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OMS No. 1545-0008 OMS No.

1545-0008

a Control number 1 Wages, tips, other compensation 2 Federal income tax withheld a Control number 11 Wages, tips, other compensation 12 Federal income tax withheld
645613 120227 39 26492.36 5613 I 120227 26492.36
3 Social securitywages 4 Social securitytax withheld 3 Social security wages 4 Social security tax wijhheld
.
90000.00 5579.36 90000.0 5579.36
5 Medicarewages and tips 6 Medicaretax withheld 5 Medicare wages and tips 6 Medicare tax withheld
130141 17 1887 05 ]l' 130 1887.05
c Employer's name, address, and ZIP code , c Employer'sname, address, and ZIPcode
RW.JUHAT RAIlfAY 186 180 RWJUH AT RAHNAY 186
865 STONE STREET i 865 STONE STREET
RAIlfAY, NEW JERSEY 07065 IRAIlfAY, NEW JERSEY 07065
UIDI 221487305000 ! UIDI 221487305000

7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social securitytips" 8 Allocatedtips 9 Advance EICpayment

10 Dependent care benefits 11 Nonqualified plans c12a 10 Dependent care benefits 11 Nonqualifiedplans c12a
I 44 16 3C I 44 16
b. Employeridentificationnumber c12b b. Employer identification number c12b
22 -1487305 lE I 9913 78 22-1487305 3E I 9913 78
--'Other c12c 14Other c12c
SI [ 124.50 3 I SDI 124.50 3 I
UNEM 99.61 c12d UNEN '99.61 c12d
\lIDPF 6.23 3 I \llDPF 6.23 s I
e Employee'sname, address, and Zip code e Employee'sname, address, and Zip code
LUZ NERCADO 00628 LUZ NERCADO
32 WOODVIEW AVENUE I 32 IfOODVIEW AVENUE
FORDS, NJ 08863 FORDS, NJ 08863

d Employee social securijy number Third-party


siCk pay
d Employee social securijy number
135-84-2049
200S 15 State Employer's
315665001
state 1.0. no.
131811.67
~ Wage and Tax 17 Stateincometax 18 local wages, tips, etc. 18 Local wages. tips,

.2W - 2 Statement
etc.

6755
Copy 2 for EMPLOYEE'S 19 Localincometax 20 Locality name 20 Locality name
State, City, or Local
Income Tax Return
Department of the Treasu~nternal Revenue Service Department of the Treasury-Internal Revenue Service

OMS No. 1545-0008 OMS No. 1545.0008

a Control number 11 Wages, tips, other compensation 12 Federal income tax withheld a Control number 11 Wages, tips, other compensation 12 Federal income tax withheld
645613 645613 I 120227.39 26492.36
3 Social security wages 3 Social security wages 4 Social security tax withheld
90000.00 5579.36 90000.00 5579.36
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicaretax withheld
I
130141.17 1887.05 2 130141.17 1887.05

c Employer'sname, address, and ZIPcode c Employer's name, address, and ZIP code
RW.JUH AT RAIlfAY
865 STONE STREET
RAIlfAY, NEW JERSEY
186

07065
UIDI 221487305000
180 RWJUH AT RAIlfAY R86
865 STONE STREET
RAIlfAY,
NEW JERSEY
UIDI 221487305000
07065 /'
7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social security tips 8 Allocated tips 9 Advance EIC payment I
10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12 10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12
rc I 44.16 C I 44.16
b. Employeridentificationnumber 12b b. Employeridentificationnumber 12b
-1487305 I 9913.78 22-1487305 E I 9913.78
14Other 12c 14Other 12c
SI I 124 .50 I SDI 124 .50 I
12d 12d
UN EN 99.61
\lIDPF 6.23 I
UNEN 99.61
\llDPF 6.23 I .
e Employee'sname, address, and Zip code e Employee's name, address, and Zip code
LUZ NERCADO 00628 LUZ NERCADO
32 NOODVIEW AVENUE 32 IfOODVIEW AVENUE
FORDS, NJ 08863 FORDS, NJ 08863

Third-party
siCk pay
d Employee social security number
135-84-2049
16 State wages, tips,

131811.67
etc.

200S J.:: State Employer's


state1.0.no.
315665001
17 State income tax 18 tips, etc. Wage and Tax 17 Stateincometax 18 Local
gW 2
Local wages, wages, lips, etc.

6755.68 ~ - Statement 6755.68


19 Local income tax 20 Locality name Copy C For 19 Locatincometax 20 Locality name
EMPLOYEE'S RECORDS

DepartmentoftheTreasury-lnlernal
RevenueService DepartmenloftheTreasury-lntemal
Revenue'
. This information is being furnished to the Internal Revenue Service. If you are
This information is being furnished to the Internal Revenue Service required to file a tax return, a negligence penalty or other sanction may be imposed (See Notice to
II on you ifthisincome istaxable toreport it.
andyoufail onback of C1
I

--

r
Form 1040X
(Rev November 2005)
Department of the Treasury ~ Internal Revenue Service
Amended U.S. Individual Income Tax Return OMS No. 1545-0074
~ See separate instructions.
---- -------- - . . ___ ___n - --- 2005
- - - - 1 -. -- - - _ __ ded
ended ,
Your first name MI last name Your social security number
LUZ R. MERCADO 135-84-2049
MI last name
Please If a joint return, spouse's first name Spouse's social security number
print
or Homeaddress(no.and street)or P.O. box if mail is not deliveredto your home Apt no. Phonenumber
type
32 WOODVIEW AVENUE 732-499-6117
City, townor postoffice.If you havea foreignaddress,see instructions. State ZIP code
For PaperworkReduction
FORDS, NJ 08863 Act Notice, see instructions.
A If the address shown above is different from that shown on your last return filed with the IRS and you would like us to change it,
check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _. . . . . . . . .

B Filing status. Be sure to complete this line. Note. You cannot change from joint to separate returns after the due date.
On originalreturn ~ D Single D Married filing jointly D Married filing separately ~ Head of household D Qualifying widow(er)

On this return ~ Single D D


Married filing jointly
. If the qualifyingpersonis a child but notyour dependent,see instructions.
D Married filing separately ~ Head of household. D Qualifying widow(er)

A Original B Net change - C Correct


Use Part II on page 2 to explain any changes amount or as amount of increase amount
previously adjusted or (decrease) -
Income and Deductions (see instructions) (see instructions) explain in Part II
1 Adjusted gross income (see instructions) ... .. .. ...... . ... . 1 105,367. 105,367.
2 Itemizeddeductionsor standarddeduction(see instructions). . . . . . . . . . . . 2 32,432. 32,432.
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 72,935. 72,935.
4 Exemptions.If changing,fill in Parts I and II on page2. . . . . 4 19,200. -3,200. 16,000.
5 Taxableincome.Subtract line 4 from line 3. .. .. ...... . . ... 5 53,735. 3,200. 56,935.
6 Tax(see instructions). Methodusedin columnC. --------- Tables 6 12,298. 12,298.
Tax 7 Credits (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Lia. 8
Subtract line 7 from line 6. Enterthe result but not lessthan zera . . . . . . . . 8 12,298. 12,298.
bility
9 Other taxes (see instructions).. .. . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Total tax. Add lines 8 and 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 12,298. 12,298.
11 Federalincometax withheldand excesssocial securityand
tier 1 RRTAtax withheld. If changing,see instructions.. . .. . 11 26,492. 26,492.
12 Estimatedtax payments,including
Pay- amount applied from prior year's return. . . . . . . . . . . . . . . . . . . . 12
ments 13 Earned income credit (EIC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Additionalchild tax credit from Form 8812.. .. . . .... . . . . .. . 14
15 Creditsfrom Form2439, Form4136, or Form 8885......... 15
16 Amount paid with request for extension of time to file (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Amount of tax paid with original return plus additionaltax paid after it was filed. . . . . . . .. .. . . . . . . . . . . . 17
18 Total payments. Add lines 11 through 17 in column C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 26,492 .
Refund or Amount You Owe
19 Overpayment,if any, as shownon original return or as previouslyadjusted by the IRS.. . . . . . . . . . . . . . . 19 14,194.
20 Subtract line 19from line 18 (see instructions)..................................................... 20 12,298.
21 Amountyou owe. If line 10, columnC, is more than line 20, enter the differenceand see instructions. 21
22 If line 10, column C, is less than line 20, enter the difference.. .. .. . . . . . . . . . . .. .. . . . . . . .. . . . . . . . . . . . 22
23 Amount of line 22 you want refunded to you.. ........ . ......... .... ..... ... .... .. ...... .. . . .. ..... 23
24 Amount of line 22 you wantapplied to your estimated tax. . . .. 24 I I 1
'I N I
Sign Here Under penalties of perjury, I declare that I have filed an ori\linal return and that I have examined this amended return, includingaccomanying schedules and
statements,and tothe bestofmyknowledgeand belief,thISamendedreturnis true,correct,and complete.Declarationof preparer(0 er thantaxpayer)is
based on all informationof whichthe preparer has any knowledge.
Joint retum?
See instrs.
rceep a copy
or your
records.
I I
Yoursignature Date Spouse's signature. If a joint return, both must sign Date
Date
Preparer's
signature JACK KAPLAN, EA ;1yJe.lf: Preparer'sSSNor
PO 0 0 2 2 4 3 7PTIN
Paid I : IX] I

Firm's name EIN 22-3761453


Preparer's 21E_n________________________
Use Only (0lt.0ursif
se -employed), 9grgy____________________
address,and
ZIPcode Avenel, NJ 07001 Phoneno. (732) 602-9010
BAA FDIA1812l 12/02/05 Form 1040X (Rev 11-2005)

I
LUZ R. MERCADO
!':orm 1040X (Rev 11-2005) 135-84-2049 Page 2
Parl1U:1j Exemptions. See Form 1040 or 1040A instructions.
Complete this part only if you are: A Original number C Correct
· Increasing or decreasing the number of exemptions claimed on line 6d
of the return you are amending, or
of exemptions
reported or as
B Net change number of
exemptions
·individualsdisplacedby HurricaneKatrina.
Increasing or decreasing the excemption amount for housing previously adjusted

25 Yourselfand spouse .. . ... .. .. .. .. .. ... .... 1 1


Caution. If someone can claim you as a dependent, you cannot
claim an exemption for yourself.
26 Your dependent children who lived with you ... . .. . 4 -1 3
27 Your dependent children who did not live with you due to divorce or separation. . . . . .
28 Other dependents . . .. .. . . . . .. . . . . . . .. . . . . . . . . . . . . . . .. .. . . . . . . . . . 1 1
29 Total number of exemptions. Add lines 25 through 28. . . . . . . . . . . . . . 6 -1 5
30 Multiplythe number of exemptions claimed on line 29 by the
amount listed below for the tax year you are amending. Enter
the result here and on line 4.
Tax Exemption But see the instructions for line 4 if
~ amount the amount on line 1 is over:
2005 . $3,200 $109,475
2004 3,100 107,025
2003 3,050 104,625
2002 3,000 103,000
31 If you are claiming an exemption amount for housing individuals
~ 19,200. -3,200. 16,000.

displaced by Hurricane Katrina, enter the amount from Form 8914,


line 2 (see Instructions for line 4) ~
32 Add lines 30 and 31. Enter the result here and on line 4 . . . . . . . . . .. I32 19,200. -3,200. 16,000.

33 Dependents (children and other) not claimed on original (or adjusted) return:
(a) First name Last name -I (b) Der endent's (c) Dependent's (d) Number of children
socia secunty relationship v' if on 33 who:
number to you qualifying
child for
child tax
credit · lived with you ~
. did not live
D
with you due to
divorce or sep-
aration (see
instructions)..
Dependents
~ D
on 33 not
entered above ~
Explanation of Changes
Enter the line number from page 1 of the form for each item you are changing and give the reason for each change. Attach only
the supporting forms and schedules for the items changed. Ifyou do not attach the required information, your Form 1040X may
be returned. Be sure to include your name and social security number on any attachments.

If the change relates to a net operating loss carryback or a general business credit carryback, attach the schedule or form that
shows the year in which the loss or credit occurred. See the instructions. Also, check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~

DEPENDENT ANNALIZA MERCADO WAS DELETED FROM ORIGINAL RETURN

PartIII Presidential Election Cam ai n Fund. Checkin below will not increase your tax or reduce your refund.
If you did not previously want $3 to go to the fund but now want here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
to, check ~

If a joint return and your spouse did not previously want $3 to go to the fund but now wants to, check here.. . . . . . . . . . . . . . . . . . . . . . . . .. ~

Form 1040X (Rev 11-2005)

FDIA1812L 12102105

I
SCHEDULE A Itemized Deductions OMS No. 1545-0074

(Form 1040)

Department of the Treasury


~ Attach to Form 1040. 2005
Attachme, "
Internal Revenue Service (99) ~ See Instructions for Schedule A (Form 1040). Sequence-,No. 07
Name(s) shown on Form 1040 Your social security number

LUZ R. MERCADO
Medical Caution. Do not include expenses reimbursed or paid by others.
and
and dental expenses (see instructions). .. ..... .. .. .... .... .. ....
Dental 1 Medical

Expenses 2 Enteramount fromForm1040,line3& . . . .. ~


3 Multiply line 2 by 7.5% (.D75) U
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -D-.. . . . . . . . . . . . . . . . . . . . . . . . . . . 4 o.
5 State and local (check only one box):
a ~ Incometaxes, or 1-. ............. 5 6,986.
Taxes You
Paid b DGeneral sales taxes (see instructions) J
6 Real estate taxes (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . .. 6 1 5,987.
(See 7 Personal property taxes. . . . .. .. . . .. .. . . .. .. .. . . . . . . .. . . . . . . .. 17
instructions.) 8 Other taxes. List type and amount ~ _ __ _ _ _ _ __ _ _ _
8
,9 Addlhles5through-8~~ ~ ~ ~ ~.~~ .~.-:.-:.-:.-:.-:.-:.-:.-:.-:.-:.-:.~ .1 9 12,973.
Interest 10 Homemtginterestandpointsreported toyouonForm1098 Se.e.St.1 10 15,437.
You Paid 11 Homemortgageinterestnotreportedto youonForm1098. If paidto theperson
from whom you boughtthe home, see instructions and showthat person'sname,
identifying number, and address ~
(See ------------------------------
instructions.)
------------------------------
------------------------------
Note.
Personal re~rt~toyo~ ~ Fo~
12 POlntSn-;;-t 1098:S; ;nstrsfo~spcl~u~s-:-.-:-
Stult. _:_2112 I 180.
interestis
not 13 Investmentinterest. Attach Form 4952 if required.
deductible. (See instrs.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. W
14 Add lines 10 through 13.. .. .. .. .. .. .. .. .. .. .. . .. .. .. .. . .. .. . . .. . . .. .. .. .. . .. .. . .. .. .. .. .. I 14 15,617.
Gifts to 15a Total gifts by cash or check. If you made any gift of $25D or
Charity more, see instrs .. . .See..Statement. 31 15al 2,200.
b Gifts by cash or check after August 27, 2005,
If you made that you elect to treat as qualified
a gift and contributions(see instructions).. .. .. .. ... ~
got a benefit 16 Other than by cash or check. If any gift of $25D or
for it, see more, see instructions. You must attach Form 8283 if
instructions. over$50D. .. ... ... .. .. .. ... .. .. .. I 16 0
17 Carryover from prior year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. m
18 Addlines15a,16,& 17................................................................... i181 2,200.
Casualty and
Theft Losses 19 Casualty or theft loss(es). Attach Form 4684. (See instructions.). . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 I o.
Job Expenses 20 Unreimbursed employee expenses - job travel, union dues,
and Certain job education, etc. Attach Form 21D6 or 2106-EZ if
Miscellaneous required. (See instructions.)
Deductions
~
--------------
------------------------------
------------------------------
21 Tax preparation fees. . . . . .. .. . . . . .. .. .. .. . . . . . . . . . . . . . . . . . . . . 210.
(See 22 Other expenses - investment, safe deposit box, etc. List
instructions.) type and amount ~ _ __ _ _ __ _ _ __ _ _ _ _ __ _ _ _
~~~~ka~~~e~t_~__________________ 3,539.
23 Add lines 20 through 22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,749.
24 EnteramountfromForm1040,line38. . . .. 24 105, 367 .
25 Multiplyline24by2%(.02)... .. .. .. .. .. .. .. .. . .. .. . .. .. .. .. . . 25 2 107 , .
26 Subtract line 25 from line 23. If line 25 is more than line 23, enter -D-. . . . . . . . . . . . . . . . . . . . . . . 1,642.
27 Other - from list in the instructions. List type and amount ~ _ _ _ _ __ _ _ _ _ __ __ _
Other
Miscellaneous --------------------------------------------
Deductions 27 o.
Total 28 Is Form 1040, line 38, over $145,950 (over $72,975 if MFS)?
Itemized
Deductions
[!] No. Your deduction is not limited. Add the amounts in the far right column

DYes.
for lines 4 through 27. Also, enter this amount on Form 1040, line 40.
Your deduction may be limited. See instructions for the amount to enter. } ~I 28

29 If YOUelect to itemize deductionseyenthouahthey are less than your standarddeduction.check here ~

BAA For Paperwork Reduction Act Notice, see Form 1040 instructions. FDIA0301L 11/18/05 Schedule A (Form 1040) 20D5

I
OMS No. 1545-0074
Form 6251 Alternative MinimumTax - Individuals
(Rev January 2006)
Department of the Treasury ~ See separate instructions. 2005
Attachment
Internal Revenue Service (99) ~ Attach to Fonn 1040 or Form 1040NR. Sequence No. 32
Name(s) shown on Form 1040 Yoursocial security number

See instructions for how to com


If filing Schedule A (Form 1040), enter the amount from Form 1040, line 41 (minus any amount on Form'
8914, line 2), and go to line 2. Otherwise, enter the amount from Form 1040, line 38 (minus any amount on
Form 8914, line 2), and go to line 7. (If less than zero, enter as a negative amount.). . .. .. . . . . . . . . . . . . . . . . . . 1 72,935.
2 Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4 or 2- 1/2% of Form 1040, line38.. . . 2
3 Taxes from Schedule A (Form 1040), line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 12,973.
4 Enter the home mortgage interest adjustment, if any, from line 6 of the worksheet in the instructions. . .. .. . . 4
5 Miscellaneous deductions from Schedule A (Form 1040), line 26. .. .. .. . . .. . . . . .. . . . . . . . . . . . . . . .. . . . . .. .. . . 5 1,642.
6 If Form 1040, line 38, is over $145,950 (over $72,975 if married filing separately), enter the amount from
line 9 of the Itemized Deductions Worksheet in the Instructions for Schedules A and 8 (Form 1040). .. 6
7 Tax refund from Form 1040, line 10 or line 21 . . .. . . .. .. . . . . . . . . .. .. . . . . .. . . . . .. . . . . . . . . . . . . . . .. .. . . .. . . .. 7
8 Investment interest expense (difference between regular tax and AMT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Depletion (difference between . . . . . . . . . . . . .. . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . 9
regular tax and AMT)
10 Net operating loss deduction from Form 1040, line 21. Enter as a positive amount.. 10
11 Interest from specified private activity bonds exempt from the regular tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11
12 Qualified small business stock (7% of gain excluded under section 1202). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 12
13 Exercise of incentive stock options (excess of AMT income over regular tax income). . . . . . . . . . . . .. .. .. .. . . .. 13
14 Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, Code A) ... ,... .. .. 14
15 Electing large partnerships (amount from Schedule K-1 (Form 1065-8), box 6) . .. . . . . . . . . . . . . . . .. . . . . .. . . .. 15
16 Disposition of property (difference between AMT and regular tax gain or loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16
17 Depreciation on assets placed in service after 1986 (difference between regular tax and AMT). .. .. .. 17
18 Passive activities (difference between AMT and regular tax income or loss) . . . . . . . . . . . . . . . _. . . . . . . . . . . . . . .. 18
19 Loss limitations (difference between AMT and regular tax income or loss).. . . .. . . . . . . .. . . . . , . . . . . . . . . .. .. .. 19
20 Circulation costs (difference between regular tax and AMT), . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20
21 Long-term contracts (difference between AMT and regular tax income). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21
22 Mining costs (difference between regular tax and AMT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 22

23 Research and experimental costs (difference between regular tax and AMT). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23
24 Income from certain installment sales before January 1, 1987. . . .. . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . .. 24
25 Intangible drilling costs preference. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 25
26 Other adjustments, including income-based related adjustments. . . .. . . . . .. . . . . . . . . . . . . . . . . .. . . .. . . . . .. . . .. 26
27 Alternative tax net operating loss deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 27
28 Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately and line 28
is more than $191,000, see instructions.), 1 28 87,550.
~artU I Alternative Minimum Tax
29 Exemption. (If this form is for a child under age 14, see instructions.)
AND line 28 is THEN enter on
IF your filing status is ... not over. .. line 29 ...
Single or head of household $112,500.............. $40,250
Married filing jointly or qualifying widow(er). . . . . . . . . . . . . .
Married filing separately. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If line 28 is over the amount shown above for your filing status, see instructions.
150,000. . . . . . . . . . . . . .
75,000. . . . . . . . . . . . . .
58,000
29,000 } .... ... 40,250.

30 Subtract line 29 from line 28. If zero or less, enter -0- here amI on lines 33 and 35 and stop here.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47,300.
31 -If you reported capital gain distributions directly on Form 1040, line 13; you reported
qualified dividendson Form 1040,line 9b; or you had a gain on both lines 15 and 16 of

}
ScheduleD (Form 1040) (as refiguredfor the AMT, if necessary),complete Part III on page
2 and enter the amount from line 55 here. ..... .. 12,298.
- All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately),

32
multiply line 30 by 26% (.26). Otherwise, multiply line 30 by 28% (.28) and subtract $3,500
($1,750 if married filing separately) from the result.
Alternative minimum tax foreign tax credit (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
J
33 Tentative minimum tax. Subtract line 32 from line 31. . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 I 12,298.
34 Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040,
line 47). If you used Schedule J to figure your tax, the amount for line 44 of Form 1040 must be refigured
without using Schedule J (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 9,729.
35 Alternative minimum tax. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on
Form 1040,line 45. .. .. .. .. .. . .. .. .. ... . . . .. 35 2,569.
BAA For Paperwork Reduction Act Notice, see separate instructions. FDIA5312L01113/06 Form 6251 (2005) (Rev 1-2006)

I
NJ-'040X STATE OF NEW JERSEY
2005 AMENDED
INCOME TAX RESIDENT RETURN

For Tax Year Jan. Dec 31,2005, Or Other Tax Year Beginning , 2005, Ending

, You must enter your


social security number below ,
T YourSocialSecurityNumber LastName,First Nameand Initial (Jointfilers enterfirst nameand initial of each - Enterspouselast nameONLYifdifferent)
A
x 135-84-2049 MERCADO LUZ R.
p Spouse'sSocialSecurityNumber Homeaddress(Numberand Street,includingapartmentnumberor rural route)
A
Y
E 32 WOODVIEW AVENUE
R County/Municipality
Code City,Town,Post Office State ZIP Code
I NJ 08863
D FORDS,
E
N NJ RESIDENCY If you were a New Jersey resident for ONLY part of the From to
T STATUS taxable year, give the period of New Jersey residency: MONTH DAY YEAR MONTH DAY YEAR
I
F
I As Originally
c FILING STATUS EXEMPTIONS Amended
A Reported
T
I
0
ON ON 6 Regular X Yourself - Spouse
"'"" U
Domestic
Partner
6 1 1
N ORIGINALAMENDED 7 Age 65 or Over Yourself - Spouse. . . . . . . . . . . . . 7
--
A RETURN
- RETURN
- 8 Blindor Disabled L- Yourself - Spouse. . . . . . . . . . . . . 8
N
D 1 - _ Single 9 Numberof your qualified dependent
children.
.. .... ... .. .. 9 4 3
s 2 - - Married,filingjointreturn 10
10Number of other dependents. . . . . . . . .. .. . . . . .. . 1 1
T
A 3 - _ Married,filing separatereturn 11 Dependents attending colleges. . . . . . .. .. . . . . .. . 11
T
u
s
4 X -
X Headofhousehold - 12Totals (ForLine12a- AddLines6,7,8,and11).. ... .. 12a 1 1
5 Qualifyingwidow(er) (For Line 12b - Add Line 9 and Line 10)... . . . .. . 12b 5 4
13 GUBERNATORIALELECTIONSFUND Checkingbelow will not increaseyour tax or reduceyour refund.

Checkhere---
Checkhere--- R If you
jointdid not and
return previouslywant
if spousedidtonot
have $1 go to the fund
previouslywant but $1
to have nowtowant
go toitthe
to do so.but now wants it to do so.
fund
As Originally Amended
Reported (See Instructions)
'0'
14 Wages,salaries,tips, and other
employee compensation. . . . . . . . . . . . . . . . . . . . . . . . . 14 131,812
". * r 131,812
Ii! [
15a Taxable Interest Income.. .. ...... . . .. ...... .... . 15a 18 "I 18

15 b xLr:T .i : .? .:. i.I.


16 Dividends.. .. . . . . . . . . .. . . .. . . .. .. . . . . .. . . . . . . . . . 16
..... 15b
!J
I
'
I
@
17 Net profits from business. . . . . . . . . . . . . . . . . . . . . . . . 17
18 Net gains or income from disposition
of property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Pensions,Annuities a TaxableAmount Received... 19a ;
and IRA Withdrawals : $I
b Less New Jersey
Pension Exclusion. .......... 19b ' .1
c Subtract Line 19b from tI
Line 19a . . . . . . . . . . . . . . . . . . . . 19c pc
@ ",'.
.TI,
20 Distributive Share of Partnership Income. . . . . . . . . . 20 ::
21 Net pro rata share of S Corporation Income. . . . . . . 21
22 Net gain or income from rents, royalties,
patents and copyrights. . .. .. . . . . .. . . . . . . .. .. .. .. . 22
23 Net GamblingWinnings... .. ....... .............. 23
,
@
24 Alimony and separate maintenance @
payments received. ............................. 24 TI
..@
25 Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
pI1
if @
26 Total Income (Add Lines 14, 15a, 16, 17, 18, 19c, E ;11 @

20, 21, 22, 23, 24, and 25) .. .. . .. .. .. .. .. .. . .. .. . 26 131,830 III


, .. 4 "* 131,830
NJIA0412L 12129/05

I
LUZ R. MERCADO
-'135-84-2049
Amended
Page
- 2
As Originally
Reported (See Instructions)
27 "
Total Income (From Line 26, Page 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 131 830 131 830
28 Other Retirement Income Exclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
29 New Jersey Gross Income (Subtract Line 28 from Line 27).. . . . . . . . . . . . 29 131 830 131 830
30 Exemptions (See instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 8.500 7 000
31 Medical Expenses (See instructions NJ-104D} . . . . . . . . . . . . . . . . . . . . . . . . . 31
32 "
Alimony and separatemaintenancepayments.... .. .. ...... ... . .. .. ... 32
33 Qualified Conservation Contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
34 Health Enterprise Zone Deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
35 Total Exemptionsand Deductions(Add Lines 30, 31,32,33, and34}... 35 8.500 7 000
36 Taxable Income (Subtract Line35fromLine29)...... ......... . ....... 36 123 330 124 830
37 PropertyTax Deduction... ........ . ..... .... .... .... ......... . ....... 37 5.987 5 987
38 NEWJERSEYTAXABLEINCOME(Subtract Line 37 from Line 36)...... 38 117 343 118 843
39 TAX: (see instructions). . .. .. .. .. . . . . .. .. . . . . ... . . . .. .. . . .. .. . . . . . . .. . 39 3 708 3 791
40 Credit For Income Taxes Paid To Other Jurisdictions.. ......... . ....... 40 '.'.
i
41 Balance of Tax (Subtract Line 40 from Line 39). . . . . . . . . . . . . . . . . . . . . . . . 41 3 708 .....
3791
42 UseTax Due on Out-of-StatePurchases(see instructionsNJ.l040).. . . . 42
43 Total Tax (Add Line 41 and Line 42). . . . . . . . . .. . . . . . . . . . . .. .. . . . . . . .. . 43 3 708 3 791
44 Total New Jersey Income Tax Withheld.. . . . . .. .. . . .. .. . . .. .. . . . . . . .. . 44 6.756 6 756
45 Property Tax Credit. . . . . .. .. . . . . . . . . . . . . . . . . .. . . . . .. . . . . .. .. . . . . . . .. . 45 '"
46 NewJerseyEstimatedTax Payments/Creditfrom 2004tax return.. . . . . . 46
47 New Jersey Earned Income Tax Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 f
48 EXCESS New Jersey UI/HCIWD Withheld (see instructions NJ-104D). . . . 48
49 EXCESS New JerseyDisabilitYInsuranceWithheld(see instructions NJ-1040).. . . . . . . . . . . 49
50 Amount Paid with original return, assessments and/or with request
for extension to file. .. . . .. .. . . . . .. . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . .. . . . 50
51 Total payments (Add Lines 44 through 50} .. ..... .. .. .... ..... .. ... ... 51 6.756 6 756
52 Refund previously issued from Original Return. . . . . . . . . . . . . . . . . . . . . . . . . 52 3 048 3 048
53 Net Payments(SubtractLine 52 from Line 51).... .... .. .. ........ . ... . 53 3.708 :1 3.708
54 If payments(Line 53) are LESSTHANtax (Line43) enter AMOUNT OFTAXYOUOWE... .. .... .. .. .... 54 83
55 If payments (Line 53) are MORE THAN tax (line 43) enter OVERPAYMENT. ................ ........ .... 55
56 Amount of Line 55 to be (A) REFUNDED. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56A
(B) CREDITED to vour 2006 tax.. .. .. .. .. .. .. . .. .. .. . .. .. .. .. .. .. .. .. .. .. .. 56B
Enterbelow,name,socialsecuritynumber,and addressas shownon orinal return(if sameas indicatedon page I, write'Same').If changingfrom separateto joint return,enter names,
socialsecuritynumbers,and addressesusedon originalreturns. (Note: ou cannotchangefrom jointto separatereturnsafterthe duedate has passedunlessyou havedoneso for Federal
tax purposes.)
Same
Your SSN
Spouse's SSN

Enterlast name,first name,middleinitial, socialsecuritynumber,andbirth year of yourdependentswhowerenot claimedas dependentson originalreturn.

Explanationof Changes to Income,Deductions, and Credits. Enter the linereference for whichyou are reportinga change and give the
reason foreach change.
See Statement 1

Ifamending Line40, completethe calculations below:


(IncomefromOtherJurisdictions) X =
(Income from New Jersev sources) (NewJerseyTaxline 39)
Under the penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the Pay amount on line 54 in full.
best of my knOWlede and belief, it is true, correc and complete. If prepared by a person other than taxpayer, this declaration is based Write SSN(s) on check or money
on all information 0 which the preparer has any knowledge. order and make payable to:
-
SIGN
- Yoursignature Date
- Spouse'ssignature(If filing jointly,BOTHmustsign.)
STATEOF NEWJERSEY TGI
Mail your return to:
Divisionof Taxation
RevenueProcessingCenter
POBox 111
Trenton,NJ08645-0111
HERE PaidPreparer'sSignature FederalEmployerIdentificationNumber
If Refund:
JACK KAPLAN, EA POO022437 Divisionof Taxation
Firm'sName FederalEmployerIdentificationNumber RevenueProcessingCenter
Kaplan & Bender PO Box555
Trenton,NJ 08647-0555
1030 St. Georges Ave. 22-3761453 You may also pay bye-check
Avenel, NJ 07001 orcreditcard.
Division
Use 1 2 3 4 5 6 7

NJIA0412L 12/29/05