Tax Return

File by Mail Instructions for your 2013 Federal Tax Return
Important: Your taxes are not finished until all required steps are completed.

elizabeth D & Efren O Supanga
97 Farnham Rd
South Windsor, CT 06074
|

Balance
| Your federal tax return (Form 1040) shows no balance due or refund
Due/
| amount.
Refund
|
______________________________________________________________________________________
|
|
| Your tax return - The official return for mailing is included in
| this printout. Remember to sign and date the return.
|
| Mail your return to:
| Department of the Treasury
| Internal Revenue Service Center
| Kansas City, MO 64999-0002
|
| Deadline: Postmarked by Tuesday, April 15, 2014
|
| Note: Your state return may be due on a different date. Please
| review your state filing instructions.
|
| Don't forget correct postage on the envelope.
______________________________________________________________________________________
|
|
What You
| Keep these instructions and a copy of your return for your records.
Need to
| If you did not print one before closing TurboTax, go back to the
Keep
| program and select File tab, then select the Print for Your Records
| category.
______________________________________________________________________________________
|
|
2013
| Adjusted Gross Income
$
0.00
Federal
| Taxable Income
$
0.00
Tax
| Total Tax
$
0.00
Return
| No Refund or Amount Due
$
0.00
Summary
| Effective Tax Rate
0.00%
______________________________________________________________________________________
|

What You
Need to
Mail

Page 1 of 1

Hi elizabeth and Efren ,
We just want to thank you for using TurboTax this year!
your taxes easy and accurate, year after year.

It's our goal to make

With TurboTax Basic:
Breathe easy. The calculations on your return are backed with our
100% Accuracy Guarantee.
Here's the final wrap up for your 2013 taxes:
- We double checked your return for errors along the way.
- We helped with step-by-step guidance to get your answers on the right
IRS forms.
- We made sure you didn't miss a deduction even if something in your life
changed, like a new job, new house - or more kids!
Your Head Start On Next Year:
When you come back next year, taxes will be so easy! We'll have all
your information saved and ready to transfer in to your new return.
We'll ask you questions about what changed since we last talked, and
we'll be ready to get you the credits and deductions you deserve, no
matter what life throws at you.
Also included:
- We provide the Audit Support Center free of charge in the unlikely
event you get audited.
With TurboTax State:
- You saved time by automatically transferring your federal tax
information to your state return
Many happy returns from TurboTax.

Form

1040

2013

(99)

Department of the Treasury—Internal Revenue Service

U.S. Individual Income Tax Return

For the year Jan. 1–Dec. 31, 2013, or other tax year beginning

, 2013, ending

IRS Use Only—Do not write or staple in this space.

See separate instructions.

, 20

Your social security number

Last name

Your first name and initial

elizabeth D

815-10-7192

Supanga

Spouse’s social security number

Last name

If a joint return, spouse’s first name and initial

Efren

OMB No. 1545-0074

O

889-98-6003

Supanga
Apt. no.

Home address (number and street). If you have a P.O. box, see instructions.

▲

97 Farnham Rd
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign postal code
a box below will not change your tax or
refund.
You
Spouse

South Windsor CT 06074
Foreign country name

Filing Status
Check only one
box.

Exemptions

Foreign province/state/county

1

4

Single
Married filing jointly (even if only one had income)

2
3

c

Head of household (with qualifying person). (See instructions.) If
the qualifying person is a child but not your dependent, enter this
child’s name here. ▶

Married filing separately. Enter spouse’s SSN above
and full name here. ▶

6a
b

5

Qualifying widow(er) with dependent child

Yourself. If someone can claim you as a dependent, do not check box 6a .
Spouse
.
Dependents:

(1) First name

.

.

.

.

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.

(2) Dependent’s
social security number

Last name

.

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.

}

(4) ✓ if child under age 17
qualifying for child tax credit
(see instructions)

(3) Dependent’s
relationship to you

If you did not
get a W-2,
see instructions.

Adjusted
Gross
Income

2

Dependents on 6c
not entered above

d

Attach Form(s)
W-2 here. Also
attach Forms
W-2G and
1099-R if tax
was withheld.

Boxes checked
on 6a and 6b
No. of children
on 6c who:
• lived with you
• did not live with
you due to divorce
or separation
(see instructions)

If more than four
dependents, see
instructions and
check here ▶

Income

Make sure the SSN(s) above
and on line 6c are correct.

Total number of exemptions claimed

.

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7

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8b
. .

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8a

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9a

10
11

Qualified dividends . . . . . . . . . . .
9b
Taxable refunds, credits, or offsets of state and local income taxes
Alimony received . . . . . . . . . . . . . . .

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10
11

12
13
14

Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . .
Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶
Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . .

.

12
13
14

15a
16a
17

IRA distributions .
15a
b Taxable amount
. . .
Pensions and annuities 16a
b Taxable amount
. . .
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E

15b
16b
17

18
19
20a

Farm income or (loss). Attach Schedule F .
Unemployment compensation . . . .
Social security benefits 20a

18
19
20b

21
22

See Line 21 Statement
Other income. List type and amount
Combine the amounts in the far right column for lines 7 through 21. This is your total income

7

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

.

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.

.

8a
b
9a

Taxable interest. Attach Schedule B if required .
Tax-exempt interest. Do not include on line 8a .
Ordinary dividends. Attach Schedule B if required

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b

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.
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. . . . . .
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b Taxable amount

23

Educator expenses

24

Certain business expenses of reservists, performing artists, and
fee-basis government officials. Attach Form 2106 or 2106-EZ

25

Health savings account deduction. Attach Form 8889

.

24
25

26
27
28

Moving expenses. Attach Form 3903 . . . . . .
Deductible part of self-employment tax. Attach Schedule SE .
Self-employed SEP, SIMPLE, and qualified plans
. .

26
27
28

29
30
31a

Self-employed health insurance deduction
Penalty on early withdrawal of savings . .

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.
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32
33
34

Alimony paid b Recipient’s SSN ▶
IRA deduction . . . . . . .
Student loan interest deduction . .
Tuition and fees. Attach Form 8917 .

29
30
31a

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32
33
34

35
36
37

Domestic production activities deduction. Attach Form 8903
35
Add lines 23 through 35 . . . . . . . . . . . . .
Subtract line 36 from line 22. This is your adjusted gross income

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▶

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Add numbers on
lines above ▶

2

0.

21
22

0.
0.

23

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.

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA

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▶

36
37

REV 03/03/14 TTO

0.
Form

1040

(2013)

Page 2

Form 1040 (2013)

Tax and
Credits
Standard
Deduction
for—
• People who
check any
box on line
39a or 39b or
who can be
claimed as a
dependent,
see
instructions.
• All others:
Single or
Married filing
separately,
$6,100
Married filing
jointly or
Qualifying
widow(er),
$12,200
Head of
household,
$8,950

Other
Taxes

38

Amount from line 37 (adjusted gross income)

39a

Check
if:

b

If you have a
qualifying
child, attach
Schedule EIC.

Refund

Sign
Here

Paid
Preparer
Use Only

.

You were born before January 2, 1949,
Spouse was born before January 2, 1949,

.

.

Blind.
Blind.

.

}

.

.

.

.

.

.

Total boxes
checked ▶ 39a

If your spouse itemizes on a separate return or you were a dual-status alien, check

44
45
46

Alternative minimum tax (see instructions). Attach Form 6251 .
Add lines 44 and 45 . . . . . . . . . . . . . .

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.

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b

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. .
8919

.
.

.
.

Credit for child and dependent care expenses. Attach Form 2441

47
48

49
50
51

Education credits from Form 8863, line 19 . . . . .
Retirement savings contributions credit. Attach Form 8880
Child tax credit. Attach Schedule 8812, if required . . .

49
50
51

52
53
54
55

Residential energy credits. Attach Form 5695 . . . .
52
3800 b
8801 c
Other credits from Form: a
53
Add lines 47 through 53. These are your total credits . . . . .
Subtract line 54 from line 46. If line 54 is more than line 46, enter -0-

56
57

Self-employment tax. Attach Schedule SE . . . .
Unreported social security and Medicare tax from Form:

58
59a
b

Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required
Household employment taxes from Schedule H

.

.

.

. . . .
a
4137

▶

.

.

.

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.

First-time homebuyer credit repayment. Attach Form 5405 if required . . . .
Form 8959 b
Form 8960 c
Instructions; enter code(s)
Taxes from: a

.

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.

.

Add lines 55 through 60. This is your total tax

.

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.

.

Federal income tax withheld from Forms W-2 and 1099 . .
2013 estimated tax payments and amount applied from 2012 return

64a
b

Earned income credit (EIC) . . . . . .
Nontaxable combat pay election
64b
Additional child tax credit. Attach Schedule 8812 .

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▶

43
44
45
46

0.

55
56
57

0.

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▶

60
61

0.

62
63
64a
65
66

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67
68

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69
70
71
72

Excess social security and tier 1 RRTA tax withheld . . . .
69
Credit for federal tax on fuels. Attach Form 4136 . . . .
70
Credits from Form: a
2439 b
Reserved c
8885 d
71
Add lines 62, 63, 64a, and 65 through 71. These are your total payments .

73

If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid

74a
b
d

Amount of line 73 you want refunded to you. If Form 8888 is attached, check here . ▶
Routing number
Checking
Savings
X X X X X X X X X ▶ c Type:
Account number
X X X X X X X X X X X X X X X X X
Amount of line 73 you want applied to your 2014 estimated tax ▶ 75
Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions ▶

67
68

77
77
Estimated tax penalty (see instructions) . . . . . . .
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Designee’s
name ▶

13,400.
-13,400.
7,800.
0.
0.

58
59a
59b

American opportunity credit from Form 8863, line 8 .
Reserved . . . . . . . . . . . . .
Amount paid with request for extension to file . .

75
76

40
41
42

54
▶

.

.

62
63

65
66

.
.

.
.

Foreign tax credit. Attach Form 1116 if required .

0.

39b
.
.

.
.

47
48

38

1

here ▶

Exemptions. If line 38 is $150,000 or less, multiply $3,900 by the number on line 6d. Otherwise, see instructions
Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . .
Form 4972 c
Tax (see instructions). Check if any from: a
Form(s) 8814 b

Phone
no. ▶

72
73
74a

76

0.

Yes. Complete below.

No

Personal identification
▶
number (PIN)

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.

Your signature

Date

Your occupation

Spouse’s signature. If a joint return, both must sign.

Date

Spouse’s occupation

▲

Joint return? See
instructions.
Keep a copy for
your records.

.

42
43

▶

Third Party
Designee

.

Itemized deductions (from Schedule A) or your standard deduction (see left margin)
Subtract line 40 from line 38
. . . . . . . . . . . . . . . . .

Direct deposit?
See
▶
instructions.

Amount
You Owe

.

40
41

60
61

Payments

{

.

none

(860)990-8409
If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
PTIN
Check
if
self-employed

none

Print/Type preparer’s name

Firm’s name

Daytime phone number

▶

Firm’s address ▶

Preparer’s signature

Self-Prepared

Date

Firm's EIN

▶

Phone no.
REV 03/03/14 TTO

Form 1040 (2013)

Federal Information Worksheet

2013

G Keep for your records

Part I ' Personal Information

Information in Part I is completely calculated from entries on Personal Information Worksheets.

Taxpayer:
First name
Middle initial
Last name
Social security no.
Occupation
Date of birth
Age as of 1-1-2014
Daytime phone
Legally blind
Date of death

Spouse:
First name
Middle initial
Last name
Social security no.
Occupation
Date of birth
Age as of 1-1-2014
Daytime phone
Legally blind
Date of death

elizabeth
D
Suffix
Supanga
815-10-7192
none
05/05/1946 (mm/dd/yyyy)
67
(860)990-8409 Ext

Efren
O
Suffix
Supanga
889-98-6003
none
03/10/1952 (mm/dd/yyyy)
61
Ext

Dependent of Someone Else:
Can taxpayer be claimed as dependent of another
person (such as parent)?
Yes
X No
If yes, was taxpayer claimed as dependent on that
person’s return?
Yes
No

Dependent of Someone Else:
Can spouse be claimed as dependent of another
person (such as parent)?
Yes
X No
If yes, was spouse claimed as dependent on that
person’s return?
Yes
X No

Credit for the Elderly or Disabled (Schedule R):
Is the taxpayer retired on total
and permanent disability?
Yes
X No

Credit for the Elderly or Disabled (Schedule R):
Is the spouse retired on total
and permanent disability?
Yes
X No

Presidential Election Campaign Fund:
Does the taxpayer want $3 to go to the Presidential
Election Campaign Fund?
Yes
X No

Presidential Election Campaign Fund:
Does the spouse want $3 to go to the Presidential
Election Campaign Fund?
Yes
X No

Part II ' Address and Federal Filing Status (enter information in this section)
Address
97 Farnham Rd
City
South Windsor
Foreign province/county
Foreign code
Foreign country

Apt no.
State
CT
ZIP code
Foreign postal code

APO/FPO/DPO address, check if appropriate
Home phone
Check to print phone number on Form 1040

APO
Home

06074

FPO

X Taxpayer daytime

DPO
Spouse daytime

Federal filing status:
1 Single
X
2 Married filing jointly
3 Married filing separately
Check this box if you did not live with your spouse at any time during the year
Check this box if you are eligible to claim your spouse’s exemption (see Help)
4 Head of household
If the ’qualifying person’ is your child but not your dependent:
Child’s First name
MI
Last Name
Child’s social security number
5 Qualifying widow(er)
Check the appropriate box for the year your spouse died

Suff
2011
2012

Part III ' Dependent/Earned Income Credit/Child and Dependent Care Credit Information
Information in Part III is completely calculated from entries on Dependent/Nondependent Info Worksheets.
Date of birth
(mm/dd/yyyy)

First name
Last name

MI
Suff

Social security
number
Relationship

Age

C
o
d
e

Not
qual
for
child
tax cr

* "Yes" - qualifies as dependent, "No" - does not qualify as dependent

Qualified
child/dep
care exps
incurred
and paid
2013

E
I
C

Lived
with
taxpyr
in
U.S.

Educ
Tuitn
and
Fees

*
D
e
p

elizabeth D & Efren

O Supanga

Page 2

815-10-7192

Part IV ' Earned Income Credit Information (you must answer these questions to calculate EIC)
Is the taxpayer or spouse a qualifying child for EIC for another person?
Was the taxpayer’s (and spouse’s if married filing jointly) home in the United States
for more than half of 2013?
If the SSN of the taxpayer, or spouse if married filing jointly, was obtained to
get a federally funded benefit, such as Medicaid, and the Social Security card
contains the legend Not Valid for Employment, check this box (see Help)
Check if you are filing head of household and your spouse is a nonresident alien
and you lived with your spouse during the last six months of 2013
Was EIC disallowed or reduced in a previous year and are you required to file
Form 8862 this year?
Check if you were notified by the IRS that EIC cannot be claimed in 2013 or
if you are ineligible to claim the EIC in 2013 for any other reason

Yes

No

Yes

No

Yes

No

Part V ' Direct Deposit or Direct Debit Information (not applicable for Form 9465)
Do you want to elect direct deposit of any federal tax refund?

Yes

X

No

Do you want to elect direct debit of federal balance due (Electronic filing only)?

Yes

X

No

If you selected either of the options above, fill out the information below:
Name of Financial Institution (optional)
Check the appropriate box
Checking
Routing number
Account number

Savings

Enter the following information only if you are requesting direct debit of balance due:
Enter the payment date to withdraw from the account above
Balance-due amount from this return

Part VI ' Additional Information for Your Federal Return
Standard Deduction/Itemized Deductions:
Check this box if you are itemizing for state tax or other purposes even though your itemized
deductions are less than your standard deduction
Check this box if you are married filing separately and your spouse itemized deductions
Check this box to take the standard deduction even if less than itemized deductions
Main Form Selection:
Check this box to calculate Form 1040 even if you qualify to use Form 1040A or 1040EZ
Real Estate Professionals:
Do you or your spouse qualify for the special passive activity rules for
taxpayers in real property business? (see Help)

Yes

No

Credit for Qualified Retirement Savings Contributions (Form 8880):
Is the taxpayer a full-time student?
Is the spouse a full-time student?

Yes
Yes

No
No

Foreign Tax Credit (Form 1116):
Check this box to file Form 1116 even if you’re not required to file Form 1116
Resident country

USA

Excludable Income from Am. Samoa, Guam, Commonwealth of the N. Mariana Islands, or Puerto Rico:
Excludable income of bona fide residents of American Samoa, Guam, or the
Commonwealth of the Northern Mariana Islands
Excludable income from Puerto Rico
Dual Status Alien Return:
Check this box if you are a dual-status alien
Third Party Designee:
Caution: Review transferred information for accuracy.
Do you want to allow another person to discuss this return with the IRS?
Yes
If Yes, complete the following:
Third party designee name
Third party designee phone number
Personal Identification number (enter any 5 numbers)
If you are entitled to a filing extension or other disaster relief provision as declared by the IRS,
enter the appropriate information (see Help)

No

elizabeth D & Efren

O Supanga

815-10-7192

Page 3

Part VI ' Additional Information for Your Federal Return - Continued
Personal Representative for deceased taxpayers:
Name of personal representative required for E-filed
returns when Form 1310 is not filed or it is not the
surviving spouse

Part VII ' State Filing Information
Identity Protection PIN:
If the IRS sent the taxpayer an Identity Protection PIN, enter it here
If the IRS sent the spouse an Identity Protection PIN, enter it here

Taxpayer:
Enter the taxpayer’s state of residence as of December 31, 2013
Check the appropriate box:
Taxpayer is a resident of the state above for the entire year
Taxpayer is a resident of the state above for only part of year
Date the taxpayer established residence in state above
In which state (or foreign country) did the taxpayer reside before this change?

CT
X

Spouse:
Enter the spouse’s state of residence as of December 31, 2013
Check the appropriate box:
Spouse is a resident of the state above for the entire year
Spouse is a resident of the state above for only part of year
Date the spouse established residence in state above
In which state (or foreign country) did the spouse reside before this change?

Nonresident states:
Nonresident State(s)

Taxpayer/Spouse/Joint

Check this box if you are in a Registered Domestic Partnership or a civil union
If you checked the box on the line above, also check the appropriate box below:
Check if this is your individual federal return you are filing with the IRS
Check if this is the joint return created to file joint state tax return (see Help)
Check this box if you are in a same-sex marriage
If you checked the box on the line above, also check the appropriate box below:
Check if this is your federal return to be filed.
Check if this is your individual return for filing state return only (see Help)

CT
X

Personal Information Worksheet
For the Taxpayer

2013

G Keep for your records
QuickZoom to another copy of Personal Information Worksheet
QuickZoom to Federal Information Worksheet

Part I ' Taxpayer's Personal Information
First name

Social security no.

815-10-7192

Date of birth

05/05/1946

Occupation

Middle initial

Last name
Supanga
Suffix
Member of U.S. Armed Forces in 2013?
Yes

elizabeth

(mm/dd/yyyy)

none

D

age as of 1-1-2014
Daytime phone

67

(860)990-8409

Marital status
Married
If widowed, check the appropriate box for the year your spouse died:
After 2013
2013
2012
2011
Are you retired on total and permanent disability? (for Schedule R, see Help).
Check if this person is legally blind
If deceased, enter the date of death

No

X

Ext

Before 2011
Yes

X

No

(mm/dd/yyyy)

Were you under the age of 16 as of 1-1-2014 and this is the first year you
are filing a tax return?

Yes

Do you want $3 to go to Presidential Election Campaign Fund?

Yes

No

X

No

Part II ' Questions for Individuals Who Could Be Or Are Dependents of Another Taxpayer
1 Can someone (such as your parent) claim you as a dependent?
2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return?
Questions 3 through 5 are only required for individuals who claim the
American Opportunity Credit.
3 Were you a full-time student during any part of five months during 2013?
4 Did your earned income exceed one-half of your support?
5 Was at least one of your parents alive on December 31, 2013?

Yes

X

Yes

Yes
Yes
Yes

No
No

X

No
No
No

Part III ' Taxpayer's State Residency Information
Enter this person’s state of residence as of December 31, 2013
Check the appropriate box:
This person is a resident of the state above for the entire year
This person is a resident of the state above for only part of year
Date this person established residence in state above
In which state (or foreign country) did this person reside before this change?

Part IV ' Dependent Care Expenses
Qualified dependent care expenses incurred and paid for this person in 2013

CT
X

Personal Information Worksheet
For the Spouse

2013

G Keep for your records
QuickZoom to another copy of Personal Information Worksheet
QuickZoom to Federal Information Worksheet

Part I ' Spouse's Personal Information
First name

Middle initial

Social security no.

889-98-6003

Date of birth

03/10/1952

Occupation

Last name
Supanga
Suffix
Member of U.S. Armed Forces in 2013?
Yes

Efren

(mm/dd/yyyy)

none

O

age as of 1-1-2014

No

61

Daytime phone

Ext

Marital status
If widowed, check the appropriate box for the year your spouse died:
After 2013
2013
2012
2011
Are you retired on total and permanent disability? (for Schedule R, see Help).
Check if this person is legally blind
If deceased, enter the date of death

Before 2011
Yes

X

No

(mm/dd/yyyy)

Were you under the age of 16 as of 1-1-2014 and this is the first year you
are filing a tax return?

Yes

Do you want $3 to go to Presidential Election Campaign Fund?

Yes

No

X

No

Part II ' Questions for Individuals Who Could Be Or Are Dependents of Another Taxpayer
1 Can someone (such as your parent) claim you as a dependent?
2 If you answered ’Yes’ to question 1, are you actually claimed as a dependent
on that person’s tax return?
Questions 3 through 5 are only required for individuals who claim the
American Opportunity Credit.
3 Were you a full-time student during any part of five months during 2013?
4 Did your earned income exceed one-half of your support?
5 Was at least one of your parents alive on December 31, 2013?

Yes

X

No

Yes

X

No

Yes
Yes
Yes

No
No
No

Part III ' Spouse's State Residency Information
Enter this person’s state of residence as of December 31, 2013
Check the appropriate box:
This person is a resident of the state above for the entire year
This person is a resident of the state above for only part of year
Date this person established residence in state above
In which state (or foreign country) did this person reside before this change?

Part IV ' Dependent Care Expenses
Qualified dependent care expenses incurred and paid for this person in 2013

CT
X

Federal Carryover Worksheet

2013

G Keep for your records
Name(s) Shown on Return

elizabeth D & Efren

Social Security Number

O Supanga

815-10-7192

2012 State and Local Income Tax Information (See Tax Help)
(a)
State or
Local ID

(b)
Paid With
Extension

(c)
Estimates Pd
After 12/31

(d)
Total Withheld/Pmts

(e)
Paid With
Return

(f)
Total Overpayment

(g)
Applied
Amount

Totals
Other Tax and Income Information
1
2
3
4
5
6
7
8

2012

Filing status
Number of exemptions for blind or over 65 (0 - 4)
Itemized deductions
Check box if required to itemize deductions
Adjusted gross income
Tax liability for Form 2210 or Form 2210-F
Alternative minimum tax
Federal overpayment applied to next year estimated tax

1
2
3
4
5
6
7
8

2013

2 MFJ
1
0.
0.
0.

QuickZoom to the IRA Information Worksheet for IRA information

Excess Contributions
9a
b
10 a
b
11 a
b

Taxpayer’s excess Archer MSA contributions as of 12/31
Spouse’s excess Archer MSA contributions as of 12/31
Taxpayer’s excess Coverdell ESA contributions as of 12/31
Spouse’s excess Coverdell ESA contributions as of 12/31
Taxpayer’s excess HSA contributions as of 12/31
Spouse’s excess HSA contributions as of 12/31

2013
2012
2011
2010
2009
2008

2013

2012

2013

9a
b
10 a
b
11 a
b

Loss and Expense Carryovers
Note: Enter all entries as a positive amount
12 a Short-term capital loss
b AMT Short-term capital loss
13 a Long-term capital loss
b AMT Long-term capital loss
14 a Net operating loss available to carry forward
b AMT Net operating loss available to carry forward
15 a Investment interest expense disallowed
b AMT Investment interest expense disallowed
16 Nonrecaptured net Section 1231 losses from:
a
b
c
d
e
f

2012

12 a
b
13 a
b
14 a
b
15 a
b
16 a
b
c
d
e
f

Tax Summary

2013

G Keep for your records

Name (s)
elizabeth D & Efren

O Supanga

Total income
Adjustments to income
Adjusted gross income
Itemized/standard deduction
Exemption amount
Taxable income
Tentative tax
Additional taxes
Alternative minimum tax
Total credits
Other taxes
Total tax
Total payments
Estimated tax penalty
Amount Overpaid
Refund
Amount Applied to Estimate
Balance due
Which Form 1040 to file?
You must use Form 1040 because
you had miscellaneous taxable income(loss).

0.
0.
13,400.
7,800.
0.
0.

0.

Compare to U. S. Averages

2013

G Keep for your records
Name(s) Shown on Return

elizabeth D & Efren

Social Security No

O Supanga

Your 2013 adjusted gross income (AGI)
National adjusted gross income range used below

815-10-7192

from

0. to

0.
14,999.

Note: National average amounts have been adjusted for inflation. See Help for details.

Selected Income, Deductions, and Credits

Actual
Per Return

National
Average

Salaries and wages
Taxable interest
Tax-exempt interest
Dividends
Business net income
Business net loss
Net capital gain
Net capital loss
Taxable IRA
Taxable pensions and annuities
Rent and royalty net income
Rent and royalty net loss
Partnership and S corporation net income
Partnership and S corporation net loss
Taxable social security benefits

8,513.
1,316.
6,737.
2,120.
7,928.
17,944.
8,388.
2,434.
5,535.
7,012.
8,222.
16,359.
17,436.
91,448.
3,523.

Medical and dental expenses deduction
Taxes paid deduction
Interest paid deduction
Charitable contributions deduction
Total itemized deductions

8,635.
3,244.
7,666.
1,492.
15,524.

Child care credit
Education tax credits
Child tax credit
Retirement savings contributions credit
Earned income credit
Other Information

Adjusted gross income
Taxable income
Income tax
Alternative minimum tax
Total tax liability

126.
259.
132.
175.
1,935.
Actual
Per Return

National
Average

0.
0.
0.
0.

2,542.
2,827.
306.
8,995.
458.

elizabeth D & Efren O Supanga

815-10-7192

1

Smart Worksheets from your 2013 Federal Tax Return
SMART WORKSHEET FOR: Form 1040: Individual Tax Return
Other Adjustments to Income Smart Worksheet
A

Foreign housing deduction
QuickZoom to Form 2555 for taxpayer
Jury duty pay given to employer
Reforestation amortization and expenses
Repayment of sub-pay under the Trade Act of 1974
Expenses from the rental of personal property
Contributions to section 501(c)(18)(D) pension plans
Archer MSA deduction. Attach Form 8853

B
C
D
E
F
G
H

and/or for spouse

0.

0.

SMART WORKSHEET FOR: Form 1040: Individual Tax Return
Tax Smart Worksheet
A
1
2
3
4
5
6
7
B
C
D
E
F
G

Tax
Check if from:
Tax table
Tax Computation Worksheet (see instructions)
Schedule D Tax Worksheet
Qualified Dividends and Capital Gain Tax Worksheet
Schedule J
Form 8615
Foreign Earned Income Tax Worksheet
Additional tax from Form 8814
Additional tax from Form 4972
Tax from additional Form(s) 4972
Recapture tax from Form 8863
IRC Section 197(f)(9)(B)(ii) election for an additional tax
Tax. Add lines A through F. Enter the result here and on line 44

0.
X

0.

SMART WORKSHEET FOR: Form 1040: Individual Tax Return
Other Credits Smart Worksheet
A
B
C
D
E
F

Form 3800 Credit
Form 8396 Credit
Form 8801 Credit
Form 8834 Credit
Form 8839 Credit
Form 8859 Credit

G
H
I
J
K

Form 8910 Credit
Form 8911 Credit
Schedule R
Form 8936 Credit
Form
Credit

0.

elizabeth D & Efren O Supanga

815-10-7192

1

Additional information from your 2013 Federal Tax Return
Some forms were not able to fit all of the information you entered. We've included this information below.

Form 1040: Individual Tax Return
Line 21 - Other Income

Continuation Statement
Description

Amount

Recovery of Bad Debts deducted in prior year

0.

Jury Duty Pay

0.

Bartering Income not Reported Elsewhere

0.

Personal Property Rental Income

0.

Not for Profit Activity Income

0.

Total

0.

Electronic Filing Instructions for your 2013 Connecticut Tax Return
Important: Your taxes are not finished until all required steps are completed.

elizabeth D & Efren O Supanga
97 FARNHAM RD
SOUTH WINDSOR, CT 06074
|

Balance
| Your Connecticut state tax return (Form CT-1040) shows that you have
Due/
| no balance due nor a refund due to you: DO NOT mail a payment or
Refund
| expect to receive a refund from the Connecticut Department of Revenue.
______________________________________________________________________________________
|
|

No
| No signature form is required since you signed your return
Signature
| electronically.
Document
|
Needed
|
______________________________________________________________________________________
|
|

What You
| Your Electronic Filing Instructions (this form)
Need to
| Printed copy of your state and federal returns
Keep
|
______________________________________________________________________________________
|
|

2013
| Taxable Income
$
0.00
Connecticut
| Total Tax
$
0.00
Tax
| No Refund or Amount Due
$
0.00
Return
|
Summary
|
______________________________________________________________________________________
|

Page 1 of 1

elizabeth D & Efren

O Supa

Do not send this sheet with your return.
Checklist for ſling your Connecticut income tax return:
1.

Be sure that Page 1 of your return is not printed on the back of this sheet.

2.

Verify that the address lines on the return are correct and proper abbreviations are used.

3.

If the Employer or Payer’s Federal ID # is not listed on Page 2, Lines 18a through 18g, Column A, all withholding
claimed will be disallowed and your return will not be successfully processed.

4.

Do not attempt to remove or modify the solid boxes that print out on your return. Altering target marks may affect the
processing of your return.

5.

Do not send “Draft” or “Unapproved” versions of your return. This will delay or stop the processing of your return.

6.

Do not make manual (hand written or typed) corrections to your return; this is a machine readable return. Changes
may only be made by reentering information in your software and re-printing the return.

7.

Do not use this return to change or amend previously ſled returns. You must use Form CT-1040X to change or amend
a previously ſled Connecticut income tax return. (File Form CT-1040X electronically at www.ct.gov/TSC using the
Taxpayer Service Center.)

8.

Do not attach or send copies of forms W-2 or 1099.

9.

Send all completed pages of CT-1040 and Schedule CT-EITC. Send all four pages of your completed return, both
pages of your completed CT EITC schedule, and any other supporting schedules.

10.

Make check payable to: Commissioner of Revenue Services

11.

To ensure proper posting, write your SSN(s) (optional) and “2013 Form CT-1040” on your check.

12.

To mail your return, use the following addresses:
For all tax returns with payment:
Department of Revenue Services
PO Box 2935
Hartford CT 06104-2935
For refunds and tax returns without payment:
Department of Revenue Services
PO Box 5002
Hartford CT 06102-5002

13.

Verify that all ſelds print completely and any preparer information is ſlled out and legible before ſling this return. If
you ſnd any errors, do not make manual changes. Re-enter information in your software and re-print the return.

14.

If you wish to directly deposit a refund into a checking or savings bank account, conſrm that Lines 25a through 25d
have been completed. You must enter bank information on both the federal and Connecticut returns for each to be
correctly deposited.

Do not send this sheet with your return.

REV 03/09/14 TTO

20
1301115554

Form CT-1040 - 2013, Page 1 of 4
Connecticut Resident Income Tax Return

2013

Other taxable year, beginning:

N

S

Y

N

FJ

and ending:

N

FS

HH

N

815 - 10 - 7192

889 - 98 - 6003

ELIZABETH

D

SUPANGA

N

Dec.

EFREN

O

SUPANGA

N

Dec.

97 FARNHAM RD
N
SOUTH WINDSOR

Clip check here. Do not staple.
Do not send W-2 or 1099 forms.



QW

CT

06074

CT-8379



1301115554
REV 03/06/14 TTO

CT-2210

N

CT-1040CRC



1. Federal adjusted gross income (from federal Form 1040, Line 37; Form 1040A, Line 21; or
Form 1040EZ, Line 4)
2. Additions to federal adjusted gross income (from Schedule 1, Line 39)
3. Add Line 1 and Line 2
4. Subtractions from federal adjusted gross income (from Schedule 1, Line 50)
5. Connecticut adjusted gross income: Line 4 subtracted from Line 3.
6. Income tax
7. Credit for income taxes paid to qualifying jurisdictions (from Schedule 2, Line 59)
8. Line 7 subtracted from Line 6. If Line 7 is greater than Line 6, “0” is entered.
9. Connecticut alternative minimum tax (from Form CT-6251)
10. Add Line 8 and Line 9.
11. Credit for property taxes paid on your primary residence, motor vehicle, or both (from Schedule 3, Line 68)
12. Line 11 subtracted from Line 10. If less than zero, “0” is entered.
13. Total allowable credits (from Schedule CT-IT Credit, Part 1, Line 11)
14. Connecticut income tax: Line 13 subtracted from Line 12. If less than zero, “0” is entered.
15. Individual use tax (from Schedule 4, Line 69). If no tax is due, “0” is entered.
16. Total tax: Add Line 14 and Line 15.

1301115554

N

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

1301215552

Form CT-1040, Page 2 of 4


17. 

17. Amount from Line 16
W-2, W-2G, and 1099 Information
Col. A - Employer or Payer’s Fed. ID #
Col. B - CT Wages, Tips, etc.

-

18a.
18b.
18c.
18d.
18e.
18f.
18g.

815107192









0

Col. C - CT Income Tax Withheld

0
0
0
0
0
0
0

0
0
0
0
0
0
0
0

18h. Additional Connecticut withholding (from Supplemental Schedule CT-1040WH, Line 3) 18h.
18.
19.
20.
20a.
21.
22.
23.

0
0
0
0
0
0
0

24. Total contributions of refund to designated charities (from Schedule 5, Line 70)

24.

0

25. Refund: Lines 23 and 24 subtracted from Line 22.
If you have not elected to direct deposit, the refund may be issued by debit card or check.

25.

0

25e.
26.
27.

0
0

28.
29.
30.

0
0
0

18. Total Connecticut income tax withheld: Amounts in Column C.
19. All 2013 estimated tax payments and any overpayments applied from a prior year
20. Payments made with Form CT-1040 EXT
20a. Earned income tax credit (from Schedule CT-EITC, Line 16)
21. Total payments: Add Lines 18, 19, 20, and 20a.
22. Overpayment: If Line 21 is more than Line 17, Line 17 subtracted from Line 21.
23. Amount of Line 22 you want applied to your 2014 estimated tax

25a. Acct. type

Ck.

Sv.

25b. Rout. #

25c. Acct. #

25d. Refund going to a bank account outside the U.S. 25d.
25e. Debit card
26. Tax due: If Line 17 is more than Line 21, Line 21 subtracted from Line 17.
27. If late: Penalty entered. Line 26 multiplied by 10% (.10).
28. If late: Interest entered.
Line 26 multiplied by number of months or fraction of a month late, then by 1% (.01).
29. Interest on underpayment of estimated tax (from Form CT-2210)
30. Total amount due: Add Lines 26 through 29.

I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to
the best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return
or document to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both. The declaration of
a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.
Your signature

Sign Here


Keep a copy for your records.

Home/cell telephone number

Date



Spouse’s signature (if joint return)

Date



Daytime telephone number



Paid preparer’s signature



Date



Telephone number

Preparer’s SSN or PTIN





Firm’s name, address, and ZIP code

FEIN

 SELF-PREPARED
Third Party Designee - Complete the following to authorize DRS to contact another person about this return.
Designee’s name

Telephone number





1301215552

Personal identification number (PIN)



1301215552
REV 03/06/14 TTO

1301315550



Form CT-1040, Page 3 of 4

815107192

Schedule 1 - Modifications to Federal Adjusted Gross Income
31. Interest on state and local government obligations other than Connecticut
32. Mutual fund exempt-interest dividends from non-Connecticut state or municipal government
obligations
33. Reserved for future use.
34. Taxable amount of lump-sum distributions from qualified plans not included in federal adjusted
gross income
35. Beneficiary’s share of Connecticut fiduciary adjustment: Entered only if greater than zero.
36. Loss on sale of Connecticut state and local government bonds
37. Domestic production activities (from federal Form 1040, Line 35)

31.

0

32.
33.

0

34.
35.
36.
37.

0
0
0
0

38. Other - specify 

38.

0

39. Total additions: Add Lines 31 through 38.
40. Interest on U.S. government obligations
41. Exempt dividends from certain qualifying mutual funds derived from U.S. government obligations
42. Social Security benefit adjustment (from Social Security Benefit Adjustment Worksheet)
43. Refunds of state and local income taxes
44. Tier 1 and Tier 2 railroad retirement benefits and supplemental annuities
45. 50% of military retirement pay
46. Beneficiary’s share of Connecticut fiduciary adjustment: Entered only if less than zero.
47. Gain on sale of Connecticut state and local government bonds

39.
40.
41.
42.
43.
44.
45.
46.
47.

0
0
0
0
0
0
0
0
0

48. CHET contributions

48.

0

49. Other - specify 

49.

0

50. Total subtractions: Add Lines 40 through 49.

50.

0

Schedule 2 - Credit for Income Taxes Paid to Qualifying Jurisdictions
51. Modified Connecticut adjusted gross income

51.

0

Acct. #:

Col. A
52. Qualifying jurisdiction’s name and two-letter code

52.

Col. B





53. Non-Connecticut income included on Line 51 and reported
on a qualifying jurisdiction’s income tax return

53.

0

0

54. Line 53 divided by Line 51

54.

0.0000

0.0000

55. Income tax liability: Line 11 subtracted from Line 6.

55.

0

0

56. Line 54 multiplied by Line 55

56.

0

0

57. Income tax paid to a qualifying jurisdiction

57.

0

0

58. Lesser of Line 56 or Line 57

58.

0

0

59. Total credit: Add Line 58, all columns.

59.

1301315550

1301315550
REV 03/06/14 TTO

0

Form CT-1040, Page 4 of 4

1301415558
Schedule 3 - Property Tax Credit
Qualifying Property
Name of Connecticut Tax Town or District
Description of Property
Date(s) Paid
Amount Paid

Primary Residence

815107192

Auto 1

Auto 2










60.



0






0

61.

0

62.

0

63. Total property tax paid: Add Lines 60, 61, and 62.

63.

64. Maximum property tax credit allowed

64.



300

65. Lesser of Line 63 or Line 64.

65.



0

66. Property tax credit limitation decimal amount: If zero, the amount from Line 65 is entered on Line 68.

66.



0.00

67. Line 65 multiplied by Line 66.

67.



0

68. Line 67 subtracted from Line 65.

68.

0

Schedule 4 - Individual Use Tax
69a. Use tax at 1% (from Connecticut Individual Use Tax Worksheet, Section A, Column 7)

69a.

0

69b. Use tax at 6.35% (from Connecticut Individual Use Tax Worksheet, Section B, Column 7)

69b.

0

69c. Use tax at 7% (from Connecticut Individual Use Tax Worksheet, Section C, Column 7)

69c.

0

69. Individual use tax: Add Lines 69a, 69b, and 69c.

69.



0

Schedule 5 - Contributions to Designated Charities
70a. AR

70a.

0

70b. OT

70b.

0

70c. ES/W

70c.

0

70d. BCR

70d.

0

70e. SNS

70e.

0

70f. MFRF

70f.

0

70. Total Contributions: Add Lines 70a through 70f.

70.

Taxpayer email

1301415558

1301415558
REV 03/06/14 TTO



0

Connecticut Information Worksheet

2013

G Keep for your records
Part I ' Personal Information
Taxpayer:
Spouse:
Last Name
Supanga
Last Name
Supanga
First Name
elizabeth
First Name
Efren
Middle Initial
D
Suffix
Middle Initial
O
Suffix
Social Security No.
815-10-7192
Social Security No.
889-98-6003
Date of Birth
05/05/1946
Date of Birth
03/10/1952
Date of Death
Date of Death
Daytime Phone
(860)990-8409 *
Daytime Phone
Home Phone
*
Home Phone
* Check one box for taxpayer and one box for spouse to print daytime phone numbers on Form CT-1040
or CT-1040NR, page 2. Check daytime or home box to print on Form CT-1040EXT or CT-1040X.
Address
97 FARNHAM RD
City
SOUTH WINDSOR
State
Taxpayer email address
[email protected]

Apt no.

CT

ZIP Code

06074

Connecticut forms provide only two lines of 30 characters each for the main address (not including City,
State, and Zip). We may have abbreviated certain words in your address. If the address below is
incorrect or incomplete, please adjust. If using "c/o" or "Attn:", enter these on the first Address line only.
Address, Line 1 97 FARNHAM RD
Address, Line 2

Part II ' Main Form
Form CT-1040: Resident Tax Return (Long form)
Form CT-1040NR/PY: Nonresident Tax Return
Form CT-1040NR/PY: Part-Year Resident Tax Return
Connecticut residency dates (use MM/DD/YYYY format)
From

X

To

Part III ' Filing Status

X

*
*

Single
Married filing jointly
Married filing separately
Spouse’s full name
Spouse’s social security number
Taxpayer did not live with spouse for the entire year
Head of household (with qualifying person)
Qualifying widow(er) with dependent child

Part IV ' Other Information
I qualify as a farmer or fisherman
Yes No
X My city and zip code of residence are different than what’s entered above
If so, enter resident City
5 digit resident Zip code

elizabeth D & Efren

O Supanga

815-10-7192

Part V ' Direct Deposit Information or Direct Debit Information
Yes No

X Elect direct deposit of state tax refund
Use direct debit of state tax payment (Electronic Filing Only)
Bank Information:
If you selected either of the options above, fill out the information below:
Name of Financial Institution (optional)
Account type
Checking
Savings
Routing number
Account number
Payment date to withdraw from the account above
State balance-due amount from this return
Yes No
Elect to receive a state issued debit card instead of a paper check

International ACH Transactions
Yes No
Will the funds for this refund (or payment) go to (or come from) an account outside the U.S.?

Part VI ' Third Party Designee Information
Yes No
Do you want to allow another person to discuss this return with Connecticut?
If Yes, complete the following:
Designee’s name
Designee’s phone number
Personal identification number

Part VII ' Extension Status
Yes No

X Tax return due date extended?
Extended due date
QuickZoom to Form CT-1040 EXT: Application for Extension of Time to File Inc Tax Return
Part VIII ' Amended Return
Filing a Connecticut amended return
Enter the tax year you are amending
Previous Connecticut payment made
Previous Connecticut refund received
QuickZoom to Form CT1040-X: Amended Income Tax Return
QuickZoom to Form CT-1040: Resident Income Tax Return
QuickZoom to Form CT-1040NR/PY: Nonresident and Part-Year Resident Income Tax Return
ctiw1201.SCR 03/05/14

Page 2