1040 U.S.

Individual Income Tax Return 2020 (99)

Form Department of the Treasury—Internal Revenue Service

OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

Filing Status Single Married filing jointly Married filing separately (MFS) X Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying

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one box.
person is a child but not your dependent a
Your first name and middle initial Last name Your social security number
ANDREA M SALAZAR 474 35 3185
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

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Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
503 W 8TH ST TRLR D Check here if you, or your
spouse if filing jointly, want $3
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
to go to this fund. Checking a
STORM LAKE IA 50588 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse

At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes X No
Standard Someone can claim: You as a dependent
EW 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, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4)  if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more

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than four ABELLA E FONSECA SALAZAR 775 55 3032 DAUGHTER X
dependents,
see instructions
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and check
here a
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1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . 1 1,644.

Attach 2a Tax-exempt interest . . . 2a 2b
b Taxable interest . . . . .
Sch. B if
required.
3a
4a
5a
Qualified dividends .
IRA distributions . .
Pensions and annuities . .
.
.
.
.
5a
3a
4a FI
b Ordinary dividends .
b Taxable amount . .
b Taxable amount . .
.
.
.
.
.
.
.
.
.
.
.
.
3b
4b
5b
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Standard 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b

Deduction for—
7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . a 7 0.
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• Single or
Married filing 8 Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . 8 8,520.
separately,
$12,400 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . a 9 10,164.
• Married filing 10 Adjustments to income:
NO

jointly or
Qualifying a From Schedule 1, line 22 . . . . . . . . . . . . . . 10a 602.
widow(er),
$24,800
b Charitable contributions if you take the standard deduction. See instructions 10b 0.
• Head of c Add lines 10a and 10b. These are your total adjustments to income . . . . . . . . a 10c 602.
household,
$18,650 11 Subtract line 10c from line 9. This is your adjusted gross income . . . . . . . . . a 11 9,562.
• If you checked 12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 18,650.
any box under
Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . . . . . . 13
Deduction,
see instructions.
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 18,650.
0.
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15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- . . . . . . . . . 15
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2020)
Form 1040 (2020) ANDREA M SALAZAR 474-35-3185 Page 2
16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 0.
17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17 0.
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 0.
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . 19

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20 Amount from Schedule 3, line 7 . . . . . . . . . . . . . . . . . . . . 20 0.
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 0.
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 0.
23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . 23 1,204.
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . a 24 1,204.
25 Federal income tax withheld from:

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a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 77.
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 77.
• If you have a 26 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . PYEI . . 10,407
. . . . . . . . . . 27 3,545.
attach Sch. EIC.
• If you have 28 Additional child tax credit. Attach Schedule 8812 . . . PYEI
. . 10,407
. . 28 1,186.
nontaxable 29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
combat pay,
see instructions. 30
31
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Recovery rebate credit. See instructions . . . . . . . . . .
Amount from Schedule 3, line 13 . . . . . . . . . . . .
30
31
2,900.
32 Add lines 27 through 31. These are your total other payments and refundable credits . . . a 32 7,631.
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . a 33 7,708.
34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 6,504.

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Refund
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . a 35a 6,504.
Direct deposit? ab Routing number 0 7 3 9 2 1 4 3 3 a c Type: X Checking Savings
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See instructions. a
d Account number 1 9 0 0 8 6 5 7 8 5
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36 Amount of line 34 you want applied to your 2021 estimated tax . . a 36

Amount 37 Subtract line 33 from line 24. This is the amount you owe now . . . . . . . . . . a 37 0.
You Owe
For details on
how to pay, see
instructions.

Third Party
38
Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
2020. See Schedule 3, line 12e, and its instructions for details.
Estimated tax penalty (see instructions) . . . . . . . . . a
Do you want to allow another person to discuss this return with the IRS? See
38 FI
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Designee instructions . . . . . . . . . . . . . . . . . . . . a Yes. Complete below. X No

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Designee’s Phone Personal identification
name a no. a number (PIN) a
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
Sign belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
NO

Here Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
F

(see inst.) a
Joint return? WAL-MART
See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.) a
Phone no. 712-730-3453 Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid
P01856558 X Self-employed
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Preparer MILAYDYS GONZALEZ

Firm’s name a COLE'S TAX & TRANSPORTATION LLC Phone no. 786-448-8313
Use Only Firm’s address a 908 BILL BAGGS RD YANKTON, SD 57078 Firm’s EIN a 85-2949657
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2020)

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SCHEDULE 1 OMB No. 1545-0074
Additional Income and Adjustments to Income
(Form 1040)
Department of the Treasury
a Attach to Form 1040, 1040-SR, or 1040-NR. 2020
Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 01

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Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
ANDREA M SALAZAR 474-35-3185
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . 1
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a

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b Date of original divorce or separation agreement (see instructions) a
3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . 3 8,520.
4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . .
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7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income. List type and amount a
8

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9 Combine lines 1 through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR,
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 8,520.
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Part II Adjustments to Income
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10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government

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officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . .
Health savings account deduction. Attach Form 8889 . . . . . . . . . . . .
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12
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13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . 13
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14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . 14 602.
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . 15
NO

16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . 16

17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . 17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient’s SSN . . . . . . . . . . . . . . . . . . . . a
c Date of original divorce or separation agreement (see instructions) a
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19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees deduction. Attach Form 8917 . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and
on Form 1040, 1040-SR, or 1040-NR, line 10a . . . . . . . . . . . . . . . 22 602.
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040) 2020

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SCHEDULE 2 OMB No. 1545-0074
Additional Taxes
(Form 1040)
Department of the Treasury
a Attach to Form 1040, 1040-SR, or 1040-NR. 2020
Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 02

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Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
ANDREA M SALAZAR 474-35-3185
Part I Tax
1 Alternative minimum tax. Attach Form 6251 . . . . . . . . . . . . . . . . 1
2 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . 2

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3 Add lines 1 and 2. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 17 . . 3
Part II Other Taxes
4 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . 4 1,204.
5 Unreported social security and Medicare tax from Form: a 4137 b 8919 . 5
6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored
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accounts. Attach Form 5329 if required . . . . . . . . . . . . . . . . . . 6
7a Household employment taxes. Attach Schedule H . . . . . . . . . . . . . 7a
b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if
required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b

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8 Taxes from: a Form 8959 b Form 8960
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c Instructions; enter code(s) 8
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9 Section 965 net tax liability installment from Form 965-A . . . 9

10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form
1040 or 1040-SR, line 23, or Form 1040-NR, line 23b . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see your tax return instructions. FI Cat. No. 71478U
10 1,204.
Schedule 2 (Form 1040) 2020
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SCHEDULE C Profit or Loss From Business OMB No. 1545-0074

2020
(Form 1040) (Sole Proprietorship)
a Go to www.irs.gov/ScheduleC for instructions and the latest information.
Department of the Treasury Attachment
Internal Revenue Service (99) a Attach to Form 1040, 1040-SR, 1040-NR, or 1041; partnerships generally must file Form 1065. Sequence No. 09

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Name of proprietor Social security number (SSN)
ANDREA M SALAZAR 474-35-3185
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
CLEANING a 9 9 9 9 9 9
C Business name. If no separate business name, leave blank. D Employer ID number (EIN) (see instr.)

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E Business address (including suite or room no.) a

City, town or post office, state, and ZIP code

F Accounting method: (1) X Cash (2) Accrual (3) Other (specify) a
G Did you “materially participate” in the operation of this business during 2020? If “No,” see instructions for limit on losses . X Yes No
H If you started or acquired this business during 2020, check here . . . . . . . . . . . . . . . . . a

I Did you make any payments in 2020 that would require you to file Form(s) 1099? See instructions . . . . . . . . Yes X No
J If “Yes,” did you or will you file required Form(s) 1099? . . . . . . . . . . . . . . . . . . . . . Yes No
Part I Income EW
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on
Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . a 1 9,000.
2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3 9,000.
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4

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5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5 9,000.
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . 6
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7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . a 7 9,000.
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Part II Expenses. Enter expenses for business use of your home only on line 30.
8 Advertising . . . . . 8 80. 18 Office expense (see instructions) 18
9

10
11
Car and truck expenses (see
instructions) . . . . .
Commissions and fees .
Contract labor (see instructions)
9
10
11
19
20
a
b
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Pension and profit-sharing plans .
Rent or lease (see instructions):
Vehicles, machinery, and equipment
Other business property . . .
20a
20b
19
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12 Depletion . . . . . 12 21 Repairs and maintenance . . . 21

13 Depreciation and section 179
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22 Supplies (not included in Part III) . 22 400.
expense deduction (not
included in Part III) (see 23 Taxes and licenses . . . . . 23
instructions) . . . . . 13 24 Travel and meals:
NO

14 Employee benefit programs a Travel . . . . . . . . . 24a

(other than on line 19) . . 14 b Deductible meals (see
15 Insurance (other than health) 15 instructions) . . . . . . . 24b
16 Interest (see instructions): 25 Utilities . . . . . . . . 25
a Mortgage (paid to banks, etc.) 16a 26 Wages (less employment credits) . 26
b Other . . . . . . 16b 27a Other expenses (from line 48) . . 27a
17 Legal and professional services
17 b Reserved for future use . . . 27b
28 Total expenses before expenses for business use of home. Add lines 8 through 27a . . . . . . a 28 480.
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29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29 8,520.

30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method. See instructions.
Simplified method filers only: Enter the total square footage of (a) your home:
and (b) the part of your home used for business: . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30

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31 Net profit or (loss). Subtract line 30 from line 29.
• If a profit, enter on both Schedule 1 (Form 1040), line 3, and on Schedule SE, line 2. (If you
checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3. 31 8,520.
• If a loss, you must go to line 32.

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32 If you have a loss, check the box that describes your investment in this activity. See instructions.
• If you checked 32a, enter the loss on both Schedule 1 (Form 1040), line 3, and on Schedule
SE, line 2. (If you checked the box on line 1, see the line 31 instructions). Estates and trusts, enter on 32a X All investment is at risk.
Form 1041, line 3. 32b Some investment is not
at risk.
• If you checked 32b, you must attach Form 6198. Your loss may be limited.
For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11334P Schedule C (Form 1040) 2020

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SCHEDULE SE
Self-Employment Tax
OMB No. 1545-0074

2020
(Form 1040)
a Go to www.irs.gov/ScheduleSE for instructions and the latest information.
Department of the Treasury Attachment
Sequence No. 17
a Attach to Form 1040, 1040-SR, or 1040-NR.
Internal Revenue Service (99)

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Name of person with self-employment income (as shown on Form 1040, 1040-SR, or 1040-NR) Social security number of person
ANDREA M SALAZAR with self-employment income a 474-35-3185
Part I Self-Employment Tax
Note: If your only income subject to self-employment tax is church employee income, see instructions for how to report your income
and the definition of church employee income.
A If you are a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361, but you had

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$400 or more of other net earnings from self-employment, check here and continue with Part I . . . . . . . . a
Skip lines 1a and 1b if you use the farm optional method in Part II. See instructions.
1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065),
box 14, code A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve
Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code AH 1b ( )
Skip line 2 if you use the nonfarm optional method in Part II. See instructions.
2 Net profit or (loss) from Schedule C, line 31; and Schedule K-1 (Form 1065), box 14, code A (other than
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farming). See instructions for other income to report or if you are a minister or member of a religious order 2 8,520.
3 Combine lines 1a, 1b, and 2 . . . . . . . . . . . . . . . . . . . . . . . . . 3 8,520.
4a If line 3 is more than zero, multiply line 3 by 92.35% (0.9235). Otherwise, enter amount from line 3 . 4a 7,868.
Note: If line 4a is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions.
b If you elect one or both of the optional methods, enter the total of lines 15 and 17 here . . . . . 4b

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c Combine lines 4a and 4b. If less than $400, stop; you don’t owe self-employment tax. Exception: If
less than $400 and you had church employee income, enter -0- and continue . . . . . . . a 4c 7,868.
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5a Enter your church employee income from Form W-2. See instructions for
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definition of church employee income . . . . . . . . . . . . . 5a

b Multiply line 5a by 92.35% (0.9235). If less than $100, enter -0- . . . . . . . . . . . . . 5b
6
7
Add lines 4c and 5b . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Maximum amount of combined wages and self-employment earnings subject to social security tax or
the 6.2% portion of the 7.65% railroad retirement (tier 1) tax for 2020 . . . . . . . . . . .
8a Total social security wages and tips (total of boxes 3 and 7 on Form(s) W-2)
6

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7,868.

137,700.
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and railroad retirement (tier 1) compensation. If $137,700 or more, skip lines

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8b through 10, and go to line 11 . . . . . . . . . . . . . . . 8a 1,644.
b Unreported tips subject to social security tax from Form 4137, line 10 . . . 8b
c Wages subject to social security tax from Form 8919, line 10 . . . . . . 8c
NO

d Add lines 8a, 8b, and 8c . . . . . . . . . . . . . . . . . . . . . . . . . . 8d 1,644.

9 Subtract line 8d from line 7. If zero or less, enter -0- here and on line 10 and go to line 11 . . . a 9 136,056.
10 Multiply the smaller of line 6 or line 9 by 12.4% (0.124) . . . . . . . . . . . . . . . . 10 976.
11 Multiply line 6 by 2.9% (0.029) . . . . . . . . . . . . . . . . . . . . . . . . 11 228.
12 Self-employment tax. Add lines 10 and 11. Enter here and on Schedule 2 (Form 1040), line 4 . . 12 1,204.
13 Deduction for one-half of self-employment tax.
Multiply line 12 by 50% (0.50). Enter here and on Schedule 1 (Form 1040),
line 14 . . . . . . . . . . . . . . . . . . . . . . . . 13 602.
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Part II Optional Methods To Figure Net Earnings (see instructions)

Farm Optional Method. You may use this method only if (a) your gross farm income1 wasn’t more than
$8,460, or (b) your net farm profits2 were less than $6,107.
14 Maximum income for optional methods . . . . . . . . . . . . . . . . . . . . . 14
15 Enter the smaller of: two-thirds (2/3) of gross farm income1 (not less than zero) or $5,640. Also, include
this amount on line 4b above . . . . . . . . . . . . . . . . . . . . . . . . 15
Nonfarm Optional Method. You may use this method only if (a) your net nonfarm profits3 were less than $6,107
and also less than 72.189% of your gross nonfarm income,4 and (b) you had net earnings from self-employment
of at least $400 in 2 of the prior 3 years. Caution: You may use this method no more than five times.
16 Subtract line 15 from line 14 . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Enter the smaller of: two-thirds (2/3) of gross nonfarm income4 (not less than zero) or the amount on
line 16. Also, include this amount on line 4b above . . . . . . . . . . . . . . . . . 17
1 3
From Sch. F, line 9; and Sch. K-1 (Form 1065), box 14, code B. From Sch. C, line 31; and Sch. K-1 (Form 1065), box 14, code A.
2 4
From Sch. F, line 34; and Sch. K-1 (Form 1065), box 14, code A—minus the amount From Sch. C, line 7; and Sch. K-1 (Form 1065), box 14, code C.
you would have entered on line 1b had you not used the optional method.
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 11358Z Schedule SE (Form 1040) 2020

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Schedule SE (Form 1040) 2020 Attachment Sequence No. 17 Page 2
Part III Maximum Deferral of Self-Employment Tax Payments
If line 4c is zero, skip lines 18 through 20, and enter -0- on line 21.
18 Enter the portion of line 3 that can be attributed to March 27, 2020, through December 31, 2020 . . 18

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19 If line 18 is more than zero, multiply line 18 by 92.35% (0.9235); otherwise, enter the amount from line 18 19
20 Enter the portion of lines 15 and 17 that can be attributed to March 27, 2020, through December 31,
2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Combine lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . 21
If line 5b is zero, skip line 22 and enter -0- on line 23.
22 Enter the portion of line 5a that can be attributed to March 27, 2020, through December 31, 2020 . . 22

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23 Multiply line 22 by 92.35% (0.9235) . . . . . . . . . . . . . . . . . . . . . . 23
24 Add lines 21 and 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
25 Enter the smaller of line 9 or line 24 . . . . . . . . . . . . . . . . . . . . . . 25
26 Multiply line 25 by 6.2% (0.062). Enter here and see the instructions for line 12e of Schedule 3 (Form
1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Schedule SE (Form 1040) 2020

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SCHEDULE EIC Earned Income Credit OMB No. 1545-0074
(Form 1040) 1040 `
Qualifying Child Information
2020
.........
1040-SR
a Complete and attach to Form 1040 or 1040-SR only if you have a
Department of the Treasury qualifying child. EIC Attachment
Sequence No. 43

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Internal Revenue Service (99) a Go to www.irs.gov/ScheduleEIC for the latest information.
Name(s) shown on return Your social security number

ANDREA M SALAZAR 474-35-3185

• See the instructions for Form 1040 or 1040-SR, line 27, to make sure that (a) you can take the EIC, and (b)
Before you begin: 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.

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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.

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!
CAUTION
• You can't claim the EIC for a child who didn't live with you for more than half of the year.
• 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 the instructions for details.
• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

Qualifying Child Information Child 1 Child 2 Child 3

1 Child’s name
If you have more than three qualifying
children, you have to list only three to get
the maximum credit.
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First name

ABELLA FONSECA S
Last name First name Last name First name Last name
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2 Child’s SSN

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The child must have an SSN as defined in
the instructions for Form 1040 or
1040-SR, line 27, unless the child was
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born and died in 2020. If your child was

born and died in 2020 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
showing a live birth.
775-55-3032
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3 Child’s year of birth

Year 2 0 2 0 Year Year
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If born after 2001 and the child is If born after 2001 and the child is If born after 2001 and the child is
younger than you (or your spouse, if younger than you (or your spouse, if younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b;
go to line 5. go to line 5. go to line 5.
NO

4 a Was the child under age 24 at the end of

2020, a student, and younger than you (or Yes. No. Yes. No. Yes. No.
your spouse, if filing jointly)?
Go to Go to line 4b. Go to Go to line 4b. Go to Go to line 4b.
line 5. line 5. line 5.

b Was the child permanently and totally

disabled during any part of 2020? Yes. No. Yes. No. Yes. No.
Go to The child is not a Go to The child is not a Go to The child is not a
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line 5. qualifying child. line 5. qualifying child. line 5. qualifying child.

5 Child’s relationship to you

(for example, son, daughter, grandchild,
niece, nephew, eligible foster child, etc.)
DAUGHTER
6 Number of months child lived
with you in the United States
during 2020

• If the child lived with you for more than

half of 2020 but less than 7 months,
enter “7.”
• If the child was born or died in 2020 and 12 months months months
your home was the child’s home for more
than half the time he or she was alive Do not enter more than 12 Do not enter more than 12 Do not enter more than 12
during 2020, enter “12.” months. months. months.
For Paperwork Reduction Act Notice, see your tax Cat. No. 13339M Schedule EIC (Form 1040) 2020
return instructions.

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SCHEDULE 8812 OMB No. 1545-0074
(Form 1040)
Additional Child Tax Credit . .1040
`
2020
.......
1040-SR
.........
a Attach to Form 1040, 1040-SR, or 1040-NR. 1040-NR
Department of the Treasury a
8812 Attachment
Go to www.irs.gov/Schedule8812 for instructions and the latest information.

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Internal Revenue Service (99) Sequence No. 47

Name(s) shown on return Your social security number

ANDREA M SALAZAR 474-35-3185
Part I All Filers
Caution: If you file Form 2555, stop here; you cannot claim the additional child tax credit.
1 If you are required to use the worksheet in Pub. 972, enter the amount from line 10 of the Child Tax Credit

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and Credit for Other Dependents Worksheet in the publication. Otherwise, enter the amount from line 8 of your
Child Tax Credit and Credit for Other Dependents Worksheet. (See the instructions for Forms 1040 and 1040-
SR, line 19, or the instructions for Form 1040-NR, line 19.) . . . . . . . . . . . . . . . . 1 2,000.
2 Enter the amount from line 19 of your Form 1040, Form 1040-SR, or Form 1040-NR . . . . . . . . 2
3 Subtract line 2 from line 1. If zero, stop here; you cannot claim this credit . . . . . . . . . . . . 3 2,000.
4 Number of qualifying children under 17 with the required social security number: 1 x $1,400.
Enter the result. If zero, stop here; you cannot claim this credit . . . . . . . . . . . . . . . 4 1,400.
TIP: The number of children you use for this line is the same as the number of children you used for line 1 of the
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Child Tax Credit and Credit for Other Dependents Worksheet.
5 Enter the smaller of line 3 or line 4 . . . . . . . . . . . . . . . . . . . . . . . 5 1,400.
6a Earned income (see instructions) . . . . . . . . . . . . . . . . 6a 10,407.
b Nontaxable combat pay (see instructions) . . . . . . 6b
7 Is the amount on line 6a more than $2,500?

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No. Leave line 7 blank and enter -0- on line 8.
X Yes. Subtract $2,500 from the amount on line 6a. Enter the result . . . . . 7 7,907.
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8 Multiply the amount on line 7 by 15% (0.15) and enter the result . . . . . . . . . . . . . . . 8 1,186.
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Next. On line 4, is the amount $4,200 or more?

X No. If line 8 is zero, stop here; you cannot claim this credit. Otherwise, skip Part II and enter the smaller

Part II
of line 5 or line 8 on line 15.

Otherwise, go to line 9.
Certain Filers Who Have Three or More Qualifying Children
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Yes. If line 8 is equal to or more than line 5, skip Part II and enter the amount from line 5 on line 15.
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9 Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2,
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boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If
your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, see
instructions . . . . . . . . . . . . . . . . . . . . . . . 9
NO

10 Enter the total of the amounts from Schedule 1 (Form 1040), line 14, and Schedule 2
(Form 1040), line 5, plus any taxes that you identified using code “UT” and entered on
Schedule 2 (Form 1040), line 8 . . . . . . . . . . . . . . . . . 10
11 Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . 11
12 1040 and Enter the total of the amounts from Form 1040 or 1040-SR, line 27,
1040-SR filers: and Schedule 3 (Form 1040), line 10.
1040-NR filers: Enter the amount from Schedule 3 (Form 1040), line 10.
} 12
13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . 13
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14 Enter the larger of line 8 or line 13 . . . . . . . . . . . . . . . . . . . . . . . 14

Next, enter the smaller of line 5 or line 14 on line 15.
Part III Additional Child Tax Credit
15 This is your additional child tax credit . . . . . . . . . . . . . . . . . . . . . . 15 1,186.
Enter this amount on
Form 1040, line 28;
. .1040
....... Form 1040-SR, line 28; or
1040-SR
.........
Form 1040-NR, line 28.
1040-NR `

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 59761M Schedule 8812 (Form 1040) 2020

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Form 8867 Paid Preparer’s Due Diligence Checklist OMB No. 1545-0074

2020
Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC),
Child Tax Credit (CTC) (including the Additional Child Tax Credit (ACTC) and
Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
Department of the Treasury a To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS. Attachment

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Internal Revenue Service a Go to www.irs.gov/Form8867 for instructions and the latest information. Sequence No. 70
Taxpayer name(s) shown on return Taxpayer identification number

ANDREA M SALAZAR 474-35-3185

Enter preparer’s name and PTIN

MILAYDYS GONZALEZ P01856558

Part I Due Diligence Requirements

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Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I–V
for the benefit(s) claimed (check all that apply). X EIC X CTC/ACTC/ODC AOTC X HOH
1 Did you complete the return based on information for tax year 2020 provided by the taxpayer or Yes No N/A
reasonably obtained by you? . . . . . . . . . . . . . . . . . . . . . . . . X
2 If credits are claimed on the return, did you complete the applicable EIC and/or CTC/ACTC/ODC
worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS instructions, and/or the
AOTC worksheet found in the Form 8863 instructions, or your own worksheet(s) that provides the same
information, and all related forms and schedules for each credit claimed? . . . . . . . . . X
3
the following.
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Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of

• Interview the taxpayer, ask questions, and contemporaneously document the taxpayer’s responses to
determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.
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• Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing

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status and to figure the amount(s) of any credit(s) . . . . . . . . . . . . . . . . . X
4 Did any information provided by the taxpayer or a third party for use in preparing the return, or
information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If “Yes,”
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answer questions 4a and 4b. If “No,” go to question 5.) . . . . . . . . . . . . . . . X

a Did you make reasonable inquiries to determine the correct, complete, and consistent information? .

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b Did you contemporaneously document your inquiries? (Documentation should include the questions
you asked, whom you asked, when you asked, the information that was provided, and the impact the
information had on your preparation of the return.) . . . . . . . . . . . . . . . . .
Did you satisfy the record retention requirement? To meet the record retention requirement, you must
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keep a copy of your documentation referenced in 4b, a copy of this Form 8867, a copy of any
applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
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8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to figure
the amount(s) of the credit(s) . . . . . . . . . . . . . . . . . . . . . . . . X
NO

List those documents provided by the taxpayer, if any, that you relied on:

6 Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
credit(s) and/or HOH filing status and the amount(s) of any credit(s) claimed on the return if his/her
return is selected for audit? . . . . . . . . . . . . . . . . . . . . . . . . . X
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7 Did you ask the taxpayer if any of these credits were disallowed or reduced in a previous year? . . X
(If credits were disallowed or reduced, go to question 7a; if not, go to question 8.)
a Did you complete the required recertification Form 8862? . . . . . . . . . . . . . . .
8 If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete and
correct Schedule C (Form 1040)? . . . . . . . . . . . . . . . . . . . . . . . X
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 26142H Form 8867 (2020)

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Form 8867 (2020) Page 2
Part II Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
9a Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children Yes No N/A
claimed, or is eligible to claim the EIC without a qualifying child? (If the taxpayer is claiming the EIC

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and does not have a qualifying child, go to question 10.) . . . . . . . . . . . . . . X
b Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer
has supported the child the entire year? . . . . . . . . . . . . . . . . . . . . . X
c Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of
more than one person (tiebreaker rules)? . . . . . . . . . . . . . . . . . . . . X
Part III Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC,

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or ODC, go to Part IV.)
10 Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer’s dependent who is Yes No N/A
a citizen, national, or resident of the United States? . . . . . . . . . . . . . . . . . . X
11 Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the taxpayer has not lived
with the child for over half of the year, even if the taxpayer has supported the child, unless the child’s
custodial parent has released a claim to exemption for the child? . . . . . . . . . . . . X
12 Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or
separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar

Part IV
13
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statement to the return? . . . . . . . . . . . . . . . . . . . . . . . . . .
Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified
tuition and related expenses for the claimed AOTC? . . . . . . . . . . . . . . . . . . . .
Yes
X
No
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Part V Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)

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14 Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year Yes No
and provided more than half of the cost of keeping up a home for the year for a qualifying person? . . . . X
Part VI Eligibility Certification
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a You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing
status on the return of the taxpayer identified above if you:

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A. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer’s responses on the return or
in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of the credit(s);
B. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable
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credit(s) claimed and HOH filing status, if claimed;

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C. Submit Form 8867 in the manner required; and
D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under
Document Retention.
NO

1. A copy of this Form 8867.

2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
3. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer’s eligibility for the
credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was
obtained.
5. A record of any additional information you relied upon, including questions you asked and the taxpayer’s responses, to
determine the taxpayer’s eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
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a If you have not complied with all due diligence requirements, you may have to pay a $540 penalty for each failure to
comply related to a claim of an applicable credit or HOH filing status.

15 Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and Yes No
complete? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
Form 8867 (2020)

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