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

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ATS/PATS Test Scenario 8 Taxpayer: Rachel Peony SSN: 400-00-1031 Test Scenario 8 includes the following forms: • Form 1040 • Form W-2 • Schedule A • Schedule B Taxpayer Date of Birth July 15, 1975. Additional Instructions: Assume no withholding from unemployment 10
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 Rachel Peony 4 0 0 0 0 1 0 3 1 If a joint return, spouse’s first name and initial Last name Spouse’s social security number Home address (number and street). If you have a P.O. box, see instructions. 123 Juniper 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 Arcadia, FL 34269 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 1 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 you due to divorce If more than four 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 ▶ 1 Income 7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7 8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a 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 . . . . . . 10 631 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 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 11 separate instructions. Cat. No. 11320B Form 1040 (2012) 0 5655
Page 1 and 2: Procedures Test Package for the for
Page 3 and 4: INTRODUCTION…………………
Page 5 and 6: INTRODUCTION This Publication will
Page 7 and 8: Test Process Are there Differences
Page 9 and 10: WHO MUST TEST? The Submission Proce
Page 11 and 12: SOFTWARE DEVELOPER ACCEPTANCE PROCE
Page 13: The IRS will only accept these SSNs
Page 17 and 18: Employer identification number (EIN
Page 19 and 20: SCHEDULE B (Form 1040A or 1040) Dep
Page 21 and 22: Form Department of the Treasury—I
Page 25 and 26: Form 2441 (2012) Part III Dependent
Page 27 and 28: SCHEDULE 8812 (Form 1040A or 1040)
Page 29 and 30: Form 8863 Department of the Treasur
Page 31 and 32: Version A, Cycle 3 Form 8880 Depart
Page 35 and 36: Enclose, but do not attach, any pay
Page 37 and 38: Tax Year 2012 Assurance Testing Sys
Page 39 and 40: Forms and schedules that may be fil
Page 41 and 42: WHAT IS TESTED? The test package fo
Page 43 and 44: PRACTIONER PIN Taxpayers using an E
Page 45 and 46: SOCIAL SECURITY RANGE FOR STATE RET
Page 53 and 54: Form 2555 (2012) Page 3 Part V All
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
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Version A, Cycle 5 Form 1040 For (2
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SCHEDULE C (Form 1040) Profit or Lo
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SCHEDULE EIC (Form 1040A or 1040) D
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Form 8862 (Rev. December 2012) Depa
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Form 8867 Department of the Treasur
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Version A, Cycle 1 Form 8867 (2012)
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CORRECTED (if checked) PAYER’S na
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Version A, Cycle 2 Schedule E (Form
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SCHEDULE J (Form 1040) Department o
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DRAFT AS OF 9 Chemicals. . . . . .
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ATS Test Scenario 05 Taxpayer: Zeus
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Version A, Cycle 2 SCHEDULE A (Form
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Part III Complete this DRAFT part t
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Form 6198 At-Risk Limitations OMB N
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DRAFT AS OF 5 Meals and entertainme
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Employer identification number (EIN
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ATS/PATS Test Scenario 8 Taxpayer:
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Version A, Cycle 5 Form 1040A (2012
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Form 2441 Child and Dependent Care
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SCHEDULE EIC (Form 1040A or 1040) D
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Version B, Cycle 6 Schedule 8812 (F
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Form 8863 (2012) Page 2 Name(s) sho
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ATS Test Scenario 11 Taxpayer: Edga
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Section A—Farm Income—Cash Meth
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DRAFT AS OF b Multiply line 5a by 9
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ATS Test Scenario 12 Taxpayer: Susa
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ATS Test Scenario 13 Taxpayer: Apri
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Form 9465 ATS Test Scenario 14 Taxp
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ATS Test Scenario 15 Taxpayer: Lind
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Test Scenario 16 Taxpayer: Joann Bi
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Form 56 (Rev. 12-2011) Page 2 Part
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Publication 1436 (Rev. 10-2012) - Internal Revenue Service

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