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Post Office Service Provider

Location:
Atlanta, GA
Posted:
March 09, 2023

Contact this candidate

Resume:

BROWN & ASSOCIATES TAX ACCT

*** ****** ******

MACON, GA 31201

478-***-****

ICILIOUS STINSON

*** **** ****** *******

DULUTH, GA 30096-0000

ICILIOUS STINSON

*** **** ****** *******

DULUTH, GA 30096-0000

Dear Client,

Please find enclosed your 2022 Federal individual income tax return. We prepared your return based on the information provided. Please review the return carefully to ensure that there are no omissions. You should retain a copy of your return, along with any supporting documents, for a minimum of three years from the filing date. Your Federal return was filed electronically. The IRS was instructed to deposit your refund of

$2752 directly into an account at Refund Advantage. Once this direct deposit is received by the bank, the bank will deposit the funds into your bank account. This deposit will be available based on the time and date your bank receives the deposit from Refund Advantage. As your Electronic Return Originator, we will forward your required supporting documents to the IRS.

If you have any questions about your return, please feel free to contact our office. Remember that we are here throughout the year to assist you with all of your financial and tax consulting needs.

Sincerely,

February 16, 2023

BROWN & ASSOCIATES TAX ACCT

616 POPLAR STREET

MACON, GA 31201

478-***-****

ICILIOUS STINSON

509 TREE SUMMIT PARKWAY

DULUTH, GA 30096-0000

BROWN & ASSOCIATES TAX ACCT

616 POPLAR STREET

MACON, GA 31201

478-***-****

ICILIOUS STINSON

509 TREE SUMMIT PARKWAY

DULUTH, GA 30096-0000

Dear Client,

Please find enclosed your 2022 GEORGIA individual income tax return. We prepared your return based on the information provided. Please review the return carefully to ensure that there are no omissions. You should retain a copy of your return, along with any supporting documents, for a minimum of three years from the filing date. Your state return was filed electronically. The amount due is $133. Make your check or money order payable to the GEORGIA Department of Revenue and mail it along with the payment voucher provided with your return on or before April 18, 2023. Be sure to write your name and Social Security Number on your check before mailing to: If you have any questions about your return, please feel free to contact our office. Remember that we are here throughout the year to assist you with all of your financial and tax consulting needs.

Sincerely,

February 16, 2023

BROWN & ASSOCIATES TAX ACCT

616 POPLAR STREET

MACON, GA 31201

478-***-****

Georgia Department of Revenue

P O Box 740323

Atlanta, GA 30374-0323

ICILIOUS C STINSON ***-**-****

509 TREE SUMMIT PARKWAY

DULUTH GA 30096 470-***-****

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Department of the Treasury

Internal Revenue Service

OMB No. 1545-0074

Form

Your first name and initial Last name

If a joint return, spouse s first name and initial Last name 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 a foreign address, also complete spaces below.) Foreign country name Foreign province/state/county Foreign postal code 1037 CPTS 2US991 Form (2022)

Your social security number

Spouse s social security number

For the year January 1-December 31, 2022

Please

print or

type. You enter

your SSN(s) above.

See instructions on back.

Go to www.irs.gov/Form8453 for the latest information. Important!

must

SPA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see your tax return instructions. Form 1098-C, Contributions of Motor Vehicles, Boats, and Airplanes (or equivalent contemporaneous written acknowledgement)

Form 2848, Power of Attorney and Declaration of Representative (or POA that states the agent is granted authority to sign the return)

Form 3115, Application for Change in Accounting Method Form 3468 - attach a copy of the first page of NPS Form 10-168, Historic Preservation Certification Application (Part 2- Description of Rehabilitation), with an indication that it was received by the Department of the Interior or the State Historic Preservation Officer, together with proof that the building is a certified historic structure (or that such status has been requested) Form 4136 - attach appropriate certificates and, if applicable, the appropriate reseller statements for biodiesel, renewable diesel, and sustainable aviation fuel claims

Form 5713, International Boycott Report

Form 8283, Noncash Charitable Contributions, Section A (if any statement or qualified appraisal is required), or Section B, Donated Property, and any related attachments (including any qualified appraisal or partnership Form 8283) Form 8332, Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent (or certain pages from a divorce decree or separation agreement that went into effect after 1984 and before 2009) (see instructions) Form 8858, Information Return of U.S. Persons With Respect to Foreign Disregarded Entities (FDEs) and Foreign Branches (FBs) Form 8864 - attach the appropriate certificates and, if applicable, the appropriate reseller statements for biodiesel, renewable diesel, and sustainable aviation fuel claims

Form 8949, Sales and Other Dispositions of Capital Assets (or a statement with the same information), if you elect not to report your transactions electronically on Form 8949 FILE THIS FORM ONLY IF YOU ARE ATTACHING ONE OR MORE OF THE FOLLOWING FORMS OR SUPPORTING DOCUMENTS.

Check the applicable box(es) to identify the attachments. DON'T SIGN THIS FORM.

8453

8453 U.S. Individual Income Tax Transmittal for an IRS e-file Return 2022

ICILIOUS C STINSON ***-**-****

2022

29,766

2,301

2,377

2,752

X BROWN & ASSOCIATES TAX ACCT 09991

581********

Page 04

)

Department of the Treasury

Internal Revenue Service

Form

(Rev. January 2021) OMB No. 1545-0074

Taxpayer s name

Spouse s name

1037 CPTS 2USPA1 Form (Rev. 01-2021)

Social security number

Spouse s social security number

ERO firm name Enter five digits, but

don t enter all zeros

ERO firm name Enter five digits, but

don t enter all zeros

Don t enter all zeros

Under penalties of perjury, I declare that I have examined a copy of the income tax return (original or amended) I am now authorizing, and to the best of my knowledge and belief, it is true, correct, and complete. I further declare that the amounts in Part I above are the amounts from the income tax return (original or amended) I am now authorizing. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at Payment cancellation requests must be received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for the income tax return (original or amended) I am now authorizing and, if applicable, my Electronic Funds Withdrawal Consent.

I certify that the above numeric entry is my PIN, which is my signature for the electronic individual income tax return (original or amended) I am now authorized to file for tax year indicated above for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns. ERO must obtain and retain completed Form 8879.

Go to www.irs.gov/Form8879 for the latest information. 1-888-***-****.

Pub. 1345,

SPA For Paperwork Reduction Act Notice, see your tax return instructions. Submission Identification Number (SID)

Enter whole dollars only on lines 1 through 5.

Form 1040-SS filers use line 4 only. Leave lines 1, 2, 3, and 5 blank. Adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . Total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Federal income tax withheld from Form(s) W-2 and Form(s) 1099 . . . . . . . . . . . . Amount you want refunded to you . . . . . . . . . . . . . . . . . . . . . . Amount you owe . . . . . . . . . . . . . . . . . . . . . . . . . . . . I authorize to enter or generate my PIN as my

signature on the income tax return (original or amended) I am now authorizing. I will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. Check this box if you are entering your own PIN your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Your signature Date

I authorize to enter or generate my PIN as my

signature on the income tax return (original or amended) I am now authorizing. I will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. Check this box if you are entering your own PIN your return is filed using the Practitioner PIN method. The ERO must complete Part III below.

Spouse s signature Date

Enter your six-digit EFIN followed by your five-digit self-selected PIN. ERO s signature Date

Note:

1 1

2 2

3 3

4 4

5 5

Taxpayer s PIN: check one box only

only

and

Spouse s PIN: check one box only

only

and

ERO s EFIN/PIN.

Part I Tax Return Information Tax Year Ending December 31, (Enter year you are authorizing.) Part II Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return) Practitioner PIN Method Returns Only continue below Part III Certification and Authentication Practitioner PIN Method Only ERO Must Retain This Form See Instructions

Don t Submit This Form to the IRS Unless Requested To Do So 8879

8879 IRS e-file Signature Authorization

ICILIOUS C STINSON ***-**-****

509 TREE SUMMIT PARKWAY

DULUTH GA 30096 470-***-****

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Department of the Treasury

Internal Revenue Service

OMB No. 1545-0074

Form

Your first name and initial Last name

If a joint return, spouse s first name and initial Last name 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 a foreign address, also complete spaces below.) Foreign country name Foreign province/state/county Foreign postal code 1037 CPTS 2US991 Form (2022)

Your social security number

Spouse s social security number

For the year January 1-December 31, 2022

Please

print or

type. You enter

your SSN(s) above.

See instructions on back.

Go to www.irs.gov/Form8453 for the latest information. Important!

must

SPA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see your tax return instructions. Form 1098-C, Contributions of Motor Vehicles, Boats, and Airplanes (or equivalent contemporaneous written acknowledgement)

Form 2848, Power of Attorney and Declaration of Representative (or POA that states the agent is granted authority to sign the return)

Form 3115, Application for Change in Accounting Method Form 3468 - attach a copy of the first page of NPS Form 10-168, Historic Preservation Certification Application (Part 2- Description of Rehabilitation), with an indication that it was received by the Department of the Interior or the State Historic Preservation Officer, together with proof that the building is a certified historic structure (or that such status has been requested) Form 4136 - attach appropriate certificates and, if applicable, the appropriate reseller statements for biodiesel, renewable diesel, and sustainable aviation fuel claims

Form 5713, International Boycott Report

Form 8283, Noncash Charitable Contributions, Section A (if any statement or qualified appraisal is required), or Section B, Donated Property, and any related attachments (including any qualified appraisal or partnership Form 8283) Form 8332, Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent (or certain pages from a divorce decree or separation agreement that went into effect after 1984 and before 2009) (see instructions) Form 8858, Information Return of U.S. Persons With Respect to Foreign Disregarded Entities (FDEs) and Foreign Branches (FBs) Form 8864 - attach the appropriate certificates and, if applicable, the appropriate reseller statements for biodiesel, renewable diesel, and sustainable aviation fuel claims

Form 8949, Sales and Other Dispositions of Capital Assets (or a statement with the same information), if you elect not to report your transactions electronically on Form 8949 FILE THIS FORM ONLY IF YOU ARE ATTACHING ONE OR MORE OF THE FOLLOWING FORMS OR SUPPORTING DOCUMENTS.

Check the applicable box(es) to identify the attachments. DON'T SIGN THIS FORM.

8453

8453 U.S. Individual Income Tax Transmittal for an IRS e-file Return 2022

ICILIOUS C STINSON ***-**-****

509 TREE SUMMIT PARKWAY

DULUTH GA 30096

29766

21666

1073

133

ICILIOUS C STINSON ************@*****.***

BROWN & ASSOCIATES TAX ACCT

616 POPLAR STREET P00877119

MACON GA 31201

BROWN & ASSOCIATES TAX ACCT 32-0264305

616 POPLAR STREET P00877119

MACON GA 31201

Page 06

5 8 1 7 4 2

(if joint return, both must sign)

GA-8453 (REV 05/24/22) 2022 1037 CPTS 2GA991

First Name and Initial Last Name Social Security Number If Joint Return, Spouse's First Name and Initial Spouse's Last Name Spouse's Social Security Number Home Address (number and street) Apt Number Daytime Telephone Number City, Town or Post Office State Zip Code

1. Federal Adjusted Gross Income (Form 500 or Form 500X, Line 8; Form 500EZ, Line 1) 1. 2. Georgia Taxable Income (Form 500 or Form 500X, Line 15c; Form 500EZ, Line 3) 2. 3. Net Georgia Tax (Form 500 or Form 500X, Line 22, Form 500EZ, Line 6) 3. 4. Balance Due (Form 500, Line 41; Form 500X, Line 37; Form 500EZ, Line 20) 4. 5. Refund (Form 500, Line 42; Form 500X, Line 38; Form 500EZ, Line 21) 5. Date Date

Date

Firm's Name Check if also paid preparer

Address FEIN/PTIN

City, State, & Zip Code SSN/TIN

Date

Firm's Name FID/TIN

Address SSN/TIN

City, State, & Zip Code

SIGN

HERE

TAXPAYER'S SIGNATURE SPOUSE'S SIGNATURE

PRINT NAME EMAIL ADDRESS

I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER'S RETURN AND THAT THE ENTRIES ON THE GA-8453 ARE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE.

ERO's Signature

ERO's

Use

Only

IF PREPARED BY ANY PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL INFORMATION OF WHICH THE TAXPAYER HAS ANY KNOWLEDGE.

Paid Preparer's Signature

Paid

Preparer's

Use Only

Under penalties of perjury, I declare that the information I have provided to my Electronic Return Originator (ERO) and/or Online Service Provider and/or Transmitter and the amounts shown in Part I agree with the amounts shown on the corresponding lines of the electronic portion of my 2022 Georgia Income Tax Return. I declare that I have examined my tax return, including accompanying schedules and statements, and to the best of my knowledge and belief, my return is true, correct and complete. I consent that the electronic portion of my return may be sent by my ERO/Online Service Provider/Transmitter. ART

ART

ART

Amended Return

P I TAX RETURN INFORMATION

P II DECLARATION OF TAXPAYER(S)

P III DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER ERO MUST RETAIN THIS FORM.

GEORGIA DEPARTMENT OF REVENUE

UNLESS REQUIRED TO DO SO.

DO NOT SUBMIT THIS FORM TO

IRS DCN OR SUBMISSION ID

KEEP A COPY WITH YOUR RECORDS

PLEASE

DO NOT

MAIL!

GA-8453

2022

GEORGIA INDIVIDUAL INCOME TAX DECLARATION FOR ELECTRONIC FILING SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER 509 TREE SUMMIT PARKWAY

235-***-****

ICILIOUS C STINSON

DULUTH GA 30096

X X

***-**-**** 470-***-**** 008

133.00

Page 07

52500260359991822092120000000000000000800000133003 1

1

1

1

1

1

1

1

1

1

1

1

(if joint or combined return)

Individual or Fiduciary Name and Address:

TYPE OF RETURN:

Individual and Fiduciary Payment Voucher

Taxpayer s SSN or Fiduciary FEIN Spouse s SSN Tax Year DaytimeTelephoneNumber Vendor Code PLEASE DO NOT STAPLE. REMOVE ALL CHECK STUBS.

(Rev. 06/21/22)

Amended Return Paper Return Electronically Filed 09-Individual 10-Fiduciary PROCESSING CENTER

GEORGIA DEPARTMENT OF REVENUE

PO BOX 740323

ATLANTA GA30374-0323

Cut along line

Amount Paid

Payments can be made electronically on the Georgia Tax Center (GTC) gtc.dor.ga.gov/ . Georgia Public Revenue Code Section 48-2-31 stipulates that taxes shall be paid in lawful money of the United States, free of any expense to the State of Georgia. Processing Center

Georgia Department of Revenue

P O Box 740323

Atlanta, Georgia 30374-0323

Use a payment voucher with a valid scanline.

Only complete this voucher if you owe

taxes.

Complete the voucher in its entirety.

Write your SSN or FEIN on your check or money order. Make your check or money order payable to: Georgia Department of Revenue Remember if the due date falls on a weekend or holiday, the tax shall be due on the next day that is not a weekend or holiday.

Mail your voucher and payment to the address listed below if your return was filed electronically. Mail your return, payment voucher and payment to the address that appears on the return if filing a paper return.

Mail this entire page.

Staple your payment and voucher together.

Print on both sides of the paper.

Handwrite any information.

$

Do:

Do not:

525-TV

Dos and Don ts Checklist for the Individual/Fiduciary (525-TV) Payment Voucher 2022

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X

ICILIOUS C STINSON ***-**-****

509 TREE SUMMIT PARKWAY

DULUTH GA 30096

X

25,969

25,969

4,086

30,055

289

29,766

12,950

759

13,709

16,057

Page 08

Department of the Treasury Internal Revenue Service IRS Use Only Do not write or staple in this space. Credit for other dependents

Married filing

jointly or

Qualifying

surviving spouse,

$25,900

If you checked

any box under

Standard

Deduction,

see instructions.

1037 CPTS 2US011 Form (2022

Foreign postal code

Single or

Married filing

separately,

$12,950

Head of

household,

$19,400

OMB No. 1545-0074

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. Presidential Election Campaign 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

(2) Social security (3) Relationship (4) Check the box if qualifies for (see instructions):

(1) First name Last name number to you Child tax credit Attach Form(s)

W-2 here. Also

attach Forms

W-2G and

1099-R if tax

was withheld.

If you did not

get a Form

W-2, see

instructions.

Attach Sch. B

if required.

Standard

Deduction for

)

You Spouse

SPA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Head of household (HOH)

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.

If more

than four

dependents,

see instructions

and check

here

Age/Blindness

Single Married filing jointly Married filing separately (MFS) Qualifying surviving Check only spouse (QSS)

one box. If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child s name if the qualifying person is a child but not your dependent:

At any time during 2022, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, gift, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) You as a dependent Your spouse as a dependent

Spouse itemizes on a separate return or you were a dual-status alien Were born before January 2, 1958 Are blind Was born before January 2, 1958 Is blind

(see instructions):

Total amount from Form(s) W-2, box 1 (see instructions) Household employee wages not reported on Form(s) W-2 Tip income not reported on line 1a (see instructions) Medicaid waiver payments not reported on Form(s) W-2 (see instructions) Taxable dependent care benefits from Form 2441, line 26 Employer-provided adoption benefits from Form 8839, line 29 Wages from Form 8919, line 6

Other earned income (see instructions)

Nontaxable combat pay election (see instructions)

Add lines 1a through 1h

Tax-exempt interest Taxable interest

Qualified dividends Ordinary dividends

IRA distributions Taxable amount

Pensions and annuities Taxable amount

Social security benefits Taxable amount

If you elect to use the lump-sum election method, check here (see instructions) Capital gain or (loss). Attach Schedule D if required. If not required, check here Other income from Schedule 1, line 10

Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your Adjustments to income from Schedule 1, line 26

Subtract line 10 from line 9. This is your

(from Schedule A)

Qualified business income deduction from Form 8995 or Form 8995-A Add lines 12 and 13

Subtract line 14 from line 11. If zero or less, enter -0-. This is your Yes No

Someone can claim:

You: Spouse:

1 a 1a

b 1b

c 1c

d 1d

e 1e

f 1f

g 1g

h 1h

i 1i

z 1z

2a 2a b 2b

3a 3a b 3b

4a 4a b 4b

5a 5a b 5b

6a 6a b 6b

c

7 7

8 8

9 total income 9

10 10

11 adjusted gross income 11

12 Standard deduction or itemized deductions 12

13 13

14 14

15 taxable income 15

Filing Status

Dependents

1040

Digital

Assets

Standard

Deduction

U.S. Individual Income Tax Return

Income

1040 2022

CANDACE BROWN (RTRP)

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. . .

1,724

1,724

1,724

577

2,301

2,377

2,377

2,676

2,676

5,053

2,752

2,752

291471024 X

22321022603599911

LABOR

************@*****.***

P00877119

BROWN & ASSOCIATES TAX ACCT 478-***-****

616 POPLAR STREET MACON GA 312**-**-*******

Page 09

Form (2022)

If you have a

qualifying child,

attach Sch. EIC.

Direct deposit?

See instructions.

Joint return?

See instructions.

Keep a copy for

your records.

Email address

Form 1040 (2022) Page

. .

Designee s Phone Personal identification

name no. number (PIN)

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, must Date Spouse s occupation If the IRS sent your spouse an Identity Protection PIN, enter it here

(see inst.)

Phone no.

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

Firm s name Phone no.

Firm s address Firm s EIN

1037 CPTS 2US012

both sign.

SPA Go to www.irs.gov/Form1040 for instructions and the latest information.

(see instructions). Check if any from Form(s):

Routing number

Account number

Tax 8814 4972

Amount from Schedule 2, line 3

Add lines 16 and 17

Child tax credit or credit for other dependents from Schedule 8812 Amount from Schedule 3, line 8

Add lines 19 and 20

Subtract line 21 from line 18. If zero or less, enter -0- Other taxes, including self-employment tax, from Schedule 2, line 21 Add lines 22 and 23. This is your

Federal income tax withheld from:

Form(s) W-2

Form(s) 1099

Other forms (see instructions)

Add lines 25a through 25c

2022 estimated tax payments and amount applied from 2021 return Earned income credit (EIC)

Additional child tax credit from Schedule 8812

American opportunity credit from Form 8863, line 8 Reserved for future use

Amount from Schedule 3, line 15

Add lines 27, 28, 29, and 31. These are your

Add lines 25d, 26, and 32. These are your

34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you Amount of line 34 you want . If Form 8888 is attached, check here Type: Checking Savings

Amount of line 34 you want

Subtract line 33 from line 24. This is the .

For details on how to pay, go to www.irs.gov/Payments or see instructions Estimated tax penalty (see instructions)

Do you want to allow another person to discuss this return with the IRS? See instructions Complete below.

16 1 2 3 16

17 17

18 18

19 19

20 20

21 21

22 22

23 23

24 total tax 24

25

a 25a

b 25b

c 25c

d 25d

26 26

27 27

28 28

29 29

30 30

31 31

32 total other payments and refundable credits 32

33 total payments 33

overpaid 34

35a refunded to you 35a

b c

d

36 applied to your 2023 estimated tax 36

37 amount you owe

37

38 38

Yes. No

1040

Third Party

Designee

2

Tax and

Credits

Payments

Refund

Amount

You Owe

Paid

Preparer

Use Only

Sign

Here

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ICILIOUS C STINSON ***-**-****

4,086

4,086

Page 10

Department of the Treasury

Internal Revenue Service

OMB No. 1545-0074

Attachment

Sequence No.

1037 CPTS 2US0A1 Schedule 1 (Form 1040) 2022

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

Go to www.irs.gov/Form1040 for instructions and the latest information. SPA For Paperwork Reduction Act Notice, see your tax return instructions. Name(s) shown on Form 1040, 1040-SR, or 1040-NR

(Form 1040)

Your social security number

1 Taxable refunds, credits, or offsets of state and local income taxes Alimony received

Date of original divorce or separation agreement (see instructions): Business income or (loss). Attach Schedule C

Other gains or (losses). Attach Form 4797 4

Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F

Unemployment compensation

Other income:

Net operating loss Gambling

Cancellation of debt

Foreign earned income exclusion from Form 2555 Income from Form 8853

Income from Form 8889

Alaska Permanent Fund dividends

Jury duty pay

Prizes and awards

Activity not engaged in for profit income

Stock options

Income from the rental of personal property if you engaged in the rental for profit but were not in the business of renting such property Olympic and Paralympic medals and USOC prize money (see instructions)

Section 951(a) inclusion (see instructions)

Section 951A(a) inclusion (see instructions)

Section 461(l) excess business loss adjustment

Taxable distributions from an ABLE account (see instructions) Scholarship and fellowship grants not reported on Form W-2 s Nontaxable amount of Medicaid waiver payments included on Form 1040, line 1a or 1d Pension or annuity from a nonqualifed deferred compensation plan or a nongovernmental section 457 plan

Wages earned while incarcerated

Other income. List type and amount:

Total other income. Add lines 8a through 8z

Combine lines 1 through 7 and 9. Enter here and on Form



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