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Completed IRS 1040 Example

The document is a 2016 U.S. Individual Income Tax Return for taxpayer Narendra Baijnauth, who filed as single with an adjusted gross income of $11,535. The total tax calculated was $1,044, with a refund due of $787. The preparer of the return was A A Ali, who charged a preparation fee of $550.

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chambers8028
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© © All Rights Reserved
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0% found this document useful (0 votes)
86 views18 pages

Completed IRS 1040 Example

The document is a 2016 U.S. Individual Income Tax Return for taxpayer Narendra Baijnauth, who filed as single with an adjusted gross income of $11,535. The total tax calculated was $1,044, with a refund due of $787. The preparer of the return was A A Ali, who charged a preparation fee of $550.

Uploaded by

chambers8028
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

US 1040 Main Information Sheet 2016

Taxpayer Spouse
PRINTED 02/06/2018
SSN 014-82-4228
NARENDRA BAIJNAUTH Birth 09/22/1974
Death
Day Phone 407-437-3134
4309 BAY VISTA DR Evening 407-437-3134
KISSIMMEE FL 34746 Cell or Fax
PIN 24226

Email
Taxpayer Occupation COURIER Spouse Occupation
Filing Status SINGLE

Preparer ID: 12 Preparation Fee: 550.00 Date: 02/06/2018

Preparer: A A ALI LLB LLM MBA CPA CGMA Time in return 96 min.

Recap of 2016 Income Tax Return

Earned Income . . . . . . . . 6,083. Federal Tax . . . . . . . . . . . 1,044.


Federal AGI . . . . . . . . . . . 11,535. Withholding . . . . . . . . . . .
Taxable Income . . . . . . . . 1,185. Refund/(Due) . . . . . . . . . . (787.)
EIC . . . . . . . . . . . . . . . . . . 257. Tax Bracket . . . . . . . . . . . 10.0 %

State . . . . . . . . . . . . . .
Tax . . . . . . . . . . . . . . .
Withholding . . . . . . . .
Refund/Due . . . . . . . .
State . . . . . . . . . . . . . .
Tax . . . . . . . . . . . . . . .
Withholding . . . . . . . .
Refund/Due . . . . . . . .

REMARKS:

Walmart
Bank Product Information Advance Only Check Direct Deposit Debit Card
Direct2Cash
Qualifying refund . . . . . . . .
Fees . . . . . . . . . . . . . . . . . . .
Net refund . . . . . . . . . . . . . .
Advance . . . . . . . . . . . . . . . .
Federal disbursement . . . .
State disbursement . . . . . .
Check one . . . . . . . . . . . . . .

© 2016 Universal Tax Systems, Inc. and/or its affiliates and licensors. All rights reserved. US104001
Department of the Treasury—Internal Revenue Service (99)
1040 U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2016, or other tax year beginning , ending See separate instructions.
Your first name M.I. Last name Suffix Your social security number
NARENDRA BAIJNAUTH 014-82-4228
If a joint return, spouse's first name M.I. Last name Suffix Spouse's social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above
4309 BAY VISTA DR 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 Campaign
KISSIMMEE FL 34746 Check here if you, or your spouse if filing
Foreign country name Foreign province/state/county Foreign postal code jointly, want $3 to go to this fund. Checking
a box below will not change your tax or
refund. You Spouse

Filing Status 1 X Single 4 Head of household (with qualifying person). (See instructions.) If
the qualifying person is a child but not your dependent, enter this
2 Married filing jointly (even if only one had income) child's name here.
3 Married filing separately. Enter spouse's SSN above
and full name here.
Check only one First name Last name SSN
box. First name Last name 5 Qualifying widow(er) with dependent child
Boxes checked
Exemptions 6a X Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . . . . on 6a and 6b 1
b Spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No. of children
on 6c who:
c Dependents: (4) if child under age 17
(2) Dependent's (3) Dependent's lived with you 0
Enter Dependents on "Ln 6c - Dependents" tab below. social security number relationship to you
qualifying for child tax credit
did not live with
(1) First name Last name (see instructions)
you due to divorce
If more than four or separation 0
dependents, see (see instructions)
Dependents on 6c
instructions and not entered above
0
check here Add numbers on
d Total number of exemptions claimed . . . . . . . . . . . . . . . . . . . . . . . . lines above 1
Income 7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . . 7
8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . 8a
Attach Form(s)
bTax-exempt interest. Do not include on line 8a . . . . . . . . . 8b
W-2 here. Also
9a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . 9a
attach Forms
bQualified dividends . . . . . . . . . . . . . . . . . . . . 9b
W-2G and
10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . . 10
1099-R if tax
was withheld. 11 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . . . . . . 12 6,546
13 Capital gain or (loss). Attach Schedule D if required. If not required, check here 13
If you did not
14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . . 14
get a W-2,
15a IRA distributions . . . . . . . . . 15a b Taxable amount . . . . . 15b
see instructions.
16a Pensions and annuities . . . . . . 16a b Taxable amount . . . . . 16b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . 17 5,452
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20a Social security benefits . . . . . . 20a b Taxable amount . . . . . 20b
21 Other income. List type and amount 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income . . . 22 11,998
23 Educator expenses . . . . . . . . . . . . . . . . . . . . 23
Adjusted
24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ . . . . 24
Income 25 Health savings account deduction. Attach Form 8889 . . . . . . . 25
26 Moving expenses. Attach Form 3903 . . . . . . . . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE . . . . 27 463
28 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . 28
29 Self-employed health insurance deduction . . . . . . . . . . . 29
30 Penalty on early withdrawal of savings . . . . . . . . . . . . 30
31a Alimony paid b Recipient's SSN 31a
32 IRA deduction . . . . . . . . . . . . . . . . . . . . . . 32
33 Student loan interest deduction . . . . . . . . . . . . . . . 33
34 Tuition and fees. Attach Form 8917 . . . . . . . . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903 . . . . . 35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 463
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . . . . . . 37 11,535
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2016)
BCA
Form 1040 (2016) US1040$2 NARENDRA BAIJNAUTH 014-82-4228 Page 2
38 Amount from line 37 (adjusted gross income). . . . . . . . . . . . . . . . . . . . . . . 38 11,535
Tax and 39a Check You were born before January 2, 1952, Blind.
Credits if:
{
Spouse was born before January 2, 1952, Blind.
Total boxes
checked 39a
}
b If your spouse itemizes on a separate return or you were a dual-status alien, check here. . . 39b
Standard
Deduction
40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . . . . . 40 6,300
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 5,235
• People who 42 Exemptions. If line 38 is $155,650 or less, multiply $4,050 by the number on line 6d. Otherwise, see instructions . . . . 42 4,050
check any
box on line 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . . . . . . . . 43 1,185
39a or 39b or 119
44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44
who can be
claimed as a 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . . . . . . . 45
dependent,
see
46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . . . . . . . . 46
instructions. 47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 119
• All others: 48 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . 48
Single or
Married filing
49 Credit for child and dependent care expenses. Attach Form 2441 . . . . 49
separately, 50 Education credits from Form 8863, line 19 . . . . . . . . . . . . . 50
$6,300
Married filing
51 Retirement savings contributions credit. Attach Form 8880 . . . . . . 51
jointly or 52 Child tax credit. Attach Schedule 8812, if required . . . . . . . . . . 52 * Enter filing
Qualifying status on page 1.
widow(er), 53 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . 53
$12,600
Head of
54 Other credits from Form: a 3800 b 8801 c 54
household, 55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . . . . . . . . 55
$9,300
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . . . . . . . . 56 119
57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . . . 57 925
Other
58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . . . . . 58
Taxes 59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . . . . 59
60a Household employment taxes from Schedule H . . . . . . . . . . . . . . . . . . . . . . 60a
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . . . . . . . 60b
61 Health care: individual responsibility (see instructions) Full-year coverage X. . . . . . . 61
62 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 62
63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . . . . . . . . . . 63 1,044
Payments 64 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . 64
65 2016 estimated tax payments and amount applied from 2015 return . . . 65
If you have a 66a Earned income credit (EIC) . . . . . . . . . . . . . . . . . . 66a 257
qualifying b Nontaxable combat pay election . . . . . 66b
child, attach 67 Additional child tax credit. Attach Schedule 8812 . . . . . . . . . . . 67
Schedule EIC.
68 American opportunity credit from Form 8863, line 8 . . . . . . . . . . 68
69 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . 69
70 Amount paid with request for extension to file . . . . . . . . . . . . 70
71 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . 71
72 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . 72
73 Credits from Form: a 2439 b Reserved c 8885 d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . . . . . . . . 74 257
75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid . . . . 75
Refund 76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here. . . . . 76a
b Routing number c Type: Checking Savings
Direct deposit?
See d Account number
instructions. 77 Amount of line 75 you want applied to your 2017 estimated tax . . . 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions . . . . . 78 787
You Owe 79 Estimated tax penalty (see instructions) . . . . . . . . . . . . . . . 79
Do you want to allow another person to discuss this return with the IRS (see instructions)? X Yes. Complete below. No
Third Party
Designee's Phone Personal identification
Designee name no. number (PIN)
A A ALI CPA 407-298-1040 01040
Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and
Here accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature Date Your occupation Daytime phone number
Joint return? See
instructions. COURIER 407-437-3134
Keep a copy for Spouse's signature. If a joint return, both must sign. Date Spouse's occupation If the IRS sent you an Identity Protection
your records.

Print/Type preparer's name Preparer's signature Date Check if PTIN


Paid A A ALI LLB LLM MBA CPA A A ALI LLB LLM MBA CPA 02/06/2018 self-employed P00234657
Preparer Firm's name A A ALI CPA PA Firm's EIN 20-4051817
Use Only Firm's address 1322 N PINE HILLS RD Phone no. 407-298-1040
ORLANDO FL 32808 Form 1040 (2016)
Detach Here and Mail With Your Payment and Return

Department of the Treasury


Internal Revenue Service 2016 Form 1040-V Payment Voucher
Use this voucher when making a payment with Form 1040 Amount you are paying Dollars
Do not staple this voucher or your payment to Form 1040 by check or money order 787.
Make your check or money order payable to the "United States Treasury"
Write your Social Security Number (SSN) on your check or money order
1045
10

NARENDRA BAIJNAUTH
4309 BAY VISTA DR PO BOX 1214
KISSIMMEE FL 34746 Charlotte NC 28201-1214

014824228 YI BAIJ 30 0 201612 610


SCHEDULE C Profit or Loss From Business OMB No. 1545-0074
(Form 1040) (Sole Proprietorship)
Department of the Treasury Information about Schedule C and its separate instructions is at www.irs.gov/schedulec. Attachment
Internal Revenue Service (99) Attach to Form 1040, 1040NR, or 1041; partnerships generally must file Form 1065. Sequence No. 09
Name of proprietor Social security number (SSN)
NARENDRA BAIJNAUTH 014-82-4228
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
COURIER 492110
C Business name. If no separate business name, leave blank. D Employer ID number (EIN), (see instr.)

E Business address (including suite or room no.)


City, town or post office, state, and ZIP code
F Accounting method: (1) X Cash (2) Accrual (3) Other (specify)
G Did you "materially participate" in the operation of this business during 2016? If "No," see instructions for limit on losses . . . . X Yes No
H If you started or acquired this business during 2016, check here . . . . . . . . . . . . . . . . . . . . .
I Did you make any payments in 2016 that would require you to file Form(s) 1099? (see instructions) . . . . . . . . Yes X No
J If "Yes," did you or will you file required Forms 1099? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Part I Income
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you
on Form W-2 and the "Statutory employee" box on that form was checked . . . . . . . . . . . 1 7,200.
2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 7,200.
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . 5 7,200.
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . 6
7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 7,200.
Part II Expenses. Enter expenses for business use of your home only on line 30.
8 Advertising . . . . . . . 8 18 Office expense (see instructions) . 18
9 Car and truck expenses (see 19 Pension and profit-sharing plans 19
instructions) . . . . . . 9 654. 20 Rent or lease (see instructions):
10 Commissions and fees . . 10 a Vehicles, machinery, and equipment . 20a
11 Contract labor (see instructions) 11 b Other business property . . . 20b
12 Depletion . . . . . . . 12 21 Repairs and maintenance . . 21
13 Depreciation and section 179 22 Supplies (not included in Part III) 22
expense deduction (not
included in Part III) (see 23 Taxes and licenses . . . . . 23
instructions) . . . . . . . . 13 24 Travel, meals, and entertainment:
14 Employee benefit programs a Travel . . . . . . . . . . 24a
(other than on line 19). . . 14 b Deductible meals and
15 Insurance (other than health) . 15 entertainment (see instructions) 24b
16 Interest: 25 Utilities . . . . . . . . . 25
a Mortgage (paid to banks, etc.) 16a 26 Wages (less employment credits) . . 26
b Other . . . . . . . . . 16b 27a Other expenses (from line 48) . 27a
17 Legal and professional services . 17 b Reserved for future use . . . 27b
28 Total expenses before expenses for business use of home. Add lines 8 through 27a . . . . . . . 28 654.
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . . . . . 29 6,546.
30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method (see instructions).
Simplified method filers only: enter the total square footage of: (a) your home:
and (b) the part of your home used for business: . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30. . . . . . . . . . . . 30
31 Net profit or (loss). Subtract line 30 from line 29.
If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2.
(If you checked the box on line 1, see instructions) Estates and trusts, enter on Form 1041, line 3. 31 6,546.
If a loss, you must go to line 32.

32 If you have a loss, check the box that describes your investment in this activity (see instructions).
If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and 32a X All investment is at risk.
on Schedule SE, line 2. (If you checked the box on line 1, see the line 31 instructions.)
32b Some investment is
Estates and trusts, enter on Form 1041, line 3.
not at risk.
If you checked 32b, you must attach Form 6198. Your loss may be limited.
For Paperwork Reduction Act Notice, see the separate instructions. Schedule C (Form 1040) 2016
BCA
Schedule C (Form 1040) 2016 NARENDRA BAIJNAUTH 014-82-4228 Page 2
Part III Cost of Goods Sold (see instructions)

33 Method(s) used to
value closing inventory: a Cost b Lower of cost or market c Other (attach explanation)
34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory?
If "Yes," attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

35 Inventory at beginning of year. If different from last year's closing inventory, attach explanation . . 35

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . . . 36

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . . . 37

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 . . . . . 42
Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on
line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 to find
out if you must file Form 4562.

43 When did you place your vehicle in service for business purposes? (month, day, year) 01/01/2016

44 Of the total number of miles you drove your vehicle during 2016, enter the number of miles you used your vehicle for:

a Business 1212 b Commuting (see instructions) c Other

45 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . . . . X Yes No

46 Do you (or your spouse) have another vehicle available for personal use? . . . . . . . . . . . . . . . X Yes No

47 a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . . . . . X Yes No

b If "Yes," is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes No


Part V Other Expenses. List below business expenses not included on lines 8–26 or line 30.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . . . . 48


Schedule C (Form 1040) 2016
Schedule E (Form 1040) 2016 Attachment Sequence No. 13 Page 2
Name(s) shown on return. Do not enter name and social security number if shown on other side. Your social security number
NARENDRA BAIJNAUTH 014-82-4228
Caution: The IRS compares amounts reported on your tax return with amounts shown on Schedule(s) K-1.
Part II Income or Loss From Partnerships and S Corporations Note: If you report a loss from an at-risk activity for
which any amount is not at risk, you must check the box in column (e) on line 28 and attach Form 6198. See instructions.
27 Are you reporting any loss not allowed in a prior year due to the at-risk, excess farm loss, or basis limitations, a prior year
unallowed loss from a passive activity (if that loss was not reported on Form 8582), or unreimbursed
partnership expenses? If you answered "Yes," see instructions before completing this section. Yes X No
(b) Enter P for (c) Check if (d) Employer (e) Check if
28 (a) Name partnership; S foreign identification any amount is
for S corporation partnership number not at risk
A STATE TO STATE COURIER INC S 26-1920502
B
C
D
Passive Income and Loss Nonpassive Income and Loss
(f) Passive loss allowed (g) Passive income (h) Nonpassive loss (i) Section 179 expense (j) Nonpassive income
(attach Form 8582 if required) from Schedule K-1 from Schedule K-1 deduction from Form 4562 from Schedule K-1
A 16,035. 21,487.
B
C
D
29 a Totals 21,487.
b Totals 16,035.
30 Add columns (g) and (j) of line 29a . . . . . . . . . . . . . . . . . . . . . . . . . . 30 21,487.
31 Add columns (f), (h), and (i) of line 29b . . . . . . . . . . . . . . . . . . . . . . . . . 31 ( 16,035. )
32 Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the
result here and include in the total on line 41 below . . . . . . . . . . . . . . . . . . . . 32 5,452.
Part III Income or Loss From Estates and Trusts
(b) Employer
33 (a) Name
identification number
A
B
Passive Income and Loss Nonpassive Income and Loss
(c) Passive deduction or loss allowed (d) Passive income (e) Deduction or loss (f) Other income from
(attach Form 8582 if required) from Schedule K-1 from Schedule K-1 Schedule K-1
A
B
34 a Totals
b Totals
35 Add columns (d) and (f) of line 34a . . . . . . . . . . . . . . . . . . . . . . . . . 35
36 Add columns (c) and (e) of line 34b . . . . . . . . . . . . . . . . . . . . . . . . . 36 ( )
37 Total estate and trust income or (loss). Combine lines 35 and 36. Enter the result here and
include in the total on line 41 below . . . . . . . . . . . . . . . . . . . . . . . . . 37
Part IV Income or Loss From Real Estate Mortgage Investment Conduits (REMICs)—Residual Holder
(c) Excess inclusion from
(b) Employer (d) Taxable income (net loss) (e) Income from
38 (a) Name
identification number
Schedules Q, line 2c
from Schedules Q, line 1b Schedules Q, line 3b
(see instructions)

39 Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below 39
Part V Summary
40 Net farm rental income or (loss) from Form 4835. Also, complete line 42 below . . . . . . . . 40
41 Combine lines 26, 32, 37, 39, and 40. Enter the result here and on Form 1040, line 17, or Form 1040NR, line 18 .
Total income or (loss). 41 5,452.
42 Reconciliation of farming and fishing income. Enter your gross
farming and fishing income reported on Form 4835, line 7; Schedule K-1
(Form 1065), box 14, code B; Schedule K-1 (Form 1120S), box 17, code
V; and Schedule K-1 (Form 1041), box 14, code F (see instructions) . . . 42
43 Reconciliation for real estate professionals. If you were a real estate
professional (see instructions), enter the net income or (loss) you reported
anywhere on Form 1040 or Form 1040NR from all rental real estate activities in
which you materially participated under the passive activity loss rules . . . 43
BCA Schedule E (Form 1040) 2016
014-82-4228
2016 K-1 DETAIL REPORT

Short Long
Current Loss Allowed Term Term Sect. Rental Passive PTP
Gain/ Carry Gain/ Sch. B Capital Capital 1231 Sect. Carryover Carryover Carryover
Entity P/S Loss Forward Loss Interest Gains Gains Gain 179 Sch E 4797 Sch E 4797 Sch E 4797
--------------- - ------- ------- ------- ------- ------- ------- ------- ----- ------- ------- ------- ------- ------- -------
STATE TO STATE S 21487 21487 16035
----- ----- -----
21487 21487 16035
US Schedule EIC Earned Income Credit Worksheet 2016
Name: NARENDRA BAIJNAUTH SSN: 014-82-4228

Figure Your Credit


1 Amount from Form 1040 or 1040A, line 7, 1040EZ, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter the amount included in line 1 that was received
a by penal institution inmates for their work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b as a pension or annuity from a nonqualified deferred compensation plan or a nongovernmental section 457 plan.
This amount should be shown in box 11 of Form W2 and should be included in line 1 above . . . . . . . . . . . . . . . . . . . . . . . .
c for Medicaid waiver payments incorrectly reported on Form W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Taxable scholarship or fellowship grant not reported on Form(s) W2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Line 1 minus line 1a, line 1b, and line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4a If you were self-employed or reported income and expenses on Schedules C or CEZ as a statutory employee,
see instructions. If a member of the clergy, check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,083.
Nontaxable combat pay included?
Taxpayer Spouse Both No
Nontaxable combat pay . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Earned income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6083. 6,083.
6 Credit from EIC table on line 5 income . . . . . . . . . . . . . . . 465.
7 Adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . 11535.
8 Credit from EIC table on line 7 income, if line 7
greater than
$8,299 ($13,849 if married filing jointly) and no
qualifying children
$18,199 ($23,749 if married filing jointly)
and 1 or more qualifying children . . . . . . . . . . . . . . . . 257.
9 Earned income credit. If line 7 is less than
$8,300 ($13,850, $18,200, $23,750), line 6.
Otherwise the smaller of line 6 or line 8 . . . . . . . . . . . . . . . 257. 257.

© 2016 Universal Tax Systems, Inc. and/or its affiliates and licensors. All rights reserved. USWEIC$2
Schedule SE (Form 1040) 2016 Attachment Sequence No. 17 Page 2
Name of person with self-employment income (as shown on Form 1040 or Form 1040NR) Social security number of person
NARENDRA BAIJNAUTH with self-employment income 014-82-4228
Section B—Long Schedule SE
Part I Self-Employment Tax
Note. If your only income subject to self-employment tax is church employee income, see instructions. Also see instructions for the
definition of church employee income.
A If you are a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361, but you
had $400 or more of other net earnings from self-employment, check here and continue with Part I . . . . . . . .
1 a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065),
box 14, code A. Note. Skip lines 1a and 1b if you use the farm optional method (see instructions) . 1a
b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve
Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code Z . 1b ( )
2 Net profit or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K-1 (Form 1065),
box 14, code A (other than farming); and Schedule K-1 (Form 1065-B), box 9, code J1.
Ministers and members of religious orders, see instructions for types of income to report on
this line. See instructions for other income to report. Note. Skip this line if you use the nonfarm
optional method (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . 2 6,546.
3 Combine lines 1a, 1b, and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6,546.
4 a If line 3 is more than zero, multiply line 3 by 92.35% (0.9235). Otherwise, enter amount from line 3 4a 6,045.
Note. If line 4a is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions.
b If you elect one or both of the optional methods, enter the total of lines 15 and 17 here . . . . . 4b
c Combine lines 4a and 4b. If less than $400, stop; you do not owe self-employment tax. Exception.
If less than $400 and you had church employee income, enter -0- and continue. . . . . . 4c 6,045.
5 a Enter your church employee income from Form W-2. See
instructions for definition of church employee income . . . . . . . 5a
b Multiply line 5a by 92.35% (0.9235). If less than $100, enter -0- . . . . . . . . . . . . . . 5b
6 Add lines 4c and 5b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6,045.
7 Maximum amount of combined wages and self-employment earnings subject to social security
tax or the 6.2% portion of the 7.65% railroad retirement (tier 1) tax for 2016 . . . . . . . . . 7 118,500 00
8 a Total social security wages and tips (total of boxes 3 and 7 on Form(s)
W-2) and railroad retirement (tier 1) compensation. If $118,500 or
more, skip lines 8b through 10, and go to line 11 . . . . . . . . . 8a
b Unreported tips subject to social security tax (from Form 4137, line 10) 8b
c Wages subject to social security tax (from Form 8919, line 10) . . . 8c
d Add lines 8a, 8b, and 8c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8d
9 Subtract line 8d from line 7. If zero or less, enter -0- here and on line 10 and go to line 11 . . 9 118,500.
10 Multiply the smaller of line 6 or line 9 by 12.4% (0.124) . . . . . . . . . . . . . . . . . 10 750.
11 Multiply line 6 by 2.9% (0.029) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 175.
12 Self-employment tax. Add lines 10 and 11. Enter here and on Form 1040, line 57, or Form 1040NR, line 55 12 925.
13 Deduction for one-half of self-employment tax.
Multiply line 12 by 50% (0.50). Enter the result here and on
Form 1040, line 27, or Form 1040NR, line 27 . . . . . . . . . . 13 463.
Part II Optional Methods To Figure Net Earnings (see instructions)
Farm Optional Method. You may use this method only if (a) your gross farm income¹ was not more
than $7,560, or (b) your net farm profits² were less than $5,457.
14 Maximum income for optional methods . . . . . . . . . . . . . . . . . . . . . . . 14 5,040 00
15 Enter the smaller of: two-thirds (²/ 3) of gross farm income¹ (not less than zero) or $5,040. Also
include this amount on line 4b above . . . . . . . . . . . . . . . . . . . . . . . . 15
Nonfarm Optional Method. You may use this method only if (a) your net nonfarm profits³ were less than $5,457
and also less than 72.189% of your gross nonfarm income, and (b) you had net earnings from self-employment
of at least $400 in 2 of the prior 3 years. Caution. You may use this method no more than five times.
16 Subtract line 15 from line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Enter the smaller of: two-thirds (²/3) of gross nonfarm income (not less than zero) or the
amount on line 16. Also include this amount on line 4b above . . . . . . . . . . . . . . . 17
¹ From Sch. F, line 9, and Sch. K-1 (Form 1065), box 14, code B. ³ From Sch. C, line 31; Sch. C-EZ, line 3; Sch. K-1 (Form 1065), box 14, code
A; and Sch. K-1 (Form 1065-B), box 9, code J1.
² From Sch. F, line 34, and Sch. K-1 (Form 1065), box 14, code
A—minus the amount you would have entered on line 1b had you not From Sch. C, line 7; Sch. C-EZ, line 1; Sch. K-1 (Form 1065), box 14, code
used the optional method. C; and Sch. K-1 (Form 1065-B), box 9, code J2.
Schedule SE (Form 1040) 2016
Form 982 Reduction of Tax Attributes Due to Discharge of OMB No. 1545-0046
(Rev. January 2016) Indebtedness (and Section 1082 Basis Adjustment)
Attach this form to your income tax return. Attachment
Department of the Treasury
Internal Revenue Service Information about Form 982 and its instructions is at www.irs.gov/form982. Sequence No. 94
Name shown on return Identifying number
NARENDRA BAIJNAUTH 014-82-4228
Part I General Information (see instructions)
1 Amount excluded is due to (check applicable box(es)):
a Discharge of indebtedness in a title 11 case . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Discharge of indebtedness to the extent insolvent (not in a title 11 case) . . . . . . . . . . . . . . . . . X
c Discharge of qualified farm indebtedness . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d Discharge of qualified real property business indebtedness . . . . . . . . . . . . . . . . . . . . . .
e Discharge of qualified principal residence indebtedness . . . . . . . . . . . . . . . . . . . . . . . .
2 Total amount of discharged indebtedness excluded from gross income . . . . . . . . . . . 2 8,373.
3 Do you elect to treat all real property described in section 1221(a)(1), relating to property held for sale to
customers in the ordinary course of a trade or business, as if it were depreciable property? . . . . . . Yes No
Part II Reduction of Tax Attributes. You must attach a description of any transactions resulting in the reduction in
basis under section 1017. See Regulations section 1.1017-1 for basis reduction ordering rules, and, if
applicable, required partnership consent statements. (For additional information, see the instructions for Part II.)
Enter amount excluded from gross income:
4 For a discharge of qualified real property business indebtedness applied to reduce the basis of
depreciable real property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 That you elect under section 108(b)(5) to apply first to reduce the basis (under section 1017) of
depreciable property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Applied to reduce any net operating loss that occurred in the tax year of the discharge or carried
over to the tax year of the discharge . . . . . . . . . . . . . . . . . . . . . . . . . 6

7 Applied to reduce any general business credit carryover to or from the tax year of the discharge . 7
8 Applied to reduce any minimum tax credit as of the beginning of the tax year immediately after
the tax year of the discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Applied to reduce any net capital loss for the tax year of the discharge, including any capital loss
carryovers to the tax year of the discharge . . . . . . . . . . . . . . . . . . . . . . 9
10 a Applied to reduce the basis of nondepreciable and depreciable property if not reduced on line 5.
DO NOT use in the case of discharge of qualified farm indebtedness . . . . . . . . . . . . 10a
b Applied to reduce the basis of your principal residence. Enter amount here ONLY if line 1e is
checked. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10b
11 For a discharge of qualified farm indebtedness applied to reduce the basis of:
a Depreciable property used or held for use in a trade or business or for the production of income
if not reduced on line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11a

b Land used or held for use in a trade or business of farming . . . . . . . . . . . . . . . . 11b

c Other property used or held for use in a trade or business or for the production of income . . . . 11c

12 Applied to reduce any passive activity loss and credit carryovers from the tax year of the discharge 12

13 Applied to reduce any foreign tax credit carryover to or from the tax year of the discharge . . . . 13
Part III Consent of Corporation to Adjustment of Basis of Its Property Under Section 1082(a)(2)

Under section 1081(b), the corporation named above has excluded $ from its gross income
for the tax year beginning and ending .
Under that section, the corporation consents to have the basis of its property adjusted in accordance with the regulations prescribed
under section 1082(a)(2) in effect at the time of filing its income tax return for that year. The corporation is organized under the laws
of .
(State of incorporation)

Note: You must attach a description of the transactions resulting in the nonrecognition of gain under section 1081.
For Paperwork Reduction Act Notice, see instructions. Form 982 (Rev. 1-2016)
BCA
OMB No. 1545-1629
Form 8867 Paid Preparer's Due Diligence Checklist
Earned Income Credit (EIC), Child Tax Credit (CTC), and American Opportunity Tax Credit (AOTC)
Department of the Treasury To be completed by preparer and filed with Form 1040, 1040A, 1040EZ, 1040NR, 1040SS, or 1040PR. Attachment
Internal Revenue Service Information about Form 8867 and its separate instructions is at www.irs.gov/form8867 . Sequence No. 70
Taxpayer name(s) shown on return Taxpayer identification number
NARENDRA BAIJNAUTH 014-82-4228
Enter preparer's name and PTIN
A A ALI LLB LLM MBA CPA CGMA P00234657
Due Diligence Requirements

Please complete the appropriate column for all credits claimed on this return
EIC CTC/ACTC AOTC
(check all that apply).
1 Did you complete the return based on information for tax year 2016
provided by the taxpayer or reasonably obtained by you? . . . . . . . . . X Yes No Yes No Yes No

2 Did you complete the applicable EIC and/or CTC/ACTC worksheets found in
the Form 1040, 1040A, 1040EZ, or 1040NR instructions, and/or the AOTC
worksheet found in the Form 8863 instructions, or your own worksheet(s) that
provides the same information, and all related forms and schedules for each
credit claimed? . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes No Yes No Yes No
3 Did you satisfy the knowledge requirement? Answer "Yes" only if you can
answer "Yes" to both 3a and 3b. To meet the knowledge requirement, did you: X Yes No Yes No Yes No
a Interview the taxpayer, ask adequate questions, and document the taxpayer's
responses to determine that the taxpayer is eligible to claim the credit(s)? . . X Yes No Yes No Yes No
b Review adequate information to determine that the taxpayer is eligible to
claim the credit(s) and in what amount? . . . . . . . . . . . . . . . X Yes No Yes No Yes No

4 Did any information provided by the taxpayer, a third party, or reasonably


known to you in connection with preparing the return appear to be incorrect,
incomplete, or inconsistent? (If "Yes," answer questions 4a and 4b. If "No," go
to question 5.) . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No Yes No Yes No
a Did you make reasonable inquiries to determine the correct or complete
information? . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes No Yes No Yes No

b Did you document your inquiries? (Documentation should include the


questions you asked, whom you asked, when you asked, the information that
was provided, and the impact the information had on your preparation of the
return.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes No Yes No Yes No

5 Did you satisfy the record retention requirement? To meet the record retention
requirement, did you keep a copy of any document(s) provided by the taxpayer
that you relied on to determine eligibility or to compute the amount for the
credit(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes No Yes No Yes No

In addition to your notes from the interview with the taxpayer, list those
documents, if any, that you relied on.
1099

6 Did you ask the taxpayer whether he/she could provide documentation to
substantiate eligibility for and the amount of the credit(s) claimed on the return? X Yes No Yes No Yes No

7 Did you ask the taxpayer if any of these credits were disallowed or reduced in a
previous year? . . . . . . . . . . . . . . . . . . . . . . . . . .
(If credits were disallowed or reduced, go to question 7a; if not, go to question 8.) X Yes No Yes No Yes No

a Did you complete the required recertification form(s)? . . . . . . . . . . Yes No Yes No Yes No
8 If the taxpayer is reporting self-employment income, did you ask adequate
questions to prepare a complete and correct Form 1040, Schedule C? . . . . X Yes No Yes No Yes No
For Paperwork Reduction Act Notice, see separate instructions. Form 8867 (2016)
BCA
Form 8867 (2016) NARENDRA BAIJNAUTH 014-82-4228 Page 2

Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to question 10.)

EIC CTC/ACTC AOTC

9a Did you explain to the taxpayer the rules about claiming the EIC when a child
is the qualifying child of more than one person (tie-breaker rules), and have
you determined that this taxpayer is, in fact, eligible to claim the EIC for the
number of children for whom the EIC is claimed? . . . . . . . . . . . . Yes No

b Did you explain to the taxpayer that he/she may not claim the EIC if the
taxpayer has not lived with the child for over half the year, even if the taxpayer
has supported the child? . . . . . . . . . . . . . . . . . . . . . Yes No
Due Diligence Questions for Returns Claiming CTC and/or additional CTC (If the return does not claim CTC or Additional CTC,
go to question 11.)
10 a Does the child reside with the taxpayer who is claiming the CTC/ACTC? (If
"Yes," go to question 10c. If "No," answer question 10b.) . . . . . . . . . Yes No

b Did you ask if there is an active Form 8332, Release/Revocation of Claim to


Exemption for Child by Custodial Parent, or a similar statement in place and,
if applicable, did you attach it to the return? . . . . . . . . . . . . . . Yes No
c Have you determined that the taxpayer has not released the claim to another
person? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Credit Eligibility Certification. )
11 Did the taxpayer provide substantiation such as a Form 1098-T and receipts
for the qualified tuition and related expenses for the claimed AOTC? . . . . . Yes No
You have complied with all due diligence requirements with respect to the credits claimed on the return of the
taxpayer identified above if you:
A. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for all credits
claimed;
B. Submit Form 8867 in the manner required;
C. Interview the taxpayer, ask adequate questions, document the taxpayer's responses on the return or in your notes,
review adequate information to determine if the taxpayer is eligible to claim the credit(s) and in what amount(s); and
D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions
under Document Retention.
1. A copy of Form 8867,
2. The applicable worksheet(s) or your own worksheet(s) for any credits claimed,
3. Copies of any taxpayer documents you may have relied upon to determine eligibility for and the amount of the credit(s),
4. A record of how, when, and from whom the information used to prepare this form and worksheet(s) was obtained, and
5. A record of any additional questions you may have asked to determine eligibility for and amount of the credits, and
the taxpayer's answers.
If you have not complied with all due diligence requirements for all credits claimed, you may have to pay a $510
penalty for each credit for which you have failed to comply.

Credit Eligibility Certification


12 Do you certify that all of the answers on this Form 8867 are, to the best of your
knowledge, true, correct and complete? . . . . . . . . . . . . . . . . X Yes No
Form 8867 (2016)
--

February 06, 2018

NARENDRA BAIJNAUTH
4309 BAY VISTA DR
KISSIMMEE, FL 34746

Dear NARENDRA,

Enclosed is your 2016 Federal 1040 income tax return.

Your Federal income tax balance due is $787.00.

Your Federal tax return has been filed electronically. To pay your balance due, please make
your check or money order payable to UNITED STATES TREASURY and write your Social
Security Number, daytime phone number, and ''2016 Form 1040'' on the check. Mail the
enclosed Form 1040-V and your payment on or before 4/18/2017 to the Internal Revenue
Service at the address on Form 1040-V. Do not staple or otherwise attach your payment to
Form 1040-V.

Please retain the enclosed copy of the return for your records.

If you have any questions, please call us. We appreciate the opportunity to serve you.

Sincerely,

A A ALI LLB LLM MBA CPA CGMA


OMB No. 1545-0074
IRS e-file Signature Authorization
Form 8879
US8879$1 Don't send to the IRS. This isn't a tax return.
Department of the Treasury Keep this form for your records.
Internal Revenue Service Information about Form 8879 and its instructions is at www.irs.gov/form8879 .

Submission Identification Number (SID)


5027852017057g001833
Taxpayer's name Social security number
NARENDRA BAIJNAUTH 014-82-4228
Spouse's name Spouse's social security number

Part I Tax Return Information — Tax Year Ending December 31, 2016 (Whole dollars only)
1 Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4; Form 1040NR,
line 37) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 11,535.
2 Total tax (Form 1040, line 63; Form 1040A, line 39; Form 1040EZ, line 12; Form 1040NR, line 61) . . . . 2 1,044.
3 Federal income tax withheld from Forms W-2 and 1099 (Form 1040, line 64; Form 1040A, line 40;
Form 1040EZ, line 7; Form 1040NR, line 62a) . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Refund (Form 1040, line 76a; Form 1040A, line 48a; Form 1040EZ, line 13a; Form 1040-SS, Part I, line 13a;
Form 1040NR, line 73a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Amount you owe (Form 1040, line 78; Form 1040A, line 50; Form 1040EZ, line 14; Form 1040NR, line 75) 5 787.
Part II Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)
Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements
for the tax year ending December 31, 2016, and to the best of my knowledge and belief, it is true, correct, and accurately lists all amounts and sources of income
I received during the tax year. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my
intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement
of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable,
I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution
account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial
institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the
authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be
received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic
payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the
personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent.

Taxpayer's PIN: check one box only


X I authorize A A ALI CPA PA to enter or generate my PIN 24226
ERO firm name Enter five digits, but
as my signature on my tax year 2016 electronically filed income tax return. don't enter all zeros

I will enter my PIN as my signature on my tax year 2016 electronically filed income tax return. Check this box only if you are
entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.
Your signature Date 02/26/2017
Spouse's PIN: check one box only

I authorize to enter or generate my PIN


ERO firm name Enter five digits, but
as my signature on my tax year 2016 electronically filed income tax return. don't enter all zeros

I will enter my PIN as my signature on my tax year 2016 electronically filed income tax return. Check this box only if you are
entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Spouse's signature Date

Practitioner PIN Method Returns Only—continue below


Part III Certification and Authentication—Practitioner PIN Method Only

ERO's EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN. 50278501040
Don't enter all zeros
I certify that the above numeric entry is my PIN, which is my signature for the tax year 2016 electronically filed income tax return
for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner
PIN method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns.
ERO's signature A A ALI LLB LLM MBA CPA CGMA Date 02/26/2017
ERO Must Retain This Form — See Instructions
Don't Submit This Form to the IRS Unless Requested To Do So
For Paperwork Reduction Act Notice, see your tax return instructions. Form 8879 (2016)
BCA
A A ALI, CPA
1322 PINE HILLS RD
ORLANDO FL 32808
407-298-1040

NARENDRA BAIJNAUTH INVOICE DATE: 02/06/2018


SS NUMBER: 014-82-4228
4309 BAY VISTA DR TELEPHONE: 407-437-3134
KISSIMMEE FL 34746 INVOICE NO.: 1274
2016 INVOICE
Description
1 Form 1040 200.00
1 Form 1040V, Payment Voucher for Balance Due Returns
1 Schedule A, Itemized Deductions 100.00
1 Schedule C, Profit or Loss from Business 230.00
1 Schedule E, Supplemental Income and Loss
1 Schedule EIC, Earned Income Credit 25.00
1 Schedule SE, Self-Employment Tax 5.00
1 Form 982, Reduction of Tax Attributes 25.00
1 Form 8867, Paid Preparer's Due Diligence Checklist
1 Affordable Care Act Worksheet 20.00
1 K-1 Worksheet
1 Electronic Filing Fee 20.00

Remarks:
Total Charges 625.00
THANK YOU FOR CHOOSING A A ALI,CPA. Discount 75.00
Sales Tax
Payments 550.00
Amount Due
© 2016 Universal Tax Systems, Inc. and/or its affiliates and licensors. All rights reserved. INVOICE
US 1040 Three - Year Tax Summary 2016
Name: NARENDRA BAIJNAUTH SSN: 014-82-4228
Gross Income 2014 2015 2016
Wages and salaries . . . . . . . . . . . . . . . . . . . .
Interest and dividends . . . . . . . . . . . . . . . . . .
Business income . . . . . . . . . . . . . . . . . . . . . . 6,546.
Sale of assets - gain or loss . . . . . . . . . . . . . .
Pension and IRA distributions . . . . . . . . . . . .
Rents, royalties, etc . . . . . . . . . . . . . . . . . . . . 10,102. 10,800. 5,452.
Unemployment and social security . . . . . . . . .
Other income . . . . . . . . . . . . . . . . . . . . . . . . .
Total gross income . . . . . . . . . . . . . . . . . . . . . . 10,102. 10,800. 11,998.
Adjustments to Income . . . . . . . . . . . . . . . . . 463.
Adjusted gross income . . . . . . . . . . . . . . . . . 10,102. 10,800. 11,535.
Itemized or Standard Deductions
Medical expense deduction . . . . . . . . . . . . . .
Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contributions . . . . . . . . . . . . . . . . . . . . . . . . .
Miscellaneous deductions . . . . . . . . . . . . . . .
Other itemized deductions . . . . . . . . . . . . . . .
Total deductions . . . . . . . . . . . . . . . . . . . . . . . 6,200. 6,300. 6,300.
Exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,950. 4,000. 4,050.
Taxable Income . . . . . . . . . . . . . . . . . . . . . . . (48.) 500. 1,185.
Tax (2016 - 1040, line 44) . . . . . . . . . . . . . . . . 0 51. 119.
Alternative minimum tax . . . . . . . . . . . . . . . . .
Other taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . 95. 925.
Credits and Payments
Credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Withholding . . . . . . . . . . . . . . . . . . . . . . . . . .
EIC and Additional Child Tax Credit . . . . . . . . 257.
Estimated tax payments . . . . . . . . . . . . . . . . .
Other payments . . . . . . . . . . . . . . . . . . . . . . .
Total credits and payments . . . . . . . . . . . . . . 257.
Tax liability after credits . . . . . . . . . . . . . . . . . 95. 51. 1,044.
Estimated tax penalty . . . . . . . . . . . . . . . . . . .
Refund or (Balance Due) . . . . . . . . . . . . . . . . (95.) (51.) (787.)
Federal marginal tax bracket . . . . . . . . . . . . . 10.0 % 10.0 % 10.0 %
Tax preparation fee . . . . . . . . . . . . . . . . . . . . 550.00 500.00 550.00
State refund or (balance due)
1st resident state refund (balance due) . . . . .
2nd resident state refund (balance due) . . . . .
1st part-year state refund (balance due) . . . . .
2nd part-year state refund (balance due) . . . .
1st nonresident state refund (balance due) . . .
2nd nonresident state refund (balance due) . .
3rd nonresident state refund (balance due) . .
4th nonresident state refund (balance due) . .
5th nonresident state refund (balance due) . .
NOTES FOR 2016:

© 2016 Universal Tax Systems, Inc. and/or its affiliates and licensors. All rights reserved. USSUMRY1
US Preparer Use Form 2016
Name: NARENDRA BAIJNAUTH SSN: 014-82-4228
Preparer Use Fields

Question Answer

AAA T27467

NOTES

Taxpayer Reminders

© 2016 Universal Tax Systems, Inc. and/or its affiliates and licensors. All rights reserved. USWPRUSE

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