ThePAINTERS

FORM1040A:U.S.INDIVIDUALINCOMETAXRETURN

Name: Norman Q.PainterandDorothyT.Painteraremarried(Nov.5,2000)andwillfileajointreturnfor2012.NeitherNormannorDorothyis blind, andbothareunderage65.

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.

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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.