Federal Electronic Filing Instructions

Tax Year 2019

You are responsible for confirming the status of your electronically filed
return. You can confirm the status of your return by going to /ef/efile-center. You will
need to enter the primary social security number and last name on the return along
with your ZIP code.

Self Select PIN: You do not need to mail any paper signature forms to the IRS. Your
return has been successfully filed once you receive your acceptance from the IRS.

Refund:
You have elected to receive your refund of $456 via direct deposit.

You can start checking the status of your refund within 24 hours of e-filing at the IRS
website https://www.irs.gov/Refunds under Where's My Refund. The IRS issues most
refunds in less than 21 days. Updates to refund status are made once daily - usually
at night.

Federal Electronic Filing Instructions Page 1

 Department of the Treasury–Internal Revenue Service (99)
1040 2019
Form
U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only – Do not write or staple in this space.
Filing status: X Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is
one box.
a child but not your dependent.
Your first name and middle initial Last name Your social security number

AMY O PACHECO QUISPE 651-08-1820

If joint return, spouse's first name and middle initial Last name Spouse's social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Check here if you, or your spouse if filing
S6330 BLUFF RD jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change

MERRIMAC, WI 53561 You Spouse

Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see inst. and check here

Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4) check if qualifies for (see inst.):
(1) First name Last name Child tax credit Credit for other dependents

Standard
Deduction for -
EFILE COPY
1
2a
3a
4a
Wages, salaries, tips, etc. Attach Form(s) W-2
Tax-exempt interest
Qualified dividends
IRA distributions
2a
3a
4a
b
b
b Taxable amount
1
2b
3b
4b
5,980.

c Pensions and annuities 4c d Taxable amount 4d

5a Social security benefits 5a b Taxable amount 5b
6 Capital gain or (loss). Attach Schedule D if required. If not required, check here 6
7a Other income from Schedule 1, line 9 7a
b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income 7b 5,980.
8a Adjustments to income from Schedule 1, line 22 8a
b Subtract line 8a from line 7b. This is your adjusted gross income 8b 5,980.
9 Standard deduction or itemized deductions (from Schedule A) 9 12,200.
10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10
11a Add lines 9 and 10 11a 12,200.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- 11b 0.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. UYA Form 1040 (2019)
Form 1040 (2019) AMY O PACHECO QUISPE 651-08-1820 Page 2
12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a 0.
b Add Schedule 2, line 3, and line 12a and enter the total 12b
13a Child tax credit or credit for other dependents 13a
b Add Schedule 3, line 7, and line 13a and enter the total 13b 0.
14 Subtract line 13b from line 12b. If zero or less, enter -0- 14 0.
15 Other taxes, including self-employment tax, from Schedule 2, line 10 15 0.
16 Add lines 14 and 15. This is your total tax 16 0.
17 Federal income tax withheld from Forms W-2 and 1099 17 456.
If you have a 18 Other payments and refundable credits:
qualifying child, a Earned income credit (EIC) 18a
attach Sch. EIC.
If you have b Additional child tax credit. Attach Schedule 8812 18b
nontaxable
c American opportunity credit from Form 8863, line 8 18c
combat pay,
see instructions. d Schedule 3, line 14 18d
e Add lines 18a through 18d. These are your total other payments and refundable credits 18e 0.
19 Add lines 17 and 18e. These are your total payments 19 456.
20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 20 456.
Refund 21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here 21a 456.
Direct deposit?
b Routing number 291571270 c Type: X Checking Savings
See instructions. d Account number 10113327
22 Amount of line 20 you want applied to your 2020 estimated tax 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions 23 0.
you owe 24 Estimated tax penalty (see instructions) 24

EFILE COPY
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee Designee’s Phone Personal identification
No
(Other than
name no. number (PIN)
paid preparer)

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here
Your signature Date Your occupation
Joint return?
See instructions. WORKER
Keep a copy for Spouse's signature. If a joint return, both must sign. Date Spouse's occupation
your records.

Phone no. (251)320-8520 Email address

Preparer's name Preparer's signature Date PTIN Check if:
Paid
Preparer
Use Only Firm's name Phone no.
Firm's address Firm's EIN
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2019)
UYA
 Wisconsin Electronic Filing Instructions

These instructions are provided to help you understand and complete the final steps
for successfully electronically filing your Wisconsin return. We HIGHLY recommend
that you print these instructions for your reference.

You are responsible for confirming the status of your electronically filed
Wisconsin return. You can confirm the status of your return by going to
/ef/efile-center. You will need to enter the Primary Social Security Number and Last
Name on the return along with your Zip Code.

Refund:
Your Wisconsin refund of $246 will be deposited directly into your checking or
savings account.

To check on the status of your refund by phone, call:

(608) 266-8100 in Madison
(414) 227-4907 in Milwaukee, or
1-866-WIS-RFND (1-866-947-7363) toll-free.
You can also check the status of your refund at the Wisconsin Department of
Revenue website at www.revenue.wi.gov/Pages/Apps/TaxReturnStatus.aspx. You
will need to have your social security number and the exact amount of the refund you
requested. You should wait at least 5 business days after receiving acknowledgment
before you contact the Department of Revenue.

Wisconsin Electronic Filing Instructions Page 1

N
1 Wisconsin
income tax For the year Jan. 1-Dec. 31, 2019, or other tax year
2019
o
t Check here if an amended return beginning , 2019 ending , 20 .
e
Your legal last name Legal first name M.I. Your social security number

PACHECO QUISPE AMY O 651 08 1820

DO NOT STAPLE

If a joint return, spouse's legal last name Spouse's legal first name M.I. Spouse's social security number

Home address (number and street). If you have a PO Box, see page 11. Apt. no.
Tax district
S6330 BLUFF RD Check below then fill in either the name of the
City or post office State Zip code city, village, or town and the county in which you
lived at the end of 2019.
MERRIMAC WI 53561
Filing status Check below
City X Village Town

X Single City, village,

See page 5 before assembling return

or town MERRIMAC
Married filing joint return
Legal last name
County of SAUK
Married filing separate return.
Fill in spouse's SSN above Legal first name M.I.
and full name here School district number See page 57 4557
Special

EFILE COPY
Head of household (see page 12). If married, fill in spouse’s
conditions
Also, check here if married. SSN above and full name here

NO COMMAS; NO CENTS

N
1 Federal adjusted gross income (see page 12) 1 5980.00
Form W-2 wages included in line 1 5980.00
2 State and municipal interest (see page 13) 2 .00
3 Capital gain/loss addition (see page 14) 3 .00
Fill in code number and amount, see page 14.
} Fill in total other additions on line 4. .00
4 Other additions
.00 .00 .00 .00 4 .00
5 Add the amounts in the right column for lines 1 through 4 5 5980.00
6 Taxable refund of state income tax
(from federal Form 1040 or 1040-SR, Schedule 1, line 1) 6 .00
7 United States government interest 7 .00
8 Unemployment compensation (see page 16) 8 .00
9 Social security adjustment (see page 17) 9 .00
10 Capital gain/loss subtraction (see page 17) 10 .00

11 Other subtractions } Fill in code number and amount, see page 17.
Fill in total other subtractions on line 11.

.00 .00 .00

PAPER CLIP payment here

.00 .00 11 .00

12 Add lines 6 through 11 12 .00
13 Subtract line 12 from line 5. This is your Wisconsin income 13 5980.00

I-010i (R. 09-19)

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2019 Form 1 Name AMY O PACHECO QUISPE SSN 651 08 1820 Page 2 of 4
NO COMMAS; NO CENTS

14 Wisconsin income from line 13 14 5980.00

15 Standard deduction. See table on page 58, OR 15 10860.00
16 Subtract line 15 from line 14. If line 15 is larger than line 14, fill in 0 16 .00
17 Exemptions (Caution: See page 32)
a Fill in exemptions allowed 1 x $700 17a 700.00
b Check if 65 or older You + Spouse = x $250 17b .00
c Add lines 17a and 17b 17c 700.00
18 Subtract line 17c from line 16. If line 17c is larger than line 16, fill in 0. This is taxable income 18 .00
19 Tax (see table on page 51) 19 .00
20 Itemized deduction credit. Enclose Schedule 1, page 4 20 .00
21 Armed forces member credit (must be stationed outside U.S. See page 34) 21 .00
22 School property tax credit
a Rent paid in 2019-heat included .00
Rent paid in 2019-heat not included .00 } table page 36 22a .00

EFILE COPY
b Property taxes paid on home in 2019 .00 table page 37 22b .00

23 Working families tax credit (see page 37) 23 .00

24 Married couple credit. Enclose Schedule 2, page 4 24 .00
25 Nonrefundable credits from line 34 of Schedule CR 25 .00
26 Net income tax paid to another state. Enclose Schedule OS 26 .00
27 Add lines 20 through 26 27 .00
28 Subtract line 27 from line 19. If line 27 is larger than line 19, fill in 0. This is your net tax 28 .00
29 Sales and use tax due on internet, mail order, or other out-of-state purchases (see page 40) 29 .00
If you certify that no sales or use tax is due, check here X
30 Donations (decreases refund or increases amount owed)
a Endangered resources .00 e Military family relief .00
b Cancer research .00 f .00
c Veterans trust fund .00 g .00
d Multiple sclerosis .00 h Special Olympics Wisconsin .00
Total (add lines a through h) 30i .00
31 Penalties on IRAs, retirement plans, MSAs, etc. (see page 42) .00 x .33 = 31 .00
32 Other penalties (see page 42) 32 .00

33 Add lines 28, 29, 30i, 31 and 32 33 .00

34 Wisconsin tax withheld. Enclose withholding statements 34 246.00
35 2019 estimated tax payments and amount applied from 2018 return 35 .00
36 Earned income credit. Number of qualifying children
Federal
credit .00 x %= 36 .00

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 2019 Form 1 Page 3 of 4
Name(s) shown on Form 1 Your social security number

AMY O PACHECO QUISPE 651 08 1820

NO COMMAS; NO CENTS

37 Farmland preservation credit. a Schedule FC, line 17 37a .00

b Schedule FC-A, line 13 37b .00

38 Repayment credit (see page 44) 38 .00

39 Homestead credit. Enclose Schedule H or H-EZ 39 .00
40 Eligible veterans and surviving spouses property tax credit 40 .00
41 Refundable credits from Schedule CR, line 40. 41 .00
42 42 .00

43 Add lines 34 through 42 43 246 .00

44 44 .00

45 Subtract line 44 from line 43 45 246.00

46 If line 45 is larger than line 33, subtract line 33 from line 45.
This is the AMOUNT YOU OVERPAID 46 246.00

EFILE COPY
47 Amount of line 46 you want REFUNDED TO YOU 47 246.00
48 Amount of line 46 you want
APPLIED TO YOUR 2020 ESTIMATED TAX 48 .00
49 If line 45 is smaller than line 33, subtract line 45 from line 33.
This is the AMOUNT YOU OWE. Paper clip payment to front of return 49 .00
50 50 .00
Also include on line 49 (see page 49)

Third Do you want to allow another person to discuss this return with the department (see page 50)? Yes Complete the following. No
Party Designee's Phone Personal
identification
Designee name no. number (PIN)

Sign here
Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.
Your signature Spouse's signature (if filing jointly, BOTH must sign) Date Daytime phone

(251)320-8520
I-010ai

Mail your return to: Wisconsin Department of Revenue

If tax due PO Box 268, Madison WI 53790-0001
If refund or no tax due PO Box 59, Madison WI 53785-0001
If homestead credit claimed PO Box 34, Madison WI 53786-0001

Do Not Submit Photocopies

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