Publication 1436 (Rev. 10-2012) - Internal Revenue Service

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ATS Test Scenario 07 Taxpayer: Oscar and Viola Dahlia SSN: 400-00-1038 Test Scenario 07 includes the following forms: • Form 1040 • Form W-2 (2) • Form 1099-R • Form 1099-MISC • Schedule A • Form 8283 Primary Date of Birth = April 19, 1969 Secondary Date of Birth = March 20, 1973 Dependent Date of Birth = August 22, 1992 Other Income Type Statement: Indian Gaming Proceeds 102
Form 1040 Department of the Treasury—Internal Revenue Service (99) U.S. Individual Income Tax Return 2012 OMB No. 1545-0074 Version A, Cycle 5 IRS Use Only—Do not write or staple in this space. For the year Jan. 1–Dec. 31, 2012, or other tax year beginning , 2012, ending , 20 See separate instructions. Your first name and initial Last name Your social security number Oscar Dahlia 4 0 0 0 0 1 0 3 8 If a joint return, spouse’s first name and initial Last name Spouse’s social security number Viola Dahlia 4 0 0 0 0 1 0 7 1 Home address (number and street). If you have a P.O. box, see instructions. 123 Guava St. Apt. no. ▲ Make sure the SSN(s) above and on line 6c are correct. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign Sandy, OR 97055 Check here if you, or your spouse if filing Foreign country name jointly, want $3 to go to this fund. Checking Foreign province/state/county Foreign postal code a box below will not change your tax or refund. You Spouse Filing Status 1 Single 4 Head of household (with qualifying person). (See instructions.) If 2 ✔ Married filing jointly (even if only one had income) the qualifying person is a child but not your dependent, enter this Check only one 3 Married filing separately. Enter spouse’s SSN above child’s name here. ▶ box. Exemptions 6a b and full name here. ▶ 5 Qualifying widow(er) with dependent child ✔ Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . Boxes checked } on 6a and 6b ✔ Spouse . . . . . . . . . . . . . . . . . . . . . . . . No. of children 2 c Dependents: (1) First name Last name (2) Dependent’s social security number (3) Dependent’s relationship to you (4) ✓ if child under age 17 qualifying for child tax credit (see instructions) on 6c who: • lived with you • did not live with 1 If more than four Grover Dahlia 4 0 0 0 0 1 0 7 2 you due to divorce or separation (see instructions) dependents, see instructions and Dependents on 6c not entered above check here ▶ d Total number of exemptions claimed . . . . . . . . . . . . . . . . . Add numbers on lines above ▶ 3 Income 7 8a Wages, salaries, tips, etc. Attach Form(s) W-2 . Taxable interest. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . . . . 7 8a 1343 b Tax-exempt interest. Do not include on line 8a . . . 8b 9 a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a b Qualified dividends . . . . . . . . . . . 9b 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10 502 1099-R if tax was withheld. 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11 Attach Form(s) W-2 here. For Also Testing Purposes attach Forms W-2G and 12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12 Only 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17 DRAFT AS OF 21 Other income. List type and amount 21 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income July 3, 2012 ▶ 22 If you did not get a W-2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 1040-V. 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶ 13 14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14 15 a IRA distributions . 15a b Taxable amount . . . 15b 16 a Pensions and annuities 16a b Taxable amount . . . 16b 18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18 19 Unemployment compensation . . . . . . . . . . . . . . . . . 19 20 a Social security benefits 20a b Taxable amount . . . 20b Indian Gaming 10000 Adjusted Gross Income 23 24 25 Reserved . . . . . . . . . . . . . Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ Health savings account deduction. Attach Form 8889 . 23 24 25 26 Moving expenses. Attach Form 3903 . . . . . . 26 27 Deductible part of self-employment tax. Attach Schedule SE . 27 28 Self-employed SEP, SIMPLE, and qualified plans . . 28 29 Self-employed health insurance deduction . . . . 29 30 Penalty on early withdrawal of savings . . . . . . 30 31 a Alimony paid b Recipient’s SSN ▶ 31a 32 IRA deduction . . . . . . . . . . . . . 32 33 Student loan interest deduction . . . . . . . . 33 34 Reserved . . . . . . . . . . . . . . 34 35 Domestic production activities deduction. Attach Form 8903 35 36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . ▶ 37 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see 103 separate instructions. Cat. No. 11320B Form 1040 (2012)
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Procedures Test Package for the for
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INTRODUCTION…………………
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INTRODUCTION This Publication will
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Test Process Are there Differences
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WHO MUST TEST? The Submission Proce
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SOFTWARE DEVELOPER ACCEPTANCE PROCE
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The IRS will only accept these SSNs
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Form 1040 Department of the Treasur
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Employer identification number (EIN
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SCHEDULE B (Form 1040A or 1040) Dep
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Form Department of the Treasury—I
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Form 2441 (2012) Part III Dependent
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SCHEDULE 8812 (Form 1040A or 1040)
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Version A, Cycle 3 Form 8880 Depart
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Enclose, but do not attach, any pay
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Tax Year 2012 Assurance Testing Sys
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Forms and schedules that may be fil
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WHAT IS TESTED? The test package fo
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PRACTIONER PIN Taxpayers using an E
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SOCIAL SECURITY RANGE FOR STATE RET
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Form 2555 (2012) Page 3 Part V All
Page 55 and 56: Employer identification number (EIN
Page 57 and 58: Version A, Cycle 5 Form 1040 For (2
Page 59 and 60: Form 8938 (November 2012) Departmen
Page 61 and 62: ATS Test Scenario 3 Taxpayer: Sam a
Page 67 and 68: SCHEDULE C (Form 1040) Profit or Lo
Page 69 and 70: SCHEDULE EIC (Form 1040A or 1040) D
Page 71 and 72: Form 8862 (Rev. December 2012) Depa
Page 73 and 74: Form 8867 Department of the Treasur
Page 75 and 76: Version A, Cycle 1 Form 8867 (2012)
Page 81 and 82: CORRECTED (if checked) PAYER’S na
Page 83 and 84: Version A, Cycle 2 Schedule E (Form
Page 85 and 86: SCHEDULE J (Form 1040) Department o
Page 87 and 88: DRAFT AS OF 9 Chemicals. . . . . .
Page 89 and 90: ATS Test Scenario 05 Taxpayer: Zeus
Page 95 and 96: Version A, Cycle 2 SCHEDULE A (Form
Page 97 and 98: Part III Complete this DRAFT part t
Page 99 and 100: Form 6198 At-Risk Limitations OMB N
Page 101 and 102: DRAFT AS OF 5 Meals and entertainme
Page 105: Employer identification number (EIN
Page 115 and 116: ATS/PATS Test Scenario 8 Taxpayer:
Page 123 and 124: Version A, Cycle 5 Form 1040A (2012
Page 125 and 126: Form 2441 Child and Dependent Care
Page 127 and 128: SCHEDULE EIC (Form 1040A or 1040) D
Page 129 and 130: Version B, Cycle 6 Schedule 8812 (F
Page 131 and 132: Form 8863 (2012) Page 2 Name(s) sho
Page 137 and 138: ATS Test Scenario 11 Taxpayer: Edga
Page 139 and 140: Section A—Farm Income—Cash Meth
Page 141 and 142: DRAFT AS OF b Multiply line 5a by 9
Page 143 and 144: ATS Test Scenario 12 Taxpayer: Susa
Page 145 and 146: ATS Test Scenario 13 Taxpayer: Apri
Page 147 and 148: Form 9465 ATS Test Scenario 14 Taxp
Page 149 and 150: ATS Test Scenario 15 Taxpayer: Lind
Page 151 and 152: Test Scenario 16 Taxpayer: Joann Bi
Page 153: Form 56 (Rev. 12-2011) Page 2 Part
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Publication 1436 (Rev. 10-2012) - Internal Revenue Service

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