JOHNSON XXX-XX-****
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** *** *************). CheckifanytomFomn: 1 CJesta 2U1a72 30)
** ****** **** ******** *, ine 3
** **** *** ***** ** cect fr other dependents trom Schedule 8812
‘Amount fom Schedule 3, ine
‘Add ines 19 nd 20,
‘Subtract ine 21 from ine 18. 20 or less, enter -0-
‘Other taxes, including stt-employment tax, fom Schedule 2, ine 21
‘Ack nes 22 and 22, Thi is your total tax
2520
2520
ts fs fos [x]
3
é
i
mi
upeerss
Federal income tax withhld frome
Fors) W-2
Form(s) 1099
(Other forms (se instructions)
‘Ak nes 25 through 252
2023 estimated tax payments and amount apps frm 2022 return
Earned income erect (EIC)
‘Ackonal cid tax crt ram Schack 8812
“Amarican opportunty cre om Form 8863, ine 8
Reserved for future use
‘Amount from Schade 2, ne 15
‘Add ines 27,28, 29, nd 31. Thase ar your total other payments and refundable credits
‘Acs nes 254,26, and 22. Those are your total payments
eee
3001
3000
660.
160
24
9046
12046
und
‘9526
9526
Fine 59 more than ne 24, subact ing 24 rom ine 33. This she aunt you overpaid
‘Amount of ne 34 you wact refunded to you. ¥ Form 26682 stached, check here o
Routing namcer XXX X X 2/916/6) type: fxlGhecking []Saings
‘Account oumber XX /X/X/X/X/X/ x18. 7j0/4 it
‘Amur fine 2 you want applied o your 2024 estimated tax wl
ele lels
‘Subtract in 23 from ne 24 This tha amount you owe.
Fr datas on how to pay, 90 to ww ie gov) Payments or se intructons: 7
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i Fis aires 9349 PEACHTAEE 59 ATLAWTA GA 20336 FenseN 83-2071099
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