100718855793-2 Page 1 of 2
This Product Contains Sensitive Taxpayer Data
Account Transcript
Request Date: 04-06-2021
Response Date: 04-06-2021
Tracking Number: 100718855793
FORM NUMBER: 1040A
TAX PERIOD: Dec. 31, 2016
TAXPAYER IDENTIFICATION NUMBER: XXX-XX-5641
POLL N SMIT
<<<<POWER OF ATTORNEY/TAX INFORMATION AUTHORIZATION (POA/TIA) ON FILE>>>>
--- ANY MINUS SIGN SHOWN BELOW SIGNIFIES A CREDIT AMOUNT ---
ACCOUNT BALANCE: 59,485.57
ACCRUED INTEREST: 0.00 AS OF: Apr. 19, 2021
ACCRUED PENALTY: 0.00 AS OF: Apr. 19, 2021
ACCOUNT BALANCE PLUS ACCRUALS
(this is not a payoff amount): 59,485.57
** INFORMATION FROM THE RETURN OR AS ADJUSTED **
EXEMPTIONS: 01
FILING STATUS: Single
ADJUSTED GROSS INCOME: 235,257.00
TAXABLE INCOME: 224,907.00
TAX PER RETURN: 0.00
SE TAXABLE INCOME TAXPAYER: 0.00
SE TAXABLE INCOME SPOUSE: 0.00
TOTAL SELF EMPLOYMENT TAX: 0.00
RETURN DUE DATE OR RETURN RECEIVED DATE (WHICHEVER IS LATER) Jun. 02, 2020
PROCESSING DATE Jun. 29, 2020
TRANSACTIONS
CODE EXPLANATION OF TRANSACTION CYCLE DATE AMOUNT
150 Substitute tax return prepared by IRS 06-29-2020 $0.00
n/a 11210-887-00017-0
460 Extension of time to file tax return ext. Date 10-15-2017 04-15-2017 $0.00
140 Inquiry for non-filing of tax return 07-10-2018 $0.00
971 Notice issued 07-30-2018 $0.00
CP 0059
494 Final notice before tax is determined by IRS 02-11-2020 $0.00
570 Additional account action pending 06-29-2020 $0.00
https://la2.www4.irs.gov/esrv/tds/requests/TdsProductAction.do?method=productDetails 4/6/2021
100718855793-2 Page 2 of 2
170 Penalty for not pre-paying tax 20202705 07-20-2020 $755.58
07-20-2030
806 W-2 or 1099 withholding 04-15-2017 -$23,525.00
290 Additional tax assessed 20202705 07-20-2020 $57,748.00
07-20-2030
n/a 13254-583-36957-0
495 Resolved tax determination 06-30-2020 $0.00
599 Tax return secured 07-01-2020 $0.00
166 Penalty for filing tax return after the due date 20202705 07-20-2020 $7,700.17
07-20-2030
196 Interest charged for late payment 20202705 07-20-2020 $6,971.29
276 Penalty for late payment of tax 20202705 07-20-2020 $6,844.60
971 Notice issued 07-20-2020 $0.00
CP 0022
530 Balance due account currently not collectable - not due 01-12-2021 $0.00
to hardship
960 Appointed representative 03-11-2021 $0.00
971 Notice issued 04-19-2021 $0.00
CP 071C
196 Interest charged for late payment 20211305 04-19-2021 $1,279.79
276 Penalty for late payment of tax 20211305 04-19-2021 $1,711.14
This Product Contains Sensitive Taxpayer Data
https://la2.www4.irs.gov/esrv/tds/requests/TdsProductAction.do?method=productDetails 4/6/2021