DOROTHY DUNN5329 LAUREL ST

RICHMOND, VA 232272020 INCOME TAX RETURN

INVOICE

Description Amount

Total Invoice

Amount Paid

Balance Due

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PRACTICE LAB15 PRACTICE LAB WAYWASHINGTON DC 20005

(202) 202-2022

DOROTHY DUNN5329 LAUREL STRICHMOND VA 23227

Preparer No.: 995Client No. : XXX-XX-6849Invoice Date: 12/07/2020

PREPARATION OF 2020 FEDERAL/STATE FORMS & WORKSHEETS:

FORM 1040-SR (TAX RETURN FOR SENIORS)FORM 1040 SCHEDULE 1 (ADDITIONAL INCOME AND ADJUSTMENTSFORM W-2 (WAGES AND TAX)FORM 1099-C (CANCELLATION OF DEBT)FORM 1099-R (RETIREMENT DISTRIBUTIONS)SSA WORKSHEETFORM 4868 (AUTOMATIC EXTENSION)FORM 8879 (E-FILE SIGNATURE AUTHORIZATION)ELECTRONIC PAYMENT

¤0.00

¤0.00

¤0.00

TAX YEAR: 2020 PROCESS DATE: 12/07/2020OFFICE : The Practice Lab

CLIENT : XXX-XX-6849 DOROTHY DUNN BIRTH DATE : XX/XX/1953 Age:67

ADDRESS : 5329 LAUREL ST PREPARER : 995 : RICHMOND VA 23227

Home : (251) 555-3866Work : -Cell : -STATUS : MARRIED SEPARATEFED TYPE: Direct DebitST TYPE : Regular Tax EFFECTIVE RATE: 12.96%E-MAIL :

_____________________________________________________________________________________LISTING OF FORMS FOR THIS RETURN________________________________

FORM 1040-SRSCHEDULE 1 (ADDITIONAL INCOME AND ADJUSTMENTS TO INCOME)FORM W-2FORM 1099-C (CANCELLATION OF DEBT)FORM SSA-1099 (SOCIAL SECURITY BENEFITS)FORM 1099-R (RETIREMENT DISTRIBUTIONS)FORM 8879 (E-FILE SIGNATURE AUTHORIZATION)ELECTRONIC PAYMENTFORM 4868 (AUTOMATIC EXTENSION OF TIME TO FILE)

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

FEDERAL 3 60292 0 60292 13700 0 46592 6037 0 3638 0 2399

DIRECT DEBIT INFORMATION_______________________________________________________________________________RTN: XXXXX0760 ACCOUNT: XXXXX3654 AMOUNT: ¤2,399.00 DATE: 12/07/2020

CLIENT : DOROTHY DUNN XXX-XX-6849

PREPARER : 995 DATE : 12/07/2020_____________________________________________________________________________________* W-2 INCOME FORMS SUMMARY *_____________________________________________________________________________________

T/S EMPLOYER WAGES FED WITH FICA MED TAX STATE WITH ST _________________________________________________________________________________1. T DEVEREAUXS FLOWER S 14983 1520 929 217 799 VA

TOTALS...... 14983 1520 929 217 799

* 1099-R INCOME FORMS SUMMARY *_____________________________________________________________________________________

[T/S] PAYER GROSS DIST TAXABLE AMT FED WITH STATE WITH ST _________________________________________________________________________________1. T TEACHERS RETIREMENT SY 18548 18548 2118 0

TOTALS...... 18548 18548 2118 0

* FORM SSA-1099 INCOME FORMS SUMMARY *_____________________________________________________________________________________

[T/S] PAYER SSA BENEFITS FED WITH PREMIUMS _________________________________________________________________________1. T U.S. 21748 0 1646

TOTALS...... 21748 0 1646

a Employee’s social security number

OMB No. 1545-0008

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

b Employer identification number (EIN)

c Employer’s name, address, and ZIP code

d Control number

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

f Employee’s address and ZIP code

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

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 Verification code 10 Dependent care benefits

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

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

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

a Employee’s social security number

OMB No. 1545-0008

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

b Employer identification number (EIN)

c Employer’s name, address, and ZIP code

d Control number

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

f Employee’s address and ZIP code

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

3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

9 Verification code 10 Dependent care benefits

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

12bCo d e

12cCo d e

12dCo d e

13 Statutory employee

Retirement plan

Third-party sick pay

14 Other

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

Form W-2 Wage and Tax Statement 2019

Department of the Treasury—Internal Revenue Service

Form W-2 Wage and Tax Statement 2019

Department of the Treasury—Internal Revenue Service

XXX-XX-6849

33-8373289

DEVEREAUXS FLOWER SHOP1877 BLAKELY BLVDRICHMOND VA 23229

DOROTHY DUNN5329 LAUREL STRICHMOND VA 23227

14983 1520

14983 929

14983 217

VA 0000356937 14983 799

Form 1099-R

2019

Distributions From Pensions, Annuities,

Retirement or Profit-Sharing Plans,

IRAs, Insurance Contracts, etc.

Department of the Treasury - Internal Revenue Service

This information is being furnished to

the IRS.

OMB No. 1545-0119

CORRECTED (if checked)PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

10 Amount allocable to IRR within 5 years

$

11 1st year of desig. Roth contrib.

FATCA filing requirement

Account number (see instructions) Date of payment

1 Gross distribution

$2a Taxable amount

$2b Taxable amount

not determinedTotal distribution

3 Capital gain (included in box 2a)

$

4 Federal income tax withheld

$5 Employee contributions/

Designated Roth contributions or insurance premiums

$

6 Net unrealized appreciation in employer’s securities

$7 Distribution code(s)

IRA/ SEP/

SIMPLE

8 Other

$ %9a Your percentage of total

distribution %

9b Total employee contributions

$12 State tax withheld

$$

13 State/Payer’s state no. 14 State distribution

$$

15 Local tax withheld

$$

16 Name of locality 17 Local distribution

$$

Form 1099-R (keep for your records) www.irs.gov/Form1099R

Form 1099-R

2019

Distributions From Pensions, Annuities,

Retirement or Profit-Sharing Plans,

IRAs, Insurance Contracts, etc.

Department of the Treasury - Internal Revenue Service

This information is being furnished to

the IRS.

OMB No. 1545-0119

CORRECTED (if checked)PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.

PAYER’S TIN RECIPIENT’S TIN

RECIPIENT’S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code

10 Amount allocable to IRR within 5 years

$

11 1st year of desig. Roth contrib.

FATCA filing requirement

Account number (see instructions) Date of payment

1 Gross distribution

$2a Taxable amount

$2b Taxable amount

not determinedTotal distribution

3 Capital gain (included in box 2a)

$

4 Federal income tax withheld

$5 Employee contributions/

Designated Roth contributions or insurance premiums

$

6 Net unrealized appreciation in employer’s securities

$7 Distribution code(s)

IRA/ SEP/

SIMPLE

8 Other

$ %9a Your percentage of total

distribution %

9b Total employee contributions

$12 State tax withheld

$$

13 State/Payer’s state no. 14 State distribution

$$

15 Local tax withheld

$$

16 Name of locality 17 Local distribution

$$

Form 1099-R (keep for your records) www.irs.gov/Form1099R

QNA

TEACHERS RETIREMENT SYSTEM7816 SCHOOLHOUSE BLVDRICHMOND VA 23218

83-2243770 XXX-XX-6849

DOROTHY DUNN

5329 LAUREL ST

RICHMOND VA 23227

0 0

18548

18548

2118

7

Form 8879(Rev. August 2020)

Department of the Treasury Internal Revenue Service

IRS e-file Signature Authorization

ERO must obtain and retain completed Form 8879.

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

OMB No. 1545-0074

Submission Identification Number (SID)

Taxpayer’s name Social security number

Spouse’s name Spouse’s social security number

Part I Tax Return Information — Tax Year Ending December 31, (Enter year you are authorizing.)Enter whole dollars only on lines 1 through 5.Note: Form 1040-SS filers use line 4 only. Leave lines 1, 2, 3, and 5 blank.

1 Adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Federal income tax withheld from Form(s) W-2 and Form(s) 1099 . . . . . . . . . . . . . 3

4 Amount you want refunded to you . . . . . . . . . . . . . . . . . . . . . . 4

5 Amount you owe . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

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

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

Taxpayer’s PIN: check one box only

I authorize ERO firm name

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

as my

signature on the income tax return (original or amended) I am now authorizing.

I will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. Check this box only

if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Your signature Date

Spouse’s PIN: check one box only

I authorize ERO firm name

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

as my

signature on the income tax return (original or amended) I am now authorizing.I will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. Check this box only

if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

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

Part III Certification and Authentication — Practitioner PIN Method Only

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

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

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

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

For Paperwork Reduction Act Notice, see your tax return instructions. Form 8879 (Rev. 08-2020)

QNA

DOROTHY DUNN XXX-XX-6849

60292 6037 3638

2399

12/07/2020

X PRACTICE LAB1 6 8 4 9

3 6 9 2 5 8 9 8 7 6 5

12/07/2020

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

U.S. Tax Return for Seniors 2020 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

(99)

Filing Status Check only one box.

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

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

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

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

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

City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code

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

Presidential Election Campaign

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

At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? . . . . . . . . . . . . . . . . . . . . Yes No

Standard Deduction

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

Age/Blindness { You: Were born before January 2, 1956 Are blindSpouse: Was born before January 2, 1956 Is blind

Dependents (see instructions):

If more than four dependents, see instructions and check here

(2) Social security number (3) Relationship to you

(4) if qualifies for (see instructions):(1) First name Last name Child tax credit Credit for other dependents

1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . 1Attach Schedule B if required.

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

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

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

5a Pensions and annuities 5a b Taxable amount . . 5b

6a Social security benefits . 6a b Taxable amount . . 6b

7

Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . . . . . . . . . . . . . . . . . 7

8 Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . 8

9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . 9

10 Adjustments to income:

a From Schedule 1, line 22 . . . . . . . . . . . 10a

b

Charitable contributions if you take the standard deduction. See instructions . . . . . . . . . . 10b

c Add lines 10a and 10b. These are your total adjustments to income 10c

11 Subtract line 10c from line 9. This is your adjusted gross income . . 11For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040-SR (2020)

QNA

x

DANIEL DUNN

DOROTHY DUNN XXX-XX-6849

XXX-XX-4353

5329 LAUREL ST

RICHMOND VA 23227

X

X

14983

18548

21748 18486

8275

60292

60292

Form 1040-SR (2020) Page 2

Standard Deduction See Standard Deduction Chart on the last page of this form.

12 Standard deduction or itemized deductions (from Schedule A) . . . 12

13 Qualified business income deduction. Attach Form 8995 or Form 8995-A 13

14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . 14

15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- . 15

16 Tax (see instructions). Check if any from:

1 Form(s) 8814 2 Form 4972 3 . . . . . . . 16

17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . 17

18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . 18

19 Child tax credit or credit for other dependents . . . . . . . . . . . 19

20 Amount from Schedule 3, line 7 . . . . . . . . . . . . . . . . . 20

21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . 21

22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . 22

23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . 23

24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . 24

25 Federal income tax withheld from:

a Form(s) W-2 . . . . . . . . . . . . . . . . . 25a

b Form(s) 1099 . . . . . . . . . . . . . . . . 25b

c Other forms (see instructions) . . . . . . . . . . 25c

d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . 25d

26 2020 estimated tax payments and amount applied from 2019 return . . 26

27 Earned income credit (EIC) . . . . . . . . . . .• If you have a qualifying child, attach Sch. EIC.

• If you have nontaxable combat pay, see instructions.

27

28 Additional child tax credit. Attach Schedule 8812 . . 28

29 American opportunity credit from Form 8863, line 8 . 29

30 Recovery rebate credit. See instructions . . . . . 30

31 Amount from Schedule 3, line 13 . . . . . . . . 31

32

Add lines 27 through 31. These are your total other payments and refundable credits . . . . . . . . . . . . . . . . . . . . . 32

33 Add lines 25d, 26, and 32. These are your total payments . . . . . 33Go to www.irs.gov/Form1040SR for instructions and the latest information. Form 1040-SR (2020)

QNA

DUNN XXX-XX-6849

13700

13700

46592

6037

6037

6037

0

6037

1520

2118

3638FORM 1099

3638

Form 1040-SR (2020) Page 3

Refund 34

If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . . . . . . . . . . . . . . . . . . . . 34

35

a

Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . . . . . . . . . . . . . . . . . . . . 35a

Direct deposit? See instructions.

b Routing number c Type: Checking Savings

d Account number

36

Amount of line 34 you want applied to your 2021

estimated tax . . . . . . . . . . . . . . . 36

Amount You Owe For details on how to pay, see instructions.

37 Subtract line 33 from line 24. This is the amount you owe now . . . 37

Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for 2020. See Schedule 3, line 12e, and its instructions for details.

38 Estimated tax penalty (see instructions) . . . . . 38

Third Party Designee

Do you want to allow another person to discuss this return with the IRS? See instructions . . . . . . . . . . . . . . . . . . . . . Yes. Complete below. No

Designee’s name

Phone no.

Personal identification number (PIN)

Sign Here

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

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

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

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

Phone no. Email address

Paid

Preparer

Use Only

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

Self-employed

Firm’s name Phone no.

Firm’s address Firm’s EIN

Go to www.irs.gov/Form1040SR for instructions and the latest information. Form 1040-SR (2020)

QNA

DUNN XXX-XX-6849

X X X X X X X X X

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

2399

X

12/07/20 RETIRED

12/07/20 S12345678

-PRACTICE LAB15 PRACTICE LAB WAY WASHINGTON DC 20005

202-202-2022

Form 1040-SR (2020) Page 4

Standard Deduction Chart*

Add the number of boxes checked in the “Age/Blindness” section of Standard Deduction on page 1 . . . .

Single

Married filing jointly

Qualifying widow(er)

Head of household

Married filing separately**

IF your filing

status is. . .

AND the number of

boxes checked is. . .

THEN your standard

deduction is. . .

1 $14,050 2 15,700 1 $26,100 2 27,400 3 28,700 4 30,000

1 $26,100

2 27,400 1 $20,300 2 21,950 1 $13,700 2 15,000 3 16,300 4 17,600

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

**You can check the boxes for your spouse if your filing status is married filing separately and your spouse had no income, isn’t filing a return, and can’t be claimed as a dependent on another person’s return.

Go to www.irs.gov/Form1040SR for instructions and the latest information. Form 1040-SR (2020)

QNA

DUNN XXX-XX-6849

1

SCHEDULE 1 (Form 1040)

Department of the Treasury Internal Revenue Service

Additional Income and Adjustments to Income Attach to Form 1040, 1040-SR, or 1040-NR.

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

OMB No. 1545-0074

2020Attachment Sequence No. 01

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

Part I Additional Income

1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . 1

2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a

b Date of original divorce or separation agreement (see instructions)

3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . 3

4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . 4

5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 5

6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . 6

7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . 7

8 Other income. List type and amount 8

9

Combine lines 1 through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Part II Adjustments to Income

10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11

Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . . 11

12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . 12

13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . 13

14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . 14

15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . 15

16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . 16

17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . 17

18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a

b Recipient’s SSN . . . . . . . . . . . . . . . . . . . .

c Date of original divorce or separation agreement (see instructions)

19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . 20

21 Tuition and fees deduction. Attach Form 8917 . . . . . . . . . . . . . . . 21

22

Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 10a . . . . . . . . . . . . . . . 22

For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040) 2020

QNA

DOROTHY DUNN XXX-XX-6849

FORM 1099C 8275

8275

SCHEDULE A (Form 1040)

Department of the Treasury Internal Revenue Service (99)

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

▶ Attach to Form 1040 or 1040-SR.

Caution: If you are claiming a net qualified disaster loss on Form 4684, see the instructions for line 16.

OMB No. 1545-0074

2020Attachment Sequence No. 07

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

Medical and Dental Expenses

Caution: Do not include expenses reimbursed or paid by others. 1 Medical and dental expenses (see instructions) . . . . . . . 1 2 Enter amount from Form 1040 or 1040-SR, line 11 2 3 Multiply line 2 by 7.5% (0.075) . . . . . . . . . . . . . 3 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . . 4

Taxes You Paid

5 State and local taxes.

a

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

b State and local real estate taxes (see instructions) . . . . . . . 5b c State and local personal property taxes . . . . . . . . . . 5c d Add lines 5a through 5c . . . . . . . . . . . . . . . 5d e

Enter the smaller of line 5d or $10,000 ($5,000 if married filing separately) . . . . . . . . . . . . . . . . . . . 5e

6 Other taxes. List type and amount ▶

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

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

8

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

a

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

b

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

8bc

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

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

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

Gifts to CharityCaution: If you made a gift and got a benefit for it, see instructions.

11

Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . . . . 11

12

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

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

Casualty and Theft Losses

15

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

Other Itemized Deductions

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

16

Total Itemized Deductions

17

Add the amounts in the far right column for lines 4 through 16. Also, enter this amount on Form 1040 or 1040-SR, line 12 . . . . . . . . . . . . . . . . . . . . 17

18

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

For Paperwork Reduction Act Notice, see the Instructions for Forms 1040 and 1040-SR. Schedule A (Form 1040) 2020

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DOROTHY DUNN XXX-XX-6849

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Form 48682020

Application for Automatic Extension of Time To File U.S. Individual Income Tax Return

Department of the Treasury Internal Revenue Service (99)

Go to www.irs.gov/Form4868 for the latest information.

OMB No. 1545-0074

There are three ways to request an automatic extension of time to file a U.S. individual income tax return.

1. You can pay all or part of your estimated income tax due and indicate that the payment is for an extension using Direct Pay, the Electronic Federal Tax Payment System, or using a credit or debit card. See How To Make a Payment, later.

2. You can file Form 4868 electronically by accessing IRS e-file using your tax software or by using a tax professional who uses e-file.

3. You can file a paper Form 4868 and enclose payment of your estimate of tax due (optional).

It’s Convenient, Safe, and Secure

IRS e-file is the IRS’s electronic filing program. You can get an automatic extension of time to file your tax return by filing Form 4868 electronically. You’ll receive an electronic acknowledgment once you complete the transaction. Keep it with your records. Don’t mail in Form 4868 if you file electronically, unless you’re making a payment with a check or money order. See Pay by Check or Money Order, later.

Complete Form 4868 to use as a worksheet. If you think you may owe tax when you file your return, you’ll need to estimate your total tax liability and subtract how much you’ve already paid (lines 4, 5, and 6 below).

Several companies offer free e-filing of Form 4868 through the Free File program. For more details, go to www.irs.gov/FreeFile.

Pay Electronically

You don’t need to file Form 4868 if you make a payment using our electronic payment options. The IRS will automatically process an extension of time to file when you pay part or all of your estimated income tax electronically. You can pay online or by phone. See Making Payments Electronically, later.

E-file Using Your Tax Software or Through a Tax Professional

Refer to your tax software package or tax preparer for ways to file electronically. Be sure to have a copy of your 2019 tax return—you’ll be asked to provide information from the return for taxpayer verification. If you wish to make a payment, you can pay by electronic funds withdrawal or send your check or money order to the address shown in the middle column under Where To File a Paper Form 4868, later.

File a Paper Form 4868

If you wish to file on paper instead of electronically, fill in the Form 4868 below and mail it to the address shown under Where To File a Paper Form 4868, later.

For information on using a private delivery service, see Private Delivery Services, later. Note: If you’re a fiscal year taxpayer, you must file a paper Form 4868.

General Instructions

Purpose of Form Use Form 4868 to apply for 6 more months (4 if “out of the country” (defined later under Taxpayers who are out of the country)and a U.S. citizen or resident) to file Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS. Gift and generation-skipping transfer (GST) tax return (Form 709). An extension of time to file your 2020 calendar year income tax return also extends the time to file Form 709 for 2020. However, it doesn’t extend the time to pay any gift and GST tax you may owe for 2020. To make a payment of gift and GST tax, see Form 8892. If you don’t pay the amount due by the regular due date for Form 709, you’ll owe interest and may also be charged penalties. If the donor died during 2020, see the instructions for Forms 709 and 8892.

Qualifying for the Extension To get the extra time, you must:

1. Properly estimate your 2020 tax liability using the information available to you,

2. Enter your total tax liability on line 4 of Form 4868, and 3. File Form 4868 by the regular due date of your return.

!CAUTION

Although you aren’t required to make a payment of the tax you estimate as due, Form 4868 doesn’t extend the time to pay taxes. If you don’t pay the amount due by the regular

due date, you’ll owe interest. You may also be charged penalties. For more details, see Interest and Late Payment Penalty, later. Any remittance you make with your application for extension will be treated as a payment of tax.

You don’t have to explain why you’re asking for the extension. We’ll contact you only if your request is denied.

Don’t file Form 4868 if you want the IRS to figure your tax or you’re under a court order to file your return by the regular due date.

DETACH HERE

Form 48682020

Application for Automatic Extension of Time To File U.S. Individual Income Tax Return

Department of the Treasury Internal Revenue Service (99)

OMB No. 1545-0074

For calendar year 2020, or other tax year beginning , 2020, and ending , 20 .

Part I Identification

1 Your name(s) (see instructions)

Address (see instructions)

City, town, or post office State ZIP code

2 Your social security number 3 Spouse’s social security number

Part II Individual Income Tax

4 Estimate of total tax liability for 2020 . . $

5 Total 2020 payments . . . . . .

6

Balance due. Subtract line 5 from line 4. See instructions . . . . . . . .

7 Amount you’re paying (see instructions) .8

Check here if you’re “out of the country” and a U.S. citizen or resident. See instructions . . . . . .

9

Check here if you file Form 1040-NR and didn’t receive wages as an employee subject to U.S. income tax withholding . . . . . . . . . . . . .

For Privacy Act and Paperwork Reduction Act Notice, see instructions later. Form 4868 (2020)

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