Taxes 2024
Taxes 2024
                              Tax Analysis
                                             specially prepared for
                  ENRIQUE CORUJO ESQUILIN
                            and
                   ZULEIKA ORTEGA GOMEZ
                                                      Tax Year 2024
  Information in this Client Presentation has been compiled from information in your tax return, which is based on information you have provided.
                                        ENRIQUE CORUJO ESQUILIN and ZULEIKA ORTEGA GOMEZ
                                                                              Tax Year 2024
      $2,188                      2.75%
* Effective Tax Rate is an approximation of Tax divided by Income as a percentage.
$40,000
$35,000
$30,000
$25,000
$20,000
$15,000
$10,000
$5,000
         $-
                  Taxable Income             Total Tax      Payments and Credits Bottom Line
$2,000
$1,500
$1,000
$500
         $-
                                                             Personal                                                                   Total
                 Medical &      Income or     Real estate                                  Gifts to     Casualty &
                                                            property &     Interest paid                                 Misc         Itemized
                  dental         sales tax      taxes                                      charity      theft losses
                                                            other taxes                                                              deductions
         2023        $-          $1,213           $-           $244             $-          $580            $-             $-         $2,037
         2024        $-          $1,116           $-             $-             $-          $600            $-             $-         $1,716
If charts do not match total deductions, your return may have utilized the standard deduction or was subject to other limitations.
q You had a large federal tax refund. You may wish to consider reducing your federal income
  tax withholding by filing a new Form W-4 with your employer.
q Be sure to maintain a separate business checking account to refrain from mixing personal
  and business expenses together.
q Be sure to keep a detailed annual mileage record for all vehicles used in your business. The
  record should include your business's name, the business and the total miles for the year,
  and the business trip purpose.
q You incurred an additional tax on a qualified retirement plan (including an IRA) or other tax-
  favored account for 2024. Consult with us for tax planning strategies to avoid this additional
  tax in the future.
q You may be eligible to reduce your future tax liability and save for your retirement by
  contributing to a traditional IRA, starting in 2025.
q Consider taking some college courses to enhance your job skills. You could possibly
  receive a tax benefit on the supplies, books and tuition expenses for the college courses.
q You repaid all or part of the healthcare subsidy you received from the Health Insurance
  Marketplace in the amount of $1,503 for 2024. Be sure to notify the Health Insurance
  Marketplace if your income rises during the year, or if you have other significant changes
  that would affect your health insurance, in order to avoid having to pay back the healthcare
  subsidy you received during the year.
Thank you again for your tax business this year. We look forward to meeting your future needs.
                      Accounting Firm CPA LLC
                        1235 Mount Vernon St
                          Orlando, FL 32803
                           (321) 332-1400
                 HECTOR@ACCOUNTINGFIRMCPA.COM
Please find enclosed copies of your tax return(s) for the tax year ended December 31,
2024. Instructions for filing your return(s) are attached for your convenience. Retain the
copies for your records.
Your advance payment of the premium tax credit under the Affordable Care Act of
$8,118.00 that went to the insurance company is greater than your actual premium tax
credit of $6,615.00. Consequently, the excess of $1,503.00 has increased the amount
owed on your tax return.
The federal income tax return will be electronically filed, do not mail the enclosed copy,
but retain it for your records.
        Form 1040 Federal Individual Income Tax Return
We prepared your returns based on the information you provided us. Please review the
returns carefully to ensure that there are no omissions or misstatements of material facts.
If you have any questions about your tax returns, please contact us. We appreciate this
opportunity to serve you.
Sincerely,
Your federal refund of $2,188.00 will be directly deposited in your bank account.
                      Accounting Firm CPA LLC
                        1235 Mount Vernon St
                          Orlando, FL 32803
                           (321) 332-1400
                 HECTOR@ACCOUNTINGFIRMCPA.COM
This letter is to confirm our understanding of the terms of our agreement and outline the
nature and extent of services we will provide. Based upon the information you furnish to
us, we will prepare your Federal and applicable state income tax returns for 2024.
We will not audit or verify the data you submit to us, although we may ask you for
clarification when necessary. All the information you submit to us will, to the best of your
knowledge, be correct and complete and include all other information necessary for the
completion of your tax return.
We will also prepare 2025 estimated tax vouchers if required, based on your income and
withholding taxes for 2024. If you anticipate a substantial change in income or
withholding taxes for 2025, please advise us as soon as possible. We will then determine
whether an adjustment should be made to your tax estimates.
Your returns are subject to review by the taxing authorities. Any items that may be
resolved against you by the examining agent are subject to certain rights of appeal. In the
event of an examination, we will be available upon request to represent you, or to review
the results of any examination. Billing for these additional services will be at our standard
rates.
The charges for our services are based on our fee schedule and the complexity of the
returns.
You have the final responsibility for your income tax returns. Please review them carefully
before you sign and mail them.
If the above is in accordance with your understanding of the terms and conditions of our
agreement, please sign and return a copy of this letter.
__________________________________________
HECTOR L CRUZ CPA
Accepted by:
___________________________________________
Client signature
____________________________________________
Date
               Consent to Disclosure of Tax Return Information
Federal law requires this consent form be provided to you (“you” refers to each taxpayer,
if more than one). Unless authorized by law, we cannot use your tax return information for
purposes other than the preparation and filing of your tax return without your consent. If
you consent to the disclosure of your tax return information, Federal law may not protect
your tax return information from further use or distribution.
You are not required to complete this form to engage our tax return preparation services.
If we obtain your signature on this form by conditioning our tax return preparation
services on your consent, your consent will not be valid. Your consent is valid for the
amount of time that you specify. If you do not specify the duration of your consent, your
consent is valid for one year from the date of signature.
This consent authorizes the disclosure of a copy of your entire tax return or all information
contained within your tax return to [insert to whom the disclosures will be made] for the
purpose of [describe the product or service for which the tax return information will be
used].
If you would like us to use your tax return information to determine whether these
services may be available to you while we are preparing your return, please sign and date
this consent to the use of your tax return information.
By signing below, you (including each of you if there is more than one taxpayer) authorize
us to disclose the information you provide to us during the preparation of your 2024 tax
return to [insert to whom the disclosures will be made] for the purpose of providing the
services described above.
If you believe your tax return information has been disclosed or used improperly in a
manner unauthorized by law or without your permission, you may contact the Treasury
Inspector General for Tax Administration (TIGTA) at https://www.treasury.gov/tigta/.
                      Accounting Firm CPA LLC
                        1235 Mount Vernon St
                          Orlando, FL 32803
                           (321) 332-1400
                 HECTOR@ACCOUNTINGFIRMCPA.COM
________________________________________________________________________
                                               ▲
Submission Identification Number (SID)
Taxpayer’s name                                                                                                            Social security number
           I will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. 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 III
           below.
I certify that the above numeric entry is my PIN, which is my signature for the electronic individual income tax return (original or amended) I am now
authorized to file for tax year indicated above 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.
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
   For the year Jan. 1–Dec. 31, 2024, or other tax year beginning                           , 2024, ending                                    , 20               See separate instructions.
   Your first name and middle initial                                    Last name                                                                               Your social security number
    ENRIQUE                                                              CORUJO ESQUILIN                                                                          596       26 4048
   If joint return, spouse’s first name and middle initial               Last name                                                                               Spouse’s social security number
    ZULEIKA                                                              ORTEGA GOMEZ                                                                             597       12 6923
   Home address (number and street). If you have a P.O. box, see instructions.                                                            Apt. no.        Presidential Election Campaign
    4313 DELEON ST                                                                                                                                        Check here if you, or your
   City, town, or post office. If you have a foreign address, also complete spaces below.                   State                     ZIP code            spouse if filing jointly, want $3
                                                                                                                                                          to go to this fund. Checking a
    HAINES CITY                                                                                             FL                        33844               box below will not change
   Foreign country name                                                       Foreign province/state/county                           Foreign postal code your tax or refund.
                                                                                                                                                                                You          Spouse
 Digital              At any time during 2024, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell,
 Assets               exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.)                                       Yes          No
 Standard             Someone can claim:        You as a dependent          Your spouse as a dependent
 Deduction               Spouse itemizes on a separate return or you were a dual-status alien
 Age/Blindness You:               Were born before January 2, 1960               Are blind         Spouse:                  Was born before January 2, 1960                      Is blind
 Dependents (see instructions):                                                      (2) Social security            (3) Relationship      (4) Check the box if qualifies for (see instructions):
                      (1) First name              Last name                               number                         to you                 Child tax credit           Credit for other dependents
 If more
 than four            ZULYAM N                 CORUJO-ORTEGA                         597-88-8594                 Daughter
 dependents,          ZULEINYS J               CORUJO ORTEGA                         176-57-2128                 Daughter
 see instructions
 and check
 here . .
 Income               1a      Total amount from Form(s) W-2, box 1 (see instructions) . . . . .                               .   .   .   .    .     .   .   .       1a               68,923.
                       b      Household employee wages not reported on Form(s) W-2 . . . . .                                  .   .   .   .    .     .   .   .       1b
 Attach Form(s)
 W-2 here. Also        c      Tip income not reported on line 1a (see instructions) . . . . . .                               .   .   .   .    .     .   .   .       1c
 attach Forms          d      Medicaid waiver payments not reported on Form(s) W-2 (see instructions)                         .   .   .   .    .     .   .   .       1d
 W-2G and
 1099-R if tax            e   Taxable dependent care benefits from Form 2441, line 26     .                  .      .   .     .   .   .   .    .     .   .   .       1e
 was withheld.            f   Employer-provided adoption benefits from Form 8839, line 29                    .      .   .     .   .   .   .    .     .   .   .       1f
 If you did not           g   Wages from Form 8919, line 6 . . . . . . . . . .                               .      .   .     .   .   .   .    .     .   .   .       1g
 get a Form
 W-2, see
                          h   Other earned income (see instructions) . . . .                   .   .   .     .      .   .     .   . .     .    .     .   .   .       1h                         0.
 instructions.            i   Nontaxable combat pay election (see instructions) .              .   .   .     .      .   .         1i
                          z   Add lines 1a through 1h    . . . . . . . .                       .   .   .     .      .   .     .   . .     .    .     .   .   .        1z              68,923.
 Attach Sch. B        2a      Tax-exempt interest .          .   .     2a                                  b Taxable interest   .              .     .   .   .       2b
 if required.         3a      Qualified dividends .          .   .     3a                                  b Ordinary dividends .              .     .   .   .       3b
                      4a      IRA distributions . .          .   .     4a                                  b Taxable amount . .                .     .   .   .       4b
Standard
Deduction for—        5a      Pensions and annuities . .        5a                          b Taxable amount .                            .    .     .   .   .       5b                     657.
• Single or           6a      Social security benefits . .      6a                          b Taxable amount .                            .    .     .   .   .       6b
  Married filing
  separately,          c      If you elect to use the lump-sum election method, check here (see instructions) .                           .    .     .   .
  $14,600             7       Capital gain or (loss). Attach Schedule D if required. If not required, check here                      .   .    .     .   .            7
• Married filing
  jointly or          8       Additional income from Schedule 1, line 10 . . . . . . . . . . .                                        .   .    .     .   .   .        8                2,911.
  Qualifying
  surviving spouse,   9       Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . .                           .   .    .     .   .   .        9               72,491.
  $29,200             10      Adjustments to income from Schedule 1, line 26       . . . . .                        .   .     .   .   .   .    .     .   .   .       10                2,555.
• Head of
  household,          11      Subtract line 10 from line 9. This is your adjusted gross income                      .   .     .   .   .   .    .     .   .   .       11               69,936.
  $21,900
• If you checked
                      12      Standard deduction or itemized deductions (from Schedule A)                           .   .     .   .   .   .    .     .   .   .       12               29,200.
  any box under       13      Qualified business income deduction from Form 8995 or Form 8995-A . . . .                                   .    .     .   .   .       13                   71.
  Standard
  Deduction,          14      Add lines 12 and 13 . . . . . . . . . . . . . . . . . . .                                                   .    .     .   .   .       14               29,271.
  see instructions.
                      15      Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income                      .    .     .   .   .       15               40,665.
 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.                                                                                       Form 1040 (2024)
Form 1040 (2024)                                                                                                                                                                              Page 2
Tax and             16    Tax (see instructions). Check if any from Form(s): 1 8814                             2       4972 3                                 .     .     16              4,417.
Credits             17    Amount from Schedule 2, line 3        . . . . . . . .                             .       .   . . . .              .   .   .   .     .     .     17              1,503.
                    18    Add lines 16 and 17 . . . . . . . . . . . . . . .                                                  .    .    .     .   .   .   .     .     .     18              5,920.
                    19    Child tax credit or credit for other dependents from Schedule 8812 .                               .    .    .     .   .   .   .     .     .     19              4,000.
                    20    Amount from Schedule 3, line 8        . . . . . . . . . . .                                        .    .    .     .   .   .   .     .     .     20
                    21    Add lines 19 and 20 . . . . . . . . . . . . . . .                                                  .    .    .     .   .   .   .     .     .     21              4,000.
                    22    Subtract line 21 from line 18. If zero or less, enter -0- . . . . .                                .    .    .     .   .   .   .     .     .     22              1,920.
                    23    Other taxes, including self-employment tax, from Schedule 2, line 21                               .    .    .     .   .   .   .     .     .     23                477.
                    24    Add lines 22 and 23. This is your total tax . . . . . . . .                                        .    .    .     .   .   .   .     .     .     24              2,397.
Payments            25    Federal income tax withheld from:
                      a   Form(s) W-2 . . . . . . .                    .      .   .   .   .     .     .     .       .   .    .        25a                4,453.
                     b    Form(s) 1099 . . . . . .                 .   .      .   .   .   .     .     .     .       .   .    .      25b                    132.
                     c    Other forms (see instructions) .         .   .      .   .   .   .     .     .     .       .   .    .      25c
                     d    Add lines 25a through 25c . .            .   .      .   .   .   .     .     .     .       .   .    .    . . .          .   .   .     .     .    25d              4,585.
If you have a       26    2024 estimated tax payments and amount applied from 2023 return .                                  .    .    . .       .   .   .     .     .     26
qualifying child,   27    Earned income credit (EIC) . . . . . . . . . . . .No.                                              .         27
attach Sch. EIC.
                    28    Additional child tax credit from Schedule 8812 . . . . . . .                                       .         28
                    29    American opportunity credit from Form 8863, line 8 .                  .     .     .       .   .    .         29
                    30    Reserved for future use . . . . . . . . .                             .     .     .       .   .    .         30
                    31    Amount from Schedule 3, line 15 . . . . . .                           .     .     .       .   .    .         31
                    32    Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits                                             .     .     32
                    33    Add lines 25d, 26, and 32. These are your total payments     . . . . . . . . . .                                                     .     .     33              4,585.
Refund              34    If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid                                      .     .     34              2,188.
                    35a   Amount of line 34 you want refunded to you. If Form 8888 is attached, check here .                                         .   .     .          35a              2,188.
Direct deposit?       b   Routing number 0 6 3 1 0 0 2 7 7                             c Type:      Checking                                                 Savings
See instructions.
                      d   Account number 8 9 8 1 4 0 5 2 3 8 4 0
                    36    Amount of line 34 you want applied to your 2025 estimated tax . . .         36
Amount              37    Subtract line 33 from line 24. This is the amount you owe.
You Owe                   For details on how to pay, go to www.irs.gov/Payments or see instructions .                                  .     .   .   .   .     .     .     37
                    38    Estimated tax penalty (see instructions)            .   .   .   .     .     .     .       .   .    .         38
Third Party          Do you want to allow another person to discuss this return with the IRS? See
Designee             instructions . . . . . . . . . . . . . . . . . . . . .                                                                      Yes. Complete below.                 No
                     Designee’s                                                               Phone                                                  Personal identification
                     name                                                                     no.                                                    number (PIN)
Sign                 Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
                     belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here                 Your signature                                               Date                    Your occupation                                          If the IRS sent you an Identity
                                                                                                                                                                   Protection PIN, enter it here
Joint return?                                                                                             EMPLOYEE                                                 (see inst.)
See instructions.    Spouse’s signature. If a joint return, both must sign.       Date                    Spouse’s occupation                                      If the IRS sent your spouse an
Keep a copy for                                                                                                                                                    Identity Protection PIN, enter it here
your records.                                                                                                                                                      (see inst.)
                                                                                                          EMPLOYEE
                     Phone no.                                                    Email address
                     Preparer’s name                        Preparer’s signature                                                      Date                    PTIN               Check if:
Paid                 HECTOR L CRUZ CPA         HECTOR L CRUZ CPA                                                                      03/25/2025 P00893588         Self-employed
Preparer
                      Firm’s name    Accounting Firm CPA LLC                                                                                        Phone no. (321)332-1400
Use Only
                      Firm’s address 1235 Mount Vernon St Orlando FL 32803                                                                          Firm’s EIN 27-1160831
Go to www.irs.gov/Form1040 for instructions and the latest information.                                                     BAA       REV 03/13/25 PRO                                Form 1040 (2024)
SCHEDULE 1                                                                                                                         OMB No. 1545-0074
                                Additional Income and Adjustments to Income
(Form 1040)
Department of the Treasury
                                                Attach to Form 1040, 1040-SR, or 1040-NR.                                           2024
                                                                                                                                   Attachment
Internal Revenue Service           Go to www.irs.gov/Form1040 for instructions and the latest information.                         Sequence No. 01
Name(s) shown on Form 1040, 1040-SR, or 1040-NR                                                                  Your social security number
ENRIQUE CORUJO ESQUILIN & ZULEIKA ORTEGA GOMEZ                                                                   596-26-4048
For 2024, enter the amount reported to you on Form(s) 1099-K that was included in error or for personal
items sold at a loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Note: The remaining amounts reported to you on Form(s) 1099-K should be reported elsewhere on your return depending on the
nature of the transaction. See www.irs.gov/1099k.
  Part I       Additional Income
  1     Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . .            .    .    .   .        1
  2a    Alimony received . . . . . . . . . . . . . . . . . . . . . . . .                                .    .    .   .       2a
    b   Date of original divorce or separation agreement (see instructions):
  3     Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . .                      .    .    .   .       3             2,911.
  4     Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . .                       .    .    .   .       4
  5     Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E .   .    .    .   .       5
  6     Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . .                        .    .    .   .       6
  7     Unemployment compensation . . . . . . . . . . . . . . . . . . . .                               .    .    .   .       7
  8     Other income:
    a   Net operating loss . . . . . . . . . . . . . . . . . . . .                           8a (                         )
    b   Gambling . . . . . . . . . . . . . . . . . . . . . . .                               8b
    c   Cancellation of debt . . . . . . . . . . . . . . . . . . .                           8c
    d   Foreign earned income exclusion from Form 2555 . . . . . . . . .                     8d (                         )
    e   Income from Form 8853 . . . . . . . . . . . . . . . . . .                            8e
    f   Income from Form 8889 . . . . . . . . . . . . . . . . . .                             8f
    g   Alaska Permanent Fund dividends         . . . . . . . . . . . . . .                  8g
    h   Jury duty pay . . . . . . . . . . . . . . . . . . . . .                              8h
    i   Prizes and awards . . . . . . . . . . . . . . . . . . . .                             8i
    j   Activity not engaged in for profit income     . . . . . . . . . . . .                 8j
    k   Stock options . . . . . . . . . . . . . . . . . . . . .                              8k
    l   Income from the rental of personal property if you engaged in the rental for
        profit but were not in the business of renting such property . . . . . .              8l
    m   Olympic and Paralympic medals and USOC prize money (see instructions) .              8m
    n   Section 951(a) inclusion (see instructions) . . . . . . . . . . . .                  8n
    o   Section 951A(a) inclusion (see instructions) . . . . . . . . . . . .                 8o
    p   Section 461(l) excess business loss adjustment . . . . . . . . . .                   8p
    q   Taxable distributions from an ABLE account (see instructions) . . . . .              8q
    r   Scholarship and fellowship grants not reported on Form W-2 . . . . . .                8r
    s   Nontaxable amount of Medicaid waiver payments included on Form 1040, line
        1a or 1d . . . . . . . . . . . . . . . . . . . . . . .                               8s (                         )
    t   Pension or annuity from a nonqualifed deferred compensation plan or a
        nongovernmental section 457 plan . . . . . . . . . . . . . .                          8t
    u   Wages earned while incarcerated . . . . . . . . . . . . . . .                        8u
    v   Digital assets received as ordinary income not reported elsewhere. See
        instructions . . . . . . . . . . . . . . . . . . . . . .                             8v
    z   Other income. List type and amount:
                                                                                             8z
  9     Total other income. Add lines 8a through 8z . . . . . . . . . . . . . . .                        . . . .              9
 10     Combine lines 1 through 7 and 9. This is your additional income. Enter here and on              Form 1040,
        1040-SR, or 1040-NR, line 8 . . . . . . . . . . . . . . . . . . . .                              . . . .              10            2,911.
For Paperwork Reduction Act Notice, see your tax return instructions.                                                     Schedule 1 (Form 1040) 2024
Schedule 1 (Form 1040) 2024                                                                                                           Page 2
  Part II     Adjustments to Income
 11     Educator expenses       . . . . . . . . . . . . . . . . . . . . . . . . . . .                               11
 12     Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach
        Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                       12
 13     Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . .                          13
 14     Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . . .                       14
 15     Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . . . .                      15               206.
 16     Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . .                          16
 17     Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . .                            17           2,349.
 18     Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . .                            18
 19a    Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                   19a
    b   Recipient’s SSN      . . . . . . . . . . . . . . . . . . . . . .
    c   Date of original divorce or separation agreement (see instructions):
 20     IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                     20
 21     Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . .                               21
 22     Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . .                                 22
 23     Archer MSA deduction . . . . . . . . . . . . . . . . . . . . . . . . . .                                    23
 24     Other adjustments:
    a   Jury duty pay (see instructions)    . . . . . . . . . . . . . . .                24a
    b   Deductible expenses related to income reported on line 8l from the rental of
        personal property engaged in for profit . . . . . . . . . . . . .                24b
    c   Nontaxable amount of the value of Olympic and Paralympic medals and USOC
        prize money reported on line 8m . . . . . . . . . . . . . . .                    24c
    d   Reforestation amortization and expenses . . . . . . . . . . . .                  24d
    e   Repayment of supplemental unemployment benefits under the Trade Act of
        1974 . . . . . . . . . . . . . . . . . . . . . . . .                             24e
    f   Contributions to section 501(c)(18)(D) pension plans . . . . . . . . .           24f
    g   Contributions by certain chaplains to section 403(b) plans . . . . . . .         24g
    h   Attorney fees and court costs for actions involving certain unlawful
        discrimination claims (see instructions) . . . . . . . . . . . . .               24h
    i   Attorney fees and court costs you paid in connection with an award from the
        IRS for information you provided that helped the IRS detect tax law violations   24i
    j   Housing deduction from Form 2555 . . . . . . . . . . . . . .                     24j
    k   Excess deductions of section 67(e) expenses from Schedule K-1 (Form 1041)        24k
    z   Other adjustments. List type and amount:
                                                                                         24z
 25     Total other adjustments. Add lines 24a through 24z . . . . . . . . . . . . . . . . .                        25
 26     Add lines 11 through 23 and 25. These are your adjustments to income. Enter here and on Form
        1040, 1040-SR, or 1040-NR, line 10 . . . . . . . . . . . . . . . . . . . . . .                              26           2,555.
                                                                                    BAA    REV 03/13/25 PRO       Schedule 1 (Form 1040) 2024
SCHEDULE 2                                                                                                                                         OMB No. 1545-0074
                                                              Additional Taxes
(Form 1040)
Department of the Treasury
                                                Attach to Form 1040, 1040-SR, or 1040-NR.                                                           2024
                                                                                                                                                   Attachment
Internal Revenue Service           Go to www.irs.gov/Form1040 for instructions and the latest information.                                         Sequence No. 02
Name(s) shown on Form 1040, 1040-SR, or 1040-NR                                                                                    Your social security number
ENRIQUE CORUJO ESQUILIN & ZULEIKA ORTEGA GOMEZ                                                                                     596-26-4048
 Part I Tax
  1     Additions to tax:
    a   Excess advance premium tax credit repayment. Attach Form 8962 .                       .   .   .       1a               1,503.
    b Repayment of new clean vehicle credit(s) transferred to a registered dealer
      from Schedule A (Form 8936), Part II. Attach Form 8936 and Schedule A (Form
      8936) . . . . . . . . . . . . . . . . . . . . . . . .                                                   1b
d Recapture of net EPE from Form 4255, line 2a, column (l) . . . . . . . 1d
    e   Excessive payments (EP) from Form 4255. Check applicable box and enter
        amount.
        (i)     Line 1a, column (n)      (ii)    Line 1c, column (n)
        (iii)   Line 1d, column (n)      (iv)    Line 2a, column (n) . . . .                                  1e
    f   20% EP from Form 4255. Check applicable box and enter amount. See
        instructions.
        (i)       Line 1a, column (o) (ii)    Line 1c, column (o)
        (iii)     Line 1d, column (o) (iv)    Line 2a, column (o) . . . .                                     1f
6 Uncollected social security and Medicare tax on wages. Attach Form 8919 . 6
7 Total additional social security and Medicare tax. Add lines 5 and 6 . . . . . . . . . . . 7
  8     Additional tax on IRAs or other tax-favored accounts. Attach Form 5329 if required.
        If not required, check here . . . . . . . . . . . . . . . . . . .                                          .   .   .   .    .         8                  66.
  9     Household employment taxes. Attach Schedule H                 .   .   .   .   .   .   .   .   .   .   .    .   .   .   .    .   .     9
 13     Uncollected social security and Medicare or RRTA tax on tips or group-term life insurance from Form
        W-2, box 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                               13
14 Interest on tax due on installment income from the sale of certain residential lots and timeshares . . 14
 15     Interest on the deferred tax on gain from certain installment sales with a sales price over $150,000                            .     15
 16     Recapture of low-income housing credit. Attach Form 8611 .                    .   .   .   .   .   .   .    .   .   .   .    .   .     16
                                                                                                                                              (continued on page 2)
For Paperwork Reduction Act Notice, see your tax return instructions.                                                                       Schedule 2 (Form 1040) 2024
Schedule 2 (Form 1040) 2024                                                                                                                                      Page 2
  Part II     Other Taxes (continued)
 17     Other additional taxes:
b Recapture of federal mortgage subsidy, if you sold your home see instructions 17b
f Additional tax on Medicare Advantage MSA distributions. Attach Form 8853 17f
    h   Income you received from a nonqualified deferred compensation plan that fails
        to meet the requirements of section 409A . . . . . . . . . . . .                                     17h
n Look-back interest under section 167(g) or 460(b) from Form 8697 or 8866 . 17n
    o Tax on non-effectively connected income for any part of the year you were a
      nonresident alien from Form 1040-NR . . . . . . . . . . . . .                                          17o
    p Any interest from Form 8621, line 16f, relating to distributions from, and
      dispositions of, stock of a section 1291 fund . . . . . . . . . . .                                    17p
19 Recapture of net EPE from Form 4255, line 1d, column (l) . . . . . . . . . . . . . . . 19
 21     Add lines 4, 7 through 16, 18, and 19. These are your total other taxes. Enter here and on Form 1040
        or 1040-SR, line 23, or Form 1040-NR, line 23b . . . . . . . . . . . . . . . . . .                                                     21               477.
                                                                                                        BAA       REV 03/13/25 PRO           Schedule 2 (Form 1040) 2024
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ENRIQUE CORUJO ESQUILIN                                                                                                596-26-4048
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         • If zero or less, enter -0-.
         • If more than zero and not a multiple of $1,000, enter the next multiple of $1,000. For
         example, if the result is $425, enter $1,000; if the result is $1,025, enter $2,000, etc.    . . . . . . .              10                0.
 11      Multiply line 10 by 5% (0.05) . . . . . . . . . . . . . . . . . . . . . . . . .                                         11                0.
 12      Is the amount on line 8 more than the amount on line 11? . . . . . . . . . . . . . . . . .                              12            4,000.
              No. STOP. You cannot take the child tax credit, credit for other dependents, or additional child tax credit.
              Skip Parts II-A and II-B. Enter -0- on lines 14 and 27.
              Yes. Subtract line 11 from line 8. Enter the result.
 13      Enter the amount from Credit Limit Worksheet A . . . . . . . . . . . . . . . . . .                                      13            5,920.
 14      Enter the smaller of line 12 or line 13. This is your child tax credit and credit for other dependents . . .            14            4,000.
         Enter this amount on Form 1040, 1040-SR, or 1040-NR, line 19.
           If the amount on line 12 is more than the amount on line 14, you may be able to take the additional child tax credit
             on Form 1040, 1040-SR, or 1040-NR, line 28. Complete your Form 1040, 1040-SR, or 1040-NR through line 27
                                      (also complete Schedule 3, line 11) before completing Part II-A.
For Paperwork Reduction Act Notice, see your tax return instructions.                      BAA        REV 03/13/25 PRO    Schedule 8812 (Form 1040) 2024
Schedule 8812 (Form 1040) 2024                                                                                                                     Page 2
Part II-A Additional Child Tax Credit for All Filers
Caution: If you file Form 2555, you cannot claim the additional child tax credit.
 15    Check this box if you do not want to claim the additional child tax credit. Skip Parts II-A and II-B. Enter -0- on line 27 .    .   .   .   .
 16a Subtract line 14 from line 12. If zero, stop here; you cannot take the additional child tax credit. Skip Parts II-A
       and II-B. Enter -0- on line 27 . . . . . . . . . . . . . . . . . . . . . . . . .                                        16a                     0.
    b Number of qualifying children under age 17 with the required social security number:                       x $1,700.
       Enter the result. If zero, stop here; you cannot claim the additional child tax credit. Skip Parts II-A and II-B.
       Enter -0- on line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                            16b
       TIP: The number of children you use for this line is the same as the number of children you used for line 4.
 17    Enter the smaller of line 16a or line 16b . . . . . . . . . . . . . . . . . . . . . .                                    17
 18a Earned income (see instructions) . . . . . . . . . . . . . . . .                               18a
    b Nontaxable combat pay (see instructions) . . . . . .                 18b
 19    Is the amount on line 18a more than $2,500?
            No. Leave line 19 blank and enter -0- on line 20.
            Yes. Subtract $2,500 from the amount on line 18a. Enter the result      . . . .          19
 20    Multiply the amount on line 19 by 15% (0.15) and enter the result . . . . . . . . . . . . . .                            20
       Next. On line 16b, is the amount $5,100 or more?
            No. If you are a bona fide resident of Puerto Rico, go to line 21. Otherwise, skip Part II-B and enter the
                  smaller of line 17 or line 20 on line 27.
            Yes. If line 20 is equal to or more than line 17, skip Part II-B and enter the amount from line 17 on line 27.
                  Otherwise, go to line 21.
Part II-B Certain Filers Who Have Three or More Qualifying Children and Bona Fide Residents of Puerto Rico
 21     Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2,
        boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If
        your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, or
        if you are a bona fide resident of Puerto Rico, see instructions. . . . . . . .       21
 22     Enter the total of the amounts from Schedule 1 (Form 1040), line 15; Schedule 2 (Form
        1040), line 5; Schedule 2 (Form 1040), line 6; and Schedule 2 (Form 1040), line 13 .  22
 23     Add lines 21 and 22 . . . . . . . . . . . . . . . . . . . .                           23
 24     1040 and
                                                                                              }
        1040-SR filers: Enter the total of the amounts from Form 1040 or 1040-SR, line 27,
                            and Schedule 3 (Form 1040), line 11.
        1040-NR filers: Enter the amount from Schedule 3 (Form 1040), line 11.                24
 25     Subtract line 24 from line 23. If zero or less, enter -0- . . . . . . . . . . . . .               .   .   .   .   .    25
 26     Enter the larger of line 20 or line 25 . . . . . . . . . . . . . . . . . .                        .   .   .   .   .    26
        Next, enter the smaller of line 17 or line 26 on line 27.
Part II-C Additional Child Tax Credit
 27     This is your additional child tax credit. Enter this amount on Form 1040, 1040-SR, or 1040-NR, line 28 .          .    27
                                                                             BAA       REV 03/13/25 PRO                   Schedule 8812 (Form 1040) 2024
       8889                                       Health Savings Accounts (HSAs)                                                OMB No. 1545-0074
                                                                                                                                 2024
Form
                                                  Attach to Form 1040, 1040-SR, or 1040-NR.
Department of the Treasury                                                                                                      Attachment
Internal Revenue Service             Go to www.irs.gov/Form8889 for instructions and the latest information.                    Sequence No. 52
Name(s) shown on Form 1040, 1040-SR, or 1040-NR                                                          Social security number of HSA beneficiary.
                                                                                                         If both spouses have HSAs, see instructions.
 ENRIQUE CORUJO ESQUILIN                                                                                       596-26-4048
Before you begin: Complete Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, if required.
 Part I   HSA Contributions and Deduction. See the instructions before completing this part. If you are filing jointly
          and both you and your spouse each have separate HSAs, complete a separate Part I for each spouse.
  1     Check the box to indicate your coverage under a high-deductible health plan (HDHP) during 2024.
        See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                           Self-only        Family
  2     HSA contributions you made for 2024 (or those made on your behalf), including those made by the
        unextended due date of your tax return that were for 2024. Do not include employer contributions,
        contributions through a cafeteria plan, or rollovers. See instructions . . . . . . . . . . .                        2                     0.
  3     If you were under age 55 at the end of 2024 and, on the first day of every month during 2024, you
        were, or were considered, an eligible individual with the same coverage, enter $4,150 ($8,300 for
        family coverage). All others, see the instructions for the amount to enter . . . . . . . . . .                      3              8,300.
  4     Enter the amount you and your employer contributed to your Archer MSAs for 2024 from Form 8853,
        lines 1 and 2. If you or your spouse had family coverage under an HDHP at any time during 2024, also
        include any amount contributed to your spouse’s Archer MSAs . . . . . . . . . . . . .                               4                  0.
  5     Subtract line 4 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . .                           5              8,300.
  6     Enter the amount from line 5. But if you and your spouse each have separate HSAs and had family
        coverage under an HDHP at any time during 2024, see the instructions for the amount to enter . .                    6              8,300.
  7     If you were age 55 or older at the end of 2024, married, and you or your spouse had family coverage
        under an HDHP at any time during 2024, enter your additional contribution amount. See instructions .                7
  8     Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                           8              8,300.
  9     Employer contributions made to your HSAs for 2024 . . . . . . . .                 9              62.
 10     Qualified HSA funding distributions . . . . . . . . . . . . . .                  10
 11     Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                    62.  11
 12     Subtract line 11 from line 8. If zero or less, enter -0- . . . . . . . . . . . . . . . . .                 8,238.  12
 13     HSA deduction (see instructions). . . . . . . . . . . . . . . . . . . . . . . .                                0.  13
 Part II       HSA Distributions. If you are filing jointly and both you and your spouse each have separate HSAs, complete
               a separate Part II for each spouse.
 14a Total distributions you received in 2024 from all HSAs (see instructions) . . . . . . . . . .                        14a
    b Distributions included on line 14a that you rolled over to another HSA. Also include any excess
      contributions (and the earnings on those excess contributions) included on line 14a that were
      withdrawn by the due date of your return. See instructions     . . . . . . . . . . . . . .                          14b
    c Subtract line 14b from line 14a . . . . . . . . . . . . . . . . . . . . . . . .                                     14c
 15   Qualified medical expenses paid using HSA distributions (see instructions) . . . . . . . . .                         15
 16   Taxable HSA distributions. Subtract line 15 from line 14c. If zero or less, enter -0-. Also, include this
      amount in the total on Schedule 1 (Form 1040), Part I, line 8f . . . . . . . . . . . . . .                           16
 17a If any of the distributions included on line 16 meet any of the Exceptions to the Additional 20%
      Tax (see instructions), check here . . . . . . . . . . . . . . . . . . . . . .
    b Additional 20% tax (see instructions). Enter 20% (0.20) of the distributions included on line 16 that
      are subject to the additional 20% tax. Also, include this amount in the total on Schedule 2 (Form
      1040), Part II, line 17c . . . . . . . . . . . . . . . . . . . . . . . . . . .                                      17b
Part III       Income and Additional Tax for Failure To Maintain HDHP Coverage. See the instructions before
               completing this part. If you are filing jointly and both you and your spouse each have separate HSAs,
               complete a separate Part III for each spouse.
 18     Last-month rule . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                          18
 19     Qualified HSA funding distribution . . . . . . . . . . . . . . . . . . . . . . .                                   19
 20     Total income. Add lines 18 and 19. Include this amount on Schedule 1 (Form 1040), Part I, line 8f .                20
 21     Additional tax. Multiply line 20 by 10% (0.10). Include this amount in the total on Schedule 2 (Form
        1040), Part II, line 17d . . . . . . . . . . . . . . . . . . . . . . . . . . .                                     21
For Paperwork Reduction Act Notice, see your tax return instructions.                           REV 03/13/25 PRO                   Form 8889 (2024)
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Form   8867                                Paid Preparer’s Due Diligence Checklist
                                            Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC),
                                                                                                                                   OMB No. 1545-0074
                                                                                                                                        For tax year
(Rev. November 2024)
                                         Child Tax Credit (CTC) (including the Additional Child Tax Credit (ACTC) and                   20     24
                                       Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
Department of the Treasury         To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, or 1040-SS.             Attachment
Internal Revenue Service                 Go to www.irs.gov/Form8867 for instructions and the latest information.                   Sequence No. 70
Taxpayer name(s) shown on return                                                                          Taxpayer identification number
 ENRIQUE CORUJO ESQUILIN & ZULEIKA ORTEGA GOMEZ                                                             596-26-4048
Preparer’s name                                                                                           Preparer tax identification number
 HECTOR L CRUZ CPA                                                                                          P00893588
 Part I Due Diligence Requirements
Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I–V
for the benefit(s) claimed (check all that apply).                          EIC       CTC/ACTC/ODC            AOTC          HOH
   1    Did you complete the return based on information for the applicable tax year provided by the taxpayer   Yes     No    N/A
        or reasonably obtained by you? . . . . . . . . . . . . . . . . . . . . . . .
  2     If credits are claimed on the return, did you complete the applicable EIC and/or CTC/ACTC/ODC
        worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-SS, or Schedule 8812 (Form 1040)
        instructions, and/or the AOTC worksheet found in the Form 8863 instructions, or your own worksheet(s)
        that provides the same information, and all related forms and schedules for each credit claimed? . .
  3     Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of
        the following.
        • Interview the taxpayer, ask questions, and contemporaneously document the taxpayer’s responses to
           determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.
        • Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing
           status and to figure the amount(s) of any credit(s) . . . . . . . . . . . . . . . . .
  4     Did any information provided by the taxpayer or a third party for use in preparing the return, or
        information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If “Yes,”
        answer questions 4a and 4b. If “No,” go to question 5.) . . . . . . . . . . . . . . .
    a Did you make reasonable inquiries to determine the correct, complete, and consistent information? .
    b Did you contemporaneously document your inquiries? (Documentation should include the questions
      you asked, whom you asked, when you asked, the information that was provided, and the impact the
      information had on your preparation of the return.) . . . . . . . . . . . . . . . . .
  5   Did you satisfy the record retention requirement? To meet the record retention requirement, you must
      keep a copy of your documentation referenced in question 4b, a copy of this Form 8867, a copy of any
      applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
      8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
      taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to figure
      the amount(s) of the credit(s) . . . . . . . . . . . . . . . . . . . . . . . .
        List those documents provided by the taxpayer, if any, that you relied on:
  6     Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
        credit(s) and/or HOH filing status and the amount(s) of any credit(s) claimed on the return if his/her
        return is selected for audit? . . . . . . . . . . . . . . . . . . . . . . . . .
  7     Did you ask the taxpayer if any of these credits were disallowed or reduced in a previous year? .                .
        (If credits were disallowed or reduced, go to question 7a; if not, go to question 8.)
    a   Did you complete the required recertification Form 8862? . . . . . . . . . . . . . .                             .
  8     If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete                 and
        correct Schedule C (Form 1040)? . . . . . . . . . . . . . . . . . . . . . .                                      .
For Paperwork Reduction Act Notice, see separate instructions.                         REV 03/13/25 PRO                        Form   8867 (Rev. 11-2024)
Form 8867 (Rev. 11-2024)                                                                                                                   Page 2
 Part II       Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
  9a    Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children          Yes       No      N/A
        claimed, or is eligible to claim the EIC without a qualifying child? (If the taxpayer is claiming the EIC
        and does not have a qualifying child, go to question 10.) . . . . . . . . . . . . . .
      b Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer
        has supported the child the entire year? . . . . . . . . . . . . . . . . . . . . .
      c Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of
        more than one person (tiebreaker rules)? . . . . . . . . . . . . . . . . . . . .
Part III       Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC,
               or ODC, go to Part IV.)
 10      Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer’s dependent who is          Yes       No      N/A
         a citizen, national, or resident of the United States? . . . . . . . . . . . . . . . . . .
 11      Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the child has not lived with
         the taxpayer for over half of the year, even if the taxpayer has supported the child, unless the child’s
         custodial parent has released a claim to exemption for the child? . . . . . . . . . . . .
 12      Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or
         separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar
         statement to the return? . . . . . . . . . . . . . . . . . . . . . . . . . .
Part IV        Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
 13      Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified            Yes     No
         tuition and related expenses for the claimed AOTC? . . . . . . . . . . . . . . . . . . . .
 Part V        Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)
 14      Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year                Yes     No
         and provided more than half of the cost of keeping up a home for the year for a qualifying person? . . . .
Part VI        Eligibility Certification
         You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing status
         on the return of the taxpayer identified above if you:
           A. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer’s responses on the return or
              in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing
              status and to figure the amount(s) of the credit(s);
            B. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable
               credit(s) claimed and HOH filing status, if claimed;
            C. Submit Form 8867 in the manner required; and
            D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under
               Document Retention.
               1. A copy of this Form 8867.
               2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
               3. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer’s eligibility for the
                  credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
               4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was
                  obtained.
               5. A record of any additional information you relied upon, including questions you asked and the taxpayer’s responses, to
                  determine the taxpayer’s eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
         If you have not complied with all due diligence requirements, you may have to pay a penalty for each failure to comply
         related to a claim of an applicable credit or HOH filing status (see instructions for more information).
 15      Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and            Yes     No
         complete? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
                                                                                        REV 03/13/25 PRO                Form   8867 (Rev. 11-2024)
Form   8962                                                  Premium Tax Credit (PTC)
                                                                                                                                                                   OMB No. 1545-0074
                                                                                                                                                                    2024
Department of the Treasury
                                                        Attach to Form 1040, 1040-SR, or 1040-NR.
                                                                                                                                                                    Attachment
Internal Revenue Service                   Go to www.irs.gov/Form8962 for instructions and the latest information.                                                  Sequence No. 73
Name shown on your return                                                                                               Your social security number
 ENRIQUE CORUJO ESQUILIN & ZULEIKA ORTEGA                                                                                   596-26-4048
  A. You cannot take the PTC if your filing status is married filing separately unless you qualify for an exception. See instructions. If you qualify, check the box
 Part I         Annual and Monthly Contribution Amount
   1      Tax family size. Enter your tax family size. See instructions . . .             .    .     .    .    .   .    .    . .      .   .    .   .   .      1                        4
   2a     Modified AGI. Enter your modified AGI. See instructions . . .                   .    .     .    .    .   .         2a               69,936.
     b    Enter the total of your dependents’ modified AGI. See instructions              .    .     .    .    .   .         2b
   3      Household income. Add the amounts on lines 2a and 2b. See instructions                     .    .    .   .    .    .   .    .   .    .   .   .      3            69,936.
   4      Federal poverty line. Enter the federal poverty line amount from Table 1-1, 1-2, or 1-3. See instructions. Check the
          appropriate box for the federal poverty table used. a         Alaska    b      Hawaii     c      Other 48 states and DC                             4           30,000.
   5      Household income as a percentage of federal poverty line (see instructions) . . . . . . . . . . . .                                                 5             233 %
   6      Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . .
   7      Applicable figure. Using your line 5 percentage, locate your “applicable figure” on the table in the instructions  . .                              7             0.0332
   8a     Annual contribution amount. Multiply line 3 by                                 8b Monthly contribution amount. Divide line 8a
          line 7. Round to nearest whole dollar amount 8a
                                                  2,322.                                       8b
                                                                                            by 12. Round to nearest whole dollar amount                                        194.
 Part II        Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit
   9      Are you allocating policy amounts with another taxpayer or do you want to use the alternative calculation for year of marriage? See instructions.
              Yes. Skip to Part IV, Allocation of Policy Amounts, or Part V, Alternative Calculation for Year of Marriage. No. Continue to line 10.
 10       See the instructions to determine if you can use line 11 or must complete lines 12 through 23.
              Yes. Continue to line 11. Compute your annual PTC. Then skip lines 12–23                                     No. Continue to lines 12–23. Compute
              and continue to line 24.                                                                                     your monthly PTC and continue to line 24.
                         (a) Annual enrollment   (b) Annual applicable          (c) Annual                (d) Annual maximum
                                                                                                                                                                   (f) Annual advance
         Annual                                    SLCSP premium                                           premium assistance         (e) Annual PTC allowed
                           premiums (Form(s)                               contribution amount                                                                  payment of PTC (Form(s)
       Calculation                                 (Form(s) 1095-A,                                      (subtract (c) from (b); if     (smaller of (a) or (d))
                                                                                                                                                                    1095-A, line 33C)
                            1095-A, line 33A)          line 33B)                 (line 8a)               zero or less, enter -0-)
 11      Annual Totals
                                                                                 (c) Monthly
                         (a) Monthly enrollment (b) Monthly applicable                                    (d) Monthly maximum                                  (f) Monthly advance
                                                                            contribution amount
        Monthly            premiums (Form(s)       SLCSP premium                                           premium assistance       (e) Monthly PTC allowed payment of PTC (Form(s)
                                                                            (amount from line 8b
       Calculation        1095-A, lines 21–32, (Form(s) 1095-A, lines                                    (subtract (c) from (b); if    (smaller of (a) or (d)) 1095-A, lines 21–32,
                                                                           or alternative marriage
                               column A)           21–32, column B)                                      zero or less, enter -0-)                                   column C)
                                                                             monthly calculation)
 12       January
 13       February
 14       March
 15       April                   1,002.                       929.                     194.                             735.                          735.                  902.
 16       May                     1,002.                       929.                     194.                             735.                          735.                  902.
 17       June                    1,002.                       929.                     194.                             735.                          735.                  902.
 18       July                    1,002.                       929.                     194.                             735.                          735.                  902.
 19       August                  1,002.                       929.                     194.                             735.                          735.                  902.
 20       September               1,002.                       929.                     194.                             735.                          735.                  902.
 21       October                 1,002.                       929.                     194.                             735.                          735.                  902.
 22       November                1,002.                       929.                     194.                             735.                          735.                  902.
 23       December                1,002.                       929.                     194.                             735.                          735.                  902.
 24       Total PTC. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total here . . . . .                                     24            6,615.
 25       Advance payment of PTC. Enter the amount from line 11(f) or add lines 12(f) through 23(f) and enter the total here                                  25            8,118.
 26       Net PTC. If line 24 is greater than line 25, subtract line 25 from line 24. Enter the difference here and on Schedule 3
          (Form 1040), line 9. If line 24 equals line 25, enter -0-. Stop here. If line 25 is greater than line 24, leave this line
          blank and continue to line 27     . . . . . . . . . . . . . . . . . . . . . . . . .                                                                 26
Part III        Repayment of Excess Advance Payment of the Premium Tax Credit
 27       Excess advance payment of PTC. If line 25 is greater than line 24, subtract line 24 from line 25. Enter the difference here                         27            1,503.
 28       Repayment limitation (see instructions)     . . . . . . . . . . . . . . . . . . . . . .                                                             28            1,900.
 29       Excess advance PTC repayment. Enter the smaller of line 27 or line 28 here and on Schedule 2 (Form 1040), line 1a                                   29            1,503.
For Paperwork Reduction Act Notice, see your tax return instructions.                                                                                                 Form 8962 (2024)
Form 8962 (2024)                                                                                                                                        Page 2
Allocation 2
 31     (a) Policy Number (Form 1095-A, line 2)       (b) SSN of other taxpayer                    (c) Allocation start month    (d) Allocation stop month
Allocation 3
 32     (a) Policy Number (Form 1095-A, line 2)       (b) SSN of other taxpayer                    (c) Allocation start month    (d) Allocation stop month
Allocation 4
 33     (a) Policy Number (Form 1095-A, line 2)       (b) SSN of other taxpayer                    (c) Allocation start month    (d) Allocation stop month
                                (a) Alternative family size (b) Alternative monthly         (c) Alternative start month         (d) Alternative stop month
 36     Alternative entries                                 contribution amount
        for your spouse’s
        SSN
                                                                      BA         REV 03/13/25 PR                                             Form 8962 (2024)
                                   Schedule C Two-Year Comparison                                      2024
                                              G Keep for your records
       Note: Transferred data will not be displayed in the prior year column unless you have entered
       current year data on the Schedule C.