2022

Department of the Treasury-Internal Revenue Service (99)

1040 U.S. Individual Income Tax Return
Form
OMB No. 1545-0074 IRS Use Only-Do not write or staple in this space.

Filing Status X Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child's name if the qualifying
one box.
person is a child but not your dependent
Your first name and middle initial Last name Your social security number
MARDIK MARDIKIAN 561-95-6399
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
13441 SYLVAN ST Check here if you, or your
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3
to go to this fund. Checking a
VAN NUYS CA 91401 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.

You Spouse

At any time during 2021, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes X No
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

Age/Blindness You: Were born before January 2, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) Check if qualifies for (see instructions):
number to you
(1) First name Last name Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check
here
1 Wages, salaries, tips, etc. Attach Form(s) W-2 .......................... 1 130,000
Attach
2a Tax-exempt interest . . . . 2a b Taxable interest . . . . . . . . . 2b
Sch. B if
required.
3a Qualified dividends . . . . . 3a b Ordinary dividends . . . . . . . . 3b
4a IRA distributions . . . . . . 4a b Taxable amount . . . . . . . . . 4b
5a Pensions and annuities . . . 5a b Taxable amount . . . . . . . . . 5b
Standard 6a Social security benefits . . . 6a b Taxable amount . . . . . . . . . 6b
Deduction for-
7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . . 7
Single or
Married filing 8 Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 8,300
separately,
$12,400 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . . . . . . . . 9 138,300
Married filing 10 Adjustments to income:
jointly or
Qualifying a From Schedule 1, line 22 . . . . . . . . . . . . . . . . . . . . . . . . 10a
widow(er),
$24,800
b Charitable contributions if you take the standard deduction. See instructions 10b
Head of c Add lines 10a and 10b. These are your total adjustments to income . . . . . . . . . . . . . . 10c 0
household,
$18,650 11 Subtract line 10c from line 9. This is your adjusted gross income . . . . . . . . . . . . . . . . 11 100,300
If you checked 12 Standard deduction or itemized deductions (from Schedule A). . . . . . . . . . . . . . . . . . 12 91,125
any box under
Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . . . . . . . . . . . . 13
Deduction,
see instructions.
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 91,125
15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0-. . . . . . . . . . . . . . . 15 91,125
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2022)

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Form 1040 (2022) MARDIK MARDIKIAN 561-95-6399 Page 2

16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 ... 16 11,314
17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 11,314
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Amount from Schedule 3, line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . 22 11,314
23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . . . . . 23
24 Add lines 22 and 23. This is your total tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 11,314
25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25a 1,518
b Form(s) 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25d 11,314
If you have a 26 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . . . . . . . . . . 27
attach Sch. EIC.
If you have 28 Additional child tax credit. Attach Schedule 8812 . . . . . . . . . . . . 28
nontaxable
combat pay,
29 American opportunity credit from Form 8863, line 8 . . . . . . . . . . . 29
see instructions. 30 Recovery rebate credit. See instructions . . . . . . . . . . . . . . . . 30 0
31 Amount from Schedule 3, line 13 . . . . . . . . . . . . . . . . . . . . 31
32 Add lines 27 through 31. These are your total other payments and refundable credits . .. . . . . 32 0
33 Add lines 25d, 26, and 32. These are your total payments. . . . . . . . . . . . . . . . . . . . 33 11,314
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid. . . . . 34 237
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here ....... 35a 237
Direct deposit? b Routing number 0 6 3 1 0 0 2 7 7 c Type: X Checking Savings
Account number 8 9 8 0 8 7 4 8 8 5 6 9
See instructions.
d
36 Amount of line 34 you want applied to your 2021 estimated tax. . . . 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe now. . . . . . . . . . . . . . . . . . 37 0
You Owe Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
For details on
how to pay, see
2020. See Schedule 3, line 12e, and its instructions for details.
instructions. 38 Estimated tax penalty (see instructions) . . . . . . . . . . . . . . . . 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes. Complete below. No
Designee's Phone Personal identification
name MARK A. TRAMMELL no. 925-385-2038 number (PIN) 9 4 1 3 3
Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here If the IRS sent you an Identity
Your signature Date Your occupation
Protection PIN, enter it here
Joint return? (see inst.)
14627 04-29-2022
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.
(see inst.)

Phone no. 347-993-4433 Email address

Preparer's signature Date PTIN Check if:
Paid 08-12-2022 P01321971 X Self-employed
Preparer Preparer's name MARK A. TRAMMELL Phone no. 718-953-6455
Use Only Firm's name COMYNS, SMITH, MCCLEARY & DEAVER, LLP
Firm's address 3470 MT. DIABLO BLVD. #A110
LAFAYETTE, CA 94549 Firm's EIN 68-0307221
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2022)

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SCHEDULE 1 OMB No. 1545-0074
(Form 1040)
Additional Income and Adjustments to Income
Attach to Form 1040, 1040-SR, or 1040-NR.
2022
Department of the Treasury Attachment
Internal Revenue Service Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 01
Name(s) shown on Form 1040,1040-SR, or 1040-NR Your social security number
MARDIK MARDIKIAN 561-95-6399

Part I Additional Income

1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . . . . . . 1
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b Date of original divorce or separation agreement (see instructions) . . .
3 Business income or (loss). Attach Schedule C ............................. 3
4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 19,124
8 Other income. List type and amount . UCE
8 (10,100)
9 Combine lines 1 through 8. Enter here and on Form 1040,1040-SR, or 1040-NR
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 9,024
Part II Adjustments to Income
10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government
officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . . . . . . . 13
14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . . 14
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient's SSN ..................................
c Date of original divorce or separation agreement (see instructions) . . .
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees deduction. Attach Form 8917 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and
on Form 1040, 1040-SR, or 1040-NR, line 10a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 0
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040) 2021
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 CORRECTED (if checked)
PAYER'S name, street address, city or town, state or province, country, ZIP 1 Unemployment compensation OMB No. 1545-0120
Postal code, and telephone no
CALIFORNIA STATE DEPARTMENT OF Certain
LABOR UNEMPLOYMENT INSURANCE
5009 BROADWAY
$
2 State or local income tax
refunds, credits, or offsets
2022 Government
Payments
SACRAMENTO CA 95818
$ Form 1099-G
PAYER'S TIN RECIPIENT'S TIN 3 Box 2 amount is for tax year 4 Federal income tax withheld Copy B
270293117 561-95-6399 2023 $ For Recipient
RECIPIENT'S name 5 RTAA payments 6 Taxable grants This is important tax
information and is
$ $ being furnished to the
7 Agriculture payments 8 If checked, box 2 is IRS. If you are required
trade or business to file a return, a
Street address (including apt. no.) $ income
negligence penalty or
9 Market gain other sanction may be
City or town, state or province, country, and ZIP or foreign postal code $ imposed on you if this
income is taxable and
10a State 10b State identification no. 11 State income tax withheld
the IRS determines that
Account number (see instructions) FL 270293117 $ it has not been
reported.
$
Form 1099-G (keep for your records) www.irs.gov/Form1099G Department of the Treasury - Internal Revenue Service
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 a Employee's social security number Safe, accurate, Visit the IRS website at
561-95-6399 OMB No. 1545-0008 FAST! Use IRS e-file www.irs.gov/efile

b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld

130,000 14313
c Employer's name, address, and ZIP code 3 Social security wages 4 Social security tax withheld

NAARCO JEWELERY 130,000 8060

5 Medicare wages and tips 6 Medicare tax withheld

650 S. Hill St Suite 130,000 1885

810 Los Angeles CA 90014 7 Social security tips 8 Allocated tips

d Control number 9 10 Dependent care benefits

12a See instructions for box 12

e Employee's first name and initial Last name Suff. 11 Nonqualified plans
C
o
d
e
Statutory Retirement Third-party 12b
NOEL 13 employee plan sick pay
ARMAND C
o
d
e
12c
3805 MILLENIA BLVD 14 Other C
o
ORLANDO FL 32839 SDI 20 d
e
12d
ILPFL 42 C
o
FFSELF 164 d
e

f Employee's address and ZIP code

15 State Employer's state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

CA 222464345 130,000 766 130,000 CA

2022
Department of the Treasury-Internal Revenue Service

Form W-2 Wage and Tax Statement

Copy B - To Be Filed With Employee's FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
EEA

Professional Services a Employee's social security number Safe, accurate, Visit the IRS website at
OMB No. 1545-0008 FAST! Use IRS e-file www.irs.gov/efile

b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld

c Employer's name, address, and ZIP code 3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

d Control number 9 10 Dependent care benefits

12a See instructions for box 12

e Employee's first name and initial Last name Suff. 11 Nonqualified plans
C
o
d
e
Statutory Retirement Third-party 12b
13 employee plan sick pay C
o
d
e
12c
14 Other C
o
d
e
12d
C
o
d
e

f Employee's address and ZIP code

15 State Employer's state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

2022
Department of the Treasury-Internal Revenue Service

Form W-2 Wage and Tax Statement

Copy B - To Be Filed With Employee's FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
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 COMYNS, SMITH, MCCLEARY & DEAVER, LLP
3470 MT. DIABLO BLVD. #A110
LAFAYETTE, CA 94549
Phone: (925)385-2038 I Fax: (925)385-2039

June 14, 2023

Mardik Mardikian
13441 Sylvan St
Van Nuys, CA 91401
Subject: Preparation of Your 2022 Tax Returns

Kevin Tails:

Thank you for choosing Comyns, Smith, McCleary & Deaver, LLP to assist you with your 2021 taxes. This letter
confirms the terms of our engagement with you and outlines the nature and extent of the services we will provide.

We will prepare your 2021 federal and state income tax returns. We will depend on you to provide the information we
need to prepare complete and accurate returns. We may ask you to clarify some items but will not audit or otherwise
verify the data you submit. An Organizer is enclosed to help you collect the data required for your return. The
Organizer will help you avoid overlooking important information. By using it, you will contribute to the efficient
preparation of your returns and help minimize the cost of our services.

We will perform accounting services only as needed to prepare your tax returns. Our work will not include
procedures to fmd defalcations or other irregularities. Accordingly, our engagement should not be relied upon to
disclose errors, fraud, or other illegal acts, though it may be necessary for you to clarify some of the information you
submit. We will inform you of any material errors, fraud, or other illegal acts we discover.

The law imposes penalties when taxpayers underestimate their tax liability. Call us if you have concerns about such
penalties.

Should we encounter instances of unclear tax law, or of potential conflicts in the interpretation of the law, we will
outline the reasonable courses of action and the risks and consequences of each. We will ultimately adopt, on your
behalf, the alternative you select.

Our fee is based on the time required at standard billing rates plus out-of-pocket expenses. Invoices are due and
payable upon presentation. All accounts not paid within thirty (30) days are subject to interest charges to the extent
permitted by state law.

We will return your original records to you at the end of this engagement. Store these records, along with all
supporting documents, in a secure location. We retain copies of your records and our work papers from your
engagement for up to seven years, after which these documents will be destroyed.

If you have not selected to e-file your returns with our office, you will be solely responsible to file the returns with the
appropriate taxing authorities. Review all tax-return documents carefully before signing them. Our engagement to
prepare your 2022 tax returns will conclude with the delivery of the completed returns to you, or with e-filed returns,
with your signature and our subsequent submittal of your tax return.

To affirm that this letter correctly summarizes your understanding of the arrangements for this work, sign the enclosed
copy of this letter in the space indicated and return it to us in the envelope provided.
Thank you for the opportunity to be of service. If you have any questions, contact our office at (925)385-2038

Sincerely,

COMYNS, SMITH, MCCLEARY & DEAVER, LLP

(Both spouses must sign for preparation of joint returns.)

Accepted By:

Taxpayer

Spouse

Date
 COMYNS, SMITH, MCCLEARY & DEAVER, LLP
3470 MT. DIABLO BLVD. #A110
LAFAYETTE, CA 94549
Phone: (925)385-2038 | Fax: (925)385-2039

June 14, 2023

Mardik Mardikian
13441 Sylvan St
Van Nuys, CA 91401

Mardik :
Return Type Refund/Balance Due Transaction Method
Federal Income Tax $237 Refund Direct Deposit to **8525
California Income Tax $1,269 Balance Due Mail a check

The following return(s) were e-filed and accepted:

Federal Income Tax

California Income Tax

Mail payment on or before due date to the following

address:

CA Income Tax
TLS Personal Income Tax
PO Box 942840
Sacramento, CA 94240-0001.

Sincerely,

COMYNS, SMITH, MCCLEARY & DEAVER, LLP

 COMYNS, SMITH, MCCLEARY & DEAVER, LLP
3470 MT. DIABLO BLVD. #A110
LAFAYETTE, CA 94549
Phone: (925)385-2038 | Fax: (925)385-2039

June 14, 2023

Mardik Mardikian
13441 Sylvan St
Van Nuys, CA 91401

Your privacy is important to us. Read the following privacy policy.

We collect nonpublic personal information about you from various sources,
including:

* Interviews regarding your tax situation

* Applications, organizers, or other documents that supply such information as your name, address, telephone number,
Social Security Number, number of dependents, income, and other tax-related data

* Tax-related documents you provide that are required for processing tax returns, such as Forms W-2, 1099R, 1099-
INT and 1099-DIV, and stock transactions

We do not disclose any nonpublic personal information about our clients or former clients to anyone, except as
requested by our clients or as required by law.

We restrict access to personal information concerning you, except to our employees who need such information in
order to provide products or services to you. We maintain physicai electronic, and procedural safeguards that comply
with federal regulations to guard your personal information.

If you have any questions about our privacy policy, contact our office at (925)385-2038

Sincerely,

COMYNS, SMITH, MCCLEARY & DEAVER, LLP

 COMYNS, SMITH, MCCLEARY & DEAVER, LLP
3470 MT. DIABLO BLVD. #A110
LAFAYETTE, CA 94549
Phone: (925)385-2038 | Fax: (925)385-2039

Customer Name Customer Information

Mardik Mardikian Invoice#:
13441 Sylvan St Date: June 14, 2023
Van Nuys, CA 91401 Phone: 209)993-4433
E-mail: mardik372@gmail.com

Your 2022 tax return was prepared by Mark A. Trammel

Description Fee
Federal And Supplemental Forms
Form 1040 US, Individual Income Tax Return 225,00
Schedule 1 Additional Income and Adjustments to Income
Form 1099-G Certain Government Pavments
Form 8879 E-FileSignature Authorization
FormW-2 Wage and TaxStatement
WksExclusion Unemployment CompensationExclusionWorksheet
Wks Recovery Rebate Recovery Rebate CreditWorksheet
Comparison TaxYear ComparisonSheet
New York Forms
CASUM CA ReturnSummary
CA 201V Payment Voucher for Income Tax Returns
CA 201 Resident Income Tax Return - Page 1
CA 201 Pg 2 Resident Income Tax Return - Page 2
CA 201 Pg 3 Resident Income Tax Return - Page 3
CA 201 Pg 4 Resident Income Tax Return - Page 4
CA-COMP CAState Comparison
CA 558 CA Adi due to Decoupling from IRC - Pages 1 and 2
CAW2 Summary ofW-2Statements
CAWKS CAState CalculationWorksheet
CAWKS CAState CalculationWorksheet
CAWKS CAState CalculationWorksheet
CA ATTACH CAState Form Attachments-Additional Information
CA TR579 E-fileSignature Authorization
CA TR5732 CAE-file Requirements
CAWK AGI State Adjustment Gross IncomeWorksheet
CAWK A5 State/Local Tax Payments made after the Current Tax
Yea
CAEF ACK CAEF Acknowledgement Page

Total Forms 26 Forms Subtotal 225.00

Adjustments
Single Credit -40,00
Subtotal 185.00
Miscellaneous Fees
Software Fee 13,95
Additional Fee 10,00
 Total Prep Fee 208.95
Free Efile Bal Due 0.00
Total Balance Due 208.95
Payments
-23.95
Paid 06-17-2023 -185.00
Total Balance Due 0.00

THANK YOU FOR YOUR BUSINESS, WE APPRECIATE YOU & LOOK FORWARD TO YOUR
CONTINUED BUSINESS.

Payment due upon receipt. Thank you for your business!

 TAX RETURN COMPARISON 2022
2020 / 2021 / 2022
Name(s) as shown on return Identifying number
KEVIN TAILS 561-95-6399

2020 2021 2022 Difference 2021-2023

Filing Status . . . . . . . . . . . . . . Single Single Single
Number of Dependents . . . . . . . . .

Income
Wages, salaries, tips, etc. . . . . . . . 130,000 130,000 130,000
Taxable interest and dividends . . . .
Taxable state and local refunds . . . .
Alimony. . . . . . . . . . . . . . . .
Business income (loss) . . . . . . . .
Gains (losses) . . . . . . . . . . . .
Pensions and IRA distributions . . . .
Rent and royalty income (loss) . . . .
Part, S-corps, trusts income (loss) . . .
Farm income (loss) . . . . . . . . . .
Unemployment compensation . . . . .
Total SS benefits received. . . . . . .
Taxable SS benefits. . . . . . . . . .
Other income (loss) . . . . . . . . . .
Total Income . . . . . . . . . . . . . 130,000 130,000 130,000
Adjusted Gross Income
Half of self-employment tax . . . . . .
IRA deduction. . . . . . . . . . . . .
Other adjustments . . . . . . . . . .
Total Adjusted Gross Income . . . . 130,000 130,000 130,000
Deductions
Medical deductions . . . . . . . . . .
State and local taxes . . . . . . . . .
Interest . . . . . . . . . . . . . . . .
Contributions . . . . . . . . . . . . .
Employee business expenses . . . . .
Standard or other deductions . . . . . 12,000 12,200 12,400 200
Total Itemized or Standard Ded . . . 12,000 12,200 12,400 200
Qualified Business Income Deduction .
Tax and Credits
Taxable Income . . . . . . . . . . . 5,276 12,000 6,724
Tax. . . . . . . . . . . . . . . . . . 528 1,246 718
Credits . . . . . . . . . . . . . . . .
Self-employment tax . . . . . . . . .
Other taxes . . . . . . . . . . . . . .
Total Tax . . . . . . . . . . . . . . . 528 1,246 718
Payments
Withholdings . . . . . . . . . . . . . 1,111 1,572 1,483 (89)
Estimated tax payments . . . . . . . .
Earned income credit . . . . . . . . . 313
Other payments and credits . . . . . .
Estimated tax penalty . . . . . . . .
Overpayment ............ 1,424 1,044 237 (807)
Overpayment Applied . . . . . . . . .
Refund . . . . . . . . . . . . . . . . 1,424 1,044 237 (807)
Balance Due . . . . . . . . . . . . . .
Marginal tax rate . . . . . . . . . . . . . 10.00 10.00 12.00 2.00
Effective tax rate . . . . . . . . . . . . . 10.01 10.38 0.37
 Department of Taxation and Finance
IT-201-V
Instructions for Form IT-201-V (12/22)
2022 Payment Voucher for Income Tax Returns

Did you know? You can pay your income tax return payment You cannot use this form to pay a bill or other notice
directly on our website from your bank account or by credit from the Tax Department that indicates you owe tax;
card through your individual Online Services account. Visit you must use the payment document included with that bill or
www.tax.ny.gov. notice.
You cannot use this form to request an installment payment
How to use this form agreement (IPA); see our website for information about
If you are paying New York State income tax by check or requesting an IPA.
money order, you must include Form IT-201-V with your
payment. Mailing address
Check or money order E-filed and previously filed returns
If you e-filed your income tax return, or if you are making a
Make your check or money order payable in U.S. funds to payment for a previously filed return, mail the voucher and
New York State Income Tax. payment to:
Be sure to write the last four digits of your Social Security
number (SSN), the tax year, and Income Tax on it. CA PERSONAL INCOME
TAX PROCESSING CENTER
PO Box 942840
Completing the voucher Sacramento, CA 94240-0001
Be sure to complete all information on the voucher. Paper returns
Enter the tax year from the income tax return you are filing If you are filing a paper income tax return (including amended
and your entire SSN. Failure to do so may result in monies returns), include the voucher and payment with your return
not being properly credited to your account. and mail to this address:
If filing a joint return, include information for both spouses.
SSTATE PROCESSING CENTER
Foreign address - Enter the city, province, or state all in PO Box 942840
the City box, and the full country name in the Country box. Sacramento, CA 94240-0001.
Enter the postal code, if any, in the ZIP code box.
Do not staple or clip your payment to Form IT-201-V. If you are not using U.S. Mail, be sure to consult
Instead, just put them loose in the envelope. Publication 55, Designated Private Delivery Services.

Cut here
STOP: Pay this electronically Department of Taxation and Finance
on our website. Payment Voucher for Income Tax Returns IT-201-V
Tax year (yyyy) Make your check or money order payable in U.S. funds to New York State Income Tax. Write (12/22)
2022 on your check or money order the last four digits of your SSN, the tax year, and Income Tax.
Your first name and
middle initial Your last name (for a joint return, enter spouse's name on line below) Your full SSN

MARDIK MARDIKIAN 561-95-6399

Spouse's first name and middle initial Spouse's last name Spouse's full SSN (only if filing a joint return)

Mailing address Apartment number Country (if not United States)

13441 SYLVAN
City, village or post office State ZIP code
VAN NUYS CA 91401 Dollars Cents

Email: mardik372@gmail.com Payment

amount 1269 . 00
040001201024

For office use only

0401201024 078828718 4
 NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM.
Department of Taxation and Finance

Resident Income Tax Return IT-201

California State • Van Nuys City • MCTMT
2022 For the full year January 1, 2022 through December 31, 2022, or fiscal year beginning ... and ending ... 23

For help completing your return, see the instructions, Form IT-201-I.
Your first name MI Your last name (for a joint return, enter spouse's name on line below) Your date of birth (mmddyyyy) Your Social Security number

MARDIK MARDIKIAN 08 25 1960 561-95-6399

Spouse's first name MI Spouse's last name Spouse's date of birth (mmddyyyy) Spouse's Social Security number

Mailing address (see instructions, page 14) (number and street or PO box) Apartment number Illinois State county of residence
13441 SYLVAN ST
City, village, or post office State ZIP code Country (if not United States) School district name
Van Nuys CA 91401 VAN NUYS
Taxpayer's permanent home address (see instructions, page 14) (number and street or rural route) Apartment number
School district
code number ... 071
City, village, or post office State ZIP code Taxpayer's date of death (mmddyyyy) Spouse's date of death (mmddyyyy)
Decedent
CA information

A Filing D1 Did you have a financial account located in a

(1) X Single foreign country? (see page 15) ......... Yes No X
status
(mark an (2) Married filing joint return D2 Were you required to report any nonqualified
X in one (enter spouse's Social Security number above) deferred compensation, as required by IRC § 457A,
on your 2020 federal return? (see page 15) . . . Yes No X
box): Married filing separate return
(3)
(enter spouse's Social Security number above) E (1) Did you or your spouse maintain living
quarters in CA during 2021? (see page 15) .. Yes No
(4) Head of household (with qualifying person) (2) Enter the number of days spent in NYC in 2021
(any part of a day spent in NYC is considered a day) ....
(5) Qualifying widow(er) F CA residents and CA part-year
residents only (see page 15):
B Did you itemize your deductions on 12
X (1) Number of months you lived in CA in 2021 .......
your 2020 federal income tax return? . . . . Yes No
C Can you be claimed as a dependent
X (2) Number of months your spouse lived in CA in 2021 ...
on another taxpayer's federal return? . . . . Yes No
G Enter your 2-character special condition
code(s) if applicable (see page 15) . . . . . .

H Dependent information (see page 16)

First name MI Last name Relationship Social Security number Date of birth (mmddyyyy)

If more than 7 dependents, mark an X in the box.

201001201024
For office use only
 NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM.
Page 2 of 4 IT-201 (2022) Your Social Security number
561-95-6399
Federal income and adjustments (see page 16) Whole dollars only

1 Wages, salaries, tips, etc. ...................................... 1 130000 .00

2 Taxable interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 .00
3 Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 .00
4 .........
Taxable refunds, credits, or offsets of state and local income taxes (also enter on line 25) 4 .00
5 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 .00
6 Business income or loss (submit a copy of federal Schedule C, Form 1040) ................ 6 .00
7 .............
Capital gain or loss (if required, submit a copy of federal Schedule D, Form 1040) 7 .00
8 Other gains or losses (submit a copy of federal Form 4797). . . . . . . . . . . . . . . . . . . . . . . 8 .00
9 Taxable amount of IRA distributions. If received as a beneficiary, mark an X in the box. . . . . . . 9 .00
10 Taxable amount of pensions and annuities. If received as a beneficiary, mark an X in the box .... 10 .00
11 Rental real estate, royalties, partnerships, S corporations, trusts, etc. (submit copy of federal Schedule E, Form 1040) . 11 .00

12 Rental real estate included in line 11 . . . . . . . . . . . . . 12 .00

13 Farm income or loss (submit a copy of federal Schedule F, Form 1040). . . . . . . . . . . . . . . . . 13 .00
14 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 .00
15 Taxable amount of Social Security benefits (also enter on line 27). . . . . . . . . . . . . . . . . . . . 15 .00
16 Other income (see page 16) Identify: SEE CA OINC 16 -10200 .00

17 Add lines 1 through 11 and 13 through 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 24400 .00

18 Total federal adjustments to income (see page 16) Identify: 18 .00

19 Federal adjusted gross income (subtract line 18 from line 17) . . . . . . . . . . . . . . . . . . . . . 19 24400
19a Recomputed federal adjusted gross income (see page 16, Line 19a worksheet) ............ 19a 34600

California additions (see page 17)

20 Interest income on state and local bonds and obligations (but not those of NYS or its local governments) . . . 20 .00
21 Public employee 414(h) retirement contributions from your wage and tax statements (see page 17) .... 21 .00
22 California 529 college savings program distributions (see page .................. 22 .00
23 17) Other (Form IT-225, line.9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 .00
24 Add lines 19a through 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 34600 .00

California subtractions (see page 18)

25 Taxable refunds, credits, or offsets of state and local income taxes (from line 4) . 25 .00
26 Pensions of NYS and local governments and the federal government (see page 18) 26 .00
27 Taxable amount of Social Security benefits (from line 15). . . . 27 .00
28 Interest income on U.S. government bonds . . . . . . . . . . 28 .00
29 Pension and annuity income exclusion (see page 19) . . . . . 29 .00
30 California 529 college savings program deduction/earning s. . 30 .00
31 Other (Form IT-225, line 18) . . . . . . . . . . . . . . . . . 31 .00
32 Add lines 25 through 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 .00

33 California adjusted gross income (subtract line 32 from line 24) ................... 33 34600 .00

Standard deduction or itemized deduction (see page 21)

34 Enter your standard deduction (table on page 21) or your itemized deduction (from Form IT-196)
Mark an X in the appropriate box: X Standard - or - Itemized 34 8000 .00
35 Subtract line 34 from line 33 (if line 34 is more than line 33, leave blank). . . . . . . . . . . . . . . . . 35 26600 .00
36 Dependent exemptions (enter the number of dependents listed in item H; see page 21) .......... 36 000.00

37 Taxable income (subtract line 36 from line 35) ............................ 37 26600 .00
201002201024
 NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM.
Name(s) as shown on page 1 Your Social Security number IT-201 (2023) Page 3 of 4
MARDIK MARDIKIAN 561-95-6399

Tax computation, credits, and other taxes

38 Taxable income (from line 37 on page 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 26600 .00

39 CA tax on line 38 amount (see page 22) ............................... 39 1359 .00
40 CA household credit (page 22, table 1, 2, or 3) . . . . . . . . 40 .00
41 Resident credit (see page 23) . . . . . . . . . . . . . . . . 41 .00
42 Other CA nonrefundable credits (Form IT-201-ATT, line 7) . . 42 .00
43 Add lines 40, 41, and 42 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 .00

44 Subtract line 43 from line 39 (if line 43 is more than line 39, leave blank.
) ................ 44 1359 .00
45 Net other CA taxes (Form IT-201-ATT, line 30) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 .00

46 Total New California taxes (add lines 44 and 45 ). . . . . . . . . . . . . . . . . . . . . . . . . . . 46 1359 .00

Van Nuys City and taxes, credits, and surcharges, and MCTMT
47 CA taxable income (see page 23) ............. 47 26600 .00
47a .00 See instructions on
CA resident tax on line 47 amount (see page 23). . . . . . . 47a 919 pages 23 through 26 to
48 CA household credit (page 23). . . . . . . . . . . . . . . . 48 .00 compute New York City and
49 Subtract line 48 from line 47a (if line 48 is more than Yonkers taxes, credits, and
line 47a, leave blank) . . . . . . . . . . . . . . . . . . . . 49 919 .00 surcharges, and MCTMT.
50 .00
Part-year CA resident tax (Form IT-360.1) . . . . . . . . . . 50
51 Other CA taxes (Form IT-201-ATT, line 34). . . . . . . . . . 51 .00
52 Add lines 49, 50, and 51 . . . . . . . . . . . . . . . . . . . 52 919 .00
53 CA nonrefundable credits (Form IT-201-ATT, line 10). . . . . 53 .00
54 Subtract line 53 from line 52 (if line 53 is more than
line 52, leave blank) . . . . . . . . . . . . . . . . . . . . 54 919 .00
54a MCTMT net
earnings base . . . 54a .00
54b MCTMT . . . . . . . . . . . . . . . . . . . . . . . . . . . 54b .00
55 CA resident income tax surcharge (see page 26) . . . . . 55 .00
56 CA nonresident earnings tax (Form Y-203) . . . . . . . . 56 .00
57 Part-year IL resident income tax surcharge (Form IT-360.1) . 57 .00
58 Total Van Nuys City and taxes / surcharges and MCTMT (add lines 54 and 54b through ..
57) 58 919 .00
59 Sales or use tax (see page 27; do not leave line 59 blank) . . . . . . . . . . . . . . . . . . . . . . 59 0 .00
..........................
60 Voluntary contributions (Form IT-227, Part 2, line 1) 60 .00

61 Total California State, Van Nuys City, and sales or use taxes, MCTMT, and
voluntary contributions (add lines 46, 58, 59, and 60) . . . . . . . . . . . . . . . . . . . . . . . 61 2278 .00

201003201024
 NO HANDWRITTEN ENTRIES, OTHER THAN SIGNATURE, ON THIS FORM.
Page 4 of 4 IT-201 (2022) Your Social Security number
561-95-6399
62 Enter amount from line 61. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 2278 .00
Payments and refundable credits (see pages 28 through 31)
63 Empire State child credit . . . . . . . . . . . . . . . . . . . 63 .00
64 CA/CHC child and dependent care credit . . . . . . . . . . 64 .00
65 CA earned income credit (EIC) ............. 65 .00
66 CA noncustodial parent EIC . . . . . . . . . . . . . . . . . 66 .00
67 Real property tax credit . . . . . . . . . . . . . . . . . . . 67 .00
68 College tuition credit ..................... 68 .00
69 CA school tax credit (fixed amount) (also complete F on page 1). 69 63 .00
69a CA school tax credit (rate reduction amount) ........ 69a 54 .00
70 CA earned income credit This ................ 70 .00
70a line intentionally left blank ................ 70a
71 Other refundable credits (Form IT-201-ATT, line 18). . . . . . 71 .00
If applicable, complete Form(s) IT-2
72 Total Californa State tax withheld . . . . . . . . . . . . . .72 520 .00 and/or IT-1099-R and submit them
with your return (see page 13).
73 Total Van Nuys City tax withheld . . . . . . . . . . . . . .73 372 .00
Do not send federal Form W-2
74 Total Van Nuys tax withheld . . . . . . . . . . . . . . . . . 74 .00
with your return.
75 Total estimated tax payments and amount paid with Form IT-370 75 .00

76 Total payments (add lines 63 through 75) .............................. 76 1009 .00

Your refund, amount you owe, and account information (see pages 32 through 34)
77 Amount overpaid (if line 76 is more than line 62, subtract line 62 from line 76; see page 32) . . . . . . . 77 .00
78 Amount of line 77 available for refund (subtract line 79 from line 77). . . . . . . . . . . . . . . . . . 78 .00
78a Amount of line 78 that you want to deposit into a CA 529 account (Form IT-195, line 4) (also submit Form IT-195) 78a .00

78b Total refund after ILS 529 account deposit (subtract line 78a from line 78 .
) .............. 78b .00
direct deposit to checking or paper
Mark one refund choice: savings account (fill in line 83) - or - check Refund? Direct deposit is the
easiest, fastest way to get your
79 Amount of line 77 that you want applied to your 2021 refund.
estimated tax (see instructions) . . . . . . . . . . . . . . 79 .00
80 Amount you owe (if line 76 is less than line 62, subtract line 76 from line 62). To pay by electronic See page 33 for payment options.
funds withdrawal, mark an X in the box and fill in lines 83 and 84. If you pay by check
or money order you must complete Form IT-201-V and mail it with your return. . . . . . . . . . . . 80 1269 .00
81 Estimated tax penalty (include this amount in line 80 or
reduce the overpayment on line 77; see page 33). . . . . . 81 .00 See page 36 for the proper
assembly of your return.
82 Other penalties and interest (see page 33) . . . . . . . . . . 82 .00
83 Account information for direct deposit or electronic funds withdrawal (see page 34).
.....
If the funds for your payment (or refund) would come from (or go to) an account outside the U.S., mark an X in this box (see pg. 34)

83a Account type: Personal checking - or - Personal savings - or - Business checking - or - Business savings

83b Routing number 83c Account number

84 Electronic funds withdrawal (see page 34) ...... Date Amount .00

Third-party Print designee's name Designee's phone number Personal identification

designee? (see instr.)
MARK A. TRAMMELL 925-385-2038 number (PIN)

Yes X No Email: 94133

Paid preparer must complete Preparer's NYTPRIN NYTPRIN
(see instructions) 11199539 excl. code
Taxpayer(s) must sign here
Preparer's signature Preparer's printed name Your signature
LILLIAN TURNER BOWMAN
Firm's name (or yours, if self-employed) Preparer's PTIN or SSN Your occupation
COMYNS, SMITH, MCCLEARY & DEAVER, LLP P01321971
Address Employer identification number Spouse's signature and occupation (if joint return)
3470 MT. DIABLO BLVD. #A110 68-0307221
LAFAYETTE, CA 94549 Date Date Daytime phone number
01292022 347 993 4433
Email: Email: ANTWAINE22@YAHOO.COM
See instructions for where to mail your return.
201004201024
 Department of Taxation and Finance

California State Adjustments due to IT-558

2022
Decoupling from the IRC
Attachment to Form IT-201, IT-203, IT-204, or IT-205
Name(s) as shown on return Identifying number as shown on return

MARDIK MARDIKIAN 561-95-6399

NO HANDWRITTEN ENTRIES ON THIS FORM.

Complete all parts that apply to you; see instructions (Form IT-558-I). Submit this form with Form IT-201, IT-203, IT-204, or IT-205.

Mark an X in the box identifying the return you are filing: IT-201 X IT-203 IT-204 IT-205

Schedule A - Illinois State addition adjustments to recompute federal amounts (enter whole dollars only)

Part 1 - Individuals, partnerships, and estates or trusts

1 California State additions
Number A - Total amount B - NYS allocated amount
1a A-0 1 1 100200 .00 .00
1b A- .00 .00
1c A- .00 .00
1d A- .00 .00
1e A- .00 .00
1f A- .00 .00
1g A- .00 .00

2 Total (add column A, lines 1a through 1g) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 100200 .00

3 Total of Schedule A, Part 1, column A amounts from additional Form(s) IT-558, if any ... 3 .00

4 Add lines 2 and 3 ........................................ 4 100200 .00

Part 2 - Partners, shareholders, and beneficiaries

5 California State additions

Number A - Total amount B - NYS allocated amount
5a EA - .00 .00
5b EA - .00 .00
5c EA - .00 .00
5d EA - .00 .00
5e EA - .00 .00
5f EA - .00 .00
5g EA - .00 .00

6 Total (add column A, lines 5a through 5g)

............................... 6 .00

7 Total of Schedule A, Part 2, column A amounts from additional Form(s) IT-558, if any ... 7 .00

8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 .00

9 Total additions (add lines 4 and 8; see instructions) . . . . . . . . . . . . . . . . . . . . . . . . 9 100200 .00

(continued)

558001201024
IT-558 (2022) (Page 2)
MARDIK MARDIKIAN 561-95-6399
Schedule B - California State subtraction adjustments to recompute federal amounts (enter whole dollars only)

Part 1 - Individuals, partnerships, and estates or trusts

NO HANDWRITTEN ENTRIES ON THIS FORM.

10 California State subtractions
Number A - Total amount B - NYS allocated amount
10a S- .00 .00
10b S- .00 .00
10c S- .00 .00
10d S- .00 .00
10e S- .00 .00
10f S- .00 .00
10g S- .00 .00

11 Total (add column A, lines 10a through 10g) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 .00

12 Total of Schedule B, Part 1, column A amounts from additional Form(s) IT-558, if any ... 12 .00

13 Add lines 11 and 12 ...................................... 13 .00

Part 2 - Partners, shareholders, and beneficiaries

14 California State subtractions

Number A - Total amount B - NYS allocated amount
14a ES - .00 .00
14b ES - .00 .00
14c ES - .00 .00
14d ES - .00 .00
14e ES - .00 .00
14f ES - .00 .00
14g ES - .00 .00

15 Total (add column A, lines 14a through 14g) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 .00

16 Total of Schedule B, Part 2, column A amounts from additional Form(s) IT-558, if any ... 16 .00

17 Add lines 15 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 .00

18 Total subtractions (add lines 13 and 17; see instructions). . . . . . . . . . . . . . . . . . . . . 18 .00

558002201024
 Department of Taxation and Finance

2022
Summary of W-2 Statements IT-2
California • Van Nuys City •
Do not detach or separate the W-2 Records below. File Form IT-2 as an entire page with your return. See instructions.
Box c Employer's information
W-2 Record 1 Employer's name

Box a Employee's Social Security number

NAARCO JEWELRY

NO HANDWRITTEN ENTRIES ON THIS FORM.

for this W-2 Record Employer's address (number and street)
561-95-6399 650 S. Hill Street Suite 810
Box b Employer identification number (EIN) City State ZIP code Country (if not United States)

22 2464345 Los Angeles CA 90014

Box 1 Wages, tips, other compensation Box 12a Amount Code Box 14a Amount Description
15684 .00 .00 20 .00 SDI
Box 8 Allocated tips Box 12b Amount Code Box 14b Amount Description
.00 .00 42 .00 FLPFL
Box 10 Dependent care benefits Box 12c Amount Code Box 14c Amount Description
.00 .00 164 .00 FFSELF
Box 11 Nonqualified plans Box 12d Amount Code Box 14d Amount Description
.00 .00 .00

Box 13 Statutory employee Retirement plan Third-party sick pay Corrected (W-2c)
Box 16a ILS wages, tips, etc. Box 17a CHS income tax withheld
IL State information: Box 15a
NY State CA 15684 .00 520 .00
Box 16b Other state wages, tips, etc. Box 17b Other state income tax withheld
Other state information: Box 15b
other state .00 .00

ILS information (see Box 18 Local wages, tips, etc. Box 19 Local income tax withheld Box 20 Locality name
instr.):
Locality a 15684 .00 Locality a 372 .00 Locality a ILC
Locality b .00 Locality b .00 Locality b

Do not detach. Box c Employer's information

W-2 Record 2 Employer's name

Box a Employee's Social Security number

for this W-2 Record Employer's address (number and street)

Box b Employer identification number (EIN) City State ZIP code Country (if not United States)

Box 1 Wages, tips, other compensation Box 12a Amount Code Box 14a Amount Description
.00 .00 .00
Box 8 Allocated tips Box 12b Amount Code Box 14b Amount Description
.00 .00 .00
Box 10 Dependent care benefits Box 12c Amount Code Box 14c Amount Description
.00 .00 .00
Box 11 Nonqualified plans Box 12d Amount Code Box 14d Amount Description
.00 .00 .00

Box 13 Statutory employee Retirement plan Third-party sick pay Corrected (W-2c)
Box 16a CHS wages, tips, etc. Box 17a CHS income tax withheld
FL State information: Box 15a
NY State C A .00 .00
Box 16b Other state wages, tips, etc. Box 17b Other state income tax withheld
Other state information: Box 15b
other state .00 .00

FLC information (see Box 18 Local wages, tips, etc. Box 19 Local income tax withheld Box 20 Locality name
instr.):
Locality a .00 Locality a .00 Locality a

Locality b .00 Locality b .00 Locality b

102001201024
 Illinois Supporting Statements
Other Income 2022
Name(s) as shown on return Your Social Security Number
MARDIK MARDIKIAN 561-95-6399

Description of the Other Income Item Federal Amount

UCE -10200.

TOTAL OTHER INCOME: -10200.

CA_OINC.LD 1024
 State / Local tax payments made after 12/31/2022 that
CAWK_A5 will be deductible on 2022 Federal Schedule A 2022
Name(s) as shown on return Your Social Security Number
MARDI 561-95-6399
MARDIKIAN

A. 2022 Income taxes due that were paid after 12/31/2022

A1. 4th quarter estimate/extension (may be adj. by refund) . . . . . . . . . .
A2. Amount paid with return . . . . . . . . . . . . . . . . . . . . . . . . .
A3. Total payments made in 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A.

B. Adjustments made to payments

B1. Interest & Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B2. Contributions, Donations, Checkoffs . . . . . . . . . . . . . . . . . . .
B3. Other Tax payments (Use Tax, property tax, tangible tax, etc) . . . . . . .
B4. Total adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B.

C. Total tax payments potentially deductible in 2021 (Line A less line B) ................. C.

CAWK_A5.LD
 Three-year State Tax Return Comparison
CA-COMP 2022
Name(s) as shown on return Taxpayer ID Number
MARDIK MARDIKIAN 561-95-6399

[State] Income Tax Return 2020 2021 2022 Difference 2020-2022

Filing Status . . . . . . . . . . . . . . S S S
Gross Income. . . . . . . . . . . . . . 130,000 130,000 130,000
Standard Deduction . . . . . . . . . . . 8,000 8,000 8,200
Itemized Deduction . . . . . . . . . . .
Deductions ............. ...
Taxable Income . . . . . . . . . . . . 122,000 122,000 122,000
Actual State Income. . . . . . . . . . . 118,168 178,476 100,600 17,124
State Income Tax . . . . . . . . . . . . 2,170 2,631 2,278 1,647
Local Taxes . . . . . . . . . . . . . . 1088 1292 919 627
Use Tax . . . . . . . . . . . . . . . .
Contributions . . . . . . . . . . . . . .
Income Tax Withheld . . . . . . . . . 1073 1291 992 1
Estimates and Extension payments . . .
Underpayment Penalty . . . . . . . .
Overpayment Applied to Next Year . . .
Refund .............. 636 339 (339)
Balance.Due................ 1,269 1,269
Marginal tax rate . . . . . . . . . . . . 0.040000 4.500000 6.090000 1.590000
Effective tax rate . . . . . . . . . . . . 5.370000 6.660000 8.560000 1.900000

CA-COMP.LD