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New Tax Return Transcript - IRS tax forms

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Page 1 of 6 This Product Contains Sensitive Taxpayer Data Tax Return Transcript Request Date: 08-09-2018Response Date: 08-09-2018Tracking Number: 100200235179 Customer File Number: 0987654321 SSN Provided: XXX-XX-5084 Tax Period Ending: Dec. 31, 2017 The following items reflect the amount as shown on the Return (PR), and the amount as adjusted (PC), if applicable. They do not show subsequent activity on the account. SSN: XXX-XX-5084 SPOUSE SSN: NAME(S) SHOWN ON Return : DRAKADDRESS: 123 DAFILING STATUS: SingleFORM NUMBER: 1040CYCLE POSTED: 20181005RECEIVED DATE: , 2018 REMITTANCE: $ EXEMPTION NUMBER: 1 DEPENDENT 1 NAME CTRL: DEPENDENT 1 SSN: DEPENDENT 2 NAME CTRL: DEPENDENT 2 SSN: DEPENDENT 3 NAME CTRL: DEPENDENT 3 SSN: DEPENDENT 4 NAME CTRL: DEPENDENT 4 SSN: PTIN: PREPARER EIN: Income WAGES, SALARIES, TIPS, ETC: $13, TAXABLE INTEREST INCOME: SCH B: $ TAX-EXEMPT INTEREST: $ ORDINARY DIVIDEND INCOME: SCH B: $ QUALIFIED DIVIDENDS: $ REFUNDS OF STATE/LOCAL TAXES: $ 8/9/2018 SAMPLEPage 2 of 6 ALIMONY RECEIVED: $ BUSINESS INCOME OR LOSS (Schedule C): $2, BUSINESS INCOME OR LOSS: SCH C PER COMPUTER: $2, CAPITAL GAIN OR LOSS: (Schedule D): $ CAPITAL GAINS OR LOSS: SCH D PER COMPUTER: $ OTHER GAIN

Page 1 of 6 This Product Contains Sensitive Taxpayer Data Tax Return Transcript Request Date: 08-09-2018

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