Appendix A

Please use this information for your Tax Return and Paper.

*All people, businesses, and information are fictional. Any relation to an actual person or business is accidental.

Harold Petersan

SSN: 0XX-01-1XXX

Date of Birth (DOB): 05/27/1975

Gross Pay: $51,750

401(k) contributions: $4,140

Healthcare costs (payroll deductions): $1347

Reported wages: $46,263

Social Security Wages: $50,403

Medicare Wages: $50,403

State Wages: $46,263

Taxes withheld:

Federal: $2896.06

Social Security: $3124.99

Medicare: $730.34

State: $682.38

sdi (mandatory disability insurance): $393.24

Employer: PointMark, INC

Address: 1111 One Park Place

City: One City

State: California

Zip code: 11111

Employers FED ID number: 33-01XXX11

Sarah Petersan

SSN: 001-02-XXXX

DOB: 08/11/1979

Gross Pay: $50,000

401(k) contributions: $4,000

Healthcare costs (payroll deductions): $1347

Reported wages: $44,653

Social Security Wages: $48,653

Medicare Wages: $48,653

State Wages: $44,653

Taxes withheld:

Federal: $2795.28

Social Security: $3016.49

Medicare: $704.98

State: $658.63

sdi (mandatory disability insurance): $379.55

Employer: CompanyOne

Address: 1111 Place Road

City: One City

State: California

Zip code: 11112

Employers FED ID number: 33-01XXX22

Dependent:

Tara Petersan

SSN: 001-XX-XX00

DOB: 12/29/2004

Child Care Costs: $10,320

Child Care Provider: fabulous daycare center

Address: 121 Place Road

City: One City

State: California

Zip code: 11111

Identifying number: 33-XXXX011

Life Change Events

Home Sale:

Primary residence sale price $520,000

cost basis (incurred three years prior) $300,000

Property Tax paid: $1,500

Mortgage Interest paid: $14,400