Jeff Bell 2012 Tax Return

COVER PAGE Filing Checklist for 2012 Tax Return Filed On Standard Forms Prepared on: 12/01/2013 12:18:43
pm Return: /Users/luou/Desktop/Jeff Bell 2012 Tax Return.T12
To le your 2012 tax return, simply follow these instructions:
Step 1. Sign and date the return

Because you're ling a joint return, Je! and Ivy both need to sign the tax return. If your return is signed by a representative for you, you must have a power of attorney attached that specically authorizes the representative to sign your return. To do this, you can use Form 2848, Power of Attorney and Declaration of Representative.
Step 2. Assemble the return

These forms should be assembled behind Form 1040 --U.S. Individual Income Tax Return - Schedule A - Schedule B - Schedule C - Schedule D - Schedule E - Schedule SE - Form 4797 - Form 6251 - Form 8582 - Page 1 - - Page 2 (Regular Tax) - - Page 3 (Regular Tax) - Form 8824 - Form 8829 - Form 1040-V Staple these documents to the front of the rst page of the return: Form W-2: Wage and Tax Statement 1st (MGM) Form W-2c: Corrected W-2
Step 3. Mail the return

Mail the return to this address:
Department of the Treasury Internal Revenue Service Austin, TX 73301-0002

We recommend that you use one of these IRS-approved methods to send your return. Retain the proof of mailing to avoid a late ling penalty: - U.S. Postal Service certied mail. - DHL Same Day Service. - FedEx Priority Overnight, Standard Overnight, 2Day, International Priority, or International First. - United Parcel Service Next Day Air, Next Day Air Saver, 2nd Day Air, 2nd Day Air A.M., Worldwide Express Plus, or Worldwide Express.
- FedEx Priority Overnight, Standard Overnight, 2Day, International Priority, or International First. - United Parcel Service Next Day Air, Next Day Air Saver, 2nd Day Air, 2nd Day Air A.M., Worldwide Express Plus, or Worldwide Express.
Step 4. Keep a copy

Print a second copy of the return for your records. We recommend that you also print and retain these supporting forms, which don't need to be sent to the IRS: - - Background Worksheet - - Dependents Worksheet - - Child Tax Credit Worksheet - - Last Year's Data Worksheet - - Form 1099-INT/OID - - Form 1099-DIV - - Form 1099-G - - Home Mortgage Interest Worksheet - - Charitable Worksheet - - Depreciation Summary - - Depreciation Worksheet - - Vehicle Worksheet - - Rentals & Royalties - - K-1 Partnership/S Corporation
2012 return information - Keep this for your records

Here is some additional information about your 2012 return. Keep this information with your records. You will need your 2012 AGI to electronically sign your return next year.
Quick Summary
Income Adjustments $365,648 $2,237
Adjusted gross income

Deductions Exemption(s)
$363,411
$25,301 $15,200
Taxable income
Tax withheld or paid already Actual tax due Refund applied to next year -
$322,910
$61,000 $67,985 $0
You Owe
$6,985
F o r m
For the year Jan. 1Dec. 31, 2012, or other tax year beginning
1040
Department of the TreasuryInternal Revenue Service
(99)
U.S. Individual Income Tax Return

Last name
2012
OMB No. 1545-0074 ,20
IRS Use OnlyDo not write or staple in this space.
, 2012, ending
Your first name and initial
See separate instructions. Your social security number
Jeff
If a joint return, spouse's first name and initial
Bell
Last name
111-11-1111
Spouse's social security number
Ivy 4326 Orange Blossom Trail
Bell
Apt. no.
123-45-6781
Make sure the SSN(s) above and on line 6c are correct. 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
Home address (number and street). If you have a P.O. box, see instructions.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Dallas
Foreign country name
TX
75080
Foreign postal code
Foreign province/state/county
You
Spouse
Filing Status
Check only one box.
1 2 3
Single
Married filing jointly (even if only one had income) Married filing separately. Enter spouse's SSN above and full name here.
Head of household (with qualifying person). (See instr.) If the qualifying person is a child but not your dependent, enter this child's name here. Qualifying widow(er) with dependent child . . . . . . .
(4)
if child under age 17 qualifying for child tax credit (see instructions)
Exemptions
6a b c
Spouse Dependents:
X X
Yourself. If someone can claim you as a dependent, do not check box 6a

(2) Dependent's social security number (3) Dependent's relationship to you
Boxes checked on 6a and 6b
2 2
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
No. of children on 6c who:
(1) First name
Last name
If more than four dependents, see instructions and check here
Anna Tyler
Bell Bell
123-45-6784 Daughter 123-45-6788 Daughter
lived with you did not live with you due to divorce or separation (see instructions) Dependents on 6c not entered above
d Total number of exemptions claimed
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Add numbers on lines above
Income
Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld. If you did not get a W-2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 1040-V.
Adjusted Gross Income
7 8a b 9a b 10 11 12 13 14 15a 16a 17 18 19 20a 21 22 23 24
Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . Taxable interest. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Tax-exempt interest. Do not include on line 8a . . . . . . . . . . . . . 8b Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . . . . . . 0 Qualified dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . . . . . Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . . . . . . . . . . . Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . . . . . . . . . . . . Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IRA distributions . . . . . . . . . . . . . . 15a b Taxable amount . . . Pensions and annuities . . . . . . . . . . 16a b Taxable amount . . . Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20a Social security benefits b Taxable amount . . . . . . . . GAMBLING Other income. List type and amount _ _ _ _ _ _ _ _ _ _ _ _____________________ Combine the amounts in the far right column for lines 7 through 21. This is your total income Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 0 Certain business expenses of reservists, performing artists, and 0 fee-basis government officials. Attach Form 2106 or 2106-EZ . . . . . . 24 0 25 25 Health savings account deduction. Attach Form 8889 . . . . . . . . . . 0 26 26 Moving expenses. Attach Form 3903 . . . . . . . . . . . . . . . . . . . 2,237 27 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . 27 0 28 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . 28 0 29 Self-employed health insurance deduction . . . . . . . . . . . . . . . . 29 0 30 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . 30 31a 31a Alimony paid b Recipient's SSN 0 32 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 33 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . 33 34 Tuition and fees. Attach Form 8917. 34 0 35 Domestic production activities deduction. Attach Form 8903 . . . . . . . 35
7 8a 9a 10 11 12 13 14 15b 16b 17 18 19 20b 21 22
100,000 24,000 0 0 31,664 200,000 0 0 0 5,784 0 4,200 365,648
KIA
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . . . . . . . . . For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
36 37
2,237 363,411 Form 1040 (2012)
Form 1040 (2012)
Jeff
38
Bell
111-11-1111
38
Tax and Credits

Standard Deduction for People who check any box on line 39a or 39b or who can be claimed as a dependent, see instructions. All others: Single or Married filing separately, $5,950 Married filing jointly or Qualifying widow(er), $11,900 Head of household, $8,700
Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . . . . . . . . . . . . . . . Blind. You were born before January 2, 1948, 39a Check Total boxes 0 checked 39a if: Spouse was born before January 2, 1948, Blind. 39b b If your spouse itemizes on a separate return or you were a dual-status alien, check here 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 Itemized deductions (from Schedule A) or your standard deduction (see left margin)
Subtract line 40 from line 38 Exemptions. Multiply $3,800 by the number on line 6d
Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 962 election .
Page 2 363,411
. . . . . .
40 41 42 43 44 45
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0-
25,301 338,110 15,200 322,910 52,788 11,308 64,096
Alternative minimum tax (see instructions). Attach Form 6251
. . . . . . . . . . . . . . . . . . . . . . . .
Add lines 44 and 45
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . 47 Credit for child and dependent care expenses. Attach Form 2441 . . . . 48 49 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . 50 Retirement savings contributions credit. Attach Form 8880 . . . . . . 51 Child tax credit. Attach Schedule 8812, if required . . . . . . . . . . . 52 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . . 53 b c 3800 8801 Other credits from Form: a
0 0 0
46
0
54 55 56 57 58 59a 59b 60 61
Add lines 47 through 53. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . Subtract line 54 from line 46. If line 54 is more than line 46, enter -0. . . . . . . . . . . . . . Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Unreported social security and Medicare tax from Form: a 4137 b 8919 . . . . . . .
Other Taxes
58 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . . . . 59 a Household employment taxes from Schedule H . . . . . . . . . . . . . . . . . . . . . . . . . . . b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . . . . . . . . 60 Other taxes Enter code(s) from instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 61 62 63 Add lines 55 through 60. This is your total tax . . . . . . . . . . . . . . . . . . . . . . . . . 25,000 62 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . 36,000 2012 estimated tax payments and amount applied from 2011 return . . 63 64a 65 66 67 68 69 70 71 . . . . . . . . . . . . . . Savings
0 64,096 3,889 0 0 0 0 67,985
Payments
If you have a qualifying child, attach Schedule EIC.
64a Earned income credit (EIC) . . . . . . . . . . . . . . . . . . . . . . 64b b Nontaxable combat pay election . . . . 65 66 67 68 69 70 71 72 Additional child tax credit. Attach Schedule 8812 . . . . . American opportunity credit from Form 8863, line 8 . . . . Reserved . . . . . . . . . . . . . . . . . . . . . . . . . Amount paid with request for extension to file . . . . . . . Excess social security and tier 1 RRTA tax withheld . . . Credit for federal tax on fuels. Attach Form 4136 Credits from Form: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . .
Reserved c a 2439 b 8801 d 8885. Add lines 62, 63, 64a, and 65 through 71. These are your total payments
0
72 73 74a
61,000
Refund
Direct deposit? See instructions.
73
If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid
. . .
74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here b Routing number XXXXXXXXX c Type: Checking d Account number
XXXXXXXXXXXXXXXXX 6,985 X
No
Amount You Owe Third Party Designee Sign Here

Joint return? See instructions. Keep a copy for your records.
75 Amount of line 73 you want applied to your 2013 estimated tax 75 76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions 76 77 Estimated tax penalty (see instructions) . . . . . . . . . . . . . . . . 77 Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below
Designee's name Phone no. Personal indentification number (PIN)
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 Spouse's signature. If a joint return, both must sign. Print/Type preparer's name Firm's name Firm's address Preparer's signature
Date Date
Your occupation
Daytime phone number
Regional Manager
Spouse's occupation
222-222-2222
If the IRS sent you an Identity Protection PIN, enter it here (see inst.)
Self-employeed CPA
Date Firm's EIN Phone no.
Paid Preparer Use Only

KIA
Check if self-employed
PTIN
Form 1040 (2012)
SCHEDULE A (Form 1040)

Department of the Treasury (99) Internal Revenue Service
Itemized Deductions
Information about Schedule A and its separate instructions is at www.irs.gov/form1040. Attach to Form 1040.
OMB No. 1545-0074
Attachment Sequence No.
2012
07
Name(s) shown on Form 1040
Your social security number
Jeff
Bell
111-11-1111
Medical and Dental Expenses Taxes You Paid
1 2 3 4 5
6 7 Personal property taxes . . . . . . . . . . . . . . . . . . . . . 8 Other taxes. List type and amount ______________ From _ _ _Rental _______________________________
Caution. Do not include expenses reimbursed or paid by others. 5,000 Medical and dental expenses (see instructions) . . . . . . . . . 1 363,411 Enter amount from Form 1040, line 38 . . 2 27,256 Multiply line 2 by 7.5% (.075) . . . . . . . . . . . . . . . . . . . 3 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0. . . . . . . . . . . . State and local (check only one box): a. Income taxes or 10,966 . . . . . . . . . . . . . . . . . . 5 b. X General sales taxes 3,500 Real estate taxes (see instructions) . . . . . . . . . . . . . . . 6 7
5,324
Interest You Paid

Note. Your mortgage interest deduction may be limited (see instructions).
Gifts to Charity
If you made a gift and got a benefit for it, see instructions.
9 Add lines 5 through 8 10 Home mortgage interest and points reported to you on Form 1098 . . . . . . . . . . 11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address __________________________________ __________________________________ __________________________________ 12 Points not reported to you on Form 1098. See instructions for special rules . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Mortgage insurance premiums (see instructions) 14 Investment interest. Attach Form 4952 if required. (See instructions) 15 Add lines 10 through 14 . . . . . . . . . . . . . . . . . . . . . . 16 Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $500 . . . . . . 18 Carryover from prior year . . . . . . . . . . . . . . . . . . . . . 19 Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . . .
11 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
19,801
11 12 13
2,800 0 0
15
14 . . . . . . . . . . . 16 17
2,800
1,500 0 0
19 20
18 . . . . . . . . . . .
1,500 0
Casualty and Theft Losses 20 Job Expenses 21 and Certain Miscellaneous Deductions
Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . . . . . . . . . . . Unreimbursed employee expensesjob travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) _______________________ __________________________________ 0 21 __________________________________ 22 Tax preparation fees . . . . . . . . . . . . . . . . . . . . . . . 22 23 Other expensesinvestment, safe deposit box, etc. List type and amount ________________________ 6,120 OTHER 23 __________________________________ 6,120 24 Add lines 21 through 23 . . . . . . . . . . . . . . . . . . . . . 24 363,411 25 Enter amount from Form 1040, line 38 . . 25 7,268 26 Multiply line 25 by 2% (.02) . . . . . . . . . . . . . . . . . . . . 26 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0. . . . . . . . . . Other 28 Otherfrom list in instructions. List type and amount _ GAMBLING _____________ Miscellaneous _______________________________________________
27
0 1,200 25,301
Deductions Total Itemized Deductions

KIA
1,200
28 29
29 Add the amounts in the far right column for lines 4 through 28. Also, enter this amount on Form 1040, line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 If you elect to itemize deductions even though they are less than your standard deduction, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see Form 1040 instructions.
Schedule A (Form 1040) 2012
SCHEDULE B
(Form 1040A or 1040)

Department of the Treasury (99) Internal Revenue Service
Interest and Ordinary Dividends

Attach to Form 1040A or 1040.
Information about Schedule B (1040A or 1040) and its instructions is a www.irs.gov/form1040.
OMB No. 1545-0074
2012
08
Amount
Name(s) shown on return
Jeff
Bell
List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see instructions and list this interest first. Also, show that buyer's social security number and address
111-11-1111
Part I Interest
(See instructions for Schedule B, and the instructions for Form 1040A, or Form 1040, line 8a.) 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.
City of Dallas Ford Motor Company From K-1
3,000 15,000 6,000
2 3
Add the amounts on line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note: If line 4 is over $1,500, you must complete Part III. 5 List name of payer
2 3 4
24,000
24,000
Amount
Part II Ordinary Dividends
K&R
______________________________________________
(See the instructions for Schedule B, and the instructions for Form 1040A, or Form 1040, line 9a.)
5
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.
Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note. If line 6 is over $1,500, you must complete Part III.
You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a Yes No foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. 7a At any time during 2012, did you have a financial interest in or signature authority over a financial Part III account (such as a bank account, securities account, or brokerage account) located in a foreign X Foreign country? See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If "Yes," are you required to file Form TD F 90-22.1 to report that financial interest or signature Accounts authority? See Form TD F 90-22.1 and its instructions for filing requirements and exceptions to X those requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and Trusts b If you are required to file Form TD F 90-22.1, enter the name of the foreign country where the (See financial account is located ___________________________________________ instructions.) During 2012, did you receive a distribution from, or were you the grantor of, or transferor to, a 8 X foreign trust? If "Yes," you may have to file Form 3520. See instructions. . . . . . . . . . . . . . . . . . . . . KIA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule B (Form 1040A or 1040) 2012
SCHEDULE C (Form 1040)

Department of the Treasury Internal Revenue Service (99)
Profit or Loss From Business

(Sole Proprietorship) For information on Schedule C and its instructions, go to www.irs.gov/schedulec
Attach to Form 1040, 1040NR, or 1041; partnerships generally must file Form 1065.
OMB No. 1545-0074
2012
09
Name of proprietor
Social security number (SSN)
Ivy
A C E F G H I J 1 2 3 4 5 6 7 8 9 10 11 12 13
Bell
123-45-6781 531310
Principal business or profession, including product or service (see instructions)
B Enter code from instructions
Part-time Consulting CPA

Business name. If no separate business name, leave blank. Business address (including suite or room no.) City, town or post office, state, and ZIP code Accounting method:
D Employer ID number (EIN), (see instr.)
Orange _ _ 4326 _____ _ _ _ _ _ _Blossom _ _ _ _ _ _ _ Trail _____________________________ Dallas TX 75080
(1) X Cash (2) Accrual (3) Other (specify) ______________________________ Did you "materially participate" in the operation of this business during 2012? If "No," see instructions for limit on losses . . . . X . . Yes . . . . . No . . . . . If you started or acquired this business during 2012, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes Did you make any payments in 2012 that would require you to file Form(s) 1099? (see instructions) . . . . . . . . . . . . . No X Yes If "Yes," did you or will you file required Forms 1099? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No
Part I
Income
1 . . . . . 2 3 4 5 6 7 18 19 20a 20b 21 22 23 24a 24b 25 26 27a 27b 28 29 30
Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on form W-2 and the "Statutory employee" box on that form was checked. . . . . . . . . . . . . . . . . . . Returns and allowances (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . . . . Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
75,000 6,000 69,000 0 69,000 69,000
Part II
Expenses.
. . . . . . . . . 8 9 10 11 12
Enter expenses for business use of your home only on line 30.
18 Office expense (see instructions) Pension and profit-sharing plans Rent or lease (see instructions): a Vehicles, machinery, & equipment b Other business property 21 22 23 13 14 15 25 16a 16b 17 26 27a Repairs and maintenance Taxes and licenses a Travel . . . . . . . . . . . . . . . . . . . .
Advertising
Car and truck expenses (see instructions) . . . . . . . . . Commissions and fees Depletion . . . Contract labor (see instructions) . . . . . . . . . . Depreciation and section 179 expense deduction (not included in Part III) (see instructions) . . . . . . . . . Employee benefit programs (other than on line 19) . . . . Insurance (other than health) . Interest: Mortgage (paid to banks, etc.) . Other . . . . . . . . . . . . Legal and professional services
3,730
19 20
Supplies (not included in Part III) Travel, meals, and entertainment:
. . . . . . . . .
6,000 1,000 5,100 575
24
14 15 16 a b 17 28 29 30 31
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Deductible meals and entertainment (see instructions) Utilities Wages (less employment credits) Other expenses (from line 48) b Reserved for future use
. . . . . . . . . . . . . . . .
10,000 30,405 38,595 6,931 31,664 X
4,000
Total expenses before expenses for business use of home. Add lines 8 through 27a Tentative profit or (loss). Subtract line 28 from line 7
. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expenses for business use of your home. Attach Form 8829. Do not report such expenses elsewhere
Net profit or (loss). Subtract line 30 from line 29. If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2. (If you checked the box on line 1, see instr.) Estates and trusts, enter on Form 1041, line 3. If a loss, you must go to line 32. 32 If you have a loss, check the box that describes your investment in this activity (see instructions). If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and on Schedule SE, line 2. (If you checked the box on line 1, see the line 31 instructions). Estates and trusts, enter on Form 1041, line 3. If you checked 32b, you must attach Form 6198. Your loss may be limited. KIA For Paperwork Reduction Act Notice, see your tax return instructions.
31
32a 32b
All investment is at risk. Some investment is not at risk.
Schedule C (Form 1040) 2012
Part III
33 34
Ivy Cost of Goods Sold (see instructions)

a Cost
Bell
123-45-6781
Page
Method(s) used to value closing inventory:
Lower of cost or market
Other (attach explanation) Yes No
Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If "Yes," attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inventory at beginning of year. If different from last year's closing inventory, attach explanation Purchases less cost of items withdrawn for personal use Cost of labor. Do not include any amounts paid to yourself Materials and supplies Other costs . . . . . 35 36 37 38 39 40 41 42
35 36 37 38 39 40 41 42
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Add lines 35 through 39 Inventory at end of year
Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4
Part IV
Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must file Form 4562. 06/07/11 ___ __________
43 44
When did you place your vehicle in service for business purposes? (month, day, year)
Of the total number of miles you drove your vehicle during 2012, enter the number of miles you used your vehicle for: a Business
4,940 ______ _ _ _ _ _ _ b Commuting (see instructions)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c Other
9,060 ______ ___________ X

Yes Yes Yes Yes No
45 46 47a b
Was your vehicle available for personal use during off-duty hours?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Do you (or your spouse) have another vehicle available for personal use? Do you have evidence to support your deduction? If "Yes," is the evidence written?
X X
No No No
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part V
Other Expenses. List below business expenses not included on lines 826 or line 30. 1,500 250 4,200 3,300 750
_ _ Subscriptions ___________________________________________________________ _ _ Dues ___________________________________________________________
at a_ MGM _ _ Lodging: _ _ _ _ _ _ _ _ not ____ ___ ___________________________________________ MGM _ _ Lodging: _ _ _ _ _ _ _ _ at _ _ _a __ ______________________________________________ rentals, limos,taxis _ _ car ____ ________ _______________________________________________
_____________________________________________________________ _____________________________________________________________ _____________________________________________________________
48 KIA
Total other expenses. Enter here and on line 27a
. . . . . . . . . . . . . . . . . . . . . . . . . . .
48
10,000
SCHEDULE D (Form 1040)

Department of the Treasury Internal Revenue Service
Capital Gains and Losses

(99) Attach to Form 1040 or Form 1040NR. Information about Schedule D and its separate instructions is at www.irs.gov/form1040. Use Form 8949 to list your transactions for lines 1, 2, 3, 8, 9, and 10.
OMB No. 1545-0074
Attachment Sequence No. 12 Your social security number
2012
Jeff Part I
Bell Short-Term Capital Gains and LossesAssets Held One Year or Less
(d) Proceeds (sales price) from Form(s) 8949, Part I, line 2, column (d) (e) Cost or other basis from Form(s) 8949, Part I, line 2, column (e)
111-11-1111
Complete Form 8949 before completing line 1, 2, or 3. This form may be easier to complete if you round off cents to whole dollars. 1 2 3 Short-term totals from all Forms 8949 with box A checked in Part I . . . . . . . . . . . . . . . . . . Short-term totals from all Forms 8949 with box B checked in Part I . . . . . . . . . . . . . . . . . . Short-term totals from all Forms 8949 with box C checked in Part I . . . . . . . . . . . . . . . . . .
(g) Adjustments to gain or loss from Form(s) 8949, Part I, line 2, column (g)
(h) Gain or (loss) Subtract column (e) from column (d) and combine the result with column (g)
0 0 0
0 0 0
. . . . . . . . . .
0 0 0
4 5 6 7
0 0 0 0
4 5 6 7
Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824
Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Net short-term capital gain or (loss). Combine lines 1 through 6 in column (h). If you have any long-term capital gains or losses, go to Part II below. Otherwise, go to Part III on next page . . . . . .
0) 0
Part II
Long-Term Capital Gains and LossesAssets Held More Than One Year
(d) Proceeds (sales price) from Form(s) 8949, Part II, line 4, column (d) (e) Cost or other basis from Form(s) 8949, Part II, line 4, column (e) (g) Adjustments to gain or loss from Form(s) 8949, Part II, line 4, column (g) (h) Gain or (loss) Subtract column (e) from column (d) and combine the result with column (g)
Complete Form 8949 before completing line 8, 9, or 10. This form may be easier to complete if you round off cents to whole dollars. 8 9 10 11 Long-term totals from all Forms 8949 with box A checked in Part II . . . . . . . . . . . . . . . . . . Long-term totals from all Forms 8949 with box B checked in Part II . . . . . . . . . . . . . . . . . . Long-term totals from all Forms 8949 with box C checked in Part II . . . . . . . . . . . . . . . . . .
0 0 0
0 0 0
0 0 0
11 12 13 14 15
0 0 0 200,000
Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) . from Forms 4684, 6781, and 8824 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 . Capital gain distributions. See the instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 13 14 15
KIA
0 ( 0) 200,000
Long-term capital loss carryover. Enter the amount, if any, from line 13 of your Capital Loss Carryover Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Net long-term capital gain or (loss). Combine lines 8 through 14 in column (h). Then go to Part III on page 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see your tax return instructions.
Schedule D (Form 1040) 2012
Schedule D (Form 1040) 2012
Jeff
Bell
111-11-1111
Page
Part III
16
Summary
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Combine lines 7 and 15 and enter the result
200,000
If line 16 is a gain, enter the amount from line 16 on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 17 below. If line 16 is a loss, skip lines 17 through 20 below. Then go to line 21. Also be sure to complete line 22. If line 16 is zero, skip lines 17 through 21 below and enter -0- on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 22. 17 Are lines 15 and 16 both gains? X Yes. Go to line 18. No. Skip lines 18 through 21, and go to line 22. 18 19 Enter the amount, if any, from line 7 of the 28% Rate Gain Worksheet in the instructions . . . . . 18
0 0
Enter the amount, if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Are lines 18 and 19 both zero or blank?
19
20
X Yes. Complete the Qualified Dividends and Capital Gain Tax Worksheet in the instructions
for Form 1040, line 44 (or in the instructions for Form 1040NR, line 42). Do not complete lines 21 and 22 below. No. Complete the Schedule D Tax Worksheet in the instructions. Do not complete lines 21 and 22 below.
21
If line 16 is a loss, enter here and on Form 1040, line 13, or Form 1040NR, line 14, the smaller of: The loss on line 16 or ($3,000), or if married filing separately, ($1,500) . . . . . . . . . . . . . . . . . . . . . . . . . . 21 ( )
Note. When figuring which amount is smaller, treat both amounts as positive numbers. 22 Do you have qualified dividends on Form 1040, line 9b, or Form 1040NR, line 10b? Yes. Complete the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44 (or in the instructions for Form 1040NR, line 42). No. Complete the rest of Form 1040 and Form 1040NR.
KIA Schedule D (Form 1040) 2012
SCHEDULE E (Form 1040)

Supplemental Income and Loss

(From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.)
Attach to Form 1040, 1040NR, or Form 1041.
OMB No. 1545-0074
Information about Schedule E and its separate instructions is at www.irs.gov/form1040.
2012
No No
13
Jeff Part I
Bell 111-11-1111 Income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personal property, use
Schedule C or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40.
A Did you make any payments in 2012 that would require you to file Form(s) 1099? (see instructions) B If Yes, did you or will you file all required Forms 1099? 1a Physical address of each property (street, city, state, and ZIP code)
A B C
X X
Yes Yes
7421 Frankford Rd Dallas TX 75252
1b
A B C
Type of Property (from list below)
2 For each rental real estate property listed above, report the number of fair rental and personal use days. Check the QJV box only if you meet the requirements to file as a qualified joint venture. See instructions.
3 Vacation/Short-Term Rental 4 Commercial 5 Land 6 Royalties
Fair Rental Days
Personal Use Days
QJV
A B C
365
Type of Property:
1 Single Family Residence 2 Multi-Family Residence 7 Self-Rental 8 Other (describe) A B C
Income:
Properties:
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
3 Rents received . . . . . . . . . . . . . . . . . . . . . . . . . 4 Royalties received . . . . . . . . . . . . . . . . . . . . . .
24,000 0 0 0 2,992 0 0 0 0 13,962 0 0 0 3,989 0 7,273 0 28,216 -4,216
Expenses:
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23a b c d e 24 25 26 Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . Auto and travel (see instructions) . . . . . . . . . . . . . . Cleaning and maintenance . . . . . . . . . . . . . . . . . . Commissions . . . . . . . . . . . . . . . . . . . . . . . . . Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . Legal and other professional fees . . . . . . . . . . . . . . Management fees . . . . . . . . . . . . . . . . . . . . . . Mortgage interest paid to banks, etc. (see instructions) . . . Other interest . . . . . . . . . . . . . . . . . . . . . . . . . Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depreciation expense or depletion . . . . . . . . . . . . . . Other (list) ________________________ Total expenses. Add lines 5 and 19 . . . . . . . . . . . . .
0 0
0 0 )
Subtract line 20 from line 3 (rents) and/or 4 (royalties). If result is a (loss), see instructions to find out if you must file Form 6198 . 21
KIA
Deductible rental real estate loss after limitation, if any, 4,216 ) ( ) ( on Form 8582 (see instructions) . . . . . . . . . . . . . . . 22 ( 24,000 Total of all amounts reported on line 3 for all rental properties . . . . . . . . . . 23a 0 Total of all amounts reported on line 4 for all royalty properties . . . . . . . . . . 23b 13,962 Total of all amounts reported on line 12 for all properties . . . . . . . . . . . . . 23c 7,273 Total of all amounts reported on line 18 for all properties . . . . . . . . . . . . . 23d 28,216 23e Total of all amounts reported on line 20 for all properties . . . . . . . . . . . . . Income. Add positive amounts shown on line 21. Do not include any losses . . . . . . . . . . . . 24 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here.. 25 ( Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the total on line 41 on page 2 NPA -4,216 26
0 4,216 )
-4,216
Schedule E (Form 1040) 2012
Schedule E (Form 1040) 2012 Name(s) shown on return. Do not enter name and social security number if shown on page 1.
Attachment Sequence No. 13 Page 2 Your Social security number
Jeff Part II
27
Bell Income or Loss From Partnerships and S Corporations
111-11-1111
Caution. The IRS compares amounts reported on your tax return with amounts shown on Schedule(s) K-1.
Note. If you report a loss from an at-risk activity for which any amount is not at risk, you must check the box in column (e) on line 28 and attach Form 6198. See instructions.
Are you reporting any loss not allowed in a prior year due to the at-risk or basis limitations, a prior year unallowed loss from a passive activity (if that loss was not reported on Form 8582), or unreimbursed partnership expenses? If you answered Yes, see instructions before completing this section.
(a) Name (b) Enter P for partnership; S for S corporation (c) Check if foreign partnership (d) Employer identification number
Yes
No
28 A B C D
(e) Check if any amount is not at risk
K&R
Passive Income and Loss

(f) Passive loss allowed (attach Form 8582 if required) (g) Passive income from Schedule K-1 (h) Nonpassive loss from Schedule K-1
Nonpassive Income and Loss

(i) Section 179 expense deduction from Form 4562 (j) Nonpassive income from Schedule K-1
A B C D 29a b 30 31 32
10,000
10,000 Totals 0 0 0 Totals Add columns (g) and (j) of line 29a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Add columns (f), (h), and (i) of line 29b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the result here and include in the total on line 41 below . . . . . . . . . . . . . . . . . . . . . . . 32 Income or Loss From Estates and Trusts
(a) Name
0 10,000 0 ) 10,000
(b) Employer identification number
Part III
33
A B
Passive Income and Loss

(c) Passive deduction or loss allowed (attach Form 8582 if required) (d) Passive income from Schedule K-1
Nonpassive Income and Loss

(e) Deduction or loss from Schedule K-1 (f) Other income from Schedule K-1
A B
34a b 35 36 37
0 Totals 0 0 Totals Add columns (d) and (f) of line 34a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Add columns (c) and (e) of line 34b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total estate and trust income or (loss). Combine lines 35 and 36. Enter the result here and include in the total on line 41 below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a) Name (b) Employer identification number (c) Excess inclusion from Schedules Q, line 2c (see instructions) (d) Taxable income (net loss) from Schedules Q, line 1b
0
35 36 37
(e) Income from Schedules Q, line 3b
0 0 ) 0
Part IV
38 39 40 41 42
Income or Loss From Real Estate Mortgage Investment Conduits (REMICs)Residual Holder 0 0
39 40 41
Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below .
0 0 0 5,784
Part V
Summary
. . . . . . . . .
Net farm rental income or (loss) from Form 4835. Also, complete line 42 below
Reconciliation of farming and fishing income. Enter your gross farming and fishing income reported on Form 4835, line 7; Schedule K-1 (Form 1065), box 14, code B; Schedule K-1 (Form 1120S), box 17, code U; and Schedule K-1 (Form 1041), line 14, code F (see instructions) . . . Reconciliation for real estate professionals. If you were a real estate professional (see instructions), enter the net income or (loss) you reported anywhere on Form 1040 or Form 1040NR from all rental real estate activities in which you materially participated under the passive activity loss rules . .
Total income or (loss). Combine lines 26, 32, 37, 39, and 40. Enter the result here and on Form 1040, line 17, or Form 1040NR, line 18 .
42
43
43
-4,216
Schedule E (Form 1040) 2012
KIA
SCHEDULE SE (Form 1040)

Self-Employment Tax
Information about Schedule SE and its separate instructions is at www.irs.gov/form1040. Attach to Form 1040 or Form 1040NR. Social security number of person with self-employment income
OMB No. 1545-0074
2012
17
Name of person with self-employment income (as shown on Form 1040)
Ivy
Bell
123-45-6781
Before you begin: To determine if you must file Schedule SE, see the instructions.
May I Use Short Schedule SE or Must I Use Long Schedule SE?

Note. Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SE in the instructions.
Did you receive wages or tips in 2012? No
Are you a minister, member of a religious order, or Christian Science practitioner who received IRS approval not to be taxed Yes on earnings from these sources, but you owe self-employment tax on other earnings?
Yes
Was the total of your wages and tips subject to social security or railroad retirement (tier 1) tax plus your net earnings from self-employment more than $110,100?
Yes
No
Are you using one of the optional methods to figure your net earnings (see instructions)?
No Yes
Did you receive tips subject to social security or Medicare tax that you did not report to your employer?
Yes
No
Did you receive church employee income (see instructions) reported on Form W-2 of $108.28 or more?
No Yes No
Did you report any wages on Form 8919, Uncollected Social Security and Medicare Tax on Wages?
Yes
No
You may use Short Schedule SE below
You must use Long Schedule SE on page 2
Section AShort Schedule SE. Caution. Read above to see if you can use Short Schedule SE.
1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form
1065), box 14, code A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code Y .
1a 1b (
0 0)
Net profit or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K-1 (Form 1065), box 14, code A (other than farming); and Schedule K-1 (Form 1065-B), box 9, code J1.
Ministers and members of religious orders, see instructions for types of income to report on this line. See instructions for other income to report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 3
31,664 31,664
Combine lines 1a, 1b, and 2.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Multiply line 3 by 92.35% (.9235). If less than $400, you do not owe self-employment tax; do not file this schedule unless you have an amount on line 1b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note. If line 4 is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions.
29,242
Self-employment tax. If the amount on line 4 is:
$110,100 or less, multiply line 4 by 13.3% (.133). Enter the result here and on Form 1040, line 56, or Form 1040NR, line 54. More than $110,100, multiply line 4 by 2.9% (.029). Then, add $11,450.40 to the result. Enter the total here and on Form 1040, line 56, or Form 1040NR, line 54. . . . . . . . . . . . .
6 Deduction for employer-equivalent portion of self-employment tax. If the amount on line 5 is: $14,643.30 or less, multiply line 5 by 57.51% (.5751) More than $14,643.30, multiply line 5 by 50% (.50) and add $1,100 to the result. Enter the result here and on Form 1040, line 27, or Form 1040NR, line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,889
2,237
Schedule SE (Form 1040) 2012
KIA
Form
4797
Jeff Bell
(Also Involuntary Conversions and Recapture Amounts Under Sections 179 and 280F(b)(2))
Attach to your tax return. Information about Form 4797 and its separate instructions is at www.irs.gov/form4797.
Sales of Business Property
OMB No. 1545-0184
2012
27
Name(s) shown on return 1
Identifying number
111-11-1111
1
Enter the gross proceeds from sales or exchanges reported to you for 2012 on Form(s) 1099-B or 1099-S (or substitute statement) that you are including on line 2, 10, or 20 (see instructions) . . . . . . . . . . . . . . . . . . .
Part I
2
27,000 Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other Than Casualty or TheftMost Property Held More Than 1 Year (see instructions)
(b) Date acquired (mo., day, yr.) (c) Date sold (mo., day, yr.) (d) Gross sales price (e) Depreciation allowed or allowable since acquisition (f) Cost or other basis, plus improvements and expense of sale (g) Gain or (loss)
Subtract (f) from the sum of (d) and (e)
(a) Description of property
0 0 0
3 4 5 6 7 Gain, if any, from Form 4684, line 39 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 5 6 7
Section 1231 gain from installment sales from Form 6252, line 26 or 37 . . . . . . . . . . . . . . . . . . . . . . . . Section 1231 gain or (loss) from like-kind exchanges from Form 8824 . . . . . . . . . . . . . . . . . . . . . . . . . Gain, if any, from line 32, from other than casualty or theft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Combine lines 2 through 6. Enter the gain or (loss) here and on the appropriate line as follows: . . . . . . . . . . . Partnerships (except electing large partnerships) and S corporations. Report the gain or (loss) following the instructions for Form 1065, Schedule K, line 10, or Form 1120S, Schedule K, line 9. Skip lines 8, 9, 11, and 12 below. Individuals, partners, S corporation shareholders, and all others. If line 7 is zero or a loss, enter the amount from line 7 on line 11 below and skip lines 8 and 9. If line 7 is a gain and you did not have any prior year section 1231 losses, or they were recaptured in an earlier year, enter the gain from line 7 as a long-term capital gain on the Schedule D filed with your return and skip lines 8, 9, 11, and 12 below. Nonrecaptured net section 1231 losses from prior years (see instructions) . . . . . . . . . . . . . . . . . . . . . . Subtract line 8 from line 7. If zero or less, enter -0-. If line 9 is zero, enter the gain from line 7 on line 12 below. If line 9 is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line 9 as a long-term capital gain on the Schedule D filed with your return (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . .
0 0 200,000 200,000
8 9
0 0 0 0 0
Part II
10
Ordinary Gains and Losses (see instructions)
Ordinary gains and losses not included on lines 11 through 16 (include property held 1 year or less):
11 12 13 14 15 16 17 18
Loss, if any, from line 7 Gain, if any, from line 31
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gain, if any, from line 7, or amount from line 8, if applicable
Net gain or (loss) from Form 4684, lines 31 and 38a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ordinary gain from installment sales from Form 6252, line 25 or 36 . . . . . . . . . . . . . . . . . . . . . . . . . . Ordinary gain or (loss) from like-kind exchanges from Form 8824 . . . . . . . . . . . . . . . . . . . . . . . . . . . Combine lines 10 through 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For all except individual returns, enter the amount from line 17 on the appropriate line of your return and skip lines a and b below. For individual returns, complete lines a and b below: a If the loss on line 11 includes a loss from Form 4684, line 35, column (b)(ii), enter that part of the loss here. Enter the part of the loss from income-producing property on Schedule A (Form 1040), line 28, and the part of the loss from property used as an employee on Schedule A (Form 1040), line 23. Identify as from "Form 4797, line 18a." See instructions . b Redetermine the gain or (loss) on line 17 excluding the loss, if any, on line 18a. Enter here and on Form 1040, line 14 .
11 12 13 14 15 16 17
) 0 0 0 0 0
18a 18b Form
KIA
For Paperwork Reduction Act Notice, see separate instructions.
0 4797 (2012)
Form 4797 (2012)
Part III
19 A B C D
Jeff Bell 111-11-1111 Gain From Disposition of Property Under Sections 1245, 1250, 1252, 1254, and 1255 (see instructions)
(b) Date acquired (mo., day, yr.)
Page 2
(a) Description of section 1245, 1250, 1252, 1254, or 1255 property:
(c) Date sold (mo., day, yr.)
Land in Citrus County
06/06/90
09/02/12
These columns relate to the properties on lines 19A through 19D.
Property A
. . . . 20 21 22 23 24 25a 25b
Property B
Property C
Property D
20 21 22 23 24 25 a b 26 a b c d e f g 27
Gross sales price (Note: See line 1 before completing.) . Cost or other basis plus expense of sale . . . . . . . . . Depreciation (or depletion) allowed or allowable . . . . . Adjusted basis. Subtract line 22 from line 21 . . . . . . . Total gain. Subtract line 23 from line 20 If section 1245 property:
200,000
0 200,000 0
0 0 0
0 0 0
0 0 0
. . . . . . . . . . .
Depreciation allowed or allowable from line 22 . . . . . . . Enter the smaller of line 24 or 25a . . . . . . . . . . . . . . If section 1250 property: If straight line depreciation was used,
enter -0- on line 26g, except for a corporation subject to section 291.
Additional depreciation after 1975 (see instructions)
. . . . .
26a 26b 26c 26d 26e 26f 26g
Applicable percentage multiplied by the smaller of line 24 or line 26a (see instructions) . . . . . . . . . . . . . . . Subtract line 26a from line 24. If residential rental property or line 24 is not more than line 26a, skip lines 26d and 26e . Additional depreciation after 1969 and before 1976 . . . . . Enter the smaller of line 26c or 26d . . . . . . . . . . . . . Section 291 amount (corporations only) . . . . . . . . . . . Add lines 26b, 26e, and 26f . . . . . . . . . . . . . . . . . If section 1252 property: Skip this section if you did not dispose of farmland or if this form is being completed for a partnership (other than an electing large partnership). Soil, water, and land clearing expenses Enter the smaller of line 24 or 27b . . . . . . . . . . .
0 200,000 0 0
a b c 28 a
27a 27b 27c
Line 27a multiplied by applicable percentage (see instructions) . . . . . . . . . . . . . . . If section 1254 property: Intangible drilling and development costs, expenditures for development of mines and other natural deposits, mining exploration costs, and depletion (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . Enter the smaller of line 24 or 28a If section 1255 property: Applicable percentage of payments excluded from income under section 126 (see instructions) . . . . . . . . . Enter the smaller of line 24 or 29a (see instructions) . . . . . . . . . . . . . . . . . .
0 0
0 0
0 0
28a 28b
b 29 a b
29a 29b
Summary of Part III Gains. Complete property columns A through D through line 29b before going to line 30.
30 31 32 Total gains for all properties. Add property columns A through D, line 24 . . . . . . . . . . . . . . . . . . . . . . . . 30 31
Add property columns A through D, lines 25b, 26g, 27c, 28b, and 29b. Enter here and on line 13 . . . . . . . . . . . Subtract line 31 from line 30. Enter the portion from casualty or theft on Form 4684, line 33. Enter the portion from other than casualty or theft on Form 4797, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
200,000 0
Part IV
200,000 32 Recapture Amounts Under Sections 179 and 280F(b)(2) When Business Use Drops to 50% or Less (see instructions)
(a) Section 179 (b) Section 280F(b)(2)
33 Section 179 expense deduction or depreciation allowable in prior years . . . . . . . . . . . . . . 34 Recomputed depreciation (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Recapture amount. Subtract line 34 from line 33. See the instructions for where to report . . . . . KIA
33 34 35
0
Form
0 4797 (2012)
Form
6251
Alternative Minimum TaxIndividuals

Information about Form 6251 and its separate instructions is at www.irs.gov/form6251. Attach to Form 1040 or Form 1040NR.
OMB No. 1545-0074
Attachment Sequence No. Your social security number
2012
32
Name(s) shown on Form 1040 or Form 1040NR
Jeff Bell 111-11-1111 Part I Alternative Minimum Taxable Income (See instructions for how to complete each line.)
1 2
If filing Schedule A (Form 1040), enter the amount from Form 1040, line 41, and go to line 2. Otherwise, enter the amount from Form 1040, line 38 and go to line 7. (If less than zero, enter as a negative amount.) . . . . . . . . . Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4, or 2.5% (.025) of Form 1040, line 38. If zero or less, enter -0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Taxes from Schedule A (Form 1040), line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter the home mortgage interest adjustment, if any, from line 6 of the worksheet in the instructions for this line . .
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
338,110 0 19,801 0 0
(
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Miscellaneous deductions from Schedule A (Form 1040), line 27

Skip this line. It is reserved for future use
. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax refund from Form 1040, line 10 or line 21 . Investment interest expense (difference between regular tax and AMT) . . . . . . . . . . . . Depletion (difference between regular tax and AMT) . . . . . . . . . . . . . . . . . . . . . Net operating loss deduction from Form 1040, line 21. Enter as a positive amount . . . . . . Alternative tax net operating loss deduction . . . . . . . . . . . . . . . . . . . . . . . . . . Interest from specified private activity bonds exempt from the regular tax . . . . . . . . . . . Qualified small business stock (7% of gain excluded under section 1202) . . . . . . . . . . . Exercise of incentive stock options (excess of AMT income over regular tax income) . . . . . Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A) . . . . . . . . . Electing large partnerships (amount from Schedule K-1 (Form 1065-B), box 6) . . . . . . . . Disposition of property (difference between AMT and regular tax gain or loss) . . . . . . . . Depreciation on assets placed in service after 1986 (difference between regular tax and AMT) Passive activities (difference between AMT and regular tax income or loss) . . . . . . . . . . Loss limitations (difference between AMT and regular tax income or loss) . . . . . . . . . . . Circulation costs (difference between regular tax and AMT) . . . . . . . . . . . . . . . . . . Long-term contracts (difference between AMT and regular tax income) . . . . . . . . . . . . Mining costs (difference between regular tax and AMT) . . . . . . . . . . . . . . . . . . . . Research and experimental costs (difference between regular tax and AMT) . . . . . . . . . Income from certain installment sales before January 1, 1987 . . . . . . . . . . . . . . . . Intangible drilling costs preference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other adjustments, including income-based related adjustments . . . . . . . . . . . . . . . Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately, see
instructions)
0) 0 0
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
0 0 0 0 0 0 0
0 0 357,911 26,772 331,139 64,096
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part II
29 30 31
Alternative Minimum Tax (AMT)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exemption. See instructions 35, and go to line 34.
Subtract line 29 from line 28. If more than zero, go to line 31. If zero or less, enter -0- here and on lines 31, 33, and
If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter. If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040, line 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured for the AMT, if necessary), complete Part III on page 2 and enter the amount from line 54 here. All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately), multiply line 30 by 26% (.26). Otherwise, multiply line 30 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result.
. . .
31
32 33 34
Alternative minimum tax foreign tax credit (see instructions) Tentative minimum tax. Subtract line 32 from line 31
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
32 33
0 64,096 52,788 11,308 6251 Form (2012)
Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040, line 47). If you used Schedule J to figure your tax, the amount from line 44 of Form 1040 must be refigured without using Schedule J (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34 35
35
KIA
AMT. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on Form 1040, line 45
Form 6251 (2012)
Page 2
Part III
36 37
Tax Computation Using Maximum Capital Gains Rates

Complete Part III only if you are required to do so by line 31 or by the Foreign Earned Income Tax Worksheet in the instructions.
Enter the amount from Form 6251, line 30. If you are filing Form 2555 or 2555-EZ, enter the amount from line 3 of the worksheet in the instructions for line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
36
331,139
Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 13 of the Schedule D Tax Worksheet in the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, if necessary) (see instructions). If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter .
Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT, if necessary) (see instructions). If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter . . . . . . . . . . . . . . . . . . . . . . . . . . . .
37
200,000
38
38
39
40 41 42 43
If you did not complete a Schedule D Tax Worksheet for the regular tax or the AMT, enter the amount from line 37. Otherwise, add lines 37 and 38, and enter the smaller of that result or the amount from line 10 of the Schedule D Tax Worksheet (as refigured for the AMT, if necessary). If you are filing Form 2555 or 200,000 39 2555-EZ, see instructions for the amount to enter . . . . . . . . . . . . . . . Enter the smaller of line 36 or line 39 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtract line 40 from line 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
40 41 42
200,000 131,139 34,096
If line 41 is $175,000 or less ($87,500 or less if married filing separately), multiply line 41 by 26% (.26). Otherwise, multiply line 41 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result . . . . . . .
Enter: $70,700 if married filing jointly or qualifying widow(er), $35,350 if single or married filing separately, or $47,350 if head of household.
. . . . . . . .
43
70,700
44
Enter the amount from line 7 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 14 of the Schedule D Tax Worksheet in the instructions for Schedule D (Form 1040), whichever applies (as figured for the regular tax). If you did not complete either worksheet for the regular tax, enter -0. . . . . . . . . . . . . . . . . . . . . Subtract line 44 from line 43. If zero or less, enter -0Enter the smaller of line 36 or line 37 Enter the smaller of line 45 or line 46 Subtract line 47 from line 46 Multiply line 48 by 15% (.15) . . . . . . . . . . . . .
44 45 46 47 48
122,910 0 200,000 0 200,000

49
45 46 47 48 49
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30,000
50 51 52 53 54
KIA
If line 38 is zero or blank, skip lines 50 and 51 and go to line 52. Otherwise, go to line 50. 50 Subtract line 46 from line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . Multiply line 50 by 25% (.25) Add lines 42, 49, and 51 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 52 53 54
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
64,096 89,219 64,096 Form 6251 (2012)
If line 36 is $175,000 or less ($87,500 or less if married filing separately), multiply line 36 by 26% (.26). Otherwise, multiply line 36 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result . . . . . . . . Enter the smaller of line 52 or line 53 here and on line 31. If you are filing Form 2555 or 2555-EZ, do not enter this amount on line 31. Instead, enter it on line 4 of the worksheet in the instructions for line 31 . . . . . . . . . . .
Form
8582
See separate instructions. Attach to Form 1040 or Form 1041. Information about Form 8582 and its instructions is available at www.irs.gov/form8582.
Passive Activity Loss Limitations
OMB No. 1545-1008
Caution: Complete Worksheets 1, 2 and 3 before completing Part I. Rental Real Estate Activities With Active Participation (For the definition of active participation see Special Allowance for Rental Real Estate Activities in the instructions.) 1a Activities with net income (enter the amount from Worksheet 1, 0 column (a)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a b Activities with net loss (enter the amount from Worksheet 1, column 0 ) (b)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b ( c Prior years unallowed losses (enter the amount from Worksheet 1, 0 ) column (c)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c ( d Combine lines 1a, 1b, and 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Commercial Revitalization Deductions From Rental Real Estate Activities ) 2a Commercial revitalization deductions from Worksheet 2, column (a) . 2a ( b Prior year unallowed commercial revitalization deductions from ) Worksheet 2, column (b) . . . . . . . . . . . . . . . . . . . . . . 2b ( c Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . All Other Passive Activities 3a Activities with net income (enter the amount from Worksheet 3, column (a)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Activities with net loss (enter the amount from Worksheet 3, column (b)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Prior years unallowed losses (enter the amount from Worksheet 3, column (c)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a 3b ( 3c (
Jeff Part I
Bell 2012 Passive Activity Loss
Attachment Sequence No. Identifying number
2012
88
111-11-1111
1d
2c (
0)
10,000 0 ) 0 )
3d 4
d Combine lines 3a, 3b, and 3c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Combine lines 1d, 2c, and 3d. If this line is zero or more, stop here and include this form with your return; all losses are allowed, including any prior year unallowed losses entered on line 1c, 2b, or 3c. Report the losses on the forms and schedules normally used . . . . . . . . . . . . If line 4 is a loss and:
10,000 10,000
Line 1d is a loss, go to Part II. Line 2c is a loss (and line 1d is zero or more), skip Part II and go to Part III. Line 3d is a loss (and lines 1d and 2c are zero or more), skip Parts II and III and go to line 15.
Caution: If your filing status is married filing separately and you lived with your spouse at any time during the year, do not complete Part II or Part III. Instead, go to line 15.
Part II
5 6 7
Special Allowance for Rental Real Estate Activities With Active Participation
5
Note: Enter all numbers in Part II as positive amounts. See instructions for an example. Enter the smaller of the loss on line 1d or the loss on line 4 . . . . . . . . . . . . . . . . . . . 6 Enter $150,000. If married filing separately, see instructions . . . . Enter modified adjusted gross income, but not less than zero (see instructions) . 7 Note: If line 7 is greater than or equal to line 6, skip lines 8 and 9, enter -0- on line 10. Otherwise, go to line 8. 8 Subtract line 7 from line 6 . . . . . . . . . . . . . . . . . . . . . . Multiply line 8 by 50% (.5). Do not enter more than $25,000. If married filing separately, see instructions . Enter the smaller of line 5 or line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If line 2c is a loss, go to Part III. Otherwise, go to line 15.
8 9 10
9 10
Part III
11 12 13 14 15 16
KIA
Special Allowance for Commercial Revitalization Deductions From Rental Real Estate Activities
Note: Enter all numbers in Part III as positive amounts. See the example for Part II in the instructions. Enter $25,000 reduced by the amount, if any, on line 10. If married filing separately, see instructions 11 Enter the loss from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Reduce line 12 by the amount on line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Enter the smallest of line 2c (treated as a positive amount), line 11, or line 13 . . . . . . . . . . 14
Part IV
Total Losses Allowed

15 16
Form
Add the income, if any, on lines 1a and 3a and enter the total . . . . . . . . . . . . . . . . . . Total losses allowed from all passive activities for 2012. Add lines 10, 14, and 15. See instructions to find out how to report the losses on your tax return . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see instructions.
8582 (2012)
Jeff Bell 111-11-1111 Caution: The worksheets must be filed with your tax return. Keep a copy for your records. Worksheet 1For Form 8582, Lines 1a, 1b, and 1c (See instructions.)
Form 8582 (2012)
Page 2
Current year Name of activity (a) Net income (line 1a) (b) Net loss (line 1b)
Prior years (c) Unallowed loss (line 1c)
Overall gain or loss (d) Gain (e) Loss
Total. Enter on Form 8582, lines 1a, 1b, and 1c . . . . . . . . . . . . . . . .
Worksheet 2For Form 8582, Lines 2a and 2b (See instructions.)

Name of activity (a) Current year deductions (line 2a) (b) Prior year unallowed deductions (line 2b) (c) Overall Loss
Total. Enter on Form 8582, lines 2a and 2b . . . . . . . . . . . . . . .
0 Worksheet 3For Form 8582, Lines 3a, 3b, and 3c (See instructions.)
Current year Name of activity (a) Net income (line 3a) (b) Net loss (line 3b) Prior years (c) Unallowed loss (line 3c)
0
Overall gain or loss (d) Gain (e) Loss
K&R
10,000
10,000
10,000 0 0 Worksheet 4Use this worksheet if an amount is shown on Form 8582, line 10 or 14 (See instructions.)
Name of activity Form or schedule and line number to be reported on (see instructions)
(a) Loss (b) Ratio (c) Special allowance (d) Subtract column (c) from column (a)
Total. Enter on Form 8582, lines 3a, 3b, and 3c . . . . . . . . . . . . . . . .
Total
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.00
Worksheet 5Allocation of Unallowed Losses (See instructions.)

Name of activity Form or schedule and line number to be reported on (see instructions)
(a) Loss (b) Ratio (c) Unallowed loss
Total KIA
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.00
Form 8582 (2012)
Jeff Bell Worksheet 6Allowed Losses (See instructions.)

Form 8582 (2012)
111-11-1111
Page 3
Name of activity
Form or schedule and line number to be reported on (see instructions)
(a) Loss
(b) Unallowed loss
(c) Allowed loss
0 0 Worksheet 7Activities With Losses Reported on Two or More Forms or Schedules (See instructions.)
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a) Name of activity: (b) (c) Ratio (d) Unallowed loss
(e) Allowed loss
Form or schedule and line number to be reported on (see instructions): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1a Net loss plus prior year unallowed loss from form or schedule . . . b Net income from form or schedule . . . . . . . . . . . . c Subtract line 1b from line 1a. If zero or less, enter -0- . Form or schedule and line number to be reported on (see instructions): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1a Net loss plus prior year unallowed loss from form or schedule . . . b Net income from form or schedule . . . . . . . . . . . . c Subtract line 1b from line 1a. If zero or less, enter -0- . Form or schedule and line number to be reported on (see instructions): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1a Net loss plus prior year unallowed loss from form or schedule . . . b Net income from form or schedule . . . . . . . . . . . . c Subtract line 1b from line 1a. If zero or less, enter -0- . Total KIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.00
Form 8582 (2012)
Form
8824
Like-Kind Exchanges
(and section 1043 conflict-of-interest sales)
Attach to your tax return.
OMB No. 1545-1190
Name(s) shown on tax return
Attachment Sequence No. 109 Identifying number
2012
Jeff Part I
Bell Information on the Like-Kind Exchange
111-11-1111
Note: If the property described on line 1 or line 2 is real or personal property located outside the United States, indicate the country. 1 Description of like-kind property given up: Tract in ____ _ _ Levy _ _ _ _ County _________________________________________________________ ___________________________________________________________________ 2 Description of like-kind property received: Tract in ____ _ _ Dixie _ _ _ _ _County ________________________________________________________ ___________________________________________________________________ 06/06/90 3 3 Date like-kind property given up was originally acquired (month, day, year) . . . . . . . . . . . . . 4 Date you actually transferred your property to other party (month, day, year) . . . . . . . . . . . . 4
02/10/12
5 Date like-kind property you received was identified by written notice to another party (month, day, year). See instructions for 45-day written identification requirement . . . . . . . . . . . . . . . 6 Date you actually received the like-kind property from other party (month, day, year). See instructions .
5 6
7 Was the exchange of the property given up or received made with a related party, either directly or indirectly (such as through an intermediary)? See instructions. If Yes, complete Part II. If No, go to Part III . . . . .
Yes
X No
Part II
8
Related Party Exchange Information

Relationship to you Related party's identifying number
Name of related party Address (no., street, and apt., room, or suite no., city or town, state, and ZIP code)
9 During this tax year (and before the date that is 2 years after the last transfer of property that was part of the exchange), did the related party sell or dispose of any part of the like-kind property received from you (or an intermediary) in the exchange or transfer property into the exchange, directly or indirectly (such as through an intermediary), that became your replacement property? . . . . . . . . . . . . . . . . . . . . . . . 10 During this tax year (and before the date that is 2 years after the last transfer of property that was part of the exchange), did you sell or dispose of any part of the like-kind property you received? . . . . . . . . . . . .
Yes
No
Yes
No
If both lines 9 and 10 are No and this is the year of the exchange, go to Part III. If both lines 9 and 10 are No and this is not the year of the exchange, stop here. If either line 9 or line 10 is Yes, complete Part III and report on this years tax return the deferred gain or (loss) from line 24 unless one of the exceptions on line 11 applies. 11 If one of the exceptions below applies to the disposition, check the applicable box: a b c
KIA
The disposition was after the death of either of the related parties. The disposition was an involuntary conversion, and the threat of conversion occurred after the exchange. You can establish to the satisfaction of the IRS that neither the exchange nor the disposition had tax avoidance as one of its principal purposes. If this box is checked, attach an explanation (see instructions).
For Paperwork Reduction Act Notice, see the instructions.
Form
8824 (2012)
Form 8824 (2012) Name(s) shown on tax return. Do not enter name and social security number if shown on page 1.
Page 2 Your social security number
Jeff Part III
Bell 111-11-1111 Realized Gain or (Loss), Recognized Gain, and Basis of Like-Kind Property Received
Caution: If you transferred and received (a) more than one group of like-kind properties or (b) cash or other (not like-kind) property, see Reporting of multi-asset exchanges in the instructions.
Note: Complete lines 12 through 14 only if you gave up property that was not like-kind. Otherwise, go to line 15. 12 13 14 Fair market value (FMV) of other property given up . . . . . . . . . . . 12 13 Adjusted basis of other property given up . . . . . . . . . . . . . . . . . Gain or (loss) recognized on other property given up. Subtract line 13 from line 12. Report the gain or (loss) in the same manner as if the exchange had been a sale . . . . . . . . . . . . . . Caution: If the property given up was used previously or partly as a home, see Property used as home in the instructions. Cash received, FMV of other property received, plus net liabilities assumed by other party, reduced (but not below zero) by any exchange expenses you incurred (see instructions) . . . . . FMV of like-kind property you received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Add lines 15 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Adjusted basis of like-kind property you gave up, net amounts paid to other party, plus any exchange expenses not used on line 15 (see instructions) . . . . . . . . . . . . . . . . . . . . Realized gain or (loss). Subtract line 18 from line 17 . . . . . . . . . . . . . . . . . . . . . . . Enter the smaller of line 15 or line 19, but not less than zero . . . . . . . . . . . . . . . . . . . Ordinary income under recapture rules. Enter here and on Form 4797, line 16 (see instructions) Subtract line 21 from line 20. If zero or less, enter -0-. If more than zero, enter here and on Schedule D or Form 4797, unless the installment method applies (see instructions) . . . . . . . Recognized gain. Add lines 21 and 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deferred gain or (loss). Subtract line 23 from line 19. If a related party exchange, see instructions Basis of like-kind property received. Subtract line 15 from the sum of lines 18 and 23 . . . . .
14
15 16 17 18 19 20 21 22 23 24 25
. . . . . . . . . . .
15 16 17 18 19 20 21 22 23 24 25
25,000 175,000 200,000 200,500 -500 0 0 0 0 -500 175,500
Part IV
Deferral of Gain From Section 1043 Conflict-of-Interest Sales
Note: This part is to be used only by officers or employees of the executive branch of the Federal Government or judicial officers of the Federal Government (including certain spouses, minor or dependent children, and trustees as described in section 1043) for reporting nonrecognition of gain under section 1043 on the sale of property to comply with the conflict-of-interest requirements. This part can be used only if the cost of the replacement property is more than the basis of the divested property. 26 27 28 Enter the number from the upper right corner of your certificate of divestiture. (Do not attach a copy of your certificate. Keep the certificate with your records.) . . . . . . . . . . . . . . . . Description of divested property ------------------------------------------------------------------------------------------------------------------------------------------------------------Description of replacement property ---------------------------------------------------------------------------------------------------------------------------------------------------------29 30 31 32 33 Date divested property was sold (month, day, year) Sales price of divested property (see instructions) Basis of divested property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 31 32 29
. . . . . . . . . . . . . . . . . . . . . . . . .
Realized gain. Subtract line 31 from line 30
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Cost of replacement property purchased within 60 days after date of sale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtract line 33 from line 30. If zero or less, enter -0-
34 35 36 37 38
KIA
. . . . . . . . . . . . . . . . . . . . . . . .
34 35 36 37 38
Form
Ordinary income under recapture rules. Enter here and on Form 4797, line 10 (see instructions) . Subtract line 35 from line 34. If zero or less, enter -0-. If more than zero, enter here and on Schedule D or Form 4797 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deferred gain. Subtract the sum of lines 35 and 36 from line 32 Basis of replacement property. Subtract line 37 from line 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0 0 0 8824 (2012)
Form
8829
Ivy
Expenses for Business Use of Your Home

File only with Schedule C (Form 1040). Use a separate Form 8829 for each home you used for business during the year. Information about Form 8829 and its separate instructions is at www.irs.gov/form8829.
OMB No. 1545-0074
Name(s) of proprietor(s)
Attachment Sequence No. 176 Your social security number
2012
Part I
1 2 3 4 5 6 7
Bell Part of Your Home Used for Business
123-45-6781 420 1,400 30.00
Area used regularly and exclusively for business, regularly for daycare, or for storage of 1 inventory or product samples (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Total area of home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Divide line 1 by line 2. Enter the result as a percentage . . . . . . . . . . . . . . . . . . . . . . . For daycare facilities not used exclusively for business, go to line 4. All others go to line 7. hr. 4 Multiply days used for daycare during year by hours used per day . . . . 5 8,784 hr. Total hours available for use during the year (366 days X 24 hrs) (see instructions) . . . . . 6 Divide line 4 by line 5. Enter the result as a decimal amount . . . . . . . Business percentage. For daycare facilities not used exclusively for business, multiply line 6 by line 3 7 (enter the result as a percentage). All others, enter the amount from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30.00
Part II
8
Figure Your Allowable Deduction

8
Enter the amount from Schedule C, line 29, plus any gain derived from the business use of your home and shown on Schedule D or Form 4797, minus any loss from the trade or business not derived from the business use of your home and shown on Schedule D or Form 4797. See instructions. . . 9 Casualty losses (see instructions) . . . . . . . . . 4,000 Deductible mortgage interest (see instructions) . . 10 5,000 Real estate taxes (see instructions) . . . . . . . . 11 9,000 0 Add lines 9, 10, and 11 . . . . . . . . . . . . . . . 12 2,700 13 Multiply line 12, column (b) by line 7 . . . . . . . . Add line 12, column (a) and line 13 . . . . . . . . Subtract line 14 from line 8. If zero or less, enter -0- . Excess mortgage interest (see instructions) . . . . 16 Insurance . . . . . . . . . . . . . . . . . . . . . . 17 Rent . . . . . . . . . . . . . . . . . . . . . . . . 18 Repairs and maintenance . . . . . . . . . . . . . 19 Utilities . . . . . . . . . . . . . . . . . . . . . . . 20 0 0 Other expenses (see instructions) . . . . . . . . . 21 0 0 Add lines 16 through 21 . . . . . . . . . . . . . . 22 0 Multiply line 22, column (b) by line 7 . . . . . . . . . . . . . . . . . . . . 23 3,000 Carryover of operating expenses from 2011 Form 8829, line 42 . . . . . 24 Add line 22 in column (a), line 23, and line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Allowable operating expenses. Enter the smaller of line 15 or line 25 . . . . . . . . . . . . . . . . Limit on excess casualty losses and depreciation. Subtract line 26 from line 15 . . . . . . . . . . . 0 Excess casualty losses (see instructions) . . . . . . . . . . . . . . . . . 28 1,231 29 Depreciation of your home from line 41 below . . . . . . . . . . . . . . . 30 Carryover of excess casualty losses and depreciation from 2011 Form 8829, line 43 Add lines 28 through 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Allowable excess casualty losses and depreciation. Enter the smaller of line 27 or line 31 . . . . Add lines 14, 26, and 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Casualty loss portion, if any, from lines 14 and 32. Carry amount to Form 4684 (see instructions) Allowable expenses for business use of your home. Subtract line 34 from line 33. Enter here and on Schedule C, line 30. If your home was used for more than one business, see instructions . . . . .
See instructions for columns (a) and (b) before completing lines 9-21. (a) Direct expenses (b) Indirect expenses
38,595
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
14 15
2,700 35,895
25 26 27
3,000 3,000 32,895
31 32 33 34 35
1,231 1,231 6,931 0 6,931 160,000 160,000 48,000 2.5640 1,231 0 0

Form
Part III
36 37 38 39 40 41 42 43
KIA
Depreciation of Your Home

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 37 38 39 40 41 42 43
Enter the smaller of your home's adjusted basis or its fair market value (see instr.) Value of land included on line 36 . . . . . . . . . . . . . . . . . . . . . . . . . Basis of building. Subtract line 37 from line 36 . . . . . . . . . . . . . . . . . . Business basis of building. Multiply line 38 by line 7 . . . . . . . . . . . . . . . Depreciation percentage (see instructions) . . . . . . . . . . . . . . . . . . . . Depreciation allowable (see instructions). Multiply line 39 by line 40. Enter here and on line 29 above
. . . . . . . . . . . . . . .
Part IV
Carryover of Unallowed Expenses to 2013
Operating expenses. Subtract line 26 from line 25. If less than zero, enter -0. . . . . . . . . . . . Excess casualty losses and depreciation. Subtract line 32 from line 31. If less than zero, enter -0.
8829 (2012)
2012
Form 1040- V
Detach Here and Mail With Your Payment and Return
KIA
Form
1040-V (2012)

Use this voucher when making a payment with Form 1040. Do not staple this voucher or your payment to Form 1040. Make your check or money order payable to the "United States Treasury." Write your social security number (SSN) on your check or money order.
2012
Form 1040-V Payment Voucher

Amount you are paying by check or money order
Dollars
111-11-1111
123-45-6781
6,985
KIA 1017
Jeff Bell Ivy Bell 4326 Orange Blossom Trail Dallas
TX 75080
111111111 DJ BELL 30 0 201212 610
SUPPORTING FORMS
RE: 2012 Tax Returns PREPARED FOR: Jeff Bell PRINTED ON: December 01, 2013 PREPARED USING: H&R Block 2012 [7803] SSN: 111-11-1111
SUPPORTING FORMS WHICH CAN BE SUBMITTED TO THE IRS SUPPORTING FORMS IN YOUR RETURN
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Background Worksheet - Background Information Worksheet Dependents Worksheet - Worksheet for Dependents1 Dependents Worksheet - Worksheet for Dependents2 Child Tax Credit Worksheet - Child Tax Credit Worksheet Last Year's Data Worksheet - Last Year's Data Worksheet Form 1099-INT/OID - Interest Income Worksheet1 Form 1099-INT/OID - Interest Income Worksheet2 Form 1099-DIV - Dividends and Distributions Form 1099-G - Certain Government Payments Home Mortgage Interest Worksheet - Home Mortgage Interest Worksheet Charitable Worksheet - Charitable Donations Worksheet Depreciation Summary - Summary of Assets Depreciation Worksheet - Depreciation Worksheet Vehicle Worksheet - Vehicle Expense Worksheet Rentals & Royalties - Rentals and Royalties Worksheet K-1 Partnership/S Corporation - K-1 (Partnership/S Corporation) Worksheet
**************** DO NOT MAIL THIS PAGE ****************
BACKGROUND BACKGROUND INFORMATION WORKSHEET 1. YOUR NAME, ADDRESS AND TELEPHONE NUMBER
2012
Your name (rst, MI, last, Jr/III) . . . . . . . . . . Jeff Bell Spouse's name (rst,MI,last,Jr/III) . . . . . . . . .Ivy Bell C/O information, if necessary . . . . . . . . . . . Foreign address (not APO/FPO) Your street and apartment # (if any) . . . . . . .4326 Orange Blossom Trail Your city, state, and ZIP code . . . . . . . . . . . .Dallas , TX 75080 Foreign country . . . . . . . . . . . . . . . . . . . . . . . . . . . . Foreign province/state/county . . . . . . . . . . . . . . . . Foreign postal code . . . . . . . . . . . . . . . . . . . . . . . . . Your telephone number (daytime) . . . . . . . . 222-222-2222 I live outside the U.S. and Puerto Rico and my main place of work is outside the U.S. and Puerto Rico, or I'm in military or naval service outside the U.S. and Puerto Rico. Check here if you received a letter from the IRS with an identity protection personal identication number (IP PIN). IP PIN's are uncommon. They are sent to certain taxpayers taxpayers who have had a problem with identity theft. 6-digit IP PIN . . . . . . . . . . . . . . . . . . . . . . . .
2. GENERAL INFORMATION a. b. c. d. e. f. Yours

Social Security number . . . . . . . 111-11-1111 Date of birth (MM/DD/YYYY) . . .07/01/1968 "X" if legally blind . . . . . . . . . . . . Enter "X" if disabled . . . . . . . . . . . Occupation . . . . . . . . . . . . . . . . Regional Manager "X" if you want $3 to go to Pres. Elec. Campaign Fund . . . . . .
Your spouse's
123-45-6781 03/20/1969
Self-employeed CPA
g. If this return is for a
Primary taxpayer
Spouse
3. FILING STATUS a. Choose your ling status below:
deceased person, enter the date of death . . . . . . . . . . . . h. Full-time student (see help panel for details) Single Married ling joint return Married ling separate return Head of household Qualifying widow(er) b. If you are married ling separately, check the applicable box. I want to itemize my deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I want to use the standard deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Check the box if you are married ling separately AND you and your spouse lived apart throughout 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. If ling status is head of household, and qualifying person is a child but not your dependent, enter the child's name . . . . . . . and SSN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Click here to clear or make a new selection . . . . . . . . . . e. If qualifying widow(er), enter the year your spouse died . . . . . . . . . . . . . . . . . . . . f. Dual-Status Alien: Enter "X" if you or your spouse is a dual-status alien AND you are NOT entering on this tax return your combined worldwide
e. If qualifying widow(er), enter the year your spouse died . . . . . . . . . . . . . . . . . . . . f. Dual-Status Alien: Enter "X" if you or your spouse is a dual-status alien AND you are NOT entering on this tax return your combined worldwide BACKGROUND (CONT'D) PAGE 2
Jeff Bell
Click here to clear or make a new selection . . . . . . . . . .
income. If you enter "X," your standard deduction is zero . . . . . . . . . . . . . . . . . . . . .
SSN:
2012
111-11-1111
4. EXEMPTIONS FOR YOU AND YOUR SPOUSE a. Place an "X" here if anyone else (a parent, e.g.) can claim you as a
dependent on his or her tax return. (Joint lers enter "X" only if someone else can claim you, AND your tax before withholding is zero.) . . . . . . . . . . . b. Enter "Y" if you are entitled to an exemption for yourself . . . . . . . . . . . . . . . . . . . . . . Y c. If married, place an "X" here if anyone else (a parent, e.g.) can claim your spouse as an exemption on his or her tax return. (Joint lers enter "X" only if someone else can claim your spouse, AND your tax before withholding is zero.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Enter "X" if you are entitled to an exemption for your spouse . . . . . . . . . . . . . . . . . . .
YES e. You had at least one parent living on the last day of 2012 . . . . . . . . . . . . . . . f. 5. TAXES PAID/WITHHELD a. Estimated taxes paid (do not include 2011 refund applied): Date Amount
12/31/2012 36,000 If you answered yes to the previous question and you were ages 18-23 on the last day of 2012, answer the next question. Your earned income was less than half of your support in 2012 . . . . . . . . . .
Your Exemption for Alternative Minimum Tax
NO
b. Amount paid with Form 4868 (for October returns) . . . . . . . . . . . . . . . . . . c. Withholding on Form 1099-B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Withholding on Form 1099-PATR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. PAYING YOUR TAXES BY CREDIT CARD a. Conrmation number, if taxes are being paid by credit card. b. Amount charged to credit card (not including convenience
fee), if taxes are being paid by credit card . . . . . . . . . . . . . . . . . . . . . . .
Total estimated tax payments . . . . . . . .
36,000
7. REFUND INFORMATION Direct Deposit

Would you like to speed your refund by having the IRS deposit it directly into your account at a bank or other nancial institution in the United States? If so, ll in the following regarding the account and place an X here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a. Routing Transit Number ("RTN") . . . . . . . . . . . . . . . . . . . . . . b. Depositor Account Number ("DAN") . . . . . . . . . . . . . . . . . . . Note: Here is a sample of the numbers you might find at the bottom of a check, with "RTN," "DAN," and check number identified. RTN: DAN: Check number: Checking Savings Amount to be deposited in rst account . . . . . . . . . . . . . . . Routing Transit Number ("RTN") . . . . . . . . . . . . . . . . . . . . . . Depositor Account Number ("DAN") . . . . . . . . . . . . . . . . . . . Type of account: Checking Savings d. Amount to be deposited in second account . . . . . . . . . . . . . 3a. Routing Transit Number ("RTN") . . . . . . . . . . . . . . . . . . . . . . b. Depositor Account Number ("DAN") . . . . . . . . . . . . . . . . . . . c. Type of account: Checking Savings d. Amount to be deposited in third account . . . . . . . . . . . . . . .
123404567 123-4567 c. Type of account:
0101
d. 2a. b. c.
Applying Refund to Your 2013 Estimated Tax

If you are due a refund this year, do you want to apply any of it to 2013
d. Amount to be deposited in third account . . . . . . . . . . . . . . . Applying Refund to Your 2013 Estimated Tax BACKGROUND (CONT'D) PAGE 3 8. THIRD PARTY DESIGNEE
Do you want to allow another person to discuss this return with Yes No the IRS? If Yes, complete the following information: Designee's name: Designee's phone number: Designee's personal identication number (PIN): How was this return prepared: By yourself. With help of an IRS-sponsored program (if so, enter one of the following: TC, TCE, TC-X, TCE-X, VITA, VITA-T, Self-Help, IRS-Prepared, IRS-Reviewed, Outreach): . Enter information below about any 2012 state tax returns you're ling. For each state, select the residency status that applies for 2012. Jeff Bell If you are due a refund this year, do you want to apply any of it to 2013 estimated tax? If so, please enter the amount here
SSN:
2012
111-11-1111
9. RETURN ASSISTANCE
10.
STATE TAX RETURNS Name of state(s)
Your residency status
Spouse's residency status
DEPENDENTS
Jeff Bell
WORKSHEET FOR DEPENDENTS
2012 SSN: 111-11-1111
SECTION I BASIC INFORMATION

Tell us about the person you want to claim as a dependent:
First Name
Anna
MI Last Name
Bell
Soc. Sec. No.
Date of Birth
05/02/1992
ITIN
123-45-6784
Relationship
Daughter
Type of Dependent
Child Lived with You
Time Lived With You
Lived With All Year or Born Month's person lived with you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Person's age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 DOB string . . . . . . May 2, 1992 Person is fosterchild placed with you by court order/placement agency . . . . . . . . . . . . . Was this person a US citizen/resident alien of the US in 2012? . . . . . . . . . . . . . . . . If no, was this person a resident of Canada or Mexico in 2012? . . . . . . . . . . . . . . . . Is this person your adopted child who lived with you all year? . . . . . . . . . . . . . . . . . If tax ID is an ITIN is substantial presence test satised?.. . . . . . . . . . . . . . . . . . . . . If NO to substantial presence test are there special circumstances? . . . . . . . . . . . . .
Yes
No
SECTION II QUICK ENTRY
If you're not sure this person qualifies, check NO and go to Section III. Are you sure this person qualies as your dependent in 2012 . . . . . . . . . . . . . . . . .
Yes
No
IF YOU ANSWERED YES - STOP!
You do not need to complete the rest of this worksheet. We will prevent you from checking this box if you have not completed all the information in Section I, or if we've determined (based upon that information) this person cannot be your dependent.
SECTION III DEPENDENT QUALIFICATION TESTS PART A ALL DEPENDENTS
Do not complete this Section unless you answered NO in Section II.
Yes 1. Will the person named in Section I le a joint return in 2012? . . . . . . . . . . . . . . * If NO, go to line 3. * If YES, go to line 2. 2. Does this person satisfy the exception to the dependent
joint return test? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See the FAQ to the right to learn about the exception to joint return test. * If YES, go to Part B, line 3. * If NO STOP. You cannot claim this person as your dependent.
No
PART B DETERMINE WHETHER PERSON IS YOUR QUALIFYING CHILD 3. If this person is your child, are any of these statements true? . . . . . . . . . . . . . . * You are divorced or legally separated under a decree of divorce * You are separated under a written separation agreement from the
Answer NO if this person is not your child. * If NO, go to line 4. * If YES, complete the MINI-WORKSHEET FOR LINE 3. or separate maintenance from the child's other parent. child's other parent.
* You lived apart during the last 6 months of the calendar year.
Yes 4. Did this person live in your home for more than half the year? . . . . . . . . . . . . .
If YES, go to line 5. If NO: * If you also answered NO to line 3 go to Part C. You cannot claim this person as your Qualifying Child, but you may be able to claim this person as your Qualifying Relative. * If you answered YES to line 3 and YES to line h or line j of the MINI-WORKSHEET FOR LINE 3 go to line 5. * If you answered YES to line 3 and you did NOT check line h or line j of the MINI-WORKSHEET FOR LINE 3, go to Part C. You cannot claim this person as your Qualifying Child, but you may be able to claim this person as your Qualifying Relative.
No
5. Is this person's relationship valid for a Qualifying Child? . . . . . . . . . . . . . . . . . .

We calculate this answer based upon the relationship selected in Section I. Check this box if this person is your fosterchild, placed in your care by an authorized placement agency or by judgment, decree, or other valid court order. * If YES go to line 6.
We calculate this answer based upon the relationship selected in Section I. Check this box if this person is your fosterchild, placed in your care by an authorized placement agency or by judgment, decree, or other valid court order. * If YES go to line 6. * If NO go to PART C. You cannot claim this person as your Qualifying Child, but you may be able to claim this person as your Qualifying Relative.
6. Was this person under age 19 at the end of the year? . . . . . . . . . . . . . . . . . . . .

We calculate this based on this person's date of birth in Section I. * If YES, skip lines 7-9 and go to line 10. * If NO, go to line 7.
7. Was this person a student in 2012? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * If NO, go to line 9. * If YES, go to line 8. 8. Was this person under age 24 at the end of the year? . . . . . . . . . . . . . . . . . . . .
We calculate this based on this person's date of birth in Section I. * If YES, skip line 9 and go to line 10. * If NO, go to line 9.
9. Was this person permanently and totaly disabled?. . . . . . . . . . . . . . . . . . . . . . . * If YES, go to line 11. * If NO go to line 10. 10. Is this person younger than taxpayer (or spouse if MFJ)?. . . . . . . . . . . . . . . . . . * If YES, go to line 11. * If NO go to PART C. You cannot claim this person as your
Qualifying Child, but you may be able to claim this person as your Qualifying Relative.
11. 12.
Did this person provide over half his/her own support in 2012? . . . . . . . . . . . * If NO, read the caution below and go to line 12. * If YES, STOP. You cannot claim this person as your dependent. Do you want to claim this person as your dependent? . . . . . . . . . . . . . . . . . . . If you do not have the better claim to the dependent exemption, you should only answer YES to line 12 if you know the other taxpayer will not claim this person as a dependent.
PART C DETERMINE WHETHER PERSON IS YOUR QUALIFYING RELATIVE

Complete this Part only if this person is not a Qualifying Child and we directed you to complete this Part in Part B.
13.
Yes
Although not your Qualifying Child, is this person a Qualifying Child for somebody else? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See the FAQ to the right to see who can be a Qualifying Child. * If NO, go to line 14. * If YES STOP. You cannot claim this person as your dependent. Is this person's relationship valid for a Qualifying Relative? . . . . . . . . . . . . . . . . See the FAQ to the right to see who can be a Qualifying Relative. * If YES, go to line 15. * If NO STOP. You cannot claim this person as your dependent. Did this person have more than $3,800 of gross income in 2012? . . . . . . . . . . . See the FAQ to the right to learn what is considered gross income. * If NO, go to line 16. * If YES STOP. You cannot claim this person as your dependent. Did you (and your spouse if married ling jointly) provide more than half the support for this person during 2012? . . . . . . . . . . . . . . . . . . . . . . TIP! Answer YES if a multiple support agreement lets you claim this person. Note: We calculate line 16 if you completed the MINI-WORKSHEET FOR LINE 5. See the FAQ to the right to learn what is considered support. * If YES, this person is your Qualifying Relative and we'll make this person your dependent. * If NO, this person is not your Qualifying Relative or your dependent.
No
14.
15.
16.
DEPENDENTS
Jeff Bell
WORKSHEET FOR DEPENDENTS
2012 SSN: 111-11-1111
SECTION I BASIC INFORMATION

Tell us about the person you want to claim as a dependent:
First Name
Tyler
MI Last Name
Bell
Soc. Sec. No.
Date of Birth
06/30/1997
ITIN
123-45-6788
Relationship
Daughter
Type of Dependent
Child Lived with You
Time Lived With You
Lived With All Year or Born Month's person lived with you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Person's age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 DOB string . . . . . . June 30, 1997 Person is fosterchild placed with you by court order/placement agency . . . . . . . . . . . . . Was this person a US citizen/resident alien of the US in 2012? . . . . . . . . . . . . . . . . If no, was this person a resident of Canada or Mexico in 2012? . . . . . . . . . . . . . . . . Is this person your adopted child who lived with you all year? . . . . . . . . . . . . . . . . . If tax ID is an ITIN is substantial presence test satised?.. . . . . . . . . . . . . . . . . . . . . If NO to substantial presence test are there special circumstances? . . . . . . . . . . . . .
Yes
No
SECTION II QUICK ENTRY
If you're not sure this person qualifies, check NO and go to Section III. Are you sure this person qualies as your dependent in 2012 . . . . . . . . . . . . . . . . .
Yes
No
IF YOU ANSWERED YES - STOP!
You do not need to complete the rest of this worksheet. We will prevent you from checking this box if you have not completed all the information in Section I, or if we've determined (based upon that information) this person cannot be your dependent.
SECTION III DEPENDENT QUALIFICATION TESTS PART A ALL DEPENDENTS
Do not complete this Section unless you answered NO in Section II.
Yes 1. Will the person named in Section I le a joint return in 2012? . . . . . . . . . . . . . . * If NO, go to line 3. * If YES, go to line 2. 2. Does this person satisfy the exception to the dependent
joint return test? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See the FAQ to the right to learn about the exception to joint return test. * If YES, go to Part B, line 3. * If NO STOP. You cannot claim this person as your dependent.
No
PART B DETERMINE WHETHER PERSON IS YOUR QUALIFYING CHILD 3. If this person is your child, are any of these statements true? . . . . . . . . . . . . . . * You are divorced or legally separated under a decree of divorce * You are separated under a written separation agreement from the
Answer NO if this person is not your child. * If NO, go to line 4. * If YES, complete the MINI-WORKSHEET FOR LINE 3. or separate maintenance from the child's other parent. child's other parent.
* You lived apart during the last 6 months of the calendar year.
Yes 4. Did this person live in your home for more than half the year? . . . . . . . . . . . . .
If YES, go to line 5. If NO: * If you also answered NO to line 3 go to Part C. You cannot claim this person as your Qualifying Child, but you may be able to claim this person as your Qualifying Relative. * If you answered YES to line 3 and YES to line h or line j of the MINI-WORKSHEET FOR LINE 3 go to line 5. * If you answered YES to line 3 and you did NOT check line h or line j of the MINI-WORKSHEET FOR LINE 3, go to Part C. You cannot claim this person as your Qualifying Child, but you may be able to claim this person as your Qualifying Relative.
No
5. Is this person's relationship valid for a Qualifying Child? . . . . . . . . . . . . . . . . . .

We calculate this answer based upon the relationship selected in Section I. Check this box if this person is your fosterchild, placed in your care by an authorized placement agency or by judgment, decree, or other valid court order. * If YES go to line 6.
We calculate this answer based upon the relationship selected in Section I. Check this box if this person is your fosterchild, placed in your care by an authorized placement agency or by judgment, decree, or other valid court order. * If YES go to line 6. * If NO go to PART C. You cannot claim this person as your Qualifying Child, but you may be able to claim this person as your Qualifying Relative.
6. Was this person under age 19 at the end of the year? . . . . . . . . . . . . . . . . . . . .

We calculate this based on this person's date of birth in Section I. * If YES, skip lines 7-9 and go to line 10. * If NO, go to line 7.
7. Was this person a student in 2012? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * If NO, go to line 9. * If YES, go to line 8. 8. Was this person under age 24 at the end of the year? . . . . . . . . . . . . . . . . . . . .
We calculate this based on this person's date of birth in Section I. * If YES, skip line 9 and go to line 10. * If NO, go to line 9.
9. Was this person permanently and totaly disabled?. . . . . . . . . . . . . . . . . . . . . . . * If YES, go to line 11. * If NO go to line 10. 10. Is this person younger than taxpayer (or spouse if MFJ)?. . . . . . . . . . . . . . . . . . * If YES, go to line 11. * If NO go to PART C. You cannot claim this person as your
Qualifying Child, but you may be able to claim this person as your Qualifying Relative.
11. 12.
Did this person provide over half his/her own support in 2012? . . . . . . . . . . . * If NO, read the caution below and go to line 12. * If YES, STOP. You cannot claim this person as your dependent. Do you want to claim this person as your dependent? . . . . . . . . . . . . . . . . . . . If you do not have the better claim to the dependent exemption, you should only answer YES to line 12 if you know the other taxpayer will not claim this person as a dependent.
PART C DETERMINE WHETHER PERSON IS YOUR QUALIFYING RELATIVE

Complete this Part only if this person is not a Qualifying Child and we directed you to complete this Part in Part B.
13.
Yes
Although not your Qualifying Child, is this person a Qualifying Child for somebody else? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . See the FAQ to the right to see who can be a Qualifying Child. * If NO, go to line 14. * If YES STOP. You cannot claim this person as your dependent. Is this person's relationship valid for a Qualifying Relative? . . . . . . . . . . . . . . . . See the FAQ to the right to see who can be a Qualifying Relative. * If YES, go to line 15. * If NO STOP. You cannot claim this person as your dependent. Did this person have more than $3,800 of gross income in 2012? . . . . . . . . . . . See the FAQ to the right to learn what is considered gross income. * If NO, go to line 16. * If YES STOP. You cannot claim this person as your dependent. Did you (and your spouse if married ling jointly) provide more than half the support for this person during 2012? . . . . . . . . . . . . . . . . . . . . . . TIP! Answer YES if a multiple support agreement lets you claim this person. Note: We calculate line 16 if you completed the MINI-WORKSHEET FOR LINE 5. See the FAQ to the right to learn what is considered support. * If YES, this person is your Qualifying Relative and we'll make this person your dependent. * If NO, this person is not your Qualifying Relative or your dependent.
No
14.
15.
16.
CHILD TAX CR WKS
Form 1040 line 51 and 1040A line 33
CHILD TAX CREDIT WORKSHEET
2012
SSN: 111-11-1111 Jeff Bell To calculate your Child Tax Credit, we complete Parts I and II of the Child Tax Credit Worksheet below. However, if any one of the following bullet-points apply we complete the Publication 972 Worksheet and not the Child Tax Credit Worksheet. You are claiming any of the following credits: 1. Mortgage Interest Credit (Form 8396) 2. Adoption Credit (Form 8839) 3. Residential energy e"cient property credit (Form 5695, Part II) 4. D.C. First-time Homebuyer Credit (Form 8859) You excluded income from Puerto Rico or American Samoa (Form 4563). You are ling Form 2555 or Form 2555-EZ. CHILD TAX CREDIT WORKSHEET PART I
The child tax credit is based on the number of qualifying children who lived with you during 2012. We automatically calculate the number of your qualifying children based upon information on the Dependent Worksheet. Number of qualifying children 1 X $1,000 Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Adjusted gross income (Form 1040, ln 38, Form 1040A, ln 22) . . . . . . . . . . 2 Amount corresponding to your ling status . . . . . . . . . . . . . . . . . . . . . . . . .3 Married ling jointly - $110,000 Single, head of household, or qualifying widow(er) - $75,000 Married ling separately - $55,000 Is amount on line 2 more than amount on line 3? No - Leave line 4 blank and enter zero on line 5. Yes - Ln 2-ln 3 increased to next multiple of $1,000 . . . . . . . . . . . . .4 Line 4 times 5% (.05) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Is amount on line 1 more than amount on line 5? No - STOP! You cannot take the child tax credit on Form 1040, line 51, or Form 1040A, line 33. You also cannot take the additional child tax credit on Form 1040, line 65 or Form 1040A, line 39. Complete the rest of your Form 1040 or 1040A. Yes - Ln 1 - ln 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
1. 2. 3.
1,000 363,411 110,000
4. 5. 6.
254,000 12,700
PART II 7. Regular tax (1040 ln 46; 1040A ln 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 8. Add the following amounts from: Form 1040: Form 1040A:
Line 47 0 Line 48 Line 29 + Line 49 Line 31 + Line 50 Line 32 + 0 Form 5695, Line 32 + Form 8834, Line 23 + Form 8910, Line 22 + Form 8936, Line 23 + Schedule R, Line 22 + TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Are the amounts on lines 7 and 8 the same? Yes - STOP! You can't take the child tax credit because there's no tax to reduce. You may qualify for the additional child tax credit. No - Subtract line 8 from 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Is the amount on line 6 greater than the amount on line 9? Yes - Enter the amount from line 9. You may qualify for the additional child tax credit. No - Enter the amount from line 6. This is your Child Tax Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 X $1,000 Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Adjusted gross income (Form 1040, ln 38, Form 1040A, ln 22) . . . . . . . . . . 2 Modications to adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Modied adjusted gross income. Line 2 + line 3 . . . . . . . . . . . . . . . . . . . . . 4 Amount corresponding to your ling status . . . . . . . . . . . . . . . . . . . . . . . . .5 Married ling jointly - $110,000 Single, head of household, or qualifying widow(er) - $75,000 Married ling separately - $55,000 Is amount on line 4 more than amount on line 5?
9.
10.
PUBLICATION 972 WORKSHEET 1. Number of qualifying children 2. 3. 4. 5.
6.
5. Amount corresponding to your ling status . . . . . . . . . . . . . . . . . . . . . . . . .5
6.
7. 8.
9. 10.
Married ling jointly - $110,000 Single, head of household, or qualifying widow(er) - $75,000 Married ling separately - $55,000 Is amount on line 4 more than amount on line 5? No - Leave line 6 blank. Enter -0- on line 7. Yes - Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 If the result is not a multiple of $1,000, increase it to the next multiple of $1,000. For example, increase $425 to $1,000, increase $1,025 to $2,000, etc. Line 6 times 5% (.05) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Is amount on line 1 more than amount on line 7? No - STOP! You cannot take the child tax credit on Form 1040, line 51, or Form 1040A, line 33. You also cannot take the additional child tax credit on Form 1040, line 65 or Form 1040A, line 39. Complete the rest of your Form 1040 or 1040A. Yes - Ln 1 - ln 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Regular tax (1040 ln 46; 1040A ln 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Add the following amounts from:
Form 1040:
11.
12. 13.
Line 47 Line 48 Line 29 + Line 49 Line 31 + Line 50 Line 32 + Form 5695, Line 32 + Form 8834, Line 23 + Form 8910, Line 22 + Form 8936, Line 23 + Schedule R,Line 22 + TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Are you claiming any of the following credits? Mortgage interest credit, Form 8396 Adoption credit, Form 8839 Residential energy e"cient property credit, Form 5695, Part I District of Columbia rst-time homebuyer credit, Form 8859 No. Enter the amount from line 10. YES. Complete the Line 11 Worksheet (below) to gure the amount to enter here. Amount from line 10 or line 15 of the Line 11 Worksheet . . . . . . . . . . . . .11 Subtract line 11 from line 9 (not less than -0-) . . . . . . . . . . . . . . . . . . . . . 12 Is the amount on line 8 more than the amount on line 12? No. Enter the amount from line 8. Yes. Enter the amount from the line 12 . . . . . . . . . . . . . . . . . . . . . . .13
Form 1040A:
LINE 11 WORKSHEET PUBLICATION 972

See IRS Publication 972
1. Amount from line 8 of the Publication 972 Worksheet . . . . . . . . . . . . . . . . . 1 2. Taxable earned income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3. Is the amount on line 2 > $3,000? No. Leave line 3 blank, enter -0- on line 4,
Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4. Multiply the amount on line 3 by 15% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5. Is the amount on line 1 of the Publication 972
YES. Subtract $3,000 from the amount on line 2.
and go to line 5.
6.
7.
Worksheet $3,000 or more? No. If line 4 is: Zero, enter the amount from line 1 on line 12 of this worksheet. Do not complete the rest of this worksheet. Instead, go back to the Publication 972 Worksheet and enter the amount from line 10 on line 11 and complete lines 12 & 13. If line 4 is not zero leave ln. 6 through 9 blank, enter -0- on line 10, and go to line 11. YES. If line 4 is equal to or > line 1, leave lines 6 through 9 blank, enter -0- on line 10, and go to line 11. Otherwise, go to line 6. Social Security, Medicare, Tier 1 taxes: i. Withheld from Form(s) W-2 . . . . . . . . . ii. If you (and/or your spouse if married and ling a joint return) were a railroad employee, enter the amount of Tier 1 tax withheld from your pay (from W-2, box 14). Employee representatives enter 50% of your total Tier 1 tax and Tier 1 Medicare tax you paid for 2012 . . . . . . . . . . . . . . . . Total Social Security/Medicare/Tier 1 tax . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Self-employment tax adjustment (1040 line 27), Social Security tax on unreported tip income (1040 line 57)
7.
8. 9. 10. 11. 12.
13.
14. 15. FORM 1040 AND 1040A EARNED INCOME WORKSHEET

See IRS Publication 972
tax you paid for 2012 . . . . . . . . . . . . . . . . Total Social Security/Medicare/Tier 1 tax . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Self-employment tax adjustment (1040 line 27), Social Security tax on unreported tip income (1040 line 57) and uncollected Social Security and Medicare or RRTA taxes shown in box 12 of your Form(s) W-2 with codes A, B, M and N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EIC plus excess FICA & RRTA tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Line 8 minus line 9 (not less than -0-) . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Enter the larger of 4 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Is line 11 more than line 1? No. Subract ln. 11 from ln. 1 and enter the result. Yes. Enter -0-. Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Enter the total of the amounts from Form 8396, line 9, and Form 8839, line 12, and Form 5695, line 17, and Form 8859, line 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Enter the amount from line 10 of the Pub. 972 Worksheet . . . . . . . . . . . . 14 Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
1a. Amount from Form 1040 or 1040A, line 7 . . . . . . . . . . . . . . . . . . . . . . . . .1a b. Nontaxable combat pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b
Next, if you are ling Schedule C, C-EZ, F, or SE, or you received a Sch. K-1 (Form 1065/1065-B), go to ln. 2a. Otherwise, skip lines 2a through 2e and go to line 3. Note: If you are filing Form 1040A, skip lines 2-3 and go to line 4a. 2a. Enter any statutory employee income reported on line 1 Schedule C or C-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a b. Enter any net prot or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K-1 (Form 1065), box 14 code A (other than farming); Schedule K-1 (Form 1065-B) box 9 code J1*. Reduce any Schedule K-1 amounts as described in the instructions for completing Schedule SE in the Partner's Instructions for Schedule K-1. Do not include any statutory employee income or any other amounts exempt from self-employment tax. Options and commodities dealers must add any gain or subtract any loss (in the normal course of dealing in or trading section 1256 contracts) from section 1256 contracts or related property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2b c. Enter any net farm prot or (loss) from Schedule F, line 34, and from farm partnerships, Schedule K-1 (Form 1065), box 14, code A.* Reduce this amount by any Schedule K-1 amounts as described in the instructions for completing Schedule SE in the Partner's Instructions for Schedule K-1. Do not include on this line any amounts exempt from self-employment tax . . . . . . . . . . . . . 2c 0 d. If you used the farm optional method to gure net earnings from self-employment, enter the amount from Sch. SE, Section B, line 15. Otherwise, skip this line and enter on ln. 2e the amt. from ln. 2c . . . . . . . . . . . . . . . . .2d e. If line 2c is a prot, enter the smaller of line 2c or 2d. If line 2c is a (loss), enter the (loss) from line 2c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e 3. Add lines 1a, 1b, 2a, 2b, & 2e. If zero or less, stop. Do not complete the rest of this worksheet. Enter -0- on line 2 3 of the Line 11 Worksheet or line 4a of Schedule 8812........... 4. Enter any amount included on line 1a that is: a. A scholarship or fellowship grant not reported on Form W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a 0 b. For work done as an inmate in a penal institution (Enter "PRI" and this amount on the dotted line next to line 7 of Form 1040 or Form 1040A) . . . . . . . . . . . . . . . . . . . . . . . .4b c. A pension or annuity from a nonqualied deferred compensation plan or a nongovernmental section 457 plan (enter "DFC" and this amount on the dotted line next to line 7 of Form 1040 or Form 1040A). This amount may be shown in box 11 of your Form W-2. If you received such an amount but box 11 is blank, contact your employer for the amount received as a pension/annuity . . . . . . . . . . . . . . .4c 0 Note: If you are filing Form 1040A, skip lines 5 - 6 and go to line 7. 5a. Enter any amount included on line 3 that is also
0 0
0 0
the amount received as a pension/annuity . . . . . . . . . . . . . . .4c 0 Note: If you are filing Form 1040A, skip lines 5 - 6 and go to line 7. 5a. Enter any amount included on line 3 that is also included on Form 2555, line 43, or Form 2555-EZ, line 18 Do not include any amount that is also included on line 4a, 4b, or 4c . . . . . . . . . . . . . . . . . . . . . . . . . . 5a b. Enter the amount, if any, from Form 2555, line 44, that is also deducted on Form 1040 line 27, Sch. C, C-EZ, or F, or included on Sch. E in partnership net income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5b c. Subtract 5b from 5a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5c 0 6. Enter the amount from Form 1040, line 27 . . . . . . . . . . . . . . . 6 0 7. Form 1040 lers add lines 4a-4c, 5c, and 6. Form 1040A lers add lines 4a-4c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 8. Form 1040 lers subtract line 7 from line 3. Form 1040A lers add 1a + 1b less line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Note: We enter line 8 on line 2 of the Line 11 Worksheet or line 4a of Schedule 8812. If you have Sch. K-1 amounts and you are not required to file Sch. SE, complete the appropriate line(s) of Sched. SE Section A. Put your name and Social Security number on Schedule SE and attach it to your return. This is your Child Tax Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . We enter this amount on Form 1040, line 51, or Form 1040A, line 33.
0 0
LAST YR DATA WKS

Jeff Bell
LAST YEAR'S DATA WORKSHEET SSN:
2012
111-11-1111
Married ling joint return Married ling separate return Head of household Qualifying widow(er) Spouse's Social Security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b Form led: Form 1040 Form 1040A Form 1040EZ 2 Number of exemptions (1040 line 6, 1040A line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Number of additional deductions (1040 line 39a, 1040A line 23a) . . . . . . . . . . . . . . . . 4 Adjusted gross income (1040 line 37, 1040A ln 21, 1040EZ ln 4) . . . . . . . . . 0 5 Itemized deductions (1040, above line 40) . . . . . . . . . . . . . . . . . . . . . . . . . . 9,000 6 Tax less certain credits (1040 line 55, 1040A line 35, 1040EZ line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Self-employment tax (1040 line 56) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Alternative minimum tax (1040 line 45, 1040A line 28 write-in) . . . . . . . . . . 9a Household employment tax (1040 line 59a) . . . . . . . . . . . . . . . . . . . . . . . . . . 9b Homebuyer credit repayment, Form 5405, line 8 (1040 line 59b) . . . . . . . . . . 10 Earned income credit (1040 ln 64a, 1040A ln 38a, 1040EZ ln 8a) . . . . . . . . . . 11 Refund applied to 2012 (1040 line 75, 1040A line 44) . . . . . . . . . . . . . . . . . . . 12 Interest on tax due on installment income from lots/timeshares . . . . . . . . . . . 13 Interest on deferred tax on gain from certain installment sales with sales price over $150,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Tax on income received from nonqualied deferred compensation plan that fails to meet requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2011 Form 1040, 1040A or 1040EZ 1a Filing status: Single
2011 Schedule D 15 Used Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Line 6 of Qualied Dividends and Capital Gain Tax Worksheet or
Yes
No
17 Line 19 of Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Line 10 of Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Line 7 of Qualied Dividends and Capital Gain Tax Worksheet or 20 Short-term capital loss carryforward (line 8 of Capital
line 13 of Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
line 14 of Schedule D Tax Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Loss Carryover Worksheet in 2012 Schedule D instructions) . . . . . . . . . . . . . . . Loss Carryover Worksheet in 2012 Schedule D instructions) . . . . . . . . . . . . . . .
21 Long-term capital loss carryforward (line 13 of Capital
20 Short-term capital loss carryforward (line 8 of Capital
21 Long-term capital loss carryforward (line 13 of Capital LAST YEAR'S DATA (CONT'D) PAGE 2
Jeff Bell
Loss Carryover Worksheet in 2012 Schedule D instructions) . . . . . . . . . . . . . . . Loss Carryover Worksheet in 2012 Schedule D instructions) . . . . . . . . . . . . . . .
SSN:
2012
111-11-1111
2011 Form 2555 22 Line 46 (yours) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Line 48 (yours) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Line 46 (spouse's) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Line 48 (spouse's) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2011 Form 4136 26 Total fuel tax credit (line 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2011 Form 4952 27 Disallowed investment interest expense (line 7) . . . . . . . . . . . . . . . . . . . . . . . . 28 Disallowed investment interest expense (AMT) (line 7) . . . . . . . . . . . . . . . . . . . 2011 Form 5329 29 Tax on early distribution (line 4) (yours) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Tax on early distribution (line 4) (spouse's) . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Tax on distribution from education account (line 8) (yours) . . . . . . . . . . . . . . . 32 Tax on distribution from education account (line 8) (spouse's) . . . . . . . . . . . . . 2011 Form 5405 33 a 2011 Homebuyer credit (Part II, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b 2011 Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 2011 Date of purchase (Part I, line B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 2011 Purchase price of the property (Part II, line 1) . . . . . . . . . . . . . . . . . . . . . 2011 Form 5695 36 Nonbusiness energy property credit (line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . 2011 Form 6251 37 Adjusted gross income minus itemized deductions (line 1) . . . . . . . . . . . . . . . 38 Medical and dental expenses (line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Taxes from Schedule A if you itemize (line 3) . . . . . . . . . . . . . . . . . . . . . . . . . 40 Certain interest on a home mortgage (line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Miscellaneous deductions (line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Amount from line 6 (enter as negative) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Tax refund from Form 1040 (line 7; enter as negative) . . . . . . . . . . . . . . . . . . 44 Investment interest expense (reg. - AMT) (line 8) . . . . . . . . . . . . . . . . . . . . . . . 45 Depletion di!erences (line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Net operating loss (line 10; enter as positive) . . . . . . . . . . . . . . . . . . . . . . . . . 47 Interest from specied private activity bonds (line 12) . . . . . . . . . . . . . . . . . . . 48 Qualied small business stock (line 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Regular tax minus 4972 amount and foreign tax credit (line 34) . . . . . . . . . . . Your 2010 and 2011 Form 8606 50 Line 20b of 2010 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Line 25b of 2010 Form 8606
Amount attributable to rollovers from qualied retirement plans to Roth IRAs . . . . . . . . . . . . . . . . . . . . Amount attributable to in-plan rollovers to designated Roth accounts . . . . . . . . . . . . . . . . . . . . 52 Line 38 of 2011 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Line 48 of 2011 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Your Spouse's 2010 and 2011 Form 8606 54 Line 20b of 2010 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Line 25b of 2010 Form 8606
Amount attributable to rollovers from qualied retirement plans to Roth IRAs . . . . . . . . . . . . . . . . . . . . Amount attributable to in-plan rollovers to designated Roth accounts . . . . . . . . . . . . . . . . . . . . 56 Line 38 of 2011 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Line 48 of 2011 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amount attributable to in-plan rollovers to designated Roth accounts . . . . . . . . . . . . . . . . . . . . 56 Line 38 of 2011 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Line 48 of 2011 Form 8606 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LAST YEAR'S DATA (CONT'D) PAGE 3

Jeff Bell
SSN:
2012
111-11-1111
2011 Form 8801 58 Prior Year AMT less AMT (Line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Fuel credit (Line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Allowable minimum tax credit (line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Minimum tax credit carryforward (line 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Line 57 of 2010 return (line 57) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2011 Form 8812 63 Additional child tax credit (line 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2011 Form 8859 64 DC rst-time homebuyer credit carryforward (line 4) . . . . . . . . . . . . . . . . . . . . 2011 Form 8885 65 Health insurance credit (yours) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Health insurance credit (spouse's) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Miscellaneous 2011 Taxes 67 Recapture of investment credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Recapture of low-income housing credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Recapture of qualied electric veh credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Recapture of Indian employment credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Recapture of new markets credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Section 72(m)(5) excess benets tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Tax on excess parachute payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Tax on accumulation distribution of trusts . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Tax on medical savings account distributions . . . . . . . . . . . . . . . . . . . . . . . . . 76 Recapture of employer-provided childcare facilities . . . . . . . . . . . . . . . . . . . . . 77 Tax on health savings account distributions . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Tax on Medicare Advantage MSA distributions . . . . . . . . . . . . . . . . . . . . . . . . . 79 Recapture of alternative motor vehicle credit . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Recapture of alternative fuel vehicle refueling property credit . . . . . . . . . . . . . 81 Recapture of health coverage tax credit advance payment . . . . . . . . . . . . . . . . 82 Tax for failure to maintain HDHP coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Recap of charitable deduction for fractional tang pers prop int . . . . . . . . . . . . 84 Income taxes deducted 85 Sales tax calculated 86 State or local income tax deducted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Sales tax you could have deducted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Sales tax on major purchases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Electronic Filing Information 89 Personal Identication Number (PIN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General sales taxes deducted 5,000
Spouse's Personal Identication Number (PIN) . . . . . . . . . . . . . . . . . . . . . . . . .
Amounts Needed for Form 2210 90 Refundable Part of the American Opportunity Credit (F8863, L14) . . . . . . . . . . 91 Adoption Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Refundable Credit for Prior Year Minimum Tax (F8801, L27) . . . . . . . . . . . . . . 93 Credit Determined Under Section 1341(a)(5)(B) . . . . . . . . . . . . . . . . . . . . . . . .
FORM 1099-INT/OID Interest paid by:
Is this interest for: You
INTEREST INCOME WORKSHEET

Your spouse City of Dallas Both of you
2012
FORM 1099-OID Box 1 - Original issue discount for 2012: Box 2 - Other periodic interest: Box 3 - Early withdrawal penalty: Box 4 - Federal income tax withheld: Box 6 - Original issue discount on U.S. Treasury obligations: Box 7 - Investment expenses: Box 8 - State: Box 9 - State identication number: Box 10 State tax withheld: SELLER-FINANCED MORTGAGE INTEREST
Buyer's name . . . . . . . . . . . . . . . . . . . . . . Buyer's Social Security number . . . . . . . . . Buyer's address . . . . . . . . . . . . . . . . . . . . Interest received in 2012 . . . . . . . . . . . . .
FORM 1099-INT Box 1 - Interest income: $ 3,000 Box 2 - Early withdrawal penalty: $ Box 3 - Interest on U.S. Savings Bonds and Treasury obligations: $ Box 3 includes Series EE or I Savings Bond interest . . . . . . . . . . . . . . . . . Box 4 - Federal income tax withheld: $ Box 5 - Investment expenses: $ Box 6 - Foreign tax paid: $ Box 7 - Foreign country or U.S. possession: Box 8 - Tax-exempt interest: $ Box 9 - Specied private activity bond interest: $ Box 10 Tax-exempt bond CUSIP no.: Box 11 State: Box 12 State identication number: Box 13 State tax withheld: $ $ $ $ $ $ $ $
ADJUSTMENTS
Amount of adjustment:
Nominee interest OID adjustment Accrued interest adjustment required Amortizable bond premium U.S. Savings Bond adjustment (not the same as Form 8815 adj.) Other adjustment (frozen deposit, etc.)
FORM 1099-INT/OID Interest paid by:
Is this interest for: You
INTEREST INCOME WORKSHEET

Your spouse Both of you Ford Motor Company
2012
FORM 1099-OID Box 1 - Original issue discount for 2012: Box 2 - Other periodic interest: Box 3 - Early withdrawal penalty: Box 4 - Federal income tax withheld: Box 6 - Original issue discount on U.S. Treasury obligations: Box 7 - Investment expenses: Box 8 - State: Box 9 - State identication number: Box 10 State tax withheld: SELLER-FINANCED MORTGAGE INTEREST
Buyer's name . . . . . . . . . . . . . . . . . . . . . . Buyer's Social Security number . . . . . . . . . Buyer's address . . . . . . . . . . . . . . . . . . . . Interest received in 2012 . . . . . . . . . . . . .
FORM 1099-INT Box 1 - Interest income: $ 15,000 Box 2 - Early withdrawal penalty: $ Box 3 - Interest on U.S. Savings Bonds and Treasury obligations: $ Box 3 includes Series EE or I Savings Bond interest . . . . . . . . . . . . . . . . . Box 4 - Federal income tax withheld: $ Box 5 - Investment expenses: $ Box 6 - Foreign tax paid: $ Box 7 - Foreign country or U.S. possession: Box 8 - Tax-exempt interest: $ Box 9 - Specied private activity bond interest: $ Box 10 Tax-exempt bond CUSIP no.: Box 11 State: Box 12 State identication number: Box 13 State tax withheld: $ $ $ $ $ $ $ $
ADJUSTMENTS
Amount of adjustment:
Nominee interest OID adjustment Accrued interest adjustment required Amortizable bond premium U.S. Savings Bond adjustment (not the same as Form 8815 adj.) Other adjustment (frozen deposit, etc.)
FORM 1099-DIV
Is this 1099-DIV for: You
DIVIDEND INCOME WORKSHEET

Your spouse Both of you $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
2012
Dividends paid by: K&R Box 1a Total ordinary dividends: Box 1b - Qualied dividends: Box 2a Total capital gain distributions: Box 2b - Unrecaptured section 1250 gain: Box 2c Section 1202 gain: Box 2d - Collectibles (28%) gain: Box 3 Nondividend distributions: Box 4 Federal income tax withheld: Box 5 Investment expenses: Box 6 Foreign tax paid: Box 7 Foreign country or U.S. possession: Box 8 Cash liquidation distribution: Box 9 Noncash liquidation distribution: Box 10 Exempt-interest dividends: Box 11 Spec'd private activity bond interest dividends: Box 12 State: Box 13 State identication number: Box 14 State tax withheld: ADJUSTMENTS
Nominee dividend Amount of adjustment:
10,000
Restricted stock dividend
FORM 1099-G
CERTAIN GOVERNMENT PAYMENTS
Jeff Bell Is this 1099-G for . . . . . . Yourself Your spouse Both of you Check the box if this 1099-G is marked corrected . . . . . . . . . . . . . . . Check what kind of payment is shown on this 1099-G. State tax refund Unemployment compensation Other government payment
2012 OMB No. 1545-0120 SSN: 111-11-1111
PAYER's name, street, city, state, ZIP, and telephone.

Paid by: Government Payer's Address: Street: City: State: Telephone: Payer ID #
ZIP:
RECIPIENT's name, street, city, state, ZIP, and account number.

Recipient's Name (rst, middle initial, last, su"x): Jeff Bell Recipient's Address: Street: 4326 Orange Blossom Trail City: State: Account #: Do Do Dallas ZIP: TX 75080
NOT carry name from Bkgd Wkst NOT carry address from Bkgd Wkst
Box 1 Box 2 Box 3 Box 4 Box 5 Box 6 Box 7 Box 8 Box 9 Box 10a Box 10b Box 11
Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Amount in Box 1 repaid in 2012 . . . . . . . . . . . . . . . . . . . . . State or local income tax refunds, credits or o!sets . . . . . . . . . . . . . . . 2 19,000 Note: Please use the Last Year's Data Worksheet if there is an amount in box 2. 3 2011 Box 2 amount is for tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Federal income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 ATAA/RTAA payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Taxable grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Agriculture payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Check if box 2 is trade or business income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Market gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10a TX State identication number . . . . . . . . . . . . . . . . . . . . . .10b State income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
SSN: 111-11-1111 Jeff Bell Is this Worksheet for . . . . . . . . . Yourself Your spouse Both of you No Was this mortgage secured by your main or second home? . . . . . . . . . . Yes Description of Property . . . . . . . . . . . . . . . . . . Name of lender/bank/co-op . . . . . . . . . . . . . . . .Jack No Did you receive a Form 1098 for this mortgage? . . . . . . . . . . . . . . . . . . .Yes No Did you pay this interest to a nancial institution? . . . . . . . . . . . . . . . . . Yes A. 1. 2. MORTGAGE FOR WHICH YOU RECEIVED A FORM 1098
Mortgage interest received, from Form 1098, box 1 . . . . . . . . . . . . . . . . . . . Points paid on purchase of principal residence, from Form 1098, box 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a. Refund of overpaid interest, from Form 1098, box 3 . . . . . . . . . . . . . . . . . . . b. Portion of line 3a that is taxable in 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Real estate tax paid in 2012, from Form 1098, box 4 . . . . . . . . . . . . . . . . . . 5. Deductible mortgage insurance premiums that were paid in connection with a loan to buy, build, or substantially improve your main or second home . . . . . . . . . . . . . . . . . . . 6. Other amounts related to this mortgage a. Additional deductible interest paid to this nancial institution and not shown on Form 1098. Attach statement . . . . . . . . . . b. Additional deductible points paid to buy/improve main home and not shown on Form 1098 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Other points which must be spread out over the life of the mortgage (e.g., points for a 2nd home, points for a renancing -- see IRS Pub. 936 for details). Enter the total amount of such points that you paid in 2012 or before. We will calculate the portion that is deductible in 2012. See Help panel if mortgage ended in 2012 . . . . . . . . . . . . . . . d. Additional deductible qualied mortgage insurance premiums paid during 2012 under a mortgage insurance contract issued after December 31, 2006, in connection with a loan to buy, build, or substantially improve main or second home and not reported above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOME MORTGAGE INTEREST WORKSHEET
2012
B. 1.
MORTGAGE FOR WHICH YOU DID NOT RECEIVE A FORM 1098
2. 3.
4. 5.
Deductible mortgage interest not reported on Form 1098 . . . . . . . . . . . . . . . Did you buy your home from the recipient of the interest? Yes If "Yes," provide the following information about the recipient: Deductible points paid on loan used to buy, build, or improve main home and not reported on Form 1098 . . . . . . . . . . . . . . . . . . . . . . . . . Other points which must be spread out over the life of the mortgage (e.g., points for a 2nd home, points for a renancing -- see IRS Pub. 936 for details). Enter the total amount of such points that you paid in 2012 or before. We will calculate the portion that is deductible in 2012. See Help panel if mortgage ended in 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . Taxable portion of any refund of overpaid interest . . . . . . . . . . . . . . . . . . . . Deductible qualied mortgage insurance premiums paid during 2012 under a mortgage insurance contract issued after December 31, 2006 in connection with a loan to buy, build, or substantially improve main or second home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4,000 No
C. 1.
ADDITIONAL INFORMATION FOR AMORTIZABLE POINTS

Length of mortgage in years. Enter zero if mortgage paid o! in 2012 . . . . . . . . . . . .
connection with a loan to buy, build, or substantially improve main or second home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. 1. 2.
ADDITIONAL INFORMATION FOR AMORTIZABLE POINTS

Length of mortgage in years. Enter zero if mortgage paid o! in 2012 . . . . . . . . . . . . Date loan was made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
MORTGAGE INTEREST WORKSHEET, p. 2
2012
Jeff
Bell
SSN: Copy #
1
111-11-1111
D.
ALLOCATIONS Destination
Form 8829 Rental Wkst Schedule F
Description
Part-time Consulting
Pct of Property (by area) Used In Activity

30.00 % % % % % %
Rental Wkst Schedule F
MORTGAGE INTEREST WORKSHEET, p. 3

Jeff Bell
% % % % %
2012
SSN: 111-11-1111 EXPLANATORY STATEMENT
CHARITABLE
Jeff PART I Bell
CHARITABLE DONATIONS WORKSHEET CASH OR MONEY DONATIONS (SCHEDULE A, LINE 16) Name of Charity Type Amount
500 1,000
2012 SSN: 111-11-1111
1a.
Salvation Army(Tampa branch) Texas Governors Election Campaign Fun
1b. Sum of entries from table above . . . . . . . . . . . . . . . . . . . . . . . . . . . . (a) (b) Subject to Subject to 50% Limit 30% Limit 2. From K-1 . . . . . . . . . . . . . . . . . . . . . . . . . 0 3. Mileage for charitable purposes a. From DeductionPro . . . . . . . . . . . . . . b. Other than from DeductionPro . . . . . c. Total miles . . . . . . . . . . . . . . . . . . . . 0 4. Line 3c * 14 cents per mile . . . . . . . . . . . . 0 5. Parking fees, tolls, and other
out-of-pocket expenses for charitable purposes a. From DeductionPro . . . . . . . . . . . . . . b. Other than from DeductionPro . . . . . c. Total out-of-pocket expenses . . . . .
1b
1,500
(c) Total
0 0
0 0
6.
0 Total cash or money donations. Sum of 1b, 2(c), 4(c), 5(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0 1,500
c. 6.
Other than from DeductionPro . . . . . Total out-of-pocket expenses . . . . .
0 1,500
Total cash or money donations. Sum of 1b, 2(c), 4(c), 5(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PART II
6
0 0 0 0
NONCASH OR ITEM DONATIONS (SCHEDULE A, LINE 17)
1a. Noncash or item donations: 50% limit . . . . . . . . . . . . . . . 1b. Noncash or item donations: 30% limit . . . . . . . . . . . . . . . 1c. Noncash or item donations: 30% limit, 1d. Noncash or item donations: 20% limit,
capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Total noncash or item donations. Sum of lines 1a - 1d . . . . . . . . . . . . . . . . . . . . . .
1d. Noncash or item donations: 20% limit,
capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0 0 0
2. Total noncash or item donations. Sum of lines 1a - 1d . . . . . . . . . . . . . . . . . . . . . . CARRYOVERS FROM PRIOR YEARS TO CURRENT YEAR (SCHEDULE A, LINE 18) PART III Carryover of charitable Regular Capital Gain donations from: 50% 30% 30% 20% a. 2011 . . . . . . . . . . . . . . . . b. 2010 . . . . . . . . . . . . . . . . c. 2009 . . . . . . . . . . . . . . . . d. 2008 . . . . . . . . . . . . . . . . e. 2007 . . . . . . . . . . . . . . . . f. Totals . . . . . . . . . . . . . . . . 0 0 0
c. d. e. f. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43.
2009 . . . . . . . . . . . . . . . . 2008 . . . . . . . . . . . . . . . . 2007 . . . . . . . . . . . . . . . . Totals . . . . . . . . . . . . . . . . PART IV
0 1,500 0 0 0 0 0 0 0
LIMITS (SCHEDULE A, LINE 19)
44. Summary of Deductions and Carryovers 45. Total deduction this year . . . . . . . . . . . . . 46. Total carryover to next year . . . . . . . . . . .
Current-year donations subject to 50% limit . . . . . . . . . . . . . . . . . . . . . . . Carryover donations subject to 50% limit . . . . . . . . . . . . . . . . . . . . . . . . . . Current-year donations subject to 30% limit . . . . . . . . . . . . . . . . . . . . . . . Carryover donations subject to 30% limit . . . . . . . . . . . . . . . . . . . . . . . . . . Current-year capital gain donations subject to 30% limit . . . . . . . . . . . . . . . Carryover capital gain donations subject to 30% limit . . . . . . . . . . . . . . . . . . Current-year capital gain donations subject to 20% limit . . . . . . . . . . . . . . . Carryover capital gain donations subject to 20% limit . . . . . . . . . . . . . . . . . . Adjusted gross income . . . . . . . . . . . . . . 363,411 Your 50% limit. Line 9 * 0.5 . . . . . . . . . . 181,706 Smaller of line 1 or line 10 . . . . . . . . . . . . 1,500 Line 1 minus line 11 . . . . . . . . . . . . . . . . Line 10 minus line 11 . . . . . . . . . . . . . . . 180,206 Smaller of line 2 or line 13 . . . . . . . . . . . . 0 Line 2 minus line 14 . . . . . . . . . . . . . . . . Line 13 minus line 14 . . . . . . . . . . . . . . . 180,206 Sum of lines 1, 2, 5, and 6 . . . . . . . . . . . 1,500 Your 30% limit. Line 9 * 0.3 . . . . . . . . . . 109,023 Line 10 minus line 17 . . . . . . . . . . . . . . . 180,206 Smallest of lines 3, 18, or 19 . . . . . . . . . . 0 Line 3 minus line 20 . . . . . . . . . . . . . . . . Line 19 minus line 20 . . . . . . . . . . . . . . . 180,206 Line 18 minus line 20 . . . . . . . . . . . . . . . 109,023 Smallest of lines 4, 22, or 23 . . . . . . . . . . 0 Line 4 minus line 24 . . . . . . . . . . . . . . . . Line 16 - sum of lines 20 and 24 . . . . . . 180,206 Smallest of lines 5, 18, or 26 . . . . . . . . . . 0 Line 5 minus line 27 . . . . . . . . . . . . . . . . Line 26 minus line 27 . . . . . . . . . . . . . . . 180,206 Line 18 minus line 27 . . . . . . . . . . . . . . . 109,023 Smallest of lines 6, 29, or 30 . . . . . . . . . . 0 Line 6 minus line 31 . . . . . . . . . . . . . . . . Line 29 minus line 31 . . . . . . . . . . . . . . . 180,206 Line 30 minus line 31 . . . . . . . . . . . . . . . 109,023 Line 23 minus line 24 . . . . . . . . . . . . . . . 109,023 Your 20% limit. Line 9 * 0.2 . . . . . . . . . . 72,682 Smallest of lines 7, 33, 34, 35, or 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Line 7 minus 37 . . . . . . . . . . . . . . . . . . . Line 33 minus line 37 . . . . . . . . . . . . . . . 180,206 Line 34 minus line 37 . . . . . . . . . . . . . . . 109,023 Line 35 minus line 37 . . . . . . . . . . . . . . . 109,023 Line 36 minus line 37 . . . . . . . . . . . . . . . 72,682 Smallest of lines 8, 39, 40, 41, or 42 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Line 8 minus line 43 . . . . . . . . . . . . . . . . 1,500
0 0
0 0
0 0
44. Line 8 minus line 43 . . . . . . . . . . . . . . . . Summary of Deductions and Carryovers 45. Total deduction this year . . . . . . . . . . . . . 46. Total carryover to next year . . . . . . . . . . . CARRYOVERS TO FUTURE YEARS PART V Carryover of charitable Regular donations from: 50% a. 2012 . . . . . . . . . . . . . . . . 0 b. 2011 . . . . . . . . . . . . . . . . c. 2010 . . . . . . . . . . . . . . . . d. 2009 . . . . . . . . . . . . . . . . e. 2008 . . . . . . . . . . . . . . . . f. Totals . . . . . . . . . . . . . . . . 0
PART VI
0 1,500 0
30%
0
Capital Gain 30%

0
20%
0
SUMMARY OF AMOUNTS FOR SCHEDULE A

1,500 0 0 1,500 0
1. 2. 3. 4. 5.
1 2 3 4 Carryovers to future years (next year's Sch A, line 18) . . . . . . . . . . . . 5

Cash or money donations (to Schedule A, line 16) . . . . . . . . . . . . . . . Noncash or item donations (to Schedule A, line 17) . . . . . . . . . . . . . Carryovers from prior years (to Schedule A, line 18) . . . . . . . . . . . . . Deductible donations (to Schedule A, line 19) . . . . . . . . . . . . . . . . . .
DEPRECIATION SUMMARY
Jeff Bell
DEPRECIATION SUMMARY Wks/Form Copy # Date in Service ("Copy#")

COPY # 01/01/2005
Activity name or Asset Description (Name of Form) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50.
* SCHEDULE E * Rental home Subtotal.....
Original Basis (1,2,3...)

1 200,000
2012 SSN: 111-11-1111 Depreciation Allowed
7,273 7,273
DEPRECIATION
Jeff Bell
(For Vehicles, use the "Vehicle Worksheet")
DEPRECIATION WORKSHEET - NO VEHICLES SSN:
2012
111-11-1111
1. DESCRIPTION OF ASSET
Briey describe this asset (no cars or trucks): Rental home
2. DESTINATION FORM a. Form to which we should carry information about this asset: . . . . . . . . . . . . . . . . . 2 b. Which copy of that tax form (1=1st copy; 2=2nd copy, etc) . . . . . . . . . . . . . . . . . 1 c. Activity name on that tax form . . . . . . . . . . . 7421 Frankford Rd Dallas TX 3. DATE PLACED IN SERVICE, ETC. a. Date placed in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01/01/05 b. Check here if you sold, gave away, or abandoned the asset in 2012 . . . . . . . . . . . . c. If line b. is checked, enter month in which the sale, etc. d. Check here if you acquired this asset in a like-kind
took place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . exchange or involuntary conversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d-1 Check here if you are making an election under Regulations section 1.168(i)-6(i) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Residential rental real estate
4. TYPE OF ASSET a. Enter the type of asset: i.
5.
BUSINESS AND INVESTMENT PERCENTS a. Business use percent in 2012 (0-100) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 b. Investment use percent in 2012 (0-100) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. ALTERNATIVE DEPRECIATION SYSTEM (ADS) a. Check here if you're required to use ADS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Check here if you're using ADS, even though you're not required to . . . . . . . . . . . . 7. BONUS DEPRECIATION a. Check here if this is property eligible for 50% bonus depreciation b. c. d. e. f.
under Section 168(k) of the Internal Revenue Code . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is property eligible for 100% bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is specied GO Zone extension property . . . . . . . . . . . . . . . . . . Check here if this is qualied disaster assistance property . . . . . . . . . . . . . . . . . . Check here if this is qualied cellulosic biofuel plant property or qualied reuse and recycling property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if you checked box a., b., c., d., or e. above and you are electing out of bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
if placed in service before 1999, "X" here to continue treating as 7-year property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii. Computer software: "X" here if this software was included in the cost of the underlying hardware . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note: If this software is a Section 197 intangible, you will need to amortize its cost. See the IRS instructions to Form 4562 for details and override as necessary. b. Low income housing that was rst placed in service 1981-86? . . . . . . . . . . . . . . . . N c. Depreciation Code (1-26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 d. Is this "listed property" (if "Y," depreciation may be slower) . . . . . . . . . . . . . . . . . . N i. If "Y", do you have evidence to support your business/investment use? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii. Is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii. If you used this property as an employee, was your use for the convenience of the employer and required as a Yes No condition of employment? . . . . . . . . . . . . . . . . . . . . . . . . .
Residential rental appliances, carpets, and furniture:
DEPRECN WKS DEPRECIATION WORKSHEET ASSET: Rental home 8. BASIS, SECTION 179 EXPENSE DEDUCTION, AND BONUS DEPRECIATION a. i. Total original basis (cost) when property was acquired . . . . . . . . . . ii. Portion of original basis for land . . . . . . . . . . . . . . . . . . . . . . . . . . .
2012 page 2
200,000
ASSET: Rental home 8. BASIS, SECTION 179 EXPENSE DEDUCTION, AND BONUS DEPRECIATION a. i. Total original basis (cost) when property was acquired . . . . . . . . . . ii. Portion of original basis for land . . . . . . . . . . . . . . . . . . . . . . . . . . . iii. Original basis not for land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Section 179 amount: i. For assets placed in service before 2012: Enter the Sec 179
amount (if any) for year the asset was placed in service . . . . . . . . . . For assets placed in service in 2012: (a) Maximum section 179 amount before taking business percentage into account (enter manually if qualied empowerment zone property or qualied section 179 disaster assistance property) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) Maximum allowable section 179 amount, after taking business percentage into account . . . . . . . . (c) Section 179 claimed this year . . . . . . . . . . . . . . . . Deduction for removal of barriers to disabled and elderly; disabled access credit; enhanced oil recovery credit; basis adjustment to investment credit property under sec. 50(c) . . . . . . . . . . . . Basis after Sec. 179: Original Cost * (Bus % + Investment %), minus section 179 and disabled access, etc . . . . . . . . . . . . . . . . . . . . . . . Bonus depreciation for 2012: 100%/50%/30% of line d . . . . . . . . . . . . . . . Prior year bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depreciable basis: Original Cost * (Bus % + Investment %), minus Sec. 179, disabled access, etc., bonus depreciation . . . . . . . . . . . . Note: See the IRS instructions to Form 4562 and IRS Publication 946 for information about when you may need to "recapture" your Section 179 deduction or bonus depreciation.
page 2
200,000 200,000
ii.
c. d. e. f. g.
200,000 0 200,000
9. MISCELLANEOUS QUESTIONS a. Check here to elect under section 168(i)(4) to group assets into one or b. Number of years over which this asset is being depreciated. (We c. If this asset is eligible, do you elect the (slower) 150% declining d. If this asset is eligible, do you elect the (slower) straight line
more general asset accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . calculate this entry if you're using regular ACRS or MACRS.) . . . . . . . . . . . . . . . 27.50 balance method (applies for MACRS; usually leave blank) . . . . . . . . . . . . . . . . . . . . method (applies for MACRS; usually leave blank) . . . . . . . . . . . . . . . . . . . . . . . . . . . for assets placed in service in 2012) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N Is this asset post-'88 property that is used in farming? . . . . . . . . . . . . . . . . . . . . . . N
e. Does the "mid-quarter" convention apply? (We calculate this 10. f.
DEPRECIATION CALCULATION a. Method (200DB=200% declining balance; SL=Straight line) . . . . . . . . . . . . . . SL b. Convention (HY=Half year; MQ=Mid-quarter; MM=Mid-month;
11.
c. The bottom line: Amount of depreciation allowed . . . . . . . . . . . . . . . . . 7,273 CALCULATION OF ALTERNATIVE MINIMUM TAX ADJUSTMENTS a. Is this real estate (Y/N)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. If not real estate, is this leased property (Y/N)? . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Number of years (term) for AMT depreciation . . . . . . . . . . . . . . . . . . . . . . . d. If placed in service after 1986, is this excluded from AMT
(e.g. unit-of-production, lm or videotape, sound recording) (Y/N; usually "N") . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e. Category of Alt Min Tax (if any) that applies: Pre-87 leased prop, other than real estate (6251 line 27b). Pre-87 real estate (6251 line 27a). 1987 and later prop (whether or not real estate, 6251 line 18). None--no Alt Min Tax exposure for this property. f. AMT Method (150DB=150% declining balance; SL=Straight line) . . . . . . . . . . . None g. AMT Convention (HY=Half year; MQ=Mid-quarter; MM=Mid-month; FM=Full-month) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/A h. Alt Min Tax Depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FM=Full-month) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MM
f. AMT Method (150DB=150% declining balance; SL=Straight line) . . . . . . . . . . . None g. AMT Convention (HY=Half year; MQ=Mid-quarter; MM=Mid-month;
h. Alt Min Tax Depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i. Alt Min Tax Adjustment (Reg Dep'n - Alt Min Tax Dep'n) . . . . . . . . . . . . 0 DEPRECN WKS DEPRECIATION WORKSHEET 2012 ASSET: Rental home page 3 12. SUMMARY a. Regular depreciation allowed this year (from above) . . . . . . . . . . . . . . . 7,273 b. Bonus depreciation allowed this year (from above) . . . . . . . . . . . . . . . . 0 c. Section 179 deduction allowed this year (from above) . . . . . . . . . . . . . 0 d. Depreciation chart for this asset (up to 20 years). Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Dep'n 6,970 7,273 7,273 7,273 7,273 7,273 7,273 7,273 7,273 7,273 Basis 193030 185757 178484 171211 163938 156665 149392 142119 134846 127573 Year 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Dep'n 7,273 7,273 7,273 7,273 7,273 7,273 7,273 7,273 7,273 7,273 Basis 120300 113027 105754 98,481 91,208 83,935 76,662 69,389 62,116 54,843 13. STATE DEPRECIATION a. If bonus depreciation is being claimed on your federal return, b. c. d.
the amount of 2012 bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . If bonus depreciation was claimed in a prior year under federal law, the amount of prior year bonus depreciation . . . . . . . . . . . The amount of federal depreciation to which you would have been entitled in 2012 for this asset without the federal laws allowing bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The di!erence between the amount of depreciation actually being taken for this asset on your federal return and the amount of depreciation to which you would have been entitled without the federal laws allowing bonus depreciation . . . . . . . . . . . . . .
FM=Full-month) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/A
Jeff
PART 1. a. Briey describe this vehicle (e.g., "Car, Taurus") . . . . . . . . . . . .Acura b. Form to which we should carry information about c. Which copy of that tax form
this vehicle . . . . . . . . . . . . . . . . . . . . . . . . . . (1=1st copy; 2=2nd copy, etc.) . . . . . . . . . . 1 1
CAR & TRUCK WORKSHEET - DEPRECIATION or STANDARD MILEAGE FOR VEHICLES YOU STARTED USING AFTER 1980 SSN: Bell DESCRIPTION OF VEHICLE AND DESTINATION FORM - ALL VEHICLES
2012
111-11-1111
d. Activity name on that tax form . . . . . . . . . . . e. "X" if this is a vehicle you leased . . . . . . . . . . . . . . . . . . . . . . . . . . . . e-1. If you leased this vehicle, "X" if you used f. "X" if rural mail carrier using your own vehicle . . . . . . . . . . . . . . . . . g. Check here if you acquired this vehicle in a like-kind
standard mileage in a previous tax year . . . . . . . . . . . . .
PART 2. FIGURING "BUSINESS PERCENT" - ALL VEHICLES Preliminary Questions a. Date vehicle was placed in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06/07/11 a-1 Check here if you converted this vehicle from
100% personal use to business/investment use in 2012 and you don't have mileage records for the personal use . . . . . . . . . . . . . . . . . . . . . . . . . b. Check here if you sold, gave away, or abandoned the vehicle in 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If line b. is checked, enter month in which the sale, etc. took place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b-1 Check here if you converted this vehicle from business/investment use to 100% personal use in 2012 and you don't have mileage records for the personal use . . . . . . . . . . . . . . . . . . . . . . . . .
exchange or involuntary conversion . . . . . . . . . . . . . . . . . . . . . . . . . g-1 Check here if you are making an election under Regulations section 1.168(i)-6(i) . . . . . . . . . . . . . . . . . . Note: Here is how to take the standard mileage deduction for more than one vehicle per business on Form 2106 or Form 2106-EZ. If you used two vehicles consecutively (one after the other) or alternately (at different times), you should treat them as one vehicle on the Vehicle Worksheet, and combine the miles traveled. You may ignore this note if you're using actual expenses.
Ownership/Lease Questions c. # months you owned/leased the vehicle this year (from above) . . . . . . . . . . . . 12 Note: We calculate line "c" based on the date placed d. # months you used vehicle at least partly for business . . . . . . . . . . . . . . . . . . . 12 e. # months of exclusively personal use (c-d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Mileage Questions
For the # months in use this year, that is, for the time described on line "d" above, please enter: f. # Business/investment miles: . . . . . . . . . . . . . . . . . . . . . . . . . g. # Commuting miles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . h. # Other personal miles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i. Total miles (f+g+h) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . j. Average daily round-trip commuting mileage . . . . . . . . . . . . . k. Business/investment% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l. If investment% > 0, check here if you also used 4,940 9,060 14,000 35.29 in service and month sold, abandoned, etc.
i. j. k. l.
PART 3. VEHICLE EXPENSES OTHER THAN DEPRECIATION - ALL VEHICLES Note: Enter the full amount for the entire year in column "a" unless
Total miles (f+g+h) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,000 Average daily round-trip commuting mileage . . . . . . . . . . . . . Business/investment% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.29 If investment% > 0, check here if you also used this vehicle more than 50% for business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expense Chart
otherwise noted. We'll figure the business portion automatically. If you use the standard mileage method, you may not deduct any of these expenses on the Vehicle Worksheet, except parking and tolls and, if you're self-employed, personal property taxes and interest.
a. Total Amt
b. Bus. %
c. Deductible Amt
(a*b)
a. Auto insurance . . . . . . . . . . . . . . b. Garage rent . . . . . . . . . . . . . . . . . c. Interest (only deductible if d. e. f. g. h. i. j.
300
35.29
105 705 176
Sched C, C-EZ or F vehicle) . . . . . 2,000 35.29 Gasoline . . . . . . . . . . . . . . . . . . . Registration, license . . . . . . . . . . Personal property taxes . . . . . . . . 500 35.29 Repairs . . . . . . . . . . . . . . . . . . . . Tires . . . . . . . . . . . . . . . . . . . . . . Oil . . . . . . . . . . . . . . . . . . . . . . . . Other expenses, e.g., temporary rentals . . . . . . . . . . . . k. Total expenses from column a . . . . 2,800 Note: The amount from line k is carried to line 23 of Form 2106 if you indicated that you're using that form. l. Deductible amount (total of column c) . . . . . . . . . . . . . . . . . . . . . . m. Plus: Tolls, hourly parking on business trips (local and out of town) . . . . . . . . . . . . . . . . . . . . . n. TOTAL deductible amount (line l + line m) . . . . . . . . . . . . . . . . . . .
988 988
Special Section for Certain Self-Employed Taxpayers Note: You may need to use this section if you're directing this Vehicle Worksheet to a Schedule C AND you rented or leased the vehicle.
Special Section for Certain Employees Note: You may need to use this section if you're directing this Vehicle Worksheet to a Form 2106 AND you rented or leased the vehicle,
received the vehicle from your employer, or were a rural mail carrier. Otherwise, you may skip this section.
Otherwise, you may skip this section. a. Business portion of vehicle rental or lease costs . . . . . . . . . . b. Inclusion amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note: For any vehicle first leased after 1986, there may be an inclusion amount if the value of the vehicle when new was over $12,800. For more information, see the IRS instructions for lines 20a and 20b of Schedule C and see IRS Publication 463. c. Line a - line b (to Schedule C) . . . . . . . . . . . . . . . . . . . . . . .
Employees Who Rented or Leased Vehicle a. Vehicle rental or lease costs . . . . . . . . . . . . . . . . . . . . . . . . b. Inclusion amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note: For any vehicle first leased after 1986, there may be an
Employees with Employer-Provided Vehicle a. Value of employer-provided vehicle (if on Rural Mail Carriers
inclusion amount if the value of the vehicle when new was over $12,800. For more information, see the IRS instructions for line 24b of Form 2106 and see IRS Publication 463.
W-2 at 100% annual lease value) . . . . . . . . . . . . . . . . . . . .
Employees with Employer-Provided Vehicle a. Value of employer-provided vehicle (if on
Rural Mail Carriers a. Equipment maintenance allowance . . . . . . . . . . . . . . . . . . . PART 4. DEPRECIATION AND STANDARD MILEAGE - OWNED VEHICLES ONLY a. Original cost (including sales tax & basis of trade-in) . . . . . . . . . . . . . Note: See the help panel to the right if this vehicle is or was b. If placed in service before this year, was the standard
eligible for the alternative motor vehicle credit. mileage method used in the year the vehicle was placed in service? (If checked, skip to "Standard Mileage" questions.) . . . . . . . . . . . . . . . .
W-2 at 100% annual lease value) . . . . . . . . . . . . . . . . . . . .
PART 5. QUESTIONS FOR DEPRECIATION - OWNED VEHICLES ONLY Listed property and "SUV's" a. Check here if this is a "passenger automobile" . . . . . . . . . . . . . . . . . . . . . . . . . . . a-1. Check here if this is a truck or van placed in service b.
c. d.
Bonus depreciation e. Check here if this is property eligible for 100% bonus f.
after 2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is any other property used as a means of transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b-1. If you used this vehicle as an employee and you checked box a., a-1, or b. above, was your use of the vehicle for your employer's convenience and Yes No required as a condition of your employment? . . . . . . . . Check here if this is NOT listed property (most people will leave this box blank) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is a "sport utility vehicle" under section 179(b)(6) of the Internal Revenue Code . . . . . . . . . . . . . . . . . . . . . . . . . . . depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is property eligible for 50% bonus depreciation under Section 168(k) of the Internal Revenue Code, as amended by the Economic Stimulus Act of 2008, the American Recovery and Reinvestment Act of 2009, or the American Taxpayer Relief Act of 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is property eligible for 50% bonus depreciation under Section 168(k) of the Internal Revenue Code, prior to amendment by the Economic Stimulus Act of 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is property eligible for 30% bonus depreciation under Section 168(k) of the Internal Revenue Code, prior to amendment by the Economic Stimulus Act of 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is qualied New York Liberty Zone property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if this is qualied Gulf Opportunity Zone property . . . . . . . . . . . . . . . . Check here if this is qualied disaster assistance property . . . . . . . . . . . . . . . . . . Check here if you checked box e., f., g., h., i., j., or k. above and you are electing out of bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For vehicles placed in service before 2012, section 179 and bonus depreciation amounts: 1) Section 179 amount (if any) from the year the vehicle was rst placed in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 2) Bonus depreciation amount (if any) from the year the vehicle was rst placed in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 placed in service before 2012, check here if the vehicle was eligible for 100% bonus depreciation and you are not electing the safe harbor method of accounting described in Revenue Procedure 2011-26 . . . . . . . . . . . . Note: If you check this box, you will not be allowed a depreciation deduction for this vehicle in 2012. For vehicles placed in service in 2012, section 179 and bonus depreciation amounts: 1) Maximum section 179 amount, before taking into account luxury limit and business percentage . . . . . . . . . . . . . . . . 2) Maximum allowable section 179 amount, after taking into account luxury limit and business percentage . . . . . . . . . . . . . . . . 3) Section 179 deduction claimed this year . . . . . . . . . . . . . . . . . . . . 4) Basis after Sec. 179: Original cost * business percentage, minus Sec. 179 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5) Bonus depreciation: 100%/50%/30% of line 4 (but not more than line 2 minus line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depreciable basis: Original cost * business percentage,
g. h. i. j. k. l. m.
Passenger Automobile Eligible For 100% Bonus Depreciation in Prior Year n. For a "passenger automobile" (including a qualifying truck or van)
o.
p.
5) Bonus depreciation: 100%/50%/30% of line 4 (but not more p.
percentage, minus Sec. 179 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alternative Depreciation System (ADS) q. Check here if you're required to use ADS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r. Check here if you're using ADS, even though not required to . . . . . . . . . . . . . . . s. If you checked box q. or r. and you used the vehicle before 1987, t. u. v. w. x. y. z. aa. bb.
than line 2 minus line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depreciable basis: Original cost * business percentage, minus Sec. 179 and bonus depreciation . . . . . . . . . . . . . . . . . . . . . . .
enter the number of years for depreciation (3, 5, or 12) . . . . . . . . . . . . . . . . . . If the property is eligible, do you elect the (slower) 150% declining balance method (usually leave blank) . . . . . . . . . . . . . . . . . . . . . If the property is eligible, do you elect the (slower) straight-line method (usually leave blank) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Does the mid-quarter convention apply to this vehicle (we calculate this if the vehicle was placed in service this year) . . . . . . . . . . . . . . . . . N Is this post-'88 property that is used in farming? . . . . . . . . . . . . . . . . . . . . . . . . N "Luxury car" limit on 2012 depreciation & Sec 179 . . . . . . . . . . . . . . . 4,900 "Luxury car" limit, reduced for non-business . . . . . . . . . . . . . . . . . . . 1,729 Method (200DB = 200% declining balance; 150DB = 150% declining balance; SL = Straight line) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200DB Convention (HY=Half year; MQ=Mid-quarter) . . . . . . . . . . . . . . . . . . . . . . . . . HY "Y" if depreciation is limited to the lesser of the actual depreciation or the "luxury car" limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Y
aa. bb.
cc. PART 6. QUESTIONS FOR STANDARD MILEAGE - OWNED OR LEASED VEHICLES a. Enter an "X" if you're eligible for standard mileage for this vehicle.
balance; SL = Straight line) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200DB Convention (HY=Half year; MQ=Mid-quarter) . . . . . . . . . . . . . . . . . . . . . . . . . HY "Y" if depreciation is limited to the lesser of the actual depreciation or the "luxury car" limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Y Amount of depreciation allowable . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
To be eligible for standard mileage: (1) you can't use 5+ vehicles in business or for investment at a time; (2) if you own the vehicle, you must have used standard mileage for the vehicle's rst year; and (3) if you lease the vehicle, you must have used standard mileage for the entire lease period (with the exception of the period, if any, before January 1, 1998) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Standard mileage method deduction: # cents per mile * (number of business/investment miles) . . . . . . . . . . . . . . . . . . . . . . . . . 2,742 c. Plus: (Garage rent * bus %) + Business Tolls (above) . . . . . . . . . . . . . . . . 988 Note: If you are self-employed (i.e., you're directing this Vehicle Worksheet to a Schedule C or Schedule F), then we also include on line 6c (and ultimately on line 6d) the deductible amount of your interest and taxes from the Expense Chart in Part 3. d. TOTAL Standard Mileage (Std mileage amt + parking + tolls) . . . . . . . . . 3,730
PART 7.
a. Enter # years estimated useful life of vehicle . . . . . . . . . . . . . . . . . . . . . . . . 5 b. Enter estimated salvage value at end of useful life . . . . . . . . . . . . . c. Straight line depreciation this year . . . . . . . . . . . . . . . . . . . . . . . . 0 d. TOTAL straight line depreciation + expenses this year . . . . . . . . . 988 e. TOTAL Standard Mileage (from above) . . . . . . . . . . . . . . . . . . . . . . 3,730 f. Larger of the two is . . . . . . . . . Straight line Standard mileage g. Your choice . . . . . . . . . . . . . . . Straight line Standard mileage PART 8. FOR VEHICLES PLACED IN SERVICE THIS YEAR AND ELIGIBLE FOR STANDARD MILEAGE: COMPARISON OF STANDARD MILEAGE TO ACTUAL EXPENSES, INCLUDING REGULAR DEPRECIATION FOR OWNED VEHICLES OWNED OR LEASED VEHICLES a. The totals allowable over the next . . . . . . 6 year(s), assuming the current
FOR VEHICLES PLACED IN SERVICE BEFORE THIS YEAR, WHERE STANDARD MILEAGE WAS USED PREVIOUSLY: COMPARISON OF STANDARD MILEAGE TO STRAIGHT LINE DEPRECIATION WITH EXPENSES - OWNED VEHICLES ONLY
mileage, business percents, expenses, etc. will not change, are: for Standard Mileage; with a residual basis. for Actual Expenses (MACRS); with a residual basis. Note: Ignore residual basis if this is a leased vehicle. A higher residual basis is better. It means less taxable gain if you sell the vehicle. Or, it increases the amount you may depreciate on a new vehicle if you trade this vehicle in. b. Recommendation: We recommend . . Actual expenses; Standard mileage. c. Your choice . . . . . . . . . . . . . . . . . . . . Actual expenses; Standard mileage. Note for Owners: If you choose actual expenses, you can't change your choice in future years. If you choose standard mileage, you can switch to actual expenses in future years but will no longer be entitled to use accelerated depreciation. Also, your circumstances may change, and our choice may turn out not to have been the best choice. Note for Lessees: Whatever method you choose, you can't change your choice in future years. Your circumstances may change, and our choice may turn out not to have been the best choice. Note re 100% Bonus Depreciation: Our choice does not take into account the special safe harbor calculations under IRS Revenue Procedure 2011-26. Revenue Procedure 2011-26 applies to certain vehicles for which 100% bonus depreciation was taken in 2010 or 2011. Consult your tax advisor
Note re 100% Bonus Depreciation: Our choice does not take into account
PART 9.
the special safe harbor calculations under IRS Revenue Procedure 2011-26. Revenue Procedure 2011-26 applies to certain vehicles for which 100% bonus depreciation was taken in 2010 or 2011. Consult your tax advisor if this situation affects you.
INFORMATION QUESTIONS FROM THE IRS - ALL VEHICLES
a. Do you (or your spouse) have another vehicle
b. Is personal use during o!-duty hours permitted? . . . . . . . . . . . . . . . . . c. Was the vehicle used primarily by a more than 5% d. Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . e. If yes, is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PART 10. CALCULATION OF ALTERNATIVE MINIMUM TAX ADJUSTMENTS - OWNED VEHICLES ONLY a. AMT Method (150DB=150% declining balance; SL=Straight line) . . . . . . . . . . . . .None b. AMT Convention (HY=Half year; MQ=Mid-quarter) . . . . . . . . . . . . . . . . . . . . . . . . .NA c. Alt Min Tax Depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Alt Min Tax Adjustment (Reg Dep'n - Alt Min Tax Dep'n) . . . . . . . . . . . . . . 0 Note: If you designated this Vehicle Worksheet to carry to Form 2106,
Form 2106-EZ, or Schedule A, then the AMT adjustment on line 10d above does not carry to Form 6251. owner (of the business) or related person? . . . . . . . . . . . . . . . . . . . . . .
available for personal purposes (Y/N)? . . . . . . . . . . . . . . . . . . . . . . . . .
PART 11. SUMMARY - ALL VEHICLES a. Depreciation allowable this year (from above) . . . . . . . . . . . . . . . . . . . . . . b. Standard mileage allowable this year (from above) . . . . . . . . . . . . . . . . . . . c. Other deductible expenses (from above) . . . . . . . . . . . . . . . . . . . . . . . . . . d. Alternative Minimum Tax adjustment this year (from above) . . . . . . . . . . . e. Alternative motor vehicle credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. Depreciation chart for this vehicle. Note: If some use is "personal,"
0 2,742 988 0
then residual basis will be less than the sum of depreciation amounts. This chart assumes a constant business use from year to year. The chart does not reect computations under the safe harbor method in Revenue Procedure 2011-26. Note: This chart is for illustration only and may not always be accurate for your situation. Year 2011 2012 2013 2014 2015 2016 2017 2018 2019 Dep'n 0 0 0 0 0 0 0 0 0 Basis 0 0 0 0 0 0 0 0 0 Year 2021 2022 2023 2024 2025 2026 2027 2028 2029 Dep'n 0 0 0 0 0 0 0 0 0
2020 0 0 2030 0
Dep'n 0 0 0 0 0 0 0 0 Basis 0 0 0 0 0 0 0 0 Year 2021 2022 2023 2024 2025 2026 2027 2028 Dep'n 0 0 0 0 0 0 0 0 Basis 0 0 0 0 0 0 0 0 12. STATE DEPRECIATION a. If bonus depreciation is being claimed on your federal return, b. c. d.
0 0 2029 0 0
0 0 2030 0 0
the amount of 2012 bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . If bonus depreciation was claimed in a prior year under federal law, the amount of prior year bonus depreciation . . . . . . . . . . . The amount of federal depreciation to which you would have been entitled in 2012 for this asset without the federal laws allowing bonus depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The di!erence between the amount of depreciation actually being taken for this asset on your federal return and the amount of depreciation to which you would have been entitled without the federal laws allowing bonus depreciation . . . . . . . . . . . . . .
RENTALS AND ROYALTIES
RENTALS AND ROYALTIES WORKSHEET
Jeff Bell Check whose activity this is: Taxpayer Spouse Both Did you make any payments in 2012 that would require you to le Form(s) 1099 (see instructions)? If "Yes," did you or will you le all required Forms 1099? Check which kind of activity this is: Rental Royalty Type of property: 4 If "Other", description:
SSN:
2012
111-11-1111
Yes Yes
No No
I. IDENTIFYING INFORMATION 1a. (Rentals only) Enter the following information about this property:
Street: 7421 Frankford Rd City/town: Dallas Percent ownership (if less than 100%): Check here if the property was a dwelling: Check here if the property was your main or second home: Check here if the property was located in a foreign country (see Help panel for details): Check here if you meet the requirements to le as a qualied joint venture (QJV). See IRS instructions for more information: b. (Royalties only) Enter the name of this activity: Name:
State: TX
ZIP:
75252 100.0 %
II. DAYS OF USE -- DWELLING 1a. Number of days rented at fair rental price (and not personal use) . . . . . . . . . . . . . . . . b. Number of days o!ered for rent (and not rented, not personal use) . . . . . . . . . . . . . . c. Number of days of personal use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i. Number of days included on line c. for which you used
property as main home if: (i) you rent or try to rent property at fair rental price for 12 or more consecutive months before or after using as main home; or (ii) you rent or try to rent property at fair rental price for less than 12 consecutive months after using as main home, and period ends because you sell or exchange property . . . . . . . . . . . . . . . . . . ii. Number of days included on line c. for which you used property for personal purposes while it was rented at fair rental price . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii. Number of days included on line c. for which you rented the property at less than fair rental price . . . . . . . . . . . . . . . . . . . . d. Total days owned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e. Check here if the rental unit is a "residence" AND it was rented for less than 15 days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. Check here if the rental unit is a "residence" AND it was rented for 15 days or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g. If box 1f is checked, select an allocation method for itemizable expenses: IRS Method Tax Court method h. Percentage for allocation of non-itemizable expenses related to dwelling: (1a + 1b)/1d, but if 1c > 0, then (1a + 1c.ii)/(1a + 1c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 % i. Percentage for allocation of itemizable expenses: Same as line 1h, but if Tax Court's allocation method chosen, then (1a + 1c.ii)/1d . . . . . . . . . . . 100.00 %
1a. b. c. d. 1. 2. 3. 4. 5. 6. 7.
III.
DAYS OF USE -- NON-DWELLING
Number of days rented . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365 Number of days o!ered for rent (and not rented, not personal use) . . . . . . . . . . . . . . 0 Total days owned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366 Percentage for allocation of expenses related to non-dwelling: (1a + 1b)/1d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 %
IV.
AT-RISK/PASSIVE ACTIVITY QUESTIONS
Check here if you are subject to the at-risk rules and some of your investment is NOT at risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Amount at risk at end of 2012 (or allowed loss from Form 6198): . . . . . . . . . Skip questions 3 - 7 if this is a royalty. Check here if you were a "real estate professional" and materially participated in this rental activity in 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Check here if you actively participated in this rental activity in 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Prior year passive loss carryforward amount (or zero) . . . . . . . . . . . . . . . . . . Check here if you totally disposed of this activity in 2012 . . . . . . . . . . . . . . . . . . . . . . . Gain or loss on disposition of activity or activity property: a. For purposes of regular tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. 6. 7.
Prior year passive loss carryforward amount (or zero) . . . . . . . . . . . . . . . . . . Check here if you totally disposed of this activity in 2012 . . . . . . . . . . . . . . . . . . . . . . . Gain or loss on disposition of activity or activity property: a. For purposes of regular tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. 6. 7.
RENTALS/ROYALTIES
Jeff
Prior year passive loss carryforward amount (or zero) . . . . . . . . . . . . . . . . . . Check here if you totally disposed of this activity in 2012 . . . . . . . . . . . . . . . . . . . . . . . Gain or loss on disposition of activity or activity property: a. For purposes of regular tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. For purposes of Alternative Minimum Tax . . . . . . . . . . . . . . . . . . . . . . .
WORKSHEET FOR RENTALS AND ROYALTIES Income/ Expense

24,000 0 24,000
Bell
V. 1.
INCOME
Ownership Portion
SSN: Rental Portion
2012
111-11-1111
Amount Allowed
Rents/royalties received a. From 1099-MISC, K-1 . . . . . . . . b. Other rent/royalty income . . . . . c. Total income . . . . . . . . . . . . . . .
24,000 0
24,000 0
24,000 0
1. 2.
VI.
EXPENSES
0 0 3,000 7,273 0 3,000 0 0 7,273 0 0 0 0 0 14,000 0 2,992 0 0 7,273 0 0 0 0 0 13,962 0 0 0 0 3,989 0 0 0 0 2,992 0 0 7,273 0 0 0 0 0 13,962 0 0 0 0 3,989 0 0 0
3. 4. 5. 6. 7. 8. 9. 10. 11. 12.
13. 14. 15. 16. 17. 18.
Advertising . . . . . . . . . . . . . . . . . . . Auto and travel . . . . . . . . . . . . . . . . a. Std mlg & vehicle exp . . . . . . . . b. Other auto and travel . . . . . . . . c. Total travel . . . . . . . . . . . . . . . . Cleaning and maintenance . . . . . . . Commissions . . . . . . . . . . . . . . . . . Depletion . . . . . . . . . . . . . . . . . . . . Depreciation . . . . . . . . . . . . . . . . . . FICA & employment taxes . . . . . . . . Insurance . . . . . . . . . . . . . . . . . . . . Legal and professional fees . . . . . . . Management fees . . . . . . . . . . . . . . Non-mortgage interest . . . . . . . . . . Mortgage interest and points . . . . . a. Mortgage interest paid to banks and shown on Fm 1098 . . b. Other mortgage interest . . . . . . c. Points paid to banks and shown on Form 1098 . . . . . . . . d. Other points . . . . . . . . . . . . . . . Property taxes . . . . . . . . . . . . . . . . . Other taxes . . . . . . . . . . . . . . . . . . . Repairs . . . . . . . . . . . . . . . . . . . . . . Supplies for rental activity . . . . . . . . Utilities . . . . . . . . . . . . . . . . . . . . . . Other expenses related just to rental activity . . . . . . . . . . . . . . .
14,000
4,000
0 4,000 0 0 0
Type
19.
Other expenses related to operating or maintaining prop . . . .
0 0
0 0
0 0
Type
Totals (bef passive activity calc) 20. Adj. for part-rental prop . . . . . . . . . 21. Net income or loss . . . . . . . . . . . . . -4,273 22. Amount not deducted for rental activity this year.
0 0 -4,273
0 0 -4,216
0 0 -4,216 0
Any remaining amounts on this line 22 may be deducted in future years (if the activity is conducted "for prot") . . . . . . . . . . . . . . . . . . . .
21. 22.
Net income or loss . . . . . . . . . . . . . -4,273 -4,273 -4,216 Amount not deducted for rental activity this year. Any remaining amounts on this line 22 may be deducted in future years (if the activity is conducted "for prot") . . . . . . . . . . . . . . . . . . . .
-4,216 0
RENTALS/ROYALTIES
Jeff Bell
WORKSHEET FOR RENTALS AND ROYALTIES (4) Prior year unallowed loss (or 0) (5) This year unallowed loss.
SSN:
2012
111-11-1111
VII. (1) Is this a passive activity?

N
PASSIVE ACTIVITY COMPUTATION (2) (3) Rental real Activity's estate w/ active net income participation? or loss
Y -4,216
(6) Allowed income or loss this year.

0 -4,216
VIII. (1) Is this a passive activity?

N
ALTERNATIVE MINIMUM TAX (AMT) WORKSHEET FOR RENTAL ACTIVITIES (2) (3) (4) (5) (6) Rental real Activity's Prior year This year Allowed income estate w/ active net income unallowed unallowed or loss this participation? or loss loss (or 0) loss. year.
Y -4,216 0 -4,216
SCHEDULE K-1 K-1 (PARTNERSHIP/S CORPORATION) WORKSHEET (Partnership/S Corporation)

Jeff Bell
2012 SSN:
111-11-1111
Information About the Partnership/Corporation 1. 2. 3. 4. 5. 1. 2. 3.

Partnership/corporation employer id no: Partnership/corporation name: Type of entity (check one) Partnership S corporation Check if foreign partnership: Check if publicly traded partnership: K&R
Information About the Partner/Shareholder
(Partners only) Type of partner: General partner or LLC member-manager Limited partner or other LLC member Check if entire investment at risk: Check if you are reporting (i) any loss not allowed in a prior year due to the at-risk or basis limitations, or (ii) unreimbursed partnership expenses:
Partner/Shareholder's Share of Current Year Income, Deductions, Credits, and Other Items
1.(1)
Ordinary business income (loss): X if non-passive X if passive Carryforward loss, box 1. Carryforward loss, box 1-AMT X if total disposition this year. Gain/loss on disposition. Gain/loss on disposition-AMT.
10,000
2.(2)
Net rental real estate income (loss): X if passive (other than real estate in which you actively participated) X if real estate in which you actively participated X if non-passive (real estate professional) Special type (uncommon): Rental of land Carryforward loss, box 2. Carryforward loss, box 2-AMT X if total disposition this year. Gain/loss on disposition. Gain/loss on disposition-AMT. Other net rental income (loss): Carryforward loss, box 3. Carryforward loss, box 3-AMT X if total disposition this year. Gain/loss on disposition. Gain/loss on disposition-AMT. (P'ship only) Guaranteed payments: Activity type: Interest income: 6,000 If you'll be using a state edition of our program, enter here the portion of box 5(4) that is from U.S. Treasury obligations: Ordinary dividends: If you'll be using a state edition of our program, enter here the portion of box 6a(5a) that is from U.S. Treasury obligations: Qualied dividends: Royalties: Copy number of Rentals & Royalties Wksht: Be careful not to use a copy on which you've entered data for another rental or royalty activity. Net short-term capital gain (loss): Net long-term capital gain (loss): Collectibles (28%) gain (loss): Unrecaptured section 1250 gain: i. From sale or exchange of
Self-rental
3.(3)
4. 5.(4)
6a.(5a)
6b.(5b) 7.(6)
8.(7) 9a.(8a) 9b.(8b) 9c.(8c)
9a. 9b.(8b) 9c.(8c)
Net long-term capital gain (loss): Collectibles (28%) gain (loss): Unrecaptured section 1250 gain: i. From sale or exchange of partnership's or S corp's business assets ii. From the sale or exchange of an interest in a partnership iii. From an estate, trust, regulated investment company (RIC), or real estate investment trust (REIT) Net section 1231 gain (loss) allocable to: Box 1 (ordinary income activ) Box 2 (rental real estate activ) Box 3 (other rental activity) Other income (loss)
10.(9)
11.(10)
Additional information for box 11 (10):
Enter the following amounts, if any, included in box 11 (10), code A. REMIC taxable income (net loss) REMIC excess inclusion REMIC sec 212 expenses Enter manually in the appropriate place in your return any box 11 (10), code A items not reported above. Enter information about box 11 (10), code C amounts manually on Form 6781 as appropriate. Enter the following amounts, if any, included in box 11, code F (box 10, code E). Also enter the activity type for the amount so that we know to which activity to allocate the amount. Recoveries of tax benet items Activity Gambling winnings (if not gambling business) Activity Gambling losses (if not gambling business) Activity Sec 751(b) (receivables, inventory) Activity Specially allocated ord gain/loss Activity Net short-term capital gain/loss Activity Net long-term capital gain/loss Total for year Activity 28% rate gain/loss Activity
type: type: type: type: type: type: type: type:
12.(11)
Section 179 deduction allocable to: Box 1 (ordinary income activity) Box 2 (rental real estate activity) Box 3 (other rental activity) Total Section 179 deduction 0 Note: See the IRS instructions to Form 4562 and IRS Publication 946 for rules relating to the maximum section 179 deduction you can take. You may need to adjust amounts in your return in certain situations. 13.(12) Other deductions
Note: If you enter an amount in box 13 with code M (for a
partnership K-1), make sure to fill out the mini-worksheet for Form 1040, Line 29, especially line e. This is necessary to ensure that excess amounts carry to Schedule A. Note: Special rules apply to food inventory contributions and qualified conservation contributions. Adjust amounts in your return as necessary. Additional information for box 13 (12): Enter the following amounts, if any, included in box 13 (12). Other taxes Other miscellaneous deductions Payments to traditional IRA Payments to Roth IRA Payments to qualied plan (e.g., Keogh plan):
14.
Payments to traditional IRA Payments to Roth IRA Payments to qualied plan (e.g., Keogh plan): Prot-sharing plan Money purchase plan Dened benet plan Payments to SEP plan Payments to SIMPLE IRA plan Penalty on early withdrawal of savings Check if part'ship/S corp gave you Form 8283 (Partnership only) Self-employment earnings (loss)
Note: If there is an amount shown in box 14 with code A, enter "1" if 15.(13)
the activity is a non-farm activity and "2" if it is a farm activity: . . . . . . . . . . . . . 1 Credits
Note: If you have an amount shown in box 15(13) with code O and
are filing a traditional paper return, please write "From Schedule K-1" in the margin on Form 1040.
16.(14)
Foreign transactions Name of country/U.S. possession (code A): Other information reported in box 16 (14):
17.(15)
Gross income sourced at partner/ shareholder level (i) U.S. source (ii) Foreign source Deductions allocated and apportioned at partner/shareholder level (1) Interest expense (a) U.S. source (b) Foreign source (2) Other (a) U.S. source (b) Foreign source Total foreign taxes (1) Tax withheld at source on dividends (2) Taxes withheld at source on rents/royalties Amount on preceding line related to non-passive rents/royalties (3) Tax withheld at source on interest (4) Other foreign taxes paid or accrued. Alternative minimum tax (AMT) items
Enter the following amounts, if any, included on box 17 (15) or on an attached statement: Accl. dep, leased prop, pre-87 Accl. dep, real prop, pre-87 OIL and GAS (1) Gross income, oil and gas (2) Deductions, oil and gas (3) Excess intangible drilling costs, oil and gas (4) Excess depletion,oil & gas GEOTHERMAL
18.
Deductions, oil and gas Excess intangible drilling costs, oil and gas (4) Excess depletion,oil & gas GEOTHERMAL (1) Gross income, geothermal (2) Deductions, geothermal (3) Excess intangible drilling costs, geothermal If you've entered an amount in box 17 and the underlying activity is a passive activity, enter "1" if the activity is an ordinary trade or business activity, "2" if it is a rental real estate activity, and "3" if it is another kind of rental activity (leave the box blank if the activity is not a passive activity) . . . . . . . . . . . . (Partnership only) Tax-exempt income and nondeductible expenses
(2) (3)
19.
16.
Generally, increase the adjusted basis of your interest in the partnership by any amount shown with box 18, code B. Generally, decrease the adjusted basis of your interest in the partnership by any amount shown with box 18, code C. (Partnership only) Distributions
(S corporation only) Items a!ecting shareholder basis
Generally, increase the adjusted basis of your S corporation stock by any amount shown with box 16, code B. Generally, decrease the adjusted basis of your S corporation stock by any amount shown with box 16, code C. If distributions shown with box 16, code D, exceed the basis of your stock, treat the excess as capital gain from the sale or exchange of property and report it on the Capital Gains and Losses Worksheet.
20.(17)
Other information
20.(17)
Other information
K-1 WORKSHEET(Partnership/S Corp)

Jeff Is this a passive activity? Y Bell
(1)
Rental real estate w/ active participation? N
(2)
PASSIVE ACTIVITY CALCULATIONS (3) (4)

Activity's Prior year net income unallowed or loss loss (or 0) 10,000 0 0
Page 2 SSN: 111-11-1111

This year unallowed loss
(5)
Allowed income or loss this year 0 10,000 0 0 0 0
(6)
ALLOCATIONS - Allocations of Passive Income and Loss Items to Tax Forms (1) (2) (3) K-1 Item Ordinary Real Other a. Schedule E, from ln 1,2,3 (1) Passive (col's f and g) . . . . . . . . (2) Nonpassive (col's h & j) . . . . . . b. Frm 4797 (Sec 1231),from 10 . . . c. Sched E (Sec 179), from 12 (1) Passive (col. f) . . . . . . . . . . . . . (2) Nonpassive (col. i) . . . . . . . . . . d. Att Wks (Oth. Inc.) from 11 . . . . . e. Att Wks (Oth. Inc.) from 11 . . . . . f. Schedule A line 27, from 11 . . . . g. Form 4797 line 10, from 11 . . . . h. Form 4797 line 10, from 11 . . . . i. Schedule D line 5, from 11 . . . . . j. Schedule D line 12, from 11 (1) Total for year . . . . . . . . . . . . . . (2) 28% rate gain/loss . . . . . . . . . . Subtotal before dispositions . . . . . . . . k. Dispositions--MANUALLY enter
on Form 4797 or Schedule D . . . . Income Activity Estate Activity
(4)
Total, (1)..(3), for Scheds 0 0 0 10,000 0 0 0 0 0 0 0 0 0 0 0 0 10,000 0 10,000
Rental Activity
10,000 0 0
0 0 0
10,000
0 0
Total . . . . . . . . . . . . . . . . . . . . . . . . . 10,000 0 ALTERNATIVE MINIMUM TAX (AMT) PASSIVE ACTIVITY CALCULATIONS (1) (2) (3) (4) (5)
Is this a passive activity? Y Rental real estate w/ active participation? N Activity's Prior year net income unallowed or loss loss (or 0) 10,000 0 0 This year unallowed loss
Allowed income or loss this year 0 10,000 0 0 0 0
(6)

Jeff Bell 2012 Tax Return

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Jeff Bell 2012 Tax Return

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COVER PAGE Filing Checklist for 2012 Tax Return Filed On Standard Forms Prepared on: 12/01/2013 12:18:43

pm Return: /Users/luou/Desktop/Jeff Bell 2012 Tax Return.T12

To le your 2012 tax return, simply follow these instructions:

Step 1. Sign and date the return

Step 2. Assemble the return

Step 3. Mail the return

Department of the Treasury Internal Revenue Service Austin, TX 73301-0002

Step 4. Keep a copy

2012 return information - Keep this for your records

Adjusted gross income

Department of the TreasuryInternal Revenue Service

U.S. Individual Income Tax Return

OMB No. 1545-0074 ,20

IRS Use OnlyDo not write or staple in this space.

Your first name and initial

See separate instructions. Your social security number

Ivy 4326 Orange Blossom Trail

Yourself. If someone can claim you as a dependent, do not check box 6a

Boxes checked on 6a and 6b

No. of children on 6c who:

(1) First name

If more than four dependents, see instructions and check here

123-45-6784 Daughter 123-45-6788 Daughter

d Total number of exemptions claimed

Add numbers on lines above

Adjusted Gross Income

7 8a b 9a b 10 11 12 13 14 15a 16a 17 18 19 20a 21 22 23 24

7 8a 9a 10 11 12 13 14 15b 16b 17 18 19 20b 21 22

100,000 24,000 0 0 31,664 200,000 0 0 0 5,784 0 4,200 365,648

2,237 363,411 Form 1040 (2012)

Form 1040 (2012)

Tax and Credits

25,301 338,110 15,200 322,910 52,788 11,308 64,096

Alternative minimum tax (see instructions). Attach Form 6251

Add lines 44 and 45

0 64,096 3,889 0 0 0 0 67,985

Amount You Owe Third Party Designee Sign Here

Daytime phone number

Paid Preparer Use Only

Form 1040 (2012)

SCHEDULE A (Form 1040)

OMB No. 1545-0074

Attachment Sequence No.

Name(s) shown on Form 1040

Your social security number

Medical and Dental Expenses Taxes You Paid

Interest You Paid

Deductions Total Itemized Deductions

For Paperwork Reduction Act Notice, see Form 1040 instructions.

Schedule A (Form 1040) 2012

(Form 1040A or 1040)

Interest and Ordinary Dividends

OMB No. 1545-0074

Attachment Sequence No.

Name(s) shown on return

Your social security number

City of Dallas Ford Motor Company From K-1

3,000 15,000 6,000

Part II Ordinary Dividends

SCHEDULE C (Form 1040)

Profit or Loss From Business

OMB No. 1545-0074

Attachment Sequence No.

9,060 _____ X