impact Payment (EIP3) in the amount of $4,200 in 2021. • They are all U.S. citizens with valid Social Security numbers.
1.
What is the total amount of other income reported on the Washingtons' Form 1040, Schedule 1 ?
Which of the following credits are the Washingtons’ eligible to claim on their tax return?
A. Child tax credit
B. Credit for other dependents
C. Child and dependent care credit
D. None of the above
3. What is the Washington’s total federal income tax withholding? $________ (Do not enter dollar signs, commas, periods, or decimal points in your answer.)
Transcribed Image Text:Form 13614-C
(October 2021)
Department of the Treasury - Internal Revenue Service
Intake/Interview & Quality Review Sheet
OMB Number
You will need:
• Tax Information such as Forms W-2, 1099, 1098, 1095.
• Social security cards or ITIN letters for all persons on your tax return.
Picture ID (such as valid driver's license) for you and your spouse.
1545-1964
Please complete pages 1-4 of this form.
You are responsible for the information on your return. Please provide
complete and accurate information.
If you have questions, please ask the IRS-certified volunteer preparer.
Volunteers are trained to provide high quality service and uphold the highest ethical standards.
To report unethical behavior to the IRS, email us at wi.voltax@irs.gov
Part I-Your Personal Information (If you are filing a joint return, enter your names in the same order as last year's return)
1. Your first name
М.
Last name
Best contact number
Are you a U.S. citizen?
区 Yes
GILBERT
WASHINGTON
2. Your spouse's first name
M.I.
YOUR PHONE #
O No
Last name
Best contact number
Is your spouse a U.S. citizen?
区 Yes
TARA
WASHINGTON
O No
3. Mailing address
123 TAYLOR AVENUE
Apt #City
State
ZIP code
YOUR CITY
YS
YOUR ZIP
4. Your Date of Birth
5. Your job title
6. Last year, were you:
a. Full-time student
図 No
O Yes X No
Yes
5/05/1964
TEACHER
b. Totally and permanently disabled
9. Last year, was your spouse:
口 Yes
区 No
c. Legally blind
7. Your spouse's Date of Birth
8. Your spouse's job title
a. Full-time student
Yes
区 No
03/11/1956
RETIRED
b. Totally and permanently disabled
O Yes
図 No
c. Legally blind
Yes 図No
10. Can anyone claim you or your spouse as a dependent?
11. Have you, your spouse, or dependents been a victim of tax related identity theft or been issued an ldentity Protection PIN?
O Yes X No
O Unsure
O Yes X No
12. Provide an email address (optional) (this email address will not be used for contacts from the Internal Revenue Service)
Part II – Marital Status and Household Information
1. As of December 31, 2021, what
Never Married
(This includes registered domestic partnerships, civil unions, or other formal relationships under state law)
was your marital status?
図 Married
区 No
a. If Yes, Did you get married in 2021?
b. Did you live with your spouse during any part of the last six months of 2021? X Yes No
Date of final decree
Yes
Divorced
Legally Separated
Date of separate maintenance decree
Widowed
Year of spouse's death
2. List the names below of:
If additional space is needed check here and list on page 3
• everyone who lived with you last year (other than your spouse)
anyone you supported but did not live with you last year
To be completed by a Certified Volunteer Preparer
Did the
taxpayer(s)
provide more pay more than
half the cost of
Is this
Did this
Did the
Full-time Totally and
Student Permanently person a
Did this
Relationship Number of US
to you (for
example:
Resident Single or
of US,
Date of Birth
taxpayer(s)
Name (first, last) Do not enter your
name or spouse's name below
person
provide
person
have less
than $4,300 than 50% of
(mm/dd/yy)
months
Citizen
Married as
qualifying
child/relative more than
of any other 50% of his/ of income? support for
person?
(yes/no)
of 12/31/21 last year Disabled
(yes/no) (yes/no)
lived in
(yes/no) Canada,
your home
last year
or Mexico (S/M)
last year
maintaining a
(yes,no,n/a) this person? home for this
person?
(yes/no)
son,
daughter,
parent,
none, etc)
(c)
her own
(yes/no)
(yes/no/n/a)
support?
(yes,no,n/a)
(d)
(e)
(f)
(g)
(h)
(1)
(a)
(b)
YES
NO
8/06/2002
SON
12
YES
YES
CHANDLER WASHINGTON
Form 13614-C (Rev. 10-2021)
www.irs.gov
Catalog Number 52121E
Transcribed Image Text:Visit the IRS website at
www.irs.gov/efile
Safe, accurate,
FASTI Use
IRS file
a Employee's social security number
416-00-XXXX
2 Federal income tax withheld
$2,800
OMB No. 1545-0008
1 Wages, tips, other compensation
$35,502.00
4 Social security tax withheld
$2,263.12
b Employer identification number (EIN)
35-700XXX
3 Social security wages
c Employer's name, address, and ZIP code
$36,502.00
6 Medicare tax withheld
5 Medicare wages and tips
$529.28
$36,502.00
COOLIDGE ELEMENTARY SCHOOL
2565 DEATON STREET
YOUR CITY, STATE ZIP
8 Allocated tips
7 Social security tips
10 Dependent care benefits
d Control number
12a See instructions for box 12
$1,000.00
Suff.
11 Nonqualified plans
e Employee's first name and initial
Last name
12b
13 Statutory
employee
Retirement
plan
Third-party
sick pay
GILBERT WASHINGTON
X
12c
123 TAYLOR AVENUE
14 Other
YOUR CITY, YOUR STATE, ZIP
12d
f Employee's address and ZIP code
20 Locality name
18 Local wages, tips, etc. 19 Local income tax
16 State wages, tips, etc. 17 State income tax
$350.00
15 State Employer's state ID number
YS
35-700XXX
$35,502.00
Department of the Treasury-Internal Revenue Service
W-2 Wage and Tax Statement
2021
Form
Copy B-To Be Filed With Employee's FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
OCORRECTED (if checked)
Distributions From
Pensions, Annuities,
Retirement or
Profit-Sharing Plans,
IRAS, Insurance
Contracts, etc.
PAYER'S
ne, street address, city or town, state or province,
1 Gross distribution
OMB No. 1545-0119
country, ZIP or foreign postal code, and telephone no.
18,485.00 2021
OAK ENTERPRISES
2a Taxable amount
2250 DELTA AVENUE
YOUR CITY, YOUR STATE, ZIP
$4
Form 1099-R
2b Taxable amount
not determined
Total
Copy B
distribution
Report this
income on your
federal tax
return. If this
form shows
federal income
tax withheld in
PAYER'S TIN
RECIPIENT'S TIN
3 Capital gain (included in 4 Federal income tax
box 2a)
withheld
41-200XXXX
RECIPIENT'S name
417-00-XXXX
24
5 Employee contributions/
Designated Roth
contributions or
insurance premiums
1,849.00
6 Net unrealized
appreciation in
employer's securities
TARA WASHINGTON
box 4, attach
this copy to
24
24
IRA
SEP/
SIMPLE
Street address (including apt. no.)
7 Distribution
8 Other
your return.
123 TAYLOR AVENUE
code(s)
7
$4
This information is
City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contributions
YOUR CITY, YOUR STATE, ZIP
%
being furnished to
the IRS.
distribution
% $
15 State/Payer's state no.
10 Amount allocable to IRR
13,500.00
11 1st year of desig. 12 FATCA filing 14 State tax withheld
Roth contrib.
within 5 years
16 State distribution
requirement
$
24
%24
24
24
Account number (see instructions)
13 Date of
17 Local tax withheld
18 Name of locality
payment
19 Local distribution
$4
24
24
24
Form 1099-R
www.irs.gov/Form1099R
Department of the Treasury Internal Revenue Service
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