2019 Turbo Tax Return

Review your print out for checklist items.
1040 U.S. Individual Income Tax Return 2019

Form Department of the Treasury—Internal Revenue Service (99)
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) 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. a
Your first name and middle initial Last name Your social security number
Durril M Butler 377-21-3791
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
29445 Valley Bnd
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 your
Farmington Hills MI 48331-2470 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see instructions and here a
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) if qualifies for (see instructions):
(1) First name Last name Child tax credit Credit for other dependents
Madison M Butler 899-24-8010 Daughter
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1 23,223.

2a Tax-exempt interest . . . . 2a b Taxable interest. Attach Sch. B if required 2b
3a Qualified dividends . . . . 3a b Ordinary dividends. Attach Sch. B if required 3b
Standard
Deduction for— 4a IRA distributions . . . . . 4a b Taxable amount . . . . . . 4b
• Single or Married
filing separately,
c Pensions and annuities . . . 4c d Taxable amount . . . . . . 4d
$12,200 5a Social security benefits . . . 5a b Taxable amount . . . . . . 5b
• Married filing
6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . a 6
jointly or Qualifying
widow(er), 7a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . 7a 0.
$24,400
• Head of b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . . . . . . . . a 7b 23,223.
household,
$18,350
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . . . . . . 8a
• If you checked b Subtract line 8a from line 7b. This is your adjusted gross income . . . . . . . . . . . a 8b 23,223.
any box under
Standard 9 Standard deduction or itemized deductions (from Schedule A) . . . . . 9 18,350.
Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10
see instructions.
11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . 11a 18,350.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . . . . . . . . . 11b 4,873.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019)
Form 1040 (2019) Page 2
12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a 488.
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . . . . . . . a 12b 488.
13a Child tax credit or credit for other dependents . . . . . . . . . . 13a 488.
b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . . . . . . . a 13b 488.
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 . . . . . . . . . . . . . . . . . . a 16 0.
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . . . 17 1,899.
• If you have a
18 Other payments and refundable credits:
qualifying child, a Earned income credit (EIC) . . . . . . . . . . . . . . . 18a 2,855.
attach Sch. EIC.
• If you have b Additional child tax credit. Attach Schedule 8812 . . . . . . . . . 18b 1,400.
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 . . . . . a 18e 4,255.
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . . . . . . . a 19 6,154.
Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid . . . . . . 20 6,154.
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here . . . . . . a 21a 6,154.
Direct deposit? a b Routing number 0 7 2 0 0 0 0 9 6 a c Type: Checking Savings
See instructions.
a d Account number 6 8 2 7 0 1 4 3 6 3
22 Amount of line 20 you want applied to your 2020 estimated tax . . . . a 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions . . . . . a 23
You Owe 24 Estimated tax penalty (see instructions) . . . . . . . . . . . a 24
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 No
(Other than Designee’s Phone Personal identification
paid preparer) name a no. a number (PIN) a
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 If the IRS sent you an Identity
Protection PIN, enter it here
F
Joint return? Warehouse Assistant (see inst.)

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.)
Phone no. Email address

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Preparer Self-employed
Firm’s name a Self-Prepared Phone no.
Use Only
Firm’s address a Firm’s EIN a
Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 08/20/20 Intuit.cg.cfp.sp Form 1040 (2019)
SCHEDULE EIC Earned Income Credit OMB No. 1545-0074
(Form 1040 or 1040-SR) 1040 `
Qualifying Child Information
2019
.........
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
Internal Revenue Service (99) a Go to www.irs.gov/ScheduleEIC for the latest information. Sequence No. 43
Name(s) shown on return Your social security number
• See the instructions for Form 1040 or 1040-SR, line 18a, 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.
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.
F
!
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 First name Last name First name Last name First name Last name
If you have more than three qualifying

children, you have to list only three to get
the maximum credit. Madison M Butler
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040 or
1040-SR, line 18a, unless the child was
born and died in 2019. If your child was
born and died in 2019 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. 899-24-8010
3 Child’s year of birth
Year 2 0 1 6 Year Year
If born after 2000 and the child is If born after 2000 and the child is If born after 2000 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.
4 a Was the child under age 24 at the end of

2019, 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 2019? 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
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 2019
• If the child lived with you for more than

half of 2019 but less than 7 months,
enter “7.”
• If the child was born or died in 2019 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 2019, enter “12.” months. months. months.
For Paperwork Reduction Act Notice, see your tax REV 08/20/20 Intuit.cg.cfp.sp Schedule EIC (Form 1040 or 1040-SR) 2019
BAA
return instructions.
SCHEDULE 8812 OMB No. 1545-0074
Additional Child Tax Credit . . 1040
.......
`
2019
(Form 1040 or 1040-SR) 1040-SR
.........
a
Attach to Form 1040, 1040-SR, or 1040-NR. 1040-NR
Department of the Treasury
a Go to www.irs.gov/Schedule8812 for instructions and the latest 8812 Attachment
Internal Revenue Service (99) information. Sequence No. 47
Name(s) shown on return Your social security number

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
and Credit for Other Dependents Worksheet in the publication. Otherwise:
1040 and Enter the amount from line 8 of your Child Tax Credit and Credit for Other Dependents
1040-SR filers: Worksheet (see the instructions for Forms 1040 and 1040-SR, line 13a).
1040-NR filers: Enter the amount from line 8 of your Child Tax Credit and Credit for Other Dependents
Worksheet (see the instructions for Form 1040-NR, line 49).
} 1 2,000.
2 Enter the amount from Form 1040, line 13a; Form 1040-SR, line 13a; or Form 1040-NR, line 49 . . . . . 2 488.
3 Subtract line 2 from line 1. If zero, stop here; you cannot claim this credit . . . . . . . . . . . . 3 1,512.
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
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 23,223.
b Nontaxable combat pay (see instructions) . . . . . . 6b
7 Is the amount on line 6a more than $2,500?
No. Leave line 7 blank and enter -0- on line 8.
Yes. Subtract $2,500 from the amount on line 6a. Enter the result . . . . . 7 20,723.
8 Multiply the amount on line 7 by 15% (0.15) and enter the result . . . . . . . . . . . . . . . 8 3,108.
Next. On line 4, is the amount $4,200 or more?
No. If line 8 is zero, stop here; you cannot claim this credit. Otherwise, skip Part II and enter the smaller
of line 5 or line 8 on line 15.
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.
Otherwise, go to line 9.
Part II Certain Filers Who Have Three or More Qualifying Children
9 Withheld social security, Medicare, and Additional Medicare taxes from
Form(s) W-2, 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
}
10 1040 and Enter the total of the amounts from Schedule 1 (Form 1040 or 1040-SR),
1040-SR filers: line 14, and Schedule 2 (Form 1040 or 1040-SR), line 5, plus any taxes
that you identified using code “UT” and entered on Schedule 2 (Form
1040 or 1040-SR), line 8. 10
1040-NR filers: Enter the total of the amounts from Form 1040-NR, lines 27 and
56, plus any taxes that you identified using code “UT” and
entered on line 60.
11 Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . 11
12 1040 and Enter the total of the amounts from Form 1040 or 1040-SR, line
1040-SR filers: 18a, and Schedule 3 (Form 1040 or 1040-SR), line 11.
1040-NR filers: Enter the amount from Form 1040-NR, line 67.
} 12
13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . 13
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 1,400.
Enter this amount on
Form 1040, line 18b;
Form 1040-SR, line 18b; or
. . 1040
.......
Form 1040-NR, line 64.
1040-SR
.........
1040-NR `
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 08/20/20 Intuit.cg.cfp.sp Schedule 8812 (Form 1040 or 1040-SR) 2019
Tax History Report 2019
G Keep for your records
Name(s) Shown on Return

Durril M Butler
Five Year Tax History:
2015 2016 2017 2018 2019
Filing status HH HH
Total income 14,228. 23,223.
Adjustments to income
Adjusted gross income 14,228. 23,223.
Tax expense 525. 843.
Interest expense
Contributions
Misc. deductions
Other itemized ded’ns
Total itemized/
standard deduction 18,000. 18,350.
Exemption amount 0. 0.
QBI deduction
Taxable income 0. 4,873.
Tax 488.
Alternative min tax
Total credits 0. 488.
Other taxes 0.
Payments 6,046. 6,154.
Form 2210 penalty
Amount owed
Applied to next
year’s estimated tax
Refund 6,046. 6,154.
Effective tax rate % -34.17 -18.32
**Tax bracket % 10.0 10.0
**Tax bracket % is based on Taxable income.

IMPORTANT DISCLOSURES
If you are owed a federal tax refund, you have a right to choose how you will receive the refund. There
are several options available to you. Some options cost money and some options are free. Please read
about these options below.
You can file your federal tax return electronically or by paper and obtain your federal tax refund directly
from the Internal Revenue Service ("IRS") for free. If you file your tax return electronically, you can
receive a refund check directly from the IRS through the U.S. Postal Service in 21 to 28 days
from the time you file your tax return or the IRS can deposit your refund directly into your
bank account in less than 21 days from the time you file your tax return unless there are
delays by the IRS. If you file a paper return through the U.S. Postal Service, you can receive
a refund check directly from the IRS through the U.S. Postal Service in 6 to 8 weeks from the
time the IRS receives your return or the IRS can deposit your refund directly into your bank
account in 6 to 8 weeks from the time the IRS receives your return. However, if your return
contains Earned Income Tax Credit or Additional Child Tax Credit, the IRS will issue your
refund no earlier than February 15, 2020.
You can file your tax return electronically, select the Refund Processing Service ("RPS") for an additional fee
of $40.00 (the "RPS fee"), and have your federal income tax refund processed through a processor using banking
services of a financial institution. The RPS allows your refund to be deposited into a bank account intended for
one-time use at Green Dot Bank ("Bank") and deducts your TurboTax fees and other fees you authorize from your
refund. The balance is delivered to you via the disbursement method you select. If you file your tax return
electronically and select the RPS, the IRS will deposit your refund with Bank. Upon Bank's receipt of your refund,
Santa Barbara Tax Products Group, LLC, a processor, will deduct and pay from your refund the RPS fee, any fees
charged by TurboTax for the preparation and filing of your tax return and any other amounts authorized by you and
disburse the balance of your refund proceeds to you. Unless there are delays by the IRS, refunds are received in
less than 21 days from the time you file your tax return electronically. However, if your return contains
Earned Income Tax Credit or Additional Child Tax Credit, the IRS will issue your refund no earlier than
February 15, 2020.
The RPS is not necessary to obtain your refund. If you have an existing bank account, you do not need to
use the RPS, which requires the payment of a fee, in order to receive a direct deposit from the IRS. You
may consult the IRS website (IRS.gov) for information about tax refund processing.
If you select the RPS, no prior debt you may owe to Bank will be deducted from your refund.
You can change your income tax withholdings which might result in you receiving additional funds
throughout the year rather than waiting to receive these funds potentially in an income tax refund next
year. Please consult your employer or tax advisor for additional details.
This Agreement requires all disputes to be resolved by way of binding arbitration.

The terms of the arbitration provision appear in Section 11.
Information regarding low-cost deposit accounts may be available at www.mymoney.gov .
The chart below shows the options for filing your tax return (e-file or paper return), the RPS product,
refund disbursement options, estimated timing for obtaining your tax refund proceeds, and costs
associated with the various options.
WHAT TYPE WHAT ARE YOUR WHAT IS THE WHAT COSTS DO YOU
OF FILING DISBURSEMENT ESTIMATED TIME TO INCUR IN ADDITION
METHOD? OPTIONS? RECEIVE REFUND? TO TAX PREPARATION
FEES?
PAPER RETURN IRS direct deposit to Approximately No additional cost.

your personal bank 6 to 8 weeks 2
No Refund Processing account.
Service
Check mailed by IRS Approximately
to address on tax 6 to 8 weeks 2
return.
ELECTRONIC IRS direct deposit to Usually within No additional cost.

FILING your personal bank 21 days 2
(E-FILE) account.
No Refund Processing Check mailed by IRS Approximately

Service to address on tax 21 to 28 days 2
return.
ELECTRONIC (a) Direct deposit to Usually within $ 40.00 3

(E-FILE) account, or
Refund Processing (b) Load to your

Service debit card 1.
1You may incur additional charges from the issuer of the debit card if you select to have your tax refund
loaded on a debit card.
2However, if your return contains Earned Income Tax Credit or Additional Child Tax Credit, the IRS will
issue your refund no earlier than February 15, 2020.
3Thisfee consists of an RPS Fee, a TurboTax fee and any fees for additional products and services purchased.
See Section 4 of the Refund Processing Service Agreement for more details.
Questions? Call 877-908-7228

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The purpose of this agreement is to confirm that you are eligible for this payment option. By
agreeing, you allow Intuit, the maker of TurboTax software, to verify that your refund is enough
to cover total fees and applicable sales tax and to evaluate your current and future eligibility for the
Refund Processing Service.
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"Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use
your tax return information for purposes other than the preparation and filing of your tax return without
your consent. If you consent to the disclosure of your tax return information, Federal law may not
protect your tax return information from further use or distribution.
You are not required to complete this form to engage our tax return preparation services. If we obtain
your signature on this form by conditioning our tax return preparation services on your consent, your
consent will not be valid. You specify that your consent is valid for three years from the date of this
signature."
If you believe your tax return information has been disclosed or used improperly in a manner
unauthorized by law or without your permission, you may contact the Treasury Inspector General for
Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.
To agree, enter your name(s) and date in the boxes below and select the "I Agree" button on the
bottom of the page.
I authorize Intuit, the maker of TurboTax, to use the information provided in this 2019 return to
determine whether a portion of the refund can be used to pay my fees and to evaluate my current
and future eligibility for the Refund Processing Service.
Durril Butler
First Name Last Name
Please type the date below:

01/28/2020
Date
sbia5009 3/11/2019
Read and accept this Disclosure Consent
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Green Dot Bank, Member FDIC (’BANK’) and to Santa Barbara Tax Products Group, LLC (’SBTPG’),
the administrator and servicer of this payment option: your identifying information, your deposit
information and your refund amount.
We transmit this information so that you may use this payment option. BANK and SBTPG will use
your information in accordance with their applicable refund processing service agreement and
privacy policy.
"Federal law requires this consent form be provided to you. Unless authorized by law, we cannot
disclose your tax return information to third parties for purposes other than the preparation and filing of
your tax return without your consent. If you consent to the disclosure of your tax return information,
Federal law may not protect your tax return information from further use or distribution.
consent will not be valid. If you agree to the disclosure of your tax return information, your consent is
valid for the amount of time that you specify. If you do not specify the duration of your consent, your
consent is valid for one year from the date of signature."
To agree, enter your name and date in the boxes below and select the "I Agree" button on the
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I authorize Intuit, the maker of TurboTax, to disclose to BANK and SBTPG that portion of my
2019 tax return information that is necessary to enable BANK and SBTPG to process
my refund.
Sign this agreement by entering your name:
Durril Butler

01/28/2020
Date
sbia1301.SCR 12/17/15
In order to finalize your request for this payment option, we need to send the following information to
Civista Bank of Sandusky, OH (’BANK’) and to Santa Barbara Tax Products Group, LLC (’SBTPG’),
the administrator and servicer of this payment option: your identifying information, your deposit
information and your refund amount.
We transmit this information so that you may use this payment option. BANK and SBTPG will use
your information in accordance with their applicable refund processing service agreement and
privacy policy.
bottom of the page.
I authorize Intuit, the maker of TurboTax, to disclose to BANK and SBTPG that portion of my
2019 tax return information that is necessary to enable BANK and SBTPG to process
my refund.
Date
sbia1301.SCR 12/17/15
FORM 1040 or FORM 1040-SR WORKSHEET 2019
NOTE: Form 1040, 1040-SR and Schedules 1 - 3 are fully calculated.
Use this worksheet to enter all data which will flow to the Form 1040 or Form 1040SR and Schedules 1- 3.
Use these QuickZooms to jump to the entry sections for Schedules 1- 3 on this Worksheet:
Form 1040 or Form 1040SR Worksheet Navigation QuickZooms
QuickZoom to Schedule 1 ' Additional Income and Adjustments to Income
QuickZoom to Schedule 2 ' Additional Taxes
QuickZoom to Schedule 3 ' Additional Credits and Payments
Form 1040 or Form 1040-SR - Personal Info, Filing Status, Dependent Info
For the year January 1 - December 31, 2019, or other tax year
beginning , 2019, ending , 20 .
Your First Name MI Last Name Your Social Security No.

If Joint Return, Spouse’s First Name MI Last Name Spouse’s Social Security No.
Home Address (No. and Street). If You Have a P.O. Box, See Instructions. Apt. No.
29445 Valley Bnd
City, Town or Post Office. If you have a foreign address, also complete below. State ZIP Code
Farmington Hills MI 48331-2470
Foreign country name Foreign province/state/county Foreign postal code
QuickZoom to explanation statement for overseas extension
Presidential Election Campaign
Checking a box below will not change your tax or refund.

Check here if you, or your spouse if filing jointly, want $3 to go to this fund You Spouse
Filing Status
Check only one box.
All entries for filing status and dependents should be made on the Federal Information Worksheet.
Single
Married filing jointly (even if only one had income)
Married filing separately. Enter spouse’s SSN above and full name here.
X Head of household (with qualifying person). (See instr.) If the qualifying person is a child but not
your dependent, enter this child’s name here.
Qualifying widow(er) (See instructions)
If more than four dependents, see instructions and check here
Dependents:
(1) First name Last name (2) (3) (4)
Dependent’s Dependent’s b if qualifies for (see instr):
social security relationship under age Credit for
number to you 17 qualify- other
ing for child dependents
tax credit
Madison M Butler 899-24-8010 Daughter X
QuickZoom to the Federal Information Worksheet

QuickZoom to the Dependent and Nondependent Information Worksheet
Durril M Butler 377-21-3791 Page 2
Someone can claim you as a dependent

Someone can claim your spouse as a dependent
a Check if: You were born before January 2, 1955, Blind.

Spouse was born before January 2, 1955, Blind.
Total boxes checked a
b If your spouse itemizes on a separate return or you were a
dual-status alien, check here b
Form 1040 or Form 1040-SR, Lines 1 - 6
1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 23,223.

2a Tax-exempt interest 2a
b Taxable interest 2b
3a Qualified dividends (see instructions) 3a
b Ordinary dividends. Attach Schedule B if required 3b
4 IRA distributions 4a
Taxable amount (see instructions) 4b
Pensions and annuities 4c
Taxable amount (see instructions) 4d
5 a Social security benefits 5a
b Taxable amount (see instructions) 5b
6 Capital gain or (loss). Attach Schedule D if required.
If not required, check here 6
QuickZoom to Schedule 1 ' Additional Income and Adjustments to Income
Form 1040 or Form 1040-SR, Lines 7 and 8
7a Other income from Schedule 1, line 9 7a 0.

b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6 and 7a. This is your total income. 7b 23,223.
8a Adjustments to income from Schedule 1, line 22 8a
b Subtract line 8a from line 7b. This is your adjusted gross income. 8b 23,223.
AGI including excludable Puerto Rico Income 23,223.
Form 1040 or Form 1040-SR, Line 9 ' Standard or Itemized Deduction
9 Standard deduction or itemized deductions (from Schedule A)

Standard Deduction for '
@ People who checked blind or over 65 or who can be claimed
as a dependent, see instructions.
@ All others:
? Single or Married filing separately: $12,200
? Married filing jointly or Qualifying widow(er): $24,400
? Head of household: $18,350
QuickZoom to the Standard Deduction Worksheet
Itemized deductions (from Schedule A) or your standard
deduction, see above 9 18,350.
Subtract itemized or standard deduction from adjusted gross income amount 4,873.
10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10

11 a Add lines 9 and 10 11a 18,350.
b Taxable Income. Subtract line 11a from line 8b 11b 4,873.
12 a Tax. (see instructions). Check if any from:

1 Form(s) 8814
2 Form 4972
3
488.
b Add Schedule 2, line 3 and line 12a and enter total 12b 488.
QuickZoom to Schedule 2 - Additional Tax section
Form 1040 or Form 1040-SR, Line 13 - 16
13 a Child tax credit/credit for other dependents 13a 488.

b Add Schedule 3, line 7 and line 13a and enter the total 13b 488.
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 1,899.
18 Other payments and refundable credits:
a Earned income credit (EIC) 2,855.
Nontaxable combat pay election
b Add’l child tax credit. Attach Schedule 8812 1,400.
c American opportunity credit from Form 8863, line 8
d Schedule 3, line 14
e Add lines 18a through 18d.
These are your other payments and refundable credits 18e 4,255.
19 Add Lines 17 and 18e.
These are your total payments 19 6,154.
QuickZoom to Schedule EIC Worksheet, pg. 2 if credit is not calculated
QuickZoom to "due diligence checklist" substitute for Form 8867
Refund:
20 If total Payments is more than total tax, subtract total tax from payments
This is the amount you overpaid 20 6,154.
21 a Amount of overpayment you want refunded to you.
If Form 8888 is attached, check here 21 6,154.
b Routing number 072000096
c Type:
X Checking
Savings
d Account number 6827014363
22 Amount of overpayment on line 20 you want applied to
your 2020 estimated tax
Form 1040 or Form 1040SR, Lines 23 - 24
Amount You Owe:

23 Subtract line total payments from total tax 23
24 Estimated tax penalty (see instructions) 24
QuickZoom to Late Penalties and Interest Worksheet QuickZoom

Schedule 1 - Additional Income and Adjustments
At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest
in any virtual currency? (Entry is required when Schedule 1 is part of the return) Yes X No
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes (see instr.) 1 0.
Alimony Received Smart Worksheet
Taxpayer Spouse Date of divorce/sep *

A
B
* Check the box if the pre-2019 decree was modified after 2018 to treat the payments as nontaxable
2a Alimony received Taxpayer Spouse 2a

b Date of original divorce or separation agreement
3 Business income or (loss). Attach Schedule C 3
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 6
7 Unemployment compensation (see instr.) 7
8 Other income. List type and amount (see instructions).
8
9 Combine lines 1 through 8.
Enter here and include on Form 1040 or 1040SR, line 7a 9 0.
Total Income. Combine Form 1040 lines 1- 6 and Schedule 1, line 9 , enter
on Form 1040, line 7b 23,223.
Quickzoom to 1040 Worksheet, line 7b ' Total Income QuickZoom
Part II Adjustments to Income
10 Educator expenses 10
11 Certain business expenses of reservists, performing artists, and fee-basis
government officials. Attach Form 2106 11
12 Health savings account deduction. Attach Form 8889 12
13 Moving expenses. Attach Form 3903 13
14 Deductible part of self-employment tax. Attach Schedule SE 14
15 Self-employed SEP, SIMPLE, and qualified plans 15
16 Self-employed health insurance deduction 16
17 Penalty on early withdrawal of savings 17
Alimony Paid Smart Worksheet
Recipient’s name Recipient’s SSN Date of divorce/sep * Alimony paid

A
B
* Check the box if the pre-2019 decree was modified after 2018 to treat the payments as nondeductible
18 a Alimony paid 18 a
b Recipient’s SSN
c Date of original divorce or separation agreement
19 IRA deduction 19
20 Student loan interest deduction 20
21 Tuition and fees. Attach Form 8917 21
22 Add lines 10 through 21
These are your adjustments to income. Enter on Form 1040 or 1040-SR, line 8a 22
Schedule 2 - Additional Taxes
Part I Tax
1 Alternative minimum tax (see instructions). Attach Form 6251 1

2 Excess advance premium tax credit repayment. Attach Form 8962 2
3 Add lines 1 and 2.
Enter here and include on Form 1040 or Form 1040SR, line 12b 3
Part II Other Taxes
4 Self-employment tax.
Attach Schedule SE 4
5 Unreported social security and Medicare tax from Form:
a 4137 b 8919
Explain underreported tips 5
6 Additional tax on IRAs, other qualified retirement plans, etc.
Attach Form 5329 if required 6
7a Household employment taxes from Schedule H 7a
b First-time homebuyer credit repayment. Attach Form 5405 if required b
8 Taxes from:
a Form 8959
b Form 8960
c Instructions; enter code(s)
8
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 15 10 0.
Total tax (add line 10 and Schedule 3, line 7b) 0.
Schedule 3 - Additional Credits and Payments
Part I Nonrefundable Credits
1 Foreign tax credit. Attach Form 1116 if required 1
2 Credit for child and dependent care expenses. Attach Form 2441 2
3 Education credits from Form 8863, line 19 3
4 Retirement savings contributions credit. Attach Form 8880 4
5 Residential Energy Credit. Attach Form 5695 5
6 Other credits from Form:
a 3800
b 8801
c 6
7 Add lines 1 through 6 plus child tax credit/credit for other dependents line 13a
Enter here and include on Form 1040 or 1040-SR, line 13b 7 488.
a Total non-refundable credits
b Subtract total credits on line 7 from tax on line 12b above 0.
Quickzoom to 1040 Worksheet, line 16 ' Total Tax QuickZoom
Part II Other Payments and Refundable Credits
8 2019 estimated tax payments
and amount applied from 2018 return 8
9 Net premium tax credit. Attach Form 8962 9
10 Amount paid with request for extension to file 10
11 Excess social security and tier 1 RRTA tax withheld 11
12 Credit for federal tax on fuels. Attach Form 4136 12
13 Credits from Form:
a 2439
b Reserved
c 8885
d 13
14 Total Payments (Part II, lines 8-13) and Withholding (Form 1040, line 17) 14 6,154.
Other Payments and Refundable Credits (Form 1040, line 18e) 4,255.
Third Party Designee
Do you want to allow another person to discuss this return

with the IRS (see instructions)? Yes. Complete the following. X No
Designee’s Name
Phone No. Personal Identification Number (PIN)
Signature and Paid Preparer

Sign Here
Joint return? See instructions.
Keep a copy of this return for your records.
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 year. Declaration of preparer (other than taxpayer)
is based on all information of which preparer has any knowledge.
If the IRS sent you
an Identity Protection
Your Signature Date Your Occupation PIN, enter it here
Warehouse Assistant G
Spouse’s Signature. If joint, both must sign. Date Spouse’s Occupation
G
Daytime Phone No.
(248)787-1355
Paid Preparer’s Use Only
Print/Type Preparer’s name Preparer’s PTIN Check if:
3rd Party Designee
Preparer’s Signature Date Self-employed
Firm’s Adress (or yours if self-employed) Firm’s EIN. Phone No.
Self-Prepared
State ZIP Code
Filing Address Information

Send Form 1040 to: You have chosen to electronically file this return.
Form 8960 Form 8960 Worksheet 2019
Lines 4b, 5b, 7, 9, 10
Name(s) Shown on Return Your SSN

Line 4b - Adjustment for trade or business income or loss
(a) Activity name (b) Gain or

loss
Enter additional adjustments not included above:
Adjustment for trade or business income not subject to net investment tax
Line 5b - Adjustment for gain or loss on dispositions
(a) Activity name (b) Gain or

loss
Capital loss carryover adjustment from 2018 for net investment tax purposes
Enter additional adjustments not included above and check the box if a capital gain or loss:
Net gain or loss from disposition of property not subject to net investment tax
Capital gain/loss not included in net investment income
(a) Activity name (b) Capital

Gain or Loss
Capital gain or loss from sale of property not subject to net investment income tax
Calculation of line 5b adjustment due to capital loss carryforward
1 Net capital loss not included in net investment income 1 0.

2 Capital loss carryover to next year 2
3 Lesser of line 1 or line 2 (Included as an adjustment on line 5b table above) 3 0.
Line 7 - Other modifications to investment income
1 Casualty and theft losses reported on Schedule A, line 15 1

2 Amounts reported on Form 8814, line 12 2
3 Adjustment for distributions from estates and trusts 3
4 Schedules C and F income/loss included in net investment income 4
5 Substitute interest and dividend payments 5
6 Recovery of a prior year deduction 6
7 7
8 Total other modifications to investment income 8

Line 9b - State, local, and foreign income taxes allocable to net investment income
1 State and local income taxes 1

2 Investment income 2
3 Total adjusted gross income 3
4 Divide line 2 by line 3. Enter result as a decimal amount 4
5 State and local income taxes allocable to investment income 5
6 State and local taxes (Schedule A, line 5e) 6
7 Lesser of line 5 or line 6 7
8 Foreign income taxes 8
9 Foreign income taxes allocable to investment income. Line 8 times line 4. 9
10 Add lines 7 and 9. State, local and foreign income taxes allocable to
investment income 10
Lines 9 and 10 - Application of Itemized Deduction Limitations Worksheet
Part III - Application of Section 68 to Deductions Properly Allocable to Investment Income
1 Reserved 1
2 Enter the amount of state, local, and foreign income taxes that are properly
allocable to investment income 2
3 Enter the amount of other Itemized Deductions subject to the section 68
limitation and properly allocable to investment income before any itemized
deduction limitation:
3
4 Enter the total deductions properly allocable to investment income subject to
the section 68 limitation. Enter the sum of lines 1 through 3 4
5 Enter the amount of total itemized deductions allowed after the section 68
limitation. Form 1040, line 8 5
6 Enter all other itemized deductions allowed but not subject to the section 68
deduction limitation: 6
7 Subtract line 6 from line 5 7
8 Enter the lesser of line 7 or line 4 8
Part IV - Reconciliation of Schedule A Deductions to Form 8960 plus additional expenses, lines 9 and 10
(A) (B) (C)
Reenter the amounts and descriptions from Part III, lines 1-3 Fraction Column A
(see Help) times B
Miscellaneous Itemized Deductions properly allocable to Investment
Income reportable on Form 8960, line 9c:
1 Reserved
2 State, local, and foreign income taxes x =
Itemized Deductions Subject to Section 68 reportable on Form 8960, line 10:

3 x =
x =
x =
x =
Penalty on early withdrawal of savings
Other modifications:
Total additional modifications to Form 8960, line 10
Calculation of Former Passive Activity Suspended Losses Allowed as Deduction Against NII
1) Former Passive Activity Suspended Losses
(a) Activity name (b) Suspended (c) Suspended (d) Used against (e) Used against
12/31/2018 12/31/2019 activity other passive
2) Former Passive Activity Suspended Losses - Schedule D
3) Former Passive Activity Suspended Losses - Form 4797
Federal Information Worksheet 2019
Part I ' Personal Information
Information in Part I is completely calculated from entries on Personal Information Worksheets.
Taxpayer: Spouse:
First name Durril First name
Middle initial M Suffix Middle initial Suffix
Last name Butler Last name
Social security no. 377-21-3791 Social security no.
Occupation Warehouse Assistant Occupation
Date of birth 09/30/1993 (mm/dd/yyyy) Date of birth (mm/dd/yyyy)
Age as of 1-1-2020 26 Age as of 1-1-2020
Daytime phone (248)787-1355 Ext Daytime phone Ext
Legally blind Legally blind
Date of death Date of death
Dependent of Someone Else: Dependent of Someone Else:
Can taxpayer be claimed as dependent of another Can spouse be claimed as dependent of another
person (such as parent)? Yes X No person (such as parent)? Yes No
If yes, was taxpayer claimed as dependent on that If yes, was spouse claimed as dependent on that
person’s return? Yes X No person’s return? Yes No
Credit for the Elderly or Disabled (Schedule R): Credit for the Elderly or Disabled (Schedule R):
Is the taxpayer retired on total Is the spouse retired on total
and permanent disability? Yes No and permanent disability? Yes No
Presidential Election Campaign Fund: Presidential Election Campaign Fund:
Does the taxpayer want $3 to go to the Presidential Does the spouse want $3 to go to the Presidential
Election Campaign Fund? Yes X No Election Campaign Fund? Yes No
Part II ' Address and Federal Filing Status (enter information in this section)
US Address:
Address 29445 Valley Bnd Apt no.
City Farmington Hills State MI ZIP code 48331-2470
Foreign Address: Check this box to use foreign address
Address Apt no.
City
Foreign code Foreign country
Foreign province/county Foreign postal code
APO/FPO/DPO address, check if appropriate APO FPO DPO
Home phone
Check to print phone number on Form 1040 Home X Taxpayer daytime Spouse daytime
Print Form 1040-SR instead of Form 1040 Yes X No
Federal filing status:
1 Single
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/blind/over age 65 (see Help)
X 4 Head of household
If the ’qualifying person’ is your child but not your dependent:
Child’s First name MI Last Name Suff
Child’s social security number
5 Qualifying widow(er)
Check the appropriate box for the year your spouse died 2017 2018
Are you a dependent with a qualifying child Yes No
Enter qualifying person’s name:
Child’s First name MI Last Name Suff
Child’s social security number
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 Date of death Not
(mm/dd/yyyy) (mm/dd/yyyy) qual
credit
Qualified other
Not child/dep Lived dep
C qual care exps with Educ *
Social security o for incurred E taxpyr Tuitn D
First name MI number d child and paid I in and e
Last name Suff Relationship Age e tax cr 2019 C U.S. Fees p
Madison M 899-24-8010 11/21/2016
Butler Daughter 3 L E 12 Yes
* "Yes" - qualifies as dependent, "No" - does not qualify as dependent

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? Yes X No
Was the taxpayer’s (and spouse’s if married filing jointly) home in the United States
for more than half of 2019? X Yes No
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 2019
Check if you were notified by the IRS that EIC cannot be claimed in 2019 or
if you are ineligible to claim the EIC in 2019 for any other reason
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 Yes No
Do you want to elect direct debit of federal balance due (Electronic filing only)? Yes No
If you selected either of the options above, fill out the information below:
Name of Financial Institution (optional) Comerica
Check the appropriate box Checking X Savings
Routing number 072000096 Account number 6827014363
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
Amended Returns:
Do you want to elect direct debit of federal amended balance due (e-File only)? Yes No
Enter the payment date to withdraw from the account above
Balance-due amount from this amended 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
Real Estate Professionals:

Do you or your spouse qualify for the special passive activity rules for
taxpayers in real property business? (see Help) Yes No
Credit for Qualified Retirement Savings Contributions (Form 8880):

Is the taxpayer a full-time student? Yes No
Is the spouse a full-time student? Yes No
American Opportunity and Lifetime Learning Credit (Form 8863)

For 2019, were you (or your spouse if married) a nonresident alien for any part
of the year, and did not elect to be treated as a resident alien? Yes No
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
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
Check this box to print ’DUAL-STATUS STATEMENT’ on Form 1040
Third Party Designee:

Caution: Review transferred information for accuracy.
Do you want to allow another person to discuss this return with the IRS? Yes No
If Yes, complete the following:
Third party designee name
Third party designee phone number
Personal Identification number (enter any 5 numbers)
Part VI ' Additional Information for Your Federal Return - Continued
Personal Representative for deceased taxpayers:

Name of personal representative required for E-filed
returns when Form 1310 is not filed or it is not the
surviving spouse
Part VII ' State Filing Information
Identity Protection PIN:

If the IRS sent the taxpayer an Identity Protection PIN, enter it here
If the IRS sent the spouse an Identity Protection PIN, enter it here
Taxpayer:
Enter the taxpayer’s state of residence as of December 31, 2019 MI
Check the appropriate box:
Taxpayer is a resident of the state above for the entire year X
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?
Spouse:
Enter the spouse’s state of residence as of December 31, 2019
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 or a civil union
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)
Use the PIN that you signed last year’s tax return with.
Taxpayer’s Prior year PIN
Spouse’s Prior year PIN
These signature PINs are chosen by the taxpayer and spouse and used for e-filing your tax return
Taxpayer’s PIN used to sign the return 29445
Spouse’s PIN used to sign the return
Taxpayer:
Drivers license or state ID number B346155585754
Issued by what state MI
License or ID license X ID neither decline
Spouse
Drivers license or state ID number
Issued by what state
License or ID license ID neither decline
Personal Information Worksheet 2019
For the Taxpayer
QuickZoom to another copy of Personal Information Worksheet

QuickZoom to Federal Information Worksheet
Part I ' Taxpayer's Personal Information
First name Durril Middle initial Last name

M Butler
Suffix
Social security no. 377-21-3791 Member of U.S. Armed Forces in 2019? Yes X No
Date of birth 09/30/1993 (mm/dd/yyyy) age as of 1-1-2020 26
Occupation Warehouse Assistant Daytime phone (248)787-1355 Ext
Marital status Single

If widowed, check the appropriate box for the year your spouse died:
After 2019 2019 2018 2017 Before 2017
Are you retired on total and permanent disability? (for Schedule R, see Help). Yes No
Check if this person is legally blind Yes X No
If deceased, enter the date of death (mm/dd/yyyy)
Were you under the age of 16 as of 1-1-2020 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 X 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? Yes X No

2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return? Yes X No
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 2019? Yes No
4 Did your earned income exceed one-half of your support? Yes No
5 Was at least one of your parents alive on December 31, 2019? Yes No
Part III ' Taxpayer's State Residency Information
Enter this person’s state of residence as of December 31, 2019 MI

This person is a resident of the state above for the entire year X
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 2019
Unreimbursed medical expenses paid for qualifying person in 2019
Employment taxes paid for dependent care providers in 2019
Full-time student for 5 calendar months during 2019? Yes No
Disabled person who was not physically or mentally capable of self-care? Yes No
This person is a qualifying person for the child and dependent care credit Yes X No
Dependent and Nondependent Information Worksheet 2019
QuickZoom to another copy of Dependent and Nondependent Information Worksheet

QuickZoom to Federal Information Worksheet
First name Madison Middle initial M Last name Butler

Suffix
Social security no. 899-24-8010
Date of birth 11/21/2016 (mm/dd/yyyy) age as of 12-31-2019 3

Did this person pass away in 2019 (deceased)? Yes No Date of death
Relationship to taxpayer or spouse Daughter

CAUTION: If claiming a child other than your own, see Relationship in the Tax Help.
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 No
Dependency code * L 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
Check this box if:

- The taxpayer filing this return is filing as Qualifying Widow(er)
- This dependency code for this dependent is type X
- This dependent would qualify as a qualifying child for the Qualifying Widow(er) filing status,
except the dependent’s gross income was $4,200 or more, or was filing a married filing joint
return, or the taxpayer could be claimed as a dependent
Part II ' Earned Income Credit and Child Tax Credit
Is this person a U.S. citizen, U.S. national, or a U.S. resident? X Yes No

Is this person a resident of Canada or Mexico? Yes X No
This person is adopted and you are a U.S. citizen or U.S. national
TurboTax Web Only:
Was the adoption final as of December 31, 2019? Yes No
Was the person placed with you for adoption after 2019, or was the adoption
final in 2019 or later? Yes No
The adopted child lived with you all year Yes No
*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.
Child is a potentially qualifying child for earned income credit X Yes No

Child is a nondependent, but may qualify for earned income credit Yes No
You, and no one else, is claiming this nondependent for the earned income credit Yes No
Months lived with taxpayer in the United States 12
Qualifying for the earned income credit * E Qualifying child
*EIC code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Check if Social Security number is not valid for employment
Check if this person is not a qualifying child for the child tax credit
Check if this person is not a qualifying person for the credit for other dependents
Dependent has ITIN

Dependent name Madison M Butler Page 2
Part III ' Dependent Care Expenses
Qualified child or dependent care expenses incurred and paid in 2019

Unreimbursed medical expenses paid for qualifying person in 2019
Employment taxes paid for dependent care providers in 2019
Child or dependent is a qualifying person for the child and dependent care credit X Yes No
Child is a nondependent, but may qualify for the child and dependent care credit Yes No
Part V ' Dependent’s State Residency Information
Enter this person’s state of residence as of December 31, 2019

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 VI ' Identity Protection Pin
If the IRS sent an Identity Protection PIN for this dependent, enter it here
Form 1040 Forms W-2 & W-2G Summary 2019
Name(s) Shown on Return Social Security Number

Form W-2 Summary
Box No. Description Taxpayer Spouse Total
1 Total wages, tips and compensation:

Non-statutory & statutory wages not on Sch C 23,223. 23,223.
Statutory wages reported on Schedule C
Foreign wages included in total wages
Unreported tips 0. 0.
2 Total federal tax withheld 1,899. 1,899.
3 & 7 Total social security wages/tips 23,223. 23,223.
4 Total social security tax withheld 1,440. 1,440.
5 Total Medicare wages and tips 23,223. 23,223.
6 Total Medicare tax withheld 337. 337.
8 Total allocated tips
9 Not used
10 a Total dependent care benefits
b Offsite dependent care benefits
c Onsite dependent care benefits
11 Total distributions from nonqualified plans
12 a Total from Box 12
b Elective deferrals to qualified plans
c Roth contrib. to 401(k), 403(b), 457(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 QSEHRA benefits
n 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 Compensation
e Total RR Tier 1 tax
f Total RR Tier 2 tax
g Total RR Medicare tax
h Total RR Additional Medicare tax
i Total RRTA tips
j Total other items from box 14
16 Total state wages and tips 23,223. 23,223.
17 Total state tax withheld 843. 843.
19 Total local tax withheld
Form W-2 Wage and Tax Statement 2019
Name Social Security Number

Spouse’s W-2 Military: Complete Part VI on Page 2 below.

Do not transfer this W-2 to next year
a Employee’s social security no. 377-21-3791 1 Wages, tips, other 2 Federal income
b Employer ID number (EIN) 75-3086852 compensation tax withheld
c Employer’s name, address, and ZIP code 23,222.88 1,899.05
EZ-GROOM INC 3 Social security wages 4 Social security tax withheld
23,222.88 1,439.82
Street 10411 CAPITAL 5 Medicare wages and tips 6 Medicare tax withheld
City OAK PARK 23,222.88 336.73
State MI ZIP Code 48237 7 Social security tips 8 Allocated tips
Foreign Province A Enter unreported tips in Part VII on Page 2 below.

Foreign Postal Code
Foreign Country
9 10 Dependent care benefits
d Control number 00500050H312
11 Nonqualified plans Distributions from sect. 457
X Transfer employee information from and nonqualified plans
the Federal Information Worksheet (Important, see Help)
e Employee’s name 12 Enter box 12 below
First Durril M.I. M
Last Butler Suff. 13 Statutory employee
f Employee’s address and ZIP code Retirement plan
Street 29445 Valley Bnd Third-party sick pay
City Farmington Hills
State MI ZIP Code 48331-2470 14 Enter box 14 below after entering boxes 18, 19, and 20.
Foreign Province NOTE: Enter box 15 before entering box 14.
Foreign Postal Code
Foreign Country
Box 12 Box 12 If Box 12 code is:

Code Amount 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 Box 15 Box 16 Box 17

State Employer’s state I.D. number State wages, tips, etc. State income tax
MI 753086852 23,222.88 843.11
I confirm that the state withholding identification number(s) are accurate X
Box 20 Box 18 Box 19 Associated

Locality name Local wages, tips, etc. Local income tax State
Box 14 TurboTax Identification of Description or Code

Description or Code Amount (Identify this item by selecting the identification from
on Actual Form W-2 the drop down list. If not on the list, select "Other".)
Wages, Salaries, & Tips Worksheet 2019

The following amounts are included in the total entered on line 1 of Form 1040 or on line 8 of Form 1040NR:
Taxpayer Spouse Total
1 Wages, from Form W-2 23,223. 23,223.

2 Miscellaneous income, from Form 8919
3 Items from Form 1099-R:
a Disability before minimum retirement age
b Return of contributions
4 Excess reimbursement, from Form 2106
5a Taxable tips, from Form 4137
b Noncash tips
6 Excess moving expense reimbursement,
from Form 3903
7 Wages earned as a household employee (if
less than $2,100 and without a Form W-2)
8 Items not on Form W-2 or Form 1099-R:
a Sick pay or disability payments
b Total foreign source income
c Check this box if the amount on line 8b is
eligible for the foreign exclusion/deduction
d Ordinary income from employer stock
transactions not reported on Form W-2
9 Other earned income:
a Non-gov unemployment received/repaid 2019
b
10 Subtotal.
Add lines 1 through 9 23,223. 23,223.
11 Taxable employer-provided dependent care
benefits, from Form 2441
12 Taxable employer-provided adoption benefits
less any excluded benefits from Form 8839
13 Scholarship/fellowship income not on
Form W-2
14 Other non-earned income:
15 Total of lines 10 through 14 23,223. 23,223.

Form 1040 or Child Tax Credit and 2019
Form 1040-SR Credit for Other Dependents Worksheet
Line 12a G Keep for your records
Name as Shown on Return Social Security No.
Note: ? To be a qualifying child for the child tax credit, the child must be under age 17 at the end of 2019
and meet the other requirements listed in the instructions for Form 1040.
? 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 Number of qualifying children under age 17 with the
required social security number: 1 X $2,000.
Enter the result 1 2,000.
2 Number of other dependents, including qualifying
children without the required social security
number: 0 X $500. Enter the result 2
3 Add lines 1 and 2 3 2,000.
4 Enter the amount from Form 1040 or 1040-SR, line 8b 4 23,223.
5 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, 5 0.
line 15.
1040NR filers: Enter -0-.
6 Add lines 4 and 5. Enter the total 6 23,223.
7 Enter the amount shown below for your filing status.
? Married filing jointly ' $400,000
? All other filing statuses ' $200,000 7 200,000.
8 Is the amount on line 6 more than the amount on
line 7?
X No. Leave line 8 blank. Enter -0- on line 9.
Yes. Subtract line 7 from line 6 8
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.
9 Multiply the amount on line 8 by 5% (.05). Enter the result 9 0.
10 Is the amount on line 3 more than the amount on line 9?
No. Stop.
You cannot take the child tax credit or credit for other dependents on
Form 1040 or 1040-SR, line 13a. You also cannot take the additional child
tax credit on Form 1040 or 1040-SR, line 18b, or Form 1040-NR, line 64.
X Yes. Subtract line 9 from line 3. Enter the result. Go to Part 2 10 2,000.
Part 2
11 Enter the amount from Form 1040 or 1040-SR, line 12b 11 488.
12 Add the amounts from '
Schedule 3, line 1
Schedule 3, line 2 +
Form 5695, line 30 +
Schedule R, line 22 +
Enter the total 12 0.
13 Subtract line 12 from line 11 13 488.
14 Are you claiming any of the following credits?
? Mortgage interest credit, Form 8396
? Adoption Credit, Form 8839
? Residential energy efficient property credit, Form 5695, Part I
? District of Columbia first-time homebuyer credit, Form 8859
X No. Enter -0-
Yes. If you are filing Form 2555, enter -0-. 14 0.
Otherwise, Complete the Line 14 Worksheet below to
figure the amount to enter here.
15 Subtract line 14 from line 13. Enter the result 15 488.
16 Is the amount on line 10 of this worksheet more than the amount on line 15?
No. Enter the amount from line 10
X Yes. Enter the amount from line 15. This is your child
See the TIP below. tax credit and credit for 16 488.
other dependents
Enter this amount on
Form 1040, line 13a
Form 1040-SR, line 13a
Form 1040NR, line 49
TIP: You may be able to take the additional child tax credit on Form 1040 or 1040-SR, line 18b,
only if you answered ’Yes’ on line 16 and line 1 is more than zero.
? First, complete your Form 1040 or 1040-SR through line 18a (also complete Schedule 3, line 11)
? Then, use Schedule 8812 to figure any additional child tax credit.
Schedule D Unrecaptured Section 1250 Gain Worksheet 2019
Line 19 G Keep for your records

Regular Alternative
Tax Minimum Tax
If you are not reporting a gain on Form 4797, line 7, skip lines 1
through 9 and go to line 10.
1 If you have a section 1250 property in Part III of Form 4797 for
which you made an entry in Part I of Form 4797 (but not Form
6252), enter the smaller of line 22 or line 24 of Form 4797 for that
property. If you did not have any such property, go to line 4. 1
2 Enter the amount from Form 4797, line 26g, for the property for
which you made an entry on line 1 2
4 Enter the total unrecaptured section 1250 gain included on lines
26 or 37 of Form(s) 6252 from installment sales of trade or
business property held more than one year 4
5 Enter the total of any amounts reported on a Schedule K-1 from a
partnership or an S corporation as "unrecaptured section 1250
gain". 5
6 Add lines 3 through 5 6
7 Enter the smaller of line 6 or the gain from Form
4797, line 7 7
8 Enter the amount, if any, from Form 4797, line 8 8
9 Subtract line 8 from line 7. If zero or less, enter -0- 9
10 Enter the amount of any gain from sale of an interest in a
partnership attributable to unrecaptured section 1250 gain 10
11 Enter the total of any amounts reported to you as "unrecaptured
section 1250 gain" from an estate, trust, real estate investment
trust or mutual fund
Regular AMT
a On Form 1099-DIV
b On Form 2439
c On Schedule(s) K-1
d On Form 1099-R
e From Form 8814
f Other
Total 11
12 Enter the total of any unrecaptured section 1250 gain from sales
(including installment sales) or other dispositions of section 1250
property held more than 1 year for which you did not make
an entry in Part I of Form 4797 for the year of sale 12
13 Add lines 9 through 12 13
14 If you had any section 1202 gain or collectibles gain or (loss),
enter the total of lines 1 thru 4 of the 28% Rate Gain Worksheet.
Otherwise, enter -0- 14 0. 0.
15 Enter the (loss), if any, from Schedule D, line 7. If Schedule D, line
7, is zero or a gain, enter -0- 15 0. 0.
16 Enter your long-term capital loss carryovers from Schedule D, line
14, and Schedule K-1 (Form 1041), line 11, code C 16
a Enter your capital gain excess, if you are filing Form 2555 a 0.
17 Combine lines 14 through 16a. If the result is a (loss), enter it as a
positive amount. If the result is zero or a gain, enter -0- 17 0. 0.
18 Unrecaptured section 1250 gain. Subtract line 17 from line 13. If
zero or less, enter -0-. If more than zero, enter the result here and
on Schedule D, line 19 18
Schedule D 28% Rate Gain Worksheet 2019

Regular Alternative
Tax Minimum Tax
1 Enter the total of all collectibles gain or (loss) from items you
reported on Form 8949, Part II 1
2 Enter as a positive number the amount of any section 1202
exclusion you reported in column (g) of Form 8949, Part II, with
code "Q" in column (f), that is 50% of the gain, plus 2/3 of any
section 1202 exclusion you reported in column (g) of Form
8949, Part II, with code "Q" in column (f), that is 60% of the
gain, plus 1/3 of any section 1202 exclusion you reported in
column (g) of Form 8949, Part II, with code "Q" in column (f),
that is 75% of the gain.
50 % 60 % 75%
Exclusion Exclusion Exclusion
a Schedule D
b Form 8814
c Schedule B
d Form 6252
e Form 2439
f Other
Total 2
3 Enter the total of all collectibles gain or (loss) from:
Regular AMT
a Form 4684, line 4 (but only
if line 15 is more than zero)
b Form 6252
c Form 6781, Part II
d Form 8824
Total 3
4 Enter the total of any collectibles gain reported to you on:
Regular AMT
a Form 1099-DIV, box 2d
b Form 2439, box 1d
c Schedule K-1 from a
partnership, S corporation,
estate, or trust
d Disposition of interest in
partnership or S corporation
e Other
Total 4
5 Enter your long-term capital loss carryovers from Schedule D,
line 14, and Schedule K-1 (Form 1041), line 11, code C 5
6 If Schedule D, line 7, is a (loss), enter that (loss) here.
Otherwise, enter -0-. 6
7 Combine lines 1 through 6. If zero or less, enter -0-. If more
than zero, also enter this amount on Schedule D, line 18 7
8 Enter the amount of any capital gain excess 8 0.
9 Subtract line 8 from line 7. If zero or less, enter -0-.
Enter this amount on Schedule D Tax Worksheet, line 11a 9 0. 0.
Form 1040 Schedule D Tax Worksheet 2019

1 a Enter your taxable income from Form 1040, line 11b 1a 4,873.
b Enter the amount from your (and your spouse’s) Form 2555, lines 45 and 50 b
c Add lines 1a and 1b 1c 4,873.
2 a Enter your qualified dividends
from Form 1040, line 3a 2a
b Enter any capital gain excess
attributable to qualified dividends b
c Subtract line 2b from line 2a 2c
3 Amount from Form 4952, line 4g 3
4 a Amount from Form 4952, line 4e 4 a
b Amount from the dotted line
next to Form 4952, line 4e b
c Line 4b, if applicable, 4a, if not c
5 Subtract line 4c from line 3. 5 0.
6 Subtract line 5 from line 2c. If zero or less, enter -0- 6 0.
7 a Enter line 15 of Schedule D 7a
b Enter line 16 of Schedule D b
c Enter the smaller of line 7a or line 7b 7c 0.
8 Enter the smaller of line 3 or line 4c 8
9 a Subtract line 8 from line 7. 9a 0.
b Enter any capital gain excess attributable to
capital gains b
c Subtract line 9b from line 9a 9c 0.
10 Add lines 6 and 9c 10 0.
11 a Enter the amount from Schedule D, line 18 11 a 0.
b Enter the amount from Schedule D, line 19 b
c Add lines 11a and 11b 11 c 0.
12 Enter the smaller of line 9c or line 11c 12 0.
13 Subtract line 12 from line 10 13 0.
14 Subtract line 13 from line 1c. If zero or less, enter -0- 14 4,873.
15 Enter:
? $39,375 if single or married filing separately,
? $78,750 if married filing jointly or qualifying widow(er), or 15 52,750.
? $52,750 if head of household.
16 Enter the smaller of line 1c or line 15 16 4,873.
17 Enter the smaller of line 14 or line 16 17 4,873.
18 Subtr ln 10 from ln 1c. If zero or less, enter -0- 18 4,873.
19 Enter the smaller of line 1c or:
? $160,725 if single or married filing sep,
? $321,450 if MFJ or qual widow(er), or 19 4,873.
20 Enter the smaller of line 14 or line 19 20 4,873.
21 Enter the larger of line 18 or line 20 21 4,873.
22 Subtract line 17 from line 16. This amount is taxed at 0% 22 0.
If lines 1c and 16 are the same, skip lines 23 through 43 and go to line 44. Otherwise, go to line 23.
23 Enter the smaller of line 1c or line 13 23
24 Enter the amount from line 22 (if line 22 is blank, enter -0-) 24
26 Enter:
? $434,550 if single,
? $244,425 if married filing separately, 26
? $488,850 if married filing jointly or qualifying widow(er), or
27 Enter the smaller of line 1c or line 26 27
28 Add lines 21 and 22 28
30 Enter the smaller of line 25 or line 29 30
31 Multiply line 30 by 15% (0.15) 31
If lines 1 and 32 are the same, skip lines 33 through 43 and go to line 44. Otherwise, go to line 33
34 Multiply line 33 by 20% (0.20) 34
If Schedule D, line 19, is zero or blank, skip lines 35 through 40 and go to line 41. Otherwise, go to line 35.
35 Enter the smaller of line 9c above or Schedule D, line 19 35
37 Enter the amount from line 1c above 37
40 Multiply line 39 by 25% (0.25) 40
If Schedule D, line 18, is zero or blank, skip lines 41 through 43 and go to line 44. Otherwise, go to line 41.
41 Add lines 21, 22, 30, 33, and 39 41
42 Subtract line 41 from line 1c 42
43 Multiply line 42 by 28% (0.28) 43
44 Figure the tax on the amount on line 21. If the amount on line 21 is less than $100,000,
use the Tax Table to figure this tax. If the amount on line 21 is $100,000 or more,
use the Tax Computation Worksheet 44 488.
45 Add lines 31, 34, 40, 43, and 44 45 488.
46 Figure the tax on the amount on line 1c. If the amount on line 1c is less than $100,000,
use the Tax Table to figure this tax. If the amount on line 1c is $100,000 or more,
use the Tax Computation Worksheet 46 488.
47 Tax on all taxable income (including capital gains and qualified dividends).
Enter the smaller of line 45 or line 46. Also include this amount on Form 1040, line 12a 47 488.
Form 1040 Qualified Dividends and Capital Gain Tax Worksheet 2019

1 Enter the amount from Form 1040 or 1040-SR, line 11b 1

2 Enter the amount from Form
1040 or 1040-SR, line 3a 2
3 Are you filing Schedule D?
Yes. Enter the smaller of line 15
or 16 of Schedule D. If
either line 15 or 16 is blank
or loss, enter -0- 3
No. Enter the amount from Form
1040 or 1040-SR, line 6.
5 If filing Form 4952 (used to figure
investment interest expense
deduction), enter any amount from line
4g of that form. Otherwise, enter -0-. 5
8 Enter:
$39,375 if single or married filing separately,
$78,750 if married filing jointly or qualifying widow(er), 8
$52,750 if head of household.
11 Subtract line 10 from line 9 (this amount taxed at 0%) 11
13 Enter the amount from line 11 13
14 Subtract line 13 from line 12. 14
15 Enter:
$434,550 if single,
$244,425 if married filing separately, 15
$488,850 if married filing jointly or qualifying widow(er),
$461,700 if head of household.
20 Multiply line 19 by 15% (0.15) 20
23 Multiply line 22 by 20% (0.20) 23
24 Figure the tax on the amount on line 7. If the amount on line 7 is less than
$100,000, use the Tax Table to figure the tax. If the amount on line 7 is
$100,000 or more, use the Tax Computation Worksheet 24
25 Add lines 20, 23, and 24 25
26 Figure the tax on the amount on line 1. If the amount on line 1 is less than
$100,000, use the Tax Table to figure this tax. If the amount on line 1 is
$100,000 or more, use the Tax Computation Worksheet 26
27 Tax on all taxable income. Enter the smaller of line 25 or line 26 here and on
Form 1040 or 1040-SR, line 12a. 27
Tax Payments Worksheet 2019

Estimated Tax Payments for 2019 (If more than 4 payments for any state or locality, see Tax Help)
Federal State Local
Date Amount Date Amount ID Date Amount ID
1 04/15/19 04/15/19 04/15/19
2 06/17/19 06/17/19 06/17/19
3 09/16/19 09/16/19 09/16/19
4 01/15/20 01/15/20 01/15/20
Tot Estimated
Payments
Tax Payments Other Than Withholding Federal State ID Local ID

(If multiple states, see Tax Help)
6 Overpayments applied to 2019

7 Credited by estates and trusts
8 Totals Lines 1 through 7
9 2019 extensions
Taxes Withheld From: Federal State Local
10 Forms W-2 1,899. 843.

11 Forms W-2G
12 Forms 1099-R
13 Forms 1099-MISC, 1099-K and 1099-G
14 Schedules K-1
15 Forms 1099-INT, DIV and OID
16 Social Security and Railroad Benefits
17 Form 1099-B St Loc
18 a Other withholding St Loc
b Other withholding St Loc
c Other withholding St Loc
d Positive Adjustment St Loc
e Negative Adjustment St Loc
f Additional Medicare Tax
19 Total Withholding Lines 10 through 18f
1,899. 843.
20 Total Tax Payments for 2019 1,899. 843.
Prior Year Taxes Paid In 2019 State ID Local ID

(If multiple states or localities, see Tax Help)
21 Tax paid with 2018 extensions

22 2018 estimated tax paid after 12/31/2018
23 Balance due paid with 2018 return
24 Other (amended returns, installment payments, etc)
Schedule A Tax and Interest Deduction Worksheet 2019
Lines 5 - 12 G Keep for your records

Tax Deductions
1 State and local taxes:

Optional Sales Tax Tables
a Available Income:
(1) Income from Form 1040, line 7 23,223.
(2) Nontaxable income entered elsewhere on return
(3) Available income: 2018 refundable credits in excess of tax 2,585.
(4) Enter any additional nontaxable income
(5) Total available income 25,808.
b Sales Tax Per State of Residence:
Enter state in column (1), then enter total (combined) state and local sales tax rate in column (4).
Arizona, Colorado, Louisiana, Mississippi, New York or South Carolina only:
Double-click in column (4) to select your locality for each state entered.
(1) (2) (3) (4) (5) (6) (7) (8) (9)

S Date Date Enter State Local State Local Prorated
t Lived in Lived in Total Sales Sales Sales Sales or Total
a State State State & Tax Tax Tax Tax Amount
t From To Local Rate Rate (%) Table Amount
e Rate (%) (%) (4) - (5) Amount
c Total general sales tax using tables

d Sales Tax Paid on Specific Items (see help):
(1) (2) (3) (4) (5) (6) (7) (8)

ST Total Description Type Cost Rate if Actual Specific
State & Different Sales Tax Item
Local Amount Deduction
Rate Paid
e Total sales tax deduction on specific items

f Total general sales tax per tables plus sales tax on specific items
g Actual State and Local General Sales Tax:
Actual sales taxes (enter the total sales taxes paid during the year on all items)
h State and Local Income Taxes:
State and Local Income taxes 843.00
i State and Local Tax Deduction to Schedule A, line 5a:
Greater of line 1f, line 1g, or line 1h (to Schedule A, line 5a) 843.00
j Check a box to choose to use income taxes paid, sales taxes paid, or whichever
provides the greater deduction:
Income Taxes Sales Taxes Greater amount X
2 State and local real estate taxes:

a Real estate taxes paid on principal residence not entered on Form 1098
b Real estate taxes paid on principal residence entered on Home Mortgage Int. Wks
c Real estate taxes paid on additional homes or land
Personal portion of real estate taxes from Schedule E Worksheet for:
d Principal residence
e Vacation home
f Less real estate taxes deducted on Form 8829
g Foreign real propety taxes included in lines 2a-2f above
h Add lines 2a through 2f, less line 2g (to Schedule A, line 5b)
3 State and local personal property taxes:
a Auto registration fees based on the value of the vehicle.
2018 Amount Enter 2019 description:
b Non-business portion of personal property taxes from Car & Truck Exp Wks
c Other personal property taxes
d Add lines 3a through 3c (to Schedule A, line 5c)
4 Other taxes:
a Other taxes from Schedule(s) K-1
b Foreign taxes from interest and dividends
c Foreign taxes from Schedule(s) K-1
d Other foreign taxes (not used to claim a foreign tax credit)
e Other taxes.
2018 Amount Enter 2019 description:
f Foreign real propety taxes included in lines 4a-4e above

g Add lines 4a through 4e, less line 4f (to Schedule A, line 6)
Interest Deductions
5 Home mortgage interest and points reported on Form 1098:

a Mortgage interest and points from the Home Mortgage Interest Worksheet
b Qualified mortgage interest from Schedule E Worksheet
c Less home mortgage interest/points deducted on Form 8829
d Less home mortgage interest from Form 8396, line 3
e Add lines 5a through 5d (to Sch A, line 8a) or line A2 from above
6 Home mortgage interest not reported on Form 1098:
a Mortgage interest from the Home Mortgage Interest Worksheet
b Less home mortgage interest deducted on Form 8829
c Add lines 6a and 6b (to Sch A, line 8b) or line B2 from above
7 Points not reported on Form 1098:
a Amortizable points from the Home Mortgage Interest Worksheet
b Other points not on Form 1098 from the Home Mortgage Interest Worksheet
c Less points deducted on Form 8829
d Add lines 7a through 7c (to Schedule A, line 8c) or line C2 from above
Schedule A State and Local Tax Deduction Worksheet 2019

State and Local Income Taxes
State income taxes:

1 State income tax withheld 1 843.
2 2019 state estimated taxes paid in 2019 2
3 2018 state estimated taxes paid in 2019 3
4 Amount paid with 2018 state application for extension 4
5 Amount paid with 2018 state income tax return 5
6 Overpayment on 2018 state income tax return applied to 2019 tax 6
7 Other amounts paid in 2019 (amended returns, installment payments, etc.) 7
8 State estimated tax from Schedule(s) K-1 (Form 1041) 8
Local income taxes:
9 Local income tax withheld 9
10 2019 local estimated taxes paid in 2019 10
11 2018 local estimated taxes paid in 2019 11
12 Amount paid with 2018 local application for extension 12
13 Amount paid with 2018 local income tax return 13
14 Overpayment on 2018 local income tax return applied to 2019 tax 14
15 Other amounts paid in 2019 (amended returns, installment payments, etc.) 15
16 Local estimated tax from Schedule(s) K-1 (Form 1041) 16
Other:
17 17
18 Total Add lines 1 through 17 18 843.
19 State and local refund allocated to 2019 19
20 Nondeductible state income tax from line 28 20
21 Total reductions Add lines 19 and 20. 21
22 Total state and local income tax deduction Line 18 less line 21 22 843.
Nondeductible State Income Tax (Hawaii Only)
23 Nontaxable federal employee cost of living allowance 23

24 Adjusted gross income 24
26 Nondeductible percent. Line 23 divided by line 25 26 %
27 Hawaii state income tax included in line 18 27
28 Nondeductible Hawaii state income tax. Multiply line 26 by line 27. 28
Charitable Deduction Limits Worksheet 2019
For Current Year Contributions

Step 1 ' Enter your other charitable contributions made during the year.
1 Enter your cash contributions for qualified disaster relief 1
2 Enter your contributions of capital gain property "for the use of" any qualified
organization 2
3 Enter your other contributions "for the use of" any qualified organization.
Don’t include any contributions you entered on a previous line 3
4 Enter your other contributions to qualified organizations that aren’t 50% limit
organizations. Don’t include any contributions you entered on a previous line 4
5 Enter your contributions of capital gain property to 50% limit organizations
deducted at fair market value. Don’t include any contributions you entered on
a previous line. 5
6 Enter your noncash contributions to 50% limit organizations other than capital
gain property you deducted at fair market value. Be sure to include
contributions of capital gain property to 50% limit organizations if you reduced
the property’s fair market value. Don’t include any contributions you entered
on a previous line 6
7 Enter your cash contributions to 50% limit organizations. Don’t include any
contributions you entered on a previous line 7
Step 2 ' Figure your deduction for the year (if any result is zero or less, enter -0-)
8 Enter your adjusted gross income (AGI) 8 23,223.
A Cash contributions subject to the limit based on 60% of AGI
(If line 7 is zero, leave lines 9 through 11 blank)
9 Multiply line 8 by 0.6 9
10 Deductible amount. Enter the smaller of line 7 or line 9 10
11 Carryover. Subtract line 10 from line 7 11
B Noncash contributions subject to the limit based on 50% of AGI
C Contributions (other than capital gain property) subject to limit based on 30% of AGI
(If lines 3 and 4 are both zero, leave lines 16 through 22 blank)
17 Add lines 5, 6, and 7 17
21 Deductible amount. Enter the smallest of line 18, 19, or 20 21
D Contributions of capital gain property subject to limit based on 30% of AGI
E Contributions subject to the limit based on 20% of AGI
30 Add lines 10, 14, 21, and 27 30
36 Deductible amount. Enter the smallest of line 2, 31, 33, 34,
or 35 36
F Qualified contributions for certain disaster relief efforts
39 Add lines 10, 14, 21, 27, and 36 39
G Deduction for the year
43 Add lines 10, 14, 21, 27 and 36. Enter the total here
and include the deductible amounts on Schedule A (Form
1040), line 11 or line 12 whichever is appropriate. Also,
enter the amount from line 41 on the dotted line next to the
line 11 entry space 43
44 Carryover to next year. Add lines 11, 15, 22, 28 and 37 44
Note: Any amounts in the carryover column are not deductible this year but can be carried over to next
year. See Carryovers, later, for more information about how you will use them next year.
Charitable Deduction Limits Worksheet 2019
For Carryover Contributions

Step 1 ' Enter your other charitable contributions made during the year.
1 Enter your cash contributions for qualified disaster relief 1
2 Enter your contributions of capital gain property "for the use of" any qualified
organization 2
3 Enter your other contributions "for the use of" any qualified organization.
Don’t include any contributions you entered on a previous line 3
4 Enter your other contributions to qualified organizations that aren’t 50% limit
organizations. Don’t include any contributions you entered on a previous line 4
5 Enter your contributions of capital gain property to 50% limit organizations
deducted at fair market value. Don’t include any contributions you entered on
a previous line. 5
6 Enter your noncash contributions to 50% limit organizations other than capital
gain property you deducted at fair market value. Be sure to include
contributions of capital gain property to 50% limit organizations if you reduced
the property’s fair market value. Don’t include any contributions you entered
on a previous line 6 0.
7 Enter your cash contributions to 50% limit organizations. Don’t include any
contributions you entered on a previous line 7 0.
Step 2 ' Figure your deduction for the year (if any result is zero or less, enter -0-)
8 Enter your adjusted gross income (AGI) 8 23,223.
Percentage Used in
of line 8 Current Year
a 60% AGI limit to line 9 13,934. Less 0. a 13,934.
b 50% AGI limit to line 12 11,612. Less 0. b 11,612.
c 30% AGI limit, Section C to line 19 6,967. Less 0. c 6,967.
d 30% AGI limit, Section D to line 26 6,967. Less 0. d 6,967.
e 20% AGI limit to line 35 4,645. Less 0. e 4,645.
A Cash contributions subject to the limit based on 60% of AGI
B Noncash contributions subject to the limit based on 50% of AGI
C Contributions (other than capital gain property) subject to limit based on 30% of AGI
(If lines 3 and 4 are both zero, leave lines 16 through 22 blank)
17 Add lines 5, 6, and 7 17
D Contributions of capital gain property subject to limit based on 30% of AGI
E Contributions subject to the limit based on 20% of AGI
30 Add lines 10, 14, 21, and 27 30
36 Deductible amount. Enter the smallest of line 2, 31, 33, 34,
or 35 36
F Qualified contributions for certain disaster relief efforts (Not applicable for carryovers)
39 Add lines 10, 14, 21, 27, and 36 39
G Deduction for the year
43 Add lines 10, 14, 21, 27 and 36. Enter the total here
and include the deductible amounts on Schedule A (Form
1040), line 11 or line 12 whichever is appropriate. Also,
enter the amount from line 41 on the dotted line next to the
line 11 entry space 43
44 Carryover to next year. Add lines 11, 15, 22, 28 and 37 44
Note: Any amounts in the carryover column are not deductible this year but can be carried over to next
year. See Carryovers, later, for more information about how you will use them next year.
Charitable Contributions Summary 2019
Part I Cash Contributions Summary
(a) (b) (c) (d)
Name of Charitable Organization Total 60% 30% 100%
Limit Limit Limit
Totals:
Part II Non-Cash Contributions Summary

Total Other Property Capital Gain Property
(a) (b) (c) (d) (e)

Name of Charitable Organization Total 50% 30% 30% 20%
Limit Limit Limit Limit
Totals:
Part III Contribution Carryovers to 2020
Total Cash and Other Capital Gain
Non-Capital Gain Property Property
(a) (b) (c) (d) (e) (f) (g)

Total 100% 60% 50% 30% 30% 20%
Limit Limit Limit Limit Limit Limit
1 2019 contributions
2 2019 contributions
allowed
3 Carryovers from:
a 2018 tax year 0. N/A 0. 0.
b 2017 tax year N/A
c 2016 tax year N/A
d 2015 tax year N/A
e 2014 tax year N/A
4 Carryovers
allowed in 2019 N/A
5 Carryovers
disallowed in 2019 N/A
6 Carryovers to 2020:
a From 2019
b From 2018 N/A
c From 2017 N/A
d From 2016 N/A
e From 2015 N/A
f From 2014 N/A
Part IV Special Situations in Your Return for Current Year Donations

1 Was the entire interest given for all property donated to all charities? X Yes No
2 Were restrictions attached to any charities’s right
to use or dispose of any property donated to any charity? Yes X No
3 Did you give to anyone other than the charity the right to income from any
of the donated property or to possession of any of the donated property? Yes X No
4 Was any charity other than a 60%/50% charity? Yes X No
Schedule A Miscellaneous Itemized Deductions Worksheet 2019
Lines 16 G Keep for your records

FOR STATE USE ONLY: Employee Business Expenses ' Subject to 2% Limitation
1 Deductible expenses from Form 2106, line 10 less deductions for

performing artists and armed forces reservists claimed elsewhere 1
2 a Qualified Educator Expenses (from Educator Expenses Worksheet) 2a
b Educator Expense Deduction (from 1040, line 23) 2b
c Excess Educator Expenses (line 2a less line 2b) 2c
3 Union and professional dues 3
4 Professional subscriptions 4
5 Uniforms and protective clothing 5
6 Job search costs 6
7 Tax preparation fees 7
8 Entertainment expenses 8
9 Other:
9
10 Combine lines 1 through 9 10
FOR STATE USE ONLY: Investment

Miscellaneous Expenses ' Subject to 2% Limitation Expense T
Check the box in investment column if an investment expense
11 Depreciation and amortization deductions X 11

12 Casualty/theft losses of property used in services as an employee 12
13 REMIC expenses, from Schedule E X 13
14 Investment expenses related to interest and dividend income X 14
15 Expenses related to portfolio income, from Schedule(s) K-1 X 15
16 Miscellaneous deductions, from Schedule(s) K-1 16
17 Excess deductions on termination, from Schedule(s) K-1 17
18 Investment counsel and advisory fees X 18
19 Certain attorney and accounting fees X 19
20 Safe deposit box rental fees X 20
21 IRA custodial fees X 21
22 Loss incurred from total distribution of all traditional IRAs 22
23 Loss incurred from total distribution of all Roth IRAs 23
24 Loss incurred from final distribution of a QTP investment 24
25 Hobby expense (limited to hobby income) 25
26 Other:
a Prior year government unemployment benefits repaid in 2019 26
b
27 Combine lines 11 through 26 27
FOR FEDERAL AND STATE USE:

Other Miscellaneous Deductions ' Not Subject to 2% Limitation
28 Expenses related to portfolio income, from Schedule(s) K-1 X 28

29 Federal estate tax paid on decedent’s income reported on this return 29
30 Impairment-related expenses of a handicapped employee, from Form 2106 30
31 Amortizable bond premiums on bonds acquired before 10/23/86 31
32 Gambling losses 32
33 Deduction for repayment of amounts under claim of right if over $3,000 33
34 Casualty/theft losses of income-producing property 34
35 Unrecovered investment in annuity 35
36 Ordinary loss attributable to certain debt instruments 36
37 Net Qualified Disaster Loss 37
38 Combine lines 28 through 37 (to Schedule A, line 16) 38
Form 1040 or Standard Deduction Worksheet for Dependents 2019
1040-SR, Line 9 G Keep for your records

Use this worksheet only if someone can claim you, or your spouse if filing jointly, as a dependent.
1 Is your earned income* more than $750?
Yes. Add $350 to your earned income. Enter the total 1
No. Enter $1,100
2 Enter the amount shown below for your filing status.
? Single or married filing separately ' $12,200
? Married filing jointly ' $24,400 2 18,350.
? Head of household ' $18,350
3 Standard deduction.
3 a Enter the smaller of line 1 or line 2. If born after January 1, 1955, and not
blind, stop here and enter this amount on Form 1040 or 1040-SR, line 9.
Otherwise, go to line 3b 3a
3 b If born before January 2, 1955, or blind, multiply the number claimed on top of
page 2 of Form 1040 Wkst by $1,300 ($1,650 if single or head of household) 3b
3 c Add lines 3a and 3b. Enter the total here and on Form 1040 or 1040-SR, ln 9 3c
*Earned income includes wages, salaries, tips, professional fees, and other compensation received for
personal services you performed. It also includes any taxable scholarship or fellowship grant. Generally,
your earned income is the total of the amount(s) you reported on Form 1040 or 1040-SR, line 1,
and Schedule 1, lines 3 and 6, minus the amount, if any, on Schedule 1, line 14. Earned income, for
the purpose of figuring your standard deduction, doesn’t include qualified disability trust distributions.
Earned Income Worksheet 2019

Part I ' Earned Income Credit Worksheet Computation
Taxpayer Spouse Total

1 If filing Schedule SE:
a Net self-employment income
b Optional Method and Church Employee income
c Add lines 1a and 1b
d One-half of self-employment tax
e 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 as a statutory employee,
enter the amount from line 1 of that
Schedule C
4 Add lines 1e, 2c and 3. To EIC Wks, line 5
Part II ' Form 2441 and Standard Deduction Worksheet Computations
5 Net self-employment earnings (line 4 above)

6 Wages, salaries, and tips less distributions
from nonqualified or section 457 plans, etc 23,223. 23,223.
7a Taxable employer-provided adoption benefits
b Foreign earned income exclusion
8 Add lines 5 through 7b. To Form 2441, lines 19
and 20 23,223. 23,223.
9a Taxable dependent care benefits
b Nontaxable combat pay
10 Add lines 8, 9a & 9b . To Form 2441, lines
4 and 5 23,223. 23,223.
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 5, 6, 7a, 9a and 11 through 13.
To Standard Deduction Worksheet 23,223. 23,223.
Part III ' IRA Deduction Worksheet Computation
15 Net self-employment income or (loss)

16 Wages, salaries, tips, etc 23,223. 23,223.
17 Net self-employment loss
18 Alimony received
19 Nontaxable combat pay
20 Foreign earned income exclusion
21 Keogh, SEP or SIMPLE deduction
22 Combine lines 15 through 21. To IRA Wks, ln 2 23,223. 23,223.
Part IV ' Schedule 8812 and Child Tax Credit Line 14 Worksheet Computations
23 Self-employed, church and statutory employees

24 Wages, salaries, tips, etc 23,223. 23,223.
25 Nontaxable combat pay
26 Combine lines 23 through 25. To Schedule
8812, line 6a & Line 14 Wks, line 2 23,223. 23,223.
Form 4952 Investment Interest Expense Worksheet 2019

Investment Interest Expense ( Form 4952, line 1)

1 Investment interest expense, from Schedule K-1 1
2 Investment interest expense from royalties 2
3 Other investment interest expense:
a 3a
b b
c c
d d
4 Total investment interest expense. Add lines 1 through 3. 4
Gross Income from Property Held for Investment (Form 4952, line 4a)
5 Taxable investment income:
a From Schedule B, Interest and Dividend Income 5a
b From Schedules K-1, Partnerships, S Corporations, Estates and Trusts b
c From Form 8814, Parents’ Election to Report Child’s Interest and Dividends c
d Total d
6 Royalty income, from Schedule E 6
7 Net passive income from publicly traded partnerships 7
8 Income from nonpassive trade or business without material participation 8
9 Other investment income:
a 9a
b b
c c
d d
10 Total investment income. Add lines 5d through 9. 10
Net Capital Gain Income (Form 4952, lines 4d and 4e)

Regular Tax Alt Min Tax
11 a Net gains from Schedule D, line 16 11 a

b Less net gains from property not held for investment b
c Net gains from property held for investment. c
12 a Net capital gains from Schedule D, lesser of ln 15 or ln 16 12 a

b Less net capital gains from property not held for investment b
c Net capital gains from property held for investment. c
Investment Expenses (Form 4952, line 5)

13 Royalty expenses 13
14 Investment expenses reported on schedule K-1 partnership or S-corp 14
15 Expenses from nonpassive trade or business without material participation 15
16 Other investment expenses:
a 16 a
b b
c c
d d
17 Total investment expenses. Add lines 13 through 17. 17
Allocation of Investment Interest Expense (Schedule A, line 14)

Regular Tax Alt Min Tax
18 Allowed investment interest expense, Form 4952, line 8 18

19 Less amount deducted on other forms and schedules: 19
a Deducted on Schedule E, page 2 for passthru entities a
b Deducted on Schedule E, page 1 for royalties b
c Other amounts deducted on other forms and schedules c
d Total amount deducted on other forms and schedules d
20 Investment interest expense. 20
Form 1040 Earned Income Credit Worksheet 2019

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 Enter the amount from Form 1040 line 1

less amounts considered not earned for EIC purposes 1 23,223.
2 Adjustments to line 1 amount:
a Income reported as wages and as self-employment income 2a
b Other income entered as wages that is not considered earned income b
c Distributions from section 457 and other nonqualified plans reported on W-2 c
3 Subtract lines 2a, 2b and 2c from line 1 3 23,223.
4a Taxpayer’s nontaxable combat pay election for EIC 4a
b Spouse’s nontaxable combat pay election for EIC b
c Total nontaxable combat pay election 4c
5 If you were self-employed or used Schedule C
as a statutory employee, enter the amount from the
Earned Income Worksheet, line 4 5
6 Medicaid Waiver Payments reported as nontaxable 6
7 Earned income. Add lines 3, 4, 5, and 6 7 23,223.
8 Enter the credit, from the EIC Table, for the amount on line 7. Be sure to use
the correct column for filing status and number of children 8 2,855.
If line 8 is zero, stop. You cannot take the credit.

Enter "No" on the dotted line next to Form 1040, line 18a.
9 Enter your AGI from Form 1040, line 8b 9 23,223.

10 If you have:
? No qualifying children, is the amount on line 9 less than $8,650
($14,450 if married filing jointly)?
? 1 or more qualifying children, is the amount on line 9 less than $19,050
($24,850 if married filing jointly)?
Yes. Go to line 11 now.

X 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 10 2,855.
11 Earned income credit.
? If ’Yes’ on line 10, enter the amount from line 8
? If ’No’ on line 10, enter the smaller of line 8 or line 10 11 2,855.
Enter line 11 amount on Form 1040, line 18a.

Compliance and Due Diligence Information
1 Is this how long your dependents lived with you in the U.S in 2019?
Yes, all of the above is correct.

No, I’ll go back and review my dependent information.
The IRS may ask you for documents to prove you lived with anyone you’re claiming for the Earned
Income Credit.
Is this where you lived with your dependents the longest in 2019?
2 Yes, my dependents lived with me at this address.

No, I’d like to add an additional address where I lived with my dependents. Use the Interview to
add an additional address where you lived with your dependents the longest in 2019.
Compliance and Due Diligence Indicator X

Disqualified from Earned Income Credit Yes X No
Potential qualifying child count 1

Non dependent potential qualifying child count 0
Qualifying child count (max 3) 1
Schedule SE Adjustments Worksheet 2019

(a) Taxpayer (b) Spouse
QuickZoom to the Short Schedule SE (Schedule SE, page 1)

QuickZoom to the Long Schedule SE (Schedule SE, page 2)
A Use Long Schedule SE, even if qualified to use Short Schedule SE

B Approved Form 4029. Exempt from SE tax on all income
C Chapter 11 bankruptcy net profit or loss for Schedule SE, line 3
D QuickZoom to the Explanation statement for any adjustment to
SE income/loss shown on a partnership K-1. (See Help)
Part I Farm Profit or (Loss) Schedule SE, line 1

1 Total Schedules F
2 Farm partnerships, Schedules K-1
3 Other SE farm profit or (loss) (See Help)
4 Less SE exempt farm profit or (loss) (See Help)
5 Total for Schedule SE, line 1
6 Conservation Reserve Program payments not subject to self-
employment tax reported on:
a Schedule F, line 4b
b Schedule K-1 (Form 1065), box 20, code AH
c Total CRP payments not subject to SE tax
Part II Nonfarm Profit or (Loss) Schedule SE, line 2

1a Total Schedules C
b Less SE exempt Schedules C (approved Form 4361)
2 Nonfarm partnerships, Schedules K-1
3 Forms 6781
4 Other SE income reported as income on Form 1040, line 7
5a Clergy Form W-2 wages
b Clergy housing allowance
c Less clergy business deductions
d QuickZoom to the Explanation statement for entry on line 5c
6 Other SE nonfarm profit or (loss) (See Help)
7 Less other SE exempt nonfarm profit or (loss) (See Help)
8 Total for Schedule SE, line 2
9 Exempt Notary Public income for Schedule SE, line 3 (See Help)
Part III Farm Optional Method Schedule SE, page 2, Part II

1 Use Farm Optional Method
2 Gross farm income from Schedules F
3 Gross farming or fishing income from partnership Schedules K-1
4 Other gross farming or fishing self-employment income
5 Total gross income for Farm Optional Method
Part IV Nonfarm Optional Method Schedule SE, page 2, Part II

1 Use Nonfarm Optional Method (Must have had net SE earnings
of $400 or more in 2 of prior 3 years and used the
Nonfarm Optional Method less than 5 times)
2 Gross nonfarm income from Schedules C
3 Gross nonfarm income from partnership Schedules K-1
4 Other gross nonfarm self-employment income
5 Total gross income for Nonfarm Optional Method
Form 4684 Casualty and Theft Worksheet 2019
Use a separate worksheet for each casualty or theft event.
Name(s) shown on return Social Security No.

Part I Casualty or Theft Event Information
1 Description of this casualty or theft event

2 Date of casualty or theft event
3 Use of property, check one if not a Ponzi loss (line 5c):
a Personal (includes home office deducted under simplified method, see tax help)
b Business, employment, or income-producing
4 If box 3a is checked, check one:
a This event qualifies as a Hurricane Harvey or Tropical Storm Harvey Disaster
b This event qualifies as a Hurricane Irma Disaster
c This event qualifies as a Hurricane Maria Disaster
d This event qualifies as a 2017 California Wildfire Disaster (01/01/2017-01/18/2018)
e This event is a qualified federally declared major disaster
f This event is a federally declared disaster (not "qualified")
g This event qualifies as a 2016 federally declared disaster area
h This event does not qualify as a federally declared disaster
i Enter the FEMA disaster decl. number if any line 4a-g is checked (ex. DR-1234)
5 If box 3b is checked, check one:
a Check if the property was used in a passive activity
b Check if the property was not used in a passive activity
c Check if this is a Rev Proc 2009-20 Ponzi-Type loss
6 Worksheet Copy Number 1
Part II Property Information for All Properties Damaged or Stolen in the Casualty or Theft Event
a Description including type of property

b For personal use property, enter the address, city, state and ZIP code
c Date acquired d Cost or other basis

e Insurance or other reimbursement
f FMV before event g FMV after event
h Was this a total loss ? Yes No
i If personal use, is this a collectible ? Yes No
j If business use, check one: Business Employ Income
k If home office (standard method) enter: Sch C No Sch C Ln 27
a Description including type of property
b For personal use property, enter the address, city, state and ZIP code
c Date acquired d Cost or other basis

e Insurance or other reimbursement
f FMV before event g FMV after event
h Was this a total loss ? Yes No
i If personal use, is this a collectible ? Yes No
j If business use, check one: Business Employ Income
k If home office (standard method) enter: Sch C No Sch C Ln 27
Form 6251 Schedule D Tax Worksheet 2019
Line 37 as refigured for the
Alternative Minimum Tax

(a) (b) (c)

Before Allocation of After
Allocation of Capital Gain Allocation of
Capital Gain Excess * Capital Gain
Excess * Excess
1 Not applicable
2 Enter your total qualified dividends as refigured for
the Alternative Minimum Tax (AMT):
a Total qualified dividends
b Adjustment from Schedules K-1
c Other adjustments to qualified dividends
d Total. Combine lines 2a, 2b, and 2c 0. 0.
3 Enter the amount from Form 4952 for AMT, line 4g
4 Enter the amount from Form 4952 for AMT, line 4e
5 Subtract line 4 from line 3. If zero or less, enter -0- 0. 0.
6 Subtract line 5 from line 2. If zero or less, enter -0- 0. 0.
7 Net long-term capital gain:
a Enter the gain from line 15 of Schedule D
as refigured for the AMT 0.
b Enter the gain from line 16 of Schedule D
c Enter the smaller of line 7a or line 7b 0. 0.
8 Enter the smaller of line 3 or line 4
9 Subtract line 8 from line 7c. If zero or less, enter -0- 0. 0. 0.
10 Add lines 6 and 9 0. 0.
A Enter the amount from Form 6251, line 6. 0.
B Capital gain excess. Subtract line A from line 10. * 0.
11 Total 28% rate and unrecaptured section 1250 gain:
a Enter the gain from line 18 of Schedule D
b Enter the gain from line 19 of Schedule D
as refigured for the AMT
c Add lines 11a and 11b 0.
12 Enter the smaller of line 9 or line 11c 0.
13 Subtract line 12 from line 10. Also enter this amount
on Form 6251, line 13. 0.
* Capital gain excess applies only if filing Form 2555, Foreign Earned Income.
Form 6251 Alternative Minimum Tax Worksheet 2019

Taxable Income ' Line 1
1 Enter the amount from Form 1040 or 1040-SR, line 11b, if more than zero. If
Form 1040 or 1040-SR, line line 11b, is zero, subtract lines 9 and 10 of Form
1040 of 1040-SR from line 8b of Form 1040 or 1040-SR and enter the result
here. (If less than zero, enter as a negative amount.) 1 4,873.
2 Additions to income 2
3 Add lines 1 and 2 3 4,873.
4 Subtractions from income 4
5 Subtract line 4 from line 3. Enter on Form 6251, line 1 5 4,873.
Taxes ' Line 2a
1 Generation skipping transfer taxes included on Schedule A, line 6 1
Refund of Taxes ' Line 2b
1 Taxable refund of state and local income tax 1 0.

2 Amount and description of any refund of state and local personal property
taxes, foreign income or real property taxes deducted after 1986 2
3 Total tax refund adjustment. Enter on Form 6251, line 2b 3 0.
Alternative Tax Net Operating Loss Deduction (ATNOLD) ' Line 2f
1 Alternative minimum taxable income (AMTI) without ATNOLD 1 23,223.

2 Enter adjustments 2
3 Adjustment for domestic production activities deduction 3
4 Adjusted AMTI without ATNOLD. Add lines 1-3 4 23,223.
5 ATNOLD limitation. Multiply line 4 by 90% 5 20,901.
6 Enter ATNOL carried to 2018 from other year(s) 6
7 Enter ATNOL included above attributable to qualified disaster losses 7
8 ATNOL above not attributable to qualified disaster losses. Line 6 minus 7 8
9 ATNOL deduction other than qualified disaster losses. Lesser of line 5 or 8 9
10 ATNOL Disaster Deduction. Lesser of line 7 or (line 4 minus line 9) 10
11 ATNOLD. Add lines 9 and 10. Enter on Form 6251, line 2f, as neg 11
Incentive Stock Options ' Line 2i
1 Incentive stock options adjustment from Schedule K-1 worksheets 1

2 Incentive stock options from Employer Stock Transaction Worksheets 2
3 Incentive stock options from Exercise of Stock Options Worksheets 3
4 Other incentive stock options 4
5 Total incentive stock options. Enter on Form 6251, line 2i 5
Alternative Minimum Taxable Income ' Line 4
If married filing separately and Form 6251, line 4, is more than $733,700:
1 Alternative minimum taxable income, Form 6251 1
2 Threshold amount 2
4 Multiply line 3 by 25% (.25) 4
5 Smaller of line 4 or $55,850 5
6 Add line 1 and line 5. Enter on Form 6251, line 4 6
Exemption ' Line 5
1 Enter $71,700 if single or head of household, $111,700 if married filing jointly

or qualifying widow(er), $55,850 if married filing separately 1 71,700.
2 Enter your alternative minimum taxable income from Form 6251, line 4 2 23,223.
3 Enter $510,300 if single or head of household, $1,020,600 if married filing
jointly or qualifying widow(er), $510,300 if married filing separately 3 510,300.
4 Subtract line 3 from line 2. If zero or less, enter -0- 4 0.
5 Multiply line 4 by 25% (.25) 5 0.
6 Subtract line 5 from line 1. If zero or less, enter -0-. Enter on 6251, line 5 6 71,700.
Form 6251 Foreign Earned Income 2019
Line 7 Alternative Minimum Tax Worksheet

1 Enter the amount from Form 6251, line 6 1

2 a Enter the amount from your (and your spouse’s if filing jointly) Form 2555,
lines 45 and 50 2a
b Enter the total amount of any itemized deductions or exclusions you couldn’t
claim because they are related to excluded income 2b
c Subtract line 2b from line 2a. If zero or less, enter 0 2c
3 Add line 1 and line 2c 3
4 Tax on the amount on line 3.
? If you reported capital gain distributions directly on Form 1040 or 1040-SR,
line 6; or you reported qualified dividends on Form 1040 or 1040-SR, line
3a; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040 or
1040-SR) (as refigured for the AMT, if necessary), enter the amount from
line 3 of this worksheet on Form 6251, line 12. Complete the rest of Part III
of Form 6251. However, before completing Part III, see Form 2555, later, to
see if you must complete Part III with certain modifications. Then enter the
amount from Form 6251, line 40, here.
? All Others: If line 3 is $194,800 or less ($97,400 or less if married filing
separately), multiply line 3 by 26% (0.26). Otherwise, multiply line 3 by
28% (0.28) and subtract $3,896 ($1,948 if married filing separately) from
the result. 4
5 Tax on amount on line 2c. If line 2c is $194,800 or less ($97,400 or less if
married filing separately), multiply line 2c by 26% (0.26). Otherwise, multiply
line 2c by 28% (0.28) and subtract $3,896 ($1,948 if married filing separately)
from the result 5
6 Subtract line 5 from line 4. Enter the result here and on Form 6251, line 7. 6
Federal Carryover Worksheet 2019

2018 State and Local Income Tax Information
(a) (b) (c) (d) (e) (f) (g)

State or Paid With Estimates Pd Total With- Paid With Total Over- Applied
Local ID Extension After 12/31 held/Pmts Return payment Amount
MI 525. 265.
Totals 525. 265.
2018 State Extension Information 2018 Locality Extension Information
(a) (b) (a) (b)

State Paid With Extension Locality Paid With Extension
2018 State Estimates Information 2018 Locality Estimates Information
(a) (c) (a) (c)

State Estimates Paid After 12/31 Locality Estimates Paid After 12/31
2018 State Taxes Due Information 2018 Locality Taxes Due Information
(a) (e) (a) (e)

State Paid With Return Locality Paid With Return
2018 State Refund Applied Information 2018 Locality Refund Applied Information
(a) (g) (a) (g)

State Applied Amount Locality Applied Amount
2018 State Tax Refund Information 2018 Locality Tax Refund Information
(a) (d) (f) (a) (d) (f)

Total Total Total Total
State Withheld/Pmts Overpayment Locality Withheld/Pmts Overpayment
MI 525. 265.
Federal Carryover Worksheet page 2 2019
Other Tax and Income Information 2018 2019
1 Filing status 1 4 HH 4 HH
2 Number of exemptions for blind or over 65 (0 - 4) 2
3 Itemized deductions 3 525. 843.
4 Check box if required to itemize deductions 4
5 Adjusted gross income 5 14,228. 23,223.
6 Tax liability for Form 2210 or Form 2210-F 6 0. 0.
7 Alternative minimum tax 7
8 Federal overpayment applied to next year estimated tax 8
QuickZoom to the IRA Information Worksheet for IRA information
Excess Contributions 2018 2019
9a Taxpayer’s excess Archer MSA contributions as of 12/31 9a

b Spouse’s excess Archer MSA contributions as of 12/31 b
10 a Taxpayer’s excess Coverdell ESA contributions as of 12/31 10 a
b Spouse’s excess Coverdell ESA contributions as of 12/31 b
11 a Taxpayer’s excess HSA contributions as of 12/31 11 a
b Spouse’s excess HSA contributions as of 12/31 b
Loss and Expense Carryovers 2018 2019

Note: Enter all entries as a positive amount
12 a Short-term capital loss 12 a

b AMT Short-term capital loss b
13 a Long-term capital loss 13 a
b AMT Long-term capital loss b
14 a Net operating loss available to carry forward 14 a
b AMT Net operating loss available to carry forward b
15 a Investment interest expense disallowed 15 a
b AMT Investment interest expense disallowed b
16 Nonrecaptured net Section 1231 losses from: a 2019 16 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
17 AMT Nonrecap’d net Sec 1231 losses from: a 2019 17 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
Federal Carryover Worksheet page 3 2019
Credit Carryovers 2018 2019
18 General business credit 18

19 Adoption credit from: a 2019 19 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
20 Mortgage interest credit from: a 2019 20 a
b 2018 b
c 2017 c
d 2016 d
21 Credit for prior year minimum tax 21
22 District of Columbia first-time homebuyer credit 22
23 Residential energy efficient property credit 23
Other Carryovers 2018 2019
24 Section 179 expense deduction disallowed 24

25 Excess a Taxpayer (Form 2555, line 46) 25 a
foreign b Taxpayer (Form 2555, line 48) b
housing c Spouse (Form 2555, line 46) c
deduction: d Spouse (Form 2555, line 48) d
Charitable Contribution Carryovers
26 2018 Carryover of Other Property Capital Gain Cash Qualified

charitable
contributions from: (a) 50% (b) 30% (c) 30% (d) 20% (e) 60% (f) 100%
a 2018 0. 0.
b 2017
c 2016
d 2015
e 2014
27 2019 Carryover of Other Property Capital Gain Cash

charitable
contributions from: (a) 50% (b) 30% (c) 30% (d) 20% (e) 60%
a 2019
b 2018
c 2017
d 2016
e 2015
28 Amount overpaid less earned income credit 2,585.
Qualified Business Income Deduction (Section 199A) carryovers 2018 2019
29 Qualified business loss carryforward 29

30 Qualified PTP loss carryforward 30
2018 State Capital Loss Carryovers (For users not transferring from the prior year)
State Short-term AMT Short-term Long-term AMT Long-term Capital Loss AMT Capital Loss
ID Capital Loss Capital Loss Capital Loss Capital Loss (combined) (combined)
for State for State for State for State for State for State
Form 8582 Modified Adjusted Gross Income Worksheet 2019

Description Amount
Income
Wages 23,223.
Interest income before Series EE bond exclusion
Dividend income
Tax refund 0.
Alimony received
Nonpassive business income or loss
Royalty and nonpassive rental activities income or loss
Nonpassive partnership income or loss
Nonpassive S corporation income or loss
Nonpassive farm rental income or loss
Nonpassive farm income or loss
Nonpassive estate and trust income or loss
Real estate mortgage investment conduits
Business gains and losses from nonpassive activities
Capital gains and losses
Taxable IRA distributions
Taxable pension distributions
Unemployment compensation
Other income
Total income 23,223.
Adjustments
Educator expenses
Certain business expenses of reservists, performing artists, and government officials
Health savings account deduction
Moving expenses
Self-employed SEP, SIMPLE, and qualified plans
Self-employed health insurance deduction
Penalty on early withdrawals of savings
Alimony paid
Other adjustments
Total adjustments
Modified adjusted gross income 23,223.

Two-Year Comparison 2019

Durril M Butler
Income 2018 2019 Difference %
Wages, salaries, tips, etc 14,228. 23,223. 8,995. 63.22

Interest and dividend income
State tax refund 0. 0.
Business income (loss)
Capital and other gains (losses)
IRA distributions
Pensions and annuities
Rents and royalties
Partnerships, S Corps, etc
Farm income (loss)
Social security benefits
Income other than the above
Total Income 14,228. 23,223. 8,995. 63.22
Adjustments to Income
Adjusted Gross Income 14,228. 23,223. 8,995. 63.22
Itemized Deductions
Medical and dental
Income or sales tax 525. 843. 318. 60.57
Real estate taxes
Personal property and other taxes
Interest paid
Gifts to charity
Casualty and theft losses
Miscellaneous
Total Itemized Deductions 525. 843. 318. 60.57
Standard or Itemized Deduction 18,000. 18,350. 350. 1.94
Qualified Business Income Deduction
Taxable Income 0. 4,873. 4,873.
Income tax 0. 488. 488.

Additional income taxes
Alternative minimum tax
Total Income Taxes 0. 488. 488.
Nonbusiness credits 0. 488. 488.
Business credits
Total Credits 0. 488. 488.
Self-employment tax
Other taxes 0. 0.
Total Tax After Credits 0. 0. 0.
Withholding 1,185. 1,899. 714. 60.25
Estimated and extension payments
Earned income credit 3,461. 2,855. -606. -17.51
Additional child tax credit 1,400. 1,400. 0. 0.00
Other payments
Total Payments 6,046. 6,154. 108. 1.79
Form 2210 penalty
Applied to next year’s estimated tax
Refund 6,046. 6,154. 108. 1.79
Balance Due
Current year effective tax rate -18.32 %

Tax Summary 2019
Name (s)
Durril M Butler
Total income 23,223.

Adjustments to income
Adjusted gross income 23,223.
Itemized/standard deduction 18,350.
Qualified business income deduction
Taxable income 4,873.
Tentative tax 488.
Additional taxes
Alternative minimum tax
Total credits 488.
Other taxes
Total tax 0.
Total payments 6,154.
Estimated tax penalty
Amount Overpaid 6,154.
Refund 6,154.
Amount Applied to Estimate
Balance due 0.
Compare to U. S. Averages 2019
Name(s) Shown on Return Social Security No

Your 2019 adjusted gross income (AGI) 23,223.

National adjusted gross income range used below from 15,000. to 29,999.
Note: National average amounts have been adjusted for inflation. See Help for details.
Actual National
Selected Income, Deductions, and Credits Per Return Average
Salaries and wages 23,223. 22,601.

Taxable interest 748.
Tax-exempt interest 4,031.
Dividends 2,533.
Business net income 13,751.
Business net loss 9,956.
Net capital gain 3,960.
Net capital loss 2,289.
Taxable IRA 8,963.
Taxable pensions and annuities 13,133.
Rent and royalty net income 6,899.
Rent and royalty net loss 7,343.
Partnership and S corporation net income 12,174.
Partnership and S corporation net loss 11,729.
Taxable social security benefits 2,632.
Medical and dental expenses deduction 9,639.

Taxes paid deduction 843. 3,620.
Interest paid deduction 6,814.
Charitable contributions deduction 2,610.
Total itemized deductions 843. 16,864.
Child care credit 439.

Education tax credits 780.
Child tax credit 488. 484.
Retirement savings contributions credit 182.
Earned income credit 2,855. 4,052.
Other Information Actual National

Per Return Average
Adjusted gross income 23,223. 23,220.

Taxable income 4,873. 9,917.
Income tax 488. 1,221.
Alternative minimum tax 2,128.
Total tax liability 0. 1,424.
CUSTOMER SERVICE: 877-908-7228
Santa Barbara Tax Products Group, LLC
and Green Dot Bank Refund Processing Service Agreement ("Agreement")
Name Durril M Butler

Social Security No. 377-21-3791
This Agreement contains important terms, conditions and disclosures about the processing of your refund
(the "Refund Processing Service") by Santa Barbara Tax Products Group, LLC ("Processor"), a third party
processor using banking services of Green Dot Bank ("Bank"). Read this Agreement carefully before
accepting its terms and conditions, and print a copy and/or retain this information electronically for future
reference. As used in this Agreement, the words "you" and "your" refer to the applicant or both the applicant
and joint applicant if the 2019 federal income tax return is a joint return (individually and collectively,
"Applicant"). The words "we," "us" and "our" refer to Bank and Processor.
1. NOTICE: No Requirement To Use the Refund Processing Service In Order To File Electronically.
YOU UNDERSTAND THAT A REFUND PROCESSING FEE OF $40.00 ("REFUND PROCESSING FEE") IS
CHARGED BY PROCESSOR TO ESTABLISH A TEMPORARY ACCOUNT TO RECEIVE YOUR FEDERAL TAX
REFUND, TO PROCESS IT, TO DEDUCT YOUR TURBOTAX FEES, AND OTHER AUTHORIZED FEES FROM
THAT ACCOUNT, AND TO FORWARD FUNDS TO YOU. THE REFUND PROCESSING FEE IS NOT A LOAN; IT
IS DUE TO PROCESSOR WHETHER OR NOT THE FEDERAL TAX REFUND OCCURS BUT PROCESSOR WILL
NOT PURSUE COLLECTION OF THE REFUND PROCESSING FEE IF YOUR FEDERAL TAX REFUND DOES
NOT OCCUR. THIS FEE IS COLLECTED ONLY AT THE TIME THE REFUND OCCURS. YOU CAN AVOID THIS
FEE AND NOT USE THE REFUND PROCESSING SERVICE BY INSTEAD PAYING THE APPLICABLE
TURBOTAX FEES TO INTUIT INC. BY CREDIT OR DEBIT CARD AT THE TIME YOU FILE YOUR
2019 FEDERAL INCOME TAX RETURN AND ELECTING TO HAVE YOUR REFUND DIRECTLY DEPOSITED IN
YOUR OWN BANK ACCOUNT OR MAILED TO YOU. IF YOU DO USE THE REFUND PROCESSING SERVICE,
YOU CAN EXPECT TO RECEIVE THE PROCEEDS FROM YOUR FEDERAL TAX REFUND WITHIN 21 DAYS
FROM WHEN THE INTERNAL REVENUE SERVICE ("IRS") ACCEPTS YOUR RETURN UNLESS THERE
ARE PROCESSING DELAYS BY THE IRS (OR UNLESS YOUR RETURN CONTAINS EARNED INCOME TAX
CREDIT OR ADDITIONAL CHILD TAX CREDIT, IN WHICH CASE THE IRS WILL ISSUE YOUR REFUND NO
EARLIER THAN FEBRUARY 15, 2020). THE REFUND PROCESSING SERVICE WILL NEITHER SPEED UP
NOR DELAY YOUR FEDERAL TAX REFUND. THE COST OF PREPARING YOUR TAX RETURN IS NOT ANY
MORE OR LESS IF YOU PURCHASE THE REFUND PROCESSING SERVICE.
2. Authorization to Release Personal Information. You authorize the IRS to disclose any information to
Bank and Processor related to the funding of your 2019 federal tax refund. You also authorize Intuit Inc., as
the transmitter of your electronically filed tax return, to disclose your tax return and contact information to
Bank and Processor for use in connection with the Refund Processing Service being provided pursuant to
this Agreement and Bank and Processor to share your information with Intuit Inc. You also represent that
any authorizations you have made in this Section 2 have also been obtained from and are made with respect
to your spouse, if this is a jointly filed return. None of Intuit Inc., Bank or Processor will disclose or use your
tax return information for any other purpose, except as permitted by law. Bank and Processor will not use
your tax information or contact information for any marketing purpose. Please see the Privacy Policy
at the end of this Agreement describing how Bank may use or share your personal information.
3. Summary of Terms
Expected Federal Refund $ 6,154.00
Less Processor Refund Processing Fee $ 40.00
Less TurboTax Fees $ 80.00
Less Fees for Additional Products and Services Purchased $
Expected Proceeds* $ 6,034.00
* These charges are itemized. This is only an estimate. The amount will be reduced by any applicable sales taxes, and if
applicable, a Return Item Fee and an Account Research and Processing Fee paid to Processor as set forth in Sections 4, 6 and
7 below.
4. Temporary Deposit Account Authorization. You hereby authorize Bank to establish a temporary deposit
account ("Deposit Account") for the purpose of receiving your tax year 2019 federal tax refund from the IRS.
Bank or Processor must receive an acknowledgement from the IRS that your return has been electronically
filed and accepted for processing before the Deposit Account can be opened. You authorize Processor to
deduct from your Deposit Account the following amounts: (i) the Refund Processing Fee; (ii) the fees and
charges related to the preparation, processing and transmission of your tax return ("TurboTax Fees"); and
(iii) fees for Additional Products and Services Purchased, plus applicable taxes. You also authorize Processor
to deduct thirty dollars ($30.00) as a returned item processing fee (the "Return Item Fee") from your Deposit
Account for the additional processing required in the event that your deposit is returned or cannot be
delivered as directed in Section 7 below. A fee of $30.00 (the "Account Research and Processing Fee") may
be charged if we are required to provide additional processing to return the funds to the IRS. These fees will
be deducted from the Deposit Account and will be retained by Processor. You authorize Processor to
disburse the balance of the Deposit Account to you after making all authorized deductions or payments. If
the Deposit Account does not have sufficient funds to pay the TurboTax Fees and the fees for Additional
Products and Services Purchased as set forth in Section 3, (a) you authorize Processor to automatically
deduct such fees (or any portion thereof) via ACH, electronic check, or wire transfer directly from the
account into which you authorized Processor to deposit your expected proceeds as set forth in Section
7, and (b) if you made alternative arrangements with TurboTax for payment of such fees, those
arrangements will be attempted prior to any automatic deduction.
5. Acknowledgements. (a) You understand that: (i) neither Bank nor Processor can guarantee the amount
of your tax year 2019 federal tax refund or the date it will be issued, and (ii) neither Bank nor Processor is
affiliated with the transmitter of the tax return (Intuit Inc.) and neither warrants the accuracy of the
software used to prepare the tax return. (b) You agree that Intuit Inc. is not acting as your agent and is not
under any fiduciary duty with respect to the processing of your refund by Bank and Processor. (c) Your
refund may be held or returned to the IRS if it is suspected of fraud or identity theft.
6. Truth in Savings Disclosure. The Deposit Account is being opened for the purpose of receiving your (or
both spouses if this is a jointly filed return) tax year 2019 federal tax refund. Processor and Bank will deduct
from the Deposit Account the fees set forth in Section 3, including the $ 40.00 Refund Processing Fee for
opening and maintaining the Deposit Account and processing your tax refund. No other deposits may be
made to the Deposit Account. No withdrawals will be allowed from the Deposit Account except to collect the
fees stated in this Section, Section 3, Section 7, and as provided in Section 4. No interest is payable on the
deposit; thus, the annual percentage yield and interest rate are 0%. The Deposit Account will be closed after
all authorized deductions have been made and any remaining balance has been disbursed to you. We will
also charge a Return Item Fee of $30.00 if the refund cannot be delivered as directed in Section 7 of this
Agreement. A $30.00 Account Research and Processing Fee may be charged if we are required to provide
additional processing to return the funds to the IRS. These fees will be deducted from the Deposit Account
and will be retained by Processor. Questions or concerns about the Deposit Account should be directed to
Santa Barbara Tax Products Group, LLC, 11085 North Torrey Pines Road, Suite 210, La Jolla, CA 92037 or
via the Internet at http://sbtpg.com.
7. Disbursement Methods (Select One): You agree that the disbursement method selected below
will be used by Processor to disburse funds to you.
a) Direct Deposit to Turbo(SM) Debit Visa(R) Card: If you choose this option, you authorize and
request Processor to transfer the balance of your Deposit Account to Bank, which
issues the Turbo(SM) Debit Visa Card ("Card") you have obtained or are obtaining, so that Bank
may deposit the balance of your refund into your Card account. Additional fees may be charged
for the use of the Card. Please review the Deposit Account Agreement associated with the use of
your Card to learn of other fees, charges, terms and conditions that will apply. Processor
will not be responsible for your funds once they have been deposited with Bank.
b) X Direct Deposit to Checking or Savings Account: If you choose this option, the balance of your
Deposit Account will be disbursed to you electronically by ACH direct deposit to your personal bank
account designated below. If a joint return is filed, the bank account may be a joint account or the
individual account of either spouse.
DIRECT DEPOSIT ACCOUNT TYPE:

X Checking
Savings
RTN # 072000096
Account # 6827014363
Note: To ensure that there are no delays in receiving your refund, please contact your financial
institution to confirm that you are using the correct RTN (routing) and account number. If you or your
representative enter your account information incorrectly and your deposit is returned to Bank, the
Deposit Account balance minus a $30.00 Return Item Fee will be disbursed to you via a cashier’s
check mailed to your physical address of record. Bank, Processor and Intuit Inc. are not
responsible for the misapplication of a direct deposit that results from error, negligence or malfeasance
on the part of you or your representative. In cases where Bank has received your federal tax refund
but is unable to deliver the funds directly to you, funds may be held at Bank until claimed, or returned
to the IRS. An Account Research and Processing Fee of $30.00 may be charged if we are required to
provide additional processing to return the funds to the IRS. Return Item and Account Research and
Processing Fees will not exceed $60.00 in the aggregate, and will be deducted from the Deposit
Account for federal tax refunds that continue to be undeliverable and unclaimed and must be returned
to the IRS. These fees will be retained by Processor. Due to the risk of fraudulent diversion of tax
refunds, we will not process any address or account changes for purposes of disbursing your tax
refund. If we become aware that your address or checking or savings account has changed after you
sign this Agreement but before your federal tax refund is received by us, upon receipt of your federal
tax refund from the IRS we will return your tax refund to the IRS after deducting our Refund Processing
Fee, TurboTax Fees and other applicable fees. We will do our best to escalate the return of your
federal tax refund to the IRS and you will need to work with the IRS directly for disbursement.
You must notify Processor in writing 3 business days prior to the date the account will be debited
(as set forth in the email and/or written notices sent to you) to revoke the authorization
for applicable fees agreed to in Section 4, and to afford Processor a reasonable opportunity
to act on your request. You may notify us in writing at: Santa Barbara Tax Products Group, LLC,
11085 North Torrey Pines Road, Suite 210, La Jolla, California 92037.
8. FEDERAL ELECTRONIC FUND TRANSFER ACT DISCLOSURES: In case of errors or questions about
electronic transfers to or from the Deposit Account, write to Santa Barbara Tax Products Group, LLC, 11085
North Torrey Pines Road, Suite 210, La Jolla, California 92037 or telephone (877) 908-7228 and provide
your name, a description or explanation of the error, and the dollar amount of the suspected error. We will
determine whether an error occurred within 10 business days after we hear from you and will correct any
error promptly. If we need more time, however, we may take up to 45 business days to investigate
your complaint or question. If we decide to do this, we will credit your Deposit Account within 10 business days
for the amount you think is in error, although in most circumstances you won’t have use of the money until
we complete our investigation. If we ask you to put your complaint or question in writing and we do not receive
it within 10 business days, we may not credit your Deposit Account. For errors involving transfers of funds to
or from the Deposit Account within 30 business days after the first deposit to the Deposit Account was made,
(i) we may take up to 90 business days to investigate your complaint or question, and (ii) we may take up to
20 business days to credit your Deposit Account for the amount you think is in error. We will tell you the results
within three business days after completing our investigation. If we decide that there was no error, we will
send you a written explanation. You may ask for copies of the documents that we used in our investigation.
Business Days: Our business days are Monday through Friday, excluding federal holidays. Saturday,
Sunday, and federal holidays are not considered business days, even if we are open.
Confidentiality: We will disclose information to third parties about your account or the transfers you make:
? To complete transfers as necessary;

? To verify the existence and condition of your account upon the request of a third party, such as a credit
bureau or merchant;
? To comply with government agency or court orders;
? If you give us your written permission; or
? As explained in the Privacy Policy following this Agreement.
Our Liability: If we do not complete a transfer to your account on time or in the correct amount according to
this Agreement, we may be liable for your losses or damages. In addition to all other limitations of liability
set forth in this Agreement, we will not be liable to you if, among other things:
? Circumstances beyond our control (natural disasters, such as fire or flood) prevent the transfer, despite
reasonable precautions that have been taken.
? The funds in your account are subject to legal process or other claim restricting such transfer.
? You or your representative provide us with inaccurate information.
9. Compensation. In addition to any fees paid directly by you to Intuit Inc., Processor will pay
compensation to Intuit Inc. in consideration of Intuit Inc.’s provision of various programming, testing, data
processing, transmission, systems maintenance, status reporting and other software, technical and
communications services. The Refund Processing Fee will be retained by Processor for its Refund
Processing Service. Processor shall pay Bank for its banking services.
10. Governing Law. The enforcement and interpretation of this Agreement and the transactions
contemplated herein shall be governed by the laws of the United States, including the Electronic Signatures
in Global and National Commerce Act, and, to the extent state law applies, the substantive laws of Ohio.
11. Arbitration Provision. You acknowledge that the services set forth in this Agreement are being made
available and priced by Processor on the basis of your acceptance of the following arbitration provision
("Arbitration Provision"). By entering into this Agreement, you acknowledge that you are giving up the right
to litigate Claims (as defined below) if you, Bank or Processor elects arbitration of the Claims pursuant to
this provision, except as otherwise expressly provided herein, and you hereby knowingly and voluntarily
waive the right to trial of all Claims subject to this Agreement. You further acknowledge that you have read
this Arbitration Provision carefully, agree to its terms, and are entering into this Agreement voluntarily and
not in reliance on any promises or representations whatsoever except those contained in this Agreement.
ARBITRATION NOTICE
THIS AGREEMENT CONTAINS AN ARBITRATION PROVISION. PLEASE READ THIS PROVISION
CAREFULLY, AS IT AFFECTS YOUR LEGAL RIGHTS.
11.1. Arbitration of Claims: Except as expressly provided herein, any claim, dispute or controversy
(whether based upon contract; tort, intentional or otherwise; constitution; statute; common law; or equity
and whether pre-existing, present or future), including initial claims, counter-claims, cross-claims and
third-party claims, arising from or relating directly or indirectly to this Agreement, including the validity,
enforceability, interpretation, scope, or application of the Agreement and this Arbitration Provision (except
for the prohibition on class or other non-individual claims, which shall be for a court to decide) ("Claim")
shall be decided, upon the election of you, Bank or Processor (or our agents, employees, successors,
representatives, affiliated companies, or assigns), by binding arbitration before the American Arbitration
Association ("AAA"). Arbitration replaces the right to litigate a claim in court or to have a jury trial. The
AAA’s phone number is 800-778-7879 and website is http://www.adr.org. You may obtain copies of the
current rules, forms, and instructions for initiating an arbitration using the above information.
11.2. Other Claims Subject to Arbitration: In addition to Claims brought by you, Claims made by anyone
connected with you or anyone making a Claim through you (including a taxpayer filing jointly, employee,
agent, representative, affiliated company, predecessor or successor, heir, assignee, or trustee in bankruptcy)
against us shall be subject to arbitration as described herein.
11.3. Exceptions: We agree not to invoke our right to arbitrate any individual Claim you bring in small
claims court or an equivalent court so long as the Claim is pending only in that court. This Arbitration
Provision also does not limit or constrain our right to interplead funds in the event of claims to the Account
by several parties.
11.4. Individual Claims Only: Claims may be submitted to arbitration on an individual basis only. Claims
subject to this Arbitration Provision may not be joined or consolidated in arbitration with any Claim of any
other person or be arbitrated on a class basis, in a representative capacity on behalf of the general public
or on behalf of any other person, unless otherwise agreed to by the parties in writing. However, taxpayers
filing jointly and party to this Agreement are considered as one person; Processor and its officers, directors,
employees, agents, and affiliates are considered as one person; and Bank and its officers, directors,
employees, agents, and affiliates are considered as one person.
11.5. Arbitration Fees: If you initiate arbitration, we will advance any arbitration fees, including any required
deposit. If we initiate or elect arbitration, we will pay the entire amount of the arbitration fees, including any
required deposit. We will also be responsible for payment and/or reimbursement of any arbitration fees to
the extent that such fees exceed the amount of the filing fees you would have incurred if your Claim had
been brought in the state or federal court nearest your residence with jurisdiction over the Claims.
11.6. Procedure: A single arbitrator will resolve the Claims. The arbitrator will be a lawyer with at least ten
years experience or who is a former or retired judge. The arbitration shall follow the rules and procedures of
the arbitration administrator in effect on the date the arbitration is filed, except when there is a conflict or
inconsistency between the rules and procedures of the arbitration administrator and this Arbitration
Provision, in which case this Arbitration Provision shall govern. Any in-person arbitration hearing for a Claim
shall take place within the federal judicial district in which you live or at such other reasonably convenient
location as agreed by the parties. The arbitrator shall apply applicable substantive law consistent with the
Federal Arbitration Act, 9 U.S.C. § 1 et seq. (the "FAA") and shall honor all claims of privilege and
confidentiality recognized at law. All statutes of limitations that would otherwise be applicable shall apply
to any arbitration proceeding. The arbitrator shall be empowered to grant whatever relief would be available
in court under law or in equity. Any appropriate court may enter judgment upon the arbitrator’s award.
This Arbitration Provision is made pursuant to a transaction involving interstate commerce, and shall be
governed by the FAA.
12. Customer Identity Validation Disclosure. To help Bank, Processor and the government identify and fight
tax refund fraud, as well as fight the funding of terrorism and money laundering activities, Bank and
Processor obtain, verify, and record information that identifies each Refund Processing Service client. What
this means for you: When you apply to use the Refund Processing Service for the purpose of receiving your
federal tax refund, we will ask for your name, address, date of birth, and other information that will allow us
to identify you. We may also ask to see your driver’s license or other identifying documents if we need to
perform additional due diligence on your account.
YOUR AGREEMENT
Bank and Processor agree to all of the terms of this Agreement. By selecting the "I Agree" button in
TurboTax: (i) You authorize Bank to receive your 2019 federal tax refund from the IRS and Processor to
make the deductions from your refund described in the Agreement, (ii) You agree to receive all
communications electronically in accordance with the "Communications" section of the Tax Year 2019
TurboTax(R) User Agreement, (iii) You consent to the release of your 2019 federal tax refund deposit
information and application information as described in Section 2 of this Agreement; and (iv) You
acknowledge that you have reviewed, and agree to be bound by, the Agreement’s terms and conditions. If
this is a joint return, selecting "I Agree" indicates that both spouses agree to be bound by the terms and
conditions of the Agreement.
GREEN DOT BANK’S PRIVACY POLICY

Rev. 10/2018
FACTS WHAT DOES GREEN DOT BANK DO WITH YOUR PERSONAL INFORMATION?
Why? Financial companies choose how they share your personal information. Federal law gives
consumers the right to limit some but not all sharing. Federal law also requires us to tell you how
we collect, share, and protect your personal information. Please read this notice carefully to
understand what we do.
What? The types of personal information that we collect and share depend on the product or service
you have with us. This information can include:
? Social Security number and account balances

? account transactions and purchase history
? transaction history and overdraft history
How? All financial companies need to share customers’ personal information to run their everyday
business. In the section below, we list the reasons financial companies can share their
customers’ personal information; the reasons Green Dot Bank chooses to share
and whether you can limit the sharing.
Reasons we can share your Does Green Dot Bank Can you limit this sharing?
personal information Share?
For our everyday business purposes '

such as to process your transactions,
maintain your account(s), respond to court Yes No
orders and legal investigations, or report to
credit bureaus.
For our marketing purposes ' No We don’t share

to offer our products and services to you.
For joint marketing with other Yes No

financial companies.
For our affiliates’ everyday

business purposes ' Yes No
information about your transactions
and experiences.

business purposes ' No We don’t share
information about your creditworthiness.
For our affiliates to market to you. No We don’t share
For nonaffiliates to market to you. Yes Yes
To limit our Visit us online: https://www.turboprepaidcard.com/privacy-settings

sharing Your choice(s) will apply to only the card number you enter when making your choice(s).
If you have more than one card or account with us, you will need to make your choice(s)
for each card or account separately.
Please note:
If you are a new customer, we can begin sharing your information 30 days from the date
we sent this notice. When you are no longer our customer, we continue to share your
information as described in this notice.
However, you can contact us at any time to limit our sharing.
Questions? Call 1-888-285-4169 or go to www.turboprepaidcard.com

Page 2
What we do
How does Green Dot Bank To protect your personal information from unauthorized access
protect my and use, we use security measures that comply with federal law.
personal information? These measures include computer safeguards and secured files
and buildings.
How does Green Dot Bank We collect your personal information, for example, when you
collect my
personal information? ? open an account or make deposits or withdrawals from your
account
? use your debit card or provide account information
? give us your contact information
We also collect your personal information from others, such as

credit bureaus, affiliates, or other companies.
Why can’t I limit all sharing? Federal law gives you the right to limit only
? sharing for affiliates’ everyday business purposes ' information

about your creditworthiness
? affiliates from using your information to market to you
? sharing for nonaffiliates to market to you.
State laws and individual companies may give you additional rights
to limit sharing. See below for more on your rights under state law.
What happens when I limit sharing for an Your choices will apply to everyone on your account.
account I hold jointly with someone else?
Definitions
Affiliates Companies related by common ownership or control. They can be

financial and nonfinancial companies.
? Our affiliates include companies with a common corporate

identity of Green Dot (such as our parent bank holding company
Green Dot Corporation) and tax processing services companies
such as Santa Barbara Tax Products Group, LLC.
Nonaffiliates Companies not related by common ownership or control. They can

be financial and nonfinancial companies.
? The only nonaffiliates we share with are Intuit Inc. and its
affiliates and subsidiaries.
Joint marketing A formal agreement between nonaffiliated financial companies that

together market financial products or services to you.
? The only joint marketing partners we share with are Intuit Inc.
and its affiliates and subsidiaries.
Other important information
Depending on where you live, you may have additional privacy protections under state law. We will comply
with applicable state laws before sharing nonpublic personal information about you. We may do this by
sending a separate notice of those rights to you. For example, if you are a resident of California, Illinois,
North Dakota or Vermont, we will not share with nonaffiliates except for our everyday business purposes
or with your consent.
sbia0912.SCR 01/13/20
CUSTOMER SERVICE: 877-908-7228
Santa Barbara Tax Products Group, LLC
and Civista Bank Refund Processing Service Agreement ("Agreement")
Name
Social Security No.
This Agreement contains important terms, conditions and disclosures about the processing of your refund
(the "Refund Processing Service") by Santa Barbara Tax Products Group, LLC ("Processor"), a third party
processor using banking services of Civista Bank ("Bank"). Read this Agreement carefully before
accepting its terms and conditions, and print a copy and/or retain this information electronically for future
reference. As used in this Agreement, the words "you" and "your" refer to the applicant or both the applicant
and joint applicant if the 2019 federal income tax return is a joint return (individually and collectively,
"Applicant"). The words "we," "us" and "our" refer to Bank and Processor.
1. NOTICE: No Requirement To Use the Refund Processing Service In Order To File Electronically.
YOU UNDERSTAND THAT A REFUND PROCESSING FEE OF $ ("REFUND PROCESSING FEE") IS
CHARGED BY PROCESSOR TO ESTABLISH A TEMPORARY ACCOUNT TO RECEIVE YOUR FEDERAL TAX
REFUND, TO PROCESS IT, TO DEDUCT YOUR TURBOTAX FEES, AND OTHER AUTHORIZED FEES FROM
THAT ACCOUNT, AND TO FORWARD FUNDS TO YOU. THE REFUND PROCESSING FEE IS NOT A LOAN; IT
IS DUE TO PROCESSOR WHETHER OR NOT THE FEDERAL TAX REFUND OCCURS BUT PROCESSOR WILL
NOT PURSUE COLLECTION OF THE REFUND PROCESSING FEE IF YOUR FEDERAL TAX REFUND DOES
NOT OCCUR. THIS FEE IS COLLECTED ONLY AT THE TIME THE REFUND OCCURS. YOU CAN AVOID THIS
FEE AND NOT USE THE REFUND PROCESSING SERVICE BY INSTEAD PAYING THE APPLICABLE
TURBOTAX FEES TO INTUIT INC. BY CREDIT OR DEBIT CARD AT THE TIME YOU FILE YOUR
2019 FEDERAL INCOME TAX RETURN AND ELECTING TO HAVE YOUR REFUND DIRECTLY DEPOSITED IN
YOUR OWN BANK ACCOUNT OR MAILED TO YOU. IF YOU DO USE THE REFUND PROCESSING SERVICE,
YOU CAN EXPECT TO RECEIVE THE PROCEEDS FROM YOUR FEDERAL TAX REFUND WITHIN 21 DAYS
FROM WHEN THE INTERNAL REVENUE SERVICE ("IRS") ACCEPTS YOUR RETURN UNLESS THERE
ARE PROCESSING DELAYS BY THE IRS (OR UNLESS YOUR RETURN CONTAINS EARNED INCOME TAX
CREDIT OR ADDITIONAL CHILD TAX CREDIT, IN WHICH CASE THE IRS WILL ISSUE YOUR REFUND NO
EARLIER THAN FEBRUARY 15, 2020). THE REFUND PROCESSING SERVICE WILL NEITHER SPEED UP
NOR DELAY YOUR FEDERAL TAX REFUND. THE COST OF PREPARING YOUR TAX RETURN IS NOT ANY
MORE OR LESS IF YOU PURCHASE THE REFUND PROCESSING SERVICE.
2. Authorization to Release Personal Information. You authorize the IRS to disclose any information to
Bank and Processor related to the funding of your 2019 federal tax refund. You also authorize Intuit Inc., as
the transmitter of your electronically filed tax return, to disclose your tax return and contact information to
Bank and Processor for use in connection with the Refund Processing Service being provided pursuant to
this Agreement and Bank and Processor to share your information with Intuit Inc. You also represent that
any authorizations you have made in this Section 2 have also been obtained from and are made with respect
to your spouse, if this is a jointly filed return. None of Intuit Inc., Bank or Processor will disclose or use your
tax return information for any other purpose, except as permitted by law. Bank and Processor will not use
your tax information or contact information for any marketing purpose. Please see the Privacy Policy
at the end of this Agreement describing how Bank may use or share your personal information.
3. Summary of Terms
Expected Federal Refund $
Less Processor Refund Processing Fee $
Less TurboTax Fees $
Less Fees for Additional Products and Services Purchased $
Expected Proceeds* $
* These charges are itemized. This is only an estimate. The amount will be reduced by any applicable sales taxes, and if
applicable, a Return Item Fee and an Account Research and Processing Fee paid to Processor as set forth in Sections 4, 6 and
7 below.
4. Temporary Deposit Account Authorization. You hereby authorize Bank to establish a temporary deposit
account ("Deposit Account") for the purpose of receiving your tax year 2019 federal tax refund from the IRS.
Bank or Processor must receive an acknowledgement from the IRS that your return has been electronically
filed and accepted for processing before the Deposit Account can be opened. You authorize Processor to
deduct from your Deposit Account the following amounts: (i) the Refund Processing Fee; (ii) the fees and
charges related to the preparation, processing and transmission of your tax return ("TurboTax Fees"); and
(iii) fees for Additional Products and Services Purchased, plus applicable taxes. You also authorize Processor
Page 2
to deduct thirty dollars ($30.00) as a returned item processing fee (the "Return Item Fee") from your Deposit
Account for the additional processing required in the event that your deposit is returned or cannot be
delivered as directed in Section 7 below. A fee of $30.00 (the "Account Research and Processing Fee") may
be charged if we are required to provide additional processing to return the funds to the IRS. These fees will
be deducted from the Deposit Account and will be retained by Processor. You authorize Processor to
disburse the balance of the Deposit Account to you after making all authorized deductions or payments. If
the Deposit Account does not have sufficient funds to pay the TurboTax Fees and the fees for Additional
Products and Services Purchased as set forth in Section 3, (a) you authorize Processor to automatically
deduct such fees (or any portion thereof) via ACH, electronic check, or wire transfer directly from the
account into which you authorized Processor to deposit your expected proceeds as set forth in Section
7, and (b) if you made alternative arrangements with TurboTax for payment of such fees, those
arrangements will be attempted prior to any automatic deduction.
5. Acknowledgements. . (a) You understand that: (i) neither Bank nor Processor can guarantee the
amount of your tax year 2019 federal tax refund or the date it will be issued, and (ii) neither Bank nor
Processor is affiliated with the transmitter of the tax return (Intuit Inc.) and neither warrants the accuracy of
the software used to prepare the tax return. (b) You agree that Intuit Inc. is not acting as your agent and is
not under any fiduciary duty with respect to the processing of your refund by Bank and Processor. (c) Your
refund may be held or returned to the IRS if it is suspected of fraud or identity theft.
6. Truth in Savings Disclosure. The Deposit Account is being opened for the purpose of receiving your (or
both spouses if this is a jointly filed return) tax year 2019 federal tax refund. Processor and Bank will deduct
from the Deposit Account the fees set forth in Section 3, including the $ Refund Processing Fee for
opening and maintaining the Deposit Account and processing your tax refund. No other deposits may be
made to the Deposit Account. No withdrawals will be allowed from the Deposit Account except to collect the
fees stated in this Section, Section 3, Section 7, and as provided in Section 4. No interest is payable on the
deposit; thus, the annual percentage yield and interest rate are 0%. The Deposit Account will be closed after
all authorized deductions have been made and any remaining balance has been disbursed to you. We will
also charge a Return Item Fee of $30.00 if the refund cannot be delivered as directed in Section 7 of this
Agreement. A $30.00 Account Research and Processing Fee may be charged if we are required to provide
additional processing to return the funds to the IRS. These fees will be deducted from the Deposit Account
and will be retained by Processor. Questions or concerns about the Deposit Account should be directed to
Santa Barbara Tax Products Group, LLC, 11085 North Torrey Pines Road, Suite 210, La Jolla, CA 92037 or
via the Internet at http://sbtpg.com.
7. Disbursement Methods (Select One): You agree that the disbursement method selected below
will be used by Processor to disburse funds to you.
a) Direct Deposit to Turbo(SM) Debit Visa(R) Card: If you choose this option, you authorize and
request Processor to transfer the balance of your Deposit Account to Green Dot Bank, which issues
the Turbo(SM) Debit Visa Card ("Card") you have obtained or are obtaining, so that Green Dot Bank
may deposit the balance of your refund into your Card account. Additional fees may be charged for
the use of the Card. Please review the Deposit Account Agreement associated with the use of your
Card to learn of other fees, charges, terms and conditions that will apply. Neither Bank nor
Processor will be responsible for your funds once they have been deposited with Green Dot Bank.
b) Direct Deposit to Checking or Savings Account: If you choose this option, the balance of your
Deposit Account will be disbursed to you electronically by ACH direct deposit to your personal bank
account designated below. If a joint return is filed, the bank account may be a joint account or the
individual account of either spouse.
DIRECT DEPOSIT ACCOUNT TYPE:

Checking
Savings
RTN #
Account #
Note: To ensure that there are no delays in receiving your refund, please contact your financial
institution to confirm that you are using the correct RTN (routing) and account number. If you or your
representative enter your account information incorrectly and your deposit is returned to
Bank, the Deposit Account balance minus a $30.00 Return Item Fee will be disbursed to you via a
cashier’s check mailed to your physical address of record. Bank, Processor and Intuit Inc. are not
responsible for the misapplication of a direct deposit that results from error, negligence or malfeasance
on the part of you or your representative. In cases where Bank has received your federal tax refund
but is unable to deliver the funds directly to you, funds may be held at Bank until claimed, or returned
to the IRS. An Account Research and Processing Fee of $30.00 may be charged if we are required to
Page 3
provide additional processing to return the funds to the IRS. Return Item and Account Research and
Processing Fees will not exceed $60.00 in the aggregate, and will be deducted from the Deposit
Account for federal tax refunds that continue to be undeliverable and unclaimed and must be returned
to the IRS. These fees will be retained by Processor. Due to the risk of fraudulent diversion of tax
refunds, we will not process any address or account changes for purposes of disbursing your tax
refund. If we become aware that your address or checking or savings account has changed after you
sign this Agreement but before your federal tax refund is received by us, upon receipt of your federal
tax refund from the IRS we will return your tax refund to the IRS after deducting our Refund Processing
Fee, TurboTax Fees and other applicable fees. We will do our best to escalate the return of your
federal tax refund to the IRS and you will need to work with the IRS directly for disbursement.
You must notify Processor in writing 3 business days prior to the date the account will be debited
(as set forth in the email and/or written notices sent to you) to revoke the authorization
for applicable fees agreed to in Section 4, and to afford Processor a reasonable opportunity
to act on your request. You may notify us in writing at: Santa Barbara Tax Products Group, LLC,
11085 North Torrey Pines Road, Suite 210, La Jolla, California 92037.
8. FEDERAL ELECTRONIC FUND TRANSFER ACT DISCLOSURES: In case of errors or questions about
electronic transfers to or from the Deposit Account, write to Santa Barbara Tax Products Group, LLC, 11085
North Torrey Pines Road, Suite 210, La Jolla, California 92037 or telephone (877) 908-7228 and provide
your name, a description or explanation of the error, and the dollar amount of the suspected error. We will
determine whether an error occurred within 10 business days after we hear from you and will correct any
error promptly. If we need more time, however, we may take up to 45 business days to investigate your
complaint or question. If we decide to do this, we will credit your Deposit Account within 10 business days
for the amount you think is in error, although in most circumstances you won’t have use of the money until
we complete our investigation. If we ask you to put your complaint or question in writing and we do not
receive it within 10 business days, we may not credit your Deposit Account. For errors involving transfers of
funds to or from the Deposit Account within 30 business days after the first deposit to the Deposit Account
was made, (i) we may take up to 90 business days to investigate your complaint or question, and (ii) we
may take up to 20 business days to credit your Deposit Account for the amount you think is in error. We will
tell you the results within three business days after completing our investigation. If we decide that there
was no error, we will send you a written explanation. You may ask for copies of the documents that we
used in our investigation.
Business Days: Our business days are Monday through Friday, excluding federal holidays. Saturday,
Sunday, and federal holidays are not considered business days, even if we are open.
Confidentiality: We will disclose information to third parties about your account or the transfers you make:
? To complete transfers as necessary;

? To verify the existence and condition of your account upon the request of a third party, such as a credit
bureau or merchant;
? To comply with government agency or court orders;
? If you give us your written permission; or
? As explained in the Privacy Policy following this Agreement.
Our Liability: If we do not complete a transfer to your account on time or in the correct amount according to
this Agreement, we may be liable for your losses or damages. In addition to all other limitations of liability
set forth in this Agreement, we will not be liable to you if, among other things:
? Circumstances beyond our control (natural disasters, such as fire or flood) prevent the transfer, despite
reasonable precautions that have been taken.
? The funds in your account are subject to legal process or other claim restricting such transfer.
? You or your representative provide us with inaccurate information.
9. Compensation. In addition to any fees paid directly by you to Intuit Inc., Processor will pay
compensation to Intuit Inc. in consideration of Intuit Inc.’s provision of various programming, testing, data
processing, transmission, systems maintenance, status reporting and other software, technical and
communications services. The Refund Processing Fee will be retained by Processor for its Refund
Processing Service. Processor shall pay Bank for its banking services.
10. Governing Law. The enforcement and interpretation of this Agreement and the transactions
contemplated herein shall be governed by the laws of the United States, including the Electronic Signatures
in Global and National Commerce Act, and, to the extent state law applies, the substantive laws of Ohio.
Page 4
11. Arbitration Provision. You acknowledge that the services set forth in this Agreement are being made
available and priced by Processor on the basis of your acceptance of the following arbitration provision
("Arbitration Provision"). By entering into this Agreement, you acknowledge that you are giving up the right
to litigate Claims (as defined below) if you, Bank or Processor elects arbitration of the Claims pursuant to
this provision, except as otherwise expressly provided herein, and you hereby knowingly and voluntarily
waive the right to trial of all Claims subject to this Agreement. You further acknowledge that you have read
this Arbitration Provision carefully, agree to its terms, and are entering into this Agreement voluntarily and
not in reliance on any promises or representations whatsoever except those contained in this Agreement.
ARBITRATION NOTICE
THIS AGREEMENT CONTAINS AN ARBITRATION PROVISION. PLEASE READ THIS PROVISION
CAREFULLY, AS IT AFFECTS YOUR LEGAL RIGHTS.
11.1. Arbitration of Claims: Except as expressly provided herein, any claim, dispute or controversy
(whether based upon contract; tort, intentional or otherwise; constitution; statute; common law; or equity
and whether pre-existing, present or future), including initial claims, counter-claims, cross-claims and
third-party claims, arising from or relating directly or indirectly to this Agreement, including the validity,
enforceability, interpretation, scope, or application of the Agreement and this Arbitration Provision (except
for the prohibition on class or other non-individual claims, which shall be for a court to decide) ("Claim")
shall be decided, upon the election of you, Bank or Processor (or our agents, employees, successors,
representatives, affiliated companies, or assigns), by binding arbitration before the American Arbitration
Association ("AAA"). Arbitration replaces the right to litigate a claim in court or to have a jury trial. The
AAA’s phone number is 800-778-7879 and website is http://www.adr.org. You may obtain copies of the
current rules, forms, and instructions for initiating an arbitration using the above information.
11.2. Other Claims Subject to Arbitration: In addition to Claims brought by you, Claims made by anyone
connected with you or anyone making a Claim through you (including a taxpayer filing jointly, employee,
agent, representative, affiliated company, predecessor or successor, heir, assignee, or trustee in bankruptcy)
against us shall be subject to arbitration as described herein.
11.3. Exceptions: We agree not to invoke our right to arbitrate any individual Claim you bring in small
claims court or an equivalent court so long as the Claim is pending only in that court. This Arbitration
Provision also does not limit or constrain our right to interplead funds in the event of claims to the Account
by several parties.
11.4. Individual Claims Only: Claims may be submitted to arbitration on an individual basis only. Claims
subject to this Arbitration Provision may not be joined or consolidated in arbitration with any Claim of any
other person or be arbitrated on a class basis, in a representative capacity on behalf of the general public
or on behalf of any other person, unless otherwise agreed to by the parties in writing. However, taxpayers
filing jointly and party to this Agreement are considered as one person; Processor and its officers, directors,
employees, agents, and affiliates are considered as one person; and Bank and its officers, directors,
employees, agents, and affiliates are considered as one person.
11.5. Arbitration Fees: If you initiate arbitration, we will advance any arbitration fees, including any required
deposit. If we initiate or elect arbitration, we will pay the entire amount of the arbitration fees, including any
required deposit. We will also be responsible for payment and/or reimbursement of any arbitration fees to
the extent that such fees exceed the amount of the filing fees you would have incurred if your Claim had
been brought in the state or federal court nearest your residence with jurisdiction over the Claims.
11.6. Procedure: A single arbitrator will resolve the Claims. The arbitrator will be a lawyer with at least ten
years experience or who is a former or retired judge. The arbitration shall follow the rules and procedures of
the arbitration administrator in effect on the date the arbitration is filed, except when there is a conflict or
inconsistency between the rules and procedures of the arbitration administrator and this Arbitration
Provision, in which case this Arbitration Provision shall govern. Any in-person arbitration hearing for a Claim
shall take place within the federal judicial district in which you live or at such other reasonably convenient
location as agreed by the parties. The arbitrator shall apply applicable substantive law consistent with the
Federal Arbitration Act, 9 U.S.C. § 1 et seq. (the "FAA") and shall honor all claims of privilege and
confidentiality recognized at law. All statutes of limitations that would otherwise be applicable shall apply
to any arbitration proceeding. The arbitrator shall be empowered to grant whatever relief would be available
in court under law or in equity. Any appropriate court may enter judgment upon the arbitrator’s award.
This Arbitration Provision is made pursuant to a transaction involving interstate commerce, and shall be
governed by the FAA.
Page 5
12. Customer Identity Validation Disclosure. To help Bank, Processor and the government identify and fight
tax refund fraud, as well as fight the funding of terrorism and money laundering activities, Bank and
Processor obtain, verify, and record information that identifies each Refund Processing Service client. What
this means for you: When you apply to use the Refund Processing Service for the purpose of receiving your
federal tax refund, we will ask for your name, address, date of birth, and other information that will allow us
to identify you. We may also ask to see your driver’s license or other identifying documents if we need to
perform additional due diligence on your account.
YOUR AGREEMENT
Bank and Processor agree to all of the terms of this Agreement. By selecting the "I Agree" button in
TurboTax: (i) You authorize Bank to receive your 2019 federal tax refund from the IRS and Processor to
make the deductions from your refund described in the Agreement, (ii) You agree to receive all
communications electronically in accordance with the "Communications" section of the Tax Year 2019
TurboTax(R) User Agreement, (iii) You consent to the release of your 2019 federal tax refund deposit
information and application information as described in Section 2 of this Agreement; and (iv) You
acknowledge that you have reviewed, and agree to be bound by, the Agreement’s terms and conditions. If
this is a joint return, selecting "I Agree" indicates that both spouses agree to be bound by the terms and
conditions of the Agreement.
Rev. 02/2015
Civista Bank Tax Product Privacy Policy
FACTS What does Civista Bank do with your Personal Information?
Why? Financial Companies choose how they share your personal information. Federal law gives
consumers the right to limit some but not all sharing. Federal law also requires us to tell you how
we collect, share and protect your personal information. Please read this notice carefully to
understand what we do.
What? The types of personal information that we collect and share depend on the product or service
you have with us. This can include:
? Social Security number and account balances

? payment history and transaction history
? overdraft history and account transactions
When you are no longer our customer, we continue to share your information as described in
this notice.
How? All Financial Companies need to share customers’ personal information to run their everyday
business. In the section below we list the reasons financial companies can share their
customers’ personal information; the reasons Civista Bank chooses to share
and whether you can limit the sharing.
Reasons we can share your Does Civista Bank Can you limit this sharing?
personal information Share?
For our everyday business purposes '

such as to process your transaction,
maintain your account(s), respond to court Yes No
orders and legal investigations, or report to
credit bureaus.
For our marketing purposes ' No We don’t share

to offer our products and services to you.
For joint marketing with other No We don’t share

financial companies.

information about your transactions
and experiences.

information about your creditworthiness.
For our affiliates to market to you. No We don’t share
For non affiliates to market to you. No We don’t share
Questions? Call Toll Free: 800-901-6663 or go to www.civistabank.com

Page 2
Who we are
Who is providing this notice? Civista Bank
What we do
How does Civista Bank To protect your personal information from unauthorized access
protect my and use, we use security measures that comply with federal law.
personal information? These measures include computer safeguards and secured files
and buildings.
How does Civista Bank We collect personal information about you when you apply for a tax
collect my related product. This includes information in your application, such
personal information? as your name, address, social security number, income,
deductions, refund and the like. We also collect information about
your transactions with us, tax preparers and similar providers, such
as payment histories, balances due, and tax information. We may
also collect information concerning your credit history from a
consumer reporting agency.
Why can’t I limit all sharing? Federal law gives you the right to limit only:
? Sharing for affiliates everyday business purposes '

information about your creditworthiness,
? Affiliates from using your information to market to you,
? Sharing for non affiliates to market to you.
State laws and individual companies may give you additional rights
to limit sharing.
Definitions
Affiliates Companies related by common ownership or control. They can be

financial and nonfinancial companies.
? Civista Bank does not share with our affiliates.
Non affiliates Companies not related by common ownership or control. They can
be financial or nonfinancial companies.
? Civista Bank does not share with non

affiliates so they can market to you.
Joint Marketing A formal joint marketing agreement between non affiliated financial
companies that together market financial products or services
to you.
? Civista Bank does not jointly market.
Other Important Information
This Notice is adopted in recognition of our obligations under Title V of Gramm-Leach Bliley Act of 1999.
This Notice applies only to individuals who have applied for a tax-related bank product.
sbia1514.SCR 01/13/20
ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING
Taxpayer: Durril M Butler

Primary SSN: 377-21-3791
Federal Return Submitted: January 28, 2020 05:00 PM PST

Federal Return Acceptance Date: 01/28/2020
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 July 15, 2020. 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 July 15, 2020, your Intuit electronic postmark will indicate
July 15, 2020, 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 July 15, 2020, and a corrected return is submitted and accepted
before July 20, 2020. If your return is submitted after July 20, 2020, 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, 2020. 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, 2020, and the corrected return is submitted
and accepted by October 20, 2020.
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.
We need your consent - Early Access
"Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use
your tax return information for purposes other than the preparation and filing of your tax return without
your consent.
consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not
specify the duration of your consent, your consent is valid for one year from the date of signature."
bottom of the page.
First Name Last Name
Date
F7216U01 SBIA5001
bottom of the page.
Date
sbia5101 F7216D
To, enable the Tax Identity restoration protection service that you purchased
as part of a bundle, we need your consent to send some of your
personal information to our partner, ID Notify.
Entering your name and date below allows us to disclose the data below to IDNotify,
provided by CSIdentity Corp., an Experian company. With your consent, we will send the following:
First Name, Middle Initial, Last Name, Date of Birth, Phone Number, Street Address, City, State,
Zip, Social Security Number, Email Address, Username, and a randomly generated Subscriber Number.
bottom of the page.
I authorize Intuit to send my information listed above to CSIdentity Corporation.
Date
sbia5102 F7216D02
IMPORTANT DISCLOSURES
If you are owed a federal tax refund, you have a right to choose how you will receive the refund. There
are several options available to you. Please read about these options below.
You can file your federal tax return electronically or by paper and obtain your federal tax refund directly
from the Internal Revenue Service ("IRS") for free. If you file your tax return electronically, you can
receive a refund check directly from the IRS through the U.S. Postal Service in 21 to 28 days from
the time you file your tax return or the IRS can deposit your refund directly into your bank account in less
than 21 days from the time you file your tax return unless there are delays by the IRS. If you file a paper
return through the U.S. Postal Service, you can receive a refund check directly from the IRS through the
U.S. Postal Service in 6 to 8 weeks from the time the IRS receives your return or the IRS can deposit
your refund directly into your bank account in 6 to 8 weeks from the time the IRS receives your return.
However, if your return contains Earned Income Tax Credit or Additional Child Tax Credit, the IRS will
You can file your tax return electronically, select the Refund Processing Service ("RPS"), and have your federal
income tax refund processed through a processor using banking services of a financial institution. The RPS allows
your refund to be deposited into a bank account intended for one-time use at Green Dot Bank ("Bank") and deducts
your TurboTax fees and other fees you authorize from your refund. The balance is delivered to you via the
disbursement method you select. If you file your tax return electronically and select the RPS, the IRS will deposit
your refund with Bank. Upon Bank's receipt of your refund, Santa Barbara Tax Products Group, LLC, a processor,
will deduct and pay from your refund any fees charged by TurboTax for the preparation and filing of your tax return
and any other amounts authorized by you and disburse the balance of your refund proceeds to you. Unless there are
delays by the IRS, refunds are received in less than 21 days from the time you file your tax return electronically.
However, if your return contains Earned Income Tax Credit or Additional Child Tax Credit, the IRS will issue your
refund no earlier than February 15, 2020.
The RPS is not necessary to obtain your refund. If you have an existing bank account, you do not need
to use the RPS in order to receive a direct deposit from the IRS. You may consult the IRS website
(IRS.gov) for information about tax refund processing.
If you select the RPS, no prior debt you may owe to Bank will be deducted from your refund.
You can change your income tax withholdings which might result in you receiving additional funds
throughout the year rather than waiting to receive these funds potentially in an income tax refund next
year. Please consult your employer or tax advisor for additional details.
This Agreement requires all disputes to be resolved by way of binding arbitration.

The terms of the arbitration provision appear in section 10.
Information regarding low-cost deposit accounts may be available at www.mymoney.gov .
The chart below shows the options for filing your tax return (e-file or paper return), the RPS product,
refund disbursement options, estimated timing for obtaining your tax refund proceeds, and costs
associated with the various options.
WHAT TYPE WHAT ARE YOUR WHAT IS THE WHAT COSTS DO YOU
OF FILING DISBURSEMENT ESTIMATED TIME TO INCUR IN ADDITION
METHOD? OPTIONS? RECEIVE REFUND? TO TAX PREPARATION
FEES?
PAPER RETURN IRS direct deposit to Approximately Free

your personal bank 6 to 8 weeks 3
No Refund Processing account.
Service
Check mailed by IRS Approximately
to address on tax 6 to 8 weeks 3
return.
ELECTRONIC IRS direct deposit to Usually within Free

(E-FILE) account.
No Refund Processing Check mailed by IRS Approximately

Service to address on tax 21 to 28 days 3
return.
ELECTRONIC (a) Direct deposit to Usually within Free option with your
FILING your personal bank 21 days 3 purchase of TurboTax
(E-FILE) account, or Premium Services or
TurboTax MAX 2
Refund Processing (b) Load to your
Service debit card 1.
1You may incur additional charges from the issuer of the debit card if you select to have your tax refund
loaded on a debit card.
2This fee consists of a TurboTax Fee, the cost of TurboTax Premium Services or TurboTax MAX and any fees
for additional products and services purchased. Note that the cost of TurboTax Premium Services and TurboTax MAX
ranges depending on the edition of TurboTax purchased. See Section 4 of the Refund Processing Service
Agreement on the next page for the cost of the service you have chosen.
3However, if your return contains Earned Income Tax Credit or Additional Child Tax Credit, the IRS will
Questions? Call 877-908-7228

Pro Delegation Worksheet 2019
Check this box if you are preparing this return as a PRO preparer
Preparer / Electronic Return Originator (ERO) Information
Print name in signature area?

Preparer Name
Preparer Tax ID # (PTIN)
NY Tax Preparer Registration # or NY Exclusion Code
For NM, OR Preparers Only: State ID#
Preparer E-mail Print date on return?
Preparer Phone CAF #
Electronic Filing Only: ERO Practitioner PIN
Electronic Filing and Printing of Tax Return Information

Original Returns:
File federal return electronically
File state returns electronically
Select state returns to file electronically:
State(s)
Amended Returns:
File federal amended return(s) electronically
File state amended return(s) electronically
Select state amended return(s) to file electronically:
State(s)
New! State e-file disclosure consent:

By using a computer system and software to prepare and transmit my client’s return electronically, I
consent to the disclosure of all information pertaining to my use of the system and software to create my
client’s return and to the electronic transmission of my client’s return to the state Department of
Revenue, as applicable by law.
Print and Mail Selections (use only if e-file ineligible):

Federal return printed and mailed to IRS
State return printed and mailed to state agency
Select state returns to file by mail:
State(s)
Practitioner PIN Program:

Sign return electronically using Practitioner PIN
Choose one:
Automatically generate PIN equal to last 5 digits of taxpayer(s) SSN (See help)
Taxpayer(s) entered own PIN(s)
Preparer entered PIN(s) on behalf of taxpayer(s)
Taxpayer’s PIN (enter any 5 numbers).
Spouse’s PIN filing a joint return (enter any 5 numbers)
Date PIN entered
Identity Verification Information
Driver’s License and/or State Id:

Taxpayer and Spouse (if applicable) driver’s license and/or state identification must be completed on the
federal information worksheet prior to e-filng the return.
Documents Used to Verify Primary Taxpayer Identity:

Driver’s license
State issued identification card
Passport
Account statement from financial institution
Utility billing statement
Credit card billing statement
Finish and File Info:

To indicate a client return download in FnF
fdiv8001.SCR 08/24/20
Durril M Butler 377-21-3791 1
Smart Worksheets from your 2019 Federal Tax Return
SMART WORKSHEET FOR: Schedule 8812: Additional Child Tax Credit
Disaster Relief Smart Worksheet

CTC Earned Income from 2018 Schedule 8812 Line 6a 14,228.
Nontaxable Combat Pay from 2018 return
If your main home was in a qualified disaster area in 2019 when the disaster
occurred, and you are electing to use your 2018 earned income,
check here
If you do not qualify for the Earned Income Credit and/or you did not transfer
your tax return from last year, Quickzoom here to enter 2018 earned income
on the Election to Use 2018 Earned Income for Eligible Disaster Victims
Smart Worksheet
SMART WORKSHEET FOR: 1040/1040SR Wks: Form 1040 or Form 1040-SR Worksheet
Tax Smart Worksheet
A Tax 488.
Check if from:
1 Tax table X
2 Tax Computation Worksheet (see instructions)
3 Schedule D Tax Worksheet
4 Qualified Dividends and Capital Gain Tax Worksheet
5 Schedule J
6 Form 8615
7 Foreign Earned Income Tax Worksheet
B Additional tax from Form 8814
C Additional tax from Form 4972
D Tax from additional Form(s) 4972
E Recapture tax from Form 8863
F IRC Section 197(f)(9)(B)(ii) election for an additional tax
G Health Coverage Tax Credit Recovery, Form 8885, Line 5, if negative
H Additional tax from Form 8621
I Tax. Add lines A through G. Enter the result here and include in tax below 488.
SMART WORKSHEET FOR: 1040/1040SR Wks: Form 1040 or Form 1040-SR Worksheet
Excess Social Security and Tier I RRTA Tax Withheld Smart Worksheet
The calculated amount for Excess social security and tier 1 RRTA tax withheld could include
a portion that needs to be removed. When a taxpayer has multiple W-2’s, each with the same
EIN, excess withholding can only be claimed if the Employer’s Name’s in box c of the W-2’s
reflect separate business entities. This could occur when a parent company has multiple
subsidiaries, or when a temp agency issues W-2’s for distinctly different jobs. If you have
multiple W-2’s with the same EIN, for the same taxpayer, and for the same job, reduce the
amount calculated on Line A below by the excess withholdings from only those W-2’s.
A Total Excess Social Security or Tier I RRTA tax withheld claimed as a credit 0.
SMART WORKSHEET FOR: Federal Information Worksheet
2017 Tax Cuts & Jobs Act

Apply 15-year recovery period to qualified improvement property
(asset types J2, J3, J4 and J5)
placed in service after December 31, 2017?
Yes No X
IMPORTANT NOTE: The Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into
law on March 27, 2020 has retroactively made qualified improvement property 15-year property.
Refer to Tax Help
SMART WORKSHEET FOR: Dependent Information Worksheet (Madison)
Dependency/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 How many months did this person live with you? The whole year
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
B Who are the parents of this person?
(Used to determine if additional questions are necessary for children of divorced parents.)
Both Taxpayer and spouse
Taxpayer X
Spouse
C Did this person provide more than 1/2 of their own support? Yes X No
D Was this person married on December 31, 2019 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)? Yes No
Detailed answers for this question. This dependent:
- Was married on December 31, 2019 Yes No
- If married, filed a joint return for the year Yes No
- If filed joint return, only filed to get a refund of
tax withheld or estimated tax payments Yes No
- If filed married filing separate, neither spouse
had a tax liability on their return if they had
filed separately Yes No
E Is this person a Full time student? Yes No
F Is this person’s gross income less than $4,200? Yes No
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? Yes No
G Is there an agreement with this person’s other parent about who can claim
this person as a dependent? X Yes No
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
1 TurboTax Web Only:
Is the other parent claiming this dependent per the custody
agreement? Yes No
Has the other parent waived their legal right so you can claim this
dependent on your tax return? Yes No
H Who will be claiming this person as a dependent as a result of:
- an agreement between the parents
- 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? X
Other parent in different return?
Someone else in different return?
SMART WORKSHEET FOR: Child Tax Cr and Cr for Other Depend Wks
Line 7 Smart Worksheet
If your employer withheld or you paid Additional Medicare Tax or Tier 1 RRTA taxes, use this
worksheet to figure the amount to enter on line 7.
Social security tax, Medicare tax, and Additional Medicare Tax on Wages.
A Enter the social security tax withheld (Form(s) W-2, box 4) 1,440.
B Enter the Medicare tax withheld (Form(s) W-2, box 6). Box 6 includes any
Additional Medicare Tax withheld 337.
C Enter any amount from Form 8959, line 7 0.
D Add line A, B, and C 1,777.
E Enter the Additional Medicare Tax withheld (Form 8959 line 22) 0.
F Subtract line E from line D 1,777.
Additional Medicare Tax on Self-Employment Income.

G Enter one-half of the Additional Medicare Tax, if any, on self-employment
income (one-half of Form 8959, line 13)
Tier 1 RRTA taxes as an employee of a railroad (enter amounts on lines H, I, J, and K) or employee
representative (enter amounts on lines L, M, N, and O). Do not include amounts in Form W-2,
box 14 that are identified as Additional Medicare Tax or Tier 2 tax. Do not include amounts shown
on Form CT-2 on line 3 for Additional Medicare Tax or line 4 for Tier 2 tax.
H Enter the Tier 1 tax (Form(s) W-2, box 14) 0.

I Enter the Medicare Tax (Form(s) W-2, box 14) 0.
J Enter the Additional Medicare Tax, if any, or RRTA compensation as an
employee (Form 8959, line 17). Do not use the same amount from Form 8959,
line 17 for both this line and line N.
K Add lines H, I, and J 0.
L Enter one-half of Tier 1 tax (one-half of Forms CT-2, line 1 for all 4 quarters
of 2019)
M Enter one-half of Tier 1 Medicare tax (one-half of Forms CT-2, line 2 for all 4
quarters of 2019)
N Enter one-half of the Additional Medicare Tax, if any, on RRTA compensation
as an employee representative (one-half of Form 8959, line 17). Do not use the
the same amount from Form 8959, line 17 for this line and line J
0 Add line L, M, and N
Line 7 Amount
P Add line F, G, K and O. Enter here and on Line 14 Worksheet, line 7 1,777.
SMART WORKSHEET FOR: Misc Itemized Deductions Wks
Depreciation Smart Worksheet

A Enter Section 179 carryover from prior year
B QuickZoom to the Asset Entry Worksheet
C QuickZoom to the Depreciation/Amortization Reports
D QuickZoom to Form 4562 for Schedule A
E Treat all MACRS assets for activity as qualified Indian reservation property? Yes X No
F Treat all assets acquired after Aug. 27, 2005 as
qualified GO Zone property? Regular Extension X No
G Treat all assets acquired after May 4, 2007 as
qualified Kansas Disaster Zone property? Yes X No
H Was this property located in a Qualified Disaster Area? Yes X No
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
1a Taxpayer, prior year nontaxable combat pay from 2018
2 Election for earned income credit (EIC):
Elect taxpayer’s nontaxable combat pay as earned income for EIC? Yes No
3 Election for dependent care benefits (DCB):
Elect taxpayer’s nontaxable combat pay as earned income for DCB? Yes No
4 Election for child and dependent care credit:
Elect taxpayer’s nontaxable combat pay as earned income
for child and dependent care credit? Yes No
B Spouse:
1 Spouse, nontaxable combat pay
1a Spouse, prior year nontaxable combat pay from 2018
2 Election for earned income credit (EIC):
Elect spouse’s nontaxable combat pay as earned income for EIC? Yes No
3 Election for dependent care benefits (DCB):
Elect spouse’s nontaxable combat pay as earned income for DCB? Yes No
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
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 6,154. Amount due

Eligible Hurricane and Widfire Victims Smart Worksheet

Election to use 2018 earned income for EIC and Additional Child Tax Credit
The "Yes" box must be marked on Line A and Line B for 2018 earned income to be used
for EIC and Additional Child Tax Credit calculations.
A Elect to use 2018 earned income for EIC
and Additional Child Tax Credit Yes No
B Taxpayer is eligible to elect to use 2018 earned income
(see Publication 4492 for details) Yes No
C Earned income for EIC from your 2018 return 14,228.

D Current year earned income for EIC 23,223.
If Line D is equal to or greater than Line C the taxpayer is not eligible
to use 2018 earned income for EIC and Additional Child Tax Credit
calculations.
E You may compare the tax benefit of electing to use 2019 Earned
Income by checking the boxes on line A and B
Overpayment 6,154. Amount due
Investment Income Smart Worksheet
A Taxable and tax exempt interest

B Dividend income
C Capital gain net income
D Royalty and rental of personal property net income
E Passive activity net income:
1 Rental real estate net income or loss
2 Farm rental net income or loss
3 Partnerships and S corporations net income or loss
4 Estates and trusts net income or loss
5 Total of lines 1 through 4
6 Total passive activity net income, line 5 if greater than zero
F Interest and dividends from Forms 8814
G Adjustments
H Total investment income, add lines A through G 0.
Is line H, total investment income over $3,600?

X No. You may take the credit.
Yes. Stop. You cannot take the credit.
Qualifying Children Smart Worksheet
Year of birth
Was the child under

age 24 at the end of Was the child Lived
2019, a student, and permanently and with
Social security younger than you totally disabled taxpayer
First name MI number (or your spouse, if during any part of in the
Last name Suff Relationship filing jointly)? 2019? U.S.
Madison M 899-24-8010 2016

Butler Daughter Yes No Yes No 12
Michigan Department of Treasury (Rev. 05-19), Page 1 of 2 Issued under authority of Public Act 281 of 1967, as amended.
2019 MICHIGAN Individual Income Tax Return MI-1040 Amended Return

(Include Schedule AMD)
Return is due April 15, 2020. Type or print in blue or black ink.
1. Filer’s First Name M.I. Last Name 2. Filer’s Full Social Security No. (Example: 123-45-6789)
DURRIL M BUTLER
If a Joint Return, Spouse’s First Name M.I. Last Name
377 21 3791
3. Spouse’s Full Social Security No. (Example: 123-45-6789)
Home Address (Number, Street, or P.O. Box)
29445 VALLEY BND
City or Town State ZIP Code 4. School District Code (5 digits – see page 60)
FARMINGTON HILLS MI 48331-2470 63200
5. STATE CAMPAIGN FUND 6. FARMERS, FISHERMEN, OR SEAFARERS
Check if you (and/or your spouse, if a. Filer
¿OLQJDMRLQWUHWXUQZDQWRI\RXUWD[HV Check this box if 2/3 of your income is from farming,
to go to this fund. This will not increase b. ¿VKLQJRUVHDIDULQJ
Spouse
your tax or reduce your refund.
7. 2019 FILING STATUS. Check one. 8. 2019 RESIDENCY STATUS. Check all that apply.
a. X Single * If you check box “c,” complete a. X Resident
line 3 and enter spouse’s full name * If you check box “b” or
b. 0DUULHG¿OLQJMRLQWO\ below: b. Nonresident * “c,” you must complete
and include Schedule
NR.
c. 0DUULHG¿OLQJVHSDUDWHO\ c. Part-Year Resident *
9. EXEMPTIONS. NOTE: If someone else can claim you as a dependent, check box 9eHQWHURQOLQHDDQGHQWHURQOLQH9e (see instr.).
a. Number of exemptions (see instructions) ............................................................. 9a. 2 x 4,400 9a. 8800 00

b. Number of individuals who qualify for one of the following special exemptions: deaf,
blind, hemiplegic, paraplegic, quadriplegic, or totally and permanently disabled 9b. x 9b. 00
c. 1XPEHURITXDOL¿HGGLVDEOHGYHWHUDQV ................................................................. 9c. x 9c. 00
d. 1XPEHURI&HUWL¿FDWHVRI6WLOOELUWKIURP0'++6VHHLQVWUXFWLRQV ..................... 9d. x 9d. 00
e. Claimed as dependent, see line 9 NOTE above .................................................. 9e. 9e. 00
f. Add lines 9a, 9b, 9c, 9d and 9e. Enter here and on line 15 ............................................................................. 9f. 8800 00
10. Adjusted Gross Income from your U.S. Forms 1040 or 1040NR (see instructions) ................................ 10. 23223 00
11. Additions from Schedule 1, line 9. Include Schedule 1 ............................................................................ 11. 00
12. Total. Add lines 10 and 11 .......................................................................................................................... 12. 23223 00
13. Subtractions from Schedule 1, line 28. Include Schedule 1 .................................................................... 13. 0 00
14. Income subject to tax. Subtract line 13 from line 12. If line 13 is greater than line 12, enter “0” ............ 14. 23223 00
15. Exemption allowance. Enter amount from line 9f or Schedule NR, line 19.............................................. 15. 8800 00
16. Taxable income. Subtract line 15 from line 14. If line 15 is greater than line 14, enter “0” ...................... 16. 14423 00
17. Tax. Multiply line 16 by 4.25% (0.0425) ..................................................................................................... 17. 613 00

NON-REFUNDABLE CREDITS AMOUNT CREDIT
18. Income Tax Imposed by government units outside Michigan.

Include a copy of the return (see instructions)........................ 18a. 00 18b. 00
19. Michigan Historic Preservation Tax Credit carryforward (see
instructions) ............................................................................ 19a. 00 19b. 00
20. Income Tax. Subtract the sum of lines 18b and 19b from line 17.
If the sum of lines 18b and 19b is greater than line 17, enter “0” ............................................................... 20. 613 00
REV 07/17/20 INTUIT.CG.CFP.SP
+ 1555 2019 05 01 27 5 Continue on page 2. This form cannot be processed if page 2 is not completed and included.
2019 MI-1040, Page 2 of 2
Filer’s Full Social Security Number 377 21 3791
21. Enter amount of Income Tax from line 20. .................................................................................................. 21. 613 00
22. Voluntary Contributions from Form 4642, line 10. Include Form 4642...................................................... 22. 00
23. USE TAX. Use tax due on Internet, mail order or other out-of-state purchases from
Worksheet 1 (see instructions) ................................................................................................................... 23. 0 00
24. Total Tax Liability. Add lines 21, 22 and 23 ................................................................................... 24. 613 00
REFUNDABLE CREDITS AND PAYMENTS
25. Property Tax Credit. Include MI-1040CR or MI-1040CR-2 ..................................................................... 25. 1376 00
26. Farmland Preservation Tax Credit. Include MI-1040CR-5 ..................................................................... 26. 00

FEDERAL MICHIGAN
27. Earned Income Tax Credit. Multiply line 27a by 6% (0.06) and
enter result on line 27b. ........................................................... 27a. 2855 00 27b. 171 00
28. Michigan Historic Preservation Tax Credit (refundable). Include Form 3581. ........................................... 28. 00
29. Michigan tax withheld from Schedule W, line 6. Include Schedule W (do not submit W-2s) ................. 29. 843 00
30. Estimated tax, extension payments and 2018 credit forward ..................................................................... 30. 00
31. 2019 AMENDED RETURNS ONLY. Taxpayers completing an original 2019 return should skip to line 32.
Amended returns must include Schedule AMD (see instructions).
If you had a refund and/or credit forward on the original return, check box 31a and enter this amount as a
31a. negative number on line 31c.
If you paid with the original return, check box 31b and enter the amount paid with the original return, plus
31b. DQ\DGGLWLRQDOWD[SDLGDIWHU¿OLQJDVDSRVLWLYHQXPEHURQOLQHF'RQRWLQFOXGHLQWHUHVWRUSHQDOW\ 31c. 00
32. Total refundable credits and payments. Add lines 25, 26, 27b, 28, 29, 30 and 31c ........................ 32. 2390 00
REFUND OR TAX DUE
33. If line 32 is less than line 24, subtract line 32 from line 24. If applicable, see instructions.
Include interest 00 and penalty 00 ......................... YOU OWE 33. 00
34. Overpayment. If line 32 is greater than line 24, subtract line 24 from line 32 ................................ 34. 1777 00
35. Credit Forward. Amount of line 34 to be credited to your 2020 estimated tax for your 2020 tax return ... 35. 00
36. Subtract line 35 from line 34. ...................................................................................... REFUND 36. 1777 00
DIRECT DEPOSIT a. Routing Transit Number b. Account Number c. Type of Account
'HSRVLW\RXUUHIXQGGLUHFWO\WR\RXU¿QDQFLDO 1. X Checking 2. Savings
LQVWLWXWLRQ6HHLQVWUXFWLRQVDQGFRPSOHWHDE
DQGF 072000096 6827014363
Deceased Taxpayer. If Filer and/or Spouse died after December 31, 2018, enter dates below. 3UHSDUHU&HUWL¿FDWLRQ ,GHFODUHXQGHUSHQDOW\RISHUMXU\WKDW
ENTER DATE OF DEATH ONLY. Example: 04-15-2019 (MM-DD-YYYY) WKLVUHWXUQLVEDVHGRQDOOLQIRUPDWLRQRIZKLFK,KDYHDQ\NQRZOHGJH
Preparer’s PTIN, FEIN or SSN
Filer Spouse
Preparer’s Name (print or type)

7D[SD\HU&HUWL¿FDWLRQ ,GHFODUHXQGHUSHQDOW\RISHUMXU\WKDWWKHLQIRUPDWLRQLQWKLVUHWXUQ
DQGDWWDFKPHQWVLVWUXHDQGFRPSOHWHWRWKHEHVWRIP\NQRZOHGJH SELF-PREPARED
Filer’s Signature Date Preparer’s Business Name, Address and Telephone Number
Spouse’s Signature Date
By checking this box, I authorize Treasury to discuss my return with my preparer.
Refund, credit, or zero returns. Mail your return to: Michigan Department of Treasury, Lansing, MI 48956
Pay amount on line 33 (see instructions). Mail your check and return to: Michigan Department of Treasury, Lansing, MI 48929
+ 1555
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1555 2019 25 03 27 9
Michigan Department of Treasury (Rev. 04-19), Page 1
Schedule W
2019 MICHIGAN Withholding Tax Schedule
Issued under authority of Public Act 281 of 1967, as amended.
Type or print in blue or black ink. Attachment 13

INSTRUCTIONS: If you had Michigan income tax withheld in 2019, you must complete a Withholding Tax Schedule (Schedule W) to claim the
withholding on your Individual Income Tax Return0,OLQH5HSRUWPLOLWDU\SD\LQ7DEOHDQGPLOLWDU\UHWLUHPHQWEHQH¿WVDQGWD[DEOH
UDLOURDGUHWLUHPHQWEHQH¿WVERWK7LHUDQG7LHULQ7DEOHHYHQLIQR0LFKLJDQWD[ZDVZLWKKHOG,QFOXGH\RXUFRPSOHWHG6FKHGXOH:ZLWK)RUP
MI-1040. See complete instructions on page 2 of this form. If you need additional space, include another Schedule W.
)LOHU¶V)LUVW1DPH M.I. /DVW1DPH )LOHU¶V)XOO6RFLDO6HFXULW\1R([DPSOH
DURRIL M BUTLER 377 21 3791

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TABLE 1: MICHIGAN TAX WITHHELD OR MILITARY PAY REPORTED ON W-2, W-2G or CORRECTED W-2 FORMS
A B C D E
(QWHU³;´IRU (PSOR\HU¶VLGHQWL¿FDWLRQQXPEHU Box 1 — Wages, tips, Box 17 — Michigan
Filer or Spouse ([DPSOH %R[F²(PSOR\HU¶VQDPH other compensation income tax withheld
X 75-3086852 EZ-GROOM INC 23223 00 843 00
00 00
00 00
00 00
00 00
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4. SUBTOTAL. (QWHUWRWDORI7DEOHFROXPQ( ............................................................................... 4. 843 00
TABLE 2: MICHIGAN TAX WITHHELD OR MILITARY RETIREMENT BENEFITS AND RAILROAD RETIREMENT
BENEFITS (BOTH TIER 1 AND TIER 2) REPORTED ON 1099 FORMS
A B C D E
(QWHU³;´IRU 3D\HU¶VIHGHUDOLGHQWL¿FDWLRQ Taxable pension distribution, Michigan income
Filer or Spouse QXPEHU([DPSOH 3D\HU¶VQDPH misc. income, etc. (see inst.) tax withheld
00 00
00 00
00 00
00 00
00 00
(QWHU7DEOH6XEWRWDOIURPDGGLWLRQDO6FKHGXOH:IRUPVLIDSSOLFDEOH ...................................................... 00
SUBTOTAL.(QWHUWRWDORI7DEOHFROXPQ( ............................................................................... 00
6. TOTAL.$GGOLQHVDQG(QWHUKHUHDQGFDUU\WR0,OLQH............................................ 6. 843 00
+ 1555 2019 57 01 27 6
Michigan Information Worksheet 2019
Taxpayer: Spouse:
Last Name Butler Last Name
First Name Durril First Name
Middle Initial M Suffix Middle Initial Suffix
Social Security No. 377-21-3791 Social Security No.
Date of Birth 09/30/1993 (mm/dd/yyyy) Date of Birth (mm/dd/yyyy)
Age as of 12/31/2019 26 Age as of 12/31/2019
Date of death Date of death
Occupation Warehouse Assistant Occupation
Work Phone (248)787-1355 Work Phone
Home Phone
Print phone number on city returns Home X TP work Spouse work
c/o Name
Address 29445 Valley Bnd Apt No.
City Farmington Hills State MI ZIP Code 48331-2470
Foreign province/county Foreign postal code
Foreign country
School District Code 63200
Part II ' Main Form
Taxpayer Spouse (if different)

X Form MI-1040: Full-Year Resident
Form MI-1040: Nonresident
Form MI-1040: Part-Year Resident
Enter Nonresident and Part-Year Resident allocations on Schedule NR
Taxpayer residency dates From To
Spouse residency dates From To
City Resident Status (complete if filing a city income tax return):

Detroit Full-year resident Nonresident Part-year resident
Spouse’s residency
if different
Other cities:
Caution: Turbotax does not support filing of Hudson city returns (see tax help)
Important: Complete the table below to indicate the residency status and activate the income tax
return(s) for any of the following cities: (The program will prepare Form(s) CF-1040 for you)
? Albion ? Battle Creek ? Benton Harbor ? Big Rapids ? East Lansing ? Flint
? Grand Rapids ? Grayling ? Hamtramck ? Highland Park ? Ionia ? Jackson
? Lansing ? Lapeer ? Muskegon ? Muskegon Heights ? Pontiac ? Portland
? Port Huron ? Saginaw ? Springfield ? Walker
Residency Status Part-year residents only:
Do Taxpayer’s Former address Dates of residency

City name Full Non Part- Not
year res year File Spouse’s Former address From To
Part III ' Filing Status

X Single
Married, filing jointly
Married, filing separately
Part IV ' Dependent Information

Full Name Relationship Age Disabled Special Filing a
Veteran exemption 2019
code Michigan
tax return
Madison M Butler Daughter 3
Stillbirth Exemption
New for 2019 a stillbirth exemption is available if you are a parent of a stillborn delivered during 2019 and
have been issued a Certificate of Stillbirth from the Michigan Department of Health and Human Services.
Enter number of Certificates of Stillbirth from MDHHS if any
(If claiming this exemption include a copy of the MDHHS certificate with the return.)
Schedule NR: If one spouse is a full-year resident while the other is a part-year or nonresident,
enter number of certificates attributable to the full-year resident spouse
enter number of certificates attributable to the part-year or nonresident spouse
Part V ' Homeowner/Renter Information

Taxpayer’s status:
Homeowner who paid property tax
Renter (including alternate housing facilities)
Mobile home park resident
QuickZoom to Property Tax Information Worksheet
Part VI ' Electronic Filing Information

Fed/State (F/S) Return:
Yes No
X Use Federal Signature (PIN) in place of MI-8453 (See Help)
State-Only (SO) Return:

Yes No
Use Electronic Signature Alternative, (ESA) (Shared Secrets) in place of MI-8453 (See Help)
Michigan EF Signature:
TP’s Prior Year Adjusted Gross Income or Household Income (See Help)
TP’s Prior Year Refund or Tax Due Amount (See Help)
Spouse’s Prior Year Adjusted Gross Income or Household Income (See Help)
Spouse’s Prior Year Refund or Tax Due Amount (See Help)
Detroit EF Signature:
TP’s Prior Year Adjusted Gross Income (See Help)
TP’s Prior Year Refund or Tax Due Amount (See Help)
Spouse’s Prior Year Adjusted Gross Income (See Help)
Spouse’s Prior Year Refund or Tax Due Amount (See Help)
Part VII ' Direct Deposit Information or Direct Debit Information
Note: Direct Deposit or Direct Debit is only available on an original return and may not be used to issue a
refund or a payment on an amended return.
State Information:
Yes No
X Use direct deposit for any state tax refund
Use direct debit for state tax payment (Electronic Filing Only)?
State balance-due amount from this return

Enter the payment date to withdraw from the account below
City Information:
X Use direct deposit for any city tax refund (see help)
X Use direct debit for any city tax due (see help)
Enter the payment date to withdraw from the account below
Bank Information (State and City):

For any of the above options, fill out information below:
For direct deposit or electronic funds withdrawal, fill out information below:
Name of financial institution Comerica
Account type Checking X Savings
Routing number 072000096
Account number 6827014363
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 ' Additional Return Information
Exemptions:
Taxpayer Spouse
Blind
Deaf
Paraplegic/Hemiplegic/Quadriplegic
Totally and Permanently Disabled
Disabled Veteran
Can be claimed as a dependent on someone else’s return
Person Filing on Behalf of Deceased:

Use federal Form 1310 in place of Form MI-1310
Personal Representative
Claimant
First Name Middle Initial Last Name
Address
City State ZIP Code
Address Change for CF-1040 city returns only (excludes Detroit):
Address is same as last year
State Campaign Fund:

Yes No
X Does TP want $3 to go to State Campaign Fund?
Does spouse want $3 to go to State Campaign Fund?
Third Party Designee (See Help):

Yes No
Detroit returns only)?
TP authorizes another person (designee) to discuss return with city Income Tax
Department (CF-1040 only)?
Designee’s name (other than preparer)
Designee’s phone number (other than preparer)
Personal identification number
Part IX ' Extension Status
State Extension:
Yes No
X Tax return due date extended?
Extended due date
QuickZoom to Form 4: Application for extension to file tax returns
City Extensions (excludes Detroit):

Yes No
Extended due date
QuickZoom to Form CF-4868: Application for extension to file Michigan city tax returns
QuickZoom to Form CF-4868-EFT: Application for extension to file Michigan city tax returns
Detroit City Extensions:

Yes No
Extended due date
QuickZoom to Form 5209: Application for extension to file Detroit city tax return
Spouse, if Yes No
different X Tax return due date extended?
residency Extended due date
QuickZoom to Form 5209: Application for extension to file spouse’s Detroit city tax return
Part X ' Amended Return
Filing a Michigan amended return

Enter the tax year you are amending
Payment with original return NOTE: Do not include penalties or interest
Overpayment from original return
QuickZoom to Schedule AMD: Amended Return Explanation of Changes
QuickZoom to Form MI-1040: Individual Income Tax Return
miiw1112.SCR 12/23/19
Total Household Resources Worksheet 2019
Name as Shown on Return Social Security Number

Household Income Computation (for full year and part-year residents)
Full year residents: Column A Column B

Complete column A only. Received
Part-year residents: Total during
Complete columns A and B. Amount Michigan
QuickZoom to Schedule NR before completing column B residency
1 Wages, salaries, tips, sick, strike and SUB pay 1 23,223.
Interest and dividends:

2 a Taxable interest and dividend income
less: interest and dividend income from Schedules K-1
b Nontaxable interest
Interest and dividends (including nontaxable interest) 2
Net business and farm income:

3 a U.S. Schedule C income or loss
b Net farm income or loss
c Other gains or losses
d Income from Schedules K-1
Net business and farm income 3
Net royalty and rent income:

4 U.S. Schedule E income (if negative, enter 0) 4
Retirement pension and annuity benefits:

5 a Pension and IRA distributions
b Lump-sum distribution
Name of payer:
Retirement pension and annuity benefits 5
Capital gains or (losses):

6 a Capital gains less capital losses
b Excluded gain on sale of residence
Combine lines 6a and 6b 6
Alimony and other taxable income:

7 a Gambling/lottery winnings
b Prizes and awards from Form 1099-MISC
c Combine lines 7a and 7b
d Line 7c minus $300
e Other income from Form 1099-MISC
f Alimony received if due to divorce granted prior to 2019
g Other taxable income
h Combine lines 7d through 7g
less: prior year Michigan Property Tax Credit (see tax help)
Total. Describe: 7
Social security, SSI and railroad retirement benefits:

8 a Social security or railroad retirement benefits
b Less deductions for medicare premiums
c Supplemental security income
d Death benefits and amounts received for minor children or
other dependent adults who live with you
Combine lines 8a through 8d 8
9 Child support and foster parent payments 9

10 Unemployment compensation 10
11 Cash or merchandise received or expenses paid on your behalf
(rents, taxes, utilities, food, medical care, etc.) by parents,
relatives or friends in excess of $300 11
Other nontaxable income:

12 a Compensation for damages to character or for personal
injury or sickness
b An inheritance or life insurance proceeds (from
other than spouse)
c Death benefits paid by or on behalf of an employer
d Minister’s housing allowance
e Forgiveness of debt to the extent not included in income
less: exception for ’workout’ loan modification
f Adoption subsidies
g Combat pay from W-2, box 12 code Q
h Nongovernmental scholarship, stipend, grant, or GI bill benefits
and payments made directly to an educational instititution
i Reimbursement from dependent care and/or medical care
spending accounts
j If you are married, filing separately include your spouse’s income
unless you maintained separate homesteads. Complete and
attach Form 5049
k Other (see Tax Help). Enter description:
Total. Describe: 12
13 Workers’ compensation, veterans’ disability

compensation 13
14 FIP and other MDHHS benefits 14
15 Subtotal. Add lines 1 through 14 15 23,223.
Adjustments:
16 a IRA deduction
b Moving expenses
c One half of self-employment tax
d Self-employment health insurance deduction
e SEP, SIMPLE or qualified plans
f Penalty for early withdrawal
g Alimony paid if deductible on U.S. Form 1040
h Student loan interest deduction
i Health savings account deduction
j Net operating loss deduction:
(1) Federal net operating loss deduction
(2) Federal modified taxable income (see Help)
(3) Enter the smaller of (1) or (2). If less than zero, enter -0-
k Educator expenses
l Tuition and fees deduction
m Certain business expenses of reservists, performing artists,
and fee-basis government officials
n Domestic production activities deduction
o Archer MSA deduction
p Jury duty pay given to employer
q Other adjustments
16 Total adjustments. Describe:
16
17 a Medical insurance or HMO premiums you paid for

you and your family (after tax premiums only)
b Automobile insurance premiums (medical care portion only)
17 Total medical insurance (line 17a plus line 17b) 17
19 Total Household Resources. Subtract line 18 from line 15 19 23,223.
QuickZoom to Form MI-1040CR (Homestead Property Tax Credit)

QuickZoom to Form MI-1040CR2 (Property Tax Credit for Veterans and Blind People)
QuickZoom to Form MI-1040CR7 (Home Heating Credit)
miiw1212.SCR 02/04/20
Form MI-1040ES Estimated Tax Worksheet 2020
Name(s) Shown on Return Your Social Security Number

Part I 2020 Estimated Tax Amount Options
1 Select One of Six Ways to Calculate the Required Annual Payment for 2020 Estimates:
a 100% (110%) of 2019 taxes (default, see Tax Help) X 0.
b 100% of tax on 2020 estimated taxable income 0.
c 90% of tax on 2020 estimated taxable income 0.
d 66-2/3% of tax on 2020 estimated taxable income (farmers and fishermen) 0.
e Equal to 100% of overpayment (no vouchers) 1,777.
f Enter total amount you want to use for estimates and check box
2 Selected estimated tax amount:
a 2020 Required Annual Payment based on your choice above 0.
b Estimated amount of 2020 income tax withholding 843.
c Total of estimated tax payments required for 2020 (line 2a less line 2b) 0.
3 Select Estimated Tax Payment option:
a Calculate estimates if $ 501 or more (default) X
b Calculate estimates if (specify amount) or more
c Calculate estimates regardless of amount
d Do not calculate estimates
Part II Overpayment Application Options
1 Amount of overpayment available (Form MI-1040, line 33) 1,777.

2 Select Overpayment Application Amount Option:
a Apply none (refund entire overpayment) X
b Apply all (increase estimate if required)
c Apply to extent of total estimated tax and refund excess
d Apply to extent of first quarter amount and refund excess
e Enter amount you want to apply
f Amount applied to 2020 estimated tax 0.
g Overpayment to be refunded (line 1 less line 2f) 1,777.
3 Select Overpayment Application Sequence:
a X H Consecutively b H Evenly
Part III Rounding and Printing Options
1 Select Rounding Option:

a X H Round up to b H Round up to c H Round up to d H Round to
next $1 next $10 next $100 nearest $1
2 Select Voucher Printing Option:
a H Print (per Part I, lines 3a - c) b H Print only name, etc. c X H Do not print vouchers
Part IV Estimated Tax Payment Summary
1 2 3 4 Total
Jul 15, 2020 Jul 15, 2020 Sep 15, 2020 Jan 15, 2021
1 If you have already made

payments, enter amounts
2 Indicate which payment is
due next. (e.g. if it is now
July 26, 2020, check col. 3) X
3 Required payment
4 Overpayment applied
5 Net payment due
6 Voucher amounts
QuickZoom to voucher
Part V Changes to Income, Credits and Withholding for 2020
2019 income and deductions are shown in the ’2019 Actual’ column below.
*Caution: For each line in the ’2020 Estimated’ column, enter the estimated 2020 amount if different from
2019. Otherwise, the ’2019 Actual’ amount will be used for that line. If zero, you must enter zero.
2019 Actual *2020 Estimated
1 Federal adjusted gross income 23,223.

2 Additions
3 Subtractions 0. 0.
4 Exemption allowance amount 8,800.
5 Credits:
a Credit for income tax paid to another jurisdiction
b Other nonrefundable credits
c Property tax credit 1,376.
d Farmland preservation tax credit
e Michigan earned income tax credit 171. 171.
f Michigan Historic Preservation Tax Credit
6 Income tax withheld 843.
Part VI 2020 Estimated Taxable Income and Tax
1 Estimated 2020 income subject to tax 1 23,223.

2 Exemption allowance amount 2 8,800.
3 Balance. Subtract line 2 from line 1 3 14,423.
4 Estimated tax. Multiply line 3 by 4.25% (.0425) 4 613.
5 All estimated credits 5 1,547.
6 Subtract line 5 from line 4. This is your 2020 tax based on your
estimate of 2020 income 6 0.
MIIW3112.SCR 05/05/20
Property Tax Information Worksheet 2019

The homestead referenced on this worksheet was NOT located in Michigan
* Caution: marking this box disables the Homestead Property Tax Credit and the Home Heating Credit
MI-1040CR-2 eligibility:
1 Blind and own your homestead.
Veteran with service-connected disability. Enter percent of disability %
Surviving spouse of veteran deceased in service
Veteran of wars before World War I, pensioned veteran, his/her surviving spouse, or
an active military
Surviving spouse of a veteran of the Korean War, World War II or World War I
Homeowners:
A B C
Lived in If you bought or sold

same your home in 2019
residence
all year Bought Sold
B B B
* Caution: the amount calculated on line 2b, column A is the amount paid. If the amount billed is
different, enter the amount billed or mark the box below to prevent calculation of property taxes levied.
Do not calculate line 2b, column A
2 a Number of days occupied 365
b Property taxes levied in 2019
Home Office Worksheet

lines c, d and e only apply if part of the home was used for business - all others continue with line f
c Percent of home used for business * % % %

d Business portion of taxes (Line 2b X line 2c) *
e Personal portion of taxes (Line 2b - line 2d)
f Taxable value of homestead
3 Address on December 31, 2019, if different from your current address:

Address
City State ZIP Code
4 Address of homestead sold during 2019:
Address
City State ZIP Code
Renters or Mobile Home Park Residents

(Do not include Alternate Housing Facility information, see line 6 below):
5 a Enter information below:
Veterans
Address of mobile home Landowner’s name only -
park or homestead rented and address Millage
rate
Number of Number of months Monthly Do not

months /days paid $3 mobile rent transfer to
rented home tax 2020
Name robert lubinski

Address 29445 Valley bend Address 30500 northwestern farmington hills 48334
City farmington hills State MI City farmington hills State FL
Zip code 48331 Zip code 48331
Months 12 Months Monthly Rent 1,100.
Days
Name
Address Address
City State City State
Zip code Zip code
Months Months Monthly Rent
Days
b Renters age 65 and older: If you moved from one rental homestead to another during
the last two years, enter the final month’s rent on your previous rented homestead
Alternate Housing Facilities

6 Name of housing project or landowner
Address
City State ZIP Code
a Subsidized housing or Service-fee housing residents:

If you lived in one of these types of facilities for all or part of 2019, check the appropriate box below
Subsidized Housing
Service Fee Housing
Number of months rented
Number of days rented
Total rent paid in 2019
Percentage attributed to property (Service Fee Housing only) (defaults to 10%) %
b Special housing:
If you lived in one of these types of facilities for all or part of 2019, check the appropriate box below
Cooperative Housing
Home for the Aged
Nursing Home
Adult Foster Care Home
Paid Room and Board
Your prorated share of taxes paid by the landowner
miiw2012.SCR 04/30/15
Tax Payments Worksheet 2019
Name Social Security Number

Tax Payments for the Current Year
State
Date Payment
1 First Payment
2 Second Payment
3 Third Payment
4 Fourth Payment
Additional Payments
5 Payment
Payment
Payment
Payment
Payment
6 Overpayment from previous year applied to current year 6

7 Amount paid with current year extension 7
8 Total tax payments 8
Income Taxes Withheld for the Current Year
9 State withholding on Forms W-2 9 843.

10 State withholding on Forms W-2G 10
11 State withholding on Forms 1099-R 11
12 a State withholding on Forms 1099-MISC 12 a
b State withholding on Forms 1099-G b
c State withholding on Forms 1099-K c
13 Other state tax withholding 13
14 Total income tax withheld 14 843.
15 Date return will be filed and balance paid 15
othv0301.SCR 01/15/20
Form MI-1040 Worksheet 1 - Use Tax 2019

Use the table below to list your purchases or

X check here if no purchases were made requiring Use Tax
Description of Date of Purchase

Item Purchased Purchase Price
1 Itemized purchases of $0 to $1,000 x 6 percent (.06) OR

Use Tax Table amount 1
2 Single purchases $1,000 or more x 6 percent (.06) 2
3 Sales Tax Paid to Another State on These Purchases 3
4 Total Use Tax Due (Line 1 plus Line 2 minus Line 3) 4
Enter amount from line 4 above on your 2019 MI-1040, line 23. If the amount on line 4 is 0, enter 0
on your 2019 MI-1040, line 23.
MIIW1501.SCR 04/30/15
Tax Summary 2019
Name(s)
Durril M Butler
Federal Adjusted Gross Income 23,223.

Michigan Additions
Michigan Subtractions 0.
Exemptions 8,800.
Michigan Taxable Income 14,423.
Tax 613.
Non-refundable Credits
Use Tax 0.
Total Tax 613.
Refundable Credits 1,547.
Michigan Tax Withheld 843.
Total Payments and Credits 2,390.
Interest and/or Penalty
Amount Due
Overpayment 1,777.
Amount applied to 2020 estimated tax
Refund 1,777.

2019 Turbo Tax Return

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1040 U.S. Individual Income Tax Return 2019

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

Madison M Butler 899-24-8010 Daughter

1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1 23,223.

Joint return? Warehouse Assistant (see inst.)

Phone no. Email address

Qualifying Child Information Child 1 Child 2 Child 3

If you have more than three qualifying

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

b Was the child permanently and totally

5 Child’s relationship to you

• If the child lived with you for more than

Name(s) shown on return Your social security number

Name(s) Shown on Return

Five Year Tax History:

2015 2016 2017 2018 2019

Total income 14,228. 23,223.

Adjusted gross income 14,228. 23,223.

Tax expense 525. 843.

Other itemized ded’ns

Taxable income 0. 4,873.

Alternative min tax

Total credits 0. 488.

Payments 6,046. 6,154.

Form 2210 penalty

Refund 6,046. 6,154.

Effective tax rate % -34.17 -18.32

**Tax bracket % 10.0 10.0

**Tax bracket % is based on Taxable income.

This Agreement requires all disputes to be resolved by way of binding arbitration.

Information regarding low-cost deposit accounts may be available at www.mymoney.gov .

PAPER RETURN IRS direct deposit to Approximately No additional cost.

ELECTRONIC IRS direct deposit to Usually within No additional cost.

No Refund Processing Check mailed by IRS Approximately

ELECTRONIC (a) Direct deposit to Usually within $ 40.00 3

Refund Processing (b) Load to your

Questions? Call 877-908-7228

IRS regulations require the following statements:

Please type the date below:

IRS regulations require the following statements:

Sign this agreement by entering your name:

Please type the date below:

IRS regulations require the following statements:

Sign this agreement by entering your name:

Please type the date below:

Your First Name MI Last Name Your Social Security No.

QuickZoom to explanation statement for overseas extension

Presidential Election Campaign

Checking a box below will not change your tax or refund.

If more than four dependents, see instructions and check here

Madison M Butler 899-24-8010 Daughter X

QuickZoom to the Federal Information Worksheet

Someone can claim you as a dependent

a Check if: You were born before January 2, 1955, Blind.

Form 1040 or Form 1040-SR, Lines 1 - 6

1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 23,223.

Form 1040 or Form 1040-SR, Lines 7 and 8

7a Other income from Schedule 1, line 9 7a 0.

Form 1040 or Form 1040-SR, Line 9 ' Standard or Itemized Deduction