Form

1040

Name, Address, and SSN See separate instructions.

P R I N T C L E A R L Y

Presidential Election Campaign

Filing Status Check only one box.

Exemptions

Department of the Treasury—Internal Revenue Service

For the year Jan. 1–Dec. 31, 2010, or other tax year beginning Last name Your first name and initial

Richard A

Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.

If you did not get a W-2, see page 20.

Enclose, but do not attach, any payment. Also, please use Form 1040-V.

Adjusted Gross Income

IRS Use Only—Do not write or staple in this space.

, 2010, ending

, 20

OMB No. 1545-0074 Your social security number

Burton

871-19-1234

Elizabeth T

Spouse’s social security number

Burton

839-19-2102 Apt. no.

Home address (number and street). If you have a P.O. box, see instructions.

c

8456 Loch Lloyed City, town or post office, state, and ZIP code. If you have a foreign address, see instructions.

a

Check here if you, or your spouse if filing jointly, want $3 to go to this fund 1 2 3

Single Married filing jointly (even if only one had income)

4

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Spouse . Dependents:

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(2) Dependent’s social security number

Last name

Michael Burton Christopher Burton Lisa Burton

Total number of exemptions claimed

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You

a

Qualifying widow(er) with dependent child

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(4)  if child under age 17 qualifying for child tax credit (see page 15)

Son Son Daughter

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Wages, salaries, tips, etc. Attach Form(s) W-2 . Taxable interest. Attach Schedule B if required . Tax-exempt interest. Do not include on line 8a . Ordinary dividends. Attach Schedule B if required

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8a

105,302. 438.

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9a

847.

7

10 11

12 13 14

Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . Capital gain or (loss). Attach Schedule D if required. If not required, check here a Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . .

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12 13 14

15a 16a 17

IRA distributions . 15a b Taxable amount . . . Pensions and annuities 16a b Taxable amount . . . Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E

15b 16b 17

18 19 20a

Farm income or (loss). Attach Schedule F . Unemployment compensation . . . . Social security benefits 20a

18 19 20b

21 22

Other income. List type and amount Combine the amounts in the far right column for lines 7 through 21. This is your total income

23

Educator expenses

24

Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ

25

Health savings account deduction. Attach Form 8889

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24 25

26 27 28

Moving expenses. Attach Form 3903 . . . . . One-half of self-employment tax. Attach Schedule SE Self-employed SEP, SIMPLE, and qualified plans .

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26 27 28

29 30 31a

Self-employed health insurance deduction Penalty on early withdrawal of savings . .

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32 33 34

Alimony paid b Recipient’s SSN a IRA deduction . . . . . . . Student loan interest deduction . . Tuition and fees. Attach Form 8917 .

29 30 31a

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32 33 34

35 36 37

Domestic production activities deduction. Attach Form 8903 35 Add lines 23 through 31a and 32 through 35 . . . . . . . Subtract line 36 from line 22. This is your adjusted gross income

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3

5

847. . .

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Add numbers on lines above a

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2

Dependents on 6c not entered above

10 11

. .

Boxes checked on 6a and 6b No. of children on 6c who: • lived with you • did not live with you due to divorce or separation (see instructions)

Qualified dividends . . . . . . . . . . . 9b Taxable refunds, credits, or offsets of state and local income taxes Alimony received . . . . . . . . . . . . . . .

b

Spouse

child’s name here. a

5

(3) Dependent’s relationship to you

839-19-2022 839-19-2032 839-19-2042

.

Head of household (with qualifying person). (See instructions.) If

Yourself. If someone can claim you as a dependent, do not check box 6a .

6a

7 8a b 9a

.

the qualifying person is a child but not your dependent, enter this

Married filing separately. Enter spouse’s SSN above and full name here. a b c

.

Make sure the SSN(s) above and on line 6c are correct.

Checking a box below will not change your tax or refund.

Riverbank CA 95367

d

Income

(99)

Last name

If a joint return, spouse’s first name and initial

(1) First name

If more than four dependents, see instructions and check here a

2010

U.S. Individual Income Tax Return

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. . . . . . . . . . . . b Taxable amount

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21 22

106,587.

23

47.

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For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA

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. a

36 37

REV 06/22/11 TTW

47. 106,540. Form 1040

(2010)

Form 1040 (2010)

Tax and Credits

38

Amount from line 37 (adjusted gross income)

39a

Check if:

b 40

If your spouse itemizes on a separate return or you were a dual-status alien, check here a

39b Itemized deductions (from Schedule A) or your standard deduction (see instructions) . .

41

Subtract line 40 from line 38

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42 43

Exemptions. Multiply $3,650 by the number on line 6d . . . . . . . . . . . Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- .

. .

44 45 46

Tax (see instructions). Check if any tax is from: a Form(s) 8814 Alternative minimum tax (see instructions). Attach Form 6251 . . Add lines 44 and 45 . . . . . . . . . . . . . . .

47 48

Foreign tax credit. Attach Form 1116 if required .

Credit for child and dependent care expenses. Attach Form 2441

47 48

49 50 51

Education credits from Form 8863, line 23 . . . . . Retirement savings contributions credit. Attach Form 8880 Child tax credit (see instructions) . . . . . . . .

49 50 51

52 53 54 55

Residential energy credits. Attach Form 5695 . . . . 52 3800 b 8801 c Other credits from Form: a 53 Add lines 47 through 53. These are your total credits . . . . . Subtract line 54 from line 46. If line 54 is more than line 46, enter -0-

56 57

Self-employment tax. Attach Schedule SE . . . . Unreported social security and Medicare tax from Form:

{

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You were born before January 2, 1946, Spouse was born before January 2, 1946,

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Blind. Blind.

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871-19-1234 Page 2 106,540. . 38

Total boxes checked a 39a

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b . . . .

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. . 8919

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58 59 60

Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required

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.

a Form(s) W-2, box 9 b Schedule H Add lines 55 through 59. This is your total tax .

. .

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Payments

61 62 63

Federal income tax withheld from Forms W-2 and 1099 . . 2010 estimated tax payments and amount applied from 2009 return Making work pay credit. Attach Schedule M . . . . . . .

61 62

11,932.

63

800.

If you have a qualifying child, attach Schedule EIC.

64a b

Earned income credit (EIC) . . . . Nontaxable combat pay election 64b Additional child tax credit. Attach Form 8812

65 66 67 68 69 70 71 72

Refund

Sign Here

Paid Preparer Use Only

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. b

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Form 5405, line 16 . . . . . .

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64a

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American opportunity credit from Form 8863, line 14 . First-time homebuyer credit from Form 5405, line 10 . Amount paid with request for extension to file . . .

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65 66

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. .

a

55 56 57 58 59 60

6,281.

1,000.

67 68

. . . . 69 Credit for federal tax on fuels. Attach Form 4136 . . . . 70 Credits from Form: a 2439 b 8839 c 8801 d 8885 71 Add lines 61, 62, 63, 64a, and 65 through 71. These are your total payments .

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a

74a b d

Amount of line 73 you want refunded to you. If Form 8888 is attached, check here . a Routing number Checking Savings X X X X X X X X X a c Type: Account number X X X X X X X X X X X X X X X X X Amount of line 73 you want applied to your 2011 estimated tax a 75 Amount you owe. Subtract line 72 from line 60. For details on how to pay, see instructions ▶

75 76

3,815. 6,281.

54 a

Excess social security and tier 1 RRTA tax withheld

77 77 Estimated tax penalty (see instructions) . . . . . . . Do you want to allow another person to discuss this return with the IRS (see instructions)? Designee’s name a

Phone no. a

13,732. 7,451. 7,451.

72 73 74a

76

a

Yes. Complete below.

No

Personal identification a number (PIN)

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.

Your signature

F

Joint return? See page 12. Keep a copy for your records.

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. .

If line 72 is more than line 60, subtract line 60 from line 72. This is the amount you overpaid

a


Third Party Designee

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. .

73

Direct deposit? See a instructions.

Amount You Owe

.

10,096.

2,000.

.

c

44 45 46

315. 1,500.

. .

. . . . a 4137

43

Form 4972 . . . . . . a . . . .

. .

Other Taxes

17,024. 89,516. 18,250. 71,266. 10,096.

40 41 42

Your occupation

Date

Spouse’s occupation

Daytime phone number

Manager

Spouse’s signature. If a joint return, both must sign.

Inerior Designer

Print/Type preparer’s name

Firm’s name

Date

a

Preparer’s signature

Date

Check if self-employed

PTIN

Firm's EIN a

SELF PREPARED

Phone no.

Firm’s address a REV 06/22/11 TTW

Form 1040 (2010)

Itemized Deductions

SCHEDULE A (Form 1040)

OMB No. 1545-0074

2010

Department of the Treasury Internal Revenue Service (99)

a Attach

a See

to Form 1040.

Instructions for Schedule A (Form 1040).

Attachment Sequence No. 07 Your social security number

Name(s) shown on Form 1040

Richard A & Elizabeth T Burton Medical and Dental Expenses Taxes You Paid

1 2 3 4 5

871-19-1234

Caution. Do not include expenses reimbursed or paid by others. Medical and dental expenses (see instructions) . . . . . 1 Enter amount from Form 1040, line 38 2 Multiply line 2 by 7.5% (.075) . . . . . . . . . . . 3 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . State and local (check only one box): a Income taxes, or . . . . . . . . . . . 5 b General sales taxes Real estate taxes (see instructions) . . . . . . . . . 6

Note. Your mortgage interest deduction may be limited (see instructions).

.

.

}

6 7 New motor vehicle taxes from line 11 of the worksheet on back (for certain vehicles purchased in 2009). Skip this line if you checked box 5b . . . . . . . . . . . . . . 8 Other taxes. List type and amount a

Interest You Paid

.

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.

4

4,854. 3,457.

7

8 9 Add lines 5 through 8 . . . . . . . . . . . . . . . . 10 Home mortgage interest and points reported to you on Form 1098 10

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.

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.

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.

9

8,311.

8,713.

8,713.

11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person’s name, identifying no., and address a 11 12 Points not reported to you on Form 1098. See instructions for 12 special rules . . . . . . . . . . . . . . . . . 13 Mortgage insurance premiums (see instructions) . . . . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Add lines 10 through 14 . . . . . . . . . . . . . . .

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15

16 Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . 16 17 Other than by cash or check. If any gift of $250 or more, see If you made a gift and got a instructions. You must attach Form 8283 if over $500 . . . 17 benefit for it, 18 Carryover from prior year . . . . . . . . . . . . 18 see instructions. 19 Add lines 16 through 18 . . . . . . . . . . . . . . .

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19

Gifts to Charity

Casualty and Theft Losses 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . . . . . . . Job Expenses 21 Unreimbursed employee expenses—job travel, union dues, and Certain job education, etc. Attach Form 2106 or 2106-EZ if required. Miscellaneous 21 (See instructions.) a Deductions 22 Tax preparation fees . . . . . . . . . . . . . 22

20

23 Other expenses—investment, safe deposit box, etc. List type and amount a

Other Miscellaneous Deductions

24 25 26 27 28

23 Add lines 21 through 23 . . . . . . . . . . . . 24 Enter amount from Form 1040, line 38 25 Multiply line 25 by 2% (.02) . . . . . . . . . . . 26 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- . Other—from list in instructions. List type and amount a

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27

28

29 Add the amounts in the far right column for lines 4 through 28. Also, enter this amount Total on Form 1040, line 40 . . . . . . . . . . . . . . . . . . . . . 29 Itemized Deductions 30 If you elect to itemize deductions even though they are less than your standard deduction, check here

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For Paperwork Reduction Act Notice, see Form 1040 instructions. BAA

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REV 06/22/11 TTW

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17,024.

a Schedule A (Form 1040) 2010

Form

2441

Child and Dependent Care Expenses

OMB No. 1545-0074

1040

..........

1040A

..........

a

Department of the Treasury Internal Revenue Service (99)

2010

1040NR

Attach to Form 1040, Form 1040A, or Form 1040NR. a

`

2441

See separate instructions.

Attachment Sequence No. 21 Your social security number

Name(s) shown on return

Richard A & Elizabeth T Burton 871-19-1234 Part I Persons or Organizations Who Provided the Care—You must complete this part. (If you have more than two care providers, see the instructions.) 1

(a) Care provider’s name

(b) Address (number, street, apt. no., city, state, and ZIP code)

Challenges Daycare

(c) Identifying number (SSN or EIN)

4119 Elm Street Riverbank CA 95367

(d) Amount paid (see instructions)

391-96-4999

3,500.

a Complete only Part II below. Did you receive No dependent care benefits? a Complete Part III on the back next. Yes Caution. If the care was provided in your home, you may owe employment taxes. If you do, you cannot file Form 1040A. For details, see the instructions for Form 1040, line 59, or Form 1040NR, line 58.

Part II 2

Credit for Child and Dependent Care Expenses

Information about your qualifying person(s). If you have more than two qualifying persons, see the instructions. (b) Qualifying person’s social security number

(a) Qualifying person’s name Last

First

Lisa

Burton

839-19-2042

3

Add the amounts in column (c) of line 2. Do not enter more than $3,000 for one qualifying person or $6,000 for two or more persons. If you completed Part III, enter the amount from line 31 . . . . . . . . . . . . . . . . . . . . . . . . . .

4 5

Enter your earned income. See instructions . . . . . . . . . . . . . . . If married filing jointly, enter your spouse’s earned income (if your spouse was a student or was disabled, see the instructions); all others, enter the amount from line 4 . . . .

6 7

Enter the smallest of line 3, 4, or 5 . . . . . . . Enter the amount from Form 1040, line 38; Form 1040A, line 22; or Form 1040NR, line 37. . . . .

8

9 10 11

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(c) Qualified expenses you incurred and paid in 2010 for the person listed in column (a)

1,575.

3 4

1,575. 37,425.

5 6

67,877. 1,575.

8

X

106,540. 7 Enter on line 8 the decimal amount shown below that applies to the amount on line 7 If line 7 is: But not over Over

Decimal amount is

If line 7 is:

$0—15,000 15,000—17,000

.35 .34

$29,000—31,000 31,000—33,000

.27 .26

17,000—19,000 19,000—21,000 21,000—23,000 23,000—25,000

.33 .32 .31 .30

33,000—35,000 35,000—37,000 37,000—39,000 39,000—41,000

.25 .24 .23 .22

25,000—27,000 27,000—29,000

.29 .28

41,000—43,000 43,000—No limit

.21 .20

Over

But not over

Decimal amount is

Multiply line 6 by the decimal amount on line 8. If you paid 2009 expenses in 2010, see the instructions . . . . . . . . . . . . . . . . . . . . . . . . . Tax liability limit. Enter the amount from the Credit Limit Worksheet in the instructions. . . . . . . 10,096. 10 Credit for child and dependent care expenses. Enter the smaller of line 9 or line 10 here and on Form 1040, line 48; Form 1040A, line 29; or Form 1040NR, line 46 . . . .

For Paperwork Reduction Act Notice, see your tax return instructions. BAA

9

11

REV 06/22/11 TTW

.20

315.

315. Form 2441 (2010)

Page 2

Form 2441 (2010)

Part III

Dependent Care Benefits

12 Enter the total amount of dependent care benefits you received in 2010. Amounts you received as an employee should be shown in box 10 of your Form(s) W-2. Do not include amounts reported as wages in box 1 of Form(s) W-2. If you were self-employed or a partner, include amounts you received under a dependent care assistance program from your sole proprietorship or partnership . . . . . . . . . . . . . . . . . . 13 Enter the amount, if any, you carried over from 2009 and used in 2010 during the grace period. See instructions . . . . . . . . . . . . . . . . . . . . . . . 14 Enter the amount, if any, you forfeited or carried forward to 2011. See instructions . . . 15 Combine lines 12 through 14. See instructions . . . . . . . . . . . . . . . 16 Enter the total amount of qualified expenses incurred in 2010 for the care of the qualifying person(s) . . . 16 2,075. 17 17 Enter the smaller of line 15 or 16 . . . . . . . . 500. 18 18 Enter your earned income. See instructions . . . . 37,425. 19 Enter the amount shown below that applies to you. • If married filing jointly, enter your spouse’s earned income (if your spouse was a student or was disabled, see the instructions for line 5). • If married filing separately, see instructions.

}

.

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.

19

12

500.

13 14 ( 15

500.

)

67,877.

• All others, enter the amount from line 18. 20 20 Enter the smallest of line 17, 18, or 19 . . . . . . 500. 21 Enter $5,000 ($2,500 if married filing separately and you were required to enter your spouse’s earned income on line 19) . . . . . . . . . . . . . 21 5,000. 22 Is any amount on line 12 from your sole proprietorship or partnership? (Form 1040A filers go to line 25.) No. Enter -0-. Yes. Enter the amount here . . . . . . . . . . . . . . . . . . . . 23 500. 23 Subtract line 22 from line 15 . . . . . . . . . 24 Deductible benefits. Enter the smallest of line 20, 21, or 22. Also, include this amount on the appropriate line(s) of your return. See instructions . . . . . . . . . . . . .

22

0.

24

0.

25 Excluded benefits. Form 1040 and 1040NR filers: If you checked "No" on line 22, enter the smaller of line 20 or 21. Otherwise, subtract line 24 from the smaller of line 20 or line 21. If zero or less, enter -0-. Form 1040A filers: Enter the smaller of line 20 or line 21 . .

25

500.

26 Taxable benefits. Form 1040 and 1040NR filers: Subtract line 25 from line 23. If zero or less, enter -0-. Also, include this amount on Form 1040, line 7; or Form 1040NR, line 8. On the dotted line next to Form 1040, line 7; or Form 1040NR, line 8, enter “DCB.” Form 1040A filers: Subtract line 25 from line 15. Also, include this amount on Form 1040A, line 7. In the space to the left of line 7, enter “DCB” . . . . . . . . . . . . . .

26

0.

27

3,000.

28

500.

29

2,500.

30

1,575.

To claim the child and dependent care credit, complete lines 27 through 31 below. 27 Enter $3,000 ($6,000 if two or more qualifying persons) . . . . . . . . . . . . 28 Form 1040 and 1040NR filers: Add lines 24 and 25. Form 1040A filers: Enter the amount from line 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Subtract line 28 from line 27. If zero or less, stop. You cannot take the credit. Exception. If you paid 2009 expenses in 2010, see the instructions for line 9 . . . . . 30 Complete line 2 on the front of this form. Do not include in column (c) any benefits shown on line 28 above. Then, add the amounts in column (c) and enter the total here. . . . . 31 Enter the smaller of line 29 or 30. Also, enter this amount on line 3 on the front of this form and complete lines 4 through 11 . . . . . . . . . . . . . . . . . . . .

31

1,575. Form 2441 (2010)

REV 06/22/11 TTW

Form

Education Credits (American Opportunity and Lifetime Learning Credits)

8863 a

Department of the Treasury Internal Revenue Service (99)

2010

See separate instructions to find out if you are eligible to take the credits. a Attach to Form 1040 or Form 1040A.

Name(s) shown on return

Attachment Sequence No. 50 Your social security number

Richard A & Elizabeth T Burton

! F

OMB No. 1545-0074

871-19-1234

You cannot take both an education credit and the tuition and fees deduction (see Form 8917) for the same student for the same year.

CAUTION

Part I

American Opportunity Credit Caution: You cannot take the American opportunity credit for more than 4 tax years for the same student.

1

(a) Student’s name (as shown on page 1 of your tax return) First name Last name

Michael Burton

(b) Student’s social security number (as shown on page 1 of your tax return)

(c) Qualified expenses (see instructions). Do not enter more than $4,000 for each student.

839-19-2022

(d) Subtract $2,000 from the amount in column (c). If zero or less, enter -0-.

4,000.

2,000.

(e) Multiply the amount in column (d) by 25% (.25)

500.

(f) If column (d) is zero, enter the amount from column (c). Otherwise, add $2,000 to the amount in column (e).

2,500.

2 Tentative American opportunity credit. Add the amounts on line 1, column (f). If you are taking the lifetime learning credit for a different student, go to Part II; otherwise, go to Part III . . . . . . a

Part II

2,500. 2 Lifetime Learning Credit Caution: You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year.

3

(a) Student’s name (as shown on page 1 of your tax return)

First name

4 5 6

Last name

Add the amounts on line 3, column (c), and enter the total . . . . . Enter the smaller of line 4 or $10,000 . . . . . . . . . . . Tentative lifetime learning credit. Multiply line 5 by 20% (.20). If you Part III; otherwise go to Part IV . . . . . . . . . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions. BAA

(b) Student’s social security number (as shown on page 1 of your tax return)

. . . . . . . . . . . . . . . . . . . . have an entry on line 2, go to . . . . . . . . . REV 06/22/11 TTW

(c) Qualified expenses (see instructions)

4 5 6 Form 8863 (2010)

Page 2

Form 8863 (2010)

Part III 7 8 9 10 11 12

Refundable American Opportunity Credit

Enter the amount from line 2 . . . . . . . . . . . . . . . . . . Enter: $180,000 if married filing jointly; $90,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . 8 Enter the amount from Form 1040, line 38,* or Form 1040A, line 22 . . . 9 Subtract line 9 from line 8. If zero or less, stop; you cannot take any education credit . . . . . . . . . . . . . . . . . . . 10 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . . . . . 11 If line 10 is: • Equal to or more than line 11, enter 1.000 on line 12 . . . . . . . . .

.

.

14

15 16 17 18 19 20 21

22 23

2,500.

12

1.000

13

2,500.

14

1,000.

15

1,500.

73,460. 20,000. .

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}

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.

.

.

Multiply line 7 by line 12. Caution: If you were under age 24 at the end of the year and meet the conditions on page 4 of the instructions, you cannot take the refundable American opportunity credit. Skip line 14, enter the amount from line 13 on line 15, and check this box . . a Refundable American opportunity credit. Multiply line 13 by 40% (.40). Enter the amount here and on Form 1040, line 66, or Form 1040A, line 43. Then go to line 15 below . . . . . . . . .

Part IV

7

180,000. 106,540.

• Less than line 11, divide line 10 by line 11. Enter the result as a decimal (rounded to at least three places) . . . . . . . . . . . . . . . . . . . . . 13

. . . . .

Nonrefundable Education Credits

Subtract line 14 from line 13 . . . . . . . . . . . . . . . . . . . . . . . Enter the amount from line 6, if any. If you have no entry on line 6, skip lines 17 through 22, and enter the amount from line 15 on line 6 of the Credit Limit Worksheet (see instructions) . . . . Enter: $120,000 if married filing jointly; $60,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . 17 Enter the amount from Form 1040, line 38,* or Form 1040A, line 22 . . . 18 Subtract line 18 from line 17. If zero or less, skip lines 20 and 21, and enter zero on line 22 . . . . . . . . . . . . . . . . . . . . 19 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, or qualifying widow(er) . . . . . . . . . . . . . . . . . 20 If line 19 is: • Equal to or more than line 20, enter 1.000 on line 21 and go to line 22 • Less than line 20, divide line 19 by line 20. Enter the result as a decimal (rounded to at least three places) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Multiply line 16 by line 21. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) a Nonrefundable education credits. Enter the amount from line 11 of the Credit Limit Worksheet (see instructions) here and on Form 1040, line 49, or Form 1040A, line 31 . . . . . . . . .

16

21 22

1,500.

23

*If you are filing Form 2555, 2555-EZ, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter. Form 8863 (2010)

REV 06/22/11 TTW

SCHEDULE M (Form 1040A or 1040) Department of the Treasury Internal Revenue Service (99)

OMB No. 1545-0074

Making Work Pay Credit a Attach

a

to Form 1040A or 1040.

2010 Attachment Sequence No.

See separate instructions.

Name(s) shown on return

Richard A & Elizabeth T Burton

▲ ! CAUTION

▲ ! CAUTION

166

Your social security number

871-19-1234

To take the making work pay credit, you must include your social security number (if filing a joint return, the number of either you or your spouse) on your tax return. A social security number does not include an identification number issued by the IRS. Only the Social Security Administration issues social security numbers.

You cannot take the making work pay credit if you can be claimed as someone else's dependent or if you are a nonresident alien.

Important: Check the “No” box on line 1a and see the instructions if: (a) You have a net loss from a business, (b) You received a taxable scholarship or fellowship grant not reported on a Form W-2, (c) Your wages include pay for work performed while an inmate in a penal institution, (d) You received a pension or annuity from a nonqualified deferred compensation plan or a nongovernmental section 457 plan, or (e) You are filing Form 2555 or 2555-EZ. 1a

Do you (and your spouse if filing jointly) have 2010 wages of more than $6,451 ($12,903 if married filing jointly)? Yes. Skip lines 1a through 3. Enter $400 ($800 if married filing jointly) on line 4 and go to line 5. No. Enter your earned income (see instructions) . . . . . . . 1a

b Nontaxable combat pay included on line 1a (see instructions) . . . . . . . . . 2

Multiply line 1a by 6.2% (.062) .

.

.

.

.

.

.

.

.

.

.

.

2

3

Enter $400 ($800 if married filing jointly) .

.

.

.

.

.

.

.

.

.

.

3

4

Enter the smaller of line 2 or line 3 (unless you checked “Yes” on line 1a) .

5

Enter the amount from Form 1040, line 38*, or Form 1040A, line 22 .

.

5

106,540.

6

Enter $75,000 ($150,000 if married filing jointly)

.

.

6

150,000.

7

Is the amount on line 5 more than the amount on line 6? No. Skip line 8. Enter the amount from line 4 on line 9 below. Yes. Subtract line 6 from line 5 . . . . . . . . . . .

.

7

8

Multiply line 7 by 2% (.02)

.

.

.

.

.

.

.

.

.

.

.

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.

.

.

8

9

Subtract line 8 from line 4. If zero or less, enter -0-

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

9

800.

No. Enter -0- on line 10 and go to line 11. Yes. Enter the total of the payments you (and your spouse, if filing jointly) received in 2010. Do not enter more than $250 ($500 if married filing jointly) . . . . . . . . . . . .

10

0.

Making work pay credit. Subtract line 10 from line 9. If zero or less, enter -0-. Enter the result here and on Form 1040, line 63; or Form 1040A, line 40 . . . . . . . . . . . . . .

11

800.

10

11

.

.

.

.

.

1b

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

4

800.

Did you (or your spouse, if filing jointly) receive an economic recovery payment in 2010? You may have received this payment in 2010 if you did not receive an economic recovery payment in 2009 but you received social security benefits, supplemental security income, railroad retirement benefits, or veterans disability compensation or pension benefits in November 2008, December 2008, or January 2009 (see instructions).

*If you are filing Form 2555, 2555-EZ, or 4563 or you are excluding income from Puerto Rico, see instructions. For Paperwork Reduction Act Notice, see your tax return instructions.

BAA

REV 06/22/11 TTW

Schedule M (Form 1040A or 1040) 2010

Form 1040 Line 44

Qualified Dividends and Capital Gain Tax Worksheet

2010

G Keep for your records

Name(s) Shown on Return

Social Security Number

Richard A & Elizabeth T Burton

871-19-1234

1 2 3

4 5

6 7 8

9 10 11 12 13 14 15 16

17 18

19

Enter the amount from Form 1040, line 43 1 71,266. Enter the amount from Form 1040, line 9b 2 847. 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 -03 X No. Enter the amount from Form 1040, line 13. Add lines 2 and 3 4 847. If filing Form 4952 (used to figure investment interest expense deduction), enter any amount from line 4g of that form. Otherwise enter -05 0. Subtract line 5 from line 4. If zero or less, enter -06 847. Subtract line 6 from line 1. If zero or less, enter -07 70,419. Enter: $34,000 if single or married filing separately, $68,000 if married filing jointly or 8 68,000. qualifying widow(er), or $45,550 if head of household. Enter the smaller of line 1 or line 8 9 68,000. Enter the smaller of line 7 or line 9 10 68,000. Subtract line 10 from line 9 (this amount taxed at 0%) 11 0. Enter the smaller of line 1 or line 6 12 847. Enter the amount from line 11 13 0. Subtract line 13 from line 12. 14 847. Multiply line 14 by 15% (.15) 15 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 this tax. If the amount on line 7 is $100,000 or more, use the Tax Computation Worksheet 16 Add lines 15 and 16 17 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 18 Tax on all taxable income. Enter the smaller of line 17 or line 18 here and on Form 1040, line 44 19

127.

9,969. 10,096.

10,181. 10,096.

Tax Payments Worksheet

2010

G Keep for your records Name(s) Shown on Return

Social Security Number

Richard A & Elizabeth T Burton

871-19-1234

Estimated Tax Payments for 2010 (If more than 4 payments for any state or locality, see Tax Help) Federal Date

Amount

State Date

Amount

Local ID

Date

Amount

1

04/15/10

04/15/10

04/15/10

2

06/15/10

06/15/10

06/15/10

3

09/15/10

09/15/10

09/15/10

4

01/18/11

01/18/11

01/18/11

ID

5

Tot Estimated Payments Tax Payments Other Than Withholding (If multiple states, see Tax Help) 6 7 8 9

Federal

Forms W-2 Forms W-2G Forms 1099-R Forms 1099-MISC and 1099-G Schedules K-1 Forms 1099-INT, DIV and OID Social Security and Railroad Benefits Form 1099-B St Loc Other withholding St Loc Other withholding St Loc Other withholding St Loc Total Withholding Lines 10 through 18c Total Tax Payments for 2010

Prior Year Taxes Paid In 2010 (If multiple states or localities, see Tax Help) 21 22 23 24

ID

Local

ID

Overpayments applied to 2010 Credited by estates and trusts Totals Lines 1 through 7 2010 extensions

Taxes Withheld From: 10 11 12 13 14 15 16 17 18 a b c 19 20

State

Tax paid with 2009 extensions 2009 estimated tax paid after 12/31/09 Balance due paid with 2009 return Other (amended returns, installment payments, etc)

Federal

State

Local

11,932.

3,694.

1,160.

11,932. 11,932.

3,694. 3,694.

1,160. 1,160.

State

ID

Local

ID

Education Tuition and Fees Summary

2010

G Keep for your records Name(s) Shown on Return

Your Social Security No.

Richard A & Elizabeth T Burton

871-19-1234

Part I - Qualified Education Expense Summary (a) Student’s name First Name Last Name Social Security Number

MI Suffix

(b) Qualified Education Expenses

(c) Qualified for:

Yes

Michael Burton 839-19-2022

6,087. Amer Opp Cr 6,087. Lifetime Cr 6,087. Tuition Ded 6,087.

No

(d) Elected Credit or Deduction if manual

X X X

(e) Elected Credit or Deduction if automatic

X

Amer Opp Cr Lifetime Cr Tuition Ded Amer Opp Cr Lifetime Cr Tuition Ded

Total qualified expenses

6,087. Amer Opp Cr 6,087. Lifetime Cr 6,087. Tuition Ded

Part II - Optimize Education Expenses for the Lowest Tax Automatic 1

Launch OPTIMIZER - Check to launch Automatic Education Expense Optimizer now

2

Automatic - Check to use the Credit choices calculated in Part I, column (e) above or Manual - Check to use the Credit choices you entered in Part I, column (d) above

3

X

Richard A & Elizabeth T Burton

871-19-1234

Part III - Summary of Net Tax, Deduction, and Credits Net Tax Liability based on the Credit combination selected in Part II 1 2 3 4 5 6 7 8 9 10 a b c d e f 11

Total tax Making work pay and government retiree credit. Earned income credit (EIC) Additional child tax credit. First-time homebuyer credit from Form 5405 Credit for federal tax paid on fuels from Form 4136 Refundable credit from Form 8801 Health Coverage Tax Credit from Form 8885 Net tax Liability without carryforwards Credit Carryforwards General Business Credit 10 a Mortgage interest credit b Foreign tax credit c Residential Energy Credit d Other carryover e Other carryover f Total Carryovers Net tax liability with carryforwards

2 3 4 5 6 7 8

1

6,281.

9

5,481.

11

5,481.

12 13 14 15

0.

800.

10

Tuition and Fees Deduction Summary 12 13 14 15

Total 2010 tuition and fees paid for purposes of deduction Modified adjusted gross income Maximum deduction allowed Allowable Tuition and Fees Deduction (lesser of line 12 or line 14) American Opportunity, Lifetime Learning Credits Summary

16 17 18

Tentative American Opportunity Credit Tentative Lifetime Learning Credit Total Education Credits (after limitations)

16 17 18

2,500. 2,500.

Federal Carryover Worksheet

2010

G Keep for your records Name(s) Shown on Return

Social Security Number

Richard A & Elizabeth T Burton

871-19-1234

2009 State and Local Income Tax Information (See Tax Help) (a) State or Local ID

(b) Paid With Extension

(c) Estimates Pd After 12/31

(d) Total Withheld/Pmts

(e) Paid With Return

(f) Total Overpayment

(g) Applied Amount

Totals Other Tax and Income Information 1 2 3 4 5 6 7 8

2009

Filing status Number of exemptions for blind or over 65 (0 - 4) Itemized deductions after limitation Check box if required to itemize deductions Adjusted gross income Tax liability for Form 2210 or Form 2210-F Alternative minimum tax Federal overpayment applied to next year estimated tax

2010

2 MFJ

1 2 3 4 5 6 7 8

17,024. 106,540. 4,481.

QuickZoom to the IRA Information Worksheet for IRA information

Excess Contributions 9a b 10 a b 11 a b

Taxpayer’s excess Archer MSA contributions as of 12/31 Spouse’s excess Archer MSA contributions as of 12/31 Taxpayer’s excess Coverdell ESA contributions as of 12/31 Spouse’s excess Coverdell ESA contributions as of 12/31 Taxpayer’s excess HSA contributions as of 12/31 Spouse’s excess HSA contributions as of 12/31

2010 2009 2008 2007 2006 2005

2010

2009

2010

9a b 10 a b 11 a b

Loss and Expense Carryovers 12 a Short-term capital loss b AMT Short-term capital loss 13 a Long-term capital loss b AMT Long-term capital loss 14 a Net operating loss available to carry forward b AMT Net operating loss available to carry forward 15 a Investment interest expense disallowed b AMT Investment interest expense disallowed 16 Nonrecaptured net Section 1231 losses from: a b c d e f

2009

12 a b 13 a b 14 a b 15 a b 16 a b c d e f

2010

Federal Carryover Worksheet page 2

Richard A & Elizabeth T Burton

871-19-1234

Loss and Expense Carryovers (cont’d) 17

AMT Nonrecap’d net Sec 1231 losses from:

a b c d e f

2010 2009 2008 2007 2006 2005

20

21 22 23

General business credit Adoption credit from: a 2010 b 2009 c 2008 d 2007 e 2006 f 2005 Mortgage interest credit from: a 2010 b 2009 c 2008 d 2007 Credit for prior year minimum tax District of Columbia first-time homebuyer credit Residential energy efficient property credit

Section 179 expense deduction disallowed Excess a Taxpayer (Form 2555, line 46) foreign b Taxpayer (Form 2555, line 48) housing c Spouse (Form 2555, line 46) deduction: d Spouse (Form 2555, line 48)

2009

2010

2009

2010

18 19 a b c d e f 20 a b c d 21 22 23

Other Carryovers 24 25

2010

17 a b c d e f

Credit Carryovers 18 19

2009

24 25 a b c d

File by Mail Instructions for your 2010 California Tax Return Important: Your taxes are not finished until all required steps are completed. (If you prefer, you can still e-file. Go to the end of these instructions for more information.) Richard A & Elizabeth T Burton 8456 Loch Lloyed Riverbank, CA 95367 | | Your California state tax return (Form 540) shows you owe a balance | due of $246.00. | | You are paying by check. ______________________________________________________________________________________ | | What You | Your tax return - The official return for mailing is included in Need to | this printout. Remember to sign and date the return. Mail | | Your payment - Mail a check or money order for $246.00, payable to | "Franchise Tax Board". Write your Social Security number and "2010 | Form 540" on the check. Mail the return and check together, but do | not staple or attach the check to the return. | | Your payment voucher - This printout includes a payment voucher | (Form 540-V). Mail this voucher with your payment. | | Attach the following to your California tax return: | - a copy of your federal return | - any Form(s) W-2G, 592-B, 593, and 1099s that have | California withholding you may have received | to the front of your return. Do not attach any Form(s) W-2. | | Mail your return, attachments, payment and payment voucher to: | Franchise Tax Board | PO Box 942867 | Sacramento, CA 94267-0009 | | Deadline: Postmarked by April 18, 2011 | | Don't forget correct postage on the envelope. ______________________________________________________________________________________ | | What You | Keep these instructions and a copy of your return for your records. Need to | If you did not print one before closing TurboTax, go back to the Keep | program and select Print & File tab, then select the Print for Your | Records category. ______________________________________________________________________________________ | | 2010 | Taxable Income $ 94,370.00 California | Total Tax $ 3,940.00 Tax | Total Payments/Credits $ 3,694.00 Return | Payment Due $ 246.00 Summary | Effective Tax Rate 9.6% ______________________________________________________________________________________ |

Balance Due/ Refund

Page 1 of 2

File by Mail Instructions for your 2010 California Tax Return Important: Your taxes are not finished until all required steps are completed. (If you prefer, you can still e-file. Go to the end of these instructions for more information.) Richard A & Elizabeth T Burton 8456 Loch Lloyed Riverbank, CA 95367 | | Your printed state tax forms may have special formatting on them, | such as bar codes or other symbols. This is to enable fast | processing. Don't worry, these forms have been approved by your | taxing authority and are acceptable for printing and mailing. ______________________________________________________________________________________ | | Changed | You can still file electronically. Just go back to TurboTax, select Your Mind | the Print & File tab, then select the E-file category. We'll walk About | you through the process. Once you file, we will let you know if your e-filing? | return is accepted (or rejected) by the state taxing agency. ______________________________________________________________________________________ |

Special Formatting

Page 2 of 2

Voucher at bottom of page.

IF AMOUNT OF PAYMENT IS ZERO, DO NOT MAIL THIS VOUCHER.

WHERE TO FILE:

Using black or blue ink, make check or money order payable to the “Franchise Tax Board.” Write the taxpayer’s social security number (SSN) or individual taxpayer identification number (ITIN) and “2010 Form 540-V” on the check or money order. Detach the voucher below. Enclose, but do not staple, your payment and Form 540-V with your computer-generated Form 540 return and mail to: FRANCHISE TAX BOARD PO BOX 942867 SACRAMENTO CA 94267-0009

Make all checks or money orders payable in U.S. dollars and drawn against a U.S. financial institution.

WHEN TO FILE:

Calendar Year – File and Pay by April 15, 2011*.

When the due date falls on a weekend or holiday, the deadline to file and pay without penalty is extended to the next business day. *Due to the federal Emancipation Day holiday on April 15, 2011, tax returns and payments received on April 18, 2011, will be considered timely.

PAY ONLINE:



IF NO PAYMENT IS DUE, DO NOT MAIL THIS VOUCHER

DETACH HERE

TAXABLE YEAR

2010

Use Web Pay and enjoy the ease of our free online payment service. Go to ftb.ca.gov and search for payment options. Do not mail this voucher if you use Web Pay.

Payment Voucher for 540 Returns

871-19-1234 RICHARD ELIZABETH

CA

540-V 10

95367 246.

Amount of payment

For Privacy Notice, get form FTB 1131.



CALIFORNIA FORM

BURT ** 839-19-2102 A BURTON T BURTON

8456 LOCH LLOYED RIVERBANK

DETACH HERE

175

1261106

REV 06/22/11 TTW

Form 540-V 2010

For Privacy Notice, get form FTB 1131.

FORM

California Resident Income Tax Return 2010

540 C1 Side 1

APE

ATTACH FEDERAL RETURN

871-19-1234 RICHARD ELIZABETH

BURT ** 839-19-2102 A BURTON T BURTON

8456 LOCH LLOYED RIVERBANK 01 06 09 10 12 14 16 17 18 31 34 41 42 43 44 45 46 61 62 63 64 71

REV 06/22/11 TTW

2 0 0 3 105302 0 0 106540 12170 4435 0 0 0 0 0 0 0 0 0 0 3940 3694

CA

95367

03-24-1965 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0

72 73 74 75 76 77 78 91 92 93 94 95 400 401 402 403 404 405 406 407

P AC A R RP

10

408 410 413 415 416 417 418 110 111 112 113 115 116 117

0 0 0 0 0 0 0 0 246 0 0 0 0 0

06-26-1967 APE FS 3800 3803 SCHG1 5870A 5805 5805F DESIGNEE TPID FN

0 0 0 0 0 0 0 0

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.

Sign Here It is unlawful to forge a spouse’s/ RDP’s signature. Joint tax return? (see page 17)

Your signature_____________________________________Spouse’s/RDP’s signature (if a joint return, both must sign) _____________________________________ Daytime phone number (optional) ____________________________________ Date ____________________________________ Your email address (optional). Enter only one. __________________________________________________________________________________________________________ Paid preparer’s signature (declaration of preparer is based on all information of which preparer has any knowledge) Paid preparer’s PTIN/SSN

฀ ฀

SELF-PREPARED Firm’s name (or yours, if self-employed)

Firm’s address

฀ ฀FEIN

Do you want to allow another person to discuss this return with us (see page 17)? . . . . . . . . . . . . . . . . . . __________________________________________________________________ Print Third Party Designee’s Name

175

3101106

฀

Yes

No

__________________________________ Telephone Number

Filing Status

871-19-1234 A & ELIZABETH T BURTON Your name: RICHARD ______________________________________Your SSN or ITIN: ______________________________ 1 2 3 4 5

Single Married/RDP filing jointly. (see page 3) Married/RDP filing separately. Enter spouse’s/RDP’s SSN or ITIN above and full name here _____________________________________ Head of household (with qualifying person). (see page 3) Qualifying widow(er) with dependent child. Enter year spouse/RDP died. __________ If your California filing status is different from your federal filing status, check the box here . . . . . . . . . . . . . . . . . . . . . . . . . . . .

฀฀

6 If someone can claim you (or your spouse/RDP) as a dependent, check the box here (see page 7) . . . . . . . . . . . . . . . . . . . . . . .

Exemptions

Taxable Income

12 13 14 15 16 17 18 19

105,302. State wages from your Form(s) W-2, box 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Enter federal adjusted gross income from Form 1040, line 37; Form 1040A, line 21; Form 1040EZ, line 4 . . . . . . . . . . . . . . . . . . California adjustments – subtractions. Enter the amount from Schedule CA (540), line 37, column B . . . . . . . . . . . . . . . . . . . Subtract line 14 from line 13. If less than zero, enter the result in parentheses (see page 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . California adjustments – additions. Enter the amount from Schedule CA (540), line 37, column C . . . . . . . . . . . . . . . . . . . . . . California adjusted gross income. Combine line 15 and line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enter the larger of your CA standard deduction OR your CA itemized deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Subtract line 18 from line 17. This is your taxable income. If less than zero, enter -0-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 14 15 16 17 18 19

Tax

31 32 33 34 35

Tax. Check box if from: Tax Table Tax Rate Schedule FTB 3800 FTB 3803 . . . . . . . . . . . . . . . . . . . . . . . . Exemption credits. Enter the amount from line 11. If your federal AGI is more than $162,186 (see page 10) . . . . . . . . . . . . . . . . Subtract line 32 from line 31. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tax. (see page 11) Check box if from:฀ Schedule G-1 Form FTB 5870A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Add line 33 and line 34. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31 32 33 34 35

41 42 43 44 45 46 47 48

New jobs credit, amount generated (see page 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 New jobs credit, amount claimed (see page 11). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ฀ 42 43 Credit _________________________________________ Code ____________ amount . . . . . . . . . . . . . . . . . . . . . . . . . . . Credit _________________________________________ Code ____________ amount . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 To claim more than two credits (see page 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Nonrefundable renter’s credit (see page 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Add line 42 through line 46. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Subtract line 47 from line 35. If less than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Other Taxes

61 62 63 64

Alternative minimum tax. Attach Schedule P (540) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mental Health Services Tax (see page 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other taxes and credit recapture (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Add line 48, line 61, line 62, and line 63. This is your total tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

71 California income tax withheld (see page 13). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 72 2010 CA estimated tax and other payments (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ฀ 72 73 Real estate and other withholding (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ฀ 73 74 74 Excess SDI (or VPDI) withheld (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Child and Dependent Care Expenses Credit (see page 13). Attach form FTB 3506. 75 Qualifying person’s social security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 _______ _____________ 76 Qualifying person’s social security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 _______ _____________ 77 Enter the amount from form FTB 3506, Part III, line 8. . . . . . . . . . . . . . . . . . . . . . . . 77 78 78 Child and Dependent Care Expenses Credit from form FTB 3506, Part III, line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Add line 71, line 72, line 73, line 74, and line 78. These are your total payments (see page 14) . . . . . . . . . . . . . . . . . . . . . . . . 79

Use Overpaid Tax/ Tax Due Tax

Special Credits

7 Personal: If you checked 1, 3, or 4 above, enter 1 in the box. If you checked 2 or 5, enter 2 in the box. Whole dollars only 198. If you checked the box on line 6, see page 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2 X $99 = $___________________ 8 Blind: If you (or your spouse/RDP) are visually impaired, enter 1; if both are visually impaired, enter 2. . 8 X $99 = $___________________ X $99 = $___________________ 9 Senior: If you (or your spouse/RDP) are 65 or older, enter 1; if both are 65 or older, enter 2 . . . . . . . . . 9 10 Dependents: Enter name and relationship. Do not include yourself or your spouse/RDP. _____________________________ MICHAEL BURTON SON 297. ฀10 3 X $99 = $___________________ _________________________ __________________________ Total dependent exemptions. . 495. $ ___________________ 11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 32 . . . . . . . . . . . . . . . . . . . 11

Payments

6

91 92 93 94 95

Overpaid tax. If line 79 is more than line 64, subtract line 64 from line 79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Amount of line 91 you want applied to your 2011 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Overpaid tax available this year. Subtract line 92 from line 91 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tax due. If line 79 is less than line 64, subtract line 79 from line 64 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Use Tax. This is not a total line (see page 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Side 2 Form 540

C1

2010

175

3102106

61 62 63 64

91 92 93 94

106,540. 106,540. 106,540. 12,170. 94,370. 4,435. 495. 3,940. 3,940.

3,940. 0.

3,940. 3,694.

3,694.

246.

95

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Code 400 401 402 403 404 405 406 407 408 410 413 415 416 417 418

110 Add code 400 through code 418. This is your total contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

110

111 AMOUNT YOU OWE. Add line 94, line 95, and line 110 (see page 15). Mail to: FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0009 . . . . . . . . . . . . . . . Pay online – Go to ftb.ca.gov and search for web pay.

112 Interest, late return penalties, and late payment penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 113 Underpayment of estimated tax. Check box: FTB 5805 attached ฀ FTB 5805F attached . . . . . . . . . . . . . . . . . . . 113 114 Total amount due (see page 16). Enclose, but do not staple, any payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

Refund and Direct Deposit

Amount You Owe

California Seniors Special Fund (see page 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Alzheimer’s Disease/Related Disorders Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Fund for Senior Citizens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rare and Endangered Species Preservation Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State Children’s Trust Fund for the Prevention of Child Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Breast Cancer Research Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Firefighters’ Memorial Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Emergency Food for Families Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Peace Officer Memorial Foundation Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Sea Otter Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Cancer Research Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Arts Council Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Police Activities League (CALPAL) Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . California Veterans Homes Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Safely Surrendered Baby Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interest and Penalties

Contributions

RICHARD A & ELIZABETH T BURTON 871-19-1234 Your name: ______________________________________Your SSN or ITIN: ______________________________

115 REFUND OR NO AMOUNT DUE. Subtract line 95 and line 110 from line 93 (see page 16). Mail to: FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0009 . . . . . . . . . . . . . . . . . .

Amount

246.

111

246.

115

Fill in the information to authorize direct deposit of your refund into one or two accounts. Do not attach a voided check or a deposit slip (see page 16). Have you verified the routing and account numbers? Use whole dollars only. All or the following amount of my refund (line 115) is authorized for direct deposit into the account shown below: Checking Savings ฀Type ฀Account number

116 Direct deposit amount

The remaining amount of my refund (line 115) is authorized for direct deposit into the account shown below: Checking Savings ฀ ฀Routing number ฀Type ฀Account number

117 Direct deposit amount

175

Form 540

฀Routing number

REV 06/22/11 TTW

3103106

C1

2010 Side 3

TAXABLE YEAR

DO NOT ATTACH PAYMENT TO THIS SCHEDULE

CALIFORNIA SCHEDULE

2010

Wage and Tax Statement

W-2

Important: Attach this form to the back of your Forms 540/540A, 540 2EZ, or Form 540NR (Long or Short). Name(s) as shown on return

SSN or ITIN

RICHARD A & ELIZABETH T BURTON

8

7

1

-1

9

-1

2

3

4

Caution: If this form is filled out do not send your Form(s) W-2 to the Franchise Tax Board. If your Form(s) W-2 are from multiple states, attach copies showing California tax withheld to this schedule. Also attach Form(s) 592-B, 593, and 1099. If this schedule is blank, attach your Form(s) W-2 to the lower front of your tax return.

Taxpayer W-2 information. 1st W-2

2nd W-2

871-19-1234 39-1603999 State & Employer’s State ID Number (box 15) CA 39-1603999 Employer Name (box c) THE GOLF STOP State Wages, Tips, etc. (box 16) 37,425. CA State Income Tax (box 17) 1,647. Social Security Wages (box 3) 37,425. SDI/VPDI (Local Income Tax) (box 14 or 19) 412.

Social Security Wages (box 3) SDI/VPDI (Local Income Tax) (box 14 or 19)

3rd W-2 Social Security Number (box a) Employer ID Number (EIN) (box b) State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17) Social Security Wages (box 3) SDI/VPDI (Local Income Tax) (box 14 or 19)

4th W-2 Social Security Number (box a) Employer ID Number (EIN) (box b) State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17) Social Security Wages (box 3) SDI/VPDI (Local Income Tax) (box 14 or 19)

Social Security Number (box a) Employer ID Number (EIN) (box b)

Social Security Number (box a) Employer ID Number (EIN) (box b) State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17)

Spouse/RDP W-2 information. 1st W-2 Social Security Number (box a) Employer ID Number (EIN) (box b) State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17) Social Security Wages (box 3) SDI/VPDI (Local Income Tax) (box 14 or 19)

839-19-2102 39-1604999 CA 39-1604999 MACRO INTERIOR DESIGN 67,877. 2,047. 67,877. 748.

2nd W-2 Social Security Number (box a) Employer ID Number (EIN) (box b) State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17) Social Security Wages (box 3) SDI/VPDI(Local Income Tax) (box 14 or 19)

3rd W-2 Social Security Number (box a) Employer ID Number (EIN) (box b)

4th W-2 Social Security Number (box a) Employer ID Number (EIN) (box b)

State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17)

State & Employer’s State ID Number (box 15) Employer Name (box c) State Wages, Tips, etc. (box 16) CA State Income Tax (box 17)

Social Security Wages (box 3) SDI/VPDI (Local Income Tax) (box 14 or 19)

Social Security Wages (box 3) SDI/VPDI (Local Income Tax) (box 14 or 19)

1. Total state wages from the Form(s) W-2 for taxpayer (Add box 16 from all Form(s) W-2 for taxpayer) For nonresidents or part-year residents, enter your total California wages from all your Form(s) W-2 for taxpayer (Add box 16 from all Form(s) W-2 for taxpayer) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

37,425. . . . . . . . . . . . $__________________ 2. Total state wages from the Form(s) W-2 for spouse/RDP (Add box 16 from all Form(s) W-2 for spouse/RDP) For nonresidents or part-year residents, enter the total California wages from all Form(s) W-2 for spouse/RDP (Add box 16 from all Form(s) W-2 for spouse/RDP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

67,877. . . . . . . . . . . . . . $__________________ 3. Total California Wages from all Form(s) W-2 (Add line 1 and line 2, and enter here and on Form 540 2EZ, line 9; Form 540 or Form 540NR (Long or Short), line 12. If completing Form 540X, 105,302. report any W-2 income on line 1a, column B, that was not reported on your original tax return.) . . . . . . . $__________________ For Privacy Notice, get form FTB 1131.

175

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Schedule W-2 2010

SCHEDULE

TAXABLE YEAR

2010

CA (540)

California Adjustments — Residents

Important: Attach this schedule behind Form 540, Side 3 as a supporting California schedule. Name(s) as shown on return

R I C H A R D

SSN or ITIN

A

&

E L I Z A B E T H

T

B U R T O

Part I Income Adjustment Schedule Section A – Income 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

22

A

8

7

Federal Amounts (taxable amounts from your federal return)

1 B

Wages, salaries, tips, etc. See instructions before making an entry in column B or C . . . . 7 105,302. Taxable interest (b)________________________. . . . . . . . . . . . . . . . . . . . . . . . . . . . .8(a) 438. 847. . . . . . . . . . . .9(a) Ordinary dividends. See instructions. (b) ________________________ 847. Taxable refunds, credits, offsets of state and local income taxes . . . . . . . . . . . . . . . . . . . 10 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Capital gain or (loss). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Other gains or (losses) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 IRA distributions. See instructions. (a) ____________________ . . . . . . . . . . . . . . . .15(b) Pensions and annuities. See instructions. (a) ____________________ . . . . . . . . . . .16(b) Rental real estate, royalties, partnerships, S corporations, trusts, etc.. . . . . . . . . . . . . . . 17 Farm income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Social security benefits (a) ____________________ . . . . . . . . . . . . . . . . . . . . . . . . .20(b) Other income. a California lottery winnings e NOL from FTB 3805D, 3805Z, b Disaster loss carryover from FTB 3805V 3806, 3807, or 3809 21 _______________ c Federal NOL (Form 1040, line 21) f Other (describe): d NOL carryover from FTB 3805V ________________________ ________________________ Total. Combine line 7 through line 21 in column A. Add line 7 through line 21f in 106,587. column B and column C. Go to Section B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 _______________

{

-1

9

Subtractions See instructions

a _____________ b _____________ c _____________ d _____________ e _____________ f _____________

-1

2 C

3

4

Additions See instructions

a _____________ b _____________ c _____________ d _____________ e _____________ f _____________

Section B – Adjustments to Income 23 24

Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Certain business expenses of reservists, performing artists, and fee-basis government officials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Health savings account deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Moving expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 One-half of self-employment tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Penalty on early withdrawal of savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31a Alimony paid. (b) Recipient’s: SSN ___ ___

32 33 34 35 36

37

Last name ______________________________ . . . . IRA deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tuition and fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Domestic production activities deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23 24 25 26 27 28 29 30

47.

31a 32 33 34 35

Add line 23 through line 31a and line 32 through line 35 in columns A, B, and C. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

47.

Total. Subtract line 36 from line 22 in columns A, B, and C. See instructions . . . . . . . . 37

106,540. REV 06/22/11 TTW

For Privacy Notice, get form FTB 1131.

175

7731104

Schedule CA (540) 2010 Side 1

Part II Adjustments to Federal Itemized Deductions 38

17,024. Federal itemized deductions. Add the amounts on federal Schedule A (Form 1040), lines 4, 9, 15, 19, 20, 27, and 28 . . . . . . . . . . 38 _________________

39

Enter total of federal Schedule A (Form 1040), line 5 (State Disability Insurance, and state and local income tax, or 4,854. General Sales Tax), line 7 (new motor vehicle tax), and line 8 (foreign income taxes only). See instructions . . . . . . . . . . . . . . . . . 39 _________________

40

12,170. Subtract line 39 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 _________________

41

Other adjustments including California lottery losses. See instructions. Specify _________________________________. . . . . . 41 _________________

42

12,170. Combine line 40 and line 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 _________________

43

Is your federal AGI (Form 540, line 13) more than the amount shown below for your filing status? Single or married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$162,186 Head of household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$243,283 Married/RDP filing jointly or qualifying widow(er) . . . . . . . . . . . . . . . . . . . . .$324,376 No. Transfer the amount on line 42 to line 43. Yes. Complete the Itemized Deductions Worksheet in the instructions for Schedule CA (540), line 43 . . . . . . . . . . . . . . . . . . . . . . 43

12,170.

Enter the larger of the amount on line 43 or your standard deduction listed below Single or married/RDP filing separately . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$3,670 Married/RDP filing jointly, head of household, or qualifying widow(er) . . . . . . .$7,340 Transfer the amount on line 44 to Form 540, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

12,170.

44

Side 2

Schedule CA (540) 2010

175

7732104

REV 06/22/11 TTW

Richard A & Elizabeth T Burton

871-19-1234

1

Additional information from your 2010 California Tax Return Some forms were not able to fit all of the information you entered. We've included this information below.

Form 540: California Resident Income Tax Return Additional Dependents Statement

Continuation Statement

Dependent(s)

Relationship

CHRISTOPHER BURTON

SON

LISA BURTON

DAUGHTER