2005

2006

2007

2008

2009

Type of return – single/ joint

Date filed

Return prepared by:

Income items

·         Wages

·         Dividends

·         Interest

·         Long term capital gains

·         Short term capital gains

·         Retirement plan income

·         Business income

·         Other income

Adjusted gross income

Deduction items

·         Mortgage interest

·         Other interest

·         Property taxes

·         State income taxes

·         Other taxes

·         Charitable contributions

·         Deductible medical exp.

·         Other deductions

# Exemptions claimed

Taxable income

Regular income tax

Alternative minimum tax

Self employment tax

Total tax

Taxes withheld

Estimated taxes paid

Taxes due (refund)