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ThePAINTERS FORM1040A:U.S. INDIVIDUAL INCOME TAX RETURNN Name: Norman Q.Painter and Dorothy.Painter are married (Nov.5 2000) and will file a joint return for 2012.Neither Norman nor Dorothy is blind and both are under age 65. Theyrenttheirhomeat1721W.240th St Lomita CA90721. Theirhometelephone numberis-310/541- 111l. Theirnineyearolddaughter(DOB: 7/1/2003) EmilyPainter whosesocial securitynumberis644-36-3871 hasJivedathomeaHyear. TheirsonHunter wasborn9-12-2006 andhissocial securitynumberis612-45-9145andalsolived withhisparentsforthefullyear. Mr.Painterworksasacomputer analyst andreceivedwagesof$31 000 fromwhich$1 950infederal incometaxesand$475instateincometaxeswaswithheld.Hissocialsecurity numberis567-45-3888.Mr.Painterwasborn04/28/1978. Mr.Painterisalsopayingoffastudentloanandtheinterestfortheyearis$300 Mr.Painterisnotrequired topayanyestimatedtaxes andchoosestonotdosothis year. Mrs.Painter worksasanadministrativeassistant andreceivedwagesof$18 000 fromwhich$600in federalincometaxesand$200instateincometaxeswaswithheld. Hersocialsecurity numberis412-45-6798.Mrs.Painterwasbornon06-12-1980. ThePainters received$245ofinterest incomefrom aU.S.financial institution StateBank.ThePainters electtohave$3gotothePresidentialElection CampaignFund. ThePainters electtohaveanyrefund directlydepositedtotheirchecking account.Theirbank’s routingnumberis011000013andtheiraccount numberis004002006 ThePainters maybeabletoclaim thechildtaxcredit.TheymustfilloutaworksheetaccompanyingForm1040A todeterminetheireligibilityandanycredit amount. ThePainters mayalsobeeligiblefortheearnedincomecredit (EiC).Theymust complete aquestionnaire worksheetandScheduleEICtodeterminetheireligibilityandanycreditamount. .gif”> Page1 The PaintershaveelectedtohaveValerieBushpreparetheirtaxes. ValerieBush(PTIN #POl765432) preparesForm8867 PaidPreparer ‘sEarnedIncomeCreditChecklist iftheyqualifyforEIC. Requiredformsare: 1040AUSIncomeTaxReturn(2012)2012Child TaxCreditWorksheetSchedule8812 -ChildTaxCredit ScheduleB-InterestandOrdinaryIncome ScheduleEICEarnedIncomeCredit Form8867PaidPreparers EarnedIncomeCredit Checklist AdditionalDocument: EICInstructionsand EiCtaxtables. Please refertoifneededfortheEarnedIncomeCreditcalculation.
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