=== FILED IN DISTRICT COURT OKLAHOMA COUNTY IN THE DISTRICT COURT OF OKLAHOMA COUNTY, NOV 2 0 2019 STATE OF OKLAHOMA THE STATE OF OKLAHOMA, Plaintiff, ) ) ) ) VS. ) KENDRA DAISHON COLEMAN, ) ) ) RIGK 'WARREN COURT CLIRK Q'iezz '. == No. CF-2019-4488 ) Defendant. DEFENDANT'S DEMURRER TO THE INFORMATION OR, IN THE ALTERNATIVE, MOTION DISQUALIFY THE PROSECUTOR COMES NOW the Defendant, Kendra Daishon Coleman (also referred to herein as "Judge .Coleman"), by and through counsel, and hereby prays for an Order granting her demurrer to the Felony Information filed October 28, 2019, pursuant to 22 O.S. §504, or, in the alternative, an Order from this Comt disqualifying the Oklahoma County District Attorney (hereafter "Prosecutor" or "State") and request for evidentiary hearing. In support of this Motion, the Defendant shows and informs the Court as follows: FACTUAL BACKGROUND 1. On January 14, 2019, the Defendant was sworn in and assigned to the Criminal Docket as a District Judge of Oklahoma County. 2. On May 2i, 2019, the Prosecutor sought the recusal of the Defendant, as a sitting District Judge in Oklahoma County, related to her assignment to hear the case of State ofOklahoma v. AntwonDemetris Burks, CF-2017-2859. 1 When the Defendant refused the Prosecutor's demand for recusal, personal threats were made by Mr. Prater towards the Defendant, a "purported" 1 State v. Burks is a highly publicized dog-mauling case in which Mr. Burks was charged with manslaughter in the second degree. criminal investigation allegedly ensued, and judicial complaints and criminal filings ensued by the Prosecutor. 3. The State took no further action related to Judge Coleman presiding over any criminal or other matter until September 3, 2019 (the day before Burks was scheduled to be set for trial), when the State presented for an In Camera Hearing requesting Judge Coleman recuse "in all criminal matters and other matters wherein the State of Oklahoma might be a paity in a civil case or represent any witnesses in any cases." See Exhibit 7, Hrg. Trans., 9/3/2019, at 4:3-12. 4. At this hearing, and without pointing to a single piece of evidence on the record in any case demonstrating Judge Coleman could not preside over such cases in an unbiased and impartial manner, Mr. Prater, on behalf of the State, proceeded to advise Judge Coleman he had "filed a judicial complaint on ... you last week ... That complaint contains complaints regarding your violations of the judicial canons and the laws of the State of Oklahoma regarding campaign finance ... repo1ting .. .Therefore, Judge, for those reasons, we do not believe that the State of Oklahoma ... we do believe that our due process has been violated. We have no idea who your campaign contributors have been. We have no idea who may have undue influence over you. We have .. .no confidence that. .. you can be a neutral and detached judge in any given matter with anyone appearing before you." Mr. Prater noted the State also believed Judge Coleman could not be fair based merely on the fact the District Attorney had filed a judicial complaint against her. See Exhibit 7, Hrg. Trans., 9/3/2019, at 5:2-7:7 (Emphasis Added). 2 2 In addition to the fact that the State has yet to point to anything on the record indicating Judge Coleman had shown favoritism toward any attorney or party or had acted biased against the State, it is ce1tainly a dangerous precedent to allow an attorney to create an appearance of impropriety, requiring recusal, by filing a judicial complaint against the judge. Such complaint should be used for clear abuses of power, not as a tool to ensure an attorney need never appear before a judge with whom it often disagrees. 2 5. Judge Coleman denied this in camera blanket request for recusal. See Exhibit 7, Hrg. Trans., 9/3/2019, 6:11. 6. On September 4, 201 9, Mr. Prater filed District Attorney ' s Motion to Recuse Judge Kendra Coleman Pursuant to Rule 15 of the Rules for the District Courts of Oklahoma in the matter In Re: Recusal of Judge Kendra Coleman, Case No. MI-19-916. See Exhibit 8, DA's Mtn to Recuse, 9/4/2019. 7. Though the District Attorney's Motion utilized inflammatory language asserting Judge Coleman willfully hid campaign contributions and was "seemingly bent on returning campaign favors," the only "bias" the District Attorney could point to on the paii of Judge Coleman centered on her ruling in the State v. Burks matter, arguing: In what would later appear to be no mere random selection, this Comi accepted the Burks case for trial - a case in which the defendant was represented by an attorney who not only made substantial monetary contributions to the Court's campaign, but also played a significant role in other fundraising activities as well. In direct contravention to its obligations under the Code of Judicial Conduct and longstanding opinions of the Judicial Ethics Advisory Panel, this Comi proceeded to make a number of pre-trial evidentiary rulings calculated to cripple the prosecution of the case in favor of her benefactor without ever disclosing to the District Attorney's Office the fact of defense counsel's campaign activities. Though the case was only temporarily transferred from Judge Mai on the morning of trial, this Comt commented that it read the preliminaiy hearing transcripts for no explicable reason, questioned the veracity of witness testimony, criticized the State's rationale for filing the charge, excluded photographic evidence depicting the brutality of the attack, and even attempted to direct the State on how to question its witnesses and how those witnesses were to testify concerning the nature of the dogs involved in the attack. This Court's rulings made it evident that it did not want the jury to see the truth; in effect, this Court sought to give vicious dogs more civil rights than the innocent victim who had been killed: And to what end? Those answers would soon be apparent. See Exhibit 8, DA' s Mtn to Recuse, 9/4/2019, at 3-4. 8. Mr. Prater fmther claimed that "[u]nbeknownst to the State at the time this Court undertook the Burks case, defense counsel" was a contributor in Judge Coleman ' s campaign. Mr. Prater further claimed the State was also unaware Judge Coleman's dog had been involved in "an attack on another animal." According to Mr. Prater's Motion, the State was unaware of this 3 information on the morning of trial. Mr. Prater, however, did not explain how this information was learned over the lunch hour. Mr. Prater also did not explain why, after learning this information, the State waited until after Judge Coleman ' s rulings were announced related to the photographs to move for her recusal. See Exhibit 8, DA's Mtn to Recuse, 9/4/2019, at 4. 9. At the meeting held for Judge Coleman to give her ruling as to the recusal request, the District Attorney presented with another attorney in her office. Judge Coleman asked why an additional attorney, who had not been present the day prior, was necessary. The attorney, Jimmy Harmon, began speaking to Judge Coleman in a disrespectful tone and interrupting her while she was trying to speak. Judge Coleman advised she would not allow an attorney to speak with her in a disrespectful tone, interrupt her, or direct her hearing. Mr. Hannon then began an argument with Judge Coleman, causing Judge Coleman to advise she would allow him to remain in the hearing but asking him to not speak any further. See Exhibit 9, Hrg. Trans. 9/4/2019, at 4:4-7:16. 10. Judge Coleman advised Mr. Prater the timing of his blanket request for recusal had not been lost on her, given it came the day before the hearing to set the State v. Burks matter for trial and advising based on his conduct and prior conversations between the two, his action in filing the Motion was done in bad faith because he simply did not like the Court's pretrial rulings. Judge Coleman also advised she believed the language of Rule 15 applied to individual cases only and did not allow for blanket recusal requests as to every case on her criminal docket. Mr. Prater advised he had no authority for his motion, but that nothing prohibited the filing of a blanket motion. See Exhibit 9, Hrg. Trans. 9/4/2019, at 8:9-19:1. 11. When Judge Coleman denied Mr. Prater's blanket recusal request, Mr. Prater noted the Judge had not "acknowledged the fact that I've filed a ... Judicial Complaint against you ... You feel like ... that has no issue and would not cause any issue with you being biased against 4 the State of Oklahoma, when you understand that I'm seeking your removal from the bench[?]" See Exhibit 9, Hrg. Trans. 9/4/2019, at 19:2-14 (Emphasis Added). 12. Judge Coleman advised, "I don ' t understand that. I understand you .. . filed a judicial complaint, but that's okay." See Exhibit 9, Hrg. Trans. 9/4/2019, at 19: 15-17. 13. Mr. Prater responded: "I am telling you now, I'm seeking [your] removal from the bench, and I will be contacting the Attorney General this afternoon and asking him to move forward on a petition to remove you before the Multi-County Grand Jury. You need to be aware of that, Judge. This is not a threat." See Exhibit 9, Hrg. Trans. 9/4/2019, 19: 18- 25 (Emphasis Added). 14. On September 17, 2019, a True Bill of Indictment ("Misdemeanor Indictment") was filed alleging four (4) counts of failing to file Oklahoma income tax returns, in violation of 68 O.S. §240.A, specifically for the tax years 2015, 2016, 2017, and 2018. 15. Prior to the filing of the Misdemeanor Indictment, Defendant The Honorable Kendra Daishon Coleman filed the following Oklahoma income tax returns: a. 2015: Transmitted and Accepted June 6, 2016. [See Form 51 lEF and Drake 2015 Tax Software Report attached as Exhibit 1]; b. 2016: Transmitted October 16, 2017 and Accepted October 17, 2017. [See OKEF_ACK and 2016 Drake Tax Software Report attached as Exhibit 2]; c. 201 7: Transmitted and Accepted September 12, 2019 [See Form 511 EF and Drake 2017 Tax Software Repo11 attached as Exhibit 3]; and d. 2018: Transmitted and Accepted September 13, 2019 [See Drake 2018 Tax Software Repo11 and Form 51 lEF attached as Exhibit 4; see also Affidavit of Suzanne Hays attached as Exhibit 5]. 5 [Emphasis added.] 16. Upon information and belief, false testimony was presented to the Grand Jury by the State resulting in the fi ling of the Misdemeanor Indictment. The Prosecutor remains silent on how the falsity of the indictment occurred. 17. On September 19, 2019, the Defendant filed a Demurrer to the Indictment which was set for hearing before the Honorable Phillip C. Corley, Judge of the District Court of Payne County, Oklahoma, on Thursday, October 31, 2019, at 9:00 a.m. at the Payne County Courthouse in Stillwater, Oklahoma. 18. On October 28, 2019, the Prosecutor filed an Information (Case No. CF-2019- 4488) charging the Defendant with the crime of knowingly and intentionally failing to file state income tax returns with the intent to evade payment pursuant to 68 O.S. §2376(A). See Felony Information with Affidavit of Probable Cause signed by Investigator Randy Johnson attached hereto as Exhibit 6. 19. The State' s only response to the Defendant' s Demurrer to Indictment was the filing of the State's Notice of Dismissal filed October 30, 2019. 20. At the October 31 , 2019, hearing on the Defendant's Demurrer to the Indictment, the Honorable Phillip C. Corley accepted the State's dismissal of the Misdemeanor Indictment. 21. The State admits in the Affidavit of Probable Cause attached to the Felony Information that, "On September 12, 2019, The Oklahoma Tax Commission received an Oklahoma State Tax Return from Kendra Daison Coleman, which indicated she owed $1,210 for tax year 201 7. This amount remains unpaid and is delinquent except for a single $25. 00 payment." See Exhibit 6 at page 2 of the Probable Cause Affidavit. 6 22. Judge Coleman paid State income taxes in the amount of $1 ,400.00 for tax year 2017, evidencing no intent to evade payment of taxes. See Exhibit 10, Coleman 20_17 Federal and State Tax Return Information Showing Proof of Payment of Income Taxes (Both State and Federal). 23. Judge Coleman is working on a payment plan with the Internal Revenue Service and makes monthly payments on her State income taxes. ARGUMENT AND AUTHORITIES I. The Felony Information Must be Dismissed Because the State Cannot Prove as A Matter of Law that the Defendant Intentionally Failed to File Her 2017 Taxes with the Intent to Evade Payment. Based on the Affidavit of Probable Cause signed by Investigator Randy Johnson on October 28, 2019, and for the reasons set fo1th above, the State cannot demonstrate that the facts stated in the Inf01mation constitute a public offense pursuant to 22 O.S. §504(4). 22 O.S. §504 sets forth the following grounds for demUITer to Indictment or Information: The defendant may demur to the indictment or information when it appears upon the face thereof either: 1. That the grand jury by which an indictment was found had no legal authority to inquire into the offense charged, by reason of its not being within the legal jurisdiction of the county. 2. That it does not substantially conform to the requirements of this chapter. 3. That more than one offense is charged in the indictment or information. 4. That the facts stated do not constitute a public offense. 5. That the indictment or information contains any matter which, if true, would constitute a legal justification or excuse of the offense charged, or other legal bar to the prosecution. A demurrer to the Information pursuant to 22 O.S. §504(4) is limited to those defects which appear on the face of the Information. State v. Hammond, 1989 OK CR 25, ~5 , 775 P.2d 826, 7 citing State v. Truesdall, 1980 OK CR 97, ~2, 620 P.2d 427. As the Couti can see from paragraphs 21-23 above, the Felony Information fails as a matter of law because (1) the Defendant filed her taxes for the tax year 2017; and (2) made payments for taxes owed for the tax year 201 7. How can anyone possibly be guilty of feloniously refusing to file a tax return with the intent to evade payment when that person has both filed her tax return and made payments for that tax year prior to being charged by information? This does not constitute a public offense. Simply put, based on the facts as alleged, the Defendant cannot be convicted of failing to file her 201 7 tax return while possessing the intent to invade payment of her taxes for the year 2017 pursuant to 68 O.S. §2376(A). Therefore, the Felony Information must be dismissed because no public offense exists under the facts as charged. II. The Prosecutor Is Not Impartial And Must Be Disqualified. The Court is empowered and required to disqualify a prosecutor whenever a couti dete1mines that the prosecutor has a relationship or interest in the subject matter or to the patties in the case justifying disqualification. See State v. Hall, 1923 OK CR 220, 217 P. 229; Steeley v. State, 1920 OK CR 46, 187 P. 821. Oklahoma law forbids a lawyer from continuing in a matter when that lawyer's personal interests have a reasonable probability of materially limiting the representation of a client. 3 Okla. Stat. tit. 5, Ch. 1, App.3A Rule 1.7(b). This core principle of professional responsibility applies with full force to prosecutors. An indispensable part of a prosecutor's representation of his client -the State -- in a criminal proceeding is "the impartial prosecution of those accused of crime and the 3 The Restatement, § 125, recognizes that a lawyer is precluded from representing a client " if there is a substantial risk that the lawyer's representation of the client would be materially and adversely affected by the lawyer's financial or other personal interests." See also ABA Standards for Criminal Justice, The Prosecution Function, Std. 3-1.3(±). 8 duty to see that an accused is accorded a fair trial." Lux v. Commonwealth, 484 S.E.2d 145, 148 (Va. App. 1997). The prosecutor's duty is based as much on constitutional law as the Rules of Professional Conduct. See, e.g., Berger v. US., 295 U.S. 78, 55 S. Ct. 629, 79 L. Ed. 1314 (1935). Moreover, the prosecutor owes this duty to the State, not just to the defendant. Thus, a prosecutor who does not adhere to this duty is not properly representing his client. See State v. Williams, 529 A.2d 653, 660 (Conn. 1987), quoting State v. Ferrone, 113 A. 452, 455 (Conn. 1921) ("[the prosecutor's] conduct and language in the trial of cases in which human life or libe11y are at stake should be forceful, but fair, because he represents the public interest, which demands no victim and asks no conviction through the aid of passion, prejudice or resentment."). Further, prosecutors in our adversarial system have a unique role, beyond that of the usual advocate, which demands a higher degree of impaitiality and objectivity. "[The prosecutor] is the representative, not of an ordinaiy paity to a controversy, but of a sovereignty whose obligation to govern impaitially is as compelling as its obligation to govern at all; and whose interest, therefore, in a criminal prosecution is not that it shall win a case, but that justice shall be done." Berger, 295 U.S. at 88. See also ABA Std. 3-l.2(c) ("duty of the prosecutor is to seek justice, not merely to convict"). "A prosecutor has the responsibility of a minister of justice and not simply that of an advocate. This responsibility carries with it specific obligations to see that the defendant is accorded procedural justice, that guilt is decided upon the basis of sufficient evidence, and that special precautions are taken to prevent and to rectify the conviction of innocent persons." Okla. Stat. tit. 5, Ch. 1, App.3A Rule 3.8 Comment. "A prosecutor should not pe1mit his or her professional judgment or obligations to be affected by his or her own political, financial, business, prope11y, or personal interests." ABA Std. 3-1.3(f). "A defendant has the right to be treated the same as any 9 other person in the same circumstances and thus has the right to expect the prosecutor to be free of the influence of private parties who may have a particular reason for wanting to see the defendant prosecuted and convicted." People v. Parmar, 104 Cal.Rptr. 2d 31, 86 Cal.App.4 th 781, 797 (2001), citing Eubanks, supra, 14 Cal.4th at pp. 590, 599, 59 Cal.Rptr.2d 200, 927 P.2d 310. "A motion to disqualify a prosecutor turns on the necessity for independence and impartiality of the district attorney. A district attorney must be independent of private influences because our law does not authorize private prosecutions." Id. "This advantage of public prosecution is lost if those exercising the discretionary duties of the district attorney are subject to conflicting personal interests which might tend to compromise their impartiality." Id. Wacoche v. State, 1982 OK CR 55, ~ 27,644 P.2d 568,574 (holding that "prosecutors ... must at all times avoid even the appearance of impropriety throughout all phases of a criminal proceeding")(emphasis added); 4 See State ex rel. Okla. Bar Ass'n v. Miller, 2013 OK 49, ~ 30 n. 43,309 P.3d 108, 121 (citing NDAA National Prosecution Standard (2nd Ed. 1991) [NDAA] and noting the ABA Standards are similar to the NDAA which confirm that a prosecutor has duties that go beyond the corollary duty imposed upon prosecutors by constitutional law). In Miller, the Court described "the dark, unseen, ugly, shocking nightmare vision of a prosecutor who loves victory more than he loves justice." (Taylor, J. dissenting, declaring he would have ordered disbarment); NDAA 3-1.1 through 3-1.6 Commentary (stating " [g]iven the prosecutor's responsibility to seek justice for all the people, there are axioms regarding investigations that follow. A prosecutor should not conduct an investigation motivated by any characteristics of the victim or perpetrator that are categories irrelevant to the elements of the crime 4 The appearance of impropriety standard applies to prosecutors and judges. or the motive therefore. The prosecutor should not conduct an investigation in an illegal or improper manner.... ") (emphasis added); NDAA 1-3.1 Conflict Avoidance (stating "[a] prosecutor should not hold an interest or engage in activities, financial or otherwise, that conflict, have a significant potential to conflict, or are likely to create a reasonable appearance of conflict with the duties and responsibilities of the prosecutor's office nor should he or she allow his or her agents to do so") (emphasis added); NDAA 1-3 .3( d) Specific Conflicts (stating that "t]he prosecutor should excuse himself or herself from any investigation, prosecution, or other matter where personal interests of the prosecutor would cause a fair-minded, objective observer to conclude that the prosecutor's neutrality, judgment, or ability to administer the law in an objective manner may be compromised") (emphasis added). A fair-minded, objective observer could easily conclude that the misdemeanor and felony filings are in retaliation for Judge Coleman's denial of Oklahoma County District Attorney David Prater's wrongful disqualification attempts. The record reflects at paragraphs 11 and 13 above that the Prosecutor has admitted his bias: • When Judge Coleman denied Mr. Prater's blanket recusal request, Mr. Prater noted the Judge had not "acknowledged the fact that I've filed a ... Judicial Complaint against you .. .You feel like ... that has no issue and would not cause any issue with you being biased against the State of Oklahoma, when you understand that l':m seeking your removal from the bench[?]" See Exhibit 9, Hrg. Trans. 9/4/2019, at 19:2-14 (Emphasis Added). • Mr. Prater responded: "I am telling you now, I'm seeking [your] removal from the bench, and I will be contacting the Attorney General this afternoon and asking him to move forward on a petition to remove you before the Multi-County Grand Jury. You need to be aware of that, Judge. This is not a threat." See Exhibit 9, Hrg. Trans. 9/4/2019, 19: 18-25 (Emphasis Added). III. Untruthful Testimony Was Presented to the Grand Jury. Perjury in this context is the making of a false statement under oath that a matter is true when in fact the witness or declarant believes the statement to be false. See 21 O.S. §491. The lack of 11 materiality of the false statement is not a defense to pe1jury. See 21 O.S . §498(b). Whoever procures another to commit pe1jury is guilty of subornation. See 21 O.S. §504. Moreover, lawyers have an additional duty of candor to the tribunal and cannot offer untruthful testimony nor allow such testimony to stand without rectification. Okla. Stat. tit. 5, Ch. 1, App.3A Rule 3.3. The Rule does not tum on whether the attorney offered the evidence; rather the Rule is designed to assure candor to the tribunal regardless of who offered the criminal or fraudulent testimony. Id. On September 17, 2019, a True Bill oflndictment ("Misdemeanor Indictment") was filed alleging four (4) counts of failing to file Oklahoma income tax returns, in violation of 68 O.S . §240.A, specifically for the tax years 2015, 2016, 2017, and 2018. Prior to the filing of the Misdemeanor Indictment, it is undisputed that the Defendant, The Honorable Kendra Daishon Coleman, filed her Oklahoma income tax returns for the tax years 2015, 2016, 2017, and 2018 . Upon information and belief, false testimony was presented to the Grand Jury resulting in the filing of the Misdemeanor Indictment. The Defendant has requested a copy of the transcript of the testimony given at the proceeding pursuant to 22 O.S. §340(8) and documents pursuant to 22 O.S. §354(8) at her expense. 5 The Prosecutor owes a duty of candor to the tribunal and cannot offer untruthful testimony nor allow such testimony to stand without rectification. Okla. Stat. tit. 5, Ch. 1, App.3A Rule 3.3. The Rule does not turn on whether the attorney offered the evidence; rather the Rule is designed to assure candor to the tribunal regardless of who offered the criminal or fraudulent testimony. Id. The Prosecutor remains silent on how the falsity of the indictment occurred. Such a failure undennines the structural integrity of this case sufficiently to wanant the Prosecutor's disqualification. 5 011 November 18, 2019, Defendant's counsel, Joe E. White, Jr., emailed District Attorney Prater and First Assistant District Attorney Harmon requesting this information. As of the filing of this Motion, Mr. White has not received any response. 12 IV. Request for Evidentiary Hearing. The Defendant requests an evidentiary hearing so the trial court can weigh the evidence and make the necessmy specific findings of fact to suppmt its decision on whether disqualification is wananted. "Upon presentation of a motion to disqualify for an alleged conflict of interest, the trial court must hold an evidentiary hearing, and, if the trial court grants the motion to disqualify, the order of disqualification must include specific findings of fact supporting the decision. " Holden, P. C. v. Sezin, 2009 OK CIV APP 6, ~10, 202 P .3d 868, citing Piette v. Bradley & Lese berg, 1996 OK 124, ~ 2, 930 P.2d 183, 184. Further, such an order may be appealable immediately and on appeal in such cases, "the function of an appellate court is to determine whether the [trial comt's] findings are suppo1ted by substantial competent evidence and whether the findings are sufficient to support the trial comt's conclusions of law." Id., citing Prospective Investment and Trading Co., Ltd. v. GBK Corp. , 2002 OK CIV APP 113, ~ 13 , 60 P.3d 520, 524." WHEREFORE, the Defendant prays for an Order dismissing and setting aside the felony Information filed October 28, 2019, and request for evidentimy hearing or, in the alternative, Order from this Comt disqualifying the Oklahoma County District Attorney as well as any offending 1t deems just and p Respectfully submitted, / ( JO- E. WHITE, JR. A #12930 OBA#l8869 CHARLES C. WEDDLE OBA #30930 KA TE C. THOMPSON WHITE & WEDDLE, P. C. 630 N.E. 63rd Street Oklahoma City, Oklahoma 73105 (405) 858-8899 (405) 858-8844 FAX joe@whiteandweddle.com charles@whiteandweddle.com kate@whiteandweddle.com 13 Attorneys for Defendant, The Honorable Kendra Coleman CERTIFICATE OF SERVICE On this 20th day of November, 2019, a true and correct copy of the within and foregoing Defendant Kendra Daishon Coleman's Motion to Disqualify Prosecutor was served on the following: David W. Prater, Esq. Jimmy Harmon, Esq. District Attorney ' s Office 320 Robert S. Kerr Avenue, Suite 505 Oklahoma City, Oklahoma ?_3_!_Ql_ _ .// ,-/ 2 ~'~ -/ JOE R WHITE, ~- 14 R. ~ EXHIBIT lfilDrnke 20i5 fax Softwor, Tools RP.port, l.nst Year Dalil -SP.lufi Heip ----:File-;=EF=:::~~==-==== ~ -:=::::=============::=:.::-:::::.=- :::...:-.=: - - ::.....: - =-:::_ ,.-:::::;: .-:.::::: -c= ·- == ·· =- ::= -----:;:= ~ ==::::.,--- - ----- : Drake 2015 .. Search EF Database on~ . . '·• . -~s~·,, -s~~/l;l~Jtlil!lle to seareh tor.. Name: . ,.::::.._: . Taiqiayer: Go._ _ JcoLE;Mi\N ICOLEMAN 1 Ci:!ARLES & -----·-·-----·---·---- KENDRA D OK !· I Spouse: i' _Fl-Gener~ lnfom1atton IF2 - Banl below, The·due dale an Ml PARt rwo for el~ctronlc payment is 4-20-16, For a balance due return with a non-electronic payment enclose a payment with the 511-V and submit on or before the due date of it-18-16. 1:r::=1:.n1;mw@Jmtn.:◊.Nn;1)»tr~tl*-¥S.B.1M'@M!'tnnw:;:rrnmitw:~1rn:tf'!::mtnm11rnrtm:::t'M1 &:mm:r:n1@ntrnm:m:::n:::=:=ntnm=:n:t:nJ · I conse.rit iha\.rhy refund be-directly d.eposit!ld a~·designaied in the electrorile P.brtl\m.dmy 20ifr9Rialiorn~ lncomeot~x return. If I tiave·filed a joint return, this Is ah ·irrevocable appointment oftlie oiher spouse as an·agen(to receive \he refund.- ~ ~ I .iu\liorize..the.Okiahoma State Treasury and:Jts.deslg'nated Fln·anclai Agenlto inltiate'. ail ACH elecironlc funds withdrawal (direct debit) entry to,th'e flriariciaf'institutiori ·account indicated In the tax preparation software for pay men~ of my Oklahoma taxes owed on ihls .return .i.nd/or a p,ayrnent of-e.stirnat.ed tax. I ,:ils9 authiirize the financial Institutions involved in the processing of the electronic payment:ohaxes to. receive confidential Information necessary lo answer inquiries and resolve issues related to the payment. If I have fl_l~d ~ baiance·due·return, I understand·that if the 0kl.i.ho.n:ia Tax Oommissioh (OTC) cfoes riot.rec.elve f~il arid 'timeiypaymeritbf my tai< liability; I will:remalri liable for the tai< liability and all applicable Inter.est and pe·nalties. 0 ·Unger p~naltie~ of perJl/ry, I declare·i hav~,.~ornp;,r..ed ihe Information contained on·my retur.n, with Information.I have provided to my Electronic Return 'Orlgln;iio.-r (ERO), ani:rthe \]mounts descri'tied In Part One above, agree with the amounts shown on the ·correspondirig lines of my 2015 Oklahoma income tax reli.Jrh. To'the best cif iny kriciwiedge a·nd belief, my return is true, coireci, and complet!l. l'i:oriser,t.tlic1t my re/urn, including this declaration and accom• . panyln~ scheclul.!ls and staiernents,J:1.e sent to the OTC by 1)1Y ERO. In aMIUon:, by us[~g a computer system '8nd s9.riware to preP.are·and transl)llt my retu.m-el~ctrii:n.icaliy, I consent 1.o.lhe•dls,.ctosure to.. the· Oklahoma Tax ·comnilssion of all infonnation pertaining to my use of the system and s·oftware· and to °theliJ!m;h)lsslon of iny .tax. return ·e1eclronic~lly. S!!)n 06-06~2016 Your ·Signature. . . . Date Spoi.Jse•s ,s ·ignature (lfjoinfreturii, both ·musfsfgri) ba·te mPARr THREE muw1s.¢.JtAR1:str1:oN:~~•Ma.e:s.rtr1tt.0:w1~:::ro.;mum.ti'u~a.tQ.JNAmma:::uaa.0:ooM~Nmab1mnaaJ$ffA~Rrn@t1::=:=::1 I.declare r h.:ive·reviewed the above taxpayer'.s return and \he eritries on Form 511 EF are complete and correct to the best of my knowledge. (EROs who are colleckirs ·.are not responsjble for·reviewing the taxpayer'~ return; however, I.hey rilust ensure Form 511 EF accurately reflects the data on the return.) I have bbtai~~d taxpayefs signature on Fcirm'511 EF aild I have provided the taxpayer with a copy cif all fomis and Information to be filed with the OTC, and have followed all olher requirements described In Pub. 1345, Handbook for Electronic Filers of Individual Income Tax Returns (Tax Year 2015). If I am also a Paid Pr~parer, under penalties of perjury I declare I have examined the above t;,xpayer's retum and accompanying sche(lules and statements; and lo the best of my °lF1! ,~ -- - , . .... , - , <- C.\l,r-1f Y DEFENDANT. (Cf= 2UJ9,~ 4 4 88 ) Q /L".H~J:\ et-i _, . OCT 2 B 20\9 RICK \v'ARREN IN THE NAME AND BY THE AUTHORITY OF THE STATE OF OKLAHOMA, COMES NO\\COURT CLERK DA YID W, PRATER THE DULY ELECTED, QUALIFIED AND ACTING 9~J BlCI.A.+:J;:0RNEY''m"' AND FOR OKLAHOMA COUNTY, DISTRICT NO. 7, ST ATE OF OKLAHOMA, AND ON HlS OFFICIAL OATH INFORMS THE DISTRICT COURT TilA T COUNT I : ON OR ABOUT FROM THE 16TH DAY OF OCTOBER, 2018, TO THE I 2TH DAY OF · - SEPTEMBER, 2019, -THE CRIME 0F-FAILURE TO FILE STATE IN Ce ME TAX RETURN WAS- FELONIOUSLY COMMITTED IN OKLAHOMA COUNTY, STA TE OF OKLAHOMA, BY KENDRA D. COLEMAN, AN OKLAHOMA RESIDENT AND PERSON REQUIRED TO FILE A STATE INCOME TAX RETURN BY RECEIVING INCOME IN EXCESS OF THE SUM OF THE STANDARD DEDUCTION AND THE PERSONAL EXEl\1PTION, WHO KNOWINGLY AND INTENTIONALLY FAILED TO FILE A STATE INCOME TAX RETURN AS REQUIRED BY LAW WITH THE INTENT TO EV ADE PAYMENT OF STA TE INCOME TAXES CONTRARY TO THE PROVISIONS OF SECTION 2376(A) OF TITLE 68 OF THE OKLAHOMA STATUTES AND AGAINST THE PEACE AND DIGNITY OF THE STA TE OF OKLAHOMA. - DAVID W. PRATER DISTRICT KrTORNEY-;-DISTRICTNO: 7 - - -OMA COUNTY, OKLAHOMA 0 (___ CT,'.\.TTORNEY Report Date and Time: I 0/28/2019 12 :0 I Case#: INFORMATION CF19104482 I HA VE EXAMINED THE FACTS IN THJS CASE AND RECOMJvlEND THAT AW ARRANT DO ISSUE, (22 O.S .: 231 ). DAVID W. PRATER DISTRICT ATTORNEY, DISTRICT NO. 7 OKLAHOMA COUNTY, OKLAHOMA BY - - - - - - - - - - - - - -- ASSISTANT DISTRICT ATTORNEY NAME OF WITNESSES OKLAHOMA COUNTY CLERK 320 ROBERTS KERR FLR 2 OKLAHOMA CITY, OK 73102 JERRY LEONARD 201 NW 63D STR STE210 - O.Kb-AH0MA- CITY, OK 731 I 6 - - - Report Date and Time: 10/28/2019 12:01 RANDY JOHNSON OKLAHOMA COUNTY DISTRICT ATTORNEY 505 COUNTY OFFICE BLDG. OKLAHOMA CITY OK, 73102 IN THE DISTRICT COURT OF OKLAHOMA CDUNTV AFFIDAVIT OF STATE OF OKLAHOMA PROBABLE CAUSE VS. Coleman. Kendra Dalson BIF 04mm; ssu :21 Park AM, ch. OK 73102 STATE 0' DKLAHO MA) 1) Retusal to Filegetum with gtent to Evado anmgm 0! Taxes: 050 Title 58. Chapter 1. 2376 A (1 count) I. Randy Jonnsan. have over :1 years or law enlomemem experience at the city and county levels. I have over 2312 hours ol training the Oklahoma Council on Law Enlurcement Education and Training. I have been omitted as a peace tn the state of Oklahoma and the Oklahoma District Attorney's Councll currently employs me as a state pallce omcer. lam presently assigned to Oklahoma Judicial Oklahoma County; as a criminal In my capacity, as an Investigator, I have developed the following lnlurmation. During the tax year 2017, Kendra Daison Coleman resided and worked in the State or Oklahoma and reported earning a gross income of 365.693. The statutory deadline to tile taxes for the 2017 tax year was April, 15, 2018. ll Ms. Coleman tor an extension to file her 2017 tax return, her filing deadline would have been extended to Oclaber 15, 2018. Kendra Dalson Coleman tailed to tile a state tax return by either statutory deadline. Prevlously. Kendra Dalson Coleman has filed an Oklahoma Stale Tax Return on time for the tax years 012008 and 2009 when the State 0' Oklahoma owed her a relund. Kendra Dalson Coleman tiled an Oklahoma State Tax Return alter the extension deadlines tor the tax years 2010. where she owed $2,300, 2011. where she owed $2011; 2012. where she owed 52.440 and 2014. where she owed $7,352, The Okahoma State Tax Commission tax warrants against Kendra Dalson Coleman for each 01 these years because she again tailed to pay the taxes she owed to the Oklahoma Tax Commission. The 2010, 2012. and 2014 warrants were issued under the name of Kendra D. Gill. Kendra Daison Coleman filed an Oklahoma State Tax Return late bul wllhin the extension lime period tor the tax years 2015, where she owed $2.629 and 2016, where she owed $3,898. The Oklahoma Slate Tax Commission issued tax warrants against Kendra Daison Coleman for both at these years because although she tiled her tax returns, she did not pay the taxes she owed to the Oklahoma Tax Commission On January 7, 2016, the Internal Revenue Service issued a tax lien against Kendra Daison Coleman under the name of Kendra D. Gill for tax years 2010, 2011, 2012 and 2013 for unpaid federal taxes. On January 9, 2016, the Internal Revenue Service issued a tax lien against Kendra Daison Coleman under the name of Kendra D. Gill for the tax year of 2014 for unpaid federal taxes . On June 1, 2018, the Internal Revenue Service issued a tax lien against Kendra Daison Coleman for the tax years of 2015 and 2016 for unpaid federal taxes. The total federal tax liens levied by the Internal Revenue Service against Ms. Coleman total $83,926 .18. On August 20, 2019, the Oklahoma Tax Commission sent Kendra Daison Coleman a letter informing her that they had not received a state tax return for 2017 with a list of taxes still owed from previous years. _ On September 4, _2019, _District Attorney David Prater filed a Motion to _Recuse Judg~ . Kendra Coleman in Oklahoma County District Court for unrelated matters. On September 11, 2019, The Daily Oklahoman published an article about Kendra Daison Coleman's failure to pay taxes to the Oklahoma State Tax Commission and the Internal Revenue Service On September 12, 2019, the Oklahoma Tax Commission received an Oklahoma State Tax Return from Kendra Daison Coleman, which indicated she owed $1,210 for tax year 2017. This amount remains unpaid and is delinquent except for a single $25.00 payment. Records of the Oklahoma Tax Commission indicated that as of September 13, 2019, Kendra Daison Coleman owed a combined $23,674.83 for tax years 2011, 2012, 2015, 2016, and 2017. On October 2, 2019, the Oklahoma Multicounty Grand Jury indicted Kendra Daison Coleman on four counts of failing to File Income Tax Returns, including count three for the tax year of 2017. Kendra Daison Coleman's biography indicates that she received a bachelor's degree in accounting from Fort Valley State University where she was on a full academic scholarship, a Master's Degree in Business Administration from Oklahoma City University, and a Juris Doctor degree from Oklahoma City University School of Law. Ms. Coleman is currently employed as an Oklahoma County District Judge earning $139,298 annually. · This pattern of failure to timely file tax returns and pay taxes to both the state and federal government:, demonstrates Kendra Dai son Coleman's •tntent to evade her state inco; ,1e tax liability during years she owed substantial amounts of money. However, during the years the Oklahoma Tax Commission owed Kendra Daison Coleman a tax refund, she filed her state ta x returns in a timely manner. This behavior demonstrates_ that Kendra Daison Coleman was aware of her obligaiion to file state tax returns and pay state income taxes, but failed to file a state tax return for tax year 2017 until approximately eleven (11) months past the extension deadline, and only after her failure to do so had been widely publicized, in an effort to evade payment of income taxes to the Oklahoma Tax Commission . This information is presented to establish probable cause that a crime has been committed and that crime was committed by the named party. This is not and should not be construed as a fact by fact recounting of the case. Based on the above listed facts I submit that there is sufficient evidence to establish probable cause for charges of: 1) Refusal to File Return with Intent to Evade Payment of Taxes : OSC Title 68, Chapter 1, Section 2376 A (1 count) THIS INCIDENT OCCURRED IN OKLAHOMA CITY, OKLAHOMA COUNTY, STATE OF OKLAHOMA. / .y /::' . -:a:i'td for the _ , State of Oklahoma 12,:\-,ii(:-' ·:·_,::\ \ ,bi-'\• ·;";, ; ; F1\\/,~-·\;-lh,.tt~7it;~J;' Ce rtifica t e No. 17 82 9:_ ::-. ~, · ~, , . , >i l_·;kb.h--: ,~,a ·~~('_'.~:·_:_.: ~~ ...'. ,· .. - .:-:·: ,,.~· (~>~~rl i i ie<.l St·r ,._,r-cl1;?t~i;::. ~-!i~);!~-=.lt-r£•~~str . (::~~It-\ ~i l ?ff.~~ r-v'l y Cet't:tfkiYi ri:,'.:/.Fh>/i;;'2.1., 1~r:Jr, 25 DISTRICT COUT OF OKLAHOMA -- OFFICIAL TRANSCRIPT ~tt.' ,,-+2 EXHIBIT ?10? 784 a Employee's SSN C Employer's name, address, and ZIP code KENDRA D GILL- ATTORNEY AT LAW KENDRA D GILL- ATTORNEY AT LAW DB 3601 N. CLASSEN BLVD., #109 2 Fed inc lax withheld 4 SS laxwithheld 14000. 00 FormW~2 5 Medicare wages & lips 6 Medicare lax withheld 14000.00 203 . 00 Wage and 868.00 Sutt. Employee's name. address, and ZIP code 10 Depdnl care beneITls 11 NonqualiITed plans 13 14 Other Statement r ~5 ~~~~i~~~eg~~2'~a~~~ 6 12a Relirement plan • • n Third-party sick pay Copy B To Be Filed wllh Employee's FEDERAL Tmc Rclurn This fnformalion is being furnished lo lhe Internal Revenue Service. ---- ------ --------- -------- REV 12121/17 QBDT Departm enl ol lhe Treasury - IRS - Employee's SSN ---- --- ----------- -4784 C Employe(s name, address, and ZIP code "KENDRA D GILL- ATTORNEY AT LAW KENDRA D GILL- ATTORNEY AT LAW DB 3601 N, CLASSEN BLVD. , #109 OKLAHOMA. CITY 20 Locality name 19 Local income lax 18 l ocal wages, lips, elc 00 Slalawlg4soltoe'.co~ ~7 Slaleincol~;o. 2017 I I 12c I 12d I 12b □ □ Slalulory employee . KENDRA D GILL 5915 N.E. 63RD STREET OKLAHOMA CITY OK 73141 a Tax 9 8 Al!o:;;,icd lips OK 73118 d Conlrol numbe r e 0MB No. 15~5-000B 3 Social securily wages 3500.00 14000.00 7 Social secLlriiy lips OKLAHOMA CITY 27-2529258 b Employer idenlificalion number {EIN) 1 Wgs, lips, other compn b 1 ·--.------ - 14000.00 3500.00 5 868.00 Form 14000.00 203.00 14000.00 7 Social security lips 8 Allocaled_lips 10 Depdnl care benems 11 Nonqualified plans 12a 13 14 Olher 12b 2017 I e Employee's name, address. and ZIP code Sulf, □ □ SlalulorY employee, GILL KENDRA D 5915 N.E. 63RD STREET OKLAHOMA CITY OK 73141 ~5 i~• i ~;~~e{;~~~l~;;•-O~ r 6 Reliremenl plan . - , Third-party sick pay 6~ Slalew;_g'1s(i1 14 e•lcOQ_,~7 Stale inco I 00 • OO 1 W=2. Tax Statement 9 OK 73118 d Control number --- - - · Wage and 6 Medicare lax withheld Medicare wages & lips ... 0MB No. 1545--00D8 3 Social security wages 2 Fed inc lax withheld 4 SS lax withheld - -·--·--- - ----- --·- 27-2529258 Employer idenlifiealion number (EIN) Wgs, lips, olhercompn _________ ------------- · I Copy 2To Be Filed With 12c Employee's State, . I City, or Local 12d Income Tax Return. t ---------- --------18 I 19 L~cal income la~ Local wages, lips, etc . 20 Locality name -------- REV 12121/17 OBDT 4 73,1 a Employee's SSN c Employer's name, addre.ss, and ZIP cotfe ,,,.,..., KENDRA D GILL- ATTORNEY AT LAW KE:NDRA D GILL- ATTORNEY AT LAW DB 3601 N. CLASSEN BLVD., #109 OKLAHOMA CITY OK 0MB No. 1545-0003 b Employer iden\ificollon number (EIN) 27-2529258 v · This informollon is being furnished !o !he IRS. If you arc required lo file a lax return, a negligence penally or olher sanclion may be imposed,..,cfn you ir lhis income is laxable and you fail to report ii. 1 Wgs, lips, other comp'V "2 Fed inc lax withheld t, /3 Social security wages\, 1 4 000.00 / 868 . 00 73118 3500.00 , 14000. 00 \, 5 Medicare wages & lip\s./ '6 Medicare lax withheld c 4 SS lax withheld 14000.00 8 Allocaled lips 7 Social security lips 203.00 Statement Employee's name, address, and ZIP code Suff. 10 Depdn·1care benefils 11 Nonqualified plans 12a 13 14 Olher 12b Slalulory employee, GILL KENDRA D 5915 N.E. 63RD STREET . OK 73141 OKLAHOMA CITY / 15 SlolV, Employe(sslolelDNo. / Reliremenl plan , • / Third-par1y sick pay tlt16 Slalewages,lips,elc v.,.17 Slateincome lax □ □ I I I 12c ,., 2017 Copy C For EMPLOYEE'S RECORDS . (See N,;:,tice to Employee.) t - --------- --------- V 18 local wages, lips, etc '- _oK__"~wTH-13922900 -02 ___ 14000.00 _ __ _ _ 14 00 . 00 REV 12121/17 OBDT Tax 9 d Control No. e ;;:g~~~ 12d I 19 Local income tax 20 Locality name --- - --- - Schedule K-1 (Form 1120S) 2ou1 n IPart III I For calendar year 2017, or tax year Deparlmenl of lhe TreasUl)I 1 lnlemal Revenue Service 2017 beginning A Shareholder's Share of Current Year Income, Deductions, Credits, and Other Items Ordinal)' business income (loss) V 1 13 Credils ending Information About the Corporation 2 Nel renlal real eslale incoIT\e (loss) 3 Olher nel renlal income {loss) 4 lnlerest income Sa Ordinal)' dividenqs Sb Qu alified dividends 6 Royallies 7 Nel short-lerm capilal gain {loss) Corpora lion's employer idenlilie~lion number 27-2529258 V CorPoralion1s name, address, cily, slate. and ZIP code B Kendra D Gill - Attorney at Law / dba The Gill Law Firm LLC 3601 N Classen Blvd Suite 109 ~ 0 Oklahoma Citv C 671117 0MB No. 1545-0123 Amended K-1 51,693 Shareholder's Share of ·Income, Deductions, Credits, etc. J> See page 2 of form and separate instructions. IPart I I n· FinalK-1 Foreign transactions 14 OK 73118 !.f:!S ~nler where corporalion filed relurn ____- -- - ·· _ ___ . - ·· . - ------- -~ ----- ·-- - - ·----·--- . .N!lU9ng:le.(l11_capilal gain.{loss) ____···- -·· OGDEN IPart II I ~-•-lr~gzmber E Sb Colleclibles (28%) gain {loss) Sc Unrecaplured seclion 1250 9ain 9 Nel section 1231 gain (loss) Information About the Shareholder Shareholders name, address, cily, slale, 71P code Kendra D Coleman, 1p 5915 NE 63rd St Oklahoma City F Shareholders percentage of slock ownership for lax year . . OK 73141 . . ..... 100_00000 % 11 Seclion 179 deduction 16 ./ 12 i/ 'Olher deduclions 0 al rn :::i Cf) -a:,_ 0 lL rl~1 1 }ti ~ ~~ I/~ I ~ l I; ~ , ;1r1,~1 ~ ~ 1 I l~JJ~'. ,r I ~· I ' ' '/I~ , '. 1 ~. { ' I ' 1 ' ' ) ': : I ;/ If Y. / ✓ 1,092 A .c C Alternalive rninimum lax {AMT) ilerns 15 Olher income {loss) STMT C* I D✓ 17 I Hems affecting shareholder basis 52,313 Olher information , { •~, * See attached statement for additional information. For Paperwork Reduction Act Notice, see the Instructions for Form 1120S. EEA wv11•1.irs.gov/Form112os Schedule K-1 {Form 1120S) 2017 1/· Schedule K~1 Sup lemental information 2017 Shareholder's ID Number Shareholde~s name Kendra D Coleman 784 S Corporalion's EIN Name of S Corporalion Kendra D Gill - Attorne at Law 27-2529258 Form 11208 Schedule K'--], - Line 16 Code Description C Other Nondeductible Expenses r/ Meals and Entertainment✓ Amount 2,170 2 , 1 7 o______ / 2,.170 Total. ( 1120SK_1.LD2 Shareholder's Adjusted Basis Woriksheet 20il7 Keep lor your records. Shareholder Number: Shareholder Name: Corporation Name: Taxyearending: . l 2 - 3 1 - 2 O l 7 • 784 ..... -- -Kendra D Coleman Kendra D Gill Attorne at Law ownershlp¾:10 0 . EIN 0 0 0 000 27-2529258 Stock basis Sloclc basis, beginning ol year (Nol less lhan zero) 2 Addilional Capilal Conhibulions ol Slock Purchased 3 lnc,eases for income and gain ilems: 2 a Ordinary Income (Sch K-1, Line 1) a b Real Eslale Renlal Income (Sch K-1, Line 2) b C c Olher Renlal Income (S ch K-1, Line 3c) d lnleresl, Dividends & Royallies (Sch K-1, Lines 4, 5 & 6) d e Capilal Gain (Sch K-1, Lines 7 & Sa) e Olher Porlfolio Income (Sch K-1, Line 10a) g Secljon 1231 Gain (Sch K-1, Line 9) g h Olher Income (Sch K-1; Line 10) h I< 51,693 3a-h Tola! Income and Gain Hems (Tola! lines 3a-3h) Increase for Non-Taxable Income (Sch K-1, Lines 16a & b) 511693 31 fncrease for Excess Depletion Adjuslmenl 3j Increase from Recaplure al Business Credits (See IRC § 49(a), 50(a), 50(c)(2) & 1371(d)) 3k 31 -- -- 1- - Gain lrom-179-asset- Charles T Coleman 5 Qualifyingwidow(er) (see instructions) Yourself. If someone can claim you as a dependent, do not check box 6a b Spouse . c Dependents: (1) First.name •. . . . • . • . . . . . . . . . . • . . . .• (2) Depend ent's social security number ·-- (3) Dependent's relationship to.you -·-· Lastname } □ □ □ □ d ependents, see instructions and I> □ d Income Attach Form(s) W-2 here. Also attach Forms W-2Gand 1 099-R if tax was withheld. If you did not get a W-2, see instructions. Adjusted Gross Income ... . . . . Total number of exemptions claimed 7 Wages, salaries, tips, etc. Attach Form(s) W-2 7 Ba Taxable interest. Attach Schedule B if required Ba b Tax-exempt interest. Do not include on line 8a 9a b : f ~; f Ordinary dividends. Attach Schedule B if required Qualified dividends ... . . . . : f ~; f . . . . 10 Taxable refunds, credits, or offsets of state and local income taxes 11 Alimony received 12 Business income or {loss). Attach Schedule C or C-EZ ... . . . . . . .. .. ... . . . 11 12 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here Other gains or (losses). Attach Form 4797 15a 16a 17 18 19 20a 21 22 23 24 IRA distributions I . . . . . , 15a -1 Pensions and annuities . . . ... I> . . □ b Taxable amount b Taxable amount 16a Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or {loss). Attach Schedule F . . Unemployment compensation I 20a I Social security benefits . . ... ... ... . . .. . . Ib Taxable amount other income Combine the amounts in the far right column for lines 7 through 21. This is your total income Educator expenses . . . . . . . . . . . .. . you due to divorce or separation (see instructions) Dependents on 6c '17 1 not entered above Add numbers on lines above I> 14,000 10 .. .. .. 1 9a . .. 14 . . . .. . Boxes checked on 6a and 6b No. of children (4) Chk if child under on 6cwho: age 17 qualifying . O lived .with you . · for child tax credit 0 did not five with see instructions If more than four check here Spouse l>--,--,---------------------------- Married filing sepa rately. Enter spouse's SSN above andfull name here. You Head of household (with qualifying person). (See instru ctions.) If the qualifying p erson is a c hild but not your dependent, enter this child's name here. Married filing jointly (even if only one had income) 2 3 4 Single )> 13 14 15b 16b 17 18 19 20b 21 22 51,693 65,693 23 Certain business expenses of reservists, performing artists, and 24 25 26 fee-basis government officials. Attach Form 2106 or 2106-EZ 25 26 27 28 Self-employed SEP, SIMPLE, and qualified plans 29 Self-employed health insurance deduction Health savings account deduction. Attach Form 8889 Moving expenses. Attach Form 3903 .. . .. Deductible part of self-employment tax. Attach Schedule SE 30 Penalty on early withdrawal of savings 31a Alimony paid b Recipient's SSNt> 32 33 34 35 IRA deduction .. .. 31a . . .. . . . .. Student loan interest deduction .. Tuition and fees. Attach Form 8917 Domestic production activities deduction. Attach Form 8903 . . . . 27 28 29 30 32 33 34 35 .... 36 Add lines 23 through 35 37 Subtract line 36 from line 22. This is your adjusted gross income . For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. EEA 36 )> 37 0 65,693 Form 1040 {2017) '• Form 1040 (2017)Kendra Tax and Credits 0 All others: Single or Married filing separately, $6,350 Married filing jointly or Qualifying widow(er), $12,700 Col e man 39a C h~k { if: B wece bom before Jaooa,y 2, 1953, Spouse was born before January 2 , 1953, Bliod'} Tolal boxes Blind. checked I> 39a Itemized deductions (from Schedule A) or your standard deduction (see left margin) 41 Subtract line 40 from line 38 42 43 T axable income. Subtract line 42 from line 4 1. lfline 42 is more than line 41, enter -0 - . 44 Tax (see instructions). Check if any from : a 41 Exemptions. If line 38 is $156,900 or less, multiply $4,050 by the number on line 6d. otherwise, see instructions 42 DF□rm(sJ 8814 DF□rm 4972 b 45 Alternative minimum tax (see instruction s). Attach Form 6251 46 Excess advance premium tax credit repayment Attach Form 8962 47 Add lines 44, 45, and 46 48 Foreign tax credit. Attach Form 1116 if required 49 Credit for child and dependent care expenses. Attach Form 2441 50 Education credits from Form 8863, line 19 .. .. 45 I> 47 50 51 Retirement s avings contributions credit. Attach Form 8880 51 Child tax credit. Attach Schedule 8812, if required 52 53 Residential energy credits. Attach Form 5695 Other credits from Form: a D 3800 b Ds801 ... 53 0 54 0 Add lines 48 through 54. These are your total credits . . . .. . . . . . . . . . . . . .. . - from line 47 . If line 55 is more than line 47, enter ~0- ·- . . ....... ·- I> .. 57 S elf-employment tax. Attach Schedule SE ...... . . . . . . . . . . . . . . . . a D4137 b □ 8919 57 Unreported social security and Medicare tax from Form: 58 Taxes 59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 59 .... - ........ . . . . . ... If you have a qualifying child, attach Schedule EiC. 62 63 Taxes from: aO Form 8959 Form 8960 cO Instructions; enter cade(s) Add lines 56 through 62. This is your total tax . . . . . . . 64 Federal income tax withheld from Forms W-2 and 1099 65 2017 estimated tax payments and amount applied from 2016 return . Earned income credit (EiC) I> I 66b I 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 70 Amount paid with request for ex tension to file 70 69 71 Excess social security and tier 1 RRTA tax withheld 71 72 Credit for federal tax on fuels. Attach Form 4136 72 73 74 8885 d o _ 73 Add lines 64, 65, 66a, and 67 through 73. These are your total payments 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 76a 2439 b D Reserved c 10,161 63 3,500 66a 67 Credits from Form: a D 1,541 61 65 . . . . . . . . . ...... Nontaxable combat pay election . . • g-~ 62 0 . . 62 . ... . . ... 64 66a b Refund b□ -- 60b □ Health care: individual responsibility (see instructions) Full-year coverage -· 60a b First-time homebuyer credit repayment Attach Form 5405 if required 61 0 55 5ff 58 60 a Household employmenttaxes from Schedule H 8,6 2 0 49 ......... 54 46 48 ■ 52 Subtract lm-e 55 43 44 cO .. . .. . ..... . . . .. •••• 10,100 55,593 4,050 51,5 43 8 620 40 . ............. . ....... . ...... other Payments 478 4 Page 2 65,693 38 If your spouse itemizes on a separ_ate return or you were a dual-status alien, check here . . . I> 39b 40 Head of 55 household, --- · s 6 · $9;350- h . . . . . ................... BY'" Amount from line 37 (adjusted gross income) b Standard Deduction for • 0 Peoplewho check any box on line 39a or 39b or who can be claimed as a dependent, see instructions. D 38 D ... . ... 9. Amount of line 75_you want refunded to you. ff F.orm 8888 is attached, check here I> 3,500 74 75 • I> D 76a 77 I I I I I I I I I l1>c Type: Checking D Savings Account number I I I I I I I I I I I I . I I I' I Amount of line 75 you want applied to your 2018 estimated tax . . . I> I 77 I Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions I> You Owe 79 Estimated tax penalty (see instructions) Third Party Do you want to allow another person to discuss this return with the IRS (see instructions) ? Yes. Complete below. No Designee's S H EA Phone Personal Identification 1 1 IS IS 1 I 0 S - 715 - 0 2 2 S number(PIN) name I> Uzanne ays no. I> 4 I> . 2 . 2 . . .3 . Designee Sign Here b I> Direct deposit? See instructions. d I> Routing number . ... . ...... 6,774 78 11 3 IB! D Under penalties of perjury, I declare tha l I have exa mined this return and accompanying schedules and statements, and lo the best of my kno\1,1edge 2nd belief, th ey are true, correct, and accurately list all amounts 2nd sources of income I received during lhe lax yeu . Declaration of preparer {other th an taxpayer) is based on 211 iniormaUon of which preparer h2s any knowledge. Your signature Dale h., 74369 Date b ate 9-12-2019 PrinVfype prepare~s name Michele 1 Firm s address I> The I> 3126 s Havs Edmond, Identity Protection PIN (see inst.) 1 Spouse s occupation Preparer's signature Firm's name Daytime phone number Your occupation 09-12-2019 Attorney Joint return? Seev s pauses , s1gna · ture. If a J·□m · t re tum, both must sign. · instructions. Keep a CORY for your recoros. Paid Preparer Use Only I 79 ., Check LJ if I I I I I I PTIN P02215749 self-employed Orefice Group Inc Boulevard OK St e 73013 EEA Go to www.irs.gov/Form 1040 for instru ctions and the latest information . Firm's EIN I> 324 Phone no. 405-7l5 - 0225 Form 1040 (2 017) Schedule E (Form 1040) 2017 13 Attachment Sequence No. Page 2 Name(s) shown on return. Do not enlern ame and social security number if shown on page 1. Kendra D Coleman -4784 Caution: The IRS compares amounts reported on your tax return with amounts shown on Schedule(s) K-1. IPart II I Income or Loss From Partnerships and S Corporations Note: If you report a loss from an at-risk activity for which any amount is not at risk, you must check the box in column (e) on line 28 and attach Form 6198. See instructions. 27 Are you reporting any loss not allowed in a prior year due to the at-risk, excess farm loss, or basis limitations, a prior year unallowed loss from a passive activity (if that loss was not reported on Form 8582 ), or unreimbursed partnership expenses? If you answered "Yes," see instructions-before completing this section . . . . . . . . . . . . . . . . . . . . . . . Yes D 28 (b) Enter P for partnership; S for S corooration (a) Name AKendra D Gill s Attorney at Law - (c) Check if foreign nartnershin C D Passive Income and Loss IBJ □ □ □ □ 27-2529258 Nonpassive Income and Loss (g) Passive income from Schedule K-1 (h) Nonpassive loss from Schedule K-1 No (e) Check if any amount is not at risk number □ □ □ □ B (f) Passive loss allowed (attach Form 8582 if required) (d) Employer idenlificalion U) Nonpassive income (i) Section 179 expense deduction from Form 4562 from Schedule K-1 51,693 A B .. C - . .. -· - ... ·- ·- ··· -. - -· - .. - . ... ·- -~-. .- D 29a Totals b Totals I I 51,693 . .. . . . ... . . ... . .. .. . 30 .. 31 30 Add columns (g) and (j) of line 29a 31 Add columns (f), (h), and (i) of line 29b 32 Total partnership and S corporation income or (loss). Combine lines 30 and 31. Enter the . . . . ... result here and include in the total on line 41 below I Part HI I ... . . . . . .. . . . .. 51,693 ) { 51,693 32 Income or Loss From Estates and Trusts 33 (b) Employer identification number (a) Name A B Passive Income and Loss (c) Passive deduction or loss allowed (attach Form 8582 if required) Nonpassive Income and Loss (d) Passive income from Schedule K-1 (e) Deduction or loss from Schedule K-1 (f) Other income from Schedule K-1 AJ Bl 34a Totals b Totals I I .. . . ... . . . . . .. . . .. . .. .. . . . . . .. . .. . . . . . . . . . . 35 Add columns (d) and (f) of line 34a 36 Add columns (c) and (e) of line 34b 37 Total estate and trust income or (loss). Combine lines 35 and 36. Enter the result here and 35 . . { 36 ) ... .. .. . . ... . .. . . 37 Income or Loss From Real Estate Mortgage Investment Conduits (REMICs) - Residual Holder include in the total on line 41 below IPart IV I 38 39 (a) Name (b) Employer identification number (c) Excess inclusion from Schedules Q, line 2c (see instructions) (d) Taxable income (net loss) from Schedules Q, line 1b . . 39 Combine lines 26, 32, 37, 39, and 40. Enterlhe result here and on Form 1040, line 17, or Form 1040NR, line 18 l> 41 Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below IPart VI .. (e) Income from Schedules Q, line 3b Summarv 40 Net farm rental income or (loss) from Form 4835. Also, complete line 42 below 41 Total income or {loss). 42 Reconciliation of farming and fishing income. Enter your gross .. . . . 40 I 51,693 farm ing and fishing income reported on Form 4835, line 7; Schedule K-1 (Form 1065), box 14, code B; Schedule K-1 (Form 1120S), box 17, code V; and Schedule K-1 (Form 1041), box 14, code F (see instructions) 43 .. 42 Reconciliation for real estate professionals. If you were a real estate professional (see instructions), enter the net income or (loss) you reported anywhere on Form 1040 or Form 1040NR from all rental real estate activities in which you materially participated under the passive activity loss rules EEA 43 I Schedule E (Form 1040) 2017 Note:Jf you are having trouble viewing this on a mobile device,please click the alternate link. lfyou arc eligible to pay current tax half, button will appear !1erc to pay. All others will have to be paid in full from previous screen. ~-)k(ahoni a ( :ouH :~- ·t·;1 \ ;~) si1~•n1 . AcctNo:-131549070- - TaxYeiir: 2dff Tax Dist: 200 Fire Dist: j t}/ L!/ 2(: 19 t); !17 :4') .\ Z..·t Tax type: REAL ESTATE TIF Dist: jray Group: 716 Addn: UNPLTD PT SEC 04 12N 2W Lot: 000 Block: 000 Legal Description: PTE 1/2 OF SW4 SEC 412N 2W BEG 656.87J1T W OF SE/C OF E 1/2 OF SW4 W328.43FT N666.27FT E328.43FT S666.27FT TO BEG OR TR 3 UNREC PLAT r:lick ht•rc to review (he cnncnl nhxsicnl udd-re!iis rl'cnrcfl'd in th~ County Assessor's Office. Click hL•rc to rc\'icw lrnw t)n•sl~ 1·nxcs nn• :1rmortimw1l. COLEMAN CHARLES T & KENDRA 15915 NE 63RD ST ~KLAHOMA CITY, OK 73141-9655 ~ym@b . . / 122817F61057912/28/2017 $2,188.11 v P Assessed Value: Exempt Amount: Net Value: Rate/$1000: TAXAMOUNT: Net Payments: Tax Balance: Costs: Interest: 19,304 0 19,304 113.35 2,188.11 2,188.11 0.00 0.00 0.00 TOTAL AMOUNT DUE $0.00 IF PAID Refunds IMMEDIATELY: ~ales/Endorsement Information Tax Roll Correction Information Contact Us !Payment Vo1Ucher lflling Instructions 2017 Date to file by: 04-17-2018 Payment: $9,069 Address to file: Int erna l Revenue Service P.O . Box 802501 Cincinnati, OH 45280-2501 Other Instructions: If paper-filing y our 20 17 return, mail the tax return , voucher, and c he ck to the address on the voucher. Do not staple the voucher and payment to the return or to each other. If your return was e-filed, mail the voucher and c heck to the address on the voucher. Make your check or money order payable to "United States Treasurylf_ . Enter your SSN and 11 2017 Form 1040" on your c heck or --m oney order. To pay by credit card, go to www.1040paytax.com . Taxpayer Records: Amount Paid Check Number Date Mailed Form 1040-V (2017) Amount to pay includes penalties and interest of $2,295 _ _ _ _ _ _ _ _ _ V _ Detach Here and Mail With Your Payment and Return _ V _ § LL 1040=V Department of the Treasu,y Internal Revenue Seivice (99) 1 Your social security number (SSN) Payment Voucher I> Do not staple or attach this voucher to 2 If a joint return, SSN shown second on your return 0MB No. 1545-0074 2017 our pa ment or return. 3Amount you are paying by check or money order. Make your check or money order payable to "United Slates Treasu ' Dollars Cents 9,069 EEA Kendra D Coleman 5915 NE 63rd St Oklahoma City, OK 73141 Internal Revenue Service p . o. Bo x 802501 Cincinnati, OH 45280 - 2501 For Paperwork Reduction Act Notice, see your tax return instructions. 443924784 WL COLE 30 0 2 □ 1712 610 i!RS e4ile Signah.11re AuHwri2:ai:uon Form l> Return completed Form 8879 to your ERO. (Do not send 0MB No. 1545-0074 to IRS.) Department of lhe Treasury l> Go to www.irs.gov/Form8879 for the latest information. Internal Revenue Seivice Submission Identification Number (SID) ~ Taxpayer's name Kendra D Coleman 4784 Spouse's name ecurity number 0351 Tax Return Information -Tax Year Endin December 31, 2017 1 Adjusted gross income (Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 4; Form 1040NR, line37) . . . • . . . • . . . . . . . . • • . • . . . . . . . • ·• . . • • · . . . . . • . . • •• 1 2 Total tax (Form 1040, line 63; Form 1040A, line 39; Form 1040EZ, line 12; Form 1040NR, line 61) 2 65,693 10,161 3 3,500 3 Federal income tax withheld from Forms W-2 and 1099 (Form 1040, line 64; Form 1040A, line 40; Form 1040EZ, line 7; Form 1040NR, line 62a) • • • • • • . . • . . • • • . . . • . • . • . . • 4 Refund (Form 1040, line ?Ba; Form 1040A, line 48a; Form 1040EZ, line 13a; Form 1040-SS, Part I, line 13a; 5 Amount you owe (Form 1040, line 78; Form 1040A. line 50; Form 1040EZ, line 14; Form 1040NR, line 75) 4 Form 1040NR, line 73a) 6,774 our return Under penalties of perjury, I declare that I have examined a copy of my electronic individual income tax return and accompanying schedules and statements for the tax year ending December 31, 2017, and to the best of my knowledge and belief, ii is true, correct, and·accurately lists all amounts and sources of income I received during the tax year. I further declare that the amounts in Part I above are the amounts from my electronic income tax return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any reiund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial institution lo debit the entry to this account. This authorization is to remain in full force and effect until I notify.the U.S. Treasury Financial Agent to terminate the authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537. Payment cancellation requests must be received no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number (PIN) below is my signature for my electronic income tax return and, if applicable, my Electronic Funds Withdrawal Consent. Taxpayer's PIN: check one box only ~ The Hays Group Inc to enter or generate my PIN 7 43 6 9 · ERO firm name Enter five digits, but as my signature on my tax year 2017 electronically filed income tax return. don't enter all zeros I authorize D I will enter my PIN as my signature on my tax year 2017 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part Ill below. Your signature l> _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Date l> 0 9 -12 - 2 019 Spouse's PIN: check one box only D I authorize_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _to enter or generate my PIN _ _ _ _ _ _ __ ERO firm name Enter five digits, but don't enter all zeros as my signature on my tax year 2017 electronically filed income tax return. D I will enter my PIN as my signature on my tax year 2017 electronically filed income tax return. Check this box only if you are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part Ill below. Spouse's signature I> _ _ _ _ _ _ __ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Pait 111 Date l> --------------- Practitioner PIN Method Returns Onl - continue below Certification and Authentication - Practitioner PIN Method Onl ERO's EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN. 732644-22553 Don't enter all zeros I certify that the above numeric entry is my PIN, which is my signature for the tax year 2017 electronically filed income tax return for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the requirements of the Practitioner PIN method and Pub.1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns. ERO's signature l> _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ __ Date I> 0 9 - 12 - 2 0 19 ERO Must Retain This Form - See Instructions Don't Submit This Form to the IRS Unless Requested To Do So For Paperwprlc Reduction Act Notice, see your tax return instructions. EEA Form 8879 (2017) ~ I ial security number 4784 II Safe 1 accurate, FASTtUse 0MB No. 1545-0008 b Employer identification number (Ell,) 1 Visit the IRS website at www.irs.gov/efile IRS e-file 2 Federal income tax v1ithheld 4 Social security tax withheld 6 Medicare lax withheld 8 /..!located tips VVages, tips, other compensation 14,000 27-2529258 3 500 3 Social securily wages C Employer's name, address, and ZIP code Kendra D Gill Attorney At Law 14,000 5 Medicare wages and tips 3601 N Classen Blvd Suite 109 Oklahoma Ci ty OK 73118 7 Social security tips d Control number 9 Verification code e Employee's first name and initial 868 14,000 Suff. Last name 203 10 Dependent care benefits 12a See instructions for box 12 11 Nonqualified plans . C I D d Kendra D Gill 5915 NE 63rd St Oklahoma City Slalulo,y employee 13 Retirement Third-party 12b n C sick pay plan n n . I ~ 12c 14 other OK . . C I ~ 73141 12d C I ~ f Employee's address and ZIP code 15 Slate 17 16. Slate wages, lips, etc. Employer's slate ID number State income tax 14,000 OK1 13922988-02 18 19 Local income tax Local wages, tips, etc, 20 Locality name 1,400 I I I W Form try) Wage and Tax 0 Department of the Tre aswy-lnternal Revenue Seivice Lb Statement Copy B - To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished lo the Internal Revenue Service. EEA ' f ormation on T h e in t he Form I a W-2 was use d to prepare Employee's social security number I t he taxpayer's 1 C Employer's name, address, and ZIP code d Control number Suff. Last name Employee's first name and initial tax return Visit the IRS website at www.irs.gov/efi/e 2 Federal income tax withheld 3 Social security wages 4 Social security tax withheld 5 Medicare wages and lips 6 Medicare tax withheld 7 Social security lips 8 Allocated tips 9 Verification code 11 Wages, lips, other compensation 10 Dependent care benefits 12a See instructions for box 12 Nonqualified plans . C D d 13 StatutDI)' employee Retirement plan n n 14 Other Third-party 12b n d e sick pay C D I I 12c . C ~ 12d C ~ f b>VTh e Hays Group In C IRS e-fi!e FASTIUse 0MB No. 1545-0008 b Employer identification number (EIN) e Fe d era1 2017 Safe, accurate, ' I I Employee's address and ZIP code ·J5 Slate Employer's slate ID number 16 State wages, lips, etc. 17 Stale income lax 18 Local wages, tips, etc. 19 Local income lax 20 Localiiy name I I I I G')) Wage and Tax Form W c&;, Statement Copy B - To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. EEA Department of the Treasury-Internal Revenue Seivice Interest andl !Penalty Calculation form '1040 2017 (Keep for your records) Name(s) as shown on relurn Kendra D Coleman 4784 Failure to Pay Penalty Tax due 12 ...•.............. . Months latex .005 (.25 max) . • X Failure to Pay penalty . 6,661 6. % - - - -000 --400 Failure to File Penalty 6,661 Tax due 11 25.000 2.500 Months late x .05 (.25 max) Late payment factor (.025 max) Late filing factor . • • . . . . . % % ••.•••••• X Failure to File penalty . . . . . . 22.500 % 1,499 If return filed more than 60 days late, the minimum penalty is the smaller of $210 or 100% of the unpaid tax. Interest Worksheet Tax due #of Interest Days Rate . ---.. . . Failure to File penalty . 4/18 - 6/30/2018 .. 7/1 - 9/30/2018 • . 10/1 - 12/31/2018 1/1 - 03/31/2019 4/1 - 6/30/2019 . . 7/1 - 9/30/2019 . . . (107) 92 92 90 91 92 5.000 5.000 5.000 5.000 5.000 5.000 Interest Amount 6,661 1,499 8,160 8,040 8,141 8,244 8,346 8,450 Amount (12 0) 101 103 102 104 106 Balance 6,661 8,160 8,040 81141 8,244 8,346 8,450 8,556 10/1 - 12/31/2019 1/1 - 03/31/2020 4/1 - 6/30/2020 . . 7/1 - 9/30/2020 . . . 10/1 -12/31/2020 1/1 - 03/31/2021 4/1 - 6/30/2021 7/1 - 9/30/2021 10/1 -12/31/2021 Date filed . . . . . 09-12-2019 Total Tax With Penalties and Interest Amount you owe fform 1040, Line 78) Failure to Pay penalty . Failure to File penalty . . . . . Interest ..... . Total tax due . . . . . . . . • PENALTY.LO 6,774 400 1,499 396 9,069 Slhared IResponsibimy fPaymei1lf Worksheet 2017 ( Keep for your records) Name(s) as shown on return Kendra D Coleman ------4784 This worksheet is a combination of Steps 2-5, Worksheets A and 8, and the Shared Responsibility Payment Worksheet shown in the instructions for Form 8965. If you or another member of your tax household had neither minimum essential coverage nor a coverage exemption for any month during 2017, use the Shared Responsibility Payment Worksheet, below, to figure your shared responsibility payment. Complete the monthly columns by placing "X's" in each month in which you or another member of your tax household had neither minimum essential coverage nor a coverage exemption. Jan Name Kendra D Coleman 1. Feb Mar Apr X X X May Jun Jul X X X X Aug Sep X Oct X Nov X Dec X X Total number of X's in a month. If 5 or more, enter 5 2. . . ... 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Total number of X's in a month for individuals 18 or over* 3. . . .. One-half th e number of X's in a month for individuals under 1a• .. 0.0 0.0 0.0 0. 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 1.0 1. 0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1. 0 1.0 695.0 695.0 695.0 695.0 695.0 695.0 695.0 695 .0 695.0 695.0 695.0 695.0 4. Add lines 2 and 3 for each month 5. .. . . Multiply line 4 by $695 for each month. If $2,085 or more, enter $2,085 .. .. ... 6. Sum of the monthly amounts entered on line 1 7. Enter your household income (see Household income) 8. Enter your filing threshold (see Eiliog TbcesbQlds For Most PeQple) 9. Subtract line 8 from line 7 12 65,693.00 4,050.00 61,643.00 10. Multiply line 9 by 2.5% (.025) 11. Is line 10 more than $2,085? . . .. . . . . .. 1,541.08 D Yes. Multiply line 10 by the number of months for which line 1 is more than zero } No. Enter the amount from line 14 of the Flat Dollar Amount Worksheet 18,492.96 Ix] 12. Divide line 11 by 12.0 13. Multiply line 6 by $272** . ... . . . . . . . . . .. .. . . . .. . .... . . . . . .. .. 1,541.08 . . 14. Enter the smaller of line 12 or line 13 here and on Form 1040, line 61; Form 1040A, line 38; or Form .. . .. . . . . .. . .. 1040EZ, line 11. This is your shared responsibility payment 3,264.00 .. . .. . . Rounded amount will carry to main form 1,541.08 1,541 *For purposes of figuring the shared responsibility payment, an individual is considered under 18 for an entire month if he or she did not tum 18 before the first day of the month. An individual turns 18 on the anniversary of the day the individual was born. For example, someone born on March 1, 1999, is considered age 18 on March 1, 2017, and therefore, is not considered age 18 for purpos~s of the shared responsibility payment until April 2017. **$272 is the 2017 national average premium for a bronze level health plan available through the Martketplace for one individual and should not be changed. WK_89651.LD Houselhold Income Worksheets for !Form 8965 and !Fiat !Dollar Amount Worksheet 201 7 (Keep for your records) Name(s) as shown on return Taxl.D Kendra D Coleman 784 - Household Income Worksheet 1. Enter your adjusted gross income (AGI) from Form 1040, line 38; Form 1040A, line 22; or Form 1040NR, line 37 1. 65,693 5. 0 2. Enter any lax-exempt interest from Form 1040, line Sb; Form 1040A, line Sb; or .. Form 1040NR, line 9b 2. 3. Enter any amounts from Form 2555, lines 45 and 50, and Form 2555-EZ, line 18 3. 4. 4. . . 5. Modified AGI. Add lines 2 through 4 6. Amount from Dependents' Combined Modified AGI Worksheet, line 5 . . 6. 7. Household income. Add lines 1, 5, and 6. Enter here and on the Shared Responsibility Payment Worksheet, line 7 .. 8. Premiums paid through a salary reduction arrangement 7. 65,693 9. 65,693 8. 9. Household income for computing Coverage Exemption "A". Add lines 7 and 8 .. 10. Non-taxable social security received by taxpayers and dependents who were required to file a return . 10 . 11. Household income for computing Coverage Exemption "G" for residents of a state that did not . . expand Medicaid. Add lines 7 and 1O 65,693 . 11 . Dependents' Combined Modified AGI Worksheet ~ Line 2b 1. Enter the AGI for your dependents from Form 1040, line 38; Form 1040A, line 22; Form 1040EZ, line 3; and . Form 1040NR, line 37 . 1. 2. Enter any tax-exempt interest for your dependents from Form 1040, line Sb; Form 1040A, line Sb; Form 1040EZ, the amount written to the left of the line 2 entry space; and .. Form 1040NR, line 9b . . 2. 3. Enter any amounts for your dependents from Form 2555, lines 45 and 50, and Form 2555-EZ, line 18 . . . . .. 4. Add lines 2 and 3 . .. 3. . . 4. . 5. Add lines 1 and 4. Enter here and on Household Income Worksheet, line 6 .. . .. . . Household income (Household Income Worksheet, line 11) as a percentage of Federal Poverty Line .. The Filing Threshold for this return is . . 5. 4,050 11,880 553 .. The Federal Poverty Line for this household is Flat Dollar Amount Worksheet CAUTION! Do not complete this worksheet unless the amount on line 1O of the Shared Responsibility Payment Worksheet is less than $2,085. For each month, is the amount on line 5 of the Shared Responsibility Payment Worksheet less than the amount on line 10 of the Shared Responsibility Payment Worksheet?* 1. January 2. February . 3. March .. .. .. . . 4. April 5. May 6. June 7. July 8. August 9. September . . . . . .. . . . . . . .. .. .. 10. October 11. November . . 12. December .. 13. Add the amounts in each column .. . . Yes No Enter the amount Enter the amount from line 10 from line5 1 541. 08 1,541.08 1,541.08 1,541.08 1,541.08 1,541.08 1,541.08 1,541.08 1,54 1. 08 1,541.08 1,541.08 1,541.08 18,492.96 14. Add the amounts on line 13 of both columns. Enter the result on line 11 of the Shared Responsibility Payment Worksheet .. 18,492.96 'If the amount on_line 1 of the Shared Responsibility Payment Worksheet is -0- for any month, leave both columns of this worksheet blank for that month. WK_B9652.LD Slharehoider's Adjusfod !Basis Workslhee'I:, jpage 1 Keep for your records. Kendra D Coleman Kendra D Gill - Attorne Name of Shareholder: Name of Corporation: ss a t Law EIN 4784 2 72529 2 5 8 Stock basis 0 Stock basis, beginning of year (Not less than zero) 2 Additional Capital Contributions of Stock Purchased 3 Increases for income and gain items: 2 5_1_,~ 6_9_3 a Ordinary Income (Sch K, Lin e ·1) a ___ b Real Estate Rental Income (Sch K, Line 2) b C c Oiher Rental Income (Sch K, Line 3c) d Interest, Dividends & Royalties (Sch K, Lines 4, 5 & 6) Capital Gain (Sch K, Lines 7 & Ba) e - - ------- ----------------e ----- ---d O!her Portfolio Income (Sch K, Line 10a) g Section 1231 Gain (Sch K, Line 9) 9 _ _ _ _ _ _ _ __ h Other Income (Sch K, Line 10e) h _ _ _ _ _ _ __ 5_1~,_6_9_3_ Total Income and Gain Items (Total lines 3a-3h) Increase for Non-Taxable Income (Sch K, Lines 16a & b) 3a-h _ _ _ 3i j Increase for Excess Depletion Adjustment 3j k Increase from Recapture ofBusiness Credits (See IRC § 49(a), 50(a), 50(c)(2) & 1371(d)) 3k Gain from 179 asset disposition 3I --------4 _ _ _5_1~,_6_9_3_ 4 Stock Basis Before Distributions (Add lines 1 through 3) 5 Reduction for Non-Taxable Dislribulions (Sch K, Line 16d) s ___5_2~,_3_1_3_ Stock Basis Before Non-Ded. Expense (Cannot be negative) 6 Decrease for Non-Deductible Expense/Credit Adj (Sch K. Line 16c & 13) 7 8 Stock Basis Before Allowable Losses & Deductions (Cannot be negative) 8 9 Decreases for Loss and Deduction items 7 a Ordinary Loss (Page 2, Col d, Line 9a) b Real Estate Rental Loss (Page 2, Cold, Line 9b) b c Other Rental Loss (Page 2, Col d, Line 9c) C d Capital Loss (Page 2, Col d, Line 9d) d Other Portfolio Loss (Page 2, Cold, Line 9e) e Section 1231 Loss (Page 2, Col d, Line 9f) g other Loss (Page 2, Col d, Line 9g) g h Charitable Contributions (Page 2, Col d, Line 9h) h Section 179 Expense (Page 2, Col d, Line 9i) Portfolio Income Expenses (Page 2, Col d, Line 9j) j Other Deductions (Page 2, Col d, Line 9k) k Interest Expense on Investment Debt (Page 2, Col d, Line 91) m Section 59(e) Expenditures (Page 2, Col d, Line 9m) m Total Loss and Deduction Items (Total Lines 9a-9m) n Other decreases (Page 2, Col d, Line 9n) 9n o Loss from 179 asset disposition (Page 2, Cold, Line 9o) 9o 9a-m Total Decrease for Loss and Deductions Items and Business Credits 9 10 Less: net increase applied to debt basis 10 11 Stock Basis at End of Year (Line 8 minus line 9 minus line 10) (not less than zero) 11 Debt Basis 12 Debt basis at beginning of year (not less than zero) 12 13 New loans lo corporation during year 13 14 Restoration of Debt Basis (Line 10) 14 15 Less: Loans repaid by corporation during the year 15 16 Less: A pplied against excess loss and deductions/ non-deductible items 16 17 Debt basis at the end of tax year (combine lines 12-16) (not less than zero) 17 18 Shareholde(s total basis at end of tax year (combine lines 11 and 17) 18 Carryover Total Disallowed Losses 19 Total Beginning of year 20 Add: Losses and deductions this year 21 Less: 22 End of year (Not less than zero) WK_ISBAS.LD 0 a e k ----------------- 2,499 3,262 Applied this year 5,761 Debt Basis Applied Against Excess Losses and Deductions 0 Shareholder's Adj1Usil:ed !Basis Worksheet, page 2 2(0)17 Keep for your records. NameofShareholderKendra D Coleman NameofCorporation:Kendra D Gill - Attorn e 784 ss at Law EIN 2 72 5 2 92 5 8 Allocation perceniage line 9 Losses and deductions allowed divided by Total Losses and deductions Allocation percentage line 7 Losses and deductions allowed divided by Total Losses and deductions Sch K1 Line: (A) (B) (C) (D) (E) Beginning of Year Losses and Deductions Current Year Losses and Deductions Total Losses and Deductions Allowed Losses and Deductions in Current Year Disallowed Losses and Deductions in Current Year 9a Ordinary.Losses b Rental Real Estate Losses 2 c Other Rental Losses 3 d Short-term capital losses 7 d Long-term capital losses Ba e Other portfolio losses 10, Code A f 1231 losses 9 g 1256 losses 10, Code C g SIT Cap (Not Portfolio) 10, CodeEF g LIT Cap Total (Not Portfolio) 10, Code EG g Other losses 10, Code 8, ED, EE h CC Cash50% 12, Code A h CC Cash30% 12, Code 8 h CC Noncash 50% 12, Code C h CC Noncash 30% 12, Code D h CC Capital Gain ~rop 30% 12, Code E h CC Capital Gain Prop 20% 12, Code F h CC 100% Section 179 1,092 800 12, Code G 1,092 1,092 800 800 11 Code A Section 179 Qua!. Real Property 11 codes j Portfolio 2% 12, Code K Portfolio Other 12, Code L k Deductions - royalty income 12, Code I k Reforestation expense 12, code o k Film and TV Prod Exp 12, code SE k Interest Exp - Schedule E 12, code SA k CCF Contributions 12, Code sc k Interest penalty 12, Code SD k Oil and gas depletion k other deductions l Interest Exp Investment Sch A 12, Code H & ss m Sec. 59(e)(2) Circulation Costs 12, codeJA m Sec. 59(e)(2) Research Costs 12, Code JB m Sec. 59(e)(2) Mining Costs 12, code Jc m Sec. 59(e)(2) Intangible Drilling 12, code JD n Other decreases o Loss from 179 asset Total deductible losses and deductions 7 1 092 1 892 1 892 1 699 2,170 2,170 3,869 Nondeductible expenses & credit adj 16, Code C * 3,262 4,062 2,499 Prior year losses on 7 will not be deducted in the current year, and will not be included in column C, unless 'Elect to take losses and deductions before non-deductible items' is checked. Totals * 800 WK_ISBAS.LD2 5,761 Carryover Worksheet Ust of items that wm carryover to the 2«n 8 fax return 2017 (Keep for your records) Name(s) as shown on return Kendra D Coleman Itemized Deductions Carryover Amount Contributions subject to 100% of AGI limitations Contributions subject to 50% of AGI !imitations . . . . • . . . . . . . . . . .... Contributions subject to 30% of AGI limitations (50% capital gains appreciated property) . Contributions subject to 30% of AGI limitations Contributions subject to 20% of AGI limitations (30% capital gains appreciated property) Taxable state and local refunds to Form 1040, line 10 . 1,210 State/local taxes paid in 2018 to flow to the Schedule A State donations and contributions carryover State overpayment applied to next year Expenses Office in home operating expenses . . Office in home excess casualty losses and depreciation Disallowed investment interest expense AMT Reg. Tax Section 179 expense . . . . . . . . . Operating expenses, from Form WK_E, Sch E - Rental limitation on deductions when used for personal use Excess depreciation, from Form WK_E, Sch E - Rental limitation on deductions when used for personal use Losses Short-term capital loss AMT Long-term capital loss AMT Reg. Tax Net operating loss AMT Reg. Tax AMT Reg. Tax AMT Reg . Tax . . Nonrecaptured net section 1231 losses from WK_1231C Reg.Tax Credits Mortgage interest credit . • . . . Credit for prior year minimum tax Foreign Tax credit . . . . . . . . District of Columbia first time home owner's credit Res. energy efficient property credit other Preparer Fee . . • . . . . . • . . Overpayment applied to next year's estimates Estimated Tax Payment 1 Estimated Tax Payment2 Estimated Tax Payment3 Estimated Tax Payment4 10,161 2·, 610 Federal tax liability for 2210 calculation State tax liability for state 221 O calculation IRA basis . . . . . . Passive Activity At Risk Limitations WK_CARRY.LD Taxpayer Spouse FOR iAXYEAR.2017 KENDRA D COLEMAN The Hays Group Inc 3126 S Boulevqrd Ste 324 Edmond, OK 73013 (405)715-0225 'flln.e JH21y§ G Irfflill]]_J) ][nnc 3 126 S Boulevard Ste 324 Edmond, OK 73013 shays@thehaysgroup.com Phone: (405)715-0225 J Fax: (866)379-2025 September 12, 2019 Kendra D Coleman 5915 NE 63rd St Oklahoma City, OK 73141 Kendra D Coleman: Return Type Federal Income Tax Oklahoma Income Tax Refund/Balance Due $9,069 Balance Due $1,585 Balance Due Transaction Method Mail a check Mail a check The following return(s) ·will bee-filed and do not need to be mailed to the taxing authority: Federal Income Tax Oklahoma Income Tax Mail payment on or before due date to the following address: Federal Income Tax Internal Revenue Service P.O. Box 802501 Cincinnati, OH 45280-2501 Oklahoma Income Tax Oklahoma Tax Commission PO Box26890 Oklahoma City, OK 73126-0890 Sincerely, Michele Orefice The Hays Group Inc 'flln~ Hay§ Girt01l1l[ll Kllnc 3126 S Boulevard Ste 324 Edmond, OK 73013 shays@thehaysgroup.com Phone: (405)715-0225 I Fax: (866)379-2025 September 12, 2019 Kendra D Coleman 5915 NE 63rd St Oklahoma City, OK 73141 Your privacy is important to us. Read the following privacy policy. We collect nonpublic personal information about you from various sources, including: * Interviews regarding your tax situation * Applications, organiz.ers, or other documents that supply such information as your name, address, telephone number, Social Security Nrunber, number of dependents, income, and other tax-related data * Tax-related docrunents you provide that are required for processn1g tax returns, such as Forms W-2, 1099R, 1099INT and 1099-DN, and stock transactions We do not disclose any nonpublic personal information about our clients or fonner clients to anyone, except as requested by our clients or as required by law. We restrict access to personal information concerning you, except to our employees who need such niformation in order to provide products or services to you. We maintan1 physical, electronic, and procedural safeguards that comply with federal regulations to guard your personal information. If you have any questions about our privacy policy, contact our office at (405)715-0225 . Sincerely, Michele Orefice The Hays Group Inc 2017 TAX RETURN COMPARISON 2015 / 2016 /2017 Name(s) as shown on return Kendra D Coleman . . .;84 2015 .. . . Filing Status 2016 2017 Difference 2016-2017 3 1 Number of Exemptions 1 Income 14,000 14,000 51,693 51,693 65,693 65,693 65,693 65,693 3,588 6,512 3,588 6,512 10,100 4,050 10,100 4,050 .. 51,543 8,620 51,543 8,620 . . .. 1,541 10,161 1,541 10,161 3,500 3,500 6,774 OK 55,993 2,610 6,774 55,993 2,610 1,585 25 . 00 16.72 1,585 25.00 16.72 Wages, salaries, tips, etc. . Taxable interest and dividends Taxable state and local refunds . .. . Alimony . . . . .. . . . .. . Bu 9iness income (loss) Gains (losses) . . Pensions and IRA distributions Rent and royalty income (loss) Part, S-corps, trusts income (loss) . .. Farm income (loss) Unemployment compensation Total SS benefits received. Taxable SS benefits .. Other income (loss) •. .. Total Income . Adjusted Gross Income Half of self-employment tax IRA deduction. .. . . Other adjustments ... .. Total Adjusted Gross Income Deductions Medical deductions State and local taxes Interest . . .. Contributions . Employee business expenses . . Standard or other deductions .. Total Itemized or Standard Ded . . . .... Exemption Amount Tax and Credits Taxable Income . . . . Tax . . Credits .. Self-employment tax Other taxes . Total Tax-. Payments Withholdings . . . ... . . . Estimated tax payments • Earned income credit . . Other payments and credits ... Overpayment Overpayment Applied . Refund ... Balance Due • . . . .. . . Resident State . Taxable income . Tax .. Refund . . ... .. Balance Due . Marginal tax rate . Effective tax rate . . .. DO NOT MAIL OKLAHOMA TAX RETURN - FORM 511 OR FORM 511NR See instructions fo determine if you are required fo send Form 511EF to the OTC. 2Ql17 Form 511EF OKLAHOMA INDIVIDUAL INCOME TAX DECLARATION FOR !ELECTRONIC FILING Your first name and middle initial Last name Your social secu1ity number Kendra D Coleman If a joint return, spouse's first name and middle initial Last name 4 7 8 4 Spouse's social security number I -I Mailing address (number and street, including apartment number, rural route or PO Box) 5915 NE 63rd St Filing status ~ City, State, ZIP Oklahoma City, OK □ PART ONE 1 2 3 4 5 73141 Total number of exemptions [Q:fil TAX RETURN INFORMATION (WH0LE DOLLARS ONLY) Oklahoma Adjusted Gross Income (511, Line 7) or Adjusted Gross Income: All Sources (511 NR, Line 7) ............ . Oklahoma Income Tax and Use Tax (511, Line 22 or 511 NR, Line 26) Oklahoma Income Tax Payments and Credits (511, Line 33 or 511 NR, Line 34) Refund (511, Line 38 or 511 NR, Line 39) . . . . . . . . . . . . . . . . . . . . . Balance Due (511, Line 43 or 511 NR, Line 44) . . . . . . . . . . . . . . . . . . 65 693 2,610 1,400 1 00 00 3 00 4 00 5 1,585 00 For a balance due return with an electronic payment complete line 6b below. The due date for an electronic payment is April 20th. For a balance due return with a non-electronic payment enclose a payment with the 511-V and submit on or before the due date of April 15th. If the Internal Revenue Code (IRC) of the IRS provides for a later due date, your payment may be made by the later due date and will be considered timely. If the due date falls on a weekend or legal holiday when OTC offices are closed, your payment is due the next business day. DECLARAT10N OF TAXPAYER 0PARTTWO ~ 2 I consent that my refund be directly deposited as designated in the electronic portion of my 2017 Oklahoma income tax return. If I have filed a joint return, this is an irrevocable appointment of the other spouse as an agent to receive the refund. I authorize the Oklahoma State Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my Oklahoma taxes owed on this return and/or a payment of estimated tax. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. If I have filed a balance due return, I understand that if the Oklahoma Tax Commission (OTC) does not receive full and timely payment of my tax liability, I will remain liable for the tax liability and all applicable interest and penalties. Under penalties of perjury, I declare I have _compared the information contained on my return, with information I have provided lo my Electronic Return Originator (ERO), and the amounts described in Part One above, agree with ihe amounts shown on the corresponding lines of my 2017 Oklahoma income tax return. To the best of my knowledge and belief, my return is true, correct, and complete. I consent that my return, including this declaration and accompanying schedules and statements, be sent to the OTC by my ERO. In addition, by using a computer system and softv,,are to prepare and transmit my return electronically, I consent to the disclosure to the Oklahoma Tax Commission of all information pertaining to my use of the system and software and to the transmission of my tax return electronically. Sign 09-12-2019 Here: Dale Your Signature DPART THREE I Spouse's Signature (ff joint return, both must sign) Date DECLARATION OF ELECTRONIC RETURN ORIGINATOR (ERO) AND PAID PREPARER I declare I have reviewed the above taxpayer's return and the entries on Form 511 EF are complete and correct to the best of my knowledge. (EROs who are collectors are not responsible for reviewing the taxpayer's return; however, they must ensure Form 511 EF accurately reflects the data on the return.) I have obtained the taxpayer's signature on Form 511 EF and I have provided the taxpayer with a copy of all forms and information to be filed with the OTC, and have followed all other requirements described in Pub. 1345, Handbook for Electronic Filers of Individual Income Tax Returns (Tax Year 2017). If I am also a Paid Preparer, under penalties of perjury I declare I have examined the above taxpayer's return and accompanying schedules and statements, and lo the best of my knowledge and belief, they are true, correct, and complete. This Paid Preparer declaration is based on all information of which I have any knowledge. ERO Use Only 09-12-20 1 9 P00232495 -------------------------------------------ERO or Paid Preparer's Signature PTIN Dale Paid Preparer Use Only 09-12-2019 P02215749 - - - - -- - - - - - - - - - - - - - - Date ------ - - - - -- - - - - - - - - - - - -Paid Preparer Signature PTIN Firm name (or yours if self-employed), address and ZIP The Hays Group Inc 3126 S Boulevard Ste 324 Edmond, OK 73013 Phone number 4 0 5 - 715 - 0 2 2 5 !Tl-I STATE Of' OKLAIHOMA ~NDiVHJUAL ~l\l!COME TAX !PAYMENT VOUCH!ER Reporting Period Due Date* Penalty and interest may be assessed if payment is not sent 01 -01 -2017 fo 12-31-2017 Your first name, middle inilial and last name 04-15-2018 by the due date. Your Social Security Number (if filing a joint return, enter the SSN shown first Kendra D Coleman If joint retu rn, spouse's first name, middle initial and last name Mailing address (numb er and street, including apartment number, rural route or PO Box) Daytime phone number (optional) 5915 NE 63rd St Cily, State, ZIP Do IlQI enclose a copy of your Oklahoma Citv OK 73141 Oklahoma Tax Commission Oklahoma tax return. Balance Due 1,585 Post Office Box 26890 Oklahoma City, OK 73126-0890 Amount of Payment 1,585 !Form 5111 2(0)11 OKlA!HIOMA RlES~DlEN1' ~~~COMIE TAX RlETlUJlRN Your Social Security Number Spouse's Social Security Number Qoint return only) Place an •x• in this b_ ox if this taxpayer □ Is deceased ----p AMENDED RETURN! 1-....a.aa:..a...:.a.=.'----t Place an 'X' in this box if this is an amended 511. See Place an 'X' in this □ Schedule box if this taxpayer 511 _H_.,J)-...__ is deceased -----p' 7V j_J I-.- - - - - - - - - - - l- D Kendra 0:: Oo Coleman If a joint return, spouse's first name, middle initial and last name 0 1- < w ID AGE 65 OR OVER?(Please see instructions) "~~ ,- = ~ NOTE: IF YOU MAY BE CLAIMED AS A DEP•. ON ANOTHER RETURN. ENTER •o• FOR YOUR REGULAR EXEMPTION. - Yourself D Spouse I Round to Nearest Whole Dollar 1 Federal adjusted gross income (from Federal 1040, 1040A, or 1040EZ) Oklahoma Subtractions (provide Schedule 511~A) Line 1 minus line 2 _ _ _ _ . _ . _ . _ _ _ . __ . . . _ 4 Out-of-state income, except wages. Describe (4a) (Provide Federal schedule with detailed description; see instructions) Line 3 minus line 4b _ _ _ ____ . _ . • _ . __ . _ _ _ _ __ .. _ . _ . _ _ ____ _ 7 - ¥; 00 NUMBER OF OTHER DEPENDENTS 2 3 6 WR ITE THE TOTAL - PART ONE: TO ARRIVE AT OKLAHOMA ADJUSTED GROSS INCOME 5 0 .~: 00 NUMBER OF DEPENDENT CHILDREN 4 * Please list the ear spouse died in box at right: A DD THE TOTALS FROM ..q-THE4 BOXES. - .__ IQ_ 1 !~ ' + 65 1 2 3 65,693 4b 5 Oklahoma Additions (provide Schedule 511-B) - - .. - 6 Oklahoma adjusted gross income (line 5 plus line 6) _ . __ . _ . _ _ _ 7 693 65 693 65,693 00 00 00 00 00 00 00 (If line 7 is different than line 1, provide a copy of yo_ur Federal rfilturn.) PART TWO: OKLAHOMA TAXABLE INCOME, TAX AND CREDITS W 00 ------➔j-° °--11 8 1 t- Oklahoma Adjustments (provide Schedule 511-C) - - - • • - • - - - - - - - · · · · - · · - • - IJ] Oklahoma income after adjustments (line 7 minus line 8) ... __ .. _ . . ___ . ___ . _ _ 9 . 65 , 693 _ . STOP AND READ: If line 4b is zero, complete lines 10-11_ If line 4b is more than zero, se e SCheel ue I 511 -D an d d o no como,e I te I"mes 10 -11 1OA Federal itemized deductions from Federal Schedule A, line 29 . _ _ _ _ _ _ . . _10A I (Provide copy of the Federal Schedule A.) (If you did not itemize, skip lines 1OA and 1OB; enter the Oklahoma standard deduction on line 10C) 1OB State and local sales or income taxes included in line 1OA . - - . . . - . 10BI 10,100 loo 1,400 loo 1 oc Oklahoma itemized deductions (line 10A minus line 1OB) or Oklahoma standa rd deduction (Single or Married Filing Separate: $6,350 ° Married Filing Joint or Qualifying Wido w(er): $12,700 • Head of Household: $9,350) _ _ _ _ _ _ _ _ _ _ . _ _ _ _ _ . __ __ _ . _ _ _ ........ 11 12 13 --. ... Exemptions ($1,000 x total number of exemptions claimed above) · Total d eductions and exemptions (add lines 10C and 11 or amount from Sch. 511-D, line5) Oklahoma Taxable Income (line 9 minus line 12) __ . _ . _ . ____ _ - - 10C _ 11 12 _ 13 8 700 00 1,000 00 9,700 00 55 993 00 14 Oklahoma In come Tax from Tax Table (see pages 20-31 of instruction s) If using Farm Income Averaging, enter tax from Form 573, line 22 and enter a "1" in box. If paying the Health Savings Account additional 10% tax, add additional tax here and enter a "2" in box. 2,610 00 If recapturing the Oklahoma Affordable Housing Tax Credit, add recaptured credit here and enter a "3" in box - - . 14 STOP AND READ: lfline 7 is equal to or larger than line 1, complete lines 15 and 16. lfline 7 is smaller than line 1, complete Schedules 511-E and 511 " F . 15 00 15 Oklahoma child care/child tax credit (see instructions) 16 00 16 Oklahoma earned income credit (see instructions) . _ .. _ . __ . _ 00 - - - - _ 17 17 Credit for ta xes paid to another state (provide Form 511 TX) · - - 00 18 Form 511CR - Oth er Credits Form. List 511CR line number claimed here: 1a □ c=J 19 Income Tax (line 14 minus lines 15-18) Do not enter less than zero DO NOT PAY THIS AMOUNT. PAYMENT IS FIGURED ON LINE 43_ . _ - . _ 19 2 ,610 00 2017 For m 511 - Res ident In come Tax Return - Pa ge 2 Name(s) shown•-;'·, Your Social Security Number: 011F!lrm9_:!f=··/. •Kendra D Coleman '' PART THREE: TAX, CREDITS AND PAYMENTS 20 Total from line 19 21 . . . . . . . . . . . . .. . . . . . . . . . .• . . . . . . 20 mail order, or other o ut-of-state purchases . . . . 21 Use tax due on Internet, .. . . . . . . . . . . . . . . . • . . . •.• (qualified farmer D ). . . . . . . . 25 2017 payment with extension . . . . . . . . . . . . . . 1,400 24 00 25 00 26 Low Income Property Tax Credit (provide Form 538-H) 26 00 27 00 28 00 29 00 29 Credits from Form . . . . . • . . . . . . . . . • . . b)O 578 a)O 577 . . . 2,610 00 1 400 00 00 27 Sales Tax Relief Credit (provide Form 538-S) 28 Natural Disaster Tax Credit (provide Form 576) 00 00 22 23 Oklahoma withholding (provide all W-2s, 1099s or other withholding statements)23 24 2017 estimated tax payments 610 [KJ (For use tax table, see page 11 of the Packet) If you certify that no use tax is due, place an 'X' here: 22 Balance (add lines 20 and 21) 2 30 Amount paid with original return plus additional paid after it was filed (amended return only) . . . • . . . . . . . . . . . . . . . . . . . . . . 31 Payments and credits (add lines 23-30) 30 00 ........ .. .... . 31 32 Overpayment, if any, as shown on original return and/or prior amended return(s) or as previously adjusted by Oklahoma (amended return only) 33 Total payments and credits (line 31 minus 32) 32 ..... . 00 1 400 33 00 PART FOUR: REFUND . . .. If line 33 is more than line 22, subtract line 22 from line 33. This is your ove rpayment to 2018 Amount of line 34 to be applied estimated tax (original return only) I Ioo I I oo (For further information regarding estimated tax, see page 4 of the 511 Packet.)35 Schedule 511-G provides you with the opportunity to make a financial gift from your refund to av ariety of Oklahoma organizations. Please place the line number of the organization from Schedule 511-G in the box b elow. If you give to more than one organization, put a "99" in the box. Provide Schedule 511-G . D 36 Donations from ~our refund (total from Schedule 511-G) Total deductions from refund (add lines 35 and 36) . . . 37 Amount to be refunded 38 Direct Deposit Note: to you (line 34 minus line 37) ~ Verify your account and routing numbers are correct. If your direct deposit fails to process or you do not choose direct deposit, you will receive a debit card. See the 511 Packet for direct deposit and debit card information. o I oo 34 I oo I oo ls this refund going to or through an account that is located outside of the United States? Deposit my refund in my: 0 checking account ·0 savings account Routing Number: Account Number: •. · I I □ Yes I I PART FIVE: AMOUNT YOU OWE 39 If line 22 is more than line 33, subtract line 33 from line 22. This is your tax due . 39 40 Donation: Support the Oklahoma General Revenue Fund (original return only) . 40 41 .□) Underpayment of estimated tax interest (annualized installment method 1,210 00 00 41 57 00 42 318 1 585 00 (If you have an underpayment of estimated tax {line 41) & overpayment (line 34), see instructions.) 42 For delinquent payment add penalty of 5% plus interest at 1.25% per month . . . . • . . . . . . . . . . . . . . . . . . . . . 43 Total tax, donation, penalty and interest (add lines 39-42) Under penalty of perjury, I declare the inform2tion contained in this document, and all attachmenls and schedules, is !rue 2nd correct lo the best of my knowledge and belief, Taxpayers signature Date Spouse's signature 09-12-2019 Taxpayers occupation 257 . . . . . . . . . . . . . . . 43 Place an "X" in this box If the Oklahoma Tax Commission may discuss lhis return with your lax preparer • • • • Date • ~ L___:=j Paid Preparers signature !Jate Spouse's occupation 09-12-2019 Paid Preparers address and phone number 405-715 -0 225 3126 s Boulevard Ste 32 Daytime Phone (oplional) E:dmond, OK 73013 Attorney DayLime Phone (optional) 61 $ $ Paid Preparers PTIN P02215749 DO NOT STAPLE DOCUMENTATIONTOTHIS FORM. TO ATTACH ITEMS, PLEASE USEA PAPER CLIP. MAILING ADDRESS FOR THIS FORM: OKLAHOMA TAX COMMISSION, INCOME TAX 2-D RETURN, P.O. BOX 269045, OKLAHOMA CITY, OK 73126-9045 The Oklahoma Tax Commission is not required to give actual notice to taxpayers of changes in any state tax law. 00 Stafo of Oklahoma UNDERPAYMENT OF ESTIMATED TAX VVORKSHEET 2 SSN or.FEIN Name as shown on return 0 Kendra D Coleman 1 7 SEGTJ0N ONE: ANNUALIZED METHOD D Check the box to the left if you are using the annualized income installment method. If your income varied during the year because, for example, you operated your business on a seasonal basis, you may be able to lower or eliminate the amount of one or more required installments by using the annualized income installment method. If you checked the box, you must complete and enclose with your return this form and Form OW-8-P-SUP-I for individuals or OW-8-P-SUP-C for corporations and trusts. These forms can be obtained from our website at www.tax.ok.gov. ,- SECTION TWO: WORKSHEET ~'_ _ _ _ _ _ _P_a_r1_(1_:_R_e_,q_u_ir_e_d_A_n_n_u_a_l_P_a,,_ym_e_n_t_ _ _ _ _ _--"I 1. Income tax shown on your current year's tax return 2. Oklahoma credits (refundable and nonrefundable) _________ _·. :11· _ _ _ _ _ _ 2_,_6_1_0__, ~ 3. Oklahoma tax liability. Subtract line 2 from line 1 2 , 610 If less than $1,000 stop here; you do not owe the interest. 4 . Multiply line 3 by 70% (0.70) . . . . . . . . . . . . .4r-------l-----=1~,~8=2~7I . 5 l__,_,_4....:.0....:.0__, 5. Withholding taxes ' - I_ _ _ _ Do not Include any estimated tax payments on this line. 6. Subtract line 5 from line 3 . . . . . . • . . . . . . . ·5 1__,_,_2;_;_;1....:..0-----' ' - I_ _ _ _ If less than $500 stop here; you do not owe the interest. .7 7. Tax liability shown on your previous year's tax return 4' 3961 Previous year's return must be for 12 months. If you were not required to file an income tax return for the previous tax year stop here; you do not owe the interest. . . . . . . . . . .. 8. Required annual payment Enter the smaller of line 4 or line 7 I Note: If line 5 is equal to or more than line 8 stop here; you do not owe the interest. Part 2: Figure Your Underpayment 9. Required a11nual payment . . . • . . . . . . . . . . . I Column A April 15th First Quarter 9 I - 8 Due Date of Installments* ColumnB June 15th Second Quarter Column C Sept. 15th Third Quarter 1, 8271 I Column D Jan. 15th Fourth Quarter 457 457 457 456 350 350 350 350 350 350 350 350 Enter 1/4 of line 8 in each column unless you have checked the box in Section 1 If checked, enter the amounts from Form OW-8-P-SUP-I or OW-8-P-SUP-C. 10. a. Tax withheld (see instructions) . . . b. Estimated tax paid (see instructions) 1 Oa . . . . . • . . . . 10b c. Add lines 10a and 1 Ob . . . . . . . . . • . . . . . . . 10 C If line 1Oc is equal to or more than line 9 for all payment periods stop here; you do not owe the interest. Complete lines 11 -17 of one column before continuing ... 11. Enter amount, if any, from line 17 of previous column 1 12. Add lines 1 Oc and 11 2 350 350 350 3 107 214 321 350 243 136 29 107 214 321 427 21 18 13 . • . . . . . . . . . . . . . . . 13. Add amounts on lines 15 and 16 of the previous column 14. For Column A only, enter the amountfrom line 1Oc 14 For Columns B, C, and D, subtract line 13 from line 12. If zero or less, enter 0. 15. If the amount on line 14 is zero, subtract line 12 from line 13. Otherwise, enter O • . • . • . • . • • • • 15 16. Underpayment. If line 9 is equal to or more than line 14, subtract line 14 from 9. Then go to line 11 of next column 16 17. Overpayment. If line 14 is equal to or more than line 9, subtract line 9 from 14. Then go to line 11 of next column 17 Complete lines 18 and 19 after completion of Part 3... 18. Interest due for each quarter (from Part 3) 18 19. Total Interest. Add line 18, Columns A, B, C and D . 19 *If the due date falls on a weekend or holiday, adjust the due date to the next business day. Also, adjust the quarter due date as needed for fiscal year taxpayers. Line 1O: You are considered to have paid one-fourth of your withholding on each payment due dale unless you can show otherwise. Estimated tax must be entered in the quarter in which ii was paid (ie, Column A, payments made by 4/15; Column B, payments made 4/16 through 6/15; Column C, payments made 6/16 lhrough 9/15; and Column D, payments made 9/16 through 1/15 of the following year). Payments made after the due date of the fourth quarter estimate shall not be included on this line as an estimated tax payment, but shall be used in the underpayment worksheet as a prepayment of tax (see instructions for Part 3). Include in the first quarter any overpayment of tax from your previous tax year's return that you elected to apply lo this year's estimated tax. Line 19: Enter total interest here and on your income tax return . 5 57 ffi]~[§] ~ 2017 Form OW-8-P Oklahoma Underpayment of Estimated Tax Worksheet - Page 2 @]..,,,. .: •• rot~~ IiiiilSSNorF Name as shown on return I_Kendra D Coleman -- - - -- -- - - - -- -- - - - -- - - - '_ L - - - - - ----''-"-'-'-''-'--="'---- I Part 3: Com~utation of Interest Complete each quarter before going to the next qua1ier. First Quarter I Column A Column B Date of Payment Amount of Payment 1784 ,._ _ _ __ _ __ _ _ _ Column C Balance Due After Payment Column D Column E Number of Days Interest I ~ Due Date 4/15 O Enter required payment from Part 2, line 9, Column A. Enter any withholding. Enter apply from previous year, if any. Enter any estimated tax payment Enter tax payment made after 4/15. 4/15 4/15 4/15 350 04-17 107 457 107 107 107 365 21 Enter tax payment made after 4/15. 21 Total interest due for first quarter. Second Quarter O Due Date 6/15 Enter required payment from Part 2, line 9, Column B. Enter any withholding not used in prior quarter. Enter any estimated tax not used in prior quarter. Enter tax payment made after 6/15. 6/15 6/15 350 04-17 107 457 107 107 306 18 Enter tax payment made after 6/15. 18 Total interest due for second quarter. Third Quarter O Due Date 9/15 Enter required payment from Part 2, line 9, Column C. Enter any withholding not used in prior quarters. Enter any estimated tax not used in prior quarters. Enter tax payment made after 9/15. 9/15 9/15 350 04-17 107 457 107 107 214 13 Enter lax payment made after 9/15. 13 Total interest due for third quarter. Fourth Quarter O Due Date 1/15 Enter required payment from Part 2, line 9, Column D. Enter any withholding not used in prior quarter. Enter any estimated tax not used in prior quarter. Enter tax payment made after 1/15. 1/15 1/15 350 04-17 106 456 106 106 92 5 Enter lax payment made after 1/15. Total interest due for fourth quarter. Instructions to Part 3 In the first line of ea_ ch quarter, Part 3, Column C, enter the required payment from Part 2, line 9. Then complete each line across before proceeding to the next line. Column C in each quarter must be brought lo zero, unless all payments have already been applied, before proceeding to the next quarter. Column A- Enter the date the estimated tax paymenl(s) was actually paid. Estimated tax payments and withholding payments which are paid on or before the quarterly due date are considered timely paid; therefore, the date is preprinted on the form. If the preprinted dale falls on a weekend or holiday, adjust the date to the next business day. Any balance due, paid with your tax return, is considered a payment for this purpose and should be listed using the dale you filed your return or the original due date, whichever is earlier. Column B- Enter payments according lo the date paid or deemed paid, the earliest dale of payment being applied first. Only use the · portion of a payment necessary to bring the balance due to zero. Withholding payments are deemed paid on the quarterly due date(s). Enter on the withholding line tax(es) withheld, on or before the quarterly due date, that have not been applied to a previous quarter. Enter on the estimated tax line estimated tax paymenls paid on or before the quarterly due dale, which have not been applied to a previous quarter. Enter on the tax payment line( s) any payment made after the quarterly due dale. If more lines are needed for tax paymenls, list each payment separately on an attached schedule using Columns A through. E. Column C- Compute the balance due after each payment. If there are no payments entered on the withholding and estimated lax lines, bring the required payment down to the estimated tax line in Column C and complete Columns D & E. Column D- Column C balance, for each line, is considered past due until the next payment is made. Compute the number of days past due from the date of this payment until the date of the next payment or the original due date, if no payment is made. Column E-Column Cx Number of days in Column Dx 20% divided by 365 5 Siate of Oklahoma 2~17 ~M D~VHD!UAl WV~2 DATA S!HllElET ~ This form must be attached as a schedule to the return without cutting into separate W-2s. It should be attached as the last page of the return. If you have more than 3 W-2s, please use as many copies of this form as needed to include all W-2s. 5111W I INOTE: Only send Form 511Wwith your return. DO NOT send yo·urW-2s. Original W-2s must be .kept with the taxpayer's copy of return. W-2 Data First Em lo er For St2te, City, or Local T2x Departmen t 1) Wages, tips, end other income 784 2) Federal income tax withhe ld 14,000 B) Employer ID number 3) Social security wages 3,500 4) Social security tax withheld Kendra D Gill Attorney At t-------------t-------~------+--------------t 272529258 14,000 868 D) Control number 5) Medicare Wage s and tips 6) Medicare tax withheld 3601 N Classen Blvd Suite Oklahoma City OK 73118 E) Employee's first, initial, and last name 14 000 7) Social security tips 8) Allocated tips 10) Dependent care benefits 11) Nonqualified plans 203 9) Verification cod e 13JS!al empl. Kendra D Gill 5915 NE 63rd St Oklahoma City OK 73141 12a) Code- See instrs. for box 12 12b) Code 12c) Code 12d) Code D Retirement plan 3rd party sick pay D □ 14) other F) Employee's address and ZIP Employer's state ID no. 15) Slate 16) Stale wages, tips, etc 17) Stale income tax 18) Local wages, lips, etc. 20) Locality name 19J Local income tax _OK_l 13922988 - 02 ________ 14_,_000 __ ________ __ 1, 400___ _________________ _ - W2D t - aa s econ dEmp oyer A) Employee's social security number For Slate, City, or Local Tax Department 1) Wages, lips, and other income 2J Federal income tax withheld CJ Employer's name, address, and ZIP B) Employer ID number 3) Social security wages 4J Social security tax withheld D) Control number 5) Medicare Wages and tips 6) Medicare tax withheld 7) Social security Ups 8) Allocated tips 9J Verification code 10) Dependent care benefits 11) Nonqualified plans E) Employee's first, initial, and lest name 13JStat empl. 12a) Code - See inslrs. for box 12 12b) Code 12cJ Code 12d) Code D r etirement plan D I 3rd party sick pay D 14JOther I I F) Employee's address and ZIP Employer's state ID no. 15)Slale 16J Slate wages, tips, etc 17J Slate income tax 18J Local wages, tips, etc. 19J Local income tax _____ !____ __ ____ ____ _---------------- -- ----------- ------ --- --- ---------- --- -------------- -- --------------- I W-2 Darn 20) Locality name Th'Ir d Emp over AJ Employee's social security number For State, City, or Local Tax Department 1J Wages, tips, and other income 2J Federal income tax withheld C) Employer's name, address, and ZIP B) Employer ID number 3J Social security wages 4J Social security tax withhe ld D) Control number 5J Medicare Wages and tips 6J Medicare tax withheld 7) Social security tips 8J Allocated tips 9) Verification code 1OJ Dependent care benefits 11) Nonqualified plans E) Employee's first, initial, and last name 13JStat empl. 12a) Code - See instrs. for box 12 12bJ Coae 12c) Code 12d) Code D 1~etirement plan D I 3rd party sick pay D 14) other I I F) Employee's address and ZIP 15)State Employer's state ID no. 16) Sta te wages, lips, etc 17) Stale income lax 18) Loc al wages, tips, etc. ___ __ !____ __________ _------ ---------- ------------------- --- ---------------I 19) Local income tax 20) Locality name -- - ----- ---- -- ------------ ----- - - OKWIK A5 State I Local tax payments made after 12/31/2017 that 2017 will be deductible on 20'18 Federal Schedule A Name(s) as shown on return Kendra D Coleman A. 2017 Income taxes due that were paid after 12/31/2017 A1. 4th quarter estimate/extension (may be adj. by refund) A2. Amount paid with return . . . A3. Total payments made in 2018 1,585 A. 1,585 B. 375 G, 1,210 B. Adjusbnents made to payments B1. Interest & Penalty . . . . . B2. Contributions, Donations, Checkoffs . . . . . . . . . . . . B3. Other Tax payments (Use Tax, property tax, tangible tax, etc) B4. Total adjusbnents . . . . . . . . . . . . . . . . . C. Total tax payments deductible in 2018 (Line A less line B) OKWK_A5.LD 375