LUIS R ORTIZ SOLTERO

Tax Return Signature/Consent to Disclosure

On-Line Self Select PIN without Direct Debit

Perjury Statement
Under penalties for perjury, I declare that I have examined this return, including any accompanying statements and schedules and, to the best of my
knowledge and belief, it is true, correct, and complete.

Consent to Disclosure
I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send my return to IRS and to receive the following
information from IRS: a) an acknowledgement of receipt or reason for rejection of transmission; b) an indication of any refund offset; c) the reason
for any delay in processing or refund; and, d) the date of any refund.

I am signing this Tax Return and Electronic Funds Withdrawal Consent, if applicable, by entering my Self
Select PIN below.

Taxpayer's PIN: 24837 Date: 02/19/2020

Taxpayer's Date of Birth: 08/29/1990
Taxpayer's Prior Year Adjusted Gross Income: 1,480.
Taxpayer's Prior year PIN
Taxpayer's Electronic Filing PIN
Spouse's PIN:
Spouse's Date of Birth:
Spouse's Prior Year Adjusted Gross Income:
Spouse's Prior year PIN
Spouse's Electronic Filing PIN

8453OL(D) (2019) FD8453OD-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 Name: LUIS R ORTIZ SOLTERO

IRS Direct Deposit Information

Routing Transit Number (RTN) 101089742

Depositor Account Number (DAN) 8558729726

Refund Transfer Proceeds - Direct Deposit Information

Routing Transit Number (RTN) 122106455

Depositor Account Number (DAN) 601902711

8453OL(D) (2019) FD8453OD-2WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 ACD - 31012 (2019) State of New Mexico Taxation and Revenue Department
Rev. 07/ 20/ 2019
INDIVIDUAL INCOME TAX DECLARATION FOR
PIT-8453 ELECTRONIC FILING AND TRANSMITTAL 2019
For the year January 1 - December 31, 2019

Your first name and middle initial Last name Social security number
RESIDENCY
LUIS R ORTIZ SOLTERO 628-30-4837 R STATUS

Spouse's first name and middle initial Last name Social security number
RESIDENCY
STATUS

Your mailing address, city, state, and ZIP code

68 BILLY MITCHELL PLACE ROSWELL NM 88203
FILING STATUS (Check one) (3) Married filing separately (Enter spouse's name and social security number.)
X (1) Single (4) Head of household (Enter name of person who qualifies you as head of household if that person is
(2) Married filing jointly not counted as a qualified exemption on your federal return.)
(5) Qualifying widow(er)

PART I TAX RETURN INFORMATION (WHOLE DOLLARS ONLY)

1. Federal Adjusted Gross Income (PIT-1 return, line 9) 1. 22,395

2. Net New Mexico Income Tax (PIT-1 return, line 22) 2. 175
3. Total Payments and Credits (PIT-1 return, line 32) 3. 563
4. Tax Due (PIT-1 return, line 33) 4.

5. Overpayment (PIT-1 return, line 39) 5. 388

PART II DECLARATION OF TAXPAYER

I declare the amounts described in Part I above agree with the amounts shown on the corresponding lines of my New Mexico personal income tax
return, and that I have examined the contents of my electronic return and accompanying schedules and statements. To the best of my knowledge
and belief, my return is true, correct, and complete. I consent that my return, including accompanying schedules and statements, be electronically
transmitted to the New Mexico Taxation and Revenue Department.

PLEASE
SIGN COPY ONLY COPY ONLY
HERE
Your signature Date Spouse's signature (If joint return, BOTH MUST sign.)

PART III DECLARATION OF PREPARER/TRANSMITTER (if applicable)

PAID PREPARER'S, ELECTRONIC RETURN ORIGINATOR'S or OTHER THIRD- PARTY TRANSMITTER'S USE ONLY

I declare the above taxpayer's return is based on all pertinent information of which I have knowledge. I have verified that the taxpayer's name shown
on this declaration agrees with the name that appears on the proof of account. A copy of all forms and information to be filed with or transmitted to
the New Mexico Taxation and Revenue Department have been provided to the taxpayer.

Preparer's/Transmitter's signature Date

Check if self-employed Preparer's PTIN NM CRS identification number (if applicable)

Firm's name (or yours, if self-employed)

Address (number, street, city, and state) ZIP code

When required to submit a copy of this form to the Department, mail the form and attachments to:
New Mexico Taxation and Revenue Department, P.O. Box 5418, Santa Fe, NM 87502-5418
PIT-8453D (2019) NM8453D-1WV 1.51
Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 ACD - 31012 (2019) State of New Mexico Taxation and Revenue Department
Rev. 07/ 20/ 2019
INDIVIDUAL INCOME TAX DECLARATION FOR
PIT-8453 ELECTRONIC FILING AND TRANSMITTAL 2019
For the year January 1 - December 31, 2019
INSTRUCTIONS
Page 1 of 2

Who Must Submit this Form to the Department The electronic return transmitter must advise the taxpayer of
the taxpayer's responsibility for keeping all documentation
Taxpayers who must submit 2019 PIT returns through the Federal\
related to the tax filing for 10 years from the end of the calendar
State e-file program (a third-party software program), may now
year when the return was due or filed. The electronic return
be able to attach or include supporting documentation with transmitter also must retain Form PIT-8453 and all supporting
the electronic file. If all supporting documents are submitted documents for a period of three years from the end of the
with the electronic file, form PIT- 8453 is NOT required to be calendar year when the return was due or filed.
submitted to the Department.
How to Complete this Form
Form PIT-8453 is only required to be submitted if an elec- Complete the taxpayer name(s), address, social security
tronically filed return does not attach or include supporting number(s), residency status, and filing status information as
documentation in order to support the return data, exemptions, reported on Form PIT- 1. Mark the residency status box for
deductions, or credits. See the list of supporting documentation the primary taxpayer and the spouse exactly as it is marked
on PIT- 1 return, with R for resident, N for non- resident, P for
on page 2 of these instructions.
part- year resident, and F for first- year resident.
When submitting PIT-8453 and one or more supporting docu-
PART I Tax Return Information. Complete lines 1 through 5
ments, do not include copies of Form PIT-1 or Schedules with the information from the taxpayer's return data. The numbers
PIT-S, PIT-ADJ, PIT-RC, PIT-B, PIT-D, or PIT-CR. on these lines must match the entries on the corresponding
lines of the electronic return.
Individuals electronically filing their own return through New
Mexico Taxpayer Access Point (TAP) are instructed by the pro- PART II Declaration of Taxpayer. The taxpayer and spouse,
gram when required to complete and submit Form PIT-8453. if married filing jointly, must sign PART II authorizing the
electronic transmission of their return and declaring that the
Who Must Complete this Form taxpayer information provided on Form PIT-8453 is true,
Form PIT-8453 must be completed when a tax preparer, elec- correct, and complete. A blank Form PIT-8453 must be treated
tronic return originator (ERO), or other third-party transmitter the same as a blank tax return in that a tax preparer, electronic
electronically transmits a 2019 New Mexico Personal Income return originator, or other third-party transmitter must not allow
Tax (PIT-1) return to the Department. any taxpayer to sign a blank Form PIT- 8453 or tax return. The
taxpayer may review the completed tax return on a display terminal.
Special Instructions for a Paid Tax Preparer, Electronic
Return Originator, or Other Third Party Transmitter PART III Declaration of Preparer/Transmitter. The tax preparer,
When a 2019 New Mexico personal income tax return is elec- electronic return originator, or other third-party transmitter must
tronically transmitted through a paid tax preparer, electronic complete PART III. Individuals who electronically transmitted
return originator, or other third-party transmitter, the tax pre- their own returns leave Part III blank. If a person other
parer or transmitter must complete Form PIT-8453 and obtain than the transmitter prepares the return, the paid preparer's
a signature(s) from the taxpayer(s), even if the form is not signature is also required. Instead of obtaining the paid
required to be submitted to the Department. Form PIT-8453 preparer's signature on the PIT- 8453, the ERO may attach to
authorizes a tax preparer or other third party to electronically Form PIT- 8453 a copy of the return bearing the paid preparer's
transmit (file) the tax return on behalf of the taxpayer and signature.
authenticates the electronic portion of the return.

After Form PIT-8453 has been completed and signed, paid tax
preparers and other third-party transmitters must provide the
taxpayer a copy of the prepared return and Form PIT-8453.

PIT-8453D (2019) NM8453D-2WV 1.51

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 Name: LUIS R ORTIZ SOLTERO SSN: XXX-XX-4837
New Mexico Direct Deposit Information

Routing Transit Number (RTN) 122106455

Depositor Account Number (DAN) 601902711
Type of Account Checking
Amount of Deposit 388

PIT-8453D (2019) NM8453D-3WV 1.51

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 2019 Federal Tax Return Filing Instructions
FOR THE YEAR ENDING
December 31, 2019

LUIS R ORTIZ SOLTERO

Prepared for

Gross Income $ 22,395

Tax Adjusted Gross Income $ 22,395
Summary Total Deductions $ 12,200
Total Taxable Income $ 10,195
Total Tax $ 1,027
Total Payments $ 1,721
Refund Amount $ 694
Amount You Owe $ 0

Make check United States Treasury

payable to

Since you are filing your return electronically and you chose
Mailing to use an electronic signature, you do not mail your return.
Address

Instructions
STEP 1 - Once your e-filed return has been accepted, you will receive
an e-mail
STEP 2 - Keep a copy
Print a copy of the return for your records.
Please attach a copy of each W-2, W-2G, 1099G and 1099R to your return.

Checklist (2019) FDCHECKE-1WV 1.0 Ver 0249

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 ACD - 31012 (2019) State of New Mexico Taxation and Revenue Department
Rev. 07/ 20/ 2019
INDIVIDUAL INCOME TAX DECLARATION FOR
PIT-8453 ELECTRONIC FILING AND TRANSMITTAL 2019
For the year January 1 - December 31, 2019

Your first name and middle initial Last name Social security number
RESIDENCY
LUIS R ORTIZ SOLTERO 628-30-4837 R STATUS

Spouse's first name and middle initial Last name Social security number
RESIDENCY
STATUS

Your mailing address, city, state, and ZIP code

68 BILLY MITCHELL PLACE ROSWELL NM 88203
FILING STATUS (Check one) (3) Married filing separately (Enter spouse's name and social security number.)
X (1) Single (4) Head of household (Enter name of person who qualifies you as head of household if that person is
(2) Married filing jointly not counted as a qualified exemption on your federal return.)
(5) Qualifying widow(er)

PART I TAX RETURN INFORMATION (WHOLE DOLLARS ONLY)

1. Federal Adjusted Gross Income (PIT-1 return, line 9) 1. 22,395

2. Net New Mexico Income Tax (PIT-1 return, line 22) 2. 175
3. Total Payments and Credits (PIT-1 return, line 32) 3. 563
4. Tax Due (PIT-1 return, line 33) 4.

5. Overpayment (PIT-1 return, line 39) 5. 388

PART II DECLARATION OF TAXPAYER

I declare the amounts described in Part I above agree with the amounts shown on the corresponding lines of my New Mexico personal income tax
return, and that I have examined the contents of my electronic return and accompanying schedules and statements. To the best of my knowledge
and belief, my return is true, correct, and complete. I consent that my return, including accompanying schedules and statements, be electronically
transmitted to the New Mexico Taxation and Revenue Department.

PLEASE
SIGN
HERE
Your signature Date Spouse's signature (If joint return, BOTH MUST sign.)

PART III DECLARATION OF PREPARER/TRANSMITTER (if applicable)

PAID PREPARER'S, ELECTRONIC RETURN ORIGINATOR'S or OTHER THIRD- PARTY TRANSMITTER'S USE ONLY

I declare the above taxpayer's return is based on all pertinent information of which I have knowledge. I have verified that the taxpayer's name shown
on this declaration agrees with the name that appears on the proof of account. A copy of all forms and information to be filed with or transmitted to
the New Mexico Taxation and Revenue Department have been provided to the taxpayer.

Preparer's/Transmitter's signature Date

Check if self-employed Preparer's PTIN NM CRS identification number (if applicable)

Firm's name (or yours, if self-employed)

Address (number, street, city, and state) ZIP code

When required to submit a copy of this form to the Department, mail the form and attachments to:
New Mexico Taxation and Revenue Department, P.O. Box 5418, Santa Fe, NM 87502-5418
PIT-8453 (2019) NM8453-1WV 1.61
Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 F (99)
O
R
1040 D epart ment of t h e Treasury - Int ernal Revenue Service

M U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only - D o not w rit e or st aple in t h is space.

Filing status X Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er)(QW)
Check only If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child's name if the qualifying person is
one box. a child but not your dependent.
Your first name and middle initial Last name Your social security number
LUIS R ORTIZ SOLTERO 628-30-4837
If joint return, spouse's first name and middle initial Last name Spouse's social security no.

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Ch eck h ere if y ou, or y our spouse
68 BILLY MITCHELL PLACE if f iling j oint ly, w ant $3 t o go t o t h is
f und . Ch eck ing a b ox b elow w ill not
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). ch ange y our t ax or ref und .
ROSWELL, NM 88203 You Spouse
Foreign country name Foreign province/county Foreign postal code If more t h an f our d epend ent s,
see inst. and here

Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were dual- status alien

Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social securit y no. (3) Relat ionsh ip t o y ou (4) if q ualif ies f or (see inst .):
Cred it f or ot h er
(1) First name Last name Ch ild t ax cred it
d epend ent s

1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 22,395.

Standard 2a Tax-exempt interest 2a b Taxab le int erest . At t ach Sch .B if req uired 2b
Deduction for - 3a Qualified dividends 3a b Ord inary d iv. At t ach Sch . B if req uired 3b
Single or married
f iling separat ely, 4a IRA distributions 4a b Taxable amount 4b
$12,200
c Pension and annuities 4c d Taxable amount 4d
M arried f iling
j oint ly or 5a Social security benefits 5a b Taxable amount 5b
Qualifying 6 Capital gain or (loss). Attach Schedule D if required. If not required, check here 6
widow(er),
$24,400 7a Other income from Schedule 1, line 9 7a
Head of b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income 7b 22,395.
h ouseh old ,
$18,350 8a Adjustments to income from Schedule 1, line 22 8a
If y ou ch ecked b Subtract line 8a from line 7b. This is your adjusted gross income 8b 22,395.
any box under
St and ard
9 Standard deduction or itemized deductions (from Schedule A) 9 12,200.
D ed uct ion, 10 Qualified business income deduction. Attach Form 8995 or Form 8995- A 10
see inst ruct ions.
11a Add lines 9 and 10 11a 12,200.
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter - 0- 11b 10,195.
KBA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019)

1040 (2019) FD1040-1WV 1.25

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
Form 1040 (2019) LUIS R ORTIZ SOLTERO 628-30-4837 Page 2
12a Tax (see inst.)Check if any from Form(s):1 8814 2 4972 3 12a 1,027.
b Add Schedule 2, line 3, and line 12a and enter the total 12b 1,027.
13a Child tax credit or credit for other dependents 13a
b Add Schedule 3, line 7, and line 13a and enter the total 13b
14 Subtract line 13b from line 12b. If zero or less, enter - 0- 14 1,027.
15 Other taxes, including self- employment tax, from Schedule 2, line 10 15
16 Add lines 14 and 15. this is your total tax 16 1,027.
17 Federal income tax withheld from Forms W-2 and 1099 17 1,721.
If you have a
q ualif y ing ch ild , 18 Other payments and refundable credits:
at t ach Sch .EIC
a Earned income credit (EIC) 18a
If you have
nontaxable b Additional child tax credit. Attach Schedule 8812 18b
comb at pay, see
inst ruct ions. c American opportunity credit from Form 8863, line 8 18c
d Schedule 3, line 14 18d
e Add lines 18a through 18d. These are your total other payments and refundable credits 18e
19 Add lines 17 and 18e. These are your total payments 19 1,721.
Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 20 694.
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here 21a 694.
D irect d eposit ? b Routing number 101089742 c Type: X Checking Savings
See inst ruct ions.
Account number 8558729726
d
22
Amount of line 20 you want applied to your 2020 estimated tax 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions 23
You Owe 24 Estimated tax penalty (see instructions) 24
Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See inst. Yes. Complete below.
Third Party
Designee X No
(Ot h er t h an Designee's Phone Personal id ent if icat ion numb er
paid preparer) name no. (PIN)
Und er penalt ies of perj ury, I d eclare t h at I h ave examined t h is ret urn and accompany ing sch ed ules and st at ement s, and t o t h e b est of my k now led ge and b elief ,
Sign t h ey are t rue, correct , and complet e. D eclarat ion of preparer (ot h er t h an t axpay er) is b ased on all inf ormat ion of w h ich preparer h as any k now led ge.
Here
If t h e IRS sent y ou an ID
Joint return? Your signature Date Your occupation Protection
See instructions. PIN, enter it
CDL DRIVER here (see inst.)
Keep a copy for If t h e IRS sent y our spouse
your records. Spouse's signature. If a joint return, both must sign. Date Spouse's occupation an ID Prot ect ion
PIN, enter it
here (see inst.)
Phone no. Email address
Paid Preparer's name Preparer's signature Date PTIN Check if:
Preparers 3rd Part y D esignee

Use Only Firm's name Phone no. self - employ ed

Firm's address Firm's EIN

Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2019)
 2019 STATE TAX RETURN FILING INSTRUCTIONS
NEW MEXICO
FOR THE YEAR ENDING
December 31, 2019

Prepared for LUIS R ORTIZ SOLTERO

Tax Gross Income $ 22,395

Summary Adjusted Gross Income $ 22,395
Total Deductions $ 12,200
Total Taxable Income $ 8,054
Total Tax $ 175
Total Payments $ 563
Refund Amount $ 388
Amount You Owe $ 0

Make check Not Applicable

payable to

Mailing Not Applicable

Address

Special SIGN AND DATE YOUR RETURN

Instructions Please sign and date Form NM-8453.
Keep a copy with your records for three years.
KEEP A COPY
Click on Main Menu and then E-File or Print to print your
return. Attach your copy of each W-2, W-2G, 1099R or 1099G
with withholding. Keep with your records for three years.

Check List (2019) STCHECK-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
2019 PIT-1 NEW MEXICO PERSONAL INCOME TAX RETURN
For the year January 1 - December 31, 2019
or fiscal year beginningF.1 ending F.2
If amending use Form 2019 PIT- X.
1029 03 2
Age 65 Residency
Print y our name (f irst , mid d le, last ) SOCIAL SECURITY NUM B ER Blind or over status Taxpay er's d at e of b irt h
1a LUIS R ORTIZ SOLTERO 1b 628-30-4837 1c 1d 1e R 1f 08/29/1990
Print y our spouse's name (f irst , mid d le, last ). If married f iling sep, includ e spouse.
Spouse's d at e of b irt h
2a 2b 2c 2d 2e 2f

Taxpay er's d at e of d eat h

3a X If t h e ad d ress is new or ch anged , mark t h is b ox. 4. If a d eceased t axpay er's ref und must If t axpay er or spouse
b e mad e pay ab le t o a person ot h er d ied b ef ore t h is 4c
M ailing Ad d ress (Numb er and st reet ) t h an t h e t axpay er or spouse named ret urn is f iled , ent er
on t h is ret urn, ent er b elow t h e name d at e of d eat h . Spouse's d at e of d eat h
3b 68 BILLY MITCHELL PLACE and social securit y numb er of t h at
4d
City person. You must also at t ach Form
State Post al/ Z IP Cod e
RPD - 41083.
3c ROSWELL NM 88203 4a
Residency status:
For t axpay er and spouse
If f oreign ad d ress, ent er count ry Foreign province and / or st at e (1e & 2e), enter:
Name
3d R if RESID ENT
4b
N if NON- RESID ENT
1 EXEMPTIONS. Taxpayer, spouse, d epend ent s, and ot h er d epend ent s SSN
5. report ed on f ed eral Form 1040. If you are a d epend ent or ot h er d epend ent of
F if FIRST- YEAR RES.
anot h er t axpayer, ent er 00. (See inst ruct ions) P if PART- YEAR RES.
EXTENSION OF TIME TO FILE.
If you h ave a f ed eral or st at e ext ension,
6a 6b 7. FILING STATUS. Mark only one box.
mark t h e b ox and ent er t h e ext ension d at e.
8. DEPENDENTS AND OTHER DEPENDENTS. As listed on your federal return. X (1) Single
(You must report t h e f irst 5 d epend ent s and ot h er d epend ent s in t h is t ab le. Use Sch . PIT- S f or ad d it ional ent ries.) (2) Married filing jointly
Column 1 Column 2 Column 3
First name Last name D epend ent 's SSN D t of b irt h (M M / D D / CCYY) (3) Married filing separately(Ent er spouse's name
and social securit y numb er in 2a and 2b .)

(4) Head of household (Ent er name of person

q ualif y ing y ou as h ead of h ouseh old if t h at person is not
count ed as a q ualif ied d epend ent on y our f ed eral ret urn.)
(4a)
(5) Qualifying widow(er) with dependent child

9. FEDERAL ADJUSTED GROSS INCOME. (from federal Form 1040 or 1040SR, line 8b) 9 22,395
10. If you itemized your federal deduction amount, enter the amount of state and local tax deduction claimed on
federal Form 1040, Schedule A, line 5a. See the worksheet in the instructions + 10

11. Total Additions to federal adjusted gross income (PIT- ADJ, line 5). Attach PIT- ADJ 0
+ 11

12. Federal standard or itemized deduction amount (from federal Form 1040, line 9) 12,200
- 12
12a. If you itemized, mark the box 12a

13. Deduction for certain dependents. See the worksheet in the instructions - 13

14. New Mexico low-and middle-income tax exemption. See PIT-1 instructions - 14 2,141
15. Total Deductions and Exemptions from federal income (PIT- ADJ, line 22). Attach PIT- ADJ
- 15 0
16. Medical care expense deduction. See PIT-1 instructions
- 16 0
You must complet e b ot h lines 16 and 16a or t h e d ed uct ion w ill b e d enied .

16a. Unreimbursed and uncompensated medical care expenses 16a 0

17. NEW MEXICO TAXABLE INCOME. Add lines 9, 10 and 11, then subtract lines 12, 13, 14, 15 and 16 = 17 8,054
Cannot be less than zero.
18. New Mexico tax on amount on line 17 or from PIT- B, line 14
18 175
18a. From Rate Table = R. From PIT- B, line 14 = B 18a R
19. Additional amount for tax on lump-sum distributions. See PIT-1 instructions + 19
20. Credit for taxes paid to another state. You must have been a New Mexico resident during all or
part of the year. Include a copy of other state's return. See PIT-1 instructions - 20
21. Business- related income tax credits applied, from Schedule PIT- CR, line A. Attach PIT- CR - 21 0
22. NET NEW MEXICO INCOME TAX. Add lines 18 and 19, then subtract lines 20 and 21. Cannot be less
than zero
= 22 175
Electronic filers: If you file your New Mexico Personal Income Tax return online and also pay tax due online,
your due date is April 30, 2020. All others must file by April 15, 2020. See PIT- 1 instructions for details. Continue on the next page.
2019 PIT- 1 (page 2)
NEW MEXICO PERSONAL INCOME TAX RETURN
2
YOUR SOCIAL SECURITY NUMBER
628-30-4837
Do not submit a photocopy of this form to the Department. Submit only original forms and keep
a copy for your records. If submitting this return by mail, send to:

New Mexico Taxation and Revenue Department

P.O. Box 25122
Santa Fe, New Mexico 87504-5122

23. The amount on line 22 from page 1 23 175

24. Total claimed on rebate and credit schedule (PIT- RC, line 25). Attach PIT- RC 24 0
25. Working families tax credit.(You must complet e b ot h lines 25 and 25a or t h e d ed uct ion w ill b e d enied .) + 25
25a . The amount of federal earned income credit (EIC)
reported on your 2019 federal income tax return 25a
26. Refundable business-related income tax credits from Schedule PIT-CR, line B. Attach PIT-CR + 26
27. New Mexico income tax withheld. Attach annual statements of income and withholding + 27 563
28. New Mexico income tax withheld from oil and gas proceeds. Attach 1099- Misc or RPD- 41285 + 28
29. New Mexico income tax withheld from a pass- through entity. Attach 1099- Misc or RPD- 41359 + 29
30. 2019 estimated income tax payments. See PIT-1 instructions + 30
31. Other Payments + 31
32. TOTAL PAYMENTS AND CREDITS. Add lines 24 through 31 = 32 563
33. TAX DUE. If line 23 is greater than line 32, enter the difference here 33 0
34. Penalty on underpayment of estimated tax. If you want penalty computed for you, leave blank + 34 0
35. Special method allowed for calculation of underpayment of estimated tax penalty. If you owe penalty on
underpayment of estimated tax and you qualify, enter 1, 2, 3, 4, or 5 in the box. Attach RPD- 41272 35. 0
36. Penalty. See PIT- 1 instructions. If you want penalty computed for you, leave blank + 36

37. Interest. See PIT- 1 instructions. If you want interest computed for you, leave blank + 37
38. TAX, PENALTY, AND INTEREST DUE. Add lines 33, 34, 36, and 37 = 38

39. OVERPAYMENT. If line 23 is less than line 32, enter the difference here 39 388
40. Refund voluntary contributions (PIT- D, line 17). Attach PIT-D - 40

41. Amount from line 39 you want applied to your 2020 Estimated Tax - 41

42. AMOUNT TO BE REFUNDED TO YOU. Line 39 minus lines 40 and 41 = 42 388

!! REFUND EXPRESS !! H AVE IT D IRECTL Y D EPOSITED ! SEE INSTRUCTIONS AND COM PL ETE AL L REQUIRED: You must answer this question.
QUESTIONS IN TH IS B L OCK. WIL L TH IS REFUND GO TO OR TH ROUGH AN ACCOUNT
Ch oose one.
RE.3 Type: L OCATED OUTSID E TH E UNITED STATES? If y es, y ou
RE.1 Routing number: 122106455 Checking
Mark X by
y our ch oice.
X may not use t h is ref und d elivery opt ion. See inst ruct ions.
RE.2 Account number: 601902711 Savings RE.4 YES NO X
I d eclare I h ave examined t h is ret urn, includ ing accompanying sch ed ules and st at e- Paid preparer's use only:
ment s, and t o t h e b est of my know led ge and b elief it is t rue, correct , and complet e.
Your signat ure Date
Signature of preparer Date

D river's L icense, St at e ID No. or ent er "NONE" or "D ECL INED " State Expirat ion D at e
501084484 NM 10/15/2026 P.1 Firm's name (or yours, if self-employed)
Spouse's signat ure Date P.2 NM CRS identification number
P.3 Preparer's PTIN
Spouse's D river's L icense, St at e ID No. State Expirat ion D at e
or ent er "NONE" or "D ECL INED " P.4 FEIN
P.5 Preparer's phone number
(If filing jointly, BOTH must sign even if only one had income.)
Mark this box if Form RPD- 41338 is on file for this taxpayer.
Taxpayer's phone number 575-416-2389 P.6 See PIT-1 instructions.
Taxpayer's email address
 Page 2
ORTIZ SOLTERO LUIS R 628-30-4837
New Mexico Low- and Middle- Income Tax Exemption Worksheet

Complete this worksheet to determine your New Mexico low-and middle-income tax exemption for PIT-1 line 14.
Do not attach this worksheet to your PIT-1. Keep a copy in your records.

You are eligible to claim the New Mexico low- and middle- income tax exemption if:

Your filing status is and your federal adjusted gross income is

Single $36,667 or less
Married filing jointly or surviving spouse $55,000 or less
Head of household $55,000 or less
Married filing separately $27,500 or less

1. Enter the amount reported on PIT-1, line 9.

If your federal adjusted gross income is greater than
the amount listed in the table above for your filing
status, do not complete this form because you do not qualify for
this exemption 1. 22,395

2. If your filing status on PIT-1, line 7 is:

Single, enter $20,000.
Married filing jointly or qualified widow(er), enter $30,000.
Head of household, enter $30,000.
Married filing separately, enter $15,000. 2. 20,000

3. Subtract line 2 from line 1. If the result is negative,

enter zero here, skip line 4, and enter zero on line 5 3. 2,395

4. If your filing status on PIT-1, line 7 is:

Single, enter 0.15.
Married filing jointly or qualified widow(er), enter 0.10.
Head of household, enter 0.10.
Married filing separately, enter 0.20. 4. 0.15

5. Multiply line 3 by line 4 and enter the result 5. 359

6. Subtract line 5 from $2,500 6. 2,141

7. Enter the number of exemptions* reported on PIT-1, line 5 7. 1

8. Multiply line 6 by line 7. Enter this amount here and on PIT- 1, line 14 8. 2,141

* Exemptions include the taxpayer, spouse, dependents, and other dependents

reported on federal Form 1040 or 1040- SR for federal income tax purposes. See PIT- 1, line 5,
instructions on page 20 for more details.

www.tax.newmexico.gov