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

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Form 4868 Department of the Treasury Internal Revenue Service (99) Application for Automatic Extension of Time To File U.S. Individual Income Tax Return For calendar year 2012, or other tax year beginning , 2012, ending , 20 . Part I Identification Part II Individual Income Tax 1 Your name(s) (see instructions) 4 Estimate of total tax liability for 2012 . . $ April May Hyacinth 5 Total 2012 payments . . . . . . Address (see instructions) 6 Balance due. Subtract line 5 from line 4 624 Red Oak St (see instructions) . . . . . . . OMB No. 1545-0074 2012 7 Amount you are paying (see instructions) City, town, or post office State ▶ 0 ZIP Code 8 Check here if you are “out of the country” and a U.S. Acme 2 Your social security number 400-00-1043 M I 49610 3 Spouse's social security number citizen or resident (see instructions) . . . . . . ▶ 9 Check here if you file Form 1040NR or 1040NR-EZ and did not receive wages as an employee subject to U.S. income tax withholding . . . . . . . . . . ▶ For Privacy Act and Paperwork Reduction Act Notice, see page 4. 142 Cat. No. 13141W Form 4868 (2012) 4135 5038
Form 9465 ATS Test Scenario 14 Taxpayer: Mark Daisy SSN: 400-00-1044 143
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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
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Version A, Cycle 5 Form 1040 For (2
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Form 8938 (November 2012) Departmen
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ATS Test Scenario 3 Taxpayer: Sam a
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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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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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CORRECTED (if checked) PAYER’S na
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 103 and 104: Form 1040 Department of the Treasur
Page 105 and 106: Employer identification number (EIN
Page 107 and 108: Form 1040 Department of the Treasur
Page 111 and 112: CORRECTED (if checked) PAYER’S na
Page 115 and 116: ATS/PATS Test Scenario 8 Taxpayer:
Page 117 and 118: Version A, Cycle 5 Form 1040 For (2
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: ATS Test Scenario 13 Taxpayer: Apri
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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