Sample Tax Return Transcript PDF Details

There are many different types of tax forms, and each one serves a specific purpose. The Sample Tax Return Transcript Form is used to provide information about your income and taxes paid. This form can be helpful if you are applying for a loan or student aid, or if you are trying to dispute taxes that were filed against you. It is important to understand how this form works and what information it contains so that you can ensure the accuracy of your return.

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QuestionAnswer
Form NameSample Tax Return Transcript
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesofficial transcript of a tax return template, tax return transcript template, what is a return transcript, how to read a tax return transcript

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Page 1 of 6

This Product Contains Sensitive Taxpayer Data

Tax Return Transcript

 

Request Date:

08-09-2018

 

Response Date:

08-09-2018

 

Tracking 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: DRAK

ADDRESS:

 

123 DA

FILING STATUS:

Single

FORM NUMBER:

 

1040

CYCLE POSTED:

20181005

RECEIVED DATE:

Jan.15, 2018

REMITTANCE:

 

$0.00

EXEMPTION NUMBER:

1

DEPENDENT 1

N ME CTRL:

 

DEPENDENT 1

SSN:

 

DEPENDENT 2

N ME CTRL:

 

DEPENDENT 2

SSN:

 

DEPENDENT 3

N ME CTRL:

 

DEPENDENT 3

N:

 

DEPENDENT 4

N ME CTRL:

 

DEPENDENT 4

N:

 

PTIN:

 

 

PREPARER EIN:

 

Income

WAGES, SALARIES, TIPS, ETC:

$13,000.00

TAXABLE INTEREST INCOME: SCH B:

$0.00

TAX-EXEMPT INTEREST:

$0.00

ORDINARY DIVIDEND INCOME: SCH B:

$0.00

QUALIFIED DIVIDENDS:

$0.00

REFUNDS OF STATE/LOCAL TAXES:

$0.00

8/9/2018

Page 2 of 6

ALIMONY RECEIVED:

 

$0.00

BUSINESS INCOME OR LOSS (Schedule C):

 

$2,500.00

BUSINESS INCOME OR LOSS: SCH C PER COMPUTER:

 

$2,500.00

CAPITAL GAIN OR LOSS: (Schedule D):

 

$0.00

CAPITAL GAINS OR LOSS: SCH D PER COMPUTER:

 

$0.00

OTHER GAINS OR LOSSES (Form 4797):

 

$0.00

TOTAL IRA DISTRIBUTIONS:

 

$0.00

TAXABLE IRA DISTRIBUTIONS:

 

$0.00

TOTAL PENSIONS AND ANNUITIES:

 

$0.00

SAMPLE

$0.00

TAXABLE PENSION/ANNUITY AMOUNT:

 

RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E):

 

$0.00

RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E) PER COMPUTER:

 

$0.00

RENT/ROYALTY INCOME/LOSS PER COMPUTER:

 

$0.00

ESTATE/TRUST INCOME/LOSS PER COMPUTER:

 

$0.00

PARTNERSHIP/S-CORP INCOME/LOSS PER COMPUTER:

 

$0.00

FARM INCOME OR LOSS (Schedule F):

 

$0.00

FARM INCOME OR LOSS (Schedule F) PER COMPUTER:

 

$0.00

UNEMPLOYMENT COMPENSATION:

 

$0.00

TOTAL SOCIAL SECURITY BENEFITS:

 

$0.00

TAXABLE SOCIAL SECURITY BENEFITS:

 

$0.00

TAXABLE SOCIAL SECURITY BENEFITS PER COM UTER:

 

$0.00

OTHER INCOME:

 

$0.00

SCHEDULE EIC SE INCOME PER COMPUTER:

 

$2,323.00

SCHEDULE EIC EARNED INCOME PER COMPUTER:

$15,323.00

SCH EIC DISQUALIFIED INC COMPUTER:

 

$0.00

TOTAL INCOME:

$15,500.00

TOTAL INCOME PER COMPUTER:

$15,500.00

Adjustments to Income

EDUCATOR EXPENSES:

 

$0.00

EDUCATOR EXPENSES PER CO PUTER:

$0.00

RESERVIST AND OTHER

BUSINESS EXPENSE:

$0.00

HEALTH

VINGS

CCT

DEDUCTION:

$0.00

HEALTH S VINGS

CCT

DEDUCTION PER CO PTR:

$0.00

MOVING EXPENSES: F3903:

$0.00

SELF EMPLOYMENT T X DEDUCTION:

$177.00

SELF EMPLOYMENT T X DEDUCTION PER COMPUTER:

$177.00

ELF EMPLOYMENT T X DEDUCTION VERIFIED:

$0.00

KEOGH/ EP CONTRIBUTION DEDUCTION:

$0.00

ELF-EMP HE LTH INS DEDUCTION:

$0.00

EARLY WITHDRAWAL OF

AVINGS PENALTY:

$0.00

ALIMONY PAID

N:

 

 

ALIMONY PAID:

 

 

$0.00

IRA DEDUCTION:

 

 

$0.00

IRA DEDUCTION PER COMPUTER:

$0.00

STUDENT LOAN INTEREST DEDUCTION:

$0.00

STUDENT LOAN INTEREST DEDUCTION PER COMPUTER:

$0.00

STUDENT LOAN INTEREST DEDUCTION VERIFIED:

$0.00

TUITION AND FEES DEDUCTION:

$0.00

TUITION AND FEES DEDUCTION PER COMPUTER:

$0.00

DOMESTIC PRODUCTION ACTIVITIES DEDUCTION:

$0.00

8/9/2018

Page 3 of 6

DOMESTIC PRODUCTION ACTIVITIES DEDUCTION PER COMPUTER:

 

$0.00

OTHER ADJUSTMENTS:

 

 

$0.00

ARCHER MSA DEDUCTION:

 

$0.00

ARCHER MSA DEDUCTION PER COMPUTER:

 

$0.00

TOTAL ADJUSTMENTS:

 

 

$177.00

TOTAL ADJUSTMENTS PER COMPUTER:

 

$177.00

ADJUSTED GROSS INCOME:

$15,323.00

ADJUSTED GROSS INCOME PER COMPUTER:

$15,323.00

SAMPLE

 

Tax and Credits

 

 

65-OR-OVER:

 

 

NO

BLIND:

 

 

 

 

NO

SPOUSE 65-OR-OVER:

 

 

NO

SPOUSE BLIND:

 

 

NO

STANDARD DEDUCTION PER COMPUTER:

 

$4,850.00

ADDITIONAL STANDARD DEDUCTION PER COMPUTER:

 

$0.00

TAX TABLE INCOME PER COMPUTER:

$10,473.00

EXEMPTION AMOUNT PER COMPUTER:

 

$3,100.00

TAXABLE INCOME:

 

 

$7,373.00

TAXABLE INCOME PER COMPUTER:

 

$7,373.00

TOTAL POSITIVE INCOME PER COMPUTER:

$15,500.00

TENTATIVE TAX:

 

 

$749.00

TENTATIVE TAX PER COMPUTER:

 

$749.00

FORM 8814 ADDITIONAL TAX AMOUNT:

 

$0.00

TAX ON INCOME LESS SOC SEC INCOME PER COM UTER:

 

$0.00

FORM 6251 ALTERNATIVE MINIMUM TAX:

 

$0.00

FORM 6251 ALTERNATIVE INI UM TAX PER CO UTER:

 

$0.00

FOREIGN TAX CREDIT:

 

$0.00

FOREIGN TAX CREDIT PER CO PUTER:

 

$0.00

FOREIGN INCOME EXCLUSION PER CO PUTER:

 

$0.00

FOREIGN INCOME EXCLUSION TAX PER CO PUTER:

 

$0.00

EXCESS ADVANCE PREMIUM TAX CREDIT REPAY ENT OUNT:

 

$0.00

EXCESS

DV NCE PREMIUM T X CREDIT REP Y ENT VERIFIED A OUNT:

 

$0.00

CHILD & DEPENDENT C RE CREDIT:

 

$0.00

CHILD & DEPENDENT C RE CREDIT PER COMPUTER:

 

$0.00

CREDIT FOR ELDERLY

ND DIS BLED:

 

$0.00

CREDIT FOR ELDERLY

ND DIS BLED PER COMPUTER:

 

$0.00

EDUCATION CREDIT:

 

 

$0.00

EDUCATION CREDIT PER COMPUTER:

 

$0.00

GRO EDUC TION CREDIT PER COMPUTER:

 

$0.00

RETIREMENT

AVINGS CNTRB CREDIT:

 

$0.00

RETIREMENT

AVINGS CNTRB CREDIT PER COMPUTER:

 

$0.00

PRIM RET

 

AV CNTRB: F8880 LN6A:

 

$0.00

EC RET

AV CNTRB: F8880 LN6B:

 

$0.00

TOTAL RETIREMENT

AVINGS CONTRIBUTION: F8880 CMPTR:

 

$0.00

RESIDENTIAL ENERGY CREDIT:

 

$0.00

RESIDENTIAL ENERGY CREDIT PER COMPUTER:

 

$0.00

CHILD TAX CREDIT:

 

 

$0.00

CHILD TAX CREDIT PER COMPUTER:

 

$0.00

ADOPTION CREDIT: F8839:

 

$0.00

ADOPTION CREDIT PER COMPUTER:

 

$0.00

8/9/2018

Page 4 of 6

FORM 8396 MORTGAGE CERTIFICATE CREDIT:

$0.00

FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER:

$0.00

F3800, F8801 AND OTHER CREDIT AMOUNT:

$0.00

FORM 3800 GENERAL BUSINESS CREDITS:

$0.00

FORM 3800 GENERAL BUSINESS CREDITS PER COMPUTER:

$0.00

PRIOR YR MIN TAX CREDIT: F8801:

$0.00

PRIOR YR MIN TAX CREDIT: F8801 PER COMPUTER:

$0.00

F8936

ELECTRIC MOTOR VEHICLE CREDIT AMOUNT:

$0.00

F8936

ELECTRIC MOTOR VEHICLE CREDIT PER COMPUTER:

$0.00

SAMPLE

$0.00

F8910

ALTERNATIVE MOTOR VEHICLE CREDIT AMOUNT:

F8910

ALTERNATIVE MOTOR VEHICLE CREDIT PER COMPUTER:

$0.00

OTHER CREDITS:

$0.00

TOTAL CREDITS:

$0.00

TOTAL CREDITS PER COMPUTER:

$0.00

INCOME TAX AFTER CREDITS PER COMPUTER:

$749.00

Other Taxes

SE TAX:

 

$354.00

SE TAX PER COMPUTER:

 

$354.00

SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS:

 

$0.00

SOCIAL SECURITY AND MEDICARE TAX ON UNRE ORTED TI

ER COM UTER:

$0.00

TAX ON QUALIFIED PLANS F5329 (PR):

 

$0.00

TAX ON QUALIFIED PLANS F5329 PER COM UTER:

 

$0.00

IRAF TAX PER COMPUTER:

 

$0.00

TP TAX FIGURES (REDUCED BY IRAF) PER COM UTER:

 

$1,103.00

IMF TOTAL TAX (REDUCED BY IRAF) PER COM UTER:

 

$1,103.00

OTHER TAXES PER COMPUTER:

 

$0.00

UNPAID FICA ON REPORTED TIPS:

 

$0.00

OTHER TAXES:

 

$0.00

RECAPTURE TAX: F8611:

 

$0.00

HOUSEHOLD EMPLOYMENT TAXES:

 

$0.00

HOUSEHOLD EMPLOYMENT TAXES PER CO PUTER:

 

$0.00

HEALTH C RE RESPONSIBILITY PEN LTY:

 

$0.00

HEALTH C RE RESPONSIBILITY PEN LTY VERIFIED:

 

$0.00

HEALTH COVER GE REC PTURE: F8885:

 

$0.00

RECAPTURE T XES:

 

$0.00

TOTAL SSESSMENT PER COMPUTER:

 

$1,103.00

TOTAL T X LI BILITY TP FIGURES:

 

$1,103.00

TOTAL T X LI BILITY TP FIGURES PER COMPUTER:

 

$1,103.00

Payments

FEDERAL INCOME TAX WITHHELD:

$1,000.00

HEALTH CARE: INDIVIDUAL RESPONSIBILITY:

$0.00

HEALTH CARE FULL-YEAR COVERAGE INDICATOR:

0

E TIMATED TAX

PAYMENT :

$0.00

OTHER PAYMENT CREDIT:

$0.00

REFUNDABLE EDUCATION CREDIT:

$0.00

REFUNDABLE EDUCATION CREDIT PER COMPUTER:

$0.00

REFUNDABLE EDUCATION CREDIT VERIFIED:

$0.00

EARNED INCOME CREDIT:

$0.00

EARNED INCOME CREDIT PER COMPUTER:

$0.00

EARNED INCOME CREDIT NONTAXABLE COMBAT PAY:

$0.00

8/9/2018

Page 5 of 6

SCHEDULE 8812

NONTAXABLE COMBAT PAY:

$0.00

EXCESS SOCIAL

SECURITY & RRTA TAX WITHHELD:

$0.00

SCHEDULE 8812

TOT SS/MEDICARE WITHHELD:

$0.00

SCHEDULE 8812

ADDITIONAL CHILD TAX CREDIT:

$0.00

SCHEDULE 8812

ADDITIONAL CHILD TAX CREDIT PER COMPUTER:

$0.00

SCHEDULE 8812

ADDITIONAL CHILD TAX CREDIT VERIFIED:

$0.00

AMOUNT PAID WITH FORM 4868:

$0.00

FORM 2439 REGULATED INVESTMENT COMPANY CREDIT:

$0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS:

$0.00

SAMPLE

$0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS PER COMPUTER:

HEALTH COVERAGE TX CR: F8885:

$0.00

PREMIUM TAX CREDIT AMOUNT:

$0.00

PREMIUM TAX CREDIT VERIFIED AMOUNT:

$0.00

PRIMARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT:

$0.00

SECONDARY NAP

FIRST TIME HOME BUYER INSTALLMENT AMT:

$0.00

FIRST TIME HOMEBUYER CREDIT REPAYMENT AMOUNT:

$0.00

FORM 5405 TOTAL HOMEBUYERS CREDIT REPAYMENT PER COMPUTER:

$0.00

SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER:

$0.00

SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER (2):

$0.00

FORM 2439 AND

OTHER CREDITS:

$0.00

TOTAL PAYMENTS:

$1,000.00

TOTAL PAYMENTS PER COMPUTER:

$1,000.00

Refund or Amount Owed

AMOUNT YOU OWE:

$103.00

APPLIED TO NEXT YEAR'S ESTIMATED TAX:

$0.00

ESTIMATED TAX PENALTY:

$0.00

TAX ON INCOME LESS STATE REFUND PER CO UTER:

$0.00

BAL DUE/OVER PYMT USING TP FIG PER CO PUTER:

$103.00

BAL DUE/OVER PYMT USING CO PUTER FIGURES:

$103.00

FORM 8888 TOTAL REFUND PER CO PUTER:

$0.00

Third Party Designee

THIRD P RTY DESIGNEE ID NU BER:

 

AUTHORIZ TION INDIC TOR:

0

THIRD RTY DESIGNEE N ME:

 

Schedule C--Profit or Loss From Business

OCIAL

ECURITY NUMBER:

 

EMPLOYER

ID NUMBER:

 

BU INE

NAME:

 

DE CRIPTION OF BU INE /PROFESSION:

DRAK

NAICS CODE:

000000

ACCT MTHD:

 

FIR T TIME CHEDULE C FILED:

N

TATUTORY EMPLOYEE IND:

N

INCOME

GROSS RECEIPTS OR SALES:

$2,700.00

RETURNS AND ALLOWANCES:

$0.00

NET GROSS RECEIPTS:

$0.00

COST OF GOODS SOLD:

$0.00

SCHEDULE C FORM 1099 REQUIRED:

NONE

8/9/2018

Page 6 of 6

SCHEDULE C FORM 1099 FILED:

NONE

OTHER INCOME:

$0.00

EXPENSES

CAR AND TRUCK EXPENSES:

$0.00

DEPRECIATION:

$0.00

INSURANCE (OTHER THAN HEALTH):

$0.00

MORTGAGE INTEREST:

$0.00

LEGAL AND PROFESSIONAL SERVICES:

$0.00

SAMPLE

$0.00

REPAIRS AND MAINTENANCE:

TRAVEL:

$0.00

MEALS AND ENTERTAINMENT:

$0.00

WAGES:

$0.00

OTHER EXPENSES:

$0.00

TOTAL EXPENSES:

$200.00

EXP FOR BUSINESS USE OF HOME:

$0.00

SCH C NET PROFIT OR LOSS PER COMPUTER:

$2,500.00

AT RISK CD:

 

OFFICE EXPENSE AMOUNT:

$0.00

UTILITIES EXPENSE AMOUNT:

$0.00

COST OF GOODS SOLD

INVENTORY

AT

BEGINNING OF

YEAR:

$0.00

INVENTORY

AT

END OF YEAR:

 

$0.00

Schedule SE--Self-Employment Tax

SSN OF SELF-EMPLOYED TAXPAYER:

XXX-XX-5084

NET FARM PROFIT/LOSS: SCH F:

$0.00

CONSERVATION RESERVE PROGRAM PAY ENTS:

$0.00

NET NONFARM PROFIT/LOSS:

$2,500.00

TOTAL SE INCOME:

$2,500.00

SE QUARTERS COVERED:

4

TOTAL SE TAX PER COMPUTER:

$353.12

SE INCOME COMPUTER VERIFIED:

$0.00

SE INCOME PER COMPUTER:

$2,308.00

TOTAL NET E RNINGS PER CO PUTER:

$2,308.00

LONG FORM ONLY

TENTATIVE

CHURCH RNINGS:

$0.00

TOTAL SOC

SEC & RR W GES:

$0.00

E

T X

COMPUTER:

$286.19

E MEDIC RE INCOME PER COMPUTER:

$2,308.00

E MEDICARE TAX PER COMPUTER:

$66.93

E FARM OPTION METHOD U ED:

0

E OPTIONAL METHOD INCOME:

$0.00

Form 8863 - Education Credits (Hope and Lifetime Learning Credits)

PART III - ALLOWABLE EDUCATION CREDITS

GROSS EDUCATION CR PER COMPUTER:

$0.00

TOTAL EDUCATION CREDIT AMOUNT:

$0.00

TOTAL EDUCATION CREDIT AMOUNT PER COMPUTER:

$0.00

 

 

This Product Contains Sensitive Taxpayer Data

 

 

 

 

 

 

8/9/2018

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