Tax return (2)
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  • 1. Electronic Filing Instructions for your 2011 Federal Tax ReturnImportant: Your taxes are not finished until all required steps are completed. Declaration Control Number: Accepted: 01/22/2012 norma J buchanon p.o. box 501 forreston, IL 61030 | Balance | Your federal tax return (Form 1040A) shows a refund due to you in the Due/ | amount of $8,234.00. Applicable fees were deducted from your original Refund | refund amount of $8,234.00. Your refund is now $8,176.10. Because you | chose to have your TurboTax fees deducted from your refund, you will | receive e-mail from the University National Bank of Saint Paul, MN, | which handles this transaction. The IRS estimates that you can expect | your tax refund to be direct deposited into your account on or around | 02/01/2012. This is only an estimate. The account information you | entered - Account Number: 50002194 Routing Transit Number: 271184425. |______________________________________________________________________________________ | Wheres My | Before you call the Internal Revenue Service with questions about Refund? | your refund, give them 7 to 14 days processing time from the date | your return is accepted. If then you have not received your refund, | or the amount is not what you expected, contact the Internal Revenue | Service directly at 1-800-829-4477. You can also check www.irs.gov | and select the "Wheres my refund?" link. |______________________________________________________________________________________ | No | No signature form is required since you signed your return Signature | electronically. Document | Needed | |______________________________________________________________________________________ | What You | Your Electronic Filing Instructions (this form) Need to | Printed copy of your federal return Keep | |______________________________________________________________________________________ | 2011 | Adjusted Gross Income $ 24,094.00 Federal | Taxable Income $ 4,494.00 Tax | Total Tax $ 0.00 Return | Total Payments/Credits $ 8,234.00 Summary | Amount to be Refunded $ 8,234.00 | Effective Tax Rate -21.20% |______________________________________________________________________________________ Page 1 of 1
  • 2. Hi norma,We just want to thank you for using TurboTax this year! Its our goal to makeyour taxes easy and accurate, year after year. With TurboTax Federal Free Edition: - Your filed return has 100% guaranteed accurate calculations* - You received a printed copy of your return with supporting documents for your records Many happy returns from TurboTax.
  • 3. Form Department of the Treasury—Internal Revenue Service1040A U.S. Individual Income Tax Return (99) 2011 IRS Use Only—Do not write or staple in this space.Your first name and initial Last name OMB No. 1545-0074 Your social security numbernorma J buchanon 329-50-5462If a joint return, spouse’s first name and initial Last name Spouse’s social security numberHome address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above ▲p.o. box 501 and on line 6c are correct.City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaignforreston IL 61030 Check here if you, or your spouse if filing jointly, want $3 to go to this fund. CheckingForeign country name Foreign province/county Foreign postal code a box below will not change your tax or refund. You SpouseFiling 1 Single 4 Head of household (with qualifying person). (See instructions.)status 2 Married filing jointly (even if only one had income) If the qualifying person is a child but not your dependent,Check only 3 Married filing separately. Enter spouse’s SSN above and enter this child’s name here. ▶one box. full name here. ▶ 5 Qualifying widow(er) with dependent child (see instructions) }Exemptions 6a Yourself. If someone can claim you as a dependent, do not check Boxes checked on box 6a. 6a and 6b 1 b Spouse No. of children on 6c who: c Dependents: (4) ✓ if child under (2) Dependent’s social (3) Dependent’s • lived with age 17 qualifying forIf more than six you 2 security number relationship to you child tax credit (seedependents, see (1) First name Last name instructions) • did not liveinstructions. with you due to xavier Z taylor 324-96-0331 Grandchild divorce or ethan A watson 335-08-3033 Grandchild separation (see instructions) Dependents on 6c not entered above Add numbers on lines d Total number of exemptions claimed. above ▶ 3Income 7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7 24,094.AttachForm(s) W-2 8a Taxable interest. Attach Schedule B if required. 8ahere. Also b Tax-exempt interest. Do not include on line 8a. 8battachForm(s) 9a Ordinary dividends. Attach Schedule B if required. 9a1099-R if tax b Qualified dividends (see instructions). 9bwas 10 Capital gain distributions (see instructions). 10withheld. 11a IRA 11b Taxable amountIf you did not distributions. 11a (see instructions). 11bget a W-2, see 12a Pensions and 12b Taxable amountinstructions. annuities. 12a (see instructions). 12bEnclose, but donot attach, anypayment. Also, 13 Unemployment compensation and Alaska Permanent Fund dividends. 13please use Form 14a Social security 14b Taxable amount1040-V. benefits. 14a (see instructions). 14b 15 Add lines 7 through 14b (far right column). This is your total income. ▶ 15 24,094.Adjustedgross 16 Educator expenses (see instructions). 16income 17 IRA deduction (see instructions). 17 18 Student loan interest deduction (see instructions). 18 19 Tuition and fees. Attach Form 8917. 19 20 Add lines 16 through 19. These are your total adjustments. 20 21 Subtract line 20 from line 15. This is your adjusted gross income. ▶ 21 24,094.For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA Form 1040A (2011) REV 12/01/11 TTO
  • 4. Form 1040A (2011) Page 2Tax, credits, 22 Enter the amount from line 21 (adjusted gross income). 22 24,094.andpayments 23a Check if: { You were born before January 2, 1947, Spouse was born before January 2, 1947, Blind Total boxes Blind checked ▶ 23a } b If you are married filing separately and your spouse itemizesStandard deductions, check here ▶ 23bDeductionfor— 24 Enter your standard deduction. 24 8,500.• People who 25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 25 15,594.check anybox on line 26 Exemptions. Multiply $3,700 by the number on line 6d. 26 11,100.23a or 23b orwho can be 27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.claimed as a This is your taxable income. ▶ 27 4,494.dependent,see 28 Tax, including any alternative minimum tax (see instructions). 28 448.instructions. 29 Credit for child and dependent care expenses. Attach• All others:Single or Form 2441. 29Married filing 30 Credit for the elderly or the disabled. Attachseparately,$5,800 Schedule R. 30Married filing 31 Education credits from Form 8863, line 23. 31jointly orQualifying 32 Retirement savings contributions credit. Attachwidow(er),$11,600 Form 8880. 32Head of 33 Child tax credit (see instructions). 33 448.household,$8,500 34 Add lines 29 through 33. These are your total credits. 34 448. 35 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is your total tax. 35 0. 36 Federal income tax withheld from Forms W-2 and 1099. 36 3,125.If you have 37 2011 estimated tax payments and amount applieda qualifying from 2010 return. 37child, attach 38a Earned income credit (EIC). 38a 3,557.ScheduleEIC. b Nontaxable combat pay election. 38b 39 Additional child tax credit. Attach Form 8812. 39 1,552. 40 American opportunity credit from Form 8863, line 14. 40 41 Add lines 36, 37, 38a, 39, and 40. These are your total payments. ▶ 41 8,234. 42 If line 41 is more than line 35, subtract line 35 from line 41.Refund This is the amount you overpaid. 42 8,234.Direct 43a Amount of line 42 you want refunded to you. If Form 8888 is attached, check here ▶ 43a 8,234.deposit?See ▶ b Routing ▶ c Type: Checking Savingsinstructions number 2 7 1 1 8 4 4 2 5and fill in43b, 43c, ▶ d Accountand 43d or number 5 0 0 0 2 1 9 4Form 8888. 44 Amount of line 42 you want applied to your 2012 estimated tax. 44Amount 45 Amount you owe. Subtract line 41 from line 35. For details on how to pay,you owe see instructions. ▶ 45 46 Estimated tax penalty (see instructions). 46Third party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete the following. Nodesignee Designee’s name ▶ Phone no. ▶ Personal identification 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 knowledgeSign and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (otherhere than the taxpayer) is based on all information of which the preparer has any knowledge. Your signature Date Your occupation Daytime phone numberJoint return? ▲See page 13. cashier (815)742-2174Keep a copy Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protectionfor your PIN, enter itrecords. here (see inst.) Print/type preparers name Preparer’s signature Date PTINPaid Check ▶ if self-employedpreparer Firms name ▶ Firms EIN ▶ SELF PREPAREDuse only Firms address ▶ Phone no. REV 12/01/11 TTO Form 1040A (2011)
  • 5. SCHEDULE EIC Earned Income Credit 1040A ◀ OMB No. 1545-0074(Form 1040A or 1040) 2011 .......... Qualifying Child Information 1040Department of the Treasury Complete and attach to Form 1040A or 1040 EIC AttachmentInternal Revenue Service (99) only if you have a qualifying child. Sequence No. 43Name(s) shown on return Your social security numbernorma J buchanon 329-50-5462 • See the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, to makeBefore you begin: sure that (a) you can take the EIC, and (b) you have a qualifying child. • Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card. Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s social security card is not correct, call the Social Security Administration at 1-800-772-1213.▲ • 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 page 2 for details.!CAUTION • It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.Qualifying Child Information Child 1 Child 2 Child 31 Child’s name First name Last name First name Last name First name Last name If you have more than three qualifying children, you only have to list three to get the maximum credit. xavier Z taylor ethan A watson2 Child’s SSN The child must have an SSN as defined in the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, unless the child was born and died in 2011. If your child was born and died in 2011 and did not have an SSN, enter “Died” on this line and attach a copy of the child’s birth certificate, death certificate, or hospital medical records. 324-96-0331 335-08-30333 Child’s year of birth Year 1 9 9 9 Year 2 0 0 8 Year If born after 1992 and the child was If born after 1992 and the child was If born after 1992 and the child was younger than you (or your spouse, if younger than you (or your spouse, if younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b; go to line 5. go to line 5. go to line 5.4 a Was the child under age 24 at the end of 2011, a student, and younger than you (or Yes. No. Yes. No. Yes. No. your spouse, if filing jointly)? Go to line 5. Go to line 4b. Go to line 5. Go to line 4b. Go to line 5. Go to line 4b. b Was the child permanently and totally disabled during any part of 2011? Yes. No. Yes. No. Yes. No. Go to The child is not a Go to The child is not a Go to The child is not a line 5. qualifying child. line 5. qualifying child. line 5. qualifying child.5 Child’s relationship to you (for example, son, daughter, grandchild, niece, nephew, foster child, etc.) Grandchild Grandchild6 Number of months child lived with you in the United States during 2011 • If the child lived with you for more than half of 2011 but less than 7 months, enter “7.” • If the child was born or died in 2011 and 12 months 12 months months your home was the child’s home for the entire time he or she was alive during Do not enter more than 12 Do not enter more than 12 Do not enter more than 12 2011, enter “12.” months. months. months. Schedule EIC (Form 1040A or 1040) 2011For Paperwork Reduction Act Notice, see your tax BAA REV 11/22/11 TTOreturn instructions.
  • 6. 8812 Additional Child Tax Credit 1040 ◀ OMB No. 1545-0074 2011Form 1040A 1040NRDepartment of the Treasury 8812 AttachmentInternal Revenue Service (99) Complete and attach to Form 1040, Form 1040A, or Form 1040NR. Sequence No. 47Name(s) shown on return Your social security number norma J buchanon 329-50-5462 } Part I All Filers 1 1040 filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040, line 51). 1040A filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040A, line 33). 1 2,000. 1040NR filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040NR, line 48). If you used Pub. 972, enter the amount from line 8 of the Child Tax Credit Worksheet in the publication. 2 Enter the amount from Form 1040, line 51, Form 1040A, line 33, or Form 1040NR, line 48 . . . . . . 2 448. 3 Subtract line 2 from line 1. If zero, stop; you cannot take this credit . . . . . . . . . . . . . 3 1,552. 4a Earned income (see instructions on back) . . . . . . . . . . . . 4a 24,094. b Nontaxable combat pay (see instructions on back) . . . . . . . . . . . . . 4b 5 Is the amount on line 4a more than $3,000? No. Leave line 5 blank and enter -0- on line 6. Yes. Subtract $3,000 from the amount on line 4a. Enter the result . . . 5 21,094. 6 Multiply the amount on line 5 by 15% (.15) and enter the result . . . . . . . . . . . . . . 6 3,164. Next. Do you have three or more qualifying children? No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the smaller of line 3 or line 6 on line 13. Yes. If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on line 13. Otherwise, go to line 7. Part II Certain Filers Who Have Three or More Qualifying Children 7 Withheld social security and Medicare taxes from Form(s) W-2, boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If you } worked for a railroad, see instructions on back . . . . . . . . . . 7 8 1040 filers: Enter the total of the amounts from Form 1040, lines 27 and 57, plus any taxes that you identified using code “UT” and entered on line 60. 1040A filers: Enter -0-. 8 1040NR filers: Enter the total of the amounts from Form 1040NR, lines 27 and 55, plus any taxes that you identified using code “UT” and entered on line 59. } 9 Add lines 7 and 8 . . . . . . . . . . . . . . . . . . . 9 10 1040 filers: Enter the total of the amounts from Form 1040, lines 64a and 69. 1040A filers: Enter the total of the amount from Form 1040A, line 38a, plus any excess social security and tier 1 RRTA 10 taxes withheld that you entered to the left of line 41 (see instructions on back). 1040NR filers: Enter the amount from Form 1040NR, line 65. 11 Subtract line 10 from line 9. If zero or less, enter -0- . . . . . . . . . . . . . . . . . 11 12 Enter the larger of line 6 or line 11 . . . . . . . . . . . . . . . . . . . . . . 12 Next, enter the smaller of line 3 or line 12 on line 13.Part III Additional Child Tax Credit13 This is your additional child tax credit . . . . . . . . . . . . . . . . . . . 13 1,552. Enter this amount on Form 1040, line 65, 1040 Form 1040A, line 39, or 1040A Form 1040NR, line 63. 1040NR ◀For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 11/22/11 TTO Form 8812 (2011)
  • 7. We Need Your Consent to Use Your Tax InformationThe IRS requires that we obtain your consent to use specific information in your tax return to determineif you can use this payment method. Protecting Your PrivacyBecause you have selected this payment option, Intuit, the maker of TurboTax software, needs to checka few items in your return to determine whether you can pay your fees from your refund. For example,you must reside in the U.S. and your refund must be large enough to make the payment.We’re asking your permission to perform these checks and providing some important information toyou as required by the IRS. To agree, simply enter your name(s) and the date in the boxes below afterreading the consent and select "I Agree". I authorize Intuit, the maker of TurboTax, to use the information provided in this 2011 return todetermine whether a portion of the refund can be used to pay for tax preparation.IRS regulations require the following statements:"Federal law requires this consent form be provided you you. Unless authorized by law, we cannot use,without your consent, your tax return information for purposes other than the preparation and filing ofyour tax return.You are not required to complete this form. If we obtain your signature on this form by conditioning ourservices on your consent, your consent will not be valid. Your consent is valid for the amount of timethat you specify. If you do not specify the duration of your consent, your consent is valid for one year."norma buchanonTaxpayer’s First Name Taxpayer’s Last NameSpouse’s First Name Spouse’s Last name(if applicable) (if applicable)Please type the date below:01/22/2012DateIf you believe your tax return information has been disclosed or used improperly in a mannerunauthorized by law or without your permission, you may contact the Treasury Inspector General forTax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.
  • 8. Finally, We Need Your Consent to Disclose Your Tax InformationBefore we continue with processing your payment by transferring money from your tax refund, weneed to ask for your permission again, this time to forward certain of your information to University NationalBank of St. Paul, MN (’BANK’) and to Santa Barbara Tax Processing Group, LLC, (’SBTPG’), theadministrator and servicer of your tax refund transfer. To consent, type your first and last name andtoday’s date in the boxes below. How this protects your privacyBecause you are choosing to pay for your tax preparation with money from your refund, Intuit, themaker of TurboTax software, needs to send a limited amount of personal information from your taxreturn information, (such as your identifying information, deposit information, and refund amount)to BANK and to SBTPG, the administrator and servicer of payment for tax preparation servicesfrom your tax refund. Your information is sent via a secure SSL encrypted transmission for thesole purpose of refund processing tax preparation service payment. BANK and SBTPG arecontractually obligated to protect the confidentiality of your information.We’re asking your permission to disclose that information, and also providing some importantinformation to you as required by the IRS. To agree, simply enter your name(s) and the date in theboxes below after reading this consent and select "I Agree". I authorize Intuit, the maker of TurboTax, to disclose to BANK and SBTPG that portion ofmy 2011 tax return information that is necessary to enable BANK and SBTPG to process myrefund and pay for my tax preparation.IRS regulations require the following statements:"Federal law requires this consent form be provided to you. Unless authorized by law, we cannotdisclose, without your consent, your tax return information to third parties for purposes other than thepreparation and filing of your tax return. If you consent to the disclosure of your tax return information,Federal law may not protect your tax return information from further use or distribution.You are not required to complete this form. If we obtain your signature on this form by conditioning ourservices on your consent, your consent will not be valid. If you agree to the disclosure of your taxreturn information, your consent is valid for the amount of time that you specify. If you do not specifythe duration of your consent, your consent is valid for one year."norma buchanonPlease type the date below:01/22/2012DateIf you believe your tax return information has been disclosed or used improperly in a mannerunauthorized by law or without your permission, you may contact the Treasury Inspector General forTax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.sbia1301.SCR 12/01/11
  • 9. ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILINGTaxpayer: norma J buchanonPrimary SSN: 329-50-5462Federal Return Submitted: January 22, 2012 04:48 PM PSTFederal Return Acceptance Date: 01/22/2012The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The IntuitElectronic Postmark documents the filing date of your income tax return, and the electronic postmarkinformation should be kept on file with your tax return and other tax-related documentation.There are two important aspects of the Intuit Electronic Postmark:1. THE INTUIT ELECTRONIC POSTMARK.The electronic postmark shows the date and time Intuit received the federal return, and is deemed thefiling date if the date of the electronic postmark is on or before the date prescribed for filing of thefederal individual income tax return.TIMELY FILING:For your federal return to be considered filed on time, your return must be postmarked on or beforemidnight April 17, 2012. Intuit’s electronic postmark is issued in the Pacific Time (PT) zone. If you arenot filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark timeto determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone andyou electronically file your return at 9 AM on April 17, 2012, your Intuit electronic postmark will indicateApril 17, 2012, 6 AM. If your federal tax return is rejected, the IRS still considers it filed on time if theelectronic postmark is on or before April 17, 2012, and a corrected return is submitted and acceptedbefore April 22, 2012. If your return is submitted after April 22, 2012, a new time stamp is issued toreflect that your return was submitted after the IRS deadline and, consequently, is no longer consideredto have been filed on time.If you request an automatic six-month extension, your return must be electronically postmarked bymidnight October 15, 2012. If your federal tax return is rejected, the IRS will still consider it filed on timeif the electronic postmark is on or before October 15, 2012, and the corrected return is submitted andaccepted by October 20, 2012.2. THE ACCEPTANCE DATE.Once the IRS accepts the electronically filed return, the acceptance date will be provided by the IntuitElectronic Filing Center. This date is proof that the IRS accepted the electronically filed return.
  • 10. Electronic Filing Instructions for your 2011 Illinois Tax ReturnImportant: Your taxes are not finished until all required steps are completed. norma J buchanon p.o. box 501 forreston, IL 61030 | Balance | Your Illinois state tax return (Form IL-1040) shows a refund due to Due/ | you in the amount of $442.00. Your tax refund should be direct Refund | deposited into your account within 7 to 14 days after your return is | accepted. The account information you entered - Account Number: | 50002194 Routing Transit Number: 271184425. |______________________________________________________________________________________ | Wheres My | Before you call the Illinois Department of Revenue with questions Refund? | about your refund, give them 7 to 14 days processing time from the | date your return is accepted. If then you have not received your | refund, or the amount is not what you expected, contact the Illinois | Department of Revenue directly at 1-217-782-3336. From outside of | Illinois use 1-800-732-8866. You can also visit the Illinois | Department of Revenue web site at www.ILtax.com. |______________________________________________________________________________________ | No | No signature form is required since you signed your return Signature | electronically. Document | Needed | |______________________________________________________________________________________ | What You | Your Electronic Filing Instructions (this form) Need to | Printed copy of your state and federal returns Keep | Copies of Forms W-2, W-2G, and 1099-R | Copies of other states tax returns, if applicable |______________________________________________________________________________________ | 2011 | Taxable Income $ 18,094.00 Illinois | Total Tax $ 905.00 Tax | Total Payments/Credits $ 1,347.00 Return | Amount to be Refunded $ 442.00 Summary | |______________________________________________________________________________________ Page 1 of 1
  • 11. Illinois Department of Revenue 2011 Form IL-1040 Individual Income Tax Return or for fiscal year ending / tax.illinois.gov Do not write above this line. Step 1: Personal Information 329-50-5462 norma J buchanon p.o. box 501 forreston IL 61030 C Filing status (see instructions) Single or head of household Married filing jointly Married filing separately Widowed D Check if same-sex civil union return (see instructions) Step 2:1 Federal adjusted gross income from your U.S. 1040, Line 37; U.S. 1040A, Line 21; or (Whole dollars only) U.S. 1040EZ, Line 4 1 24,094 .00 Income 2 Federally tax-exempt interest and dividend income from your U.S. 1040 or 1040A, Line 8b; or U.S. 1040EZ 2 .00 3 Other additions. Attach Schedule M. 3 .00Staple W-2 and 1099 forms here 4 Total income. Add Lines 1 through 3. 4 24,094 .00 Step 3: 5 Social Security benefits and certain retirement plan income received if included in Line 1. Attach Page 1 of federal return. Base 5 .00 Income 6 Illinois Income Tax overpayment included in U.S. 1040, Line 10 6 .00 7 Other subtractions. Attach Schedule M. 7 .00 Check if Line 7 includes any amount from Schedule 1299-C. 8 Add Lines 5, 6, and 7. This is the total of your subtractions. 8 .00 9 Illinois base income. Subtract Line 8 from Line 4. 9 24,094 .00 Step 4: 10 a Number of exemptions from your federal return 3 x $2,000 a 6,000 .00 Exemptions b If someone can claim you as a dependent, see instructions. x $2,000 b .00 c Check if 65 or older: You + Spouse = x $1,000 c .00 d Check if legally blind: You + Spouse = x $1,000 d .00 Exemption allowance. Add Lines a through d. 10 6,000 .00 Step 5: 11 Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12. 11 18,094 .00 Net 12 Nonresidents and part-year residents: Check the box that applies to you during 2011 Income Nonresident Part-year resident, and write the Illinois base income from Schedule NR. Attach Schedule NR. 12 .00 Step 6: 13 Residents: Multiply Line 11 by 5% (.05). Nonresidents and part-year residents: Write the tax from Schedule NR. 13 905 .00 Tax 14 Recapture of investment tax credits. Attach Schedule 4255. 14 .00 15 Income tax. Add Lines 13 and 14. Cannot be less than zero. 15 905 .00Staple your check Step 7: 16 Income tax paid to another state while an Illinois resident. Attach Schedule CR. 16 .00 Tax After Non- 17 Property tax and K-12 education expense credit amount from refundable Schedule ICR. Attach Schedule ICR. 17 .00 Credits 18 Credit amount from Schedule 1299-C. Attach Schedule 1299-C. 18 .00 19 Add Lines 16, 17, and 18. This is the total of your credits. Cannot exceed the tax amount on Line 15. 19 0 .00 20 Tax after nonrefundable credits. Subtract Line 19 from Line 15. 20 905 .00 ID: 3WM REV 12/23/11 TTO This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of IL-1040 front (R-12/11) this information is required. Failure to provide information could result in a penalty.
  • 12. 21 Tax after nonrefundable credits from Page 1, Line 20 21 905 .00 22 Household employment tax. See instructions. Step 8: 22 .00 Other 23 Use tax on internet, mail order, or other out-of-state purchases from UT Worksheet or UT Table in the instructions. Do not leave blank. Taxes 23 0 .00 24 Total Tax. Add Lines 21, 22, and 23. 24 905 .00 9:Step 25 Illinois Income Tax withheld. Attach W-2 and 1099 forms. 25 1,169 .00 Payments 26 Estimated payments from Forms IL-1040-ES and IL-505-I,and including overpayment applied from 2010 return 26 .00Refundable 27 Pass-through entity tax payments. Attach Schedule K-1-P or K-1-T. 27 .00Credit 28 Earned Income Credit from Schedule ICR. Attach Schedule ICR. 28 178 .00 29 Total payments and refundable credit. Add Lines 25 through 28. 29 1,347 .00 Step 10: 30 Overpayment. If Line 29 is greater than Line 24, subtract Line 24 from Line 29. 30 442 .00 Result 31 Underpayment. If Line 24 is greater than Line 29, subtract Line 29 from Line 24. 31 .00 Step 11: 32 Late-payment penalty for underpayment of estimated tax. 32 .00 a Check if at least two-thirds of your federal gross income is from farming. Underpaymentof Estimated Tax b Check if you or your spouse are 65 or older and permanentlyPenalty and living in a nursing home. Donations c Check if your income was not received evenly during the year and you annualized your income on Form IL-2210. Attach Form IL-2210. 33 Voluntary charitable donations. Attach Schedule G. 33 .00 34 Total penalty and donations. Add Lines 32 and 33. 34 .00 Step 12: 35 If you have an overpayment on Line 30 and this amount is greater than Line 34, subtract Line 34 from Line 30. This is your remaining overpayment. 35 442 .00Refund or Amount You 36 Amount from Line 35 you want refunded to you 36 442 .00Owe 37 Complete to direct deposit your refund Routing number 2 7 1 1 8 4 4 2 5 Checking or Savings Account number 5 0 0 0 2 1 9 4 38 Subtract Line 36 from Line 35. This amount will be applied to your 2012 estimated tax. 38 0 .00 39 If you have an underpayment on Line 31, add Lines 31 and 34. or If you have an overpayment on Line 30 and this amount is less than Line 34, subtract Line 30 from Line 34. This is the amount you owe. 39 .00 Step 13: Under penalties of perjury, I state that I have examined this return, and, to the best of my knowledge, it is true, correct, and complete.Sign and Date (815)742-2174 Your signature Date Daytime phone number Your spouse’s signature Date Self-Prepared Paid preparer’s signature Date Preparer’s phone number Preparer’s FEIN, SSN, or PTINThird Party Check, and complete below, if you want to allow another person to discuss this return with the Illinois Department Designee of Revenue. Designee’s Designee’s Name (please print) Phone numberForm 1099-G Next year (in January 2013), we will no longer automatically mail 1099-G forms. Instead, we ask that you get this Information information from our website. Check the box if you still want us to mail you a paper Form 1099-G next year. If no payment enclosed, mail to: If payment enclosed, mail to: ILLINOIS DEPARTMENT OF REVENUE ILLINOIS DEPARTMENT OF REVENUE PO BOX 1040 SPRINGFIELD IL 62726-0001 GALESBURG IL 61402-1040 ID: 3WM REV 12/23/11 TTOIL-1040 back (R-12/11) DR AP RR DC
  • 13. Illinois Department of Revenue 2011 Schedule ICR Illinois Credits Attach to your Form IL-1040 IL Attachment No. 23Read this information first You must complete IL-1040 through Line 15 and Schedule CR, if Complete this schedule only if you are eligible for the applicable, before completing this schedule. Illinois Property Tax Credit The total amount of Illinois Property Tax Credit and K-12 K-12 Education Expense Credit Education Expense Credit cannot exceed tax. Only the Earned Income Credit may exceed tax. Earned Income Credit (EIC)Step 1: Provide the following informationnorma J buchanon 3 2 9 – 5 0 – 5 4 6 2 Your name as shown on your Form IL‑1040 Your Social Security numberStep 2: Figure your nonrefundable credit1 Write the amount of tax from your IL-1040, Line 15. 1 905.002 Write the amount of credit for tax paid to other states from your IL-1040, Line 16. 2 .003 Subtract Line 2 from Line 1. 3 905.00Section A - Illinois Property Tax Credit (See instructions for directions on how to obtain your property number)4 a rite the total amount of Illinois Property Tax paid during the W year for the real estate that includes your principal residence. tax 4a .00 b Write the property number for the property listed above. 4b c Write the property number for an adjoining lot, if included in Line 4a. 4c d Write the property number for another adjoining lot, if included in Line 4a. 4d e rite the portion of your tax bill that is deductible as a business W expense on U.S. income tax forms or schedules, even if you did not take the federal deduction. 4e .00 f Subtract Line 4e from Line 4a. 4f .00 g ultiply Line 4f by 5% (.05). M 4g .00 5 Compare Lines 3 and 4g, and write the lesser amount here. 5 0.006 Subtract Line 5 from Line 3. 6 905 .00Section B - K-12 Education Expense Credit You must complete the K-12 Education Expense Credit Worksheet on the backof this schedule and attach any receipt you received from your student’s school.7 a Write the total amount of K-12 education expenses from Line 13 of the worksheet on the back of this schedule. 7a .00 b You may not take a credit for the first $250 paid. 7b 250.00 c Subtract Line 7b from Line 7a. If the result is negative, enter “zero.” 7c .00 d Multiply Line 7c by 25% (.25). Compare the result and $500, and write the lesser amount here. 7d .008 Compare Lines 6 and 7d, and write the lesser amount here. 8 .00Section C - Total Nonrefundable Credit9 Add Lines 5 and 8. This is your nonrefundable credit amount. Write this amount on Form IL-1040, Line 17. 9 0.00 ID: 3WM REV 12/22/11 TTO Continued on Page 2 IL-1040 Schedule ICR (R-12/11) Page 1 of 4
  • 14. Schedule ICR — Page 2Step 3: Figure your refundable creditEarned Income Credit10 a Write the amount of federal EIC as shown on your U.S. 1040, Line 64a; U.S. 1040A, Line 38a; or U.S. 1040EZ, Line 8a. 10a 3,557 .00 b Multiply the amount on Line 10a by 5% (.05). 10b 178 .00 c Illinois residents: Write 1.0. Nonresidents and part-year residents: Write the decimal from Schedule-NR, Line 48. 10c 1.0000 d Multiply Line 10b by the decimal on Line 10c. 10d 178 .00 11 Write the amount from Line 10d here. This is your Illinois Earned Income Credit. Write this amount on Form IL-1040, Line 28. 11 178 .00 Section B Continued - K-12 Education Expense Credit Worksheet (continued from Step 2, Section B) You must complete this section and attach any receipt you received from your student’s school.12 Complete the following information for each of your qualifying students. If a student attended more than one qualifying school during the calendar year, please list separately. If you need more space, attach a separate piece of paper following this format. A B C D E F Student’s name Social Security number Grade School name School city Total tuition, (K-12 only) (IL K-12 schools only or write (IL cities only) book/lab fees “home school,” if applicable) a - - b - - c - - d - - e - - f - - g - - h - - i - - j - - 13 Add the amounts in Column F for Lines 12a through 12j (and the amounts from Column F of any additional pages you attached). This is the total amount of your qualified education expenses for this year. Write this amount here and on Step 2, Line 7a of this schedule. 13 .00 This form is authorized as outlined under the Illinois Income Tax Act. Disclosure ofPage 2 of 4 ID: 3WM REV 12/22/11 TTO this information is required. Failure to provide information could result in a penalty. IL-1040 Schedule ICR (R-12/11)