2010TaxReturn

Th is H &R B lock Advantage document provides inf ormat ion th at could h elp you improve your tax and f inancial situat ion. It s contents sh ould be considered in conjunct ion w ithinf ormat ion you receive f rom oth er sources th at are f amiliar w ith your specif ic circumstances. Tax services of f ered th rough subsid iaries of H RB Tax Group, Inc.

$9,207.00 See the Filing Checklist for instructions.

Georgia

RefundFederal Yes $9,207.00

PAUL M. MILLER AND LAURA A.MILLER02/04/2011

$378.00Yes See the Filing Checklist for mailing instructions.

Prepared For:

(Balance Due) Payment Information DeliveryRefund /

Total Savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $8,350.00

efileTax Return

Today's Savings

Filing, Refund and Balance Due Information

* Claiming the Child Tax Credit for you this year helped you reduce your federal taxes by:

$5,666.00* Because you qualified for a $5,666 Earned Income Credit (EIC) this year, you saved:

income. It is the highest federal tax bracket that affects your tax calculation. The Effective TaxRate is the percentage of your total income that you paid in taxes. For 2010, your Marginal TaxRate is 0% and your Effective Tax Rate is 0%.

$2,684.00

* In simple terms, the Marginal Tax Rate is the tax rate that you pay on your last dollar of taxable

Advantage (2010) FDADVICE-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

$2,684$0$2,684Total payments $9,207$0$9,207

Earned income credit$800$0

$5,666Additional child tax credit

$5,666$0

$20,979Alternative minimum taxable income

$9,207

$0Married Filing JointlyFiling status

$20,979

$0$9,207Overpayment $9,207$0$9,207Refund due

$800

$83$0Total income $0$20,979

$83$20,896Wages, salaries, tips $0

Unemployment compensation$20,896

$20,979

$57Federal withholding $0Making work pay and government retiree credits

$57

$20,979$20,979Total income less total adjustments $0

Year 2009Year 2010

2010 Tax Return Summary

INCOME Change($)

REFUND

PAYMENTS

ADJUSTED GROSS INCOME

OTHER COMPUTATIONS

Federal Year over Year Comparison

Client Sum (2010) FDBASUM-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

Adoption credit Families who adopt children 2010 and 2011 Complete the adoption before the end of 2012Be aware that the credit will be nonrefundable for taxpayers who adopt in 2012 and later

Roth IRA conversions Higher income individuals and /or married filing separate taxpayers who in the past were not able to convert traditional IRA funds to a Roth account are now eligible

2010 and forward

Convert IRA to Roth IRA if appropriate for the taxpayerConsider filing an extension for 2010 allowing time to determine whether or not to defer taxation to 2011 and 2012 (default) OR pay tax in 2010

Homebuyer Credit Qualifying individuals who purchase a principal residenceTaxpayers who claimed 2008 credit based on 2008 purchase

Claim credit for home purchaseBegin repayment of 2008 credit, if applicable

Th is H &R B lock Advantage document provides inf ormat ion th at could h elp you improve your tax and f inancial situat ion. It s contents sh ould be considered in conjunct ion w ith inf ormat ion you receive f rom oth er sources th at are f amiliar w ith your specif ic circumstances. Tax services of f ered th rough subsid iaries of H &R B lock Services, Inc.

* Ind ividuals may w ant to consider ad just ing th eir income tax w ith h old ing during th e year (and th ereby increasing th eir paych ecks), if indeed any of th ese provisions signif icant ly reduces th eir end- of - year tax liab ilit y.


1 of 2

The adoption credit increased to $13,170 for 2010 and $13,360 for 2011 ANDCredit is fully refundableCarryforward from prior years is fully refundable

For years starting in 2010, the $100,000 modified AGI limit for conversions to Roth IRAs is eliminated2010 conversions taxed one half in 2011 and one half in 2012 unless elect to pay tax on conversion in 2010For years starting in 2010, married filing separate taxpayers are now eligible to do a conversion

Up to $8,000 refundable credit (up to $6,500 credit for existing homeowners)2008 credit recapture must start in 2010

The credit will be refundable for taxpayer who adopts in 2010 and 2011For adoptions in 2012 the credit will generally be nonrefundable but remain at the increased amount of $13,360 plus the inflation index

This may increase taxes now, but the expectation is in the long run overall tax will be reduced

Generally expired 4/30/10

Credit generally expires 4/30/10 with closing by 10/1/10 for those using written binding contract extensionTax liability may increase by applicable portion of 2008 credit recapture

Making Work Pay Credit (MWPC)Refundable credit of up to $400 ($800 MFJ) per qualified taxpayer

Individuals other than dependents and nonresident aliens who work

Expires 12/31/10

In 2010, claim credit and complete Schedule M ANDEconomic Recovery Payments that were not received in 2009 but received in 2010 must be offset against MWPCIn 2011, be aware current law expires 12/31/10 ANDEvaluate W-4 withholding and / or quarterly estimates as appropriate

In 2010, be aware that some clients who received an Economic Recovery Payment will receive a lower MWPCIn 2011, since MWPC expired, take home pay will be less due to income tax withholding for most working taxpayersSee Payroll Tax Holiday

Nonbusiness Energy CreditExtended and modified for 2011A nonrefundable credit for 30% (2009 and 2010) or 10% (2011) of costs for qualifying residential improvements for heating and cooling efficiency (e.g., windows, doors, HVAC)For 2009 and 2010, the max credit is $1,500 collectively for 2009 and 2010For 2011, the credit has been extended but the maximum credit reverts to a $500 lifetime credit ($200 for windows)

Taxpayers who invest in qualifying improvements to their home

Expires 12/31/11

Purchase and install energy efficient improvements by 12/31/11Claim allowable credit

For 2009 and 2010, 30% of cost of qualifying purchases up to $1,500 for 2009 and 2010 combinedFor 2011, 10% of cost of qualifying purchases up to $500 lifetime credit

American Opportunity Credit (AOC)Credit of up to $2,500 for first four years of collegePartially refundable up to $1,000

College students or their parents if claiming the student as a dependent

Expires 12/31/12

Be aware credit expires 12/31/12Beginning in 2013 or if not qualifying, claim the Hope or lifetime learning credit as appropriate

After 2012, there may be fewer tax benefits available for education expenses

6

4

2

1

3

5

When is it What does the at tax time

Who is impacted?What is it?taxpayer need to do?

Impact to the taxpayer

Key Tax laws effective for 2010 and / or future years

effective?#

As of January 10, 2011

QUICK REFERENCE

Implications of Key Tax Law Changes

-

Action Plan (2010) FDADVAN-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.


* Ind ividuals may w ant to consider ad just ing th eir income tax w ith h old ing during th e year (and th ereby increasing th eir paych ecks), if indeed any of th ese provisions signif icant ly reduces th eir end- of - year tax liab ilit y.


These changes are the key year- over- year tax law changes. There are many more tax law changes and regulatory changes such as annual inflationary adjustments and other tax law changes that impact a smaller group of individuals, etc.

2 of 2

Educator Expense Deduction Elementary and secondary(K - 12) educators who purchase supplies for their classrooms

2010 and 2011 Keep receipts for supplies purchased for the classroomProvide receipts to their tax professionalTaxpayer must first seek reimbursement from employer before deducting expenses

State and Local Sales Tax Taxpayers who made substantial purchases in 2010

Bring in receipts for their state and local sales tax paid on large purchases such as cars

Tuition and Fees Deduction Individuals who pay qualified education expenses while enrolled in or attending an eligible postsecondary educational institution in 2010

Be aware that the tuition and fees deduction has been extended through 12/31/11File Form 8917, Tuition and Fees Deduction

A $250 deduction for expenses paid or incurred for books, supplies, computer equipment, other equipment, and supplementary materials purchased and used by the educator in the classroom

Taxpayers who itemize deductions may deduct state and local sales taxes paid in lieu of state and local income taxes paid

Taxpayers enrolled in or attending an eligible postsecondary educational institution may claim up to a $4,000 deduction for tuition and fees paid during 2010

A $250 adjustment to income for 2010 and 2011 for qualifying taxpayersTaxpayer does not need to itemize to claim the deduction

Could result in a lower tax liability for taxpayers who itemize and have a larger sales tax than income tax deduction

Up to a $4,000 adjustment to income for 2010 for qualifying taxpayersTaxpayer does not need to itemize to claim this deduction

AMT PatchIncreases the AMT exemption amounts for two yearsFor 2010, exemption amounts will be $47,450 ($72,450 MFJ)

Individuals with AMT preference items and adjustments that will increase AMT income

Consider income and/or expenses that have AMT impact and consider avoiding or deferring them if possible

Higher exemption may reduce AMT exposure, but taxpayer may still be subject to AMT

Payroll Tax Holiday - Not an income tax eventFor 2011, employees and self-employed individuals will pay 2 percentage points less in social security taxEmployees will pay 4.2% (instead of 6.2%) in social security taxes on wages earned up to $106,800Self-employed individuals will pay self-employment tax at a rate of 13.3% (instead of 15.3%)

All taxpayers who earn income subject to social security tax

Nothing - the payroll tax holiday decreases the amount of social security tax paid which increases the amount of take home pay

There is no impact as this does not affect the income tax returnTaxpayers may start planning how to use the social security taxes saved. Options include paying down debt, increasing retirement savings, funding a college savings account, etc.

2011

2010 and 2011

2010 and 2011

2010 and 2011

9

10

11

8

7

What is it?effective?

#

Key provisions that expired at the end of 2009 which have been extended through 2011

at tax timeWho is impacted?

When is it What does the Impact to the taxpayertaxpayer need to do?

As of January 10, 2011

QUICK REFERENCE

Implications of Key Tax Law Changes

-

Action Plan (2010) FDADVAN-2WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

3102101/28/1977

44,833.

3102108/11/1977

44,833.

02/02/2011

Under penalties for perjury, I declare that I have examined this return, including any accompanying statements and schedules and, to the best of my

Taxpayer's Prior year PIN

for any delay in processing or refund; and, d) the date of any refund.

Spouse's Prior year PIN

Taxpayer's Electronic Filing PIN

knowledge and belief, it is true, correct, and complete.

Spouse's Electronic Filing PIN

information from IRS: a) an acknowledgement of receipt or reason for rejection of transmission; b) an indication of any refund offset; c) the reason I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send my return to IRS and to receive the following

Spouse's PIN:

Taxpayer's Prior Year Adjusted Gross Income:

Declaration Control Number (DCN)

Spouse's Date of Birth:Spouse's Prior Year Adjusted Gross Income:

Taxpayer's Date of Birth:

-

Date:

-

Taxpayer's PIN:

Tax Return Signature/Consent to DisclosureOn-Line Self Select PIN without Direct Debit

Perjury Statement

Select PIN below.I am signing this Tax Return and Electronic Funds Withdrawal Consent, if applicable, by entering my Self

Consent to Disclosure

10 0 LAURA A MILLERPAUL M MILLER

8453OL(D) (2010) FD8453OD-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

20,97920,97933,300

00

9,2079,207

0

PAUL M MILLER

LAURA A MILLER

United States Treasury

Since you are filing your return electronically and you choseto use an electronic signature, you do not mail your return.Mailing

FOR THE YEAR ENDING

Summary

Instructions

Prepared for

payable to

Address

December 31, 2010

Tax

Make check

2010 Federal Tax Return Filing Instructions

Amount You Owe $

Adjusted Gross Income

Total Tax $

Gross Income

$$

Total DeductionsTotal Taxable Income

Refund AmountTotal Payments

$$

$$

Print a copy of the return for your records.Please attach a copy of each W-2, W-2G, 1099G and 1099R to your return.

STEP 2 - Keep a copy

STEP 1 - Once your e-filed return has been accepted, you will receivean e-mail

Checklist (2010) FDCHECK-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

173-66-7465

204-64-3554

X

X

X2

4

6

BRIANNA MILLER ELISABETH MILLER ELLA MILLER KALI MILLER

207-76-7386221-94-9722222-98-4272668-48-3330

DAUGHTERDAUGHTERDAUGHTERDAUGHTER

XXXX

20,896.

83.

20,979.

20,979.

PRINT

L

AE

LR

C

Y

under age 17if child

qualif y ing f orch ild tax cr.(see pg 16)

(4)

entered above

on 6c who:

D ependents

you

(see instr)

Boxes

Add numbers

please use

(99)

No. of ch ildren

above

If th e qualif y ing person is a ch ild but not your dependent , enter th is

lived w ith

on 6c not

on lines

See separate

ch ecked on6a and 6b

ch ild 's name h ere.

IRS Use Only - D o not w rite or staple in th is space.

inst ruct ions.

to d ivorce orw ith you due

get a W- 2, see

separation

page 20.

not at tach , anypayment . Also,

Enclose, but do

did not live

M arried f iling separately. Enter spouse's SSN above & f ull name below .

If you d id not

OMB No. 1545-0074

and on line 6c are correct.

Taxable amount

see instructions.

If more

dependents,

SingleMarried filing jointly (even if only one had income)

(see instructions).

IRA deduction (see instructions).

(see instructions).

Check here if you, or your spouse if filing jointly, want $3 to go to this fund

Subtract line 20 from line 15. This is your adjusted gross income.

Taxable amount

change your tax or refund.

9a

Checking a box below will not

20

Make sure the SSN(s) above

10

13

11b

14b

17

15

IRA

Department of the Treasury - Internal Revenue ServiceForm

than six

Social security

Form 1040A (2010)

Total number of exemptions claimed.

11a

Head of household (with qualifying person). (See instructions.)

relationship to you

Add lines 7 through 14b (far right column). This is your total income.

8bOrdinary dividends. Attach Schedule B if required.

distributions.

(1) First name

16

Student loan interest deduction (see instructions).

security number

Tax- exempt interest. Do not include on line 8a.

Add lines 16 through 19. These are your total adjustments.

Unemployment compensation and Alaska Permanent Fund dividends.

12a

benefits. 14a

12b

21

Capital gain distributions (see instructions).

annuities.Pensions and

18

8a

9b

Tuition and fees. Attach Form 8917.

Last name

If someone can claim you as a dependent, do not check box 6a.Qualifying widow(er) with dependent child (see instructions)one box.

Check only

Taxable amount

19

(see instructions).

Taxable interest. Attach Schedule B if required.

7Wages, salaries, tips, etc. Attach Form(s) W-2.

Qualified dividends (see instructions).b

Educator expenses (see instructions).

Form 1040-V.

c (3) Dependent's

d

Dependents:

6a

b

11b

7

8a

9a

12b

14b

b

Election Campaign You Spouse

Your social security number

Spouse's social security number

Presidential

1

Yourself.

Spouse

(2) Dependent's social

2

3

5

10

18

Form(s)

17

was withheld.

20

1099-R if tax

AttachForm(s) W-2

attachhere. Also

14a

15

13

11a

12a

21

19

16

KBA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.

4

and SSN

status

Adjustedgrossincome

Income

Filing

Name,Address,

Exemptions

U.S. Individual Income Tax Return 20101040A

31021 2231 HIGHWAY 19SLAURA A MILLERPAUL M MILLER

GA, DUBLIN

1040A (2010) FD1040A-1WV 1.18Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

X

X

173-66-7465PAUL M & LAURA A MILLER20,979.

11,400.9,579.21,900.

0.0.

0.

0.

9,207.

9,207.9,207.

2,684.

5,666.

57.

101089742

3384092371

MAINTENANCE

HOMEMAKER

800.

(see inst rucions).Tax, including any alternative minimum tax

(see inst ruct ions).Estimated tax penalty(see inst ruct ions)?Do you want to allow another person to discuss this return with the IRS

know ledge and belief , th ey are t rue, correct , and accurately list all amounts and sources of income I received during th e tax year. D eclarat ionof preparer (oth er th an th e taxpayer) is based on all inf ormat ion of w h ich th e preparer h as any know ledge.

Under penalt ies of perjury, I declare th at I h ave examined th is return and accompanying sch edules and statements, and to th e best of my

American opportunity credit from Form 8863, line 14.

Form 8888.

40

43

Check

Subtract line 24 from line 22. If line 24 is more than line 22, enter - 0- .

Making work pay credit. Attach Schedule M.

Retirement savings contributions credit. Attach Form 8880.33

a qualifyingchild, attach

Child tax credit (see instructions).

Nontaxable combat pay election.

If you have

Complete the following.

41bSchedule EIC. 42

Add lines 38, 39, 40, 41a, 42, and 43. These are your total payments.

Additional child tax credit. Attach Form 8812.

This is the amount you overpaid.

44

Enter your standard deduction (see instructions).

2010 estimated tax payments and amountapplied from 2009 return.

41a

39

Earned income credit (EIC).

RoutingSavingsChecking

Amount of line 45 you want applied to your

Accountnumber

Type:

45If line 44 is more than line 37, subtract line 37 from line 44.

Amount of line 45 you want refunded to you. If Form 8888 is attached, check here

number

to pay, see instructions.

2011 estimated tax.

262524

Education credits from Form 8863, line 23.

22

27

30

Credit for child and dependent care expenses. Attach Form 2441.

Subtract line 26 from line 25. If line 26 is more than line 25, enter - 0- .

Schedule R.

2928

Credit for the elderly or the disabled. Attach

3534

Add lines 35 and 36. This is your total tax.

Enter the amount from line 21 (adjusted gross income).

3736Advance earned income credit payments from Form(s) W-2, box 9.

38

3231

Subtract line 34 from line 28. If line 34 is more than line 28, enter - 0- .Add lines 29 through 33. These are your total credits.

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

Amount you owe. Subtract line 44 from line 37. For details on how

PTIN

Personal ID numberPhone no.

if: Blind

Date

Designee's name

Your occupation

Spouse's occupationDaterecords.

Print/Type preparer's name

Daytime phone number

Spouse was born before January 2, 1946,

Check if

23b

Exemptions. Multiply $3,650 by the number on line 6d.

This is your taxable income.

If you are married filing separately and your spouse itemizes

self-employedPreparer's signature

(PIN)

deductions, see page 29 and check here

Blind23a

Direct

and 46d or

and fill in

Form 1040A (2010)

48

46b, 46c,

See instructions

Firm's address

47

46adeposit?

Firm's name

Page 2

See page 17.Joint return?

Firm's EIN

Spouse's signature. If a joint return, both must sign.

DateYour signature

Phone no.

NoYes. 49

Form 1040A (2010)

for yourKeep a copy

40

35

49

37

36

38

32

34

39

22

46a

48

d

c

45

44

47

b

31

28

30

26

25

29

33

b

41a

27

43

42

b

23a Total boxeschecked

24

You were born before January 2, 1946,

use only

Third partydesignee

preparer

Signhere

Paid

Amountyou owe

Refund

payments

Tax, credits,and

1040A (2010) FD1040A-2WV 1.18Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

PAUL M & LAURA A MILLER 173-66-7465

MILLER MILLER

207-76-7386 221-94-9722

DAUGHTER DAUGHTER

12 12

BRIANNA ELISABETH

1997 2001

ELLAMILLER

222-98-4272

2004

DAUGHTER

12

Internal Revenue Service (99)D epartment of th e Treasury

Sequence No.

Be sure the child's name on line 1 and social security number (SSN) on line 2 agree with the child's social security card. Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child's

Year

Attachment

First name

Year

social security card is not correct, call the Social Security Administration at 1- 800- 772- 1213.

have to list three to get the

Last name

If born after 1991 and the child was

go to line 5.if filing jointly), skip lines 4a and 4b; younger than you (or your spouse,

if filing jointly), skip lines 4a and 4b; go to line 5.

and younger than you (or

younger than you (or your spouse, If born after 1991 and the child was

the child's birth certificate, death on this line and attach a copy of

records.certificate, or hospital medical

not have an SSN, enter "Died"

your spouse, if filing jointly)?

go to line 5.

born and died in 2010 and did died in 2010. If your child was

months.

months

maximum credit.

Do not enter more than 12 months.

than 7 months, enter "7."

or she was alive during 2010, Do not enter more than 12

months.

Complete and attach to Form 1040A or 1040

enter "12."

if filing jointly), skip lines 4a and 4b;

foster child, etc.)

of 2010?

younger than you (or your spouse,

See the instructions for Form 1040A, lines 41a and 41b, or Form 1040, lines 64a and 64b, to make

It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

sure that (a) you can take the EIC, and (b) you have a qualifying child.

The child must have an SSN as

Was the child under age 24 at

Do not enter more than 12

If the child was born or died in

more than half of 2010 but less

child's home for the entire time he 2010 and your home was the

defined in the instructions for

the end of 2010, a student,

grandchild, niece, nephew,

totally disabled during any part

months

unless the child was born and

Form 1040A, lines 41a and 41b, or

Was the child permanently and

Form 1040, lines 64a and 64b,

only if you have a qualifying child.

months

First name

(for example, son, daughter,

Name(s) shown on return

If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See separate

Last name

instructions for details.

If you have more than three qualifying children, you only

OMB No. 1545-0074

Last name

YearIf born after 1991 and the child was

If the child lived with you for

First name

The child is not aqualifying child.The child is not a

Schedule EIC (Form 1040A or 1040) 2010For Paperwork Reduction Act Notice, see your tax return instructions.KBA

Continue.qualifying child.


Go to line 5.Continue.Continue.Go to line 5.

(Form 1040A or 1040)

Go to line 5. Continue.

Continue.Continue.qualifying child.The child is not a

to you

No.Yes.

3

2010

Number of months child

Child's relationship 5

Child 3Qualifying Child Information

United States during

Yes.

Child's name

No.No.

6lived with you in the

Child's year of birth

Yes. No.Yes.

Child's SSN

Yes.

1

Child 2

4

2

No.

Child 1

No.Yes.b

a

Before you begin:

SCHEDULE EIC

43

Earned Income CreditQualifying Child Information

1040-Sch EIC (2010) FDEIC-1WV 1.31Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

2,684.

Sequence No.Attachment

47


4,000.

0.4,000.

20,896.

17,896.2,684.

1,598.

0.

1,598.

5,666.

0.2,684.

X

X

Form 8812

.

.

.

.

D epartment of th e TreasuryInternal Revenue Service (99)

No.

Form 1040, line 65,

(2010)

Complete and attach to Form 1040, Form 1040A, or Form 1040NR.

Form 1040A, line 42, or

Is the amount on line 4a more than $3,000?

Multiply the amount on line 5 by 15% (.15) and enter the result

Enter this amount on

No.

Next. Do you have three or more qualifying children?

Yes.

Form 1040NR, line 62.

Enter the amount from Form 1040NR, line 64.

Enter the amount from Form 1040, line 51, Form 1040A, line 33, or Form 1040NR, line 48 OMB No. 1545-1620Subtract line 2 from line 1. If zero, stop; you cannot take this credit

instructions)Nontaxable combat pay (see separate

27 and 55, plus any taxes that you identified using code Enter the total of the amounts from Form 1040NR, lines

Sequence No.Attachment

Enter -0-.

Earned income (see separate instructions)

"UT" and entered on the dotted line next to line 59.

Yes.

(see separate instructions).

Subtract line 10 from line 9. If zero or less, enter - 0-

If you used Pub. 972, enter the amount from line 8 of the worksheet on page 4 of the publication.

Enter the larger of line 6 or line 11

OMB No. 1545-0074

Enter the amount from line 6 of your Child Tax Credit Worksheet (see the

41a, plus any excess social security and tier 1 RRTA

Enter the amount from line 6 of your Child Tax Credit Worksheet (see the

taxes withheld that you entered to the left of line 44


64a and 69.

Form

Instructions for Form 1040NR, line 48).

Instructions for Form 1040A, line 33).

smaller of line 3 or line 6 on line 13.

line 13. Otherwise, go to line 7.If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on

This is your additional child tax credit

If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the

"UT" and entered on the dotted line next to line 60.27 and 57, plus any taxes that you identified using code

1040A filers:

Add lines 7 and 8

Leave line 5 blank and enter -0- on line 6.

Enter the total of the amounts from Form 1040, lines

6. If married filing jointly, include your spouse's amounts with yours. If youWithheld social security and Medicare taxes from Form(s) W- 2, boxes 4 and

worked for a railroad, see separate instructions

1040 filers:

Instructions for Form 1040, line 51). Enter the amount from line 6 of your Child Tax Credit Worksheet (see the

Enter the total of the amounts from Form 1040, lines

Enter the total of the amount from Form 1040A, line1040A filers:

1040 filers:

Subtract $3,000 from the amount on line 4a. Enter the result

1040NR filers:


1040 filers:

1040NR filers:

1040NR filers:

1040A filers:

9

8

10

10

7

7

9

8

13

12

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

13

11

Next, enter the smaller of line 3 or line 12 on line 13.12

11

4

3

a

4b

2

1

1

3

2

5

4a

5

66

b

Additional Child Tax CreditPart III

All FilersPart I

Part II Certain Filers Who Have Three or More Qualifying Children

47

Additional Child Tax Credit

8812

8812 (2010) FD8812-1WV 1.13Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.


See separate instructions.

X

800

20,979

X

150,000

X

0

800

800

Attach to Form 1040A or 1040.D epartment of th e TreasuryInternal Revenue Service (99)

Did you (or your spouse, if filing jointly) receive an economic recovery payment in 2010? You may

but you received social security benefits, supplemental security income, railroad retirement

Enter -0- on line 10 and go to line 11.

AttachmentSequence No.

here and on Form 1040, line 63; or Form 1040A, line 40

Schedule M (Form 1040A or 1040) 2010

Enter the total of the payments you (and your spouse, if filing jointly) received in 2010. Do

issues social security numbers.

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

You cannot take the making work pay credit if you can be claimed as someone else's dependent or if you are a nonresident alien.

* If you are filing Form 2555, 2555- EZ, or 4563 or you are excluding income from Puerto Rico, see instructions.


have received this payment in 2010 if you did not receive an economic recovery payment in 2009

Making work pay credit. Subtract line 10 from line 9. If zero or less, enter - 0- . Enter the result

not enter more than $250 ($500 if married filing jointly)

OMB No. 1545-0074


Subtract line 8 from line 4. If zero or less, enter - 0-

Enter the amount from Form 1040, line 38* , or Form 1040A, line 22

benefits, or veterans disability compensation or pension benefits in November 2008, December

Enter $75,000 ($150,000 if married filing jointly)

Subtract line 6 from line 5Skip line 8. Enter the amount from line 4 on line 9 below.

Is the amount on line 5 more than the amount on line 6?

Multiply line 1a by 6.2% (.062)

Nontaxable combat pay included on line 1a (see instructions)

section 457 plan, or

Enter $400 ($800 if married filing jointly)

2008, or January 2009 (see instructions).

(e) You are filing Form 2555 or 2555- EZ.

Multiply line 7 by 2% (.02)

Do you (and your spouse if filing jointly) have 2010 wages of more than $6,451 ($12,903 if married filing jointly)?

Enter the smaller of line 2 or line 3 (unless you checked "Yes" on line 1a)

Important: Check the "No" box on line 1a and see the instructions if:

on your tax return. A social security number does not include an identification number issued by the IRS. Only the Social Security AdministrationTo take the making work pay credit, you must include your social security number (if filing a joint return, the number of either you or your spouse)

(a) You have a net loss from a business,

(c) Your wages include pay for work performed while an inmate in a penal institution, (d) You received a pension or annuity from a nonqualified deferred compensation plan or a nongovermental

Enter your earned income (see instructions)Skip lines 1a through 3. Enter $400 ($800 if married filing jointly) on line 4 and go to line 5.

(b) You received a taxable scholarship or fellowship grant not reported on a Form W- 2,

11

3

2

1b

4

6

55

4

Yes.

1a

1aNo.

3

2

b

Yes.

10

9

No.

11

KBA

10

8

9

8

7

Yes. 7

6

No.

(Form 1040A or 1040)SCHEDULE M Making Work Pay Credit

166

1040 Sch M (2010) FDM-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

December 31, 2010

PAUL M MILLER and LAURA A MILLER

Not Applicable

Not Applicable

SIGN AND DATE YOUR RETURN

KEEP A COPYClick on Main Menu and then E-File or Print to print yourreturn. Attach your copy of each W-2, W-2G, 1099R or 1099G

20,97920,979

5790

5383378

0

GEORGIA

Please sign and date Form GA 8453-OL. When filing a joint return,both you and your spouse need to sign the form.Keep a copy with your records for three years.

with withholding. Keep with your records for three years.

FOR THE YEAR ENDING

Instructions

Prepared for

Mailing

TaxSummary

payable to

Address

Make check

Special

2010 STATE TAX RETURN FILING INSTRUCTIONS

$$

Gross Income

$Total Taxable Income

Adjusted Gross Income$

Total Deductions

$$

$$

Total PaymentsTotal Tax

Amount You OweRefund Amount

Check List (2010) STCHECK-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

M

221-94-9722 DAUGHTER

MILLERELISABETH

204-64-3554

1

GA

2231 HIGHWAY 19S

31021DUBLIN

MILLER

LAURA

173-66-7465PAUL

MILLER

A

B

BRIANNA MILLER


X X 2

ELLA MILLER


0

SEE ATTACHMENT

M arried f iling separate (Spouse's social securit y number must be entered above) H ead of H ouseh old or Qualif y ing Widow (er)M arried f iling joint

Filing Status

Residency Status

DEPT USE ONLY

Single

At tach ed

CK IF AD D R H AS CH ANGED

500 UET Except ion

See Tax B ooklet on Page 8

5.

4.

2.

Georgia Department of Revenue

A.

DEL

C. D.B.

Enter your Residency Status with the appropriate number4.

SPOUSE'S FIRST NAME

MI

LAST NAME

3.

YOUR FIRST NAME YOUR SOCIAL SECURITY NUMBER

MI SPOUSE'S SOCIAL SECURITY NUMBER

LAST NAME

EXT

2.

1.

(COUNTRY IF FOREIGN)

FULL-YEAR RESIDENT

Last Name

Social Security Number

PART-YEAR RESIDENT

ADDRESS (NO. AND STREET or P.O. BOX) (Use 2nd addr line for Apt, Suite or Bldg number)

6b. Spouse

Special Program Code

Number of exemptions (Check appropriate box(es) and enter total in 6c.)

Relationship to You

Version 1

SUFFIX

Individual Income Tax Return

6c.

CITY STATE ZIP CODE

6a. Yourself

(Approved software version)


SUFFIX

Dependents (If you have more than 3 dependents, attach a list of additional dependents)

First Name, MI. Last Name

Enter Filing Status with appropriate letter (See Tax Booklet Page 10)

First Name, MI.

Relationship to You

7.

Last Name

First Name, MI.

Relationship to You


5.

3. NONRESIDENTTO1.

6.

Part- Year Residents and Nonresidents must omit Lines 9 thru 14 and use Schedule 3 of Form 500, page 6

(Rev. 10/10)Georgia Form

Page 1

500

2010

1100402711

500 (2010) GA500-1WV 1.2Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

2

173-66-7465

20979

3000

3000

17979

17400

5

579

5

383

5400

120004

20979

4

6

X

7b. Add Lines 6c and 7a. Enter total

a.

b.

you must enclose a copy of your Federal Form 1040 Pages 1 and 2.

7b.

9.

10.

x 1,300 =

8.

Total Itemized Deductions used in computing Federal Taxable Income. If you use itemized deductions, you must enclose Federal Schedule A

7a.

11c.11b.

11a.

Less adjustments: see Tax Booklet on Page 12, Line 12

Georgia Total Itemized Deductions

Federal Itemized Deductions (Schedule A-Form 1040) 12a.

12b.

c. 12c.

Self: 65 or over?

20.

19.

14b.

14a.

15.

14c.

16.

18.

17.


multiplied by $3,000 14b.

14a.

Number on Line 7a.

multiplied by $2,700

Add Lines 14a. and 14b. Enter total

Number on Line 6c.

Subtract either Line 11c or Line 12c from Line 10; enter balance

Georgia taxable income (Line 13 less Line 14c or Schedule 3, Line 14)

Credits from Schedule 2, Page 5, Line 12 of Form 500

Tax (Use Tax Table in the Tax Booklet on Pages 19- 21)

13. 13.

17.

16.

18.

20.

19. Georgia Income Tax Withheld

Balance (Line 16 less Line 17) if zero or less than zero, enter zero

Estimated Tax for 2010 and Form IT-560

15.

14c.

9.

8.

7a.

12.

11.

10.

(Enter total but not more than the amount on Line 16)

(Enter Tax Withheld Only and enclose W- 2s, 1099s, etc.)

Total of boxes

Spouse: 65 or over?

c.

Blind?Blind?

Total Standard Deduction (Line 11a + Line 11b)

Adjustments from Schedule 1 (see Tax Booklet on Page 10, Line 9)

Federal adjusted gross income (From Federal Form 1040, 1040A or 1040EZ)

Number of Dependents (DO NOT include yourself or your spouse)

b.

Standard Deduction (Do not use FEDERAL STANDARD DEDUCTION)

Georgia adjusted gross income (Net total of Line 8 and Line 9)

Version 1


Use EITHER Line 11c OR Line 12c (Do not write on both lines)

(Do not use FEDERAL TAXABLE INCOME) If the amount on Line 8 is $40,000 or more, or your gross income is less than your W- 2's

YOUR SOCIAL SECURITY NUMBER

See Tax Booklet on Page 11 Line 11

If amount on line 8, 9, 10, 13 or 15 is negative, check box. Example:

Georgia Form 500 Page 2

2010

H&R BLOCK

1100402721

1029-02701 2010 004 T1GA 10500 (2010) GA500-2WV 1.2Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

[email protected]

Processing Center

02/04/11For Information Only

For Information Only

378

378

383

173-66-7465

02/04/11

478-772-0131

X

(Refund) Mail Return To: Georgia Department of Revenue

PO Box 105597 Atlanta, GA 30348-5597

D o you w ant to auth orize D OR to d iscuss

NOYESth is return w ith th e named preparer.

Save the Cure Fund (No gift of less than $1.00)

THIS IS THE AMOUNT YOU OWE

21.

22.

Signature of Preparer

(Check box if deceased)

36.36.

35.

ENCLOSE ALL ITEMS IN RETURN ENVELOPE. DO NOT STAPLE YOUR CHECK, W- 2'S OR TAX RETURN

(If you are due a refund) Subtract the sum of Lines 25 thru 34 from Line 2435.

Georgia Student Finance Authority Fund (No gift of less than $1.00)

22.

24.

23.

25.

Total prepayment credits (Add Lines 19 and 20)

33.

If Line 22 exceeds Line 18 enter OVERPAYMENT amount

If Line 18 exceeds Line 22 enter BALANCE DUE STATE

32.

27.

26.

29.

28.

Georgia Wildlife Conservation Fund (No gift of less than $1.00)

and belief it is true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which the preparer has knowledge.


31.

Georgia National Guard Foundation (No gift of less than $1.00)

31.

30.

(Check box if deceased)

30.

Statewide Land Conservation Program (No gift of less than $1.00)

GA. Under penalty of perjury, I declare that I have examined this return, including accompanying schedules & statements, and to the best of my knowledge

Spouse's Signature

Taxpayer's Signature

Georgia Public Revenue Code Section 48- 2- 31 stipulates that taxes shall be paid in lawful money of the United States, free of any expense to the State of

Dog & Cat Sterilization Fund (No gift of less than $1.00)

34. 34.(If you owe) Add lines 23, 26 thru 34

23.

24.

Georgia Children and Elderly Fund (No gift of less than $1.00)

Georgia Cancer Research Fund (No gift of less than $1.00)

Form 500 UET (Estimated tax penalty)

25.

29.

28.

33.

32.

27.

26.

TAXPAYER EMAIL ADDRESS

NAME OF PREPARER OTHER THAN TAXPAYER

PHONE NUMBER

YOUR SOCIAL SECURITY NUMBER

DATE

PREPARER'S SSN/PTINPREPARER'S FEIN PHONE NUMBER

DATE

DO NOT WRITE IN THIS BOXDepartment Use Only

Version 1

Amount to be credited to 2011 ESTIMATED TAX


THIS IS YOUR REFUND

Georgia Form

2010

500 Page 3

1100402731

500 (2010) GA500-3WV 1.2Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

KALI-----------------------------------------------------------------------------Name SSN Relationship

DAUGHTER668-48-3330MILLER

Name: PAUL M & LAURA A MILLER2010Supporting Schedules

SSN: 173-66-7465

DependentsGA Form 500, Page 1-----------------------------------------------------------------------------

PAUL M MILLER 173-66-7465

000

0

0

00

0

00

0

00

20,896

0

20,896

0

0

Also enter th is amount on Form 1040, line 66b. See Combat pay, Nontaxable on th is page

Add all of your nontaxable combat pay (and your spouse's if f iling joint ly) if you elect to include it in earned income.* *

11.

* * Th e elect ion cannot be made on th e return of a taxpayer w h ose tax year ended bef ore October 5, 2005, due to h is or h er death .

2.

1.

4.

3.

3.

amount included in your earned income. To f ind out if th e income on line 26 or line 40 of Sch edule E is f rom a passive act ivit y, see th e Sch edule E inst ruct ions. If any of th e rentalreal estate income (or loss) included on Sch edule E, line 26, is not f rom a passive act ivit y, print "NPA" and th e amount of th at income (or loss) on th e dot ted line next to line 26.

Inst ruct ions f or lines 12 and 13. In f iguring th e amount to enter on lines 12 and 13, do not take into account any royalty income (or loss) included on line 26 of Sch edule E or any

included on line 11 above

included on line 11 above

estate income reported on your (and your spouse's) Sch edule C, line 31, or Sch edule C- EZ, line 3, but not

Enter th e total of all net income or losses f rom qualif ied joint ventures th at are passive act ivit ies w ith rental real

on th is line.)

11.included in net earnings f rom self - employment . D o not include th is amount on line 12 or 13 below

4.

1.

2.

th e rental of personal property deducted on Form 1040, line 36

property sh ow n on Form 1040, line 21

9.

Subt ract th e amount on line 9 of th is w orksh eet f rom th e amount on line 8. (If th e result is less th an zero, enter zero.)

Enter any expenses f rom Sch edule E, line 21, related to royalty income, plus any expenses f rom

8.

10.

12.

Add th e amounts on lines 1, 2, 3, 4, 7, 10, and 14. Enter th e total. Th is is your Investment Income

Combine th e amounts on lines 11, 12 and 13 of th is w orksh eet . (If th e result is less th an zero, enter - 0- .)

13.

12.

Enter th e total of any losses f rom passive act ivit ies (such as losses included on Sch edule E, lines 26,

14.

13.

Enter th e total of any net income f rom passive act ivit ies (such as income included on Sch edule E, lines 26, 29a

15

Enter any gain f rom Form 4797, Sales of B usiness Property, line 7. If th e amount on th at line is a loss,

Enter th e amount f rom Form 1040, line 13. If th e amount on th at line is a loss, enter - 0-

Subt ract line 6 of th is w orksh eet f rom line 5 of th is w orksh eet . (If th e result is less th an zero, enter - 0- .)

enter - 0- . (B ut , if you complete lines 8 and 9 of Form 4797, enter th e amount f rom line 9 instead.)

6.

4.on your return (If your ch ild received an Alaska Permanent Fund d ividend, use Worksh eet 2, on th e next page, to f igure th e amount to enter

5.

4.

5.

9.

8. Enter any royalty income f rom Sch edule E, line 4, plus any income f rom th e rental of personal

10.

7.

Enter th e amount f rom Form 1040, line 21, th at is f rom Form 8814 if you are f iling th at f orm to report your ch ild 's interest and d ividend income

6.

7.

3.

dot ted line next to line 7 of Form 1040).

1.

employer f or th e amount received as a pension or annuity.may be sh ow n in box 11 of th e Form W- 2. If taxpayer received such an amount but box 11 is b lank, contact th e

Amount received as a pension or annuity f rom a non qualif ied def erred compensat ion plan or a nongovernmental

Amount paid to an inmate in a penal inst itut ion f or w ork (put "PRI" and th e amount subt racted on th e

2.

sect ion 457 plan (put "D FC" and th e amount subt racted on th e dot ted line next to line 7 of Form 1040). Th is amount

EARNED INCOM E

2. Subt ract th at amount f rom th e amount on Form 1040, line 7. Enter th e result on line 1.

1. D etermine h ow much of th e amount on Form 1040, line 7, w as also reported on Sch edule SE, line 2.

2.

1.

amount on Form 1040, line 7, and enter th e result on line 1.* Ch urch Employees. D etermine h ow much of th e amount on Form 1040, line 7, w as also reported on Sch edule SE, line 5a. Subt ract th at amount f rom th e

If you are f iling Sch edule SE and th e amount on line 2 of th at sch edule includes an amount th at w as also reported on Form 1040, line 7:Clergy. Th e f ollow ing inst ruct ions apply to ministers, members of religious orders w h o h ave not taken a vow of poverty, and Ch rist ian Science pract it ioners.

Taxable sch olarsh ip or f ellow sh ip grant not reported on a Form W- 2.

16.

29b (col. (f )), 34b (col. (c)), or 40). (See inst ruct ions below f or lines 12 and 13.) D o not include any amount you

Yes. You cannot take th e cred it .

Is th e amount on line 15 more th an $3,100?

(col. (g)), 34a (col. (d)), or 40). (See inst ruct ions below f or lines 12 and 13.) D o not include any amount you

15.

14.

Enter any amount f rom Form 1040, line 8b, plus any amount on Form 8814, line 1b

Enter any amount f rom Form 1040, line 9a

Enter any amount f rom Form 1040, line 8a

th is publicat ion to f ind out if th e you can take th e cred it ; in th at case, go to Rule 7, next .)

Subt ract , if included on line 7, any:

Enter amount f rom Form 1040, line 7*

No. Go to Step 3 of th e Form 1040 inst ruct ions f or lines 64a and 64b to f ind out if you can take th e cred it (unless you are using

3.

Keep for Your RecordsUse this worksheet to figure investment income for the earned income credit when you file Form 1040.

Passive Activities

Capital Gain Net Income

Royalties and Rental Income from Personal Property

Interest and Dividends

SSNNameWorksheet 1.� Investment Income If You Are Filing Form 1040

Worksheet 2. Earned Income

X

WS EIC (2010) FDEICWS-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

PAUL M MILLER 173-66-7465

20,89620,896

20,8965,666

20,979

5,666

X

X

X

Enter any net f arm prof it (or loss) f rom Sch edule F, line 36, and f rom f arm partnersh ips, Sch edule K- 1 (Form 1065), box 14, code A*

Reminder -

Enter this amount on

Enter any amount from Form 1040, line 29

No. STOP You cannot take the credit.

No. Go to line 10.

1 qualifying child, is line 4b less than $35,535 ($40,545 if married filing jointly)?

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

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

Enter any net profit (or loss) from Schedule C, line 31; Schedule C- EZ, line 3; Schedule K- 1 (Form 1065), box 14,

Enter the total earned income from Part 4, line 4b, of this worksheet

If you have:

Look up the amount on line 6 above in the EIC Table in the Appendix to find the credit. Enter the credit here

Enter the amount from Form 1040, line 38

1 or more qualifying children, is the amount on line 8 less than $16,450 ($21,500 if married filing jointly)?Yes.

No qualifying children, is the amount on line 8 less than $7,500 ($12,500 if married filing jointly)?

Are the amounts on lines 8 and 6 the same?Yes.

code A (other than farming); and Schedule K-1 (Form 1065-B), box 9, code J1*

3 or more qualifying children, is line 4b less than $43,352 ($48,362 if married filing jointly)?

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

Combine lines 1f, 2c, 3, and 4a. This is the total earned incomeIf you have:

Enter your earned income from Worksheet 2, line 4

Combine lines 2a and 2b

Yes. Enter the amount from line 4b on line 6.

2 qualifying children, is line 4b less than $40,363 ($45,373 if married filing jointly)?

No qualifying children, is line 4b less than $13,460 ($18,470 if married filing jointly)?

Combine lines 1a, 1b, and 1cEnter the amount from Schedule SE, Section A, line 6, or Section B, line 13, whichever appliesSubtract line 1e from 1d

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

Form 1040, line 64a.

This is the earned income credit

Enter the amount from Schedule SE, Section A, line 3, or Section B, line 3, whichever applies

Look at the amounts on lines 10 and 7. Then, enter the smaller amount on line 11.No.

If line 7 is zero, STOP You cannot take the credit.

1a.

d.

c.

b.

f.

3.

f.

3.

e. e.

d.

c.

1a.

b.

b.

c.

2a.

b.

c.

4a.

9.

10.

6.

8.

6.

11. 11.

2a.

Look up the amount on line 8 in the EIC Table in the Appendix to find the credit. Enter the credit hereLeave line 10 blank; enter the amount from line 7 on line 11.

7.

b.

7.

5.

b.

4a.

8.

10.

Statutory Employees Filing Schedule C or C-EZ

Your Earned Income Credit

PART 1

All Filers Using EIC Worksheet B

PART 3

Filers Who Answered "No" on Line 9

Self-Employed and People With Church Employee Income Filing Schedule SE

PART 2 Self-Employed NOT Required to File Schedule SE

All Filers Using Worksheet BPART 5

PART 4

PART 7

PART 6

- Earned Income Credit (EIC) - Lines 64a and 64bB.

If your EIC for a year after 1996 was reduced or disallowed,

Name SSN

the credit for 2010.see page 50 to find out if you must file Form 8862 to take

Worksheet

WS EIC (2010) FDEICWS-2WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

Name(s) SSN

4,000

20,979

0

20,979

110,000

0

4,000

0

0

0

0

0

173-66-7465PAUL M MILLER

X

X

X

X

4

STOP

Note: You may be able to take th e addit ional ch ild tax cred it on Form 1040, line 65; Form 1040A, line 42; or Form 1040NR, line 62, only if you answ ered "Yes" on line 13.

Th en, use Form 8812 to f igure any addit ional ch ild tax cred it .First , complete your Form 1040 th rough line 64a (also complete line 69), Form 1040A th rough line 41a, or Form 1040NR th rough line 61 (also complete line 64).

Married filing separately - $55,000

Multiply the amount on line 6 by 5% (.05). Enter the result.

+

Single, head of household, or qualifying widow(er) - $75,000

Line 32 Line 47Line 50

Line 47Line 29

Add the following amounts from:

++

Enter the total.

Yes.

No.


Enter the amount from Form 1040, line 46; Form 1040A, line 28; or Form 1040NR, line 44.

Enter the amount from Form 1040, line 38; Form 1040A, line 22;

Subtract line 7 from line 1. Enter the result. Go to line 9.

For example, increase $425 to $1,000, increase $1,025 to $2,000, etc.

1040A and 1040NR Filers. Enter - 0- .

Add lines 2 and 3. Enter the total.

+

Exclusion of income from Puerto Rico, and Amounts from Form 2555, lines 45 and 50; Form 2555- EZ, line 18;

Enter the amount shown below for your filing status.

Line 31Line 49

Married filing jointly - $110,000

Residential energy efficient property credit, Form 5695, Part II.District of Columbia first-time homebuyer credit. Form 8859.

1040 filers. Enter the total of any -


+

No.

If the result is not a multiple of $1,000, increase it to the next multiple of $1,000Yes.

Line 46

++

Schedule R, line 22

Form 8834, line 22Form 8910, line 21

No.

Yes.

Subtract line 11 from line 9. Enter the result.Is the amount on line 8 of this worksheet more than the amount on line 12?

See the NOTE below. Enter this amount on Form 1040,line 51; Form 1040A, line 33; or

Enter the amount from line 8.Enter the amount from line 12.

Subtract line 5 from line 4.

Are you claiming any of the following credits?Mortgage interest credit, Form 8396.

x $1,000. Enter the result.Number of qualifying children:

No. Enter the amount from line 10.

Leave line 6 blank. Enter - 0- on line 7.

Yes. Complete the Line 11 Worksheet to figure the amount to enter here.

1040NR, line 48. You also cannot take the additional child tax credit on Form 1040, line 65; Form1040A, line 42; or Form 1040NR, line 62. Complete the rest of your Form 1040, 1040A, or Form 1040NR.

You cannot take the child take credit on Form 1040, line 51; Form 1040A, line 33; or Form

or Form 1040NR, line 37.

and Form 4563, line 15.

Form 1040NR, line 48.

+

Form 5695, line 11

+Line 48Line 45

1

child tax credit.

12

2.

3

6.

1.

4

13

4.

5.

5

7.

12.

11

2

11.

10.

9

13.

10

7

8

Form 8936, line 14

6

9.

This is your

3.

8.

Form 1040 or Form 1040A or Form 1040NR

Child Tax Credit Worksheet - 2010

WS CTC (2010) FDCTC-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

Name(s) SSN 173-66-7465PAUL M MILLER

20,896

20,896

20,896

worksheet in the Schedule M instructions.amount on line 1a of that form only if you check the "No" checkbox. You do not have to complete the

If you have any Schedule K- 1 amounts and you are not required to file Schedule SE, complete the appropriate line(s) of Schedule SE, Section A.

for the amount received as a pension or annuity

Enter any 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.* Reduce this amount by any

partnership expenses deducted on Schedule E. Do not include any statutory employee income or any other amounts

Enter any statutory employee income reported on line 1 of Schedule C or C- EZ

course of dealing in or trading section 1256 contracts) from section 1256 contracts or related property

Form 1040, line 27 or Form 1040NR, line 27; Schedule C; Schedule C-EZ; or Schedule F

Enter the amount from Form 1040, line 7, or Form 1040NR, line 8

Next, if you are filing Schedule C, C- EZ, F, or SE, or you received a Schedule K- 1 (Form 1065 or Form1065- B), go to line 2a. Otherwise, skip lines 2a through 2e and go to line 3.

If married filing jointly, include your spouse's amounts with yours when completing this worksheet.

Before you begin:

Use this worksheet only if you were sent here from the Line 11 Worksheet or line 4a of Form 8812, Additional Child Tax Credit.

Disregard community property laws when figuring the amounts to enter on this worksheet.

Enter the amount of any nontaxable combat pay received. Also enter this amount on Form 8812, line 4b.

If you are claiming the making work pay credit on Schedule M (Form 1040A or Form 1040), also enter this

your Form W- 2. If you received such an amount but box 11 is blank, contact your employer

This amount should be shown in Form(s) W- 2, box 12, with code Q

partnership section 179 expense deduction, any depletion on oil and gas properties, and any unreimbursed nonfarm

Do not include any amounts exempt from self- employment tax

exempt from self- employment tax. Options and commodities dealers must add any gain or subtract any loss (in the normal

Subtract line 5b from line 5a

included on Schedule E in partnership net income or (loss) or deducted on

dotted line next to line 7 of Form 1040 or line 8 of Form 1040NR)

Enter the amount from Form 1040, line 27 or Form 1040NR, line 27

If you were sent here from the Line 11 Worksheet enter this amount on line 2 of that worksheet.

Subtract line 7 from line 3Add lines 4a through 4c, 5c, and 6

2555, line 43, or Form 2555- EZ, line 18. Do not include anyamount that is also included on line 4a, 4b, or 4c aboveEnter the portion, if any, from Form 2555, line 44, that is also

Enter any amount included on line 3 that is also included on Form

A pension or annuity from a nonqualified 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 line 8 of Form 1040NR). This amount may be shown in box 11 of

If you were sent here from Form 8812, enter this amount on line 4a of that form.

If you used the farm optional method to figure net earnings from self- employment, enter

box 14, code A.* Reduce this amount by any partnership section 179 expense deduction, depletion on oil Schedule E.

Combine lines 1a, 1b, 2a, 2b, and 2e. If zero or less, stop. Do not complete the rest of this worksheet. Instead,

the amount from Schedule SE, Section B, line 15. Otherwise, skip this line and enter online 2e the amount from line 2cIf line 2c is a profit, enter the smaller of line 2c or line 2d. If line 2c is a (loss), enter the (loss) from line 2c

For work done while an inmate in a penal institution (enter "PRI" and this amount on the

Put your name and social security number on Schedule SE and attach it to your return.*

A scholarship or fellowship grant not reported on Form W-2

Enter any net farm profit or (loss) from Schedule F, line 36, and from farm partnerships, Schedule K- 1 (Form 1065),

enter - 0- on line 2 of the Line 11 Worksheet or line 4a of Form 8812, whichever appliesEnter any amount included on line 1a that is:a.

b.

d.

e.

4.

5.

3.

1.

2.

6.

b.

c.

a.

7.

8.

5b.

1b.

5a.

4b.

4c.

b.

7.

8.

6.

a.

5c.

4a.

c.

1a.

2a.

c.

a.

b.

2d.

2e.

3.

2b.

2c.

Taxable Earned Income Worksheet - 2010

WS CTC (2010) FDCTC-2WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

11,400

X

11,400

11,400

is more than $125,000 ($250,000 if married filing jointly) but less than $145,000 ($290,000 if (line 3 below)

1040 - Worksheet F - Recapture of COBRA Premium Assistance for Higher Income Taxpayers

No.

Yes.

4.

Add $300 to your earned income. Enter the total

Go to line 3.

7.

5.

6.

amount shown on line 9 and identify it as "COBRA"

60 or Form 1040NR, line 57. On thedotted line next to that line, enter the4.

Enter $950

2.

3.

Enter the smaller of line 1 or line 3

Is your earned income* more than $650?

If born before January 2, 1946, or blind, multiply the number on Form 1040, line 39a, Form 1040A, line 23a, by $1,100

No.

Enter the amount shown below for your filing status.

Can you (or your spouse if filing jointly) be claimed as a dependent?

Yes.

9.

Skip line 3; enter the amount from line 1 on line 4.

8.

Single or married filing separately - $5,700

Add lines 4, and 5. Enter the total here and on Form 1040, line 40; Form 1040A, line 24

Head of household - $8,400Married filing jointly or Qualifying widow(er) - $11,400

here and include it on Form 1040, line

2. Enter the total of any amounts from

1.Form 1040NR, line 35)

Form 2555, lines 45 and 50; Form

American Somoa and Puerto Rico15, and any exclusion of income from2555-EZ, line 18; and Form 4563, line

1. Enter your AGI (Form 1040, line 38 or

and go to line 5.

Do not complete this worksheet if you checked the box on line 39b; your standard deduction is zero. Also, do not complete this worksheet if you must use Schedule L to figure your standard deduction; see Exception on page 35.

you reported on Form 1040, lines 7, 12, and 18, minus the amount, if any, on line 27.

($1,400 if single or head of household). Otherwise, enter -0-

*Earned income includes wages, salaries, tips, professional fees, and other compensation received for personal services you performed. It alsoincludes any amount received as a scholarship that you must include in your income. Generally, your earned income is the total of the amount(s)

3. Modified AGI. Add lines 1 and 2

2010

places) as a decimal (rounded to at least 3

premium assistance* you received in8. Enter the amount of the COBRA

9. Multiply line 8 by line 7. Enter result

Enter $125,000 ($250,000 if married

Subtract line 4 from line 35.

filing jointly)

7. Divide line 5 by line 6. Enter the result

jointly)6. Enter $20,000 ($40,000 if married filing

6.

2.

1.

3.

5.

4. 4.

5.

6.

3.

1.

*Contact your former employer or health insurance plan to obtain the total premium assistance, if unknown.

Keep for Your Records

Standard Deduction Worksheet 1040, Line 40; 1040A, Line 24

Instructions: Use the following worksheet to figure the taxable portion of your COBRA premium if your modified AGI

married filing jointly).

173-66-7465PAUL M & LAURA A MILLER

WS 1040 (2010) FD1040WS-1WV 1.0Form Sof tw are Copyrigh t 1996 - 2011 H RB Tax Group, Inc.

2010TaxReturn

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