JB BPRITZKER.COM Attached are the state and federal tax return summaries for 18 Pritzker from 2014 through 2016. In 2014, JB Pritzker paid federal taxes at a rate of 37.3%, in 2015 he paid federal taxes at a rate of 24.3% and in 2016 he paid federal taxes at a rate of 27.7%. 0 Between 2014 and 2016, trusts benefitting JB Pritzker paid an additional $24.95 million in Illinois taxes and $128.97 million in federal taxes. 0 JB Pritzker has made $15.3 million in personal charitable donations and his Foundation has made charitable donations of $53.8 million over that same period of time. JB FOR GOVERNOR PO BOX A3801 CHICAGO, ILLINOIS 60690 PAID FOR BY JB FOR GOVERNOR 015 1040 U.S. Individual income Tax Return OMB No. 1645-0074 IRS Use Only - Do not write or angle in this space. For the your Jan. 1-Doc. 31, 2016. or other tax year . 2010, ending ?20 $88 ?Erato .ns?mouons. Your first name and initial Last name You social enmity number JAY ROBERT PRITZKER if a joint return. spouse's first name and initial Last name Spouse's social eeculty number MARY Home address (number and street). if you have a P.0. box. see Instructions. Apt. no. Make we the SSW) ohm City. town or post otflce, slate. and ZIP code. if you have I foreign lactose. also complete space: below. Presidential-Election Campaign CHICAGO IL 60606 this fund. Checking a box below Foreign country name Foreign province/state/county Foreign postal code wil not change you tax or re?und. I: You Spouse Filing Status 1 Sinole 4 Cl Head of household(with qualifying person). if the qualifying 2 Married filing (even if only one had income) person is a child but not your dependent. enter this child's Check only 3 Married filing separately. Enter spouse's SSN above name here. one box. and full name here. 5 widow(er) with dependent child Exemptions St Yourself. ll someone can claim you as a dependent. do not check box 6a 3333213?" Spouse . No. or cnllaen Dependents: (21 Dependents social Lh?t?d?e?r 3'9? '17 you 2 relationship to - (11ml name Last name "um? you ?$231 did not live with you due to divorce THEODORA PRITZKER DAUGHTER amalgam, It more than four DONALD SON dependents, SEE Dependents on 8r: instructions and new Add numbers it number of exemptions claimed . m} 4 Income 7 Wages. salarieS. tips, etc. Attach FormiS) W-2 7 8a Taxable Interest Attach Schedule it required . Attach Form(s) Tax-exempt interest. Do notinclude on line W-2 here. Also 9: Ordinary dividends. Attach Schedule if required .. . .. attach Forms Outlined dividends at 911, 799 . STMT 11 #333? 10 Taxable relunds. credits, or offsets of state and local income taxes STMT7 STMT9 was withheld. 11 Alimony received 1' 12 Business Income or (I055). Attach Schedule or C-Capital gain or (loss). Attach Schedule 0 if required. If not required. check here [w-2, 14 Other gains or (losses). Attach Form 4797 see instructions. 15: IRA distributions 15: Taxable amount 15b 16a Pensions and annuities 163 Taxable amount 16b 17 Rental real estate, royalties, partnerships. corporations, trusts, etc. Attach Schedule Farm income or (loss). Attach Schedule 1e 19 Unemployment compensation 19 20a Social security benefits ., 20: Taxable amount 20b 21 Other income. List type and amount SEE STATEMENT 6 2t 50 444 . 22 Combine the amounts in the far right column for lines 7 througj?t This is our total Income Educatorexpenses 23 .21" Adjusted 24 315?13'23? 24 ,j?l :3 67?35 25 Health savings account deduction. Attach Form 8889 25 Income 26 Moving expenses. Attach Form 3903 26 5:7: 27 Deductible part of self-employmenttax. Attach Schedule SEW Self-employed SEP, SIMPLE, and qualified plans ze if} 29 Sell-employed health insurance deduction :72" 30 Penalty on early withdrawal of savlnos 30 31a Alimony paid Recipient's SSN 31: 32 IRA deduction _32 33 Student loan interest deduction as 84 Tuition and tees. Attach Form 8917 34-191 35 Domestic production activities deduction. Attach Form 8903 Add lines 23 through 010001 11-30-10 37 Subtract line 36 from line 22. This is your Master! gross Income LHA For Disclosure. Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2016) 520/6 CA [oi/0 I rm manure) JAY ROBERT MARY Peeo 2 Tax and 88 Amounttrom line 37 (adjusted gross income079d? 89a Check You were born beiore January 2. 1952, El Blind. Total boxes omega?. "2 Spouse was born betore Januaryz. 1952. Blind. checked 881 &wum_ a li your spouse itemizies on a separate return or you were a duei~status alien, check here 8817 333%? "mm ?muons ("0m Schedule A) or your Iiandard deduction (see martenmum-,1: it Submoihetoiromiineas 9 .686 . 884? Mucuone- 42 Exemptions. Ii line 38 is $155,650 or less. multiply $4,050 by the number on line ed. Otherwise. see inst. 48 mm We. Subtract iine 421iomllne 41. Ii tine 42 to more than line 41. enter ML 44 Tax. Checitilanytrom: Form(s)8814 8D Form4972 ca 3. 592. 397- 45 Alternative minimum tax. Attach Form 6251 0 46 Exam advance overturn tax credit repayment ether Form 8962 mum-he t7 3,592,397. to . _48 14.365 m?mm 49 Credit tor chiid and dependent care expenses. Attach Form 2441 43 git-m? so Education credits irorn Form 8863. line 19 JL $12,000 51 Retirement savings contributions credit. Attach Form 8880 51 :23; 52 Child tart credit Attach Schedule 8812. It required 52 some 58 Residential energy credits. Attach Form 5895 . 58 Other credits from Form: a 3800 8801 54 306 . 66 Add Ilnes 48 duouoh 54. Those are your total credits Subtract line 55 item line 47. ii line 55 Is more than line suiemoioymentmemn sweetness 60 042. Other se Unrcportec social security and Medicare tax irom Form: a 4137 8919 Taxes so Additional tax on IRAs. other quali?ed retirement pians, etc. Attach Form 5329 it required 60: Household emoioymenitexes irom Schedule First-emu homcbuyer credit repayment. much Form 5405 Ii required 81 Health care: individual responsibility (see instructions) Fill-year coverage e2 Taxestrom: on Form 8959 Form 8950 InsL: enter code(5) STATEMENT 14 502 586 . A diin 6throu nee. mist er .. 4.140.357. Payments ed Federal Income taxttrithhetd irom Forms w-2 and me ed 85 2016 estimated tax payments and amount appiled irom 2015 when 1: STATEMENT 1 5 mm? 33a Earned Income credit(?lc) 881i .. . 7: dild. ottuh Nontaictble combat pay election I see I my I 37 Additional dilld hut credit. Attach Schedule 8812 7 7 $.55 at American opportunity creditirom Form 8863.llne8 _68 it 89 Net premium tax credit. Attach Form 8962 4.1 - 70 zo 5,000,000. 71 security and tier 1 RRTAtaxwiihheid 7t 72 Credit 10* MW 0" "1?18- A?id? Form 4135 72 73 Credits trom Form: el:]2439 t-emec Deeds 73 74 Add lines 64 65 67 throu .These are our total a his 3 019 301 . Refund 7s 11 line 74 is more than line so. subtract line 63 irom line 74. This Is the amount you overpaid Mom 78; nimguni of line 75 cu want relunded to you. It Form 8888 Is attachedxgiecilmge . . 77 Amount oi line 75 you went II 2017 tlmated tax Amount 78 Amouniyou owe. Subtract line 74 irom due 63. For details on how to pay, see instructions You Owe 9 Estimated tax enei see Instruction arty Do you want to allow another person to dismiss this return with the IRS (seen instructions 7 Yes. Com riete below. ?councilman-don see . TM "wees-WM actuation: Here You emotion om accomm- IizI i1 ?30m; .. - must-Inn. Ilium-mutation ty id I "In HOUSEWI FE Prep-o?- 0?00". 0010 Paid' Preparer 10/10/17 Use Only mom TAX LLP 180 EAST BROAD STREET Illinois Department of Revenue 2016 Form IL-1 040 Individual Income Tax Return ortor fiscal year ending Over 80% of taxpuers ?le It is easy and you will get your refund faster. Vl'slt tax. gov. Step 1: Personal Information JAY ROBERT PRITZKER MARY PRITZKER CHICAGO IL 60606 00 not write above this line. Filing status (see instructions) I I Single or head of household I I Married filing Iointiy I I Married filing separately CI Vl?dowed Step 2: 1 Federal adjusted gross income from your federal Form 1040, Line 37; 1040A. Line 21; or (Whole dollars only) Income 104052. Line Federally tax-exempt interest and dividend income from your federal Form 1040 or 1040A, Line 8b; or federal Form 104052Other additions. Attach Schedule Total income. Add Lines 1 through .00 Step 3: 5 Social Security bene?ts and certain retirement plan income Base received if included in Line 1. Attach Page 1 of federal return. 5 .00 Income 5 Illinois Income Tax overpayment included in federal Form 1040, Line 10Other subtractions. Attach Schedule Check it Line 7 includes any amount from Schedule 12990. 3 3 Add Lines 5. 6. and 7. This is the total of your subtractionsIllinois base income. Subtract Line 8 from Line .00 Step 4: 10 a Number of exemptions from your federal return. i $2,175 a 8 7 0 0 .00 Exemptions If someone can claim you as a dependent. see instructions. $2,175 .00 3' 0 Check if 65 or older: You Cl Spouse $1,000 .00 43 Check if legally blind: l:l You l:l Spouse $1,000 .00 :3 Exemption allowance. Add Lines 8 through Step 5: 11 Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12Nonresidents and part-year residents: Income Check the box that applies to you during 2016 Nonresident Part-year resident, and enter the Illinois base income from Sch. NR. Attach Sch. NR. 12 .00 Step 6: Fiscal ?iers see instructions before completing Step 6. Calendar-year filers continue to Line 13. A Tax 13 Resldents: Multiply Line 11 by 3.75% (.0375). Cannot be less than zero. Nonresidents and part-year residents; Enter the tax from Schedule NRRecapture of investment tax credits. Attach Schedule 4255. 14 .00 15 Income tax. Add Lines 13 and 14. Cannot be less than zero.00 EStep 7- 16 . . - ncome tax paid to another state while an lilin0ls reSIdent. Tax After Attach Schedule CRNon- 17 Property tax and K-12 education expense credit amount from refundable Schedule Attach Schedule ICRCredits 18 Credit amount from Schedule 1299-0. Attach Schedule 12990Add Lines 16, 17. and 18. This is the total of your credits. Cannot exceed the tax amount on Line 15Tax after nonrefundable credits. Subtract Line 19 from Line 15.00 ?"1040 page ~[his form is authorized as outlined under the Illinois income Tax Act. oi ID: 28X 649001 08-22-17 this information is required. Failure to provnde nformalion could result in a penalty. 20/4 IL lo yo 2" Tax alter nonrefundable credits from Page .00 Step 8: 22 Household employment tax. See instructions. 22 .00 Other 23 Use tax on Intemet-mail order. or other out-oI-state purchases from Texas UT Wontsheet or UTTablo in the instructions. Do not leave blank. 23 0 .oo 24 Compassionate Use at Medical Cannabis Pilot Program Act Surcharge 24 25 TotaleAddUnes21,22.23.and24. 25 456/79ng Step 9: 26 Illinois Income Tax withheld. Attach all w-2 and 1099 terms. 26 .oo Payments 27 Estimated payments from Forms and ".5054. and including any overpayment applied from a prioryear remm.00 Refundable 28 withholding payments. Attach Schedule or K-1-T. 28 .00 Credit 29 Earned income Credit trom schedule ICR. Attach Schedule 29 .oo 30 Total payments and refundable credit. Add Lines 26 through 29.o_o Step 10: 31 Overpayment. ilUne so Is greater thanLlnezs. subtract Line so. 31 2'72 169 .00 Result 32 Underpayrnent. If Line 25 is greater than Une so. subtract Line so trorn Line 25. 32 on Step 1 12 33 Late-payment penalty tor underpayment of estimated tax 33 .00 Underpayment a Check It at least two-thirds at your tederai gross income is trorn ol Estimated Check Ilyou or your spouse are 65 or older and permanently Tax Penalty living in a musing home. I: and Donations Check It your income was not received evenly during the year and you annualized your Income on Form IL-2210. Attach Form IL-2210. Check It you were not required to tile an Illinois individual Income Tax retum in the previous tax year. 34 Voluntary charitable donations. Attach Schedule a. 34 .oo 35 Total penalty and donations. Add Lines you have an overpayment on Line 31 and this amount is greater than Retund or Line 35. subtract Une 35 from Line 31. This is your remaining overpayment. 36 272 1 5 9 .00 Amount You 37 Amount from Line 36 you want reiunded to you. Check one box on Line 38. See Instructionscheck this box. Routing number I: creature or Cl Savings Account number CI Individual Income Tax rerund debit card paper check 39 Amount to be applied to estimated tax. Subtract uh: 37 trom Line as. See instructionsyou have an underpayment on Une 32. add Lines 32 and 35. 0f - liyou have an overpayment on Line 31 and this amount is less than Une 35, .00 subtract Line 31 trom Une 35. This is the amount you owe. See instructions. - - 4? Step 13: Uh ly. I state that I have examined this return. and, to the best oi my knowi MIZIIT . Date Date Deytlmophonenumber 1? 1? 17 Pa dprepua a one to Proper-'- phone mm a proper I Third PW Check. and com etc the designee's name and phone number below. to allow another person to discuss this retum and any Doslenoe previous retum at a?ects the liability reported on this return with the iillnois Department or Revenue. Doolpnoa?a me We print) Designed. phone mantra . II no payment enclosed. mail to: . Ii neymentenciosed. mil to: i I ILLINOIS DEPARTMENT OF REVENUE ILLINOIS DEPARTMENT OF REVENUE mm 00-22-17 ID: 28X n-ioto pogo eta-01m) SPRINGFIELD IL 82710-0001 SPRINGFIELD IL 62728-0001 0R AP RR 0c IR 1040 U. S. Individual Income Tax Return 99)l2__015 OMB No 1545-00" Use Only- Do not wrlte or staple in this space For the year Jan. 1- Dec. 31, 2015, or other tax you beginning H2015 ending 20 See 99.9?52.9 Ingimctlong name and initial Last name You JAY ROBERT PRITZKER ii a (oint return, spouse?s first name and initial Last name Spouse's social ?curry number MARY PRITZKER Home address (number and street). 11 you have a P.0. box, see instructions. Apt. no. Maire sue the SSlti(e) Ibove and on line do are correct. City, town or post omco, sills, and ZIP code. if you have a ioreign adaess, also complele spaces below. CHICAGO, IL 60606 Foreign country name Foreign province/state/county Foreign postal code Presidential lecion Campaign Check here it you, or you spouse if illino jointly. want $3 to go to this lund. Checking a box below will not change your tax or refund. You Spouse Filing Status 1 [3 Single 4 Head of household (with qualifying person). If the qualiiying 2 3] Married tiling jointly (even i1 only one had income) person is a child but not your dependent, enter this child's 3 Married tiling separately. Enter spouse's SSN above name here. Check only one box and iull name here. 5 El Oualiiying widow(er) with depen dent child - Yourseli. If someone can claim you as a dependent, do not check box Be 2 Exemptlons DIZlSpouse . . No.6cr on 02 It more than iour dependents, see instructions and (3) Depandent'a ?am THEODORA DAUGHTER DONALD PRITQKER SON Dependents on or: not entered above check here Add numbers Total number 01 exemptions claimed . . . . .. . 9:33:55 4 Income 7 Waoes salaries tips. etc. Attach Formts) W-2 7 8a Taxable interest Attach Schedule it required Tax-exempt interest 00 not include on line Attach Form(s) w-2 hm, ?so 9: Ordinary dedends Attach Schedule It required attach Forms Oualliied dividends Taxable refunds. credlts. or offsets 01 state and local Income taxes 10 0 - (m ?mm, 11 Alimony received 11 12 Business income or (loss) Attach Schedule Capital gain or (loss). Attach Schedule it required. it not required, check here Other trains or (lessee). Attach Form 4797 . 14 - 5 5 . see instructions. 15a IRA distributions 15a Taxable amount . 15b 16: Pensions and annuities 16: Taxable amount 16b 17 Rental real estate. royalties. partnerships, corporations. trusts. etc. Attach Schedule ?lm income or Attach Schedule .. .. . 18 19 unemployment compensation 19 20a Social security bene?ts Um I I Taxable amount A 21 Other income. List type and amount 21 22 Combine the amounts in the 1ar right column ior lines 7 throum 21. This Educator exoenses 23 Adjust? 24 3: 513033" 24 Gross 25 Health savings account deduction. Attach Form 8889 25 {19.3" 26 Movino expenses. Attach Form 3903 26 27 Deductible part 01 sell-employment tax. Attach Schedule Self-employed SEP, SIMPLE, and quali?ed plans 23 29 Self-employed health insurance deduction 29 2 3 9 84 . 30?; 30 Penalty on early withdrawal of savlnos 30 31a Alimony paid 1: Recipient's 331: 31. it; 3 32 IRA deduction 32 -tr; 83 Student loan Interest deduction as Leis)" 34 Turned and tees Attach Form 8917 34 35 Domestlc production actIVItles deduction. Attach Form 8903 Add lines 23 ttrrouon .12_-3_0-15 37 Subtract l_i_ne 36 from line 22. This is your adiustod gross income LHA For Disclosure. Privacy Act. and Paperwork Reduction Act Notice. see separate instructions. Form 1040 (2015) worms) JAY ROBERT MARY i Pee-2 Tax and 88 Amount trorn line 37 (adiusted cross Income) -9 9 4 527 . 079d? 38a cheek You were born baiore January 2 1951. Blind Total boxes It I: Spouse was born before Januaryz. 1951. Blind. checked see most- I) ll your spouse Itemtaes on a separate return or you were a dual-status alien, check here 8811 _to Itemized deductions (lrorn Schedule A) or your standard deduction (see ielt marginmay; 41 smiraotilneaulromllneas hmcibnm 42 Exemptions. it line 38 is $154,950 or less. multiply $4,000 by the number on line 6d. Otherwise, see InsL 48 Taxable Income. Subtract line 42 lrom line 41. ll line 42 is more than line 41. enter -0- 44 m. Checkllanylrom: at: Form(s)8814 Form 4972 mm 1291 TAX 2. 312 567 . 45 Aiiemaiivs minimum tax Attach Form 6251 0 . 46 Excess advance premium tax credit repayment Attach Form 8982 mto?mmo 47 Additnes44,45.and46 . 2 312 557- 343.100 48 Foreign tax credit. Attach Form 1116 it required mm"! 48 Credit tor child and dependent aare expenses. Attach Form 2441 it I WM 50 560001500 credits lrom Form 3353. line 19 st Retirement savings contributions credit. Attach Form st 33%, 52 cm? i? 6'90"- Aiiadi 8812. ii required 42 mm 58 Residential mercy credits Attach Form 5695 A -. - .-. er OtltercreditslromForm: e-seoo aljeeot eCl 44 136.821; . 55 Add lines ?thrown ?These are your total neon 58 Subtract line 55 trorn iina 47. ll line 55 is more than line 47 enter -ScheduieSE 57 82 730 - Other 58 Unreported social security and Medicare tax irom Form: a 4137 8919 Taxes 59 Additional tax on iRAs, other quali?ed retirement plans. etc. Attach Form 5329 it required 60: Household employment taxes irom Schedule Firsi?iimo homobwer credit repaymni. Atiadl Form 5405 it required 81 Health care: individual responsibility (see instructions) Full-year coverage 82 Taxes tram: a Form 8959 a Form 8960 inst: enter code(3) Add lines 56 through 62. This is your totaltsx Payments or Federal income tax withheld nom terms we and 1099 84 as 2015 estimated taxpayrnenls and amount applied item 2014 return mm? 38a Earned Income credit (EIC) 66s., . and. enact: Nontaxable combat pay election I 66b I Egg; . .11 Ml . 57 Additional tax credit Attach Schoduie aatz 67 88 American opportunity credit lrorn Form 8863. line 8 69 Net premium tax credit. Attach Form 8962 70 7o 1.915.000. 71 Excess social security and tier 1 MIA tax withheld 7t 72 Credit tor lederai tax on tools Attach Form 4136 72 73 Credits lrorn Form: eljenme Closes dB 73 A and 71hr 1173.1 . . 3.203.472. Refund 75 ii line 74 is more than tine 63. subtract line 63 trorn line 74. This is the amount you overpaid 777 wunt 01 line 7 want retunded to you. ll Form 8888 Is attactledkchedir here I: See to boom? l>01yoe memwin anumbul mm 7 Amount oi line 75 cu want i 4 our 2018 estimatedta Amount 78 Amount you owe. Subtract line 74 trorn line 63. For details on how to pay. You owe Estimated tax one! see instructions 7 0 . 00 you want to allow another son to discuss this return with the IRS (seam instructions - Yes.c Designee Dasllnee'a Sign - - - one Your mason 00M. rthono lumber on Spouse's occupation it the the wit you an identity "mm [pin in, HOUSEWIFE '1 Sign? 10/10/16 Use Only Fbm?onnmo TAX LLP 180 EAST BROAD STREET rum-mm >cowmairs, on 43g) Illinois Department of Revenue 2015 Form lL-1040 individual Income Tax Return or forfiscal year ending Over 80% of taxpa yers ?le electronically. It is easy and you will get your relund faster. Visit tax. Illinois. gov. Step 1: Personal information JAY ROBERT PRITZKER MARY PRITZKER Do not write above title line. CHICAGO IL 60606 0 Filing status (see instructions) Single or head of household Married ?ling jointly Married tiling separately Widowed Check if you or your spouse are a military veteran and want your name and address shared with the Illinois Department of Veterans' Affairs. 1: You 1: Spouse Step 2: 1 Federal adjusted gross income from your US. 1040, Line 37; US. 1040A. Line 21; or (Whole dollars only) Income U.S. 1040EZ, Line Federally tax-exempt interest and dividend income from your U.S. 1040 or 1040A, Line 8b; or U.S.1040EZOther additions. Attach Schedule Total income. Add Lines 1 through .00 Step 3: 5 Social Security benefits and certain retirement plan income 1 Base received if included in Line 1. Attach Page1 of federal return. 5 .00 Income 6 Illinois Income Tax overpayment included in US. 1040. Line 10. 6 .00 7 Other subtractions. Attach Schedule Check if Line 7 includes any amount from Schedule 1299-0. 3 8 Add Lines 5, 6. and 7. This is the total of your subtractionsIllinois base income. Subtract Line 8 from Line Step 4: 10 a Number of exemptions from yourfederal return. 4? $2,150 a 8 I 6 00 .00 Exemptions if someone can claim you as a dependent, see instructions. $2,150 .00 3' 0 Check if 65 or older: You Cl Spouse $1,000 .00 8; Check it legally blind: I: You Spouse $1,000 .00 3 Exemption allowance. Add Lines a through d. 10 8 6 0 0 .00 Step 5: 11 Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12Nonresidents and part-year residents: Income Check the box that applies to you during 2015 1:1 Nonresident Part-year resident, and enter the Illinois base income from Sch. NR. Attach Sch. NR. 12 .00 A Step 65 13 Residents: Multiply Line 11 by 3.75% (.0375). Cannot be less than zero. Tax Nonfesidents and parteyear residents; Enter the tax from Schedule NRRecapture of investment tax credits. Attach Schedule 4255. 14 .00 15 income tax. Add Unes 13 and 14. Cannot be less than zeroStep 7: 16 Income tax paid to another state while an Illinois resident. Tax After Attach Schedule onNOII- 17 Property tax and K-12 education expense credit amount from refundable Schedule Attach Schedule ICRCredits 18 Credit amount from Schedule 1299-0. Attach Schedule 12990Add Lines 16. 17. and 18. This is the total of your credits. Cannot exceed the tax amount Tax after nonrefundable credits. Subtract Line 19 from Line 15. 18 0 0 4 0 .00 I-- 1040 page 12/15) 54 1 ID: 28X 0 1-07- 18 This form is authorized as outlined under the llimola Income Tax Act. Disclosure of this iniormetion is required. Failue to provide information could result in a penalty. i~ a; ?mfmm? 21 Tax alter nonretundabie credits from Page 1. Line 20.00 Step 83 22 Household employment tax. See Instructions. 22 .00 Other 23 Use tax on Intemet. mail order. or other out-ol-state purchases from Taxes UT Worksheet or UT Table in the Instructions. no not leave blank. 23 0 .oo 24 Compassionate Use 01 Medical Cannabis Pilot Program Act Surcharge 24 .00 25 Total Tax. Add Lines 21.00 Step 9: 26 Illinois income Tax withheld. Attach all we and 1099 terms. 26 .00 Payment: 27 Estimated payments lrom Forms and lLSos-l. and Including any overpayment applied from a prior year retum.00 Roiundablo 28 Paaethrough withholding payments. Attach Schedule K-1-P or K-1-T. 28 .09 Credit 29 Earned income Credit irom Schedule Attach Schedule ion. 29 .oo 30 Total payments and refundable credit. Add Unes 26 through 29. 30 340 2 50 .00 Step 10: 31 Overpayment. ll Line 30 is greater than Line 25. subtract Une 25 lrom Une 30. 31 Result 32 Underpayment. ll Une 25 is greater than Line 30. subtract Lille 30 from Une 25. 32 .00 Step 11: 33 Latepayment penalty for underpayment oi estimated tax 33 .00 Underpayment a Check Ii at least two-thirds of your lederal gross income 13 from taming. of Estimated Check II you or your spouse are 65 or older and permanently Tax Penalty living in a nursing home. and Donations Check II your Income was not received evenly during the year and you amuaiized your income on Form iL-2210. Attach Form iL-2210. it Check it you were not mquired to ?le an Illinois individual income Tax return in the previous tax year. 34 Voluntary charitable donations. Attach Schedule G. 34 too 35 Total penalty and donations. Md Lines 33 and s4. 35 - .00 Step 123 36 ll you have an overpayment on Une 31 and this amount is greater than Refund or Une 35. subtract Line 35 from Line 31. This is your remaining overpayment.00 Amount You 37 Amount from Line 36 you want refunded to you. Check one box on Line 38. See instructionschoose to receive my relund by direct deposit - Complete the inlormatlgn 9219:! ii you choc; this box. Routing number Checking or I: Savings Account number Illinois Individual income Tax reiund debit card paper Check 39 Amount to be applied to estimated tax. Subtract Une 37 1mm Une as. See instructionsyou have an underpayment on Line 32. add Lines 32 and 35. or It you have an overpayment on Une 31 and this amount is less than Une 35. subtract Une 31 from Une 35. This Is the amount you owe. See instructions. 40 .00 Step 13: Sign and Date l0/li_liv 10/10/16 . .. leper-Ia 59 mm! Third Party Check and omitt- tlio doalgnal' a name and phone number below. to allow snout-r poison to discuss this lotion and any previous man that ailects tile lioblity Designee laden littoral-n with he ItmoiaDopuiment cl Rove Oasignee'a name [please print) Doolgnoo'o phone number Form 1099-8 [3 It you are unable to obtain your Form 1099-6 from our website. you may check the box to receive a paper 1099-8 form next year. We will mail you a 109943 lorm it you meet the criteria requiring us to issue one to you. . Ii no payment enclosed, mail to: . Ii payment enclosed. mail to: ILLINOIS DEPARTMENT OF REVENUE I ILLINOIS DEPARTMENT OF REVENUE ?m SPRINGFIELD ll. 62719-0001 SPRINGFIELD IL 02720-0001 01-07-10 ID: 28X IL-INO page 2 (?42/15) on an no in E1040 u. 8. Individual Income Tax Retum(99 '2014 OMB no 1545 0074 I IRS Use Only- Do not write or staple In this space For the you Jan. 1- Dec. 31, 2014, or other in you beginnln9.,2014 enoing 50? sogeretolnetructione Your first name and initial Last name Your social eecuity number JAY ROBERT PRITZKER li a joint return, spouse?s iirst name and initial Last name Spouse's social security number MARY PRITZKER Home address (number and street). If you have a P.0. pox, see instructions. Apt no. Make me me SSW above A City. town or post oliice. state. and ZIP code. it you have a foreign address, also complete spaces below. CHICAGO, IL 60606 and on line 6c are correct. Presr 30155] E?cion C?potgn Check here Il you, or our spouse ll filing want to go to this fund Checking a box below Foreign country name Foreign province/state/county Foreign postal code ?m i? MW- 13 You :1 Spouse . 1 Single 4 Head of household (with qualifying person). lithe qualifying Filing Status . .. . . . . . . . . 2 MarrIed fIlIng Iomtly (even It only one had income) person Is a mm but not your dependent, enter this mm 5 Check only 3 Married filing separately. Enter spouse's SSN above name here. one box. and full name here. 5 [j Qualifying widow(er) with dependentchild Exemptions 6a LXJ Yourself. If someone can claim you as a dependent, do notcheck box 6a Spouse No. Dependents: (2) Dependents social (35:55:23: Jimmy. Timmy, you i (1) First name Last name securIty number you 0 did Wiih you oudue to divorce THEODORA PRITZ KER DAUGHTER 5mm, It more than four DONALD PRITZKER SON dependents, see Dependent: on Go ?nstruc?ons and not EDOVB cheat here Add numbers it Total number of exemptions claimed 3343:?) 4 Income 7 Waocs. salaries tips. etc. Attach FormIs) W-2 7 8a Taxable interest. Attach Schedule it required Attach Form(s) Tax-exemptinterest. Do not include on line Ba I 2 4 04 . w-2 here, ?so 9- Ordinary dividends. Attach Schedule it required attach Forms Quali?ed d'widends Taxable refunds, credits, or offsets of state and local income taxes was wmlhekl 11 Alimony received 11 12 Income 0' ('Ossl- Schedule Capital gain or (loss). Attach Schedule if required. If not required check here Other oaths or (losses). Attach Form 4797 14 1 5 7 . see instructions. 15a IRA distributions 15a Taxable amount 15b 16a Pensions and annuities 18: Taxable amount 16b 17 Rental real estate, royalties, partnerships, corporations, trusts, etc. Attach Schedule Farm income or (I055). Attach ScheduIeF 18 19 Unemployment compensation 19 20: Social security benefits 20a 11 Taxable amount 20b 21 Other income. List type and amount SEE STATEMENT Combine the amounts in the column for lines 7 through 21. This is our total Income Educator exuenses 23 Adjusted 24 misstatement :1 We? 24 Gross 25 Health savings account deduction. Attach Form 8889 25 '"00m8 26 Moving exuenses Attach Form 3903 26 27 Deductible part of sell-employment tax. Attach Schedule Self-employed SEP, SIMPLE, and qualified plans 2t! 29 Self-employed health insurance deduction Penalty on early withdrawal of savings 30 313 Alimony paid Recipient's SSN 2 31a 32 IRA deduction 32 33 Student loan Interest deduction 33 34 Tuition and tees Attach Form 8917 34 35 Domestic production activities deduction. Attach Form 8903 Add ""05 23 ""00073939.14 37 Subtract line 36 from line 22 This Is your adjusted gross income LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Form 1040 (2014) You Owe 7e Estimatodtax enel Paid Preparer Use Only 12-31- ll 104012014) JAY ROBERT MARY me. 2 Tax and 38 Amount from line 37 (adjusted gross income0'01?? 38a Check You were born beiorc Januaryz. 1950. Blind. Total boxes 0.1m to, it Spouse was born be1ore January 2. 1950. Blind. checked 88s agent-wrung L. Ilyour spouse ltemlzes on a separate return or you were a dint-statue alien, check here 88b 3 . on or 40 itemized deduction: (item Schedule A) oryour standard deduction (see ielt margin390 ?who can gnome-.3; 41 Subtractnnuouomlnesa Inmwm 42 Exemptions It line 38 is $152. 525 or less. multiply $3.950 by the number on line 6d. Otherwise. see inst. 42 0 . 48 Taxable income. Subtract line 421mm line 41. it the 42 is more than line 41, enter -Check it any irom: el:l Formls) 8814 el: Form 4972 Alternative we Attach Form 6251 45 - 48 Excess advance premium tax credit repayment Attach Form 8982 40 1:27.115" 47 Addiines44.45.and46 47 1.0727526- smo 4! Permutaxcred?-Attenh Form 1116itrenuired 48 14. 585 - immune 49 Credit lorchiid and dependent we expenses. Attach Form 2441 4e OuoiM?D 50 Education credits irom Form 8863. line 19 50 m? 61 Retirement savings contributions credit Attach Form 8880 61 mg? 52 Child tax credit. Attach Scheduie 8812. it required 52 tonne 53 Residential envoy credits.Amett Form 5695 53 54 Other credits from Form: 3800 it 8801 54 65 Add lines 48 tnrouon 54. These are your total credits Subtract line 551mm line 47 ll line 55 is more titan line 47. enter -Seli- employmenttax Attach Schedute Other 88 Unreported social security and Medicare taxtrom Form: a 4137 DC: 8919 53 Taxes 58 Additional tax on iRAst other quailtied retirement plans. etc. Attach Form 5329 It required 58 30' ?0039mm lax? "0m 30'3?? 80: First-time hemebuyer revetment- Attach Form 5405 If required 4 80b 81 Health care: Individual responsibility (see instructions) Fill-year coverage [El 81 82 Taxes trom: Form 8959 it. Form 8980 cl:l inst; enter code(3) STATEMENT 1.171.224- Payments :4 Federal income tax withheld trom Forms W-2 and 1099 84 2014 estimated tax payments and amount applied from 2013 return mm" :3th Eemed income credit (Elli) 88a cute em 8 Nontaxable combat pay emotion [y . 07 Schedule 8612 87 88 American Opportunity credit trom Form 8353. 8 98 . 89 Net premium tax eredlt Attach Form 8962 ee . 2 -. 70 Amount paid with request tar extension to tile Excess social 8chth and tier 1 HRTA lax Mlliheld 71 - 72 Credit for lederai tax on fuels. Attach Form 4136 72 78 Credits lrom Form: a 2439 ll Emmet Email I: 78 74 Add lines 64. 65. 66a. and 67 through 73. These are your total payments Refund 75 it late 74 is more than line es. subtract line 63 from line 74. This is the amount you overpaid 7e. Amount 01 line 75 cu want relundedto you ll Form leaitached. check here 78:. Soc will}? Elm 77 Amount 01 line?you went applied to your 2015 estimated tax Amount 78 Amountyou owe. Subtract line 74 from line 63. For details on how to pay, see instructions 70 Ooylhm phone nun-nil ka?e eddtm COLUMBUS 0H 4 3215 oowplon 70,4 7/29/ OUSEWIFE rm. I Print/7r] -opw err-m r? l_l ll .i ?we TAR LLP smelt.? 180 EAST BROAD su?h?s?su m. no. Illinois Department of Revenue 2014 Form lL-1040 Individual Income Tax Return or tor Ilecal year ending Step 1: Personal Information JAY ROBERT PRITZKER MARY PRITZKER CHI CAGO . ID IL 60506 Filin status {see hetructlons] Single or head of household E1 Married ?ling jointly Married ?ling separately 1:1 Widowed Check it you or your spouse are a military veteran and want your name and address shared with the Illinois Do not wile above line. De rtmant of Idaterans' Affairs- You 1:1 ?nal line Step 2: 1 Federal adjusted gross income from your US. 1040. Line U.S. 1040A. Line 21: or {Whole dollars only] Income u.s. 1o4oEz. Line Federally tax-exempt interest and dividend income from your US. 1040 or 1040A, Una 3b; or us. 1040EZOther additions. Attach schedule Total Income. Add Lines1 through 3. 4 3 4 53 '1 .00 Ste-'13 3: 5 Social Security benefits and certain retirement plan income 5356 received it included in Line 1.Attach Page 1 of federal return. 5 .00 Income 3 Illinois Income Tax overpayment included in 1.1.3. 1040, Line 10. .00 7 Other subtractions. Attach Schedule Check it Line includes any amount from Schedule 1299-0. 1:1 :5 3 Add Lines 5. S. and This is the total of your subtractioneIllinois base income. Subtract Line 0 from Line .00 Step 4: 10 a Number of exemptions from your federal return. i $2,125 a 3 5 0 .00 ell Exemptions If someone can claim you its a dependent, see instructions. $2,125 I: .00 3 Check if 65 or older: 1:1 You Spouse 551.000 0 .00 3 Check if legally blind: You Spouse be Exemption allowance. Add Lines a through 31:91) 5: 11 Residents: Net income. Subtract Line 10 Item Line 9. Skip Line 12Nola-residents and pelt-tear residents: INCOME Check the box that applies to you during 2014 1:1 Nonresident Part- -year resident and enter the Illinois bode income from Sch. NFL Attach SchResidents: Multiply Line 11 by 5% Cannot be less than zero. :1 Tax 010an and may?; residents: Enter the tax from Schedule NHFiecapture of Investment tax credits. Attach Schedule 4255. 14 .00 15 Income tax. Add Lines 13 and 14. lL'Janrlot be less than zeroStep 7: 1'6 income tax paid to another state while an Illinois resident. 35; Tax After Attach schedule on. 16 .oo '5 Non- 17 Property tax and K-12 education expense credit amount from E. refundable Schedule Ice. Attach schedule lCFiCredits 13 Credit amount from Schedule Attach Schedule 1299-Add Lines 1S. and is. This Is the total at your credits. 7 Cannot exceed the tax amount on Line 15Tax after nonrefundable credits. Subtract Llne 191mm Line 15. 0 .00 lL-lotlo page I Ila-121m 44900] ID: 23X til-14-15 This term Is authorized as outlined under the Illinois Income Tax Act. Disclosure ct this Intermatlen is required. Failure to provide informanon coda result in a penalty. 21 Tax etter nonieiundable credits irom Page i. Una 20. 21 -00 Step 8: 22 Household employment tax. See Instructions. 22 .00 Other 23 Use tax on hternet. mail order. or other outoi-stete purchases from Texas UT Worksheet or UT Table In the Instructions. Do not leave blank. 23 OJ 24 Compassionate Use of Medical Cannabis Plot Program Act Surcharge 24 .00 25 Total Tax. Add Une.00 Step 9: 25 income Tax wltt?held. Attach all W-2 and 1099 tonne. 23 .00 Payments 2? Estimated payments from Forms IL-10-10-ES and L-505-I. end Including anyoverpayment applied irome prioryesr return. 27 50 000 .00 Reimdeble 28 Pass-through entity tax payments. Attach Schedule K-1-P or K-1-T. 28 .00 Credit 29 Earned Income Credit irom Schedule Attach Schedule 29 .00 30 Total payments and refundable credit. Add Lhea 26 through 29.00 Step 10: 31 Overpayment. ii Une so ie greater than Une 25. subtract Una 25 lrom Line 30.00 Result 32 Underpayment. II Line 25 is greater than Une so. subtract Una so irom Line 25. 32 .00 Step 1 1: 33 late-payment penalty for underpayment oi estimated tax 33 .00 Underpayment 3 Check It at least two-thirds at your federal gross income is from tanning. El ot Estimated Check It you or your spouse are 65 or older and pennaneritiy Tex Penalty living In a nurelng home. Cl and Donations Check If your income was not received evenly during the year and you annualized your Income on Form IL-2210. Attach Form lL-2210. it Check It you'vveie not required to tile an Illinois Individual income Tax retum in the previous tax year. Voluntary charitable dmetlons. Attach Schedule a 34 .00 Total penalty and donations. Add Lhee 33 and 34. 35 .00 Step 12: 36 Reiundor 36 $0,000.00 Amount You 37 Amount irom Une 36 you want rotunda! to you. Check one box on Line 38. See instructions. 37 .00 Owe 38 Cl direct dapeeit - Complete the lnIormatlon below you check this box. Routing number Cl Checking orl:l Savings Account number iilinoie individual Income Tax rerund debit card paper check 39 Amount to be applied to estimated tax. Subtract Une s7 tram IJno asaddLinesSZend 35. or Uneai subtract Line 31 from Une 35. This Is the amount you owe. See 40 .00 Step 13: Under pens ury. i state that I have examined this return. and, to the best of my - - . and complete. )v?l . ?7/2015' 3 - Iy num om Wire 0W v' Third Party 33 chu?rgmemeagmm-em endeir?e??wnmeaem. Design? Deeignee'e matinee print) Outsnee?e phone mam Form 1099-0 it you are unable to obtain your Form 109961rom our website, you may check the box to receive a paper 1099-6 form next year. inter-motion We wtil mail you a 10996 form It you meet the criteria requiring us to Issue one to you. Ii no payment enclosed. mil to: If payment enclosed. mall to: I ILLINOIS DEPARTMENT OF REVENUE ILLINOIS DEPARTMENT OF REVENUE IL 62110-0001 SPRINGFIELD lL 82728-0001 ?9002 01-10-15 ID: 28): on oc