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

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

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ATS/PATS Test Scenario 9<br />

Taxpayer: Sara Phlox<br />

SSN: 400-00-<strong>10</strong>39<br />

Test Scenario 9 includes the following forms:<br />

• Form <strong>10</strong>40A<br />

• Form W-2<br />

• Form 2441<br />

• �Schedule EIC<br />

• Schedule 8812<br />

• Form 8863<br />

• Form 8880<br />

Additional Instructions:<br />

Primary Date of Birth October 31, 1978<br />

1st dependent Date of Birth December 25, 2006<br />

2nd dependent Date of Birth October 15, 2008<br />

Form 2441 - Three child care providers:<br />

Future Stars 69-0000041 $1,000<br />

606 Sassafras St<br />

Tiptop, VA 24630<br />

Our Home 69-0000042 $1,000<br />

707 Sassafras St<br />

Tiptop, VA 24630<br />

Growing Tree 69-0000043 $2,000<br />

808 Sassafras St<br />

Tiptop, VA 24630<br />

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