$1040 Department of the Treasury? Internal Revenue Service U..S le?16 Individual Income Tax Return OMB NO. 1545- 0074 1R8 Use Only-? Do not write or staple in this space. For the year Jan. 1?Dec. 31. 2016. or other tax year beginning .2016 ending 20 See separate instructions Your first name and initial Last name Your social security number Daniel Bis If a joint return, spouse's first name and initial Last name Spouse?s social security number Karin Steinbrueck Home address (number and street). it you have a PO. box, see instructions. Apt. no. 3255 Central St. Make sure the above and on line 6c are correct. A City, town or post office. state, and ZIP code. if you have a foreign address, also complete spaces below (see instructionS). Evanston IL 60201 Presidential Election Campaign Check here if you. or your spouse if filing Foreign country name Foreign province/state/county Foreign postal code jointly. want 53 to go to this fund. Checking a box below wilt not change your tax or refund. [3 You a Spouse an9 Status 1 Single 4 Head of household (with qualifying person). (See instructions.) if 2 g] Married filing jointly (even it only one had income) the qualifying person is a child but not your dependent, enter this Check only one 3 i: Married filing separately. Enter spouse?s SSN above Child's name here- DOX- and fuil name here. 5 Qualifying widow(er) with dependent child Exemptions 63 Yourself. if someone can claim you as a dependent, do not check box 6a . Eggeasa?gegged 2 Spouse . i (4) /-ifch'ld ?ndet ago 17 c??dren . . I on o: Elliot A Biss Son 2:322:21: 13:; Theodore Biss Son (see ?swam?? . Dependents on Go Instructions and not entered above check here [3 Add numbers on at Total number of exemptions claimed lines above 4 Income 7 Wages, salaries, tips, etc. Attach FormisTaxable interest. Attach Schedule if required . . . 8a 2 6 0 . Tax-exempt interest. Do not include on line 8a 8b 1 Gugilfemgg 93 Ordinary dividends. Attach Schedule a if required . . . 9a 0 . attach Forms Qualified dividends 9b 1 W-ZG and 10 Taxable refunds. credits, or offsets of state and local income taxes Alimony received 11 was w'thheld' 12 Business income or {loss}. Attach schedule 0 or 82 12 13 Capital gain or (loss). Attach Schedute if required If not required, check here t: 13 14 Other gains or (losses). Attach Form 4797see instructions. 153 ERA distributions 15a Taxable amount 15b 16a PendonsandannUMes 163 Taxd?eanwunt 16b 17 Rental real estate, royaities. partnerships, corporations, trusts, etc. Attach Schedule 17 3 031 . 18 Farm income or (loss). Attach Schedule . 18 19 Unemployment compensation . . . . . . 19 20a Social security benefits 1 20a Taxable amount 20b 21 Other income. List type and amount 21 2 Combine the amounts in the far right 22 32 568. . 23 Educatorexpenses . . . . . . . 23 Ad-?USted 24 Certain business expenses of reservists, performing artists, and Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24 income 25 Heaith savings account deduction. Attach Form 8889 25 26 Moving expenses. Attach Form 3903 . . 26 27 Deductible part of self employment tax. Attach Schedule SE . 27 28 Self-employed SEP, SIMPLE, and quaiified plans 28 29 Self-employed health insurance deduction 29 30 Penalty on early withdrawal of savings . 30 31 a Alimony paid Recipient?s SSN 31 a 32 deduction . . . 32 33 Student loan interest deduction 33 34 Tuition and fees. Attach Form 8917. . . . 34 35 Domestic production activities deduction. Attach Form 8903 35 36 Addhnes23?uough35 . . . . . . 36 37 Subtract iine 36 from line 22. This Is your adjusted gross income . . . . . 37 32 56 8 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA REV Form 1040 (2016) Form 1040 (2016) Page 2 38 Amount from line 37 (adj usted gross incomeTax and 393 Check You were born before January 2 1952, El Blind. Total boxes Credits if: Spouse was born before January 2, 1952, Blind. checked 39a if your spouse itemizes on a separate return or you were a dualastatus alien. check here> 39b[:l Standafd ?49 itemized deductions (from Schedule A) or your standard deduction (see left margin) 40 3 4 0 . [zed?action 41 Subtract line 40 from line People who 42 Exemptions. it line 38 Is $155 650 or less muitiply 050 by the number on line 6d Otherwise see instructions 42 6 2 00 . g?icg?name 43 Taxable Income. Subtract line 42 from line 41. lt line 42 is more than line 41. enter -ysv?igraiggeor 44 Tax (see instructions). Check if any from: a Formls) 8814 El Form 4972 0 El 44 29 6 . 33333;? a 45 Alternative minimum tax (see instructions). Attach Form 6251 45 see 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . 46 in?rm??- 47 Add lines Foreign tax credit. Attach Form 1116 if required. 48 Married filing 49 Credit for child and dependent care expenses Attach Form 2441 49 separately, 50 Education credits from Form 8863 line 19 . 50 0 0 . Married tiling 51 Retirement savings contributions credit Attach Form 8880 51 ?ght/(559 52 Child tax credit. Attach Schedule 8812, if required. 52 1 9 6 . gjgf?gglg?) 53 Residential energy credits. Attach Form 5695 . . . 53 Head of 54 Other credits from Form: a ll 3800 8801 54 ggt?egold. 55 Add lines 48 through 54 These are your total credits . . . . 55 2 9 6 . 56 Subtract line 55 from line 47 if line 55 is more than line 47, enter . . . . . . 56 0 . 57 Selt- -emp oyment tax Attach Scheduie Other 58 Unreported social security and Medicare tax from Form: a 4137 8919 58 Taxes 59 Additional tax on IRAs, other qualified retirement plans. etc. Attach Form 5329 if required 59 603 Household employment taxes from Scheduie . 603 First? time homebuyer credit repayment. Attach Form 5405 if required 60b 61 Health care: individual responsibility {see instructions) Full-year coverage 61 . 62 Taxes from: a Form 8959 El Form 8960 {j instructions; enter code(5) 62 63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . 63 0 . Payments 64 Federal income tax withheld from Forms and 1099 64 2 076 . 65 2016 estimated tax payments and amount applied from 2015 return 65 23:13:33,319 8 66a Earned Income credit (EIC) 66a child, attach Nontaxable combat pay election 66b 5 SChedule 510- 67 Additional child tax credit. Attach Schedute 8812 67 8 04 . 68 American opportunity credit from Form 8863. line 8 68 69 Net premium tax credit. Attach Form 8962 . 69 70 Amount paid with request for extension to file 70 71 Excess social seCurity and tier 1 RRTA tax withheld 71 72 Credit for federal tax on fuels. Attach Form 4136 72 73 Creditsfrom Form: a 2439 [3 Reserved 8885 73 .. . 74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . 74 3 88 0 . Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 75 3 8 8 0 . 763 Amount of iine 75 you want refunded to you. If Form 8888 is attached, check here 76a 3 8 8 0 . Direct deposit? Routing number 1 I . I I ?0 Type: Checking Savings 369 Account number 2 i Instructions. . . . 77 Amount of iIne 75 you want applied to your 2017 estimated tax 77 . Am0unt 78 Amount you owe. Subtract tine 74 from tine 63. For details on how to pay, see instructions 78 You Owe '79 Estimated tax penalty (see instructions) I 79 . 3'33"} Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No DeSIgnee 5 5:60: Sig Under penalties of periury, I declare that have examined this return and accompanying scheduies and statements. and to the best of my knowledge and belief, they are true. correct, and accurately list ail ampunts and sources of income I received dunng the tax year. Declaration of preparer [other than taxpayer, :3 based on alt Information of which preparer has any know-edge. Here Your signature Date Your occupation Daytime phone number See State Senator Keep a copy for Spouse?s signature. if a joint return. both must sign. Date Spouse's occupation if the IRS sent you an identity Protection your records Candidate :54 i??etiri'isul?l Paid Preparer Use Only Print/Type preparer?s name Preparer?s signature Date Check II self-employed PTIN Firm?s name Self-Prepared Firm's EIN Firm's address Phone no. Form 1040 (2016) SCHEDULE A (Form 1040) Department of the Treasury internal Revenue Service (99} Itemized Deductions Information about Schedule A and its separate instructions is at >Attach to Form 1040. OMB No. 1545-0074 2?16 Attachment Sequence No. 07 Name(s) shown on Form 1040 Daniel Biss Karin Steinbrueck Your social security number Caution: Do not include expenses reimbursed or paid by others. 1:51: Medicai 1 Medical and dental expenses (see instructionsEnmramoumfnunFonn104lee38 i2i 32,568. 13 a? Dental 3 Multiply line 2 by 10% (0.10). But if either you or your spouse was Expenses born before January 2, 1952, multiply line 2 by 7.5% (0.075) instead Subtract iine 3 from line 1. If line 3 is more than line 1, enter . 4 Taxes You 5 State and local (check only one box): Paid a Income taxes, or 5 867 . General sales taxes 6 Real estate taxes (see instructions) 6 5 943 . 7 Personal property taxes . 7 8 Other taxes. List type and amount its?) 8 9 Add lines 5 through Interest 10 Home mortgage interest and points reported to you on Form 1098 10 6 403 . You Paid 11 Home mortgage interest not reported to you on Form 1098 if paid to the person from whom you bought the home, see instructions Note: and show that person?s name, identifying no, and address Your mortgage interest deduction may 11 F79 'imited (see 12 Points not reported to you on Form 1098. See instructions for ?Buucuon$' spedaln?es- . 12 13 Mortgage insurance premiums (see instructions). . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 - 15 Add lines10thr0ugh 14. 15 6,403. Gifts to 16 Gifts by cash or check if you made any gift of $250 or more, Charity see instructions. . 16 2 6 . ?you made a 17 Other than by cash or check if any gift of $250 or more, see gift and got a instructions You must attach Form 8283 if over $500 . 17 7 . bene?t for ?n 18 Carryover from prior year 18 . see ?Strum? 19 Add lines 16 through 18 . 19 197. Casua?yand Theft Losses 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . 20 571099595 21 Unreimbursed empioyee expenses?job travel, union dues, and Certain job education, etc. Attach Form 2106 or if required. Misceilaneous (See instructions) analyse-assessesnsaeseasen. 21 92. 22 Tax preparation fees . 22 9 8 . 23 Other expenses?minvestment, safe deposit box etc. List type and amount 23 24 Add?nes21tmcugh23. . . . 24 190. 25 Enter amount from Form 1040 line 38 izsl 32 ,568Subtract line 26 from line 24. If line 26 Is more than tine 24 enter 27 0 . Other 28 Other?from list in instructions. List type and amount Miscellaneous . Deductions 23 Totai 29 Itemized No. Your deduction is not iimited. Add the amounts in the far right column Deduc?ons 29 13,410. Ci Yes. Your deduction may be timited. See the itemized Deductions Worksheet in the instructions to figure the amount to enter. 30 If you elect to itemize deductions even though they are less than your standard deduction, check here . . For Paperwork Reduction Act Notice, see Form 1040 instructions. BAA REV 0125/17 Schedule A (Form 1040} 2016 SCHEDULE 8 (Form 1040A or 1040) (Rev. January 2017) Department of the Treasury internal Revenue Service (99) Interest and Ordinary Dividends Attach to Form 1040A or 1040. Information about Scheduie and its instructions is at OMB No. 1545-0074 2?16 Attachment Sequence No. 08 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number Part 1 Amount Interest (See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note: if you received a Form Form 1099-OID, or substitute statement from a brokerage firm, list the firm?s name as the 2 payer and enter the total interest shown on that form. 4 1 List name of payer. if any interest is from a selier-tinanced mortgage and the buyer used the property as a personal residence, see instructions on back and list this interest first. Also, show that buyer?s social security number and address 2 6 1 0 . 40 Addtheamountsonlinei2,610. 40 Exciudable interest on series EE and U.S. savings bonds issued after 1989. AttachForm8815Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040,iine 8a 4 2,610. 40 Note: if line 4 is over $1,500, you must complete Part Amount Part II 5 Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 53a.) Note: it you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm?s name as the payer and enter the ordinary 6 dividends shown on that form. List name of payer 0. Add the amounts on line 5. Enter the total here and on Form or Form 1040, line 9a . . . . 6 Note: if line 6 is over $1,500, you must complete Part lli. You must complete this part if you had over $1,500 of taxable interest or ordinary dividends; had a foreign account; or (0) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Yes Part ll! 73 Foreign Accounts and Trusts (See instructions on back) 8 At any time during 2016, did you have a financial interest in or signature authority over a financiai account (such as a bank account, securities account, or brokerage account) iocated in a foreign country? See instructions . . . . it ?Yes,? are you required to file Form 114, Report of Foreign Bank and Financial Accounts (FEAR), to report that financial interest or signature authority? See Form 114 and its instructions for requirements and exceptions to those requirements . . if you are required to file Form 114, enter the name of the foreign country where the financiai account is located During 2016, did you receive a distribution from, or were you the grantor of, or transieror to, a foreign trust? if ?Yes,? you may have to file Form 3520. See instructions on back . . . . . . For Paperwork Reduction Act Notice, see your tax return instructions. BAA Schedule (Form 1040A or 1040) 2016 SCHEDULE Supplemental Income and Loss (Form 1040) (From rental real estate, royalties, partnerships, corporations, estates, trusts, REMICs, etc.) Department of the Treasury Attach to Form 1040, 1040MB, or Form 1041. Internal Revenue Service (99} information about Schedule and its separate instructions is at OMB No. 1545-0074 2?16 Attachment Sequence No. 13 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number 7 Part I Income or Loss From Rental Real Estate and Royalties Note: if you are in the business of renting personal property, use Schedule or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. A Did you make any payments in 2016 that would require you to file Form(s) 1099? (see instructions) If ?Yes,? did you or will you file required Forms 1099? Yes IMO Yes [:lNo 1a Physical address of each property (street, city, state, ZIP code) A 712 W. Vine Street Champaign IL 6 1820 1 Type of Property 2 For each rental real estate property listed Fair Rental Personal use JV (from list below) above, report the number of fair rental and Days Days personal use days. Check the ox A _l only if you meet the requirements to file qualiI ed joint venture. See instructions. Type of Property: 1 Single Family Residence 3 Vacation/Short-Terrn Rental 5 Land 7 Self-Rental 2 Multi-Famlly Residence 4 Commercial 6 R0 alties 8 Other (describe) Income: PrOperties: A 3 Rents received . . . . . . . . . . . . . 3 8 400 . 4 Royalties received . 4 Expenses: 5 Advertising . 5 6 Auto and travel (see instructions) 6 7 Cleaning and maintenance 7 9 10 . 8 Commissions. 8 9 insuranceLegal and other professional fees . . . . . . . 10 11 Management fees . . . 11 12 Mortgage interest paid to banks, etc (see instructions) 12 2 7 . 13 Other interestRepairsSupplies . . . . . . . . . . . . . . . 15 16 Taxes2,496. 17 Utilities3.43. 18 Depreciation expense or depletion . . . . . . 18 0 . 19 Other (list)> 19 20 Total expenses. Add lines 5 through Subtract line 20 from line 3 (rents) and/or 4 (royalties). If result is a (loss) see instructions to find out if you must file Form 6198 . . . . . . . 21 3,031. 22 Deductible rental real estate loss after limitation if any, on Form 8582 (see instructions233 Total of ali amounts reported on line 3 for all rental properties 23a Total of all amounts reported on line 4 for all royalty properties 23b 0 Total of all amounts reported on line 12 for all properties 23c Total of all amounts reported on line 18 for all properties 23d Total of all amounts reported on line 20 for all properties 23e 24 Income. Add positive amounts shown on line 21. Do not include any losses 3,031. 25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here 25 26 Total rental real estate and royalty Income or (loss). Combine lines 24 and 25. Enter the result here. If Parts II, Ill, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the total on line 41 on page 2 26 3,031. For Paperwork Reduction Act Notice, see the separate instructions. BAA Schedule (Form 1040) 2016 SCHEDULE 8812 . . (Form 1040A or1040) Child Tax Credit >Attach to Form 1040, Form 1040A, or Form 1040NR. Department of the Treasury Information about Schedule 8812 and its separate instructions is at Attachment Internal Revenue Service (98) . . Sequence No. 47 Name(s) shown on return i Your social security number Daniel Biss Karin Steinbrueck Filers Who Have Certain Child Dependen?s) with an l'l'lN (individual Taxpayer Identi?cation Number) OMB NO. 1545-0074 2?16 Complete this port onlyfor eaclt dependent who has on and for whom you are claiming the child tax credit. lfyom' dependent is not a qualifying child for the credit, you cannot include that dependent in the calculation of this credit. . Answer the following questions for each dependent listed on Form 1040. line 6c: Form l040A. line 6c; or Form 1040NR, line 70. who has an ITIN Individual Taxpayer Identification Number) and that you indicated is a qualifying child for the child tax credit by checking column (4) for that dependent. A For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit. did this child meet the substantial presence test? See separate instructions. Yes El No For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit. did this child meet the substantial presence test? See separate instructions. [3 Yes No For the third dependent identified with an and listed as a qualifying child for the child tax credit. did this child meet the substantial presence test? See separate instructions. El Yes [1 No For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit. did this child meet the substantial presence test? See separate instructions. Yes No Note: If you have more than four dependents identified with an and listed as a qualifying child for the child tax credit. see separate instructions Part ll? Additional Child Tax Credit Filers 1 If you file Form 2555 or 2555-EZ stop here; you cannot claim the additional child tax credit. I If you are required to the worksheet in Pub. 972. enter the amount from line 8 of the Child Tax Credit Worksheet in the publication. Otherwise: 1040 ?lers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the 2,000- for Form 1040. line 52). 1040A ?lers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040A. line 35). 1040NR ?lers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Instructions for Form 1040NR. line 49). Enter the amount from Form 1040, line 52; Form 1040A. line 35: or Form 1040NR. line 49 19 6 - Subtract linerrom line 1.lf zero. stop here: you cannot claim this credit . . . . . . . . . . . 3 1,804. 4a Earned income (see separate instructions26,733. ls) (A) to Nontaxable combat pay (see separate instructionsl4b Is the amount on line 4a more than $3,000? Cl No. Leave line 5 blank and enter -0- on line 6. El Yes. Subtract $3000 from the amount on line 4a. Enter the result . . . Multiply the amount on line 5 by 15% (0.15) and enter the resultNext. Do you have three or more qualifying children? Ul N0. If line 6 is zero. stop here: you cannot claim this credit. Otherwise. skip Pan ill and enter the smaller of line 3 or line 6 on line 13. YES- If line 6 is equal to 01' more than line 3. skip Part and enter the amount from line 3 on line 13. Otherwise. go to line 7. For Paperwork Reduction Act Notice, see your tax return instructions. BAA Schedule 8812 (Form 1040A or 1040) 2016 Schedule 8812 (Form 1040A or 1040) 2016 Page 2 Certain Filers Who Have Three or More Qualifying Children 7 Withheid social security. Medicare. and Additional Medicare taxes from Form(s) W~2i boxes 4 and 6. If married filing jointly. include your spouse?s amounts with yours. if your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes. see separate instructions . . . . . . 7 8 1040 filers: Enter the totai of the amounts from Form 1040, lines i 27 and 58, plus any taxes that you identified using code and entered on line 62. 1040A ?lers: Enter -0-. 8 1040NR ?lers: Enter the total of the amounts from Form 1040NR. lines 27 and 56. plus any taxes that you identified using code and entered on line 60. 10 1040 filers: Enter the total of the amounts from Form 1040. lines 66a and 71. 1.040A filers: Enter the total of the amount from Form 1040A. line 42a. plus any excess social security and tier i RRTA 10 taxes withheld that you entered to the left of line 46 (see separate instructions). 1040NR filers: Enter the amount from Form 1040NR. line 67Enterthelargerofline?orlinell . . . . . . . . . . . . . . . . . . . . . . 12 Next, enter the smaller of iine 3 or line 12 on line 13. Part iV. Additional Child Tax Credit 13 This is your additional child tax credit . 8 0 4 . Enter this amount on 1 Form 1040. line 67. Form 1040A. line 43, or Form 1040NR. lino REV 01?25?17inw'i1091dpsp Schedule 8812 (Form 1040A or 1040} 2016 8863 Education Credits Form (American Opportunity and Lifetime Learning Credits) Attach to Form 1040 or Form 1040A. Department of the Treasury Internal Revenue Service (99) Information about Form 8863 and its separate instructions is at OMB No. 1545-0074 2016 Attachment Sequence No.50 Name(s) shown on return Daniel Biss Karin Steinbrueck you complete Parts I and II. Your social security number Complete a separate Part on page 2 for each student for whom you're claiming either credit before Refundable American Opportunity Credit 2 3 8 After completing Part Ill for each student enter the total of all amounts from all Parts ill, line 30 Enter: $180, 000 if married filing jointly; $90,000 if single, head of household, orqualifying widow(erEnter the amount from Form 1040, line 38, or Form 1040A, line 22. if you're filing Form 2555 2555 EZ, or 4563, or you're excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . 3 Subtract line 3 from line 2. if zero or less, stOp; you can't take any education credit . . . . 4 Enter: $20, 000 if married filing jointly; $10, 000 if single head of household, or qualifying widow(erline 4 is: . Equal to or more than line 5, enter1.000 on line Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to at least three places) Multiply line 1 by line 6. Caution: if you were under age 24 at the end of the year and meet the conditions described in the instructions, you can't take the refundable American opportunity credit; skip line 8, enter the amount from line 7 on line 9, and check this box . . . . El Refundable American opportunity credit. Multiply line 7 by 40% (O. 40). Enter the amount here and on Form 1040, line 68, or Form 1040A, line 44 Then go to line 9 belowNonrefundable Education Credits Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) After completing Part ill for each student, enter the total of all amounts from all Parts Ill, line 31. It zero, skip lines 11 through 17, enter -0- on line 18, and go to line 19 Enter the smaller of line 10 or $10,000 Multiply line 11 by 20% (0.20) . . Enter: $131, 000 if married ?ling jointly; $66 000 if single head of household, or qualifying widow(er500. 11 500. 100. Enter the amount from Form 1040, line 88, or Form 1040A, line 22 if you re filing Form 2555, 2555- EZ, or 4563, or you re excluding income from Puerto Rico see Pub. 970 for the amount to enter . . . 14 32 568 . Subtract line 14 from line 13. if zero or less, skip lines 16 and 17, enter 0? online18, andgotoline19 . . . 15 98,432. Enter: $20, 000 if married filing jointly; $10, 000 if single head of household, or qualifying widow(erline 15 Is: 0 Equal to or more than line 16, enter 1.000 on line 17 and go to line 18 0 Less than line 16, divide line 15 by line 16. Enter the result as a decimal (rounded to at least three places) . . . - Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet {see instructions) here and on Form 1040, line 50, or Form 1040A, line 33 12 1.000 18 100. 19 100. For Paperwork Reduction Act Notice, see your tax return instructions. BAA Form 8863 (2016) Form 8863 (2016) Name(s) shown on return Daniel 8155 Karin Steinbrueck each student. Page 2 Your social security number Complete Part for each student for whom you're claiming either the American opportunity credit or lifetime learning credit. Use additional copies of page 2 as needed for Part'lit- Student and Educational institution information See instructions. 20 Student name (as shown on page 1 of your tax return) 21 Student social security number (as shown on page 1 of your tax return) Karin Steinbrueck 22 Educationai institution information (see instructions) a. Name of first educational institution Northwestern University b. Name of second educationai institution (if any) (1) Address. Number and street (or PO. box). City, town or post office, state, and ZIP code. if a foreign address, see instructions. 555 Clark Street Evanston IL 602081221 (1) Address. Number and street (or PO. box). City, town or post office, state, and ZIP code. if a foreign address, see instructions. (2) Did the student receive Form 1098-T (2) Did the student receive Form from this institution for 2016? Yes No from this institution for 2016? El yes No (3) Did the student receive Form 1098-T (3) Did the student receive Form from this institution for 2015 with box Ci Yes [2 No from this institution for 2015 with box [3 Yes No 2 tilled in and box 7 checked? If you checked ?No? in both (2) and (3), skip (4). (4) If you checked ?Yes? in (2) or (3), enter the institution?s federal identification number (from Form 1098-T). 2 tilted in and box 7 checked? if you checked ?No? in both (2) and (3), skip (4). (4) if you checked ?Yes? in (2) or (3), enter the institution's federal identification number (from Form 36~2167817 23 Has the Hope Scholarship Credit or American opportunity Yes StOp' credit been claimed for this student for any 4 tax years El Go to tine 31' forthis student. No Go to line 24. before 2016? 24 Was the student enrolied at least half-time for at least one academic period that began or is treated as having begun in 2016 at an eligible educations? institution in a program . 1 . leading towards a postsecondary degree, certificate, or Yes GO to line 25' it]; to line 31 other recognized postsecondary educational credential? See instructions. 25 Did the student complete the first 4 years of postsecondary Yes Stop! education before 2016? See instructions. (30 to tine 31 for this No Go to line 26. student. 26 Was the student convicted, before the end of 2016, of a Yes a. Stop! No Complete lines 27 felony for possession or distribution of a controiled substance? El Go to line 31 for this A t. student. through 30 for this studen You can?t take the American opportunity credit and the lifetime learning credit for the same student in the same year. if you complete lines 27 through 30 for this student, don?t complete line 31. American Opportunity Credit 27 Adjusted quaiified education expenses (see instructions). Don't enter more than $4,000 . 27 28 Subtract $2,000 from line 27. If zero or less, enter -0-. 28 29 Multipiy tine 28 by 25% (0.25line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on tine 29 and enter the result. Skip line 31. include the totai of all amounts from all Parts lil, line 30, on Part E, line 1 . 30 Lifetime Learning Credit 31 Adjusted qualified education expenses (see instructions). include the totai of all amounts from all Parts ill, line 31,on Part Ii, tine10 31 500. Form 8863 (2016) Illinois Department of Revenue 2016 Form IL-1040 individual Income Tax Return or for iiscai year ending Over 80% of taxpayers ?le electronically. It is easy and you will get your refund faster. Visit talelinois. gov. Step 1: Personal Information DO W9 above Ill Daniel Biss Karin Steinbrueck 3255 Central St. Evanston IL 6 0201 Filing status (see instructions) '3 Single or head of household Married filing jointly 1:1 Married filing separately Widowed Step 2: 1 Federal adjusted gross income from your tederat Form 1040, Line 37; 1040A, Line 21; or Who?? d01'a'5 on?Y) Income 104052, Line 4 1 32 568 .00 2 Federaily tax-exempt interest and dividend income from your federal Form 1040 or 1040A, 0 Line 8b; or federal Form 1040EZ 2 .00 3 3 Other additions. Attach Schedule M. 3 00 ?5 4 Total income. Add Lines 1 through 3. 4 32 568 Step 33 Sociat Security benefits and certain retirement plan income a Base received if included in Line 1. Attach Page 1 of federal return. 5 .00 Income 6 Illinois income Tax overpayment included in federal Form 1040, Line 10 6 l9 4 .00 7 Other subtractions. Attach Schedule M. 7 .00 Check it Line 7 includes any amount from Schedule 1299-0. 8 Add Lines 5, 6, and 7. This is the total of your subtractions. 8 1 94 00 9 Illinois base income. Subtract Line 8 from Line 4. 9 32 374 Step 4: 10 a Number of exemptions from yourfederal return _4 $2,175 a 8 700 .00 3,3 Exemptions If someone can ciaim you as a dependent, see instructions. $2,175 00 Check if 65 or older: El You Spouse $1,000 0 .00 (1 Check if legally blind: You Spouse $1,000 .00 Exemption allowance. Add Lines a through d. 10 81700.00 Step 5: Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12Nonresiden ts and part-year residents: income Check the box that applies to you during 2016 Nonresident Part-year resident, and enter the tllinois base income from Scheduie NR. Attach Schedule NR. 12 0 '7 Step 6: 13 Residents: Multiply Line 11 by 3.75% (.0375). Cannot be tess than zero. 3 Tax Nonresidents and part-year residents: Enter the tax from Schedule NRRecapture of investment tax credits. Attach Schedule 4255. 14 gm 3 15 Income tax. Add Lines 18 and 14. Cannot be less than zero. 15 888 .00 3 Step 7: 16 Income tax paid to another state while an Illinois resident. 3 Tax After Attach Schedule CR. 16 .00 a Nam 17 Property tax and K-12 education expense credit amount from . 3 Credits 18 Credit amount from Schedule 1299-0. Attach Schedule 1299?0 18 .00 19 Add Lines 16, 17, and 18. This is the total of your credits. Cannot exceed the tax amount on Line 15. 19 Mm 20 Tax after nonrefundable credits. Subtract Line 19 from Line 15This form IS authorized as outlined under the income Tax Act. Disclosure of this information is required. Faiiure to provide information could result in a canal! . IL-1040 front 21 Tax after nonrefundabte credits from Page 1, Line 20 2t 59 1 ,00 Step 33 22 Household employment tax. See instructions. 22 Other 23 Use tax on internet, mail order, or other out-of-state purchases from Taxes UT Worksheet or UT Table in the instructions. Do not leave biank. 23 2 .00 24 Compassionate Use of Medical Cannabis Pilot Program Act Surcharge 24 .00 25 TotalTax. Add Lines 21Step 9: 26 Illinois tncome Tax withheld. Attach ail W-2 and 1099 forms. 26 8 6 7 .00 Payments 27 Estimated payments from Forms IL-1040-ES and iL-505-l, and including any overpayment appiied from a prior year return 27 .00 Refundabie 28 Pass-through withholding payments. Attach Schedule or 28 .00 CredIt 29 Earned Income Credit from Schedule ECR. Attach Schedule 29 00 30 Totat payments and refundable credit. Add Lines 26 through 29. 3O 8 67 .00 Step 10: 31 Overpayment. If Line 30 is greaterthan Line 25, subtract Line 25 from Line 30. 31 255 .00 Result 32 Underpayment. If Line 25 is greater than Line 30, subtract Line 30 from Line 25. 32 .00 Step 11 33 Late-payment penalty for underpayment of estimated tax 33 00 Underpayment 8 Check if at least two-thirds of your federal gross income is from farming. of Estimated Tax Check if you or your spouse are 65 or older and permanently Penalty and living in a nursing home. Donations . . . . Check if your Income was not received evenly during the year and you annualized your income on Form tL-2210. Attach Form iL~22tO. Check it you were not required to file an Illinois Individual Income Tax return in the previous tax year. El 34 Voiuntary charitabte donattons. Attach Schedule G. 34 .00 35 Total penalty and donations. Add Lines 33 and 34. 35 .00 Step 12: 36 If you have an overpayment on Line 31 and this amount is greater than Refund or Line 35, subtract Line 35 from Line 31 . This is your remaining overpayment. 36 255 .00 Amount YOU 37 Amount from Line 36 you want refunded to you. Check one box on Line 38. See instructionschoose to receive my refund by direct deposit - Complete the information below if you check this box. Routing number XChecking or I: Savings numb I I I I [3 Illinois individual Income Tax refund debit card paper check 39 Amount to be applied to estimated tax. Subtract Line 37 from Line 36. See instructions. 39 0 .00 40 If you have an underpayment on Line 32, add Lines 32 and 35. or I If you have an overpayment on Line 31 and this amount is less than Line 35, subtract Line 31 from Line 35. This is the amount you owe. See instructions. 40 .iKl Step 13; Under penalties of perjury, I state that I have examined this return, and, to the best of my knowledge, it is true, correct, and . compiete. Sign and Date a. Your signature Date Daytime phone number Your spouse?s signature Date Self?Prepared Paid preparers signature Date Preparer?s phone number Paid preparer's PTIN Third Party [3 Check, and complete the designee?s name and phone number below, to aliow another person to discuss this return Designee and any previous return that affects the liabitity reported on this return with the Illinois Department of Revenue. Designee?s name (please print) If no payment enclosed, mail to: If payment enclosed, mail to: ILLINOIS DEPARTMENT OF REVENUE ILLINOIS DEPARTMENT OF REVENUE SPRINGFIELD ll. 62719-0001 SPRINGFIELD IL 62726-0001 lL-1040 back (9-1211 6) aa'omsm APW RR DC IR Schedule Page 2 Step 3: Figure your refundable credit Earned Income Credit 10 a Enter the amount of federal EIC as shown on your federal Form 1040, Line 66a; federal Form 1040A, Line 42a; or federat Form 1040EZ, Line 8a. 10a .00 Multiply the amount on Line 10a by 10% (.10). 10b .00 Illinois residents: Enter 1.0. Nonresidents and part~year residents: Enter the decimal from Schedule NR, Line 48. 100 (1 Multiply Line 10b by the decimal on Line 100. 10d .00 11 Enter the amount from Line 10d here. This is your lilinois Earned Income Credit. Enter this amount on Form lL-1040, Line 29. 11 .00 continued - K-12 Education Expense Credit Worksheet (continued from Step 2, Section B) You must complete this section and attach any receipt you received from your student?s school. 12 Complete the following information for each of your qualifying students. if a student attended more than one qualifying school during the caiendar year. please list separately. If you need more space, attach a separate piece of paper following this format. A Student?s name Social Security number Grade School name School city Total tuition, (K-12 only) (IL K-12 schools only or enter (IL cities only) bookllabfees ?home school," if applicable) 13 Add the amounts in Column for Lines 12a through 12j (and the amounts from Column of any additionat pages you attached). This is the total amount of your quaiified education expenses for this year. Enter this amount here and on Step 2, Line 7a of this schedule. "9 13 00 This form is authorized as outlined under the income Tax Act. Disclosure of ID: 3WM this information is required. Failure to provide information could result in a penalt . 1L-1040 Scheduie back .. 1040 orm Department of the Treasury? Internal Revenue Service U.S. Individual Income Tax Return (99) Ia ?15 For the year Jan. l?Dec. 31, 2015, or other tax year beginning 2015, ending OMB No. 154543074 Use Only?Do not write or staple in this space. I See separate instructions. Your social security number Your ?rst name and initial Last name Daniel Biss if a joint return. spouse?s first name and initial Last name Karin Steinbrueck Spouse's social security number Home address (number and street). if y0u have a PO. box. see instructions. Apt. no. A Make Sure the above City, town or post office, state. and ZIP code. If you have a foreign address, also complete spaces below (see instructions). and on line 60 are correct; Presidential Election Campaign Check here if you. or your spouse ii filing Foreign ocuntry name Foreign province/stateleounty Foreign postal code jointly. want 83 to go to this fund. Checking a box below will not change your tax or remndr a You Spouse Filing Status Check only one box. 1 2 8] Married filing jointly (even if only one had income) 3 Married filing separately. Enter sp0use?s SSN above i1 Single and full name here. 4 [3 Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child's name here. 5 CI Qualifying widow(er) with dependent child Exemptions XI Yourself. if someone can claim you as a dependent, do not check box 6a . 6a Boxes checked on Ga and 6b 2 XI Spouse . . . . . . . . . I. . . No. of c?ildren . if child under age 17 on So o: Dependents' (2) Dependent Dependem qualifying for child tax credit lived with you 2 social security number relationship to you (1) First name Last name (see instructions) 0 did not live with Elliot A 83138 Son 3:23;:r3iglilvorce If more than four Theodore Biss 9 Son (see instructions) gapencientsl 598 Dependents on 60 instructions and not entered above check here [3 Add numbers on Total number of exemptions claimed . lines above 4 Income 7 Wages, salaries, tips, etc. Attach Form(Taxable interest. Attach Schedule if required . . . . 3 8 8 . Tax-exempt interest. Do not include on line 8a . I 8b I 93 Ordinary dividends. Attach Schedule if required . . . . 4 1 . attach Forms Qualified dividends . . I 9b I w?2e and 10 Taxable refunds. credits, or offsets of state and local income taxes 2 15 . 1099-8 if tax 11 Alimony received . . . . . . . . . was Withheld' 12 Business income or (loss). Attach Schedule Capital gain or (loss). Attach Schedule it required. If not required. check here 13 3 0 9 . 'f ?ouv??dznot 14 Other gains or (losses). Attach Form 4797 . . . . . . . 14 15a distributions 158 Taxable amount 15!) 16a Pensions and annuities 16a Taxable amount 16b 17 Rental real estate, royalties, partnerships, corporations, trusts, etc. Attach Schedule t? 2 372 . 18 Farm income or (loss). Attach Schedule . 18 19 Unemployment compensation . . . . . 19 20a Social security benefits I 20a I Taxable amount 20b 21 Other income. List type and amount 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income Educator expenses . . . . . . . . 23 AdIUSted 24 Certain business expenses of reservists, performing artists, and Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24 Income 25 Health savings ac00unt deduction. Attach Form 8889 25 26 Moving expenses. Attach Form 3903 . . 26 27 Deductible part of self-employment tax. Attach Schedule 8 27 28 Self-employed SEP, SIMPLE. and Qualified plans 28 29 Seif~employed health insurance deduction 29 30 Penalty on early withdrawal of savings . 30 31a Alimony paid Recipient?s SSN 31a 32 IRA deduction . . . . 32 33 Student loan interest deduction . 33 1 . 34 Tuition and fees. Attach Form 8917. . . . 34 35 Domestic production activities deduction. Attach Form 8903 35 36 Add lines 23 through Subtract line 36 from line 22. This is your adjusted gross income For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. 3AA REV 12130115 Form 1040 (2015) Form 1040 (2015) Page 2 38 Amount from line 37 (adiusted gross incomeTax and 398 Check You were born before January 2, 1951, :1 Blind, Totai boxes . if: Spouse was born before January 2, 1951. Biind. checked 393 Credits . . . if your spouse itemizes on a separate return or you were a duet-status alien, check here} Standard itemized deductions (from Schedule A) or your standard deduction (see ieft margin) 15 047 . a?c?mtwn 4t Subtract line 40 from line People who 42 Exemptions. if line 38 is $154,950 or ?653. multipiy $4,000 by the number on iine 6d. Otherwise, see instructions 3. 6 0 0 . (6230:5235- 43 Taxable income. Subtract tine 42 from line 41. it line 42 is more than tine 41, enter -0- 3 8 2 83 . ?g??agge? 44 Tax (doe instructions). Check if any from: a Form(s) 8814 Form 4972 4 7 66 . claimed as a 45 Alternative minimum tax (see instructions)- Attach Form 6251 235mm" 46 Excess'?idvance premium tax credit repayment. Attach Form 8962 . . . . . instruciims- 47 Add lines 44Ail others: . . . . Single or 48 Foreign tax credit. Attach Form 1116 if recurred . . . . 48 Married filing 49 Credit for child and dependent care expenses. Attach Form 2441 49 seParately? 50 Education credits from Form 8863, line Married filing 51 Retirement savings COntributions credit. Attach Form 8880 51 52 Child tax credit. Attach Schedule 8812, if requiredResidential energy credits. Attach Form 5695 . 53 Head of 54 Other credits from Form: a El 3800 8801 Cl 54 55 Add lines 48 through 54. These are your total credits . . . . . . . . 2 02 0 56 Subtract iine 55 from ?ne 47. If line 55 is more than iine 47, enter -Self-employment tax. Attach Schedule Other 58 Unreported sociai security and Medicare tax from Form: a 4137 8919 Taxes 59 Additionai tax on IRAs. other qualified retirement plans. etc. Attach Form 5329 if required 60a Househcid employment taxes from Schedule . . . . . . . . . . . . . . 60a First-time homebuyer credit repayment. Attach Form 5405 it required . . . . . . . . 60b 61 Heaith care: individual responsibility (see instructions} Full?year coverage . 62 Taxes from: a Form 8959 Form 8960 0 Instructions; enter code(3) UT 29 . 63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . 2 7 75 . Payments 64 Federai income tax withheld from Forms W2 and 1099 . . 64 5 140 . 65 2015 estimated tax payments and amount applied from 2014 return 65 If yo.? have a 66a Earned income credit (EEC66a quaiifying chiid? attach Nontaxable combat pay eiection 66%) Schedule EC. 67 Additional child tax credit. Attach Schedule 8812 . . . . . 67 68 American opportunity credit from Form 8863, line 8 . . . 68 69 Net premium tax credit. Attach Form 8962 . . . . . . 69 70 Amount paid with request for extension to file . . . . . 70 Excess sociai security and tier 1 RRTA tax withheld . . . . 71 72 Credit for federai tax on fuels. Attach Form 4136 . . . . 72 73 Credits from Form: a CI 2439 Resaved 8885 Cl 73 74 Add lines 64, 65, 66a, and 67 thr0ugh 73. These are your total payments . . . . . 5 1 4 0 Refund 75 If ?ne 74 is more than line 63, subtract tine 63 from line 74. This is the amount you overpaid 2 365 . 763 Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . 763 2 365 . Direct deposit? Routing number I I I i . kc Type: I Checking Sayings see . Account number 77 Amount of line 75 you want appiied to your 2016 estimated tax I 77 I Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions 73 YOU Owe 79 Estimated tax penalty (see instructionsThird party Do you want to allow another person to discuss this return with the IRS (see instructions)? [1 Yes. Compiete below, Designee 2:22?? tartaric?: Under penalties of periury, i declare that have examined this return and accompanying schedules and statements. and to the best of my knowledge and belief, Here they are true. correct. and compiete. Deciaration of preparer (other than taxpayer) is based on all information of which preparer has any knowiedge. Your Signature Date Your occupation Daytime phone number see State Senator Keep a copy for Spouse's signature. if a joint return, both must sign. Date Spouse's occupation if the this sent you an identity Protection Candidate Paid Print/Type preparer?s name Preparer's signature Date Check if PTIN Preparer self-employed Use Only Firm's name Self?Prepared Firm?s EIN Firm?s address Phone no. REV imonsmtuacgopsp Form 1040 (2015) . . .1 4 74 $5335 A Itemized Deductions if; information about Schedule A and its separate instructions is at epartment of the Treasury Attachment internal Revenue Service (99) VAttach to Form 1040. Sequence Na 07 Name(s) shown on Form 1040 Your social security number Daniel Biss Karin Steinbrueck Caution: Do not include expenses reimbursed or paid by others. Medical 1 Medical and dentai expenses (see instructions) 1 and 2 Enter amount from Form 1040, line 38 i 2 Dentai 3 Multiply line 2 by 10% (.10). But if either you or your spouse was Expenses born before January 2, 1951, muitiply line 2 by 7.5% (.075) instead 4 Subtract line 3 from tine 1. if tine 3 is more than line 1, enter -0- . Taxes You 5 State and local (check only one box): Paid a Income taxesGeneral sates taxes 6 Real estate taxes (see instructionsPersonal property taxes . . . . 7 - 8 Other taxes. List type and amount 8,017. Interest 10 Home mortgage interest and points reported to you on Form 1098 6 889 . You paid 11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions Note: and show that person?s name, identifying no., and address Your mortgage interest deductiOn may be ?miied (889 12 Points not reported to you on Form 1098. See instructions for special ruies . . . . . . . . . . 12 13 Mortgage insurance premiums (see instructions) . . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Addiines10through146,889. Gifts to 16 Gifts by cash or check. if you made any gift of $250 or more, Charity see instructionsIfyou made a 17 Other than by cash or check. it any gift of $250 or more, see gift and got a instructions. You must attach Form 8283 if over $500 . 17 3.4 1 . bene?t for it; 18 Carryover from prior year 18 see 19 Add lines 16 through 18 . 141. Casualty and Theft Losses 20 Casualty or theft ioss(es). Attach Form 4684. (See instructions.) . Expenses 21 Unreimbursed employee expenseswjob travel, union dues, and Certain job education, etc. Attach Form 2106 or 2106-EZ 11 required. . Miscellaneous (See instructions.) 21 9 3 - 22 Tax preparation fees . . . . . . . . . . . 127 . 23 Other expensesminvestment, safe deposit box, etc. List type and amount 23 24 Add lines 21 through 220. 25 Enter amount from Form 1040, line 38 l25l 69 330. 26 Multiply tine 25 by 2% (.02387. 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- 0 . Other 28 Other?from list in instructions. List type and amount Miscellaneous Deductions Total 29 is Form 1040, tine 38, over $154,950? Itemized No. Your deduction is not limited. Add the amounts in the far right column Deductions for tines 4 through 28. Also, enter this amount on Form 1040, line 40. 29 15 04 7 . Yes. Your deduction may be limited. See the itemized Deductions Worksheet in the instructions to figure the amount to enter. 30 if you elect to itemize deductions even though they are less than your standard deduction, check here . . For Paperwork Redu ction Act Notice, see Form 1040 instructions. BAA REV12r?a-Uil51ntutogdp5p Schedule A (Form 1040) 2015 SCHEDULE (Form 1040) Supplemental Income and Loss 1 (From rental real estate, royalties, partnerships, corporations, estates, trusts, etc.) Attach to Form 1040, 1040MB, or Form 1041. Department of the Treasury lntemal Revenue Service (99) Information about Schedule and its separate instructions is at OMB No. 1545-0074 @@15 Attachment Sequence No. 13 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number income or Loss From Rental Real Estate and Royalties Note: if you are in the business of renting personai property. use Scheduie or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. A Did you make any payments in 2015 that wouid require you to file Form(s) 1099? (see instructions) If ?Yes,? did you or will you file required Forms 1099? Yes Yes No DNO 1a Physicai address of each property (street, city, state, ZIP code) A 712 W. Vine Street Champaign IL 61820 ?3 TYPE Of Property 2 For each rental real estate property listed Fair Renta? Personal Use QJV (from ?st begow) above, report the number of fair rental and Days Days personal use days. Check the QJV box A "l only ityou meet the requirements quaii zed somt venture. See instructions. 8 [j 0 El Type of Preperty: 1 Single Family Residence 3 Rental 5 Land 7 Self?Rental 2 Multi-Family Residence 4 Commercial 6 R0 alties 8 Other (describe) Income: Properties: A 3 Rents received 3 8 4 0 . 4 Royalties received . 4 Expenses: 5 Advertising . . . . . 5 6 Auto and travel (see instructions) 6 7 Cleaning and maintenance 7 1 208 . 8 Commissions. 8 9 insurance490, 10 Legal and other professionai fees . 10 11 Management fees . . . . . . . . . . 11 12 Mortgage interest paid to banks, etc. (see instructions) 12 7 07 . 13 Other interest. 13 14 Repairs. 14 15 Supplies 15 16 Taxes Utilities148. 18 Depreciation expense or depletion . . . . . 18 0 . 19 Other (list) 19 20 Total expenses. Add lines 5 through Subtract line 20 from line 3 (rents) and/or 4 (royalties). lf result is a (loss), see instructions to find out if you must tileForm6198 . . . . . . . . . 21 2,372. 22 Deductible rental real estate loss after limitation, if any, on Form 8582 (see instructions23a Total of alt amounts reported on line 3 for all rental properties 23a 8 400 . Total of ali amounts reported on line 4 for all royalty properties 23b 0 Total of all amounts reported on line 12 for all properties 230 1 7 07 . Total of all amounts reported on line 18 for ali properties 23d 0 . Total of all amounts reported on line 20 for all properties . . . 23e 6 i 028 - 24 Income. Add positive amounts shown on line 21. Do not include any losses . . . . . 24 2 372 . 25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here 25 26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. if Parts IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17. or Form 1040NR, line 18. Otherwise. include this amount in the total on line 41 on page For Paperwork Reduction Act Notice, see the separate instructions. BAA REV 12123115 Schedule (Form 1 040) 2015 Education Credits (American Opportunity and Lifetime Learning Credits) Attach to Form 1040 or Form 1040A. Form Department of the Treasury internal Revenue Service (99) information about Form 8863 and its separate instructions is at OMB No. 1545-0074 2?15 Attachment Sequence No. 50 Name(s) shown on return Daniel Biss Karin Steinbrueck CAUTION before you complete Parts I and II. Your social security number Complete a separate Part on page 2 for each student for whom you are claiming either credit Refundable American Opportunity Credit 1 After completing Part ill for each student, enter the total of alt amounts from all Parts line 30 2 Enter: $180,000 if married filing jointly; $90,000 if single, head of household, widow(erEnter the amount from Form 1040, line 38, or Form 1040A, line 22. 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 . . . . . . . . 3 4 Subtract line 3 from line 2. If zero or less, st0p; you cannot take any education credit . . . 4 5 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, orqualifyingwidow(erline4 is: 0 Equal to or more than line 5, enter 1.000 on line Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to at least three places) 7 Multiply line 1 by line 6. Caution: if you were under age 24 at the end of the year and meet the conditions described in the instructions, you cannot take the refundable American opportunity credit; skip line 8, enter the amount from line 7 on line 9, and check this box . . . . 8 Refundabie American Opportunity credit. Multiply line 7 by 40% (.40). Enter the amount here and on Form 1040, line 68, or Form 1040A, line 44. Then go to line 9 below. 8 Nonrefundable Education Credits 9 Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) 9 10 After completing Part Ill for each student, enter the total of all amounts from all Parts ill, line 31. If zero, skip tines 11 through 17, enter on line 18, and go to iine 19 100 . 11 Enter the smaller of line 10 or $10,000 100 . 12 Muitiply line 11 by 20% (.20Enter: $130,000 if married filing jointly; $65,000 if singie, head of household, or qualifying widow(erEnter the amount from Form 1040, line 38, or Form 1040A, line 22. 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 . . . . . . . . 14 69 330 . 15 Subtract line 14 from line 13. if zero or less, skip lines 16 and 17, enter oniine18,andgotoline19 . . . . . . . . . . . . . . . 15 60,670. 16 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, orqualifying widow(er20,000. 17 if line 15 is: 0 Equal to or more than line 16, enter 1.000 on line 17 and go to line 18 0 Less than line 16, divide line 15 by line 16. Enter the resuit as a decimal (rounded to at ieast three places). 1.000 18 Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) 20 . 19 Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet (see instructions) here and on Form 1040, line 50, or Form 1040A, line 33 19 20 . For Paperwork Reduction Act Notice, see yoor tax return instructions. BAA REV 12/2015 Form 8863 (2015) Form 8863 (2015) Name(s) shown on return Daniel Biss Karin Steinbrueck A CAUTION each student. Page 2 Your social security number Complete Part for each student for whom you are claiming either the American opportunity credit or lifetime learning credit. Use additional copies of page 2 as needed for See instructions. Student and Educational Institution information 20 22 Student name (as shown on page 1 of your tax return) Karin Steinbrueck Educational institution information (see instructions) a. Name of first educational institution Northwestern University 21 Student sociai security number (as shown on page 1 of your tax return) b. Name of second educational institution (if any) (1) Address. Number and street (or PO. box). City, town or post office, state, and code. If a foreign address, see instructions. 555 Clark Street Evanston IL 602081221 (1) Address. Number and street (or PO. box). City, town or post office, state, and ZIP code. If a foreign address, see instructions. (2) Did the student receive Form 1098-T Yes No from this institution for 2015? (2) Did the student receive Form from this institution for 2015? Yes No (3) Did the student receive Form from this institution for 2014 with Box Yes No 2 filied in and Box 7 checked? (3) Did the student receive Form from this institution for 2014 with Box 2 Yes [3 N0 filled in and Box 7 checked? If you checked ?No? in both (2) and (3), skip (4). (4) if you checked ?Yes? in (2) or (3), enter the institution?s federal identification number (from Form if you checked ?No? in both (2) and (3), skip (4). (4) if you checked ?Yes? in (2) or (3), enter the institution?s federal identification number (from Form 1098?1). 36?2167817 23 Has the Hope Scholarship Credit or American opportunity . . . Yes w- Stop! credlt been claimed for this student for any 4 tax years Go to ?ne 31 forms student NO Go to ?ne 24. before 2015? 24 Was the student enroiled at least bait-time for at least one academic period that began or is treated as having begun in 2015 at an eligibie educational institution in a program . I . leading towards a postsecondary degree, certificate?[1831 other recognized postsecondary educational credential? (see instructions) 25 Did the student complete the first 4 years of postsecondary Yes Stop! education before 2015 (see instructions)? Go to line 31 for this No Go to line 26. student. 26 Was the student conwcted, before the end of 2015, of a Yes _.stop1 I NO Compgete?nes 27 felony for possession or distribution of a controiled I: Go to line 31 for this through 30 for this Student substance? student. You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year. If you complete lines 27 through 30 for this student, do not complete line 31. American Opportunity Credit 27 Adjusted quaiified education expenses (see instructions). Do not enter more than $4,000 . . . . 27 28 Subtract $2,000 from line 27. If zero or less, enter line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29 and enter the result. Skip line 31. Include the total of all amounts from ail Parts lil, line 30, on Part l, iine 1 . 30 Lifetime Learning Credit 31 Adjusted qualified education expenses (see instructions). Include the total of ail amounts from all Parts ill, line 31, on Part II, line 10 . . 31 100. Form 8863 (2015) lilinois Department of Revenue 2015 Form lL-1040 lndividuai Income Tax Return or for fiscai year ending Over 80% of taxpayers fiie electronically. it is easy and you get your refund faster. Visit 1 Staple your check and Staple W-2 and 1099 forms here Step 1 Persona! Information 00 We above in- Daniel Biss Karin Steinbrueck - status (see instructions) Single or head or household Married jointly Married iiling 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. You Spouse Step 2: 1 Federal adjusted gross income from your US. 1040, Line 37; US. 1040A. Line 21; or Who?? douars on'V) income US. 1040EZ, Line 4 1 69 33 0.00 2 Federally tax-exempt interest and dividend income from your US. 1040 or 1040A, Line 8b; or US. 104082 2 .00 3 Other additions. Attach Schedule M. 3 4 Total income. Add Lines 1 through 3. 4 69 330.00 Step 3: Social Security benefits and certain retirement plan income Base received if inciuded in Line 1. Attach Page 1 of federai return. 5 .00 |ncome 6 iliinois Income Tax overpayment included in US. 1040. Line 10 6 23.5 .00 7 Other subtractions. Attach Scheduie M. 7 388 .00 Check if Line 7 includes any amount from Schedule 1299-C. 1:1 8 Add Lines 5, 6, and 7. This is the total of your subtractions. 8 6 03 9 Illinois base income. Subtract Line 8 from Line 4. 9 67 7 27 .00 Step 4: 10 a Number of exemptions from yourfederai return A $2,150 a 3 600 .00 Exemptions If someone can claim you as a dependent, see instructions. $2,150 00 Check if 65 or older: You Spouse $1,000 0 .00 Check if legally blind: You Spouse $1,000 00 Exemption allowance. Add Lines a through d. 10 8 600 .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 Nonresident Part-year resident, and enter the illinois base income from Schedule NR. Attach Schedule NR. 12 00 Step 6: 13 Residents: Multiply Line 11 by 3.75% (.0375). Cannot be less than zero. Tax Nonresidents and part?year residents: Enter the tax from Schedule NRRecapture of investment tax credits. Attach Scheduie 4255. 14 .00 15 income tax. Add Lines 13 and 14. Cannot be less than zeroStep 7: 16 Income tax paid to another state while an resident. I Tax After Attach Schedule CR. 16 .00 New 17 Property tax and K-12 education expense credit amount from refundabie Schedule ICR. Attach Schedule ICR. 17 295 00 credits 18 Credit amount from Schedule 1299-0. Attach Schedule 1299?0. 18 00 19 Add Lines 16. 17, and 18.This is the total of your credits. Cannot exceed the tax amount on Line 15. 19 2 95 .00 20 Tax after nonrefundable credits. Subtract Line 19 from Line 15. 20 . 922 .00 ID: 3WM REVOIIWIS front [This form is authorized as outlined under the illinois income Tax Act. Disclosure 01 this information is re uired. Faiiure to provide information could resuit in a oenalt . 21 Tax after nonrefundable credits from Page 1, Line 20 21 I 9 22 .00 Step 8: 22 Househotd employment tax. See instructions. 22 other 23 Use tax on internet, mail order, or other out-of?state purchases from Taxes UT Worksheet or UT Table in the instructions. Do not leave blank. 23 38 .99 24 Compassionate Use of Medical Cannabis Pilot Program Act Surcharge 24 .00 25 Total Tax. Add Lines 21Step 9: 26 Illinois Income Tax withheld. Attach all W-2 and 1099 forms. 26 2 I 1 6 .00 Payments 27 Estimated payments from Forms IL-1040-ES and lL-505-l, and including any overpayment appiied from a prior year return 27 .99 Refuwable 28 Pass-through withholding payments. Attach Schedule K-1-P or K-1-T. 28 no cred? 29 Earned Income Credit from Schedule lCFl. Attach Schedule 29 .129 30 Total payments and refundable credit. Add Lines 26 through 29. 3O 2 6 .00 Step 10: 31 Overpayment. If Line 30 is greater than Line 25, subtract Line 25 from Line 30. 31 156 129 Result 32 Underpayment. If Line 25 is greater than Line 30, subtract Line 30 from Line 25. 32 in} Step 11: 33 Late~payment penalty for underpayment of estimated tax 33 (it; Underpayment a Check if at least two-thirds of your federal gross income is from farming. of Estimated Tax Check if you or your spouse are 65 or older and permanently Penalty and living in a nursing home. Donations . . . . 0 Check If your income was not received evenly during the year and you annuaiized your income on Form lL-2210. Attach Form Check if you were not required to file an illinois individual Income Tax return in the previous tax year. El 34 Voluntary charitable donations. Attach Schedule G. 34 35 Total penalty and donations. Add Lines 33 and 34. 35 Step 12: 36 if you have an overpayment on Line 31 and this amount is greater than petund or Line 35, subtract Line 35 from Line 31 . This is your remaining overpayment. 36 156 .00 Amount YOU 37 Amount from Line 36 you want refunded to you. Check one box on Line 38. See instructionschoose to receive my refund by :VRouting number I I I I I Illinois Individual Income Tax refund debit card El paper check 39 Amount to be applied to estimated tax. Subtract Line 37 from Line 36. See instructions. 39 0 00 40 If you have an underpayment on Line 32, add Lines 32 and 35. or If you have an overpayment on Line 31 and this amount is less than Line 35, subtract Line 31 from Line 35. This is the amount you owe. See instructions. 40 gig} Step 13: Under penalties of perjury, I state that I have examined this return, and, to the best of my knowledge, it is true, correct, and complete. Sign and Date Your signature Date Daytime phone number Your spouse?s signature Date Self~Prepared Paid preparers signature Date Preparers phone number Preparers FEIN. SSN, or PTIN Third Party Check, and complete the designee?s name and phone number below, to allow another person to discuss this return Designee and any previous return that affects the liability reported on this return with the Illinois Department of Revenue. Designee's name (please print) Designee?s phone number Form 1099-(5 It you are unable to obtain your Form from our website, you may check the box to receive a paper 1099-(3 form Information next year. We will mail you a 1099-6 form if you meet the criteria requiring us to issue one to you. If no payment enclosed, mail to: If payment enclosed, mail to: DEPARTMENT OF REVENUE ILLINOIS DEPARTMENT OF REVENUE lL-1040 bad< (Ft-12115) REV RR DC IR Illinois Department of Revenue 2G15 Schedule Other Additions and Subtractions for Individuals Attach to your Form lL-1040 1L Attachment No, 15 Read this information first Complete this schedule if you are required to add certain income on Form lL-i040, Line 3, or if you are entitled to take subtractions on Form IL-1040, Line 7. It you are required to complete Schedule 1299-0, Schedule F, or Form IL-4562, you must do so before you complete this schedule. Step 1: Provide the following information Daniel Biss Karin Steinbrueck Your name as shown on Form IL-1040 our Sociai Security number Step 2: Figure your additions for Form lL-1040, Line 3 Enter the amount of (Whole dollars 0W) 1 Your chiid?s federally tax-exempt interest and dividend income as reported on US. Form 8814 1 2 Distributive share of additions you received from a partnership, corporation, trust, or estate. Attach iliinois Schedule K-1-P or Schedule K-1-T. 2 .00 3 Lloyds pian of Operations loss, it reported on your behalf on Form IL-1065 and included in your adjusted gross income 3 4 Earnings distributed from Section 529 college savings and tuition programs it not included in your adjusted gross income (Do not include distributions from ?Bright Start,? ?Bright Directions,? or ?College Illinois? programs or programs that meet certain disclosure requirements - see instructions.) 4 .00 5 illinois speciai depreciation addition amount from Form IL-4562, Step 2, Line 4. Attach Form iL-4562. 5 6 Business expense recapture (nonresidents oniy) 6 7 Recapture of deductions for contributions to lilinois college savings pians transferred to an out-of-state pian 7 8 Credit taken on Schedule 12990 for student~assistance contributions you made as an empioyer 8 .00 9 Recapture of deductions for contributions to college savings plans withdrawn for nonqualified expenses or refunded 9 00 10 Other income identify each item 10 .09 11 Total Additions. Add Lines 1 through 10. Enter the amount here and on Form IL-1040, Line 3. 11 .00 Step 3: Figure your subtractions for Form lL-1040, Line 7 Enter the amount of 12 Contributions made to the following coliege savings plans: a ?Bright Start? College Savings Pool 123 .00 ?College Illinois? Prepaid Tuition Program 12b 0 ?Bright Directions" Coliege Savings Pool 120 .m 13 Distributive share of subtractions from a partnership, corporation, trust, or estate. (Do not claim these same subtractions on any other line of this scheduie. See instructions.) Attach lliinois Schedule K-1 -P or K-1-T identifying you as the partner, sharehoider, or beneficiary and iisting your Social Security number. 13 .00 14 Restoration of amounts held under claim of right under Internal Revenue Code, Section 1341 14 .00 15 Contributions to a job training project 15 mg) 16 Expenses related to federal credits or federally tax~exempt income 16 ?$10 17 Interest earned on investments through the Home Ownership Made Easy Program 17 18 lliinois special depreciation subtraction amount from Form lL-4562, Step 3, Line 10. Attach Form iL-4562. 18 09 Enter the following only it included in Form lL?1040, Lines 1, 2, or 3: 19 Military pay earned. Attach military 19 .90 20 US. Treasury bonds, biils, notes, savings bonds, and US. agency interest from US. 1040A or 1040. Attach a copy of US. 1040A or 1040, Scheduie B, if required federallyAugust 1, 1969, valuation limitation amount from your Schedule F, Line 17. Attach Schedule and required federai forms. 21 .00 22 River edge redeveiopment zone and high impact business dividend subtraction amount from your Scheduie 1299-0, Step 2, Line 7. Attach Schedule 1299-0. 22 23 Add Lines 12a through 22 and enter the amount here and on Page 2, Line 24. 23 388 .00 Step 3: Continued 3'me wE Standard Itemized deductions (from Schedule A) or your standard deduction (see left marginSubtract line 40 from line People who 42 Exemptions. Ii line 38 is $152, 525 or less. multiply 950 by the number on line 8d Otherwise, see instructions ggicgna?i'e 43 Taxable Income. Subtract line 42 from line 41. if line 42 is more than tine 41, enter -Tax (see instructions). Check if any from; a Form(s) 8814 Form 4972 2 629 . claimed as a 45 Alternative minimum tax (see instructions). Attach Form 6251 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . instructions 47 Add lines 5:232er 48 Foreign tax credit Attach Form 1116 if required . . . 48 Married filing 49 Credit for child and dependent care expenses Attach Form 2441 49 separately, 50 Education credits from Form 8863, line 19 . . . . 50 Married tiling 51 Retirement savings contributions credit Attach Form 8880 51 52 Child tax credit. Attach Schedule 8812, if required. 52 2 oo 330383 53 Residential energy credits. Attach Form 5695 . . . . 53 Head of 54 Other credits from Form: 3 Ci 3800 Ci 8801 54 gg?saa?told, 55 Add lines 48 through 54. These are your total credits . . . . . 2 000 - 56 Subtract line 55 from line 47 if line 55 is more than line 47 enter -Self-employment tax. Attach Schedule Other 58 Unreported social security and Medicare tax from Form: a 4137 8919 Taxes 59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 60a Household employment taxes from Schedule . . 603 First-time homebuyer credit repayment. Attach Form 5405 if required . 60b 61 Health care: individual responsibility {see instructions) Full-year coverage 62 Taxes from: a Form 8959 [3 Form 8960 instructions; enter code(s) 63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . 629 . Payments 64 Federal income tax withheld from Forms and 1099 . . 64 3 '7 53 . 2014 estimated tax payments and amount applied from 2013 return 65 if you have a 663 Earned income credit 66a qualifying child, attach Nontaxable combat pay election i 66b i SChedUie EIC- 67 Additional child tax credit. Attach Schedule 8812 . . . . . 67 68 American opportunity credit from Form 8863, line 8 . . . 68 69 Net premium tax credit. Attach Form 8962 . . . . . . 69 70 Amount paid with request for extension to file . . . . . 70 71 Excess social security and tier 1 RRTA tax withheld . . . . 71 72 Credit for federal tax on fuels. Attach Form 4136 . . . . 72 73 Credits from Form: a El 2439 Reserved 0 Reserved 73 74 Add lines 64, 65. 66a, and 67 through 73. These are y0ur total payments . . . . . 3 '7 53 . Refund 75 If line 74 is more than line 63, subtract tine 63 from line 74. This is the amount you overpaid 3 24 . 76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here 76a 3 124 . Direct deposit? Routing number >cType: El Checking Savings F339 5 Account number 77 Amount of line 75 you want applied to your 2015 estimated tax i 77 Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions 73 You owe 79 Estimated tax penalty (see instructionsThird Party Do you want to allow another person to discuss this return with the (see instructions)? Yes. Complete below. No . Designee?s Phone Personal identification DeSIgnee name no. number (PIN) a? I I Sign 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, Her they are true. correct. and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. 8 Your signature Date Your occupation Daytime phone number Joint return? See instructions, State Senator Keep a copy for Spouse's signature. If a joint return, both must sign. Date Spouse's occupation IRS sent you an identity Protection . .enter it your fecordS- Candidate here (seeinst.)i i Print/T re arer?s name Pr r' PTIN Pald YD l3 l3 epae aure ae Check Dif self-em lo ed Preparer USE Only Firm 3 name Self-Prepared Firm EIN Firm's address Phone no. REV osnonsmmupsp Form 1040 (2014) SCHEDULE A (Form 1040) Department of the Treasury Itemized Deductions internal Revenue Service (99) >Attach to Form 1040. Name(s) shown on Form 1040 Daniel Biss Karin Steinbrueck Information about Schedule A and its separate instructions is at OMB No. 1545~0074 2?14 Attachment Sequence No. 07 Your social security number Caution. Do not include expenses reimbursed or paid by others. Medical 1 Medical and dental expenses (see instructions) and 2 Enter amount from Form 1040, line 38 [2 Dental 3 Multiply line 2 by 10% (.10). But if either you or your spouse was Expenses born before January 2, 1950, multiply line 2 by 7.5% (.075) instead 4 Subtract line 3 from line 1. It line 3 is more than line 1, enter -0- . Taxes You 5 State and locai (check only one box): Paid a Elncometaxesmr . . . . . . . . . . . 5 2,346. General sales taxes 6 Real estate taxes (see instructions) 5 7 50 . 7 Personal property taxes . 8 Other taxes. List type and amount 8,096. Interest 10 Home mortgage interest and points reported to you on Form 1098 7 3 6 7 . You Paid 11 Home mortgage interest not reported to you on Form 1098. if paid to the person from whom you bought the home. see instructions Note- and show that person?s name. identifying no., and address Your mortgage interest deduction may be limited (see 12 Points not reported to you on Form 1098. See instructions for instructions). special rulesMortgage' Insurance premiums {see instructionsInvestment interest. Attach Form 4952 if required. {See instructions.) 14 15 Add linesiothrough 14. 7,367. Gifts to 16 Gifts by cash or check if you made any gift of $250 or more, Charity see instructions . . 16 6 5 0 . if you made a 17 Other than by cash or check. if any gift of $250 or more, see gift and got a instructions. You must attach Form 8283 if over $500 . . . 17 92 . bent?? for it; 18 Carryover from prior year . . - . . . . . . . . . 18 see 19 Add lines 16 through 18 . 1 742 . Casualty and Theft Losses 20 Casualty or theft |oss(es). Attach Form 4684. (See instructions.) . 30?) Expenses 21 Unreimbursed employee expenses?job travel, union dues, and Certain job education, etc. Attach Form 2106 or 2106-EZ if required. Miscellaneous (See instructions) 21 12- Deductions 22 Tax preparation fees . . . . . 90 . 23 Other expenses?investment, safe deposit box, etc. List type and amount 24 Add lines 21 through 23Enter amount from Form 1040, line 38 l25l 56 875 . 26 Multiply line 25 by 2% (02Subtract line 26 from line 24. if line 26 Is more than line 24 enter 0-- . . 0 . Other 28 Other?from list In instructions. List type and amount Miscellaneous Deductions Total 29 Is Form 1040, line 38, over $152,525? Itemized No. Your deduction is not limited. Add the amounts in the far right column Deductions for lines 4 through 28. Also, enter this amount on Form 1040, line 40. CI Yes. Your deduction may be limited. See the itemized Deductions Worksheet in the instructions to figure the amount to enter. 30 It you elect to itemize deductions even though they are less than your standard For Paperwork Reduction Act Notice, see Form 1040 instructions. BAA REV Schedule A (Form 1040) 2014 SCHEDULE Supplemental Income and Loss OMB No. 1545-0074 (Form 1040) (From rental real estate, royalties, partnerships, corporations, estates, trusts, REMICs, etc.) 2 1 4 Department of the Treasury Attach to Form 1040' or .Form 1041' Attachment (mama: Revenue Service {99) InformatIon about Schedule and Its separate Instructions Is at Sequence No. 13 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number Income or Loss From Rental Real Estate and Royalties Note. if you are in the business of renting personal property, use Schedule or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. A Did you make any payments in 2014 that would require you to file Form(s) 1099? (see instructions) If ?Yes," did you or will you file required Forms 1099Physical address of each property (street, city, state, code) A 7 12 W. Vine Street Champaign IL 61820 113 Type Of Property 2 For each rental real estate property listed Fair Rental Personal Use JV (from list below) above, report the number of fair rental and Days Days personal use days. Check the QJV box A 1 only if you meet the requirements to file as A 35 5 0 a quali ed joint venture. See instructions. Type of Property: 1 Single Family Residence 3 Vacation/Short-Term Rental 5 Land 7 Self-Rental 2 Multi?Family Residence 4 Commercial 6 R0 alties 8 Other (describe) income: 1 Properties: A 3 Rents received 3 8 400 . 4 Royalties received . 4 Expenses: 5 Advertising . 5 6 Auto and travel (see instructions) 6 7 Cleaning and maintenance 7 48 0 . 8 Commissions. 8 9 insurance. . 9 48 . 10 Legal and other professional fees . 10 11 Management fees 11 12 Mortgage interest paid to banks etc. (see instructionsOther interest. 13 14 Repairs. 14 15 Supplies 15 16 Taxes 16 2 453 . 17 Utilities . . 17 164 . 18 Depreciation expense or depletion . 18 . 19 Other( (list) 19 20 Total expenses. Add lines 5 through Subtract line 20 from line 3 (rents) and/or 4 (royalties). if result is a (loss), see instructions to find out if you must file Form 6198 . . . 21 1 354 . 22 Deductible rental real estate loss after limitation, if any, on Form 8582 {see instructions) . . 22 23a Total of all amounts reported on line 3 for all rental properties 23a 8 4 0 0 Total of all amounts reported on line 4 for all royalty properties 23b 0 Total of all amounts reported on line 12 .for all properties 23c 2 4 6 8 Total of all amounts reported on line 18 for all properties 23d 0 Total of all amounts reported on line 20 for all properties 23s 7 I 04 5 24 Income. Add positive amounts shown on line 21. Do not include any losses 24 354 . 25 Losses. Add royalty losses from line 2t and rental real estate losses from line 22 Enter total losses here 25 26 Total rental real estate and royalty Income or (loss). Combine lines 24 and 25. Enter the result here. It Parts ll, N, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 104ONR, line l8. Otherwise, include this amount in the total on line 41 on page 2. 26 1 354 - For Paperwork Reduction Act Notice, see the separate instructions. BAA REV 12mm Schedule (Form 1040) 2014 Individual income Tax Return or for fiscal year ending .. Over 80% of taxpayers ?le electronically. it is easy and you will get your refund faster. Visit talelinois. gov. illinois Department of Revenue 2014 Form lL~1040 Step 1: Personal Information Do not write above this line. Ill? I '?i'w'll 'r 1. rl 'li. Daniel Biss Karin Steinbrueck Filing status (see instructions) Single or head of household Married filing jointly Married filing separately El 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. You El Spouse Step 2: 1 Federal adjusted gross income from your US. 1040, Line 37; US. 1040A, Line 21; or (Who'e dog'als on?) Income U.S.1040EZ, Line 4 1 55 825 .00 2 Federally tax-exempt interest and dividend income from your US. 1040 or 1040A, Line 8b; or US 1040EZ 2 in 3 Other additions. Attach Schedule M. 3 4 Total income. Add Lines 1 through 3. 4 56 875 Step 3: 5 Social Security benefits and certain retirement plan income Base received if included in Line 1. Attach Page 1 of federal return. 5 00 lncome 6 Illinois Income Tax overpayment included in US. 1040, Line 10 6 .00 7 Other subtractions. Attach Schedule M. 7 .00 Check if Line 7 includes any amount from Schedule 1299-0. l3 8 Add Lines 5, 6, and 7. This is the total of your subtractions. 8 9 Illinois base income. Subtract Line 8 from Line 4. 9 56 875 Step 4: 10 a Number of exemptions from your federal return $2,125 a 8 500 00 Exemptions If someone can claim you as a dependent, see instructions. $2,125 1) 00 0 Check if 65 or older: You Spouse $1,000 .00 Check if legally blind: You Spouse $1,000 mi Exemption allowance. Add Lines a through d. 10 8 500 00 Step 5: 11 Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12Nonresidents and part-year residents: Check the box that applies to you during 2014 Nonresident 1:1 Part-year resident, and enter the lilinois base income from Schedule NR. Attach Schedule NR. 12 00 Income Step 6: 13 Residents: Multiply Line 11 by 5% (.05). Cannot be less than zero. Staple your check and 9 Staple and 1099 forms here Tax Nonresidents and part-year residents: Enter the tax from Schedule NRRecapture of investment tax credits. Attach Schedule 4255. 14 .012 15 income tax. Add Lines 13 and 14. Cannot be less than zero. 15 2 .4 1. 9 .00 Step 7: 16 Income tax paid to another state while an ltlinois resident. Tax After Attach Schedule CR. 16 .1112 Non- 17 Preperty tax and K-12 education expense credit amount from refundabfe Scheduie ICR. Attach Schedule 17 288 .00 Credits 18 Credit amount from Schedule 1299-0. Attach Schedule 18 .00 19 Add Lines 16, 17, and 18. This is the total of your credits. Cannot exceed the tax amount on Line 15. 19 MM 20 Tax after nonrefundable credits. Subtract Line 19 from Line 15. 20 2 131.00 lD: REVO:I301:5In1uiI.cg.clp.sp 10.1040 front This form is authorized as outlined under the Income Tax Act, Disclosure of this information is uir . Failure to rovide information could result in a enalt . 21 Tax after nonrefundable credits from Page t, Line 20 21 2 . 1 3 ,00 Step 3: 22 Househoid emptoyment tax. See instructions. 22 .99 Other 23 Use tax on internet, mait order, or other out-of?state purchases from Taxes UT Worksheet or UT Table in the instructions. Do not ieave blank. 23 3 3 24 Compassionate Use of Medical Cannabis Pilot Program Act Surcharge 24 ,00 25 Total Tax. Add Lines 21Step 9: 26 illinois income Tax withheld. Attach all and 1099 forms. 26 2 . 346 .00 Payments 27 Estimated payments from Forms and and including any overpayment applied from a prior year return 27 Refundable 28 Pass-through entity tax payments. Attach Schedule or K-1-T. 28 .09 Credit 29 Earned Income Credit from Schedule iCFi. Attach Schedule 10R. 29 .99 30 Total payments and retundabie credit. Add Lines 26 through 29. 30 2 34 6 90 3:99 10: 31 Overpayment. It Line 30 is reater than Line 25, subtract Line 25 from Line 30. 31 mm 9 Result 32 Underpayment. if Line 25 is greater than Line 30, subtract Line 30 from Line 25. 32 00 Step 11: 33 Late?payment penalty for underpayment of estimated tax 33 .99 Underpayment a Check if at least two-thirds of your federai gross income is from farming. of Estimated Tax Check if you or your spouse are 65 or older and permanently Penalty and living in a nursing home. Donations . . . . 0 Check if your income was not received evenly during the year and you annuaiized your income on Form IL-2210. Attach Form lL-2210. Check if you were not required to file an lliinois individual Income Tax return in the previous tax year. 34 Vciuntary charitable donations. Attach Schedule G. 34 .09 35 Total penalty and donations. Add Lines 33 and 34. 35 Step 12: 36 If you have an overpayment on Line 31 and this amount is greater than Refund or Line 35. subtract Line 35 from Line 31 . This is your remaining overpayment. 36 17 7 00 Amount YOU 37 Amount from Line 36 you want refunded to you. Check one box on Line 38. See instructionschoose to receive my refund by direct deposrt Comptete the information below it you check this box Routing number L-.. XChecking orD Sayings Illinois income Tax refund debit card El paper check 39 Amount to be applied to estimated tax. Subtract Line 37 from Line 36. See instructions. 39 40 If you have an underpayment on Line 32, add Lines 32 and 35. or If you have an overpayment on Line St and this amount is less than Line 35, subtract Line 31 from Line 35. This is the amount you owe. See instructions. 40 33! Step 13; Under penalties of perjury, state that have examined this return, and, to the best of my knowledge, it is true, correct, and . complete. Sign and Date Your signature Date Daytime phone number Your spouse's signature Date Self-Prepared Paid preparer's signature Date Preparers phone number Preparers FEIN. SSN. or Third Party Check, and complete the designee?s name and phone number beiow, to allow another person to discuss this return Designee and any previous return that affects the liability reported on this return with the Illinois Department of Revenue. Designee's name (please print) Designee's phone number Form 1099-G If you are unable to obtain your Form 1099-(3 from our website, you may check the box to receive a paper form information next year. We will mail you a form if you meet the criteria requiring us to issue one to you. If no payment enclosed, mail to: If payment enclosed, mail to: DEPARTMENT OF REVENUE DEPARTMENT OF REVENUE iD? 3WM SPRINGFIELD 1L 62719-0001 SPRINGFIELD IL 62726-0001 imam-Wm Wm RR DC Illinois Department of Revenue 2014 Schedule Credits Attach to your Form lL-1040 IL Attachment No. 23 Read thIS Information ?(St 0 You must compiete Form iL-1040 through Line 15 and Complete this schedule only if you are eligible for the Schedule CR, if applicable, before completing this schedule. . lliinois Property Tax Credit 0 The total amount of Illinois Property Tax Credit and K-12 Education Expense Credit cannot exceed tax. Only the Ed 1' Ex d't ucaron pe se re I Earned Income Credit may exceed tax. 0 Earned Income Credit (EIC) Step 1: Provide the following information Daniel Biss Karin Steinbrueck . .. . . Your name as shown on your Form Your Social Security number Step 2: Figure your nonrefundable credit 1 Enter the amount of tax from your Form iL?1040, Line 15Enterthe amount of credit for tax paid to other states from your Form lL-1040, Line 16. 2 .00 3 Subtract Line 2 from Line 1. 3 2 4 19 00 Section A - tilInOIs Property Tax Credit (See instructions for dIrecttons on how to obtain your property number) 4 a Enter the total amount of lliinois Property Tax paid during the tax year for the real estate that includes your principal residence. 4a 5 750 .00 Enter the county and property number for the property tisted above. 4b COOK 05?33?321?057?0000 County Property number 0 Enter the county and property number for an adjoining lot, it included in Line 4a. 4c County Property number Enter the county and property number for another adjoining lot, if included in Line 4a. 4d County Property number Enter the portion of your tax bill that is deductible as a business expense on US. income tax forms or schedules, even if you did not take the federal deduction. 4e 0 .00 Subtract Line 4e from Line 4a. 4f 5 750.00 9 Multiply Line 4r by 5% (.05). 49 288 .00 5 Compare Lines 3 and 49, and enter the tesser amount here. 5 288 .00 6 Subtract Line 5 from Line 3 6 2 131 .00 Sectlon K-12 Education Expense Credit You must complete the K-12 Education Expense Credit Worksheeton the back of this schedule and attach any receipt you received from your student?s school. 7 a Enterthe total amount of K-12 education expenses from Line 13 of the worksheet on the back of this schedule. 7a .00 You may not take a credit for the first $250 paid. 7b 250.00 Subtract Line 7b from Line 7a. If the result is negative, enter ?zero.? 70 .00 Multipty Line 70 by 25% (.25). Compare the result and $500, and enter the lesser amount here. 7d .00 8 Compare Lines 6 and 7d and enter the lesser amount here 8 .00 Section Total Nonrefundable CredIt 9 Add Lines 5 and 8.This is your nonrefundable credit amount. Enter this amount on Form lL-1040, Line 17. 9 288 .00 Peg? at lL-1040 Schedule ICR front (Ft-12114) Schedule lCFi Page 2 Step 3: Figure your refundable credit Earned Income Credit 10 a Enter the amount of federal as shown on your US 1040, Line 66a; U.S. 1040A, Line 42a; or U.S. 1040EZ, Line 8a. 10a .00 Muttiply the amount on Line 10a by 10% (.10). 10b .00 0 Illinois residents: Enter 1.0. Nonresidents and part-year residents: Enter the decimal from Schedule NR, Line 48. 100 Multipiy Line 10b by the decimal on Line 100. 10d .00 11 Enter the amount from Line 10d here. This is your illinois Earned Income Credit. Enter this amount on Form lL-1040, Line 29. I-F 11 .00 Section Continued - K-12 Education Expense Credit Worksheet (continued from Step 2, Section B) You must complete this section and attach any receipt you received from your student?s school. 12 Comptete the following information for each of your qualifying students. If a student attended more than one qualifying school during the calendar year, please list separately. If you need more space, attach a separate piece of paper foltowing this format. A Student?s name Social Security number Grade School name School city Total tuition, (K-12 only) (It. K-12 schools oniy or enter (Ii. cities only) booidlabfees ?home school,? if applicable) 13 Add the amounts in Column for Lines 12a through 12} (and the amounts from Column of any additional pages you attached). This is the total amount of your qualified education expenses for this year. Enter this amount here and on Step 2, Line 7a of this schedule. 13 .00 This form is authorized as outlined under the illinois income Tax Act. Disclosure oi 3WM FlEVOi/161l5lnnzit.cg.dp.sp this information is re uired. Failure to provide information could result in a penalt Schedule ICR back 1040 Department of the Treasury??Internal Revenue Service U.S. Individual Income Tax Return For the year Jan. 1?090. 31, 2013, or other tax year beginning (99) [eo13 ,2013, ending OMB No. 1545-0074 20 IRS Use Only?Do not write or staple in this space. See separate instructions. Your ?rst name and initiai Last name Your social security number Daniel Bis it a joint return, spouse's first name and initial Last name Spouse's social security number Karin Steinbrueck Home address (number and street). if you have a PO. box, see instructions. Foreign country name Apt. no. A Make sure the above and on line 60 are correct. City, wn pt of?c, . nd code. if you have a foreign address, also complete spaces below (see instructions). Foreign province/state/county Foreign postal code Presidential Election Campaign Check here if you, or your spouse if filing jointly. want $3 to go to this fund. Checking a box below will not change you tax or refund. You 8) Spouse Filing Status Check only one box. 1? [3 Single 2 8} Married jointly (even if only one had income) 3 Married separately. Enter spouse?s SSN above and full name here. 4 Head of household (with quaiifying person). (See instructions.) if the Quaiifying person is a chiid but not your dependent, enter this child's name here. 5 [j Qualifying widow(er) with dependent child Exemptions 6a g] Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . gg?easaigegged spouse . - . . (4) ifchiid undo-rage? Elliot A Biss Son gaggamggme If more than four Theodore Biss Son (see instructions) _m dependlems? see Dependents on 60 Instruotlons and not entered above web check here Add numbers on Total number of exemptions ciaimed . lines above 4 Income 7 Wages. salaries, tips, etc. Attach Form(Taxable interest. Attach Schedule if required . . . . Tax-exempt interest. Do not include on line 8a . . 1 8b 9a Ordinary dividends. Attach Schedule if required . . . . . . 43 . attach Forms Qualified dividends . . Taxabie refunds, credits, or offsets of state and local income taxes 2 68 . 10994? if tax 11 Alimony received . . . . . . . . . . . . . . . . was Withheld 12 Business income or (loss). Attach Schedule or C-Capital gain or (loss). Attach Schedule it required. If not required, check here El 13 97 . If ?ou?dznot 14 Other gains or (losses). Attach Form 4797 . . . . . . . 14 2:8 ?nst;u?tions_ 15a IRA distributions 15a Taxable am0unt 15b 16a Pensions and annuities 16a to Taxable amount 16b 17 Rental real estate, royaities, partnerships, corporations, trusts, etc. Attach Schedule 17 - 6 64 . 18 Farm income or (loss). Attach Schedule . 18 19 Unemployment compensation . . . . . . 19 203 Social security benefits i 20a I Taxabie amount 20b 21 Other income. List type and amount 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income Educator expenses . . . . . . . . 23 AdIUSted 24 Certain business expenses of reservists, performing artists. and Gross tee-basis government of?cials. Attach Form 2106 or 2106-EZ 24 Income 25 Heatth savings account deduction. Attach Form 8889 25 26 Moving expenses. Attach Form 3903 26 27 Deductible part of setf?em ployment tax. Attach Schedule 8 27 28 Seifuemployed SEP, SIMPLE, and quali?ed plans 28 29 Self?employed heaith insurance deduction 29 30 Penalty on early withdrawal of savings . 30 31a Aiimony paid Recipient?s SSN 31a 32 IRA deduction . . . . 32 33 Student loan interest deduction . 33 34 Tuition and fees. Attach Form 8917. . . . 34 35 Domestic production activities deduction. Attach Form 8903 35 I 36 Add tines 23 through Subtract line 36 from line 22. This is your adjusted gross income 37 54 2 1 8 . For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. 8AA nev 02114114 Tl?Mac Form 1040 (2013) Form 1040 {2013) Page 2 Tax and 38 Amount from line 37 (adiusted gross incomecredits 39a Check [3 You were born before January 2, 1949, Blind. }Tota| boxes if: Spouse was born before January 2, 1949, Blind. checked I 39a Standard to if your Spouse itemizes on a separate return or you were a dual-status aiien. check here} 39b[:l 251mm" it) Itemized deductions (from Schedule A) or your standard deduction (see left margin) 2 0 502 . People who 41 Subtract line 40 from line 33;, 7 16 . ggicgn??z'e 42 Exemptions. If line 38 is $150,000 or less. multiply $3,900 by the number on line 8d. Otherwise, see instructions 1 5 6 0 0 - aigejra?ggem 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -O- 43 8 6 . 33933;? 44 Tax (see instructions). Check it any from: a El Form(s) 8814 [3 Form 4972 Alternative minimum tax (see instructions). Attach Form 6251 . 45 ?Swab??- 46 Add lines Foreign tax credit. Attach Form 1116 if reduired . 47 Married filing 48 Credit for child and dependent care expenses. Attach Form 2441 48 se?arate'y? 49 Education credits from Form 8863, line Married filing 50 Retirement savings contributions credit. Attach Form 8880 50 2 0 . 51 Child tax credit. Attach Schedute 8812, if required. 51 1 544 . gg??a 52 Residential energy credits. Attach Form 5695 52 - Head or 53 Other credits from Form: a 3800 El 8801 El 53 househowt 54 Add lines 47 through 53. These are your totai credits . . . . 3. 80 4 . 55 Subtract line 54 from line 46. It line 54 is more than tine 46, enter -0- 0 . Other 56 Self?employment tax. Attach Schedule Taxes 57 Unreported social security and Medicare tax from Form: a 4137 El 8919 58 Additional tax on IRAs, other qualified retirement pians, etc. Attach Form 5329 if required 59a Househoid employment taxes from Schedule . . . First~tirne homebuyer credit repayment. Attach Form 5405 if required . 60 Taxes from: a Cl F0rm 8959 Form 8960 instructions; enter code(5) 61 Add lines 55 through 60. This is your total tax . . . 0 . Payments 62 Federal income tax withheld from Forms W-2 and 1099 2013 estimated tax payments and amount applied from 2012 return If bave 8? 64a Earned income credit 2:592:23? Nontaxable combat pay election 1 64b I Schedule EIC. 65 Additional child tax credit. Attach Schedule 8812 66 American opportunity credit from Form 8863, line 8 . 67 Reserved. . .. 68 Amount paid with request for extension to file 69 Excess sociai secmity and tier 1 RRTA tax withheld 70 Credit for federal tax on fuels. Attach Form 4136 71 Credits from Form: a E12439 Reserved 8885 Cl 72 Add lines 62, 63, 64a, and 65 through 71. These are your total payments 4 1 39 . Refund 73 It line 72 is more than line 61, subtract line 61 from tine 72. This is the amount you overpaid 4 18 9 . 74a Amount of line 73 you want refunded to you. if Form 8888 is attached, check here 748 4 8 9 . Direct deposit? Routing number >cType: Checking El savings iifmc?ons Account number 75 Amount of line 73 you want applied to your 2014 estimated tax I 75 I Amount 76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions 75 You owe 77 Estimated tax penalty (see instructions) . . 77 I Third Party 00 you want to aliow another person to discuss this return with the (see instructions)? CI Yes. Compiete below. No Designee Designee's Phone Personal identification name no. number (PIN) Sign Under penalties of periury, I deciare that have examined this return and accompanying schedules and statements. and to the best of my knowledge and belief. Here they are true. correct. and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Joint return? See signature Date Your occupation Daytime phone number instructions. State Senator Keep a copy for >Spouse?s signature. if a joint return, both must sign. Date Spouse?s occupation If the IRS sent you an identity Protection your records. PIN, enter it Graduate Student here (see inst.) ai preparer?s name Preparer?s signature Date Check if PTIN Preparer self-employed Use only Firrn's name Self?Prepared Firm?s Finn?s address Phone no. REV 02/14/14 Form 1040 (2013) 3.3?33325 A itemized Deductions 0g? 1545 0074 Information about Schedule A and its separate instructions is at 1 3 epartment of the Treasury Attachment Internal Revenue Service (99) Attach to Form 1040. Sequence No 07 Name(s) shown on Form 1040 Your social security number Daniel Biss Karin Steinbrueck A. Caution. Do not include expenses reimbursed or paid by others. Medical 1 Medicai and dentai expenses (see instructions) 1 and 2 Enter amount from Form 1040, line 38 2 i Dental 3 Muitipiy line 2 by 10% (.10). But if either you or your spouse was Expenses born before January 2, 1949, multiply line 2 by 7.5% (.075) instead 4 Subtract line 3 from line 1. if line 3 is more than line 1, enter -0- . Taxes You 5 State and iocai (check oniy one box): Paid 3 income taxes, or 5 2 324 . Generai sales taxes 6 Reai estate taxes (see instructionsPersonal property taxes . . . . 8 Other taxes. List type and amount 8,036. interest 10 Home mortgage interest and points reported to you on Form 1098 7 8 15 . You paid 11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions Note. and show that person?s name, identifying no., and address Your mortgage interest -. deductiOn may F99 limited (see 12 Points not reported to you on Form 1098. See instructions for mswaionS)? special rulesMortgage insurance premiums (see instructions) . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Addline810through1410,699. Gifts to 16 Gifts by cash or check. if you made any gift of $250 or more, Charity see instructions"you made a 17 Other than by cash or check. If any gift of $250 or more, see gift and got a instructions. You must attach Form 8283 if over $500 . 17 1 02 . ben??t for ?9 18 Carryover from prior year 18 See '?5W0t'ons' 19 Add lines to through 18 . 1, 002 . Casualty and Theft Losses 20 Casuaity ortheft loss(es). Attach Form 4684. (See instructions.) . Expenses 21 Unreimbursed emptoyee expenseswjob travel, union dues, and Certain job education, etc. Attach Form 2106 or 2106-EZ if required. Miscellaneous (See instructions.) 21 1: 75 7 - Deductions 22 Tax preparation fees . . . . . . . . . . . . . 92 . 23 Other expenses?investment, safe deposit box, etc. List type and amount 24 Addiines21through231,849. 25 Enter amount from Form 1040, line 38 125) 54 218 . 26 Multiply iine25 by21,084. 27 Subtract line 26 from iine 24. if line 26 is more than line 24, enter 765 . Other 28 Other?from list in instructions. List type and amount 3* Miscellaneous Deductions Total 29 Is Form 1040, tine 38, over $150,000? itemized No. Your deduction is not limited. Add the amounts in the far right column Deductions for tines 4 through 28. Also, enter this amount on Form 1040, line 40Yes. Your deduction may be limited. See the itemized Deductions Worksheet in the instructions to figure the amount to enter. 30 if you eiect to itemize deductions even though they are iess than your standard deduction, check here . For Paperwork Reduction Act Notice, see Form 1040 instructions. 8AA REV 02114/14 Tl?Mac Schedule A (Form 1040) 2013 SCHEDULE (Form 1040) Department of the Treasury lntemal Revenue Service (99) Supplemental Income and Loss (From rental real estate, royalties, partnerships, corporations, estates, trusts, etc.) Attach to Form 1040, 1040MB, or Form 1041. information about Schedule and its separate instructions is at OMB No. 1545-0074 2?13 Attachment Sequence No. 13 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personal property, use Schedule or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40. A Did you make any payments in 2013 that would require you to file Form(s) 1099? (see instructions) Yes No if ?Yes,? did you or will you file required Forms 1099? [3 Yes Cl No la Physical address of each property (street, city, state, code) A 7 12 W. Vine Street Champaign IL 61820 0 1b Type of Property 2 For each rental real estate property listed Fair Rental Personal Use QJV (from list bebw) above, report the number of fair rental and Days Days personal use clays. Check the QJV box A "2 only ifiyou meet the requirements to file quail led 50int venture. See Instructions. 3 Type of Property: 1 Single Family Residence 3 Vacation/Short-Term Rental 5 Land 7 Self-Rental 2 Multi?Family Residence 4 Commercial 6 R0 alties 8 Other (describe) income: Properties: A 3 Rents received 3 8 4 00 . 4 Royalties received . 4 Expenses: 5 Advertising . . . . . 5 6 Auto and travel (see instructions) 6 7 Cleaning and maintenance 7 7 85 . 8 Commissions. 8 9 Insurance442. 10 Legal and other professional fees . 10 11 Management fees . . . . . . . . . . 11 12 Mortgage interest paid to banks, etc. (see instructionsOther interest. 13 14 Repairs. 14 15 Supplies 15 16 Taxes 16 2 4O 7 . 17 Utilities117. 18 Depreciation expense or depletion . Other (list) 19 20 Total expenses. Add lines 5 through Subtract line 20 from line 3 (rents) and/or 4 (royalties). if result is a (loss), see instructions to find out if you must fileForm6198 . . . . . . . . . 21 ?664. 22 Deductible rental real estate loss after limitation, if any, on Form 8582 (see instructions233 Total of all amounts reported on line 3 for all rental properties 23a 8 4 0 0 . Total of all amounts reported on line 4 for all royalty properties 23b Total of all amounts reported on line 12 for all properties 23c 2 525 - Total of all amounts reported on line 18 for all properties 23d 2 7 88 Total of all amounts reported on line 20 for all properties . . . 23e 9 0 64 . 24 income. Add positive amounts shown on line 21. Do not include any losses . . . . . 24 25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here 25 664 . 26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. if Parts ll, W, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 104ONR. line 18. Otherwise. include this amount in the total on line 41 on page 2. 26 ?6 64 . For Paperwork Reduction Act Notice, see the separate instructions. BAA REV 02/14/14 Schedule (Form 1040) 2013 SCHEDULE 8812 (Form 1040A or 1040) Child Tax Credit Department of the Treasury Internal Revenue Service (99} Attach to Form 1040, Form 1040A, or Form 1040NR. information about Schedule 8812 and its separate instructions is at OMB No. 1545-0074 2013 Attachment Sequence No. 47 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number ??lers Who Have Certain Child Dependent(s) with an ITIN (individual Taxpayer identification Number) Complete this part oniy for each dependent who has an ITIN and for whom you are claiming the child tax credit. If. your dependent does not qualify for the credit, you cannot include that dependent in the caicuiation of this credit. Answer the following questions for each dependent listed on Form 1040, line 6c; Form 1040A, line 6c; or Form 2040NR, line 7c, who has an ITIN (Individuai Taxpayer Identification Number) and that you indicated qualified for the child tax credit by checking column (4) for that dependent. A For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit. did this child meet the substantial presence test? See separate instructions. Yes No For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions. El Yes El No For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test? See separate instructions. El Yes Cl No For the fourth dependent identified with an FUN and listed as a quaiifying child for the child tax credit. did this child meet the substantial presence test? See separate instructions. Ci Yes No Note. If you have more than four dependents identi?ed with an ITIN and listed as a qualifying chitd for the child tax credit. see the instructions and check here Park It Additional Child Tax Credit Filers 1 1040 ?lers: Instructions for Form [040, iine 51). 1040A ?lers: Instructions for Form 1040A. line 33). 1040NR filers: Instructions for Form 1040NR. line 48). Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Enter the amount from line 6 of your Child Tax Credit Worksheet (see the Enter the amount from iine 6 of your Child Tax Credit Worksheet (see the If you used Pub. 972. enter the amount from line 8 of the Child Tax Credit Worksheet in the publication. Enter the amount from Form 1040, line 51; Form 1040A, line 33; or Form tine 48 3 Subtract tine 2 from time i. If zero. stop; you cannot take this credit . 4a Earned income (see separate instructions) Nontaxable combat pay (see separate instructions) - i4bi 1 2,000. Is the amount on line 4a more than $3,000? No. Leave line 5 blank and enter on line 6. Yes. Subtract $3.000 from the amount on line 4a. Enter the result . 6 Multiply the amount on tine 5 by 15% (.15) and enter the result Next. Do you have three or more qualifying children? 1,544456. 43 54,474. 51,474. 7 721. El N0. If line 6 is zero, stop; you cannot take this credit. Otherwise. skip Part and enter the smaller of line 3 or line 6 on line 13. Yes. If line 6 is equal to or more than line 3, skip Part and enter the amount from line 3 on line 13. Otherwise, go to line 7. For Paperwork Reduction Act Notice, see your tax return instructions. 8AA REV 02/14/14 'n'Mac Schedule 8812 (Form 1040A or 1040) 2013 Schedule 8812 (Form 1040A or 1040) 2013 Page 2 Certain Filers Who Have Three or More Qualifying Children 7 Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2. boxes 4 and 6. If married filing jointly, include your spouse?s amounts with yours. If your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes. see separate instructions . 7 8 1040 ?lers: Enter the total of the amounts from Form 1040. lines 27 and 57. plus any taxes that you identified using code and entered on line 60. 1040A filers: Enter -0-. 8 10403331319?: Enter the total of the amounts from Form 104ONR. lines 27 and 55. plus any taxes that you identified using code and entered on line 59. 9 Add lines 7 and 8 . 9 10 1040 filers: Enter the total of the amounts from Form 1040, lines 6421 and 69. 1040A filers: Enter the total of the amount from Form 1040A, line 3821, plus any excess social security and tier 1 RRTA 10 taxes withheld that you entered to the left of Zine 41 see separate instructions). 1040NR ?lers: Enter the amount from Form 104ONR, line 65. 11 Subtract line 10 from line 9. If zero or less. enter -0- 12 Enter the larger of line 6 or line 11 . . . Next, enter the smaller of line 3 or line on line 13. Additional Child Tax Credit 13 This is your additional child tax credit . . . . L13 456 . Enter this amount on Form [040. line 65, Form 1040A. line 39, or Form 1040NR, line 63. REV Schedule 8812 (Form 1040A or 1040) 2013 Education Credits 8863 Department of the Treasury Internal Revenue Service (99) Attach to Form 1040 or Form 1040A. (American Opportunity and Lifetime Learning Credits) information about Form 8863 and its separate instructions is at OMB No. 1545-0074 2?13 Attachment Sequence No. 50 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social security number A CAUTION before you complete Parts I and Il. Complete a separate Part on page 2 for each student for whom you are claiming either credit Refundable American Opportunity Credit '1 After completing Part ill for each student, enter the total of all amounts from all Parts line 30 10 0 . 2 Enter: $180,000 if married filing jointly; $90,000 it single, head of househoid, or qualifying widow(erEnter the amount from Form 1040, line 38, or Form 1040A, iine 22. if you are filing Form 2555, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . . 3 54 218 . 4 Subtract line 3 from line 2. It zero or iess, stOp; you cannot take any educationcredit . . . . . . . . . . . . . . . . 4 125,782. 5 Enter: $20,000 if married filing jointly; $10,000 if single, head of household, orquaiifyingwidow(er20,000. 6 if line 4 is: - Equal to or more than line 5, enter 1.000 on line Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded Multiply line 1 by line 6. Caution: If you were under age 24 at the end of the year and meet the conditions described in the instructions, you cannot take the refundable American opportunity credit; skip line 8, enter the amount from line 7 on line 9, and check this box 100 . 8 Refundable American Opportunity credit. Multiply line 7 by 40% (.40). Enter the amount here and on Form 1040, line 66, or Form 1040A, line 40. Then go to line 9 belowNonrefundabie Education Credits 9 Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) 9 6 0 . 10 After completing Part ill for each student, enter the total of all amounts from all Parts Ill, line 31. If zero, skip lines 11 through 17, enter -0- on line 18, and go to line 19 11 Enter the smaller of line 10 or $10,000 12 Muitiplyiine11 by 20% (.20Enter: $127,000 if married filing jointly; $63,000 if single, head of household, or qualifying widow(erEnter the amount from Form 1040, line 38, or Form 1040A, line 22. it 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 . . . . . 14 15 Subtract line 14 from line 13. If zero or less, skip lines 16 and 17, enter -0- online18,andgotoline19 . . . . . . . . . . . . 15 16 Enter: $20,000 if married filing jointly; $10,000 it single, head of household, orqualifyingwidow(erline 15 is: 0 Equal to or more than line 16, enter 1.000 on fine 17 and go to line 18 0 Less than line 16, divide line 15 by line 16. Enter the result as a decimai (rounded to at least three 18 Multiply line 12 by tine 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) 19 Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet (see instructions) here and on Form 1040, line 49, or Form 1040A. line 31 19 60 . For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 02/14/14 ?I'i'Mac Form 8863 (2013) Form 8863 (2013) Page 2 Name(s) shown on return Daniel Biss Karin Steinbrueck A CAUTION each student. Your social security number Complete Part for each student for whom you are claiming either the American opportunity credit or lifetime learning credit. Use additional capies of Page 2 as needed for Student and Educational institution information See instructions. Student name (as shown on page i of your tax return) Karin Steinbrueck Educational institution information (see instructions) a. Name of first educational institution 20 22 Northwestern University 21 Student sociai security number (as shown on page 1 of your tax return) b. Name of second educational institution (if any) (1) Address. Number and street (or PO. box). City, town or post office, state, and ZIP code. If a foreign address, see instructions. 1881 Sheridan Road Evanston IL 60201 (1) Address. Number and street (or P.O. box). City, town or post office, state, and code. If a foreign address, see instructions. (2) Did the student receive Form from this institution for 2013? (3) Did the student receive Form 1098?"? from this institution for 2012 with Box Yes N0 2 filled in and Box 7 checked? if you checked ?No? in both (2) and (3), skip (4). (4) if you checked ?Yes? in (2) or (3), enter the institution's federal identification number (from Form 1098-1). Yes No Did the student receive Form 1098-T from this institution for 2013? Did the student receive Form from this institution for 2012 with Box 2 Cl Yes El N0 filled in and Box 7 checked? if you checked ?No? in both (2) and (3), skip (4). (4) if you checked ?Yes? in (2) or (3), enter the institution's federal identification number (from Form 1098?1). (2) Yes No (3) 36-2167817 23 Has the Hope Scholarship Credit or American opportunity Yes Stop! credit been claimed for this student for any 4 tax years Go to line 31 forthis student. No Go to line 24. before 2013? 24 Was the student enrolled at least half?time for at least one academic period that began in 2013 at an eligibie educational institution in a program leading towards a Yes Go to line 25. No Stop! Go to line 31 postsecondary degree, certificate, or other recognized for this student. postsecondary educational credential? (see instructions) 25 Did the student complete the first 4 years of post-secondary Yes Stop! education before 2013? Go to iine 31 for this No Go to line 26. student. 26 Was the student convicted, before the end of 2013, of a yes Stop! NO See Tip beiow and felony for possession or distribution of a controlled Go to line 31 for this complete either lines 27-30 substance? student. or line 31 for this student. do not complete line 31. When you figure your taxes, you may want to compare the American opportunity credit and lifetime learning credits, and choose the credit for each student that gives you the lower tax liability. You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year. If you complete lines 27 through 30 for this student, American Opportunity Credit Adjusted qualified education expenses (see instructions). Do not enter more than $4,000 27 100 . 28 Subtract $2,000 from line 27. If zero or less enter iine 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29 and enter the resuit. Skip line 31. include the total of ail amounts from all Parts Ill, line 30 on Part 1, line 1 30 100 . Lifetime Learning Credit 31 Adjusted qualified education expenses (see instructions). include the total of ail amounts from ali Parts Ill, iine 31, on Part ll, iine 10 31 Form 8863 (2013) Form Department of the Treasury internal Revenue Service Nameis) shown on return Credit for Qualified Retirement Savings Contributions Attach to Form 1040, Form 1040A, or Form 1040MB. information about Form 8880 and its instructions is at Daniel Biss Karin Steinbrueck You cannot take this credit if either of the following applies. OMB No. 1545-0074 @0313 Attachment Sequence No. 54 Your social security number dependent on someone else?s 2013 tax return, or was a student (see instructions). 0 The amount on Form 1040, line 38; Form 1040A, line 22; or Form line 37 is more than $29,500 ($44,250 if head of household; $59,000 if married filing jointly). - The personis) who made the qualified contribution or elective deferral was born after January 1, 1996, is claimed as a You Your spouse 1 Traditional and Roth IRA contributions for 2013. Do not inciude roliover contributions . . . . . . . . . . . . . . . 1 5 2 Eiective deferrals to a 401 or other qualified employer plan, voluntary employee contributions, and 501(c)(18)(D) pian contributions for 2013 (see instructionsAdd linesi and2 . . . . . . . . . . . . . . 3 5,000. 4 Certain distributions received after 2010 and before the due date (including extensions) of your 2013 tax return (see instructions). If married filing jointly, inciude both spouses? amounts in both columns. See instructions for an exception . . 4 5 Subtract tine 4 from line 3. if zero or toes, enter -each column, enter the smaller of line 5 or $2,000 . . . . . . 6 2 0 . 7 Add the amounts on line 6. if zero, stop; you cannot take this credit 2 000 . 8 Enter the amount from Form 1040, line 38*; Form 1040A, line 22; or Form 1040NR, line Enter the applicable decimai amount shown below: If line 8 is? And your filing status is-? But not Married Head of Single, Married filing Over? filing Jomtly household separately, or over? Enter on line Quaiifying Wid0W(er) $17,750 .5 .5 .5 $17,750 $19,250 .5 .5 .2 $19,250 $26,625 .5 .5 .1 1 $26,625 $28,875 .5 .2 .1 $28,875 $29,500 .5 .1 .1 $29,500 $35,500 .5 .1 .0 $35,500 $38,500 .2 .1 .0 $38,500 $44,250 .1 .1 .0 $44,250 $59,000 .1 .0 .0 $59,000 .0 .0 .0 Note: if line 9 is zero, stop; you cannot take this credit. 10 Multiply line7by|ine9 . . . . . . . . . . . . . . . . . . . . . . . 10 200. 11 Limitation based on tax liability. Enter the amount from the Credit Limit Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 11 1 I 744 12 Credit for qualified retirement savings contributions. Enter the smaller of tine 10 or line 11 here and on Form 1040, line 50; Form 1040A, line 32; or Form 1040NR, line 47 12 200 *See Pub. 590 for the am0unt to enter if you are Form 2555, 2555-EZ, or 4563 or you are exciuding income from Puerto Rico. For Paperwork Reduction Act Notice, see your tax return instructions. 3AA nev 02114111:an Form 8880 (2013) Form Attach to Form 1040 or Form 1040MB. Department of the Treasury lntemal Revenue Service (99) information about Form 2106 and its separate instructions is available at Unreimbursed Employee Business Expenses OMB No. 1545-0074 2?13 Attachment Sequence No. 129A Your name Daniel Biss State Senator Occupation in which you incurred expenses Social security numbir You Can Use This Form Only if All of the Following Apply. 0 You are an employee deducting ordinary and necessary expenses attributable to your job. An ordinary expense is one that is common and accepted in your field of trade, business, or profession. A necessary expense is one that is helpful and appropriate for your business. An expense does not have to be required to be considered necessary. 0 You do not get reimbursed by your employer for any expenses (amounts your employer included in box 1 of your Form W-2 are not considered reimbursements for this purpose). 0 if you are claiming vehicle expense, you are using the standard mileage rate for 2013. Caution: You can use the standard mileage rate for 207 3 only if: you owned the vehicle and used the standard mileage rate for the first year you placed the vehicle in service, or you leased the vehicle and used the standard mileage rate for the portion of the lease period after 1997. Figure Your Expenses 1 Complete Part ll. Multiply line 8a by 56.5c (.565). Enter the result here . 1 6 16 . 2 Parking fees, tolls, and transportation, including train, bus, etc, that did not involve overnight travel or commuting to and from work 2 3 Travel expense while away from home overnight, including lodging, airplane, car rental, etc. Do not include meals and entertainment . . . . . . . . 3 . 4 Business expenses not included on lines 1 through 3. Do not include meals and entertainment 4 1 4 1 . 5 Meals and entertainment expenses: 0 . 50% (.50). (Employees subject to Department of Transportation (DOT) hours of service limits: Multiply meal expenses incurred while away from home on business by 80% (.80) instead of 50%. For details, see instructions.) 5 6 Total expenses. Add lines 1 through 5. Enter here and on Schedule A (Form 1040), line 21 (or on Schedule A (Form 1040MB), line 7). (Armed Forces reservists, fee-basis state or local government officials, qualified performing artists, and individuals with disabilities: See the instructions for special rules on where to enter this amountInformation on Your Vehicle. Complete this part only if you are claiming vehicle expense on line 1. 7 When did you place your vehicle in service for business use? (month, day, year) @1393} 8 Of the total number of miles you drove your vehicle during 2013, enter the number of miles you used your vehicle for: a Business Commuting (see instructions) Other ??41299 9 Was your vehicle available for personal use during off-duty hours? . Yes No 10 Do you (or your spouse) have another vehicle available for personal useyou have evidence to support your deduction? Xi Yes No it ?Yes,? is the evidence written? El Yes No For Paperwork Reduction Act Notice, see your tax return instructions. 3AA REV 02/14ll4 For 2106-EZ (2013) Depreciation and Amortization (including Information on Listed Property) Attach to your tax return. 4562 Department of the Treasury internal Revenue Service (99) see separate inStrUCtionS- OMB No. 1545-0172 2?13 Attachment Sequence No. 179 Namels) shown on return Business or activity to which this form relates Daniel Biss Karin Steinbrueck Form 2 10 6 State Senator Election To Expense Certain Property Under Section 179 Note: If you have any listed property, complete Part before you complete Part l. I number 1 Maximum amount (see instructionsTotal cost of section 179 property placed in service (see instructions) . 2 3 Threshold cost of section 179 property before reduction in limitation (see instructionsReduction in limitation. Subtract line 3 from line 2. If zero or less, enter . . . . . . . . . 4 5 Dollar limitation for tax year. Subtract line 4 from line 1. if zero or less, enter if married filing separately, see instructions 5 6 Description of property Cost (business use only) Eiected cost 7 Listed property. Enter the amount from line 29 7 8 Total elected cost of section 179 property. Add amounts in column lines 6 and 7 8 9 Tentative deduction. Enter the smaller of line 5 or line 8 . . . 9 10 Carryover of disallowed deduction from line 13 of your 2012 Form 4562 . . . . . . . . 10 1 1 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 {see instructions) 11 12 Section 179 expense deduction. Add iines 9 and 10, but do not enter more than line 11 13 Carryover of disallowed deduction to 2014. Add linese and 10, iess line 12 13 Note: Do not use Part ll or Part below for listed property. Instead, use Part V. Part ll Special Depreciation Allowance and Other Depreciation (Do not include listed property.) (See instructions.) 14 Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year (see instructions) 14 15 Property subject to section 168(f)(1) election . 15 16 Other depreciation (including ACRSMACRS Depreciation (Do not inciude listed property.) (See instructions.) Section A 17 MACRS deductions for assets placed in service in tax years beginning before 2013 . 17 I 18 if you are electing to group any assets placed in service during the tax year into one or more generai asset accoums, check here . . . . . . . . . . . . . . . [3 Section B?Assets Placed in Service During 2013 Tax Year Using the General Depreciation System I I Month and year Sass for depredation Recovery 1 I I I Classmcatlon of property placed in (busmessr'investment use . Convention Method (9) Deprecration deduction instructions) pemd 193 3?year property 5-year property 7?year property 10?year property 15?year property 20?year property 9 25?year property 2 5 yrs. Residential rental 27.5 yrs. MM property 27 .5 yrs. MM i Nonresidential real 59 yrs. MM property MM Section C??Assets Placed in Service During 2013 Tax Year Using the Alternative Depreciation System 20a Class life 5/ 12-year 2 yrs. 6/ 40 yrs. MM 40- ear Summary (See instructions.) 21 Listed property. Enter amount from line Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (9), and line 21. Enter here and on the appropriate lines of your return. Partnerships and corporations?see instructions 21 141. 22 23 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs 23 For Paperwork Reduction Act Notice, see separate instructions. BAA REV Form 4562 (2013) Page 2 Ferm 4562 2013) ?Listed Property (Include automobiles, certain other vehicles, certain computers, and property used for entertainment, recreation, or amusement.) Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns through of Section A, all of Section B, and Section if applicable. Section AwDepreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.) 24a Do you have evidence to su port the business/investment use claimed? Yes [3 No 24b if ?Yes,? isthe evidence written? Yes No . Busfizzass/ Basis for (2:)preciation (9) . . Type of property (list Date placed . . . Recovery Method/ Depreciation Elected section 179 vehicles first) in service mvesrmem use or Other has?; (busmess'qnvesment period Convention deduction cost percentage use only) 25 Special depreciation allowance for qualified iisted property placed in service during the tax year and used more than 50% in a qualified business use (see instructions) . 25 26 Property used more than 50% in a qualified business use: 27 Property used 50% or less in a qualified business use: Toyota Corolla 08/22/2011 15 . 07 Computer 04/29/2012 50.00 1,409. 705. 5.00 141. 5/ 28 Add amounts in column lines 25 through 27. Enter here and on line 21, page 1 . 28 141 . 29 Add amounts in column line 26. Enter here and on line 7, page 1 . . . Section on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other ?more than 5% owner,? or related person. If you provided vehicles to your employees, first answer the questions in Section to see if you meet an exception to com pleting this section for those vehicles. I29 30 Total business/investment miles driven during the year (do not include commuting miles) . 31 32 Total commuting miles dri Total other personal miles driven 33 lines 30 through 32 34 Was the vehicle avail ven during the year (noncommuting) Total miles driven during the year. Add able for personal use during off?duty hours? . 35 Was the vehicle used primarily by a more than 5% owner or related person? 36 Is another vehicle available for personal use? Vehicle 1 (al (13) Vehicle 2 Vehicle 3 (6) Vehicle 4 Vehicle 5 (0 Vehicle Section CuQuestions for Em pioyers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section for vehicles used by employees who are not more than 5% owners or related persons (see instructions). 37 Do you maintain a written policy statement that prohibits ali personal use of vehicles, including commuting, by your employees? . 38 Do you maintain a written employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners 39 40 Do you treat ali use of vehicles by employees as personal use? Do you provide more than five vehicles to your employees, obtain infor use of the vehicles, and retain the information received? . . Do you meet the requirements concerning qualified automobile demonstration use? (See instructions.) Note: it your answer to 37, 38, 39, 40, or4l is ?Yes,? do not complete Section for the covered vehicles. Part Amortization olicy statement that prohibits personal use of vehicles, except commuting, by your mation from your employees ab0ut the Yes No Date amortization Amortization Description of costs be ins Amortizable amount Code section period or Amortization for this year 9 percentage 42 Amortization of costs that begins during your 2013 tax year (see instructions): 43 Amortization of costs that began before your 2013 tax year . . . . 43 44 Totai. Add amounts in column See the instructions for where to report . 44 REV 02/14/14 Form 4562 (2013) Illinois Department of Revenue 2013 Perm individual Income Tax Return or for fiscal year ending Over 80% of taxpayers file electronically it is easy and you will get your refund faster. Visit gov. 4.. Staple your check and Staple W-2 and 1099 forms here ID: 3WM REV TrMac Step 1: Personal Information l9, Daniel Karin Steinbrueck Filing status (see instructions) El Single or head of household Married filing jointly Married filing separately Widowed 0 Check it you are in a civil union (see instructions). :1 Step 2: 1 Federal adjusted gross income from your US. 1040, Line 37; US. 1040A, Line 21; or (Whole dollars only) mcome U.S. 104OEZ, Line 4 1 54 218.00 2 Federally tax-exempt interest and dividend income from your US. 1040 or 1040A, Line 8b; 2 1x2 3 Other additions. Attach Schedule M. 3 M) 4 Total income. Add Lines 1 through 3. 4 54 218 .132 Step 3: Social Security benefits and certain retirement plan income Base received it included in Line 1. Attach Page 1 of federal return. 5 income 6 Illinois income Tax overpayment included in US. 1040, Line 10 6 26801 7 Other subtractions. Attach Schedule M. 7 Check if Line 7 includes any amount from Schedule 1299-0. El 8 Add Lines 5, 6, and 7. This is the total of your subtractions. 8 268 .00 9 Illinois base income. Subtract Line 8 from Line 4. 9 53 950 .00 Step 4: 10 a Number of exemptions from yourfederal return mg. $2,100 a 8 400 .00 Exemptions if someone can claim you as a dependent, see instructions. $2,100 .00 0 Check if 65 or older: Cl You Cl Spouse $1,000 0 .00 Check it legally blind: You Spouse $1,000 Exemption allowance. Add Lines a through cl. 10 8 400 .gm 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 2013 Nonresident El Part-year resident, and write the Illinois base income from Schedule NR. Attach Schedule NR.12 ,gxz Step 6: 13 Residents: Multiply Line 11 by 5% (.05). Cannot be less than zero. Tax Nonresidents and part-year residents: Write the tax from Schedule NR. 1 3 14 Recapture of investment tax credits. Attach Schedule 4255. 14 .tm 15 Income tax. Add Lines 13 and 14. Cannot be less than zero. 15 2 27 8 .00 Step 7: 16 income tax paid to another state while an Illinois resident. Tax After Attach Schedule CR. 1 6 Now 17 Property tax and education expense credit amount from refundable Schedule ICR. Attach Schedule ICR. 17 28 6 00 Credits 18 Credit amount from Schedule 1299?0. Attach Schedule 1299?0. 18 19 Add Lines 16, 17, and is the total of your credits. Cannot exceed the tax amount on Line 15. 19 236 00 20 Tax after nonrefundable credits. Subtract Line 19 from Line 15 20 1 99 2 .00 This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of lhi information is recruited. Failure to provide information could result in a snail Do not write above this line. 21 Tax alter nonrefundable credits from Page 1, Line 20 21 I 9 9 2 .00 Step 8: 22 Household employment tax. See instructions. 22 Other 23 Use tax on internet, mail order, or other out-of-state purchases from Taxes UT Worksheet or UT Table in the instructions. Do not leave blank. 23 3 8 24 Total Tax. Add Lines 21Step 9; 25 Illinois Income Tax withheld. Attach all W-2 and 1099 forms. 25 2 324 payments 26 Estimated payments from Forms and lL-5054, and including overpayment applied from 20l2 return 26 .00 Refundable 27 Pass-through entity tax payments. Attach Schedule or 27 .120 Credit 28 Earned Income Credit from Schedule ICR. Attach Schedule 28 .00 29 Total payments and refundable credit. Add Lines 25 through 28. 29 A Step 10: 30 Overpayment. lf Line 29 is greater than Line 24, subtract Line 24 from Line 29. 30 2 94 .00 Result 31 Underpayment. If Line 24 is greater than Line 29, subtract Line 29 from Line 24. 31 .00 Step 11: 32 Late-payment penalty for underpayment of estimated tax. 32 00 Underpayment 3 Check it at least two-thirds of yourfederal gross income is from farming. of Estimated Tax Check it you or your spouse are 65 or older and permanently and living in a nursing home. Donations 0 Check if your income was not received evenly during the year and you annualized your income on Form iL-2210. Attach Form lL-2210. Check if you were not required to file an Individual Income Tax return in the previous tax year. El 33 Voluntary charitable donations. Attach Schedule G. 33 .00 34 Total penalty and donations. Add Lines 32 and 33. 34 .00 Step 12: 35 if you have an overpayment on Line 30 and this amount is greaterthan Refund or Line 34, subtract Line 34 from Line 30. This is your remaining overpayment. 35 29 4 00 Amount You 36 Amount from Line 35 you want refunded to you. Check one box on Line 37. See instructions. 36 0W6 37 I choose to receive my refund by direct__deposit:Qornpletethe information below if you check this box. iFiouting number 1w Checking or Savings iAccount number I: Illinois individual income Tax refund debit card El paper check 38 Subtract Line 36 from Line 35. This amount will be applied to your 2014 estimated tax. 38 "aw?0m 39 If you have an underpayment on Line 31, add Lines 31 and 34. or If you have an overpayment on Line 30 and this amount is less than Line 34, subtract Line 30 from Line 34. This is the amount you owe. See instructions. 39 will Step 13: Under penalties of perjury, I state that I have examined this return, and, to the best of my knowledge, it is true, correct, and complete. Sign and Date Your signature Date Daytime phone number Your spouse's signature Date Self?Prepared Paid preparer?s signature Date Preparers phone number Preparel?s SSN, or PTIN Third Party El Check, and complete below, to allow another person to discuss this return with the lliinois Department of Revenue. Designee Designee?s name (piease print) Designee?s phone number Form 109943 We no longer automatically mail 1099-G forms. instead, we ask that you get this information from our website. Information Check the box to receive a paper Form 1099-G next year, if you meet the criteria requiring us to issue a Form if no payment enclosed, mail to: If payment enclosed, mail to: a DEPARTMENT OF REVENUE DEPARTMENT OF REVENUE PO BOX 1040 iL 62726-0001 GALESBURG lL 61402-1040 lD: 3WM REV 02/18/14 Tl'Mac lL?l 040 bad< (Fl-12/13) DR AP RR DC lR Illinois Department of Revenue 2013 Scheduie iilinois Credits Attach to your Form iL-1040 IL Attachment No. 23 Read this Informatlon first 0 You must complete Form through Line 15 and Complete this schedule oniy if you are etigible for the Schedule OR, if appiicabie, before completing this schedule. . minois property Tax Credit 0 The totai amount of lilinois Property Tax Credit and K-12 . K42 Education Expense Credit Education Expense Credit cannot exceed tax. Only the i ed't ma dt . Earned income Credit (EEC) amed ncome I xcee ax Step 1: Provide the following information Daniel steinbrueck Your name as shown on your Form iL?1040 Your Social Security number Step 2: Figure your nonrefundable credit 1 Write the amount of tax from your Form IL-1040, Line 15. 1 2 278.00 2 Write the amount of credit for tax paid to other states from your Form lL-1040, Line 16. 2 .00 3 Subtract Line 2 from Line 1. 3 2 278 00 Section A - Illinois Property Tax Credit (See instructions for directions on how to obtain your property number) 4 a Write the total amount of lilinois Property Tax paid during the tax year for the real estate that inciudes your principal residence. 4a 5 i 7 12 .00 Write the county and property number for the property listed above. 4b COOK 05-33-321?057?0000 County Property number 0 Write the county and property number for an adjoining lot, it included in Line 4a. 4c County Property number Write the county and property number for another adjoining tot, if included in Line 4a. 4d County Property number 6 Write the portion of your tax bill that is deductible as a business expense on US. income tax forms or schedules, even if you did not take the federal deduction. 4e .00 Subtract Line 4e from Line 4aMultiply Line 4f by 5% (.05). 49 286 .00 5 Compare Lines 3 and 49, and write the iesser amount here. 5 285.00 6 Subtract Line 5 from Line 3. 6 1 I 992 .00 Section - Education Expense Credit You must compiete the Education Expense Credit Worksheet on the back of this schedule and attach any receipt you received from your student?s school. 7 8 Write the totat amount of K42 education expenses from Line 13 of the worksheet on the back of this schedule. 7a .00 You may not take a credit for the first $250 paid. 250.00 0 Subtract Line 7b from Line 7a. If the result is negative, enter ?zero.? 70 .00 Muitipiy Line 70 by 25% (.25). Compare the result and $500, and write the lesser amount here. 7d .00 8 Compare Lines 6 and 7d, and write the lesser amount here. 8 .00 Section cabal Mamas-e Credit 9 Add Lines 5 and 8.This is your nonrefundable credit amount. Write this amount on Form lL-1040, Line 17. 9 285.00 Mined Page 2 it 11.4040 Schedute lCFi front Schedule Page 2 Step 3: Figure your refundable credit Earned Income Credit If you were in a civii union as of December 31, 2013, you must recompute the federal EIC on your ?as-if-married? federal return before computing this step. 10 a Write the amount of federal EIC as shown on your U.S. 1040, Line 64a; U.S. 1040A, Line 38a; or US. 1040122, Line 8a. 108 .00 Multiply the amount on Line 103 by 10% (.10). 10b .00 illinois residents: Write 1.0. Nonresidents and part-year residents: Write the decimal from Schedule NR, Line 48. 100 Multiply Line 10b by the decimal on Line 100. 10d .00 11 Write the amount from Line 10d here. This is your lliinois Earned Income Credit. Write this amount on Form IL-1040, Line 28. 9 11 .00 Section Continued - K-12 Education Expense Credit Worksheet (continued from Step 2, Section B) You must complete this section and attach any receipt you received from your student?s school. 12 Complete the following information for each of your qualifying students. if a student attended more than one qualifying school during the calendar year, please iist separately. It you need more space, attach a separate piece of paper following this format. A Student?s name Sociai Security number Grade School name Schooi city Totai tuition, only) (IL 2 schools only or write (iL cities only) book/labfees ?home school,? if applicabie) 13 Add the amounts in Column for Lines 12a through 12} (and the amounts from Column of any additionai pages you attached). This is the total amount of your qualified education expenses for this year. Write this amount here and on Step 2, Line 7a of this schedule. 13 .00 I This form is authorized as outlined under the illinois Income Tax Act. Disclosure 01 I ID: SWM REV 0218,14 this inform ti is uir Failure to provide information could result in a Denait . SCheduIe back (312/13) ?1040 Department of the Treasury?Internal Revenue Service u.s. Individual Income Tax Return (9 9) |2?12 OMB No- 1545-0074 IRS Use Only?Do not write or stapie in this space. For the year Jan. i?Dec. 31, 2012. or other tax year beginning .2012, ending .20 See separate instructions. Your ?rst name and initial Last name Daniel Biss If a ioint return. spouse?s ?rst name and initial Last name Karin Steinbrueck Your social securii number pouse some security number Home address (number and street). it you have a P.O. box. see instructions. Apt. no. Make sure the above and on line So are correct. A City, town or post of?ce. state. and code. if you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign Check here if you, or your spouse if ?ling Foreign country name Foreign province/state/county Foreign postal code jointly, want 33 to go to this fund. Checking a box below will not change your tax or refund. 8 You El Spouse Filing Status Check only one box. 1 Cl Single 2 13] Married ?ling jointly (even if only one had income) 3 Married filing separately. Enter spouse?s SSN above the qualifying person is a chi child's name here. 4 Head of household (with qualifying person). (See instructions.) If Id but not your dependent. enter this and full name here. 5 Qualifying widow(er) with dependent child Exemptions 6a El Yourself. if someone can claim you as a dependent, do not check box 6a . . 2 Spouse I I i i (4) fctiid undera 17 ?reball?? . . . (1) "3::pendems' Last name socggaj?gi?rgber ?2 E11 iot A Biss Son El If more than four Theodore Biss - Son El (see instructions) dependents, see [3 Dependents on So instructions and not entered above check here El [3 Add numbers on it! Total number of exemptions claimed . tines above 4 'ncome 7 Wages, sataries, tips, etc. Attach Form(Taxable interest. Attach Schedule if required . . . . . . . . . . Tax-exempt interest. Do not include on line agizg?rmg 93 Ordinary dividends. Attach Schedule if required . . . . . . . . . attach Poms Qualified dividends 9b I W-ZG and 10 Taxable refunds, credits, or offsets of state and local income taxes Alimony received . . . was Withheld 12 Business income or (loss). Attach Schedule or C-EZ . 13 Capital gain or (loss). Attach Schedule 0 if required. If not required, check here [j if 14 Other gains or (losses). Attach Form 4797 . . . . . . . 2:8 Ragtime.? 15a ERA distributions 15a Taxable amount 15b 16a Pensions and annuities 16a Taxable amount 16b 17 Rental real estate, royalties, partnerships. corporations, trusts, etc. Attach Schedule 17 -869 . 18 Farm income or (loss). Attach Schedule . 18 payment. Also, 19 Unemployment compensation . . . . . . . . . . . . 19 please use 203 Social security benefits I 20a I I Taxable amount 20!) Form 21 Other income. List type and amount 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income 6 1 7 5 4 23 Educator expenses . . . . . . . 23 Ad] Listed 24 Certain business expenses of reservists, performing artists, and Gross fee- basis government officials. Attach Form 2106 or 2106- E2 24 income 25 Health savings account deduction. Attach Form 8889 25 26 Moving expenses. Attach Form 3903 . . 26 27 Deductible part of self-employment tax. Attach Schedule SE . 27 28 Self?employed SEP, SIMPLE, and qualified plans 28 29 Self~employed health insurance deduction 29 30 Penalty on early withdrawal of savings . 30 31a Alimony paid Recipient's SSN 31a 32 ERA deduction . . 32 33 Student loan interest deduction. 33 6 4 . 34 Tuition and fees. Attach Form 8917. 34 Domestic production activities deduction. Attach Form 8903 35 Add lines 23 through Subtract line 36 from line 22. This is your adjusted gross income 37 6 1 6 9 0 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA REV 02/07/13 TTO Form 1040 (2012) Form 1040 {2012) Page 2 Tax and 38 Amount from line 37 (adjusted gross incomeCredits 39a Check You were born before January 2,1948, [3 Blind. Inna: boxes if: Spouse was born before January 2, 1948, Blind. checked 393 Standard I If your spouse itemizes on a separate retum or you were a dual-status alien, check here) 9039?? ~52 Itemized deductions (from Schedule A) or your standard deduction {see left marginPeople who 41 Subtract line 40 from line ggicgna?e 42 Exemptions. Multiply 800 by the number on line 6d3531102232,? 43 Taxable Income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -claimed as a 44 Tax {see instructions). Check If any from. a CI Form(s }8814 CI Form 4972 962 election 44 2 681 . 45 Alternative minimum tax {see instructions). Attach Form 6253 . 45 46 Add lines gifgl?ztgers: 47 Foreign tax credit Attach Form 1116 if required 47 I ?3 Married titing 48 Credit for child and dependent care expenses. Attach Form 2441 48 separately, 49 Education credits from Form 8863, line 19 49 10 0 . Married filing 50 Retirement savings contributions credit. Attach Form 8880 50 51 Child tax credit. Attach Schedule 8812, if required . 51 2 00 0 . 52 Residentiai energy credits. Attach Form 5695 . . . 52 Head of 53 Other credits from Form: a 3800 El 3301 53 ,1 . . household, 54 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 55 5 8 1 . Other 56 Seif?empioyment tax. Attach Schedule Unreported social security and Medicare tax from Form: a 4137 El 8919 57 axes 58 Additional tax on lRAs other quali?ed retirement pians, etc. Attach Form 5329 if required 58 593 Household employment taxes from Schedule . . 593 First-time homebuyer credit repayment Attach Form 5405 if required 59b 60 Other taxes. Enter code(s) from instructions 61 Add lines 55 through 60. This is your total tax 5 8 1 . Payments 62 Federal income tax withheld from Forms W-2 and 1099 63 2012 estimated tax payments and amount applied from 2011 return 3 have a 64a Earned income credit (EIG) g?i?fy??gch Nontaxable combat pay election I 64!) I Schedule EIC. 65 Additional child tax credit. Attach Schedule 8812 66 American opportunity credit from Form 8863, line 8 . 67 Reserved . . . . . . 68 Amount paid with request for extension to file 69 Excess social security and tier 1 RRTA tax withheld 70 Credit for federal tax on fueis. Attach Form 4136 71 Credits from Form: a 2439 b? I Reserved [3 8801 8885 72 Add iines 62, 63, 64a, and 65 through 71. These are your total payments . . 4 093 . Refund 73 if line 72 is more than time 6?i subtract ?ne 61 from line 72. This is the amount you overpaid 3 5 12 . 74a Amount of line 73 you want refunded to you. if Form 8888 is attached, check here 3 12 . Direct deposit? Routing number __Type: Checking Savings ii?mc?ons Account number i 75 Amount of tine 73 you want appiied to your 2013 estimated tax 75 I Amount 76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions You owe 77 Estimated tax penaity (see instructionsThird Party Do you want to allow another person to discuss this return with the (see instructions}? Yes. Complete beiow. No Designee Designee's Phone Personal identification name no. number (PIN) I I Sign Under penaities of perjury, I declare that have examined this return and accompanying Schedules and statements, and to the best of my knowledge and belief. Here they are two, correct. and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Joint return? See Your signature Date Your occupation Daytime phone number instructions. State Senator Keep 3 WW for Spouse's signature. if a joint return, both must sign. Date Spouse?s occupation If the IRS sent you an identity Protection your records. PIN, enterit Graduate Student here Paid Print/Type preparer's name Preparer's signature Date Check if PTIN Preparer self-employed Use Only Firrn?s name . SELF PREPARED Firm's Firm's address Phone no. REV 02/07/13 TTO Form 1040 (2012) SCHEDULE A (Form 1040) Department of the Treasury internai Revenue Service (99) itemized Deductions Information about Scheduie A and its separate instructions is at >Attach to Form 1040. OMB No. 1545-0074 2012 Attachment Sequence No. 07 Name(s) shown on Form 1040 Daniel Biss Karin Steinbrueck Caution. Do not include expenses reimbursed or paid by others. Your social security number Medicat . . '1 and 1 MedIcai and dental expenses (see instructions) 1 . Dental 2 Enter amount from Form 1040 line 38 I 2 Expenses 3 Multiply tine 2 by 7. 5% (.075) . 3 123;; 4 Subtract line 3 from line1. If line 3 :3 more than line 1 enter 4 Taxes You 5 State and local (check only one box): Paid a El income taxesGenera? sates taxes 6 Real estate taxes (see instructionsPersonal property taxes . 7 8 Other taxes List type and amount 8,204. Interest 10 Home mortgage interest and points reported to you on l=orm 1098 10 1 1 3.2 7 . You Paid 11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions Note. and show that person?s name, identifying no.. and address Your mortgage interest deduction may 11 be limited (see 12 Points not reported to you on Form 1098. See instructions for special rulesMortgage insurance premiums (see instructions). . . 13 14 Investment interest. Attach Form 4952 it required. (See instructions.) 14 15 Add imesiOthroughM 13,178. Gifts to 16 Gifts by cash or check. If you made any gift of $250 or more Charity see instructions 16 1 1 00 . If you made a 17 Other than by cash or check If any gift of $250 or more, see gift and got a instructions. You must attach Form 8288 if over $500 . 17 14 8 . bent?? for 18 Carryover from prior year 18 see '?Strum'ons? 19 Add lines 16 through 18 . 1 248 . Casualty and Theft Losses 2O Casualty or theft loss(es). Attach Form 4684. (See instructions.) . 20 Job Expenses 21 Unreimbursed empioyee expenses?job travei, union dues, and Certain iob education, etc. Attach Form 2106 or 2106-EZ if required. Miscellaneous (See Instructions) 21 22 Tax preparation fees . . 22 23 Other expenses~investment safe deposit box etc. List type and amount 23 24 Add lines 21 through Enter amount from Form 1040, line 38 {25] 6 690 . 26 Multiply tine 25 by 2% (..02) 26 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter 0-- 177 . Other 28 Other?from list In instructions. List type and amount Miscelianeous Deduc?ons Total 29 Add the amounts in the far right column for tines 4 through 28. Also, enter this amount Itemized on Form 1040, line 40 29 22 807 . Deductions 30 if you elect to itemize deductions even though they are iess than your standard deduction, check here El For Paperwork Redu ction Act Notice, see Form 1040 instructions. BAA REV 01/10/13 TTO Schedule A (Form 1040) 2012 SCHEDULE (Form 1040) Department of the Treaswy Internal Revenue Service (99) Supplemental Income and Loss (From rental real estate, royalties, partnerships, corporations, estates, trusts, REMICs, etc.) Attach to Form 1040, 1040MB, or Form 1041. Information about Schedule and its separate instructions is at OMB No. 1545?0074 2?12 Attachment Sequence No.13 Name(s) shown on return Daniel Biss Karin Steinbrueck Your sociai security number Income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personat property, use Schedule or C-EZ (see instructions). It you are an individuat. report farm rental income or toss from Form 4835 on page 2, line 40. A Did you make any payments in 2012 that would require you to fite Form(s) 1099? (see instructions) Yes E) No If ?Yes,? did you or will you file required Forms 1099?? CI Yes No 1a Physical address of each property (street, city, state, ZIP code) A 712 W. Vine Street Champaign IL 61820 Pr rt 2 . Personal Use 1? (fi?fn?iist Falr?enta' Days Days QJV personal use days. Check the QJV box A 1 oniy it you meet the requirements to ?te as A 356 0 aqualii ed joint venture See instructions. 8 Type of Property: 1 Single Family Residence 3 Vacation/Short?Term Rental 5 Land 7 Self~Rental 2 Multi-Family Residence 4 Commercial 6 R0 atties 8 Other (describe) Income: Properties: A 3 Rents received 3 8 400 . 4 Royalties received . 4 Expenses: 5 Adva?smg . . 5 6 Auto and travel (see instructions). 6 7 Cleaning and maintenance 7 1 0 05 . 8 Commissions. 8 9 . 9 415. 10 Legal and other professional fees . 10 11 Management fees . 11 12 Mortgage interest paid to banks etc (see instructionsOther interest. 13 14 Repairs. 14 15 Supplies 15 16 Taxes 16 2 405 . 1'7 Utilities. . 17 77 . 18 Depreciation expense or depletion . 18 2 7 88 . 19 Other (fist) 19 20 Total expenses. Add lines 5 through Subtract line 20 from line 3 (rents) and/or 4 (royalties). It result is a (toss), see instructions to find out if you must file Form 6198 . 21 ?869 . 22 Deductible rental real estate loss after limitation, if any, m1Fcrn18582(seeinsch?ons) . . 22 869. 233 Totai of all amounts reported on line 3 for all rental properties 233 8 4 00 . Totai of all amounts reported on line 4 for all royalty properties 23b Total of all amounts reported on line 12 for all properties 23c 2 579 . (1 Total of all amounts reported on line 18 for all properties 23d 2 788 . Total of all amounts reported on line 20 for ail properties 23e 9 2 6 9 . 24 Income. Add positive amounts shown on iine 21. Do not include any losses . 24 25 Losses. Add royaity losses from line 21 and rentat teat estate losses from line 22 Enter total losses here 25 869 . 26 Total rental real estate and royalty Income or (loss). Combine lines 24 and 25. Enter the result here. if Parts IV, and tine 40 on page 2 do not appty to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the totat on line 41 on page 2. 26 ?8 6 9 . For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 01f30l13 170 Schedule (Form 1040} 2012 8863 Education Credits OMB No.1545 0074 Form (American Opportunity and Lifetime Learning Credits) De anmem of me has? See separate instructions to find out if you are eligible to take the credits. g) 1t 2 [mgmm Revenue Sewice r?(99) Instructions and more are at Attach to Form 1040 or Form 1040A. Seg?e?inmo 50 Nameis) shown on return Your social security number Daniel Biss Karin Steinbrueck A Complete a separate Part on page 2 for each student for whom you are claiming either credit before you complete Parts I and ii. Refundable American Opportunity Credit After completing Part lit for each student enter the total of all amounts from all Parts line 30 . 1 2 Enter: $180, 000 it married filing jointiy; $90,000 if singie, head of household, or quaIIfyIng widow(erEnter the amount from Form 1040, Iine 38, or Form 1040A, line 22 If you are filing Form 2555, 2555- -E2, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . . . . 3 4 Subtract line 3 from line 2. If zero or less, stop; you cannot take any education credit . . . . 4 5 Enter: $20, 000 if married jointly; $10, 000 if smgle head of household, or qualifying widow(eriine4 Is: 0 Equal to or more than line 5, enter 1.000 on line 6 . . . . 0 Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to at least three places) 7 Multiply line 1 by tine 6 Caution: If you were under age 24 at the end of the year and meet the conditions described in the instructions you cannot take the refundabie American opportunity credit; skip line 8, enter the amount from line 7 on line 9. and check this box . . . . 8 Refundable American opportunity credit. Multiply line 7 by 40% (.40). Enter the amount here and on Form 1040, line 66, or Form 1040A line 40. Then go to line 9 belowNonrefundable Education Credits Subtract line 8 from line 7 Enter here and on line 8 of the Credit Limit Worksheet (see instructions) 9 10 After completing Part ill for each student, enter the totai of all amounts from alt Parts ill, line 31. if zero skip lines 11 through 17, enter -0- on line 18, and go to line 19 500 - 11 Enter the smaller of line 10 or $10,000 500 . 12 Multiplyiine 11 by 20% (.20) . . 100- 13 Enter: $124, 000 if married filing jointly; $62, 000 if single head of household, or qualifying widow(erEnter the amount from Form 1040, line 38, or Form 1040A, line 22 If you are filing Form 2555, 2555- E2, or 4563, or you are excluding income from Puerto Rico, see Pub. 970 for the amount to enter . . . . . 14 61 I 590 . 15 Subtract line 14 from line 13 If zero or iess, skip lines 16 and 17, enter 0-- online18, andgotoiine19 . . . - 15 62I310- 16 Enter: $20, 000 if married filing jointiy; $10, 000 if single, head of heusehold, orquaiifyingwidoMer20I000- 17 if line 15 Is: 0 Equal to or more than line 16, enter 1 .000 on line 17 and go to line 18 0 Less than line 16 divide line 15 by tine 16. Enter the result as a decimal (rounded to at least three places) . . . . 1.000 18 Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) 18 00 . 19 Nonrefundable education credits. Enter the amount from line 13 of the Credit Limit Worksheet (see instructions) here and on Form 1040, line 49, or Form 1040A, fine 3.00 . For Paperwork Reduction Act Notice, see your tax return instructions. IRS.gov/forrn8863 BAA REV 01/18/13 170 Form 8863 (2012) Form 8863 (2012) Page 2 Name(s) shown on return Daniel Biss Karin Steinbrueck Your social securii number Complete Part for each student for whom you are claiming either the American Opportunity credit or lifetime learning credit. Use additional capies of Page 2 as needed for A CAUTION each student. Part Student and Educationat institution Information See instructions. 20 Student name (as shown on page 1 of your tax return) Karin Steinbrueck 21 Student social security number (as shown on page 1 of your tax return} 22 Educational institution information (see instructions) a. Name of first educational institution Northwestern University b. Name of second educational institution (it any) (1) Address. Number and street (or PO. box). City, town or (1) Address. Number and street (or P.O. box). City, town or post office, state, and ZIP code. if a foreign address, see instructions. 1881 Sheridan Road Evanston IL 60201 post office, state, and ZIP code. If a foreign address, see instructions. (2) Did the student receive Form1098~T Yes No Did the student receive Form 1098-1? from this institution for 2012? (2) Yes [3 No from this institution for 2012? (3) Did the student receive Form Did the student receive Form t098-T from this institution for 2011 with Box 2 Yes No filled in and Box 7 checked? (3) from this institution for 2011 with Box 8] Yes No 2 filled in and Box 7 checked? if you checked ?No? in both (2) and (3). skip (4). It you checked ?No? in both (2) and (3), skip (4). (4) if you checked ?Yes? in (2) or (3), enter the institution?s (4) if you checked ?Yes" in (2) or (3), enter the institution's federal identification number (from Form federal identification number (from Form 36?2167817 23 Has the Hope Scholarship Credit or American opportunity Yes .. Stop! No Go to line 24. credit been ciaimed for this student for any 4 prior tax years? Go to line 31 for this student. 24 Was the student enrolled at least half-time for at least one academic period that began in 2012 at an eligible educational institution in a program leading towards a Yes Go to line 25. No Stop! Go to line 31 postsecondary degree, certificate, or other recognized for this student. postsecondary educational credentiat? (see instructions) 25 Did the student complete the first 4 years of post~secondary Yes - Stop! education before 2012?? Go to tine 31 for this No Go to line 26. student. 26 Was the student convicted, before the end of 2012, of a Yes Stop! No See Tip below and felony for possession or distribution of a controlled Go to line 31 for this complete either lines 27-30 substance? student. or line 31 for this student. When you figure your taxes, you may want to compare the American opportunity credit and lifetime learning credits, and choose the credit for each student that gives you the lower tax liability. You cannot take the American opportunity credit and the lifetime learning credit for the same student in the same year. if you complete lines 27 through 30 for this student, do not complete line 31. American Opportunity Credit 27 Adjusted qualified education expenses (see instructions). Do not enter more than $4,000 27 28 Subtract $2,000 from tine 27. If zero or less enter -line 28 is zero, enter the amount from tine 27. Otherwise. add $2,000 to the amount on line 29 and enter the result. Skip line 31. Include the total of all amounts from all Parts line 30 on Part l, line 30 Lifetime Learning Credit 31 Adiusted qualified education expenses (see instructions). Include the total of all amounts from ail Parts . . . . . . . . . . . . . . . . . . . . . . .. 31 500. Form 8863 {2012) 2106 Department of the Treasury Internal Revenue Service (99) Employee Business Expenses Attach to Form 1040 or Form 1040NR. information about Form 2106 and its separate instructions is available at OMB No. 1545-0074 2?12 Attachment Sequence No. 129 Your name Daniel Biss chpation in which you incurred expenses State Representative Social securii number Employee Business Expenses and Reimbursements Step 1 Enter Your Expenses Column A Other Than Meals and Entertainment Column Meals and Entertainment Vehicle expense from line 22 or line 29. (Rurai mail carriers: See Parking fees, tolls, and transportation, including train, bus, etc., that did not involve overnight travel or commuting to and from work Travel expense while away from home overnight, including lodging, airplane, car rental, etc. Do not include meals and entertainment . Business expenses not included on iines 1 through 3. Do not include meals and entertainment Meals and entertainment expenses (see instructions) . . . Total expenses. In Coiumn A, add lines 1 through 4 and enter the result. ln Column B, enter the amount from tine 5 4,095. 4,166. Note: If you were not reimbursed for any expenses in Step 1, skip line 7 and enter the amount from line 6 on line 8. Step 2 Enter Reimbursements Received From Your Employer for Expenses Listed in Step 1 7 Enter reimbursements received from your employer that were not reported to you in box 1 of Form include any reimbursements reported under code in box 12 of your Form (see instructions). 7 2,877. 5,550. Step 3 Figure Expenses To Deduct on Schedule A (Form 1040 or Form 1040NR) 8 10 Subtract line 7 from tine 6. If zero or less, enter -0-. However, if line 7 is greater than line 6 in Column A, report the excess as income on Form 1040, line 7 (or on Form 1040MB, line 8) Note: if both columns of line 8 are zero, you cannot deduct employee business expenses- Stop here and attach Form 27 O6 to your return. In Column A, enter the amount from line 8. in Coiumn B, multiply line 8 by 50% (.50). (Employees subject to Department of Transportation (DOT) hours of service limits: Multipiy meal expenses incurred white away from home on business by 80% (.80) instead of 50%. For details, see instructions.) . . . 1,289. 9 1,289. Add the amounts on line 9 of both columns and enter the totai here. Also, enter the total on Schedule A (Form 1040), line 21 (or on Schedule A (Form 104ONR), line 7). (Armed Forces reservists, qualified performing artists, tee-basis state or local government officials, and individuals with disabilities: See the instructions for special rates on where to enter the total1,289. For Paperwork Reduction Act Notice, see your tax return instructions. BAA Fi EV 12/0311 2 TTO Form 2106 (2012) Form 2106 (2012) Part ll Vehicle Expenses Page 2 Section {tr-General information (You must complete this section if you Vehicle 1 Vehicle 2 are claImIng vehrcle expenses.) 11 Enter the date the vehicie was placed in service . . . . . . . . . 11 08/22/2011 12 Total miles the vehicle was driven during 2012 . . . . . . . . . 12 10 4 36 miles mites 13 Business miles included on line 378 miles miles 14 Percent of business use. Divide line 13 by line 12Average daily roundtrip commuting distance . . . . . . . . . . 15 10 miles miles 16 Commuting mites included on line 12 . 16 2 00 miles miles 17 Other miles Add lines 13 and 16 and subtract the total from line 12 17 858 miles miles 18 Was your vehicle available for personai use during off-duty hoursyou (or your spouse) have another vehicle available for personal useyou have evidence to support your deduction? Yes I >