Professional Documents
Culture Documents
1545-0008
a Control number 1 Wages, tips, other compensation 2 Federal income tax withheld a Control number 11 Wages, tips, other compensation 12 Federal income tax withheld
645613 120227 39 26492.36 5613 I 120227 26492.36
3 Social securitywages 4 Social securitytax withheld 3 Social security wages 4 Social security tax wijhheld
.
90000.00 5579.36 90000.0 5579.36
5 Medicarewages and tips 6 Medicaretax withheld 5 Medicare wages and tips 6 Medicare tax withheld
130141 17 1887 05 ]l' 130 1887.05
c Employer's name, address, and ZIP code , c Employer'sname, address, and ZIPcode
RW.JUHAT RAIlfAY 186 180 RWJUH AT RAHNAY 186
865 STONE STREET i 865 STONE STREET
RAIlfAY, NEW JERSEY 07065 IRAIlfAY, NEW JERSEY 07065
UIDI 221487305000 ! UIDI 221487305000
7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social securitytips" 8 Allocatedtips 9 Advance EICpayment
10 Dependent care benefits 11 Nonqualified plans c12a 10 Dependent care benefits 11 Nonqualifiedplans c12a
I 44 16 3C I 44 16
b. Employeridentificationnumber c12b b. Employer identification number c12b
22 -1487305 lE I 9913 78 22-1487305 3E I 9913 78
--'Other c12c 14Other c12c
SI [ 124.50 3 I SDI 124.50 3 I
UNEM 99.61 c12d UNEN '99.61 c12d
\lIDPF 6.23 3 I \llDPF 6.23 s I
e Employee'sname, address, and Zip code e Employee'sname, address, and Zip code
LUZ NERCADO 00628 LUZ NERCADO
32 WOODVIEW AVENUE I 32 IfOODVIEW AVENUE
FORDS, NJ 08863 FORDS, NJ 08863
.2W - 2 Statement
etc.
6755
Copy 2 for EMPLOYEE'S 19 Localincometax 20 Locality name 20 Locality name
State, City, or Local
Income Tax Return
Department of the Treasu~nternal Revenue Service Department of the Treasury-Internal Revenue Service
a Control number 11 Wages, tips, other compensation 12 Federal income tax withheld a Control number 11 Wages, tips, other compensation 12 Federal income tax withheld
645613 645613 I 120227.39 26492.36
3 Social security wages 3 Social security wages 4 Social security tax withheld
90000.00 5579.36 90000.00 5579.36
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicaretax withheld
I
130141.17 1887.05 2 130141.17 1887.05
c Employer'sname, address, and ZIPcode c Employer's name, address, and ZIP code
RW.JUH AT RAIlfAY
865 STONE STREET
RAIlfAY, NEW JERSEY
186
07065
UIDI 221487305000
180 RWJUH AT RAIlfAY R86
865 STONE STREET
RAIlfAY,
NEW JERSEY
UIDI 221487305000
07065 /'
7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social security tips 8 Allocated tips 9 Advance EIC payment I
10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12 10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12
rc I 44.16 C I 44.16
b. Employeridentificationnumber 12b b. Employeridentificationnumber 12b
-1487305 I 9913.78 22-1487305 E I 9913.78
14Other 12c 14Other 12c
SI I 124 .50 I SDI 124 .50 I
12d 12d
UN EN 99.61
\lIDPF 6.23 I
UNEN 99.61
\llDPF 6.23 I .
e Employee'sname, address, and Zip code e Employee's name, address, and Zip code
LUZ NERCADO 00628 LUZ NERCADO
32 NOODVIEW AVENUE 32 IfOODVIEW AVENUE
FORDS, NJ 08863 FORDS, NJ 08863
Third-party
siCk pay
d Employee social security number
135-84-2049
16 State wages, tips,
131811.67
etc.
DepartmentoftheTreasury-lnlernal
RevenueService DepartmenloftheTreasury-lntemal
Revenue'
. This information is being furnished to the Internal Revenue Service. If you are
This information is being furnished to the Internal Revenue Service required to file a tax return, a negligence penalty or other sanction may be imposed (See Notice to
II on you ifthisincome istaxable toreport it.
andyoufail onback of C1
I
--
r
Form 1040X
(Rev November 2005)
Department of the Treasury ~ Internal Revenue Service
Amended U.S. Individual Income Tax Return OMS No. 1545-0074
~ See separate instructions.
---- -------- - . . ___ ___n - --- 2005
- - - - 1 -. -- - - _ __ ded
ended ,
Your first name MI last name Your social security number
LUZ R. MERCADO 135-84-2049
MI last name
Please If a joint return, spouse's first name Spouse's social security number
print
or Homeaddress(no.and street)or P.O. box if mail is not deliveredto your home Apt no. Phonenumber
type
32 WOODVIEW AVENUE 732-499-6117
City, townor postoffice.If you havea foreignaddress,see instructions. State ZIP code
For PaperworkReduction
FORDS, NJ 08863 Act Notice, see instructions.
A If the address shown above is different from that shown on your last return filed with the IRS and you would like us to change it,
check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _. . . . . . . . .
B Filing status. Be sure to complete this line. Note. You cannot change from joint to separate returns after the due date.
On originalreturn ~ D Single D Married filing jointly D Married filing separately ~ Head of household D Qualifying widow(er)
I
LUZ R. MERCADO
!':orm 1040X (Rev 11-2005) 135-84-2049 Page 2
Parl1U:1j Exemptions. See Form 1040 or 1040A instructions.
Complete this part only if you are: A Original number C Correct
· Increasing or decreasing the number of exemptions claimed on line 6d
of the return you are amending, or
of exemptions
reported or as
B Net change number of
exemptions
·individualsdisplacedby HurricaneKatrina.
Increasing or decreasing the excemption amount for housing previously adjusted
33 Dependents (children and other) not claimed on original (or adjusted) return:
(a) First name Last name -I (b) Der endent's (c) Dependent's (d) Number of children
socia secunty relationship v' if on 33 who:
number to you qualifying
child for
child tax
credit · lived with you ~
. did not live
D
with you due to
divorce or sep-
aration (see
instructions)..
Dependents
~ D
on 33 not
entered above ~
Explanation of Changes
Enter the line number from page 1 of the form for each item you are changing and give the reason for each change. Attach only
the supporting forms and schedules for the items changed. Ifyou do not attach the required information, your Form 1040X may
be returned. Be sure to include your name and social security number on any attachments.
If the change relates to a net operating loss carryback or a general business credit carryback, attach the schedule or form that
shows the year in which the loss or credit occurred. See the instructions. Also, check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~
PartIII Presidential Election Cam ai n Fund. Checkin below will not increase your tax or reduce your refund.
If you did not previously want $3 to go to the fund but now want here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
to, check ~
If a joint return and your spouse did not previously want $3 to go to the fund but now wants to, check here.. . . . . . . . . . . . . . . . . . . . . . . . .. ~
FDIA1812L 12102105
I
SCHEDULE A Itemized Deductions OMS No. 1545-0074
(Form 1040)
LUZ R. MERCADO
Medical Caution. Do not include expenses reimbursed or paid by others.
and
and dental expenses (see instructions). .. ..... .. .. .... .... .. ....
Dental 1 Medical
DYes.
for lines 4 through 27. Also, enter this amount on Form 1040, line 40.
Your deduction may be limited. See instructions for the amount to enter. } ~I 28
BAA For Paperwork Reduction Act Notice, see Form 1040 instructions. FDIA0301L 11/18/05 Schedule A (Form 1040) 20D5
I
OMS No. 1545-0074
Form 6251 Alternative MinimumTax - Individuals
(Rev January 2006)
Department of the Treasury ~ See separate instructions. 2005
Attachment
Internal Revenue Service (99) ~ Attach to Fonn 1040 or Form 1040NR. Sequence No. 32
Name(s) shown on Form 1040 Yoursocial security number
23 Research and experimental costs (difference between regular tax and AMT). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23
24 Income from certain installment sales before January 1, 1987. . . .. . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . .. 24
25 Intangible drilling costs preference. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 25
26 Other adjustments, including income-based related adjustments. . . .. . . . . .. . . . . . . . . . . . . . . . . .. . . .. . . . . .. . . .. 26
27 Alternative tax net operating loss deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 27
28 Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately and line 28
is more than $191,000, see instructions.), 1 28 87,550.
~artU I Alternative Minimum Tax
29 Exemption. (If this form is for a child under age 14, see instructions.)
AND line 28 is THEN enter on
IF your filing status is ... not over. .. line 29 ...
Single or head of household $112,500.............. $40,250
Married filing jointly or qualifying widow(er). . . . . . . . . . . . . .
Married filing separately. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If line 28 is over the amount shown above for your filing status, see instructions.
150,000. . . . . . . . . . . . . .
75,000. . . . . . . . . . . . . .
58,000
29,000 } .... ... 40,250.
30 Subtract line 29 from line 28. If zero or less, enter -0- here amI on lines 33 and 35 and stop here.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47,300.
31 -If you reported capital gain distributions directly on Form 1040, line 13; you reported
qualified dividendson Form 1040,line 9b; or you had a gain on both lines 15 and 16 of
}
ScheduleD (Form 1040) (as refiguredfor the AMT, if necessary),complete Part III on page
2 and enter the amount from line 55 here. ..... .. 12,298.
- All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately),
32
multiply line 30 by 26% (.26). Otherwise, multiply line 30 by 28% (.28) and subtract $3,500
($1,750 if married filing separately) from the result.
Alternative minimum tax foreign tax credit (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
J
33 Tentative minimum tax. Subtract line 32 from line 31. . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 I 12,298.
34 Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040,
line 47). If you used Schedule J to figure your tax, the amount for line 44 of Form 1040 must be refigured
without using Schedule J (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 9,729.
35 Alternative minimum tax. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on
Form 1040,line 45. .. .. .. .. .. . .. .. .. ... . . . .. 35 2,569.
BAA For Paperwork Reduction Act Notice, see separate instructions. FDIA5312L01113/06 Form 6251 (2005) (Rev 1-2006)
I
NJ-'040X STATE OF NEW JERSEY
2005 AMENDED
INCOME TAX RESIDENT RETURN
For Tax Year Jan. Dec 31,2005, Or Other Tax Year Beginning , 2005, Ending
Checkhere---
Checkhere--- R If you
jointdid not and
return previouslywant
if spousedidtonot
have $1 go to the fund
previouslywant but $1
to have nowtowant
go toitthe
to do so.but now wants it to do so.
fund
As Originally Amended
Reported (See Instructions)
'0'
14 Wages,salaries,tips, and other
employee compensation. . . . . . . . . . . . . . . . . . . . . . . . . 14 131,812
". * r 131,812
Ii! [
15a Taxable Interest Income.. .. ...... . . .. ...... .... . 15a 18 "I 18
I
LUZ R. MERCADO
-'135-84-2049
Amended
Page
- 2
As Originally
Reported (See Instructions)
27 "
Total Income (From Line 26, Page 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 131 830 131 830
28 Other Retirement Income Exclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
29 New Jersey Gross Income (Subtract Line 28 from Line 27).. . . . . . . . . . . . 29 131 830 131 830
30 Exemptions (See instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 8.500 7 000
31 Medical Expenses (See instructions NJ-104D} . . . . . . . . . . . . . . . . . . . . . . . . . 31
32 "
Alimony and separatemaintenancepayments.... .. .. ...... ... . .. .. ... 32
33 Qualified Conservation Contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
34 Health Enterprise Zone Deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
35 Total Exemptionsand Deductions(Add Lines 30, 31,32,33, and34}... 35 8.500 7 000
36 Taxable Income (Subtract Line35fromLine29)...... ......... . ....... 36 123 330 124 830
37 PropertyTax Deduction... ........ . ..... .... .... .... ......... . ....... 37 5.987 5 987
38 NEWJERSEYTAXABLEINCOME(Subtract Line 37 from Line 36)...... 38 117 343 118 843
39 TAX: (see instructions). . .. .. .. .. . . . . .. .. . . . . ... . . . .. .. . . .. .. . . . . . . .. . 39 3 708 3 791
40 Credit For Income Taxes Paid To Other Jurisdictions.. ......... . ....... 40 '.'.
i
41 Balance of Tax (Subtract Line 40 from Line 39). . . . . . . . . . . . . . . . . . . . . . . . 41 3 708 .....
3791
42 UseTax Due on Out-of-StatePurchases(see instructionsNJ.l040).. . . . 42
43 Total Tax (Add Line 41 and Line 42). . . . . . . . . .. . . . . . . . . . . .. .. . . . . . . .. . 43 3 708 3 791
44 Total New Jersey Income Tax Withheld.. . . . . .. .. . . .. .. . . .. .. . . . . . . .. . 44 6.756 6 756
45 Property Tax Credit. . . . . .. .. . . . . . . . . . . . . . . . . .. . . . . .. . . . . .. .. . . . . . . .. . 45 '"
46 NewJerseyEstimatedTax Payments/Creditfrom 2004tax return.. . . . . . 46
47 New Jersey Earned Income Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 f
48 EXCESS New Jersey UI/HCIWD Withheld (see instructions NJ-104D). . . . 48
49 EXCESS New JerseyDisabilitYInsuranceWithheld(see instructions NJ-1040).. . . . . . . . . . . 49
50 Amount Paid with original return, assessments and/or with request
for extension to file. .. . . .. .. . . . . .. . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . .. . . . 50
51 Total payments (Add Lines 44 through 50} .. ..... .. .. .... ..... .. ... ... 51 6.756 6 756
52 Refund previously issued from Original Return. . . . . . . . . . . . . . . . . . . . . . . . . 52 3 048 3 048
53 Net Payments(SubtractLine 52 from Line 51).... .... .. .. ........ . ... . 53 3.708 :1 3.708
54 If payments(Line 53) are LESSTHANtax (Line43) enter AMOUNT OFTAXYOUOWE... .. .... .. .. .... 54 83
55 If payments (Line 53) are MORE THAN tax (line 43) enter OVERPAYMENT. ................ ........ .... 55
56 Amount of Line 55 to be (A) REFUNDED. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56A
(B) CREDITED to vour 2006 tax.. .. .. .. .. .. .. . .. .. .. . .. .. .. .. .. .. .. .. .. .. .. 56B
Enterbelow,name,socialsecuritynumber,and addressas shownon orinal return(if sameas indicatedon page I, write'Same').If changingfrom separateto joint return,enter names,
socialsecuritynumbers,and addressesusedon originalreturns. (Note: ou cannotchangefrom jointto separatereturnsafterthe duedate has passedunlessyou havedoneso for Federal
tax purposes.)
Same
Your SSN
Spouse's SSN
Explanationof Changes to Income,Deductions, and Credits. Enter the linereference for whichyou are reportinga change and give the
reason foreach change.
See Statement 1
NJIA0412L 12/29/05