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Q:Appendix A Please use this information for your Tax Return and Paper. *All people, businesses, and information are fictional. Any relation to an actual person or business is accidental. Harold Petersan SSN: 0XX-01-1XXX Date of Birth (DOB): 05/27/1975 Gross Pay: $51,750 401(k) contributions: $4,140 Healthcare costs (payroll deductions): $1347 Reported wages: $46,263 Social Security Wages: $50,403 Medicare Wages: $50,403 State Wages: $46,263 Taxes withheld: Federal: $2896.06 Social Security: $3124.99 Medicare: $730.34 State: $682.38 sdi (mandatory disability insurance): $393.24 Employer: PointMark, INC Address: 1111 One Park Place City: One City State: California Zip code: 11111 Employer’s FED ID number: 33-01XXX11 Sarah Petersan SSN: 001-02-XXXX DOB: 08/11/1979 Gross Pay: $50,000 401(k) contributions: $4,000 Healthcare costs (payroll deductions): $1347 Reported wages: $44,653 Social Security Wages: $48,653 Medicare Wages: $48,653 State Wages: $44,653 Taxes withheld: Federal: $2795.28 Social Security: $3016.49 Medicare: $704.98 State: $658.63 sdi (mandatory disability insurance): $379.55 Employer: Company One Address: 1111 Place Road City: One City State: California Zip code: 11112 Employer’s FED ID number: 33-01XXX22 Dependent: Tara Peter san SSN: 001-XX-XX00 DOB: 12/29/2004 Child Care Costs: $10,320 Child Care Provider: fabulous day care center Address: 121 Place Road City: One City State: California Zip code: 11111 Identifying number: 33-XXXX011 Life Change Events Home Sale: Primary residence sale price $520,000 cost basis (incurred three years prior) $300,000 Property Tax paid: $1,500 Mortgage Interest paid: $14,400
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