Internal Revenue Tax Credit

Location:

Columbia, MS, 39429

Salary:

$16

Posted:

September 07, 2024

Contact this candidate

Resume:

Please follow these signing and mailing instructions on pages 1 & 2 for each form.

SETC Pros does not include your personally identiﬁable information as an added privacy safeguard. Please ensure that you sign and ﬁll out each required portion. The IRS requires that form 1040-X and others are "wet-signed.” Please ﬁnd the following four (4) documents,

ensuring they appear in the following order:

1. IRS Form 1040-X: (2 Pages)

Top of Page 1 of the 1040-X:

First & Last Name, Social Security Number, and Current Address on File with the IRS, Spouse (if ﬁling jointly) – First Name, Last Name and Social Security Number Bottom of Page 2 of the 1040-X: “Sign Here”

Sign and Date,

Spouse (if ﬁling jointly) - Sign and Date

2. IRS Form 1040: (2 Pages)

Top of Page 1 of the 1040:

Sign and Date,

Spouse (if ﬁling jointly) - Sign and Date

3. Schedule 3: (2 Pages)

Top of Page 1 of the Schedule 3:

Social Security Number

4. IRS Form 7202: (3 Pages)

Top of Page 1 of the 7202:

Social Security Number

Self-Employed Tax Credit

Filing Packet

Mailing Instructions

IMPORTANT: If you are receiving Self-Employed Tax Credit, please be sure to mail your tax forms in a secure envelope.

Do not include these signing and mailing instructions when sending to the IRS. Include only the IRS Forms provided.

* This is the end of the Signing and Mailing Instructions * Please follow these instructions when completing your SETC Refund Process.

SETC Packet ﬁling addresses for Taxpayers and Tax Professionals If you live in: Mail SETC Packet to:

Connecticut, Delaware, District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin

Department of the Treasury

Internal Revenue Service

Kansas City, MO 64999-0052

Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, Texas

Department of the Treasury

Internal Revenue Service

Austin, TX 73301-0052

Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Michigan, Montana, Nebraska, Nevada, New

Mexico, North Dakota, Ohio, Oregon, South Dakota, Utah, Washington, Wyoming

Department of the Treasury

Internal Revenue Service

Ogden, UT 84201-0052

A foreign country, U.S. possession or territory; * or use an APO or FPO address, or ﬁle Form 2555, 2555-EZ, or 4563; or are a dual-status alien.

Department of the Treasury

Internal Revenue Service

Austin, TX 73301-0215

* If you live in American Samoa, Puerto Rico, Guam, the U.S. Virgin Islands, or the Northern Marian Islands. See Pub. 570

Form

1040-X

(Rev. July 2021)

Amended U.S. Individual Income Tax Return

Department of the Treasury—Internal Revenue Service

Use this revision to amend 2019 or later tax returns.

Go to www.irs.gov/Form1040X for instructions and the latest information. OMB No. 1545-0074

This return is for calendar year (enter year) or fiscal year (enter month and year ended) Your first name and middle initial Last name Your social security number If joint return, spouse’s first name and middle initial Last name Spouse’s social security number Current home address (number and street). If you have a P.O. box, see instructions. Apt. no. Your phone number City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below. See instructions. Foreign country name Foreign province/state/county Foreign postal code Amended return filing status. You must check one box even if you are not changing your filing status. Caution: In general, you can’t change your filing status from married filing jointly to married filing separately after the return due date. Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW) If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is a child but not your dependent

Enter on lines 1 through 23, columns A through C, the amounts for the return year entered above.

Use Part III on page 2 to explain any changes.

A. Original amount

reported or as

previously adjusted

(see instructions)

B. Net change—

amount of increase

or (decrease)—

explain in Part III

C. Correct

amount

Income and Deductions

Adjusted gross income. If a net operating loss (NOL) carryback is included, check here . . . . . . . . . . . . . . . 1 2 Itemized deductions or standard deduction . . . . . . . . . 2 3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . 3 4a Reserved for future use . . . . . . . . . . . . . . . . 4a b Qualified business income deduction . . . . . . . . . . . . 4b 5

Taxable income. Subtract line 4b from line 3. If the result is zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . 5 Tax Liability

Tax. Enter method(s) used to figure tax (see instructions): 6

7 Nonrefundable credits. If a general business credit carryback is included, check here . . . . . . . . . . . . . . . 7 8 Subtract line 7 from line 6. If the result is zero or less, enter -0- . . . 8 9 Reserved for future use . . . . . . . . . . . . . . . . 9 10 Other taxes . . . . . . . . . . . . . . . . . . . . 10 11 Total tax. Add lines 8 and 10 . . . . . . . . . . . . . . 11 Payments

Federal income tax withheld and excess social security and tier 1 RRTA tax withheld. (If changing, see instructions.) . . . . . . . . . 12 13 Estimated tax payments, including amount applied from prior year’s return 13 14 Earned income credit (EIC) . . . . . . . . . . . . . . . 14 15

Refundable credits from: Schedule 8812 Form(s) 243*-****-**** 8885 8962 or other (specify): 15

Total amount paid with request for extension of time to file, tax paid with original return, and additional tax paid after return was filed . . . . . . . . . . . . . . . . . . . . . . . . 16 17 Total payments. Add lines 12 through 15, column C, and line 16 . . . . . . . . . . . . . 17 Refund or Amount You Owe

18 Overpayment, if any, as shown on original return or as previously adjusted by the IRS . . . . . 18 19 Subtract line 18 from line 17. (If less than zero, see instructions.) . . . . . . . . . . . . 19 20 Amount you owe. If line 11, column C, is more than line 19, enter the difference . . . . . . . 20 21 If line 11, column C, is less than line 19, enter the difference. This is the amount overpaid on this return 21 22 Amount of line 21 you want refunded to you . . . . . . . . . . . . . . . . . . . 22 23 Amount of line 21 you want applied to your (enter year): estimated tax 23 Complete and sign this form on page 2.

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11360L Form 1040-X (Rev. 7-2021) 2021

Erica Stepney 427 31 5335

102 foxworth drive

Columbia, MS 39429

14,801 14,801

18,800 18,800

0 0

1,693 1,693

131 131

0 0

5,930 5,930

7202 4,200 4,050 8,250

14,311

8,568

5,743

4,050

Form 1040-X (Rev. 7-2021) Page 2

Part I Dependents

Complete this part to change any information relating to your dependents. This would include a change in the number of dependents. Enter the information for the return year entered at the top of page 1. A. Original number

of dependents

reported or as

previously adjusted

B. Net change —

amount of increase

or (decrease)

C. Correct

number

24 Reserved for future use . . . . . . . . . . . . . . . . 24 25 Your dependent children who lived with you . . . . . . . . . 25 26 Your dependent children who didn’t live with you due to divorce or separation . . . . . . . . . . . . . . . . . . . . 26 27 Other dependents . . . . . . . . . . . . . . . . . . 27 28 Reserved for future use . . . . . . . . . . . . . . . . 28 29 Reserved for future use . . . . . . . . . . . . . . . . 29 30 List ALL dependents (children and others) claimed on this amended return. Dependents (see instructions):

If more

than four

dependents,

see

instructions

and check

here

(d) if qualifies for (see instructions):

(a) First name Last name

(b) Social security

number

to you Child tax credit

Credit for other

dependents

Part II Presidential Election Campaign Fund (for the return year entered at the top of page 1) Checking below won’t increase your tax or reduce your refund. Check here if you didn’t previously want $3 to go to the fund, but now do. Check here if this is a joint return and your spouse did not previously want $3 to go to the fund, but now does. Part III Explanation of Changes. In the space provided below, tell us why you are filing Form 1040-X.

Attach any supporting documents and new or changed forms and schedules. Sign

Here

Remember to keep a copy of this form for your records. Under penalties of perjury, I declare that I have filed an original return, and that I have examined this amended return, including accompanying schedules and statements, and to the best of my knowledge and belief, this amended return is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information about which the preparer has any knowledge.

Your signature Date Your occupation

Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation Paid

Preparer

Use Only

Print/Type preparer’s name Preparer’s signature Date Check if self-employed

PTIN

Firm’s name Firm’s EIN

Firm’s address Phone no.

For forms and publications, visit www.irs.gov/Forms. Form 1040-X (Rev. 7-2021) THIS AMENDMENT IS BEING FILED TO CLAIM THE SICK LEAVE AND FAMILY LEAVE CREDIT AS A SELF-EMPLOYED INDIVIDUAL. THE ONLY CHANGE TO THE ORIGINAL RETURN IS THE INCLUSION OF FORM 7202 TO CLAIM THE CREDIT, ALONG WITH FORM 1040-X AND UPDATED FORM 1040 AND SCHEDULE 3.

Form

1040 U.S. Individual Income Tax Return 2021

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

Check only

one box.

Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW) If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is a child but not your dependent

Your first name and middle initial Last name Your social security number 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. City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code Foreign country name Foreign province/state/county Foreign postal code Presidential Election Campaign

Check here if you, or your

spouse if filing jointly, want $3

to go to this fund. Checking a

box below will not change

your tax or refund.

You Spouse

At any time during 2021, did you receive, sell, exchange, or otherwise dispose of any financial interest in any virtual currency? Yes No Standard

Deduction

Someone can claim: You as a dependent Your spouse as a dependent Spouse itemizes on a separate return or you were a dual-status alien Age/Blindness You: Were born before January 2, 1957 Are blind Spouse: Was born before January 2, 1957 Is blind Dependents (see instructions):

If more

than four

dependents,

see instructions

and check

here

(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 1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . 1 Attach

Sch. B if

required.

2a Tax-exempt interest . . . 2a b Taxable interest . . . . . 2b 3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b 4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b 5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b 7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . 7 8 Other income from Schedule 1, line 10 . . . . . . . . . . . . . . . . . . 8 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . 9 10 Adjustments to income from Schedule 1, line 26 . . . . . . . . . . . . . . . 10 11 Subtract line 10 from line 9. This is your adjusted gross income . . . . . . . . . 11 Standard

Deduction for—

• Single or

Married filing

separately,

$12,550

• Married filing

jointly or

Qualifying

widow(er),

$25,100

• Head of

household,

$18,800

• If you checked

any box under

Standard

Deduction,

see instructions.

12a Standard deduction or itemized deductions (from Schedule A) . . 12a b Charitable contributions if you take the standard deduction (see instructions) 12b c Add lines 12a and 12b . . . . . . . . . . . . . . . . . . . . . . . 12c 13 Qualified business income deduction from Form 8995 or Form 8995-A . . . . . . . . . 13 14 Add lines 12c and 13 . . . . . . . . . . . . . . . . . . . . . . . 14 15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- . . . . . . . . . 15 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2021) 4

Erica Stepney 427 31 5335

102 foxworth drive

Columbia MS 39429

3,668

0 0

11,980

15,648

847

14,801

18,800

Form 1040 (2021) Page 2

16 Tax (see instructions). Check if any from Form(s): 1-881*-*-**** 3 . . 16 17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17 18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 19 Nonrefundable child tax credit or credit for other dependents from Schedule 8812 . . . . . 19 20 Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . 20 21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 23 Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . . . 23 24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . 24 25 Federal income tax withheld from:

a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b c Other forms (see instructions) . . . . . . . . . . . . . 25c d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 26 2021 estimated tax payments and amount applied from 2020 return . . . . . . . . . . 26 If you have a

qualifying child,

attach Sch. EIC.

27a Earned income credit (EIC) . . . . . . . . . . . . . . 27a Check here if you were born after January 1, 1998, and before January 2, 2004, and you satisfy all the other requirements for taxpayers who are at least age 18, to claim the EIC. See instructions b Nontaxable combat pay election . . . . 27b

c Prior year (2019) earned income . . . . 27c

28 Refundable child tax credit or additional child tax credit from Schedule 8812 28 29 American opportunity credit from Form 8863, line 8 . . . . . . . 29 30 Recovery rebate credit. See instructions . . . . . . . . . . 30 31 Amount from Schedule 3, line 15 . . . . . . . . . . . . 31 32 Add lines 27a and 28 through 31. These are your total other payments and refundable credits 32 33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . 33 Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . 35a Direct deposit?

See instructions.

b Routing number c Type: Checking Savings

d Account number

36 Amount of line 34 you want applied to your 2022 estimated tax . . 36 Amount

You Owe

37 Amount you owe. Subtract line 33 from line 24. For details on how to pay, see instructions . 37 38 Estimated tax penalty (see instructions) . . . . . . . . . 38 Third Party

Designee

Do you want to allow another person to discuss this return with the IRS? See instructions . . . . . . . . . . . . . . . . . . . . Yes. Complete below. No Designee’s

name

Phone

no.

Personal identification

number (PIN)

Sign

Here

Joint return?

See instructions.

Keep a copy for

your records.

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. Your signature Date Your occupation If the IRS sent you an Identity Protection PIN, enter it here

(see inst.)

Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an Identity Protection PIN, enter it here

(see inst.)

Phone no. Email address

Paid

Preparer

Use Only

Preparer’s name Preparer’s signature Date PTIN Check if: Self-employed

Firm’s name Phone no.

Firm’s address Firm’s EIN

Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2021) 0

1,693

131

5,930

3,000

5,250

14,180

14,311

12,618

SCHEDULE 3

(Form 1040) 2021

Additional Credits and Payments

Department of the Treasury

Internal Revenue Service

Attach to Form 1040, 1040-SR, or 1040-NR.

Go to www.irs.gov/Form1040 for instructions and the latest information. OMB No. 1545-0074

Attachment

Sequence No. 03

Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number Part I Nonrefundable Credits

1 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . 1 2

Credit for child and dependent care expenses from Form 2441, line 11. Attach Form 2441 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . . . 3 4 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . . 4 5 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . . . . 5 6 Other nonrefundable credits:

a General business credit. Attach Form 3800 . . . . . . . . 6a b Credit for prior year minimum tax. Attach Form 8801 . . . . 6b c Adoption credit. Attach Form 8839 . . . . . . . . . . . . 6c d Credit for the elderly or disabled. Attach Schedule R . . . . . 6d e Alternative motor vehicle credit. Attach Form 8910 . . . . . 6e f Qualified plug-in motor vehicle credit. Attach Form 8936 . . . 6f g Mortgage interest credit. Attach Form 8396 . . . . . . . . 6g h District of Columbia first-time homebuyer credit. Attach Form 8859 6h i Qualified electric vehicle credit. Attach Form 8834 . . . . . 6i j Alternative fuel vehicle refueling property credit. Attach Form 8911 6j k Credit to holders of tax credit bonds. Attach Form 8912 . . . 6k l Amount on Form 8978, line 14. See instructions . . . . . . 6l z Other nonrefundable credits. List type and amount 6z

7 Total other nonrefundable credits. Add lines 6a through 6z . . . . . . . . . . 7 8

Add lines 1 through 5 and 7. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

(continued on page 2)

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71480G Schedule 3 (Form 1040) 2021 Erica Stepney ***-**-****

Schedule 3 (Form 1040) 2021 Page 2

Part II Other Payments and Refundable Credits

9 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . 9 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 Other payments or refundable credits:

a Form 2439 . . . . . . . . . . . . . . . . . . . . . 13a b Qualified sick and family leave credits from Schedule(s) H and Form(s) 7202 for leave taken before April 1, 2021 . . . . . . 13b c Health coverage tax credit from Form 8885 . . . . . . . . 13c d Credit for repayment of amounts included in income from earlier years . . . . . . . . . . . . . . . . . . . . . . . . 13d e Reserved for future use . . . . . . . . . . . . . . . . 13e f Deferred amount of net 965 tax liability (see instructions) . . . 13f g Credit for child and dependent care expenses from Form 2441, line 10. Attach Form 2441 . . . . . . . . . . . . . . . 13g h Qualified sick and family leave credits from Schedule(s) H and Form(s) 7202 for leave taken after March 31, 2021 . . . . . 13h z Other payments or refundable credits. List type and amount 13z

14 Total other payments or refundable credits. Add lines 13a through 13z . . . . . 14 15 Add lines 9 through 12 and 14. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Schedule 3 (Form 1040) 2021

1,880

1,200

2,170

5,250

Form 7202 2021

Credits for Sick Leave and Family Leave

for Certain Self-Employed Individuals

Department of the Treasury

Internal Revenue Service

Attach to Form 1040, 1040-SR, or 1040-NR.

Go to www.irs.gov/Form7202 for instructions and the latest information. OMB No. 1545-0074

Attachment

Sequence No. 202

Name of person with self-employment income (as shown on Form 1040, 1040-SR, or 1040-NR) Social security number of person with self-employment income

Part I Credit for Sick Leave for Certain Self-Employed Individuals (January 1, 2021, through March 31, 2021, only) 1

Number of days after December 31, 2020, and before April 1, 2021, you were unable to perform services as a self-employed individual because of certain coronavirus-related care you provided to another. (Don’t include days you included on line 1.) See instructions . . . . . . . . . . . . . . . . . 2 3 a Enter the number from line 4 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, enter -0- . . . 3a b Enter the number from line 6 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, enter -0- . . . 3b c Add lines 3a and 3b . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3c d Subtract line 3c from the number 10 . . . . . . . . . . . . . . . . . . . . . . 3d 4 a Enter the smaller of line 1 or line 3d . . . . . . . . . . . . . . . . . . . . . . . 4a b List each day included on line 4a (MM/DD):

5 Subtract line 4a from line 3d . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 a Enter the smaller of line 2 or line 5 . . . . . . . . . . . . . . . . . . . . . . . 6a b List each day included on line 6a (MM/DD):

Caution: The total of line 4a plus line 6a cannot exceed 10 days or line 3d, whichever is smaller. 7 a Net earnings from self-employment (see instructions) . . . . . . . . . . . . . . . . . 7a b Check this box if you are electing to use prior year net earnings from self-employment on line 7a . . 8 Divide line 7a by 260 (round to nearest whole number) . . . . . . . . . . . . . . . . . 8 9 Enter the smaller of line 8 or $511 . . . . . . . . . . . . . . . . . . . . . . . 9 10 Multiply line 4a by line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . 10 11 Multiply line 8 by 67% (0.67) . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 Enter the smaller of line 11 or $200 . . . . . . . . . . . . . . . . . . . . . . . 12 13 Multiply line 6a by line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14 Add lines 10 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 15 a Amount of qualified sick leave wages subject to the $511 per day limit you received from an employer for periods of leave taken after December 31, 2020, and before April 1, 2021 (see instructions) . . . . . 15a b Enter the amount from line 15 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, see instructions for amount to enter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15b c Add lines 15a and 15b . . . . . . . . . . . . . . . . . . . . . . . . . . . 15c 16 a Amount of qualified sick leave wages subject to the $200 per day limit you received from an employer for periods of leave taken after December 31, 2020, and before April 1, 2021 (see instructions) . . . . . 16a b Enter the amount from line 16 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, see instructions for amount to enter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16b c Add lines 16a and 16b . . . . . . . . . . . . . . . . . . . . . . . . . . . 16c If line 15c and line 16c are both zero, skip to line 24 and enter the amount from line 14. 17 a Add lines 13 and 16c . . . . . . . . . . . . . . . . . . . . . . . . . . . 17a b Enter the amount from line 13 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, enter -0- . . 17b c Add lines 17a and 17b . . . . . . . . . . . . . . . . . . . . . . . . . . . 17c 18 Enter the smaller of line 17c or $2,000 . . . . . . . . . . . . . . . . . . . . . . 18 19 Subtract line 18 from line 17c . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 a Add lines 10, 15c, and 18 . . . . . . . . . . . . . . . . . . . . . . . . . . 20a b Enter the amount from line 10 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, enter -0- . . 20b c Add lines 20a and 20b . . . . . . . . . . . . . . . . . . . . . . . . . . . 20c 21 Enter the smaller of line 20c or $5,110 . . . . . . . . . . . . . . . . . . . . . . 21 22 Subtract line 21 from line 20c . . . . . . . . . . . . . . . . . . . . . . . . . 22 23 Add lines 19 and 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 24 Subtract line 23 from line 14. If zero or less, enter -0-. Enter here and include on Schedule 3 (Form 1040), line 13b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 For Privacy Act and Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 56395K Form 7202 (2021) Erica Stepney ***-**-****

01/04 01/05 01/06 01/07 01/08 01/09 01/10 01/11 01/12 01/13 0

11,063

430

Form 7202 (2021) Page 2

Part II Credit for Family Leave for Certain Self-Employed Individuals (January 1, 2021, through March 31, 2021, only) 25

(Don’t enter more than 50 days. Don’t include any day you listed on either line 4b or line 6b.) See instructions 25a b Enter the amount from line 25 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, enter -0- . . 25b c Subtract line 25b from the number 50 . . . . . . . . . . . . . . . . . . . . . . 25c d Enter the smaller of line 25a or line 25c . . . . . . . . . . . . . . . . . . . . . . 25d 26 a Net earnings from self-employment (see instructions) . . . . . . . . . . . . . . . . . 26a b Check this box if you are electing to use prior year net earnings from self-employment on line 26a . . 27 Divide line 26a by 260 (round to nearest whole number) . . . . . . . . . . . . . . . . . 27 28 Multiply line 27 by 67% (0.67) . . . . . . . . . . . . . . . . . . . . . . . . . 28 29 Enter the smaller of line 28 or $200 . . . . . . . . . . . . . . . . . . . . . . . 29 30 Multiply line 25d by line 29 . . . . . . . . . . . . . . . . . . . . . . . . . 30 31 a Amount of qualified family leave wages you received from an employer for periods of leave taken after December 31, 2020, and before April 1, 2021 (see instructions) . . . . . . . . . . . . . . 31a b Enter the amount from line 31 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, see instructions for amount to enter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31b c Add lines 31a and 31b . . . . . . . . . . . . . . . . . . . . . . . . . . . 31c If line 31c is zero, skip to line 35 and enter the amount from line 30. 32 a Add lines 30 and 31c . . . . . . . . . . . . . . . . . . . . . . . . . . . 32a b Enter the amount from line 30 of your 2020 Form 7202. If you didn’t file a 2020 Form 7202, enter -0- . . 32b c Add lines 32a and 32b . . . . . . . . . . . . . . . . . . . . . . . . . . . 32c 33 Enter the smaller of line 32c or $10,000 . . . . . . . . . . . . . . . . . . . . . . 33 34 Subtract line 33 from line 32c . . . . . . . . . . . . . . . . . . . . . . . . . 34 35 Subtract line 34 from line 30. If zero or less, enter -0-. Enter here and include on Schedule 3 (Form 1040), line 13b 35 Part III Credit for Sick Leave for Certain Self-Employed Individuals (April 1, 2021, through September 30, 2021, only) 36

Number of days after March 31, 2021, and before October 1, 2021, you were unable to perform services as a self-employed individual because of certain coronavirus-related care you provided to another. (Don’t include days you included on line 36.) See instructions . . . . . . . . . . . . . . . . . 37 38 a Enter the smaller of 10 days or the number of days entered on line 36 . . . . . . . . . . . . 38a b List each day included on line 38a (MM/DD):

39 Subtract line 38a from

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