Security Social..sales proof of earnings

Location:

Brainerd, MN

Posted:

October 15, 2020

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Form

**** ********** ** *** ********—Internal Revenue Service (99)

U.S. Individual Income Tax Return 2019 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 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. a

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, 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 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

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, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind If more than four dependents,

see instructions and here a

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 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 4a IRA distributions 4a b Taxable amount 4b c Pensions and annuities . . . 4c d Taxable amount 4d 5a Social security benefits . . . 5a b Taxable amount 5b 6 Capital gain or (loss). Attach Schedule D if required. If not required, check here a 6 7a Other income from Schedule 1, line 9 7a b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income a 7b 8 a Adjustments to income from Schedule 1, line 22 8a b Subtract line 8a from line 7b. This is your adjusted gross income a 8b 9 Standard deduction or itemized deductions (from Schedule A) Standard

Deduction for—

• Single or Married

filing separately,

$12,200

• Married filing

jointly or Qualifying

widow(er),

$24,400

• Head of

household,

$18,350

• If you checked

any box under

Standard

Deduction,

see instructions.

10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10 11a Add lines 9 and 10 11a b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- 11b For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019) 12,200.

12,200.

60,650.

Nelson ***-**-****

305 W Faribault St

72,850.

Keith B

Duluth MN 55803-1732

Form 1040 (2019) Page 2

12a Tax (see inst.) Check if any from Form(s): 1-881*-*-**** 3 12a b Add Schedule 2, line 3, and line 12a and enter the total a 12b 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 14 Subtract line 13b from line 12b. If zero or less, enter -0- 14 15 Other taxes, including self-employment tax, from Schedule 2, line 10 15 16 Add lines 14 and 15. This is your total tax a 16 17 Federal income tax withheld from Forms W-2 and 1099 17 18 Other payments and refundable credits:

a Earned income credit (EIC)

• If you have a

qualifying child,

attach Sch. EIC.

• If you have

nontaxable

combat pay, see

instructions.

18a

b Additional child tax credit. Attach Schedule 8812 18b c American opportunity credit from Form 8863, line 8 18c d Schedule 3, line 14 18d

e Add lines 18a through 18d. These are your total other payments and refundable credits a 18e 19 Add lines 17 and 18e. These are your total payments a 19 Refund 20

If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 20 21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here a 21a Direct deposit?

See instructions.

a b Routing number a c Type: Checking Savings

a d Account number

22 Amount of line 20 you want applied to your 2020 estimated tax a 22 Amount

You Owe

23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions a 23 24 Estimated tax penalty (see instructions) a 24 Third Party

Designee

(Other than

paid preparer)

Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below. No

Designee’s

name a

Phone

no. a

Personal identification

number (PIN) a

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: 3rd Party Designee

Firm’s name a Phone no. Self-employed

Firm’s address a Firm’s EIN a

Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2019) No

Self-Prepared

9,207.

1 2 4 3 0 3 1 2 0

9 9 3 9 3 5 3 9 4 8 9 0

9,207.

Sales Associate

10,208.

1,001.

BAA REV 01/27/20 Intuit.cg.cfp.sp

Your Code Spouse’s Code

2019 Form M1, Individual Income Tax

Leave unused boxes blank. Do not use staples on anything you submit. Your First Name and Initial Last Name Your Social Security Number (SSN) Your Date of Birth If a Joint Return, Spouse’s First Name and Initial Spouse’s Last Name Spouse’s Social Security Number Spouse’s Date of Birth Current Home Address Check if: New Address Foreign Address City State ZIP Code

2019 Federal Filing Status (place an X in one box):

(1) Single (2) Married filing jointly (3) Married filing separately (4) Head of household (5) Qualifying widow(er) Spouse name and SSN

State Elections Campaign Fund

If you want $5 to go to help candidates for state offices pay campaign expenses, enter the code number for the party of your choice. This will not increase your tax or reduce your refund. A. Wages, salaries, tips, etc. B. IRA, pensions, and annuities C. Unemployment D. Federal taxable income From Your Federal Return (see instructions)

Place an X in box if a negative number

1 Federal adjusted gross income (from line 8b of federal Form 1040 and 1040-SR)

(if a negative number, place an X in the box) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Additions to Minnesota income from line 17 of Schedule M1M (see instructions; enclose Schedule M1M) 2 3 Add lines 1 and 2 (if a negative number, place an X in the box) 3 4 Itemized deductions (from Schedule M1SA) or your standard deduction (see instructions) 4 5 Exemptions (determine from instructions) 5 6 State income tax refund from line 1 of federal Schedule 1 6 7 Other subtractions from Minnesota income from line 46 of Schedule M1M

(see instructions; enclose Schedule M1M) 7 8 Total subtractions. Add lines 4 through 7 8 9 Minnesota taxable income. Subtract line 8 from line 3. If zero or less, leave blank. 9 10 Tax from the table in the M1 instructions 10 11 Alternative minimum tax (enclose Schedule M1MT) 11 12 Add lines 10 and 11 12 13 Full-year residents: Enter the amount from line 12 on line 13. Skip lines 13a and 13b. Part-year residents and nonresidents: From Schedule M1NR, enter the amount from line 26 on line 13, from line 22 on line 13a, and from line 23 on line 13b (enclose Schedule M1NR) 13 a b (Place an X in box if a negative number)

14 Other taxes such as the tax on lump sum distributions and recapture amounts from (check appropriate box): Schedule M1HOME Schedule M1529 Schedule M1LS 14 Political Party Code Numbers:

Republican—11

Democratic/Farmer-Labor—12

Independence—13

Grassroots/Legalize Cannabis—14

Green—15

Libertarian—16

Legal Marijuana Now—17

General Campaign Fund—99

NELSON 472845042

305 W FARIBAULT ST

DULUTH MN 55803

1555

09011961

728**-*-*-*****

12200

60650

72850

3740

0 0

* 1 9 1 1 1 1 *

KEITH B

REV 01/27/20 Intuit.cg.cfp.sp

Spouse’s Signature (If Filing Jointly)

15 Tax before credits. Add lines 13 and 14 15 16 Marriage Credit for joint return when both spouses have taxable earned income or taxable retirement income (enclose Schedule M1MA) 16 17 Credit for long-term care insurance premiums paid (enclose Schedule M1LTI) 17 18 Credit for taxes paid to another state (enclose Schedule(s) M1CR and M1RCR) 18 19 Other nonrefundable credits (enclose Schedule M1C) 19 20 Total nonrefundable credits. Add lines 16 through 19 20 21 Subtract line 20 from line 15 (if result is zero or less, leave blank) 21 22 Nongame Wildlife Fund contribution (see instructions) This will reduce your refund or increase the amount you owe 22 23 Add lines 21 and 22 23 24 Minnesota income tax withheld. Complete and enclose Schedule M1W to report Minnesota withholding from Forms W-2, 1099, and W-2G (do not send) 24 25 Minnesota estimated tax and extension payments made for 2019 25 26 Refundable credits from line 9 of Schedule M1REF (see instructions; enclose Schedule M1REF) 26 27 Total payments. Add lines 24 through 26 27 28 REFUND. If line 27 is more than line 23, subtract line 23 from line 27 (see instructions). For direct deposit, complete line 29 28 29 Direct deposit of your refund (you must use an account not associated with a foreign bank): Checking Savings

30 AMOUNT YOU OWE. If line 23 is more than line 27, subtractline 27 from line 23 (see instructions) 30 31 Penalty amount from Schedule M15 (see instructions). Also subtract this amount from line 28 or add it to line 30 (enclose Schedule M15) 31 IF YOU PAY ESTIMATED TAX and want part of your refund credited to estimated tax, complete lines 32 and 33. 32 Amount from line 28 you want sent to you 32 33 Amount from line 28 you want applied to your 2020 estimated tax 33 Your Signature Date

I declare that this return is correct and complete to the best of my knowledge and belief. Paid preparer: You must sign below. Include a copy of your 2019 federal return and schedules. Mail to: Minnesota Individual Income Tax

St. Paul, MN 55145-0010

To check on the status of your refund, visit www.revenue.state.mn.us I authorize the Minnesota Department of Revenue to discuss this return with my paid preparer or the third-party designee indicated on my federal return. I do not want my paid preparer to file my return electronically. 2019 M1, page 2

Paid Preparer’s Signature Date

Preparer’s Daytime Phone PTIN or VITA/TCE # (required) Preparer’s Email Address

Taxpayer’s Daytime Phone

Your Email Address

Account Type Routing Number Account Number

218-***-****

1555

3740

SELF-PREPARED

4218

3740

4218

3740

478

adgz7h@r.postjobfree.com

124303120 993*********

REV 01/27/20 Intuit.cg.cfp.sp

* 1 9 1 1 2 1 *

1 Minnesota wages and Minnesota tax withheld on Forms W-2, other than from Forms W-2G. If you have more than five Forms W-2, complete line 5 on the back.

A B—Box 13 C—Box 15 D—Box 16 E—Box 17

If the Form W-2 is for: If Retirement Plan Employer’s seven-digit Minnesota State wages, tips, etc. Minnesota tax withheld

• you, enter 1 box is checked, Tax ID Number (round to nearest whole dollar) (round to nearest whole dollar)

• spouse, enter 2 mark an X below.

Subtotal for additional Forms W-2 (from line 5 on page 2) Total Minnesota tax withheld on all Forms W-2 (add amounts in line 1, column E) 1 2 Minnesota tax withheld on Forms 1099, W-2G, and 1042-S. If you have more than four forms, complete line 6 on the back. A B C D

If the Form 1099, W-2G, or 1042-S is for: Payer’s seven-digit Minnesota Tax ID Income amount (see the table on Minnesota tax withheld

• you, enter 1 Number (if unknown, contact the payer) the back for amounts to include) (round to nearest whole dollar)

• spouse, enter 2

Subtotal for additional 1099, W-2G, and 1042-S (from line 6 on page 2) Total Minnesota tax withheld on all 1099, W-2G, and 1042-S (add amounts in line 2, column D) 2 3 Total Minnesota tax withheld by partnerships, S corporations, and fiduciaries

(from line 7 on page 2) 3 4 Total. Add the Minnesota tax withheld on lines 1, 2, and 3. Enter the total here and on line 24 of Form M1 4 Include this schedule with your Form M1.

If required, include Schedules KPI, KS, and KF.

2019 Schedule M1W, Minnesota Income Tax Withheld

Complete this schedule to report Minnesota income tax withheld. Include this schedule when you file your return. If you received a federal Form W-2, 1099, W-2G, 1042-S, or Minnesota Schedule KPI, KS, or KF that shows Minnesota income tax withheld, complete this schedule to determine line 24 of Form M1. List only the forms that report Minnesota income tax withheld. Round dollar amounts to the nearest whole dollar. You must include this schedule when you file your return. DO NOT send in your Forms W-2, 1099, or W-2G; keep them with your tax records. All instructions are included on this schedule. Your First Name and Initial Last Name Your Social Security Number If a Joint Return, Spouse’s First Name and Initial Spouse’s Last Name Spouse’s Social Security Number 1555

NELSON 472845042

4218

1-107****-***** 4218

* 1 9 1 3 1 1 *

KEITH B

REV 01/27/20 Intuit.cg.cfp.sp

2019 Schedule M1PR-AI, Additions to Income

Your First Name and Initial Last Name Your Social Security Number If a Joint Return, Spouse’s First Name and Initial Spouse’s Last Name Spouse’s Social Security Number Complete Schedule M1PR-AI, Additions to Income, to report amounts for line 5 of Form M1PR, Homestead Credit Refund (for Home- owners) and Renter’s Property Tax Refund. Enter the type of income that was received in Column A and the amount in Column B. See instructions to determine which types of income to include. Column A — Type of Income Received Column B —Amount You must include this schedule with your Form M1PR. If you had more than 19 items, include a statement with the type of income and amounts received.

1a 1b

2a 2b

3a 3b

4a 4b

5a 5b

6a 6b

7a 7b

8a 8b

9a 9b

10a 10b

11a 11b

12a 12b

13a 13b

14a 14b

15a 15b

16a 16b

17a 17b

18a 18b

19a 19b

20 Total of Column B. Add all amounts in Column B. Enter here and on line 5 of Form M1PR 20 2324 NELSON 472845042

EMPLOYEE ELECTIVE DEFERRAL PLAN CONTRIBUTIONS 2324

* 1 9 5 7 1 1 *

KEITH B

REV 01/27/20 Intuit.cg.cfp.sp 1555

Form

1040 Department of the Treasury—Internal Revenue Service (99) U.S. Individual Income Tax Return 2019 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space. Filing Status

Check only

one box.

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

Standard

Deduction

see instructions and here a

Dependents (see instructions): (2) Social security number (3) Relationship to you (4) if qualifies for (see instructions):

Deduction for—

• Single or Married

filing separately,

$12,200

• Married filing

jointly or Qualifying

widow(er),

$24,400

• Head of

household,

$18,350

• If you checked

any box under

Standard

Deduction,

see instructions.

12,200.

60,650.

Nelson ***-**-****

305 W Faribault St

72,850.

Keith B

Duluth MN 55803-1732

Form 1040 (2019) Page 2

a Earned income credit (EIC)

• If you have a

qualifying child,

attach Sch. EIC.

• If you have

nontaxable

combat pay, see

instructions.

18a

b Additional child tax credit. Attach Schedule 8812 18b c American opportunity credit from Form 8863, line 8 18c d Schedule 3, line 14 18d

e Add lines 18a through 18d. These are your total other payments and refundable credits a 18e 19 Add lines 17 and 18e. These are your total payments a 19 Refund 20

See instructions.

a b Routing number a c Type: Checking Savings

a d Account number

22 Amount of line 20 you want applied to your 2020 estimated tax a 22 Amount

You Owe

23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions a 23 24 Estimated tax penalty (see instructions) a 24 Third Party

Designee

(Other than

paid preparer)

Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below. No

Designee’s

name a

Phone

no. a

Personal identification

number (PIN) a

Sign

Here

Joint return?

See instructions.

Keep a copy for

your records.

(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: 3rd Party Designee

Firm’s name a Phone no. Self-employed

Firm’s address a Firm’s EIN a

Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2019) No

Self-Prepared

9,207.

1 2 4 3 0 3 1 2 0

9 9 3 9 3 5 3 9 4 8 9 0

9,207.

Sales Associate

10,208.

1,001.

BAA REV 01/27/20 Intuit.cg.cfp.sp

Contact this candidate