Patty Banyan is a single taxpayer, age 27 (birthdate May 18, 1992) living at 543 Space Drive, Houston, TX 77099. Her Social Security number is 466-33-1234. For 2019, Patty has no dependents, and received a W-2, from her job at a local restaurant where she parks cars. These wages are Patty’s only income for 2019.
Required:
Complete Form 1040 for Patty Banyan for the 2019 tax year. If there is an over-payment, she would like a refund.
- She wants to donate $3 to the Presidential Election Campaign Fund. The election to donate does not affect tax liability in any way.
- Patty has health care coverage for the full year.
- Enter all amounts as positive numbers.
- If an amount box requires no entry or the amount is zero, enter “0”.
- If required, round amounts to the nearest dollar.
| an Employee’s social security number
466-33-1234 |
OMB No. 1545-0008 | Safe, accurate, FAST! Use |
IRSe ~ file | Visit the IRS website at www.irs.gov/efile |
|
| b Employer identification number (EIN) 33-1235672 |
1 Wages, tips, other compensation 20,051.12 |
2 Federal income tax withheld 1,197.78 |
|||||
| c Employer’s name, address, and ZIP code
Burger Box |
3 Social security wages 20,051.12 |
4 Social security tax withheld 1,243.17 |
|||||
| 5 Medicare wages and tips 20,051.12 |
6 Medicare tax withheld 290.74 |
||||||
| 7 Social security tips | 8 Allocated tips | ||||||
| d Control number | 9 | 10 Dependent care benefits | |||||
| e Employee’s first name and initial Last name Suff.
Patty Banyan |
11 Nonqualified plans | 12a See instructions for box 12 | |||||
| 13Statutory employee Retirement plan Third-party sick pay
◻ ◻ ◻ |
Code | | ||||||
| 12b | |||||||
| 14 Other | Code | | ||||||
| 12c | |||||||
| Code | | |||||||
| 12d | |||||||
| Code | | |||||||
| f Employee’s address and ZIP code | |||||||
| 15 State TX |
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 | |
| Form W-2 Wage and Tax Statement Copy—To Be Filed With Employee’s FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. |
2019 | Department of the Treasury—Internal Revenue Service |
