Electronic Filing Instructions for your 2012 Federal Tax Return
Important: Your taxes are not finished until all required steps are completed.
Andrea B & david j neff
3208 gibraltar dr
rverside, CA 92506
|
| Your federal tax return (Form 1040A) shows a refund due to you in the
| amount of $9,392.00. Your tax refund will be direct deposited into
| your account. The account information you entered - Account Number:
| 4031482260 Routing Transit Number: 122000496.
______________________________________________________________________________________
|
|
When Will
| The IRS issued more than 9 out of 10 refunds to taxpayers in less
You Get
| than 21 days last year. The same results are expected in 2013. To
Your
| get your estimated refund date from TurboTax, log into My TurboTax at
Refund?
| www.turbotax.com. If you do not receive your refund within 21 days,
| or the amount you get is not what you expected, contact the Internal
| Revenue Service directly at 1-800-829-4477. You can also check
| www.irs.gov and select the "Where's my refund?" link.
______________________________________________________________________________________
|
|
What You
| Your Electronic Filing Instructions (this form)
Need to
| Printed copy of your federal return
Keep
|
______________________________________________________________________________________
|
|
2012
| Adjusted Gross Income
$
17,753.00
Federal
| Taxable Income
$
0.00
Tax
| Total Tax
$
0.00
Return
| Total Payments/Credits
$
9,392.00
Summary
| Amount to be Refunded
$
9,392.00
| Effective Tax Rate
-43.50%
______________________________________________________________________________________
|
Balance
Due/
Refund
Page 1 of 1
Hi Andrea and david,
We just want to thank you for using TurboTax this year!
your taxes easy and accurate, year after year.
It's our goal to make
With TurboTax Deluxe:
Your Head Start On Next Year:
When you come back next year, taxes will be so easy! We'll have all
your information saved and ready to transfer in to your new return.
We'll ask you questions about what changed since we last talked, and
we'll be ready to get you the credits and deductions you deserve, no
matter what life throws at you.
Here's the final wrap up for your 2012 taxes:
Your federal refund is:
$ 9,392.00
You qualified for these important credits:
- Child Tax Credit
- Earned Income Credit
Your Guarantee of Accuracy:
Breathe easy. The calculations on your return are backed with our
100% Accuracy Guarantee.
- We double checked your return for errors along the way.
- We helped with step-by-step guidance to get your answers on the right
IRS forms.
- We made sure you didn't miss a deduction even if something in your life
changed, like a new job, new house - or more kids!
Also included:
- We e-filed your federal returns for free, so you could get your refund
the fastest way possible.
- We provide the Audit Support Center free of charge, in the unlikely
event you get audited.
Many happy returns from TurboTax.
Form
Department of the Treasury—Internal Revenue Service
1040A
U.S. Individual Income Tax Return (99)
Your first name and initial
2012
IRS Use Only—Do not write or staple in this space.
Last name
Andrea B
OMB No. 1545-0074
Your social security number
neff
If a joint return, spouse’s first name and initial
david j
608-07-2576
Last name
Spouse’s social security number
neff
614-24-8933
Home address (number and street). If you have a P.O. box, see instructions.
Apt. no.
3208 gibraltar dr
c
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Filing
status
Check only
one box.
Exemptions
If more than six
dependents, see
instructions.
Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign postal code a box below will not change your tax or
refund.
You
Spouse
rverside CA 92506
Foreign country name
Make sure the SSN(s) above
and on line 6c are correct.
Foreign province/state/county
1
2
3
4
Single
Head of household (with qualifying person). (See instructions.)
Married filing jointly (even if only one had income)
If the qualifying person is a child but not your dependent,
enter this child’s name here. a
Married filing separately. Enter spouse’s SSN above and
a
5
Qualifying widow(er) with dependent child (see instructions)
full name here.
Boxes
6a
Yourself. If someone can claim you as a dependent, do not check
checked on
box 6a.
2
6a and 6b
No. of children
b
Spouse
on 6c who:
(4) if child under
c Dependents:
• lived with
(3) Dependent’s
(2) Dependent’s social
age 17 qualifying for
you
2
security number
relationship to you
child tax credit (see
}
(1) First name
David j
vincent s
Last name
Neff, ii
neff
instructions)
612-34-5678
623-45-6789
• did not live
with you due to
divorce or
separation (see
instructions)
Son
Son
Dependents
on 6c not
entered above
Add numbers
on lines
above a
d Total number of exemptions claimed.
4
Income
7
Attach
Form(s) W-2
here. Also
attach
Form(s)
1099-R if tax
was
withheld.
If you did not
get a W-2, see
instructions.
Enclose, but do
not attach, any
payment. Also,
please use Form
1040-V.
Adjusted
gross
income
Wages, salaries, tips, etc. Attach Form(s) W-2.
7
8a
b
9a
b
10
11a
Taxable interest. Attach Schedule B if required.
Tax-exempt interest. Do not include on line 8a. 8b
Ordinary dividends. Attach Schedule B if required.
Qualified dividends (see instructions).
9b
Capital gain distributions (see instructions).
IRA
11b Taxable amount
distributions.
11a
(see instructions).
12a Pensions and
12b Taxable amount
annuities.
12a
(see instructions).
8a
9a
10
11b
12b
13 Unemployment compensation and Alaska Permanent Fund dividends.
14a Social security
14b Taxable amount
benefits.
14a
(see instructions).
12,120.
15
Add lines 7 through 14b (far right column). This is your total income.
16
17
18
Educator expenses (see instructions).
IRA deduction (see instructions).
Student loan interest deduction (see instructions).
19
20
Tuition and fees. Attach Form 8917.
19
Add lines 16 through 19. These are your total adjustments.
21
Subtract line 20 from line 15. This is your adjusted gross income.
17,753.
13
a
14b
0.
15
17,753.
16
17
18
20
a
21
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA
REV 01/10/13 TTO
17,753.
Form 1040A (2012)
Form 1040A (2012)
Tax, credits, 22 Enter the amount from line 21 (adjusted gross income).
You were born before January 2, 1948,
Blind Total boxes
23a Check
and
if:
Spouse
was
born
before
January
2,
1948,
Blind checked a 23a
payments
{
b If you are married filing separately and your spouse itemizes
a 23b
deductions, check here
24 Enter your standard deduction.
24
25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-.
25
26 Exemptions. Multiply $3,800 by the number on line 6d.
26
27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.
a 27
This is your taxable income.
28 Tax, including any alternative minimum tax (see instructions).
28
29 Credit for child and dependent care expenses. Attach
Form 2441.
29
30 Credit for the elderly or the disabled. Attach
30
Schedule R.
0.
31 Education credits from Form 8863, line 19.
31
32 Retirement savings contributions credit. Attach
Form 8880.
32
0.
33 Child tax credit. Attach Schedule 8812, if required.
33
34 Add lines 29 through 33. These are your total credits.
34
35 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is
35
your total tax.
36 Federal income tax withheld from Forms W-2 and
1,670.
1099.
36
37 2012 estimated tax payments and amount applied
from 2011 return.
37
5,236.
38a Earned income credit (EIC).
38a
b Nontaxable combat pay
election.
38b
2,000.
39 Additional child tax credit. Attach Schedule 8812.
39
486.
40 American opportunity credit from Form 8863, line 8.
40
a 41
41 Add lines 36, 37, 38a, 39, and 40. These are your total payments.
42 If line 41 is more than line 35, subtract line 35 from line 41.
This is the amount you overpaid.
42
43a Amount of line 42 you want refunded to you. If Form 8888 is attached, check here a 43a
Routing
a c Type:
Checking
Savings
a b
number 1 2 2 0 0 0 4 9 6
Account
a d
number 4 0 3 1 4 8 2 2 6 0
44 Amount of line 42 you want applied to your
2013 estimated tax.
44
45 Amount you owe. Subtract line 41 from line 35. For details on how to pay,
a 45
see instructions.
46 Estimated tax penalty (see instructions).
46
Standard
Deduction
for—
• People who
check any
box on line
23a or 23b or
who can be
claimed as a
dependent,
see
instructions.
• All others:
Single or
Married filing
separately,
$5,950
Married filing
jointly or
Qualifying
widow(er),
$11,900
Head of
household,
$8,700
If you have
a qualifying
child, attach
Schedule
EIC.
Refund
Direct
deposit?
See
instructions
and fill in
43b, 43c,
and 43d or
Form 8888.
Amount
you owe
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Third party
designee
F
Sign
here
Joint return?
See instructions.
Keep a copy
for your records.
Paid
preparer
use only
}
22
Page 2
17,753.
11,900.
5,853.
15,200.
0.
0.
0.
0.
9,392.
9,392.
9,392.
Yes. Complete the following.
No
Designee’s
Phone
Personal identification
a
a
a
name
no.
number (PIN)
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other
than the taxpayer) is based on all information of which the preparer has any knowledge.
Your occupation
Daytime phone number
Your signature
Date
(951)255-9817
HR Rep
Spouse’s signature. If a joint return, both must sign.
Date
Spouse’s occupation
disabled
Print/type preparer's name
Preparer’s signature
Firm's name a
Firm's address
Date
If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
PTIN
Check a
if
self-employed
Firm's EIN a
Phone no.
a
REV 01/10/13 TTO
Form 1040A (2012)
Earned Income Credit
SCHEDULE EIC
(Form 1040A or 1040)
Qualifying Child Information
▶ Complete
OMB No. 1545-0074
◀
1040A
..........
EIC
Department of the Treasury
▶ Information about Schedule EIC (Form 1040A or 1040) and its instructions is at www.irs.gov/form1040.
Internal Revenue Service (99)
Andrea B & david j neff
!
▲
CAUTION
Attachment
Sequence No. 43
Your social security number
Name(s) shown on return
Before you begin:
2012
1040
and attach to Form 1040A or 1040 only if you have a qualifying child.
608-07-2576
• See the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, to make
sure that (a) you can take the EIC, and (b) you have a qualifying child.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card.
Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s
social security card is not correct, call the Social Security Administration at 1-800-772-1213.
• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See page 2 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
1 Child’s name
If you have more than three qualifying
children, you only have to list three to get
the maximum credit.
Child 1
First name
Child 2
Last name
David J Neff ii
First name
Child 3
Last name
First name
Last name
vincent S neff
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040A, lines 38a
and 38b, or Form 1040, lines 64a and 64b,
unless the child was born and died in
2012. If your child was born and died in
2012 and did not have an SSN, enter
“Died” on this line and attach a copy of
the child’s birth certificate, death
certificate, or hospital medical records.
3 Child’s year of birth
612-34-5678
Year
2
0
0
623-45-6789
Year
8
If born after 1993 and the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.
4 a Was the child under age 24 at the end of
2012, a student, and younger than you (or
your spouse, if filing jointly)?
Yes.
Go to
line 5.
2
1
Year
0
If born after 1993 and the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.
No.
Yes.
Go to line 4b.
0
Go to
line 5.
If born after 1993 and the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.
No.
Yes.
Go to line 4b.
Go to
line 5.
No.
Go to line 4b.
b Was the child permanently and totally
disabled during any part of 2012?
Yes.
No.
Go to
The child is not a
qualifying child.
line 5.
Yes.
Go to
line 5.
No.
The child is not a
qualifying child.
Yes.
Go to
line 5.
No.
The child is not a
qualifying child.
5 Child’s relationship to you
(for example, son, daughter, grandchild,
niece, nephew, foster child, etc.)
Son
Son
12 months
Do not enter more than 12
months.
12 months
Do not enter more than 12
months.
6 Number of months child lived
with you in the United States
during 2012
• If the child lived with you for more than
half of 2012 but less than 7 months,
enter “7.”
• If the child was born or died in 2012 and
your home was the child’s home for more
than half the time he or she was alive
during 2012, enter “12.”
For Paperwork Reduction Act Notice, see your tax
return instructions.
BAA
REV 11/13/12 TTO
months
Do not enter more than 12
months.
Schedule EIC (Form 1040A or 1040) 2012
SCHEDULE 8812
(Form 1040A
or 1040)
OMB No. 1545-0074
Child Tax Credit
▶ Attach
Department of the Treasury
Internal Revenue Service (99)
▶ Information
2012
to Form 1040, Form 1040A, or Form 1040NR.
Attachment
Sequence No. 47
about Schedule 8812 and its separate instructions is at www.irs.gov/form1040.
Your social security number
Name(s) shown on return
Andrea B & david j neff
608-07-2576
Part I
Filers Who Have Certain Child Dependent(s) with an ITIN (Individual Taxpayer Identification Number)
!
▲
CAUTION
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 1040, line 6c; Form 1040A, line 6c; or Form 1040NR, line 7c, who has an ITIN
(Individual Taxpayer Identification Number) and that you indicated qualified for the child tax credit by checking column (4) 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 substantial
presence test? See separate instructions.
No
Yes
B
For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial
presence test? See separate instructions.
No
Yes
C
For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial
presence test? See separate instructions.
No
Yes
D
For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial
presence test? See separate instructions.
No
Yes
Note. 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
1
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Additional Child Tax Credit Filers
1040 filers:
1040A filers:
1040NR filers:
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040, line 51).
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040A, line 33).
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040NR, line 48).
If you used Pub. 972, enter the amount from line 8 of the Child Tax Credit Worksheet in the publication.
2
3
4a
b
5
6
.
}
Enter the amount from Form 1040, line 51; Form 1040A, line 33; or Form 1040NR, line 48
. . . . .
Subtract line 2 from line 1. If zero, stop; you cannot take this credit . . . . . . . . . . . . .
17,753.
Earned income (see separate instructions) . . . . . . . . . . .
4a
Nontaxable combat pay (see separate
4b
instructions) . . . . . . . . . . .
Is the amount on line 4a more than $3,000?
No. Leave line 5 blank and enter -0- on line 6.
14,753.
Yes. Subtract $3,000 from the amount on line 4a. Enter the result . . .
5
Multiply the amount on line 5 by 15% (.15) and enter the result . . . . . . . . . . . . . .
Next. Do you have three or more qualifying children?
No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part III and enter the smaller of
line 3 or line 6 on line 13.
Yes. If line 6 is equal to or more than line 3, skip Part III and enter the amount from line 3 on line 13.
Otherwise, go to line 7.
For Paperwork Reduction Act Notice, see your tax return instructions. BAA
REV 12/10/12 TTO
.
.
.
.
.
.
.
▶
1
2,000.
2
3
0.
2,000.
6
2,213.
Schedule 8812 (Form 1040A or 1040) 2012
Page 2
Schedule 8812 (Form 1040A or 1040) 2012
Part III
Certain Filers Who Have Three or More Qualifying Children
7
Withheld social security and Medicare taxes from Form(s) W-2, boxes 4 and 6.
If married filing jointly, include your spouse’s amounts with yours. If you
worked for a railroad, see separate instructions . . . . . . . . . .
8
1040 filers:
1040A filers:
1040NR filers:
9
10
Enter the total of the amounts from Form 1040, lines
27 and 57, plus any taxes that you identified using code
“UT” and entered on line 60.
Enter -0-.
Enter the total of the amounts from Form 1040NR,
lines 27 and 55, plus any taxes that you identified using
code “UT” and entered on line 59.
Add lines 7 and 8 . . . . . . . . . . . . . . . . . .
Enter the total of the amounts from Form 1040, lines
1040 filers:
64a and 69.
1040A filers:
11
12
Enter the total of the amount from Form 1040A, line
38a, plus any excess social security and tier 1 RRTA
taxes withheld that you entered to the left of line 41
(see separate instructions).
1040NR filers: Enter the amount from Form 1040NR, line 65.
Subtract line 10 from line 9. If zero or less, enter -0- . . . . . . .
Enter the larger of line 6 or line 11 . . . . . . . . . . . .
Next, enter the smaller of line 3 or line 12 on line 13.
Part IV
Additional Child Tax Credit
13
This is your additional child tax credit
}
7
8
}
9
.
10
.
.
11
12
. . . . . . . . . . . . . . . . . . .
13
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
2,000.
Enter this amount on
Form 1040, line 65,
Form 1040A, line 39, or
Form 1040NR, line 63.
REV 12/10/12 TTO
Schedule 8812 (Form 1040A or 1040) 2012
Form
8863
Department of the Treasury
Internal Revenue Service (99)
Education Credits
(American Opportunity and Lifetime Learning Credits)
▶
▶ See separate instructions to find out if you are eligible to take the credits.
Instructions and more are at www.irs.gov/form8863. Attach to Form 1040 or Form 1040A.
Andrea B & david j neff
CAUTION
Part I
608-07-2576
Complete a separate Part III on page 2 for each student for whom you are claiming either credit
before you complete Parts I and II.
Refundable American Opportunity Credit
1
2
After completing Part III for each student, enter the total of all amounts from all Parts III, line 30 .
Enter: $180,000 if married filing jointly; $90,000 if single, head of
180,000.
household, or qualifying widow(er) . . . . . . . . . . . . .
2
3
Enter the amount from Form 1040, line 38, or Form 1040A, line 22. If you
are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from
17,753.
Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . .
3
Subtract line 3 from line 2. If zero or less, stop; you cannot take any
162,247.
education credit . . . . . . . . . . . . . . . . . . .
4
Enter: $20,000 if married filing jointly; $10,000 if single, head of household,
20,000.
5
or qualifying widow(er) . . . . . . . . . . . . . . . . .
If line 4 is:
• Equal to or more than line 5, enter 1.000 on line 6 . . . . . . . . . . . .
. . . .
• Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to
at least three places) . . . . . . . . . . . . . . . . . . . . .
4
5
6
7
8
}
Multiply line 1 by line 6. Caution: If you were under age 24 at the end of the year and meet
the conditions described in the instructions, you cannot take the refundable American opportunity
credit; skip line 8, enter the amount from line 7 on line 9, and check this box
. . . . ▶
Refundable American opportunity credit. Multiply line 7 by 40% (.40). Enter the amount here and
on Form 1040, line 66, or Form 1040A, line 40. Then go to line 9 below. . . . . . . . . .
Part II
9
10
11
12
13
14
15
16
17
18
19
2012
Attachment
Sequence No. 50
Your social security number
Name(s) shown on return
!
▲
OMB No. 1545-0074
1
1,214.
6
1.000
7
1,214.
8
486.
9
728.
Nonrefundable Education Credits
Subtract line 8 from line 7. Enter here and on line 8 of the Credit Limit Worksheet (see instructions)
After completing Part III for each student, enter the total of all amounts from all Parts III, line 31. If
zero skip lines 11 through 17, enter -0- on line 18, and go to line 19 . . . . . . . . . .
Enter the smaller of line 10 or $10,000 . . . . . . . . . . . . . . . . . . . .
Multiply line 11 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . .
Enter: $124,000 if married filing jointly; $62,000 if single, head of
household, or qualifying widow(er)
. . . . . . . . . . . . .
13
Enter the amount from Form 1040, line 38, or Form 1040A, line 22. If you
are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from
Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . .
14
Subtract line 14 from line 13. If zero or less, skip lines 16 and 17, enter -0on line 18, and go to line 19
. . . . . . . . . . . . . . .
15
Enter: $20,000 if married filing jointly; $10,000 if single, head of household,
or qualifying widow(er) . . . . . . . . . . . . . . . . .
16
If line 15 is:
• Equal to or more than line 16, enter 1.000 on line 17 and go to line 18
• Less than line 16, divide line 15 by line 16. Enter the result as a decimal (rounded to at least three
places) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) ▶
Nonrefundable education credits. Enter the amount from line 13 of the Credit Limit Worksheet
(see instructions) here and on Form 1040, line 49, or Form 1040A, line 31 . . . . . . . . .
For Paperwork Reduction Act Notice, see your tax return instructions. IRS.gov/form8863
BAA
10
11
12
17
18
19
REV 01/16/13 TTO
0.
Form 8863 (2012)
Page 2
Your social security number
Form 8863 (2012)
Name(s) shown on return
Andrea B & david j neff
!
▲
CAUTION
Part III
608-07-2576
Complete Part III for each student for whom you are claiming either the American
opportunity credit or lifetime learning credit. Use additional copies of Page 2 as needed for
each student.
Student and Educational Institution Information
See instructions.
20 Student name (as shown on page 1 of your tax return)
21 Student social security number (as shown on page 1 of your tax return)
david
neff
22
614-24-8933
Educational institution information (see instructions)
a. Name of first educational institution
b. Name of second educational institution (if any)
cal pol pomona
(1) Address. Number and street (or P.O. box). City, town or
post office, state, and ZIP code. If a foreign address, see
instructions.
(1) Address. Number and street (or P.O. box). City, town or
post office, state, and ZIP code. If a foreign address, see
instructions.
3801 West Temple Avenue
Pomona ca 91768
(2) Did the student receive Form 1098-T
(2) Did the student receive Form 1098-T
Yes
No
Yes
No
from this institution for 2012?
from this institution for 2012?
(3) Did the student receive Form 1098-T
(3) Did the student receive Form 1098-T
Yes
No
Yes
No
from this institution for 2011 with Box
from this institution for 2011 with Box 2
2 filled in and Box 7 checked?
filled in and Box 7 checked?
If you checked “No” in both (2) and (3), skip (4).
If you checked “No” in both (2) and (3), skip (4).
(4) If you checked “Yes” in (2) or (3), enter the institution's
(4) If you checked “Yes” in (2) or (3), enter the institution's
federal identification number (from Form 1098-T).
federal identification number (from Form 1098-T).
95-4255659
23
24
25
Has the Hope Scholarship Credit or American opportunity
credit been claimed for this student for any 4 prior tax years?
Was the student enrolled at least half-time for at least one
academic period that began in 2012 at an eligible
educational institution in a program leading towards a
postsecondary degree, certificate, or other recognized
postsecondary educational credential? (see instructions)
Yes — Stop!
Go to line 31 for this student.
No — Go to line 24.
Yes — Go to line 25.
No — Stop! Go to line 31
for this student.
Did the student complete the first 4 years of post-secondary
education before 2012?
Yes — Stop!
Go to line 31 for this
student.
No — Go to line 26.
26
Was the student convicted, before the end of 2012, of a
Yes — Stop!
No — See Tip below and
felony for possession or distribution of a controlled
Go to line 31 for this
complete either lines 27-30
substance?
student.
or line 31 for this student.
When you figure your taxes, you may want to compare the American opportunity credit and lifetime learning credits, and
TIP choose the credit for each student that gives you the lower tax liability. You cannot take the American opportunity credit
and the lifetime learning credit for the same student in the same year. If you complete lines 27 through 30 for this student,
do not complete line 31.
American Opportunity Credit
27
28
29
30
Adjusted qualified education expenses (see instructions). Do not enter more than $4,000 . . .
Subtract $2,000 from line 27. If zero or less enter -0- . . . . . . . . . . . . . . . .
Multiply line 28 by 25% (.25) . . . . . . . . . . . . . . . . . . . . . . . .
If line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29
enter the result. Skip line 31. Include the total of all amounts from all Parts III, line 30 on Part I, line 1
.
.
.
and
.
27
28
29
1,214.
0.
0.
30
1,214.
Lifetime Learning Credit
31
Adjusted qualified education expenses (see instructions). Include the total of all amounts from all Parts
III, line 31, on Part II, line 10 . . . . . . . . . . . . . . . . . . . . . . . . .
31
Form 8863 (2012)
Federal Information Worksheet
2012
G Keep for your records
Part I ' Personal Information
Information in Part I is completely calculated from entries on Personal Information Worksheets.
Taxpayer:
First name
Middle initial
Last name
Social security no.
Occupation
Date of birth
Age as of 1-1-2013
Daytime phone
Legally blind
Date of death
Spouse:
First name
Middle initial
Last name
Social security no.
Occupation
Date of birth
Age as of 1-1-2013
Daytime phone
Legally blind
Date of death
Andrea
B
Suffix
neff
608-07-2576
HR Rep
01/16/1979 (mm/dd/yyyy)
33
(951)255-9817 Ext
david
J
Suffix
neff
614-24-8933
disabled
02/05/1978 (mm/dd/yyyy)
34
Ext
Dependent of Someone Else:
Can taxpayer be claimed as dependent of another
person (such as parent)?
Yes
X No
If yes, was taxpayer claimed as dependent on that
person’s return?
Yes
No
Dependent of Someone Else:
Can spouse be claimed as dependent of another
person (such as parent)?
Yes
X No
If yes, was spouse claimed as dependent on that
person’s return?
Yes
No
Credit for the Elderly or Disabled (Schedule R):
Is the taxpayer retired on total
and permanent disability?
Yes
No
Credit for the Elderly or Disabled (Schedule R):
Is the spouse retired on total
and permanent disability?
Yes
No
Presidential Election Campaign Fund:
Does the taxpayer want $3 to go to the Presidential
Election Campaign Fund?
Yes
No
Presidential Election Campaign Fund:
Does the spouse want $3 to go to the Presidential
Election Campaign Fund?
Yes
No
Part II ' Address and Federal Filing Status (enter information in this section)
Address
3208 gibraltar dr
City
rverside
Foreign province/county
Foreign code
Foreign country
Apt no.
State
CA
ZIP code
Foreign postal code
APO/FPO/DPO address, check if appropriate
Home phone
Check to print phone number on Form 1040
APO
Home
92506
FPO
X Taxpayer daytime
DPO
Spouse daytime
Federal filing status:
1 Single
X
2 Married filing jointly
3 Married filing separately
Check this box if you did not live with your spouse at any time during the year
Check this box if you are eligible to claim your spouse’s exemption (see Help)
4 Head of household
If the ’qualifying person’ is your child but not your dependent:
Child’s First name
MI
Last Name
Child’s social security number
5 Qualifying widow(er)
Check the appropriate box for the year your spouse died
Suff
2010
2011
Part III ' Dependent/Earned Income Credit/Child and Dependent Care Credit Information
Information in Part III is completely calculated from entries on Dependent/Nondependent Info Worksheets.
Date of birth
(mm/dd/yyyy)
First name
Last name
MI
Suff
David
Neff
vincent
neff
J
ii
S
Social security
number
Relationship
612-34-5678
Son
623-45-6789
Son
Age
C
o
d
e
Not
qual
for
child
tax cr
02/12/2008
4 L
07/22/2010
2 L
* "Yes" - qualifies as dependent, "No" - does not qualify as dependent
Qualified
child/dep
care exps
incurred
and paid
2012
E
I
C
Lived
with
taxpyr
in
U.S.
Educ
Tuitn
and
Fees
*
D
e
p
E
12
Yes
E
12
Yes
Andrea B & david j neff
Page 2
608-07-2576
Part IV ' Earned Income Credit Information (you must answer these questions to calculate EIC)
Is the taxpayer or spouse a qualifying child for EIC for another person?
Was the taxpayer’s (and spouse’s if married filing jointly) home in the United States
for more than half of 2012?
If the SSN of the taxpayer, or spouse if married filing jointly, was obtained to
get a federally funded benefit, such as Medicaid, and the Social Security card
contains the legend Not Valid for Employment, check this box (see Help)
Check if you are filing head of household and your spouse is a nonresident alien
and you lived with your spouse during the last six months of 2012
Was EIC disallowed or reduced in a previous year and are you required to file
Form 8862 this year?
Yes
X
X
Yes
Yes
No
No
X
No
Check if you were notified by the IRS that EIC cannot be claimed in 2012
Part V ' Direct Deposit or Direct Debit Information (not applicable for Form 9465)
Do you want to elect direct deposit of any federal tax refund?
X
Do you want to elect direct debit of federal balance due (Electronic filing only)?
If you selected either of the options above, fill out the information below:
Name of Financial Institution (optional)
union bank
Check the appropriate box
Checking X
Routing number
122000496
Account number
Yes
No
Yes
No
Savings
4031482260
Enter the following information only if you are requesting direct debit of balance due:
Enter the payment date to withdraw from the account above
Balance-due amount from this return
Part VI ' Additional Information for Your Federal Return
Standard Deduction/Itemized Deductions:
Check this box if you are itemizing for state tax or other purposes even though your itemized
deductions are less than your standard deduction
Check this box if you are married filing separately and your spouse itemized deductions
Check this box to take the standard deduction even if less than itemized deductions
Main Form Selection:
Check this box to calculate Form 1040 even if you qualify to use Form 1040A or 1040EZ
Real Estate Professionals:
Do you or your spouse qualify for the special passive activity rules for
taxpayers in real property business? (see Help)
Yes
Credit for Qualified Retirement Savings Contributions (Form 8880):
Is the taxpayer a full-time student?
Is the spouse a full-time student?
Yes
Yes
Foreign Tax Credit (Form 1116):
Check this box to file Form 1116 even if you’re not required to file Form 1116
Resident country
USA
No
X
No
No
Excludable Income from Am. Samoa, Guam, Commonwealth of the N. Mariana Islands, or Puerto Rico:
Excludable income of bona fide residents of American Samoa, Guam, or the
Commonwealth of the Northern Mariana Islands
Excludable income from Puerto Rico
Dual Status Alien Return:
Check this box if you are a dual-status alien
Third Party Designee:
Caution: Review transferred information for accuracy.
Do you want to allow another person to discuss this return with the IRS?
Yes
If Yes, complete the following:
Third party designee name
Third party designee phone number
Personal Identification number (enter any 5 numbers)
If you are entitled to a filing extension or other disaster relief provision as declared by the IRS,
enter the appropriate information (see Help)
No
Andrea B & david j neff
608-07-2576
Page 3
Part VII ' State Filing Information
Taxpayer:
Enter the taxpayer’s state of residence as of December 31, 2012
Check the appropriate box:
Taxpayer is a resident of the state above for the entire year
Taxpayer is a resident of the state above for only part of year
Date the taxpayer established residence in state above
In which state (or foreign country) did the taxpayer reside before this change?
CA
X
Spouse:
Enter the spouse’s state of residence as of December 31, 2012
Check the appropriate box:
Spouse is a resident of the state above for the entire year
Spouse is a resident of the state above for only part of year
Date the spouse established residence in state above
In which state (or foreign country) did the spouse reside before this change?
Nonresident states:
Nonresident State(s)
Taxpayer/Spouse/Joint
Check this box if you are in a Registered Domestic Partnership, a civil union, or same-sex marriage
If you checked the box on the line above, also check the appropriate box below:
Check if this is your individual federal return you are filing with the IRS
Check if this is the joint return created to file joint state tax return (see Help)
CA
X
Personal Information Worksheet
For the Taxpayer
2012
G Keep for your records
QuickZoom to another copy of Personal Information Worksheet
QuickZoom to Federal Information Worksheet
Part I ' Taxpayer's Personal Information
First name
Social security no.
608-07-2576
Date of birth
01/16/1979
Occupation
Middle initial
Last name
neff
Suffix
Member of U.S. Armed Forces in 2012?
Andrea
(mm/dd/yyyy)
HR Rep
B
Yes
age as of 1-1-2013
Daytime phone
33
(951)255-9817
Marital status
Married
If widowed, check the appropriate box for the year your spouse died:
After 2012
2012
2011
2010
Are you retired on total and permanent disability? (for Schedule R, see Help).
Check if this person is legally blind
If deceased, enter the date of death
No
X
Ext
Before 2010
Yes
No
(mm/dd/yyyy)
Were you under the age of 16 as of 1-1-2013 and this is the first year you
are filing a tax return?
Yes
No
Do you want $3 to go to Presidential Election Campaign Fund?
Yes
No
Part II ' Questions for Individuals Who Could Be Or Are Dependents of Another Taxpayer
1 Can someone (such as your parent) claim you as a dependent?
2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return?
Questions 3 through 5 are only required for individuals who claim the
American Opportunity Credit.
3 Were you a full-time student during any part of five months during 2012?
4 Did your earned income exceed one-half of your support?
5 Was at least one of your parents alive on December 31, 2012?
Yes
X
No
Yes
No
Yes
Yes
Yes
No
No
No
Part III ' Taxpayer's State Residency Information
Enter this person’s state of residence as of December 31, 2012
Check the appropriate box:
This person is a resident of the state above for the entire year
This person is a resident of the state above for only part of year
Date this person established residence in state above
In which state (or foreign country) did this person reside before this change?
Part IV ' Dependent Care Expenses
Qualified dependent care expenses incurred and paid for this person in 2012
CA
X
Personal Information Worksheet
For the Spouse
2012
G Keep for your records
QuickZoom to another copy of Personal Information Worksheet
QuickZoom to Federal Information Worksheet
Part I ' Spouse's Personal Information
First name
Middle initial
Social security no.
614-24-8933
Date of birth
02/05/1978
Occupation
Last name
neff
Suffix
Member of U.S. Armed Forces in 2012?
david
(mm/dd/yyyy)
disabled
J
Yes
age as of 1-1-2013
34
Daytime phone
Ext
Marital status
If widowed, check the appropriate box for the year your spouse died:
After 2012
2012
2011
2010
Are you retired on total and permanent disability? (for Schedule R, see Help).
Check if this person is legally blind
If deceased, enter the date of death
No
X
Before 2010
Yes
No
(mm/dd/yyyy)
Were you under the age of 16 as of 1-1-2013 and this is the first year you
are filing a tax return?
Yes
No
Do you want $3 to go to Presidential Election Campaign Fund?
Yes
No
Part II ' Questions for Individuals Who Could Be Or Are Dependents of Another Taxpayer
1 Can someone (such as your parent) claim you as a dependent?
2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return?
Questions 3 through 5 are only required for individuals who claim the
American Opportunity Credit.
3 Were you a full-time student during any part of five months during 2012?
4 Did your earned income exceed one-half of your support?
5 Was at least one of your parents alive on December 31, 2012?
Yes
X
No
Yes
No
Yes
Yes
Yes
No
No
No
Part III ' Spouse's State Residency Information
Enter this person’s state of residence as of December 31, 2012
Check the appropriate box:
This person is a resident of the state above for the entire year
This person is a resident of the state above for only part of year
Date this person established residence in state above
In which state (or foreign country) did this person reside before this change?
Part IV ' Dependent Care Expenses
Qualified dependent care expenses incurred and paid for this person in 2012
CA
X
Dependent and Nondependent Information Worksheet
2012
G Keep for your records
QuickZoom to another copy of Dependent and Nondependent Information Worksheet
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Part I ' Personal Information
First name
Middle initial
David
Social security no.
J
Last name
Suffix
Neff
ii
612-34-5678
Date of birth
02/12/2008 (mm/dd/yyyy)
Did this person pass away in 2012 (deceased)?
age as of 12-31-2012
Relationship to taxpayer or spouse
CAUTION: If claiming a child other than your own, see Relationship in the Tax Help.
4
Yes
X No
Son
NOTE: The ability to set your answers to being the same as last year for the dependent is only
available in Step-by-Step mode and not in Forms mode.
Are the answers to the questions below for this person, to determine
whether they are your dependent, the same as they were last year?
Yes
Dependency code *
L
No
Your dependent child who lived with you
*Dependency code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Dependent is disabled
Part II ' Earned Income Credit and Child Tax Credit
Is this person a U.S. citizen, U.S. national, or a U.S. resident?
Is this person a resident of Canada or Mexico?
X Yes
Yes
No
No
This person is adopted and you are a U.S. citizen or U.S. national
The adopted child lived with you all year
*If the child is adopted, you are a U.S. citizen or U.S. national and they lived with you
all year, they are considered to meet the citizen test and the U.S. citizen box will
automatically be checked yes.
Qualifying for the earned income credit *
E
Qualifying child
*EIC code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Months lived with taxpayer in the United States
12
Check if this person is not a qualifying child for the child tax credit
If this dependent has an ITIN issued by the IRS instead of a
social security number issued by the social security administration,
did they meet the substantial presence test? (see Schedule 8812 Instructions)
Part III ' Dependent Care Expenses
Qualified child or dependent care expenses incurred and paid in 2012
Yes
No
Dependent and Nondependent Information Worksheet
2012
G Keep for your records
QuickZoom to another copy of Dependent and Nondependent Information Worksheet
QuickZoom to Federal Information Worksheet
Part I ' Personal Information
First name
Middle initial
vincent
Social security no.
S
Last name
Suffix
neff
623-45-6789
Date of birth
07/22/2010 (mm/dd/yyyy)
Did this person pass away in 2012 (deceased)?
age as of 12-31-2012
Relationship to taxpayer or spouse
CAUTION: If claiming a child other than your own, see Relationship in the Tax Help.
2
Yes
X No
Son
NOTE: The ability to set your answers to being the same as last year for the dependent is only
available in Step-by-Step mode and not in Forms mode.
Are the answers to the questions below for this person, to determine
whether they are your dependent, the same as they were last year?
Yes
Dependency code *
L
No
Your dependent child who lived with you
*Dependency code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Dependent is disabled
Part II ' Earned Income Credit and Child Tax Credit
Is this person a U.S. citizen, U.S. national, or a U.S. resident?
Is this person a resident of Canada or Mexico?
X Yes
Yes
No
No
This person is adopted and you are a U.S. citizen or U.S. national
The adopted child lived with you all year
*If the child is adopted, you are a U.S. citizen or U.S. national and they lived with you
all year, they are considered to meet the citizen test and the U.S. citizen box will
automatically be checked yes.
Qualifying for the earned income credit *
E
Qualifying child
*EIC code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Months lived with taxpayer in the United States
12
Check if this person is not a qualifying child for the child tax credit
If this dependent has an ITIN issued by the IRS instead of a
social security number issued by the social security administration,
did they meet the substantial presence test? (see Schedule 8812 Instructions)
Part III ' Dependent Care Expenses
Qualified child or dependent care expenses incurred and paid in 2012
Yes
No
Student Information Worksheet
2012
G Keep for your records
Name of Student
Social Security Number
david j neff
614-24-8933
Part I ' Student Status
1
2
Was this person a student during 2012?
What kind of school did the student attend during 2012? (Check all that apply.)
a
Elementary
c X
College (postsecondary)
e
b
High school (secondary)
d
Vocational school
f
3
Did the student receive scholarships or other education assistance?
X Yes
No
Military academy
Not applicable
X Yes
No
Part II ' College Student Information
1
2
3
4
5
6
7
8
9
Did the student complete the first 4 years of postsecondary education
as of 1/1/2012?
Yes X
Was this student enrolled at an eligible education institution during
2012?
X Yes
Was this student enrolled in a program that leads to a degree,
certificate, or credential?
X Yes
Was this student taking courses as part of a postsecondary degree
program or to acquire or improve job skills?
X Yes
Did this student take at least one-half the normal full-time workload for
one academic period?
X Yes
Has this student been convicted of a felony for possessing or distributing
a controlled substance?
Yes X
Is this student an eligible dependent of the taxpayer?
Yes
In how many prior years has an American Opportunity Credit been claimed for this student?
In how many prior years has a Hope Credit been claimed for this student
No
NA
No
NA
No
NA
No
NA
No
NA
No
No
X
NA
NA
1
1
Part III ' Education Credit and Deduction Qualifications (Determined based entries in Part II)
1
Is this student qualified for the American Opportunity Credit?
X Yes
No
2
Is this student qualified for the Lifetime Learning Credit?
X Yes
No
3
Is this student qualified for the Tuition and Fees Deduction?
X Yes
No
Part IV ' Educational Institution and Tuition Summary
Received 2011 1098T with Box 2 filled and box 7 checked? g
School Name
EIN
cal pol pomona
95-4255659
If a foreign address:
Postal code:
If a foreign address:
Postal code:
Totals
Address
(number, street, apt no.,
city, state, and ZIP Code)
3801 West Temple Avenue
Pomona
ca 91768
Tuition
paid
2,364.
Scholarships
or grants
On
Form
1098-T
1,850. Yes X
No
Yes
No X
Yes
No
Yes
No
foreign province/state:
Country:
foreign province/state:
Country:
2,364.
1,850.
david j neff
Page 2
614-24-8933
Part V ' Education Assistance (Scholarships, Fellowships, Grants, etc.)
Total
1
a
b
c
d
e
2
a
b
c
d
e
3
4
5
6
7
8
9
10
Educational assistance that is always tax-free:
Veteran or employer assistance from Form 1098-T Worksheets
Other veteran assistance
Other tax-free employer-provided assistance
Other
Total
Scholarships, fellowships, and grants not reported on Form W-2:
Scholarships and grants from Part IV above
Other scholarships and grants
Other fellowships
Other
Total
Amount representing payment for teaching, research, or other services
Amount required to be used for other than qualified education expenses
Subtract lines 3 and 4 from line 2e
Total qualified education expenses from Part VI below
If student is a candidate for a degree, enter the amount used for
qualified education expenses, otherwise, enter -0-.
Subtract line 7 from line 5
Taxable part. Add lines 3, 4, and 8.
Tax-free educational assistance. Add lines 1e and 7
Taxable
Tax-free
1,850.
1,850.
0.
1,850.
3,064.
1,850.
0.
0.
1,850.
Part VI ' Education Expenses
Description
Expenses:
1 Tuition paid from Part IV
2
3
4
5
6
7
8
9
10
11
12
Paid to institution as a
condition of enrollment:
Fees
Books, supplies, equipment
Paid to other than institution or
not a condition of enrollment:
Books, supplies, equipment
Other course-related
Room and board
Special needs expenses
Computer expenses
QTP or ESA contribution
Academic tutoring
Uniforms
Transportation
13 Total qualified expenses
Total
Amount eligible for
American
Opportunity
Credit
Lifetime
Learning
Credit
Tuition
and Fees
Deduction
2,364.
2,364.
2,364.
2,364.
2,364.
700
700
700
700
700
3,064.
3,064.
3,064.
3,064.
3,064.
3,064.
2,364.
1,850.
1,850.
1,850.
1,850.
1,850.
1,850.
1,850.
0.
0.
0.
2,364.
700.
Qualified
Higher
Education
Expense
Qualified
Higher
Education
Expense
for
for
529 Plan
ESA
Not
Not
Applicable Applicable
Qualified
Higher
Education
Expense
Qualified
Elementary
and
Secondary
for
Expense
US Bonds for ESA
Not
Not
Applicable Applicable
2,364.
Adjustments:
14
15
16
17
18
Refunds
Tax-free assistance
Deducted on Sched A
Used for credit or deduction
Used for exclusion
See tax help
19 Total adjustments.
1,850.
1,850.
1,850.
1,850.
1,850.
1,850.
1,850.
20 Adjusted qualified expenses
1,214.
1,214.
1,214.
1,214.
1,214.
1,214.
514.
0.
david j neff
614-24-8933
Page 3
Part VII ' Education Credit or Deduction Election
1
2
3
4
5
Elect credit or deduction which results in best tax outcome.
Elect the American Opportunity Credit
Elect the Lifetime Learning Credit
Elect the tuition and fees deduction
Not applicable
X
Part VIII ' Qualified Tuition Program (Section 529 Plan)
1
2
3
4
5
6
7
8
For Purposes
of
Regular
Tax
For Purposes
of 10%
Additional
Tax
For Purposes
of
Regular
Tax
For Purposes
of 10%
Additional
Tax
Total Qualified Tuition Plan (QTP) distributions from Form 1099-Q
Adjusted Qualified Higher Education Expenses
Qualified Higher Education Expenses applied to QTP distributions
Excess distributions. Subtract line 3 from line 1.
If line 4 is greater than zero, complete lines 5 through 8.
Total distributed earnings from Form 1099-Q box 2
Fraction. Divide line 3 by line 1.
Multiply line 5 by line 6.
Earnings taxable to recipient. Subtract line 7 from line 5.
Part IX ' Education Savings Account (ESA)
1
2
3
4
5
6
7
8
Total Education Savings Account (ESA) distributions from Form 1099-Q
Qualified Elementary and Secondary Education Expenses
Qualified Elementary and Secondary Education Expenses applied
Subtract line 3 from line 1.
Adjusted Qualified Higher Education Expenses
Qualified Higher Education Expenses applied to ESA distributions
Excess distributions. Subtract line 6 from line 4.
Distributions taxable to recipient
Part X ' Series EE and I U.S. Savings Bonds Issued After 1989
1
2
3
4
5
Total proceeds from U.S. Savings Bonds cashed during 2012 for this student
Adjusted Qualified Higher Education Expenses
Qualified Higher Education Expenses applied to exclusion of U.S. bond interest
Interest included in line 1
Name and address of eligible educational institution(s) attended:
Institution Name
Institution Name
Street address
Street address
City
State
Zip Code
City
State
Zip Code
Forms W-2 & W-2G Summary
Form 1040
2012
G Keep for your records
Name(s) Shown on Return
Social Security Number
Andrea B & david j neff
608-07-2576
Form W-2 Summary
Box No.
Description
1 Total wages, tips and compensation:
Non-statutory & statutory wages not on Sch C
Statutory wages reported on Schedule C
Foreign wages included in total wages
Unreported tips
2
Total federal tax withheld
3 & 7 Total social security wages/tips
4
Total social security tax withheld
5
Total Medicare wages and tips
6
Total Medicare tax withheld
8
Total allocated tips
9
Not used
10
Total dependent care benefits
11
Total distributions from nonqualified plans
12 a Total from Box 12
b Elective deferrals to qualified plans
c Roth contributions to 401(k) & 403(b) plans
d Deferrals to government 457 plans
e Deferrals to non-government 457 plans
f
Deferrals 409A nonqual deferred comp plan
g Income 409A nonqual deferred comp plan
h Uncollected Medicare tax
i
Uncollected social security and RRTA tier 1
j
Uncollected RRTA tier 2
k Income from nonstatutory stock options
l
Non-taxable combat pay
m Total other items from box 12
14 a Total deductible mandatory state tax
b Total deductible charitable contributions
c This line does not apply to TurboTax
d Total RR Tier 1 wages
e Total RR Tier 1 tax
f
Total RR Tier 2 tax
g Total RRTA tips
h Total other items from box 14
16
Total state wages and tips
17
Total state tax withheld
19
Total local tax withheld
Taxpayer
Spouse
Total
17,753.
17,753.
1,670.
19,026.
799.
19,026.
276.
1,670.
19,026.
799.
19,026.
276.
18,270.
1,274.
18,270.
1,274.
16,996.
16,996.
17,753.
231.
17,753.
231.
Form
W-2
Wage and Tax Statement
2012
G Keep for your records
Name
Social Security Number
Andrea B neff
608-07-2576
Spouse’s W-2
Do not transfer this W-2 to next year
Military: Complete Part VI on Page 2 below
a Employee’s social security No 608-07-2576
b Employer’s ID number
94-1196203
c Employer’s name, address, and ZIP code
1 Wages, tips, other
2 Federal income
compensation
tax withheld
17,752.64
3 Social security wages
Dignity Health
1,669.93
4 Social security tax withheld
19,026.28
Street
185 berry street suite
City
san francisco
State
CA
ZIP Code
94107
Foreign Country
300
5 Medicare wages and tips
799.10
6 Medicare tax withheld
19,026.28
7 Social security tips
275.88
8 Allocated tips
9
10 Dependent care benefits
d Control number
11 Nonqualified plans
Distributions from sect. 457
and nonqualified plans
(Important, see Help)
X Transfer employee information from
the Federal Information Worksheet
e Employee’s name
First Andrea
Last neff
f Employee’s address and ZIP code
Street 3208 gibraltar dr
City rverside
State CA
ZIP Code 92506
Foreign Country
Box 12
Box 12
Code
Amount
C
DD
E
12 Enter box 12 below
B
M.I.
Suff.
13
Statutory employee
Retirement plan
Third-party sick pay
X
14 Enter box 14 below after entering boxes 18, 19, and 20.
NOTE: Enter box 15 before entering box 14.
48.00
16,948.08
1,273.64
If Box 12 code is:
A: Enter amount attributable to RRTA Tier 2 tax
M: Enter amount attributable to RRTA Tier 2 tax
P: Double click to link to Form 3903, line 4
R: Enter MSA contribution for Taxpayer
Spouse
W: Enter HSA contribution for Taxpayer
Spouse
G:
Employer is not a state or local government
Box 15
State
CA
Employer’s state I.D. no.
Box 16
Box 17
State wages, tips, etc.
State income tax
91000638
17,752.64
Box 20
Box 18
Locality name
Local wages, tips, etc.
Box 14
Description or Code
on Actual Form W-2
Amount
Box 19
Local income tax
231.18
Associated
State
TurboTax Identification of Description or Code
(Identify this item by selecting the identification from
the drop down list. If not on the list, select Other).
1098-T
Tuition Statement
Worksheet
G Keep for your records
2012
Taxpayer’s name
Social Security No.
Andrea B & david j neff
608-07-2576
1098-T Information (Required):
A A Form 1098-T was received from this institution
B A Form 1098-T was received from this institution in 2011 with Box 2 filled in and
Box 7 checked
Identify Student (Required):
A If student is Andrea or david
Double-click to link this 1098-T to the applicable Taxpayer or Spouse
Student Information Worksheet
B If student is David or vincent
Double-click to link this 1098-T to the applicable Dependent Student
Information Worksheet
Filer’s name
1
cal pol pomona
Yes
No
X
Yes
No
X
david
Payments received for qualified
tuition and related expenses
$
Amounts billed for qualified tuition
and related expenses
$
Street address
3801 West Temple Avenue
City
State
Pomona
CA
Zip Code
2
91768
4,008.
Foreign province/county
Foreign postal code
3
If this box is checked, your educational institution
has changed its reporting method for 2012
4
Adjustments made for a
prior year
Foreign country
Filer’s Federal
identification number
Student’s
Social Security Number.
95-4255659
614-24-8933
$
Student’s name
6
Apt. No.
Scholarships or grants
$
Adjustments to
scholarships or grants
for a prior year
david
Street address
5
7
Checked if the amount
in box 1 or 2 includes
amounts for an
academic period
beginning January March 2013
3208 gibraltar dr
City
State
rverside
CA
Service Provider/ Acct No
Zip Code
92506
8 Check if at least
half-time student
X
$
9
Checked if a graduate
student
1,850.
10
X
Ins. contract reimb./refund
$
Reconciliation of Box 1, Payments Received for Qualified Tuition and Related Expenses
A
B
Enter portion of box 1 amount not paid during 2012
Enter portion of box 1 amount actually paid during 2012
Reconciliation of Box 2, Amounts Billed for Qualified Tuition and Related Expenses
A
B
Enter portion of box 2 amount not paid during 2012
Enter portion of box 2 amount actually paid during 2012
1,644.
2,364.
Reconciliation of Box 5, Veteran- or Employer-Provided Assistance Included in Box 5
A
B
C
D
Enter portion of box 5 amount from veteran- or tax free employer-provided assistance
Enter portion of box 5 amount from employer-provided assistance included in income
Portion of box 5 amount from scholarships or grants
Box 5 amount includes veteran- or employer-provided educational assistance
1,850.
Form 1040
Line 51
Child Tax Credit Worksheet
2012
G Keep for your records
Name as Shown on Return
Social Security No.
Andrea B & david j neff
608-07-2576
Note: ? To be a qualifying child for the child tax credit, the child must be under age 17 at the end of 2012
and meet the other requirements listed in the instructions for Form 1040 or 1040A.
? If applicable, first complete Form 2555, Foreign Earned Income and enter any exclusion of
income from U.S. Possessions on the Federal Information Worksheet.
Part 1
1
2
3
4
5
6
7
8
Number of qualifying children:
2 X $1,000. Enter the result
Enter the amount from Form 1040, line 38, or
Form 1040A, line 22
2
17,753.
1040 filers: enter the total of any '
? Exclusion of income from Puerto Rico, and
? Amounts from Form 2555, lines 45 and 50;
Form 2555-EZ, line 18; and Form 4563,
3
0.
line 15.
1040A filers: Enter -0-.
Add lines 2 and 3. Enter the total
4
17,753.
Enter the amount shown below for your filing status.
? Married filing jointly ' $110,000
? Single, head of household, or
qualifying widow(er) ' $75,000
5
110,000.
? Married filing separately ' $55,000
Is the amount on line 4 more than the amount on
line 5?
X No. Leave line 6 blank. Enter -0- on line 7.
Yes. Subtract line 5 from line 4
6
If the result is not a multiple of $1,000,
increase it to the next multiple of $1,000.
For example, increase $425 to $1,000,
increase $1,025 to $2,000, etc.
Multiply the amount on line 6 by 5% (.05). Enter the result
Is the amount on line 1 more than the amount on line 7?
No. Stop.
You cannot take the child tax credit on Form 1040, line 51, or
Form 1040A, line 33. You also cannot take the additional child tax
credit on Form 1040, line 65, or Form 1040A, line 39. Complete the
rest of your Form 1040 or 1040A.
1
2,000.
7
0.
Yes. Subtract line 7 from line 1. Enter the result. Go to Part 2
8
2,000.
Enter the amount from Form 1040, line 46, or Form 1040A, line 28
Add the amounts from '
Form 1040, line 47
Form 1040, line 48, or Form 1040A, line 29
+
Form 1040, line 49, or Form 1040A, line 31
+
Form 1040, line 50, or Form 1040A, line 32
+
Form 5695, line 14
+
Form 8834, line 23
+
Form 8910, line 22
+
Form 8936, line 15
+
Schedule R, line 22
+
Enter the total
10
Are you claiming any of the following credits?
? Mortgage interest credit, Form 8396
? Residential energy efficient property credit, Form 5695, Part II
? District of Columbia first-time homebuyer credit, Form 8859
X No. Enter the amount from line 10
Yes. Complete the Line 11 Worksheet below to figure the
amount to enter here
Subtract line 11 from line 9. Enter the result.
Is the amount on line 8 of this worksheet more than the amount on line 12?
No. Enter the amount from line 8
X Yes. Enter the amount from line 12.
This is your child
See the TIP below.
tax credit
9
0.
11
0.
12
0.
X
Part 2
9
10
11
12
13
0.
0.
13
0.
Enter this amount on
Form 1040, line 51, or
Form 1040A, line 33.
TIP: You may be able to take the additional child tax credit on Form 1040, line 65, or Form 1040A,
line 39, only if you answered ’Yes’ on line 13.
? First, complete your Form 1040 through line 64a (also complete line 69), or Form 1040A through
line 38a.
? Then, use Schedule 8812 to figure any additional child tax credit.
Form 1040
Line 20
Social Security Benefits Worksheet
2012
G Keep for your records
Name(s) Shown on Return
Social Security Number
Andrea B & david j neff
608-07-2576
Social Security/Railroad Retirement benefits received in 2011
Taxpayer
Spouse
A
B
C
D
E
Total net benefits from Box 5 of all SSA-1099 forms
Total federal tax withheld from box 6 of all SSA-1099 forms
Total Medicare B premiums withheld from all SSA-1099 forms
Total Medicare C premiums withheld from all SSA-1099 forms
Total Medicare D premiums withheld from all SSA-1099 forms
Note: If self-employed, Medicare premiums are deductible as
Self-Employed Health Insurance. If self-employed, enter premiums
on the business activity form (Schedule C, F, etc), not on Lines C, D
and E above.
F Total net benefits from Box 5 of all RRB-1099 forms
G Total federal tax withheld from box 10 of all RRB-1099 forms
H Total Medicare premiums from Box 11 of all RRB-1099 forms
1 Add amounts from line A and line F above. Also enter this amount on
Form 1040, line 20a
2 Enter one-half of line 1
3 Add the amounts on Form 1040, lines 7 (before adoption benefits exclusion),
8a (before U.S. savings bond interest exclusion), 8b, 9a, 10 through 14,
15b, 16b, 17 through 19, and line 21. Also include certain income of bona fide
residents of American Samoa or Puerto Rico.
4 Enter the total of any exclusions/adjustments for:
? Foreign earned income or housing exclusion
5 Add lines 2, 3, and 4
6 Amount from Form 1040, lines 23 through 32, plus any write-in amounts
on line 36 (other than foreign housing deduction)
7 Subtract line 6 from line 5
8 Enter $25,000 ($32,000 if married filing jointly; $0 if married filing separately
and you lived with your spouse at any time in 2012)
9 Subtract line 8 from line 7. If zero or less, enter -0-
12,120.
0.
0.
0.
0.
1
2
12,120.
6,060.
3
17,753.
4
5
23,813.
6
7
23,813.
8
9
32,000.
0.
If line 9 is zero or less, stop here; none of your social security benefits are
taxable. Enter -0- on Form 1040, line 20b. If you are married filing separately
and you lived apart from your spouse for all of 2012, enter ’D’ to the right of the
word ’benefits’ on line 20a. If line 9 is more than zero, go to line 10.
10 Enter $9,000 ($12,000 if married filing jointly; $0 if married filing separately
and you lived with your spouse at any time in 2012)
11 Subtract line 10 from line 9. If zero or less, enter -012 Enter the smaller of line 9 or line 10
13 Enter one-half of line 12
14 Enter the smaller of line 2 or line 13
15 Multiply line 11 by 85% (.85). If line 11 is zero, enter -016 Add lines 14 and 15
17 Multiply line 1 by 85% (.85)
18 Taxable social security benefits. Enter the smaller of line 16 or line 17
If prior year lump-sum benefits were received, go to line 19, otherwise,
skip line 19 and enter the amount from line 18 on line 20.
19 Taxable benefits with lump sum election. Enter the amount from line 20 of the
Lump-Sum Social Security Worksheet
20 Taxable Social Security benefits. Enter the smaller of line 18 or line 19
Also enter this amount on Form 1040, line 20b
10
11
12
13
14
15
16
17
18
19
20
Tax Payments Worksheet
2012
G Keep for your records
Name(s) Shown on Return
Social Security Number
Andrea B & david j neff
608-07-2576
Estimated Tax Payments for 2012 (If more than 4 payments for any state or locality, see Tax Help)
Federal
Date
Amount
State
Date
Amount
Local
ID
Date
Amount
1
04/17/12
04/17/12
04/17/12
2
06/15/12
06/15/12
06/15/12
3
09/17/12
09/17/12
09/17/12
4
01/15/13
01/15/13
01/15/13
ID
5
Tot Estimated
Payments
Tax Payments Other Than Withholding
(If multiple states, see Tax Help)
6
7
8
9
Federal
ID
Local
ID
Overpayments applied to 2012
Credited by estates and trusts
Totals Lines 1 through 7
2012 extensions
Taxes Withheld From:
10
11
12
13
14
15
16
17
18 a
b
c
d
e
19
Forms W-2
Forms W-2G
Forms 1099-R
Forms 1099-MISC and 1099-G
Schedules K-1
Forms 1099-INT, DIV and OID
Social Security and Railroad Benefits
Form 1099-B
St
Loc
Other withholding
St
Loc
Other withholding
St
Loc
Other withholding
St
Loc
Positive Adjustment
St
Loc
Negative Adjustment
St
Loc
Total Withholding Lines 10 through 18e
20
Total Tax Payments for 2012
Prior Year Taxes Paid In 2012
(If multiple states or localities, see Tax Help)
21
22
23
24
State
Tax paid with 2011 extensions
2011 estimated tax paid after 12/31/11
Balance due paid with 2011 return
Other (amended returns, installment payments, etc)
Federal
State
1,670.
Local
231.
0.
1,670.
1,670.
State
231.
231.
ID
Local
ID
Earned Income Worksheet
2012
G Keep for your records
Name(s) Shown on Return
Social Security Number
Andrea B & david j neff
608-07-2576
Part I ' Earned Income Credit Wks Computation
Taxpayer
Spouse
Total
1
If filing Schedule SE:
Net self-employment income
Optional Method and Church Employee income
Add lines 1a and 1b
One-half of self-employment tax
Subtract line 1d from line 1c
2
If not required to file Schedule SE:
a Net farm profit or (loss)
b Net nonfarm profit or (loss)
c Add lines 2a and 2b
3
If filing Schedule C or C-EZ as a statutory
employee, enter the amount from line 1
of that Schedule C or C-EZ
4
Add lines 1e, 2c and 3. To EIC Wks, line 5
a
b
c
d
e
Part II ' Form 2441 and Standard Deduction Worksheet Computations
5
6
Net self-employment earnings (line 4 above)
Wages, salaries, and tips less distributions
from nonqualified or section 457 plans, etc
7
Taxable employer-provided adoption benefits
8
Add lines 5 through 7. To Form 2441, lines 19
and 20
9 a Taxable dependent care benefits
b Nontaxable combat pay
10
Add lines 8, 9a and 9b . To Form 2441, lines 4
and 5
11
Scholarship or fellowship income not on W-2
12
SE exempt earnings less nontaxable income
13
Distributions from nonqualified/Sec. 457 plans
14
Add lines 8, 9a and 11 through 13. To Standard
Deduction Worksheet
17,753.
17,753.
17,753.
17,753.
17,753.
17,753.
0.
17,753.
0.
0.
17,753.
Part III ' IRA Deduction Worksheet Computation
15
16
17
18
19
20
21
22
Net self-employment income or (loss)
Wages, salaries, tips, etc
Net self-employment loss
Alimony received
Nontaxable combat pay
Foreign earned income exclusion
Keogh, SEP or SIMPLE deduction
Combine lines 15 through 21. To IRA Wks, ln 2
17,753.
17,753.
17,753.
17,753.
Part IV ' Schedule 8812 and Child Tax Credit Line 11 Worksheet Computations
23
24
25
26
27
Self-employed, church and statutory employees
Wages, salaries, tips, etc
Nontaxable combat pay
Foreign earned income exclusion
Combine lines 23 through 26. To Schedule
8812, line 4a & Line 11 Wks, line 2
17,753.
17,753.
17,753.
17,753.
Form 1040
Line 64
Earned Income Credit Worksheet
2012
G Keep for your records
Name(s) Shown on Return
Social Security Number
Andrea B & david j neff
608-07-2576
QuickZoom to Schedule EIC
QuickZoom to Dependent Information Worksheet to enter qualifying children information
QuickZoom to Wages, Salaries, & Tips Worksheet to enter earned and non-earned income
QuickZoom to page 2 of this worksheet, if credit is not calculated on line 7
1
2
a
b
c
3
4a
b
c
5
6
7
Enter the amount from Form 1040 or 1040A, line 7, or Form 1040EZ, line 1,
less amounts considered not earned for EIC purposes
Adjustments to line 1 amount:
Income reported as wages and as self-employment income
Other income entered as wages that is not considered earned income
Distributions from section 457 and other nonqualified plans reported on W-2
Subtract lines 2a, 2b and 2c from line 1
Taxpayer’s nontaxable combat pay election for EIC
4a
Spouse’s nontaxable combat pay election for EIC
b
Total nontaxable combat pay election
If you were self-employed or used Schedule C or Schedule C-EZ
as a statutory employee, enter the amount from the
Earned Income Worksheet, line 4
Earned income. Add lines 3, 4c, and 5
Enter the credit, from the EIC Table, for the amount on line 6. Be sure to use
the correct column for filing status and number of children
1
17,753.
2a
b
c
3
17,753.
4c
5
6
17,753.
7
5,236.
8
17,753.
If line 7 is zero, stop. You cannot take the credit.
Enter "No" on the dotted line next to Form 1040, line 64a.
8
9
Enter your AGI from Form 1040, line 38
If you have:
? No qualifying children, is the amount on line 8 less than $7,750
($12,950 if married filing jointly)?
? 1 or more qualifying children, is the amount on line 8 less than $17,050
($22,300 if married filing jointly)?
Yes. Go to line 10 now.
No. Enter the credit, from the EIC Table, for the amount on line 8. Be
sure to use the correct column for filing status and number of children
Earned income credit.
? If ’Yes’ on line 9, enter the amount from line 7
? If ’No’ on line 9, enter the smaller of line 7 or line 9
X
10
9
10
Enter line 10 amount on Form 1040, line 64a, Form 1040A, line 38a, or Form 1040EZ, line 8a.
5,236.
Education Tuition and Fees Summary
2012
G Keep for your records
Name(s) Shown on Return
Your Social Security No.
Andrea B & david j neff
608-07-2576
Part I - Qualified Education Expense Summary
(a)
Student’s name
First Name
Last Name
Social Security Number
MI
Suffix
(b)
Qualified
Education
Expenses
(c)
Qualified
for:
Yes
david
neff
614-24-8933
Total qualified expenses
j
1,214.
1,214.
1,214.
1,214.
No
(d)
Elected
Credit or
Deduction
if
manual
Amer Opp Cr
X
Lifetime Cr
X
Tuition Ded
X
Total Qualified Expenses
Amer Opp Cr
Lifetime Cr
Tuition Ded
Total Qualified Expenses
Amer Opp Cr
Lifetime Cr
Tuition Ded
Total Qualified Expenses
(e)
Elected
Credit or
Deduction
if
automatic
X
1,214. Amer Opp Cr
1,214. Lifetime Cr
1,214. Tuition Ded
Part II - Optimize Education Expenses for the Lowest Tax
Automatic
1
Launch OPTIMIZER - Check to launch Automatic Education Expense Optimizer now
2
Automatic - Check to use the Credit choices calculated in Part I, column (e) above
or
Manual - Check to use the Credit choices you entered in Part I, column (d) above
3
X
Part III - Summary of Deduction and Credits
Tuition and Fees Deduction Summary
1
2
3
4
Total 2012 tuition and fees paid for purposes of deduction
Modified adjusted gross income
Maximum deduction allowed
Allowable Tuition and Fees Deduction (lesser of line 1 or line 2)
1
2
3
4
0.
American Opportunity, Lifetime Learning Credits Summary
5
6
7
Tentative American Opportunity Credit
Tentative Lifetime Learning Credit
Total Education Credits (after limitations)
5
6
7
1,214.
486.
Federal Carryover Worksheet
2012
G Keep for your records
Name(s) Shown on Return
Social Security Number
Andrea B & david j neff
608-07-2576
2011 State and Local Income Tax Information (See Tax Help)
(a)
State or
Local ID
(b)
Paid With
Extension
(c)
Estimates Pd
After 12/31
(d)
Total Withheld/Pmts
(e)
Paid With
Return
(f)
Total Overpayment
(g)
Applied
Amount
Totals
Other Tax and Income Information
1
2
3
4
5
6
7
8
2011
Filing status
Number of exemptions for blind or over 65 (0 - 4)
Itemized deductions
Check box if required to itemize deductions
Adjusted gross income
Tax liability for Form 2210 or Form 2210-F
Alternative minimum tax
Federal overpayment applied to next year estimated tax
1
2
3
4
5
6
7
8
2012
2 MFJ
581.
17,753.
0.
QuickZoom to the IRA Information Worksheet for IRA information
Excess Contributions
9a
b
10 a
b
11 a
b
Taxpayer’s excess Archer MSA contributions as of 12/31
Spouse’s excess Archer MSA contributions as of 12/31
Taxpayer’s excess Coverdell ESA contributions as of 12/31
Spouse’s excess Coverdell ESA contributions as of 12/31
Taxpayer’s excess HSA contributions as of 12/31
Spouse’s excess HSA contributions as of 12/31
2012
2011
2010
2009
2008
2007
2012
2011
2012
9a
b
10 a
b
11 a
b
Loss and Expense Carryovers
Note: Enter all entries as a positive amount
12 a Short-term capital loss
b AMT Short-term capital loss
13 a Long-term capital loss
b AMT Long-term capital loss
14 a Net operating loss available to carry forward
b AMT Net operating loss available to carry forward
15 a Investment interest expense disallowed
b AMT Investment interest expense disallowed
16 Nonrecaptured net Section 1231 losses from:
a
b
c
d
e
f
2011
12 a
b
13 a
b
14 a
b
15 a
b
16 a
b
c
d
e
f
Tax History Report
2012
G Keep for your records
Name(s) Shown on Return
Andrea B & david j neff
Five Year Tax History:
2008
2009
2010
Filing status
2011
2012
MFJ
Total income
17,753.
Adjustments to income
Adjusted gross income
17,753.
Tax expense
581.
Interest expense
Contributions
Miscellaneous
deductions
Other Itemized
Deductions
Total itemized/
standard deduction
11,900.
Exemption amount
15,200.
Taxable income
0.
Tax
Alternative min tax
Total credits
0.
Other taxes
Payments
9,392.
Form 2210 penalty
Amount owed
Applied to next
year’s estimated tax
Refund
9,392.
Effective tax rate %
-43.50
**Tax bracket %
**Tax bracket % is based on Taxable income.
Tax Summary
2012
G Keep for your records
Name (s)
Andrea B & david j neff
Total income
Adjustments to income
Adjusted gross income
Itemized/standard deduction
Exemption amount
Taxable income
Tentative tax
Additional taxes
Alternative minimum tax
Total credits
Other taxes
Total tax
Total payments
Estimated tax penalty
Amount Overpaid
Refund
Amount Applied to Estimate
Balance due
Which Form 1040 to file?
You must use Form 1040A or Form 1040 because
you had dependents.
17,753.
17,753.
11,900.
15,200.
0.
0.
0.
0.
9,392.
9,392.
9,392.
0.
Compare to U. S. Averages
2012
G Keep for your records
Name(s) Shown on Return
Social Security No
Andrea B & david j neff
608-07-2576
Your 2012 adjusted gross income (AGI)
National adjusted gross income range used below
from
15,000. to
17,753.
29,999.
Note: National average amounts have been adjusted for inflation. See Help for details.
Selected Income, Deductions, and Credits
Salaries and wages
Taxable interest
Tax-exempt interest
Dividends
Business net income
Business net loss
Net capital gain
Net capital loss
Taxable IRA
Taxable pensions and annuities
Rent and royalty net income
Rent and royalty net loss
Partnership and S corporation net income
Partnership and S corporation net loss
Taxable social security benefits
Medical and dental expenses deduction
Taxes paid deduction
Interest paid deduction
Charitable contributions deduction
Total itemized deductions
Child care credit
Education tax credits
Child tax credit
Retirement savings contributions credit
Earned income credit
Other Information
Adjusted gross income
Taxable income
Income tax
Alternative minimum tax
Total tax liability
Actual
Per Return
National
Average
17,753.
0.
581.
581.
0.
0.
5,236.
Actual
Per Return
21,395.
1,451.
6,005.
2,236.
12,741.
7,956.
4,278.
2,383.
7,533.
12,643.
6,990.
8,520.
10,124.
11,787.
2,295.
7,976.
3,437.
7,996.
2,163.
15,777.
477.
811.
488.
174.
3,282.
National
Average
17,753.
0.
0.
0.
23,105.
9,833.
1,041.
2,808.
1,163.
ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING
Taxpayer:
Primary SSN:
Andrea B & david j neff
608-07-2576
Federal Return Submitted:
Federal Return Acceptance Date:
January 23, 2013
09:38 PM PST
Your return was electronically transmitted on 01/23/2013
The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The Intuit
Electronic Postmark documents the filing date of your income tax return, and the electronic postmark
information should be kept on file with your tax return and other tax-related documentation.
There are two important aspects of the Intuit Electronic Postmark:
1. THE INTUIT ELECTRONIC POSTMARK.
The electronic postmark shows the date and time Intuit received the federal return, and is deemed the
filing date if the date of the electronic postmark is on or before the date prescribed for filing of the
federal individual income tax return.
TIMELY FILING:
For your federal return to be considered filed on time, your return must be postmarked on or before
midnight April 15, 2013. Intuit’s electronic postmark is issued in the Pacific Time (PT) zone. If you are
not filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark time
to determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone and
you electronically file your return at 9 AM on April 15, 2013, your Intuit electronic postmark will indicate
April 15, 2013, 6 AM. If your federal tax return is rejected, the IRS still considers it filed on time if the
electronic postmark is on or before April 15, 2013, and a corrected return is submitted and accepted
before April 20, 2013. If your return is submitted after April 20, 2013, a new time stamp is issued to
reflect that your return was submitted after the IRS deadline and, consequently, is no longer considered
to have been filed on time.
If you request an automatic six-month extension, your return must be electronically postmarked by
midnight October 15, 2013 If your federal tax return is rejected, the IRS will still consider it filed on time
if the electronic postmark is on or before October 15, 2013, and the corrected return is submitted and
accepted by October 20, 2013.
2. THE ACCEPTANCE DATE.
Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit
Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return.
Andrea B & david j neff
608-07-2576
1
Smart Worksheets from your 2012 Federal Tax Return
SMART WORKSHEET FOR: Form 1040A: Individual Tax Return
Tax Smart Worksheet
A
Tax
Check if from:
1 Tax table
2 Qualified Dividends and Capital Gain Tax Worksheet
3 Form 8615
B
Recapture tax from Form 8863
C
Alternative minimum tax
D
Tax. Add lines A through C. Enter the result here and on line 28
0.
X
0.
SMART WORKSHEET FOR: Form 8863: Education Credits
Nonrefundable Credit -- Form 8863, Line 19
1
2
8
9
10
11
Enter amount from line 18, Form 8863
Lines 2 - 7 are reserved for future use
Enter amount from line 9, Form 8863
Add lines 1 and 8
Enter the amount from Form 1040, line 46
Enter the amount form Form 1040 lines 47 and 48 and the amount included on
Form 1040, line 53
12 Subtract line 11 from line 10
13 Enter the smaller of line 9 or line 12 here and on Form 8863, line 19
1
8
9
10
728.
728.
0.
11
12
13
0.
0.
Andrea B & david j neff
608-07-2576
SMART WORKSHEET FOR: Dependent Information Worksheet (David)
Dependency Exemption/EIC Smart Worksheet
NOTE: It is recommended that you answer the questions below using the Step-by-Step mode.
That will help insure that answers to the questions are not inconsistent.
A
B
C
D
E
F
G
H
How many months did this person live with you?
Note: if born or died in current year and lived with you entire
time or qualified missing child select "The whole year". If
more than one-half the year select 7 or more
Who are the parents of this person?
To determine if additional questions are necessary for
children of divorced parents.
Both Taxpayer and spouse
Taxpayer
Spouse
Did this person provide more than 1/2 their own support?
Was this person married on December 31, 2012 and
filing a joint return for the year (You may answer no if the
only reason the joint return is filed is to get a refund of tax
withheld or estimated tax payments and neither spouse
would have a tax liability on their return if they filed
separate returns)?
Is this person a Full time student?
Is this person’s gross income less than $3,800?
1 Did you provide over 1/2 the support for this person?
or
Did you provide over 10% of the support for the person
and with other individuals who would be able to claim
the person except for the support test over 1/2 the
support and all of you have agreed that you alone will
claim the person and you have filled out the Multiple
Support Declaration, Form 2120, to attach to your return?
Is there an agreement with this person’s other parent
about who can claim this person as a dependent?
Note: The noncustodial parent claiming the exemption for
the child must attach to their return Form 8332 from the
custodial parent releasing the claim to the exemption
for the child
Who will be claiming this person as a dependent as a result
of
an agreement between the parents
or
as a result of the rules controlling who can claim a qualifying
child when the child meets the conditions to be a
qualifying child of more than one person?
Taxpayer (includes spouse if married filing
joint) in this return?
Other parent in different return?
Someone else in different return?
The whole year
X
X
Yes
X No
Yes
Yes
Yes
No
No
No
Yes
No
Yes
No
2
Andrea B & david j neff
608-07-2576
SMART WORKSHEET FOR: Dependent Information Worksheet (vincent)
Dependency Exemption/EIC Smart Worksheet
NOTE: It is recommended that you answer the questions below using the Step-by-Step mode.
That will help insure that answers to the questions are not inconsistent.
A
B
C
D
E
F
G
H
How many months did this person live with you?
Note: if born or died in current year and lived with you entire
time or qualified missing child select "The whole year". If
more than one-half the year select 7 or more
Who are the parents of this person?
To determine if additional questions are necessary for
children of divorced parents.
Both Taxpayer and spouse
Taxpayer
Spouse
Did this person provide more than 1/2 their own support?
Was this person married on December 31, 2012 and
filing a joint return for the year (You may answer no if the
only reason the joint return is filed is to get a refund of tax
withheld or estimated tax payments and neither spouse
would have a tax liability on their return if they filed
separate returns)?
Is this person a Full time student?
Is this person’s gross income less than $3,800?
1 Did you provide over 1/2 the support for this person?
or
Did you provide over 10% of the support for the person
and with other individuals who would be able to claim
the person except for the support test over 1/2 the
support and all of you have agreed that you alone will
claim the person and you have filled out the Multiple
Support Declaration, Form 2120, to attach to your return?
Is there an agreement with this person’s other parent
about who can claim this person as a dependent?
Note: The noncustodial parent claiming the exemption for
the child must attach to their return Form 8332 from the
custodial parent releasing the claim to the exemption
for the child
Who will be claiming this person as a dependent as a result
of
an agreement between the parents
or
as a result of the rules controlling who can claim a qualifying
child when the child meets the conditions to be a
qualifying child of more than one person?
Taxpayer (includes spouse if married filing
joint) in this return?
Other parent in different return?
Someone else in different return?
The whole year
X
X
Yes
X No
Yes
Yes
Yes
No
No
No
Yes
No
Yes
No
3
Andrea B & david j neff
608-07-2576
4
SMART WORKSHEET FOR: Earned Income Credit Worksheet
Nontaxable Combat Pay Election Smart Worksheet
QuickZoom to enter nontaxable combat pay on Form W-2
A Taxpayer:
1 Taxpayer, nontaxable combat pay
2 Election for earned income credit (EIC):
Elect taxpayer’s nontaxable combat pay as earned income for EIC?
3 Election for dependent care benefits (DCB):
Elect taxpayer’s nontaxable combat pay as earned income for DCB?
4 Election for child and dependent care credit:
Elect taxpayer’s nontaxable combat pay as earned income
for child and dependent care credit?
B Spouse:
1 Spouse, nontaxable combat pay
2 Election for earned income credit (EIC):
Elect spouse’s nontaxable combat pay as earned income for EIC?
3 Election for dependent care benefits (DCB):
Elect spouse’s nontaxable combat pay as earned income for DCB?
4 Election for child and dependent care credit:
Elect spouse’s nontaxable combat pay as earned income
for child and dependent care credit?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
C You may compare the tax benefit of electing or not electing by checking a box on line A or
line B and reviewing the overpayment or amount due below:
Overpayment
9,392.
Amount due
SMART WORKSHEET FOR: Earned Income Credit Worksheet
Investment Income Smart Worksheet
A
B
C
D
E
1
2
3
4
5
6
F
G
H
Taxable and tax exempt interest
Dividend income
Capital gain net income
Royalty and rental of personal property net income
Passive activity net income:
Rental real estate net income or loss
Farm rental net income or loss
Partnerships and S corporations net income or loss
Estates and trusts net income or loss
Total of lines 1 through 4
Total passive activity net income, line 5 if greater than zero
Interest and dividends from Forms 8814
Adjustments
Total investment income, add lines A through G
Is line H, total investment income over $3,200?
X No. You may take the credit.
Yes. Stop. You cannot take the credit.
0.
Electronic Filing Instructions for your 2012 California Tax Return
Important: Your taxes are not finished until all required steps are completed.
Andrea B & david J neff
3208 gibraltar dr
rverside, CA 92506
|
| Your California state tax return (Form 540 2EZ) shows a refund due to
| you in the amount of $231.00. Your tax refund will be direct
| deposited into your account. The account information you entered | Account Number: 4031482260 Routing Transit Number: 122000496.
______________________________________________________________________________________
|
|
Where's My
| Before you call the Franchise Tax Board with questions about your
Refund?
| refund, give them 21 days processing time from the date your return
| is accepted. If then you have not received your refund, or the amount
| is not what you expected, contact the Franchise Tax Board directly at
| 1-800-338-0505. From outside of California use 1-916-845-6500. You
| can also visit the Franchise Tax Board web site at
| http://www.ftb.ca.gov/online/refund/.
______________________________________________________________________________________
|
|
What You
| Sign and date Form 8453-OL within 1 day of acceptance. Since you are
Need to
| married filing jointly, your spouse must also sign and date the form.
Sign
|
______________________________________________________________________________________
|
|
Do Not
| Do not mail a paper copy of your tax return. Since you filed
Mail
| electronically, the Franchise Tax Board already has your return.
______________________________________________________________________________________
|
|
What You
| Your Electronic Filing Instructions (this form)
Need to
| - Form 8453-OL and attachment(s)
Keep
| Printed copy of your state and federal returns
______________________________________________________________________________________
|
|
2012
| Taxable Income
$
10,071.00
California
| Total Tax
$
0.00
Tax
| Total Payments/Credits
$
231.00
Return
| Amount to be Refunded
$
231.00
Summary
| Effective Tax Rate
0.00%
______________________________________________________________________________________
|
Balance
Due/
Refund
Page 1 of 1
175
DO NOT MAIL THIS FORM TO THE FTB
Date Accepted___________________________
TAXABLE YEAR
2012
California Online e-file Return Authorization
for Individuals
Your first name and initial
Last name
ANDREA B
DAVID J
8453-OL
Your SSN or ITIN
NEFF
If joint return, spouse’s/RDP’s first name and initial
FORM
608-07-2576
Last name
Spouse’s/RDP’s SSN or ITIN
NEFF
Address (including number and street, PO Box, or PMB no.)
614-24-8933
Apt. no./Ste.no. Daytime telephone number
3208 GIBRALTAR DR
(951)255-9817
City
State
ZIP code
RVERSIDE
CA
92506
Part I Tax Return Information (whole dollars only)
1 California adjusted gross income. (Form 540, line 17; Form 540 2EZ, line 16; Long Form 540NR, line 32;
17,753.
or Short Form 540NR, line 32) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Refund or no amount due. (Form 540, line 115; Form 540 2EZ, line 28; Long Form 540NR, line 125;
231.
or Short Form 540NR, line 125) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Amount you owe. (Form 540, line 111; Form 540 2EZ, line 27; Long Form 540NR, line 121;
or Short Form 540NR, line 121) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Part II Settle Your Account Electronically for Taxable Year 2012 (Due 04/15/2013)
4m Direct deposit of refund
5 m Electronic funds withdrawal 5a Amount ___________________ 5b Withdrawal date (MM/DD/YYYY) _________________
Part III Make Estimated Tax Payments for Taxable Year 2013 These are not installment payments for the current amount you owe.
First Payment
Due 4/15/13
Second Payment
Due 6/17/13
Third Payment
Due 9/16/13
Fourth Payment
Due 1/15/14
6 Amount
7 Withdrawal date
Part IV Banking Information (Have you verified your banking information?)
231. 12 The remaining amount of my refund for direct deposit __________________
8 Amount of refund to be directly deposited to account below______________
122000496
9 Routing number________________________________________________
13 Routing number________________________________________________
10 Account number__4031482260
______________________________________________ 14 Account number_______________________________________________
11 Type of account: m Checking m Savings
15 Type of account: m Checking m Savings
Part V Declaration of Taxpayer(s)
I authorize my account to be settled as designated in Part II. If I check Part II, box 4, I declare that the direct deposit refund information in
Part IV agrees with the authorization stated on my return. I authorize an electronic funds withdrawal for the amount listed on line 5a and any
estimated payment amounts listed on line 6 from the account listed on lines 9, 10, and 11. If I have filed a joint return, this is an irrevocable
appointment of the other spouse/RDP as an agent to receive the refund or authorize an electronic funds withdrawal.
Under penalties of perjury, I declare that the information I provided to the Franchise Tax Board (FTB), either directly or through e-file
software, including my name, address, and social security number (SSN) or individual taxpayer identification number (ITIN), and the
amounts shown in Part I above, agrees with the information and amounts shown on the corresponding lines of my 2012 California income
tax return. To the best of my knowledge and belief, my return is true, correct, and complete. If I am filing a balance due return, I understand
that if the FTB does not receive full and timely payment of my tax liability, I remain liable for the tax liability and all applicable interest and
penalties. I authorize my return and accompanying schedules and statements to be transmitted to the FTB directly or through the e-file
software. If the processing of my return or refund is delayed, I authorize the FTB to disclose to me, either directly or through the e-file
software, the reason(s) for the delay or the date when the refund was sent.
Sign
Here
Your signature
Date
Spouse’s/RDP’s signature. If filing jointly, both must sign.
It is unlawful to forge a spouse’s/RDP’s signature.
Date
For Privacy Notice, get form FTB 1131.
REV 12/11/12 TTO
FTB 8453-OL C2 2012
For Privacy Notice, get form FTB 1131.
FORM
California Resident Income Tax Return 2012
540 2EZ C1 Side 1
APE
608-07-2576
ANDREA
DAVID
NEFF
B NEFF
J NEFF
3208 GIBRALTAR DR
RVERSIDE
614-24-8933
CA
P
AC
A
R
RP
12
92506
01-16-1979
02-05-1978
Filing Status
Filing Status. Check the box for your filing status. See instructions, page 6.
Check only one.
1 mSingle
2 m Married/RDP filing jointly (even if only one spouse/RDP had income)
4 m Head of household. STOP! See instructions, page 6.
5 m Qualifying widow(er) with dependent child. Year spouse/RDP died ______ .
If your California filing status is different from your federal filing status, check the box here . . . . . . . . . . . .  m
Exemptions
6If another person can claim you (or your spouse/RDP) as a dependent on his or her tax return,
even if he or she chooses not to, you must see the instructions, page 6 . . . . . . . . . . . . . . . . . . . . . . . . . .  6 m
7Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . . . . . . . . . .  7 m
2
8 Dependents: (Do not include yourself or your spouse/RDP) Enter number of dependents here . . . . . . .  8 m
First Name
Taxable
Income and
Credits
Enclose, but do
not staple, any
payment.
Dependent’s relationship
to you
Last Name
DAVID
NEFF II
SON
VINCENT
NEFF
SON
9 Total wages (federal Form W-2, box 16).
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  9
10 Total interest income (Form 1099-INT, box 1). See instructions, page 7 . . . . . .  10
11Total dividend income (Form 1099-DIV, box 1a). See instructions, page 7 . . . .  11
12Total pension income ____________ See instructions, page 7. Taxable amount.  12
13Total capital gains distributions from mutual funds (Form 1099-DIV, box 2a).
See instructions, page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  13
14 Unemployment compensation . . . . . . . . . . . . . ▌14
. 00
,
15 U.S. social security or railroad retirement benefits . . ▌15 1 2 , 1 2 0 . 0 0
16 Add line 9, line 10, line 11, line 12, and line 13. Do not include
line 14 and line 15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  16
17 Using the 2EZ Table for your filing status, enter the tax for the amount on line 16 . ▌ 17
Caution: If you check the box on line 6, STOP. See instructions, page 7,
Dependent Tax Worksheet.
18 Senior exemption: See instructions, page 7. If you are 65 and entered 1 in the
box on line 7, enter $104. If you entered 2 in the box on line 7, enter $208 . ▌ 18
19 Nonrefundable renter’s credit. See instructions, page 8 . . . . . . . . . . . . . . . . . .  19
20Credits. Add line 18 and line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Tax. Subtract line 20 from line 17. If zero or less, enter -0- . . . . . . . . . . . . . . .  21
For Privacy Notice, get form FTB 1131.
175
3111124
Whole dollars only
1 7,7 5 3 . 0 0
,
,
,
. 00
. 00
. 00
,
. 00
1 7,7 5 3
0
,
REV 01/03/13 TTO
,
. 00
. 00
.
.
.
0.
00
00
00
00
ANDREA B & DAVID J NEFF Your SSN or ITIN: __________________________
608-07-2576
Your name: _____________________________
Overpaid
Tax/
Tax Due.
Use Tax
21a Enter the amount from Side 1, line 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21a
22 Total tax withheld (federal Form W-2, box 17
or Form 1099-R, box 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  22
23 Overpaid tax. If line 22 is more than line 21a, subtract line 21a from line 22 . . . . . . . .  23
24 Tax due. If line 22 is less than line 21a, subtract line 22 from line 21a.
See instructions, page 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▌ 24
25 Use tax. This is not a total line. See instructions, page 8 .  25
Voluntary Contributions Direct
Deposit
(Refund
Only)
,2 3 1
,2 3 1
. 00
. 00
,
. 00
0
Code Amount
00
00
00
00
00
00
00
00
CA Peace Officer Memorial Foundation Fund . .  408
CA Sea Otter Fund . . . . . . . . . . . . . . . . . . . . . . .  410
Municipal Shelter Spay-Neuter Fund . . . . . . . .  412
CA Cancer Research Fund . . . . . . . . . . . . . .  413
ALS/Lou Gehrig’s Disease Research Fund . . .  414
Child Victims of Human Trafficking Fund . . . . .  419
CA YMCA Youth and Government Fund . . . . .  420
CA Youth Leadership Fund . . . . . . . . . . . . . . .  421
School Supplies for Homeless Children Fund .  422
State Parks Protection Fund/Parks Pass Purchase  423
26 Add amounts in code 400 through code 423. These are your total contributions . . . . . . .  26
Amount
You Owe
. 00
. 00
,
Code Amount
CA Seniors Special Fund. See page 13 . . . . .  400
Alzheimer’s Disease/Related Disorders Fund . . .  401
CA Fund for Senior Citizens . . . . . . . . . . . . . .  402
Rare and Endangered Species
Preservation Program . . . . . . . . . . . . . . . . .  403
State Children’s Trust Fund for the
Prevention of Child Abuse . . . . . . . . . . . . . .  404
CA Breast Cancer Research Fund . . . . . . . . .  405
CA Firefighters’ Memorial Fund . . . . . . . . . . . .  406
Emergency Food For Families Fund . . . . . . . .  407
0
,
27 AMOUNT YOU OWE. Add line 24, line 25, and line 26. If line 23 is less than line 25 and
line 26, enter the difference here. See instructions, page 9 (Do Not Send Cash). Mail to:
FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 . . . . . . . .  27
Pay online – Go to ftb.ca.gov for more information.
28 REFUND OR NO AMOUNT DUE. Subtract line 25 and line 26 from line 23. See
instructions, page 10. Mail to: FRANCHISE TAX BOARD, PO BOX 942840,
SACRAMENTO CA 94240-0001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  28
00
00
00
00
00
00
00
00
00
00
,
. 00
,
. 00
,2 3 1
. 00
Fill in the information to authorize direct deposit of your refund into one or two accounts.
Do not attach a voided check or a deposit slip. Have you verified the routing and
account numbers? Use whole dollars only.
All or the following amount of my refund (line 28) is authorized for direct deposit into the
account shown below:
 Checking
1 2 2 0 0 0 4 9 6  Savings 4 0 3 1 4 8 2 2 6 0
 Routing number
 Type
 Account number
,2 3 1. 00
 29 Direct deposit amount
The remaining amount of my refund (line 28) is authorized for direct deposit into the
account shown below:

Checking
 Savings
 Routing number
 Type
 Account number
. 00
,
 30 Direct deposit amount
Under penalties of perjury, I declare that, to the best of my knowledge and belief, the information on this return is true, correct, and complete.
Sign Here
Your signature
It is unlawful
to forge a
spouse’s/RDP’s
signature.
X
Joint return?
See instructions,
page 10.
Spouse’s/RDP’s signature (if filing jointly, both must sign)
Daytime phone number (optional)
( 9 5 1 ) 2 5 5 9 8 1 7
XDate
Your email address (optional). Enter only one email address.
Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge)
SELF-PREPARED
 PTIN
 FEIN
Firm’s name (or yours if self-employed)
SELF PREPARED
Firm’s address
Do you want to allow another person to discuss this return with us (see page 10)? . . . . . . . . . . 
m Yes m No
__________________________________________________________________ __________________________________
Print Third Party Designee’s Name
Side 2 Form 540 2EZ C1 2012
Telephone Number
175
3112124
REV 01/03/13 TTO
California Information Worksheet
2012
G Keep for your records
Part I ' Personal Information
Taxpayer:
Spouse/RDP:
First Name
Andrea
First Name
Middle Initial
B
Suffix
Middle Initial
Last Name
neff
Last Name
Social Security No.
608-07-2576
Social Security No.
Date of Birth
01/16/1979 (mm/dd/yyyy)
Date of Birth
or age as of 1-1-2013
33
or age as of 1-1-2013
Date of Death
(mm/dd/yyyy)
Date of Death
Legally blind
Legally blind
Daytime Phone
(951)255-9817 Ext
Daytime Phone
Home phone
Your email address to print on Form 540, 540 2EZ or 540NR (optional)
Check to print phone number on Form 540
X Taxpayer daytime
c/o Address
Street Address
Unit Description
City
Foreign country
Military Filers:
APO
Military indicator
david
j
Suffix
neff
614-24-8933
02/05/1978 (mm/dd/yyyy)
34
(mm/dd/yyyy)
Ext
Spouse/RDP day
Home
3208 gibraltar dr
Unit Number
State
CA
rverside
FPO
Taxpayer
Private Mailbox (PMB)
ZIP Code
92506
Spouse/RDP
Part II ' Main Form
X
Form 540: Resident Income Tax Return (Long form)
Form 540 2EZ: Resident Income Tax Return
Form 540NR: Nonresident or Part-Year Resident Income Tax Return
Enter your state of residence as of December 31, 2012
CA
X Resident entire year
Resident part of year
Date you established residence in state above
In which state (or foreign country) did you reside before this change?
QuickZoom to enter Part-Year and Nonresident income allocations on Schedule CA(NR)
Part III ' Filing Status
X
Single
Married/RDP filing joint return
Married/RDP filing separate return
You did not live with spouse at any time during the year
Yes No
If filing electronically, is spouse a CA Nonresident?
If filing electronically, is spouse Active Duty Military?
Head of household (with qualifying person) Stop. See instructions.
If the ’qualifying person’ is your child but not your dependent:
Child’s name
Child’s social security number
Qualifying widow(er)
Year spouse/RDP died
2009
2011
Check the box if your California filing status is different from your federal filing status.
Part IV ' Dependent Information
First Name
David
vincent
I
J
S
Last Name
Neff ii
neff
Social Security Number
612-34-5678
623-45-6789
Relationship
Son
Son
Andrea B & david J neff
608-07-2576
Page 2
Part V ' Standard Deduction/Itemized Deductions
Calculate California itemized deductions even if itemized
deductions are less than the standard deduction
You are married filing separately and your spouse itemized deductions
Take the standard deduction even if less than itemized deductions
Part VI ' Other Information
Prior Name:
If you filed your 2011 return under a different last name, enter the last name only from
the 2011 return
Taxpayer
Spouse/RDP
Dependent of Someone Else:
Taxpayer Spouse
Can someone (such as a parent) claim you and/or your spouse/RDP as a dependent?
Interest and Penalties:
Returns filed late: Enter interest, late return and late payment penalties
Farmers and Fishermen:
At least two-thirds of your 2011 or 2012 gross income is from farming or fishing
Return will be filed and tax due will be paid by March 1, 2013
Mandatory Electronic Payments
You are required to make California tax payments electronically
A waiver is or will be in effect for the current year
Force print all payment vouchers even if required to pay electronically
Schedule W-2:
You do not want to complete Schedule W-2
Executor/Guardian Information:
Executor/Guardian
Executor type (if filing electronically)
First Name
MI
Last Name
Third Party Designee:
Yes No
Do you want to allow another person to discuss your return with the Franchise Tax Board?
If yes, enter the person’s name
Telephone
First
Middle init
Last Name
Suffix
Disasters:
Claiming a disaster loss (see FTB Publication 1034)
QuickZoom to enter disaster explanation
Outside of the USA:
You were living or travelling outside the United States on April 15, 2013
Special Condition Text (prints at the top of Form 540, 540 2EZ or 540NR)
Part VII ' Direct Deposit Information or Direct Debit Information
Yes
X
No
Do you want to elect direct deposit of state tax refund?
Do you want direct debit of state tax payment (Electronic Filing Only)?
Bank Information:
Enter the following information if you want to directly deposit any state tax refund
or direct debit of state tax payment:
Name of Financial Institution (optional)
union bank
Account type
Checking
X
Savings
Routing number
122000496
Account number
4031482260
Enter the following information only if you are requesting direct debit of balance due:
Enter the payment date to debit the account above
State balance-due amount from this return
Suf.
Andrea B & david J neff
608-07-2576
Page 3
International ACH Transactions
Yes No
X Will the funds for this refund (or payment) go to (or come from) an account outside the U.S.?
Part VIII ' California Contributions
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
California Seniors Special Fund (Taxpayer)
California Seniors Special Fund (Spouse/RDP)
Alzheimer’s Disease and Related Disorders Fund
California Fund for Senior Citizens
Rare and Endangered Species Preservation Program
State Children’s Trust Fund for the Prevention of Child Abuse
California Breast Cancer Research Fund
California Firefighters’ Memorial Fund
Emergency Food For Families Fund
California Peace Officer Memorial Foundation Fund
California Sea Otter Fund
Municipal Shelter Spay-Neuter Fund
California Cancer Research Fund
ALS/Lou Gehrig’s Disease Research Fund
Child Victims of Human Trafficking Fund
California YMCA Youth and Government Fund
California Youth Leadership Fund
School Supplies for Homeless Children Fund
State Parks Protection Fund/Parks Pass Purchase
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Part IX ' Extension Status
Yes
No
Have you filed Form 3519 - "Payment Voucher for Automatic Extension for
Individuals" or extended the federal tax return?
If Yes, enter the extended due date
QuickZoom to Form 3519: Payment voucher for automatic extension
X
Automatic extension information for military filers (Electronic Filing Only):
Taxpayer
Beginning Military Date
Ending Military Date
Combat zone/QHDA Operation or Area Served
Part X ' Amended Return
Are you filing a California amended return?
Enter the tax year you are amending
Previous California payment made
Previous California refund received
QuickZoom here to Form 540X
QuickZoom to Form 540
QuickZoom to Form 540 2EZ
QuickZoom to Form 540NR
Spouse
Tax Payments Worksheet
2012
G Keep for your records
Name
Social Security Number
Andrea B & david J neff
608-07-2576
Tax Payments for the Current Year
State
Date
1
2
3
4
5
Payment
First Payment
Second Payment
Third Payment
Fourth Payment
Additional Payments
Payment
Payment
Payment
Payment
Payment
6
7
Overpayment from previous year applied to current year
Amount paid with current year extension
6
7
8
Total tax payments
8
Income Taxes Withheld for the Current Year
9
10
11
12 a
b
13
State withholding on Forms W-2
State withholding on Forms W-2G
State withholding on Forms 1099-R
State withholding on Forms 1099-MISC
State withholding on Forms 1099-G
Other state tax withholding
9
10
11
12 a
b
13
231.
14
Total income tax withheld
14
231.
15
Date return will be filed and balance paid
15
OTHV0301.SCR 07/12/12
Andrea B & david J neff
608-07-2576
Smart Worksheets from your 2012 California Tax Return
SMART WORKSHEET FOR: Form 540 2EZ: Resident Income Tax Return
Form 540 2EZ Tax Calculation Smart Worksheet
California Adjusted Gross Income (line 16)
Less Standard Deduction
California Taxable Income
17,753.
7,682.
10,071.
California Tax
Less Exemption Credits
Total Tax. Enter here and on line 17 below
101.
850.
0.
1