Prepared For:

RAY G. SISTOS

02/28/2018

Today's Savings

* Because you qualified for a $488 Earned Income Credit (EIC) this year, you saved: $488.00
* By deducting your home mortgage interest, you reduced your taxes by an estimated: $106.00
* By participating in a qualified retirement plan through your employer this year and making $44.00
your contributions with pretax dollars, you reduced your taxes by:
* In simple terms, the Marginal Tax Rate is the tax rate that you pay on your last dollar of taxable
income. It is the highest federal tax bracket that affects your tax calculation. The Effective Tax
Rate is the percentage of your total income that you paid in taxes. For 2017, your Marginal Tax
Rate is 0% and your Effective Tax Rate is 0%.

Total Savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $638.00

Filing, Refund and Balance Due Information

Refund /
Tax Return efile (Balance Due) Summary Message
Federal Yes $1,391.00 Refund $1,391.00 See the Filing Checklist for instructions.

Th is H &R B lock Ad vant age d ocument provid es inf ormat ion t h at could h elp y ou improve y our t ax and f inancial sit uat ion. It s cont ent s sh ould b e consid ered in conj unct ion w it h
inf ormat ion you receive f rom ot h er sources t h at are f amiliar w it h your specif ic circumst ances. Tax services of f ered t h rough sub sid iaries of H RB Tax Group, Inc.

Advantage (2017) FDADVICE-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
2017 Tax Return Summary

Federal Year over Year Comparison

INCOME Year 2017 Year 2016 Change($)
Wages, salaries, tips $6,382 $0 $6,382
Total income $6,382 $0 $6,382

ADJUSTED GROSS INCOME

Total income less total adjustments $6,382 $0 $6,382

PAYMENTS
Federal withholding $903 $0 $903
Earned income credit $488 $0 $488
Total payments $1,391 $0 $1,391

REFUND
Overpayment $1,391 $0 $1,391
Refund due $1,391 $0 $1,391

OTHER COMPUTATIONS
Alternative minimum taxable income $745 $0 $745
Total tax preferences and adjustments $1,778 $0 $1,778
Filing status Single

Client Sum (2017) FDBASUM-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 RAY G SISTOS

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: 53064 Date: 02/28/2018

Taxpayer's Date of Birth: 05/30/1964
Taxpayer's Prior Year Adjusted Gross Income: 33,570.
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) (2017) FD8453OD-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 2017 Federal Tax Return Filing Instructions
FOR THE YEAR ENDING
December 31, 2017

RAY G SISTOS
Prepared for

Gross Income $ 6,382

Tax Adjusted Gross Income $ 6,382
Summary Total Deductions $ 11,465
Total Taxable Income $ 0
Total Tax $ 0
Total Payments $ 1,391
Refund Amount $ 1,391
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 (2017) FDCHECKE-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
Form D epart ment of t h e Treasury - Int ernal Revenue Service (99)
1040 U.S. Individual Income Tax Return OM B No. 1545- 0074 IRS Use Only - D o not w rit e or st aple in t h is space.
For t h e year J an. 1- D ec. 31, 2017, or ot h er t ax year b eginning , 2017, ending , 20 See separate instructions.
Your social security number
RAY G SISTOS 540-86-9839
Spouse's social security number
3911 S TYLER ST
AMARILLO, TX 79110 M ak e sure t h e SSN(s) ab ove
and on line 6c are correct .
Presidential Election Campaign
Ch eck h ere if y ou, or y our spouse if f iling
j oint ly , w ant $3 t o go t o t h is f und . Ch eck ing
Foreign count ry name Foreign province/ st at e/ count y Foreign post al cod e a b ox b elow w ill not ch ange y our t ax or
refund.
You Spouse
1 X Single 4 H ead of h ouseh old (w it h q ualif y ing person). (See inst ruct ions.) If
Filing Status
2 Married filing jointly (even if only one had income) t h e q ualif y ing person is a ch ild b ut not y our d epend ent , ent er t h is
Check only one 3 Married filing separately.Ent er spouse's SSN ab ove & f ull name h ere. ch ild 's name h ere.
box. 5 Qualifying widow(er) (see instructions)
6a X Yourself. If someone can claim you as a dependent, do not check box 6a 1
B oxes ch eck ed
on 6a and 6b
Exemptions b Spouse No. of ch ild ren
on 6c who:
(2) D epend ent 's (3) D epend ent 's (4) if child
c Dependents: <17 for qual. lived w it h y ou
social securit y numb er relat ionsh ip t o y ou f or ch ild t ax d id not live w it h y ou
If more (1) First name Last name cr. (see inst)
d ue t o d ivorce
than four or separat ion
(see inst)
dependents,
D epend ent s
see inst and on 6c not
check ent ered ab ove
here Ad d numb ers
on lines
d Total number of exemptions claimed above 1
7 Wages, salaries, tips, etc. Attach Form(s) W- 2
Income 7 6,382.
8a Taxable interest. Attach Schedule B if required 8a
Attach Form(s) b Tax- exempt interest. Do not include on line 8a 8b
W-2 here. Also 9a Ordinary dividends. Attach Schedule B if required 9a
attach Forms
W-2G and b Qualified dividends 9b
1099-R if tax 10 Taxable refunds, credits, or offsets of state and local income taxes 10
was withheld. 11 Alimony received 11
12 Business income or (loss). Attach Schedule C or C-EZ 12
At t ach Sch ed ule D if req uired .
13 Capital gain or (loss). If not req uired , ch eck h ere 13
If you did not 14 Other gains or (losses). Attach Form 4797 14
get a W-2, 15a IRA distributions 15a b Taxable amt 15b
see instructions.
16a Pensions and annuities 16a b Taxable amt 16b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17
18 Farm income or (loss). Attach Schedule F 18
19 Unemployment compensation 19
20a Social security benefits 20a b Taxable amount 20b
21 Other income. List type and amount
21
Combine the amounts in the far right column for lines 7 through 21. This is your total income
22 22 6,382.
Educator expenses
23 23
Adjusted Certain business expenses of reservists, performing artists, and
24
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24
Income 25 Health savings account deduction. Attach Form 8889 25
26 Moving expenses. Attach Form 3903 26
27 Deductible part of self-employment tax. Attach Schedule SE 27
28 Self-employed SEP, SIMPLE, and qualified plans 28
29 Self-employed health insurance deduction 29
30 Penalty on early withdrawal of savings 30
31a Alimony paid b Recipient's SSN 31a
32 IRA deduction 32
33 Student loan interest deduction 33
34 Reserved for future use 34
35 Domestic production activities deduction. Attach Form 8903 35
36 Add lines 23 through 35 36
37 Subtract line 36 from line 22. This is your adjusted gross income 37 6,382.
KBA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2017)

1040 (2017) FD1040-1WV 1.25

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
Form 1040 (2017) RAY G SISTOS 540-86-9839 Page 2
38 Amount from line 37 (adjusted gross income) 38 6,382.
Tax and 39a Check You were born before January 2, 1953, Blind. Total boxes
Credits if: Spouse was born before January 2, 1953, Blind. checked 39a
b If your spouse itemizes on a separate return or you were a dual- status alien, check here 39b
Standard 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) 40 7,415.
Deduction
for -
People who 41 Subtract line 40 from line 38 41 (1,033.)
check any 42 Exemptions. If line 38 is $156,900 or less, mult iply $4,050 b y t h e numb er on line 6d . Ot h erw ise, see inst ruct ions 42 4,050.
box on line
39a or 39b 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter - 0- 43 0.
or who can 44 Tax (see inst .) Ch eck if any f rom: a Form(s) 8814 b Form 4972 c 44 0.
be claimed as
a dependent, 45 Alternative minimum tax (see instructions). Attach Form 6251 45
see 46 Excess advance premium tax credit repayment. Attach Form 8962 46
instructions. 47 Add lines 44, 45, and 46 47 0.
All others:
48 Foreign tax credit. Attach Form 1116 if required 48
Single or
M arried f iling 49 Credit for child and dependent care expenses. Attach Form 2441 49
separat ely,
$6,350 50 Education credits from Form 8863, line 19 50
M arried f iling 51 Retirement savings contributions credit. Attach Form 8880 51
j oint ly or
Qualifying 52 Child tax credit. Attach Schedule 8812, if required 52
widow(er),
$12,700 53 Residential energy credit. Attach Form 5695 53
Ot h er cred it s
Head of 54 from Form: a 3800 b 8801 c 54
h ouseh old ,
$9,350 55 Add ln 48 through 54. These are your total credits 55
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter - 0- 56 0.
57 Self-employment tax. Attach Schedule SE 57
Other
58 Unreported social security and Medicare tax from Form: a 4137 b 8919 58
Taxes
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 59
60a Household employment taxes from Schedule H 60a
b First- time homebuyer credit repayment. Attach Form 5405 if required 60b
61 Health care: individual responsibility (see instructions) Full-year coverage 61
enter
62 Taxes from: a Form 8959 b Form 8960 c Instructions; code(s) 62
63 Add lines 56 through 62. This is your total tax 63 0.
Payments 64 Federal income tax withheld from Forms W-2 and 1099 64 903.
65 2017 estimated tax payments and amount applied from 2016 return 65
If you have a
qualifying 66a Earned income credit (EIC) 66a 488.
child, attach b Nontaxable combat pay election 66b
Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 67
68 American opportunity credit from Form 8863, line 8 68
69 Net premium tax credit. Attach Form 8962 69
70 Amount paid with request for extension to file 70
71 Excess social security and tier 1 RRTA tax withheld 71
72 Credit for federal tax on fuels. Attach Form 4136 72
Re-
73 Cred it s f rom Form: a 2439 b served c 8885 d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments 74 1,391.
Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid
75 1,391.
76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here 76a 1,391.
Direct deposit? b Routing number 111900659 c Type: X Checking Savings
See d Account number 3095831594
instructions. 77 Amount of line 75 you want applied to your 2018 estimated tax 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions 78
You Owe 79 Estimated tax penalty (see instructions) 79
Do you want to allow another person to discuss this return with the IRS (see instructions)? X Yes. Complete below. No
Third Party
Designee's name Phone no. Personal ID number
Designee
CANDY CARL (806) 379-8915 (PIN) 79201
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 accurat ely list all amount s and sources of income I received d uring t h e t ax y ear. 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 know led ge.
Here Your signature Date Your occupation Daytime phone number
Joint return? STUDENT
See instructions. If t h e IRS sent y ou an ID Prot ect ion
Spouse's signature. If a joint return, both must sign. Date Spouse's occupation PIN, ent er it h ere (see inst .)
Keep a copy for
your records.
Print/Type preparer's name Preparer's signature Date Check if PTIN
Paid self-employed
Preparer
Firm's name Firm's EIN
Use Only
Firm's address Phone no.
Go to www.irs.gov/form1040 for instructions and the latest information. Form 1040 (2017)
 OMB No. 1545-0074
SCHEDULE A Itemized Deductions
(Form 1040) Go to www.irs.gov/ScheduleA for instructions and the latest information.
D epart ment of t h e Treasury Attach to Form 1040.
At t ach ment
Caution: If you are claiming a net qualified disaster loss on Form 4684, see the instructions for line 28.
Int ernal Revenue Service (99) Sequence No. 07
Name(s) shown on Form 1040 Your social security number
RAY G SISTOS 540-86-9839
Caution: Do not include expenses reimbursed or paid by others.
Medical 1 Medical and dental expenses (see instructions) 1
and
Dental 2 Enter amount from Form 1040, line 38 2
Expenses 3 Multiply line 2 by 7.5% (0.075) 3
4 Subtract line 3 from line 1. If line 3 is more than line 1, enter - 0- 4
Taxes You 5 State and local (check only one box):
Paid a Income taxes, or 5 0.
b General sales taxes
6 Real estate taxes (see instructions) 6 1,778.
3911 SOUTH TYLER STREET 1,778.
7 Personal property taxes 7
8 Other taxes. List type and amount
8
9 Add lines 5 through 8 9 1,778.
Interest 10 Home mortgage interest and points reported to you on Form 1098 10 5,637.
You Paid 11 Home mortgage interest not reported to you on Form 1098. If paid to the
person from whom you bought the home, see instructions and show that
Note: person's name, identifying no., and address
Your mortgage 11
interest
deduction may 12 Points not reported to you on Form 1098. See instructions for special rules 12
be limited (see 13 Reserved for future use 13
instructions). 14 Investment interest. Attach Form 4952 if required. See instructions 14
15 Add lines 10 through 14 15 5,637.
Gifts to 16 Gifts by cash or check. If you made any gift of $250 or more, see instructions
Charity 16
If you made a 17 Other than by cash or check. If any gift of $250 or more, see
gift and got a instructions. You must attach Form 8283 if over $500 17
benefit for it, 18 Carryover from prior year 18
see instructions.
19 Add lines 16 through 18 19
Casualty and 20 Casualty or theft loss(es) other than net qualified disaster losses. Attach Form 4684 and
Theft Losses enter the amount from line 18 of that form. See instructions 20
Job Expenses 21 Unreimbursed employee expenses -job travel, union dues, job education,
and Certain etc. Attach Form 2106 or 2106-EZ if required.
Miscellaneous
Deductions See inst. 21
22 Tax preparation fees 22
23 Other expenses - investment, safe deposit box, etc. List type and amount
23
24 Add lines 21 through 23 24
25 Enter amount from Form 1040, line 38 25
26 Multiply line 25 by 2% (0.02) 26
27 Subtract line 26 from line 24. If line 26 is more than line 24, enter - 0- 27
Other 28 Other - from list in instructions. List type and amount
Miscellaneous
Deductions 28
Total 29 Is Form 1040, line 38, over $156,900?
Itemized X No. Your deduction is not limited. Add the amounts in the far right column
Deductions for lines 4 through 28. Also, enter this amount on Form 1040, line 40. 29 7,415.
Yes. Your deduction may be limited. See the Itemized Deductions
Worksheet in the instructions to figure the amount to enter.
30 If you elect to itemize deductions even though they are less than your standard
deduction, check here
KBA For Paperwork Reduction Act Notice, see the Instructions for Form 1040. Schedule A (Form 1040) 2017

1040-Sch A (2017) FDA-1WV 1.9

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 OMB No. 1545-0074
Form 8965 Health Coverage Exemptions
Attach to Form 1040, Form 1040A, or Form 1040EZ.
D epart ment of t h e Treasury Attachment
Int ernal Revenue Service Go to www.irs.gov/Form8965 for instructions and the latest information. Sequence No. 75
Name as shown on return Your social security number
RAY G SISTOS 540-86-9839
Complete this form if you have a Marketplace-granted coverage exemption or you are claiming a coverage
exemption on your return.

Part I Marketplace-Granted Coverage Exemptions for Individuals. If you and/or a member of your tax
household have an exemption granted by the Marketplace, complete Part I.
(a) (b) (c)
Name of Individual SSN Exemption Certificate Number

6
Part II Coverage Exemptions Claimed on Your Return for Your Household
7 If you are claiming a coverage exemption because your household income or gross income is below the filing threshold,
check here X
Part III Coverage Exemptions Claimed on Your Return for Individuals. If you and/or a member of your tax
household are claiming an exemption on your return, complete Part III.
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p)
Name of Individual SSN Exemption Full Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
Type Year

10

11

12

13
KBA For Privacy Act and Paperwork Reduction Act Notice, see your tax return instructions. Form 8965 (2017)

8965 (2017) FD8965-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 Name RAY G SISTOS SSN 540-86-9839
Worksheet 1. Investment Income If You Are Filing Form 1040
Use this worksheet to figure investment income for the earned income credit when you file Form 1040. Keep for Your Records
Interest and Dividends
1. Ent er any amount f rom Form 1040, line 8a 1. 0
2. Ent er any amount f rom Form 1040, line 8b , plus any amount on Form 8814, line 1b 2. 0
3. Ent er any amount f rom Form 1040, line 9a 3. 0
4. Ent er t h e amount f rom Form 1040, line 21, t h at is f rom Form 8814 if y ou are f iling t h at f orm t o report y our ch ild 's int erest and d ivid end income
on your ret urn. (If your ch ild received an Alaska Permanent Fund d ivid end , use Work sh eet 2, on t h e next page, t o f igure t h e amount t o ent er
on t h is line.) 4. 0
Capital Gain Net Income
5. Ent er t h e amount f rom Form 1040, line 13. If t h e amount on t h at line is a loss, ent er - 0- 5. 0
6. Ent er any gain f rom Form 4797, Sales of B usiness Propert y, line 7. If t h e amount on t h at line is a loss,
ent er - 0- . (B ut , if you complet ed lines 8 and 9 of Form 4797, ent er t h e amount f rom line 9 inst ead .) 6. 0
7. Sub t ract line 6 of t h is w orksh eet f rom line 5 of t h is w orksh eet . (If t h e result is less t h an zero, ent er - 0- .) 7. 0
Royalties and Rental Income From Personal Property
8. Ent er any royalt y income f rom Sch ed ule E, line 23b , plus any income f rom t h e rent al of personal
propert y sh ow n on Form 1040, line 21 8. 0
9. Ent er any expenses f rom Sch ed ule E, line 20, relat ed t o royalt y income, plus any expenses f rom
t h e rent al of personal propert y d ed uct ed on Form 1040, line 36 9. 0
10. Sub t ract t h e amount on line 9 of t h is w orksh eet f rom t h e amount on line 8. (If t h e result is less t h an zero, ent er - 0- .) 10. 0
Passive Activities
11. Ent er t h e t ot al of any net income f rom passive act ivit ies (such as income includ ed on Sch ed ule E, line 26, 29a
(col. (g)), 34a (col. (d )), or 40; or an ord inary gain id ent if ied as "FPA" on Form 4797, line 10. (See inst ruct ions
b elow f or lines 11 and 12.) 11. 0
12. Ent er t h e t ot al of any losses f rom passive act ivit ies (such as losses includ ed on Sch ed ule E, lines 26, 29b (col. (f )),
34b (col. (c)), or 40; or an ord inary loss id ent if ied as "PAL " on Form 4797, line 10). (See inst ruct ions b elow f or lines
11 and 12.) 12. 0
13. Comb ine t h e amount s on lines 11 and 12 of t h is w orksh eet . (If t h e result is less t h an zero, ent er - 0- .) 13. 0
14 Ad d t h e amount s on lines 1, 2, 3, 4, 7, 10, and 13. Ent er t h e t ot al. Th is is y our invest ment income 14. 0
15. Is t h e amount on line 14 more t h an $3,450?
Yes. You cannot t ake t h e cred it .
X No. Go t o St ep 3 of t h e Form 1040 inst ruct ions f or lines 66a and 66b t o f ind out if y ou can t ak e t h e cred it (unless y ou are using
t h is pub licat ion t o f ind out if t h e you can t ake t h e cred it ; in t h at case, go t o Rule 7, next .)

Inst ruct ions f or lines 11 and 12. In f iguring t h e amount t o ent er on lines 11 and 12, d o not t ak e int o account any roy alt y income (or loss) includ ed on line 26 of Sch ed ule E or any
income (or loss) includ ed in your earned income or on line 1,2,3,4,7, or 10 of t h is w ork sh eet . To f ind out if t h e income on line 26 or line 40 of Sch ed ule E is f rom a passive act ivit y ,
see t h e Sch ed ule E inst ruct ions. If any of t h e rent al real est at e income (or loss) includ ed on Sch ed ule E, line 26, is not f rom a passive act ivit y , print "NPA" and t h e amount of
t h at income (or loss) on t h e d ot t ed line next t o line 26.

Worksheet 2. Earned Income

1. Ent er amount f rom Form 1040, line 7* 1. 6,382
2. Sub t ract , if includ ed on line 7, any:
Taxab le sch olarsh ip or f ellow sh ip grant not report ed on a Form W- 2.
Amount paid t o an inmat e in a penal inst it ut ion f or w ork (put "PRI" and t h e amount sub t ract ed on t h e
d ot t ed line next t o line 7 of Form 1040).

Amount received as a pension or annuit y f rom a non q ualif ied d ef erred compensat ion plan or a nongovernment al 2. 0
sect ion 457 plan (put "D FC" and t h e amount sub t ract ed on t h e d ot t ed line next t o line 7 of Form 1040). Th is amount
may b e sh ow n in b ox 11 of t h e Form W- 2. If t axpayer received such an amount b ut b ox 11 is b lank , cont act t h e
employer f or t h e amount received as a pension or annuit y.
Amount includ ed on Form 1040, line 7, t h at is a M ed icaid w aiver pay ment exclud ed f rom income.

3. Ad d all of your nont axab le comb at pay (and your spouse's if f iling j oint ly ) if y ou elect t o includ e it in earned income.* *
Also ent er t h is amount on Form 1040, line 66b . See Comb at pay, Nont axab le on t h is page 3.
4. EARNED INCOM E 4. 6,382
* Ch urch Employees. D et ermine h ow much of t h e amount on Form 1040, line 7, w as also report ed on Sch ed ule SE, line 5a. Sub t ract t h at amount f rom t h e
amount on Form 1040, line 7, and ent er t h e result on line 1.

* * Th e elect ion cannot b e mad e on t h e ret urn of a t axpayer w h ose t ax year end ed b ef ore Oct ob er 5, 2005, d ue t o h is or h er d eat h .

Clergy . Th e f ollow ing inst ruct ions apply t o minist ers, memb ers of religious ord ers w h o h ave not t ak en a vow of povert y , and Ch rist ian Science pract it ioners.
If y ou are f iling Sch ed ule SE and t h e amount on line 2 of t h at sch ed ule includ es an amount t h at w as also report ed on Form 1040, line 7:
1. D et ermine h ow much of t h e amount on Form 1040, line 7, w as also report ed on Sch ed ule SE, line 2.
2. Sub t ract t h at amount f rom t h e amount on Form 1040, line 7. Ent er t h e result on line 1.

WS EIC (2017) FDEICWS-1WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.
 Name RAY G SISTOS SSN 540-86-9839
Worksheet B. - Earned Income Credit (EIC) - Lines 66a and 66b
PART 1 Self-Employed and People With Church Employee Income Filing Schedule SE

1a. Enter the amount from Schedule SE, Section A, line 3, or Section B, line 3, whichever applies 1a.
b. Enter any amount from Schedule SE, Section B, line 4b, and line 5a b.
c. Combine lines 1a and 1b c.
d. Enter the amount from Schedule SE, Section A, line 6, or Section B, line 13, whichever applies d.
e. Subtract line 1d from 1c e.

PART 2 Self-Employed NOT Required to File Schedule SE

2a. Ent er any net f arm prof it (or loss) f rom Sch ed ule F, line 34, and f rom f arm part nersh ips, Sch ed ule K- 1 (Form 1065), b ox 14, cod e A* 2a.
b. Enter any net profit (or loss) from Schedule C, line 31; Schedule C- EZ, line 3; Schedule K- 1 (Form 1065), box 14,
code A (other than farming); and Schedule K-1 (Form 1065-B), box 9, code J1* b.
c. Combine lines 2a and 2b c.

PART 3 Statutory Employees Filing Schedule C or C-EZ

3. Enter the amount from Schedule C, line 1, or Schedule C- EZ, line 1, that you are filing as a statutory employee 3.

PART 4 All Filers Using EIC Worksheet B

4a. Enter your earned income from Worksheet 2, line 4 4a. 6,382
b. Combine lines 1e, 2c, 3, and 4a. This is the total earned income 4b. 6,382
If line 4b is zero or less, STOP You cannot take the credit.
5. If you have:
3 or more qualifying children, is line 4b less than $48,340 ($53,930 if married filing jointly)?
2 qualifying children, is line 4b less than $45,007 ($50,597 if married filing jointly)?
1 qualifying child, is line 4b less than $39,617 ($45,207 if married filing jointly)?
No qualifying children, is line 4b less than $15,010 ($20,600 if married filing jointly)?
X Yes. Enter the amount from line 4b on line 6. No. STOP You cannot take the credit.

PART 5 All Filers Using Worksheet B

6. Enter the total earned income from Part 4, line 4b, of this worksheet 6. 6,382
7. Look up the amount on line 6 above in the EIC Table in the Appendix to find the credit. Enter the credit here 7. 488
If line 7 is zero, STOP You cannot take the credit.
8. Enter the amount from Form 1040, line 38 8. 6,382
9. Are the amounts on lines 8 and 6 the same?
X Yes. Skip line 10; enter the amount from line 7 on line 11. No. Go to line 10.

PART 6 Filers Who Answered "No" on Line 9

10. If you have:

No qualifying children, is the amount on line 8 less than $8,350 ($13,950 if married filing jointly)?
1 or more qualifying children, is the amount on line 8 less than $18,350 ($23,950 if married filing jointly)?
Yes. Leave line 10 blank; enter the amount from line 7 on line 11.
No. Look up the amount on line 8 in the EIC Table in the Appendix to find the credit. Enter the credit here 10.
Look at the amounts on lines 10 and 7. Then, enter the smaller amount on line 11.

PART 7 Your Earned Income Credit

11. This is the earned income credit 11. 488

Enter this amount on
Form 1040, line 64a.
Reminder -
If you have a qualifying child, complete and attach Schedule EIC.

If your EIC for a year after 1996 was reduced or disallowed, see
Form 8862, who must file to find out if you must file Form
8862 to take the credit for 2017.

WS EIC (2017) FDEICWS-2WV 1.0

Form Sof t w are Copyrigh t 1996 - 2018 H RB Tax Group, Inc.