The PAINTERS

FORM 1040A: U.S. INDIVIDUAL INCOME TAX RETURN

Name: Norman Q. Painter and Dorothy T. Painter are married (Nov. 5, 2000) and will file ajoint return for 2012. Neither Norman nor Dorothy is blind, and both are under age 65.

They rent their home at 1721 W. 240th St,Lomita, CA 90721. Their home telephone number is -310/541-111l.

Their nine year old daughter (DOB: 7/1/2003), Emily Painter, whose social security number is 644-36- 3871, has Jived at home aH year.

Their son Hunter was born 9-12-2006 and his social security number is 612-45-9145 and also lived with his parents for the full year.

Mr.Painter works as a computer analyst, and received wages of $31,000, from which $1,950 in federal income taxes and $475 in state income taxes was withheld. His social security number is 567-45-3888. Mr. Painter was born 04/28/1978.

Mr. Painter is also paying off a student loan and the interest for the year is $300Mr. Painter is not required to pay any estimated taxes and chooses to not do so this year.

Mrs. Painter works as an administrative assistant and received wages of $18,000, from which $600 in federal income taxes and $200 in state income taxes was withheld. Her social security number is 412-45- 6798. Mrs. Painter was born on 06-12-1980.

The Painters received $245 of interest income from a U.S.financial institution, State Bank. The Painters elect to have $3 go to the Presidential Election Campaign Fund.The Painters elect to have any refund directly deposited to their checking account. Their bank's routing number is 011000013 and their account number is 004002006

The Painters may be able to claim the child tax credit. They must fill out a worksheet accompanying Form 1040A to determine their eligibility and any credit amount.

The Painters may also be eligible for the earned income credit (EiC). They must complete a questionnaire, worksheet and Schedule EIC to determine their eligibility and any credit amount.

Page 1

The Painters have elected to have Valerie Bush prepare their taxes. Valerie Bush (PTIN # POl 765432) prepares Form 8867, Paid Preparer 's Earned Income Credit Checklist if they qualify for EIC.

Required forms are:1040A US Income Tax Return (2012) 2012 Child Tax Credit Worksheet Schedule 8812 - Child Tax CreditSchedule B-Interest and Ordinary Income Schedule EIC Earned Income CreditForm 8867 Paid Preparers Earned Income Credit Checklist

Additional Document:EIC Instructions and EiC tax tables. Please refer to if needed for the Earned Income Credit calculation.

ALL THE NECESSARY FORMS FOLLOW THIS PROBLEM.

Page 2

Form(s)

payment. Also,

Form Department of the Treasury-Internal Revenue Service

1040A U. S. I ndi vidual I ncome Tax Return (991 2012 IRS Use Only-Do not write or

staplei n this space.

Foreign country name IForeign province/state/county IForeign postal code

Filing statusCheck only one box.

Exemptions

1 D Single 4 D Head of household (with qualifying person). (See instructions.)

2 D Married filing jointly (even if only one had income) If the qualifying person is achild but not yourdependent,3 D Manied filing separately. Enter spouse's SSN above and enter this child's name here. ..,_ --

---- full name here...,_ 5 D Qualifying widow(er) with dependent child (see instructions)

6a DYourself. If someone can claim you as a dependent, do not check } Boxeschecked onbox 6a. 6a and 6b

b DSpouse No. of children

If more than six dependents, see instructions.

Income

c

d TotaI number of exempf·ions cIa.imed

on6c who:•livedwith you

•did not live with you dueto divorce or separation (see instructions)Dependents on6c not entered above

Add numbers onines above

Attach7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7

Form(s) W-2 Sa Taxable interest. Attach Schedule B if required. 8ahere. Also b Tax-exempt interest .Do not include on line Sa. Sbattach

9a Ordinary dividends.Attach Schedule B if required. 9a1099-R if tax b Qualified dividends (see instructions). 9bwas 10 Capital Qain distributions (see instructions). 10withheld. 11a IRA 11b Taxable amountIf you did not distributions. 11a (see instructions). 11bget a W-2, see 12a Pensions and 12b Taxable amountinstructions.

annuities. 12a (see instructions). 12bEnclose,but donot attach,any 13 Unemployment compensation and Alaska Permanent Fund dividends. 13please use Form 14a Social security 14b Taxable amount1040-V. benefits. 14a (see instructions). 14b

15 Add lines 7 through 14b (far right column). This is your total income..............15Adjusted gross income

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. cat. No.11327A Form 1040A (2012)

D

Your first name and initial Last name OMB No. 1545-0074Your social security number

I iIf ajoint return, spouse's first name andinitial Last name Spouse'ssocial security number

I IHome address (number and street). If you have a P.O. box,see instructions. Apt.no.

I A Make sure the SSN(s) aboveand on line 6c are correct.City, town or post office, state,and ZIP code.If you have a foreign address, also complete spaces below {see instructions). Presidential Election Campaign

Check hem you. IX your spouse if fiing jointly, want $3 to gotothis fund.Checking a box below wil not ctmge your tax IXrefund. 0 You

16 Educator expenses (see instructions). 1617 IRA deduction (see instructions). 1718 Student loan interest deduction (see instructions). 1S

19 Tuition and fees. Attach Form 8917. 1920 Add Imes 16 through 19. These are your total adjustments. 20

21 Subtract line 20 from line 15. This is our adjusted ross income. ..,_ 21

Dependents:

(1) First name Last name

(2) Dependent's social security number

(3) Dependent's relationship to you

(4) ./if child under age 17 qualifying for child tax credit (see

instructions)DD0DDD

23

D

See

I I

Standard Deduction for-•People who check any box on line 23a or 23bor who can be claimed as a dependent,seeinstructions.•All others:Single or Married filing separately,$5,gsoMarried filing iointlx orQuahfyin8, widow(e ,$11,gooHead of household,$8,700

Form 1040A (2012) Page 2

Tax, credits, 22 En_ter_t_h=e=a- m_o_u_n_t f_ro_m lin_e2_1 (adj_u_st_e dgross in=co=me) ·-=--:--:--=-- -==- 2_2 '-and 23a Check { OYou were born before January 2, 1948, 0Blind }Total boxes payments if: OSpouse was born before January 2, 1948, OBlind checked ..,.. 23a

b If you are married filing separately and your spouse itemizesdeductions, check here .... 23b D

24 Enter your standard deduction. 2425 Subtract line 24 from line 22.If line 24 is more than line 22, enter -0-. 2526 Exemptions. Multiply $3,800 by the number on line 6d. 2627 Subtract line 26 from line 25. If line 26 is more than line 25,enter -0-.

This is your taxable income. ..... 27 2 8 Tax, including any alternative minimum tax (see instructions). 2829 Credit for child and dependent care expenses. Attach

Form 2441. 2930 Credit for the elderly or

Schedule R.the disabled. Attach

3031 Education credits from Form 8863, line 19. 3132 Retirement savings con

Form 8880.tributions credit. Attach

3233 Child tax credit. Attach Schedule 8812, if required. 333435

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

34

If you have a qualifying child,attach Schedule EiC.

Refund

Direct deposit? See instructionsand fill in43b, 43c,and 43d or Form 8888.

Amountyou owe

Third partydesignee

hereJciot mt"m?

instructions.

your total tax. 3536 Federal income tax withheld from Forms W-2 and

1099. 3637 2012 estimated tax payments and amount applied

from 2011 return. 3738a Earned income credit (EiC). 38a

b Nontaxable combat payelection. 38b

39 Additionalchild tax credit. Attach Schedule 8812. 39

40 American opportunity credit from Form 8863, line 8. 40

41 Add lines 36, 37, 38a, 39, and 40.These are our total a ments. ..,.. 4142 If line 41 is more than line 35, subtract line 35 from line 41.

This is the amount ou overpaid. 4243a Amount of line 42 ou want refunded to you.If Form 8888 is attached,check here O 43a

..,.. b I I I I I I I I I I "" c Type: D Checking D Savings

d e t l I I I I I I I I I I I I I I I I I44 Amount of line 42 you want applied to your

2013 estimatedtax. 4445 Amount you owe. Subtract line 41 from line 35. For details on how to pay,

see instructions. ..,.. 45

46 Estimated tax penal see instructions . 46Do you want to allow another person to discuss this return with the IRS (see instructions)? 0Yes.Complete the following. 0No

Oesignee's Phone Personal identification Iname .,. no. .,. number (PIN) .,. .Under penalties of perjury, Ideclare that Ihave examined this return and accompanying schedules and statements, and to the best of my knowledge

than the taxpayery is based on all information of which the preparer has any knowledge.Your signature Date Your occupation Daytime phone number

Keep a copy Spouse's signature. If a joint return. both must sign. Date Spouse's occupation If the IRS sent you an Identity Protectionfor your records. PIN, enter

.l

I I I I I I

here!see inst

Paid PrinVtype preparer's name Preparer's signature Date Check ll>- 0 if PTIN

preparerself-employed

Firm's name.,. Firm's EIN...use onlyFirm's address.,. Phone no.

Form 1040A (2012)

24

I

Note. ltrme 6 .1s over $1,500,you must complete Part Ill.You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends;(b) had a foreign account;or (c) received a distribution from, or were a grantor of, or a transferor to, a foreigntrust.

Part Ill 7a At any time during 2012, did you have a financial interest in or signature authority over a financial

Foreign account (such as a bank account,securities account, or brokerage account) located in a foreign country? See instructionsAccountsIf "Yes," are you required to file Form TD F 90-22.1to report that financial interest or signature

and Trusts authority? See Form TD F 90-22.1 and its instructions for filing requirements and exceptions to(See those requirementsinstructions on b If you are required to file Form TD F 90-22.1,enter the name of the foreign country where theback.)

financial account is located ..,.----------- --------------------------------- -------------------------------------------·----·8 During 2012, did you receive a distribution from,or were you the granter of, or transferor to, a

Yes No

For Paperwork Reduction Act Notice,see your tax return instructions. Cat. No. 17146N Schedule B(Form 1040A or 1040) 2012

26

SCHEDULE S(Form 1040A or 1040)

Department of the TreasurynternalRevenue Service (99)

Interest and Ordinary DividendsAttach to Form 1040A or 1040.

Information about Schedule B(Form 1040A or 1040) and itsinstructions is at www.irs.gov/fonn1040.

OMB No. 1545-0074

@12Attachment 08Seauence No.

Name(s) shown on return Your social security number

Part IInterest

(See instructions on back and the instructions for Form 1040A, or Form 1040,line Ba.)

Note. lf you received a Form 1099-INT, Form1099-0ID,orsubstitute statement froma brokerage firm, list the firm's name as the payer and enter the totalinterest shown on that form.

1 List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence,see instructions on back and list this interest first. Also.show that buyer's social security number and address ..,..

2 Add the amounts on line 1 . . . . . . . . . . . . . . . .3 Excludable interest on series EE and I U.S. savings bonds issued after

1989. Attach Form 8815 . . . . . . . . . . . . .4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or

Form 1040, line 8a . . . . . . . . . . . . ..,..

1

Amount

2

3

4Note. If line 4 is over $1,500, you must complete Part Ill. Amount

Part II

OrdinaryDividends(See instructions on back and the instructions for Form 1040A, or Form 1040,line 9a.)

Note. If you received a Form 1099-DIV orsubstitute statement froma brokerage firm, list the firm's name as the payer and enter the

5 List nameof payer

6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a . . . . . . . . . . . . . . . . .,..

5

6

8

8

8

a actual

mpenalty equal

be subject to a

Schedule B (Form 1040A or 1040) 2012 Page 2

General InstructionsSection references are to the Internal Revenue Code unless otherwise noted.

Future DevelopmentsFor the latestinformation about developmentsrelated to Schedule B (Form 1040A or 1040) and its instructions, such as legislation enacted after they were published, go to www.irs.gov/form1040 .

Purpose of FormUse Schedule B if any of the following appl es.

• You had over $1,500 of taxableinterest or ordinary dividends.

• You received interest from aseller-financed mortgage and the buyer used the property as a personal residence.• You have accrued interest from a bond.• You are reporting original issue discount (010)in an amountless than the amount shown on Fonn 1099-0ID.• You are reducing your interest income on a bond by the amount of amortizable bond premium.• You are claiming the exclusion ofinterest from series EE or IU.S. savings bonds issued after 1989.•You received interest or ordinary dividends asa nominee.•You had a financial interest in, or signature authority over, afinancial account in a foreign country or you received adistribution from, or were a granter of, or transferor to,a foreign trust. Part Ill of the schedule has questions about foreign accounts and trusts.

Specific InstructionsYou can list more than one payer on each entry space for lines 1 and 5, but be sure to clearly show the amount paid next to the payer's name. Add the separate amounts paid by the payers

listed on an entry space and enter the total in the "Amount•column. If you still need more space, attach separate statements that are the same size as the printed schedule. Use the same format as lines 1 and 5, but show your totals on Schedule 8.Be sure to put your name and social security number (SSN) on thestatements and attach them at the end of your return.

Part I. InterestLine 1.Report on lne 1all of your taxableinterest. Taxable interest should be shown on your Forms 1099-INT, Forms 1099-010,or substitute statements.Include interest from series EE, H, HH, and IU.S.savings bonds. List each payer's name and show the amount. Do not report on this line anytax-exempt interest from box 8 or box 9 of Fonn 1099-INT. Instead, report the amount from box 8 on line 8b of Form 1040A or 1040.If an amount is

If you received interest as a nominee, you must give the actual owner a Form 1099-INT unless the owner is yourspouse. You must also file a Form 1096and a Form 1099-INTwith the IRS. For

more details, see the General Instructions for Certain Information Returns and the Instructions for Fonns 1099-INT and 1099-0ID.

Accrued interest When you buy bonds between interest payment dates and pay accrued interest to the seller, thisinterestis taxable to the seller.If you received a Fonn 1099 for interest as a purchaser of a bond with accrued interest, follow the rules earlierunder Nominees to see how to report the accrued interest. But identify the amount to be subtracted as "Accrued Interest."

Original issue discount (010). If you are reporting OIDin an amount less than the amount shown on Form 1099-0ID, follow the rules earlier under Nominees to see how to report the OID. But identify the amount to be subtracted as "OIDAdjustment."

Amortizable bond premium. If you are reducing your interest income on a bondby the amount of amortizable bondpremium,follow the rules ear1ier under Nomineesto see how to report theinterest.But identify the amount to besubtracted as •ABP Adjustment.·Line 3. If, during 2012, you cashed series EEor IU.S. savings bondsissued after 1989 and you paid qualified higher education expenses for yourself, your spouse, or your dependents,you may be able to exclude part or all of the interest on those bonds. See Form 8815 for details.

Part II. Ordinary DividendsYou may have to file Form 5471 if, in 2012, you were an officer or director of a foreign corporation. You may also have to file Form 5471 ff, in 2012, you owned 10% or more of the total

(a) value of a foreign corporation 's stock, or (b)combined voting power of all classes of a foreign corporation's stock with voting rights. For details, see Form 5471 and its instructions.Line 5. Report online 5 all of your ordinary dividends.This amount should be shown in box 1a of your Fonns 1099-DIV or substitute statements. List each payer's name and show the amount.

Nominees. If you received a Form 1099-0Nthat includes ordinary dividends you received as a nominee (that is, in your name, but the ordinary dividends actually belong to someone else), report the total on line 5.Do this evenif you later distributed some or all of this income to others.Under your last entry on line 5, put a subtotal of all ordinary dividends listed on line 5. Below this subtotal,enter "Nominee Distribution" and show thetotal ordinary dividends you received asa nominee.Subtract this amount from the subtotal and enter the result on line 6.

If you received dividends as a nominee,you must give the owner a Form

Financial account. A financial account includes, but is not limited to, a securities, brokerage, savings, demand,checking,deposit, time deposit, or other account maintained with a financial institution (or other person perfonning the services of a financialinstitution).A financial account also includes a commodity full.res or options account, aninsurance policy with a cash value (such as a wholelife insurance policy), an annuity policy with a cash value, and shares in a mutual fund or similar pooled fund (that is, a fund that is available to the general public with a regular net asset value determination and regular redemptions).

Financial account located in a foreign countJy. A financial accountis located in a foreign country if the accountis physically located outside of the United States. For example, an account maintained with a branch of a United States bank that is physically located outside of the United States is a foreign financial account. An account maintained with abranch of a foreign bank that is physically located in the United Statesis not a foreign financial account.

Signature authority. Signature authority is the authority of an individual (alone or in conjunction with another individual) to control the disposition of assets heldin a foreign financial account by direct communication (whether in writing or otherwise) tothe bank or other financial institution that maintains the financial account. See the Instructions for Form TD F 90-22.1 (Report of Foreign Bank and Financial Accounts) for exceptions. Do not consider the exceptions relating to signature authorityin answering Question 1 online 7a.

Other definitions. For definitions of "financial interest," "United States," and other relevant terms, see theinstructions for Fonn TD F 90-22.1.Note. You can get Form TD F 90-22.1from the IRS website at www.irs.gov/publirs-pdf!f90221.pdf.Line 7a-Question 2. See Fonn TD F90-22.1andits instructions to detennine whether you must file the form. Check the "Yes" box if you are required to file the fonn; check the 'No' box if you are not required to file the fonn.

If you checked the "Yes" box to Question 2 online 7a, file Form TD F 90-22.1with the Department of Treasury at the address shown in theinstructions forthat fonn. Do not attach Form TD F 90-22.1to your tax return. To be considered timely, Form TD F90-22.1 must be received by June 30, 2013.

If you are required to file Form TD F90-22.1 but do not properly do so, youmay have to pay a civilpenalty up to$10,000. A person who willfully fails toreport an account orprovide account

identifying information mayto the greater of $100,000 or 50

percent of the balance in the account at the time of the violation. Willful violations may a/so be subject to criminal penalties.

Line 7b.If you are required to file Fonn TD Fshown in box 9 of Form 1099-INT, you generallymust reportit on line 12 of Form 6251.See the Instructions for Fonn 6251 for more details.

Seller-financed mortgages. If you soldyour home or other property and the buyer used the property as a personal residence, list first any interest the buyer paid you on a mortgage or other fonn of seller financing. Be sure to show the buyer's name, address, and SSN. You must also let the

1099-DIV unless the owner is your spouse.You must also file a Form 1096and a Form 1099-DIV with the IRS. For more

details,see the GeneralInstructions for Certainlnfonnation Returns and the Instructions for Fonn 1099-DIV.

Part Ill. Foreign Accounts and

aTrusts

90-22.1, enter the name of the foreign country or countries in the space provided on lne 7b. Attach a separate statement if you need more space.Line 8. If you received a distribution from a foreign trust, you must provide additional information.For this purpose, a loan of cash or marketable securities generally is considered to be a distribution.See Form 3520 for details.

If you were the granter of, or transferor to, abuyer know your SSN. If you do not show thebuyer's name, address, and SSN, or let the buyer know your SSN, you may have to pay a $50 penalty.

Nominees.If you received a Form 1099-INTthat includes interest you received as a nominee (thatis,in your name, but the interest actually belongs to someone else), report the total on line 1. Do this even if you later distributed some or all of this income to others. Under yourlast entry on lne 1,put a subtotalof allinterest listed on line 1. Below this subtotal,enter 'Nominee Distribution'and show the totalinterestyou received as a nominee. Subtract this amount from the subtotal and enter the result on lne 2.

Regardless of whether you are required to file Form ID F 90-22. 1 (FBAR), you may be required to file Form 8938, Statement of Specified Foreign Financial Assets, withyour income tax

retum. Failure to file Form 8938 may result in penalties and extension of the statute of limitations. See www.irs.gov/fonn8938 for more information.Line 7a-Question 1.Check the "Yes" box if at any time during 2012 you had a financial interest in or signature authority over a financial account located in a foreign country.See the definitions that follow. Check the "Yes• box even if you are not required to file Fonn TD F 90-22.1.

27

foreign trust that existed during 2012,you may have to file Fonn 3520.

Do not attach Form 3520 to Fonn 1040. Instead, file it at the address shownin itsinstructions.

If you were treated as the owner of a foreign trust under the grantor trust rules, you are also responsiblefor ensuring that the foreign trust files Fonn 3520-A. Fonn 3520-A is due on March 15, 2013, for a calendar year trust. See the instructions for Fonn 3520-A for more details.

m

e

2012 Form 1040A-Line 33

2012 Child Tax Credit Worksheet-Line 33

Keep for Your Records

1. To be a qualifying child for the child tax credit, the child must be your dependent, under age 17 at the end of 2012, and meet all the conditions in Steps I through 3 in the instructions for line 6c. Make sure you check the box on Form 1040A, line 6c, column (4), for each qualifying child.

2. If

you do not have a qualifying child, you cannot claim the child tax cred it.

3. Tf your qualifying child has an ITIN instead of an SSN, file Schedule 8812.

l@ll I. Number of qualifying children: _ x $1,000. Enter the result.

2. Enter the amount from Form I040A, line 22. ' 2_I

3. Enter the amount shown below for your filing status.

• Married filing jointly -$110,000

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

• Married filing separately -$55,000

4. Is the amount on line 2 more than the amount on line 3?

DNo. Leave line 4 blank. Enter -0- on Line 5, and go to line 6.

0 Yes. Subtract line 3 from line 2.If the result is not a multiple of $1,000, increase it to the next multiple of $1,000. For example, increase $425 to $1,000, increase $1,025 to $2,000, etc.

5. Multiply the amount on line 4 by 5% (.05). Enter the result.

6. ls the amount on line 1 more than the amount on line 5?

0 No.You cannot take the child tax credit on Form 1040A, line 33. You also cannot take the additional child tax credit on Form l040A, line 39. Complete the rest of your Form l 040A.

DYes. Subtract line 5 from line I. Enter the result.Go to Part 2.

)

Need more information orforms? Visit IRS.gov. -38-

25

Fi ers Who Have Certain Child Dependent(s) with an ITIN (Individual Taxpayer Identification Number)

Complete this part only for each dependent who has an ITIN and for whom you are claiming the child tax credit.Ifyour dependent does not qualify for the credit, you cannot include that dependent in the calculation of this credit

1

23

1

5

SCHEDULE 8812 (Form 1040Aor 1040)Department of the Treasury

Child Tax Credit..,Attach to Form 1040, Form 1040A, or Form 1040NR.

...lnfonnation about Schedule 8812 and its separate instructions is at www.irs.gov/fonn1040.

OMB No.1545-0074

@1 2AttachmentSequence No. 47

Name(s) shown on return Your social sectaity number

Answer the following questions for each dependent listed on Fonn 1040, line 6c; Form 1040A, line 6c; or Form 1040NR, line 7c, who has an ITIN (Individual Taxpayer Identification Number) and that you indicated qualified for the child tax credit by checking column (4) for that dependent.

A For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

0 Yes 0 No

B For the second dependent identified with an lTIN and listed as a qualifying child for the child tax credit, did thischild meet the substantial presence test? See separate instructions.

D Yes 0 No

C For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

0 Yes 0 No

D For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions.

D Yes 0 No

Note. If you have more than four dependents identified with an ITIN and listed as a qualifying child for the child tax credit, see the instructionsand check here . . • D

.. Additional Child Tax Credit Filers1 1040 filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the

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

Instructions for Form 1040A, line 33).

1040NR filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Ponn 1040NR, line 48).

Ifyou used Pub. 972, enter the amount from line 8 of the Ch.ild Tax Credit Worksheet in the publication.

2 Enter the amount from Form 1040, line SI; Form 1040A, line 33; or Form 1040NR, line 483 Subtract line 2 from line l. Ifzero, stop; you cannot take this credit .4a Earned income (see separate instructions) 4ab Nontaxable combat pay (see separate

instructions) I 4b I IS Is the amount on line 4a more than $3,000? -...._

0 No. Leave line 5 blank and enter -0- on line 6.D Yes. Subtract $3,000 from the amount on line 4a. Enter the result

6 Multiply the amount on line5 by 15% (.IS) and enter the result Next. Do you have three or more qualifying children?

_. -

t--6_...._ _._

0 No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part illand enter the smaller of line 3 or line 6 on line 13.

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

For Paperwork Reduction Act Notice, see your tax returninstructions. Cat. No. 59761M Schedule 8812 (Form 1040A or 1040) 2012

.

.

Schedule 8812 (Form 1040A or 1040) 2012 Page 2

Certain Filers Who Have Three or More Qualifying Children7

8

910

1112

•!.f.;1••U• AdditionalChild Tax Credit13 This is your additional child tax credit 13

Enter t/us amount on Fonn 1040, line 65, Fonn /040A, line 39, or Fonn 1040NR, line 63.

Schedule 8812 (Form 1040A or 1040) 2012

Withheld social security and Medicare taxes from Form(s) W-2, boxes 4 and 6. If married filing jointly, include your spouse's amounts with yours. If you worked for a railroad, see separate instructions1040 filers: Enter che total of the amounts from Form 1040, lines

27 and 57, plus any taxes that you identified using code "UT" and entered on line 60.

1040A filers: Enter -0-.1040NR filers: Enter the total of the amounts from Form 1040NR,

Lines 27 and 55, plus any taxes that you identified using code "UT" and entered on line 59.

Add lines 7 and 8 .1040 filers: Enter the total of the amounts from Form 1040, lines

64a and 69.1040A filers: Enter the total of the amount from Form 1040A. line

38a, plus any excess social security and tier l RRTA

7

11

8

9

10taxes withheld that you entered to the left of line 41 (see separate instructions).

1040NR filers: Enter the amount from Form 1040NR, line 65. Subtract line 10 from line 9. Ifzero or less, enter -0-Enter the larger of line 6 or line 11Next, enter the smaller of line 3 or line 12 on line 13.

u

Name(s) shown on return I Your social security number

•See the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, to make sure that (a) you can take the EiC, and (b) you have a qualifying child.

• Be sure the child's name on line I and social security number (SSN) on line 2 agree with the child's social security card. Otherwise, at the time we process your return,we may reduce or disallow your EiC. Ifthe name or SSN on the child's social security card is not correct, call the Social Security Administration at 1-800-772-1213.

• Ifyou take the EIC even though you are not eligible, you may not be allowed lo take the credit for up to 10 years. See page 2 for details.

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

Qualifying Child Information Child 1 Child 2 Child 3

1 Child's nameIf you have more than three qualifying children, you only have to list three to get the maximum credit.

First name Last name First name Last name First name Last name

2 Child's SSNThe child must have an SSN as defined inthe instructions for Form l040A, lines 38aand 38b, or Form 1040, lines 64a and 64b,unless the child was born and died in2012. lf your child was born and died in2012 and did not have an SSN, enter"Died" on this line and attach a copy ofthe child's birth certificate, deathcertificate, or hospital medical records.

3 Child's year of birthYear - ---I / ,,. ·/993 and the c/11/il 1n

'011111 r 111e111 \Olt (or wmr 11011\,.... it

,Y,ear - -- -,,, ,, 'ter /<.J<J./ and 1he child '£

,\

m11nc·r man ro11 (or rour I/Wit

Year - -

--// hnr o/1cr / 993 and 1he cllild 1rn.1"' 11111·r 1/um 1·011 for rour s111111\e. 1[

4 a Was the child under age 24 at the end of 2012, a student, and younger than you (or your spouse, if filingjointly) ?

D Yes. D No.Go to Go t11 line ./b. line 5.

D Yes. D No.( ,. (,, (,o to line ./b.line 5.

D Yes. D No.Go to G1> to line .Jb. line 5.

bWas the child permanently and totally disabled during any part of 2012? D Yes. D No.

Go to The child is not aline 5. qualifying child.

DYes. D No.C1> /1> The child is not aline 5. qualifying child.

DYes. D No.Go to The child is not aline 5. qualifying child.

5 Child's relationship to you(for example, son, daughter, grandchild , niece, nephew , foster child, etc.)

6 Number of months child lived with you inthe United States during 2012

• lf the child lived with you for more than half of 2012 but less than 7 months, enter "7."• If the child wasborn or died in 2012 and your home was the child's home for more than half the time he or she was alive during 2012, enter "12."

months Do not enter more than 12 months.

months Do not enter more than 12 months.

months Do not enter more than 12 months.

For Paperwork Reduction Act Notice, see your taxreturn instructions.

Cat. No.13339M Schedule EiC (Fonn 1040A or 1040}2012

Before you

SCHEDULE EiC(Fonn 1040A or

1040)

:, 9)

Earned Income Credit1040A

Qualifying Child Information... Complete and attach to Form 1040Aor 1040 only if you have a qualifying child.

1040

...lnfonnation about Schedule EiC (Form 1040A or 1040) and its instructionsis at

OMB No. 1545-0074

@12AttachmentS uence No. 43

28

rTIPIll....oil

You may also be able to take the additional child tax credit if your child was your dependent and under age 17 at the end of 2012. For more details, see the instructions for line 39 of Form 1040A or line 65 of Form 1040.

Schedule EiC (Form 1040A or 1040) 2012

Purpose of SchedulePage 2

After you have figured your earned income credit (EIC), use Schedule EIC to give the IRS information about your qualifying child(ren).

To figure the amount of your credit or to have the IRS figure it for you, see the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b.

Taking the EiC when not eligible. Ifyou talce the EIC even though you are not eligible and it is determined that your error is due to reckless or intentional disregard of the

EIC rules, you will not be allowed to take the credit for 2 years even if you are otherwise eligible to do so. If you fraudulently talce the EIC, you will not be allowed to talce the credit for 10 years.You may also have to pay penalties.

Future developments.For the latest information about developments related to Schedule EIC (Form I 040A or 1040) and its instructions, such as legislation enacted after they were published, go to www.irs.gov/form1040 .

Qualifying ChildA qualifying child for the EiC is a child who is your .

Son, daughter, stepchild, foster child, brother, sister, stepbrother, stepsister, half brother, half sister, or a descendant of any of them (for example, your grandchild, niece, or nephew)

was • • •

Under age 19 at the end of 2012 and younger than you (or your spouse, if filing jointly) or

Under age 24 at the end of 2012, a student, and younger than you (or your spouse, if filing jointly)

orAny age and permanently and totally disabled

Who is not filing ajoint return for 2012or is filing ajoint return for 2012 only as a claim for refund

(as defined in the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b)

Who lived with you in the United States for more than halfof 2012. If the child did not live with you for the required time,

see Exception to time lived with you in the instructions forForm 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b.

If the child was married or meets the conditions to be a qualifying child of another person (other than your spouse if filing a joint return), special rules apply. Fordetails, see Married child or Qualifying child of more than one person in the instructionsfor Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b.

29

Form 8867Department of the Treasury Internal Revenue Service

Paid Preparer's Earned Income Credit Checklist..,. To be completed by preparer and filed with Form 1040, 1040A, or 1040EZ.

"' nformation about Form 8867 and itsseparate instructionsis at www.irs.gov/torm8867.

OMB No. 1545-1629

@1 2Attachment 177Sequence No.

Taxpayer name(s) shown on return Taxpayer's social security number

For the definitions of the following terms, see Pub. 596.•InvestmentIncome • Qualifying Chld • Earned Income • Full-time Student

• •• All Taxpayers

1 Enter preparer's name and PTIN ..,..

2 Is the taxpayer's filing status married filing separately? .

..,.. If you checked "Yes" on line 2, stop; the taxpayer cannot take the EiC. Otherwise,continue.

3 Does the taxpayer (and the taxpayer's spouse if filing jointly) have a social security number (SSN) that allows him or her to work or is valid for EiC purposes? See the instructions before answering

..,.. If you checked "No" on line 3, stop; the taxpayer cannot take the EiC. Otherwise, continue.

4 Is the taxpayer filing Form 2555 or Form 2555-EZ (relating to the exclusion of foreign earned income)?

..,.. If you checked "Yes" on line 4, stop;the taxpayer cannot take the EiC. Otherwise, continue.

5a Was the taxpayer a nonresident alien for any part of 2012?

..,.. If you checked "Yes" on line 5a, go to line 5b. Otherwise, skip line 5b and go to line 6.

b Is the taxpayer's filing status married filing jointly?

..,.. If you checked "Yes" on line 5a and "No" on line 5b, stop; the taxpayer cannot take the EiC. Otherwise, continue.

6 Is the taxpayer'sinvestment income more than $3,200? See Rule 6 in Pub. 596 before answering

..,.. If you checked "Yes" on line 6, stop; the taxpayer cannot take the EiC. Otherwise, continue.

7 Could the taxpayer, or the taxpayer's spouse if filing jointly, be a qualifying chld of another person for 2012? If the taxpayer's filing status is married filing jointly, check "No." Otherwise, see Rule 10 (Rule

13 if the taxpayer does not have a qualifying child) in Pub. 596 before answering i..,. If you checked "Yes" on line 7, stop;the taxpayer cannot take the EiC. Otherwise, go to Part IIor Part 111, whichever applies.

0 Yes 0No

0Yes 0 Not-='--

OYes 0 No

0 Yes 0No

0 Yes 0No

O Yes 0No

O-=Y=e-s- -==O- ;N..o..

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 26142H

30

Form 8867 (2012)

Fonn 8867 (2012)

•=.r.;•j• Taxpayers With a Child

31

Page 2

Fonn 8867 (2012)

Caution. If there is more than one child, complete lines 8 through 14 forone child before going to the next column.

8 Child's name .9 Is the child the taxpayer's son, daughter, stepchild, foster child, brother,

sister, stepbrother, stepsister, half brother, half sister, or a descendant of any of them?

Child 1 Child 2 Child 3

0Yes O No 0Yes 0No 0Yes 0No10 Is either of the following true?

• The child is unmarried, or• The child is married, can be claimed as the taxpayer's dependent, and is not filing a joint return {or is filing it only as a claim for refund).

11 Did the child live with the taxpayer in the United States for over half of the year? See the instructions before answering

12 Was the child {at the end of 2012)-• Under age 19 and younger than the taxpayer (or the taxpayer's spouse, if the taxpayer files jointly),• Under age 24, a full-time student, and younger than the taxpayer {or the taxpayer's spouse,if the taxpayer files jointly), or• Any age and permanently and totally disabled?

..,.. If you checked "Yes" on lines 9, 10, 11, and 12, the child is the taxpayer's qualifying child; go to line 13a. If you checked "No" on line 9, 10, 11, or 12, the child is not the taxpayer's qualifying child; see the instructions for line 12.

13a Could any other person check "Yes" on lines 9, 10, 11,and 12 for the child?

..,.. If you checked "No" on line 13a, go to line 14. Otherwise,go to line 13b.

b Enter the child's relationshipto the other person(s)c Under the tiebreaker rules, is the child treated as the taxpayer's qualifying

child? See the instructions before answering..,.. If you checked "Yes" on line 13c, go to line 14. If you checked "No," the taxpayer cannot take the EiC based on this child and cannot take the EiC for taxpayers who do not have a qualifying child. If there is more than one child, see the Note at the bottom of this page. If you checked "Don't know," explain to the taxpayer that, under the tiebreaker rules, the taxpayer's IC and other tax benefits may be disallowed. Then, if the taxpayer wants to take the EiC based on this child, complete lines 14 and 15. If not, and there are no other qualifying children, the taxpayer cannot take the EiC, including the EiC for taxpayers without a qualifying child; do not complete Part Ill. If there is more than one child, see the Note at the bottom of this page.

14 Does the qualifying child have an SSN that allows him or her to work or is valid for EiC purposes? See the instructions before answering

..,.. If you checked "No" on line 14, the taxpayer cannot take the EiC based on this child and cannot take the EiC available to taxpayers without a qualifying child. If there is more than one child, see the Note at the bottom of this page. If you checked "Yes" on line 14, continue.

15 Are the taxpayer's eamed income and adjusted grossincome each less than the limit that applies to the taxpayer for 2012? See Pub. 596 for the limit .

..,.. If you checked "No" on line 15, stop;the taxpayer cannot take the EiC. If you checked "Yes" on line 15, the taxpayer can take the EiC. Complete Schedule EiC and attach it to the taxpayer's return. If there are two or three qualifying children with valid SSNs, list them on Schedule EiC in the same order as they are listed here. If the taxpayer's EiC was reduced or disallowed for a year after 1996, see Pub. 596 to see if Fonn 8862 must be filed. Go to line 20.

Note. If you checked "No" on line 13c or 14 but there is more than one child, complete lines 8 through 14 for the other child(ren) {but for no

0Yes 0No 0Yes 0No 0Yes 0No

0Yes 0No 0Yes 0No 0Yes 0No

0Yes 0No OYes 0No 0Yes ONo

0Yes 0No 0Yes 0No 0Yes 0No

OYes 0No 0Don't know

0Yes 0No ODon't know

0Yes 0No 0Don't know

OYes 0No OYes 0No 0Yes 0No

Oves ONo

20

21

22

Did you complete Form 8867 based on current information provided by the taxpayer or reasonablyobtained by you?Did you complete the EiC worksheet found in the Form 1040, 1040A, or 1040EZ instructions (or your own worksheet that provides the same information as the 1040,1040A, or 1040EZ worksheet)? .If any qualifying child was not the taxpayer's son or daughter, did you ask why the parents were notclaiming the child and document the answer?If the answer to question 13a is "Yes" (indicating that the child lived for more than half the year with someone else who could claim the child for the EiC), did you explain the tiebreaker rules and possible consequences of another person claiming your client's qualifying child?Did you ask this taxpayer any additional questions that are necessary to meet your knowledge requirement? See the instructions before answering .To comply with the EiC knowledge requirement, you must not know or have reason to know that any information used to determine the taxpayer's eligibility for, and the amount of, the EiC is incorrect. You may not ignore the implications of information furnished to or known by you, and you must make reasonable inquiriesif the information furnished appears to beincorrect, inconsistent, or incomplete.At the time you make theseinquiries, you mustdocumentin your fi es theinquiries you made and the taxpayer's responses.

0 Yes 0No

0 Yes0Yes

O No0No

DDoes not apply23

0Yes 0NoDDoes not apply

24 0Yes 0NoDDoes not apply

0YesDNo25Did you document the additional questions you asked and your client's answers? DDoes not aoolv

Form 8867 (2012)

Form 8867 (2012) Page 3

• 1•••11 Taxpayers Without a Qualifying Child16 Was the taxpayer's main home, and the main home of the taxpayer's spouse if filing jointly, in the United

States for more than half the year'? (Military personnel on extended active duty outside theUnited States are considered to be living in the United States during that duty period. See Pub. 596.) DYes DNo

1-=:..- -=o...-

.... If you checked "No" on line 16, stop;the taxpayer cannot take the EiC. Otherwise, continue.

17 Was the taxpayer, or the taxpayer's spouse if filing jointly, at least age 25 but under age 65 at theend of 2012? See the instructions before answering . DYes D No

1-='-- -=o...-

..,. If you checked "No" on line 17,stop; the taxpayer cannot take the EiC. Otherwise,continue.

18 Is the taxpayer, or the taxpayer's spouse if filing jointly, eligible to be claimed as a dependent on anyone else's federal income tax return for 2012? If the taxpayer's filing status is married filingjointly, check "No" . DYes DNo

1-='-- -=o...-

..,. If you checked "Yes" on line 18, stop; the taxpayer cannot take the EiC. Otherwise, continue.

19 Are the taxpayer's earned income and adjusted gross income each less than the limit thatapplies to the taxpayer for 2012? See Pub. 596 for the limit DYes DNo

!-='-- -==--

..,. If you checked "No" on line 19, stop; the taxpayer cannot take the EiC. If you checked "Yes" on line 19, the taxpayer can take the EiC. If the taxpayer's EiC was reduced or disallowed for a year after 1996, see Pub. 596 to find out if Form 8862 must be filed. Go to line 20.

Due Diligence Requirements

32

Form 8867 (2012) Page4

26 Which documents below, if any, did you rely on to determine EiC eligibility for the qualifying child(ren) listed on Schedule EiC? Check all that apply. Keep a copy of any documents you relied on. See the instructions before answering. If there is no qualifying child, check box a. If there is no disabled child, check box o.

Residency of Qualifying Child(ren)O a No qualifying childO b School records or statemento c Landlord or property management statementO d Health care provider statemento e Medical records0 f Child care provider records

0 i Place of worship statement 0 j Indian tribal official statement 0 k Employer statement0 I Other (specify) 'f

09 Placement agency statementO h Social service records or statement O m Did not rely on any documents,but made notes in file

0 n Did not rely on any documentsDisability of Qualifying Child(ren)

o o No disabled childO P Doctor statementO q Other health care provider statement

0 s Other {specify) 'f

o r Social services agency or program statement O t Did not rely on any documents, but made notes in file 0 u Di d not rely on any d ocuments

27 If a Schedule C is included with this return, which documents or other information, if any, did you rely on to confirm the existence of the business and to figure the amount of Schedule C income and expenses reported on the return? Check all that apply. Keep a copy of any documents you relied on.See the instructions before answering. If there is no Schedule C, check box a.

o a No Schedule CO b Business licenseo c Forms 1099

Documents or Other Information0 h Bank statementsD Reconstruction of income and expenses0 j Other {specify) 'f

O d Records of gross receipts provided by taxpayerD e Taxpayer summary of income0 f Records of expenses provided by taxpayer

0 k Did not rely on any documents, but made notes in file09 Taxpayer summary of expenses 0 I Did not rely on any documents

.... You have complied with all the due diligence requirements if you:1. Completed the actions described on lines 20 and 21 and checked "Yes" on those Jines,2. Completed the actions described on lines 22, 23, 24, and 25 (if they apply) and checked "Yes" {or "Does not apply") on those

lines,3. Submit Form 8867 in the manner required,and4. Keep all five of the following records for 3 years from the latest of the dates specified in the instructions under Document

Retention:a. Form 8867, Paid Preparer's Earned Income Credit Checklist, b.The EiC worksheet(s) or your own worksheet(s),c. Copies of any taxpayer documents you relied on to determine eligibility for or amount of EiC,d. A record of how,when, and from whom the information used to prepare the form and worksheet(s) was obtained,ande. A record of any additional questions you asked and your client's answers.

.... If you checked "No" on line 20,21,22,23, 24,or 25,you have not complied with all the due diligence requirements and mayhave to pay a $500 penalty for each failure to comply.

Form 8867 (2012)

33

Norman and Dorothy Painter

Lines 38a and 38b-Earned Income Credit (EiC)

What is the EiC?

The EiC is a credit for certain people who work. The credit may give you a refund even ifyou do not owe any tax or did not have any tax withheld.

To Take the EiC:

• Follow the steps below.• Complete the Earned Income Credit (EIC) Worksheet inthese instructions or let the IRS

figure the credit for you.• Ifyou have a qualifying child, complete and attach Schedule EIC.

For help in determining if you are eligible for the EiC, go towww.irs.gov/eitc and click on "EITC Assistant." This service is available in English and Spanish.

Ifyou take the EIC even though you are not eligible and it is determined that your error is due to reckless or intentional disregard of the EiC rules, you will not be allowed to take the credit for 2 years even if you are otherwise eligible to do so. Ifyou fraudulently take the EiC, you will not be allowed to take the credit for 10 years. See Form 8862, who must file, later. You may also haveto pay penalties.

Stepl. All Filers

1. If,in 2013:

• 3 or more children lived with you, is the amount on Form 1040A, line 22, less than$46,227 ($51,567 if married filing jointly)?

• 2 children lived with you, is the amount on Form 1040A, line 22, less than $43,038 ($48,378 if married filing jointly)?

u •q.a,,.1.:«ro:.

..

• 1 child lived with you, is the amount on Form 1040A, line 22, less than $37,870 ($43,210 if married filing jointly) ?

• No children lived with you, is the amount on Form 1040A, line 22, less than $14,340 ($19,680 if married filing jointly)?

3 or more children lived with you, is the amount on Form 1040A, line 22, less than $46,227 ($51,567 ifmarried filing jointly)? 2 children lived with you, is the amount on Form 1040A, line 22, less than $43,038 ($48,378 if married filing jointly)? 1 child lived with you, is the amount on Form 1040A, line 22, less than $37,870 ($43,210 if married filing jointly)? No children livedwith you, is the amount on Form 1040A, line 22, less than $14,340 ($19,680 ifmarried filing jointly)?

DIYes.Do.

You cannot take the credit.

IIEiC Table

2012 Earned Income Credit (EiC) Table Caution. This is not a tax table.

Example. If2. Then, go to

your filing

the column that includes

status issingle, you

tyour filinghave one qualifying m.......i ,.....

-.ct ......,.... ...

status and the !:tt:',.,._..... s.,,. r.:s1. To find your credit, read down the "At least - But child, and ,.;... ii11;;.., ""qualifying '- m. ,,u.., (w .:.D,

less than"columns and find the line that includes the number of

the amount ••11 ..m 1""-=MI._

amount you were told to look up from your EiC you are ·- '

Worksheet. children you looking uphave. Enter the from yourcredit fromthat column on

EIC

!Your EICWorksheet .

Worksheetis $2,455, 1You would enter $842.

And your filing status is-H the amount you are looking up from the worksheet is- Single,head of household, or Married filing joiotty and the number of

qualifying widow(er) children you have is- and the number of childrenyou have is-o I t 1 2 I 3 0 1 1 ii 3

At least But fess than Your credit is- Your credit is-$1 $50 $21 $91 $101 $11 $2 $9\ $10\ $1150 IOC 61 261 301 34 61 261 30! 34

30,550 30,600 0 1,166 2,625 3,296 0 2,019 3,749 4,42133,700 33,750 0 6

621,961 2,633 0 1,516 3,086 3,757

33,750 33,800 0 654 1,951 2,622

0 1,508 3,075 3,74734,900 34,950 0 471 1,7092

,3800 1,324 2,833 3,505

34,950 35,000 0 463 1,6982,370

0 1,316 2,823 3,49435,000 35,050 0 455 1,688 2,359 0 1,308 2,8

123,484

35,050 35,100 0 447 1,677 2,349 0 1,300 2,802 3,47335,100 35,150 0 439 1,666 2,338 0 1,292 2,791 3,46335,150 35,200 0 431 1,6562,327 0 1,284 2,781 3,45235,200 35,250 0 423 1,6452

,3170 1,276 2

,7703,442

35,250 35,300 0 415 1,635 2,306

0 1,268 2,76C 3,43135,300 35,35C 0 407 1,624 2

,2960 1,260 2,749 3,420

35,350 35,400 0 39S 1,6142,285 0 1,252 2,738 3,41035,400 35,45C 0 391 1,6032,275 0 1,244 2

,7283,399

35,450 35,50C 0 383 1,5932,264 c 1,236 2,717 3,38935,500 35,55C 0 375 1,5822,254 0 1,228 2,707 3

,37835,550 35,600 0 367 1,5722,243 0 1,220 2,696

3,36835,600 35,65C 0 359 1,56112,233 0 1,212 2

,6863,357

35,650 35,700 0 351 l,551 2,222 0 l,204 2,675 3,34735,700 35,75C 0 343 1,540 2,212 0 1,196 2,665 3,33635,750 35,800 0 335 l,5302,201 0 l,188 2,654 3,32635,800 35,850 0 327 1,5192,191 0 1,180 2,644 3

,31535,850 35,90C c 319 1,5092,180 0 1,172 2,633

3,30535,900 35,950 0 31I 1,498 2

,1700 1,164 2,623 3,294

35,950 36,000 0 303 1,487 2,159 0 1,156 2,612

3,28436,000 36,050 0 295 1,477 2,148 0 1,148 2,602 3,27336,050 36,IOC 0 287 1,466 2

,1380 l,140 2,591 3,263

36,100 36,15( 0 279 1,456 2,127 0 1,132 2,580

3,25236,150 36,200 0 27

11,4452,1

170 1,124 2,570 3,24

136,200 36,250 0 263 1,435 2,106

0 1,116 2,559 3,23136,250 36,300 0 255 1,4242,096 0 1,108 2,549 3,22036,300 36,350 0 247 1,4 14 2

,0850 1,100 2,538 3,210

36,350 36,400 0 239 l,4032,075

0 1,092 2,528 3,19936,400 36,450 0 231 1,3932

,0640 1,084 2,5

173,189

36,450 36,500 0 223 1,382 2,054 0 1,076 2,507 3,17836,500 36,550 0 2

151,372 2

,0430 1,068 2

,4963,168

36,550 36,600 0 207 1,361 2,033

0 l,060 2,486

3,157

36,600 36,650 0 199

1,351 2,022 0 1,052 2,475

3,14736,65C 36,700 0 191 1,340 2

,0120 1,044 2,465 3,136

36,700 36,750 0 183

1,3302,001

0 1,036 2,454

3,12636,750 36,800 0 175 1,319 1

,9910 1,028 2

,4443,115

36,800 36,850 0 167

1,308 1,980 0 1,020 2,433

3,10536,850 36,900 0 159 1,298 1,969 0 1,012 2

,4233,094

36,900 36,950 0 151

1,287 1,959 0 1,004 2,4 12

3,08436,95( 37,000 0 1

431,277 1,948 0 996 2

,4013,073

37,000 37,050 0 135 1,266 1,938 0 988 2,391

3,06237,050 37,100 0 1

271,256 1,927 0 980 2,380 3,052

37,100 37,150 0 119 1,245 1,917 0 972 2,37C

3,04137,150 37,200 0 Il

l1,235 1,906 0 964 2,359 3,031

37,200 37,250 0 103 1,224 1,89 c 956 2,349

3,02037,250 37,300 0 95 1,214 1,885 0 948 2

,3383,010

37,300 37,350 0 87 1,203 1,875 0 940 2,328

2,99937,350 37,400 0 7S 1,193 1,864 0 933 2

,3172,98937,400 37,45C 0 7l 1,182 1,854 0 925 2,307 2,97837,450 37,50< 0 63 1,172 1,843 0 917 2

,2962,968

37,500 37,550 0 55 1,161 1,833 0 909 2,286

2,95737,550 37,600 0 47 l,151 1,822 0 901 2

,2752,94737,600 37,650 0 39 1,140 1,811 0 893 2,265 2,93637,650 37,70C 0 31 1,129 1,801 0 885 2,254 2,92637,700 37,75( 0 23 1,119 1,790 0 877 2,244 2,915

37,750 37,8()( 0 15 1,108 1,78( 0 869 2,233 2,90537,800 37,850 0 7 1,098 1,769 0 861 2,222 2,89443,250 43,30 0 ( 0 622 0 0 1,075 1,74643,300 43,350 0 0 0 611 0 0 1,064 1,73643,350 43,4()( 0 0 0 601 0 0 1,054 1,72543,400 43,45 0 0 0 59C c 0 1,043 1,71543,450 43,50 0 0 0 579 0 0 1,033 1,704

43,500 43,55 c 0 0 569 0 0 1,022 1,69443,550 43,600 0 0 0 558 0 0 1,012 1,68343,600 43,650 0 0 0 548 0 0 1,001 1,67243,650 43,70 c ( 0 537 0 0 99( 1,66243,700 43,750 0 0 0 527 0 0 98( 1,65143,750 43,8()( 0 0 0 Sit 0 0 96S 1,64143,800 43,850 0 0 0 506 0 0 959 1,63043,850 43,90( 0 0 0 495 0 0 948 1,62043,900 43,950 0 0 0 485 ( 0 938 1,60943,950 44,000 0 0 0 474 0 0 927 1,59944,000 44,05C 0 0 0 464 0 0 917 1,58844,050 44,lOC 0 0 0 453 0 0 906 .l ,57844,100 44,15C 0 0 0 443 0 0 896 1,56744,150 44,20C 0 0 0 432 -( 0 885 1,55744,200 44,250 0 0 0 422 0 0 875 1,54644,250 44,30C 0 0 0 411 0 0 864 1,53644,300 44,35 0 0 0 400 0 0 85 1,52544,350 44,40 0 0 0 390 0 0 843 1,51544,400 44,45 0 0 0 379 0 0 833 1,50444,450 44,500 0 0 0 369 0 0 822 1,49344,500 44,55 c 0 0 358 0 0 811 1,48344,550 44,60C 0 0 0 348 0 0 801 1,47244,600 44,65 0 0 0 337 0 0 790 1,46244,650 44,7()( c 0 0 327 0 0 780 1,45144,700 44,750 0 0 0 316 0 0 769 1,44144,750 44,800 0 0 0 306 0 0 759 1,43044,800 44,850 0 0 0 295 0 0 748 1,42044,850 44,900 0 0 0 285 0 0 738 1,40944,900 44,950 0 0 0 274 0 0 727 1,39944,950 45,00 0 0 0 264 0 0 717 1,388

45,000 45,05 0 0 0 253 0 0 706 1,37845,050 45,100 0 0 0 243 0 0 696 1,367

45,100 45,15 0 0 0 232 0 0 685 1,35745,150 45,200 0 0 0 221 ( 0 675 1,34645,200 45,250 0 0 0 211 0 0 664 1,33645,25( 45,300 0 ( 0 2()( 0 0 654 1,325

45,300 45,350 0 0 0 190 0 0 643 1,314

45,3SC 45,4()( 0 0 0 179 ( 0 632 1,30445,400 45,45( ( 0 0 169 0 0 622 1,29345,450 45,500 0 0 0 158 0 0 611 1,28345,500 45,55( ( ( 0 148 0 0 601 1,272

45,550 45,60( ( 0 0 137 0 0 59( 1,262

45,600 45,65( 0 0 0 127 0 0 580 1,25145,650 45,7()( 0 0 0 116 0 0 569 1,241

45,700 45,750 0 0 0 106 0 0 559 1,230

45,750 45,80C ( 0 0 95 ( 0 548 1,220

45,800 45,850 0 0 0 85 ( 0 538 1,209

45,850 45,9()( 0 0 0 74 0 0 527 1,19945,900 45,95( 0 0 0 64 0 0 517 1,18845,950 46,00C 0 0 0 53 0 0 506 1,178

46,000 46,05( 0 0 0 42 0 0 496 1,16746,050 46,100 0 0 0 32 0 0 485 1,15746,100 46,15( 0 0 0 21 0 0 474 1,146

46,150 46,200 0 0 0 11 0 0 464 1,13546,250 46,30C c 0 0 0 0 0 443 1,11446,300 46,350 0 0 0 0 0 0 432 1,10446,350 46,40( 0 0 0 0 0 0 422 1,09346,400 46,450 0 0 0 0 0 0 41

11,083

46,450 46,50C 0 0 0 0 0 0 401 1,07246,500 46,55C 0 0 0 0 0 0 390 1,06246,550 46,60C 0 0 0 0 0 0 380 1,05146,600 46,65C 0 0 0 0 c 0 369 1,04146,650 46,700 0 0 0 0 0 0 359 1,03046,700 46,75( 0 0 0 0 0 0 348 1,02046,750 46,80C 0 0 0 0 0 0 33 1,00946,800 46,850 0 0 0 0 0 0 327 99946,850 46,900 0 0 0 0 0 0 317 98846,900 46,95C c 0 0 0 0 0 306 97846,950 47,000 0 0 0 0 0 0 295 96747,000 47,05C 0 0 0 ( 0 0 285 95647,050 47,100 0 0 0 0 0 0 274 94647,100 47,150 0 c 0 0 0 0 264 93547,150 47,20C 0 0 0 0 c 0 253 92547,200 47,25C 0 0 0 0 0 0 243 91447,250 47,30C 0 0 0 0 0 0 232 90447,300 47,350 0 0 0 0 0 0 222 89347,350 47,40C 0 0 0 0 0 0 211 88347,400 47,45( 0 0 0 0 0 0 20

1872

47,450 47,50C 0 0 0 0 0 0 190 86247,500 47,550 0 0 0 0 0 0 180 85147,550 47,60C 0 0 0 0 0 0 16

9841

47,600 47,65( 0 0 0 0 0 0 159

83047,650 47,70( 0 ( 0 0 0 0 148 82047,700 47,750 0 0 0 0 0 0 138 80947,750 47,80C 0 0 0 0 0 0 12

7799

47,800 47,85C 0 0 0 0 0 0 116

78847,850 47,900 0 0 0 0 0 0 1

06777

47,900 47,950 0 0 0 0 0 0 95 76747,950 48,000 0 0 0 0 0 0 85 75648,000 48,050 0 0 0 0 0 0 74 74648,050 48,100 0 0 0 0 0 0 64 73548,IOC 48,150 0 0 0 0 0 0 5

3725

48,150 48,200 0 0 0 0 0 0 43

71448,200 48,250 0 0 0 0 0 0 32 70448,250 48,300 0 0 0 0 0 0 22 69348,300 48,350 0 0 0 0 0 0 11 68348,400 48,450 0 0 0 0 0 0 0 6

6248,45C

48,500 0 0 0 0 0 0 65148,500 48,550 0 0 0 0 0 0 64148,550 48,600 0 0 0 0 0 0 0 63048,600 48,650 0 0 0 0 0 0 0 61948,650 48,700 0 0 0 0 0 0 0 60948,700 48,750 0 0 0 0 0 0 0 59848,750 48,800 0 0 0 0 0 0 0 588

48,800 48,850 0 0 0 0 0 0 57748,850 0 0 0 0 0 0 0 56748,900 48,950 0 0 0 0 0 0 0 55648,950 49,000 0 0 0 0 0 { 54649,000 49,050 0 0 0 0 0 0 0 53549,050 49,IOC 0 0 0 c 0 0 0 52549,100 49,150 0 0 0 0 0 0 0 5

1449,150 49,20C 0 0 0 0 c 0 c 50449,200 49,250 0 0 0 0 0 0 0 493

51,550

49,250 49,300 0 0 0 0 0 0 0 48349,300 49,35 0 0 0 0 0 0 0 47249,350 49,40 0 0 0 0 0 0 0 46249,400 49,45 0 0 0 0 0 0 0 45149,450 49,500 0 0 0 0 0 0 0 44049,500 49,55 0 0 0 0 0 0 0 43049,550 49,60 0 0 0 0 0 0 0 41949,600 49,650 0 0 0 0 0 0 0 40949,650 49,700 0 0 0 0 0 0 0 39849,700 49,750 0 0 0 0 0 0 0 38849,750 49,800 0 0 0 (

]0 0 0 377

49,800 49,850 0 0 0 0 0 0 0 36749,850 49,900 0 0 0 0 0 0 0 35649,900 49,95 0 0 0 0 0 0 0 34649,950 50,000 0 0 0 0 0 0 (] 33550,000 50,05 0 (

]0 0 0 0 0 325

50,050 50,100 0 0 0 0 0 0 0 31450,100 50,15 0 0 0 0 0 0 0 30450,150 50,200 0 0 0 0 0 0 0 29350,200 50,250 0 0 0 0 0 0 0 28350,250 50,300 0 0 0 0 0 0 0 27250,300 50,350 0 0 0 0 0 0 0 26150,350 50,400 0 0 0 0 0 0 0 25150,400 50,450 0 0 0 0 0 0 0 24050,450 50,500 0 0 0 0 0 0 0 23050,500 50,550 0 0 0 0 0 0 0 21950,550 50,600 (] 0 0 0 0 0 0 20950,60C 50,65 0 0 0 0 0 0 0 19850,650 50,700 0 0 0 0 0 0 0 18850,700 50,750 0 0 0 0 0 0 0 17750,750 50,800 0 0 0 0 0 0 0 16750,800 50,850 0 0 0 0 0 0 0 15650,850 50,90( 0 0 0 0 0 0 0 14650,900 50,950 0 0 0 0 0 0 0 13550,950 (] 0 0 0 0 0 0 12551,000 51,05 0 0 0 0 c 0 0 11451,050 51,lOC 0 0 0 0 0 0 10451,100 0 0 0 0 0 0 9351,150 c 0 0 0 0 0 0 82

51,200 51,250 0 0 0 0 0 0 0 7251,250 51,30 0 0 0 0 0 0 6151,300 51,35 0 0 0 0 0 0 0 5151,350 51,400 0 0 0 0 0 0 4051,400 51,45 c 0 0 0 0 0 3051,450 0 0 0 0 0 0 1951,500 0 0 0 0 0 0 9

51,567 0 0 0 0 0 0