noah & ella neumann 5001 laurel street 2019 income...

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NOAH & ELLA NEUMANN5001 LAUREL STREET

WAIPAHU, HI 967972019 INCOME TAX RETURN

INVOICE

Description Amount

Total Invoice

Amount Paid

Balance Due

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PRACTICE LAB15 PRACTICE LAB WAYWASHINGTON DC 20005

(202) 202-2022

NOAH NEUMANN & ELLA NEUMANN5001 LAUREL STREETWAIPAHU HI 96797(808) 911-9111

Preparer No.: 995Client No. : XXX-XX-0000Invoice Date: 01/15/2020

PREPARATION OF 2019 FEDERAL/STATE FORMS & WORKSHEETS:

FORM 1040-SR (TAX RETURN FOR SENIORS)FORM 1040 SCHEDULE 3 (ADDITIONAL CREDITS AND PAYMENTS)SCHEDULE B (INTEREST & DIVIDENDS)SCHEDULE EIC (EARNED INCOME CREDIT)FORM W-2 (WAGES AND TAX)FORM 1099-R (RETIREMENT DISTRIBUTIONS)SSA WORKSHEETFORM 8879 (E-FILE SIGNATURE AUTHORIZATION)FORM 8863 (EDUCATION CREDIT)FORM 8962 (PREMIUM TAX CREDIT)HI STATE RESIDENT RETURN

$0.00

$0.00

$0.00

TAX YEAR: 2019 PROCESS DATE: 01/15/2020OFFICE : The Practice Lab

CLIENT : 131-00-0000 NOAH NEUMANN BIRTH DATE : 09/21/1954 Age:65SPOUSE : 132-00-0000 ELLA NEUMANN BIRTH DATE : 03/03/1965 Age:54

ADDRESS : 5001 LAUREL STREET PREPARER : 995 : WAIPAHU HI 96797

Home : (808) 911-9111 PREPARER FEE : Work : - ELECTRONIC : Cell : - TOTAL FEES : STATUS : 2FED TYPE: Electronic MailST TYPE : Regular Tax EFFECTIVE RATE: 0.00%E-MAIL : [email protected]

_____________________________________________________________________________________DEPENDENT NAME BIRTH DATE AGE SSN RELATIONSHIP MONTHS__________________________________________________________________________________LEO NEUMANN 01/17/1996 23 133-00-0000 SON 12

_____________________________________________________________________________________

LISTING OF FORMS FOR THIS RETURN________________________________FORM 1040SCHEDULE 3 (NONREFUNDABLE CREDITS)FORM W-2FORM SSA-1099 (SOCIAL SECURITY BENEFITS)FORM 1099-R (RETIREMENT DISTRIBUTIONS)SCHEDULE B (INTEREST/DIVIDEND INCOME)SCHEDULE EIC (EARNED INCOME CREDIT)FORM 8863 (EDUCATION CREDITS)FORM 8879 (E-FILE SIGNATURE AUTHORIZATION)HI STATE RESIDENT RETURN

* QUICK SUMMARY *_____________________________________________________________________________________SUMMARY__________________________________________________________________________FILING STATUSTOTAL INCOMETOTAL ADJUSTMENTSADJUSTED GROSS INCOMEDEDUCTIONSEXEMPTIONSTAXABLE INCOMETAXCREDITSPAYMENTSREFUNDAMOUNT DUE

EARNED INCOME CREDIT

FEDERAL 2 30525 0 30525 25700 0 4825 483 483 6664 6664 0

2614

HI RESIDENT 2 30525 -25175 5350 4400 4576 0 0 0 350 485 0

0

CLIENT : NOAH NEUMANN 131-00-0000SPOUSE : ELLA NEUMANN 132-00-0000

PREPARER : 995 DATE : 01/15/2020_____________________________________________________________________________________* W-2 INCOME FORMS SUMMARY *_____________________________________________________________________________________

T/S EMPLOYER WAGES FED WITH FICA MED TAX STATE WITH ST ____________________________________________________________________________1. T RICHS BOOK STO 5000 750 310 73 350 HI

TOTALS...... 5000 750 310 73 350

* 1099-R INCOME FORMS SUMMARY *_____________________________________________________________________________________

[T/S] PAYER GROSS DIST TAXABLE AMT FED WITH STATE WITH ST ____________________________________________________________________________1. S GILMER CORP 23000 23000 2000 0

TOTALS...... 23000 23000 2000 0

* FORM SSA-1099 INCOME FORMS SUMMARY *_____________________________________________________________________________________

[T/S] PAYER SSA BENEFITS FED WITH PREMIUMS _________________________________________________________________________ 1. T U.S. 16000 0 1308

TOTALS...... 16000 0 1308

a Employee’s social security number

OMB No. 1545-0008

Safe, accurate,

FAST! Use

Visit the IRS website at www.irs.gov/efile

b Employer identification number (EIN)

c Employer’s name, address, and ZIP code

d Control number

e Employee’s first name and initial Last name Suff.

f Employee’s address and ZIP code

1 Wages, tips, other compensation 2 Federal income tax withheld

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12Co d e

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement 2019

Department of the Treasury—Internal Revenue Service

Form W-2 Wage and Tax Statement 2019

Department of the Treasury—Internal Revenue Service

a Employee’s social security number

OMB No. 1545-0008

Safe, accurate, FAST! Use

Visit the IRS website at www.irs.gov/efile

b Employer identification number (EIN)

c Employer’s name, address, and ZIP code

d Control number

e Employee’s first name and initial Last name Suff.

f Employee’s address and ZIP code

1 Wages, tips, other compensation 2 Federal income tax withheld

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12Co d e

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

131-00-0000

35-5000000

RICHS BOOK STORE1225 OVERVIEW AVEWAIPAHU HI 96797

NOAH NEUMANN5001 LAUREL STREETWAIPAHU HI 96797

5000 750

5000 310

5000 73

HI 35500000 5000 350

Form 8879Department of the Treasury Internal Revenue Service

IRS e-file Signature Authorization ERO must obtain and retain completed Form 8879.

Go to www.irs.gov/Form8879 for the latest information.

OMB No. 1545-0074

2019Submission Identification Number (SID)

Taxpayer’s name Social security number

Spouse’s name Spouse’s social security number

Part I Tax Return Information — Tax Year Ending December 31, 2019 (Whole dollars only)1 Adjusted gross income (Form 1040 or 1040-SR, line 8b; Form 1040-NR, line 35) . . . . . . . 1

2 Total tax (Form 1040 or 1040-SR, line 16; Form 1040-NR, line 61) . . . . . . . . . . . . 2

3 Federal income tax withheld from Forms W-2 and 1099 (Form 1040 or 1040-SR, line 17; Form 1040-NR, line 62a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Refund (Form 1040 or 1040-SR, line 21a; Form 1040-NR, line 73a; Form 1040-SS, Part I, line 13a) . 4

5 Amount you owe (Form 1040 or 1040-SR, line 23; Form 1040-NR, line 75) . . . . . . . . . 5

Part II Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)

Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements for the tax year ending December 31, 2019, and to the best of my knowledge and belief, they are true, correct, and complete. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent.

Taxpayer’s PIN: check one box only

I authorize ERO firm name

to enter or generate my PIN Enter five digits, but don’t enter all zeros

as my

signature on my tax year 2019 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2019 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Your signature Date

Spouse’s PIN: check one box only

I authorize ERO firm name

to enter or generate my PIN Enter five digits, but don’t enter all zeros

as my

signature on my tax year 2019 electronically filed income tax return.

I will enter my PIN as my signature on my tax year 2019 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Spouse’s signature Date Practitioner PIN Method Returns Only—continue below

Part III Certification and Authentication — Practitioner PIN Method Only

ERO’s EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN.Don’t enter all zeros

I certify that the above numeric entry is my PIN, which is my signature for the tax year 2019 electronically filed income tax return for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns.

ERO’s signature Date ERO Must Retain This Form — See Instructions

Don’t Submit This Form to the IRS Unless Requested To Do So

For Paperwork Reduction Act Notice, see your tax return instructions. Form 8879 (2019)

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NOAH NEUMANN 131-00-0000

ELLA NEUMANN 132-00-0000

30525

2750 6664

01/15/2020

01/15/2020

X PRACTICE LAB 1 0 0 0 0

X PRACTICE LAB 1 0 0 0 0

3 6 9 2 5 8 9 8 7 6 5

IRS PREPARER 01/15/2020

Form 1040-SR Department of the Treasury—Internal Revenue Service

U.S. Tax Return for Seniors 2019 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

(99)

Filing Status Check only one box.

Single Married filing jointly Married filing separately (MFS)Head of household (HOH) Qualifying widow(er) (QW)

If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is a child but not your dependent.

Your first name and middle initial Last name Your social security number

If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Foreign country name Foreign province/state/county Foreign postal code

Presidential Election Campaign

Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse

Standard

Deduction

Someone can claim: You as a dependent Your spouse as a dependentSpouse itemizes on a separate return or you were a dual-status alien

Age/BlindnessYou: Were born before January 2, 1955 Are blindSpouse: Was born before January 2, 1955 Is blind

If more than four dependents,

see inst. and here

Dependents (see instructions): (2) Social security number (3) Relationship to you (4) if qualifies for (see inst.):(1) First name Last name Child tax credit Credit for other dependents

1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . 1

Attach Schedule B if required.

2a Tax-exempt interest . . 2a b Taxable interest . . . 2b

3a Qualified dividends . . . 3a b Ordinary dividends . . 3b

4a IRA distributions . . . . 4a b Taxable amount . . . 4b

c Pensions and annuities . 4c d Taxable amount . . . 4d

5a Social security benefits . . 5a b Taxable amount . . . 5b

6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . 6

7 a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . 7a

b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . 7b

8 a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . 8a

b Subtract line 8a from line 7b. This is your adjusted gross income . . . . 8bStandard Deduction See Standard Deduction Chart below.

9 Standard deduction or itemized deductions (from Schedule A) 9

10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10

11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . 11a

b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . 11b

Standard Deduction Chart*

Add the number of boxes checked in the “Age/Blindness” section of Standard Deduction . . .

Single

Married filing jointly or Qualifying widow(er)

IF your filing

status is. . .

AND the number of

boxes checked is. . .

THEN your standard

deduction is. . .

1 13,850 2 15,500 1 25,700 2 27,000 3 28,300 4 29,600

Head of household

Married filing separately

IF your filing

status is. . .

AND the number of

boxes checked is. . .

THEN your standard

deduction is. . .

1 20,000 2 21,650 1 13,500 2 14,800 3 16,100 4 17,400

*Don’t use this chart if someone can claim you (or your spouse if filing jointly) as a dependent, your spouse itemizes on a separate return, or you were a dual-status alien. Instead, see instructions.

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040-SR (2019)

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x

NOAH NEUMANN 131-00-0000

ELLA NEUMANN 132-00-0000

5001 LAUREL STREET

WAIPAHU, HI 96797 X

X

LEO NEUMANN 133-00-0000 SON X

NON-W2 DISABILITY 28000

350

16000 2175

30525

30525

25700

25700

4825 1

Form 1040-SR (2019) Page 2

12a Tax (see instructions). Check if any from:

1 Form(s) 8814 2 Form 4972 3 12a

b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . 12b

13a Child tax credit or credit for other dependents . . . . . 13a

b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . 13b

14 Subtract line 13b from line 12b. If zero or less, enter -0- . . . . . . . . . 14

15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . 15

16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . 16

17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . 17

18 Other payments and refundable credits: • If you have

a qualifying child, attach Sch. EIC.

• If you have nontaxable combat pay, see instructions.

a Earned income credit (EIC) . . . . . . . . . . . . 18a

b Additional child tax credit. Attach Schedule 8812 . . . . 18b

c American opportunity credit from Form 8863, line 8 . . . 18c

d Schedule 3, line 14 . . . . . . . . . . . . . . . 18d

e Add lines 18a through 18d. These are your total other payments and refundable credits 18e

19 Add lines 17 and 18e. These are your total payments . . . . . . . . . 19

Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 20

21 a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here 21a

Direct deposit? See instructions.

b Routing number c Type: Checking Savings

d Account number

22 Amount of line 20 you want applied to your 2020 estimated tax 22

Amount You Owe

23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions 23

24 Estimated tax penalty (see instructions) . . . . . . 24

Third Party Designee (Other than paid preparer)

Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.

No

Designee’s name

Phone no.

Personal identification number (PIN)

Sign Here

Joint return? See instructions. Keep a copy for your records.

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Your signature Date Your occupation If the IRS sent you an Identity Protection PIN, enter it here (see inst.)

Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an Identity Protection PIN, enter it here (see inst.)

Phone no. Email address

Paid

Preparer

Use Only

Preparer’s name Preparer’s signature Date PTIN Check if:

3rd Party Designee

Self-employed

Firm’s name Phone no.

Firm’s address Firm’s EIN

Go to www.irs.gov/Form1040SR for instructions and the latest information. Form 1040-SR (2019)

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NEUMANN 131-00-0000

483

483

483

0

0

0

2750FORM 1099

2614

800

500

3914

6664

6664

6664

X X X X X X X X X

X X X X X X X X X X X X X X X X X

01/15/20

01/15/20

CASHIER

NONE(808) 911-9111 [email protected]

S64216928

- PRACTICE LAB15 PRACTICE LAB WAY WASHINGTON DC 20005

202-202-2022

SCHEDULE 3 (Form 1040 or 1040-SR)

Department of the Treasury Internal Revenue Service

Additional Credits and Payments Attach to Form 1040 or 1040-SR.

Go to www.irs.gov/Form1040 for instructions and the latest information.

OMB No. 1545-0074

2019Attachment Sequence No. 03

Name(s) shown on Form 1040 or 1040-SR Your social security number

Part I Nonrefundable Credits1 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . . . . . 12 Credit for child and dependent care expenses. Attach Form 2441 . . . . . . . . . . . . 23 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . . . . . . 34 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . . . . . . 45 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . . . . . . . . 56 Other credits from Form: a 3800 b 8801 c 67 Add lines 1 through 6. Enter here and include on Form 1040 or 1040-SR, line 13b . . . . . . . 7

Part II Other Payments and Refundable Credits8 2019 estimated tax payments and amount applied from 2018 return . . . . . . . . . . . 89 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . . . . 9

10 Amount paid with request for extension to file (see instructions) . . . . . . . . . . . . . 1011 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . . . . . . . . 1112 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . . . . . . . . 1213 Credits from Form: a 2439 b Reserved c 8885 d 1314 Add lines 8 through 13. Enter here and on Form 1040 or 1040-SR, line 18d . . . . . . . . . 14

For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 3 (Form 1040 or 1040-SR) 2019

QNA

NOAH & ELLA NEUMANN 131-00-0000

483

483

500

500

SCHEDULE A (Form 1040 or 1040-SR)

Department of the Treasury Internal Revenue Service (99)

Itemized Deductions Go to www.irs.gov/ScheduleA for instructions and the latest information.

Attach to Form 1040 or 1040-SR. Caution: If you are claiming a net qualified disaster loss on Form 4684, see the instructions for line 16.

OMB No. 1545-0074


Name(s) shown on Form 1040 or 1040-SR Your social security number

Medical and Dental Expenses

Caution: Do not include expenses reimbursed or paid by others. 1 Medical and dental expenses (see instructions) . . . . . . . 1 2 Enter amount from Form 1040 or 1040-SR, line 8b 2 3 Multiply line 2 by 7.5% (0.075) . . . . . . . . . . . . . 3 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . . 4

Taxes You Paid

5 State and local taxes.

a 5ab State and local real estate taxes (see instructions) . . . . . . . 5b c State and local personal property taxes . . . . . . . . . . 5c d Add lines 5a through 5c . . . . . . . . . . . . . . . 5d e Enter the smaller of line 5d or $10,000 ($5,000 if married filing

separately) . . . . . . . . . . . . . . . . . . . 5e 6 Other taxes. List type and amount

6 7 Add lines 5e and 6 . . . . . . . . . . . . . . . . . . . . . . . 7

Interest You PaidCaution: Your mortgage interest deduction may be limited (see instructions).

8

Home mortgage interest and points. If you didn’t use all of your home mortgage loan(s) to buy, build, or improve your home, see instructions and check this box . . . . . . . . . . .

a

Home mortgage interest and points reported to you on Form 1098. See instructions if limited . . . . . . . . . . . . . . . . 8a

b

Home mortgage interest not reported to you on Form 1098. See instructions if limited. If paid to the person from whom you bought the home, see instructions and show that person’s name, identifying no., and address . . . . . . . . . . . . . . . . . . .

8bc Points not reported to you on Form 1098. See instructions for special

rules . . . . . . . . . . . . . . . . . . . . . 8cd Mortgage insurance premiums (see instructions) . . . . . . . 8d e Add lines 8a through 8d . . . . . . . . . . . . . . . 8e

9 Investment interest. Attach Form 4952 if required. See instructions 910 Add lines 8e and 9 . . . . . . . . . . . . . . . . . . . . . . . 10

Gifts to Charity

11

Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . . . .

Caution: If you made a gift and got a benefit for it, see instructions.

1112

Other than by cash or check. If you made any gift of $250 or more, see instructions. You must attach Form 8283 if over $500. . . . 12

13 Carryover from prior year . . . . . . . . . . . . . . 13 14 Add lines 11 through 13 . . . . . . . . . . . . . . . . . . . . . . 14

Casualty and Theft Losses

15

Casualty and theft loss(es) from a federally declared disaster (other than net qualified disaster losses). Attach Form 4684 and enter the amount from line 18 of that form. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Other Itemized Deductions

16 Other—from list in instructions. List type and amount

16 Total Itemized Deductions

17

Add the amounts in the far right column for lines 4 through 16. Also, enter this amount on Form 1040 or 1040-SR, line 9 . . . . . . . . . . . . . . . . . . . . 17

18

If you elect to itemize deductions even though they are less than your standard deduction, check this box . . . . . . . . . . . . . . . . . . . .

For Paperwork Reduction Act Notice, see the Instructions for Forms 1040 and 1040-SR. Schedule A (Form 1040 or 1040-SR) 2019

State and local income taxes or general sales taxes. You may include either income taxes or general sales taxes on line 5a, but not both. If you elect to include general sales taxes instead of income taxes, check this box . . . . . . . . . . . . . . . . .

f1040sa--dft.pdf 2 1/13/2020 9:38:41 AM

QNA


1308 30525

2289

350

350

350

350

350

SCHEDULE B (Form 1040 or 1040-SR)


Interest and Ordinary Dividends Go to www.irs.gov/ScheduleB for instructions and the latest information.

Attach to Form 1040 or 1040-SR.

OMB No. 1545-0074


Name(s) shown on return Your social security number

Part I

Interest (See instructions and the instructions for Forms 1040 and 1040-SR, line 2b.) Note: If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the total interest shown on that form.

1

List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see the instructions and list this interest first. Also, show that buyer’s social security number and address

1

Amount

2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . . 2

3

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . . 3

4

Subtract line 3 from line 2. Enter the result here and on Form 1040 or 1040-SR, line 2b . . . . . . . . . . . . . . . . . . . . . . . . 4

Note: If line 4 is over $1,500, you must complete Part III. Amount

Part II

Ordinary

Dividends (See instructions and the instructions for Forms 1040 and 1040-SR, line 3b.) Note: If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the ordinary dividends shown on that form.

5 List name of payer

5

6

Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR, line 3b . . . . . . . . . . . . . . . . . . . . . . . . 6

Note: If line 6 is over $1,500, you must complete Part III.

Part III

Foreign Accounts and Trusts

Caution: If required, failure

to file FinCEN Form 114 may result in substantial penalties. See instructions.

You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Yes No

7

a

At any time during 2019, did you have a financial interest in or signature authority over a financialaccount (such as a bank account, securities account, or brokerage account) located in a foreigncountry? See instructions . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and FinancialAccounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114and its instructions for filing requirements and exceptions to those requirements . . . . . .

b

If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located

8

During 2019, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If “Yes,” you may have to file Form 3520. See instructions . . . . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions. Schedule B (Form 1040 or 1040-SR) 2019

QNA


COUNTY BANK 375

INTEREST SUBTOTAL 375ABP ADJUSTMENT -25

350

350

X

X

SCHEDULE EIC (Form 1040 or 1040-SR)


Earned Income CreditQualifying Child Information

Complete and attach to Form 1040 or 1040-SR only if you have a qualifying child.

Go to www.irs.gov/ScheduleEIC for the latest information.

1040

1040-SR . . . . . . . . .

EIC

OMB No. 1545-0074



Before you begin: • See the instructions for Form 1040 or 1040-SR, line 18a, to make sure that (a) you can take the EIC, and (b) you have a qualifying child.

• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card. Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s social security card is not correct, call the Social Security Administration at 1-800-772-1213.

!CAUTION

• You can't claim the EIC for a child who didn't live with you for more than half of the year. • If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details. • It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

Qualifying Child Information Child 1 Child 2 Child 3

1 Child’s name If you have more than three qualifying children, you have to list only three to get the maximum credit.

First name Last name First name Last name First name Last name

2 Child’s SSN The child must have an SSN as defined in the instructions for Form 1040 or 1040-SR, line 18a, unless the child was born and died in 2019. If your child was born and died in 2019 and did not have an SSN, enter “Died” on this line and attach a copy of the child’s birth certificate, death certificate, or hospital medical records showing a live birth.

3 Child’s year of birth Year

If born after 2000 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5.

Year If born after 2000 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5.

Year If born after 2000 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5.

4 a Was the child under age 24 at the end of 2019, a student, and younger than you (or your spouse, if filing jointly)?

Yes.

Go to line 5.

No.

Go to line 4b.

Yes.

Go to line 5.

No.

Go to line 4b.

Yes.

Go to line 5.

No.

Go to line 4b.

b Was the child permanently and totally disabled during any part of 2019? Yes.

Go to line 5.

No.

The child is not a qualifying child.

Yes.

Go to line 5.

No.


Yes.

Go to line 5.

No.


5 Child’s relationship to you (for example, son, daughter, grandchild, niece, nephew, eligible foster child, etc.)

6 Number of months child lived with you in the United States during 2019

• If the child lived with you for more than half of 2019 but less than 7 months, enter “7.”

• If the child was born or died in 2019 and your home was the child’s home for more than half the time he or she was alive during 2019, enter “12.”

months Do not enter more than 12 months.



For Paperwork Reduction Act Notice, see your tax return instructions.

Schedule EIC (Form 1040 or 1040-SR) 2019

QNA


LEO NEUMANN

133-00-0000

1 9 9 6

X

SON

12

Form 8863Department of the Treasury Internal Revenue Service (99)

Education Credits (American Opportunity and Lifetime Learning Credits)

Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form8863 for instructions and the latest information.

OMB No. 1545-0074



!CAUTION

Complete a separate Part III on page 2 for each student for whom you’re claiming either credit before you complete Parts I and II.

Part I Refundable American Opportunity Credit 1 After completing Part III for each student, enter the total of all amounts from all Parts III, line 30 . . 12 Enter: $180,000 if married filing jointly; $90,000 if single, head of household,

or qualifying widow(er) . . . . . . . . . . . . . . . . . . 2

3 Enter the amount from Form 1040 or 1040-SR, line 8b. If you’re filing Form2555 or 4563, or you’re excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . . . . . . . . . . . . . 3

4 Subtract line 3 from line 2. If zero or less, stop; you can’t take any educationcredit . . . . . . . . . . . . . . . . . . . . . . . . 4

5 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . . . . . . . 5

6 If line 4 is: • Equal to or more than line 5, enter 1.000 on line 6 . . . . . . . . . . . . .• Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to

at least three places) . . . . . . . . . . . . . . . . . . . . . .} . . . 6

7 Multiply line 1 by line 6. Caution: If you were under age 24 at the end of the year and meet the conditions described in the instructions, you can’t take the refundable American opportunity credit; skip line 8, enter the amount from line 7 on line 9, and check this box . . . . . . . . 7

8 Refundable American opportunity credit. Multiply line 7 by 40% (0.40). Enter the amount here and on Form 1040 or 1040-SR, line 18c. Then go to line 9 below . . . . . . . . . . . . . . 8

Part II Nonrefundable Education Credits9 Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) . 9

10 After completing Part III for each student, enter the total of all amounts from all Parts III, line 31. Ifzero, skip lines 11 through 17, enter -0- on line 18, and go to line 19 . . . . . . . . . . . 10

11 Enter the smaller of line 10 or $10,000 . . . . . . . . . . . . . . . . . . . . . 1112 Multiply line 11 by 20% (0.20) . . . . . . . . . . . . . . . . . . . . . . . . 1213 Enter: $136,000 if married filing jointly; $68,000 if single, head of household, or

qualifying widow(er) . . . . . . . . . . . . . . . . . . . 13

14 Enter the amount from Form 1040 or 1040-SR, line 8b. If you're filing Form2555 or 4563, or you’re excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . . . . . . . . . . . . . 14

15 Subtract line 14 from line 13. If zero or less, skip lines 16 and 17, enter -0- online 18, and go to line 19 . . . . . . . . . . . . . . . . . 15

16 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . . . . . . . 16

17 If line 15 is: • Equal to or more than line 16, enter 1.000 on line 17 and go to line 18 • Less than line 16, divide line 15 by line 16. Enter the result as a decimal (rounded to at least three

places) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1718 Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) 1819 Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet (see

instructions) here and on Schedule 3 (Form 1040 or 1040-SR), line 3 . . . . . . . . . . . 19For Paperwork Reduction Act Notice, see your tax return instructions. Form 8863 (2019)QNA


2000

180000

30525

149475

20000

1.000

2000

800

1200

483

Form 8863 (2019) Page 2 Name(s) shown on return Your social security number

!CAUTION

Complete Part III for each student for whom you’re claiming either the American opportunity credit or lifetime learning credit. Use additional copies of page 2 as needed for each student.

Part III Student and Educational Institution Information. See instructions.20 Student name (as shown on page 1 of your tax return) 21 Student social security number (as shown on page 1 of

your tax return)

22 Educational institution information (see instructions)a. Name of first educational institution

(1) Address. Number and street (or P.O. box). City, town or post office, state, and ZIP code. If a foreign address, see instructions.

(2) Did the student receive Form 1098-T from this institution for 2019?

Yes No

(3) Did the student receive Form 1098-T from this institution for 2018 with box 2 filled in and box 7 checked?

Yes No

(4) Enter the institution’s employer identification number (EIN) if you’re claiming the American opportunity credit or if you checked “Yes” in (2) or (3). You can get the EIN from Form 1098-T or from the institution.

–

b. Name of second educational institution (if any)

(1) Address. Number and street (or P.O. box). City, town or post office, state, and ZIP code. If a foreign address, see instructions.

(2) Did the student receive Form 1098-T from this institution for 2019?

Yes No

(3) Did the student receive Form 1098-T from this institution for 2018 with box 2 filled in and box 7 checked?

Yes No

(4) Enter the institution’s employer identification number (EIN) if you’re claiming the American opportunity credit or if you checked “Yes” in (2) or (3). You can get the EIN from Form 1098-T or from the institution.

–

23 Has the Hope Scholarship Credit or American opportunity credit been claimed for this student for any 4 tax years before 2019?

Yes — Stop! Go to line 31 for this student. No — Go to line 24.

24 Was the student enrolled at least half-time for at least one academic period that began or is treated as having begun in 2019 at an eligible educational institution in a program leading towards a postsecondary degree, certificate, or other recognized postsecondary educational credential? See instructions.

Yes — Go to line 25. No — Stop! Go to line 31 for this student.

25 Did the student complete the first 4 years of postsecondary education before 2019? See instructions.

Yes — Stop! Go to line 31 for this student.

No — Go to line 26.

26 Was the student convicted, before the end of 2019, of a felony for possession or distribution of a controlled substance?

Yes — Stop! Go to line 31 for this student.

No — Complete lines 27 through 30 for this student.

!CAUTION

You can't take the American opportunity credit and the lifetime learning credit for the same student in the same year. If you complete lines 27 through 30 for this student, don’t complete line 31.

American Opportunity Credit 27 Adjusted qualified education expenses (see instructions). Don’t enter more than $4,000 . . . . . 2728 Subtract $2,000 from line 27. If zero or less, enter -0- . . . . . . . . . . . . . . . . . 2829 Multiply line 28 by 25% (0.25) . . . . . . . . . . . . . . . . . . . . . . . . 29

30 If line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29 and enter the result. Skip line 31. Include the total of all amounts from all Parts III, line 30, on Part I, line 1 . 30Lifetime Learning Credit

31 Adjusted qualified education expenses (see instructions). Include the total of all amounts from all Parts III, line 31, on Part II, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . 31

Form 8863 (2019)QNA


LEO NEUMANN 133-00-0000

X

X

X

X

2000

2000

BUCKEYE COLLEGE

575 COLLEGE BLVDWAIPAHU HI 96797

X

X

3 3 7 0 0 0 0 0 0

of 8 Fileid: … ions/I8863/2019/A/XML/Cycle04/source 11:06 - 9-Dec-2019The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Credit Limit WorksheetComplete this worksheet to figure the amount to enter on line 19.1. Enter the amount from Form 8863,

line 18 . . . . . . . . . . . . . . . . . . . . . 1. 2. Enter the amount from Form 8863,

line 9 . . . . . . . . . . . . . . . . . . . . . . 2. 3. Add lines 1 and 2 . . . . . . . . . . . . . . 3. 4. Enter the amount from:

Form 1040 or 1040-SR, line 12b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.

5. Enter the total of your credits from:Schedule 3 (Form 1040 or 1040-SR), lines 1 and 2, and Schedule R, line 22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.

6. Subtract line 5 from line 4 . . . . . . . . . 6. 7. Enter the smaller of line 3 or line 6 here

and on Form 8863, line 19 . . . . . . . . 7.

NEUMANN 131-00-0000

1200

1200

483

483

483

Social Security Benefits Worksheet—Lines 5a and 5b Keep for Your RecordsFigure any write-in adjustments to be entered on the dotted line next to Schedule 1, line 22 (see the instructions for Schedule 1, line 22).If you are married filing separately and you lived apart from your spouse for all of 2019, enter “D” to the right of the word “benefits” on line 5a. If you don’t, you may get a math error notice from the IRS.Be sure you have read the Exception in the line 5a and 5b instructions to see if you can use this worksheet instead of a publication to find out if any of your benefits are taxable.

Before you begin:

1. Enter the total amount from box 5 of all your Forms SSA-1099 and RRB-1099. Also, enter this amount on Form 1040 or 1040-SR, line 5a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.

2. Multiply line 1 by 50% (0.50) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 3. Combine the amounts from Form 1040 or 1040-SR, lines 1, 2b, 3b, 4b, 4d, and Schedule 1,

line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 4. Enter the amount, if any, from Form 1040 or 1040-SR, line 2a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Combine lines 2, 3, and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 6. Enter the total of the amounts from Schedule 1, lines 10 through 19, plus any write-in

adjustments you entered on the dotted line next to Schedule 1, line 22 . . . . . . . . . . . . . . . . . . . . . . 6. 7. Is the amount on line 6 less than the amount on line 5?

No.STOP

None of your social security benefits are taxable. Enter -0- on Form 1040 or 1040-SR, line 5b.

Yes. Subtract line 6 from line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.

8. If you are:• Married filing jointly, enter $32,000• Single, head of household, qualifying widow(er), or married filing separately and you lived apart from your spouse for all of 2019,enter $25,000 . . . . . . . . . . . . . . . 8. • Married filing separately and you lived with your spouse at any timein 2019, skip lines 8 through 15; multiply line 7 by 85% (0.85) and enter the result on line 16. Then, go to line 17

9. Is the amount on line 8 less than the amount on line 7?No.

STOPNone of your social security benefits are taxable. Enter -0- on Form 1040 or 1040-SR, line 5b. If you are married filing separately and you lived apart from your spouse for all of 2019, be sure you entered “D” to the right of the word “benefits” on line 5a.

Yes. Subtract line 8 from line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.

10. Enter: $12,000 if married filing jointly; $9,000 if single, head of household, qualifying widow(er), or married filing separately and you lived apart from your spouse for all of 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.

11. Subtract line 10 from line 9. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Enter the smaller of line 9 or line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Enter one-half of line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Enter the smaller of line 2 or line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. 15. Multiply line 11 by 85% (0.85). If line 11 is zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. 16. Add lines 14 and 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. 17. Multiply line 1 by 85% (0.85) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. 18. Taxable social security benefits. Enter the smaller of line 16 or line 17. Also enter this amount

on Form 1040 or 1040-SR, line 5b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.

TIP If any of your benefits are taxable for 2019 and they include a lump-sum benefit payment that was for an earlier year, you may be able to reduce the taxable amount. See Lump-Sum Election in Pub. 915 for details.

Need more information or forms? Visit IRS.gov. -28-


QNA

16000

8000

28350

36350

X 36350

32000

X 4350

12000

4350

2175

2175

2175

13600

2175

AWorksheet —2019 EIC—Line 18a

1040

1040-SRor

Yes. Skip line 5; enter the amount from line 2 on line 6.

STOP

Keep for Your Records

Before you begin:

1.

2.

3.

4.

5.

1Enter your earned income from Step 5.

Enter the amount from Form 1040 or 1040-SR, line 8b.

Are the amounts on lines 3 and 1 the same?

No. Go to line 5.

If you have:

Yes. Leave line 5 blank; enter the amount from line 2 on line 6.

No. Look up the amount on line 3 in the EIC Table to find thecredit. Be sure you use the correct column for your filingstatus and the number of children you have. Enter the credithere.

Enter this amount onForm 1040 or 1040-SR, line 18a.

3

6Part 3

Part 1

Part 2

All Filers UsingWorksheet A

Filers WhoAnswered“No” onLine 4

Your EarnedIncome Credit

2

● No qualifying children, is the amount on line 3 less than $8,650($14,450 if married filing jointly)?

● 1 or more qualifying children, is the amount on line 3 less than$19,050 ($24,850 if married filing jointly)?

Look at the amounts on lines 5 and 2.Then, enter the smaller amount on line 6.

5

6. This is your earned income credit.

Reminder—

If you have a qualifying child, complete and attach Schedule EIC.

If your EIC for a year after 1996 was reduced or disallowed, seeForm 8862, who must file, earlier, to find out if you must file Form 8862 to take thecredit for 2019.

EIC

1040 or 1040-SR

CAUTION

Be sure you are using the correct worksheet. Use this worksheet only if youanswered “No” to Step 5, question 2. Otherwise, use Worksheet B.

Look up the amount on line 1 above in the EIC Table (right afterWorksheet B) to find the credit. Be sure you use the correct columnfor your filing status and the number of children you have. Enter thecredit here.

If line 2 is zero, You can’t take the credit.Enter “No” on the dotted line next to Form 1040 or 1040-SR, line 18a.


28000

3014

30525

x

x

2614

2614

BWorksheet —2019 EIC—Line 18a

STOP


Use this worksheet if you answered “Yes” to Step 5, question 2.Complete the parts below (Parts 1 through 3) that apply to you. Then, continue to Part 4.

1a.

2.

3.

1aEnter the amount from Schedule SE, Section A, line 3; or Section B, line 3, whichever applies.

Subtract line 1d from line 1c.

Don’t include on these lines any statutory employee income, any net profit from services performed as a notary public, any amount exempt from self-employment tax as the result of the filing and approval of Form 4029 or Form 4361, or any other amounts exempt from self-employment tax.

Yes. If you want the IRS to figure your credit, see Credit figured by the IRS, earlier. If you want to figure the credit yourself, enter the amount from line 4b on line 6 of this worksheet.

Part 3

Part 1

Part 2

Self-Employed, Members of the Clergy, and People With Church Employee Income Filing Schedule SE

Self-Employed NOT Required To File Schedule SE

Statutory EmployeesFiling Schedule C

2 qualifying children, is line 4b less than $46,703 ($52,493 if married filing jointly)?1 qualifying child, is line 4b less than $41,094 ($46,884 if married filing jointly)?

If you are married filing a joint return, include your spouse’s amounts, if any, with yours to figure the amounts to enter in Parts 1 through 3.

1e

c.

d.

e.

1c

Enter any amount from Schedule SE, Section B, line 4b and line 5a.

1d

Combine lines 1a and 1b.

Enter the amount from Schedule SE, Section A, line 6; or Section B, line 13, whichever applies.

=

=

For example, your net earnings from self-employment were less than $400.

a.2a

Enter any net farm profit or (loss) from Schedule F, line 34; and from farm partnerships, Schedule K-1 (Form 1065), box 14, code A*.

b. 2bEnter any net profit or (loss) from Schedule C, line 31; and Schedule K-1 (Form 1065), box 14, code A (other than farming)*.

+

Combine lines 2a and 2b. 2cc. =

Enter the amount from Schedule C, line 1, that you are filing as a statutory employee.

3

Part 4

All Filers Using Worksheet B

Note. If line 4b includes income on which you should have paid self- employment tax but didn’t, we may reduce your credit by the amount of self-employment tax not paid.

4a. Enter your earned income from Step 5.

4bb. Combine lines 1e, 2c, 3, and 4a. This is your total earned income.

5. If you have:

No qualifying children, is line 4b less than $15,570 ($21,370 if married filing jointly)?

No. You can’t take the credit. Enter “No” on the dotted line next to Form 1040 or 1040-SR, line 18a.

* If you have any Schedule K-1 amounts, complete the appropriate line(s) of Schedule SE, Section A. Reduce the Schedule K-1 amounts as described in the Partner’s Instructions for Schedule K-1. Enter your name and social security number on Schedule SE and attach it to your return.

If line 4b is zero or less, You can’t take the credit. Enter “No” on the dotted line next to Form 1040 or 1040-SR, line 18a.

4a

STOP

3 or more qualifying children, is line 4b less than $50,162 ($55,952 if married filing jointly)?

b. 1b+

–

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●

●

●

NOAH & ELLA NEUMANN

28000

28000

x

BWorksheet —2019 EIC—Line 18a—Continued

Skip line 10; enter the amount from line 7 on line 11.Yes.

STOP


6.

7.

8.

9.

10.

6Enter your total earned income from Part 4, line 4b.

Look up the amount on line 6 above in the EIC Table to find the credit. Be sure you use the correct column for your filing status and the number of children you have. Enter the credit here.

Enter the amount from Form 1040 or 1040-SR, line 8b.

Are the amounts on lines 8 and 6 the same?

Go to line 10.No.

If you have:

Leave line 10 blank; enter the amount from line 7 on line 11.Yes.

No. Look up the amount on line 8 in the EIC Table to find thecredit. Be sure you use the correct column for your filingstatus and the number of children you have. Enter the credit here.

8

11

Part 5

Part 7

All Filers UsingWorksheet B

Your EarnedIncome Credit

7

If line 7 is zero, You can’t take the credit.Enter “No” on the dotted line next to Form 1040 or 1040-SR, line 18a.

No qualifying children, is the amount on line 8 less than $8,650($14,450 if married filing jointly)?

1 or more qualifying children, is the amount on line 8 less than $19,050($24,850 if married filing jointly)?

Look at the amounts on lines 10 and 7.Then, enter the smaller amount on line 11.

10

This is your earned income credit.

Reminder—

If you have a qualifying child, complete and attach Schedule EIC.

If your EIC for a year after 1996 was reduced or disallowed, seeForm 8862, who must file, earlier, to find out if you must file Form8862 to take the credit for 2019.

Part 6

Filers WhoAnswered“No” onLine 9

CAUTION

11.

●

●

1040

1040-SRor

Enter this amount onForm 1040 or 1040-SR, line 18a.

EIC

1040 or 1040-SR

28000

3014

30525

x

x

2614

2614

FORM STATE OF HAWAII — DEPARTMENT OF TAXATION

N-11 Individual Income Tax Return(Rev. 2019)

RESIDENT Calendar Year 2019 OR

AMENDED ReturnNOL CarrybackIRS AdjustmentFirst Time Filer

1 Single

2 Married filing joint return (even if only one had income).

3 Married filing separate return. Enter spouse’s SSN and

the first four letters of last name above. Enter spouse’s full

name here. _____________________________________

4 Head of household (with qualifying person). If the qualifying

person is a child but not your dependent, enter the child’s full

name. __________________________________

5 Qualifying widow(er) (see page 9 of the Instructions)

Enter the year your spouse died

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FORM N-11 (REV. 2019)

DO NOT WRITE IN THIS AREA

Fiscal YearBeginning and Ending

IMPORTANT — Complete this Section Enter the first four letters of your last name. Use ALL CAPITAL letters

Your Social Security Number

Deceased Date of Death

Enter the first four letters of your Spouse’s last name. Use ALL CAPITAL letters

Spouse's Social Security Number

Deceased Date of Death

Enter the number of Xs on 6a and 6b ..................

Dependents: If more than 4 dependents 2. Dependent’s social1. First and last name use attachment security number 3. Relationship

(Place an X in only ONE box)

FOR OFFICE USE ONLY

CAUTION: If you can be claimed as a dependent on another person’s tax return (such as your parents’), DO NOT place an X on line 6a, but be sure to place an X above line 21.

6a Yourself ............................................ Age 65 or over ........................................................

6b Spouse............................................. Age 65 or over ........................................................} If you placed an X on lines 3 and 6b above, see the Instructions on page 9 and if your spouse meets the qualifications, place an X here

6c

and

6d

6e Total number of exemptions claimed. Add numbers entered in boxes 6a thru 6d above...............................................

Do NOT Submit a Photocopy!!

Enter number of your children listed ... 6c

Enter number of other dependents ......6d

6e

Your First Name M.I. Your Last Name Suffix

Spouse’s First Name M.I. Spouse’s Last Name Suffix

Care Of (See Instructions, page 7.)

Present mailing or home address (Number and street, including Rural Route)

City, town or post office State Postal/ZIP code

If Foreign address, enter Province and/or State Country

N11_T 2019A 01 VID60

ID NO 60

NOAH NEUMANN NEUM

131 - 00 - 0000ELLA NEUMANN

NEUM

132 - 00 - 0000

5001 LAUREL STREET

WAIPAHU HI 96797

X

X XX 3

1

4

LEO NEUMANN 133-00-0000 SON

FORM N-11 (REV. 2019)

Form N-11 (Rev. 2019) Page 2 of 4

ROUND TO THE NEAREST DOLLAR

7 Federal adjusted gross income (AGI) (see page 12 of the Instructions) ....................................... 7

8 Difference in state/federal wages due to COLA, ERS,

etc. (see page 12 of the Instructions) .................................. 8

9 Interest on out-of-state bonds

(including municipal bonds) ................................................. 9

10 Other Hawaii additions to federal AGI

(see page 12 of the Instructions) ....................................... 10

11 Add lines 8 through 10 .................. Total Hawaii additions to federal AGI 11

12 Add lines 7 and 11 ......................................................................................................................... 12

13 Pensions taxed federally but not taxed by Hawaii


14 Social security benefits taxed on federal return................. 14

15 First $6,735 of military reserve or Hawaii national

guard duty pay ................................................................... 15

16 Payments to an individual housing account ...................... 16

17 Exceptional trees deduction (attach affidavit)


18 Other Hawaii subtractions from federal AGI


19 Add lines 13 through 18

............................................Total Hawaii subtractions from federal AGI 19

20 Line 12 minus line 19 ............................................................................................Hawaii AGI 20

21 If you do not itemize your deductions, go to line 23 below. Otherwise go to page 17 of the Instructions

and enter your itemized deductions here.

21a Medical and dental expenses

(from Worksheet A-1) ...................................................... 21a

21b Taxes (from Worksheet A-2) ............................................ 21b

21c Interest expense (from Worksheet A-3) ........................... 21c

21d Contributions (from Worksheet A-4) ................................ 21d

21e Casualty and theft losses (from Worksheet A-5) ............. 21e

21f Miscellaneous deductions (from Worksheet A-6) ............. 21f

23 If you checked filing status box: 1 or 3 enter $2,200;

2 or 5 enter $4,400; 4 enter $3,212 ........................................................Standard Deduction 23

24 Line 20 minus line 22 or 23, whichever applies. (This line MUST be filled in) .................. 24

CAUTION: If you can be claimed as a dependent on another person’s return, see the Instructions on page 17, and place an X here.

TOTAL ITEMIZED DEDUCTIONS

22 Add lines 21a through 21f. If your Hawaii adjusted gross income is above a certain amount, you may not be able to deduct all of your itemized deductions. See the Instructions on page 22. Enter total here and go to line 24.

Your Social Security Number Your Spouse’s SSN

Name(s) as shown on return

N11_T 2019A 02 VID60

ID NO 60

131 - 00 - 0000 132 - 00 - 0000NOAH NEUMANN

30525

30525

23000

2175

25175

5350

4400

950

FORM N-11 (REV. 2019)

Form N-11 (Rev. 2019) Page 3 of 4

27a If tax is from the Capital Gains Tax Worksheet, enter

the net capital gain from line 14 of that worksheet .......... 27a

28 Refundable Food/Excise Tax Credit

(attach Form N-311) DHS, etc. exemptions .... 28

29 Credit for Low-Income Household

Renters (attach Schedule X) ............................................. 29

30 Credit for Child and Dependent

Care Expenses (attach Schedule X) ................................. 30

31 Credit for Child Passenger Restraint

System(s) (attach a copy of the invoice)............................ 31

32 Total refundable tax credits from

Schedule CR (attach Schedule CR) .................................. 32

33 Add lines 28 through 32 .................................................................Total Refundable Credits 33

34 Line 27 minus line 33. If line 34 is zero or less, see Instructions. .................................................. 34

35 Total nonrefundable tax credits (attach Schedule CR) .................................................................. 35

36 Line 34 minus line 35 ................................................................................................. Balance 36

37 Hawaii State Income tax withheld (attach W-2s)

(see page 28 of the Instructions for other attachments) .................. 37

38 2019 estimated tax payments............................................ 38

39 Amount of estimated tax applied from 2018 return ........... 39

40 Amount paid with extension............................................... 40

41 Add lines 37 through 40 ................................................................................. Total Payments 41

42 If line 41 is larger than line 36, enter the amount OVERPAID (line 41 minus line 36) (see Instructions) .. 42

43 Contributions to (see page 29 of the Instructions): ........................ Yourself Spouse

43a Hawaii Schools Repairs and Maintenance Fund ..................... $2 $2

43b Hawaii Public Libraries Fund ................................................... $5 $5

43c Domestic and Sexual Violence / Child Abuse and Neglect Funds ............. $5 $5

44 Add the amounts of the Xs on lines 43a through 43c and enter the total here ............................. 44

45 Line 42 minus line 44 ........................................................................................................ 45

25 Multiply $1,144 by the total number of exemptions claimed on line 6e.

If you and/or your spouse are blind, deaf, or disabled, place an X in the applicable box(es),

and see page 22 of the Instructions.

Yourself Spouse ............................................................................................... 25

26 Taxable Income. Line 24 minus line 25 (but not less than zero) ...................Taxable Income 26

27 Tax. Place an X if from Tax Table; Tax Rate Schedule; or Capital Gains Tax

Worksheet on page 39 of the Instructions.

( Place an X if tax from Forms N-2, N-103, N-152, N-168, N-312, N-338,

N-344, N-348, N-405, N-586, N-615, or N-814 is included.) .............................................. Tax 27



N11_T 2019A 03 VID60

ID NO 60

131 - 00 - 0000NOAH NEUMANN

132 - 00 - 0000

4576

X

135

135

135X

X 135

350

350

485

485

FORM N-11 (REV. 2019)

46 Amount of line 45 to be applied to your

2020 ESTIMATED TAX ..................................................... 46

47a Amount to be REFUNDED TO YOU (line 45 minus line 46) If filing late,

see page 29 of Instructions ........................................................................................................... 47a

47b Routing number 47c Type: Checking Savings

47d Account number

48 AMOUNT YOU OWE (line 36 minus line 41). ................................................................................ 48

49 PAYMENT AMOUNT Submit payment online at hitax.hawaii.gov or attach check or

money order payable to “Hawaii State Tax Collector.” .................................................................... 49

51 AMENDED RETURN ONLY – Amount paid (overpaid) on original return. (See Instructions) (attach Sch. AMD) ....... 51

52 AMENDED RETURN ONLY – Balance due (refund) with amended return. (See Instructions) (attach Sch. AMD) ..... 52

53 Did you file a federal Schedule C? Yes No If yes, enter Hawaii gross receipts your main business activity: ,

your main business product: , AND your HI Tax I.D. No. for this activity GE

54 Did you file a federal Schedule E If yes, enter Hawaii gross rents received for any rental activity? Yes No AND your HI Tax I.D. No. for this activity GE

55 Did you file a federal Schedule F? Yes No If yes, enter Hawaii gross receipts your main business activity: ,

your main business product: , AND your HI Tax I.D. No. for this activity GE

If designating another person to discuss this return with the Hawaii Department of Taxation, complete the following. This is not a full power of attorney. See page 32 of the Instructions.

Designee’s name Phone no. Identification number HAWAII ELECTION Do you want $3 to go to the Hawaii Election Campaign Fund? Yes No CAMPAIGN FUND

If joint return, does your spouse want $3 to go to the fund? Yes NoDECLARATION — I declare, under the penalties set forth in section 231-36, HRS, that this return (including accompanying schedules or statements) has been examined by me and, to the best of my knowledge and belief, is a true, correct, and complete return, made in good faith, for the taxable year stated, pursuant to the Hawaii Income Tax Law, Chapter 235, HRS.

(See page 32 of the Instructions)

Form N-11 (Rev. 2019) Page 4 of 4DE

SIG

NEE

PL

EA

SE

S

IGN

HE

RE

Preparer’s Date Check if Preparer’s identification number

Signature self-employed

Print Preparer’s Name Federal E.I. No.

Firm’s name (or yours if self-employed),

Phone No.

Address, and ZIP Code

Paid Preparer’s Information

Your signature Date Spouse’s signature (if filing jointly, BOTH must sign) Date

Your Occupation Daytime Phone Number Your Spouse’s Occupation Daytime Phone Number

Place an X in this box if this refund will ultimately be deposited to a foreign (non-U.S.) bank. Do not complete lines 47b, 47c, or 47d.



50 Estimated tax penalty. (See page 30 of

Instructions.) Do not include on line 42 or 48. Place an X in

this box if Form N-210 is attached ................... 50

Note: Placing an X the “Yes” box wiil not increase your tax or reduce your refund.

N11_T 2019A 04 VID60

ID NO 60

NOAH NEUMANN

131 - 00 - 0000 132 - 00 - 0000

485

X

X

X

XX

CASHIER NONE(808)911-9111 (808)911-9111

01/15/20 01/15/20

01/15/20 S64216928

PRACTICE LAB15 PRACTICE LAB WAY WASHINGTON DC 20005 (202)202-2022

ID NO 60

FORM N-311 (REV. 2019)

00

STATE OF HAWAII — DEPARTMENT OF TAXATION

REFUNDABLE FOOD/EXCISE TAX CREDIT

See Instructions on back

Attach to Form N-11 or Form N-15

(NOTE: References to “married” and “spouse” are also references to “in a civil union” and “civil union partner,” respectively.)

FORM

N-311 (REV. 2019)

2019

Name(s) as shown on Form N-11 or N-15 Your social security number

1 Is your federal adjusted gross income less than $50,000 (less than $30,000 if your filing status is Single)? (See the Instructions) If “Yes,” go to

line 2. If “No,” STOP. You cannot claim this credit. However, you may claim the credit for a minor child receiving support from the Department

of Human Services, etc. In this situation, only complete lines 3, 9, and 10.

2 List YOURSELF, YOUR SPOUSE, AND YOUR DEPENDENTS that meet all of the following: a) Present in Hawaii for more than nine months in 2019,

b) Not in prison, jail, or a youth correctional facility for entire taxable year, and c) Cannot be claimed as a dependent by another taxpayer.

Do not list minor children receiving more than half of their support from public agencies even though you may claim them as a dependent. List these minor children on line 3.

2 Name Relationship Name RelationshipSelf

Spouse

Enter the number of qualified persons listed above ................................................................................................................................ 2

3 List MINOR CHILDREN RECEIVING MORE THAN HALF OF THEIR SUPPORT FROM PUBLIC AGENCIES, such as the Department of Human

Services, who meet all the following requirements and are not listed above on line 2: a) Present in Hawaii for more than nine months in 2019, b) Not in prison,

jail, or a youth correctional facility for entire taxable year, c) More than half of support from public agency, and d) Cannot be claimed as a dependent by another taxpayer.

3 Caution: Do not list any children already listed on line 2 above.

Name Social Security Number Relationship Name Social Security Number Relationship

Enter the number of minor children receiving more than half of their support from public agencies. Also enter this number in the

space provided on Form N-11, line 28; or Form N-15, line 45. ............................................................................................................... 3

4 Enter the amount of your federal adjusted gross income (See the Instructions) ........................................................ 4

5 If you are married filing separately, enter your spouse’s federal adjusted gross income. ........................................... 5

6 Add lines 4 and 5. Enter the total here. ........................................................................................................................ 6

7 Enter on line 7 the amount of the tax credit shown below that applies to the amount on line 6.

If your filing status is Single and Tax credit per line 6 is: qualified exemption is: Under $5,000 ............................................................................................................................ $110 $5,000 and over but under $10,000 ............................................................................................ 100 $10,000 and over but under $15,000 ............................................................................................ 85 $15,000 and over but under $20,000 ............................................................................................ 70 $20,000 and over but under $30,000 ............................................................................................ 55 $30,000 and over ............................................................................................................................ 0

If your filing status is Married Filing Jointly, Married Filing Separately, Head of Household, or Qualifying Widower, and Tax credit per line 6 is: qualified exemption is: Under $5,000 ............................................................................................................................ $110 $5,000 and over but under $10,000 ............................................................................................ 100 $10,000 and over but under $15,000 ............................................................................................ 85 $15,000 and over but under $20,000 ............................................................................................ 70 $20,000 and over but under $30,000 ............................................................................................ 55 $30,000 and over but under $40,000 ............................................................................................ 45 $40,000 and over but under $50,000 ............................................................................................ 35 $50,000 and over ............................................................................................................................ 0

7

8 Multiply line 2 by the amount of the tax credit on line 7. Enter the total here. .............................................................. 8

9 Multiply line 3 by $110. Enter the total here. ................................................................................................................ 9

10 Add lines 8 and 9. Enter the result here and on Form N-11, line 28; or Form N-15, line 45.

This is your refundable food/excise tax credit. (Whole dollars only) ............................................................................ 10

N311_T 2019A 01 VID60

ID NO 60


NOAH NEUMANNELLA NEUMANN LEO NEUMANN SON

3

30525.00

30525.00

45.00 135.00

135

FORM N-356

Name(s) as shown on Form N-11 or N-15 Your social security number

Note: If you are only claiming a carryover of unused earned income tax credit from a prior year, skip lines 1 through 7 and begin on line 8.

QUALIFYING INDIVIDUAL TAXPAYER

1 In order to claim the tax credit, you must meet the definition of a qualifying individual taxpayer.

a Are you filing a 2019 federal income tax return and claiming the federal earned income credit? ................................ Yes No

b Are you using the same filing status on your 2019 Form N-11 or Form N-15 as used on your

2019 federal income tax return? .................................................................................................................................. Yes No

c Are you claiming the same dependents on your 2019 Form N-11 or Form N-15 as claimed on your

2019 federal income tax return? (Note: Also check “Yes” if you are not claiming any dependents

on your 2019 Hawaii and federal income tax returns.) ................................................................................................ Yes NoIf you answered “No” to any of the 3 questions, you are not a qualifying individual taxpayer. You cannot claim this credit. Do not complete this form.

ALLOWABLE TAX CREDIT FOR 2019 AND CARRYOVER COMPUTATION

2 Enter the amount of your federal earned income credit claimed on your 2019 federal income tax return ........................ 2

3 Multiply line 2 by 20% ....................................................................................................................................................... 3

Note: Residents, skip lines 4 and 5, enter “1.00” on line 6, and go to line 7.

Part-year residents and nonresidents, continue on to line 4.

4 Enter your Hawaii adjusted gross income from Form N-15, line 35, column B ................. 4

5 Enter your federal adjusted gross income from Form N-15, line 36 .................................. 5

6 Divide line 4 by line 5. (Compute to 3 decimal places and round to 2 decimal places) ..................................................... 6

7 Multiply line 3 by line 6. ..................................................................................................................................................... 7

8 Carryover of unused earned income tax credit from prior year ......................................................................................... 8

9 Tentative current year earned income tax credit — Add lines 7 and 8 .............................................................................. 9Adjusted Tax Liability

10 Enter the amount from Form N-11, line 34; or Form N-15, line 51 .................................................................................... 10

11 If you are claiming other nonrefundable tax credits, complete the worksheet in the instructions and enter

the total here. If you are not claiming other nonrefundable credits, enter zero.................................................................. 11

12 Line 10 minus line 11. This represents your adjusted tax liability. If the result is zero or less,

enter zero .......................................................................................................................................................................... 12

13 Total credit allowed — Enter the smaller of line 9 or line 12. This is your earned income tax credit allowable for

the year. Enter this amount, rounded to the nearest dollar, on the appropriate line for the credit on Schedule CR .......... 13

14 Total amount carryforward of unused credit. — Line 9 minus line 13. This represents your unused credit available to carryforward to be used against tax liability in subsequent tax years until exhausted ................................... 14

Part I

Part II


EARNED INCOME TAX CREDIT

See Instructions on back

Attach to Form N-11 or Form N-15

FORM

N-356 (Rev. 2019)

2019

N356_T 2019A 01 VID60 ID NO 60


X

X

X

2614.00

523.00

1.00

523.00

523.00

-135.00

523.00

Name(s) as shown on Form N-11, N-15, or N-40 Your Social Security Number or FEIN

PART I — COMPUTATION OF ANNUAL PENSION EXCLUSION (Complete this part only for the first year an annuity is received. Keep a copy of the first year computations for your records because you will use information from this part every year you receive payments from your annuity.)

1. Annual annuity. ........................................................................................................................................................... 1

2. Multiple (see Instructions) .......................................................................................................................................... 2 X years

3. Total expected return (line 1 multiplied by line 2). ...................................................................................................... 3

4. Employee’s contributions:

a. Previously taxed contribution.............................................................................. 4a

b. Pretax contribution ............................................................................................. 4b

c. Total employee’s contributions (line 4a plus line 4b). If there were no

employee contributions, see Instructions. .......................................................... 4c

5. Employer’s contributions. If there were no employer contributions, enter zero on

line 5, skip lines 6-9, and enter zero on lines 10 and 13. .......................................... 5

6. Total cost of annuity (line 4c plus line 5) .................................................................................................................... 6

7. Is this annuity received as part of an employer’s retirement plan because you retired or because you are a

beneficiary of someone who retired? If you checked No, skip lines 8 and 9 and enter zero on line 10. .................... 7

8. Portion of the total cost of the annuity attributable to employee contributions.

(Line 4c divided by line 6. Round to 2 decimal places.) ............................................................................................. 8

9. Exclusion ratio. Portion of the total cost of the annuity attributable to employer contributions (1.00 minus line 8)..... 9

10. Annual pension exclusion (line 9 multiplied by line 1) ................................................................................................ 10

11. Annual exclusion of the employee’s investment in the annuity contract (line 4a divided by the multiple on line 2) .... 11

PART II — COMPUTATION OF HAWAII TAXABLE ANNUITY (Complete for any year in which an annuity is received.)

12. Amount of annuity received this year. ........................................................................................................................ 12

13. Annual pension exclusion (from line 10 above, or from line 10 of your first Schedule J filed).................................... 13

14. Line 12 minus line 13. ................................................................................................................................................ 14

15. Enter total amount of annuity dividends received this year. ....................................................................................... 15

16. Portion of total cost of annuity attributable to employee’s contribution (see Instructions) .......................................... 16

17. Taxable annuity dividends (line 15 multiplied by line 16) ............................................................................................ 17

18. Add lines 14 and 17. .................................................................................................................................................. 18

19. Annual recovery of employee’s investment (from line 11 above, or from line 11 of your first Schedule J filed) ......... 19

20. Line 18 minus line 19. (For lump-sum distributions, see Instructions) ...................................................................... 20

21. Death benefit exclusion for a beneficiary of a plan participant who died before August 21, 1996, if

applicable (see Instructions) ...................................................................................................................................... 21

22. Total taxable annuity (line 20 minus line 21). Enter this amount on Form N-15, line 16, Column A, or on

Form N-40, line 8. ...................................................................................................................................................... 22

PART III — COMPUTATION OF PENSION ADJUSTMENT TO HAWAII ADJUSTED GROSS INCOME (For Form N-11 Filers Only)

23. Enter the amount of your annuity received this year that is federally taxable. ............................................................ 23

24. Pension adjustment to Hawaii Adjusted Gross Income (line 23 minus line 22).

Enter this amount on Form N-11, line 13 ................................................................................................................... 24

00

00

Yes No

SCHEDULE JFORM N-11/N-15/N-40

(REV. 2019)


SUPPLEMENTAL ANNUITIES SCHEDULEAnnuities, benefits under pension and profit-sharing plans, death

benefits, and pensions in general.

Attach to Form N-11, N-15, or N-40

2019

SCHEDULE J (FORM N-11/N-15/N-40)

GENERAL INSTRUCTIONSUse this form to compute the taxable part of distributions you re-

ceived from pensions and other annuities during the year. This form is also used for determining the taxable portion of lump-sum distributions from qualified retirement plans for which the recipient uses Form N-152 and makes the capital gain election or elects to use the 10-year averag-ing method.

To qualify as a pension, the payment must be received upon retire-ment from an employers’ retirement plan. It can be received in a lump-sum or in periodic payments. This includes payments made to a retired employee as well as payments made to the beneficiary of a retired

employee because of the employee’s death. Required distributions received by pension plan participants who have reached age 70-1/2 and who are still employed by their employers also qualify as pensions. Payments received because of separation of service before retirement do not qualify. Benefits incidental to a retirement plan received on or after termination of employment because of death or disability qualify for the pension exclusion if the other requirements for the exclusion are met.

The pension exclusion applies only to amounts attributable to em-ployer contributions. Amounts attributable to employer contributions which already have been deducted under other provisions cannot be deducted again.

SCHJ_T 2019A 01 VID60 ID NO 60


X

0.000.00

23000

noah & ella neumann 5001 laurel street 2019 income...

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