~1~ ~ ~ ~~- ~ ~c

Far the year Jan. t-k~.3i. 2039,ar ath~ tax year beglnnir~ 20~,emding ,2b ~; {'8 PrV~. `f545~EJ74
La~33t-;'~ ~ Your first name and initial Last natrae Your saciai s~uriRy number

i .~2io~,s ~
on 9~.) E If a join4 return, mouse's fast name and initial Las4 name '~ sc~c€~! si r
itae the iR5 ~'
Label. H Home address(number and treat). 1f you have a P.O. box, see page 1 A. Rpt. no. ~r ~y~~ ~Y~~
O~itersaris€3, E
pie~se print R
r tawn r ffic stet ZiP cnd . ff u have fi na res ,sQe page ~ 4. ~ ~ x y~ ~y~~~
Or ty~. E
~at~a Yom't~s or r ~rsd.
Pr~~sas#sattfal o.,
~ftott C~ttr~p~ig+ a Gk~c~ck h~r~ i€ y~ ,a~ yn~r spo~ss~ if ~i€n~ j~Entt~. ~tan~ ti to tE~~ €c~n~ ~ s 14) 1►
i ~~ 8 4 ❑ #fi~ad of ~St ha~si {w~t#s ~}~f'tfyin~ ark,{fie ¢ 1~.)Ef ~s
~`IffTlt~ .~. ~r'I~ttS
2 ~"`h?t~rr J fltii3g jtsisttiy(sv~ '€i cs~~; oz~e ham! i~~r~'s~j ~~Y~+'~J ~'; iS a d°ti3d t~ tit Yr~trr d tt~t<,[iatt~a i)tsS
Gts~ck only one s C..~ ~Sarr €i g se rat .~r~tsr ss~~s ~sa~ve c~hil~'s name #tee. a►
box. ar~8 fug t~~ tire. A S (j ~ivatifyirtg sis~tl~rs~*~er) tests 't2 iki ~e tom'!&}
Ii e~rrn~ cS s~ yr~ ~s a end~t, d~ ~a# cts k Racy 6~ .
~icem~rtians ~ ~~ ~~ ~.~
b FAO. cs# n
C
errs Bc
A ~yq~1 3 ptYit
&AGE 58EUftfj f1ltFfif3~7 €fS42tlCtflBfT[p t4f ~ffi3 ~ ~~3 C #&7F
{~~ Fi7'SE ti811Y8 L85E ff.~i'ttL C~*Sd 3`~
f—~ S7 e s3t3t a*d~
y9tti ~@
u flY C~'f
If more than four g
ds ds~ts,s~
page 17 and ---~--.__ _Q..~ ~ ~
chec#s hire ► ❑
d To#s3 nut of ii~~es ~Sa~ s
7 ~lages, s~# i~s, ti~zs, ei~ Att2~Ps ~arft'i{s) ~l-2
$t°!Cf}t'CIG
S~ T big Ot t. ,~itac#s Scl~~u~ 8 +f r~t{It §
b ~C~H°S3C~Y12~3'$ ~3i4~t'~S$. ~C# #iG#~ t3S~~~~ Cbfl ITflB E~ ~ $~
ABC#'! ~t8iTl9(s'
~A Qf~~£1.~3'gf ~f;~5. A~,~L 3 u' 1~ ~ ~ i'F3t~Lfli'~
1~4iT-21t8Ye. AFs~p
a#ia~~ ~o~°ms b t~~3fsfii~ci cfiviii~atd~ ( J78~e
tad-2G arsd f0 Tana e refLsnti~, Grec#ifs, c~ ~f R~ ~# sty€~ l lace# tncc e tax~.s #see page ~3j
its-R if ta~c 1't ~irt'~cmy dived
v~a~ xar}#f~h~►d.
92 S ii~ress 8tsc~artt~ c=r {k }. Attu Sa il~hx~e C or G-~Z .
t~ Gapita3 gala or (trams). 6tli~ch Sch to tl # ►~quirsci. !f no# r rsa~, cheek t~ i`
tf you did not ~
94 t?tit~r gai.~ cx {dos s~. 7.
get a 6~1-2,
1~a 3FiA d~s't+~u€i ~ Taxably art~t~rtt ( 2d}
ses page 22.
i~+a P~stsir~rts arui ~~i~s i b T~zat~a amotmt (s~pa~a 2~a}
i7 Ei ta1 reat ss#s~e, rctya#F#~ss. ptraarsfiip~, S r~tfc~s, t€~~~~, etc. ~ita~ S da~1a E
Encicxse, but do
i8 farm #t~rr~ or (toss}. Atta~~ ~~1t~dt~~ E .
not attach, any
~~ #3r~t 6~Yt' n#titan ~t s~cr afi .4#~► Per" r~iFi~rt ( page 2?}
{~saYt tf. Also,
pE e use 5~s~i~t ~t ~_ ~ t,~ t~ b Tae ~,trroc~rt { #z~: 27}
~a~°~n ot~#o-V. 21 C?ttr~ nr~ste. #.~~t type arFsi mtauni {see ~ 2~3) ~__.._.„_~_____ ___ _ __..___-_—______..__
~ Add tt~ ttt~s in i3~ fir ' ~~Yat ~~i~~cr~rt ~r !mss 7 fi~resu~#~ ~9. Th'ss ss yrsur tra~at is~v~tts ►
23 Ett~caltar` e zt5ss ~ pu°~a 2~} ~3
~i$~jllS'~@t~ ~g ~nhusir~s5 s~~ 09 c~~'ts, ~rt€~rrung arti~s, are#
Gross faa-his gin„mot oitc~sas. Aet ~tm 21f~i ~' ~~t~-~ 2,~:
~~1~t3i71@ 2~ } 1t#~ savirq~s s.c:~z~rs~E ~ucan.#4ftacts ~~m $6'89
#~#oaring ~xgts~_ A#g~h Et~trrt ~ 3 _ i
27 C?~te-3 ~ a~ -gin rn F tom. Att~~#~ S~ctt~€t~t~ SE 7
2$ St~f-imp ~;3'. ~~~P~. end c~u~lifi~sd piers ~8 ~.._..
~9 S~If-~stp3~p~i h~aft3f irtstir ce d~cE~ectia~ { page 3{73 ___.
~ P ty ern ply csithrf~ i+~f Says'tt~5 . p ~?
~'ia Riimcst~g+p~i b t~s~'s sf'~ SAN) 3Sa _,m__ _
lfiA dsa3~,~ctis?n Ed~ ~a[ge ~,t) 3~ __
33 ~t~ttl~tst i~r+ ent~rest d~dt~ct4~n (sue #safe 34} ~3 ._
34 7't~ffcx~ anc4 f d~xiu~n. ~tT~ch ~ta~ttit 8'17
3~ f7~1 sfic p~'t~tttac~t ~ctnri s~fuc . ~ta~1't ~um~ 89£13 _.
~ Add iiiFt ~3 t~~r~sg~x ~'i2 Ott# 3~ ti~Ctu~} :3S o
~T ~J{i'f}'~tB.€'T ~131E' ~~ ~1't}I73 ~3fC~~. ~iS~. kS ~i'?UY 3t3~it5~ `-~5 3 3TS~f $' ~~
Stt~"s3, ~ ~C't, 8?l(~ P8 1'WtQ7k R 1C~iGY#'~ a4{Ct ~tT~sL;~x ( ~ ~, CaY: t~4II. 9132LN~ ~L7ftTt
Form 1 t~~ (?tiC~l Facie 2
re 37(ad~ustad gross incoanej
,~m ~ti,n
Arrtourti #m 3$
TaX ~iYd ~
39a C~h k ~ tai' You wea~e twin before.tanuary Z, 1845, ❑.Blind. ~ Tat~i bozos ~~`
CfP.~(t8 ~ ❑ g~use was bom t~fore January 2, 1~d-5, ❑ Biind. ch+~ked ► ~9a '~`
g~~~d b If ya.~ ~pau~ i#emizes c~ a sate return o~ yea w^~e a dual-status a~i~, see page 35 a~f k hie Y
Deduction 40s itemised ~eductiona {from Schedule A) ar yaur standard eduction (sse !e~ ►~arg9n)
for--
~ People whn ~ If yc~a era increasing your standard de iu~tfon by pertain real ~t~te taus, n~ry motor
cheek any vehicle t~~s> or a rest disaster loss, attach Schsdut~ L seed deck tie ( pie 35} ,►
box on lire
39a, 39b, or 41 ~ttbtcacfi one 40a from (irte 38 +## .~'~.
40b or who ~~ ~ If Iine 38 is ~i25,it~'1 ~ #ess ancf You did not Rte+ids t~att5`~9 to a taff tern è~,;a::.>::
can be
clairneci as e di~t~e€i €+tdividu~f. mutiipfy 53,6 by the numk~r ten litre ~ci. Othesw}se> see ps~e 37 ~ {'} ~) C~
c#~~nrl~nt, Ta~a~t~ ftt~tsrt~8. Sutsteac# {i ce A2 frarn line 41. If line ~2 is t~tssre titan line 41, wigs' -0- 4±'3
sae page 35. 43
• All others: TB~c {sa8 pat~a 37j. Cluck if any tax is f€r~rrt: a ❑ Form(sj 8814 b ❑ Fom7 4~?2. 44 '~
Single ar 4E+ l~it~mati+t8 miniettvrtt Laic uses page 4D}. Attach Form 5251 +4;a
tdParrie~d filing ► +~
separately, 4S Adti(ice Qd and 45
~~700 47 ~cx i~cr~fit.Attach Farm 111& i~ r~}uir~ . *47
Ntasri~esi filing 4$ Credit ~' chi{d and d~~sxient care expsrrses_ AztaCh Form 2441 48
jointly or
4ualifyin 49 ~cftts~#ts~ et~eciits frt3tit fiomr 88~, lime 29 _ 4~
widose(ar~, 5t!
$1i,40D 50 FEet#reme~t savir~s cant~€bufians crec~if. RtEa~#~ f€r~m 888U
Head of 5i Child tart Crsc~ii (tee ¢ ~ 42) 5t
s2 Gr~siits from Fc~m: ~ ❑ 833fi b ❑8889 c[~ 563 x2 inn 4"
.
~Ei,35o ~~~
53 E} r a~tiits from darn: a ❑ 3800 b ❑88{71 ~ ❑ ~3 ";:~,. y
a4 ~..dti fines 47 fhraugh 53. T?eese are your tot~i aredlits 54
&b St~#ract tine ~ fruer9 line 46. If line ~4 is more than iirr~ 46, enter -Q- ~
58 SeP€-emplayrnent tax. Attach Schedule S~ a ~
~~hLC
57 Unreported social ^~eurfiy ~d Mr~dirare tax from Farm: a ❑ 4337 b ~ $9'I9 _ r?'
TaX~S
5$ Adtlrtians! tart on IR,~s, oitr~r quat~ect r~trc~r~nerst plans, etc. Attach ~o3m ~32~J i# requiter! ~8
53 Addi~s~tal races: a (~ A~lC payrt~ents b [~ Hou~#~d oyrs~tsnt isac~s. Attach Sc#~ H sJ
f0 Adtf links 55 it~rc~u~#a 59, 3ttis is ytuur foist D' 6i3 .~
P~y[i3~ittS 81 Fez# 'sstcc #ax ~ithh~ld from Forms W-2 and iE339 61 ~{,C9 'c~. ?~`'~«<
&2 20x9 estim~#eci t~ p~yt°r~#s 9 air~ari# i~ctftam 2t r~tum S2 ! 3E7 Cs 8~ ~~`
63 Makes °k pay arsd gavemrr~st retiree credits.,4[tactr ~ts~lu€a t~f 63 ~~ ..
If you has° a 6~a E~-ct~d ita~t~tte cr~#st {~iC} ~4a ~~`'~:
qualifying ,::::~:; <~:t4~`~:
, :> ,
b Nontaxab4a comtzat Ray e4ection ~~..,_ ___ <<<:~
child, attach , ~:_.<`
Schedule ElG. Fla Adci"tti l c~tild tax cr~iit. Attach Form 8 12 ~5a `~;~~~~:
frfi R~:func9abte sa~4ucatis~ crsciit €torn dorm ~F€3,{ire i6 ~S `"`
~`~~<y
$7 First-time hoan~tauyer cr~t#ft. Attach dorm 5405 87 4
~9~ a ::n
&& l~rtount paid with re~u~s# for e~ensaon to file(sue page 77_) ~8
69 Excess socsa! security xr~d tier 1 RRTA tas~ v+i4hh~id {s+~ page 72) ~
70 Gramsfrom ftxvn: a[]2439 b ❑ ~136 a[]8841 d ❑&885 7~1 ~1 ,~' ~' ~*a>
~"~`"
79 ,4sid fines 61, 62> 63, &4a. and 65 tl~rou~h 70. Thane are ynur fia~af ps~as4+~n:~ ► .'F'#~ ~ fJ
RefU~ld 72 if litre 73 is rvtare than title fi0, sut~ttract fine 80 fram line 71. This is the arnoimt you ovs~r#~a~sl ?2
Direct depasf4? 'per Ari10t~'i$ {>f lisp 72;~ i~~L►i't~f~ci to yflu. i9 ~'[a3`tt18888 is 8tt8Gh8fl, C#2~ek fist@ P❑ 7~
Sew pa9e 73 ►
and fill in 73b, b Rotat€Rq ntsmtxar' ~ g(~ t i ~t ~ ~ ! ~ ► c Type:
~
[] G#s~#cir~ ❑ S~viRcjs
~ ~ , ~ ~
~~t`
~ ~~:
73c, and 73d, ► d Acc~cutt nwrkt~r ! ~ ? i i r ~ '• 3 ~`
or Form 8888. 74 Amtw»# of tin$ T2~+cAu v~atrt t~3pii~d to ytr~tr ~tti0 est~m~Y~i f~c i► , '7A
A1i'tOLlC3t 76 Amt €t yo~.a mite. Sttbtr~Cf line 71 froa~t fins 60. For details on ha~v fo pay, s$e page 74 . > 7~
1'aU QtVe 78 Estimaiesl ~c a! s~ 74 7f~ <.~.'~:< ~ ""`~:`< "~>~a< `><"<
po you watt tt~ allow anat#tar person to discuss this return 6srtth the IRS {see page 75)7 [] Y~s~. Cc3 ~et~ i~ fcstinwing. [,,.] !do
ThIYd ~3tiy
Elesig~t~e a~ ~~ P mar ~^~-~-~-
r~rr~ ~TM recs. r~ ~* ,...1.,....l,..~
lht of ~Y.! late 4hat J have examined this rsYum arxi accorrEpatiY~n9 sch~eR~it~s std s4ateanc~ts. ~ci fio fire C~s4 of t~ kna cue arrc9 be#~t,
they are t ietm. paelaration of preQarar {othi~r than t~xpa;~rj is based ar+ a!t informs~tion
orm of wt+'sd~ p~sp teas ~y kr~o~ed~.
Hit'@
Joint retum7 Yaur s' a re C7ate Your oc;eupation Daytirs~s phone number
Sc~e page 15. .
. 'C-..,a...,...._._...,~_....~ ~I/ " à t~'~° I l.~Ra-~.rek t-w ,,+.aax~ ~ -4Y't C c u.,~ \
Keep a copy
fpr your pouse's sig a jai turn, bc~t ust sign. Oat Spouse's occupakion
records,
~ Date or
Rc'3lC~ Check if
signature self-employed
~tE.'~l~t`~i''S
Firm's name (a- __ ~ _ _ E1N
USA Qt7Iy yours'rfseif-employeef), -- --~-
address. and Z!P codo Phone no.
Form '~ ~~ (2009)
 ~~'°~~C1UL~ ~ 1~e~~Z~i~ ~ u~:~'o~5 OMB No. 1545- 74
~~arm to~ao~ ~~
~t~~Tg ~' A~itach to dorm i(34~U. Ses lnstructiorrs far Scfiedule A (dorm tORO}. Attachment
lntemat Revenue Service (~ 5 u~nce Na.~~
~daen~(s) shown on Eorm 104D Your social security number

~~~n. Do not include expenses reimbursed ar paid by others.

~edica3
~~~ ~ 1 Modica! and dental expenses(tee pa e A-1} 1 `t~s
~~~ 2 Enter amount from Form 1040, line 38 ~2 ~ ~.
~ ~s 3 Multiply line 2 by 7.5% {.076} 3 ~_
a Subtract line 3fram Line 1. If line 3 is more than line 1, enter -~- 4
1'3x+ 1fOu 5 State and local {cheek a~tty one box): ~ <
Pait3 ~ °Income taxes, or ~ I,~ D ~ ``"~
«~<<
~ ❑ C~nera! sales takes ~~~.~>;
A_2,} ~ Real estate taxes(see page ,~i-5} 6 ~f ?
7 New motor vehicle t~ces from line i 1 of tt~: v,+orkshee# on
beck. Skip this line if you checked bax 5b 7
8 O~ih~r tomes. List type and amount ________________—________ _____ 8
.::::.::.:::.:
~ Rdd lines 5 through 8 . 9 7~
t~[t~'es# 10 tome mcrtgag~ interest and poin#s repor2ee! to yeu on Form 1098 if! -~ t ..
~'tat~ Paid i1 Horr~ martgag~ interest nc~t r tact to you on Form 1 q93. If ~> <«
(Sep paid fry the ~rsc~n from whom you bought the hams, see `< ..
p~A-6.} ~~7 and stioev that person's narn~, identifying no., and address

Mote. __.~~.__
Pet~ostal -.._.... __..a______d_...._____________._~_ __~_.._________________________ _________ ~1
int~~# i~ 12 Points not repor#ed to you an Form 1098. S~ page A-7 for
not serial rules . 12
d~tEuctibP~. 13 Qualified mortgage insurance prerr~iums(sue page A-7) 93 '
1$ Investmc~t irrterest. Attach Form 4952 if r~uit~tf.(S~ page A-8.} 1~b
15 Add lines 10 through 14 is ~~~ ("~ ~'`_
G't[ft~ to 16 Gifts by cash or check. If you made any gi~k of $2~0 or
Gh~~it'~ more,s~ page A-8 o 'f6 ~~ t>t~
pf y~a~ rn ~ 1? ~ Other than by cash or cheek. If any gift of ~~~0 or more; see
gift ~d got a page dt-8. You must att~ctt Form 8283 if over $500. 17 ~ ~~ C~C~
tr~3~~rt far it. 48 Carryover from prior year t~ ~ ,,.
s~ape~-8. 19 Add fines 16 through i8 . «1 .C~S~ t5C"}.
Cas~~lty and
~t~~ 4.O~~S 2~ Casualty or fiheft loss{es). A~ka~h Form 4684.(See page A-10.) ~
Job Ex ~~t~eS 2i Unre~mbursec! empivye~ ex~Zens~s—job tr«vel, union dues,lob
~l~d CBit~~i1 etlueation, etc. Aftach Farm 21 Q6 or 210 -EZ if required.{S~ € r
ME ~(t~~t~~OUS page A-10.} _______________~__..________________________________..____.,4._ _ __ 21 y es t~Cs t~{3
~}B~tCtiOn~ 2~ T pr~p~ration fees 22
{S~e 23 Other exp~s~s—investment, safe deposit box, etc. List type ' - l
P ~9e A-10.) and amount _ __________________________________________________~._______. I ~ ~
__o_ __ ____ _.._______m _____________________________________________________ ~
24 Add lines 21 ti~ro~agh 23 . ~~ '
2S Enter amount from Form 1 Q40, line 38 ~ 25 ~ ( #
26 Multiply tine 25 by 2% {.02} . ~i t
27 Subtract line 26 from Pine 24. If fine 26 is mare than line 24, enter -Q- 27 f} C) Qty
Q~l~~~ 28 Qther--from list on page A-11. L.sst #ype and arr~ount ____ _ _________m_____ _ e___._____ ___
MiscBP#8rreaus -- -- -
__Fl~_________~___.._u_____:____ ____________~___________________________________~____.____________________.._________. .s
D~d~c#sorts ~8
Tofiat 29 Is Form 1 f14(i, line 38, over X166,800 {aver X83,400 if marries! ~iRing separately)?
~temiz~d ❑ado. your deduction 'ss net limited. Add the amounts in itte far right column for
psdu~tipns r. lines 4 through 28. Also, ent~'this amount an Form 1040, fine 40a. ~9 ?a2~ F ,~
lfe~. Your deduction maY k~ limited. See P9 a e A-11 for thy;amount to enter.
3U f You elect to ito mize deciuctons t ev~n thou9h theY are I~ss than Your steodard _
deduction, check here ❑ ,
for P ork R~irlu~tion pct iVotice, see Form i t34d? insizuCtions. Cat. No. 17 t45G Schedu~ A (form 11340)2(~9
Schedule A (Form i040)2009 Page ~

~ar~Csfi~eet Before you min: ~ You cannot take this deduction rf Ohs amoun4 on dorm 10140, line 38, is equal to or greater than
for Line ~-- $135,OQQ {$280,000 if married filing jointly}.
Plum ~'tttotor ~ See fhe instructions for 1ir~ 7 on page A-6.
v~~icle
taxes '~ inter the state and local sales and excise ta~css you paid in `` > `< '...:«;<a>
2009 for the purch~5e of any new motor vehicles) a#te~ 4<'~~ • ~<~<
February 16, 2(709(sue page A-6). ~< 9 >~~`<4'4
Use this
worksheet to ~ Enter 4t~ purchase price(befar~ t~ces) of the nsw mrstor vehic(e{s) 2
figure ttte
amount to enter ~ ks the amount on line 2 mare thin $49,500?
on line 7.
❑ 4~a. Enter the amour# fram ling 1.
❑ ~'e~. figure the porkic~ra of the tax from
{Keep a copy line i that is attributable #o the first
for your $19,500 of tt~ purchase price of
records.) each new motor vehic{e and enter it ,,; .:
here(sew page A-6j.
4 Enter the amount #rorn Forrt3 t Q40, ling 38 . ~ ~ ~

5 Enfer tf~ total of arEy—

• Amounts hom dorm 265 , lines 45 and 5Q;
Form 2555-EZ, line 18. and Farm 4563, line 15, .
and
~ Exclusion of income from Puerto Rico

6 Add lines 4 and 5

1 Enter $125,000(~250,OOQ if married filing jointly) ,

8 !s the amour# an line 6 more #han fh~ arrrount an tins 77 <4~~€>

~ Pta. En~e~- the amount from line 3 abave on
Schedule A, tine 7. ~3t~ r~tat eompiet~ the rest
of 4his worksheet. i s
❑ Yes. Subtract iirte 7from line 6 ~8

~ Divide the amount on lit~~ ~ by ~10,OQ0. Enter 4he result as a

d~irna! (roundt~ci to at least thr places). If the result is
i.000 or mare, enter '4.000 .

10 Mulfspiy line S by line 9 e

1f D~Fuctios~ for n~ur rr~o~~r vetsi~Ee tt~ss. Subtract line 10 from ling ~, Enter the result
here and on Schedule A, line 7.
5ch~duks A {~orn~ 1040)2QC19