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|000005c0| 20 54 41 58 41 42 4c 45 | 20 41 4d 4f 55 4e 54 20 | TAXABLE| AMOUNT |
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|000005e0| 41 4e 4e 55 49 54 49 45 | 53 2e 0d 0d 31 37 3a 20 |ANNUITIE|S...17: |
|000005f0| c5 4e 54 45 52 20 52 45 | 4e 54 53 2c 20 52 4f 59 |.NTER RE|NTS, ROY|
|00000600| 41 4c 54 49 45 53 2c 0d | 50 41 52 54 4e 45 52 53 |ALTIES,.|PARTNERS|
|00000610| 48 49 50 53 2c 20 45 53 | 54 41 54 45 53 2c 20 54 |HIPS, ES|TATES, T|
|00000620| 52 55 53 54 53 2c 20 45 | 54 43 2e 0d 41 4e 44 20 |RUSTS, E|TC..AND |
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|00000670| 43 48 45 44 55 4c 45 20 | c6 2e 0d 0d 31 39 3a 20 |CHEDULE |....19: |
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|000006c0| 55 4e 54 20 4f 46 0d d3 | 4f 43 49 41 4c 20 d3 45 |UNT OF..|OCIAL .E|
|000006d0| 43 55 52 49 54 59 20 42 | 45 4e 45 46 49 54 53 2e |CURITY B|ENEFITS.|
|000006e0| 0d 0d 32 31 3a 20 cf 54 | 48 45 52 20 49 4e 43 4f |..21: .T|HER INCO|
|000006f0| 4d 45 20 28 4c 49 53 54 | 20 54 59 50 45 20 41 4e |ME (LIST| TYPE AN|
|00000700| 44 0d 41 4d 4f 55 4e 54 | 29 2e 0d 0d 32 32 3a 20 |D.AMOUNT|)...22: |
|00000710| d4 4f 54 41 4c 20 49 4e | 43 4f 4d 45 20 28 4c 49 |.OTAL IN|COME (LI|
|00000720| 4e 45 53 20 37 2d 32 31 | 29 2e 0d 0d 0d c1 44 4a |NES 7-21|).....DJ|
|00000730| 55 53 54 4d 45 4e 54 53 | 20 54 4f 20 c9 4e 43 4f |USTMENTS| TO .NCO|
|00000740| 4d 45 0d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |ME.-----|--------|
|00000750| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0d 32 33 41 3a 20 d9 |--------|..23A: .|
|00000760| 4f 55 52 20 c9 d2 c1 20 | 44 45 44 55 43 54 49 4f |OUR ... |DEDUCTIO|
|00000770| 4e 2c 20 46 52 4f 4d 0d | 57 4f 52 4b 53 48 45 45 |N, FROM.|WORKSHEE|
|00000780| 54 2e 0d 0d 32 33 42 3a | 20 d9 4f 55 52 20 53 50 |T...23B:| .OUR SP|
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|000007a0| 54 49 4f 4e 2c 0d 46 52 | 4f 4d 20 57 4f 52 4b 53 |TION,.FR|OM WORKS|
|000007b0| 48 45 45 54 2e 0d 0d 32 | 34 3a 20 cd 4f 56 49 4e |HEET...2|4: .OVIN|
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|000007d0| 41 43 48 20 c6 4f 52 4d | 0d 33 39 30 33 20 4f 52 |ACH .ORM|.3903 OR|
|000007e0| 20 33 39 30 33 2d c6 2e | 0d 0d 32 35 3a 20 cf 4e | 3903-..|..25: .N|
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|00000820| 44 20 48 45 41 4c 54 48 | 20 49 4e 53 55 52 41 4e |D HEALTH| INSURAN|
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|00000840| 4f 4d 20 57 4f 52 4b 53 | 48 45 45 54 2e 0d 0d 32 |OM WORKS|HEET...2|
|00000850| 37 3a 20 cb 45 4f 47 48 | 20 52 45 54 49 52 45 4d |7: .EOGH| RETIREM|
|00000860| 45 4e 54 20 50 4c 41 4e | 20 41 4e 44 0d 53 45 4c |ENT PLAN| AND.SEL|
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|00000880| 45 44 55 43 54 49 4f 4e | 2e 0d 0d 32 38 3a 20 d0 |EDUCTION|...28: .|
|00000890| 45 4e 41 4c 54 59 20 4f | 4e 20 45 41 52 4c 59 20 |ENALTY O|N EARLY |
|000008a0| 57 49 54 48 44 52 41 57 | 41 4c 20 4f 46 0d 53 41 |WITHDRAW|AL OF.SA|
|000008b0| 56 49 4e 47 53 2e 0d 0d | 32 39 3a 20 c1 4c 49 4d |VINGS...|29: .LIM|
|000008c0| 4f 4e 59 20 50 41 49 44 | 2e 0d 0d 33 30 3a 20 d4 |ONY PAID|...30: .|
|000008d0| 4f 54 41 4c 20 41 44 4a | 55 53 54 4d 45 4e 54 53 |OTAL ADJ|USTMENTS|
|000008e0| 20 28 4c 49 4e 45 53 20 | 32 33 41 2d 32 39 29 2e | (LINES |23A-29).|
|000008f0| 0d 0d 0d d4 41 58 20 c3 | 4f 4d 50 55 54 41 54 49 |....AX .|OMPUTATI|
|00000900| 4f 4e 0d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |ON.-----|--------|
|00000910| 2d 2d 0d 0d 33 32 3a 20 | d9 4f 55 52 20 41 44 4a |--..32: |.OUR ADJ|
|00000920| 55 53 54 45 44 20 47 52 | 4f 53 53 20 49 4e 43 4f |USTED GR|OSS INCO|
|00000930| 4d 45 20 28 4c 49 4e 45 | 0d 32 32 2d 4c 49 4e 45 |ME (LINE|.22-LINE|
|00000940| 20 33 30 29 2e 0d 0d 33 | 33 3a 20 c1 4c 54 48 4f | 30)...3|3: .LTHO|
|00000950| 55 47 48 20 4e 4f 54 20 | 49 4e 43 4c 55 44 45 44 |UGH NOT |INCLUDED|
|00000960| 20 49 4e 20 54 48 45 0d | 50 52 4f 47 52 41 4d 2c | IN THE.|PROGRAM,|
|00000970| 20 59 4f 55 20 53 48 4f | 55 4c 44 20 43 48 45 43 | YOU SHO|ULD CHEC|
|00000980| 4b 20 42 4f 58 45 53 20 | 49 46 0d 59 4f 55 20 4f |K BOXES |IF.YOU O|
|00000990| 52 20 59 4f 55 52 20 53 | 50 4f 55 53 45 20 57 45 |R YOUR S|POUSE WE|
|000009a0| 52 45 20 4f 56 45 52 20 | 36 35 20 4f 52 0d 42 4c |RE OVER |65 OR.BL|
|000009b0| 49 4e 44 2c 20 49 46 20 | 59 4f 55 52 20 50 41 52 |IND, IF |YOUR PAR|
|000009c0| 45 4e 54 20 43 41 4e 20 | 43 4c 41 49 4d 20 59 4f |ENT CAN |CLAIM YO|
|000009d0| 55 0d 41 53 20 41 20 44 | 45 50 45 4e 44 45 4e 54 |U.AS A D|EPENDENT|
|000009e0| 20 4f 52 20 49 46 20 59 | 4f 55 20 41 52 45 20 4d | OR IF Y|OU ARE M|
|000009f0| 41 52 52 49 45 44 0d 46 | 49 4c 49 4e 47 20 41 20 |ARRIED.F|ILING A |
|00000a00| 53 45 50 41 52 41 54 45 | 20 52 45 54 55 52 4e 20 |SEPARATE| RETURN |
|00000a10| 41 4e 44 20 59 4f 55 52 | 0d 53 50 4f 55 53 45 20 |AND YOUR|.SPOUSE |
|00000a20| 49 54 45 4d 49 5a 45 53 | 20 44 45 44 55 43 54 49 |ITEMIZES| DEDUCTI|
|00000a30| 4f 4e 53 2e 0d 0d 33 33 | 2f 33 34 3a 20 d0 52 45 |ONS...33|/34: .RE|
|00000a40| 53 53 49 4e 47 20 d2 c5 | d4 d5 d2 ce 20 4f 4e 20 |SSING ..|.... ON |
|00000a50| 4c 49 4e 45 20 33 34 0d | 57 49 4c 4c 20 41 4c 4c |LINE 34.|WILL ALL|
|00000a60| 4f 57 20 59 4f 55 20 54 | 4f 20 53 45 4c 45 43 54 |OW YOU T|O SELECT|
|00000a70| 20 59 4f 55 52 20 46 49 | 4c 49 4e 47 0d 53 54 41 | YOUR FI|LING.STA|
|00000a80| 54 55 53 3a 20 d3 49 4e | 47 4c 45 2c 20 cd 41 52 |TUS: .IN|GLE, .AR|
|00000a90| 52 49 45 44 20 c6 49 4c | 49 4e 47 0d ca 4f 49 4e |RIED .IL|ING..OIN|
|00000aa0| 54 4c 59 20 28 d1 55 41 | 4c 49 46 59 49 4e 47 20 |TLY (.UA|LIFYING |
|00000ab0| d7 49 44 4f 57 29 2c 20 | cd 41 52 52 49 45 44 0d |.IDOW), |.ARRIED.|
|00000ac0| c6 49 4c 49 4e 47 20 d3 | 45 50 41 52 41 54 45 4c |.ILING .|EPARATEL|
|00000ad0| 59 20 4f 52 20 c8 45 41 | 44 20 4f 46 0d c8 4f 55 |Y OR .EA|D OF..OU|
|00000ae0| 53 45 48 4f 4c 44 2e 20 | 20 c9 4e 20 41 44 44 49 |SEHOLD. | .N ADDI|
|00000af0| 54 49 4f 4e 2c 20 59 4f | 55 20 53 45 4c 45 43 54 |TION, YO|U SELECT|
|00000b00| 0d 48 4f 57 20 4d 41 4e | 59 20 42 4f 58 45 53 20 |.HOW MAN|Y BOXES |
|00000b10| 59 4f 55 20 48 41 56 45 | 20 43 48 45 43 4b 45 44 |YOU HAVE| CHECKED|
|00000b20| 20 4f 4e 0d 4c 49 4e 45 | 20 33 33 41 20 4f 46 20 | ON.LINE| 33A OF |
|00000b30| 54 48 45 20 31 30 34 30 | 20 46 4f 52 4d 20 46 4f |THE 1040| FORM FO|
|00000b40| 52 20 c1 47 45 0d 41 4e | 44 2f 4f 52 20 c2 4c 49 |R .GE.AN|D/OR .LI|
|00000b50| 4e 44 4e 45 53 53 2e 0d | 0d d4 48 45 4e 20 59 4f |NDNESS..|..HEN YO|
|00000b60| 55 20 43 41 4e 20 43 48 | 4f 4f 53 45 20 54 4f 20 |U CAN CH|OOSE TO |
|00000b70| 45 4e 54 45 52 20 54 48 | 45 0d 53 54 41 4e 44 41 |ENTER TH|E.STANDA|
|00000b80| 52 44 20 44 45 44 55 43 | 54 49 4f 4e 2c 20 45 4e |RD DEDUC|TION, EN|
|00000b90| 54 45 52 20 59 4f 55 52 | 20 54 4f 54 41 4c 0d 44 |TER YOUR| TOTAL.D|
|00000ba0| 45 44 55 43 54 49 4f 4e | 53 20 46 52 4f 4d 20 d3 |EDUCTION|S FROM .|
|00000bb0| 43 48 45 44 55 4c 45 20 | c1 20 4f 52 20 49 4d 50 |CHEDULE |. OR IMP|
|00000bc0| 4f 52 54 0d 59 4f 55 52 | 20 54 4f 54 41 4c 53 20 |ORT.YOUR| TOTALS |
|00000bd0| 46 52 4f 4d 20 d3 43 48 | 45 44 55 4c 45 20 c1 2e |FROM .CH|EDULE ..|
|00000be0| 20 20 c9 46 20 59 4f 55 | 0d 43 48 4f 4f 53 45 20 |  .F YOU|.CHOOSE |
|00000bf0| 45 49 54 48 45 52 20 4f | 46 20 54 48 45 20 4c 41 |EITHER O|F THE LA|
|00000c00| 53 54 20 54 57 4f 2c 20 | 54 48 45 0d 50 52 4f 47 |ST TWO, |THE.PROG|
|00000c10| 52 41 4d 20 57 49 4c 4c | 20 43 4f 4d 50 41 52 45 |RAM WILL| COMPARE|
|00000c20| 20 54 48 45 20 56 41 4c | 55 45 20 54 4f 0d 59 4f | THE VAL|UE TO.YO|
|00000c30| 55 52 20 53 54 41 4e 44 | 41 52 44 20 44 45 44 55 |UR STAND|ARD DEDU|
|00000c40| 43 54 49 4f 4e 20 41 4e | 44 20 45 4e 54 45 52 20 |CTION AN|D ENTER |
|00000c50| 54 48 45 0d 48 49 47 48 | 45 52 20 4f 46 20 54 48 |THE.HIGH|ER OF TH|
|00000c60| 45 20 54 57 4f 20 56 41 | 4c 55 45 53 2e 20 20 d9 |E TWO VA|LUES.  .|
|00000c70| 4f 55 20 53 48 4f 55 4c | 44 0d 49 54 45 4d 49 5a |OU SHOUL|D.ITEMIZ|
|00000c80| 45 20 44 45 44 55 43 54 | 49 4f 4e 53 20 49 46 20 |E DEDUCT|IONS IF |
|00000c90| 54 48 45 20 54 4f 54 41 | 4c 20 49 53 0d 4d 4f 52 |THE TOTA|L IS.MOR|
|00000ca0| 45 20 54 48 41 4e 20 54 | 48 45 20 46 4f 4c 4c 4f |E THAN T|HE FOLLO|
|00000cb0| 57 49 4e 47 20 53 54 41 | 4e 44 41 52 44 0d 41 4d |WING STA|NDARD.AM|
|00000cc0| 4f 55 4e 54 53 20 46 4f | 52 20 31 39 39 34 20 28 |OUNTS FO|R 1994 (|
|00000cd0| 49 46 20 3c 36 35 20 41 | 4e 44 20 4e 4f 54 0d 42 |IF <65 A|ND NOT.B|
|00000ce0| 4c 49 4e 44 29 2e 0d 0d | 20 20 d3 49 4e 47 4c 45 |LIND)...|  .INGLE|
|00000cf0| 20 20 20 20 20 20 20 20 | 20 20 20 20 20 20 20 20 |        |        |
|00000d00| 20 20 20 20 24 33 38 30 | 30 0d 20 20 cd 41 52 52 |    $380|0.  .ARR|
|00000d10| 49 45 44 20 46 49 4c 49 | 4e 47 20 4a 4f 49 4e 54 |IED FILI|NG JOINT|
|00000d20| 4c 59 20 20 20 20 24 36 | 33 35 30 0d 20 20 d1 55 |LY    $6|350.  .U|
|00000d30| 41 4c 49 46 59 49 4e 47 | 20 57 49 44 4f 57 20 20 |ALIFYING| WIDOW  |
|00000d40| 20 20 20 20 20 20 20 20 | 24 36 33 35 30 0d 20 20 |        |$6350.  |
|00000d50| cd 41 52 52 49 45 44 20 | 46 49 4c 49 4e 47 20 53 |.ARRIED |FILING S|
|00000d60| 45 50 41 52 41 54 45 4c | 59 20 24 33 31 37 35 0d |EPARATEL|Y $3175.|
|00000d70| 20 20 c8 45 41 44 20 4f | 46 20 48 4f 55 53 45 48 |  .EAD O|F HOUSEH|
|00000d80| 4f 4c 44 20 20 20 20 20 | 20 20 20 20 24 35 36 30 |OLD     |    $560|
|00000d90| 30 0d 0d 33 35 3a 20 cc | 49 4e 45 20 33 32 20 2d |0..35: .|INE 32 -|
|00000da0| 20 4c 49 4e 45 20 33 34 | 2e 0d 0d 33 36 3a 20 d4 | LINE 34|...36: .|
|00000db0| 48 49 53 20 4c 49 4e 45 | 20 49 53 20 54 48 45 20 |HIS LINE| IS THE |
|00000dc0| 4e 55 4d 42 45 52 20 4f | 46 0d 45 58 45 4d 50 54 |NUMBER O|F.EXEMPT|
|00000dd0| 49 4f 4e 53 20 28 36 45 | 29 20 2a 20 24 32 34 35 |IONS (6E|) * $245|
|00000de0| 30 2e 20 20 c8 4f 57 45 | 56 45 52 2c 20 49 46 0d |0.  .OWE|VER, IF.|
|00000df0| 59 4f 55 52 20 41 44 4a | 55 53 54 45 44 20 47 52 |YOUR ADJ|USTED GR|
|00000e00| 4f 53 53 20 49 4e 43 4f | 4d 45 20 28 4c 49 4e 45 |OSS INCO|ME (LINE|
|00000e10| 20 33 32 29 0d 45 58 43 | 45 45 44 53 20 54 48 45 | 32).EXC|EEDS THE|
|00000e20| 20 54 48 52 45 53 48 4f | 4c 44 20 41 4d 4f 55 4e | THRESHO|LD AMOUN|
|00000e30| 54 20 46 4f 52 20 59 4f | 55 52 0d 46 49 4c 49 4e |T FOR YO|UR.FILIN|
|00000e40| 47 20 53 54 41 54 55 53 | 2c 20 54 48 45 20 41 4d |G STATUS|, THE AM|
|00000e50| 4f 55 4e 54 20 41 4c 4c | 4f 57 45 44 20 46 4f 52 |OUNT ALL|OWED FOR|
|00000e60| 0d 45 41 43 48 20 45 58 | 45 4d 50 54 49 4f 4e 20 |.EACH EX|EMPTION |
|00000e70| 49 53 20 52 45 44 55 43 | 45 44 2e 20 20 d4 48 45 |IS REDUC|ED.  .HE|
|00000e80| 0d 50 52 4f 47 52 41 4d | 20 57 49 4c 4c 20 43 41 |.PROGRAM| WILL CA|
|00000e90| 4c 43 55 4c 41 54 45 20 | 54 48 49 53 20 41 4d 4f |LCULATE |THIS AMO|
|00000ea0| 55 4e 54 2e 0d d4 48 45 | 20 46 4f 52 4d 55 4c 41 |UNT...HE| FORMULA|
|00000eb0| 20 49 53 3a 20 32 25 20 | 4f 46 20 45 41 43 48 20 | IS: 2% |OF EACH |
|00000ec0| 50 45 52 53 4f 4e 41 4c | 0d 45 58 45 4d 50 54 49 |PERSONAL|.EXEMPTI|
|00000ed0| 4f 4e 20 49 53 20 50 48 | 41 53 45 44 20 4f 55 54 |ON IS PH|ASED OUT|
|00000ee0| 20 46 4f 52 20 45 56 45 | 52 59 0d 24 32 35 30 30 | FOR EVE|RY.$2500|
|00000ef0| 20 4f 46 20 c1 c7 c9 20 | 41 42 4f 56 45 20 54 48 | OF ... |ABOVE TH|
|00000f00| 45 20 24 31 31 31 2c 38 | 30 30 0d 54 48 52 45 53 |E $111,8|00.THRES|
|00000f10| 48 4f 4c 44 20 46 4f 52 | 20 53 49 4e 47 4c 45 53 |HOLD FOR| SINGLES|
|00000f20| 2c 20 24 31 33 39 2c 37 | 35 30 20 46 4f 52 0d 48 |, $139,7|50 FOR.H|
|00000f30| 45 41 44 53 20 4f 46 20 | 48 4f 55 53 45 48 4f 4c |EADS OF |HOUSEHOL|
|00000f40| 44 53 2c 20 24 31 36 37 | 2c 37 30 30 20 46 4f 52 |DS, $167|,700 FOR|
|00000f50| 0d 4d 41 52 52 49 45 44 | 20 46 49 4c 49 4e 47 20 |.MARRIED| FILING |
|00000f60| 4a 4f 49 4e 54 4c 59 2c | 20 41 4e 44 20 24 38 33 |JOINTLY,| AND $83|
|00000f70| 2c 38 35 30 0d 46 4f 52 | 20 4d 41 52 52 49 45 44 |,850.FOR| MARRIED|
|00000f80| 20 46 49 4c 49 4e 47 20 | 53 45 50 41 52 41 54 45 | FILING |SEPARATE|
|00000f90| 4c 59 2e 0d 0d 33 37 3a | 20 d4 48 49 53 20 49 53 |LY...37:| .HIS IS|
|00000fa0| 20 59 4f 55 52 20 54 41 | 58 41 42 4c 45 20 49 4e | YOUR TA|XABLE IN|
|00000fb0| 43 4f 4d 45 2e 0d 0d 33 | 38 3a 20 d4 48 45 20 50 |COME...3|8: .HE P|
|00000fc0| 52 4f 47 52 41 4d 20 57 | 49 4c 4c 20 43 41 4c 43 |ROGRAM W|ILL CALC|
|00000fd0| 55 4c 41 54 45 20 41 4e | 0d 41 50 50 52 4f 58 49 |ULATE AN|.APPROXI|
|00000fe0| 4d 41 54 45 20 d4 c1 d8 | 2e 20 20 c6 4f 52 20 41 |MATE ...|.  .OR A|
|00000ff0| 20 4d 4f 52 45 20 45 58 | 41 43 54 0d 46 49 47 55 | MORE EX|ACT.FIGU|
|00001000| 52 45 2c 20 50 4c 45 41 | 53 45 20 52 45 46 45 52 |RE, PLEA|SE REFER|
|00001010| 20 54 4f 20 54 48 45 0d | 41 50 50 52 4f 50 52 49 | TO THE.|APPROPRI|
|00001020| 41 54 45 20 54 41 58 20 | 54 41 42 4c 45 53 2c 20 |ATE TAX |TABLES, |
|00001030| 54 41 58 20 52 41 54 45 | 0d 53 43 48 45 44 55 4c |TAX RATE|.SCHEDUL|
|00001040| 45 53 2c 20 53 43 48 45 | 44 55 4c 45 20 c4 20 4f |ES, SCHE|DULE . O|
|00001050| 52 20 46 4f 52 4d 20 38 | 36 31 35 2e 0d 0d 33 39 |R FORM 8|615...39|
|00001060| 3a 20 c1 44 44 49 54 49 | 4f 4e 41 4c 20 54 41 58 |: .DDITI|ONAL TAX|
|00001070| 45 53 20 46 52 4f 4d 20 | c6 4f 52 4d 20 34 39 37 |ES FROM |.ORM 497|
|00001080| 30 0d 4f 52 20 c6 4f 52 | 4d 20 34 39 37 32 2e 0d |0.OR .OR|M 4972..|
|00001090| 0d 34 30 3a 20 d4 4f 54 | 41 4c 2e 0d 0d 0d c3 52 |.40: .OT|AL.....R|
|000010a0| 45 44 49 54 53 0d 2d 2d | 2d 2d 2d 2d 2d 0d 0d 34 |EDITS.--|-----..4|
|000010b0| 31 3a 20 c3 52 45 44 49 | 54 20 46 4f 52 20 43 48 |1: .REDI|T FOR CH|
|000010c0| 49 4c 44 20 43 41 52 45 | 20 45 58 50 45 4e 53 45 |ILD CARE| EXPENSE|
|000010d0| 53 0d 28 41 54 54 41 43 | 48 20 c6 4f 52 4d 20 32 |S.(ATTAC|H .ORM 2|
|000010e0| 34 34 31 29 0d 0d 34 32 | 3a 20 c3 52 45 44 49 54 |441)..42|: .REDIT|
|000010f0| 20 46 4f 52 20 54 48 45 | 20 45 4c 44 45 52 4c 59 | FOR THE| ELDERLY|
|00001100| 20 4f 52 20 54 48 45 0d | 44 49 53 41 42 4c 45 44 | OR THE.|DISABLED|
|00001110| 20 28 41 54 54 41 43 48 | 20 d3 43 48 45 44 55 4c | (ATTACH| .CHEDUL|
|00001120| 45 20 d2 29 2e 0d 0d 34 | 33 3a 20 c6 4f 52 45 49 |E .)...4|3: .OREI|
|00001130| 47 4e 20 54 41 58 20 43 | 52 45 44 49 54 20 28 41 |GN TAX C|REDIT (A|
|00001140| 54 54 41 43 48 20 c6 4f | 52 4d 0d 31 31 31 36 29 |TTACH .O|RM.1116)|
|00001150| 2e 0d 0d 34 34 3a 20 cf | 54 48 45 52 20 43 52 45 |...44: .|THER CRE|
|00001160| 44 49 54 53 20 46 52 4f | 4d 20 c6 4f 52 4d 20 33 |DITS FRO|M .ORM 3|
|00001170| 38 30 30 2c 0d c6 4f 52 | 4d 20 38 33 39 36 2c 20 |800,..OR|M 8396, |
|00001180| c6 4f 52 4d 20 38 38 30 | 31 20 4f 52 20 4f 54 48 |.ORM 880|1 OR OTH|
|00001190| 45 52 2e 0d 0d 34 35 3a | 20 d4 4f 54 41 4c 20 43 |ER...45:| .OTAL C|
|000011a0| 52 45 44 49 54 53 2e 0d | 0d 34 36 3a 20 d4 4f 54 |REDITS..|.46: .OT|
|000011b0| 41 4c 20 54 41 58 20 41 | 46 54 45 52 20 43 52 45 |AL TAX A|FTER CRE|
|000011c0| 44 49 54 53 2e 0d 0d 0d | cf 54 48 45 52 20 54 41 |DITS....|.THER TA|
|000011d0| 58 45 53 0d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |XES.----|-------.|
|000011e0| 0d 34 37 3a 20 d3 45 4c | 46 2d 45 4d 50 4c 4f 59 |.47: .EL|F-EMPLOY|
|000011f0| 4d 45 4e 54 20 54 41 58 | 20 28 41 54 54 41 43 48 |MENT TAX| (ATTACH|
|00001200| 0d d3 43 48 45 44 55 4c | 45 20 d3 c5 29 0d 0d 34 |..CHEDUL|E ..)..4|
|00001210| 38 3a 20 c1 4c 54 45 52 | 4e 41 54 49 56 45 20 4d |8: .LTER|NATIVE M|
|00001220| 49 4e 49 4d 55 4d 20 54 | 41 58 20 28 41 54 54 41 |INIMUM T|AX (ATTA|
|00001230| 43 48 0d c6 4f 52 4d 20 | 36 32 35 31 29 2e 0d 0d |CH..ORM |6251)...|
|00001240| 34 39 3a 20 d2 45 43 41 | 50 54 55 52 45 20 54 41 |49: .ECA|PTURE TA|
|00001250| 58 45 53 20 28 c6 4f 52 | 4d 20 34 32 35 35 2c 20 |XES (.OR|M 4255, |
|00001260| c6 4f 52 4d 0d 38 36 31 | 31 20 4f 52 20 c6 4f 52 |.ORM.861|1 OR .OR|
|00001270| 4d 20 38 38 32 38 29 2e | 0d 0d 35 30 3a 20 d3 4f |M 8828).|..50: .O|
|00001280| 43 49 41 4c 20 d3 45 43 | 55 52 49 54 59 20 41 4e |CIAL .EC|URITY AN|
|00001290| 44 20 cd 45 44 49 43 41 | 52 45 20 54 41 58 0d 4f |D .EDICA|RE TAX.O|
|000012a0| 4e 20 54 49 50 20 49 4e | 43 4f 4d 45 20 4e 4f 54 |N TIP IN|COME NOT|
|000012b0| 20 52 45 50 4f 52 54 45 | 44 20 54 4f 0d 45 4d 50 | REPORTE|D TO.EMP|
|000012c0| 4c 4f 59 45 52 20 28 41 | 54 54 41 43 48 20 c6 4f |LOYER (A|TTACH .O|
|000012d0| 52 4d 20 34 31 33 37 29 | 2e 0d 0d 35 31 3a 20 d4 |RM 4137)|...51: .|
|000012e0| 41 58 20 4f 4e 20 41 4e | 20 c9 d2 c1 20 4f 52 20 |AX ON AN| ... OR |
|000012f0| 41 20 51 55 41 4c 49 46 | 49 45 44 0d 52 45 54 49 |A QUALIF|IED.RETI|
|00001300| 52 45 4d 45 4e 54 20 50 | 4c 41 4e 20 28 41 54 54 |REMENT P|LAN (ATT|
|00001310| 41 43 48 20 c6 4f 52 4d | 20 35 33 32 39 29 2e 0d |ACH .ORM| 5329)..|
|00001320| 0d 35 32 3a 20 c1 44 56 | 41 4e 43 45 20 45 41 52 |.52: .DV|ANCE EAR|
|00001330| 4e 45 44 20 49 4e 43 4f | 4d 45 20 43 52 45 44 49 |NED INCO|ME CREDI|
|00001340| 54 0d 50 41 59 4d 45 4e | 54 53 20 46 52 4f 4d 20 |T.PAYMEN|TS FROM |
|00001350| c6 4f 52 4d 20 d7 2d 32 | 2e 0d 0d 35 33 3a 20 d4 |.ORM .-2|...53: .|
|00001360| 4f 54 41 4c 20 54 41 58 | 2e 0d 0d 0d d0 41 59 4d |OTAL TAX|.....AYM|
|00001370| 45 4e 54 53 0d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0d 35 |ENTS.---|-----..5|
|00001380| 34 3a 20 c6 45 44 45 52 | 41 4c 20 49 4e 43 4f 4d |4: .EDER|AL INCOM|
|00001390| 45 20 54 41 58 20 57 49 | 54 48 48 45 4c 44 2e 0d |E TAX WI|THHELD..|
|000013a0| 0d 35 35 3a 20 31 39 39 | 34 20 45 53 54 49 4d 41 |.55: 199|4 ESTIMA|
|000013b0| 54 45 44 20 54 41 58 20 | 50 41 59 4d 45 4e 54 53 |TED TAX |PAYMENTS|
|000013c0| 20 41 4e 44 0d 41 4d 4f | 55 4e 54 20 41 50 50 4c | AND.AMO|UNT APPL|
|000013d0| 49 45 44 20 46 52 4f 4d | 20 31 39 39 33 20 52 45 |IED FROM| 1993 RE|
|000013e0| 54 55 52 4e 2e 0d 0d 35 | 36 3a 20 c5 41 52 4e 45 |TURN...5|6: .ARNE|
|000013f0| 44 20 49 4e 43 4f 4d 45 | 20 43 52 45 44 49 54 20 |D INCOME| CREDIT |
|00001400| 28 41 54 54 41 43 48 0d | d3 43 48 45 44 55 4c 45 |(ATTACH.|.CHEDULE|
|00001410| 20 c5 c9 c3 29 2e 0d 0d | 35 37 3a 20 c1 4d 4f 55 | ...)...|57: .MOU|
|00001420| 4e 54 20 50 41 49 44 20 | 57 49 54 48 20 c6 4f 52 |NT PAID |WITH .OR|
|00001430| 4d 20 34 38 36 38 2e 0d | 0d 35 38 3a 20 c5 58 43 |M 4868..|.58: .XC|
|00001440| 45 53 53 20 d3 4f 43 49 | 41 4c 20 d3 45 43 55 52 |ESS .OCI|AL .ECUR|
|00001450| 49 54 59 2c 20 cd 45 44 | 49 43 41 52 45 0d 41 4e |ITY, .ED|ICARE.AN|
|00001460| 44 20 d2 d2 d4 c1 20 54 | 41 58 20 57 49 54 48 48 |D .... T|AX WITHH|
|00001470| 45 4c 44 2e 0d 0d 35 39 | 3a 20 cf 54 48 45 52 20 |ELD...59|: .THER |
|00001480| 50 41 59 4d 45 4e 54 53 | 20 46 52 4f 4d 20 c6 4f |PAYMENTS| FROM .O|
|00001490| 52 4d 20 32 34 33 39 20 | 4f 52 0d c6 4f 52 4d 20 |RM 2439 |OR..ORM |
|000014a0| 34 31 33 36 2e 0d 0d 36 | 30 3a 20 d4 4f 54 41 4c |4136...6|0: .OTAL|
|000014b0| 20 50 41 59 4d 45 4e 54 | 53 2e 0d 0d 0d d2 45 46 | PAYMENT|S.....EF|
|000014c0| 55 4e 44 20 4f 52 20 c1 | 4d 4f 55 4e 54 20 c4 55 |UND OR .|MOUNT .U|
|000014d0| 45 0d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |E.------|--------|
|000014e0| 2d 2d 2d 2d 2d 2d 0d 0d | 36 31 3a 20 c1 4d 4f 55 |------..|61: .MOU|
|000014f0| 4e 54 20 4f 56 45 52 50 | 41 49 44 2e 0d 0d 36 32 |NT OVERP|AID...62|
|00001500| 3a 20 c1 4d 4f 55 4e 54 | 20 59 4f 55 20 57 4f 55 |: .MOUNT| YOU WOU|
|00001510| 4c 44 20 4c 49 4b 45 20 | 52 45 46 55 4e 44 45 44 |LD LIKE |REFUNDED|
|00001520| 2e 0d 0d 36 33 3a 20 c1 | 4d 4f 55 4e 54 20 54 4f |...63: .|MOUNT TO|
|00001530| 20 42 45 20 41 50 50 4c | 49 45 44 20 54 4f 20 59 | BE APPL|IED TO Y|
|00001540| 4f 55 52 20 31 39 39 35 | 0d 45 53 54 49 4d 41 54 |OUR 1995|.ESTIMAT|
|00001550| 45 44 20 54 41 58 2e 0d | 0d 36 34 3a 20 c1 4d 4f |ED TAX..|.64: .MO|
|00001560| 55 4e 54 20 59 4f 55 20 | 4f 57 45 2e 0d 0d 36 35 |UNT YOU |OWE...65|
|00001570| 3a 20 c5 53 54 49 4d 41 | 54 45 44 20 54 41 58 20 |: .STIMA|TED TAX |
|00001580| 50 45 4e 41 4c 54 59 20 | 28 49 4e 43 4c 55 44 45 |PENALTY |(INCLUDE|
|00001590| 44 0d 49 4e 20 4c 49 4e | 45 20 36 34 29 2e 0d    |D.IN LIN|E 64).. |
+--------+-------------------------+-------------------------+--------+--------+