2019 Chandler D Form 1040 Individual Tax Return - Records

Electronic Filing Instructions for your 2019 Federal Tax Return
Important: Your taxes are not finished until all required steps are completed.
Donald R & Barbara J Chandler

19640 Coastal Shore Terrace
Land O Lakes, FL 34638
|
Balance | Your federal tax return (Form 1040-SR) shows a balance due of $415.00.
Due/ |
Refund | Your return shows you have elected to pay your balance due of $415.00
| by Direct Debit using the following information:
| - Amount Withdrawn: $415.00
| - Account Number: 8712062960
| - Routing Transit Number: 063107513
| - Date of Withdrawal: 04/15/2020
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your federal return
Keep |
|
______________________________________________________________________________________
|
2019 | Adjusted Gross Income $ 215,293.00
Federal | Taxable Income $ 188,293.00
Tax | Total Tax $ 33,510.00
Return | Total Payments/Credits $ 33,095.00
Summary | Payment Due $ 415.00
| Effective Tax Rate 15.56%
|
______________________________________________________________________________________
|
Estimated | Estimated Payments for 2020 - Do not mail these vouchers with your
Payments to | 2019 income tax return. The estimated vouchers displayed below are
Make for Next | used to prepay your 2020 income taxes that will be filed next year.
Year's Return | If you expect to owe more than $1,000 in 2020, you may incur
| underpayment penalties if you do not make these four estimated tax
| payments. This printout includes your estimated tax vouchers for your
| federal estimated taxes (Form 1040-ES).
|
| Mail payments according to the schedule below:
|
| Voucher Number Due Date Amount
| 1 04/15/2020 $ 2,736.00
| 2 06/15/2020 $ 2,736.00
| 3 09/15/2020 $ 2,736.00
| 4 01/15/2021 $ 2,736.00
|
| Include a separate check or money order for each payment, payable to
| "United States Treasury". Write your social security number and "Form
| 1040-ES" on each check.
|
| Mail payments to:
| Internal Revenue Service
| P.O. Box 1300
| Charlotte, NC 28201-1300
|
______________________________________________________________________________________
Page 1 of 1
I Detach Here and Mail With Your Payment I
Calendar Year '
Department of the Treasury
Internal Revenue Service Due 04/15/2020 2020 Form 1040-ES Payment Voucher 1
File only if you are making a payment of estimated tax by check or money order. Mail this
voucher with your check or money order payable to the 'United States Treasury.' Write
Amount of estimated tax
your social security number and ' 2020 Form 1040-ES' on your check or money order. Do not you are paying by check
send cash. Enclose, but do not staple or attach, your payment with this voucher. or money order . . . . . . . . . G 2,736.
REV 02/23/20 TTW 1555
417-54-0387 272-42-4709
DONALD R CHANDLER INTERNAL REVENUE SERVICE
BARBARA J CHANDLER PO BOX 1300
19640 COASTAL SHORE TERRACE CHARLOTTE NC 28201-1300
LAND O LAKES FL 34638
417540387 VU CHAN 30 0 202012 430

Calendar Year '
REV 02/23/20 TTW 1555
417-54-0387 272-42-4709
417540387 VU CHAN 30 0 202012 430

Calendar Year '
REV 02/23/20 TTW 1555
417-54-0387 272-42-4709
417540387 VU CHAN 30 0 202012 430

Calendar Year '
REV 02/23/20 TTW 1555
417-54-0387 272-42-4709
417540387 VU CHAN 30 0 202012 430

1040-SR U.S. Tax Return for Seniors 2019
Form Department of the Treasury—Internal Revenue Service (99)
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
Filing Single Married filing jointly Married filing separately (MFS)

Status Head of household (HOH) Qualifying widow(er) (QW)
Check only one If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s
box. 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
Donald R Chandler 417-54-0387
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number
Barbara J Chandler 272-42-4709
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Check here if you, or your spouse if filing
19640 Coastal Shore Terrace jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your
Land O Lakes FL 34638 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see inst. and here a
Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien
You:
Age/Blindness Were born before January 2, 1955 Are blind
Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4) if qualifies for (see inst.):
(1) First name Last name Child tax credit Credit for other dependents
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . 1

Attach 2a Tax-exempt interest . . 2a b Taxable interest . . . 2b 4,111.
Schedule B
if required. 3a Qualified dividends . . . 3a 331. b Ordinary dividends . . 3b 331.
4a IRA distributions . . . . 4a b Taxable amount . . . 4b 59,796.
c Pensions and annuities . 4c d Taxable amount . . . 4d 111,695.
5a Social security benefits . . 5a 46,306. b Taxable amount . . . 5b 39,360.
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 215,293.
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . 8a
b Subtract line 8a from line 7b. This is your adjusted gross income . . . . a 8b 215,293.
Standard
Deduction 9 Standard deduction or itemized deductions (from Schedule A) 9 27,000.
See Standard
Deduction Chart
10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10
below. 11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . 11a 27,000.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . 11b 188,293.
Standard Add the number of boxes checked in the “Age/Blindness” section of Standard Deduction . . . a
Deduction IF your filing AND the number of THEN your standard IF your filing AND the number of THEN your standard
status is. . . boxes checked is. . . deduction is. . . status is. . . boxes checked is. . . deduction is. . .
Chart*
1 13,850 Head of 1 20,000
Single
2 15,500 household 2 21,650
Married 1 25,700 1 13,500
filing jointly 2 27,000 Married filing 2 14,800
or
Qualifying 3 28,300 separately 3 16,100
widow(er) 4 29,600 4 17,400
* Don’t use this chart if someone can claim you (or your spouse if filing jointly) as a dependent, your
spouse itemizes on a separate return, or you were a dual-status alien. Instead, see instructions.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040-SR (2019)
Form 1040-SR (2019) Page 2
12a Tax (see instructions). Check if any from:

1 Form(s) 8814 2 Form 4972 3 12a 33,510.
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . a 12b 33,510.
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 33,510.
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . 15 0.
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . a 16 33,510.
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . 17 25,920.
18 Other payments and refundable credits:
• If you have
a qualifying a Earned income credit (EIC) . . . . . . . . . . . . 18a
child, attach
Sch. EIC.
• If you have
b Additional child tax credit. Attach Schedule 8812 . . . . 18b
nontaxable
combat pay, c American opportunity credit from Form 8863, line 8 . . . 18c
see
instructions. d Schedule 3, line 14 . . . . . . . . . . . . . . . 18d 7,175.
e Add lines 18a through 18d. These are your total other payments and refundable credits a 18e 7,175.
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . a 19 33,095.
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? a b Routing number X X X X X X X X X a c Type: Checking Savings
See
instructions. a d Account number X X X X X X X X X X X X X X X X X
22 Amount of line 20 you want applied to your 2020 estimated tax a 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions a 23 415.
You Owe
24 Estimated tax penalty (see instructions) . . . . . . a 24
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee No
(Other than Designee’s Phone Personal identification
paid preparer) name a no. a number (PIN) a
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of
Sign my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information
Here of which preparer has any knowledge.
Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
F
Joint return? Retired (see inst.)

See instructions.
Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for
Identity Protection PIN, enter it here
your records.
Retired (see inst.)
Phone no. Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Preparer Self-employed
Use Only Firm’s name a Self-Prepared Phone no.

Firm’s address a Firm’s EIN a
Go to www.irs.gov/Form1040SR for instructions and the latest information.

BAA REV 02/23/20 TTW Form 1040-SR (2019)
SCHEDULE 3 OMB No. 1545-0074
Additional Credits and Payments
2019
(Form 1040 or 1040-SR)
a Attach to Form 1040 or 1040-SR.
Department of the Treasury Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 03
Name(s) shown on Form 1040 or 1040-SR Your social security number
Donald R & Barbara J Chandler 417-54-0387
Part I Nonrefundable Credits
1 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . . . . . 1
2 Credit for child and dependent care expenses. 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 credits from Form: a 3800 b 8801 c 6
7 Add lines 1 through 6. Enter here and include on Form 1040 or 1040-SR, line 13b . . . . . . . 7
Part II Other Payments and Refundable Credits
8 2019 estimated tax payments and amount applied from 2018 return . . . . . . . . . . . 8 7,175.
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 Credits from Form: a 2439 b Reserved c 8885 d 13
14 Add lines 8 through 13. Enter here and on Form 1040 or 1040-SR, line 18d . . . . . . . . . 14 7,175.
For Paperwork Reduction Act Notice, see your tax return instructions. REV 02/23/20 TTW Schedule 3 (Form 1040 or 1040-SR) 2019
SCHEDULE B OMB No. 1545-0074
Interest and Ordinary Dividends
2019
(Form 1040 or 1040-SR)
a Go to www.irs.gov/ScheduleB for instructions and the latest information.
Department of the Treasury a Attach to Form 1040 or 1040-SR.
Attachment
Internal Revenue Service (99) Sequence No. 08
Name(s) shown on return Your social security number
Part I 1 List name of payer. If any interest is from a seller-financed mortgage and the Amount
buyer used the property as a personal residence, see the instructions and list this
Interest interest first. Also, show that buyer’s social security number and address a
(See instructions
Bancorpsouth Bank 1,088.67
and the Ally Bank 2,978.17
instructions for Dollar Bank 14.99
Forms 1040 and
1040-SR, line 2b.) Wells Fargo Bank NA 28.93
Note: If you 1
received a Form
1099-INT, Form
1099-OID, or
substitute
statement from
a brokerage firm,
list the firm’s
name as the
payer and enter
the total interest
shown on that
form.
2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . . 2 4,110.76
3 Excludable interest on series EE and I U.S. savings bonds issued after 1989.
Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . . 3
4 Subtract line 3 from line 2. Enter the result here and on Form 1040 or 1040-SR,
line 2b . . . . . . . . . . . . . . . . . . . . . . . . a 4 4,110.76
Note: If line 4 is over $1,500, you must complete Part III. Amount
Part II 5 List name of payer a CMS Energy 330.94
Ordinary
Dividends
(See instructions
and the
instructions for
Forms 1040 and
1040-SR, line 3b.) 5
Note: If you
received a Form
1099-DIV or
substitute
statement from
a brokerage firm,
list the firm’s
name as the
payer and enter
the ordinary
dividends shown
on that form.
6 Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR,
line 3b . . . . . . . . . . . . . . . . . . . . . . . . a 6 330.94
Note: If line 6 is over $1,500, you must complete Part III.
Part III You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a
Yes No
foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust.
Foreign 7a At any time during 2019, did you have a financial interest in or signature authority over a financial
Accounts account (such as a bank account, securities account, or brokerage account) located in a foreign
and Trusts country? See instructions . . . . . . . . . . . . . . . . . . . . . . . .
Caution: If If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and Financial
required, failure Accounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114
to file FinCEN and its instructions for filing requirements and exceptions to those requirements . . . . . .
Form 114 may
result in
b If you are required to file FinCEN Form 114, enter the name of the foreign country where the
substantial financial account is located a
penalties. See 8 During 2019, did you receive a distribution from, or were you the grantor of, or transferor to, a
instructions. foreign trust? If “Yes,” you may have to file Form 3520. See instructions . . . . . . . . .
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 02/23/20 TTW Schedule B (Form 1040 or 1040-SR) 2019
Tax History Report 2019
G Keep for your records
Name(s) Shown on Return

Five Year Tax History:
2015 2016 2017 2018 2019
Filing status MFJ MFJ MFJ MFJ MFJ
Total income 197,323. 215,774. 221,668. 223,617. 215,293.
Adjustments to income
Adjusted gross income 197,323. 215,774. 221,668. 223,617. 215,293.
Tax expense 3,330. 8,167. 4,035. 6,140. 1,958.
Interest expense 4,192.
Contributions 12,972. 17,176. 19,714. 27,620. 14,169.
Misc. deductions 1,730.
Other itemized ded’ns 6,499. 16,808. 2,742.
Total itemized/
standard deduction 16,302. 37,764. 23,749. 50,568. 27,000.
Exemption amount 8,000. 8,100. 8,100. 0. 0.
QBI deduction
Taxable income 173,021. 169,910. 189,819. 173,049. 188,293.
Tax 35,468. 34,528. 39,999. 30,084. 33,510.
Alternative min tax
Total credits
Other taxes
Payments 35,073. 36,853. 38,958. 35,833. 33,095.
Form 2210 penalty
Amount owed 395. 1,041. 415.
Applied to next
year’s estimated tax
Refund 2,325. 5,749.
Effective tax rate % 17.97 16.00 18.04 13.45 15.56
**Tax bracket % 28.0 28.0 28.0 24.0 24.0
**Tax bracket % is based on Taxable income.

Charitable Organization Worksheet 2019
Name(s) Shown on Return Social Security Number

Charity Name ANIMAL LEGAL DEFENSE FUND-ALDF

Address 170 E Cotati Ave
City Cotati State CA ZIP code 94931
Combined Amounts Worksheet

Note: Amounts entered in worksheets below will be summarized in this worksheet.
Ref. No. Date Donation Description Donation Type Donation Amount
1 (not needed) Money 50.00
Total: 50.00
Prior Year Total: 50.00
ItsDeductible Item Donations Worksheet

Note: Amounts in this worksheet can only be entered using the interview process.
Ref. No. Donat. Date VM* Item Description High Value Qty. Med. Value Qty. Total Value
* VM, Valuation Method. 1 indicates it has been valued by ItsDeductible, 0 indicates you have created
a custom valuation item.
Charitable Organization Worksheet page 2 2019
Other Item Donations Worksheet

Note: Double-click to enter additional information if needed.
Ref. No. Donated Date Donation Description Donation Cost

Acquired Date Donation Type How Valued
How Acquired Donation Value Donation Allowed
Detail of Money Donations Worksheet
Don.
Ref. No. Donat. Date Each Don. Amt Per Yr Once or Recurring 2019 Amount
1 (not needed) 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur
Detail of Mileage and Transportation Costs Worksheet
Ref. No. Donation Date Description of Trip

Miles Per Trip Trips Per Yr Once or Recurring Miles Driven
Other Costs Description of Other Costs Value of Miles Total Donation Value
Once Recur
Once Recur
Once Recur
Detail of Stock Donations Worksheet
Stock
Date of Symbol, Value on Date Stock Donation Value
Ref. No. Donation # shares Donation Date Acquired Original Cost
Charitable Organization Questions
1 Was the entire interest given for all property donated to this charity? X Yes No
2 Were restrictions attached to the charity’s right

to use or dispose of any property donated to this charity? Yes No
3 Did you give to anyone other than this charity the right to income from any
of the donated property or to possession of any of the donated property? Yes No
4 What Type of charitable organization was it? Check one:

X (a) 50% charity (b) Other than 50% charity

Charity Name LIBERTY CHURCH

Address 110 E. RIVIERA BLVD
City FOLEY State AL ZIP code 36535

1 Various Money 3,550.00
Total: 3,550.00
Prior Year Total: 13,869.30



Don.
1 Various 3,550.00 1 Once X Recur 3,550.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name EQUINE VOICES RESCUE

Address PO BOX 1685
City GREEN VALLEY State AZ ZIP code 85622

Total: 50.00
Prior Year Total: 30.50



Don.

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name LIBERTY-BACKPACK PROGRAM

Address 110 E RIVIERA BLVD

Total: 500.00
Prior Year Total: 5,601.70



Don.

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name NORTH SHORE ANIMAL LEAGUE

Address 16 Lewyt St
City Port Washington State NY ZIP code 11050

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name TIGER HAVEN, INC

Address 1237 E Weisgarber Rd
City Knoxville State TN ZIP code 37950

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name ALLY CAT ALLIES

Address 7920 Norfolk Ave, Ste 600
City Bethesda State MO ZIP code

1 12/10/2019 Money 35.00
Total: 35.00
Prior Year Total:



Don.
1 12/10/2019 35.00 1 X Once Recur 35.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name ST JUDE CHILDREN'S HOSPITAL

Address PO Box 50
City Memphis State TN ZIP code 38101

1 12/28/2019 Money 100.00
Total: 100.00
Prior Year Total:



Don.
1 12/28/2019 100.00 1 X Once Recur 100.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name ALZHEIMER'S ASSOCIATION

Address 1815 West Market St, Ste 301
City Akron State OH ZIP code 44313

1 12/28/2019 Money 120.00
Total: 120.00
Prior Year Total:



Don.
1 12/28/2019 120.00 1 X Once Recur 120.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name ALDF

Address 170 E Cotati Ave
City Cotati State CA ZIP code 94931

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name GUIDE DOGS FOR THE BLIND

Address PO Box 151200
City San Rafael State CA ZIP code 94915

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name BEST FRIENDS ANIMAL SOCIETY

Address 5001 ANGEL CANYON RD
City KANAB State UT ZIP code 84741

1 12/28/2019 Money 103.00
Total: 103.00
Prior Year Total:



Don.
1 12/28/2019 103.00 1 X Once Recur 103.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name LIFESAVERS

Address PO Box 939
City Bakersfield State CA ZIP code 93302

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name ALS

Address 27001 Agoura Rd Ste 150
City Calabasas Hills State CA ZIP code 91301

1 12/09/2019 Money 25.00
Total: 25.00
Prior Year Total:



Don.
1 12/09/2019 25.00 1 X Once Recur 25.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name ASPCA

Address 424 E 92nd St
City New York State NY ZIP code 10128

1 Various Money 180.00
Total: 180.00
Prior Year Total:



Don.
1 Various 15.00 12 Once X Recur 180.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name PAWS Perf Animal Welfare Soc

Address PO Box 2713
City Lodi State CA ZIP code 95241

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name KEEPERS OF THE WILD

Address PO Box 16538
City Phoenix State AZ ZIP code 85011

1 12/28/2019 Money 25.00
Total: 25.00
Prior Year Total:



Don.
1 12/28/2019 25.00 1 X Once Recur 25.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name HABITAT FOR HORSES

Address PO Box 3767
City Houston State TX ZIP code 77253

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name CASTLETON RANCH

Address PO Box 1226
City Lancaster State CA ZIP code 93584

1 12/28/2019 Money 51.50
Total: 51.50
Prior Year Total:



Don.
1 12/28/2019 51.50 1 X Once Recur 51.50

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name LIBERTY CHURCH

Address 110 E. RIVIERA BLVD

1 Various LIBERTY CHURCH - mileage Mileage 28.98
Total: 28.98
Prior Year Total:



Don.
Once Recur
Once Recur
Once Recur
Once Recur
Once Recur

1 Various LIBERTY CHURCH - mileage

9.0 23 Once X Recur 207.0
28.98 28.98
Once Recur
Once Recur
Stock



Charity Name ARABIAN RESCUE MISSION

Address 42 GLEN RD
City COLESVILLE State NJ ZIP code 07461

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name HABITAT FOR HUMANITY

Address
City AMERICUS State GA ZIP code

1 12/28/2019 Money 100.00
Total: 100.00
Prior Year Total:



Don.
1 12/28/2019 100.00 1 X Once Recur 100.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name KINDNESS RANCH

Address 854 STATE HWY 270
City HARTVILLE State WY ZIP code 82215

1 12/28/2019 Money 75.00
Total: 75.00
Prior Year Total:



Don.
1 12/28/2019 75.00 1 X Once Recur 75.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name LAST CHANCE FOR ANIMALS

Address 8033 SUNSET BLVD #835
City LOS ANGELES State CA ZIP code 90046

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name SOUTHERN WINDS EQUINE RESCUE

Address PO BOX 3863
City WICHITA State KS ZIP code 67201

1 12/28/2019 Money 30.00
Total: 30.00
Prior Year Total:



Don.
1 12/28/2019 30.00 1 X Once Recur 30.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name WOUNDED WARRIOR PROJECT

Address 4899 BELFORT RD
City JACKSONVILLE State FL ZIP code 32256

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name LIBERTY-BACKPACK PROGRA,

Address 110 E RIVIERA BLVD

1 03/09/2019 LIBERTY-BACKPACK PROGRA, - mileage Mileage 2.10
Total: 2.10
Prior Year Total:



Don.
Once Recur
Once Recur
Once Recur
Once Recur
Once Recur

1 03/09/19 LIBERTY-BACKPACK PROGRA, - mileage

15.0 1 X Once Recur 15.0
2.10 2.10
Once Recur
Once Recur
Stock



Charity Name PAWS OF WAR

Address PO BOX 1727
City SMITHTOWN State NY ZIP code 11787

1 12/28/2019 Money 30.00
Total: 30.00
Prior Year Total:



Don.
1 12/28/2019 30.00 1 X Once Recur 30.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name EPILEPSY FDN

Address 8301 PROFESSIONAL PL E, STE 200
City LANDOVER State MD ZIP code 20785

1 12/28/2019 Money 35.00
Total: 35.00
Prior Year Total:



Don.
1 12/28/2019 35.00 1 X Once Recur 35.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name MD ANDERSON CENTER

Address PO BOX 4464
City HOUSTON State TX ZIP code 77210

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name MERCY FOR ANIMALS

Address 8033 SUNSET BLVD, STE 864
City LOS ANGELES State CA ZIP code 90046

1 12/28/2019 Money 46.35
Total: 46.35
Prior Year Total:



Don.
1 12/28/2019 46.35 1 X Once Recur 46.35

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name MORRIS ANIMAL FDN

Address 720 S COLORADO BLVD, #174A
City DENVER State CO ZIP code 80246

1 12/28/2019 Money 35.00
Total: 35.00
Prior Year Total:



Don.
1 12/28/2019 35.00 1 X Once Recur 35.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name PILOTS TO THE RESCUE

Address 931 MANHATTAN AVE, STE 2
City BROOKLYN State NY ZIP code 11222

1 12/28/2019 Money 52.50
Total: 52.50
Prior Year Total:



Don.
1 12/28/2019 52.50 1 X Once Recur 52.50

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name SHRINERS HOSPITALS FOR CHILDREN

Address 2900 ROCKY POINT DR
City TAMPA State FL ZIP code 33607

1 12/28/2019 Money 102.00
Total: 102.00
Prior Year Total:



Don.
1 12/28/2019 102.00 1 X Once Recur 102.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name VESTED INTEREST IN K9'S INC

Address PO BOX 9
City E TAUNTON State MA ZIP code 02718

1 12/28/2019 Money 30.00
Total: 30.00
Prior Year Total:



Don.
1 12/28/2019 30.00 1 X Once Recur 30.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name BIG FISH MINISTRIES

Address NORTH McKENZIE STRET

1 09/28/2019 Summary Items - ItsDeductible 1,088.50
Total: 1,088.50
Prior Year Total:

1 09/28/2019 1 Air Purifier 17.00 1 10.00 0 17.00

1 09/28/2019 1 Costume Jewelry: Bracelet 3.00 3 1.50 0 9.00
1 09/28/2019 1 Table Runner 7.00 3 5.00 0 21.00
1 09/28/2019 1 Costume Jewelry: Earrings 1.50 1 0.75 0 1.50
See Detail of Item Donations - Continued 1,040.00


Don.
Once Recur
Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name PET PARTNERS

Address 345 118th Ave SE, Ste 200
City Bellevue State WA ZIP code 98005-3587

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name AMERICA'S VET DOGS

Address 14643 DALLAS PKWY, STE 900
City DALLAS State TX ZIP code 75254

1 12/31/2019 Money 77.23
Total: 77.23
Prior Year Total:



Don.
1 12/31/2019 77.23 1 X Once Recur 77.23

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name BALDWIN HERITAGE MUSEUM ASSN

Address PO BOX 356
City ELBERTA State AL ZIP code 36530

1 03/21/2019 Summary Items - ItsDeductible 50.00
Total: 50.00
Prior Year Total:

1 03/21/2019 0 1931-32 Montgomery Ward Catalog 20.00 1 0.00 0 20.00

1 03/21/2019 0 1902 Sears Roebuck Catalog (reproduction) 10.00 1 0.00 0 10.00
1 03/21/2019 0 1895 Montgomery Ward Catalog (reproduction) 10.00 1 0.00 0 10.00
1 03/21/2019 0 1931 Bulletin "Opportunity; How to Sell...Heaters" 10.00 1 0.00 0 10.00


Don.
Once Recur
Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name GOODWILL-CYPRESS CREEK

Address 2390 WILLOW OAK DR
City WESLEY CHAPEL State FL ZIP code 33544

1 12/30/2019 Summary Items - ItsDeductible 6,365.75

2 12/30/2019 5 Jewelry-Watches-Gucci Women's Watches-knock offs @ 110.00 Items you valued 550.00
Total: 6,915.75
Prior Year Total:

1 12/30/2019 1 Men's Sweater: Pullover 16.00 1 11.00 0 16.00

1 12/30/2019 1 Men's Sweater: Vest 13.00 1 9.00 0 13.00
1 12/30/2019 1 Bath Towel 2.00 2 0.75 0 4.00
1 12/30/2019 1 Hand Towel 2.50 4 1.50 0 10.00
See Detail of Item Donations - Continued 6,322.75


2 12/30/2019 5 Jewelry-Watches-Gucci Women's Watches-knock offs @ 110.00 1,200.00

Various H - Other (Tangible) Thrift shop value
Purchase 550.00 550.00
Don.
Once Recur
Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock
1 Was the entire interest given for all property donated to this charity? Yes No



Charity Name ANIMALS ANGELS

Address po box 1056
City Westminster State MD ZIP code 21158

1 12/28/2019 Money 30.00
Total: 30.00
Prior Year Total:



Don.
1 12/28/2019 30.00 1 X Once Recur 30.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock



Charity Name TIGER CREEK

Address PO BOX 4968
City TYLER State TX ZIP code 75712

1 12/28/2019 Money 50.00
Total: 50.00
Prior Year Total:



Don.
1 12/28/2019 50.00 1 X Once Recur 50.00

Once Recur
Once Recur
Once Recur
Once Recur

Once Recur
Once Recur
Once Recur
Stock


Blank Form 2019
Name(s) Identification Number

IRA Basis Change
The 2005 basis amount of 219,775 was an error...this was an account value.
Total
Federal Information Worksheet 2019
Part I ' Personal Information
Information in Part I is completely calculated from entries on Personal Information Worksheets.
Taxpayer: Spouse:
First name Donald First name Barbara
Middle initial R Suffix Middle initial J Suffix
Last name Chandler Last name Chandler
Social security no. 417-54-0387 Social security no. 272-42-4709
Occupation Retired Occupation Retired
Date of birth 02/22/1942 (mm/dd/yyyy) Date of birth 03/06/1946 (mm/dd/yyyy)
Age as of 1-1-2020 77 Age as of 1-1-2020 73
Daytime phone (440)669-5965 Ext Daytime phone (440)567-9608 Ext
Legally blind Legally blind
Date of death Date of death
Dependent of Someone Else: Dependent of Someone Else:
Can taxpayer be claimed as dependent of another Can spouse be claimed as dependent of another
person (such as parent)? Yes X No person (such as parent)? Yes X No
If yes, was taxpayer claimed as dependent on that If yes, was spouse claimed as dependent on that
person’s return? Yes No person’s return? Yes No
Credit for the Elderly or Disabled (Schedule R): Credit for the Elderly or Disabled (Schedule R):
Is the taxpayer retired on total Is the spouse retired on total
and permanent disability? Yes No and permanent disability? Yes No
Presidential Election Campaign Fund: Presidential Election Campaign Fund:
Does the taxpayer want $3 to go to the Presidential Does the spouse want $3 to go to the Presidential
Election Campaign Fund? Yes X No Election Campaign Fund? Yes X No
Part II ' Address and Federal Filing Status (enter information in this section)
US Address:
Address 19640 Coastal Shore Terrace Apt no.
City Land O Lakes State FL ZIP code 34638
Foreign Address: Check this box to use foreign address
Address Apt no.
City
Foreign code Foreign country
Foreign province/county Foreign postal code
APO/FPO/DPO address, check if appropriate APO FPO DPO
Home phone
Check to print phone number on Form 1040 Home X Taxpayer daytime Spouse daytime
Print Form 1040-SR instead of Form 1040 X Yes No
Federal filing status:
1 Single
X 2 Married filing jointly
3 Married filing separately
Check this box if you did not live with your spouse at any time during the year
Check this box if you are eligible to claim your spouse’s exemption/blind/over age 65 (see Help)
4 Head of household
If the ’qualifying person’ is your child but not your dependent:
Child’s First name MI Last Name Suff
Child’s social security number
5 Qualifying widow(er)
Check the appropriate box for the year your spouse died 2017 2018
Are you a dependent with a qualifying child Yes No
Enter qualifying person’s name:
Child’s First name MI Last Name Suff
Child’s social security number
Part III ' Dependent/Earned Income Credit/Child and Dependent Care Credit Information
Information in Part III is completely calculated from entries on Dependent/Nondependent Info Worksheets.
Date of birth Date of death Not
(mm/dd/yyyy) (mm/dd/yyyy) qual
credit
Qualified other
Not child/dep Lived dep
C qual care exps with Educ *
Social security o for incurred E taxpyr Tuitn D
First name MI number d child and paid I in and e
Last name Suff Relationship Age e tax cr 2019 C U.S. Fees p
* "Yes" - qualifies as dependent, "No" - does not qualify as dependent

Donald R & Barbara J Chandler 417-54-0387 Page 2
Part IV ' Earned Income Credit Information (you must answer these questions to calculate EIC)
Is the taxpayer or spouse a qualifying child for EIC for another person? Yes No
Was the taxpayer’s (and spouse’s if married filing jointly) home in the United States
for more than half of 2019? Yes No
If the SSN of the taxpayer, or spouse if married filing jointly, was obtained to
get a federally funded benefit, such as Medicaid, and the Social Security card
contains the legend Not Valid for Employment, check this box (see Help)
Check if you are filing head of household and your spouse is a nonresident alien
and you lived with your spouse during the last six months of 2019
Check if you were notified by the IRS that EIC cannot be claimed in 2019 or
if you are ineligible to claim the EIC in 2019 for any other reason
Part V ' Direct Deposit or Direct Debit Information (not applicable for Form 9465)
Do you want to elect direct deposit of any federal tax refund? Yes X No
Do you want to elect direct debit of federal balance due (Electronic filing only)? X Yes No
If you selected either of the options above, fill out the information below:
Name of Financial Institution (optional) WELLS FARGO
Check the appropriate box Checking X Savings
Routing number 063107513 Account number 8712062960
Enter the following information only if you are requesting direct debit of balance due:
Enter the payment date to withdraw from the account above 04/15/2020
Balance-due amount from this return 415.
Part VI ' Additional Information for Your Federal Return

Standard Deduction/Itemized Deductions:
Check this box if you are itemizing for state tax or other purposes even though your itemized
deductions are less than your standard deduction
Check this box if you are married filing separately and your spouse itemized deductions
Check this box to take the standard deduction even if less than itemized deductions X
Real Estate Professionals:
Do you or your spouse qualify for the special passive activity rules for
taxpayers in real property business? (see Help) Yes No
Credit for Qualified Retirement Savings Contributions (Form 8880):

Is the taxpayer a full-time student? Yes No
Is the spouse a full-time student? Yes No
American Opportunity and Lifetime Learning Credit (Form 8863)

For 2019, were you (or your spouse if married) a nonresident alien for any part
of the year, and did not elect to be treated as a resident alien? Yes No
Foreign Tax Credit (Form 1116):

Check this box to file Form 1116 even if you’re not required to file Form 1116
Resident country USA
Excludable Income from Am. Samoa, Guam, Commonwealth of the N. Mariana Islands, or Puerto Rico:
Excludable income of bona fide residents of American Samoa, Guam, or the
Commonwealth of the Northern Mariana Islands
Excludable income from Puerto Rico
Dual Status Alien Return:

Check this box if you are a dual-status alien
Check this box to print ’DUAL-STATUS STATEMENT’ on Form 1040
Third Party Designee:

Caution: Review transferred information for accuracy.
Do you want to allow another person to discuss this return with the IRS? Yes No
If Yes, complete the following:
Third party designee name
Third party designee phone number
Personal Identification number (enter any 5 numbers)
Part VI ' Additional Information for Your Federal Return - Continued
Personal Representative for deceased taxpayers:

Name of personal representative required for E-filed
returns when Form 1310 is not filed or it is not the
surviving spouse
Part VII ' State Filing Information
Identity Protection PIN:

If the IRS sent the taxpayer an Identity Protection PIN, enter it here
If the IRS sent the spouse an Identity Protection PIN, enter it here
Taxpayer:
Enter the taxpayer’s state of residence as of December 31, 2019 FL
Check the appropriate box:
Taxpayer is a resident of the state above for the entire year
Taxpayer is a resident of the state above for only part of year X
Date the taxpayer established residence in state above 12/11/2019
In which state (or foreign country) did the taxpayer reside before this change? AL
Spouse:
Enter the spouse’s state of residence as of December 31, 2019 FL
Spouse is a resident of the state above for the entire year
Spouse is a resident of the state above for only part of year X
Date the spouse established residence in state above 12/11/2019
In which state (or foreign country) did the spouse reside before this change? AL
Nonresident states:
Nonresident State(s) Taxpayer/Spouse/Joint
Check this box if you are in a Registered Domestic Partnership or a civil union
If you checked the box on the line above, also check the appropriate box below:
Check if this is your individual federal return you are filing with the IRS
Check if this is the joint return created to file joint state tax return (see Help)
Use the PIN that you signed last year’s tax return with.
Taxpayer’s Prior year PIN
Spouse’s Prior year PIN
These signature PINs are chosen by the taxpayer and spouse and used for e-filing your tax return
Taxpayer’s PIN used to sign the return 01942
Spouse’s PIN used to sign the return 01946
Taxpayer:
Drivers license or state ID number C534-196-42-062-0
Issued by what state FL
License or ID license X ID neither decline
Spouse
Drivers license or state ID number C534-070-46-586-0
Issued by what state FL
License or ID license X ID neither decline
Personal Information Worksheet 2019
For the Taxpayer
QuickZoom to another copy of Personal Information Worksheet

QuickZoom to Federal Information Worksheet
Part I ' Taxpayer's Personal Information
First name Donald Middle initial Last name

R Chandler
Suffix
Social security no. 417-54-0387 Member of U.S. Armed Forces in 2019? Yes X No
Date of birth 02/22/1942 (mm/dd/yyyy) age as of 1-1-2020 77
Occupation Retired Daytime phone (440)669-5965 Ext
Marital status Married

If widowed, check the appropriate box for the year your spouse died:
After 2019 2019 2018 2017 Before 2017
Are you retired on total and permanent disability? (for Schedule R, see Help). Yes No
Check if this person is legally blind Yes X No
If deceased, enter the date of death (mm/dd/yyyy)
Were you under the age of 16 as of 1-1-2020 and this is the first year you
are filing a tax return? Yes No
Do you want $3 to go to Presidential Election Campaign Fund? Yes X No
Part II ' Questions for Individuals Who Could Be Or Are Dependents of Another Taxpayer
1 Can someone (such as your parent) claim you as a dependent? Yes X No

2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return? Yes No
Questions 3 through 5 are only required for individuals who claim the
American Opportunity Credit.
3 Were you a full-time student during any part of five months during 2019? Yes No
4 Did your earned income exceed one-half of your support? Yes No
5 Was at least one of your parents alive on December 31, 2019? Yes No
Part III ' Taxpayer's State Residency Information
Enter this person’s state of residence as of December 31, 2019 FL

This person is a resident of the state above for the entire year
This person is a resident of the state above for only part of year X
Date this person established residence in state above 12/11/2019
In which state (or foreign country) did this person reside before this change? AL
Part IV ' Dependent Care Expenses
Qualified dependent care expenses incurred and paid for this person in 2019
Unreimbursed medical expenses paid for qualifying person in 2019
Employment taxes paid for dependent care providers in 2019
Full-time student for 5 calendar months during 2019? Yes No
Disabled person who was not physically or mentally capable of self-care? Yes No
This person is a qualifying person for the child and dependent care credit Yes X No
Personal Information Worksheet 2019
For the Spouse
QuickZoom to another copy of Personal Information Worksheet

QuickZoom to Federal Information Worksheet
Part I ' Spouse's Personal Information
First name Barbara Middle initial Last name

J Chandler
Suffix
Social security no. 272-42-4709 Member of U.S. Armed Forces in 2019? Yes X No
Date of birth 03/06/1946 (mm/dd/yyyy) age as of 1-1-2020 73
Occupation Retired Daytime phone (440)567-9608 Ext
Marital status Married

If widowed, check the appropriate box for the year your spouse died:
After 2019 2019 2018 2017 Before 2017
Are you retired on total and permanent disability? (for Schedule R, see Help). Yes No
Check if this person is legally blind Yes X No
If deceased, enter the date of death (mm/dd/yyyy)
Were you under the age of 16 as of 1-1-2020 and this is the first year you
are filing a tax return? Yes No
Do you want $3 to go to Presidential Election Campaign Fund? Yes X No
Part II ' Questions for Individuals Who Could Be Or Are Dependents of Another Taxpayer
1 Can someone (such as your parent) claim you as a dependent? Yes X No

2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return? Yes No
Questions 3 through 5 are only required for individuals who claim the
American Opportunity Credit.
3 Were you a full-time student during any part of five months during 2019? Yes No
4 Did your earned income exceed one-half of your support? Yes No
5 Was at least one of your parents alive on December 31, 2019? Yes No
Part III ' Spouse's State Residency Information
Enter this person’s state of residence as of December 31, 2019 FL

This person is a resident of the state above for the entire year
This person is a resident of the state above for only part of year X
Date this person established residence in state above 12/11/2019
In which state (or foreign country) did this person reside before this change? AL
Part IV ' Dependent Care Expenses
Qualified dependent care expenses incurred and paid for this person in 2019
Unreimbursed medical expenses paid for qualifying person in 2019
Employment taxes paid for dependent care providers in 2019
Full-time student for 5 calendar months during 2019? Yes No
Disabled person who was not physically or mentally capable of self-care? Yes No
This person is a qualifying person for the child and dependent care credit Yes X No
Form 1099-INT Worksheet 2019
Ownership: Check if Taxpayer
(defaults to taxpayer) Check if Spouse
Check if Joint X
Payer’s name Bancorpsouth Bank
Box 1 Interest income for 2019 (not included in box 3) 1,088.67
Choose type if special state handling (State Use Only ' see Help).
Box 2 Early withdrawal penalty
Box 3 Interest on U.S. Savings Bonds and Treasury obligations
Box 4 Federal income tax withheld
Box 5 Investment expenses
Box 6 Foreign tax paid (All interest is considered passive. See Help)
a Check to deduct foreign taxes on Schedule A OR
b DoubleClick to link to a copy of Form 1116
c For Form 1116, select which column A B C
d Foreign source amount included in interest
Box 7 Foreign country or U.S. possession
Check this box if foreign tax is from a mutual fund or a registered
investment company. See Tax Help for additional information.
Box 8 Tax-exempt interest-Total
Tax-exempt Interest State Allocation
For each row, enter state ID in column (a) and enter percent in column (b) or
amount in column (c).
(a) (b) (c)
State or Percent of Amount of
Territory total interest interest
ID for state for state
Enter resident state ID
Enter each nonresident state on separate row
or
Enter XX for all nonresident states (that aren’t filed)
i.e. you own a fund with no resident state interest.
Total
State ID where exempt interest was earned. If more than 1 state, see Help
Box 9 Specified private activity bond included in Box 8 subject to AMT, if any OR
Private activity bond interest percentage of Box 8, if any %
Box 10 Market discount (See tax help for manual entries required if you enter amount
for market discount)
Box 11 Bond premium
Box 12 Bond premium on treasury obligations
Box 13 Bond premium on tax-exempt bond
Box 14 Tax-exempt bond CUSIP number (if various, leave blank)
Box 15 Box 16 Box 17
State State identification no. State tax withheld
I confirm that the state withholding identification number(s) are accurate

FATCA filing requirement
Adjustments to Interest
Check the box that identifies the type of adjustment being made:
N Nominee distribution A Accrued interest
O Original issue discount (OID) H Other
B Amortizable bond premium (ABP) R Bond premium on treasury obligations
T Bond premium on tax-exempt U U.S. savings bond interest previously reported
Enter adjustment amount (enter as positive if subtracting/negative if adding)
Additional Payer and Recipient Information
Payer’s TIN Recipient’s address and ZIP code
Payer’s address and ZIP code Transfer address from Federal Information Wks
Street Street
City City
State ZIP Code State ZIP Code
Foreign Country Foreign Country
Ownership: Check if Taxpayer X
Check if Joint
Payer’s name Ally Bank
Box 1 Interest income for 2019 (not included in box 3) 2,978.17
(a) (b) (c)
or
Total
Box 11 Bond premium

Street Street
City City
Ownership: Check if Taxpayer X
Check if Joint
Payer’s name Dollar Bank
Box 1 Interest income for 2019 (not included in box 3) 14.99
(a) (b) (c)
or
Total
Box 11 Bond premium

Street Street
City City
Check if Joint X
Payer’s name Wells Fargo Bank NA
Box 1 Interest income for 2019 (not included in box 3) 28.93
(a) (b) (c)
or
Total
Box 11 Bond premium

Street Street
City City
Form 1099-DIV Worksheet 2019
(defaults to taxpayer) Check if Spouse X
Check if Joint
Payer’s name CMS Energy
Box 1a Total ordinary dividends 330.94
U.S. government interest, if any, included in box 1a
Box 1b Qualified dividends 330.94
Adjusted qualified dividends
Box 2a Total capital gain distributions
Box 2b Unrecaptured Section 1250 gain
Box 2c Section 1202 gain eligible for 50% exclusion on QSB stock (See tax help)
Section 1202 gain eligible for 60% exclusion
Box 2d Collectibles (28%) gain
Box 3 Nondividend distributions
Box 5 Section 199A dividends
Adjusted 199A dividends
Box 7 Foreign tax paid (All income is considered passive. See Help)
d Foreign source amount included in dividends
Check this box if foreign tax is from a mutual fund or a regulated
Box 9 Cash liquidation distribution
Box 10 Noncash (fair market value) liquidation distribution
Box 11 Exempt-interest dividends
Tax-exempt Interest Dividends State Allocation
(a) (b) (c)
State Percent of Amount of
or total interest interest
Territory dividends dividends
or
i.e. you own a fund with no resident state dividends.
Total
State where the dividends were earned. Postal code (such as "CA" or "NY")
Box 12 a Specified private activity bond amount included in box 11 above
OR
b Percent of private activity bond amount included in %

Adjustments to Dividends or ESOP Distribution
Check the box that identifies the type of adjustment being made or if ESOP distribution:
N Nominee distribution
H Other adjustment
D ESOP distribution
Enter nominee or other adjustment amount (enter as positive)
Street Street
City City
Form 1099-R Summary 2019
Name(s) Shown on Return Social Security No.

Traditional IRA Distributions Taxpayer Spouse
Gross 1 Total gross distributions from box 1 of Form 1099-R 44,399. 15,397.
a Less: Amounts rolled over
b Less: Inherited and treat as own
c Less: Other inherited IRA amount
d Less: Return of contributions
e Less: Qualified charitable distributions
f Less: HSA funding distributions
2 Balance of gross traditional IRA distributions 44,399. 15,397.
a Gross distribution transferred to Form 8915B, 3(a)
b Qualified disaster distributions
c Less: Amount rolled over
d Gross distribution transferred to Form 8915B, 3(b)
e Less: Amount rolled over
3 Amount of line 2 converted to a Roth IRA
4 Net amount of line 2 converted to a Roth IRA
5 Amount of line 2 not converted to a Roth IRA 44,399. 15,397.
Taxable 6 Earnings on return of contributions

7 Taxable amount of inherited IRAs on line 1c
8 Taxable amount not converted to Roth IRA 44,399. 15,397.
9 Taxable amount of Roth IRA conversions
10 Taxable amount included on Form 1040, line 4b 44,399. 15,397.
11 If checked, taxable amount calculated on Form 8606
Roth IRA Distributions
Gross 12 Total gross distributions from box 1 of Form 1099-R

a Less: Rollover to another Roth IRA
c Less: Other inherited Roth IRA amount
d Less: Return of contributions
e Qualified disaster distribution
13 Roth IRA distributions subject to distribution rules
Qualified 14 Total gross qualified distributions

a Less: Rollover to another Roth IRA
c Less: Other inherited Roth IRA amount
15 Qualified distributions subject to distribution rules
Taxable 16 Net nonqualified distributions for Form 8606

17 Earnings on return of contributions
18 Taxable amount of inherited Roth IRAs on line 12c
19 Taxable earnings on nonqualified distributions
20 Taxable amount included on Form 1040, line 4b
IRA Qualified Disaster Distributions From Form 8915A and 8915B
Taxable 20 a Qualified distributions on Form 1040, line 4b 0. 0.
Recharacterizations (See Help)
Gross 21 a 2019 form code N (included on Form 1040, line 4a)

21 b 2020 form code R (not included on 1040, line 4a)
Forms 1099-R Summary 2019 Page 2
Pensions and Annuities Taxpayer Spouse
Gross 22 Total gross distributions from box 1 of Form 1099-R 72,849. 38,846.
a Less: Lump sum transferred to Form 4972
b Less: Amount not reported on Form 1040, line 4c
c Designated Roth distribution allocated to an IRR
23 Amount of line 22 converted to a Roth IRA
24 Distributions from Canada RRP Wks, line 7a
25 Gross distribution transferred to Form 1040, line 4c 72,849. 38,846.
a Less: Amount rolled over
b Amount attributable to an in-plan Roth rollover
c Gross distribution transferred to Form 8915B, 2(a)
d Qualified disaster distribution
e Less: Amount rolled over
f Gross distribution transferred to Form 8915B, 2(b)
Taxable 26 Taxable amount in box 2a, Form 1099-R 72,849. 38,846.

a Taxable amount rolled over
b Non-taxable amount rolled over
c Designated Roth contribution basis rolled to Roth IRA
d Insurance premiums for retired public safety officers
e Qualified disaster amount to Form 8915B
27 Lump sum amount transferred to Form 4972
28 Amount transferred to Form 1040, line 1
a Disability before minimum retirement age
b Return of contributions
c Insurance premiums for retired public safety officers
29 Nontaxable amount from Simplified Method
30 Capital gains from charitable gift annuities
a Capital gain subject to the 28% rate
b Unrecaptured section 1250 gain
31 Taxable amount of Roth IRA conversions
a Taxable amount of in-plan Roth rollovers
32 a Taxable amount of distributions 72,849. 38,846.
b Taxable distributions from Canada RRP Wks, line 7b
c Taxable disaster distributions from Form 8915B 0. 0.
d Taxable amount transferred to Form 1040, line 4d 72,849. 38,846.
Section 1035 Tax-free Exchange
Pensions 33 Total gross distributions from box 1 of Form 1099-R

IRAs 34 Total gross distributions from box 1 of Form 1099-R
Distributions on 2019 1099-Rs Not Reported on the 2019 Return
Code P 35 Distribution reported on 2018 tax return

Code R 36 Recharacterizations of prior year contributions or
conversions. Need not be reported on tax return.
Tax Withholding
Box 4 37 Total federal tax withheld 21,004. 4,916.

Box 10 38 Total state tax withheld
Box 13 39 Total local tax withheld
Nontaxable Distributions for Sales Tax Deduction
40 Nontaxable IRA distributions 0. 0.

41 Nontaxable pension distributions 0. 0.
Health Insurance Premiums
42 Health insurance deductible on Schedule A
Taxable Distributions included in Net Investment Income
43 Annuity payments and other distributions that

may be subject to the net investment income tax
Form 1099-R Distributions from Pensions, IRAs, etc 2019
Name Social Security Number
Source Form : 1099-R X CSA-1099-R CSF-1099-R RRB-1099-R
If Spouse's 1099-R, check this box Corrected
Do not transfer this 1099-R to next year
This section is for RRB-1099-R use only
Payer’s name, street address, city, state, and ZIP code. 1 Gross distribution $ 5,778.40
Ohio Public Emp Ret System - DC
2a Taxable amount (See Help) $ 5,778.40
277 East Town Street
Columbus OH 43215 2b Taxable amount Total
Payer’s foreign province Payer’s foreign postal code not determined A distribution A
Payer’s country Payer’s Phone No. 3 Capital gain (included 4 Federal income
in box 2a) tax withheld
$ $
Payer’s Federal Recipient’s
identification number identification number 5 Employee contributions 6 Net unrealized
31-0797516 417-54-0387 /Designated Roth contributns appreciation in
or insurance premiums employer securities
Check to transfer Recipient’s information $ $
from Federal Information Worksheet X
Recipient’s name 7 Distribn code(s) IRA/SEP/ 8 Other %
Donald R Chandler 1st code 4 SIMPLE
Street address (including apartment number) 2nd code $
City State ZIP code 9a Your percentage 9b Total employee
Land O Lakes FL 34638 of total contributions
Foreign Province Foreign Postal Code distribution % $
Foreign Country 11 1st year of desig. Roth contrib.
10 Amount allocable to IRR 12 State tax 13 Payer’s 14 State

within 5 years $ withheld State / state no. distribution
$ OH / 51-8539176 $
/ $
I confirm that the state withholding identification
FATCA filing requirement number(s) are accurate
Special use code for first state (See Help) A
Special use code for second state (See Help) A 15 Local tax 16 Name of 17 Local
withheld locality distribution
Account number $ $
SR411649268B $ $
Date of payment
A Check if NOT from a qualified retirement plan or IRA (see Help) A

A If box 7 code is J or T, check if a qualified distribution (see Help) A
A If box 7 code is J, enter amount used for first time home purchase
A If box 7 code is 2 or 5, check if this distribution is from a Roth IRA (See Help) A
A Inherited IRA If this distribution is from an inherited IRA, indicate the distribution is from the IRA of
A Treat as recipient’s own (this is treated as a rollover)
A Recipient, but was originally inherited from a spouse (treated as recipient’s IRA)
A Spouse and not treat as recipient’s own (taxable amount must be in box 2a)
A Someone other than a spouse (taxable amount must be in box 2a)
A From a traditional IRA
A From a Roth IRA
A From a SIMPLE plan (first two years of participation only)
A From a SIMPLE plan (more than two years of participation)
A From a SEP IRA
A None
A Subject to the penalty of early withdrawal
A Not subject to the penalty of early withdrawal
A Insurance A Amount of insurance premiums deductible on Schedule A
A Amount of health savings account (HSA) funding distributions
A Amount of qualified insurance premiums paid subtracted from
an eligible retired public safety officer’s distribution
A Qualified Charitable Distribution Enter IRA distributions made directly by the trustee
to a qualified charitable organization
A RMD If this is a distribution from a traditional IRA or qualified retirement plan, and
if this is a Required Minimum Distribution (RMD) (See Help),
Entire gross is RMD or the amount of gross distbn that is the RMD
Exelis Inc. -Northern Trust Company-DC
Salaried Retirement Plan 2a Taxable amount (See Help) $ 67,070.64
50 S LaSalle St
Chicago IL 60675 2b Taxable amount Total
$ $ 14,344.44

$ AL / $
/ $
Account number $ $
50B 417540387 $ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
If Spouse's 1099-R, check this box X Corrected
Exelis Inc. -Northern Trust Company-BC
Salaried Retirement Plan 2a Taxable amount (See Help) $ 11,353.32
50 S LaSalle St
$ $ 1,356.00
Barbara J Chandler 1st code 7 SIMPLE

$ AL / $
/ $
Account number $ $
50B 272424709 $ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
Northern Trust Co - BC ITT Cons Hrly Plan
50 S. LaSalle Street
$ $

$ AL / $
/ $
Account number $ $
ICHP2 272424709 $ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
JP Morgan Chase NA Tefra Acct-Valeo- BC
Benefit Payment Services 2a Taxable amount (See Help) $ 20,021.04
PO Box 710634
Columbus OH 43271 2b Taxable amount Total
$ $ 1,250.28

$ AL / $
/ $
Account number $ $
700001V01436682 $ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
AXA Equitable-DC-#304700322IA
Accumulator Customer Service 2a Taxable amount (See Help) $ 5,818.70
500 Plaza Drive, 6th Floor
Secaucus NJ 07094-3619 2b Taxable amount Total
$ $ 872.81
Street address (including apartment number) 2nd code X $

$ AL / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
Entire gross is RMD X or the amount of gross distbn that is the RMD
Payer’s name, street address, city, state, and ZIP code. 1 Gross distribution $ 875.92
AXA Equitable-DC-#304700323IA
Accumulator Customer Service 2a Taxable amount (See Help) $ 875.92
Secaucus NJ 07094-3619 2b Taxable amount Total
Payer’s foreign province Payer’s foreign postal code not determined A X distribution A
$ $ 131.39

$ AL / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
Security Benefit-BC #5440010254
One SW Security Benefit Place
Topeka KS 66636 2b Taxable amount Total
$ $ 862.23

$ / AL/273908 $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
AXA Equitable - BC #304702755IA
2a Taxable amount (See Help) $ 380.90
Secaucus NJ 07094 2b Taxable amount Total
$ $ 57.14

$ / AL39394 $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
WELLS FARGO-DC #2794-5307
1401-6945 2a Taxable amount (See Help) $ 24,669.07
2801 Market St
St Louis MO 63103 2b Taxable amount Total
$ $ 3,700.36

$ / AL/386843 $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
WELLS FARGO-BC #8010-0710
2801 Market St
$ $ 930.00

$ / AL/386843 $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
ATHENE-DC #AA10110354
PO Box 1555
Des Moines IA 50306 2b Taxable amount Total
$ $ 550.80

$ / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
WELLS FARGO-DC #1401-6945
2801 Market St
$ $ 1,185.00

$ / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
ATHENE-BC #AA10110355
PO Box 1555
Des Moines IA 50306 2b Taxable amount Total
$ $ 288.68

$ / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
AXA EQUITABLE-DC #304700323IA
RETIREMENT SERVICE SOLUTIONS 2a Taxable amount (See Help) $ 877.64
500 PLAZA DR, 6th FLOOR
SECAUCUS NJ 07094 2b Taxable amount Total
$ $ 131.65

$ / FL-135570651 $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
AXA EQUITABLE-DC #304700323IA
RETIREMENT SERVICE SOLUTIONS 2a Taxable amount (See Help) $ 584.54
SEACAUCUS NJ 07094 2b Taxable amount Total
$ $ 87.68

$ / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
AXA EQUITABLE-BC #304702755IA
$ $ 85.65

$ / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
AXA EQUITABLE-BC #304702755IA
$ $ 85.78

$ / $
/ $
Account number $ $
$ $
Date of payment

A From a Roth IRA
A From a SEP IRA
A None
Form 1040 Qualified Dividends and Capital Gain Tax Worksheet 2019
Line 12a G Keep for your records

1 Enter the amount from Form 1040 or 1040-SR, line 11b 1 188,293.
2 Enter the amount from Form
1040 or 1040-SR, line 3a 2 331.
3 Are you filing Schedule D?
Yes. Enter the smaller of line 15
or 16 of Schedule D. If
either line 15 or 16 is blank
or loss, enter -0- 3
X No. Enter the amount from Form
1040 or 1040-SR, line 6.
4 Add lines 2 and 3 4 331.
5 If filing Form 4952 (used to figure
investment interest expense
deduction), enter any amount from line
4g of that form. Otherwise, enter -0-. 5 0.
6 Subtract line 5 from line 4. If zero or less, enter -0- 6 331.
7 Subtract line 6 from line 1. If zero or less, enter -0- 7 187,962.
8 Enter:
$39,375 if single or married filing separately,
$78,750 if married filing jointly or qualifying widow(er), 8 78,750.
$52,750 if head of household.
9 Enter the smaller of line 1 or line 8 9 78,750.
11 Subtract line 10 from line 9 (this amount taxed at 0%) 11 0.
12 Enter the smaller of line 1 or line 6 12 331.
13 Enter the amount from line 11 13 0.
14 Subtract line 13 from line 12. 14 331.
15 Enter:
$434,550 if single,
$244,425 if married filing separately, 15 488,850.
$488,850 if married filing jointly or qualifying widow(er),
$461,700 if head of household.
17 Add lines 7 and 11 17 187,962.
18 Subtract line 17 from line 16. If zero or less, enter -0- 18 331.
19 Enter the smaller of line 14 or line 18 19 331.
20 Multiply line 19 by 15% (0.15) 20 50.
21 Add lines 11 and 19 21 331.
22 Subtract line 21 from line 12 22 0.
23 Multiply line 22 by 20% (0.20) 23 0.
24 Figure the tax on the amount on line 7. If the amount on line 7 is less than
$100,000, use the Tax Table to figure the tax. If the amount on line 7 is
$100,000 or more, use the Tax Computation Worksheet 24 33,460.
25 Add lines 20, 23, and 24 25 33,510.
26 Figure the tax on the amount on line 1. If the amount on line 1 is less than
$100,000, use the Tax Table to figure this tax. If the amount on line 1 is
$100,000 or more, use the Tax Computation Worksheet 26 33,539.
27 Tax on all taxable income. Enter the smaller of line 25 or line 26 here and on
Form 1040 or 1040-SR, line 12a. 27 33,510.
Form 1040 Social Security Benefits Worksheet 2019
Line 5 G Keep for your records

Social Security/Railroad Retirement benefits received in 2018 X
Taxpayer Spouse
A Total net benefits from Box 5 of all SSA-1099 forms 23,111. 23,195.
B Total federal tax withheld from box 6 of all SSA-1099 forms
C Total Medicare B premiums withheld from all SSA-1099 forms 3,251. 3,251.
D Total Medicare C premiums withheld from all SSA-1099 forms
E Total Medicare D premiums withheld from all SSA-1099 forms 383. 383.
Note: If self-employed, Medicare premiums are deductible as
Self-Employed Health Insurance. If self-employed, enter premiums
on the business activity form (Schedule C, F, etc), not on Lines C, D
and E above.
F Total net benefits from Box 5 of all RRB-1099 forms
G Total federal tax withheld from box 10 of all RRB-1099 forms
H Total Medicare premiums from Box 11 of all RRB-1099 forms
1 Add amounts from line A and line F above. Also enter this amount on
Form 1040, line 5a 1 46,306.
2 Enter one-half of line 1 2 23,153.
3 Add the amounts on Form 1040 or 1040-SR, lines 1 (before adoption benefits
exclusion), 2a (before U.S. savings bond interest exclusion), 2b, 3b, 4b, 4d, 6,
and Schedule 1, line 9. Also include certain income of bona fide residents of
American Samoa or Puerto Rico. 3 175,933.
4 Enter the total of any exclusions/adjustments for:
? Foreign earned income or housing exclusion 4
5 Add lines 2, 3, and 4 5 199,086.
6 Amount from Schedule 1, lines 10 through 19, plus any write-in amounts
on Schedule 1, line 22 (other than foreign housing deduction) 6
7 Subtract line 6 from line 5 7 199,086.
8 Enter $25,000 ($32,000 if married filing jointly; $0 if married filing separately
and you lived with your spouse at any time in 2019) 8 32,000.
If line 9 is zero or less, stop here; none of your social security benefits are
taxable. Enter -0- on Form 1040, line 5b. If you are married filing separately
and you lived apart from your spouse for all of 2019, enter ’D’ to the right of the
word ’benefits’ on line 5a. If line 9 is more than zero, go to line 10.
10 Enter $9,000 ($12,000 if married filing jointly; $0 if married filing separately

and you lived with your spouse at any time in 2019) 10 12,000.
13 Enter one-half of line 12 13 6,000.
15 Multiply line 11 by 85% (0.85). If line 11 is zero, enter -0- 15 131,823.
16 Add lines 14 and 15 16 137,823.
17 Multiply line 1 by 85% (0.85) 17 39,360.
18 Taxable social security benefits. Enter the smaller of line 16 or line 17 18 39,360.
If prior year lump-sum benefits were received, go to line 19, otherwise,
skip line 19 and enter the amount from line 18 on line 20.
19 Taxable benefits with lump sum election. Enter the amount from line 20 of the
Lump-Sum Social Security Worksheet 19
20 Taxable Social Security benefits. Enter the smaller of line 18 or line 19
Also enter this amount on Form 1040 or 1040-SR, line 5b 20 39,360.
Tax Payments Worksheet 2019

Estimated Tax Payments for 2019 (If more than 4 payments for any state or locality, see Tax Help)
Federal State Local
Date Amount Date Amount ID Date Amount ID
1 04/15/19 2,000. 04/15/19 04/15/19
2 06/17/19 1,725. 06/17/19 06/17/19
3 09/16/19 1,725. 09/16/19 09/16/19
4 01/15/20 1,725. 01/15/20 01/15/20
Tot Estimated
Payments 7,175.
Tax Payments Other Than Withholding Federal State ID Local ID

(If multiple states, see Tax Help)
6 Overpayments applied to 2019

7 Credited by estates and trusts
8 Totals Lines 1 through 7 7,175.
9 2019 extensions
Taxes Withheld From: Federal State Local
10 Forms W-2
11 Forms W-2G
12 Forms 1099-R 25,920.
13 Forms 1099-MISC, 1099-K and 1099-G
14 Schedules K-1
15 Forms 1099-INT, DIV and OID
16 Social Security and Railroad Benefits
17 Form 1099-B St Loc
18 a Other withholding St Loc
b Other withholding St Loc
c Other withholding St Loc
d Positive Adjustment St Loc
e Negative Adjustment St Loc
f Additional Medicare Tax
19 Total Withholding Lines 10 through 18f
25,920.
20 Total Tax Payments for 2019 33,095.
Prior Year Taxes Paid In 2019 State ID Local ID

(If multiple states or localities, see Tax Help)
21 Tax paid with 2018 extensions

22 2018 estimated tax paid after 12/31/2018
23 Balance due paid with 2018 return
24 Other (amended returns, installment payments, etc)
Federal Carryover Worksheet 2019

2018 State and Local Income Tax Information
(a) (b) (c) (d) (e) (f) (g)

State or Paid With Estimates Pd Total With- Paid With Total Over- Applied
Local ID Extension After 12/31 held/Pmts Return payment Amount
Totals
2018 State Extension Information 2018 Locality Extension Information
(a) (b) (a) (b)

State Paid With Extension Locality Paid With Extension
2018 State Estimates Information 2018 Locality Estimates Information
(a) (c) (a) (c)

State Estimates Paid After 12/31 Locality Estimates Paid After 12/31
2018 State Taxes Due Information 2018 Locality Taxes Due Information
(a) (e) (a) (e)

State Paid With Return Locality Paid With Return
2018 State Refund Applied Information 2018 Locality Refund Applied Information
(a) (g) (a) (g)

State Applied Amount Locality Applied Amount
2018 State Tax Refund Information 2018 Locality Tax Refund Information
(a) (d) (f) (a) (d) (f)

Total Total Total Total
State Withheld/Pmts Overpayment Locality Withheld/Pmts Overpayment
Federal Carryover Worksheet page 2 2019
Other Tax and Income Information 2018 2019
1 Filing status 1 2 MFJ 2 MFJ

2 Number of exemptions for blind or over 65 (0 - 4) 2 2 2
3 Itemized deductions 3 50,568. 18,869.
4 Check box if required to itemize deductions 4
5 Adjusted gross income 5 223,617. 215,293.
6 Tax liability for Form 2210 or Form 2210-F 6 30,084. 33,510.
7 Alternative minimum tax 7
8 Federal overpayment applied to next year estimated tax 8
QuickZoom to the IRA Information Worksheet for IRA information
Excess Contributions 2018 2019
9a Taxpayer’s excess Archer MSA contributions as of 12/31 9a

b Spouse’s excess Archer MSA contributions as of 12/31 b
10 a Taxpayer’s excess Coverdell ESA contributions as of 12/31 10 a
b Spouse’s excess Coverdell ESA contributions as of 12/31 b
11 a Taxpayer’s excess HSA contributions as of 12/31 11 a
b Spouse’s excess HSA contributions as of 12/31 b
Loss and Expense Carryovers 2018 2019

Note: Enter all entries as a positive amount
12 a Short-term capital loss 12 a

b AMT Short-term capital loss b
13 a Long-term capital loss 13 a
b AMT Long-term capital loss b
14 a Net operating loss available to carry forward 14 a
b AMT Net operating loss available to carry forward b
15 a Investment interest expense disallowed 15 a
b AMT Investment interest expense disallowed b
16 Nonrecaptured net Section 1231 losses from: a 2019 16 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
17 AMT Nonrecap’d net Sec 1231 losses from: a 2019 17 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
Federal Carryover Worksheet page 3 2019
Credit Carryovers 2018 2019
18 General business credit 18

19 Adoption credit from: a 2019 19 a
b 2018 b
c 2017 c
d 2016 d
e 2015 e
f 2014 f
20 Mortgage interest credit from: a 2019 20 a
b 2018 b
c 2017 c
d 2016 d
21 Credit for prior year minimum tax 21
22 District of Columbia first-time homebuyer credit 22
23 Residential energy efficient property credit 23
Other Carryovers 2018 2019
24 Section 179 expense deduction disallowed 24

25 Excess a Taxpayer (Form 2555, line 46) 25 a
foreign b Taxpayer (Form 2555, line 48) b
housing c Spouse (Form 2555, line 46) c
deduction: d Spouse (Form 2555, line 48) d
Charitable Contribution Carryovers
26 2018 Carryover of Other Property Capital Gain Cash Qualified

charitable
contributions from: (a) 50% (b) 30% (c) 30% (d) 20% (e) 60% (f) 100%
a 2018 0. 0.
b 2017
c 2016
d 2015
e 2014
27 2019 Carryover of Other Property Capital Gain Cash

charitable
contributions from: (a) 50% (b) 30% (c) 30% (d) 20% (e) 60%
a 2019 0.
b 2018
c 2017
d 2016
e 2015
28 Amount overpaid less earned income credit 5,749.
Qualified Business Income Deduction (Section 199A) carryovers 2018 2019
29 Qualified business loss carryforward 29

30 Qualified PTP loss carryforward 30
2018 State Capital Loss Carryovers (For users not transferring from the prior year)
State Short-term AMT Short-term Long-term AMT Long-term Capital Loss AMT Capital Loss
ID Capital Loss Capital Loss Capital Loss Capital Loss (combined) (combined)
for State for State for State for State for State for State
IRA Information Worksheet 2019

Part I Traditional IRA Taxpayer Spouse
Basis and Value

1 Total basis in traditional IRAs
2 Year-end value on 12/31/2019
3 Basis carryover as of 12/31/2019
Excess Contributions
4 Excess contributions as of 12/31/2018
5 Carryover of excess contributions to 2020
Part II Roth IRA Taxpayer Spouse
Basis (Contribution and Conversion History)

6 Basis in Roth IRA contributions
7 Basis in Roth IRA conversions 4,100. 5,900.
8 Contribution basis carryover as of 12/31/2019
9 Conversion basis carryover as of 12/31/2019 4,100. 5,900.
Excess Contributions
10 Excess contributions as of 12/31/2018
11 Carryover of excess contributions to 2020
Part III Traditional IRA Basis Detail Taxpayer Spouse
12 Basis for 2018 and earlier years

13 Adjustment due to return of excess contributions
14 Rollover of nontaxable portion of a qualified retirement plan
15 Basis received from former spouse due to divorce or inherited
16 Basis transferred to former spouse due to divorce
17 Adjusted total basis in Traditional IRAs
Part IV Traditional IRA Year-end Value Detail Taxpayer Spouse
18 Enter the combined value of all traditional IRAs

(including SEP and SIMPLE IRAs) on 12/31/2019 (See Help)
19 If any amounts were recharacterized either to or from any
traditional IRA, enter the net amounts recharacterized after
12/31/2019.
qualified charitable distributions (QCD) made in Jan. 2020
to be treated as made in December 2019 (See Help).
20 Enter the total amount of any traditional IRA distributions
that you rolled over, or intend to roll over, to another traditional
IRA, but the rollover was (or will be) made after 12/31/2019
21 Check this box if you converted all of the traditional IRAs you
had in 2019 to Roth IRAs in 2019
G Keep for your records Page 2

Part V Roth IRA Contribution and Conversion Balances Taxpayer Spouse
22 Opened a Roth IRA before 2015 Yes No Yes X No
2018 Balances (Basis - Before 2019 Transactions)
23 Cumulative regular Roth IRA contributions, including rollovers

from Roth 401(k) and Roth 403(b)
24 Cumulative pre 2015 conversions - taxable and nontaxable
25 2015 conversion contributions taxable at conversion
26 2015 conversion contributions not taxable at conversion
27 2016 conversion contributions taxable at conversion 4,100. 5,900.
2019 Transactions - Contributions Taxpayer Spouse
33 Regular Roth IRA contributions

34 Rollover from Roth 401(k) and Roth 403(b)
35 Conversion contributions taxable at conversion
36 Conversion contributions not taxable at conversion
37 Repayments of qualified Roth reservist distributions
2019 Transactions - Distributions
Distributions from regular Roth IRA contributions and from

38 rollovers from Roth 401(k) and Roth 403(b)
39 Distributions from cumulative pre 2015 conversions
40 Distributions from 2015 conversions taxable at conversion
41 Distribs. from 2015 conversions not taxable at conversion
Yes No Yes No
50 Did you have any open Roth IRA accounts on 12/31/2019? X X
Balance c/over to 2020 (Basis - After 2019 Transactions)
Cumulative regular Roth IRA contributions, including rollovers

51 from Roth 401(k) and Roth 403(b)
53 2016 conversion contributions taxable at conversion 4,100. 5,900.
G Keep for your records Page 3

Part VI Roth IRA Basis Adjustments Taxpayer Spouse
Received From Former Spouse due to Divorce or Inheritance

Transferred To Former Spouse due to Divorce

Two-Year Comparison 2019

Income 2018 2019 Difference %
Wages, salaries, tips, etc

Interest and dividend income 2,438. 4,442. 2,004. 82.20
State tax refund
Business income (loss)
Capital and other gains (losses)
IRA distributions 71,321. 59,796. -11,525. -16.16
Pensions and annuities 111,579. 111,695. 116. 0.10
Rents and royalties
Partnerships, S Corps, etc
Farm income (loss)
Social security benefits 38,279. 39,360. 1,081. 2.82
Income other than the above
Total Income 223,617. 215,293. -8,324. -3.72
Adjustments to Income
Adjusted Gross Income 223,617. 215,293. -8,324. -3.72
Itemized Deductions
Medical and dental 16,808. 2,742. -14,066. -83.69
Income or sales tax 5,000. -5,000. -100.00
Real estate taxes 799. 799. 0. 0.00
Personal property and other taxes 341. 1,159. 818. 239.88
Interest paid
Gifts to charity 27,620. 14,169. -13,451. -48.70
Casualty and theft losses
Miscellaneous
Total Itemized Deductions 50,568. 18,869. -31,699. -62.69
Standard or Itemized Deduction 50,568. 27,000. -23,568. -46.61
Qualified Business Income Deduction
Taxable Income 173,049. 188,293. 15,244. 8.81
Income tax 30,084. 33,510. 3,426. 11.39

Additional income taxes
Alternative minimum tax
Total Income Taxes 30,084. 33,510. 3,426. 11.39
Nonbusiness credits
Business credits
Total Credits
Self-employment tax
Other taxes
Total Tax After Credits 30,084. 33,510. 3,426. 11.39
Withholding 27,833. 25,920. -1,913. -6.87
Estimated and extension payments 8,000. 7,175. -825. -10.31
Earned income credit
Additional child tax credit
Other payments
Total Payments 35,833. 33,095. -2,738. -7.64
Form 2210 penalty
Applied to next year’s estimated tax
Refund 5,749. -5,749. -100.00
Balance Due 415. 415.
Current year effective tax rate 15.56 %

Tax Summary 2019
Name (s)
Total income 215,293.

Adjustments to income
Adjusted gross income 215,293.
Itemized/standard deduction 27,000.
Qualified business income deduction
Taxable income 188,293.
Tentative tax 33,510.
Additional taxes
Alternative minimum tax
Total credits
Other taxes
Total tax 33,510.
Total payments 33,095.
Estimated tax penalty
Amount Overpaid 0.
Refund 0.
Amount Applied to Estimate 0.
Balance due 415.
Compare to U. S. Averages 2019
Name(s) Shown on Return Social Security No

Your 2019 adjusted gross income (AGI) 215,293.

National adjusted gross income range used below from 200,000. to 249,999.
Note: National average amounts have been adjusted for inflation. See Help for details.
Actual National
Selected Income, Deductions, and Credits Per Return Average
Salaries and wages 188,082.

Taxable interest 4,111. 2,197.
Tax-exempt interest 8,490.
Dividends 331. 10,002.
Business net income 50,075.
Business net loss 7,891.
Net capital gain 25,998.
Net capital loss 2,362.
Taxable IRA 59,796. 42,264.
Taxable pensions and annuities 111,695. 55,876.
Rent and royalty net income 20,121.
Rent and royalty net loss 22,874.
Partnership and S corporation net income 73,510.
Partnership and S corporation net loss 19,205.
Taxable social security benefits 39,360. 27,582.
Medical and dental expenses deduction 2,742. 18,234.

Taxes paid deduction 1,958. 19,159.
Interest paid deduction 11,589.
Charitable contributions deduction 14,169. 5,909.
Total itemized deductions 18,869. 37,574.
Child care credit 604.

Education tax credits 0.
Child tax credit 669.
Retirement savings contributions credit 0.
Earned income credit 0.
Other Information Actual National

Per Return Average
Adjusted gross income 215,293. 232,775.

Taxable income 188,293. 185,654.
Income tax 33,510. 38,244.
Alternative minimum tax 2,810.
Total tax liability 33,510. 39,678.
Estimated Tax Payment Options
Name: Donald R & Barbara J Chandler

SSN: 417-54-0387
Prepare My 2020 Estimated Taxes Based on Tax Amount
90% of tax on your 2020 estimated taxable income 0.

100% of tax on your 2020 estimated taxable income 0.
66-2/3% of tax on your 2020 estimated taxable income (for farmers
and fishermen only, see Tax Help) 0.
X 100% (110%) of your 2019 taxes (prior-year exception)
Note: If your 2019 taxes were less than $1000, see Tax Help 36,861.
Amount of Estimated Taxes to Pay in 2020

Taxes based on method above 36,861.
Expected withholding for 2020 (2019 actual withholding) 25,920.
Taxes due after withholding 10,941.
Estimates you’ve already paid
Last year’s overpayment you applied to this year
Balance of estimated taxes due 10,941.
Round My Payments Up
To the next $10
To the next $100
Prepare Estimated Tax Payment Vouchers

X The amount of estimated taxes due is $1,000 or more (see Tax Help)
Even if the amount of estimated taxes due is less than $1,000
No, do not prepare estimated tax payment vouchers
Schedule of Estimated Tax Payments for 2020

Check the box for the payment date due next. We will prepare your vouchers
based on your choice.
Payment number 1, due April 15, 2020 2,736.
Payment number 2, due June 15, 2020 2,736.
Payment number 3, due September 15, 2020 2,736.
Payment number 4, due January 15, 2021 2,736.
Total estimated tax payments for 2020 10,944.
Print Estimated Tax Vouchers

X Yes, print those prepared by program
No, I will use those supplied by the I.R.S. and write in the amounts
ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING
Taxpayer: Donald R & Barbara J Chandler

Primary SSN: 417-54-0387
Federal Return Submitted: March 02, 2020 02:20 PM PST

Federal Return Acceptance Date:
Your return was electronically transmitted on 03/02/2020
The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The Intuit
Electronic Postmark documents the filing date of your income tax return, and the electronic postmark
information should be kept on file with your tax return and other tax-related documentation.
There are two important aspects of the Intuit Electronic Postmark:
1. THE INTUIT ELECTRONIC POSTMARK.

The electronic postmark shows the date and time Intuit received the federal return, and is deemed the
filing date if the date of the electronic postmark is on or before the date prescribed for filing of the
federal individual income tax return.
TIMELY FILING:
For your federal return to be considered filed on time, your return must be postmarked on or before
midnight April 15, 2020. Intuit’s electronic postmark is issued in the Pacific Time (PT) zone. If you are
not filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark time
to determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone and
you electronically file your return at 9 AM on April 15, 2020, your Intuit electronic postmark will indicate
April 15, 2020, 6 AM. If your federal tax return is rejected, the IRS still considers it filed on time if the
electronic postmark is on or before April 15, 2020, and a corrected return is submitted and accepted
before April 20, 2020. If your return is submitted after April 20, 2020, a new time stamp is issued to
reflect that your return was submitted after the IRS deadline and, consequently, is no longer considered
to have been filed on time.
If you request an automatic six-month extension, your return must be electronically postmarked by
midnight October 15, 2020. If your federal tax return is rejected, the IRS will still consider it filed on
time if the electronic postmark is on or before October 15, 2020, and the corrected return is submitted
and accepted by October 20, 2020.
2. THE ACCEPTANCE DATE.

Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit
Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return.
Donald R & Barbara J Chandler 417-54-0387 1
Smart Worksheets from your 2019 Federal Tax Return
SMART WORKSHEET FOR: Schedule B: Interest and Dividend Income
Interest Income Smart Worksheet
Payer’s Name Box 1 Box 2 Box 3 Box 8 Box 9
Early US Savings Private

To access Form 1099-INT Interest Typ Withdraw Bond/Treas. Tax-exempt ST Activity
Double-Click on payer Income Int Penalty Obligations Interest ID* Bond
Bancorpsouth Bank
1,088.67
Ally Bank
2,978.17
Dollar Bank
14.99
Wells Fargo Bank NA
28.93
SMART WORKSHEET FOR: Schedule B: Interest and Dividend Income
Dividend Income Smart Worksheet

Payer’s Name
To access 1099-DIV, Double-Click from payer
Box 1a Box 1b Box 2a Box 2b Box 3 Box 10 State Private

Tot Ordinary Qualified Capital Gain Unrecap. Nondividend Exempt- int ID* Actvty
Dividends Dividends Distributions Sec 1250 Distributions Dividends Bond
CMS Energy
330.94 330.94
SMART WORKSHEET FOR: Federal Information Worksheet
TurboTax for the Web Filing Status Smart Worksheet
Check this box to override the filing status selected thru Interview
Marital Status
Filing Status Selected
SMART WORKSHEET FOR: Federal Information Worksheet
2017 Tax Cuts & Jobs Act

Apply 15-year recovery period to qualified improvement property
(asset types J2, J3, J4 and J5)
placed in service after December 31, 2017?
Yes No X
Refer to Tax Help
SMART WORKSHEET FOR: Form 1099-R (Ohio Public Emp Ret System - DC): Pension/IRA Distributions
Qualified Disaster Distribution Smart Worksheet
A Is this a Qualified Disaster distribution

B Amount of Qualified Disaster distribution Entire distribution is qualified
or amount that is qualified
C Indicate amount, if any, of this Qualified Disaster distribution that was repaid before
filing the 2019 tax return Entire distribution repaid
or amount of partial repayment
D If this Qualified Disaster distribution was received for the purchase or construction of a
a new home and the new home was not purchased or constructed due to a qualified
disaster enter any amount repaid Entire distribution repaid
Nonstandard or Substitute Form 1099-R Smart Worksheet
A If substitute Form 1099-R needed, double-click to link to Form 4852

B Enter Form 4852, Line 9 information. "How did you determine amounts on line 7 of Form 4852?"
C Form 4852, Line 10 information. "Explain your efforts to obtain Form W-2?"
D QuickZoom to complete Form 4852

E Check box if this 1099-R is ’non-standard’ (handwritten, typewritten, or altered in any way)
Explanation Statement Smart Worksheet
If a box is checked on a line below, an explanation statement is Taxpayer Spouse

required for the situation described on that line. Highlight the
checkbox and select the help to see the required information.
Then QuickZoom to the appropriate explanation statement.
Return of IRA contribution before due date of tax return

Return of prior year excess traditional IRA contributions
Simplified Method Smart Worksheet
A If the annuity starting date is after December 31, 1997, is the annuity
payable based on the life of more than one individual? Yes No
B If line A is ’No’, enter the age of the annuitant at the annuity starting date. If line A
is ’Yes’, enter the age of the primary annuitant at the annuity starting date. (If there is
no primary annuitant, enter the age of the oldest survivor annuitant)
C If line A is "Yes", enter the age of the youngest survivor annuitant at the annuity
starting date
Note: If the annuity starting date is before January 1, 1998, enter the age of the recipient
at the annuity starting date on line B above.
SMART WORKSHEET FOR: Form 1099-R (Exelis Inc. -Northern Trust Company-DC): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (Exelis Inc. -Northern Trust Company-BC): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (Northern Trust Co - BC ITT Cons Hrly Plan): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (JP Morgan Chase NA Tefra Acct-Valeo- BC): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (AXA Equitable-DC-#304700322IA): Pension/IRA Distributions





starting date





starting date
SMART WORKSHEET FOR: Form 1099-R (Security Benefit-BC #5440010254): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (AXA Equitable - BC #304702755IA): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (WELLS FARGO-DC #2794-5307): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (WELLS FARGO-BC #8010-0710): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (ATHENE-DC #AA10110354): Pension/IRA Distributions





starting date





starting date
SMART WORKSHEET FOR: Form 1099-R (ATHENE-BC #AA10110355): Pension/IRA Distributions





starting date
SMART WORKSHEET FOR: Form 1099-R (AXA EQUITABLE-DC #304700323IA): Pension/IRA Distributions





starting date





starting date
SMART WORKSHEET FOR: Form 1099-R (AXA EQUITABLE-BC #304702755IA): Pension/IRA Distributions





starting date





starting date
SMART WORKSHEET FOR: Social Security Benefits Worksheet
Earlier Year Lump-Sum Benefits Smart Worksheet
If you received a lump-sum payment that includes benefits for one or more earlier
years after 1983, QuickZoom to the Earlier Year Lump-Sum Social Security
Worksheet to enter lump-sum payment for an earlier year(s)
If earlier year payments are entered, check this box to not make the lump-sum election
SMART WORKSHEET FOR: Estimated Tax Payment Options
For Residents of Guam or the U.S. Virgin Islands Only

Permanent resident of Guam or U.S. Virgin Islands
Nonpermanent resident of Guam or U.S. Virgin Islands
Additional information from your 2019 Federal Tax Return

Charitable Organization (BIG FISH MINISTRIES)
Detail of Item Donations - Continued Continuation Statement
1 09/28/2019 1 Lamp: Table 34.00 1 21.00 0 34.00

1 09/28/2019 1 Costume Jewelry: Necklace 2.00 1 1.00 0 2.00
1 09/28/2019 1 Tissue Box Cover 6.00 1 4.00 0 6.00
1 09/28/2019 1 Candle Holder: Pillar 8.00 2 5.00 0 16.00
1 09/28/2019 1 Baseball Cap: Adult 6.00 8 4.00 0 48.00
1 09/28/2019 1 Straightening Iron 4.00 1 2.00 0 4.00
1 09/28/2019 1 Book: Hardcover 6.00 7 4.00 0 42.00
1 09/28/2019 1 Toaster Oven 9.00 1 6.00 0 9.00
1 09/28/2019 1 Framed Art Print 16.00 3 8.00 0 48.00
1 09/28/2019 1 Dresser w/Mirror 71.00 1 50.00 0 71.00
1 09/28/2019 1 Men's Shirt: Dress Shirt 17.00 11 12.00 0 187.00
1 09/28/2019 1 Men's Shirt: Mock Turtleneck 17.00 1 12.00 0 17.00
1 09/28/2019 1 Ladder: Extension 17.00 1 12.00 0 17.00
1 09/28/2019 1 Men's Shirt: T-Shirt 7.00 9 4.00 0 63.00
1 09/28/2019 1 End Table 25.00 0 18.00 2 36.00
1 09/28/2019 1 Photo Album 5.00 3 4.00 0 15.00
1 09/28/2019 1 Entertainment Center 88.00 1 61.00 0 88.00
1 09/28/2019 1 Card Table 31.00 2 22.00 0 62.00
1 09/28/2019 1 Mobile Kitchen Island 53.00 1 37.00 0 53.00
1 09/28/2019 1 Shoes: Casual: Adult 14.00 3 10.00 0 42.00
1 09/28/2019 1 Wicker/Wooden Basket 14.00 1 8.00 0 14.00
1 09/28/2019 1 Shoes: Dress: Adult 20.00 3 11.00 0 60.00
1 09/28/2019 1 Afghan 11.00 2 8.00 0 22.00
1 09/28/2019 1 Baby Gear: Walker 9.00 1 6.00 0 9.00
1 09/28/2019 0 Storage Cabinet-Large, White 20.00 1 0.00 0 20.00
1 09/28/2019 0 Oak Wooden Bookcases 25.00 2 0.00 0 50.00
1 09/28/2019 0 Decorative plate 5.00 1 0.00 0 5.00
Total 1,040.00
Charitable Organization (GOODWILL-CYPRESS CREEK)

1 12/30/2019 1 Tablecloth 5.00 1 2.00 0 5.00

1 12/30/2019 1 Men's Swimwear: Trunks 13.00 2 9.00 0 26.00
1 12/30/2019 1 Ear Buds 5.00 4 3.00 0 20.00
1 12/30/2019 1 Wash Cloth 2.00 1 1.50 0 2.00
1 12/30/2019 1 Men's Undergarments: Socks 1.50 16 0.75 0 24.00
1 12/30/2019 1 Plastic Hangers (10-20) 2.50 1 1.00 0 2.50
1 12/30/2019 1 Women's Shirt: T-Shirt 10.00 3 7.00 0 30.00
1 12/30/2019 1 Women's Shirt: Tank 8.00 9 6.00 0 72.00
1 12/30/2019 1 Bottle Opener 5.00 2 3.00 0 10.00
1 12/30/2019 1 Cell Phone: Charger: USB 5.00 2 2.50 0 10.00
1 12/30/2019 1 Coffee Cup 1.00 5 0.75 0 5.00
1 12/30/2019 1 Candle Holder: Votive 10.00 13 7.00 0 130.00

1 12/30/2019 1 Candy Dish 6.00 1 4.00 0 6.00

1 12/30/2019 1 Jackets: Adult 33.00 2 18.00 0 66.00
1 12/30/2019 1 Mantel/Shelf Clock 15.00 1 11.00 0 15.00
1 12/30/2019 1 Surge Protector 12.00 2 9.00 0 24.00
1 12/30/2019 1 Women's Shorts: Jeans/Denim 11.00 2 8.00 0 22.00
1 12/30/2019 1 Computer Keyboard: Corded: USB 11.00 4 8.00 0 44.00
1 12/30/2019 1 Fabric Wall Hanging 13.00 1 9.00 0 13.00
1 12/30/2019 1 Glass Measuring Cup 1.50 1 1.00 0 1.50
1 12/30/2019 1 Can Opener (Manual) 3.00 1 1.50 0 3.00
1 12/30/2019 1 Faux Flower Arrangement 14.00 1 9.00 0 14.00
1 12/30/2019 1 Cat Litter Box 6.00 1 4.00 0 6.00
1 12/30/2019 1 Fishing: Rod 25.00 2 18.00 0 50.00
1 12/30/2019 1 Measuring Cups (Set) 4.00 0 3.00 1 3.00
1 12/30/2019 1 Women's Sleepwear: Lounge Pants 11.00 6 8.00 0 66.00
1 12/30/2019 1 Bean Pot 15.00 1 10.00 0 15.00
1 12/30/2019 1 Framed Art Print 16.00 2 8.00 0 32.00
1 12/30/2019 1 Glass/Ceramic Vase 11.00 1 6.00 1 17.00
1 12/30/2019 1 Women's Sleepwear: Robe 12.00 1 9.00 0 12.00
1 12/30/2019 1 Wrench: Torque 8.00 1 6.00 0 8.00
1 12/30/2019 1 Boots: Hiking: Adult 32.00 1 22.00 0 32.00
1 12/30/2019 1 Spoon Rest 3.00 1 2.00 0 3.00
1 12/30/2019 1 Smoke Detector 7.00 2 5.00 0 14.00
1 12/30/2019 1 Women's Sweater: Cardigan 13.00 2 9.00 0 26.00
1 12/30/2019 1 Women's Sweater: Pullover 14.00 2 7.00 0 28.00
1 12/30/2019 1 Spring Form Pan 3.00 1 2.00 0 3.00
1 12/30/2019 1 Mouse 6.00 5 4.00 0 30.00
1 12/30/2019 1 Picture Frame 11.00 5 7.00 0 55.00
1 12/30/2019 1 Drill Bit Set 5.00 26 4.00 0 130.00
1 12/30/2019 1 Automotive: DVD Player 21.00 3 15.00 0 63.00
1 12/30/2019 1 Jewelry Box 8.00 1 6.00 0 8.00
1 12/30/2019 1 Plastic Storage Bin 7.00 9 5.00 0 63.00
1 12/30/2019 1 Headphones 20.00 2 14.00 0 40.00
1 12/30/2019 1 Plastic Storage Drawers 5.00 1 3.00 0 5.00
1 12/30/2019 1 Wicker/Wooden Basket 14.00 1 8.00 0 14.00
1 12/30/2019 1 Women's Undergarments: Socks 3.00 4 1.00 0 12.00
1 12/30/2019 1 Board Game 6.00 1 5.00 0 6.00
1 12/30/2019 1 Shoes: Dress: Adult 20.00 1 11.00 0 20.00
1 12/30/2019 1 Window Coverings: Curtain Rod 6.00 1 5.00 0 6.00
1 12/30/2019 1 Hamper 7.00 1 5.00 0 7.00
1 12/30/2019 1 Window Coverings: Curtains 23.00 20 12.00 0 460.00
1 12/30/2019 1 Other Games 5.00 4 3.00 0 20.00
1 12/30/2019 1 Belt: Adult 6.00 4 3.00 0 24.00
1 12/30/2019 1 Lamp Shade 23.00 1 16.00 0 23.00
1 12/30/2019 1 Flashlight 2.50 1 2.00 0 2.50
1 12/30/2019 1 Lamp: Desk 13.00 1 9.00 0 13.00
1 12/30/2019 1 Costume Jewelry: Bracelet 3.00 1 1.50 0 3.00
1 12/30/2019 1 Bed Spread: Set: Queen 21.00 1 15.00 0 21.00
1 12/30/2019 1 Costume Jewelry: Earrings 1.50 1 0.75 0 1.50
1 12/30/2019 1 Costume Jewelry: Necklace 2.00 1 1.00 0 2.00
1 12/30/2019 1 Light Fixture: House or Porch Mounted 38.00 1 24.00 0 38.00

1 12/30/2019 1 Baseball Cap: Adult 6.00 8 4.00 0 48.00

1 12/30/2019 1 Dress Hat: Adult 11.00 6 7.00 0 66.00
1 12/30/2019 1 Bath Rug 5.00 4 2.00 0 20.00
1 12/30/2019 1 Western Hat: Adult 19.00 1 13.00 0 19.00
1 12/30/2019 1 Dinner Plate 2.00 4 1.50 0 8.00
1 12/30/2019 1 Baby Gear: Saucer 1.00 1 0.75 0 1.00
1 12/30/2019 1 Glass Tumbler 1.00 6 0.75 0 6.00
1 12/30/2019 1 Bread Box 6.00 1 4.00 0 6.00
1 12/30/2019 1 Men's Pants: Chinos/Khakis 11.00 6 8.00 0 66.00
1 12/30/2019 1 Pencil Sharpener: Electric 8.00 1 6.00 0 8.00
1 12/30/2019 1 Pruning Saw 11.00 1 8.00 0 11.00
1 12/30/2019 1 Men's Pants: Dress Slacks 9.00 1 7.00 0 9.00
1 12/30/2019 1 Men's Pants: Jeans/Denim 17.00 3 12.00 0 51.00
1 12/30/2019 1 Neck Tie 2.50 17 1.50 0 42.50
1 12/30/2019 1 Men's Shirt: Dress Shirt 17.00 5 12.00 0 85.00
1 12/30/2019 1 Men's Shirt: Jersey 20.00 1 14.00 0 20.00
1 12/30/2019 1 Men's Shirt: Mock Turtleneck 17.00 1 12.00 0 17.00
1 12/30/2019 1 Men's Shirt: Polo 17.00 5 12.00 0 85.00
1 12/30/2019 1 Men's Shirt: T-Shirt 7.00 6 4.00 0 42.00
1 12/30/2019 1 Nintendo 64: AV Cable 4.00 1 3.00 0 4.00
1 12/30/2019 1 Men's Shorts: Cargo 11.00 5 8.00 0 55.00
1 12/30/2019 1 Men's Shorts: Chinos/Khakis 11.00 7 8.00 4 109.00
1 12/30/2019 1 Men's Shorts: Jeans/Denim 10.00 1 7.00 0 10.00
1 12/30/2019 1 Men's Sleepwear: Lounge Pants 6.00 1 4.00 0 6.00
1 12/30/2019 1 Men's Sleepwear: Robe 17.00 1 12.00 0 17.00
1 12/30/2019 1 Area Rug 6.00 2 4.00 0 12.00
1 12/30/2019 1 Men's Sweater: Cardigan 14.00 1 10.00 0 14.00
1 12/30/2019 0 Office-Staples - 3 Boxes 4.00 3 0.00 0 12.00
1 12/30/2019 0 Electronics-AC Adapters 5.00 2 0.00 0 10.00
1 12/30/2019 0 Jewelry-Bracelet-Leather wrist cuff with vintage turquoise dangle 10.00 1 0.00 0 10.00
1 12/30/2019 0 Jewelry-Men's-Bracelet-Ribbed Stainless 25.00 1 0.00 0 25.00
1 12/30/2019 0 Stress Man Cloth Doll 5.00 1 0.00 0 5.00
1 12/30/2019 0 Garage-Squeegie 10.00 1 0.00 0 10.00
1 12/30/2019 0 Garage- Decor Twist Tie Dispenser 3.00 1 0.00 0 3.00
1 12/30/2019 0 Jewelry-Watch-Pink Leather Banded Daisy Fuentes Watch 35.00 1 0.00 0 35.00
1 12/30/2019 0 Kitchen-Alabama ice cube mold 2.50 1 0.00 0 2.50
1 12/30/2019 0 Jewelry-Men's-Watch-Brown Leather Bank with Glow In The Dark Face with Compas 30.00 1 0.00 0 30.00
1 12/30/2019 0 Kitchen-Filet Knife 5.00 1 0.00 0 5.00
1 12/30/2019 0 Office-Coin Sorter-Battery Operated 5.00 1 0.00 0 5.00
1 12/30/2019 0 Home Decor-Candle Holders-Heavy Glass Cylinders 10.00 2 0.00 0 20.00
1 12/30/2019 0 Electronics-HDMI Cable 7.00 4 0.00 0 28.00
1 12/30/2019 0 Kitchen-Box of 6 wine glass markers 10.00 1 0.00 0 10.00
1 12/30/2019 0 Jewelry-Necklace-Garnet Cross on Gold Chain 50.00 1 0.00 0 50.00
1 12/30/2019 0 Home Decor-Framed Kincaid Puzzle 20.00 1 0.00 0 20.00
1 12/30/2019 0 Purse-Vera Wang Blue Leather Purse 45.00 1 0.00 0 45.00
1 12/30/2019 0 Big Dog Lanyards 5.00 2 0.00 0 10.00
1 12/30/2019 0 Electronics-Ethernet Cable 12.00 3 0.00 0 36.00
1 12/30/2019 0 Home Decor-Framed Art-Sail Boat Water Color 65.00 1 0.00 0 65.00
1 12/30/2019 0 Kitchen-Wash Towels 1.25 3 0.00 0 3.75
1 12/30/2019 0 Office-Rulers for office 2.00 4 0.00 0 8.00

1 12/30/2019 0 Kitchen-Keurig 4 cup Coffee Maker 25.00 1 0.00 0 25.00

1 12/30/2019 0 Jewelry-Men's-Watch-Elgin with Black Leather Band, Gold and Black Round Face 50.00 1 0.00 0 50.00
1 12/30/2019 0 Office-Stylus Pens 2.00 4 0.00 0 8.00
1 12/30/2019 0 Office-1 in 3 Ring Binder 5.00 1 0.00 0 5.00
1 12/30/2019 0 Auto-Scratch Remover 5.00 1 0.00 0 5.00
1 12/30/2019 0 Jewelry-Men's-Watch-Black Leather Band with Harley Davidson Emblem 45.00 1 0.00 0 45.00
1 12/30/2019 0 Lighting-Ceiling Light Fixture-frosted bowl 12 20.00 1 0.00 0 20.00
1 12/30/2019 0 Men's Casual Short Sleeve Shirt 12.00 7 0.00 0 84.00
1 12/30/2019 0 Electronics-Fix It PC Utilities Program 5.00 1 0.00 0 5.00
1 12/30/2019 0 Kitchen-Towels 2.50 4 0.00 0 10.00
1 12/30/2019 0 Jewelry-Pendant-Silver and Black Onyx Pendant 15.00 1 0.00 0 15.00
1 12/30/2019 0 Kitchen-6 Round Woven Beaded Placemats 25.00 1 0.00 0 25.00
1 12/30/2019 0 Office-3 1 in Ring Binders 5.00 2 0.00 0 10.00
1 12/30/2019 0 Jewelry-Bracelet and Earrings Set-Vintage Silverplate 45.00 1 0.00 0 45.00
1 12/30/2019 0 Office-Imported Sketch Pad with Rope binding 10.00 1 0.00 0 10.00
1 12/30/2019 0 Kitchen-Small Ceramic Sugar Holder with spoon-hummingbird 15.00 1 0.00 0 15.00
1 12/30/2019 0 Jewelry-Earrings-Stud-Crystal, Rhinestone, pearl 25.00 4 0.00 0 100.00
1 12/30/2019 0 Kitchen-Pastry Blender 1.00 1 0.00 0 1.00
1 12/30/2019 0 Home Decor-Decorative switch plate 15.00 1 0.00 0 15.00
1 12/30/2019 0 Jewelry-Necklace-Black ribbon with ceramic pendant 15.00 1 0.00 0 15.00
1 12/30/2019 0 Home Decor-Candles-Packages of Melts 2.00 3 0.00 0 6.00
1 12/30/2019 0 Men's Ties-Harley Davidson Men's Tie 10.00 2 0.00 0 20.00
1 12/30/2019 0 Jewelry-Earrings-Gray/Black Stone, Rhinestone 10.00 3 0.00 0 30.00
1 12/30/2019 0 Office-Card and Invitation Software Kit 5.00 1 0.00 0 5.00
1 12/30/2019 0 Office-Sharpie Permanent Markers 1.00 4 0.00 0 4.00
1 12/30/2019 0 Office-500 Lined Index Cards 7.50 1 0.00 0 7.50
1 12/30/2019 0 Jewelry-Watch-Pearl Banded Dress Watch 20.00 1 0.00 0 20.00
1 12/30/2019 0 Jewelry-Men's-Bracelet-Woven Rope and Silver 35.00 1 0.00 0 35.00
1 12/30/2019 0 Home Decor-Framed Art-Perspective on a Dock 24 x 42 75.00 1 0.00 0 75.00
1 12/30/2019 0 Jewelry-Earrings-Multi-color Crystal Stones, silver 10.00 5 0.00 0 50.00
1 12/30/2019 0 Office-3 x 5 Post It Notes 4.00 2 0.00 0 8.00
1 12/30/2019 0 Extension Cords-3 Prong 5.00 11 0.00 0 55.00
1 12/30/2019 0 Home Decor-Hang-O-Matic Picture Hanging Kit 10.00 1 0.00 0 10.00
1 12/30/2019 0 Jewelry-Earrings-Brighton Angels Wings, Cross w/Blue Stone 30.00 2 0.00 0 60.00
1 12/30/2019 0 Pet Water Fountain with 4 filters 35.00 1 0.00 0 35.00
1 12/30/2019 0 Jewelry-Men's-Watch-Bulova with Black Leather Band, Black, Gold and White Face 70.00 1 0.00 0 70.00
1 12/30/2019 0 Jewelry-Men's-Bracelet-Woven Rope and Stainless 35.00 1 0.00 0 35.00
1 12/30/2019 0 Kitchen-Silver Plate Service for 10 plus accessories 150.00 1 0.00 0 150.00
1 12/30/2019 0 Office-Box of 50 Thermal Laminating Pouches 10.00 1 0.00 0 10.00
1 12/30/2019 0 Office-Box of Medium Binder Clips 3.00 1 0.00 0 3.00
1 12/30/2019 0 Office-Spiral Bound Notebook 5 x 11 3.00 5 0.00 0 15.00
1 12/30/2019 0 Small Glitter Gift Bag 2.50 2 0.00 0 5.00
1 12/30/2019 0 Jewelry-Men's-Watch-Black Leather Band with Big Dog Emblem 25.00 1 0.00 0 25.00
1 12/30/2019 0 Home Decor-Fan Pulls - Wood-Clam Shell, Metal Ball 10.00 2 0.00 0 20.00
1 12/30/2019 0 Jewelry-Men's-Watch-Fos il with Dark Brown Leather Bank, White and Gold Round Face 60.00 1 0.00 0 60.00
1 12/30/2019 0 Garage-Shurtape Duct Tape for HVAC 5.00 1 0.00 0 5.00
1 12/30/2019 0 Home Decor-Metal Yellow Bike decoration 10.00 1 0.00 0 10.00
1 12/30/2019 0 Jewelry-Necklace-Swarovski Crystal Heart Necklace 25.00 1 0.00 0 25.00
1 12/30/2019 0 Electrical Socket Extender - 3-Prong 3.00 2 0.00 0 6.00
1 12/30/2019 0 Home Decor-Candles-Pillar Candles 5.00 2 0.00 0 10.00

1 12/30/2019 0 Office-Journal Notebook (white w/gold) 8.5 x 11 5.00 1 0.00 0 5.00

1 12/30/2019 0 Purse-Kate Spade Leather Purse 50.00 1 0.00 0 50.00
1 12/30/2019 0 Electronics-VHS - Soprano's 3r Season Box 10.00 1 0.00 0 10.00
1 12/30/2019 0 Office-Isabella Fiori Leather Pen Holder 25.00 1 0.00 0 25.00
1 12/30/2019 0 Home Decor-Wood and Iron Magazine Side Table 50.00 1 0.00 0 50.00
1 12/30/2019 0 Travel-29 in Travel Luggag-Samsonite 30.00 1 0.00 0 30.00
1 12/30/2019 0 Jewelry-Jewelry Pouch Silk 5.00 1 0.00 0 5.00
1 12/30/2019 0 Kitchen-Miscellaneous fridge magnets 1.00 10 0.00 0 10.00
1 12/30/2019 0 Office-Sanitizing Wet Wipes 1.50 2 0.00 0 3.00
1 12/30/2019 0 Wire Storage Basket 3.00 1 0.00 0 3.00
1 12/30/2019 0 Garage Utility Hook 5.00 1 0.00 0 5.00
1 12/30/2019 0 Office-Cube of square notes 5.00 1 0.00 0 5.00
1 12/30/2019 0 Jewelry-Necklaces-Silver Necklace hains-small 10.00 2 0.00 0 20.00
1 12/30/2019 0 Jew lry-Men's-Watch-Metal Band Dres Watches: Gold Toned Nug et Watch with Square Gold Toned Face; Gold Toned Band with Black and Ivory Rectangle Face; Black and Gold Toned Band with Rectangle Curved Black and Gold Face 37.00 3 0.00 0 111.00
1 12/30/2019 0 Pets-Cat Toy- Catnip Stuffed Cloth Fish 3.00 1 0.00 0 3.00
1 12/30/2019 0 Office-Bic Mechanical Pencils 1.50 18 0.00 0 27.00
1 12/30/2019 0 Kitchen-8-piece Pie Slicer 4.00 1 0.00 0 4.00
1 12/30/2019 0 Jewelry-Men's-Watch-Elgin with Brown Leather Band, Gold Round Face 55.00 1 0.00 0 55.00
1 12/30/2019 0 Jewelry-Men's-Watch-Brown Leather Bank with Gold Toned Eagle/Earth Face 25.00 1 0.00 0 25.00
1 12/30/2019 0 Jewelry-Men's-Watch-Fossil with Brown Leather Bank, Gold Spiral Round Face 60.00 1 0.00 0 60.00
1 12/30/2019 0 Bath-Shower Head - Nickel 10.00 1 0.00 0 10.00
1 12/30/2019 0 Home Decor-Collegiate Fan Pulls 10.00 2 0.00 0 20.00
1 12/30/2019 0 Jewelry-Bracelet-Silver Charm Bracelet with 3 Charms 20.00 1 0.00 0 20.00
1 12/30/2019 0 Women's Hats-Beach Hat 5.00 1 0.00 0 5.00
1 12/30/2019 0 Home Decor-Framed Art-Riverbend Abstract- 37" 80.00 1 0.00 0 80.00
1 12/30/2019 0 Electronics-Laptop Lap Pillow Holder 10.00 1 0.00 0 10.00
1 12/30/2019 0 Home Decor-Fan Pull - Sea Shell 5.00 1 0.00 0 5.00
1 12/30/2019 0 Office-3 x 3 Post It Notes Packs 4.00 19 0.00 0 76.00
1 12/30/2019 0 Office-Magnifying Glass 2.50 2 0.00 0 5.00
1 12/30/2019 0 Office-Paper Clip Holders with Paper Clips 3.00 2 0.00 0 6.00
1 12/30/2019 0 Kitchen Steamer Basket 3.00 1 0.00 0 3.00
1 12/30/2019 0 Lamp Finial Gold 10.00 1 0.00 0 10.00
1 12/30/2019 0 Electronics-Amazon Firestick 35.00 1 0.00 0 35.00
1 12/30/2019 0 Electronics-Analog Converter 5.00 1 0.00 0 5.00
1 12/30/2019 0 Office-Avery Half Fold Greeting Cards 10.00 1 0.00 0 10.00
1 12/30/2019 0 Kitchen-Glass Creamer 4.00 1 0.00 0 4.00
1 12/30/2019 0 Kitchen-French Fry Potato Chipper 3.50 1 0.00 0 3.50
1 12/30/2019 0 Home Decor-Vintage Candelabra 25.00 1 0.00 0 25.00
1 12/30/2019 0 Garage-Auto SunShade 10.00 1 0.00 0 10.00
1 12/30/2019 0 Jewelry-Necklace-Goldtoned key pendant with turquoise stone on gold toned chain 20.00 1 0.00 0 20.00
1 12/30/2019 0 Home Decor-Scentsy Candle Melts Hurricane Glass Mosiac 40.00 1 0.00 0 40.00
1 12/30/2019 0 Electronics-DVD - Sporano's 1st Season Boxed Set 10.00 1 0.00 0 10.00
1 12/30/2019 0 Jewelry-Men's-Watch-Swis Army Watch with Black Cloth and Leather Band, Black and White Face 70.00 1 0.00 0 70.00
1 12/30/2019 0 Men's Belts-Harley Davidson Leather Belts 25.00 3 0.00 0 75.00
1 12/30/2019 0 Jewelry-Men's-Watches-3 with Black Leather Bands with yel ow face quartz, sun face, rectangle black face quartz 20.00 3 0.00 0 60.00
1 12/30/2019 0 Men's Ties-Metal Tie Rack 5.00 1 0.00 0 5.00
1 12/30/2019 0 Women's Clothing=Harley Davidson Women's Tshirt 20.00 1 0.00 0 20.00
1 12/30/2019 0 Men's Hats-Panama Jack Hat 25.00 1 0.00 0 25.00
1 12/30/2019 0 Electronics-Camera Holder for Selfies 5.00 1 0.00 0 5.00
1 12/30/2019 0 Jewelry-Bracelet-2 Copper Bracelets 10.00 2 0.00 0 20.00

1 12/30/2019 0 Office-Scotch Tape - Rolls 1.50 11 0.00 0 16.50

1 12/30/2019 0 Electronics-Roku Remote Sets 15.00 3 0.00 0 45.00
1 12/30/2019 0 Home Decor-DVD-CD Holder Box 5.00 1 0.00 0 5.00
1 12/30/2019 0 Home Decor-Decorative Vintage Cross 25.00 1 0.00 0 25.00
1 12/30/2019 0 Office-Box of 1,050 Multi Pricing Labels 10.00 1 0.00 0 10.00
1 12/30/2019 0 Essential Oil Diffusers 50.00 2 0.00 0 100.00
1 12/30/2019 0 Jewelry-Men's-Tie Clasp 5.00 1 0.00 0 5.00
1 12/30/2019 0 Jewelry-Men's-Watch-Metal Band Dres Watches: Seiko Rectangle Black and Gold Face; Calvin Klein Silver with Mother of Pearl Face 45.00 2 0.00 0 90.00
1 12/30/2019 0 Office-Pencil Holder Box 5.00 1 0.00 0 5.00
1 12/30/2019 0 Wicker and Wire Palm Tree Wastebasket 20.00 1 0.00 0 20.00
1 12/30/2019 0 Jewelry-Men's-Bracelet-Brown Leather 35.00 1 0.00 0 35.00
1 12/30/2019 0 Tissue Wrapping Paper- Pkgs. 3.00 2 0.00 0 6.00
1 12/30/2019 0 Jewelry-Men's-Bracelet-Onyx and Silver Links 35.00 1 0.00 0 35.00
1 12/30/2019 0 Travel-21 in Travel Luggage-Samsonite 25.00 1 0.00 0 25.00
1 12/30/2019 0 Home Decor-Fan Pulls-2 sets (silver and wood) 5.00 2 0.00 0 10.00
1 12/30/2019 0 Bath-Toilet Paper Stand 4.50 1 0.00 0 4.50
1 12/30/2019 0 Electronics-Extension Cords 3.50 2 0.00 0 7.00
1 12/30/2019 0 Jewelry-Necklace-Aquamarine and Gold Pendant 30.00 1 0.00 0 30.00
1 12/30/2019 0 Jewelry-Pin-Rhinestone Pin 10.00 1 0.00 0 10.00
1 12/30/2019 0 Men's Hats-Stetson Felt Cowboy Hat 50.00 1 0.00 0 50.00
Total 6,322.75
Electronic Filing Instructions for your 2019 Alabama Tax Return
Important: Your taxes are not finished until all required steps are completed.

Land O Lakes, FL 34638
|
Balance | Your Alabama state tax return (Form 40) shows that you have no
Due/ | balance due nor a refund due to you: DO NOT mail a payment or expect
Refund | to receive a refund from the Alabama Department of Revenue.
|
______________________________________________________________________________________
|
What You | Sign and date Form AL8453 within 1 day of acceptance. Since you are
Need to | married filing jointly, your spouse must also sign and date the form.
Sign |
|
______________________________________________________________________________________
|
Do Not | Do not mail a paper copy of your tax return. Since you filed
Mail | electronically, the Alabama Department of Revenue already has your
| return.
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | - Form AL8453
Keep | Printed copy of your state and federal returns
|
______________________________________________________________________________________
|
2019 | Taxable Income $ -29,031.00
Alabama | Total Tax $ 0.00
Tax | No Refund or Amount Due $ 0.00
Return |
Summary |
|
______________________________________________________________________________________
Page 1 of 1
FORM
40 Alabama 2019
Individual Income Tax Return
RESIDENTS & PART-YEAR RESIDENTS
For the year Jan. 1 - Dec. 31, 2019, or other tax year:
Beginning: 01/01/2019 Ending: • 09/30/2019

Your social security number Spouse’s SSN if joint return
• 417-54-0387 • 272-42-4709
• Check if primary is deceased • Check if spouse is deceased
Primary’s deceased date Spouse’s deceased date
(mm/dd/yy) • (mm/dd/yy) •
Your first name Initial Last name
• DONALD •R • CHANDLER
Spouse’s first name Initial Last name
• BARBARA •J • CHANDLER
Present home address (number and street or P.O. Box number) CHECK BOX IF AMENDED RETURN •
• 19640 COASTAL SHORE TERRACE
City, town or post office State ZIP code Foreign Country
Check if address
• LAND O LAKES •FL • 34638 • is outside U.S.
Filing Status/ 1 • $1,500 Single 3 • $1,500 Married filing separate. Complete Spouse SSN •
Exemptions 2 • $3,000 Married filing joint 4 • $3,000 Head of Family (with qualifying person).Complete Schedule HOF
5a Alabama Income Tax Withheld (from Schedule W-2, line 18, column G) . . . . . . . . . A – Alabama tax withheld B – Income
5b Wages, salaries, tips, etc. (from Schedule W-2, line 18, column I plus J): . . . . . . . . . . . . 5a • 5b •
Income 6 Interest and dividend income (also attach Schedule B if over $1,500) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 • 3,393
and 7 Other income (from page 2, Part I, line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 • 24,669
Adjustments 8 Total income. Add amounts in the income column for line 5b through line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 • 28,062
9 Total adjustments to income (from page 2, Part II, line 14). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 •
10 Adjusted gross income. Subtract line 9 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 • 28,062
11 Box a or b MUST be checked.
Check box a, if you itemize deductions, and enter amount from Schedule A, line 26.
Deductions
Check box b, if you do not itemize deductions, and enter standard deduction (see instructions)
If claiming a deduc- • a Itemized Deductions • b Standard Deduction . . . . . . . . . 11 • 20,998
tion on line 12, you
must attach page
1,2 and Schedule 1
12 Federal tax deduction (see instructions)
of your Federal Re- DO NOT ENTER THE FEDERAL TAX WITHHELD FROM YOUR FORM W-2(S) 12 • 33,095
turn, if applicable.
13 Personal exemption (from line 1, 2, 3, or 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 • 3,000
14 Dependent exemption (from page 2, Part III, line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 •
15 •
15 Total deductions. Add lines 11, 12, 13, and 14. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57,093
16 Taxable income. Subtract line 15 from line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 • -29,031
17 Income Tax due. Enter amount from tax table or check if from • Form NOL-85A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 • 0
Tax 18 Net tax due Alabama. Check box if computing tax using Schedule NTC • , otherwise enter amount from line 17. . . 18 • 0
Staple Form(s) W-2, 19 Consumer Use Tax (see instructions). If you certify that no use tax is due, check box • . . . . . . . . . . . . . . . . . . . . . . . . . . 19 • 0
W-2G, and/or 1099
here. Attach Sched-
20 Alabama Election Campaign Fund. You may make a voluntary contribution to the following:
ule W-2 to return. a Alabama Democratic Party $1 $2 none . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20a •
b Alabama Republican Party $1 $2 none . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20b •
21 Total tax liability and voluntary contribution. Add lines 18, 19, 20a, and 20b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 • 0
22 Alabama income tax withheld (from column A, line 5a) . . . . . . . . . . . . . . . . . . . . . . 22 •
23 2019 estimated tax payments/Automatic Extension Payment. . . . . . . . . . . . . . . . . . . 23 •
24 Amended Returns Only — Previous payments (see instructions) . . . . . . . . . . . . . . . 24 •
Payments 25 Refundable Credits. Enter the amount from Schedule RC, line 4 . . . . . . . . . . . . . . 25 •
26 Total payments. Add lines 22, 23, 24, and 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 •
27 Amended Returns Only — Previous refund (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 •
28 Adjusted Total Payments. Subtract line 27 from line 26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 •
29 If line 21 is larger than line 28, subtract line 28 from line 21, and enter AMOUNT YOU OWE.
AMOUNT
Place payment, along with Form 40V, loose in the mailing envelope. (FORM 40V MUST ACCOMPANY PAYMENT.) 29 •
YOU OWE
30 Estimated tax penalty. Also include on line 29 (see instructions page 12) . . . . . . . . 30 •
31 If line 28 is larger than line 21, subtract line 21 from line 28, and enter amount OVERPAID . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 • 0
OVERPAID
32 Amount of line 31 to be applied to your 2020 estimated tax . . . . . . . . . . . . . . . . . . . 32 •
Donations 33 Total Donation Check-offs from Schedule DC, line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . 33 •
34 REFUNDED TO YOU. (CAUTION: You must sign this return on the reverse side.)
REFUND Subtract lines 32 and 33 from line 31. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 •
For Direct Deposit, check here • and complete Part V, Page 2.
1555-3
REV 02/14/20 TTW

Form 40 (2019) Page 2
PART I 1 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 •

2 Business income or (loss) (attach Federal Schedule C or C-EZ) (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 •
3 Gain or (loss) from sale of Real Estate, Stocks, Bonds, etc. (attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 •
4a Total IRA distributions 4a • 59,796 4b Taxable amount (see instructions) . . . . . . . . . . . . 4b • 24,669
Other 5a Total pensions and annuities 5a • 111,695 5b Taxable amount (see instructions) . . . . . . . . . . . . 5b • 0
Income
(See page 13) 6 Rents, royalties, partnerships, estates, trusts, etc. (attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 •
7 Farm income or (loss) (attach Federal Schedule F). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 •
8 Other income (state nature and source — see instructions) 8 •
9 Total other income. Add lines 1 through 8. Enter here and also on page 1, line 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 • 24,669
PART II 1a Your IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a •
b Spouse’s IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b •
2 Payments to a Keogh retirement plan and self-employment SEP deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 •
3 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 •
4 Alimony paid. Recipient’s last name SSN • 4 •
5 Adoption expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 •
Adjustments 6 Moving Expenses (Attach Federal Form 3903) to:
to Income City State ZIP 6 •
(See page 16) 7 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 •
8 Payments to Alabama College Counts 529 Fund or Alabama PACT Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 •
9 Health insurance deduction for small employer employee (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 •
10 Costs to retrofit or upgrade home to resist wind or flood damage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 •
11 Deposits to a catastrophe savings account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 •
12 Contributions to a health savings account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 •
13 Deposits to an Alabama First-Time and Second Chance Home Buyer Savings Account (see instructions) . . . . . . . . . . . . . . . . . . . 13 •
14 Total adjustments. Add lines 1 through 13. Enter here and also on page 1, line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 •
PART III 1 Total number of dependents from Schedule DS, line 1b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 •
2 Amount allowed. (Multiply total number of dependents claimed on line 1 by the amount on the dependent chart
Dependents on page 10 of Instructions.) Enter amount here and on page 1, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 •
PART IV 1 Residency Check only one box • Full Year • Part Year From 01-01 2019 through 09-30 2019.
2 Did you file an Alabama income tax return for the year 2018? • Yes • No If no, state reason
General 3 Give name and address of present employer(s). Yours RETIRED
Information
Your Spouse’s RETIRED
All Taxpayers 4 Enter the Federal Adjusted Gross Income • $ 215,293 and Federal Taxable Income • $ 188,293 as reported on your
Must
2019 Federal Individual Income Tax Return.
Complete
This 5 Do you have income which is reported on your Federal return, but not reported on your Alabama return (other than your state tax refund)? • Yes • No
Section.
If yes, enter source(s) and amount(s) below: (other than state income tax refund)
(See page 17) Source • Amount •
Source • Amount •
PART V For Direct Deposit of your refund, complete 1, 2, 3, and 4 below. (See Page 17 of instructions to see if you qualify.)
Direct 1 Routing Number: 2 Type: Checking Savings 3 Account Number:
Deposit 4 Is this refund going to or through an account that is located outside of the United States? Yes No
DOB Iss date Exp date
Drivers (mm/dd/yyyy) • XX/XX/XXXX Your state • XX DL# • XXXXXXX (mm/dd/yyyy) • XX/XX/XXXX (mm/dd/yyyy) • XX/XX/XXXX
DOB Iss date Exp date
License Info (mm/dd/yyyy) • XX/XX/XXXX Spouse state • XX DL# • XXXXXXX (mm/dd/yyyy) • XX/XX/XXXX (mm/dd/yyyy) • XX/XX/XXXX
• I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
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 com-
plete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign Here Your Signature Date Daytime Telephone Number Your Occupation
In Black Ink (440)669-5965
Keep a copy RETIRED
of this return Spouse’s Signature (if joint return, BOTH must sign) Date Daytime Telephone Number Spouse’s Occupation
for your
records.
(440)567-9608 RETIRED
Preparer’s Signature Date Check if Self-employed Preparer’s SSN or PTIN E.I. Number
Paid SELF PREPARED •
Preparer’s Firms’s Name (or yours Daytime ZIP
if self employed) Telephone No. Code
Use Only
Address
1555-3
REV 02/14/20 TTW
SCHEDULES Alabama Department of Revenue
A,B,&DC Schedule A–Itemized Deductions 2019
(FORM 40)
(Schedules B and DC are on back page)
ATTACH TO FORM 40 — SEE INSTRUCTIONS FOR SCHEDULE A
Name(s) as shown on Form 40 Your social security number
DONALD R & BARBARA J CHANDLER 417-54-0387

The itemized deductions you may claim for the year 2019 are similar to the itemized deductions claimed on your Federal return, however, the amounts may
differ. Please see instructions before completing this schedule. PART-YEAR RESIDENTS:A resident of Alabama for only a part of the year should list below
only those deductions actually paid while a resident of Alabama.
CAUTION: Do not include expenses reimbursed or paid by others.

Medical and 1 Medical and dental expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 11,474 00
Dental Expenses 2 Enter amount from Form 40, line 10.. . . . . . . . . . . . . . 2 28,062 00
(See page 19) 3 Multiply the amount on line 2 by 4% (.04). Enter the result. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1,122 00
4 Subtract line 3 from line 1. Enter the result. If zero or less, enter –0–. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 • 10,352 00
5 Real estate taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 799 00
6 FICA Tax (Social Security and Medicare) and Federal Self-Employment Tax.. . . . . . . . . . . 6 00
Taxes You Paid 7 Railroad Retirement (Tier 1 only). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 00
(See page 19) 8 Other taxes. (List – include personal property taxes.)
OTHER TAXES 8 372 00
9 Add the amounts on lines 5 through g 8. Enter the total here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 • 1,171 00
10a Home mortgage interest and points reported to you on Federal Form 1098. . . . . . . . . . . . . 10a 00
b Home mortgage interest not reported to you on Federal Form 1098. (If paid to
Interest You Paid an individual, show that person’s name and address.)
(See page 20)
NOTE: Personal
10b 00
interest is not 11 Points not reported to you on Form 1098. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 00
deductible. 12 Investment interest. (Attach Form 4952A.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 00
13 Add the amounts on lines 10a through 12. Enter the total here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 • 00
CAUTION: If you made a charitable contribution and received a benefit in return,
see page 19.
Gifts to Charity 14 Contributions by cash or check. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4,050 00
(See page 20) 15 Other than cash or check. (You MUST attach Federal Form 8283 if over $500.). . . . . . . . . 15 1,139 00
16 Carryover from prior year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 00
17 Add the amounts on lines 14 through 16. Enter the total here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 • 5,189 00
Casualty and 18a Enter the amount from Federal Form 4684, line 16 (See page 20). . . . . . . . . . . . . . . . . . . . . 18a 00
Theft Loss b Enter 10% of your Adjusted Gross Income (Form 40, line 10). . . . . . . . . . . . . . . . . . . . . . . . . 18b 00
(Attach Form 4684) c Subtract line 18b from line 18a. If zero or less, enter –0–. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18c • 00
19 Unreimbursed employee expenses — job travel, union dues, job education, etc.
(You MUST attach Federal Form 2106 if required. See instructions.)
Job Expenses 19 00
and Most Other 20 Other expenses (investment, tax preparation, safe deposit box, etc.). List type
Miscellaneous
and amount.
Deductions
(See page 20) 20 00
21 Add the amounts on lines 19 and 20. Enter the total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 00
22 Multiply the amount on Form 40, line 10 by 2% (.02). Enter the result here.. . . . . . . . . . . . . 22 00
23 Subtract line 22 from line 21. Enter the result. If zero or less, enter –0–.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 • 00
24 Other (from list on page 21 of instructions). List type and amount.
Other
Miscellaneous
Deductions
24 • 00
Qualified Long- CAUTION: Do not include medical premiums.
Term Care Ins.
Premiums 25 Enter amount here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 • 4,286 00
Total Itemized 26 Add the amounts on lines 4, 9, 13, 17, 18c, 23, 24, and 25. Enter the total here. Then
Deductions enter on Form 40, page 1, line 11 and check 11a, Itemized Deductions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 • 20,998 00
REV 02/14/20 TTW Schedule A (Form 40) 2019
1555-3
Sch. A, B, & DC
(Form 40) 2019 Page 2
Name(s) as shown on Form 40 (Do not enter name and social security number if shown on other side) Your social security number
DONALD R & BARBARA J CHANDLER 417-54-0387
SCHEDULE B – Interest And Dividend Income
If you received more than $1500 of interest and dividend income, you must complete Schedule B. See instructions on page 21.
B
A
List Payers and Amounts Taxable Interest
Exempt Interest
and Dividends
1 BANCORPSOUTH BANK 00 817 00

ALLY BANK 00 2,234 00
I
N DOLLAR BANK 00 11 00
T 00 00
E
R 1 00 1 00
E 00 00
S
T 00 00
00 00
00 00
2 CMS ENERGY 331 00
D 00
I 00
V
I 00
D 2 00
E
N 00
D 00
S
00
00
3 TOTAL TAXABLE INTEREST AND DIVIDENDS
p g 1, line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . •
Enter here and on Form 40, page 3 3,393 00
SCHEDULE DC – Donation Check-Offs
1 You may donate all or part of your overpayment. (Enter the amount in the appropriate
pp p boxes.)
a Senior Services Trust Fund . . . . . . . . . . . . . . . . . . . . . . . • 00 j Alabama Firefighters Annuity and Benefit Fund. . . . . . . . . . . . . • 00
b Alabama Arts Development Fund . . . . . . . . . . . . . . . . . . • 00 k Alabama Breast & Cervical Cancer Program . . . . . . . . . . . . . . . • 00
c Alabama Nongame Wildlife Fund . . . . . . . . . . . . . . . . . . • 00 l Victims of Violence Assistance . . . . . . . . . . . . . . . . . . . . . . . . • 00
d Child Abuse Trust Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . • 00 m Alabama Military Support Foundation . . . . . . . . . . . . . . . . . . . . . • 00
e Alabama Veterans Program . . . . . . . . . . . . . . . . . . . . . . . • 00 n Alabama Veterinary Medical Foundation
f Alabama State Historic Preservation Fund . . . . . . . . . . • 00 Spay-Neuter Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 00
g Alabama State Veterans Cemetery at o Cancer Research Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 00
Spanish Fort Foundation, Inc. . . . . . . . . . . . . . . . . . . . . . • 00 p Alabama Association of Rescue Squads. . . . . . . . . . . . . . . . . . . • 00
h Foster Care Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 00 q USS Alabama Battleship Commission. . . . . . . . . . . . . . . . . . . . . • 00
i Mental Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 00 r Children First Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 00
2 Total Donations. Add lines 1a, b, c, d, e, f, g, h, i, j, k, l, m, n, o, p, q, and r. Enter here and on Form 40, page 1, line 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • 00
Schedules B, & DC (Form 40) 2019
REV 02/14/20 TTW
1555-3
FORM
AlAbAmA DepArtment of revenue
AL8453 Idiida Ic tax Dcaai ecic fiig
For the year January 1 – December 31, 2019
2019
Your first name and initial Last name Your social security number
. .
DONALD R CHANDLER 4 1 7 .. 5 4 ..0 3 8 7
If a joint return, spouse’s first name and initial Last name Spouse's soc. sec. no. if joint return
. .
BARBARA J CHANDLER 2 7 2 .. 4 2 ..4 7 0 9
Home address (number and street). If a P.O. Box, see instructions. Apt. no. Telephone number (optional)
19640 COASTAL SHORE TERRACE (440)669-5965

City, town or post office, state, and ZIP code

Part I 1 Alabama taxable income (Form 40, line 16 or Form 40NR, line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 -29,031
Tax Return 2 Total tax liability (Form 40, line 21) or Net tax due (Form 40NR, line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0
Information 3 Total payments (Form 40, line 26 or Form 40NR, line 26). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
(Whole dollars only.)
4 Refund (Form 40, line 34 or Form 40NR, line 33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Amount you owe (Form 40, line 29 or Form 40NR, line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Part II
1 Routing number:
Refund
and 2 Account number:
Payment
3 Type of account: Checking Savings
Information
4 Type of transaction: Direct Deposit Direct Debit
5 Paper Check (Check this box to have your refund issued by a paper check.)
Part III Under penalties of perjury, I declare that I have compared the information contained on my return with the information I have provided to my electronic return originator and
that the amounts described in Part 1 above agree with the amounts shown on the corresponding lines of my 2019 Alabama individual income tax return. To the best of my
Declaration knowledge and belief, this return, including any accompanying schedules and statements, is true, correct, and complete. Also, I hereby authorize the Alabama Department
of Revenue to disclose to my ERO described below, any information concerning the disbursement of the refund requested or any problems encountered in the processing
of Taxpayer of my return.
(Sign only after Part I
is completed.) I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
Sign
▼
Here
Your signature Date Spouse’s signature. If a joint return, BOTH must sign. Date
Part IV I declare that I have reviewed the above taxpayer’s Alabama individual income tax return and that the entries on this form are complete and correctly represented based on
all information of which I have any knowledge. I also declare that I have followed all other requirements described in IRS PUB. 1345, Revenue Procedures for Electronic Fil-
Declaration ing of Individual Income Tax Returns (Tax Year 2019), and the Alabama Handbook for Electronic Filers of Individual Income Tax Returns (Tax Year 2019). By using a com-
of puter system and software to prepare and transmit my client’s return electronically, I consent to the disclosure of all information pertaining to my use of the system and soft-
ware to create my client’s return and to the electronic transmission of my client’s tax return to the Alabama Department of Revenue, as applicable by law. If I am also the
Electronic paid preparer, under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowl-
Return edge and belief, they are true, correct, and complete.
Originator ERO’s Use Only
(ERO) and Date Preparer’s PTIN
Check if also

▼
ERO’s
Paid signature paid preparer
Preparer Firm’s name (or yours E.I. No.
▼
(See instructions.) if self-employed)

and address ZIP Code
Paid Preparer’s Use Only

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.
Date Preparer’s PTIN
Check if

▼
Preparer’s
signature self-employed
SELF-PREPARED
Firm’s name (or yours E.I. No.
▼
if self-employed)
and address ZIP Code
Form AL8453 2019
DO NOT MAIL TO ALABAMA DEPT. OF REVENUE 1555-3
REV 02/14/20 TTW

Allocation Worksheet 2019
for Part-Year Residents
Name as Shown on Return Social Security No.

Please review the federal amounts below and enter in the Alabama column the amounts attributed to your
Alabama period of residency.
Period of Residency:
Number of months lived in Alabama 9
From date 01/01 to date 09/30
Part I: Income
Total Alabama
amounts resident
amounts
1 Wages, salaries, tips, etc see income worksheet

2 Taxable interest income see interest income worksheet
3 Dividend income see dividend income worksheet
4 Alimony received
5a Business income or loss
5b Adjustment to Federal Economic Stimulus Act of 2008(if applied)
6 Gain or loss from sale of real estate, stocks, bonds see AL Schedule D
7 Taxable IRA distributions
8 Taxable pensions and annuities see pension worksheet
9a Rents, royalties, partnerships, estates, trusts, etc
9b Adjustment to Federal Economic Stimulus Act of 2008 (if applied)
10 a Farm income
10 b Adjustment o Federal Economic Stimulus Act of 2008 (if applied)
11 a Other income
11 b Adjustment o Federal Economic Stimulus Act of 2008 (if applied)
Part II: Adjustments
1a Your IRA deduction

b Your spouse’s IRA deduction
2 Payments to Keogh and SEP
3 Penalty on early withdrawal of savings
4 Alimony paid
5 Adoption expenses
6 Moving expenses
7 Self-employed health insurance deduction
8 AL PACT program or AL College Counts 529 Fund
9 Health insurance deduction for small employer employee
AL resident amount: Taxpayer Spouse
(See tax help for qualification)
10 Costs to retrofit or upgrade home to resist wind or flood damage
Enter the Costs to retrofit or upgrade from the certificate(see help)
11 Contributions to a health savings account
Part III: Deductions
1 Federal tax liability from your 2019 federal return 33,510. 33,095.
Part IV: Schedule ’A’ Adjustments
1 Medical and dental expenses 14,603. 11,474.

2 Real estate taxes 799. 799.
3 FICA tax
4 Railroad retirement
5 Other taxes G Other taxes 1,159. 372.
6 Mortgage interest and points reported on Form 1098
7 Mortgage interest not reported on Form 1098
8 Points not reported on Form 1098
9 Contributions by cash or check 6,114. 4,050.
10 Contributions other than cash or check 8,055. 1,139.
11 Carryover from prior year
12 Casualty losses from federal Form 4684, line 16
13 a Unreimbursed employee expenses 0.
13 b Adjustment to Federal Economic Stimulus Act 2008(if applied)
14 a Other expenses
14 b Adjustment to Federal Economic Stimulus Act 2008(if applied)
15 Other miscellaneous deductions
16 Qualified long-term health care insurance premiums 4,286. 4,286.
17 Qualified mortgage insurance premiums
ALIW0101.SCR 01/27/20
Alabama Information Worksheet 2019
Part I ' Personal Information
Taxpayer: Spouse:
First Name Donald First Name Barbara
Middle Initial R Suffix Middle Initial J Suffix
Last Name Chandler Last Name Chandler
Social Security No. 417-54-0387 Social Security No. 272-42-4709
Occupation Retired Occupation Retired
Date of Birth 02/22/1942 Date of Birth 03/06/1946
Date of Death Date of Death
Resident State FL Resident State FL
Work Phone (440)669-5965 Work Phone (440)567-9608
Home Phone
Print taxpayer phone number on the main form Home X Taxpayer work
Print spouse phone number on the main form Home Spouse work
Address 19640 Coastal Shore Terrace Apt
City Land O Lakes State FL ZIP Code 34638
Country, if foreign
Part II ' Main Forms
Form 40 : Resident Tax Return (Long form)

Form 40NR : Nonresident Tax Return
X Form 40 : Part-Year Resident Tax Return
Part-Year residents must complete the Part-Year Worksheet
From 01/01 , 2019 to 09/30 , 2019. Number of months 9
Alabama special rules for part-year resident with Alabama source income while nonresident:
Yes No
X Did you receive Alabama source income while a nonresident of Alabama?
Part III ' Filing Status
Single
X Married filing joint return
Married filing separate return.
Spouse name Social security number
Last First
Enter ’X’ if you did not live with your spouse during the year.
Enter ’X’ if married filing separate and you cannot itemize deductions
Unmarried head of family (with qualifying person). Qualifying person’s

name, social security number and relationship. Name
Social security number Relationship
Part IV ' Form 2210 Information
Enter tax liability from 2018 return Form 40, line 18 or Form 40NR line 20 0.
Do not file Alabama Form 2210AL
Enter adjusted gross income from 2018 return Form 40, line 10 or Form 40NR, line 12 73,759.
Part V ' General Information
Yes No
X Did you file an Alabama income tax return for the year 2018?
If no, state reason why
Name and address of your present employer:

Taxpayer:
Employer Name Address City ST Zip

X Retired
None
Spouse:
Employer Name Address City ST Zip

X Retired
None
Full and Part Year Residents only:

Yes No
X Do you have income that is reported in your federal return but not reported
in your Alabama return?
If yes, enter source(s) and amount(s) below: (other than state income tax refund)
Source Amount
Source Amount
Source Amount
Source Amount
Yes No Do you have any income earned in the year that your spouse was killed in action
X in a designated combat zone?
If yes, enter the total amount of income not taxable in Alabama
Driver’s License for Electronic Filing

Taxpayer Spouse
State Issued Driver’s License Florida Florida
Driver’s License Number C534196420620 C534070465860
Date Driver’s License Issued 12/19/2019 12/19/2019
Date Driver’s License Expires 02/22/2028 03/06/2028
State ID for Electronic Filing Taxpayer Spouse

Issuing State
State Identification number
State ID Issue Date
State ID Expiration Date
Part VI ' Direct Deposit Information or Direct Debit Information
Yes No
Use direct deposit for state tax refund?
Use paper check for state tax refund?
Use direct debit for state tax payment (Electronic Filing Only)?
Bank Information
If you selected either of the options above, fill out the information below:
Name of Financial Institution (optional)
Account type Checking Savings
Routing number
Account number
Enter the payment date to withdraw from the account above
State balance-due amount from this return
International ACH Transactions

Yes No
X Will the funds for this refund (or payment) go to (or come from) an account outside the U.S.?
Part VII ' Taxes deductible on Line 6 of Schedule A that were paid in prior years
1 Prior Year(s) Self-employment tax paid in 2018 and prior years 1

2 Social security/Medicare tax on tips paid in 2018 and prior years 2
3 Household employment taxes paid in 2018 and prior years 3
Part VIII ' Extension Status
Yes No
X Tax return due date extended?
Extended due date
QuickZoom to Form 40V
Part IX' Amended Return
Filing an Alabama amended return

Enter the tax year you are amending
Previous Alabama payment made
Previous Alabama refund received
QuickZoom here to Form 40 O
QuickZoom here to Form 40NR O
ALIW1812.SCR 09/26/19
Interest Income Statement 2019
Statement INT
Name(s) shown on return Social Security Number

Interest Income and Adjustments
Type
Payer’s Name T of Adjustment
Regular y U.S. Tax Ad- Amount Subtotal St
Interest p Government exempt just- (enter as ID
e Interest Interest ment positive)
Minus Minus Minus

Bond Bond Bond
Premium Premium Premium
on on U.S. on
regular Govt exempt
interest Interest interest
Bancorpsouth Bank
817. H 817.
Ally Bank
2,234. H 2,234.
Dollar Bank
11. H 11.
Wells Fargo Bank NA

0. H 0.
Type Type of Adjustment

(blank) Regular Taxable Interest N Nominee Distribution
M State Use Only O OID Adjustment
S Seller Financed A Accrued Interest
H Other Adjustment
U U.S. Savings Bond Previously Reported
Summary
Exempt Subtotal
1 Subtotal of all interest income 3,062.
2 Net U.S. obligations

3 Net in-state municipal bonds
4 Net tax-exempt municipal bonds from certain U.S. Territories
5 Net interest income (Line 1 minus lines 2, 3 and 4) 3,062.
Othv3401.SCR 11/02/17
Dividend Income Statement 2019
Statement DIV
Name(s) shown on return Social Security Number

Dividend Income and Adjustments
Federally Type of U.S.

Exempt Capital Adj & Interest
Interest Gain Nontax Adj Amt Amount
Payer’s Dividends Ordinary Distribu- Distribu- (enter as included in
Name Dividends tions tions positive) Dividends
* Amount
CMS Energy 331. 0.
* Enter ’X’ if tax-exempt for Alabama purposes
Summary of Dividends
1 Total Gross Dividends 331.
2 Nominee and Other Adjustments

3 Exempt-Interest Dividends
4 US Interest Amount Included in Dividends (net) 0.
5 Total Adjustment Amount 0.
6 Subtotal (Line 1 less Line 5) 331.
7 Capital Gains (net)

8 Nontaxable Distributions (net)
9 Total of Line 7 and Line 8
10 Net Dividend Income (Line 6 less Line 9) 331.
Othv2401.SCR 04/30/15
Pensions/Annuities/IRAs 2019
Income Exclusion Worksheet
Name as Shown on Return Social Security Number

Gross Taxable Taxable

Pensions/IRAs Pensions/IRAs Roth IRAs
Conversions
* #
X Ohio Public Emp Ret System - DC 5,778. 0.

X Exelis Inc. -Northern Trust Company-DC Salaried Retirement Plan 67,071. 0.
X Exelis Inc. -Northern Trust Company-BC Salaried Retirement Plan 11,353. 0.
X Northern Trust Co - BC ITT Cons Hrly Plan 7,472. 0.
X JP Morgan Chase NA Tefra Acct-Valeo- BC Benefit Payment Services 20,021. 0.
X X AXA Equitable-DC-#304700322IA Accumulator Customer Service 5,819. 0.
X X AXA Equitable-DC-#304700323IA Accumulator Customer Service 876. 0.
X X Security Benefit-DC #5440010136
X X Security Benefit-BC #5440010254 5,748. 0.
See PENIRA 47,353. 24,669. 0.
* Type of Distribution (X = IRA - Blank = Pension)

# Special Type Indicator (X = Retirement Systems not Taxable in Alabama)
Calculation of Exclusion Amounts
IRAs
1 Total IRA distributions 59,796.
2 Nontaxable IRA distributions 35,127.
3 Taxable IRA distributions 24,669.
Pensions/Annuities
1 Total Regular pension distributions 111,695.
2 4972 Distributions
3 Total Pension Distributions (line 1 plus line 2) 111,695.
4 Nontaxable pension distributions 111,695.
5 Taxable pension distributions 0.
Roth Iras
1 Alabama AGI (Form 40, line 10) 28,062.
2 Taxable Roth Ira Conversions 0.
3 Modified AGI 28,062.
Additional information from your 2019 Alabama Tax Return

Pen Excl Wks: Pensions/Annuities/IRAs Income Exclusion Wks
PENIRA Continuation Statement
X X AXA Equitable - BC #304702755IA 381. 0.

X X WELLS FARGO-DC #2794-5307 1401-6945 24,669. 24,669. 0.
X X WELLS FARGO-BC #8010-0710 6,200. 0.
X X ATHENE-DC #AA10110354 3,672. 0.
X X WELLS FARGO-DC #1401-6945 7,900. 0.
X X ATHENE-BC #AA10110355 1,925. 0.
X X AXA EQUITABLE-DC #304700323IA RETIREMENT SERVICE SOLUTIONS 878. 0.
X X AXA EQUITABLE-DC #304700323IA RETIREMENT SERVICE SOLUTIONS 585. 0.
X X AXA EQUITABLE-BC #304702755IA 571. 0.
X X AXA EQUITABLE-BC #304702755IA 572. 0.
Total 47,353. 24,669. 0.
1040-SR U.S. Tax Return for Seniors 2019
Form Department of the Treasury—Internal Revenue Service (99)
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
Filing Single Married filing jointly Married filing separately (MFS)

Status Head of household (HOH) Qualifying widow(er) (QW)
Check only one If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s
box. 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. Presidential Election Campaign
Check here if you, or your spouse if filing
19640 Coastal Shore Terrace jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your
Land O Lakes FL 34638 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see inst. and here a
Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien
You:
Age/Blindness Were born before January 2, 1955 Are blind
Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4) if qualifies for (see inst.):
(1) First name Last name Child tax credit Credit for other dependents
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . 1

Attach 2a Tax-exempt interest . . 2a b Taxable interest . . . 2b 4,111.
Schedule B
if required. 3a Qualified dividends . . . 3a 331. b Ordinary dividends . . 3b 331.
4a IRA distributions . . . . 4a b Taxable amount . . . 4b 59,796.
c Pensions and annuities . 4c d Taxable amount . . . 4d 111,695.
5a Social security benefits . . 5a 46,306. b Taxable amount . . . 5b 39,360.
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 215,293.
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . 8a
b Subtract line 8a from line 7b. This is your adjusted gross income . . . . a 8b 215,293.
Standard
Deduction 9 Standard deduction or itemized deductions (from Schedule A) 9 27,000.
See Standard
Deduction Chart
10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10
below. 11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . 11a 27,000.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . 11b 188,293.
Standard Add the number of boxes checked in the “Age/Blindness” section of Standard Deduction . . . a
Deduction IF your filing AND the number of THEN your standard IF your filing AND the number of THEN your standard
status is. . . boxes checked is. . . deduction is. . . status is. . . boxes checked is. . . deduction is. . .
Chart*
1 13,850 Head of 1 20,000
Single
2 15,500 household 2 21,650
Married 1 25,700 1 13,500
filing jointly 2 27,000 Married filing 2 14,800
or
Qualifying 3 28,300 separately 3 16,100
widow(er) 4 29,600 4 17,400
* Don’t use this chart if someone can claim you (or your spouse if filing jointly) as a dependent, your
spouse itemizes on a separate return, or you were a dual-status alien. Instead, see instructions.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040-SR (2019)
Form 1040-SR (2019) Page 2
12a Tax (see instructions). Check if any from:

1 Form(s) 8814 2 Form 4972 3 12a 33,510.
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . a 12b 33,510.
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 33,510.
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . 15 0.
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . a 16 33,510.
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . 17 25,920.
18 Other payments and refundable credits:
• If you have
a qualifying a Earned income credit (EIC) . . . . . . . . . . . . 18a
child, attach
Sch. EIC.
• If you have
b Additional child tax credit. Attach Schedule 8812 . . . . 18b
nontaxable
combat pay, c American opportunity credit from Form 8863, line 8 . . . 18c
see
instructions. d Schedule 3, line 14 . . . . . . . . . . . . . . . 18d 7,175.
e Add lines 18a through 18d. These are your total other payments and refundable credits a 18e 7,175.
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . a 19 33,095.
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? a b Routing number X X X X X X X X X a c Type: Checking Savings
See
instructions. a d Account number X X X X X X X X X X X X X X X X X
22 Amount of line 20 you want applied to your 2020 estimated tax a 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions a 23 415.
You Owe
24 Estimated tax penalty (see instructions) . . . . . . a 24
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee No
(Other than Designee’s Phone Personal identification
paid preparer) name a no. a number (PIN) a
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of
Sign my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information
Here of which preparer has any knowledge.
Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
F
Joint return? Retired (see inst.)

See instructions.
Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for
Identity Protection PIN, enter it here
your records.
Retired (see inst.)
Phone no. Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Preparer Self-employed
Use Only Firm’s name a Self-Prepared Phone no.

Firm’s address a Firm’s EIN a
Go to www.irs.gov/Form1040SR for instructions and the latest information.

BAA REV 02/23/20 TTW Form 1040-SR (2019)
SCHEDULE 3 OMB No. 1545-0074
Additional Credits and Payments
2019
(Form 1040 or 1040-SR)
a Attach to Form 1040 or 1040-SR.
Department of the Treasury Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 03
Name(s) shown on Form 1040 or 1040-SR 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. 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 credits from Form: a 3800 b 8801 c 6
7 Add lines 1 through 6. Enter here and include on Form 1040 or 1040-SR, line 13b . . . . . . . 7
Part II Other Payments and Refundable Credits
8 2019 estimated tax payments and amount applied from 2018 return . . . . . . . . . . . 8 7,175.
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 Credits from Form: a 2439 b Reserved c 8885 d 13
14 Add lines 8 through 13. Enter here and on Form 1040 or 1040-SR, line 18d . . . . . . . . . 14 7,175.
For Paperwork Reduction Act Notice, see your tax return instructions. REV 02/23/20 TTW Schedule 3 (Form 1040 or 1040-SR) 2019

2019 Chandler D Form 1040 Individual Tax Return - Records

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

2019 Chandler D Form 1040 Individual Tax Return - Records

Uploaded by

Copyright:

Available Formats

Electronic Filing Instructions for your 2019 Federal Tax Return

Donald R & Barbara J Chandler

417540387 VU CHAN 30 0 202012 430

417540387 VU CHAN 30 0 202012 430

417540387 VU CHAN 30 0 202012 430

417540387 VU CHAN 30 0 202012 430

Filing Single Married filing jointly Married filing separately (MFS)

Standard Someone can claim: You as a dependent Your spouse as a dependent

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

12a Tax (see instructions). Check if any from:

Joint return? Retired (see inst.)

Use Only Firm’s name a Self-Prepared Phone no.

Go to www.irs.gov/Form1040SR for instructions and the latest information.

Name(s) Shown on Return

Five Year Tax History:

2015 2016 2017 2018 2019

Filing status MFJ MFJ MFJ MFJ MFJ

Total income 197,323. 215,774. 221,668. 223,617. 215,293.

Adjusted gross income 197,323. 215,774. 221,668. 223,617. 215,293.

Tax expense 3,330. 8,167. 4,035. 6,140. 1,958.

Interest expense 4,192.

Contributions 12,972. 17,176. 19,714. 27,620. 14,169.

Misc. deductions 1,730.

Other itemized ded’ns 6,499. 16,808. 2,742.

Exemption amount 8,000. 8,100. 8,100. 0. 0.

Taxable income 173,021. 169,910. 189,819. 173,049. 188,293.

Tax 35,468. 34,528. 39,999. 30,084. 33,510.

Alternative min tax

Payments 35,073. 36,853. 38,958. 35,833. 33,095.

Form 2210 penalty

Amount owed 395. 1,041. 415.

Refund 2,325. 5,749.

Effective tax rate % 17.97 16.00 18.04 13.45 15.56

**Tax bracket % 28.0 28.0 28.0 24.0 24.0

**Tax bracket % is based on Taxable income.

Name(s) Shown on Return Social Security Number

Charity Name ANIMAL LEGAL DEFENSE FUND-ALDF

Combined Amounts Worksheet

Ref. No. Date Donation Description Donation Type Donation Amount

1 (not needed) Money 50.00

Prior Year Total: 50.00

ItsDeductible Item Donations Worksheet

Donald R & Barbara J Chandler 417-54-0387

Other Item Donations Worksheet

Ref. No. Donated Date Donation Description Donation Cost

Detail of Money Donations Worksheet

1 (not needed) 50.00 1 X Once Recur 50.00

Detail of Mileage and Transportation Costs Worksheet

Ref. No. Donation Date Description of Trip

Donald R & Barbara J Chandler 417-54-0387

Detail of Stock Donations Worksheet

Charitable Organization Questions

2 Were restrictions attached to the charity’s right

4 What Type of charitable organization was it? Check one:

Name(s) Shown on Return Social Security Number

Charity Name LIBERTY CHURCH

Combined Amounts Worksheet

Ref. No. Date Donation Description Donation Type Donation Amount

1 Various Money 3,550.00

Prior Year Total: 13,869.30

ItsDeductible Item Donations Worksheet

Donald R & Barbara J Chandler 417-54-0387

Other Item Donations Worksheet