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