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DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 8879 IRS e-file Signature Authorization


OMB No. 1545-0074

Department of the Treasury


Internal Revenue Service a
a ERO must obtain and retain completed Form 8879.
Go to www.irs.gov/Form8879 for the latest information.
2019

F
Submission Identification Number (SID)
Taxpayer’s name Social security number
ALBERTO J ALMEIDA LANZ 002-15-5880
Spouse’s name Spouse’s social security number

Part I Tax Return Information — Tax Year Ending December 31, 2019 (Whole dollars only)
1 Adjusted gross income (Form 1040 or 1040-SR, line 8b; Form 1040-NR, line 35) . . . . . . . 1 -2,029.
2 Total tax (Form 1040 or 1040-SR, line 16; Form 1040-NR, line 61) . . . . . . . . . . . . 2 0.

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3 Federal income tax withheld from Forms W-2 and 1099 (Form 1040 or 1040-SR, line 17; Form 1040-NR,
line 62a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Refund (Form 1040 or 1040-SR, line 21a; Form 1040-NR, line 73a; Form 1040-SS, Part I, line 13a) . 4 1,060.
5 Amount you owe (Form 1040 or 1040-SR, line 23; Form 1040-NR, line 75) . . . . . . . . . 5

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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, 2019, and to the best of my knowledge and belief, they are true, correct, and complete. 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,

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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
I authorize Zunay Rabelo
T to enter or generate my PIN 5 5 8 8 0 as my
ERO firm name Enter five digits, but
don’t enter all zeros
signature on my tax year 2019 electronically filed income tax return.
NO
I will enter my PIN as my signature on my tax year 2019 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 a Date a

Spouse’s PIN: check one box only


I authorize to enter or generate my PIN as my
ERO firm name Enter five digits, but
don’t enter all zeros
signature on my tax year 2019 electronically filed income tax return.
DO

I will enter my PIN as my signature on my tax year 2019 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 a Date a


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. 6 5 5 4 2 0 1 2 3 4 5
Don’t enter all zeros

I certify that the above numeric entry is my PIN, which is my signature for the tax year 2019 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 Date a


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. BAA REV 03/16/20 PRO Form 8879 (2019)
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

1040 U.S. Individual Income Tax Return 2019


Form Department of the Treasury—Internal Revenue Service (99)
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is
one box.
a child but not your dependent. a
Your first name and middle initial Last name Your social security number
ALBERTO J ALMEIDA LANZ 002-15-5880
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Check here if you, or your spouse if filing
12400 VISTA ISLES DR 1422
jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your

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FORT LAUDERDALE FL 33325 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see instructions and  here a

Standard Someone can claim: You as a dependent Your spouse as a dependent

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Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4)  if qualifies for (see instructions):
(1) First name Last name Child tax credit Credit for other dependents

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1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1
2a Tax-exempt interest . . . . 2a b Taxable interest. Attach Sch. B if required 2b
3a Qualified dividends . . . . 3a b Ordinary dividends. Attach Sch. B if required 3b
Standard
Deduction for—
• Single or Married
filing separately,
4a
c
IRA distributions . .
Pensions and annuities .
. .
.
.
.
4a
4c
T b Taxable amount
d Taxable amount
.
.
.
.
.
.
.
.
.
.
.
.
4b
4d
$12,200 5a Social security benefits . . . 5a b Taxable amount . . . . . . 5b
• Married filing
6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . a 6
NO
jointly or Qualifying
widow(er), 7a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . 7a -2,029.
$24,400
• Head of b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . . . . . . . . a 7b -2,029.
household,
$18,350
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . . . . . . 8a
• If you checked b Subtract line 8a from line 7b. This is your adjusted gross income . . . . . . . . . . . a 8b -2,029.
any box under
Standard 9 Standard deduction or itemized deductions (from Schedule A) . . . . . 9 12,200.
Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10
see instructions.
11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . 11a 12,200.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . . . . . . . . . 11b 0.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019)
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7
Form 1040 (2019) Page 2
12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a 0.
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . . . . . . . a 12b 0.
13a Child tax credit or credit for other dependents . . . . . . . . . . 13a
b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . . . . . . . a 13b 0.
14 Subtract line 13b from line 12b. If zero or less, enter -0- . . . . . . . . . . . . . . . 14 0.
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . 15 0.
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . . . . . . a 16 0.
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . . . 17

• If you have a
18 Other payments and refundable credits:
qualifying child, a Earned income credit (EIC) . . . . . . . . . . . . No
. . . 18a
attach Sch. EIC.
• If you have b Additional child tax credit. Attach Schedule 8812 . . . . . . . . . 18b
nontaxable c American opportunity credit from Form 8863, line 8 . . . . . . . . 18c 1,000.
combat pay, see

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instructions. d Schedule 3, line 14 . . . . . . . . . . . . . . . . . 18d 60.
e Add lines 18a through 18d. These are your total other payments and refundable credits . . . . . a 18e 1,060.
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . . . . . . . a 19 1,060.
Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid . . . . . . 20 1,060.
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here . . . . . . a 21a 1,060.

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Direct deposit? a b Routing number 0 6 3 1 0 0 2 7 7 a c Type: Checking Savings
See instructions.
a d Account number 8 9 8 0 8 3 2 6 3 9 8 2
22 Amount of line 20 you want applied to your 2020 estimated tax . . . . a 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions . . . . . a

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23
You Owe 24 Estimated tax penalty (see instructions) . . . . . . . . . . . a 24
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee No
(Other than Designee’s Phone Personal identification
paid preparer) name a no. a number (PIN) a

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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here If the IRS sent you an Identity
Your signature Date
T Your occupation
Protection PIN, enter it here
F

Joint return? SELF-EMPLOYED (see inst.)


See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records.
NO
(see inst.)

Phone no. Email address


Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Zunay Rabelo, EA 03/21/2020 P01785647
Preparer Phone no. (305)456-5945 Self-employed
Firm’s name a JRA Professional Services
Use Only
Firm’s address a 8202 NW 14 St Doral FL 33126 Firm’s EIN a 47-1458699
Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 03/16/20 PRO Form 1040 (2019)
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

SCHEDULE 1 OMB No. 1545-0074


Additional Income and Adjustments to Income
2019
(Form 1040 or 1040-SR)
a Attach to Form 1040 or 1040-SR.
Department of the Treasury Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 01
Name(s) shown on Form 1040 or 1040-SR Your social security number
ALBERTO J ALMEIDA LANZ 002-15-5880
At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any
virtual currency? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . 1
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b Date of original divorce or separation agreement (see instructions) a
3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . . . . . 3 -2,029.

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4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . . 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . 7

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8 Other income. List type and amount a
8
9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a . . . . . . . . 9 -2,029.
Part II Adjustments to Income

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10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach
Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . . 12
13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . . . 13
14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . 14
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . 15
16
17
T
Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . .
Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . .
16
17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient’s SSN . . . . . . . . . . . . . . . . . . . . . a
NO
c Date of original divorce or separation agreement (see instructions) a
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees. Attach Form 8917 . . . . . . . . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or
1040-SR, line 8a . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
For Paperwork Reduction Act Notice, see your tax return instructions. REV 03/16/20 PRO Schedule 1 (Form 1040 or 1040-SR) 2019
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

SCHEDULE 3 OMB No. 1545-0074


Additional Credits and Payments
2019
(Form 1040 or 1040-SR)
a Attach to Form 1040 or 1040-SR.
Department of the Treasury Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 03
Name(s) shown on Form 1040 or 1040-SR Your social security number
ALBERTO J ALMEIDA LANZ 002-15-5880
Part I Nonrefundable Credits
1 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . . . . . 1
2 Credit for child and dependent care expenses. Attach Form 2441 . . . . . . . . . . . . 2
3 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . . . . . . 3 0.
4 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . . . . . . 4
5 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . . . . . . . . 5
6 Other credits from Form: a 3800 b 8801 c 6

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7 Add lines 1 through 6. Enter here and include on Form 1040 or 1040-SR, line 13b . . . . . . . 7 0.
Part II Other Payments and Refundable Credits
8 2019 estimated tax payments and amount applied from 2018 return . . . . . . . . . . . 8
9 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . . . . 9 60.

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10 Amount paid with request for extension to file (see instructions) . . . . . . . . . . . . . 10
11 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . . . . . . . . 11
12 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . . . . . . . . 12
13 Credits from Form: a 2439 b Reserved c 8885 d 13

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14 Add lines 8 through 13. Enter here and on Form 1040 or 1040-SR, line 18d . . . . . . . . . 14 60.
For Paperwork Reduction Act Notice, see your tax return instructions. REV 03/16/20 PRO Schedule 3 (Form 1040 or 1040-SR) 2019

T
NO
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

SCHEDULE C Profit or Loss From Business OMB No. 1545-0074

2019
(Form 1040 or 1040-SR) (Sole Proprietorship)
a Go to www.irs.gov/ScheduleC for instructions and the latest information.
Department of the Treasury Attachment
Internal Revenue Service (99) a Attach to Form 1040, 1040-SR, 1040-NR, or 1041; partnerships generally must file Form 1065. Sequence No. 09
Name of proprietor Social security number (SSN)
ALBERTO J ALMEIDA LANZ 002-15-5880
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
DRIVER a 4 8 5 3 0 0
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.) a 12400 VISTA ISLES DR, Apt. 1422
City, town or post office, state, and ZIP code FORT LAUDERDALE, FL 33325
Other (specify) a

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F Accounting method: (1) Cash (2) Accrual (3)
G Did you “materially participate” in the operation of this business during 2019? If “No,” see instructions for limit on losses . Yes No
H If you started or acquired this business during 2019, check here . . . . . . . . . . . . . . . . . a

I Did you make any payments in 2019 that would require you to file Form(s) 1099? (see instructions) . . . . . . . . Yes No
J If “Yes,” did you or will you file required Forms 1099? . . . . . . . . . . . . . . . . . . . . . Yes No

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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 . . . . . . . . . a 1 67,639.
2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . 2

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3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3 67,639.
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5 67,639.
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 . . . . . . . . . . . . . . . . . . . . . a 7 67,639.
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
instructions) . . . . . 9 56,360.
T 19
20
Pension and profit-sharing plans .
Rent or lease (see instructions):
19

10 Commissions and fees . 10 a Vehicles, machinery, and equipment 20a


11 Contract labor (see instructions) 11 b Other business property . . . 20b
NO
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 and meals:
14 Employee benefit programs a Travel . . . . . . . . . 24a
(other than on line 19) . . 14 b Deductible meals (see
15 Insurance (other than health) 15 instructions) . . . . . . . 24b
16 Interest (see instructions): 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 13,308.
17 Legal and professional services
17 b Reserved for future use . . . 27b
DO

28 Total expenses before expenses for business use of home. Add lines 8 through 27a . . . . . . a 28 69,668.
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29 -2,029.
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 Schedule 1 (Form 1040 or 1040-SR), line 3 (or Form 1040-NR, line
13) and on Schedule SE, line 2. (If you checked the box on line 1, see instructions). Estates and 31 -2,029.
trusts, enter on Form 1041, line 3.
• 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 Schedule 1 (Form 1040 or 1040-SR), line 3 (or
Form 1040-NR, line 13) and on Schedule SE, line 2. (If you checked the box on line 1, see the line 32a All investment is at risk.
31 instructions). Estates and trusts, enter on Form 1041, line 3. 32b Some investment is 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. BAA REV 03/16/20 PRO Schedule C (Form 1040 or 1040-SR) 2019
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Schedule C (Form 1040 or 1040-SR) 2019 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

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

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

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

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

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

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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) a 12/01/2017

44
T
Of the total number of miles you drove your vehicle during 2019, enter the number of miles you used your vehicle for:

a Business 95,167 b Commuting (see instructions) c Other 3,916


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

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

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

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No


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

THIRD PARTY FEES 783.


DO

LYFT FEES 5,555.

UBER FEES 6,610.

TELEPHONE 360.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48 13,308.


REV 03/16/20 PRO Schedule C (Form 1040 or 1040-SR) 2019
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

8863 Education Credits OMB No. 1545-0074


(American Opportunity and Lifetime Learning Credits)
2019
Form
a Attach to Form 1040 or 1040-SR.
Department of the Treasury Attachment
Internal Revenue Service (99) a Go to www.irs.gov/Form8863 for instructions and the latest information. Sequence No. 50
Name(s) shown on return Your social security number
ALBERTO J ALMEIDA LANZ 002-15-5880

F
!
CAUTION
Complete a separate Part III on page 2 for each student for whom you’re claiming either credit before
you complete Parts I and II.

Part I Refundable American Opportunity Credit


1 After completing Part III for each student, enter the total of all amounts from all Parts III, line 30 . . 1 2,500.

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2 Enter: $180,000 if married filing jointly; $90,000 if single, head of household,
or qualifying widow(er) . . . . . . . . . . . . . . . . . . 2 90,000.
3 Enter the amount from Form 1040 or 1040-SR, line 8b. If you’re filing Form
2555 or 4563, or you’re excluding income from Puerto Rico, see Pub. 970 for
the amount to enter . . . . . . . . . . . . . . . . . . . 3 -2,029.

L
4 Subtract line 3 from line 2. If zero or less, stop; you can’t take any education
credit . . . . . . . . . . . . . . . . . . . . . . . . 4 92,029.
5 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or
qualifying widow(er) . . . . . . . . . . . . . . . . . . . 5 10,000.

FI
6 If line 4 is:
• Equal to or more than line 5, enter 1.000 on line 6 . . . . . . . . . . . . .
• Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to
at least three places) . . . . . . . . . . . . . . . . . . . . . .
} . . . 6 1.000

7 Multiply line 1 by line 6. Caution: If you were under age 24 at the end of the year and meet the
conditions described in the instructions, you can’t take the refundable American opportunity credit;
skip line 8, enter the amount from line 7 on line 9, and check this box . . . . . . . . a 7 2,500.
8
T
Refundable American opportunity credit. Multiply line 7 by 40% (0.40). Enter the amount here and
on Form 1040 or 1040-SR, line 18c. Then go to line 9 below . . . . . . . . . . . . . . 8 1,000.
Part II Nonrefundable Education Credits
9 Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) . 9 1,500.
NO
10 After completing Part III for each student, enter the total of all amounts from all Parts III, line 31. If
zero, skip lines 11 through 17, enter -0- on line 18, and go to line 19 . . . . . . . . . . . 10
11 Enter the smaller of line 10 or $10,000 . . . . . . . . . . . . . . . . . . . . . 11
12 Multiply line 11 by 20% (0.20) . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Enter: $136,000 if married filing jointly; $68,000 if single, head of household, or
qualifying widow(er) . . . . . . . . . . . . . . . . . . . 13
14 Enter the amount from Form 1040 or 1040-SR, line 8b. If you're filing Form
2555 or 4563, or you’re excluding income from Puerto Rico, see Pub. 970 for
the amount to enter . . . . . . . . . . . . . . . . . . . 14
15 Subtract line 14 from line 13. If zero or less, skip lines 16 and 17, enter -0- on
line 18, and go to line 19 . . . . . . . . . . . . . . . . . 15
DO

16 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or


qualifying widow(er) . . . . . . . . . . . . . . . . . . . 16
17 If line 15 is:
• Equal to or more than line 16, enter 1.000 on line 17 and go to line 18
• Less than line 16, divide line 15 by line 16. Enter the result as a decimal (rounded to at least three
places) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) a 18
19 Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet (see
instructions) here and on Schedule 3 (Form 1040 or 1040-SR), line 3 . . . . . . . . . . . 19 0.
For Paperwork Reduction Act Notice, see your tax return instructions. REV 03/16/20 PRO Form 8863 (2019)
BAA
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 8863 (2019) Page 2


Name(s) shown on return Your social security number
ALBERTO J ALMEIDA LANZ 002-15-5880

F
!
CAUTION
Complete Part III for each student for whom you’re claiming either the American
opportunity credit or lifetime learning credit. Use additional copies of page 2 as needed for
each student.
Part III Student and Educational Institution Information. See instructions.
20 Student name (as shown on page 1 of your tax return) 21 Student social security number (as shown on page 1 of
ALBERTO J your tax return)
ALMEIDA LANZ 002-15-5880
22 Educational institution information (see instructions)
a. Name of first educational institution b. Name of second educational institution (if any)

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BROWARD COLLEGE
(1) Address. Number and street (or P.O. box). City, town or (1) Address. Number and street (or P.O. box). City, town or
post office, state, and ZIP code. If a foreign address, see post office, state, and ZIP code. If a foreign address, see
instructions. instructions.

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225 EAST LAS OLAS BLVD
FORT LAUDERDALE FL 33301
(2) Did the student receive Form 1098-T (2) Did the student receive Form 1098-T
Yes No Yes No
from this institution for 2019? from this institution for 2019?

FI
(3) Did the student receive Form 1098-T (3) Did the student receive Form 1098-T
from this institution for 2018 with box Yes No from this institution for 2018 with box Yes No
7 checked? 7 checked?
(4) Enter the institution’s employer identification number (EIN) (4) Enter the institution’s employer identification number
if you’re claiming the American opportunity credit or if you (EIN) if you’re claiming the American opportunity credit or
checked “Yes” in (2) or (3). You can get the EIN from Form if you checked “Yes” in (2) or (3). You can get the EIN
1098-T or from the institution. from Form 1098-T or from the institution.
23-7181959
T
23 Has the Hope Scholarship Credit or American opportunity
Yes — Stop!
credit been claimed for this student for any 4 tax years Go to line 31 for this student. No — Go to line 24.
NO
before 2019?
24 Was the student enrolled at least half-time for at least one
academic period that began or is treated as having begun in
2019 at an eligible educational institution in a program
Yes — Go to line 25. No — Stop! Go to line 31
leading towards a postsecondary degree, certificate, or
for this student.
other recognized postsecondary educational credential?
See instructions.
25 Did the student complete the first 4 years of postsecondary Yes — Stop!
education before 2019? See instructions. Go to line 31 for this No — Go to line 26.
student.
26 Was the student convicted, before the end of 2019, of a Yes — Stop!
DO

No — Complete lines 27
felony for possession or distribution of a controlled Go to line 31 for this through 30 for this student.
substance? student.

F
!
CAUTION
You can't take the American opportunity credit and the lifetime learning credit for the same student in the same year. If
you complete lines 27 through 30 for this student, don’t complete line 31.

American Opportunity Credit


27 Adjusted qualified education expenses (see instructions). Don’t enter more than $4,000 . . . . . 27 4,000.
28 Subtract $2,000 from line 27. If zero or less, enter -0- . . . . . . . . . . . . . . . . . 28 2,000.
29 Multiply line 28 by 25% (0.25) . . . . . . . . . . . . . . . . . . . . . . . . 29 500.
30 If line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29 and
enter the result. Skip line 31. Include the total of all amounts from all Parts III, line 30, on Part I, line 1 . 30 2,500.
Lifetime Learning Credit
31 Adjusted qualified education expenses (see instructions). Include the total of all amounts from all Parts
III, line 31, on Part II, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . 31
Form 8863 (2019)
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

8867 Paid Preparer’s Due Diligence Checklist OMB No. 1545-0074

2019
Form Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC), Child Tax Credit (CTC) (including the Additional
Child Tax Credit (ACTC) and Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
Department of the Treasury a To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS. Attachment
Internal Revenue Service a Go to www.irs.gov/Form8867 for instructions and the latest information. Sequence No. 70
Taxpayer name(s) shown on return Taxpayer identification number
ALBERTO J ALMEIDA LANZ 002-15-5880
Enter preparer’s name and PTIN
Zunay Rabelo, EA P01785647
Part I Due Diligence Requirements
Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I–V
for the benefit(s) claimed (check all that apply). EIC CTC/ACTC/ODC AOTC HOH
1 Did you complete the return based on information for tax year 2019 provided by the taxpayer or Yes No N/A
reasonably obtained by you? . . . . . . . . . . . . . . . . . . . . . . . .

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2 If credits are claimed on the return, did you complete the applicable EIC and/or CTC/ACTC/ODC
worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS 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? . . . . . . . . .

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3 Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of
the following.
• Interview the taxpayer, ask questions, and contemporaneously document the taxpayer’s responses to
determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.

FI
• Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to compute the amount(s) of any credit(s) . . . . . . . . . . . . . . . .
4 Did any information provided by the taxpayer or a third party for use in preparing the return, or
information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If “Yes,”
answer questions 4a and 4b. If “No,” go to question 5.) . . . . . . . . . . . . . . .
a Did you make reasonable inquiries to determine the correct, complete, and consistent information? .
b Did you contemporaneously document your inquiries? (Documentation should include the questions
T
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.) . . . . . . . . . . . . . . . . .
5 Did you satisfy the record retention requirement? To meet the record retention requirement, you must
keep a copy of your documentation referenced in 4b, a copy of this Form 8867, a copy of any
NO
applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to
compute the amount(s) of the credit(s) . . . . . . . . . . . . . . . . . . . . .
List those documents, if any, that you relied on.

6 Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
credit(s) and/or HOH filing status and the amount(s) of any credit(s) claimed on the return if his/her
DO

return is selected for audit? . . . . . . . . . . . . . . . . . . . . . . . . .


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.)
a Did you complete the required recertification Form 8862? . . . . . . . . . . . . . . .
8 If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete and
correct Schedule C (Form 1040 or 1040-SR)? . . . . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see separate instructions. REV 03/16/20 PRO Form 8867 (2019)
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7
Form 8867 (2019) Page 2
Part II Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
9a Have you determined that the taxpayer is, in fact, eligible to claim the EIC for the number of qualifying Yes No N/A
children claimed, or is eligible to claim the EIC without a qualifying child? (Skip 9b and 9c if the taxpayer
is claiming the EIC and does not have a qualifying child.) . . . . . . . . . . . . . . .
b Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer
has supported the child the entire year? . . . . . . . . . . . . . . . . . . . . .
c Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of
more than one person (tiebreaker rules)? . . . . . . . . . . . . . . . . . . . .
Part III Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC, or ODC, go
to Part IV.)
10 Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer’s dependent who is Yes No N/A
a citizen, national, or resident of the United States? . . . . . . . . . . . . . . . . . .
11 Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the taxpayer has not lived

E
with the child for over half of the year, even if the taxpayer has supported the child, unless the child’s
custodial parent has released a claim to exemption for the child? . . . . . . . . . . . .
12 Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or
separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar

L
statement to the return? . . . . . . . . . . . . . . . . . . . . . . . . . .
Part IV Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
13 Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified Yes No
tuition and related expenses for the claimed AOTC? . . . . . . . . . . . . . . . . . . . .

FI
Part V Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)
14 Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year Yes No
and provided more than half of the cost of keeping up a home for the year for a qualifying person? . . . .
Part VI Eligibility Certification
a You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing
status on the return of the taxpayer identified above if you:
A. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer’s responses on the return or
T
in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to compute the amount(s) of the credit(s);
B. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable
credit(s) claimed and HOH filing status, if claimed;
NO
C. Submit Form 8867 in the manner required; 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 this Form 8867.
2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
3. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer’s eligibility for the
credit(s) and/or HOH filing status and to compute the amount(s) of the credit(s).
4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was
obtained.
5. A record of any additional information you relied upon, including questions you asked and the taxpayer’s responses, to
determine the taxpayer’s eligibility for the credit(s) and/or HOH filing status and to compute the amount(s) of the credit(s).
DO

a Ifyou have not complied with all due diligence requirements, you may have to pay a $530 penalty for each failure to
comply related to a claim of an applicable credit or HOH filing status.
15 Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and Yes No
complete? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
REV 03/16/20 PRO Form 8867 (2019)
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 8962 Premium Tax Credit (PTC)


OMB No. 1545-0074

2019
a Attach to Form 1040, 1040-SR, or 1040-NR.
Department of the Treasury Attachment
Internal Revenue Service a Go to www.irs.gov/Form8962 for instructions and the latest information. Sequence No. 73
Name shown on your return Your social security number
ALBERTO J ALMEIDA LANZ 002-15-5880
You cannot take the PTC if your filing status is married filing separately unless you qualify for an exception (see instructions). If you qualify, check the box . . a

Part I Annual and Monthly Contribution Amount


1 Tax family size. Enter your tax family size (see instructions) . . . . . . . . . . . . . . . . . 1 1
2a Modified AGI. Enter your modified AGI (see instructions) . . . . . . . . . 2a -2,029.
b Enter the total of your dependents’ modified AGI (see instructions) . . . . . . 2b
0.

E
3 Household income. Add the amounts on lines 2a and 2b (see instructions) . . . . . . . . . . . . 3
4 Federal poverty line. Enter the federal poverty line amount from Table 1-1, 1-2, or 1-3 (see instructions). Check the
appropriate box for the federal poverty table used. a Alaska b Hawaii c Other 48 states and DC 4 12,140.
5 Household income as a percentage of federal poverty line (see instructions) . . . . . . . . . . . . 5 0 %
6 Did you enter 401% on line 5? (See instructions if you entered less than 100%.)

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No. Continue to line 7.
Yes. You are not eligible to take the PTC. If advance payment of the PTC was made, see the instructions for
how to report your excess advance PTC repayment amount.
7 Applicable Figure. Using your line 5 percentage, locate your “applicable figure” on the table in the instructions . . 7 0.0208

FI
8a Annual contribution amount. Multiply line 3 by b Monthly contribution amount. Divide line 8a
line 7. Round to nearest whole dollar amount
8a 0. by 12. Round to nearest whole dollar amount
8b 0.
Part II Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit
9 Are you allocating policy amounts with another taxpayer or do you want to use the alternative calculation for year of marriage (see instructions)?
Yes. Skip to Part IV, Allocation of Policy Amounts, or Part V, Alternative Calculation for Year of Marriage. No. Continue to line 10.
10 See the instructions to determine if you can use line 11 or must complete lines 12 through 23.
Yes. Continue to line 11. Compute your annual PTC. Then skip lines 12–23 No. Continue to lines 12–23. Compute
and continue to line 24.
(a) Annual enrollment (b) Annual applicable
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(c) Annual
your monthly PTC and continue to line 24.
(d) Annual maximum (e) Annual premium tax (f) Annual advance
Annual SLCSP premium premium assistance
premiums (Form(s) contribution amount credit allowed payment of PTC (Form(s)
Calculation (Form(s) 1095-A, (subtract (c) from (b), if
1095-A, line 33A) (line 8a) (smaller of (a) or (d)) 1095-A, line 33C)
line 33B) zero or less, enter -0-)
NO
11 Annual Totals
(c) Monthly
(a) Monthly enrollment (b) Monthly applicable (d) Monthly maximum (f) Monthly advance
contribution amount (e) Monthly premium tax
Monthly premiums (Form(s) SLCSP premium premium assistance payment of PTC (Form(s)
(amount from line 8b credit allowed
Calculation 1095-A, lines 21–32, (Form(s) 1095-A, lines (subtract (c) from (b), if 1095-A, lines 21–32,
or alternative marriage (smaller of (a) or (d))
column A) 21–32, column B) zero or less, enter -0-) column C)
monthly calculation)

12 January 363. 372. 0. 372. 363. 358.


13 February 363. 372. 0. 372. 363. 358.
14 March 363. 372. 0. 372. 363. 358.
15 April 363. 372. 0. 372. 363. 358.
16 May 363. 372. 0. 372. 363. 358.
17 June 363. 372. 0. 372. 363. 358.
DO

18 July 363. 372. 0. 372. 363. 358.


19 August 363. 372. 0. 372. 363. 358.
20 September 363. 372. 0. 372. 363. 358.
21 October 363. 372. 0. 372. 363. 358.
22 November 363. 372. 0. 372. 363. 358.
23 December 363. 372. 0. 372. 363. 358.
24 Total premium tax credit. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total here 24 4,356.
25 Advance payment of PTC. Enter the amount from line 11(f) or add lines 12(f) through 23(f) and enter the total here 25 4,296.
26 Net premium tax credit. If line 24 is greater than line 25, subtract line 25 from line 24. Enter the difference here and
on Schedule 3 (Form 1040 or 1040-SR), line 9, or Form 1040-NR, line 65. If line 24 equals line 25, enter -0-. Stop
here. If line 25 is greater than line 24, leave this line blank and continue to line 27 . . . . . . . . . . 26 60.
Part III Repayment of Excess Advance Payment of the Premium Tax Credit
27 Excess advance payment of PTC. If line 25 is greater than line 24, subtract line 24 from line 25. Enter the difference here 27
28 Repayment limitation (see instructions) . . . . . . . . . . . . . . . . . . . . . . 28
29 Excess advance premium tax credit repayment. Enter the smaller of line 27 or line 28 here and on Schedule 2
(Form 1040 or 1040-SR), line 2, or Form 1040-NR, line 44 . . . . . . . . . . . . . . . . . 29
For Paperwork Reduction Act Notice, see your tax return instructions. BA REV 03/16/20 PR Form 8962 (2019)
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 8962 (2019) Page 2


Part IV Allocation of Policy Amounts
Complete the following information for up to four policy amount allocations. See instructions for allocation details.
Allocation 1
30 (a) Policy Number (Form 1095-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month
74145813 284-41-1403 01 12
Allocation percentage (g) Advance Payment of the PTC
(e) Premium Percentage (f) SLCSP Percentage
applied to monthly Percentage
amounts
0.33 0.33 0.33
Allocation 2
31 (a) Policy Number (Form 1095-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month

E
Allocation percentage (g) Advance Payment of the PTC
(e) Premium Percentage (f) SLCSP Percentage
applied to monthly Percentage
amounts

L
Allocation 3
32 (a) Policy Number (Form 1095-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month

FI
Allocation percentage (g) Advance Payment of the PTC
(e) Premium Percentage (f) SLCSP Percentage
applied to monthly Percentage
amounts

Allocation 4
33 (a) Policy Number (Form 1095-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month

Allocation percentage
applied to monthly
amounts
(e) Premium Percentage
T (f) SLCSP Percentage
(g) Advance Payment of the PTC
Percentage

34 Have you completed all policy amount allocations?


NO
Yes. Multiply the amounts on Form 1095-A by the allocation percentages entered by policy. Add all allocated policy amounts and non-
allocated policy amounts from Forms 1095-A, if any, to compute a combined total for each month. Enter the combined total for each month on
lines 12–23, columns (a), (b), and (f). Compute the amounts for lines 12–23, columns (c)–(e), and continue to line 24.
No. See the instructions to report additional policy amount allocations.

Part V Alternative Calculation for Year of Marriage


Complete line(s) 35 and/or 36 to elect the alternative calculation for year of marriage. For eligibility to make the election, see the instructions for line 9.
To complete line(s) 35 and/or 36 and compute the amounts for lines 12–23, see the instructions for this Part V.
(a) Alternative family size (b) Alternative monthly (c) Alternative start month (d) Alternative stop month
35 Alternative entries contribution amount
for your SSN
DO

(a) Alternative family size (b) Alternative monthly (c) Alternative start month (d) Alternative stop month
36 Alternative entries contribution amount
for your spouse’s
SSN
REV 03/16/20 PR Form 8962 (2019)
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Tax History Report 2019


G Keep for your records

Name(s) Shown on Return


ALBERTO J ALMEIDA LANZ

Five Year Tax History:

2015 2016 2017 2018 2019

Filing status MFJ Single

Total income 11,384. -2,029.

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Adjustments to income 673.

Adjusted gross income 10,711. -2,029.

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Tax expense 0.

Interest expense

FI
Contributions

Misc. deductions

Other itemized ded’ns

Total itemized/
standard deduction
T 24,000. 12,200.

Exemption amount 0. 0.
NO
QBI deduction

Taxable income 0. 0.

Tax

Alternative min tax

Total credits 0. 0.

Other taxes 1,346.


DO

Payments 4,846. 1,060.

Form 2210 penalty

Amount owed

Applied to next
year’s estimated tax

Refund 3,500. 1,060.

Effective tax rate % -43.81 0.00

**Tax bracket % 10.0 10.0

**Tax bracket % is based on Taxable income.


DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Student Information Worksheet 2019


G Keep for your records

Name of Student Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Part I ' Student Status

1 Was this person a student during 2019? X Yes No


2 What kind of school did the student attend during 2019? (Check all that apply.)
a Elementary d Vocational school g Not applicable
b High school (secondary) e Military academy
c X College (postsecondary) f Apprenticeship (Qualified Tuition Program only)
3 Qualified Tuition Program only:
a Did the student make any education loan payments to treat as expenses? Yes No
If Yes, or line 2f is checked, complete the Apprenticeship and Education Loan Smart Worksheet

E
in Part VIII, Qualified Tuition Program (Section 529 Plan) below.

Part II ' College Student Information

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1 Did the student complete the first 4 years of postsecondary education
as of 1/1/2019? Yes X No NA
2 Was this student enrolled at an eligible education institution during
2019? X Yes No NA

FI
3 Was this student enrolled in a program that leads to a degree,
certificate, or credential? X Yes No NA
4 Was this student taking courses as part of a postsecondary degree
program or to acquire or improve job skills? X Yes No NA
5 Did this student take at least one-half the normal full-time workload for
one academic period? X Yes No NA
6 Has this student been convicted of a felony for possessing or distributing
a controlled substance? Yes X No NA
7 Is this student an eligible dependent of the taxpayer? Yes No X NA
8
9
T
In how many prior years has an American Opportunity Credit been claimed for this student?
In how many prior years has a Hope Credit been claimed for this student

Part III ' Education Credit Qualifications (Determined based entries in Part II)
NO
1 Is this student qualified for the American Opportunity Credit? X Yes No

2 Is this student qualified for the Lifetime Learning Credit? X Yes No

3 Is this student qualified for the Tuition and Fees Deduction? X Yes No

Part IV ' Educational Institution and Tuition Summary


DO

Received 2018 1098T with Box 2 filled and box 7 checked? g

Address Tuition Scholar- On


School Name (number, street, apt no., paid ships Form
EIN city, state, and ZIP Code) or grants 1098-T

BROWARD COLLEGE 225 EAST LAS OLAS BLVD Yes Yes


23-7181959 FORT LAUDERDALE FL 33301 No X No X
If a foreign address: foreign province/state:
Postal code: Country:
Yes Yes
No No
If a foreign address: foreign province/state:
Postal code: Country:

Totals

Are all School Employer Identifification Numbers (EIN) known? (School EIN’s must be
entered in the program to claim the American Opportunity Credit) X Yes No
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

ALBERTO J ALMEIDA LANZ 002-15-5880 Page 2

Part V ' Education Assistance (Scholarships, Fellowships, Grants, etc.)

Total Taxable Tax-free


1 Educational assistance that is always tax-free:
a Veteran or employer assistance from Form 1098-T Worksheets
b Other veteran assistance or certain Indian tribal payments
c Other tax-free employer-provided assistance
d Total
2 Scholarships, fellowships, and grants not reported on Form W-2:
a Scholarships and grants from Part IV above
b Other scholarships, fellowships and grants

E
c Total
3 Scholarship reported in 2019 not allocable to 2019 expense
4 Amount required to be used for other than qualified education expenses
5 Subtract line 3 and 4 from line 2c

L
6 Total qualified education expenses from Part VI below 4,775.
7 If student is a candidate for a degree, enter the amount used for
qualified education expenses, otherwise, enter -0-.
8 Subtract line 7 from line 5

FI
9 Taxable part. Add lines 4 and 8.
10 Tax-free educational assistance. Add lines 1d and 7

Part VI ' Education Expenses

Description Total Amount eligible for

American Lifetime Tuition Qualified Qualified Qualified Qualified


Oppor-
tunity
T Learning
Credit
and Fees
Deduct-
Higher
Education
Higher
Education
Higher
Education
Elementary
and
Credit ion Expense Expense Expense Secondary
for for for Expense
NO
529 Plan ESA US for ESA
Bonds and QTP
Not Not Not Not
Applicable Applicable Applicable Applicable

Expenses:
1 Tuition paid from Part IV and
qualified elementary and
secondary tuition
Paid to institution as a
condition of enrollment:
2
DO

Fees 1,750. 1,750. 1,750. 1,750. 1,750. 1,750. 1,750.


3 Books, supplies, equipment 3,025. 3,025 3,025 3,025 3,025 3,025
Paid to other than institution or
not a condition of enrollment:
4 Books, supplies, equipment
5 Other course-related
6 Room and board
7 Special needs expenses
8 Computer expenses
9 QTP or ESA contribution
10 Academic tutoring
11 Uniforms
12 Transportation

13 Total qualified expenses 4,775. 4,775. 4,775. 4,775. 4,775. 4,775. 1,750.

Adjustments:
14 Refunds
15 Tax-free assistance
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7
16 Deducted on Sched A
17 Used for credit or deduction
18 Used for exclusion 0. 0. 0.
See tax help
19 Total adjustments. 0. 0. 0.

20 Adjusted qualified expenses 4,775. 4,775. 4,775. 4,775. 4,775. 4,775. 1,750. 0.

ALBERTO J ALMEIDA LANZ 002-15-5880 Page 3

Part VII ' Education Credit or Deduction Election

1 Elect credit or deduction which results in best tax outcome. X


2 Elect the American Opportunity Credit

E
3 Elect the Lifetime Learning Credit
4 Elect the tuition and fees deduction
4 Not applicable

Part VIII ' Qualified Tuition Program (Section 529 Plan)

L
For Purposes For Purposes
of of 10%
Regular Additional

FI
Tax Tax

1 Enter the total distributions from this QTP during 2019


2 Enter the amount of adjusted qualified education expenses attributable
to this QTP:
a Qualified Education Loan Payments
b Qualified Education Loan Payments applied
c
d
Qualified Apprenticeship Education Expenses
T
Qualified Apprenticeship Education Expenses applied
e Qualified Elementary and Secondary Education Expenses
f Qualified Elementary and Secondary Education Expenses applied
g Adjusted Qualified Higher Education Expenses
NO
h Adjusted Qualified Higher Education Expenses applied
3 Total qualified eduction expenses attributable to this QTP
4 Excess distributions. Subtract line 3 from line 1.
If line 4 is greater than zero, complete lines 5 through 8.
5 Total distributed earnings from Form 1099-Q box 2
6 Fraction. Divide line 3 by line 1.
7 Multiply line 5 by line 6.
8 Earnings taxable to recipient. Subtract line 7 from line 5.

Part IX ' Education Savings Account (ESA)

For Purposes For Purposes


of of 10%
DO

Regular Additional
Tax Tax

1 Total Education Savings Account (ESA) distributions from Form 1099-Q


2 Qualified Elementary and Secondary Education Expenses
3 Qualified Elementary and Secondary Education Expenses applied
4 Subtract line 3 from line 1.
5 Adjusted Qualified Higher Education Expenses
6 Qualified Higher Education Expenses applied to ESA distributions
7 Excess distributions. Subtract line 6 from line 4.
8 Distributions taxable to recipient

Part X ' Series EE and I U.S. Savings Bonds Issued After 1989

1 Total proceeds from U.S. Savings Bonds cashed during 2019 for this student
2 Adjusted Qualified Higher Education Expenses
3 Qualified Higher Education Expenses applied to exclusion of U.S. bond interest
4 Interest included in line 1
5 Name and address of eligible educational institution(s) attended:
Institution Name Institution Name
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Street address Street address

City State Zip Code City State Zip Code

L E
FI
T
NO
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Identity Verification Worksheet 2019


GSee tax help for more information on identity verification

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Driver’s License or State Id Information


Required for electronic filing, either complete the driver’s license or state id detail information below or
select the appropriate box for taxpayer and spouse to indicate why driver’s license or state id information is
not present.

Note: Providing identification numbers helps the IRS and states verify taxpayer identity which can prevent

E
unnecessary delays in tax return processing.

All identity verification information should be entered here and will automatically flow to the
state return.

L
Taxpayer/Spouse does not have a driver’s license or state id
Taxpayer Note: Alabama does not allow this option
Spouse

FI
Taxpayer/Spouse did not provide driver’s license or state id information
Taxpayer Note: Alabama, New York and Ohio do not allow this option
Spouse

Check to confirm transferred driver’s license or state id information (which appears in green) is correct X
Note: Transfer not available for returns with Alabama, Iowa, or New York state taxes. See tax help for
more information.

Driver’s License Detail


T
Taxpayer: Spouse:
NO
Issuing state FL Issuing state
License number A453010810290 License number
Issue date 05/07/2019 Issue date
Expiration date 09/07/2020 Expiration date
Does not expire Does not expire
NY Document number (first 3 chars)* NY Document number (first 3 chars)*

State Identification Card Detail

Taxpayer: Spouse:
Issuing state Issuing state
DO

Identification number Identification number


Issue date Issue date
Expiration date Expiration date
Does not expire Does not expire
NY Document number (first 3 chars)* NY Document number (first 3 chars)*

* Enter the first 3 characters of the NY document number, which is the 8 or 10 number/letter combination
found at the bottom of the NY license (or NY state ID) or on the back if it was issued after January 28, 2014.

Additional Verification Information


Use these fields to record the client status and method used to verify the taxpayer and spouse identity.

Client Status:
New client
Returning client to same preparer and firm
Returning client to same firm
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Identity Verification Method (select one):


In person
Remote via email, phone, or fax
Both in person and remote
Identity not verified

Documents Used to Verify Primary Taxpayer Identity:


X Driver’s license (complete detail above)
State issued identification card (complete detail above)
Passport
Account statement from financial institution
Utility billing statement
Credit card billing statement

E
Documents Used to Verify Spouse Identity (If you file joint return):
X Driver’s license (complete detail above)
State issued identification card (complete detail above)

L
FI
fdiv7101.SCR 12/18/19

T
NO
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 1095-A Health Insurance Marketplace Statement 2019


G Keep for your records

QuickZoom to Form 1095-A, Health Insurance Marketplace Statement


QuickZoom to Form 8962, Premium Tax Credit (PTC)

Name(s) Shown on Return Your Social Security No.


ALBERTO J ALMEIDA LANZ 002-15-5880
Owned by: (See tax help if recipient is a dependent)
X Taxpayer Spouse Spouse is covered by plan
Part I Recipient Information

1 Marketplace identifier 2 Marketplace-assigned pol. no. 3 Policy issuer’s name

E
FL 74145813 AMBETTER FROM SUNSHINE HEALTH
4 Recipient’s name 5 Recipient’s SSN 6 Recipient’s DOB
ALBERTO ALMEIDA LANZ 002-15-5880 01/29/81
7 Recipient’s spouse’s name 8 Spouse’s SSN 9 Spouse’s DOB

L
10 Policy start date 11 Policy termination date 12 Street address (including apartment no.)
01/01/19 12/31/19 12400 VISTA ISLES DR, Apt. 1422
13 City or town 14 State or province 15 Country and ZIP or foreign postal code

FI
FORT LAUDERDALE FL 33325

Part II Covered Individuals

Check this box to populate the Name, SSN, and DOB for everyone listed on the return in Part II.
Note: Checking this box again will repopulate the information below and overwrite existing entries.
T
A. Covered individual name B. Covered C. Covered D. Coverage E. Coverage
First individual SSN individual start date termination
Last date of birth date
16 ALBERTO J
NO
ALMEIDA LANZ 002-15-5880 01/29/81 01/01/19 12/31/19
17

18

19

20

Part III Coverage Information


DO

Month Copy Feature A. Monthly enrollment B. Monthly second lowest C. Monthly advance payment
See help for premiums cost silver plan (SLCSP) of premium tax credit
more info. premium
21 JANUARY 1,099.70 1,127.73 1,086.00
22 FEBRUARY 1,099.70 1,127.73 1,086.00
23 MARCH 1,099.70 1,127.73 1,086.00
24 APRIL 1,099.70 1,127.73 1,086.00
25 MAY 1,099.70 1,127.73 1,086.00
26 JUNE 1,099.70 1,127.73 1,086.00
27 JULY 1,099.70 1,127.73 1,086.00
28 AUGUST 1,099.70 1,127.73 1,086.00
29 SEPTEMBER 1,099.70 1,127.73 1,086.00
30 OCTOBER 1,099.70 1,127.73 1,086.00
31 NOVEMBER 1,099.70 1,127.73 1,086.00
32 DECEMBER 1,099.70 1,127.73 1,086.00
33 Annual Totals 13,196. 13,533. 13,032.
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 1099-K Summary 2019


G Keep for your records

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Form 1099-K Summary

Box Description Taxpayer Spouse Total

1 Net Amount of Payment Card/Third Party


Network Transactions after Adjustments 67,505. 67,505.

E
A Schedule C 67,505. 67,505.
A Schedule E
A Schedule F

L
A Other Income

4 Federal tax withheld

FI
8 State tax withheld - total

T
NO
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 1099-K Payment Card and 2019


Third Party Network Transactions Worksheet

Name Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Filer’s Federal ID No. 20-8809830


Filer’s Name LYFT, INC

CORRECTED (if checked)


Spouse’s 1099-K Do not transfer this 1099-K to next year

E
Box 1 Gross amount of payment card/third party network transactions 26,472.
Required: double-click to select the form on which to report this income:
Schedule C DRIVER

L
Schedule E
Schedule F
Other Income

FI
Box 4 Federal income tax withheld

First State
Box 6 State FL Box 7 State identification number
Box 8 State income tax withheld

Second State
Box 6
Box 8
State
State income tax withheld
Box 7
T
State identification number

I confirm that the state withholding identification number(s) are accurate


NO
1099-K Reconciliation

1 Gross amount of payment card/third party network transactions 26,472.


2 Less: Adjustments
3 Net amount of payment card/third party network transactions 26,472.
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Form 1099-K Payment Card and 2019


Third Party Network Transactions Worksheet

Name Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Filer’s Federal ID No. 45-2647441


Filer’s Name UBER

CORRECTED (if checked)


Spouse’s 1099-K Do not transfer this 1099-K to next year

E
Box 1 Gross amount of payment card/third party network transactions 41,033.
Required: double-click to select the form on which to report this income:
Schedule C DRIVER

L
Schedule E
Schedule F
Other Income

FI
Box 4 Federal income tax withheld

First State
Box 6 State Box 7 State identification number
Box 8 State income tax withheld

Second State
Box 6
Box 8
State
State income tax withheld
Box 7
T
State identification number

I confirm that the state withholding identification number(s) are accurate


NO
1099-K Reconciliation

1 Gross amount of payment card/third party network transactions 41,033.


2 Less: Adjustments
3 Net amount of payment card/third party network transactions 41,033.
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Schedule SE Adjustments Worksheet 2019


G Keep for your records

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

(a) Taxpayer (b) Spouse

QuickZoom to the Short Schedule SE (Schedule SE, page 1) X


QuickZoom to the Long Schedule SE (Schedule SE, page 2)

A Use Long Schedule SE, even if qualified to use Short Schedule SE

E
B Approved Form 4029. Exempt from SE tax on all income
C Chapter 11 bankruptcy net profit or loss for Schedule SE, line 3
D QuickZoom to the Explanation statement for any adjustment to
SE income/loss shown on a partnership K-1. (See Help)

L
Part I Farm Profit or (Loss) Schedule SE, line 1
1 Total Schedules F
2 Farm partnerships, Schedules K-1

FI
3 Other SE farm profit or (loss) (See Help)
4 Less SE exempt farm profit or (loss) (See Help)
5 Total for Schedule SE, line 1
6 Conservation Reserve Program payments not subject to self-
employment tax reported on:
a Schedule F, line 4b
b Schedule K-1 (Form 1065), box 20, code AH
c Total CRP payments not subject to SE tax
T
Part II Nonfarm Profit or (Loss) Schedule SE, line 2
1a Total Schedules C -2,029.
NO
b Less SE exempt Schedules C (approved Form 4361)
2 Nonfarm partnerships, Schedules K-1
3 Forms 6781
4 Other SE income reported as income on Form 1040, line 7
5a Clergy Form W-2 wages
b Clergy housing allowance
c Less clergy business deductions
d QuickZoom to the Explanation statement for entry on line 5c
6 Other SE nonfarm profit or (loss) (See Help)
7 Less other SE exempt nonfarm profit or (loss) (See Help)
8 Total for Schedule SE, line 2 -2,029.
DO

9 Exempt Notary Public income for Schedule SE, line 3 (See Help)

Part III Farm Optional Method Schedule SE, page 2, Part II


1 Use Farm Optional Method
2 Gross farm income from Schedules F
3 Gross farming or fishing income from partnership Schedules K-1
4 Other gross farming or fishing self-employment income
5 Total gross income for Farm Optional Method

Part IV Nonfarm Optional Method Schedule SE, page 2, Part II


1 Use Nonfarm Optional Method (Must have had net SE earnings
of $400 or more in 2 of prior 3 years and used the
Nonfarm Optional Method less than 5 times)
2 Gross nonfarm income from Schedules C
3 Gross nonfarm income from partnership Schedules K-1
4 Other gross nonfarm self-employment income
5 Total gross income for Nonfarm Optional Method
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Education Tuition and Fees Summary 2019


G Keep for your records

Name(s) Shown on Return Your Social Security No.


ALBERTO J ALMEIDA LANZ 002-15-5880

Part I - Qualified Education Expense Summary

(a) (b) (c) (d) (e)


Student’s name Qualified Qualified Elected Elected
First Name MI Education for: Credit or Credit or
Last Name Suffix Expenses Deduction Deduction

E
Social Security Number if if
Yes No manual automatic

ALBERTO J 4,775. Amer Opp Cr X X

L
ALMEIDA LANZ 4,775. Lifetime Cr X
002-15-5880 4,775. Tuition Ded X
4,775. Total Qualified Expenses
Amer Opp Cr

FI
Lifetime Cr
Tuition Ded
Total Qualified Expenses
Amer Opp Cr
Lifetime Cr
Tuition Ded
Total Qualified Expenses

Total qualified expenses


T
4,775. American Opportunity Credit
4,775. Lifetime Learning Credit
4,775. Tuition and Fees Deduction
NO
Part II - Optimize Education Expenses for the Lowest Tax

Automatic
1 Launch OPTIMIZER - Check to launch Automatic Education Expense Optimizer now

2 Automatic - Check to use the choices calculated in Part I, column (e) above X
or
3 Manual - Check to use the choices you entered in Part I, column (d) above
DO

Part III - Summary of Credits

Tuition and Fees Deduction Summary

1 Total 2019 tuition and fees paid for purposes of deduction 1


2 Modified adjusted gross income 2
3 Maximum deduction allowed 3
4 Allowable Tuition and Fees Deduction (lesser of line 1 or line 3) 4 0.

American Opportunity, Lifetime Learning Credits Summary

1 Tentative American Opportunity Credit 1 2,500.


2 Tentative Lifetime Learning Credit 2
3 Total Education Credits (after limitations) 3 1,000.
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Net Operating Loss Worksheet 2019


Regular Tax and AMT
Attach to Form 1045

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Regular Tax NOL

1 Subtract Form 1040, Line 9 from line 8b, or Form 1040NR, line
37 from line 35 and enter here 1 $ -14,229.
2 Nonbusiness capital losses before limitation. Enter as a positive number. 2

E
3 Nonbusiness capital gains (without regard to section 1202 exclusion) 3
4 If line 2 is more than line 3, enter difference; otherwise enter -0- 4 0.
5 If line 3 is more than line 2, enter difference; otherwise enter -0- 5 0.
6 Nonbusiness deductions 6 12,200.

L
7 Nonbusiness income other than capital gains 7
8 Add lines 5 and 7 8 0.
9 If line 6 is more than line 8, enter difference; otherwise enter -0- 9 12,200.
10 If line 8 is more than line 6, enter difference; otherwise enter -0-.

FI
Don’t enter more than line 5 10 0.
11 Business capital losses before limitation. Enter as a positive number 11
12 Business capital gains (without regard to any section 1202 exclusion) 12
13 Add lines 10 and 12 13 0.
14 Subtract line 13 from line 11. If zero or less, enter -0- 14 0.
15 Add lines 4 and 14 15 0.
16 Enter the loss, if any, from line 16 of Schedule D (enter as positive).
T
If none, and if there is no Section 1202 exclusion, skip lines 16
through 21 and enter on line 22 the amount from line 15 16
17 Section 1202 exclusion. Enter as a positive number 17
18 Subtract line 17 from line 16. If zero or less, enter -0- 18
NO
19 Enter the loss, if any, from line 21 of Schedule D (enter as positive) 19
20 If line 18 is more than line 19, enter difference; otherwise enter -0- 20
21 If line 19 is more than line 18, enter difference; otherwise enter -0- 21
22 Subtract line 20 from line 15. If zero or less, enter -0- 22 0.
23 Domestic production activities deduction from your 2019 return 23
24 Net Operating Loss deduction for losses from other years (enter as positive) 24
25 Net Operating Loss. Combine lines 1, 9, 17, and 21 through 24 25 -2,029.
If line 25 is zero or more, you don’t have a Net Operating Loss.
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Alternative Minimum Tax NOL

1 Current year Net Operating Loss - regular tax (line 25 above) 1 -2,029.
2a Depletion (regular tax - AMT) 2a
b Exercise of ISO (excess of AMT over regular tax) b
c Estates & trusts (1041 Sch K-1, box 12, code A) c
d Dispositions (AMT - regular tax) d
e Depreciation (regular tax - AMT) e
f Passive activities (AMT - regular tax) f
g Loss limitations (AMT - regular tax) g
h Circulation costs (regular tax - AMT) h
i Long-term contracts (AMT - regular tax) i
j Mining costs (regular tax - AMT) j

E
k Research and experimental costs (reg tax - AMT) k
l Income from certain pre-1987 installment sales l
m Intangible drilling costs preference m
n Other adjustments from 6251 line 27 n

L
o Other

FI
Subtotal - adjustments and preferences 2
3 a Itemized deductions allowed for regular NOL 3a
Less allowable AMT itemized deductions
(cannot exceed nonbusiness income):
b Other T b
Subtotal - net itemized deductions addback (cannot be less than zero) 3
4 AMT NOL deduction for losses from other years (enter as positive) 4
5 Net Operating Loss for AMT - combine lines 1 through 4 5 -2,029.
NO
If line 5 is zero or more, you don’t have a Net Operating Loss for AMT.

AMT NOL Carryover


(will not calculate if box suppressing transfer is checked)

1 Total AMT NOL carried to this year 1


2 Subtract AMT NOL deduction for those AMT NOLs carried to this year 2
3 Add current year AMT NOL (only if line 5, above, is less than zero) 3 2,029.
4 AMT NOL Carryover 4 2,029.
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Net Operating Loss Classification Worksheet 2019


Name(s) Shown on Return Social Security Number
ALBERTO J ALMEIDA LANZ 002-15-5880

(A) (B)
Item Amount Business Nonbusiness

Income (Loss)
1 Wages, salaries, tips, etc
2 Business income -2,029. -2,029.
3 Other gains

E
4 Rents
5 Royalties
6 Partnerships and S corporations
7 Estates and trusts
8 REMICs

L
9 Farm income
10 Unemployment compensation
11 Interest income
12 Dividend income

FI
13 State tax refund
14 Alimony received
15 IRA distributions
16 Pensions
17 Taxable social security
18 Other income
19 Reallocation
20 Income (Loss) Totals
Capital Gains (Losses)
T -2,029.

21 Capital gains
22 Capital losses
NO
23 Capital loss carryover
24 Capital gain distributions
25 Capital Gains Total
26 Capital Losses Total
Deductions
27 Educator expenses
28 Certain business expenses
29 Health Savings Account
30 Moving expenses
31 Self employed tax deduction
32 Keogh, SEP and SIMPLE
33 Self employed health insurance
DO

34 Early withdrawal penalty


35 Alimony paid
36 IRA deduction
37 Student loan deduction
38 Tuition and fees
39 Reserved
40 Other adjustments
Schedule A
41 Medical
42 Taxes
43 Interest expense
44 Contributions
45 Casualty
46 a Other itemized deductions
b Casualty losses included on line 46a
47 Standard deduction 12,200. 12,200.
48 Reallocation
49 Deductions Total 12,200.
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Federal Carryover Worksheet 2019


G Keep for your records

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

2018 State and Local Income Tax Information

(a) (b) (c) (d) (e) (f) (g)


State or Paid With Estimates Pd Total With- Paid With Total Over- Applied
Local ID Extension After 12/31 held/Pmts Return payment Amount

E
Totals

L
2018 State Extension Information 2018 Locality Extension Information

(a) (b) (a) (b)

FI
State Paid With Extension Locality Paid With Extension

2018 State Estimates Information 2018 Locality Estimates Information

(a)
State
(c)
Estimates Paid After 12/31
T (a)
Locality
(c)
Estimates Paid After 12/31
NO

2018 State Taxes Due Information 2018 Locality Taxes Due Information

(a) (e) (a) (e)


State Paid With Return Locality Paid With Return

2018 State Refund Applied Information 2018 Locality Refund Applied Information
DO

(a) (g) (a) (g)


State Applied Amount Locality Applied Amount

2018 State Tax Refund Information 2018 Locality Tax Refund Information

(a) (d) (f) (a) (d) (f)


Total Total Total Total
State Withheld/Pmts Overpayment Locality Withheld/Pmts Overpayment
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Federal Carryover Worksheet page 2 2019

ALBERTO J ALMEIDA LANZ 002-15-5880

Other Tax and Income Information 2018 2019

1 Filing status 1 2 MFJ 1 Single


2 Number of exemptions for blind or over 65 (0 - 4) 2
3 Itemized deductions 3 0. 0.
4 Check box if required to itemize deductions 4
5 Adjusted gross income 5 10,711. -2,029.
6 Tax liability for Form 2210 or Form 2210-F 6 0. 0.

E
7 Alternative minimum tax 7
8 Federal overpayment applied to next year estimated tax 8

QuickZoom to the IRA Information Worksheet for IRA information

L
Excess Contributions 2018 2019

9a Taxpayer’s excess Archer MSA contributions as of 12/31 9a

FI
b Spouse’s excess Archer MSA contributions as of 12/31 b
10 a Taxpayer’s excess Coverdell ESA contributions as of 12/31 10 a
b Spouse’s excess Coverdell ESA contributions as of 12/31 b
11 a Taxpayer’s excess HSA contributions as of 12/31 11 a
b Spouse’s excess HSA contributions as of 12/31 b

Loss and Expense Carryovers 2018 2019


Note: Enter all entries as a positive amount
T
12 a Short-term capital loss 12 a
b AMT Short-term capital loss b
NO
13 a Long-term capital loss 13 a
b AMT Long-term capital loss b
14 a Net operating loss available to carry forward 14 a 2,029.
b AMT Net operating loss available to carry forward b 2,029.
15 a Investment interest expense disallowed 15 a
b AMT Investment interest expense disallowed b
16 Nonrecaptured net Section 1231 losses from: a 2019 16 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
DO

f 2014 f
17 AMT Nonrecap’d net Sec 1231 losses from: a 2019 17 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Car and Truck Expenses Worksheet 2019


G Keep for your records

Sch C DRIVER

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ 002-15-5880

Vehicle Information Vehicle 1 Vehicle 2 Vehicle 3


Complete for all vehicles

1 Make and model of vehicle NISSAN VERSA


2 Date acquired

E
3 Date placed in service 12/01/2017
4 Type of vehicle A1 - Auto
5a Ending mileage reading
b Beginning mileage reading

L
c Total miles for the year 99,083
6 Business miles for the year 95,167
7 Commuting miles for the year
8 Other personal miles for the year 3,916

FI
9 Percent of business use % 96.05 % %
10 Months for special allocation. See Tax Help
11 Is another vehicle available for personal use? Yes No Yes X No Yes No
12 Was the vehicle available for personal use
during off-duty hours? Yes No X Yes No Yes No
13 Was the vehicle used primarily by a more
than 5% owner or related person? Yes No Yes X No Yes No

b If ’Yes,’ is the evidence written?


T
14 a Is there evidence to support the business use claimed? X
X
Yes
Yes
No
No

Standard Mileage Rate


NO
15 Does vehicle qualify for standard mileage rate? Yes No X Yes No Yes No
16 Was the vehicle leased? Yes No Yes X No Yes No
17 Standard mileage deduction 55,197.

Actual Expenses

18 Expenses:
a Gasoline, oil, repairs, insurance, etc
b Vehicle registration, license (excluding
property taxes)
c Vehicle lease or rental fees:
DO

1 30 days or more
2 29 days or less
3 Total vehicle lease/rental fees
d Leased vehicle inclusion amount:
1 Year lease began
2 FMV of leased vehicle
3 Number of lease days in year
4 Inclusion amount
19 Expenses subtotal
20 Expenses applicable to business
21 Vehicle depreciation and Sec 179 (from page 2)
22 Total actual expenses

Standard Mileage vs Actual Expenses Check box to force a method


M M M
23 Standard mileage 55,197.
24 Actual expenses
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Sch C DRIVER Page 2


ALBERTO J ALMEIDA LANZ 002-15-5880

Total Car and Truck Expenses Vehicle 1 Vehicle 2 Vehicle 3


Complete for all vehicles NISSAN VERSA

25 Line 23 or line 24 55,197.


26 Additional expenses:
a Business-related parking fees, tolls, etc 1,163.
b Property taxes (including property tax portion
of registration)

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c Less personal portion of property taxes
d Interest on vehicle
e Less personal portion of vehicle interest
27 Total expenses 56,360.

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28 Less business portion of lease or rental fees
less inclusion amount (if actual expenses)
29 Less business portion of depreciation
(if actual expenses)

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30 Total car and truck expenses 56,360.

Vehicle Depreciation Information ' Complete for Actual Expenses only

31 Cost or basis
32 Section 179 expense elected
33 Depreciation and Sec 179 limit for automobiles
34 a Economic Stimulus - Qualified Property
1 If yes, and if placed in service after 9/27/17,
TYes
Yes
No N/A
No
Yes
Yes
No N/A
No
Yes
Yes
No N/A
No

was this property acquired after 9/27/17?


2 For post 9/27/17, elect 50% in place of 100% Yes No N/A Yes No N/A Yes No N/A
NO
Special Depreciation Allowance
b Qualified Disaster Area - Qualified Property Yes No Yes No Yes No
c Kansas Disaster Zone - Qualified Property Yes No Yes No Yes No
Reg Ext No Reg Ext No Reg Ext No
d Gulf Opportunity Zone - Qualified Property
100% & 50% 100% & 50% 100% & 50%
e Percentage for Special Depr Allowance 30% 30% 30%
N/A N/A N/A
fElect OUT of Special Depr Allowance Yes No Yes No Yes No
gElect 30% in place of 50% Allowance Yes No Yes No Yes No
hQuickZoom to Election Stmts
DO

iSpecial Depreciation Allowance


jAMT Special Depreciation Allowance
35 Prior depreciation
36 Depreciation deduction
37 Alternative minimum tax prior depreciation
38 AMT depreciation deduction
39 AMT adjustment/preference
40 QuickZoom to Asset Life History
MACRS Property Involved in a Like-Kind Exchange
or Involuntary Conversion
41 Elect OUT of regs under Sec 1.168(i)-6(i) Yes N/A Yes N/A Yes N/A
42 If asset represents entire basis of replacement
property, enter excess basis
Pre-02/28/04 transactions only (See TaxHelp):
43 Asset ID (Enter same ID on all related assets)
44 Check if asset represents exchanged basis of
replacement property
45 Total basis of all related parts
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Sch C DRIVER Page 3


ALBERTO J ALMEIDA LANZ 002-15-5880
State Depreciation ' Complete for Actual Expenses only
46 QuickZoom to select or delete states
47 a State (CA info must be entered in CA state return, do not enter here)
b Asset status
c Vehicle description
d Vehicle number
e State cost or basis
f State Section 179 deduction
g State Section 179 deduction allowed (enter for dispositions only)
h State Special Depreciation Allowance

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i State asset class
j State depreciation method
k State MACRS convention
l State recovery period
m State depreciable basis

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n State prior depreciation
o State depreciation deduction
p If this asset represents entire basis of replacement property, enter excess basis
q Form 8824: If luxury auto, enter depreciation at 100% business use

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r State gain/loss basis, if different from state cost
o Include vehicle in state return Yes No

Disposition of Vehicle Vehicle 1 Vehicle 2 Vehicle 3


Complete for all vehicles NISSAN VERSA
47 Date of disposition
48 Sales price (business portion only)
49 Expense of sale (business portion only)
50
51
Sec 179 deduction allowed
Double-click to link sale to Form 6252
T
52 Reserved
53 Gain/loss basis, if diff from ln 30 (enter 100%)
NO
54 AMT gain/loss basis, if diff from ln 77 (100%)
55 Depreciation allowed or allowable
56 AMT depreciation allowed or allowable
57 Gain or loss
58 Alternative minimum tax gain or loss
59 Part of Form 4797 to which gain/loss carries
Detail Vehicle Depreciation Information ' Complete for Actual Expenses only
60 Subject to auto limitations? Yes No Yes No Yes No
61 Truck or van? Yes No Yes No Yes No
62 Electric passenger vehicle? Yes No Yes No Yes No
63 Heavy SUV? Yes No Yes No Yes No
64 Listed property? X Yes No X Yes No Yes No
DO

65 Eligible for Sec 179 (current yr assets only)? Yes No Yes No Yes No
66 Use IRS tables for MACRS property? Yes No Yes No Yes No
67 Qualified Indian reservation property? Yes X No Yes X No Yes No
68 Used Property? Yes No Yes No Yes No
69 Depreciation type
70 Asset class
71 Depreciation method
72 Convention (HY assumed for MACRS property)
73 QZ to set 2019 convention
74 Recovery period
75 Year of depreciation
76 Depreciable basis
77 Alternative minimum tax basis, if diff from ln 30
78 Alternative minimum tax depreciation method
79 Alternative minimum tax recovery period
80 Alternative minimum tax depreciable basis
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Section 199A (QBI Deduction) attributes


If this asset belongs to a qualified business under Section 199A, the following attributes will be used to
calculate the deduction for the qualified business.
UBIA for this asset 0. 0. 0.
This asset is ineligible for UBIA
Gains/(losses) from disposition of asset
Short term gain/(loss) 0. 0. 0.
Ordinary income from depreciation recapture 0. 0. 0.
Long term gain/(loss) 0. 0. 0.
Gain/(loss) is not eligible for 199A deduction

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NO
DO
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Two-Year Comparison 2019

Name(s) Shown on Return Social Security Number


ALBERTO J ALMEIDA LANZ

Income 2018 2019 Difference %

Wages, salaries, tips, etc 1,856. -1,856. -100.00


Interest and dividend income
State tax refund
Business income (loss) 9,528. -2,029. -11,557. -121.30
Capital and other gains (losses)
IRA distributions

E
Pensions and annuities
Rents and royalties
Partnerships, S Corps, etc
Farm income (loss)

L
Social security benefits
Income other than the above
Total Income 11,384. -2,029. -13,413. -117.82
Adjustments to Income 673. -673. -100.00

FI
Adjusted Gross Income 10,711. -2,029. -12,740. -118.94

Itemized Deductions
Medical and dental
Income or sales tax
Real estate taxes
Personal property and other taxes
Interest paid
Gifts to charity
T
Casualty and theft losses
Miscellaneous
NO
Total Itemized Deductions 0. 0. 0.
Standard or Itemized Deduction 24,000. 12,200. -11,800. -49.17
Qualified Business Income Deduction
Taxable Income 0. 0. 0.

Income tax 0. 0. 0.
Additional income taxes
Alternative minimum tax
Total Income Taxes 0. 0. 0.
Nonbusiness credits 0. 0. 0.
Business credits
DO

Total Credits 0. 0. 0.
Self-employment tax 1,346. -1,346. -100.00
Other taxes
Total Tax After Credits 1,346. 0. -1,346. -100.00
Withholding 153. -153. -100.00
Estimated and extension payments
Earned income credit 3,461. -3,461. -100.00
Additional child tax credit 1,232. -1,232. -100.00
Other payments 1,060. 1,060.
Total Payments 4,846. 1,060. -3,786. -78.13
Form 2210 penalty
Applied to next year’s estimated tax
Refund 3,500. 1,060. -2,440. -69.71
Balance Due

Current year effective tax rate 0.00 %


DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

Schedule C Two-Year Comparison 2019


G Keep for your records

Proprietor name: ALBERTO J ALMEIDA LANZ 002-15-5880


Business or profession: DRIVER

Note: Transferred data will not be displayed in the prior year column unless you have entered
current year data on the Schedule C.

2018 2018 2019 2019 2018 to 2019


Percent Percent Comparison
of Net of Net X as amount
Sales* Sales* as percent

E
Income:
1 Gross receipts or sales 70,979. 100.00 67,639. 100.00 -3340.00
2 Returns & allowances
3 Net receipts or sales 70,979. 100.00 67,639. 100.00 -3340.00

L
Cost of goods sold:
4 a Beginning inventory
b Purchases
c Cost of labor

FI
d Materials & supplies
e Other costs
f Ending inventory
5 Cost of goods sold
6 Gross profit 70,979. 100.00 67,639. 100.00 -3340.00
7 Other income
8 Gross income 70,979. 100.00 67,639. 100.00 -3340.00
Expenses:
9
10
Advertising
Car & truck expenses 46,664.
T 65.74 56,360. 83.32 9696.00
11 Commissions and fees
12 Contract labor
NO
13 Depletion
14 Depreciation & Sec 179
15 Employee benefits
16 Insurance
17 a Mortgage interest
b Other interest
18 Legal and professional
19 Office expense
20 Pension & profit-sharing
21 Rent or lease:
a Vehicle/machinery/equip
b Other business property
DO

22 Repairs & maintenance


23 Supplies
24 Taxes and licenses
25 a Travel
b Meals & entertainment
26 Utilities
27 Wages (less job credit)
28 Other expenses 14,787. 20.83 13,308. 19.68 -1479.00
29 Total expenses 61,451. 86.58 69,668. 103.00 8217.00
30 Tentative profit (loss) 9,528. 13.42 -2,029. -3.00 -11557.00
31 Office in home
32 Net profit (loss) 9,528. 13.42 -2,029. -3.00 -11557.00

Passive suspended losses:


Schedule C
Form 4797
Schedule D
*Lines 1 through 32 as a percentage of net sales revenue.
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

ALBERTO J ALMEIDA LANZ 002-15-5880 1

Smart Worksheets from your 2019 Federal Tax Return

SMART WORKSHEET FOR: Schedule C (DRIVER): Profit or Loss from Business

Business Address Information Smart Worksheet

Business street address 12400 VISTA ISLES DR, Apt. 1422


City, State and Zip Code (do not enter State and Zip Code if foreign address)
FORT LAUDERDALE FL 33325

E
Or, foreign country information:

L
SMART WORKSHEET FOR: Schedule C (DRIVER): Profit or Loss from Business

FI
Activity Summary Smart Worksheet
Supporting information provided by program. NO ENTRIES ARE NEEDED.

Regular Tax QBI Alternative


Minimum Tax

A
B
Ownership
At risk status
T Taxpayer
All
C Passive status Nonpassive
NO
Schedule C
D Tentative profit (loss) -2,029. -2,029.
E Other adjustments
F At risk disallowed loss
G Passive carryover loss
H Passive disallowed loss
I Net profit (loss) allowed -2,029. -2,029.
Related Dispositions
J Tentative profit (loss)
K At risk disallowed loss
L Passive carryover loss
M Passive disallowed loss
DO

N Net profit (loss) allowed


DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

ALBERTO J ALMEIDA LANZ 002-15-5880 2

SMART WORKSHEET FOR: Schedule C (DRIVER): Profit or Loss from Business

QBI (Section 199A) Attributes by Year Smart Worksheet


Supporting information provided by program. *MANUAL ENTRIES NEEDED

Percentage of SSTB income (by category)

Applicable % Operating % Form 4797 ord Form 4797 l/t

E
2018 0.00 0.00 0.00

Section 179 Deduction

L
Prior Year Carryovers by Year Regular Tax QBI

Before 2018

FI
A Section 179 carryover
2018
B Section 179 carryover

Allowed deductions by year Regular Tax QBI

A 2019 Section 179 election


B
C
Total deduction (all years)
Allowed deduction in 2019
T
D Freed up deduction from before 2018
NO
E Freed up deduction from 2018
F If SSTB, reduced loss from 2018

Carryforwards to 2020 Regular Tax QBI

Before 2018
A Section 179 carryforward
2018
B Section 179 carryforward
2019
C Section 179 carryforward
DO

At-Risk Limits

At-Risk Prior Year Carryovers Suspended Loss


by Year and Category Regular Tax QBI

Before 2018
A Operating loss
B Form 4797 ordinary loss
C Form 4797 long-term loss
2018
D Operating loss
E Form 4797 ordinary loss
F Form 4797 long-term loss
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

ALBERTO J ALMEIDA LANZ 002-15-5880 3

SMART WORKSHEET FOR: Form 8863: Education Credits


Nonrefundable Credit -- Form 8863, Line 19

1 Enter amount from line 18, Form 8863 1


2 Enter amount from line 9, Form 8863 2 1,500.
3 Add lines 1 and 2 3 1,500.
4 Enter the amount from Form 1040 or 1040-SR, line 12a 4 0.
5 Enter the amount from Schedule 3 (Form 1040 or 1040-SR), lines 1 and 2,
and the amount from Schedule R, line 22 5
6 Subtract line 5 from line 4 6 0.

E
7 Enter the smaller of line 3 or line 6 here and on Form 8863, line 19 7 0.

SMART WORKSHEET FOR: Form 8867: Paid Preparer's Due Diligence Checklist

L
Paid Preparer Smart Worksheet

If different from the preparer who will sign the return, select the paid preparer who determined

FI
the taxpayer’s eligibility for, and amount of, the Earned Income Credit (EIC), Child Tax Credit
(CTC), American Opportunity Tax Credit (AOTC), or Additional Child Tax Credit (ACTC).

A Enter paid preparer code from Firm/Preparer Info 01

SMART WORKSHEET FOR: Taxpayer Student Info Worksheet


T
Apprenticeship and Education Loan Smart Worksheet
NO
A Enter the amount of qualified expenses for tuition, fees, books, supplies and
equipment required for particiaption of the designated beneficiary in a
registered apprenticeship program
B Enter the amount of principal or interest payments on any qualified education
loans of the designated beneficiary (or a sibling) not to exceed $10,000 each
1 Principal
2 Interest
3 Is the interest payment on line 2 included in Part I of the Student Loan Interest
Deduction Worksheet? Yes No
QuickZoom to Student Loan Interest Deduction Worksheet
DO

SMART WORKSHEET FOR: Form 1095-A - Insurance Exchange (74145813)

Shared Policy Allocation Information Smart Worksheet


Enter shared policy information required for Part 4 of Form 8962 here. It will be calculated
to the Form 8962. This is the percentage of this policy to be reported on this tax return.
SSN of taxpayer sharing allocation Start Month Stop Month
284-41-1403 01 12
Premium Percentage SLCSP Percentage Advance Payment of the PTC Percentage
33 33 33
DocuSign Envelope ID: 0D2948DF-0C16-4A58-A57F-416B87C0EAA7

ALBERTO J ALMEIDA LANZ 002-15-5880 4

SMART WORKSHEET FOR: Net Operating Loss Worksheet


QuickZoom to NOL Classification Worksheet
QuickZoom to Form 1045
QuickZoom to Election to Forego any Farming NOL Carryback
If this is a Farming NOL, check box to not transfer NOL(s) to next year (line 25 less
line 24 for regular tax and line 4 of the AMT NOL carryover worksheet below for AMT)
Enter regular tax NOL to transfer to next year (if not line 25 less line 24)

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NO
DO

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