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VILLA POINT I ANNUAL COMPLIANCES 2 OF 2_AFFORDABLE HOUSING
C: i September 17, 2010 Irvine Apartment Management Company Attn: Barbara Breton, Senior Manager VILLA POINT I 110 Innovation Drive Irvine, California 92617 NEWPORT BEACH PLANNING DEPARTMENT Re: Villa Point I - Clearance: 2009 Annual Tenant's Certification Dear Ms. Breton: Thank you for your response to the 2009 Annual Tenant Income Certification monitoring request dated May 21, 2010. Based on the documentation submitted support household Income and monthly rents charged, all occupied units are In compliance with the income limits and allowable maximum rents in accordance with the recorded Affordable Housing Agreement. If you have any questions, please contact me at (909) 476-9696 ext 220. Sincerely, r• n Meyer Program Consultant c: Clint Whited, CDBG Consultant 3300 Newport Boulevard • Post Office Box 1768 - Newport Beach, California 92658-8915 Telephone: (949) 644-3200 • Fax: (949) 644-3229 • www.city.newport-beach.ca.us 0 Fran Meyer From: Barbara Breton lbbreton@irvinecompany.com] Sent: Monday, July 26, 2010 3:43 PM To: fineyer@mdg-Idm.com Subject: RE: Villa Point 12009- Cert. Request for additional Information Hi Fran — 1. 1 have asked the site to forward lease for #346 — I'll get that right to you. 2. Unit has not been vacant for entire time; I think it is a matter of when annual reporting dates were due. Note: M/I occurred on 8/31/09 (Metzler/Curry)) they moved out on 6/30/10, they weren't able to respond to annual requirements for 2009 — because they had left the site. 'Would you like to see a copy of their signed Tenant Income Certification at time of MI? Also, please note that as of 7/7/10 a new household has moved in (Weed/Miller). 3. Unit 676 Moved out on 6/30/10. Barbara D. Breton HCCP, COS,C10P, NCP-Exec., TaCC's Director, Affordable Housing Compliance Irvine Company Apartment Communities 110 Innovation I Irvine, California 192617-3040 Phone 949.720.34761 Fax 949.720.5257 bbrelon(Mirvinecomeanv. corn 9 IMNE C)M pAW (.APARTMENT sip ts64 COMMUNITIES Please consider the environment before priming From: Fran Meyer [mailto:fineyer@mdg-Idm.com] Sent: Monday, July 26, 2010 3:40 PM To: Barbara Breton Subject: Villa Point I 2009- Cert. Request for additional Information Ms. Brenton, In review of the documentation submitted for the 2009 Annual Tenant Certification - Villa Point I I need to following to complete clearance: n1. C py of Lease Jnit #335 was taken place to 3. Termination of Osterstock Agreement for Unit #346- Howze vacant in 2008 and reported vacan for 2009, attempt occupancy? lease, vacancy date 4(3e?/ 10 T" --- for Unit #676 for previous Thank you for your assistance in the matter, Fran Meyer has any ad vertizing occupant: C Ll TENANT INCOME CERTIFICATION X_InlualCertirmatlon RacerHHoatton _Other: Effective Date: 8 30/2009 Move -in Date; 0/00/2009 (MWDD/YYYY) PART I.pEVBLOPMENTDATA ProparlyName( f3aywODd County; Orange BIN0. N/A Address: 338 Baywood Drive, Newport Beach CA 92660 Unitlk 336 s Bedrooms: 2 Median VP I PARI'll. HOUSEHOLD COMPOSITION HH MbrB 1 Last Name Metzler Curry First Name & Middle Initial LyndaLyndey Relationship to Head of Household HEAD Data of Blrol (MM/DD 6ll9/1979 F/rSludent (YorN) N SOdal Security orAllen Reg. No. 621-28-0058 2 Cum Tobyn Son 12/18/2004 N to Follow PART IIL GROSS ANNUAL INCOME (uSE ANNUALAMOUNTB HH Mbr0 (A) Employment or Wages (B) Soc.Secudty/Penslons (C) Public Assistance (DJ other Income 1 49,123.44 1 7,920.00 Toros $49,123.44 $0.00 $0.00 $7920.00 Add totals from (A) through (0), above TOTAL INCOME (E); 67 043,44 PART IV. INCOME FROM ASSETS Hahld MbrIf (F) TypeofAsset (G) CA (H) Cash value of Asset W An11u91Income from Asset 1 Checking - Chase C 607.02 0100 1 401 K- Chas Schwab C 2,610.81 311.99 TOTALS; $3,217.83 Enter Column (H) Total Passbook Rate Ifover$8,000 $11,600.00 X 2.00% a(J)Imputed Enter the greeter of the total of column I, or J; Imputed Income TOTAL INCOME FROM ASSETS (K) $311.99 $232.00 $311.99 (L) Total Annual Household Income from ail Sources [Add (E)+(K)l $157,355.43 HOUSEHOLD CERTIFICATION & SIGNATURF-9 The lorarnanan in Wsfofmwillbousodtodetefmloemm6mmr(nmmcll Iblilty. Wm have provided lareach person(s) set forth In Pad It semplablo vedfieellon of crnrentamkipated annual Incomo. We agree to notify the landlord Immodlaleyupon any mornberofthe heratehoid=,Ara out oftha unit orany new member movingin• IAVaogreo to notify fhe landlord Immediately Upon any memberbecoming a full limo student. Undar panallos of ealury, IANe oerflWhatthe Intonation presorted In thin certification Is true and accurate to are best of mylour knowledge and belief. The undermwo Ndharundentando thalproWUingfolso reNeserdallons herein oadsgluaa an act orhaud• False, rniswrlingof incomplete infennallon mayt"Win the tetminetlod of the inane agroorMnC�r�'-J�� Ff2yLl!e� (0a) Signature (Date) Signature (Date) Signature (Date) ART V. DETERMINATION OF INCOME ELIGIBILI RECERTIFICATION ONLY: TOTAL ANNUAL HOUSEHOLD INCOME: Current Income Limit x 140% FROM ALL SOURCES $57,355.43 From Item (L) on page 1 N/A Household Incomo exceeds 140% at recertificadon: _Yes _No Current Income Limit per Family Size: $68,900 Household Income at Move -In: $57,355.43 Household Size at Move -In: 2 PART VI. RENT Tenant Paid Rent: $1,695.00 Rent Assistance $0.00 Utility Allowance: $0.00 Other non -optional charges: $0.00 GROSS RENT FOR UNIT: Unit Meets Rent Restriction at (renant paid rent plus Utility Allowance S $1,595.00 60% 50% 40% 30% 80% - 100% other non -optional charges) _ _ _ _ _ Maximum Rent Limit for the unit: $1,636.00 PART VII. STUDENT STATUS ARE ALL OCCUPANTS FULL TIME STUDENTS? • Student Explanation: 1 TANF assistance - X No If yes, Enter student explanation* 2 Job Training Program _Yes (also attach documentation) 3 Single parent/dependentchild 4 Marded/joinl return Enter 1-4 PART Vill. PROGRAM TYPE Mark the program(s) listed below (a. through a.) for which this households unit will be counted toward the property's occupancy requirements. Undereaoh program marked, indicate the household's income statuses established bythls cerifgcetioNreceni0ealion. a. ToxCredlt_ b. HOME_ c. Tax Exempt_ d. AHDP_ 9. X Villa Point I (Name orProgrem) See Part V. above. Income Status Income Status Income Status _ <=50%AMGI �60%AMGI_ <=50%AMGI Income Status _ <=60%AMGI �60%AMGI <=60%AMGI _ _ <=80%AMGI <=80%AMGI_ <=80%AMGI X 100% OI" OI•• _ OI•• _ of.. SIGNATURE OF OWNER/REPRESENTATIVE Based on the representations heroin and upon the proofs and documentation required to be submitted, the Indlvidual(s) named In Part II of this Tenant Income Cerlificetbn is/are eligible under the provisions of Section 42 and 142(d) of the Internal Revenue Code, as amended, Chapter 204-C of the Revised Statutes AOpolated of Now Hampshire, NNHFA rules (as applicable), and the Land Use Reshlction Agreement (if applicable), to live in a unit in this Protect 61C) DATE / Tenant Income Certification (September 2000) UNAER $5,000 ASSES' CERTMCATJON For households whose combin net asset% do not exceed $5,000. Complete only onq form per household; include assets of children, Household Natno: Metzler- CUrry Unit No: 2L55 AevelcpMentName: Do Ba s City: Newport Beach Complete all that apply for 1 through 4: I. My/our assets include: ( Cash ITInt R (A f;) Annual A ( ) Cash Int. (A+B) Annual Value* Rate Income Source Value* Rate Income Source $N/A $ Savings Account $607.02 0 $ 0 Checking Account $N/A $ ^ Savings Account $N/A $ Cash SN/A $ Ccriiftcates of Deposit $N/A $ Money market tbnds $N/A $ Stocks $N/A $ Bonds SN/A $ IRA Accounts $2610.81 11.95 $ 311.99 401 IC Accounts $N/A $ _ Keogh Accounts $N/A S _ Trust Funds SN/A $ Equity in real cstato $N/A $ Land Contracts $N/A, $ Lump Sum Receipts SN/A $ _ Capital investments $N/A, $ Glfc Insurance Policies (excluding Term) $N/A $ Other Rctirement/FonslonFunds not named above: $N/A $ _ Personal property held as an investment** SN/A $ other (list): PL9A3B NOTB: Ceram Ponds (t,g„ Retirement, Pension, Trust) may or may not be (Nlly) accessible to you. include only these amounts which era, *Cash value is defined u merket value minus the cost of converting tilt asset hr cash, such as brokers fees, settlement cesu, outstanding loans, emly withdrawal penalties, coo. **Personal "VV held as an investment may Inolad0. but is not limited to, gran or coin collections, an, antique ores, ate. no not includo nmmury personal properly such SR, but not necessarily limited to, household furniture, dallyuso autos, clouting, ussets of an active business, or special equipment for use by the dlsablcd� 2, ❑ Within the past two (2) years, Uwo have sold or given away assets (including cash, rest estate, etc,) for more than $1,000 below their fair market value (FMV). Those amounts* am included above and Oro equal to a total of: $ —(*the diftbrcttco between FMV and the amount rocoived, for cash ascot on which this occurred). 3. R1 r/wo have not sold or given away assets (including cash, real estate, etc,) for less than fair market value during the past two (2) years. 4, ❑ i/we do not havo any assets at this time. The net family assets (as defined In 24 CM 813.102) above do not exceed S5,000 and the annual income from the net family assets is S311.99_ This amount is included in total gross annual income. Under ponatty of perJury, Uwo eortify that the information presontod in this certification is true and accurate to the best of my/ounknowlalgo. '1110 un rgignad further understand(s) that providingfalso ropresentntioushoroin constitutes an act of fraud. Falso, misleading or incompheta information Me r/g6it tin the terming ' n of a lease agreorn N t!f t te—/ Applicont/Tenunt Date e «.,unn,rfl`Ar,s„c Date ApplicantlTenant Date Under $5,00u Asset CenifiesGon (Scptcmbcv 2000) 0 Fran Meyer From: Fran Meyer [fineyer@mdg-Idm.com] Sent: Monday, July 26, 2010 3:40 PM To: 'Barbara Breton' Subject: Villa Point 12009- cart. Request for additional Information Ms. Brenton, In review of the documentation submitted for the 2009 Annual Tenant Certification - Villa Point I I need to following to complete clearance: 1. Copy of Lease Agreement for Unit #346- Howze 2. Unit #335 was vacant in 2008 and reported vacant for 2009, has any advertizing taken place to attempt occupancy? 3. Termination of lease, vacancy date for Unit #676 for previous occupant: Osterstock Thank you for your assistance in the matter, Fran Meyer LDMAssoclates, Inc. 10722 Arrow Route, Ste #822 Rancho Cucamonga, CA. 91730 Phone: (909) 476-9696x 220 Fax: (909) 476-6086 ematl: fineveramd¢-ldm.com Tracking: i 0 E " , Irvine Apartment Communities Baywood ApartmentsNilla Point I Program Affordable Housing Agreement- dated November 13, 1990 LOW. Villa Points I"0"1 # APT. RESIDENT NAME $TTP FLOOR SIZE # OF OCC. MOVE IN DATE MOVE OUT DATE HOUSEHOL INCOME RENT $1595- Mkt RECERT DUE 281 LINDAHL 2+2 3 4109/02 N/A PHA $1,365.00 6/01/10 315 HEILIG 2+2 2 8/11190 NIA PHA $1,365.00 6/01/10 323 a STULL 2+2 2 6/29191 NIA PHA $1,365.00 ' 6/01/10 333 G COTTA 2+2 3 6118/06 COC $45,000.00 $1,490.00 - 6101/10 337 e, REESE 2+2 2 6/23/96 COC $51,430.00 - $1,365.00' 6/dl/10 344 G HELAL 2+2 4 8/20/07 COC $22,000.00 $1,485.00` 6101110 345 v MCGOWEN 2+2 1 8131/04 COC $15,192.00 - $1,250.00 6/01/10 353 L DUMITRESCU 2+2 5 10/09/07 COC $58,000.001 $1,485.00 6/61/10 356 C- SISSON 2+2 1 7/06/91 NIA PHA $1,366.00 6/01/10 358 t4 SEXTON 2+2 3/28/10 N/A PHA $1,595.00 6/01/11 613 COLE 2+2 2 97 NIA PHA $1,325.00 ' 6101/10 656 NORTH 2+2 2 3/15/97 NIA PHA - $1,340.00 6/01/10 742 VELA 2+2 2 10/12/01 COC $41,000.00 $1,485,00 6/01/10 783 MELGOZA 2+2 1 1 6/14190 1 NIA I PHA $1,315.00 t 6/01/10 MEDIAN- Villa Points ("M") # APT. RESIDENT NAME $TTP FLOOR SIZE # OF OCC. MOVE IN DATE MOVE OUT DATE HOUSEHOLD INCOME RENT $1595- Mkt RECERT DUE 325 TRAN 2+2 3 9101/07 NIA PHA $1,560.00 6101/10 335 7, ' Vacant 2+2 06/30/10 - 6 01/11 346 r-I HOWZE 2+2 2 8131/09' Tax Retur $52,358.00 $1,595.00 t 6/01/10 347 FENNERTY 2+2 2 2/05/10 NIA PHA $1595.00 6/01/11. 676 ant 2+2 6/30/10 D cob° 6101/11 735 ✓ MATHRE 2+2 2 4/01/07 COC $41,000.00 $1170.00 6/01/10 744 ✓ JOSKA 2+2 2 7/12/08 COC $52,290.00 $1.496.00 6/01/10 745 N. HAGHIGHAT 2+2 2 9112/06 COC $40 000.00 $1,496.00 6/01110 757 ✓ HUGHES 2+2 2 10/26/02 COC $35,309.00 $1,496.00 6/01/10 782 WITTMAN 2+2 2 7/01/08 COC $47900.00 $1,122.00 6101/10 838 GOMEZ 2+2 3 5/29/04 COC $60,590.00 $1170.00 6/01/10 912 • CAVANAUGH 2+2 2 4/24110 NIA $60,421.95 $1595.00 6/01/11 913 PERRY/NAVA 2+2 2 10/23/09 - EvIetIon in process $68,704.41 $1,595.00 6/01/10 915 H. HAGHIGHAT 2+2 2 10 3 03 Coe $14,400.00 $1,496.00 6/01/10 N/A 2010 MI/No support Needed at this time. COC One form for resident to return, signed by all adults PHA Copy of Section 8 Rental Agreement needed from File Tax Return Tax Return Needed from Resident No ;+/ 7,01,0 t— It 0 6 sy June 28, 2010 City of Newport CIO Ms. Fran Meyer LDM Associates, Inc. 10722 Arrow Route, Suite 822 Rancho Cucamonga, CA 91730 RE: Villa Point I 2009 Annual Compliance for Qualified Households Dear Fran, The attached information is in response to your request dated May 21, 2010 and is related to our 28 affordable units at Baywood Apartment Homes participating in the Villa Point I Program. Please let me know if you require any further information to support our current household(s) compliance. Sincerely, Company LLC, e Limited Liability Company HCM, COS, C10P, NCP-Exec.,TaCC's Director, Affordable Housing Compliance Irvine Company Apartment Communities 110 Innovation I Irvine, California 1 92617-3040 Phone 949.720.3476 1 Fax 949.720.5257 bbreton(@irvinecomgpnv.com CC: Kenneth McCarren IRVINE COMPANY I APARTMENT Since 1864 COMMUNITIES Irvine Apartment Communities Baywood Apartments/Villa Point I Program Affordable Housing Agreement- dated November 13, 1990 LOW- Villa Points " 0" # APT. RESIDENT FLOOR #OF MOVE IN MOVE NAME $TTP SIZE OCC. DATE OUT DATE 281 c LINDAHL 2+2 3 4/09/02 NIA 315 v HEILIG 2+2 2 8/11/90 N/A HOUSEHOL INCOME PHA PHA RENT $1595- Mkt $1,366.00 $1365.00 RECERT DUE 6/01/10 6101/10 323 6 STULL 2+2 2 6/29191 NIA PHA $1,365.00 6/01/10 333 & COTTA 2+2 3 6/18/05 Coe $45,000.00 $1490.00 6/01110 337 G REESE 2+2 2 6123/96 COC $51430.00 $1365.00 6/01/10 344 o HELAL 2+2 4 8/20/07 COC $22,000.00 $1485.00 6/01/10 345 Cl MCGOWEN 2+2 1 8131104 COC $15,192.00 $1,250.00 6/01/10 363 DUMITRESCU 2+2 5 10/09/07 COC $58,000.00 $1,485.00 6/01/10 356 SISSON 2+2 1 7/06/91 NIA PHA $1.365.00 6/01/10 358 tA SEXTON 2+2 3 3/28/10 NIA PHA $1,595.00 6101/11 513 COLE 2+2 2 10/09/97 NIA PHA $1,325.OD 6/01110 656 NORTH 2+2 2 3/15/97 1 NIA PHA $1340.00 6/01110 742 i^✓ VELA 1 2+2 2 1 10/12/01 COC $41,000.00 $1.485.00 6101/10 783 1 MELG02A 12+2 1 6/14/90 NIA PHA $1,315.00 6/01/10 MEDIAN- Villa Points "M" # APT. RESIDENT NAME $TTP FLOOR SIZE # OF JOCC.1 MOVE IN DATE MOVE JOUTDATE1 HOUSEHOL INCOME RENT $1595-Mkt RECERT DUE 325 TRAM 2+2 3 9/01/07 NIA PHA $1,560.00 6101110 335 ? •' Vacant 2+2 06130/11 6/01/11 346 r-I HOWZE 2+2 2 8131/09 Tax Return $52,358.00 $1,595.00 6/01/10 347 FENNERTY 2+2 2 2105/10 NIA PHA $1595.00 6/01/11 676 ant 2+2 6130MO 6/01/11 736 ✓ MATH118 2+2 2 4101/07 Coe $41,000.00 $1170.00 6/01/10 7" ✓ JOSKA 2+2 2 7112/08 COC $52,290.00 $1,496.00 6/01/10 745 N. HAGHIGHAT 2+2 2 9/12/06 COC $40 000.00 $1,496.00 6101/10 757 ✓ HUGHES 2+2 2 10/26/02 COC $35,309.00 $1496.00 6/01/10 782 WITTMAN 2+2 2 7/01/08 COC $47900.00 $1,122.00 6/01/10 838 i GOMEZ 2+2 3 5/29/04 COC $60 590.00 $1 170.00 6/01/10 912 CAVANAUGH 2+2 2 4/24/10 NIA $60,421.95 $1595.00 6/01/11 913 ERRYINAVA 2+2 2 10/23109 Eviction in process $58,704.41 $1,595.00 6/01/10 915 H. HAGHIGHAT NIA COC PHA Tax Return 2+2 2 10/31/03 Coe $14,400.0. $1,496.00 2010 MI/No support Needed at this time. One form for resident to return, signed by -all adults Copy of Section 8 Rental Agreement needed from File Tax Return Needed from Resident 6/01/10 VILLA Po1N OfftIFICA71ON OF vp4 temrnb'lot rnI19f;Wb+'bi/septa •_._.,�.,,rnpinoamed�un<�d9nmcebee°t.incd•) uWo cerflty to the management of Vlpa Point 1 {Olha(te $eYwoodApartmente} fhatr t. Tt;e and®reigned ISfar0 the only Inaoma eamfng o�+pern(a) of the tibova IndfGdtetl tweed pramlaesr and 2. o, the Tolal Annual Eggtje I ncome• of Z&+v.—�r�� .rand, �iI d o o.�� underslgnsdv!°'tuhlual(a) au[jng tments, $ sl m"lly r ntpaYment•to Yna p f 1 01f Apartments) eZtj r la ( eke k ggdd,, per month. ��,�� f • l/7'� �j� �$' TOWAnnual piplo Income lncludas; a neax or rental apeny: Inbmt. aIlk lnbft sxt ilb°n a caommtsabnnet s, Income tttfm PQWorxion paYnMnts andddlitributona d Ar,09 Pay,� Y chfladtl uAte rP?Y and ows of tapes o(pttter da>,a re t ha undersigned acknowlc Newport Sgfth are retying Qdgo($)' that • k4l(a Point .I• (tin alto ga the undeletgnetl; end fn cont, me aCDt7r4cy of the proves info • y*'Od ApadmenteJ and the Cky of raaMda the reins 0104ble for oecups - uhdealgnadine morreAttan in the feaoinq o f an panoy,ofthtabovr Wflione t tithe aPertmeietto Then unders)gh� co meted ieeand plemisas,°ement whleh to the City of N TMMO 10 the del' of a ftgm Ewa copy Of this Carmc*n of C.ontln,Ued House TMs GertitTcaNOn is hold Ehgibmy below; made ceder penahy 0f.pe7ury.ln Nqw CglUbmia on the -data, JndloaW M� and A SNta 4r NoMrrcolne Eathiny Hduaelwlq �flr Rercna}artne twueeWd Fax Numbers: dCCt}mnlurnty Resources Occupancy • (714) 480-2701 g`' ,{ 3 (714) 480-2937 Orange (,,.�0A. my �tOUSi g .a`�.�.�tbority (714)480.2919 1770 N. Broadway - Banta Ana, CA 92705 Loasing/inspections (714) 480.2700 - (714) 480.2926 Too (714) 460.2822 http://www.ocliousing.org Special Housing Programs (714)480.2812 02/08/2010 Tenant ID:10355 Irvine Apartment Communities Tlare Lindahl C/o The Bays Apts 281 Baywood Dr 1 Baywood Dr Newport Beach, CA 92660 Newport Beach CA 92650 Dear: Irvine Apartment Communities This letter is to inform you of a Cit(ANGE IN BENT as follows: Previous Tenant Share $ 936.00 Previous housing Assistance Payment $ 429.00 Previous Rent to Owner $ 1365.00 Tenant's New Share Rent $ 936.00 New Housing Assistant Payment $ 429.00 New Contract Rent $ 1365.00 IMPORTANT NOTICE - PENDING RENT INCREASES. The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field.Reptesentative when the rent increase is completed, AMENDMENT TO ]HOUSING ASSISTANCE PAY MENTs CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 04101/27010, If you have questions please call Nellie Diaz at (714) 480-2748. HAPPY Software, Inc. NW8r2MA ...n. �CComm,u.it,.y. Resources �[ I 1770 N. Broadway - Santa Ana, CA 92706 (714) 480-2700 - (714) 480-2026 TOO httpi//www.ochouslng,org 05/22/2009 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities This letter is to inform you of a CICANGE IN RENT as follows: Previous Tenant Share Previous Housing Assistance Payment Previous Rent to Owner Tenant's New Share Rent New Mousing Assistant Payment New Contract Rent TenantlD:6709 VP i 1LLL (� Fax Numbers! Occupancy (714) 480.2701 (711) 480-2997 (71,1) 480-2919 Leasing/Inspections (714) 480-2922 Special Housing Programs (714) 480.2812 Joyce E. Heilig 315 Baywood Dr Newport Beach, CA 92660 s400.00 $965.00 $1,365.00 S600.00 $765.00 S1,365.00 IMPORTANT NOTICE - PENDING RENT INCRI ASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed, AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents Of the Mousing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 07/ol/2b09. If you have questions please call Yvonne Taylor at 714-480-2709. HAPPY s0ft"re, Inc, YT6122120o9 dCCommunity Resources Orange County Housing Authority L770 N. Broadway • Santa Ana, CA 92706 (714) 480-2700 - (714) 480.2926 Too http://www,ochcusing,or9 03/25/2010 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities TenantlD:6689 Fax Numbers: occupancy (714) 480-2701 (714) 480-2937 (714)480-2919 Leasing/Inspections (714) 480-2622 Special Mousing programs (714) 480-2812 Julie W Stull 323 Baywood Dr Newport Beach, CA 92600 This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $ 364.00 previous Housing Assistance Payment $ 1001.00 Previous Rent to Owner $ 1365.00 Tenant's New Share Rent $ 224.00 New Housing Assistant Payment $ 1141.00 New Contract Rent $ 1365.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (now contract rent you requested.) You will receive a separate notice with adjusted owner portion from your 1 ield Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 04/0112010, If you have questions please call 'Yvonne Taylor at 714-480-2709, NAPPY Soitwars, Inc. YT3125/2010 VILLA POINT I (Off -site Baywood Apartments) Unit No. Ci55RTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tennots not in possession ore section 8 cortineuto or voucher, income documentetinn must be obtained.) INve certify to the management of Villa Point I (Off -site Baywood Apartments) that:. 1. The undersigned istare the only income earning occupant(s) of the above Indicated leased premises; and, 2. During p-00 , e Tot aI nual Eligible Income* of the undersigned individual(s) WIR $ �" : and, 3. During 2009, my total n 1 ren�ayment to Villa Point I (Off-ske Baywood Apartments) was $ per month. Total Annual Eligible Income includes: wages, Cps, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and districhild support, all regular and s eclabenefits t pay and allowances of a members' compensation and eryof the severance pay, alimony, child supp Armed Forces (to exclude hostile fire allowance), The t I the of Newport Beach are relying nned gthe)that Villa accuracy of thenprovided information n healeas leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach, This Certifoation is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Mamber(e): 4 Name _ Age Signature(e) of Income Earning Household Member(a): �-- --.. ... _,......__. filgnature Date:.-- VILLA Pole I (Of -site Baywood Apartments) Unfit No. , OSRTlr"ICA7210 1 Qr =N-TiNUED HOUSc.NOLD EL.It"siBILITY ;For tenants nut la vo-quSgton of it Sectwn tt cerdneaic or voucher, Iaeorre ratiq, bt nt+tntned.j INVe certify to the management of Vp1a Point t (Off-sHa Bayovood ppartrnents) th3:: The undersigned Were the only Income eeming occupant(s) of `.hs above indicated leased premises: and, 2, During 2009, t�he� -�^o1loll Annual Eligible income" of the undersigned `.ndlv!dual(s) was S ��j� and, �. During 2..008, my total mOMW reel pa rnent to Villa Point I (Off -site Baywood Apartments) was $Lr- per month. ` Tetai Annual Eligible income Includes: wages, taps. overtime, bonuses, Commissions. net trcomo from a business or rental property, irterest and dividends, scciat srnJrity payman s, retlramert rynP �r pe;fs!otl payments and distributions, disability benefits; workers' conpensakon and disalA a severance pay, a;imor+y, child support. al! regular and speciel pay and allowances of a mer her of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point i (Off -site Betywood Apartments) and the City of Newport Beach are relying on the aecuraoy of the provided information in tha leasing of an apartment to the undersigned: and in conferring on the undersigned the monetary benefits of the Agreement whtdi restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the del'. eery of a copy of this Certification of Continued Household Eligibility to the City of, Newport Beach, 'his Cariffication Is trade under penalty of perjury in Newport Beach, Cxli`ornla on the data indicated below: lt?.mes and Ages of Noe-II:COn90 Esmtng Hous¢hotd Kombor(s}: Namc Age Sig, ature(al of inoatra Eaming'loasehold Namber(s): �� rignYUiC •��� J}'IOILH Data: !2`! ✓�^ �v---._.....,.__.__.... VILLA POINT I (Off -site Baywood Apartments) 4t6C L Unit No.,, CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (Tor tenants not in possession of a Section S certificate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* not the undersigned individual(s) was $ oZ'�itW ; and, w0 riN, 44 a Wor _k%-, •!ems Y\ %AS R ' Werg.Ci irl 04%Ao—o-o- 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ $ 1, � g5 .00 per month. • Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age ' 1 6_ L)c?2Aad_kiIQl__ �! 5 hef(w P641 Nam. 3 0� Signature(s) of Income Earning Household Member(s): e-��� -' Signature Signature Signature _ Date: VILLA POINT Koff -site Baywood Apartments) Unit No. �J!� CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (for tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) INVe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) was $ L ; and, 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ / X -5V • ` ` per month. Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Eaming Household Member(s): Member(s): Name Age ev �•-•—'�"'� `='� Z✓ Sig --•—^Signature - -- '— Signature Date: 6/ � A, 0 • VILLA POINT I (Off -site Baywood Apartments) Unit No. 353 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a section 8 certificate or voucher, income documentation must be obtained.) IANe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) was $ _'J�,000 ; and, 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1111,99-100 per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, Interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information In the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): " Si tare . - Signature -- Date: �o _ �� Fax Numbers: fi C0111ri111311ty Resources occupancy (714 4eo•2701 Orange (714) 4OD-2919 1770 N. Broadway • Santa Ana, CA 92706 Leasing/Inspections (714) 480.2700 - (714) 480-2926 TDD (714) 480-2822 httpl//www.othouaing•org Special Housing Programs (714) 400.2812 07/30/2009 Tenant ID: 6690 Irvine Apartment Communities Leslie H. Sisson C/o The Bays Apts 356 Baywood Dr 1 Baywood Dr Newport Beach, CA 92660 Newport Beach CA 92660 Dear: Irvine Apartment Communities This letter is to inform you of a CHANGE IN RENT as follows; Previous Tenant Share $88.00 Previous Housing Assistance Payment $1,277.00 Previous Rent to Owner $1,365.00 Tenant's New Share pent $120.00 New Housing Assistant Payment $1,245.00 New Contract Rent 51,365.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field' Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of -the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective o9/01/2009. If you have questions please call Yvonne Taylor at 714-480.2709. HAPPY Software, Inc, YT7I30200D "1Comniunity Resources Grange County 1Jous-1,g .A11f1,A(D -ty 1770 N. $roadway - Santa Ana, CA 92706 (714) 480.2700 - (714) 480-2926 TDD http://www.ochousing.org 12/30/2009 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear; Irvine Apartment Communities TenentlD:6695 6cii Fax Numbers: Occupancy (7x4) 480.2701 (714)400.2937 (714) 480.2919 Leasing/Inspections (714) 480-2822 Special Housing Programs (714) 480.2812 Vivian J Cole 513 Baywood Dr Newport Beach, CA 92660 This letter is to inform you of a CIiANGEIN RENT as. follows: Previous Tenant Share $ 248.00 Previous Housing Assistance Payment $ 1077.00 Previous Rent to Owner $ 1325.00 Tenant's New Share Rent $ 2t0.00 New Housing Assistant Payment $ 1115.00 New Contract Rent $ 1325.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08101/2007 shall prevail except for the changes shown above. These changes will become effective 02/0112010. If you have questions please call Yvonne Taylor at 714-480-2709, HAPPY Software, Inc. YT12I3012009 • i Fax Numbers: CCommuizitSr Resources , rP ( Occupancy 11 (714) 480-2701 Grange COUnty Housing ,authority (714)48oz9%9 1770 N. Broadway . Santa Ana, CA 92706 Leasing/Inspections (714) 480-2700 • (714) 480.2926 Too (714) 480.2822 http://www.ochousing,org Special HouSIng Programs (714) 480-2812 03/25/2010 Tenant 11): 6740 Irvine Apartment Communities Dawn B. North / C/o The Bays Apts 656 Alderwood Dr 1 gaywood Dr Newport Beach, CA 92660 Newport Beach CA 92660 Dear: Irvine Apartment Communities This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $ 211.00 Previous Housing Assistance Payment $ 1129.00 Previous Rent to Owner $ 1340.00 Tenant's New Share Rent $ 158.00 New Housing Assistant Payment $ New Contract Rent 1182.00 $ 1340.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested,) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT; The contents of the PIousing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 04/01/2010. If you have questions please call Yvonne Taylor at 714480-2709. NAPPY 8oryworr, Ino, YT3125/2010 • dCComirlulli Resources Orange County Housing Authority 1770 N. Broadway • Santa Ana, CFl 92706 (714) 480-2700 • (714) 480.2926 Too http://www.Ochouslne.org 05/17/2010 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities 0 VP I 1 907ja' Fax Numbers: .1 II occupancy (714) 460-2701 (714) 480-2937 (714) 480-2919 Leasing/Inspectlons (714) 480-2622 Special HO,USIng Programs (714) 180.2812 TenantlD:1195 . Rose E. Melgoza 783 Alderwood Newport Beach, CA 92660 This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $ 193.00 Previous Housing Assistance Payment $ 1122.00 Previous Rent to owner s 1315.00 Tenant's New Share Rent $ 204.00 New Housing Assistant Payment $ 1111100 Now Contract Itent 5 1315.00 IMPORTANT NOTICE - PENDING .RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (now contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above, These changes will become effective 07/01/2010. If you have questions please call Yvonne Taylor at 714-480-2709. HAPPY Software, Ina YTO/17/2010 0 CCommunty Resources Orange County Housing Authority 1770 N. Broadway - Santa Ana, CA 92706 (714) 480-2700 - (i14) 4a0.2926 Too http://www.ochousing.org 05/07/2010 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Or Newport Beach CA 92660 Dear: Irvine Apartment Communities TenantiD:1335 lP Pax Numbers: 1 P I occupancy V (714)480-2701 (714) 480.2937 (714) 490-2919 Leaslhg/Inspectlons (714)480-2822 Special Housing Programs (714) 480.2612 Van M. Tran 325 Baywood Drive Newport Beach, CA 92660 This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $ 680.00 Previous Housing Assistance Payment $ 880.00 Previous Rent to Owner $ 1560.00 Tenant's New Share pent $ 720.00 New Housing Assistant Payment $ 840.00 New Contract Rent $ 1560.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYN'NTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 09/01/2007 shall prevail except for the changes shown above. These changes will become effective 07/01/2010. If you have questions please call Yvonne Taylor at 714A80-2709. HAPPY Software, Ina, YTS/7/2010 • Ol -*�q6� Fo,m 8$79 IRS e-tile Signature Authorization onlr3Np s9D74 Doputmem of IhsTnuury ► PonotntidtothelRS.ThL9i$r4tatexreM, f��,�� '► Murna aovAnus eeNice ► Keep m[aformforyourrecords, sepinaVuettena, DeoleratlonContralNumber(DCN) , 00-337300— -0 Taxpayceaname 9oeralsacurltvnlxnher Spouse's name spouso'esoolal socudtynumber 1 Adjusted grocemoome(Form 1040, Iins36; Corm 1a40A, MOM; r3rm 1040EZ,*ie4) . . . . . . 2 Total tax(Form 1 D40, line 60; Form 1040A, line37; Form 104012, line 11) , 3 redemllnoometaxwhhhald(Porm1o40,11ne61;Farm1040A,1Ina39;Form104oPZ,lina7) . . . 4 Refund (Porm1040,IIne73a; Form 104a4,line48e; Form 1040P2, line 12a;Form 1040•SS, ParttInel3a). . . . and awrrusea apersonalIdentification number (PIN)to ncfThisauthodcoiteooesP'^a,n.ry„uro fepA F5,eeTtaterminate theauthorlzatbn,Torevoksin e a payment I mustcontaotthe U.S. Treasury Rnsno;al Agent at 1-888.353.4537 no laterthan 2buslneasdays priorto ihepayment (Settlement) date. I also suftinthefinanClal Inathutlons Involved in the processing of the electronic paymentoftexasto receFnconllderral Information neaeasaryto answer hrquktrs end roeolve Isausafelated to thepayment I fuMerackriowledgethatthe personelidantficadon number (PIN) below Is mysignaturoformy aieatrontc Income taxtenrm and, If applicable, my Electronlo Funds Wfthdmwalconsent Taxpayer'sPIN: ohookoneboxonly X❑ [authorize _,8R BLOCK toemerorgenemtemyPIN 17216 I aemyslgnaturoonm tax EROfirmnarne Enterfrvenumbars but y year2D09aleotronkmilyllledincometsixretum. donetehtoreitxeroa WIN antermyPIN asmyelgnatureonmytaxyear2009eleotronica�r9ledincomemxretum.Checkth[sboxonlyffyouareentaringyourown PINandyour retum Isflled ueingtha Praclinthod. OnerPIN meThe ERomuatcomplato Partlll below. Youraignature►. 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ER aslgnature ► DAte►_ 04/_2AI2010 ERO Must Retain This Fonn - See Instructions Do Not Submit Thls Form to the IRS Unless Requested To Do So sm(em PoimSMIL2"".pxnghitape-9010MF107UG,FE i060.1V1.D 00 NOT MAIL THIS FORM TO THE FTB TAXAELEYSAR FORM 2009 California a.flle Signature Authorization for Individuals 8879 Yourname 1 Ca6fomiaAdjuetedQromIncome (Form 540, line 17; Farm 6402FZ,#noIs; Long Form 510NR,line n or Short Form 540NR,line 32) ............. ..... ......... 1 5 2 AmountYouOwe (Form 540,Ilne111; Form Mo2EZ,Iine27,, Long Form WNR, line 121;or3hortForm64oNR,llnQ121) 2 137. 3 RefundorNoAmount Due (Form540, line 115; Form 5402EZline 28;Long Form640NR, Una 191; orShortPorm 54oNR, the 121)................... . ........... . .......... .... . 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SPorats'slRDF's PIN: oh eck one box only ❑ lauthorree EROflrmname eemyslgnsture on my2009 e• filed Oellfomla Individual Income taxretum, Date► 04/74/203.0 toentermyMN E= Donotemerall zeros ❑ I wig emorMyPINasmysignatura on MY20090- ffM Calffamidindividugi income tax return. cho*this box onIVffyou are entering yoUrown PIN and your retum Isfiled Usingtha Practitioner PIN method.The ERO muetcompme pad III below, epaWG'Y/ROP'sligntlurd ► COPY ONLY Date 0- ERUNEFI"M FAWyoursix-digkEFIN followed byyouriW-digitself• selected PIN. 33730070567 Donotentarq xeroa toatltythatlhaobovenumer'acnlrylsmyPlN,whkhls,, yoWgnatureforthe2o090elgomlaindlvlduaiincomet6kretumforthelaxpayer(a)indkatedabove, I confirm thatl am eubmadng this return In aocordencewlth the requlrementsof the PmoddonerPIN method and FM Pub.1346, 200p e. gleHandbookfor Authorize! a-tAa Providers. ER01asignature► Dale ► 04/14/2010 ForPHvacy Notfc% gat form FTl31131. 171E887062 2009 Form _ _ DepaftentoftheTre9e� Internal Revenue service 11 Label (BN Pape 17.) A e >GavRXN to >aowzE E 10 1A CUERDA INSlabbeh L RANCITO SANWA VARG, CA 92688 Otherwise, please print e ortype. B Filing 1 nsinaltssti tls 2 MarrlodtilingJabuly(Checkonly 3Mauled Mine avowal sly, onebox, ► 250-73-7216 spollawa soolal sscurhynumber You must enter vourSSN(s)above, Cheoking at box bolow wte not changeyourtax or refund. usmoia twml quwllymg person). (eeep2g918,) if1 IV ineperson la aahlld bul Oct yourdepnndent, enterthle eel nh... ► Exemptions eo U Yourself, IfsomeonecartClafmyou isit dependent donotcheckboxea. b Li t3porrae 0 Depamderda: (1) Firstname Ilmorethen six dependents, seepage20. Lastname (2)Dependent'a (3)Dependent's soolaisecurkynumher relationship to y0u ( Boxes ch °�mda 4 JS No. or ohlldinn _ quAG onedwho: Ior 411vedwlrh u at. you _— E ed onotllve you due 10 CI b dlVatea or sopuNian pas Dace2t) _� Iy Depnndonls on ec not ontered above _^ Aad numbua d 'rotalntxnherafaxemotbncolaimed °y°11nw Income —?—Wagon salaries Ma ato.AfthFonn(s)W.2 7 35 899 Attach ornr(2 o.rZs• Be inter eo1 sd Led. attach 6 xwn 1 .Do 1 Leon 8!, forms) ea Ord[narydlv Alta uleBg aired, ge 1o99•RHtaX b Qualtneddly9okm MON. AV wAM waswhhneid. in e� rs.l .r a _ Ilyoudidnot 11a IRA 11b Tambiaamoum ownw•a�aee distributions. 11s sse a e Daaeza 12a Penstonsantl 12b Taxebhatnount enclose, but ao — annuities. 124 a28. notpotatlah.iY 18 Unemplaymentoompansagonlnaxoessof$2,400perreciplentand plaeeo use Pend Alaska Permanent Fund dividend1. 1040. v, 14a Soc181securiry e sea 6 e 8,'if SM 14b �RaQ61�Plc Adjusted ow gross Is e ! a eso. Income 17 IRA deduction (me oaao30) 17 18Slndentloan(ntereetdeduclbn(seeoaae32118 400 19 TuMonanIMMI18duot(on.Ahachfvnn8017 19 _ 20 Add Tooslethrough10 Thesearevourtotatledfustmants, _ 20 400 21 SubtratOline 20front imel6 filslsvouradNpWwosllncome. ► 21 36 2n9. KBA ForDisclosure, PrlwcyAot, anti PaparworkileductlonAclNotice,seepnges7. Form 1040A(2009) MSr20a�s)oopynontill".2010MRSTexGFDI n4o-iV1.18 Adjusted ow gross Is e ! a eso. Income 17 IRA deduction (me oaao30) 17 18Slndentloan(ntereetdeduclbn(seeoaae32118 400 19 TuMonanIMMI18duot(on.Ahachfvnn8017 19 _ 20 Add Tooslethrough10 Thesearevourtotatledfustmants, _ 20 400 21 SubtratOline 20front imel6 filslsvouradNpWwosllncome. ► 21 36 2n9. KBA ForDisclosure, PrlwcyAot, anti PaparworkileductlonAclNotice,seepnges7. Form 1040A(2009) MSr20a�s)oopynontill".2010MRSTexGFDI n4o-iV1.18 . credits, payrttettl5 290 Check J u You were bornbekt•Jenuary? 1"% to. TLJ sp b Ifyouaremamled Itemizes Blind Totatboxm Bond checked ► 0 • Peoplewho 24a - Enter_yoursamdard deduction (am lettmgmin). 24a 5.700 chocked tiny bityouareincreesingyourstenduddeduolhnbycertainrealestatetamorn•wmotorvehicle bokonln• r twlM!_ao hMKw W.r..Ad--L _— --------- Vim, sea page 34. • Allothera Singleor Marrkd tiling drep$$5,700 tifly' Marrisddr ling Uadl�l)An$y wktpW((ef), $11,4ob 28 Momptione.Ifline 22ls$125,100orlsasand 27 30 Credltfortheelderyorthedleabled.Attach 32 Retlremant•avinceconhibadlonsomdRAUachPoritlBBBp 32 33 ChlldtaxoredN(st"pmce3B) as ao01ICd from 20M relum 39 40 Making workpayandgovemmentmureacmdlls. —� Ifyouhave Attlich6clieduleM,AO aqueldyhtp 41e Earrwdjxp9aaredtt(Elcl ,. 400_ Child, attach 41a b Nontexabl ombA al 4 SchalulegC. 92 Addlibnalchlld tax aredk. Ahnrhrtaa.."4a Refund 46 Ifnne441etn anN blwall fromil (slat t i Direct Me 9mountofli ant oYort If eBBti' o ore deposit? ► b Routing I" SeePa9964 number I ► o [] Checking and fill In rypec g Q Savings 4eb,4eo, ► d Account mid4ed or number Form Sea& 47 Amount Ofllne46YOU Want applied toyour 2010891mmtadti; 47 Amount 40 Amount You owe.subtraotline S rd Blsonh you oxro Third paw Doyouwarattoall designee Dacignea_sname Yam. Completethefollowing, nr. uaa 6 sign Under panalll»ol pppr)ury,Itl9rJN�tga(IhrvedMined tm1�ntum and aCaemprrlyfnp sot Wufg6 end aINOmenle, and to tlm 0s tof rary krOWlodall rd bell el, they NetrYl. eornm, ens eCYWeIoIYY nrolemounts and eWrrgs of �nepllR lneplWdeurlpp thelax year. Snpl6ratlon hale o prepuer(elnerihenthelUpeyodb based on alnnrorm nen of wnlek lke prepNarnes My knowlotlae• Joint return? Yourslgnaluro Data our0ooua0on Seepapei7. For 3:Ufo ORIX Do not fill. ALZA P DayBmaphonenumber �yOUrOOpy YI , Spoueerssignaturo.if 10111troturn,bothmustslgn, Date pouwreowupallon reonrda. tar..,. r—*— .,_a__ .._ __ _ - Paid prepererts use -only Aft liwer�Copyripht tAaO•TafoHRE Tnx OrFouDp�Tne; �1.18 PrelpareesseNorP7IN No Form 1040A (2oo8) rorm 8863 Education Credits (,American Opportunity, Hope and oMBN s. Lifetime Learning Credits) ► a2009 3eeparate fnstructlonstoned out ifyounre sitrdbfetotak timcmdin. Nams(s)shown en rsWrn securltynumber f audon: %canndtakebolhanaducatton rodhendthstuitionandfeesdoductlon(aaoForm80771forthassmesndoMiortlrosemawar ® Atrtarican Opporwndy Credk Use Part II Iryou are claiming the Hopacredltfora stodentaflonding school In a Midwestern disasterama.If you use Partll, you cannotuse Partttorany student f (a) Students name (a) Vn 02,000 (o) Muho"s f) Ifcolumn(d)lszero, (aeatawnonpaget soot as mountln em0untincolumnantartheamountfrom ofyourtexretum) numb 1 (0),Ihero(d)by25%(.28) coUmn(o)m erwlssMrstnamB show e1 ,o� aanter-0. addS2,000totho Lastname _ _ e0o for amount In column (a). 2 Tantative American eloctt0 welvethe computalfon u e,aeunror oremanzraYearstarthasome atudont. 3 (a) Studenrsname (asshownon page p 9 (b) Students societseeuril Y (o)-qualified expenees(see d Enterthe () (e)Add (p6riamountialf ofyourtaxretum) numbar(as Instructions), Do emmountinIlarof amountfn column(d) ccolum (d) of0toam (a) column(e) Mistname ehownenpaget notentermore column(0)or Lestname ofyourtaxretum) than02,400•for eachsWdenL 91,200 Y owv mi, m,uw,viuW All MrwlulvwucA a1 alspWtxm In 8 MIaW4$MM dleaaterarea,da not antermoreth2n04,800, "Foreachstudentwhoattendedanellgib educathnalInstltutfonInaMklwa temdleosterarea,anterthesmalferOftheamountIneolumn(e)or82,400. 4 T"tativeHopecreftAdd theamountsonMe% column (Q.Ityouare taidngthelifeurnolooming credtfor a different student gotoPartllhotherwiso,got* PartV . , ► 4 IM L)failine Learning Credit. Caution: YoucminottaketheAmedcarioppofbmnycredhortheHope ereditandthe S (a) Students name (asshow#1411i, fy $m) ri (b) Studenrasoolalsecurhy (c) Qualified numbor(asshownonpage axpenssa see Arstnaman Iefyourtaxrslum) Instructions) 0 Add the amounts on line G,00fumn(o),andenterthetotal . . , , 7a 6ltertheamoliaroflines orSio,000 . . . . . . . . . . . . . . . . . . . . . . b ForstudentswhoattendndanellglbteaduoaticnellnetltutfanlnaMldwestemdlsesterarea,ontarthesmoker of 010,000 onhelrquentled expensaa included Online 8 (seespeclal ruleson pages of tholnstruelhns) o Subtmattne7bfrom line7a. , , , , , , , 8a Multiplytne7bby40Y.(.40). . . . . . . . . . . . . . . . • , . . . • . . . . bMulupyllne70by20`k(.20) . . . . . . . . . . . . . . . . . . . . . . . . Form oo Form two eaepytlphl teDe. ZalaHae T8Ra/GDDi ea iw,c •s 10 11 12 13 14 Entartheamountfromline 2. , ' Etter: $180,0001[manl0d filing Jalntly:580,0000single, head of household, orquallfymgwidow(er) Entertheaouni from Fans 1040, Una or Form 1040A,1tne22 . . . . . m Subtract line 11 from One 10, If zeroorlese, 810ptyoucannottakeany aduoationcradk Enter, S20,000If married filing Jointly; $10,000 ifaingle, head of household, arqueloyngwklow(ar) , , , If Itne 121a: •Equaltoormoredlanline IS, enter 1, IIn014 . *Lew than One10,dividelinel2byOnel tar a Pnde.d atleaetthreaplacea) . , . . .. ° 15 Muhiplylinesbyline 14.Caution: If you were underage24attheendoftheyearandmeet theconditions on page Bat the instructions, you cannot takethe refundableAmedw opportunity oreditSkipfine116,enfarthaamountfromlineiSonline17,andcheckthisbox ► Q 16 RdUM1ebhlAmedcanopp0rtunitycradILMultipyline16by400A(,40).Entertheamount 17 Subtract line l8fromOne 16 , , , , 18 Add l;no4andfine 80.ityou have noentryoeseffn ou and enter the amountfromllne 17on Una 26 ,16 Enter:S120,000Ifmarnadfilinglokdly;S60ho oll r quNifyingw1dow(er) . . - to 20 EhtertheamountfromForm 1040,line38,'OrFonn1040A,Une22 21 Subtractllns20fromUna 19.If Zero orleas,Skip lines 22and23,and enter zeroonline24. . - z1 22 Enter,:620,0001fmaMedfilingjolntiy;510,0006aingio,head ofhousehold, orquailfyingwidow(ar , , , . . , . . 22 23 I(IIne2ltg: •Equaltoormore then &ne22, then mrin online2 0 1 •t.easthanllne22,dMdethe2 lime the r adec t f} atleastthreeplaces) , 24 Multlpytlnol8byllna23 ► 26 Add line 17andNna24,ltzero,atop; you oermwttakeanynonrefundableeducation credit 26 ErdertheemcuntffomForm10m1 40,nne46,orFo1040A,Ilne28 , . . . . . 27 Enterthetotal, Ifany, ofyourcredltsfrom: •Fomr1040,linea47,48, and the amountfromSchedule Rentered on r MOM , , Jlf • Form 1040A,Iinas2gend30. . . . . , • . . . • . . . . 28 Subtractlln0271romllno26,Itzoroorle9s,atop;y k n nda education credit 28 NenrefundabreeducadoncredIM,Enterthe it 01 Ilno4g,orFom11040A,line 81 � Form am (200e) M6137MOCOPY11e11i 199e• 2010HAD7azoFTOTna 2V1,0 SCHEDU M Making Work pay and Government (Fotfi1vg0Aor1040) Retiree Credits �j MFI oQMU'aJ VIM to) ► Attaohto Fortn1040A,1040.or1a40NR. P. Suaeearetolnst In Y�f 0 Doyou (and your spouse d1111nglointly)have as of S6, arde filinglofntly)? Pr Yea Sklptlneelathrough3."r (SB001fm filingl y d No. EntaryoursamedIncome (see ctb b NoAmblecombetpayincludedon line la(saoinstructions) , , , . , , , _ . Lib 1 2 Muitlplyllnelabya.2°, pet) . . . . . . . . . . . . . . . 2 3 Enter64110(MONmarrledfilingpintty). . . . . . . . . . . . . . 1 3 4 yellgirtheemalfarofUna 20r11ne3(unisssyou as' nal 6 EntartheamOuntfromForm1040,lne33" aMl1 35.299 6 FitterS76,000(S160,0(Iplfma0fedfilingJoint . . . , :, 75 000 7 latheamounton Ine6 more then theamounton One 6? No. Skip line 6.Entertheamountfromllna4onlfne0below. Yes. Subtractllne6from One6 . , , , , , , 7 a Muidpyfne7by2%(.02). . . . . . . . . . . . . . . . . . . . . . . . . . . a 10 11 BNo. Enter-0• on One 10andgotolinell. Yoa. Enterthatotalofthepaymentstecalvedbyyou (and yourepousa,iffilklg , lolntfy).Oo notentermorethan 3260 (WW Hmanled lfling iolnty) tecolvea eNo. Enter- 0- on lino l l and Solo lineJO Yaa a If You checked 'No'anline 10,(Sf100If mgialntandtheensweronllne11IVYespous e If uehecked"Yes' online 10,enter- 0• (exeepOon;enter4,4600HAng londyand the spousewho receWedthe pension orannultydid nolreeeive an economic recoverypaymentdoseribedon line 10) 12 Addlineel0and11 , . , . , , _ 13 Subtract line l2fromnr*9.lfzeroorless, enter- 0. , 14 Makingworkpayandgovernmentretireearedlta.AddlinesllandI&Entertherasulthere and On Form 1040, MOW, Form 1040A,Nne40;orForm 1040NR,lne6o , , , , , , , , , , , , , see Form 1040A,1040, or1040NR instructions. =NnhaNNp((opy )aht rasa- 2010 HPa TNr erou�noVl.g ForPrNacyNolloa,getfortn FT81jai. 1* • California Resident Income Tax Return APE 250-73-7216 HOWZ ** 09 LAURIN E HOWZE 10 LA CUERDA RANCHO SANTA MARL 01 1 06 0 09 0 10 0 12 35699 14 0 16 0 17 35299 18 3637 31 1047 34 0 41 0 42 0 43 0 44 0 45 0 46 0 61 0 62 0 63 0 64 949 71 812 IllppueenMwrul Io i rduni'elflbWa e�jnelure, Joint rmurn? Pon Pepe 17) APE 0 FS 0 3800 0 3803 0 SCHG1 0 5870A 0 5805 5805F 0 DESIGNEE 1 TPIDP 00141879 FN 431871840 !' r �In arl'J 1 RE q.v'1af �'GPs4r9ct f Patdprepaternolpnature Occlusion of prepararle bnaod on all Intonnatlon or which prepornr bee an?enowledpe) *Ptld pnpererb 881UPTIN uo you wall' 10 snow enathorpareon to dtecuee thlc return with ne (eeepecp 17)? PRARMER Print'rnud Pa" bee18noo1e nema P 0 4187 eddrece aFEW 43-1 7 40 • % YesU No (949) 631-0309 Talephono Number 0461 3101096 r�� P AO A R RP vourname: LAURIN E 1HfOWA vourSSNor111N: 250-4216 it s 1 ai mle i n 2lHwdqthousehold(wfthquaiVngperwn),(aBepago4) Mardod/RDP811ngjointly. (see pag24) Q. s 3Marrlaf/RDPIDIngseparately. entorapauswalADFsSSNorITlNabovoend fun namehere 4 6 U Oualkying widower) wkh dependaM(;hlid. EnteryearapoueelRDPdled. 7 Porsonaltlfyouoheoked1,3,or4above, enter IInthabox,@youchocked 2or6,enter2lnthabox. Whole dollars only aIfyouchocked the box anlma8,sea paga7........................................ T 8 X 41NM$ 98. m 9 Blind:Ifyou (oryourepousdRDl)arevlsualiylmpalmd,onterl:Ifbotharevisualyimpalred,enter2 8 X S98o3 1 9 Senior If you(oryourapouearRDP) are drt dtJ r2 „ s 9 X SM.$ N 10 Oeperrdane:Enternameandrelatlon .pan ayo If ours S nde . plot a 10 LJ X sis4 -- _ 12 Statewacasfrom your Form(s)W 2, bdVjW. ,. ;..M.......... W.. a 12 35, 699. 13 P.nterfedeiar2d)ustedgross incomefrorn Form1040,una37;Fomt1010A,fine 21;Fbrm1040E 1ns4........... 13 14 CaRtomiam(ustments-3ubtrackons.EnWthaamountfromSChaduleCA(640),ana37,eolumnB.............e 14 16 Subtractilne 114from line 13, Iflesethenxaro, enter themsuh in parentheses(Seepages) ..................... is 18 Calkomiaad)ustmenle-addklons.EnrortheamountfromScheduleCA(64o),IIno37,columnC...............• 16 17 Calkomiaadjusted grossIncome, Combineline 1Band finale; ,,,,,,,,,,,,,,,,,,,,,,,,,,,•..........•..0 17 18 EnterthekrgorofyourCAstrWarddeduedonORyourCAltemizoddeduotions .........................• 16 31 Tex,Checkboxiflromt �XJ Tax Table 00 Qi 31 1,047. r 32 6 ompdon tired ts, Er tertheamounti nes then S1rge 10)...... 32 98. Q 33 Subtrootline 32 from llno3l,ifless the . Madul .........33 , ... 949. 34 Tax.(sespagell)Cheokboxitfrom: A,,,,,,,,,,•„©39 39 Add llns33andMe34 , 1 ,r 3s 949 41 Newlobscredl4amountgonerated (see page 11) •...... • 41 42 New)obaoredk,amountclelmed(seepage 11) ............................... • 42 a a 43 Credit Code amount ...,,,,...,, ► 49 E G 44 Credit Code amount ► 44 49 To claimmorothantwocredits(seepage11)............... :.........., • 45 L e 48 NomeNrldebleranWaored 12) ........... 47 Add Ina 42through line4B. Bare of 47 48 Suh ne47from line the enter •01 ...... .. .. 48 61 AltanatNeminknumtax. So ( 0) Bi .•.. 62 Mental Health ServkesT t2) . , . , . , ... .... , • g a s 63 Othorkxaeandoreditracepture("apage 13)................................. • 53 71 CAWomklncametaxWtthhatl(seepagel3).................................................... •71 812, 72 20090Aostlmetedtexandotherpaymenta(seepagal3)........................................... _ • 72 73 Real estate and otherwithhokling(seapage13).................................................. • 73 P 74 ExcessSD1(arVPDI)wlthhekt(vwpage 13) ...,..................................... 74 Q Child end 0opendeMCsreExpenewCredk( i B a �.• 75 Quayfyfngperson'aswialeeourayntanber.. ........ .. ..... 75 6 78 Qualfyln9person'ssooWseicudtynumber , 77 Entortheamountfromform PM3608,Partli a8..... ,. ..•.. ..• 77 78 Child and DopendentCaraExpensesCred mform 3 T 91 Overpak)tax, ifkns79iemorothanline 64,subtmotllne64rromline 79 ......................... 91 Z Q 92 Amountofline 91you wantapplledtoyour291oeagmatedtax ........................................ • 92 A x,D 93 .Cverpaldtaxavallablethlsyssr. SubtMCtline92fmm9ne91..................................• 93 6 04 Taxdue, [fling ....... 79k1"sthonllnnM,mArraO0ne791romtlne84 ... 94 1 U99TAX26 9e91gx,Thtslon9tatoolllrte(aeepaae14) • g5 Side 2 Form 545 of 2009 046 1 3102096 r~ Yournams: LAURIN E HOWZA YourSSNcrMN: 25 - 216 a T I 0 a 6 CalltomiaS4nlore Spectal Fund.(easpage2..................................................... Afzhalmer's DleeaWRelated Disorders Fund .................................. I .. , ................ California Fund for Senior Cldzens....... ........................ ........... I.................... Here and Endangered SpacleePreservationProgram ............................................... State Childreres TOM Fund forms Preverrtlon of Child Abuea.......................................... OWomlaBreWCancer ResearchFund ......................................................... OaMomla Mrellghtft Memorial Fund ..................................... . ..... ............... FSnargencyFood ForFamllleeFund...................................... . ...................... cikWomletPamooffiaarMamoriamPbundatlonFund................................................. Code Amount a400 s 401 a 402 s 403 0404 s 405 a 408 s 407 s 408 Callf0mlaMllftary Family Relief Rind .... .. ... ... ............... 4008 CallfomlaSea Oder Fund........... ................. 4410 CalgomlaOvarlanCancer Rosearchtlt ........ ...... ................... 6411 MunloipalShellerSpay. NautorFund .......... .................... 0412 Cal@omlaCancerResearahFund ...... ... .... ............ .... I................. 0413 AL&Lou4ehrig'sDisease Research Fund ....................................................... s414 110 Add code4p0thmughmoda414,7111sisyourtatalcontdbuUon..................................... a110 if, g}Lr 112 Intenestlateratumponal0es,and latapayment alffea ............. ........................... 172 pi, 113 Underpaymentofestimated tax. Chaekbox: F7'Dhlj05attachad Fre5e05Fatteonad .. a 113 b6 44A rM. Au. b_..._ ob e A PO Da r t 115 REFUND OR NO AMOUNTDUS. Su (line 10 II (aft re01o: FRANCHISETAX BOARD, PO BOX rs 8 0009 .. a 115 0. Flillnthalntormatbntoauthorizedkeotd sltof di o accounts notattachavolded Hera you varlfMdthe routing am accoul re ewh of Ailorthatollowing amountofmyrefund (line 116) Is authodzed lordimotdeposkinto theacwuntshown below: Checking ❑ $AV4393 • Routing number •'type • Accountnumber The remaining amoUntof myrafund (line t1e) tsauthorized fordkootdeposkintotheacwuntshown below: • Routing number ,tv a 11601re0tdepositamount 0461 3103096 r'� Farm 640 C1 2009 Side 3 Electronic Filing Instructions for your 2009 Federal Tax Return Important: Your taxes are not finished until all required steps are completed. Lindsay M Duke 2465 Del Prado La Verne, CA 91750 Balance 1 Your federal tax return (Form�1040A) shows a refund due to you in the Duel I amount of $1,420.00. Your tax refund should be direct deposited into Refund I your account within 8 to 14 days after your return is accepted. The ( account information you entered - Account Number: 1127601866 Routing ( Transit Number: 122000661. Where's My I Before you call the Internal Revenue Service with questions about Refund? I your refund, give them 8 to 14 days processing time from the date 1 your return is accepted. If then you have not received your refund, 1 or the amount is not what you expected, contact the Internal Revenue Service directly at 1-800-829-4477. You can also check www.irs.gov I and select the "Where's my refund?" link. I No I No signature form is required since you signed your return Signature ( electronically. Document 1 Needed I What You I I Your Electronic Filing Instructions (this form) Needto I Printed copy of your federal return Keep I I 2009 I 1 Adjusted Gross Income $ 16,659.00 Federal I Taxable Income $ 7,309.00 Tax I Total Tax $ 0.00 Return I Total Payments/Credits $ 1,420.00 Summary 1 Amount to be Refunded $ 1,420.00 1 Effective Tax Rate 0.00W Page 1 of 1 Hi Lindsay, We just want to thank you for using TurboTax this yearl It's our goal to make your taxes easy and accurate, year after year. With TurboTax Home & Business: Your Head Start on Next Year: When you come back next year, taxes will be so easy! All your information will be.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. Here's the final wrap up for your 2009 taxes: Your federal refund is: $ 1,420.00 You qualified for these important credits: - Education Credits Your Guarantee of Accuracy: Breathe easy. The calculations on your return are backed with our 100$ Accuracy Guarantee. - 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 asked you specific questions related to your business and found all the related deductions. - 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! Also included: - We a -filed your federal returns for free, so you could get your refund in as few as 8 days. - We provide the Audit Support Center free of charge, in the unlikely event you get audited. Many happy returns from TurboTax. • J Depedmsntof me Tnuuy— Internal flosnus SeMea Form 1040A U.S. Individual Income Tax Return 99 2009 IRSUss—Do otwoneorshoplaInIhIssince. LabelYournntnameandnakl lot rem, OMe No. 154rM4 YoursoeW security number (gee neWctbne) Lindsay M Duke 571-91-4531 Use the No joint Tatum, spouses nntneme and Intent Lest name epouae's sactslenvier number IRS label. otherwise. orlyps 't Home address (number "sift*. if you have a P.O.W&see lnsbudbns. ApaMeatOo. . You must enter 2465 Del Prado yourSSN(s)above cay,r,,, or poet once. if you have a lomlen Wdmu, no lmtmcionx Stile Woode Checking a box below will La Verne CA 91750 not change your tax or refund Presidential Election Cam aI n ► Check here if you, or yourspouse if filing ointl want $3 to go to this fund see Instructions .. r You F1 Spouse Filing 1 Single 4 U Head of household (w4hquaifyingperson).(See Instructions.) status 2 Mended 0ligjokxiy (even ifonyone had iocome) N If the quilil ingpelseniisachildbutactYeardependent, 3 Maided filing separately, Enter spouse's SSN above and enter MIS chlNis name here ► fulnamehere► 5 �Qualifying widow(er)with dependent child chlxoey one txxw (see instructions) Exemptions 6a ® Yourself, If someone can claim you as a dependent, do not check box 6a........... sox" i t tl eban. 7 Spouse . ........................................ Jb xmms men aN d "Zunte, ass blNtibnf. Income Asadt Forma) W2 Mrs. Also &tech Fo*$) 18kMR N tax tags BitNsld. xyou did not V. ions. Encim, but do ratattedi, any pymeA w fbMmtM 1�eWV. c Dependents: (1) First name Last name (2) DepPendent's soclalsecurity number (3)Dependent's relationship to you rer (4) r' rc 'onbwclhioa caws ° • IWstl died but wlal You' treat a did not a" Wft omen in"truetl�or) Dependents on eo not entered above 7 Wages, salaries, tips, etc. Attach Form(s) W2 ......................... 7 16,490. Ila Taxable Interest Attach Schedule B if required 9a 169. b Tax-exempt kxeresL Do not Include on kne Be ............. 8 It 9a Ordinary dividends. Attach Schedule B If required ....................... 9 a b Qualified dividends (see Instructions) .............. 9 b 10 Capital gain distributions (see Instructions) ........................... 10 11 a IRA distributions ......... 11 a 116 Taxabto' amount .... 116 12a Pensions and annuities ..... 12a 12bTaxable amount .... 12b 13 Unemployment compensation in excess of $2,400 per recipient and Alaska Permanent Fund dividends (see Instructions) .......................... 13 14a Social security benefits ............. 14a 14b Taxable amount ... . 4s: AAd fl.— 7 ih--h ddh rfne dnhf mh,mM W. I, un,., Wat Innnrne. . ....... ... ► Adjusted 18 Educator expenses (see Instructions) ............. 16 gross 17 IRA deduction (see instructions) ................ 17 Income 18 Student loan Interest deduction (see Instructions) ....... 18 19 Tuition and fees deduction, Attach Form 8917 ......... 19 20 Add lines 16 through 19. These are your total adjustments .................. 20 21 Subtract line 20 from line 15. This is your adjusted areas Income ............. ► 21 16,659. SAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see Instructions. Form 104DA (2009) FDw+312 02WID Form 1040A(2009) Lindsay M Duke 571-91-4531 Page 22 Enter the amount from Kno 21 (adjusted gross Income) ..................... 22 16 659 . Tax credits, and 23a Check �eYau were bent before January 2, 1945, eBYnd 1Toul boxes M. J ham betas January 2, 1945, BYsd ehedud ► 23a payments Spousewes b If you aremanled filln separately and your spouse itemizes deductions, here ► 231DEI Standard see instructions and check ........................ Deduction 24a Enter your standard deduction (see left margin) .................. . .... 24a 5,700. for — • People Who your standard deduction certain real (statetax�sor ► 24b bifyou are lvehicl L here Inaba checked any and check sea new motor vehicle taxes, attach Schedule n t box on line 25 Subtract line 24a from line 22. If line 24a is more than line 22, enter-0.............. 25 10,959. 23e,23b or 26 Exrmptbns.Iffine22Is1125,100aless and youdid not providehousingtoakidrrestemdisplaced lndlvidual, 24bcan be to can be „spy y ........ m $3,650h the number on fine 6d. Otherwise, see InsWdions........... , 28 3,650. claiined as a 27 Subtract line 26 from line 25. If line 26 Is more than line 25, enter-0-. This is your dependent, taxable Income ...................................... ► 27 7,309. see Inetra. 26 Tax, Including any alternative minimum tax e All others: (see instructions) .. ..................................... 26 733. ere retely,' 29 Credit for child and dependent care expenses. Attach Form 2441 ..... 29 65P7oo 30 Credit for the elderly or the disabled. Attach Schedule R .... 30 Married filing 31 Education credits from Form 8863, line 29 ........... 31 733. jointlyy or 32 Retirement savings contributions credit. Attach Form 8880 ... 32 Clual idow ( wMowerg, 33 Child tax credit (see Instructions) ................ 33 $11,400 34 Add lines 29 through 33. These are your total credits ..................... 34 733. Head of 35 Subtract line 34 from line 28. If line 34 Is more than line 28, enter.0............... 35 0. Household, 36 Advance earned Income credit payments from Form(s) W-2, box 9............... 35 $8,350 37 Add lines 35 and 36. This is-yourtotat tax .................. . . . .... ► 37 0. 36 Federal income tax withheld from Forms W-2 and 1099 .... 38 1, 020 . 39 2009 estimated lax payments and amount applied from 2008 return 39 If you have 40 Making wakpayand government retiree credits. Attach Schedule M.... 40 400. a qquell ngg 41 a Earned income credit(EIC).................. 41a chlkl, a ch Schedule EIC. F bNontexable combat pay election. 41 b 42 Additional child tax credit Attach Form 8812 .......... 42 43 Refundable education credit from Form 8863, line 16...... 43 44 Add bees 38, 39,40, 41a, 42, and 43. These are yourtottll payments ................. ► 44 1, 420. 45 If line 44 is more than line 37, subtract line 37 from line 44. Refund This is the amount you overpaid .............................. 45 1,420. 46s Amount of line 45 you want refunded to you. If Form 8888 Is attached, check here .. ► 46a 1,420. Dlrectdeposlt? ► bRoullng aSeend fill tructtions number ..... 122000661 ► c Type: X Checking ❑ Savings n 46b, 46c, and 46d or ► clAccount Form 8888. number ..... 1127601866 47 Amount of line 45 you want applied to your 2010 estimated tax .. 47 ....................... Amount 48 Amount you owe. Subtract line 44 from line 37. For details on how to pay, youowe see Instructions ...................................... ► 48 49 Estimated tax penalty (see instructions ............ 49 Third party Do you want In aflow another person to discuss this return with the IRS (see Insumitions)? . . . . . . LJ Yoe. Complete the following. No designee Personal Dnlgsea'a Phone idenuruaon ► name ► no. is' IPIN) Undorpenalluad Pedury, l INdae aulthave examined this return and ercempanong schedules and alelwn i le, and to the beet of my knowledge wW War they Sign ae�ue, coned anti ecanlely aetall amounts and aourro6 olinmme t mosinddudng the taxyear. oedaregon orpwaher (ogw Nm theuxpayedlebsewianaa here IMonna ion afxmkh he pupa erhae any knadedpa kNx rekm7 w YoalptuWre Date Youruwpaam Carom phone number see Instructions. , Design Assistant Keep a copy Spouses alpuWrs. Its Joint return both must sign. Data spouee'soccupegon fayourrecords. Pilpn.wrs , Date Cho Properees SSNor PTIN Paid "" ad preparer's Plane name Self -Prepared (oryraeraelr. use only emd�------- ________________________0.DPode ---------------------------e FDIAt312 0=10 Form 1040A (2009) Education Credits (American Opportunity, Hope, and OMB No. 1545-0074 Fom, 8863 Lifetime Learning Credits) 09 ► See separate Instructions to find out if you are eligible to take the credits. Adrrhmont 200 Mu°i i "^mot �Ma (99) ► 'Attach to Form7040 or Form 1040A, se u.nceNo. SO Namrp)rhoxn onnbm Yourroc' I'Mmynumber LindsayM Duke 571-91-4531 caution: a You cannot take both an education credit and the tufdon and fees deduction (see Form 8917) for the same,student for the same year. art I American Opportunity Credit Use Part 11 If you are claiming the Hope credit for a student attending school in a Midwestern disaster area. If you use Part 11, you cannot use Part I for any student. Caution: You cannot We the Amedcan ouportun1tv credit formora than 4 tax vvearms far the me student 1 (a) Student's name (b) Student's (c) Qualified �d) Subtract $2,000 (a) Multiply the (f) If column (d) is (as shown on page 1 social security expenses ((see rom the amount in amount In column zero, enter lthhe of your tax return) number (as shown Inetructlana).Do column (a). If zero (d) by 25% (.25) amount from on page 1 of not enter more or less, enter .0. column c . Other - First name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - Your tax return) than $4,000 for wise, ad 2,000 to each student. the amount in Last name column e . ---------------- --------------- --------------- 2 Tentative Amarican opportunity credit. Add the amounts online 1, column (0. Skip Part II If line 21s more then zero. If you are taking the lifetime teaming credit for a different student, go to Part III; otherwise, go to Part IV ► 2 art 11 j Hope Credit Use this part If you are claiming the Hope credltfor a student attending school in a Midwestern disaster area and elect to waive the computation method in Part 1 for all students. Caution: You cannot take the Hope credkformore than 2 tax years for the same student. 3 (a) Student's name (b) Student's (c) Qualified (d) Enlerihe (a) Add (tnl Enter one-half (as shown on page 1 social security expenses see smaller of the column (c) and oilhe amount in of your tax retum) number (as shown InstructionsS. Do amount in column (d) column (0) on page 1 of not enter more column (c) or First name your tax realm} than $2,400- for $1,20 " _ _ _ _ _ _ _ _ _ Last name each student. •Fx oK rb entwh�tl ands an%beduauonnalImW]nm M1MktWNW atrnruraro0.,e rwrenurmoreounxaw. �� WtlrnlWlpiWntlrO an eeh adumlbnelimeluUon Ina MMwulem �eanerene, solar No rorxerorlhe anaumin caumn(c) 4 Tentative Hope craft Add the amounts online 3, column (p. If you are taking the lifetime learning credit ►I 4 for a different student, no to Part III; otherwise, therwise go to Pert V...... . aft III j Lifetime Learning Credit. Caution: You cannot take the American opportunity credit or the Hope credit and the lifetime learning credit for the same student in the same year. 6 a Sudent'a name es shown on page 1 of our tax return (e Student's social (c) expeQualnses () ( Y ) securkynumbar(as expanses shown on page 1 of (see Instructions) First name Last name your tax re um) Lindsay M Duke 511-91-4531 11,458. 6 Add the amounts online 5, column (c), and enter the total ........................... . 7 e Enter the smaller of line 6 or $10,000...................................... . b For students who attended an eligible educational Institution In a Midwestern disaster area, enter the smaller of $10,000 or their qualified expenses Included on line 6 (see special rules In the instructions) ......... . c Subtract line 7b from line 7a........................................ . . . 6 a Multiply line 7b by 40% (.40).......................................... . b Multiply line 7c by 20%(.20).......................................... . c Tentative IHetime learning credit Add lines Be and 8b. If you have an entry on line 2, go to Part IV: otherwise oo to PartV ........................ .... aAA For Paperwork Reduction Act Notice, see Instructions. FDIA3801 lmsome Form 8863(2009) • :e 9 Enter the amount from line 2 . ......................... ... • • • • • • • • 10 Enter. $180,000If married filing Jointly; $90,000 if single, head of household, orqualifying wldow(er) ............................. . 10 11 Enter the amount from Form 1040, line 38,• or Form 1040A, line 22......... 11 12 Subtract line 11 from line 10. If zero or less, stop; you cannot take any education credit ................................. 12 43 Enter. $20,000 If married filing Jointly; $10,000 If single, head of household, or qualifying wldow(er) ............................. . 13 14 If line 12 Is: —7 s Equal to or more then line 13, enter 1.000 online 14 ...................: • . Less than Kne 13, divide line 12 by line 13. Enter the result as a decimal (rounded toat least three places) ................................. ..... 16 MuNpply line 9 by line 14. Caution: If you were under age 24 at the and of the year and meet the condhbna In the Instructions, you cannot take the refundable American opportunity credit. Skip r line 16. enter the amount from line 15 on line 17, and check this box .................... ► L 16 (AO). Enter the amount here and on Form --'.................. 17 Subtract line 16 from line 15.......................................... . 1$ Add line 4 and line 8c. If you have no entry on these lines, skip lines 19 through 24, and enter the amount from line 17 on line 25 .............................. ......... . 19 Enter. $120,000 If mended filing Jointly; $60,000 if single, head of household, or qualifying widow(or) .............................. . 20 Enter the amount from Form 1040, line 38%or Form 1040A, line 22........ . 21 Subtract line 20 from line 19. If zero or less, skip lines 22 and 23, and enter zeroon line 24 ................................... 22 Enter. $20,000If married filing Jointly; $10,000 If single, head of household, or qualifying wklow(er) ............................... 22 1 10,000. 23 If line 21 Is: s Equal to or more than line 22, enter the amount from line 18 on line 24 and go to Iine 25 , , . e' Less than line 22, divide line 21 by Nne 22. Enter the result as a decimal (rounded to at leastthree 23 places) ...................................... 24 Multiply line 18 by line 23............................................ ► - -- 24 2,000. 25 2,000. 25 Add line 17 and line 24. If zero, stop; you cannot take any nonrefundable education credit ............. 26 733. 26 Enter the amount from Form 1040, line 46, or Form 1040A, line 28 ......................... 27 Enter the total, If any, of your credits from: 0. Form 1040, lines 47, 48, and the amount from Schedule R entered on line 53 .....: ........ 27 s Form 1040A, lines 29 and 30 .............................. _ 26 28 Subtract line 27 from line 26. If zero or less, stop; you cannot take any nonrefundable education credit ...... 733. 29 Nonrefundable education credits. Enter the *met Isr of line 25 or line 28 here and on Form 1040, line 49, or Forth 1040A, line 31 ........ ...................................... . 29 733 . •IfyMare fling Fom125662555-E2, ff4563. a youduang rmm Puerm rum see Pub970 rerthe amount M enter. Form 6683 (2009) FDLM601 120109 SCHEDULE M Making Work pay and Government (Form 1040A or 1040) Retiree Credits �„in'na,;,,'„ss 7S 1°,,,k,�'y (99) ► Attach to Form 1040A, 1040, or 104ONR. ► See separate Instructions. 1 a Important: Sea the Instructions If you can be claimed as someone else's dependent or are filing Form 1040NR. Check the'No' box below and seethe instructions if (a) you have a net loss from a business, (b) you received a taxable scholarship orfellowship grant not reported on a Form W-2, (I yourwages Include pay for work ppeedonned while an Inmate in a penal institution, (d) you received a pens or annuity from a non qqualtllad deferred compensation plan ora nongovernmental section 457 plan, or (a) you are filing Form 2555 or 2555-FZ Do you (and your spouse If filing jointly) have 2009 wages of more than $6,451 ($12,903 if married filing Jointly)? 8 Yes. Skip lines 1a through 3. Enter $400 ($800 if married filing Jointly) on line 4 and go to line 5. L No. Enter your earned Income (see instructions) ................ 1 al b Nontaxable combat pay included on line 1 a (see Instructions) ............. . ..... I 1 bl- 2 Multiply line 1a by 62% (.062) ...... . . ................... 2 3 Enter $400 ($800) If married filing jointly) ..................... . 4 Enter the smeller of line 2 or line 3 (unless you checked 'Yes'on line to) .................... . 6 Enter the amount from Form 1040, line 38%or Form 1040A, line 22........ . 6 Enter $75,000 ($150,ODO if married filing jointly) ................. . 7 Is the amount on line 5 morethan the amount on line 6? eNo. Skip line 8. Enter the amount from line 4 on line 9 below. Yet. Subtract line 6 from line 5........................ . 8 Multiply line 7 by 2% (.02)........................................... . 6 Subtract line 8 from line 4. If zero or less, enter-0..... . ................. • • • • • • • • . 10 Did you (or your spouse, If filing jolntly) receive an economic recovery payment in 2009? You may have received this payment If you receivedd social security benefits, supplemental security Income, railroad retirement benefits, or veterans disability compensation or pension benefits (see instructions). XeNo. Enter-0- on line 10 and go to line 11. Yes. Enter the total or the payments received by you and your spouse, If filing jointly). ...... . Do not enter more then $250 ($500 if married filing Jointly) 11 Did you (oryyour spouse, If filing Jointly) receive a pension or annuity In 2009 for services performed as an employee The U.S. Government or any U.S. state or local government from work not covered by social security? Do not Include any pension or annuity reported on orm W-2. X No. Enter.0. on line 11 and go to line 12. Yes. air you checked 'No'on line 10, enter $250 ($5001f married filing Jointly and the answer online 11 is'Yes' for both spouses) • • • • • • a If you checked'Yes' on Ilne 10 enter-0- (exception: enter $250 If filing jointly and the spouse who received tote pension or annuity did not receive an economic recovery payment described on line 10) 12 Add Ilnes 10 and 11............................................... . 13 Subtract line 12fromline 9. If zero or less, enter-0. ............................... . 14 Making 63 pay yro 1040A government ant r retires credits. Add line IlinOes 11 and 13. Enter the result here and on Forth OMB No. 1645-0074 2009 seauxy nn r 'If you are filing Form 2555 2555-EZ or 4563 or you are excluding income from Puerto Rico see Instructions. BAA For Paperwork Reduction Act Notice, sea Form 1040A, 1040, or 104ONR Instructions. Schedule M (Form 1040A or 1040) 2009 FDW501 1027MD ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING TAXPAYER: Lindsay M Duke PRIMARY SSN: 571-91-4531 FEDERAL RETURN SUBMITTED: April 13, 2010 12:4B PM PDT FEDERAL RETURN ACCEPTANCE DATE: Your return was electronically transmitted on 04/13/2010 The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The Intuit Electronic Postmark documents the filing date of your income tax return, and the electronic postmark information should be kept on file with your tax return and other tax -related documentation. There are two important aspects of the Intuit Electronic Postmark: 1. THE INTUIT ELECTRONIC POSTMARK. The electronic postmark shows the date and time Intuit received the federal return, and is deemed the filing date if the date of the electronic postmark is on or before the date prescribed for filing of the federal individual income tax return. TIMELY FILING: For your federal return to be considered filed on time, your return must be postmarked on or before midnight April 15, 2010. Intuit's electronic postmark is issued in the Pacific Time (PT) zone. If you are not filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark time to determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone and you electronically file your return at 9 AM on April 15, 2010, your Intuit electronic postmark will indicate April 15, 2010, 6 AM. If your federal tax return is rejected, the IRS still considers it filed on time if the electronic postmark is on or before April 15, 2010, and a corrected return is submitted and accepted before April 20, 2010. if your return is submitted after April 20, 2010, a new time stamp is issued to reflect that your return was submitted after the IRS deadline and, consequently, is no longer considered to have been filed on time. If you request an automatic six-month extension, your return must be electronically postmarked by midnight October 15, 2010. If your federal tax return is rejected, the IRS will still consider it filed on time if the electronic postmark is on or before October 15, 2010, and the corrected return is submitted and accepted by October 20, 2010. 2. THE ACCEPTANCE DATE. Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return. FDIU0401 11119ID9 0 Electronic Filing Instructions for your 2009 California Tax Return Important: Your taxes are not finished until all required steps are completed. / / Lindsay M Duke 2465 Del Prado La Verne, CA 91750 1 Balance 1 Your California state tax return (Form 540 2EZ) shows a refund due to Due/ I you in the amount of $101.00. Your tax refund should be direct Refund I deposited into your account within 8 to 14 days after your return is accepted. The account information you entered - Account Number: 1 1127601866 Routing Transit Number: 122000661. Where's My Refund? What You Need to Sign Do Not Mail What You Need to Keep Before you call the Franchise Tax Board with questions about your refund, give them 8 to 14 days processing time from the date your return is accepted. If then you have not received your refund, or the amount is not what you expected, contact the Franchise Tax Board directly at 1-800-338-0505. From outside of California use 1-916-845-6500. You can also visit the Franchise Tax Board web site at http://www.ftb.ca.gov/online/refund/. 1 Sign and date Form 8453-OL within 1 day of acceptance. I I Do not mail a paper copy of your tax return. Since you filed electronically, the Franchise Tax Board already has your return. Your Electronic Filing Instructions (this form) - Form 8453-OL and attachment(s) Printed copy of your state and federal returns 2009 Taxable Income $ 12,940.00 California Total Tax $ 62.00 Tax Total Payments/credits $ 163-00 Return 1 Amount to be Refunded $ 101.00 Summary 1 Effective Tax Rate 2.3% Page t of 1 w s Oat DO NOT MAIL THIS FORM TO THE FTS TAXABLEYEAR California Online a -file Return Authorization FORM 2009 for Individuals 8453.OL yp,r ,r,i�e �p h�tlY lastname Your SSNartIN LINDSAY M DUKE 571-91-4531 tr)*t ratum•"msewitDpa natnr sw inluel Lntmme SPweeemDP'a SSNamN Addma(xlduang numberand WUL PO Sox, a PMB w.) Apt noAte,m DeylYna telePbone number 2465 DEL PRADO CRY state ZlPwde LA VERNE CA 91750 Part I Tax Return Information (whole dollars only) 1 Califomla ad(usled gross Income. (Form 640, line 17; Form 640 2EZ, line,16; Long Form 540NR, line 32; or Short Form MR, fine 32)............................................. 1 16,577. 2 Refund orno amount due. Form 540, line 116; Form 640 2FZ, line 28; Long Forth 640NR, line 125; or Shut Forth 540NR, line 126)............................................ 2 103'. 3 Amount you owe. (Form 540, line 111; Form 540 2EZ, line 27; Long Form 540NR, line 121; or Short Form 540NR, fine 121) .................................................. 3 Part II Settle Your Account Electronically for Taxable Year 2009 (Due 04115/10) 4 N Direct deposit of refund S Electronic funds withdrawal Sa Amounf B b Withdrawal data(MM/DD/YYYY) Part III Make Estimated Tax Payments for Taxable Year 2010These are not instalment paymemsfor mecurrent amount you Owe. First Pa Due4115110t Second ant Due6N5/110 Third 1151110 Due9 Fourth ll illnt 18 eAmount ..................... 7 Withdrawal dale . . . ............ . Part IV Banking Information (Have you verified your banking Information?) a Amount of refund to be diteclly deposited to account below 12 The remaining amount of my refund for direct deposit 101. e Routing number 122000661 13 Routing number 10 Accountnumber 1127601866 14 Account number 11 Typeofaccounl• W Checking Savings 15 Type of account: nChecking nsavings Part V Declaration of Taxpayer(s) I auaotbe my account to be settled as designated In Part II. If l check Part 11, box 4,1 declare gist the direct deposit refund Information In Pan IV agreeswith the authorization stated on return,Iau9rodreanelcuonlcflrkswithdrewalfor the amount fistedonhas 5aand any estimatedpsymentamowitsistedonOne 6framlzaaauntWed onlines 9,10, ,u,d ii. rl haveaed a inia retum. this B an irrevocable anointment of the other scousefRDP as an aaem to receive the refund or authorize an electronic funds withdrawal. It Is unlawful to forge a spouse'srRDP's signature. For Privacy Notice, gat form FTB 1131. FTB 8463-OL C2 2009 CAIA8201 02108110 0 r For Privacy Notice, get form PTO 1131. FORM California Resident Income Tax Return 2009 540 2EZ D1 aide 1 P 571-91-4531 DUKE ** 09 AC LINDSAY M DUKE A R RP 2465 DEL PRADO LA VERNE CA 91750 Filing Status Filing Status. Check the box for your filing status. See instructions. 1 X Single 2 Married/RDP filing Jointly (even If only one spouse/RDP had Income) 4 Head of household. STOP] See Instructions. 5 Qualifying widower) with dependent child. Year spouse/RDP died _ If your Celifomia filing status is different from your federal filing status check the box here . , • n Exemptions 6 If another person can claim you (or your spouse/RDP) as a dependent on his or her tax return, even if he or she chooses not to, you must see Instructions • 8 7 Senior. If you (or your spouaWRDP) are 85 or older, enter 1; if both are 65 or older, enter 2 .......... • 7 Dependent 8 Number of dependents. Enter name and relationship (Do not Include yourself or your spouse/RDP) .... • 8 Exemptions Taxable 9 Total wages (federal Form W-2, box 16). Income and See Instructions ...................................... • 9 26,490. Credits 10 Total Interest Income (Form 1099-INT, box 1). See Instructions .............. • 10 87. 11 Total dividend Income (Form 1099-DIV, box 1a). See Instructions ............. • 11 12 Total pension Income See Instructions. Taxable amount ... • 12 Enclose, but 13 Total capital gains distributions from mutual funds (Form 1099-DIV, box 2a). do not staple, See instructions ...................................... • 13 any Payment. 14 Unemployment compensation ................ 14 18 U.S. social security or railroad retirement benefits ...... 15 Attach a c of 16 Add line 9, line to, line 11, line 12, and line 13. Do not Include line 14 and line 15 .... • 16 16,577. your Form(( CA sch W-2CG. 17 Using the 2EZ Table for your filing status, enter the tax for the amount on line lit. Cau on: If you checked the box online 6, STOP. See instructions, Dependent Tax Worksheet....................................... 17 122. 18 Senior Exemption: See instructions. If you are 85 and entered 1 in the box on line 7, enter $98. If you entered 2 In the box on line 7, enter $196................. 1s 19 Nonrefundable renters credit. See Instructions ....................... • 19 60. 20 Credits. Add line 18 and line 19 .............................. 20 60. 21 Tax. Subtract line 2D from line 17. If zero or less, enter-0 .................. • 21 62. p� 3111094 r' CAM612 lzrosros 0 0 Your Nana: LINDSAY M DUKE YoorSSNormN. 571-91-4531 Owrrppaald Tax/ 211a Enter the amount from Side 1, line 21 .............................. 2a 62. Tax Dua. 22 Total tax withheld (federal Form W-2, box 17 or Form 1099-R, box 10) .... , . , .... • 22 163. 23 Overpaid tax. If line 22 Is more than line 21a, subtract line 21a from line 22......... • 23 3.01. 24 Tax due. If line 22 is less than line 21a, subtract line 22 from line 21a. Seeinstructions ......................................... 24 0. Use Tax 28 Use tax. This Is not a total line. See Instructions ........ • 26 Code Amount Code Amount CASeniors Spacial Fund. Sea lnatodlens .......... 0 400 Atsholners Dbeua/ReWed Dlsordep Fund . ... . . . . . 401 CA Fund or Senlor Clamp . . . . .. . ... . . . . . . 0 402 Rae end Endo gwo spades Preamum Program ...... 0 403 Sup Claldren's Tmst Fund for the P"dion of child Abuse ... 0 404 CASrMRCnrrcer Rseserch Fund . . . . . ... ..... 0 405 CARONMOWMemodal Fucl............... • 406 Etnerp" Food For Families FUnd............. • 407 CA Pan= Officer Mamrlal FmndsWm Funtl ..... • 408 CA MKM Psmiiy Relef Fund..... . . .... * 409 CA San Oder Fund ........ . . . .... 0 410 CA Owaran cancer Research Fund .... . .... • 411 Murodpal shear sprydlsuter Fund......... • 412 CA Caner Research Fund ............ 0 413 ALSA.ou Gehrio Dissm Research Fund ...... 0 414 26 Add amounts in code 400 through code 414. These are your total contributions ...... 0 26 Amount 27 AMOUNT YOU OWE. Add Ilne 24, line 25, and line 26. If line 231s less than line 25 You Owe and line 26, enter the difference here. See Instructions. (Do Not Send Cash) Mall to: FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 4267-0001 .. • 27 Direct Deposit Pay online — Go to ftb,ca.gov, and search for web pay. (Refund Only) 28 REFUND OR NO AMOUNT DUE. Subtract fine 26 and line 26 from line 23. See instructions. Mall to: FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 24240-0002 .............................. • 28 101. Fill in the Information to authorize direct deposit of your refund into one or two accounts. Do not attach a voided check or e deposit slip. Have you verified the routing and account numbers? Use whole dollars only. All or the following amount of my refund (line 28) is authorized for direct deposit Into the account shown below: Checking 122000661 Savings 1227601866 101. * Routing number • Type 0 Accountnumber 0 29 Direct Deposit Amount The remaining amount of my refund (line 28) is authorized for direct deposit Into the account shown below: Checking Savings • Routing number • Type • Accountnumber 0 30 Direct Deposit Amount Under penalties of per)ury, I declare that, to the best of my knowledge and belief, the Information on this return is true, correct, and complete. Yowslpnahms SpousasIROP'ssigneture(IfBrngonty, both mustelgn) Daytime phone mimber(optional) Sign Here bis�a Date Itnprooyy elfin '1ffl. DPs X X Jolntrollm4 Paid prspan's Winston, (declaration of prepawIs based on an information of which pmpamr has any knowledge) 0 paid Pnpames SSWPTIN sesestnadws. SELF PREPARED Fmn's nams for youu a"IF."luyed) Fem'saddrees 10 FEIN Do you went to allow another person to discuss this return with us (see Instructions)? ......... , • U Yes Print ThlM Party Oeslgnsi s Name Telephone Number Side 2 Form 640 2EZ C1 2009 0� 3112094 r— CATA4812 12109109 E VILLA POINT I (Offs-atte Baywood Apartments) Unlit No. 2'3 5 -73� W , M&�h(& CERTiFICATION OF CONTINUED HOUSEHOLD ELIGiBILITY (Far tonanO not In possession of it Section 8 certintnte or vouctier, income doevmentelloo must be obtelned.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that 1. The undersigned is/are the only income earning occupant(s) of the above Indicated leased premises; and, 2. During 2009 the Total Annual Eligible Income* of the undersigned Individual(s) was $ — � ; and, 3. During 2009, my total monthly rent payment to Villa Point t (Off -site Baywood Apartments) was $ I-z o per month. " Total Annual Eligible Income Includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to eXclude hostile flre allowance). The undamIgnad acknowledge(c) -that--Villa point., IAPff-site Bbywo6d-ApartftYWi1s)Wd ' fd' City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricta the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below. Names and Ages of Non -Income Earning Household Member(s): Ago of Income Earning VILLA POINT 1(Off-site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that; 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) was $ Ej 26) a r Do; and, 3. During 2009, my total ally r� payment to Villa Point I (Off -site Baywood Apartments) was $ m l per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Signature Signature 1 Date: � /3 VW_- — VILLA POINT I (Off -site Baywood Apartments) Unit No. �ah �./ s�1 qub,rw' CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point 1(Off--site Baywood Apartments) that: 1. The undersigned istare the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) was $ 46) i P(16 , -..; and, 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ - - DC per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Signature� -- — Signature Date: Signature VILLA POINT I (Off -site Baywood Apartments) Unit No! C'1�7� CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) was $ = S. "365 ``.� ; and, 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 14% ri,L_ per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Member(s): Name Age V �e rL t_ Y 1.,--IX 5,7 � t ,- - Jr! Signature(s) of Income Earning Household Member(s): Signature vJ wt_,GyL L c Signature -- —--- - i�Signature Date: /2)7,r)P _ VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession or a Section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) was c 00 ;and, 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 11. 2�Li per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): 51®nature .. .._ Signature. ._. .W --JV� Signatures_ Date: r] • VILLA POINT I (Off -site Baywood Apartments) Unit No.� CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tonants not in posso"ion of a section s certificate or voucher, Income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned Istare the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individuals) was $ 60. M ; and, 3. During 2009, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ L, 170 per month. • Total Annual Eligible Income Includes: wages, tips, overtime, bonuses, commissions, net Income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information In the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification Is made under penalty of perjury In Newport Beach, California on the date Indicated below: ' Names and Ages of Nondncoma Earning Housohoid Signatare(s) of Income Laming Household Member(s): Member(s): Nano Ago Date: VILLA POINT I (Off -site Baywood Apartments) Unit No. Y-aq J v-- ✓ CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, Income decumentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2009, the Total Annual Eligible Income* of the undersigned individual(s) r+was$!qDf/ ;and, _& -)e4l_ S�GG7Y/�JJ `1 3. During 2009, my total monthly ren payment to Villa Point I (Off -site Baywood Apartments) was $ 1 1 C1Gi�_ per month. ' Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony; child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): i Name Age r � SI9naLure 44, Signal��7 Signature Date: eye, 1/11)r-=s ;/F l2A=STGX SvT41 �J�- P_=Cl6Igt I— F6IL An R IC .o iR i- is , .e I, - . x l I,l .. ... l Irvine Apartment Communities Baywood Apartments/Villa Point I Program Affordable Housing Agreement- dated November 13, 1990 LOW. Villa Points ("On # APT. RESIDENT NAME $TTP FLOOR SIZE # OF OCC. MOVE IN DATE MOVE OUT DATE' HOUSEHOL1$1595-MkQ1 INCOME RENT RECERT DUE 59+'' 281 LINDAHL 2+2 3 4/09/02 PHA $1,365.00 4/01/09 315 HEILIG 2+2 2 , 8/11190 PHA $1,365.00 4/01/09 #3I 323 STULL 2+2. 2 6/29/91 PHA $1,365.00 4/01/09 ,1 333 COTTA 2+2 3 6/18/05 $55,400.00 � $1,490.00 4/01/09 lib` • 337 REESE 2+2 2 6/23/96 $53,803.00 /$1,365.00 4/01/09 w z1) 344 HELAL 2+2 4 8/20/07 $28,600.00 �$1,485.00 4101/09 345 MCGOWEN 2+2 1 1 1 8131/04 $15,000.00 1 $1,225,00 4101109 353 DUMITRESCU 2+2 4 10/09/07 $56,000.06 i$IA85.00 4/01/09 FA 356 SISSON 2+2 1 7/06/91 PHA $1,365.00 4/01/09 513 COLE 2+2 2 10/09/97 PHA $1,326.00 4/01/09 1r, 656 NORTH 2+2 2 3/15197 PHA $1,315.60 4/01/09 742 VELA 2+2 2 10/12/01 $27,160.00 $1,485.00 4/01/09 HICKS 2+2 2 4/16/97 $26,100.00 i$1,260.00 4/01/09 783 MELGOZA 2+2 1 6/14/go PHA $1,315.00 4/0.1/09 MEDIAN -Villa Points ("M") # APT. RESIDENT NAME $TTP FLOOR SIZE # OF JOCC.1 I MOVE IN DATE MOVE OUT DATE HOUSEHOLD INCOME RENT ($1595- Mkt) RECERT DUE 325 TRAN 2+2 1 3 1 9/01/07 PHA $1,560.00 4101/09 335 VACANT 2+2 $1,595.00 3 , 346 VACANT 2+2 $1,575.00 347 MAYFIELD 2+2 2 9/07105 $46,500.00 $1,496.00 4/01/09 ti 676 OSTERSTOCK 2+2 2 6/16/08 $36,962.00 $1,496.00 4/01/09 735 MATHRE EMP 2+2 2 4101/07 $43,099.001 t $1,660.00 4/01/09 744 JOSKA 2+2 2 7/12/08 $60,805.00 $1,496.00 4/01/09 745 N. HAGHIGHAT 2+2 2 9/12/06 $43,000.00 $1,496.00 4/01109 9 757 HUGHES 2+2 1 2 1 10/26/02 $37,376.00 $1,496.00 4101/09 782 WITTMAN EMP 2+2 2 Total number of apartments on this property: 556 # of property deemed Income Restricted (Low 80% or below): 14 # of property deemed Income Restricted (Median 100% or below): 14 TTP =Total Tenant Payment (Resident is: an Employee; on Certificate/Voucher) dCCotnmuni, Pesources Orange County Housing Authority 1770 N. Broadway • Santa Ana, CA 92706 (714) 480-2700 • (714) 486.2926 Too httpz//www,ochousing.org 04/16/2009 Fax Numbers: • Occupancy (714)480-2701 (714)A60-293? (71:4)480.2919 Leasing/Inspections (714)'480.2822 TenantlD:10355 Speclal Housing Programs (714),480.2812 Irvine Apartment Communities Tiare Lindahl C/o The Bays Apts 281 Baywood Dr 1 Baywood Dr Newport Beach, CA 92660 Newport Beach CA 92660 Dear: Irvine Apartment Communities This letter is to inform you,of a CHANGE IN RENT as follows: Previous Tenant Share $945d10 - Previous housing Assistance Payment $420.00 Previous Rent to Owner $1,365.00 TcnanVs.New Share Rent $923.00 Now Housing Assistant Payment $442.00 New Contract Rent $1,,365.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent.increase (new contract rent yotvrequested) You will receive a separate notice with adjusted owner portion from your Pield Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above, Those changes will becoao-offoctive'05/01/2009. If you have questions please call Prances Nguyen at (714) 4804753. HAPPY Software, Inc. fn4/1612009 Fax Numbers: Community Resources (7r4Occupancy 480-27 1 'w �""" ".....„. (714) 480-2937 OrangeCounty (714) 4so-29i9 1770 N. Broadway - Santa Ana, CA 92706 Leasing/Inspections (714) 480.2700 • (714) 480.2926 Too (714) 480.2822 http://www.ochousing.org SpeclarHousing Programs (714) 4804812 05/22/2009 Irvine Apartment Communities C/o The Bays-Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities Tenant lD:6709 Joyce E. Heilig 315 Baywood Dr Newport Beach, CA 92660 This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $400.00 Previous Housing Assistance -Payment $965.00 Previous Rent to Owner $1,365:00 Tenant's New Share -Rent $600;00 New Plousing.Assistant Payment $765,00 New Contract Rent $1,365;00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may notreflect a pending, rent -increase (new contract rent you requested.) You will receive a separate notice witlt_adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAY ME, NTS,GONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 07/01/2009, If you have questions please call Yvonne Taylor at 71-4-480-27-09. HAPPY soawaro, Ina YTS12MO09 . CCN.Ir-M1V W �u:.. , Rjn zxxty Resources R Orange County Housing n.g Authority 1770 N. Broadway • Saka An6, CA 92706 (714) 480-270b - (714) 480-Z926 TDD hMp;//www. ochOUsing. org 06/24/2009 Irvine Apartment'Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 ��---"Dear:�(lvine Apartment i✓arrtmunifies�' Tenanfllp: 6689 FaLIZ x Numbers: Occupancy (7141 480?2701 (714) 480.2937 (714) 480.2919 LoWng/tnspactions (714)480•2092 Spacial Housing Programs (714) 480-2812 Julle W'Stull, 323 Baywood Dr Newport Beach, CA 92660 This letter is to inform you of a CHANGE W RENT as follows; Previous Tenant Share $496.00 PreviousZousing Assistance Payment $869.00 Previous Rent to Owner $1,365.00 Tenant's New Share Rent $530.00 Now Housing Assistant Payment $835.00 New Contract Rent $1,365.00 IMPORTANT NOTICE . PENDING BENT INCREASES - The above contract rent amount may not reflect a pending rent increase (new contractrent you requested) You will receive a separate notice with adjusted owner portion fTona your Pield'Representative when -the rent inereasc is completed. A1V;GENAMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01 /2007 shall ,prevail except for the changes shown above. These changes will become effective 08/01/2009. Ifyou have questions please call Wonne Taylor at 7Z4-480-2709. HAPPY 6oflwar0, Inc, YTe/24/20091 CCoxnmuriity Resources Orange County Housing Authority 1770 N. Broadway • Santa Ana, CA 92706 (714) 480-2700 • (714) 480-2926 Too http;//wWtv.ochousing.org 07/24/2008 • 4. t �G�'r� L Fax Numbers: occupancy (714)400-2701 ,(711)T480-2937 (,7i4),480.2919 Leasing/Inspections (714)480.2822 Speciai•Housing Programs (714),480.2012 TenantiD:6690 Irvine Apartment Communities Leslie H. Sisson C/o The Bays,Apts 356 Baywood Dr 1 Baywood Dr Newport Beach, CA 92660 Newport Beach CA 92660 Dear: Irvine Apartment Communities This letter is to inform you of a CHANGE IN RE, Was follows: Previous Tenant.Share $197.00 Previous Housing Assistance Payment $1,168.00 Previous Rent to Owner $1,365.00 Tenant's New Share Rent $88.00 New, dousing Assistant Payment $1,277;00 New Contract Rent $1,365400 IMPORTANT NOTICE - FtNDING'RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new -contract rent you requested:) You will receive a separate notice with adjusted owner portion from your Rield Representative when -the rent increamis completed. AMENDMENT'TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08701/2007 shall prevail except for the changes shown above, These clianges will'beconc effective 09101/2008. If you have questions please call Yvonne Taylor at.(714) 480-2709. HAPPY Software, Inc. ' Yr07/242008 cicq' minces ty Resources Orange County Housing Authority 1770 N. Broadway , Santa Ana, CA 92706 (714) 480.2700 - (714) 480.2926 Too http://www.ochousing.org 05/20/2009 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities Tenant-ID:,6695 avLX(-,e-.( t l fax Numbers: Occupancy (714) 480-2701 (.714) 480.2937 (77A)480-2919 Leasin0(tnspections (.714) 480.2022 Special Housing Programs (714)480-2812 Vivian J Cole 513 Baywood Dr Newport Beach, .CA 92660 This letter is to inform you of a CHANGE, IN RENT as,follows: Previous Tenant Share $259.00 Previous Housing Assistance Payment $1,066.00 Previous Rent to Owner $1,325.00 Tenant's New Share Rent $248.00 New housing Assistant Payment $1,077.00 New Contract Rent $1,325.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending relit iacrease,(new contract rent you requested:) You will receive a separnto notice with,adjusted owner portion fronlyour Field Represeritative,when the rent increase is completed, AMENDMENTTO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract, signed on 08/01/2007 shall prevail except for the changes sbown.above. These changes�will become effective 06/61/2009., If you have questions please,call Yvonne Taylor at 714-480-2709. HAPPY Software, Inc. YT512012009 Fax Numbers: a Comnainlity Resources (714Occupancy0. (714) 160-2937 Orange County -'Housd'ntAut ority (714)480-2919 1770 N-, Broadway - Santa Ana, CA 92706 teasing/Inspections (714) 480-2760,- (714p400.2926 Too (714) 480118-22 http://www.ochousing.org Special HousingPrograms, (714) 480.28t2 01/28/2.009 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities Tenant ID, 6740 Dawn Bender, 656 Alderwood Dr Newport Beach, CA 92660 This letter is to inform you of a CHANGE, IN RENT a&follows: Previous Tenant Share $167.00 Previous I•iousing Assistance Payment $1,173.00 Provious Rent to Owner $1,340,00 Tenant's New Share Rent $197.00 New Housing Assistant Payment $1,143.00 New Contract Rent S1,340:00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above -contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive,a separate notice with -adjusted owner portion from your Field Representative when.tlie rent increase is completed, AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01,/2007 shall prevail except for the chauges,shown above. These changes will become effective 03/01'l2009. If you have questions -,please Call Yvonne Tnylo)•,at (714) 480-2709, HAPPY Software, Inc. YT112812009 Fax Numbers: • • , ,. ,... occupancy l�o� COTT1171L1117t 1�090i11'CGS (714)-480.2701 ^,•""•,. ."'..".""' p yy q. (714) A80,2937 Orange County � 'fous n L'.1n'1 h#Irity (714) 480-2919 1770 N. Broadway • Santa Ana, CA 92706 Leasing/Igspectlons (714) 480, 2700 • (7-14) 480-2026 Too (714) 480.2822 littp;//www,ocliousing.org Special Housing Programs (714)480-2812 05/28/2009 T.enantlD:1335 Irvine Apartment Communities Van M. Tran C/o The Bays Apts 325 Baywood Drive 1 Baywood Dr Newport Beach, CA 92660 Newport Beach CA 92660 Dear: Irvine Apartment Communities This letter is to inrortiryou of a CHANCE 1X=1 NT as follows: Previous Tenant Share $710.00 PreviousdIousing Assistance Payment $850.00 Previous. Rentto'Owner $1,560.00 Tenant's New Share Rent $680.00 New Housing Assistant Payment $880:00 New-Contrict Rent $1,560.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not,reflect a pending rent increase (new contract rentyou requested) You will receive a separate notice -with adjusted owner portion from your Meld Representative when the rent increase is completed. ATY12NDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT; The contents of the Housing Assistance Payment Contract signed on 09/0112007 shall prevailexcept for the changes shown above. These changes will become effective 07101/2009, If you have questions please call Yvonne Taylor at 714-4804709. HAPPY Software, Inc. 'YT6128/2M dCColninutaty Resources Orange County Housing Authority 1770 N. aroadway - Santa-,,Apa, CA 92706 (714) 480-2700- (714) 480.2926 Too http://www,ochousing.org 05/14/2009 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear: Irvine Apartment Communities Tenant lD:'11'95 Fax Numbers: Occupancy (714)480.2701 (714)480-2937 (714) 480.2919 Leasing/Inspections (714),480.2822 Speclai Housing,Programs (714)480.2812 Rose E. Melgoza 783 Alderwood Newport Beach, CA 92660 This letter is to inform you of a -CHANGE IN RENT as follows: Previous Tenant Share $208.00 Previous I-lonsing Assistance Payment $1,107:00 Previous Rent to Owner $1,315.00 Tenant's New Share Rent $200:00 Now Housing Assistant Payment $1,115.00 New ContractRent $1,315.00 IMPORTANT NOTICE -PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested,) You will receive a separate notice with,adjusted,ownerportion from your'Pield Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE, -PAYMENTS CONTRACT: The contents of the Rousing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 07/01/2009. Ifyoubave questions please call Yvonne,Taylor at 714.480-2709, HAPPY Software, Inc. YT5l14/2009 O July 10, 2009 City of Newport C/O Ms. Fran Meyer LDM Associates, Inc. 10722 Arrow Rout, Suite 822 Rancho Cucamonga, CA 91730 RE: Villa Point I — (Off Site Baywood) 2008 Annual Compliance for Qualified Households Dear Fran, The attached information is in response to your request dated June 5`h and is related to our 28 affordable units at The Bays Apartment Homes participating in the Villa Point I Program. Please let me know if you require any further information to support our current household(s) compliance. Sincerely, The Irvine Company LLC, A,Delaware Limited Liability Company Barbara Breton HCCP, COS, C9P, NCP-Excc.,TaCC'S SeniorManager BMR Compliance Irvine Company Apartment Communities 110 Innovation I Irvine, California 1 92617-3040 Phone 949.720.3476 1 Fax 949.720.5257 bbreton(airvinecomapny.com CC: Kenneth McCarren G, IRVINE COMPANY APARTMENT Since 1864 COMMUNITIES July 10, 2009 City of Newport C/O Ms. Fran Meyer LDM Associates, Inc. 10722 Arrow Rout, Suite 822 Rancho Cucamonga, CA 91730 RE: Villa Point I — (Off Site Baywood) 2008 Annual Compliance for Qualified Households Dear Fran, The attached information is in response to your request dated June 5`h and is related to our 28 affordable units at The Bays Apartment Homes participating in the Villa Point I Program. Please let me know if you require any further information to support our current household(s) compliance. Sincerely, The Irvine Company LLC, ¢,Delaware Limited Liability Company Barbara Breton HCCP, COS, C9P, NCP-Exec.,TaCC's Senior Manager BMR Compliance Irvine Company Apartment Communities 110 Innovation I Irvine, California 1 92617-3040 Phone 949.720.3476 1 Fax 949.720.5257 bbreton(@,irvinecomai)ny.co CC: Kenneth McCarren 14 IRVINE COMPANY,I APARTMENT Since 1864 COMMUNITIES • VILLA POINT I (Off -site Baywood Apartments) Unit No. `� 3 ./ CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) INVe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008 the Total Annual Eligible Income* of the undersigned individual(s) was $ Clb ; and, 3. During 2008, my total o thl rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1 40• 0 c) per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age 6Uo, &4-6, -7 Signature(s) of Income Earning Household Member(s): Date: /U Z A a 2 &- Signature Signature Signature VILLA POINT I (Off -site Baywood Apartments) Unit No. 337 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises and, 2. During 2008, the T�tai Annual Eligible Income* of the undersigned individual(s) was $ t7v� ; and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ / Na , ` per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification Is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Signature Signature Signature Date: 6 _ 1 % _o i VILLA POINT 1(Off--site Baywood Apartments) Ila_.PP? OC/Lb Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During'2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ Ga-O ; and, `VW�vS kac. vN.4 VS wo,rbin 'rkM6+FkS �— \h USA, worked 5 mc�bkg alio���* 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ \ i t-i 96 per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification Is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Name Age �.r "Ayy\U A9VI —+PSIutr\i\a1 Signature(s) of Income Earning Household Member(s): Signature Date: Ll Fran Meyer From: Barbara Breton [bbreton@irvinecompany.com] Sent: Friday, August 21, 2009 2:58 PM To: fineyer@mdg-Idm.com Subject: RE: The Bays - Villa Point I Affordable Program Hi Fran - I am out of the office next week. I have asked the property to circulate a new cart of compliance form to Ms. McGowen; not sure if I will get it back before the end of day. So I went to her online ledger and have pasted her info for you to see, her rent, currently is $1225 (+ a $25 pet premium). Will this suffice for our needs to close this out? - thanks Barbara Apartment : 03- 345 Apartment Type: 22Q2 Apartment Status: Normal Apartment Sub Type: CP Resident Status: Current Market Rent: 1595.00 Resident Name: Beverly McGowen Address: 345 BAYWOOD DRIVE Lease Profile Beginning Bal: $0.00 Billed: $1,250.00 Paid: $1,250.00 End Bal: $0.00 *Quoted Rent: [ ] Reqd. Security Dep: [ ] Stop Billing: [ ]{' Xecurring Charges ode e - 'Ends Begi4s Amount {---__ Next Due Frequency lJ __ __—_, Pro In I BiIlMonthly [Re V_V] [_ ] �,j' [Month) VI �' [ ] 11 [et [Monthly V. pre-m-(um Vl [- l� [ - 391 —]L! [ [Rent- [Monthly V� N.Y_-7�— [- -] [ ---7� Pet rernlurO_V] [Monthly V] [ ------3! [ .._ lY-! [____ _7 [- -_- [Rent- H,V VI _ [ ] [_ ]rr'' 9 [ _.--.._]r- [Monthly VI �- ] �' [ 9 [-- - 19 (Pet Pygmium V] [--___l=! T1 C [Monthly V] 41- [Monthly Vl [ LOWLV] ---' -- -- -- 11R[estpepri [ ]� [Monthly V] 6 T07 [ [ ] rl VJRnt - - - - -7 J 1 VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ Z— ; and, 3. During 2008, my total rat y rent paymen to Villa Point I (Off -site BaywoodSJ Apartments) was % d �% er month., e , e • Total Annual Eligibl come ' as: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age C 9 ') _ Sig atu Signature Signature Date: VILLA POINT I (Off -site Baywood Apartments) Unit No. 3 SS CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1, The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008 llie Total Annual Eligible Income" of the undersigned individual(s) was $ and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 14 � per month, * Total Annual Eligible Income Includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Date: slgnalure Va VILLA POINT I (Off -site Baywood Apartments) Unit No. % Z- CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (Tor tenants not in possession of a Section S certificate or voucher, intone documentntion must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 20�08M, the Total Annual Eligible Income" of the undersigned individual(s) was $ 52% °L&O, to; and, 3. During 2008, my total monthlyxent payment to Villa Point I (Off -site Baywood Apartments) was $ ///M W per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date Indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age I i W Signature(s) of Income Earning Household Member(s): —:�gk r' Signature Ole, Signature Signature Date: / �� E 0 VILLA POINT I (Off -site Baywood Apartments) Unit No. #7t~ LS (--� q-70—LS P-� CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (Ror tomnts not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ 11,30o :: ; and, $ ► A;a 900 s� 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ I.W) per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Name Age %sLA kAicls 31 Signature(s) of Income Earning Household Member(s): signature Signature Data: 10— I b . I • VILLA POINT I (Off -site Baywood Apartments) Unit No. (,Sy% CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (Ror tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ 46, 45-00 ; and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1., Hq6 per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, Interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification Is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non-Incomo Earning Household Member(s): Name Ago Signature(s) of Income Earning Household Member(s): `' re ure --1'-__ Signature Signature Date: 6 16Ab© VILLA POINT I (Off -site Baywood Apartments) Unit No. 762 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of Section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income" of the undersigned individual(s) was $ 3 61 q(' 2" ; and, 3. During 2008, my total m onthl rent payment to Villa Point I (Off -site Baywood Apartments) was $ �i per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age 06UeSS& —TJD 2� Signature(s) of Income Earning Household Member(s): Date: Signature A 0 0 ( 4:: a (:vt'i.t <SY .N 4Y �4, «:: ••• • Y <Y :: ) <. California Resident Income Tax Return 2008 640A cl side 1 NW W W�W,M%),YV,Cy WT)OM WMW4MW V OM V.v.,MPOW\tlVNtl OAN OFS0.W'AWOW WCOfY•YAtWS(,OW Your Orst name Imal last name your SSN or mN jp Kelly A Osterstock 2 9 6 } 9. 0 7 2 0 7 :.........................:......:...................................................:.......................................................................................................................... 1'tlointreturn,spcusesFi.P'snrstname Inieal Last name Spouse'sRCP'sSSGFiflN tAC . t W ...s........... _.. ...w .......: ..w. w..... _ .. ___ _ ..... .. _. w_._.. �.—AA Address (Including number and street, PO Box, or PMB no.) Apt. no/Ste. no. 676 Alderwood Drive ..... .......:.............:........................:.............:....................:......:.......:......:.......................... :..... ................................... Cav of you haveabreldn atltlresa see Dade el Stela RIPCoda Beach CA1926 S If you filed your2007 tax return under a different last name, write the last name only from the 2007 tax return. to Taxpayer_ at Spouse/RDP 1 0 Single 4 Head of household (with qualifying person). (see page 3) 2 �. )Married/RDP tiling jointly. (see page 3) 5 Qualifying widower) with dependent child. Enter year spouse/RDP died i.; 3 ;,>Married/RDP filing separately. Enter spouse's/RDP'sSSNorITINabove and full name here If your California filing status is different from your federal filing status, fill in the circle here ....................* p 6 If someone can claim you (or your spouse/RDP) as a dependent, fill in the circle here (see page 9)..............at 6 ...................................................................................................................................................................................................................................................................... ►For line 7, line 8, line 9, and line 10: Multiply the amount you enter in the box by the pre-printed dollar amount for that line. Whole dollars only 7 Personal: if you filled in 1, 3, or 4 above, enter 1 In the box. it you filled in 2 or 5, enter2In the box. s;t If you tilled in the circle on line 6, see page 9.................................................. 7 1 X $99 = $ 0 8 Blind: If you (or your spouse/RDP) are visually Impaired, enter 1; if both are visually Impaired, enter 2..... 8 ❑ X $99 = $ x. 9 Senior. If you (or your spouse/RDP) are 65 or older, enter t; if both are 65 or older, enter 2.......... • 9 ❑ X $99 = $ iu uepone ents: trier name are relatlonsmp.uonut rncmaeyou rsenaryaorspouselnur. Total dependent exemptions.......... • 10 ❑ X $309= $ 11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 21.......................11 $ 0 12 State wages from your Forms W-2, box 16 or CA Sch W-2, line 3 .........................0 12 :.......... .... 6 Z .4 6 .OU. 13 Enter federal adjusted gross Income from Form 1040, line 37;1040A, line 21; or 1040EL, line 4........... 13...... :.....:.....l...... • AAA $ ....00, 14 California Income Adjustments. See pages 10 and 11 for line 14a through line 14f. a State Income tax refund ............................... 14a _ . _ , , „ , 00 . It Unemployment compensation .......................... 14b... ....... ......................... ..OQ.. c U.S. social security or railroad retirement ................. 14c.......................................OQ.. d California non-taxable interest or dividend income........... 14d.......................................9Q.. a •`.•: a California IRA distributions ............................. 140 ................00. f Non-taxable pensions and annuities ...................... 141............................ DO. Total Califomla income ad ustments. Add line 14a through line 14f........................... • 14g .... 00. 17 Subtract line 14g from line 13.This is your California adjusted gross income ...................... • 17 .............. ,.......... ...... , ...:...... .... :,,00, "w18 Enterthe Your California Itemized deductions orstandard deduction larger of: shown below foryour filing status: w • Single or Marded/RDP filing separate) 3,692 • Married/RDP filing jointly, Head o1 household, or Qualifying widower) ... $7,384 If the circle on line 6 is filled in, STOP. (see page 11) ............................• 18 ....:.....:.... 19 Subtract line 18 from line 17. This is your taxable income If less than zero, enter-0 ..................19 :.... ...... :..... r........... , 6 r 3 , 0 ,1 ,100, 28 Tax. See Tax Table .......................................................................20......... ....:..........�....:6...3; 00; 21 Exemption credits. Enterthe amount from line ll. If Ilne 131s more than $163,187, see page 13.......................27 00. <- 28 Nonrefundable renter's credit. (see page 14) ..................... • 28 6 , 0 . 00 ' 29 Total credits. Add line 21 and line 28 ........................................'.................29...... ....:....t............ .,.... ,6...�...00; m 36 Subtract line 29 from line 20 .............................................................. 30...... ..... :.... ............. 32 Mental Health Services Tax. (see page 15)............ .........................• 32-,. . •. . 34 Add line 30 and line 32. This is yourtotal tax. If less than zero, enter-D. .........................• 34 :.............,............. _� 3121083 a.I;t 0• Yourname: Osterstock YourSSNorITIN: 2 9 6- 9 0- 7 2 0 7 35 Enter the amount from Side 1, line 34......................................................... 35:....:.........:.. _:...,.........:_� yuu, 36 California income tax withheld (see page 15)................... • 36 ..:..., ;..: 3;: 00. 37 2008 California estimated tax and payment with form FTB 3519 and amount applied from 2007 return............ • 37 :..•...,...:......:; 00,, ,.: 39 Excess SDI (orVPDI) withheld. To see if you qualify, (see page 15) . • 39 Child and Dependent Care Expenses Credit (see page 16). Attach fonn FTB 3506. • 40 ... ..!........... ........ ... ......;...._............ • 41...............n....... : .......,......'................................ • 42...... ...... 00. • 43 •..., 44 Total andcredits. Add line 36, line 37, line 39, and line 43............................................. payments Y•• .... 3 00, 46 Overpaid tax. If line 44 is more than line 35, subtract line 35 from line 44.............................. 45,.... c...., .... ,. .0 • 00 46 Enter the amount of line 45 you want applied to your2009 estimated tax ............................ • 46.., :..,. ,. :.0- . 0 • .00. . 47 Overpaid tax available this year. Subtract line 46 from line 45..................................... s 47:....:....,.... :....,..............�0 .... 9 . :. 46 Tax due. If line 44 Is Less than line 35, subtract line 44 from line 35. (see page 16)........................48- ...................................................................................................................................................................................................................................................................... ..:.. ,.....•.. . 49 Use Tax. This is not a total line (see page 16) .......... • ..I— „1 .„11,-.-.:M,- .•wn- ,-.a•�..-.n- CA Seniors Special Fund (see page 60) .................. ► 400 Atzhelmors Disease/Related Disorders Fund .............. ► 401 CA Fund for Senior Citizens ........................... ► 402 Rare and Endangered Species Preservation Program........ ► 403 State Children's Trust Fund for the Prevention of Child Abuse . .� ► 404 CA Breast Cancer Research Fund ....................... ► 405 D CA Firefighters' Memorial Fund ......................... ► 406 Emergency Food For Families Fund ►407 Amount, Qda Amoun 00 CA Peace Officer Memorial Foundation Fund. ►408 00 00 CA Military Family Relief Fund .......... ► 409 00 00 CA Sea Otter Fund .....................► 410 00 00 CA Ovarian Cancer Research Fund ....... ► 411 00 00 Municipal Shelter Spay -Neuter Fund ..... 0- 412 00 Oo CA Cancer Research Fund ............. ► 413 00 00 ALSA.ou Gehdg's Disease Research Fund . ► 414 00 ..................... .-- 61 Add code 400 through code 414. These are yourtmat contributions ............................. • 61.....................................RI QQ <Mw.tMNA�ICw..•Y..V.MMt.1roYtPoTY'<i Tb.w.�..amWIX#�C'�.iN�'�9%Yl�rot .. . •hvttnM'RY.MnY.i <">•.nWmY l.MO%N.:f NMfY%Ti,IY.N>5 �`wM. v.MAIX'.nCWPott R.,4f4.:!/t „ •'•^ 62 AMOUNT YOU OWE. Add line 48, line 49, and line 61 (seepage 17). Do not send cash. 1. ;rt) Mall to: FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267.0001 ................ • 62 , , 0 00 Pay Online- Go to our website at itb.ca.gov and search for web pay. :. ;:",64 Underpayment of estimated tax If form FTB 5805 is attached, till in this circle .................. • 64 -u 66 REFUND or NU AMOUNT DUE. Subtract line 49 and line 61 from line 47 (seepage 18). r' Mail to: FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240.0002................ 41 66 , , 0 -LLO sS FIII in the Information to authorize direct deposit of your refund into one or two accounts. Do not attach avoided check or deposit slip (seepage 18). Have you verified the routing and account numbers? Use whole dollars only. All or the following amount of my refund (line 66) is authorized for direct deposit into the account shown below: •Routing number *Type *Account number • 67 Direct deposit amount The remaining amount of my refund (line 66) is authorized for direct deposit Into the account shown below: ❑ Checking : ..i. ...; 0Savings :....i.....i...;.. .. 00 Imrunrnnr: Jvu ulumauuu:mus wnuu vutn yuu auvu:uolwlil: a wyy w,va,w ,F,c.c,eumu, ma, .vu F-uum---�F-,-r,,...•••,••,� , Sign I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, itstrue, correct, and Here complete. Your signature �•�� Spouse'srr♦DP's signature(if 0!L-,AlolmFyboth must sign)•....Dzgtime phone number (opdanal) It is unlawful to ( ......... ....... ).................................... forge aspouse'smDP'e X X Date -..0A/10/2009• Signature................................................................................................................................................................................:.:.:..:...........:..:......................... Paid preparer§signature(deehntlon of proparorh based on all lnlormalion of whleh preparerhas anY knewNdpe) ;Paltl preparerk SSNn'fIN anuu rewm r ' (See page 19) .. ........ .. ... ............ .... ..:F . , ....... ..... ... Flrm'S nimo(oryours, if self-employed) Flrtns ztltlress tEIN .........................................................................................................................................................................:..................... :.......... ................ . uu yuu wnur ru vuuw a:umu: pu:awr w u:m.uab uua IVLU:a w:m ua taw pdyn raai ............ u ma u rvu Print Third Party Designee's Name Telephone Number Side 2 Form 540A C1 2008 3122083 1 AA ' File by Mail Instructions for your 2008 Federal Tax'Return Important: Your taxes are not finished until all required steps are completed. OM MAT (If you prefer, you can still a -file. Go to the end of these instructions for more information.) Kelly A Osterstock 676 Alderwood Drive Newport Beach CA 92660 1 Balance i Your federal tax return (Form 1040A) shows you owe a balance due of Due/ i $141.00. Refund 1 You are paying by check. What You Need to Mail Your tax return - The official return for mailing is included in this printout. Remember to sign and date the return. Your payment - Mail a check or money order for $141.00, payable to ''United States Treasury". Write your Social Security number and 112008 Form 1040A" on the check. Mail the return and check together. Attach the first copy or Copy B of Form(s) W-2 to the front of your Form 1040A. Mail your return, attachments and payment to: Department of the Treasury Internal Revenue Service Center Fresno, CA 93888-0115 Deadline: Postmarked by Wednesday, April 15, 2009 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. I What You ) Keep these instructions and a copy of your return for your records. Needto I If you did not print one before closing TurboTax, go back to the Keep ) program and select Print & File tab, then select the Print for Your Records category. 2008 1 1 Adjusted Gross Income $ 9,993.00 Federal I Taxable Income $ 4,543.00 Tax i Total Tax $ 423.00 Return i Total Payments/Credits $ 282.00 Summary Payment Due $ 141.00 Effective Tax Rate 4.23% Changed I You can still file electronically. Just go back to TurboTax, select Your Mind ) the Print & File tab, then select the E-file category. We'll walk About ) you through the process. once you file, we will let you know if your efiling? i return is accepted (or rejected) by the Internal Revenue Service. Page 1 of 1 Fenn 1040A Dopam ant of t a Treasury — Inamal Rovo mo Sonko U.S. Individual Income Tax Return 992008 IRSuao On —Do mlwraeorstoainthae Label Your Mt name and initial Last name OMB No. 16460074 Your social security Umber (SminanagoMJ Kelly A Osterstock 296-90-7207 Usethe IRS label. Ifa)oml mom• spomm's that mine and lniaka Last nano Spouss'ssocid security amber Olhorwao, =print ertype. Homo addmss(number and steep Ifyou Mvoa P.O.bax.wehabucboM. Apamnonlm. . You must enter 676 Alderwood Drive yourSSN(s)above praaldentlal Cdy,townorpmtoinm.xyou Mvoofomlgneddmw,eooimb om. Sato Zpcoda Newport Beach CA 92660 Checking a box below will not change your tax or refund Campaign ► Check here if you, or yourspouse If filing olntl ,want $3 to got0 thlsfusee Instructions .. You Spouse Filing 1 Single 4 afhnd Head ousehdd(with quafdyirg person). (See instructions.) status 2 Married fibngjdn0y(even if only one had income) N If the qualifying person is a child but rlotyourdependent. 3 Married filing separately. Enter spouse's SSN above and enter this child's name here ► Chad only am boot. hill name here► 5 Qualifying widow(er) with dependent child see Instructions Exemptions 6a U Yourself. If someone can claim you as a dependent, do not check box 6a.......: 16aandfbaM koa on — bSpouse . . ...................................... If more than sh »olri WcOom c Dependents: (2) Dependents social security number (1) First name Last name (3)Dependents relationship to you (4) r qmaFn.ne dribm c`odA x No.or&who: chii 0chiar good lax W]LhY^a• a did not Ioouudeato aIv cs or Nparalbn (sea IMbudionq . Dependents on 6o not ardersdabovs d Total number of exemptions claimed ....... Add numbers . on Ilnsa above ► Income v vvages, samnea, ups, ea:. Human runn(s) vv-c ....................... r Attach Foml(s) 8a Taxable Interest. Attach Schedule 1 If required ........................ 8a W21fiere.Alse Mitch Forms) bTax•exempt interest. Dona include on ine Be ............. 8b 10WRiftax 9 a Ordinary dividends. Attach Schedule 1 H required ...................... 9a 1,459. was withheld. b Qualified dividends (see Instructions) .............. 9 b 9. 10 Capital gain distributions (see Instructions) .......................... 10 287. 11 a IRA distributions ..... .... 11 a 11 b I taxable amount .... 110 12a Pensions and annuities ..... 12a 12b Taxable amount .... 12b 13 Unemployment compensation and Alaska u yvvn,,... get a w•2, vermanent rung crivteencs................................. 1s reef owwom 14a Social security Encase, bN benefits ............. 14a 14 b Taxable amount .... 14b do rut attach, MY Payment. 15 Add fines 7 through 14b(tar right column). I his is yourtotal Income.. . ► 15 9,993. Adjusted 16 Educator expenses (see Instructions) ............. 16 gross 17 IRA deduction (see instructions) ................ 17 Income 18 Student loan interest deduction (see instructions) ....... 18 19 Tuition and fees deduction. Attach Form 8917 ......... 19 20 Add lines 16 through 19. These are your total adjustments ................. 20 21 Subtract line 20 from line 15. This is your adjusted gross Income ............. ► 21 9,993. BAA For Disclosure, Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 1040A (2008) FDIA1312 iV24M8 Fann1040A(2008) Kelly A Osterstock 296-90-7207 Page TeX, 22 Enterthe amount from line 21(adjusted gross income) .................... 22 9,993. credits, 23aCheck Te,Youwere hombefomJanuary2,1944, Blind �TOW boxes and lh spouse was hem before January 2,1944, Blind checked ► 23a payments b Ifyou are married filing separately and your spouse itemizes deductions, see instructions and check here ........................ ► 236 Standard c Check if standard deduction includes real estate taxes (see Instructions) .... ► 23c B Deduction 24 Enter your standard deduction (see left margin) ...................... 24 5,450. for — a People who 25 Subtract line 24 Tram line 22. If line 24 is more than line 22, enter-0 ............. 25 4,543. checked any you 26 If line 22 is over$119,975, or provided housingto a k5dwestern displaced individual, see instructions box on Tine Otherwise, mulct by p p 23a, 23b, or ply 53,50D b the tolal number of exemptions claimed on Ina 6d .............. 28 0. 23c or who 27 Subtract line 26 from line 25. If line 26 Is more than line 25, enter-0-. This is your can be taxable Income ...... . , .... .. ► 27 4,543. claimed dependent, a 28 Tax, Including any alternative minimum tax eeinstrs(see instructions) ....................................... 28 423. a All others: Singie or 29 Cmddfor child and dependent care expenses. Married filing Attach Schedule 2 . ...................... 29 separately, $5,450 30 Credit for the elderly or the disabled. Attach Schedule 3 .... 30 31 Education credits. Attach Form 8863.............. 31 Married filing Jointly or 32 Retirement savings contributions credit. Attach Form 8880 ... 32 Qual in 33 Child tax credit (see Instructions). Attach Form 890 if 33 widower-3, $10,900 required .................. 34 Add lines 29 through 33. These are your total credits .................... 34 Head of 35 Subtract line 34 from line 28. if line 34 is more than line 28, enter-0.............. 35 423. Household, $8,000 36 Advance earned Income credit payments from Form(s) W-2, box 9 .............. 36 37 Add lines 35 and 36. This is yourtotal tax ......................... ► 37 423. 38 Federal Income tax withheld from Forms W-2 and 1099 .... 38 282. 39 2008 estimated tax payments and amount applied from If you have a qualifying child, attach 2007 return .......................... 39 40a Earned Income credit (Etc) ............... No . 40a Schedule EIC. F b Nontaxable combat pay election. 40b 41 Additional child tax credit. Attach Form 8812 .......... 41 42 Recovery rebate credit (see Insus).......... . .... 42 43 Add lines 36 39 40a, 41 and 42. These are yourtotal payments ................... ► 43 282. Refund 44 If line 43 is more than line 37, subtract line 37 from line 43. This is the amount you overpaid... 44 45 a Amount of line 44 you want refunded to ou. If Form 8888 is attached, check here .. ►El 45a Direct deposit? See Instructions ►bRoudng number ..... XXXXXXXXX ► c Type: F1 Checking Savings and fill In 45b, 45c, and 45d or ►clAccount Form 8888. number ..... XXXXXXXXXXXXXXXXX 46 Amount of line 44 you want applied to your 2009 estimated tax ................. . ....... 46 Amount 47 Amount you owe. Subtract line 43 from line 37. For details on how to pay, youowe see Instructions ...................................... ► 47 141. 48 Estimated tax penalty (see Instructions ............ 48 Third party Doyou want to allow another person to discuss this return with the IRS (seeirstructions)? . . . . . . U Yes. Complete the following. No designee Personal Baemionoa's ► Phone numb I((iPIN) ► Sign Under ponahkrs ofpe4^I dedmegot l have examined this to= and accompanying schedules and slatemems, and to cola best of my kroxkdgc and belef. they arotnw,commeotl, end ecaumwy rat so amounts and souroes ofkwomu I roralvod during No tax year. Dodaroeon of pmparer(ollwr dwn cow taxpayer) Is based an all here mromwhon ofxawhliw propmar has any funmModge. Youraklnaturo I Dale Your occupation I Daytime Phom number Jdmretum? See insWdions. ' Chock if ProParorsseN orruN PreparersData Paid sigrwlwo , era w ed preparer's younlrmaan- Self -Pre.I ared use only (o omployad), ----------------------------------- EIN Pro NO. eddross. and ZIP code FDIA1312 M2410e Form 1040A(2008) Federal Information Worksheet ► Keep for your records paymentreceived (before offset) .................................... . Part I — Personal Information mronnanon in ran i is compiouny caicwawa from me rersonm mrormauon yvorasneers. Enter taxpayer and spouse Information on the applicable Personal Worksheet. Taxpayer. First Name ........ Kelly Middle Initial ....... A Suffix ......_ Lest Name........ (sterstock Social Security No..... 296-90-7207 Occupation........ Student Date of Birth ....... 10/06/1985 (mm/dd/yyyy) or Age as of 1/1/2009... 23 Daytime Phone.. Ext .. . Legally blind ...... . Date of death...... . Dependent of Someone Else: Can taxpayer be claimed as dependent of another person (such as parent)?........ © Yes No If yes, was taxpayer claimed as dependent on that person's return? .............. ©Yes No Credit for the Elderly or Disabled (Schedule R): Is the taxpayer retired on total and permanent disability? .............. Yes No Presidential Election Campaign Fund: Does the taxpayer want $3 to go to the Part II — Address and 2008 Spouse: First Name ....... . Middle Initial ....... _ Suffix ...... Last Name ....... . Social Security No.... . Occupation ...... . Date of Birth ....... (mm/dd/yyyy) or Age as of 1/1/2009.. . Daytime Phone.. Ext .. . Legally blind ...... .Li Date of death...... . Dependent of Someone Else: Can spouse be claimed as dependent of another person (such as parent)?........ ❑ Yes No If yes, was taxpayer claimed as dependent on that person's return? .............. Yes No Credit for the Elderly or Disabled (Schedule R): Is the spouse retired on total and permanent disabibty7.............. Yes No Presidential Election Campaign Fund: Does the spouse want $3 to go to the Address .......... 676 Alderwood Drive Apt NO. .. City ............. Newport Beach State..... CA ZIP Code ..... 92660 Foreign country...... . APO/FPO address, check If appropriate .......................................... APO ❑ FPO Home phone ....... . Check to print phone number on Form 1040 ................... Q Home Taxpayer daytime ❑ Spouse daytime Check if you were affected by a natural disaster in 2008.......................................... ❑ Federal filing status: 1 Single 2 Married filing jointly 3 Marled filing separately e Check this box if you did not live with yourspouse 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 Ifthe'qualifying person' Is your child but not your dependent: Child's name.... Child's social security number ... . S Qualifying widow(er) Check the appropriate box for the year your spouse died .......................... ► 2008 n 2007 n Part III — Dependent/Earned Income Credit/Child and Dependent Care Credit Information Information In Part III is completely calculated from the Dependent and Nondependent Information Worksheets. Enter Part III Information on ury r.. ...uv....................... �. First Name ------------- Las[ Name -..--.. -MI Suffix Social Security Number - - - - - - - - - - - Relationship Date --- Age of Birth - o d a quaed %?child tax credit Qualified eaxnpdensesincurred cexpe expenses Inpendent curred paid in 2008 E I C Uved with taxpayer In U.S. Education tuition and fees ndifea D e p --------------- -- ------------- - - - - - - - - ------------- -- ----------- --- --- - - "Yes' qualifies as dependent.'No' does not qualify as dependent. ruirarrz nmmou If you are eligible for the child tax credit orthe earned income credit enter amounts not considered earned income (see Help). Kelly A Osterstock 296-90-7207 Paget Part IV — Earned Income Credit Information (you must answerthese questions to calculate EIC) Is the taxpayer or spouse a qualifying child for EIC for another person? ......................... ►Yes No I I Was the taxpayers (and spouse's 8 married filing Jointly) home in the United States for more than half of 20087 .... ► Yes © No ❑ If the SSN of either the taxpayer, or spouse If married filing Jointl , 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) .................. ►El Check If you are filing head of household and your spouse is a nonresident alien and you lived with your spouse duringthe last six months of2008.............................................. .. ... ► Was EIC disallowed or reduced In a previous year and are you required to file Form 8862 this year?.......... ► Yes No X Check If you were notified by the IRS that EIC cannot be claimed in 2008.................................. ► 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 gfl No If you selected either of the options above, fill out the Information below: Name of financial Institution (optional) .............. ► Citibank Check the appropriate box ............ ► Checking X Savings LJ Routing number ................. ► 271070801 Accountnumber . . . . . . . . . ► 914108966 Iu e111W Ir11U1111HUM Iu1 ate 1r1etdl1riPoln^9le ttellt mequC t, see rU011 n4oO. Enter the following Information only if you are requesting direct debit of balance due: Enter the payment date to withdrew from the account above ..............................:... ► Balance -due amount from this return ........................................... . ► Part VI — Additional Information for Your Federal Return Standard Deductionikemlzed Deductions: Check this box 0 you are Itemizing for state tax or other purposes even though your Itemized deductions are less than your standarddeduction............................................................. ► 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: Form 1040A 1040EZ ► El Check this box to calculate Form 1040 even if you qualify to use or .......................... Real Estate Professionals: business? Help) ► ❑ Yes No Do you or your spouse qualify forthe special passive acbvhy rules fortaxpayers in real property (see . . . . . . . Credit for Qualified Retirement Savings Contributions (Form 8880): Is the taxpayer a full-time student? ................................................ ► Yes No Is the spouse a full-time student? .................................................► Yes 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 of bona fide residents of American Samoa, Guam, orihe Commonwealth of the Northern Mariana Islands Excludable Income from Puerto Rico Dual Status Allen Return: ► El Check this box If you are a dual -status alien ................................................ Third Party Designee: Caution: Review transferred Information for accuracy. ► Elyse No Do you want to allow another person to discuss this return with the IRS? ............................. If Yes, complete the following: Third party designee name .................... ► Third party designee phone number ............... ► Personal Identification number ... ► If you are entitled to a filing extension or other disaster relief provision as declared by the IRS, enterthe appropriate Information ................................... ► FDIY4912 11/05/08 Kelly A Osterstock 296-90-7207 Page Part VII — State Filing information Enter taxpayer and spouse state of residence on the applicable Personal Information Worksheet. Taxpayer: Enter the taxpayers state of residence as of December 31, 2008....................................... CA Check the appropriate box: Taxpayer Is a resident of the state above for the entire year ......................................... ► IX' Taxpayer Is a resident of the state above for only part of year ........................................ ► ❑ Date the taxpayer established residence in state above ................................. ► ....w.. .... ........ . . . . . . . . . . . . . . . . . . . . . . . . . . . Spouse: Enter the spouse's stale of residence as of December 31, 2008........................................ _ 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? ............................ ►_ Check this box if you live In the District of Columbia, Maine, Maryland, Massachusetts, New Hampshire or Vermont and file your return after June 30, 2009.......................................................... ❑ Nonresident states: Check this box If you are In a Registered Domestic Partnership, a civil union, or same -sex marriage ....................... ❑ 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 ...................................... e Check If this is the Joint return created to file Joint state tax return (see Help) .................................. . MIY4912 1110.510e Personal Information WorKsheet ZOUB For the Taxpayer ► Keep for your records QulckZoom to another copy of Personal Information Worksheet .................... ► QuickZoom to Federal Information Worksheet .............................. ► Part I — Taxpayees Personal Information First name... Kelly Middle initial . A Last name .. Osterstock Suffix ..... Social security no. .. 296-90-7207 Member of U.S. Armed Forces in 20087 . = Yes F No Date of birth ...... 10/06/1985 (mmlddlyyyy) age as of 1-1-2009.......... 23 Occupation .... Student Daytime phone.... Ext Marital status ... Single If widowed, check the appropriate box for the year your s use died: After2008 ►� 2008 ►Q 2007 ►2006 ►� Before2006 ► Can someone (such as your parent) claim you as a dependent? ............ ► X Yes No If so, are you actually claimed as a dependent on that person's tax return? .... ► X Yes No Are you retired on total and permanent disability? (for Schedule R, see Help)...... ► Yes No Check if this person is legally blind ............................ ► If deceased, enter the date of death .......................... ► (mmlddlyyyy) Do you want $3 to go to Presidential Election Campaign Fund? ............. ►= Yes FX No Part 11— Taxpayer's State Residency Information Enter this person's state of residence as of December 31, 2008 .......................... CA Check the appropriate box: 8 This person is a resident of the stale above for the entire year ........................... X 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 III — Dependent Care Expenses Qualified dependent care expenses incurred and paid for this person in 2008 ........... Kelly A Osteratock 296-90-7207 Page Part IV — Qualified Education 1 Are you enrolled In a degree, certificate, or credential program at a qualified institution? .......................................... Q Yes 0 No 2 Did you take post high-school classes at an eligible education institution to improve or acquire job skills? .............................. Yes No 3 Are you enrolled in the first or second year of education after high school? ..... Yes No 4 Did you carry at least 1/2 full-time class schedule for one academic period?....... Yes No 5 Have you been convicted of possessing or distributing a controlled substance?..... Yes No 6 Did you attend an eligible institution in the Midwestern disaster area? ......... Yes No 7 Check this box if you received a Form 1098-T ...................... 8 Check if you paid education expenses but didn't receive a Form 1098-T........ 9 Check if you received tax-free education assistance ................... 10 Qualified for the Hope credit? ............... . ................ Yes X No 11 Qualified for the lifetime leaming credit? .......................... Yes No 12 Qualified for the tuition and fees deduction? ........................ Yes I X No Check one of the three boxes below to manually choose a creditor deduction: 13 Choose to take the Hope credit? ............................. . 14 Choose to take the lifetime teaming credit? ....................... . 15 Choose to take the tuition and fees deduction? ..................... . QulckZoom to launch the Optimizer on the Education Tuition and Fees Worksheet ...... 16 Education Expenses: a Tuition amounts reported an Form(s) 1098-T ....................... b Enter other qualifying tuition paid that was not reported on a Form 1098-T....... c Enter amount of enrollment and attendance fees ..................... . d Enter amount paid directly to the institution(s) for books ................ . e Enter amount paid directly to the institution(s) for equipment ............. . f Enter amount paid directly to the institution(s) for supplies . . ............. . g Enter other expenses paid directly to the institution(s) ................. . h Total Education Expenses Add lines 16a through 16g ................ . 17 Tax -Free Education Assistance: a Scholarships or grants reported on Form(s)1098-T ........ . b Enter Scholarship amounts excluded from gross income ............... . c Enter Fellowship amounts received ........................... . d Enter Pell Grant amounts received ............................ . e Enter Veterans' educational assistance ......................... . f Enter employer -provided educational assistance .................... . g Enter other tax-free assistance .............................. . h Total Tax -Free Education Assistance Add lines 17b through 17g ......... . 18 Qualified Education Expenses. Subtract line 17h from line 16h. Calculates only if qualifying person for education .............................. . 19 Form(s)1098-T Copy No. School Name Qualified Tuition Scholarships or Grants Recovery Rebate Credit Worksheet 2008 ► Keep for your records Name(s) Sham on Return Social Security Number Kelly A Osteratock 296-90-7207 Before you begin: • See the printed Instructions for Form 1040, line 70 to find out if you can take this credit. • If you received Notice 1378, have it available. The notice shows the amount of your economic stimulus payment, which you will need to fill in line 28 below. If you do not have Notice 1378, you can find the amount of your economic stimulus payment on www.irs.gov. 1 Can you, or your spouse if filing a joint return, be claimed as a dependent on another person's return? HKNo. Go to line 2. Yes. You cannot take the credit. Stop here. 2 Does your tax return include a valid social security number for you and, if filing a joint return, your s use? Yes. Skip lines 3 and 4 and go to line 5. No. Go to line 3. 3 Are ou filing a joint return for 2008? u Yes. Go to line 4. u No. You cannot take the credit. Stop here. 4 Were either you or your spouse a member of the U.S. Armed Forces at any time during 2008? BYes. Go to line 5. No. You cannot take the credit. Stop here. 5 Enter the amount from Form 1040, line 56 ......................... 6 Enter the amount from Form 1040, line 52 ......................... 7 Add lines 5 and 6....................................... 8 Enter $600 ($1,200 if married filing jointly) ......................... 9 Enter the smaller of line 7 or line 8.............................. 10 Is the amount on line 9 at least $300 ($600 if married filing jointly)? 0 Yes. If you have at least one qualifying child for whom you entered a valid social security number' on Form 1040, line 6c, column (2), and checked the box in column (4), or have at least one qualifying child with a valid social security number' for whom you completed Form 8901, go to line 11. Otherwise, skip lines 11 through 21 and enter the amount from line 9 on line 22. IJ No. If line 7 is more than zero, go to line 11. Otherwise, skip line 11 and go to line 12. 11 Is your gross income"* more than the amount shown below for your filing status? a Program calculated gross income ............... b Adjustment to gross income ................... c Gross income ........................... • Single or marled filing separately — $8,950 • Married filing jointly — $17,900 • Head of household — $11,500 • Qualifying wtdow(er) — $14,400 eNo. Go to line 12. Yes. Skip lines 12 through 18 and go to line 19. 12 Enter the amount from Form 1040, line 20a......................... 13 Enter the amount of any nontaxable veterans' disability or death benefits you received in 2008....................................... . 14 Are You filing Forth 8812? Yes. Skip line 15. Enter on line 16 the amount from Forth 8812, line 4a. No. Go to line 15. 15 Are you filing Form 2555 or 2555-EZ to exclude foreign earned income, or using one of the optional methods to figure your net earnings from self-employment on Schedule SE, or are you a church ern loyee or member of the clergy? Yes. Fill out the Earned Income Worksheet in Pub. 972 and enter on line 16 the amount from line 8 of that worksheet. No. Go to line 16. Form 1040 Forms W-2 & W-2G Summary 2008 Keep for your records Name(s) Shown on Return Form W-2 Summary Social Security Number Box No. Description Taxpayer Spouse Total 1 Total wages, tips and compensation: Non -statutory & statutory wages not on Sch C .. Statutory wages reported on Schedule C .... . Foreign wages included In total wages...... . Unreported tips ................... . 2 Total federal tax withheld ............ 3 & 7 Total social security wages/tips ......... 4 Total social security tax withheld ........ 5 Total Medicare wages and tips ......... 6 Total Medicare tax withheld ........... 8 Total allocated lips ................ 9 Total advance earned income credit ..... . 10 Total dependent care benefits ........ . 11 Total distributions from nonqualified plans .. . 12 a Total from Box 12 ............... . b Elective deferrals to qualified plans ....... . c Roth contributions to 401(k) & 403(b) plans . . d Deferrals to government 457 plans ....... e Deferrals to non -government 457 plans .... f Deferrals 409Anonqualdeferred,compplan .. 9 Income 409A nonqual deferred comp plan ... In Uncollected Medicare tax ............ i Uncollected social security and RRTA fier 1 . . j Uncollected RRTA tier 2 ............. k Income from nonstatutory stock options ... . 1 Non-taxable combat pay ............ . on Total other items from box 12 ......... . 14 a Total deductible mandatory state tax ...... b Total deductible charitable contributions ... . c This line does not apply to TurboTax ..... d Total RR Tier 1 wages .............. e Total RR Tier 1 tax ................ f Total RR Tier 2 tax ................ g Total RRTA tips .................. h Total other items from box 14 .......... 16 Total state wages and tips............ 17 Total stale tax withheld ............. 19 Total local tax withheld .............. 8,247. 8,247. 282. 282. 8,247. 8,247. 511. 511. 8,247. 8,247. 120. 120. 106. 106 . „ , , • „ , „ 8,197. 8,197. 3. 3. E Form W-2 Name Wage and Tax Statement ► Keep for your records 2008 Social Security Number BSpouse's W-2 Military: Complete Part A on Page 2 below Do not transfer this W-2 to next year a Employee's social security No. 296-90-7207 b Employers ID number..... 33-0880183 o Employers name, address, and ZIP code RNL Industries LLC 1 Wages, tips, other compensation 8,196.51 2 Federal Income tax withheld 282.10 3 5 7 Social security wages 8,196.51 Medicare wages and tips 8,196.51 Social security tips 4 Social security tax withheld 508.17 Serypro Irvine Street 92 Corporate Park, Suite C770 CIty Irvine State CA ZIP Code 92606 Foreign Country 6 8 Medicare tax withheld 118.87 Allocated tips 9 Advance EIC payment 10 Dependent care benefits d Control number ....... . 11 Nonqualifled plans Distributions from sect. 457 and nonqualtiled plans (important see Help) xOTransfer employee Information from the Federal Information Worksheet e Employee's name First Kelly M.I. A Last Osterstock Suff._ 12 Enter box 12 below 13 Statutory employee Retirement plan Thins -party sick pay f Employee's address and ZIP code Street676 Alderwood Drive City Newport Beach 14 Enter box 14 below after entering NOTE: Enter box 15 before entering boxes 18, 19, and 20. box 14. Stale CA ZIP Cade 92660 Foreign Country Box 12 Code Box 12 Amount If Box 12 A: Enter M: Enter P: Double R: Enter G:QEmployeris code amount amount click MSAcontributlonfcr is: attributable to RRTA Tier attributable to RRTA Tier to link to Form 3903, line 4.. Taxpayer Spouse ... not a state or local government 2 tax 2 tax . .. . . Box 15 State Employees state I.D. no. Box 16 State Wages, tips, etc. Box 17 State income tax CA 461-1781-8 8,196.51 2.90 Box 20 Locality name Local wages, Box 18 tips, etc. Box Local Income 19 tax Associated State Box 14 Description or Code on Actual Form W-2 Amc CASDI Form W-2 Wage and Tax Statement 2008 ► Keep for your records Name Social Security Number Kelly A Osterstock 296-90-7207 9Spouse's W2 Military: Complete Part VI on Page 2 below Do not transfer this W-2 to next year a Employee's social security No. 296- b Employer's ID number..... 26-0 c Employer's name, address, and ZIP cod, Street 1o30u sw Allen nouievara City Beaverton State OR ZIP Code 97005 Foreign Country d Control number ....... . QTransfer employee information from the Federal Information Worksheet 1 Wages, tips, other compensation 50.00 3 Social security wages 50.00 5 Medicare wages and tips 50.00 7 Social security tips 9 Advance EIC payment 11 Nonqualified plans 12 Enter box 12 below 2 Federal income tax withheld 4 Social security tax withheld 3.10 6 Medicare tax withheld 0.73 8 Allocated Ups 10 Dependent care benefits Distributions from sect 457 and nonqualified plans (Important see Help) a Employees name I First Kelly M.I. A Last Osterstock Buff._ 13 BStatutory employee f Employee's address and ZIP code Retirement plan Street 676 Alderwood Drive Third -party sick pay City Newport Beach State CA ZIP Code 92660 14 Enter box 14 below after entering boxes 18, 19, and 20. Foreign Country NOTE: Enter box 15 before entering box 14. Box 12 Box 12 If Box 12 code is: Code Amount A: Enter amount attributable to RRTA Tier 2 tax M: Enter amount attributable to RRTA Tier 2 tax P: Double click to link to Farm 3903, line 4.. . R: Enter MSAcontribution for Taxpayer .. . Spouse ... . G:= Employer is not a state or local government BOx15 BOx16 Box17 State Employers slate I.D. no. State wages, tips, etc. State income tax CA Box 20 1 Box 18 1 Box 19 I Associated Box 14 Description or Code on Actual Forth W-2 Amount TurboTax Identification of Description or Code (Identify this item by selecting the Identification from the drop down list. If not on the list, select Other). ASDI 40.00 California SDI tax E C Name(s) Shown on Return Form 1099-DIV Worksheet ► Keep for your records 2008 Social Security Number QuickZoom to another copy of Form 1099-DIV Worksheet...................... ► QuickZoom to enter exempt -interest dividends from a mutual fund ................ ► Ownership: Check if Spouse ..................... . (defaults to taxpayer) Check if Joint .......................... e Payer's name.... Invest Financial Corporation Box 1a Total ordinary dividends ................................. 1,459.21 U.S. government interest, if any, included in box I ... . Box 1b Qualified dividends .................................... 8.61 Adjusted qualified dividends ................. . Box 2a Total capital gain distributions .............................. 286.62 Box 2b Unrecaptured Section 1250 gain .............................. Box 2c Section 1202 50% gain on QSB stock ......................... . Section 1202 60% gain (QSB Empowerment Zone stock sold after 12/22/05).. . Box 2d Collectibles (28%) gain ................................. . Box 3 Nontaxable distributions ................................. Box 4 Federal income tax withheld ............................... State income tax withheld ......... State ID Box 5 Investment expenses .................................. . Box 6 Foreign tax paid (All income Is considered passive. See Hel) ............ a Check to deduct foreign taxes on Schedule A.... OR b DoubleClick to link to a copy of Form 1116.... . c For Form 1116, select which column..... A B C d Foreign source amount included in dividends .................... Box 7 Foreign country or U.S. possession ........................... Check this box if foreign tax is from a mutual fund or a registered investment company. See Tax Help for additional information ............. Box 8 Cash liquidation distribution ............................... Box 9 Noncash (fair market value) liquidation distribution ................... Adjustments to Dividends or ESOP Distribution Check the box that identifies the type of adjustment being made or if ESOP distribution: N Nominee distribution H Other adjustment D ESOP distribution Enter nominee or other adjustment amount (enter as positive) .................... Form 1040 Qualified Dividends and Capital Gain Tax Worksheet 2008 Line 44 Keep for your records Name(s) Shown on Return l Social Security Number Kelly A Osterstock 296-90-7207 1 Enter the amount from Form 1040, line 43 ......... 1 4,543. 2 Enter the amount from Form 1040, line 9b ........... 2 9. 3 Are you filing Schedule D? Q Yes. Enter the smaller of line 15 or 16 of Schedule D. If either line 15 or 16 is loss, enter-0- .. 3 287. U No. Enter the amount from Form 1040, line 13. 4 Add lines 2 and 3 ........ 4 296. 5 If you are claiming investment Interest expense on Form 4952, enter the amount from line 4g.Othenviseenter -0-.... 5 0. 6 Subtract line 5 from line 4. If zero or less, enter -0 .. . . . . 6 296. 7 Subtract line 6 from line 1. If zero or less, enter -0 .. . . . . 7 8 Enter the smaller of; • The amount online 1 or • $32,550 if single or married filing sep, $65,100 If married filing jointly or .... 8 4,543. qualifying widow(er), or $43,650 if head of household. 9 Is the amount on line 7 equal to or more than the amount on line 8? Hxx Yes. Skip lines 9 and 10; go to line 11. No. Enter the amount from line 7 ........... 9 4,247. 10 Subract line 9 from line 8 ................... 10 296. 11 Are the amounts on lines 6 and-10 the same? 8 Yes. Skip lines 11 through 14; go to line 15 No. Enter the smaller of line 1 or line 6 ....... 11 12 Enter the amt from line 10 (if line 10 is blank, enter 0) ... 12 13 Subtract line 12 from line 11.................. 13 14 Multiply line 13 by 15% (.15) ............................... 14 15 Figure the tax on the amount on line 7. Use the Tax Table or Tax Computation Worksheet, whichever applies ............................... 15 423. 16 Add lines 14 and 15.................................... 16 423. 17 Figure the tax on the amount on line 1. Use the Tax Table or Tax Computation Worksheet, whichever applies ............................... 17 453. 18 Tax on all taxable income. Enter the smaller of line 16 or line 17 here and on Form 1040, line 44..................................... 18 423. I • Tax Payments Worksheet 2008 *, Keep for your records I Name(s) Shown on Return `Social Security Number Kelly A Osterstock 296-90-7207 Estimated Tax Payments for 2008 (If more than 4 payments for any state or locality, see Tax Help) Federal State Local Date Amount Date Amount ID Date Amount ID 1 04/15/08 04/15/08 04/15/08 2 06/16/08 06/16/08 06/16/08 3 09/15/08 09/15/08 09/15/08 4 01/15/09 01/15/09 01/15/09 5 Tot Estimated Payments.. . Tax Payments Other Than Withholding Federal State ID Local ID (If multiple states, see Tax Help) 6 Overpayments applied to 2008.... _ 7 Credited by estates and trusts 8 Totals Lines 1 through 7 ...... 9 2008 extensions ............ — Taxes Withheld From: Federal State Local 10 Forms W-2 ...................... 282. 3. 11 Forms W-2G ..................... 12 Forms 1099-R .................... 13 Forms 1099-MISC and 1099-G...........;„„„,,,„„„.;„:;. 14 Schedules K-1 .................... , 15 Forms 1099-INT, DIV and OID ........... 16 Social Security and Railroad Benefits ....... 17 Form 1099-B ....... IS _ Loc _ 18a Other withholding .... St Loc _ b Other withholding .... St Loc c Other withholding • • • . St Loc 19 Total Withholding Lines 10 through 18c... 282. 3. 20 Total Tax Payments for 2008 ........... 282. 3. Prior Year Taxes Paid In 2008 State ID Local ID (If multiple states or localities, see Tax Help) 21 Tax paid with 2007 extensions .............. _ 22 2007 estimated tax paid after 12/31/07 ......... 23 Balance due paid with 2007 return ............ _ 24 Other (amended returns, installment payments, etc) .. _ Form 1040 Standard Deduction Worksheet 2008 Line 40 ► Keep for vour records Name(s) Shown on Return I Social Security Number Kelly A Osterstock 296-90-7207 use mis worl(sneet it (a) someone can claim you, or your spouse it Hung lomny, as a aepenaenr (b) you or your spouse were born before January 2,1944, or were blind; (c) you paid real estate taxes; or (d) you have a net disaster loss on Form 4684, line 18a. 1 Enter the amount shown below for your filing status. • Single or married filing separately — $5,450 • Married filing Jointly or Qualifying widower) — $10,900 ► .. 1 • Head of household — $8,000 2 Can you be claimed as a dependant? No, Enterthe amount from line Ion line 4. Skip line 3. X Yes. Go to line 3. 3 Issvour earned Income" more than $600? Yes. Add $300 to your earned income. Enter the total ► .. J 3 No. Enter$900 4 Enter the smaller of line 1 or line 3. If bom after January 1,1944, and not blind, enter this amount on line 6. otherwise, go to line 5 ............. 4 5 If bom before January 2,1944, or blind, multiply the number on Form 1040, line 39a, or on Form 1040A, line 23a by., $1,050 ($1,350 if single or head of household) ........................ 5 6 Enter any net disaster loss from Form 4684, line 18a. If more than zero, check the box on Farm 1040, line 39c ......................... 6 7 Did you pay real estate taxes in 2008? Enter the state and local real estate taxes you paid that would be deductible on Schedule A, line 6. If you were itemizing your deductions. See the instructions for Schedule A, line 6. Do not include foreign real estate taxes .... 7 8 Enter $500 ($1,000 if married filing Jointly) ....................... 8 9 Enter the smaller of line 7 or line 8. If more than zero, check the box on Form 1040, line 39c...................................... 9 10 Add lines 4, 5, 6 and 9. Enter the total here and on Form 1040, line 40........ 10 'marnea income Incivaes wages, salaries, ups, proTesslonal Tees, ano other compensation recalvaa Tor personal services you performed. It also Includes any amount received as a scholarship that you must Include in your income. Generally, your earned income is the total of the amount(s) ,you reported on Form 1040, lines 7, 12, and 18, minus the amount, if any, on line 27; or on Forth 1040A, line 7. • Earned Income Worksheet 2008 ' Keeoforvourrecords Name(s) Shown on Return Kelly A Osterstock Social Security Number 296-90-7207 Part I — Earned Income Credit Wks Computation Taxpayer Spouse Total 1 If filing Schedule SE: a Net self-employment income ............ b Optional Method and Church Employee Income . c Add lines 1a and 1b ................. d One-half of self-employment tax .......... e Subtract line I from line 1c ............ 2 If not required to file Schedule SE: a Net farm profit or (loss) ............... b Net nonfarm profit or (loss) . . .......... . c Add lines 2a and 2b ................. 3 If filing Schedule C or C•EZ as a statutory employee, enter the amount from line 1 of that Schedule C or C-EZ ............. 4 Add lines 1e, 2c and 3. To EIC Wks, line 5 .... Part If — Form 2441 and Standard Deduction Worksheet for Dependents Computation 5 Net self-employment earnings (line 4 above) .. . 6 Wages, salaries, and tips less distributions from nonqualified or section 457 plans, etc .... 7 Taxable employer -provided adoption benefits.. . 8 Add lines 5 through 7. To Form 2441, lines 20 and 21 (or Schedule 2 of Form 1040A) ...... 9 a Taxable dependent care benefits......... . b Nontaxable combat pay .............. . 10 Add lines 8, 9a and 9b . To Form 2441, lines 4 and 5 (or Schedule 2 of Form 1040A) ....... 11 Scholarship or fellowship income not on W-2 .. . 12 $E exempt earnings less nontaxab)e income .. . 13 Distributions from nonqualified/Sec. 457 plans . . 14 Add lines 8, 9a and 11 through 13. To Standard Deduction Worksheet for Dependents, line 1 .. 8,247. 8,247. 8,247. 8,247. 8,247. 8,247. 6 , 247. 8,247. Part III — IRA Deduction Worksheet Computation 15 Net self-employment income or (loss) ....... 16 Wages, salaries, bps, etc .............. 17 Net self-employment loss .............. 18 Alimony received ................... 19 Nontaxable combat pay ............... 20 Foreign earned income exclusion ......... 21 Keogh, SEP or SIMPLE deduction ......... 22 Combine lines 15 through 21. To IRA Wks, In 2.. 8,247. 8,247. 8,247. 8,247. Part IV — Form 8812 Taxable Earned Income Computation 23 Self-employed, church and statutory employees . 24 Wages, salaries, Ups, etc .............. 25 Nontaxable combat pay ............... 26 Foreign earned income exclusion ......... 27 Combine lines 23 through 26. To Form 8812, line 4a. 8,247. 8,247. 8,247. 8,247. Federal Carryover Worksheet 2008 ► Keep for your records Name(s) Shown on Return Social Security Number Kelly A Osterstock 296-90-7207 2007 State and Local Income Tax information (See Tax Help) (a) State or Local ID (b) Paid With Extension (c) Estimates Pd After12131 (d) Total With- heldlPmts (e) Paid With Return (f) Total Over- Davment (9) Applied Amount Totals . . Other Tax and Income Information 2007 2008 1 Filing 2 Number 3 Itemized 4 Check 5 Adjusted 6 Tax liability 7 Alternative 8 Federal status .......................... of exemptions deductions after box it required to gross income for Form 2210 minimum tax overpayment applied for blind or over limitation ................ itemize deductions ...................... or Form 2210-F ...................... to next year 65 (0-4)......... ............ ............ estimated tax..... . . 1 2 3 4 5 6 7 8 1-1 1 Single 1 Single 523. ---E:l— 8,791. --t— �109.- l� 9,993. 343. 423. Exr 9s I 10 I 11. I Los 12. I M t 14. I 15. I 16 Federal Carryover Workshear page c Auvv Kelly A Osterstock 296-90-7207 Loss and Expense Carryovers (confd) 2007 2008 17 AMT Nonrecap'd net Sec 1231 losses from: a b c d e f 2008... 2007... 2006... 2005... 2004... 2003... 17 a b c d e f ter^^ Credit Carryovers 2007 2008 18 General business credit ...................... 19 Adoption credit from: a 2008 ................ b 2007................ c 2006................ d 2005................ e 2004................ f 2003 ................ 20 Mortgage interest credit from: a 1 2008 ............ b 2007............ c 2006............ d 2005............ 21 Credit for prior year minimum tax ................. 22 District of Columbia first-time homebuyer credit.......... 18 19a',."","„,„""..,,""_"",",.,"" b c d e f 20 a b C d 21 22 _ . Two -Year Comparison 2008 Name.Return .,.. „ ...._..�,...0gas-an-79.n7 Income 2007 2008 Difference % Wages, salaries, tips, etc......... Interest and dividend income....... State tax refund .............. Business income (loss) .......... Capital and other gains (losses) ..... IRA distributions .............. Pensions and annuities......... . Rents and royalties ............ Partnerships,-Soerrerelc:-' • '-' ...: Farm income (loss) .......... . -•9ociaiseeurity�benefits.:....... Income other than the above...... . Total income - - : - - :-- - - - - - - - Adjustments to Income ......... -Adjosted-Gros'slncdfife:.......... 7,578. 8,247. 669. 8.83 1,213. 11459. 246. 20.28 287. 287. - - . -8 791. -9 `393": "' 1,292. 13.67 s ts1: 9 9 Z,Z02. 13.67 Itemized Dedueftomi Medical and dental ............ Income 0r sales tax ............ Real estate taxes ............. Personal property and other taxes... . Interest paid ...:T ; ..... . Gifts to charity ............... Casualty and theftlosses.......... Miscellaneous ............... Phaseoutmfit m>s Ider"I^nons....---_. Total Itemized Deductions ........ Exemption Amount ............ 59. 109. 50. 84.75 464. -464. -100.00 523. 109. -414. -79.16 5.,35D-- I .10.0- 1.87 0. 0. 0. Taxable Income .............. 3,441. 4,543. _ 11102. 32.03 Income tax ............. •.... - AidditionatI hmo rataxes .......... Alternative minimum tax ....... 'TdtallncomeTaffes" : -'- .'...... Nonbusiness credits .......... . 'Business creMi s..::........ . Total Credits .. ........ . Self-employment tax ........... Other taxes . _ Total Talc After Credits ......... Withholding . _ , _ Estimated and extension payments .. . Earned income credit ;. _ _ ........- Additional child tax credit ......... Other.payments . Total Payments ............. Form=O paoalty--_---.-..- Applied to next year's estimated tax .. . Refund- - - -- -....... -- ...._-__, Balance Due ................ 343. 423. 80. 23.32 "343.' 123'. "SA. 23.32 u �_ 343. 423. so. 23.32 297. 282. -15. -5.05 - - - 297. 282. -15. -5.05 46. 141. 95. 206.52 Current Tax History Report 2008 � Keep for your records Namo(s) Shmm on ROLM Kelly A Osterstock Five Year Tax History: 2004 2008 1 2008 1 2007 2008 Filing status ............ Total income ............. Adjustments to Income ....... . Adjusted gross income........ Tex expense ........... 'Interest expense ......... Contributions ........... Miscellaneous deductions .. . Other itemized deductions ... . Total itemized/standard deduction Exemption amount .......... Taxable income ........... Tax .................. Alternative minimum tax ...... . Total credits ............ . Other taxes ............. . Payments .............. Form 2210 penalty ......... . Amount owed ............. Applied to next years estimated tax........... . Refund ................ Effective tax rate off, , , , , , . , , , "Tax bracket % ........... bin .Le 10,800. bi1114iU 5,279. 8,791. 9,99 10,800. 5,279. 8,791. 9,99 177. 36. 59. 109 464. 51000. 5,150. 5,350. 1 5,450 0. 0. 0. 0 _ 5,800. 129. 3,441. 4,543 583. 14. 343. 423 639. 234. 297. 282 46. 141 56. 220. 5.40 0.271 3.90 4.2 _ 101 10 10 1 ""Tex bracket % is based on Taxable Income FUM01 IN MOS .. 0 • Tax Summary ► Keep for your records Name (s) Total income ............................ Adjustments to income .................... Adjusted gross income .................... itemized/standard deduction ................ Exemption amount ....................... Taxable income .......................... Tentative tax ............................ Additional taxes .......................... Alternative minimum tax ................... Total credits ............................. Othertaxes ............................. Total tax ................................ Total payments ......................... - Estimated tax penalty ..................... Refund................................. Balance due ............................. 2008 SSN 296-90-7207 9,993. 9,993. 5,450. o. 4,543. 423. Which Form 1040 to file You must use Form 1040A or Form 1040 because you have dividend income. �4ame(s) Shown on Return ompare to U. S. Averages 2008 � Keeporyour records Social Security No Your 2008 adjusted gross income (AGq ............................... . 9,993. National adjusted gross income range used below ......... from 0. to 14,999. 1 Note: National average amounts have been adjusted for inflation. See Help for details. r Selected Income, Deductions, and Credfis Actual National Per Retum Average Salaries and wages ................................ Taxable Interest ................................ 8,247. 8,480. . Tax-exempt interest 1, 415. 415 ................................ Dividends .................................... 5,531. Business net income _ ,459, 1, 555. ................. . Business net loss ......... 7, 439. . ...................... Net capital gain .........� - 16,737. : . . . . . . . . . .. . . .. . ...... . Net capital loss 287. 7,599, .................................. Taxable IRA ................................... 348 , . -2, 3484725 Taxable pensions and annuities ......................... . Rent and royalty net income ............................ 6,851. Rent and royalty net loss. .............. 6,675. I ............ Partnership and S corporation net income ................... -15,463. Partnership and S corporation net loss ,,,,,,,,, 12, 962. , , , , , , , , , , , , Taxable social security benefits ......................... -71,048. 048 4, Medical and dental expenses deduction .................... Taxes deduction 7,760. paid ............................... Interest paid deduction .............................. 109. 2, 911 911. Charitable contributions deduction ....................... 9, Total itemized deductions ............................ ,470. . 109. 15,748. Child care credit ................................. Education tax credits ............................... 153. 153 . Child tax credit .................................. 335. Retirement savings contributions credit ..................... Earned income 233 . credit ............................... 1, 999. Other Information Actual National Per Return Average Adjusted gross income .............................. Taxable income .................................. 9,993. 5,421. Income tax ................................... 4 , 543 . 3,310. Alternative minimum tax ............................. 423. 343. Total tax liability .................................. 8, a05. 8oa 423 _ Kelly A Osterstock 296-90-72117 SMART WORKSHEETfOR: Form 104OA: Individual Tax Return Tax Smart Worksheet ATax ........................................... 423. CheokIffrom; tTax table ............................................... 2 Qualified Dividends and Capital Gain Tax Worksheet ....................... X 3 Form8615............................................... B Recapture tax from Form 8863 ............................. C Altemative minimum tax .......................... D Tax. Add lines A through C. Enter the result here and on line 28 .......... 423. KEEP FOR YOUR RECORD$ all - �,1; i VILLA POINT I (Off -site Baywood Apartments) Unit CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (hbr tenants not in possession of a section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) ;and, o5��dQ was$.� • 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ /Il Z() per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Name Ago Signature(s) of Income Member(s): Date: Signature Signature _IIb VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (Tor tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only Income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income" of the undersigned individual(s) was $ oa ;and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1gg6 `Ua per month. ' Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name A(0,4,2 Lmf Signature(s) of Income Earning Household Member(s): Age 12 , _ 61 Slgn ue Signature /� /% Signature Date: C,/ 06/11/2009 15:27 727Gi040 w HRHLOCK 0 PAGE 02 Forth_ _ _ DepaltmentoltheTreasury• Internal Revenue Service Label (scn pope 17.) A SUZANNE M iT09RA 0 Ueethe E 744 ALDERWOOD DRIVE IRSlabel, N NEWPORT BEACH, CA 92660 Otherwise, E pteaseprint R ortype. H Filing 1 usingle 4 status 2 Married Blin91ointly(aven Ifonlyonehad income) OheckOnly 3 Married fllmoseparrdely,enterspeucn'a66Nabove afull namobelow. onebox, P. 5 Exemptions If more than six dependents, seepage20. Income Attach Forms) W2 here.Also attach Form(a) 1099- R if tax waswhhheld. 11 you did not get a W-2, and Pa➢e23. ancloso, but do not attach, any payment. 018-56-0551 Spouse's soclel seeurityrlumber You must enter Checking a box b*w will not change yourtaxorrefund, Head of household (with qualifying porson). (Seepage 18.) If the qualifying person Is achild but not your dependent, emnr Ihla chlld's name have.► _._.. Yourself. If Someone can claim you asa dependent, do not check box6a, b n Spouse c Dependents: (1)fhr6tname lastname (2) Dependent's soc1a16eoUdtynumber (3)Dependent's relationship to you 4 Ifqual "Ild for find lax or. on ag 20) ALANA PORAT 610-96-8822 DAUGHTER x Boxes anan0 soon .�. No. o1 children on ecwho: 4,flved with you ? edld not live with you dua to divorce nr separaran (aeapogrpt) Dependents oneonot ontorod above 7 Wages, Salaries, flosetc, Attach Furm(s)W-2 7 49,605. 8a Taxable lntarM.AOach Sohedulel t required. Be p Tax-exempt interest, DOnptincludeonline ea, 6b 9a Ordinatyelhidends. Attach Schedule l if required, 901 11a IRA 12a Pensionsand 14a Sooialsecudty, Ills Taxableamount 12b Tembieamount 14b Taxabieamount 15 Add lines7thlnuoh 14b(far rinhlcolumn) This isvourtotal lncorne. ► 15 49,605. Adjulated gross 16 Educatorexpenses(seepada2B). 16 250. gross 17 )RAdeductlon(saepage28). 17 income 18 Student loan interest deduction (see paga3l). 18 257. 19 Tuitioh and fads deduction. Attach Form a917. 19 20 Add lines 16throu hIS. 1heaeare y9urtotal adustrnents. 20 507. _ 21 Subtract line 20from line15.ThlsIsvouradlustedgross income, ► 21 49,098. KRA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, asa poge7li, Form 1040A(2008) t040A;20M� FDJIN111 1V 1.18 Form Sotwer Cnpyrlght legs- 2009HaR Block Tax omfca.lnc. 06/11/2009 15:27 7278#40 HRBLOCK . PAGE 03 • All others; Singlear Married filing ;V,43 8r0alely, Married filing lointlYor Qualifyingg wldow(er), $10,900 23a Check ju You werebombefOreJanuary2,1944, II BlindTotalhexea If. u Spouse was bom beforoJanuary 2,1044,u Bllndjcbockad ► 23a IS If you are married g)ingseparatelyandyourspouselternim deductions See 090s32 and check hare ► 236 a Check lfrtandarddeducdanIncludes real estate taxes (sesosge32) ► 23c a4 Entaryouristaindarddeduction sea left margin). a5 Subtract line 24from line22. It Ikie24 Is more than line22 enter -0•. 26 If line 22 isover$119,975, oryou provided housing to a Midwestern displaced Indlvidual, seedaoe32. Otherwise. muhlphr350obythetotalnumberofexemptionscialmedonline 6d 26 74000, 27 Subtractllne26 from line 25. if line261s morethan lme25,enter-0-, 29 Credhforchikland dependentcareekpenses. Attach Schedule 2, 29 30 Credltfortheeldedyerthedlsabled.Attach Schedules. 30 31 Eduoetlon credits. Attach Form$863. 31 32 Retirement savings contdbutionscredit, Attach Form 8880, 32 33 Child taxcredlt(oeepage37). Attach Rolm 8901 if required. 33 39 200$CSUMatedtaxpaymentsand2moUnt Ifyouhav0 applied from2007relum 39 aqualitying 40a Earned Income cradh(E)C). 40a child attach b Nontaxableoembatoayelectton. 40b Schedule EEC. 41 Additional child texcrecilt. Attach Pone 8312. 41 42 Recovervrebatecredlt(seeworksheetonpages53and 64) 42 43 Add 11nes3e.3940a.41.and421rhaseareyourtotalo4vments ► 43 6,416. Refund 44 Ifllne43ismorethanline37,subtract llne37fromline 43 Direct deposit? see page 55 and flll In 45b, 45c, and 45d or Form am. 452 Amountat line 44 You want refunded toymu. If Form 8888is attached, check here 1 ► b Routing number ► c Type: 0Cheroking ❑Savings ► of Account line 44yoU went appl led to your 2009estlmated tax. 46 Amount rn Amountyou owe.Subtract line 43from line37. Fordetalison how You OWe tcoay.seepage56. ► 47 Are eeu....,,,w e......_..u.r-------e•n ._ Third party Do you want to allow anotherpersontodlscus6thisreturn with the IRS (see page57)? dasignee Deei9,nse„s name_ Phoneno. Yes. Completethefollowing. LJ No undnr, paealiler, of perjury, I declare that [have examined this falurn and gwompenymg t.4hodu ae and Wer ementa.00 id the beat of my Sign knowledpeene bel,0f,they are true, eorrep,and Accurately hat all amounts and soutOOa of Income l femlvee during the tax year Declhrntl0n here of preparer(oih or t hen the taxpayer)I. based on all 11110Mntlon of which the pfeparor ham any knowledge. Jointretum? Yourslgnature Date Youroccupation Dayemephonenumber Seepage17. For Info only -Do not fit 8AC8ER �ypur oFy Spountelssfignarti;;. l(rajohitreturn.bommustsigr;j Date 6pouse'aeccupailon rewrds. For Info Only -Do not fit Paid Preparer's 16 Ito Checklf PreparelrsSSNorPIIN signature fi/11 2009self•em to etl P00320121 preparers Flurolfs -em HRB TAIL GROUP INC BN 43-�1871840 use anry yoursifse�f•employed),,„--,- _ _ Form 1040A (2008) Po6rm�9 11w�Copyrlght f405. 20ea H6a clock Y¢y gerv6ldAeo?oo'16 VILLA POINT I (Off -site Baywood Apartments) Unit No. Nr �j jQGY�V" CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ �tX2 and, 3, During 2008, my total: monthly et pyrpent to Villa Point I (Off -site Baywood Apartments) was $ WI 1 " "(lam per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age 1 Signature(s) of Income Earning Household Member(s): Slg�natgur/e— �/1/ Date: VILLA POINT I (Off -site Baywood Apartments) Unit No. —75�— t�7, yam -- CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, intone documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ 3�3 75, 6 2—; and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ / 4 q & • o o per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, Interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age V I cK r 7. f�U U��s 5 G in�M.a Slgnalur r,%SSA Signature Signature Date: G /'T/ 9 t _T VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ s�, and, 3, During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ `/ ZZ per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Date: Signature Signature Signature 11: Income Tax Return Prepared For: JONATHAN R WITTMAN 782 ALDERWOOD DRIVE NEWPORT BEACH, CA 92660 Prepared By: USA Income Tax 2901 W Coast Hwy, Ste 350 Newport Beach, CA 92663 Telephone: (714)508-7905 FAX: (714)242-7545 Email: info@usamca.com 03/03/2009 02:40:21PM POOR.. QUALITY ORIGINAL (S) L ' Department of the Trea*lnlemalRevenue Service 2008 Form'1040 U.S. Individual Income Tax Return Fertha year Jan. 1-Dec. 31. 2009. or other tax year beginning ,2009, on Label L (See A Instructions) e E UsethelRS L label. H Otherwise, E please print R or type. E Presidential Filing Status Check only one box Exemptions It more then four dependents, see Instructions. was withheld. If you did not get a W-2, see Instructions Enclose, but do not attach, any payment. Also, please use Form 10404. Adjusted Gross Income Your first name and inlbal I Lastname If a joint return, spouse's first name and initial I Lastname Home address (number and street) If you have a P O. box, see instructions. ORS Use Only -Do ,20 Apt no City, town or post office, state, and ZIP code. If you have a foreign address, see Instructions. this space. OMB No. 1645-0074 Your social security number 548-71-3612 Spouse's social security number You must enter At your SSN(s) above. AIL Checking a box below will not change your tax or refund 1 I]' Single 4 Q Head of household (with qualifying person). (See Instructions) If 2 ❑ Married filing jointly (even if only one had Income) the qualifying person is a child but not your dependent, enter 3 Married filing separately. Enter spouse's SSN above this child's name here. ► and full name here ► 5 ❑ Qualifying widower) with dependent child (See Instructions) 6a © Yourself. If someone can claim you as a dependent, do not check box 6a ....... 1 Boxes on 6a and fifib tl 1 } b to S ouse 1 No. of children c Dependents: 1 First name Last name (2)Dependent's c((aisecun number (3) Dependent's (4v�)rX" ual- relationship to itfornchlleiid u lexcremt jo r PJCWbl6 refucredds,bffsetsof state and local income taxes (see Instructions) ... . 11 Alimony received . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . 12 Business Income or (loss). Attach Schedule C or C-EZ .................. . 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here ... ► ❑ 14 Other gains or (losses). Attach Form 4797 ....... ............... . 15a IRA distributions 15a b Taxable amount (see Instructions) 16a Pensions and annuities.. 16, b Taxable amount (see Instructions) 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . 18 Farm income or (loss). Attach Schedule F ....................... . 19 Unemployment compensation .. ................ . 20a Social security benefits .. 20a I I b Taxable amount (see Instructions) 21 Other income. List type and amount (see instructions) ................... . 22 Add the amounts in the far right column for lines 7 throu h 21. This is our total income ► 23 Educator expenses (see instructions) ............ 23 24 Certain business expenses of reservists, performing artists, and fee -basis government officials. Attach Form 2106 or 2106-EZ . 24 25 Health savings account deduction. Attach Form 8889 ..... 25 26 Moving expenses. Attach Form 3903 ............ 26 27 One-half of self-employment tax. Attach Schedule SE ..... 27 28 Self-employed SEP, SIMPLE, and qualified plans...... 28 29 Self-employed health insurance deduction (see instructions).. 29 30 Penalty on early withdrawal of savings ......... . 30 31a Alimony paid b Recipient's SSN ► 31a 32 IRA deduction (see instructions) ............... 32 33 Student loan Interest deduction (see Instructions) ...... 33 34 Tuition and fees deduction. Attach Form 8917......... 34 35 Domestic production activities deduction. Attach Form 8903 .. 35 36 Add lines 23 through 31a and 32 through 35 .......................: For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see Instructions. UYA on ec who: • lived with you 0 • did not live with you due to divorce - orseppmetion 0 (see instructions) — Do ancients on Sc not entorod above��0 -Aild'humbors on i ;, 1= Form 1040 (2008) I Form1040(2008) JONATHAN R WITTMAN 548 Tat 38 Amount from line )usted gross income) ..... .. ..... 38 and 39a Check ❑You a barn before January 2,1944, ❑ Blind. l To*oxes Credits J 0❑ It ❑ Spouse was born before January 2, 1944, ❑ Blind. checked ► 39a to If your spouse itemizes on a separate return or you were a dual -status alien, see instr, and check here ► 39b ❑ Standard c Check if standard deduction includes real estate taxes or disaster loss (see Instc) ........ ► 39c ❑ 40 Deduction 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin)..... 41 for- 41 Subtract line 40 from line 38 ... . • People 42 If line 38 is over $119,975, or you provided housing to a Midwestern displaced individual, see checked anyny box on line Instructions. Otherwise, multiply $3,500 by the total number of exemptions claimed online 6d, , , 42 43 sea or 39b, or 39c or who 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0. ..... 44 can be 44 Tax (see instructions). Check if any tax is from: a ❑ Form(s) 8814 b❑ Form 4972 ......... claimed as a dependent, 45 Alternative minimum tax (see instructions). Attach Form 6251 ................ 45 46 See Instr. 46 Add lines 44 and 45 ........................ ........ ► • All others: 4T Foreign tax credit. Attach Form 1116 if required ........ 47 Slagle or Mauled filing 48 Credit for child and dependent care expenses. Attach Form 2441. 48 separately, 49 Credit for the elderly or the disabled. Attach Schedule ..... 49 Married filing 50 Education credits. Attach Form 8863 . . . ........... 50 Marle jointly or 51 Retirement savings contributions credit. Attach Form 8880 .... 51Quatilyng widower)52 Child tax credit (see Instructions). Attach Form 8901 if required, , 52 $10o(or) 53 Credits from Form: a ❑ 8396 b ❑ 8839 c ❑ 5695 53 156 Head of 54 Other credits from Form: a ❑ 3800 b ❑ 8801 household,c❑ ry1$8,00055 Add lines 47 through 54. These are your total credits ..................56 Subtract line 55 from line 46. If line 55 is more than line 46, enter-0.............. 57 Self-employment tax. Attach Schedule SE ................. ......... 57 58 - 58 Unreported sociaksecurily,and�M@dlcare tax from Form: 4137 b❑ 8919..... 59 ,-a❑ ..«_.. . 'Otft@R'' '-"'S9:.'•AddfllonalttiSR;'bn;IRAg,'othegquaJlfi_e`dfetimeri4pfans},etcaAttach Form 5329 if required ... oa'Iizestiaa(]j�„ElC payments.IbSbgO?�hbisdlald eirployrterftares. AlfadfSdidkleH 60 - 9 . 0 s I Jax-paymemsrand amount applied from 2007 return ... . 64a Earned Income credit (Etc) . . . .. . . . . . ... NO. . . . r b AlxxaxaWemrrixxpayeledlon. . .I 64b 1 65 Excess social security and tier 1 RRTA lax withheld (see instr.) 66 Additional child tax credit. Attach Form 8812......... , . 67 Amount paid with request for extension to file (see instructions) 68 Credits from Form: a ❑ 2439 b ❑ 4136 c ❑ 8801 d ❑ 8885 69 First-time homebuyer credit. Attach Form 5405 ........ . 70 Recovery rebate credit (see worksheet in instructions) , , . , . -3612 Page 2 Refund 72 If line 71 is more than line 61, subtract line 61 from line 71. This is the amount you overpaid 72 4 3.2. Direct deposit? 73a Amount of line 72 you want refunded to you, If Form 8888 Is attached, check here ► ❑ 73a 4 512. See Instructions ► and rill in 73b, b Routing number Ili.c Type:® Checking ❑ Savings 73c, and 73d. ► d Account number or Form 8888. 74 Amount of line 72 you want applied to your 2009 estimated tax ► 1 74 Amount 75 Amount you owe. Subtract line 71 from line 61. For details on how to pay, see instructions ► 75 0. You Owe 76 Estimated tax penalty (see instructions 76 Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? ❑ Yes. Complete the following. ® No Designee Designee's Phone Persona( identification name ► no ► number PIN) ► I77�:] Sign Under penalties of penury, I declare that l have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,Iheyamhue,mffoct,endcompiete Declaration of prepamr(other than texpeyer) is based on all information of which prepmer has any knowledge. Here Joint return? Yoursignature Date Your occupation Daytime phone number See instructions _ —d EASING CONSULTANT 714-553-4344 Keep our oPY ,Spa ris signature. If a)ointreturn, bo must sign. Dale Spouse's occupation i,' _ •. records. --� '• Date Check if Preparers SSN or PTIN Paid signature / self-employed Preparers USA Income Tax EIN 94-3454483 Use Oni yoursFirm'name (or Y address. 2901 W Coast H Ste 350 Phone no. address, and ZIP code Newport Beach CA 92663 714-508-7905 UYA Form 1040 (2008) 0 VILLA POINT I (Off -site Baywood Apartments) Unit No. �3 b CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (tor tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ / //!f ; and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ /- " per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Zf A uF/'r 6 Cqe� Signature Date: �O - Z (o- 67 • � Sec�- ' VILLA POINT I (Off -site Baywood Apartments) 7' , Unit No. CERTIFICATION OF CONTINUED/ HOUSEHOLD ELIGIBILITY (ror tenants not in possession of a Section 8 certificate or voucher, Income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $5kQ00-oo ; and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 15f40. 00 per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off --site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date Indicated below: Names and Ages of Non income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age i 0190WAN =1r Signature Signature Date: G/ I>\ I on VILLA POINT I (Off -site Baywood Apartments) Unit No.. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (tor tenants not in possession of a Section 8 certificate or vouclur, income documentation must be obtained.) Owe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned (Rare the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the Total Annual Eligible Income* of the undersigned individual(s) was $ .9�.2 ; and, 3. During 2008, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1.490. 00 per month. Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in ponferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Signature Signature Date: G/I—t—I /Q9 VILLA POINT I (Off -site Baywoo d Apartments) Unit No. �/ J CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY Oibr tenants not in possession of a Sect ton 8 certificate or voucher, income'documentation must be obtained.) UWe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2008, the- to Anual Eligible Income* of the undersigned individual(s) was $ ! �0 ; and, 3. During 2008, my total monthly rayment to Villa Point I (Off -site Baywood Apartments) was $ 14�_ per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowiedge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age N�6 P� A �Ifiby D D )%o 1U.4 iW Signature(s) ofdncome Earning Household Member(s): Signature Date: 5r i5- 1 J'f JW1 y1,) A , • Department of the Treasury — Internal Revenue Service 2008 I(99) iRSus.omy - . 2008. ending .20 Label Yournrst name MI Lostname Your social security number (see Instructions.) Vanessa J Taw 312-92-8563 If a joint return, spouse's rest name MI Laslname Spouse's social security number Use the IRS label. Otherwise, Home address (number and sbeel). If you have a P.o box. see instructions. Apartment no. You must enter your please print or type. 676 Alderwood Drive social security number(s) above. City, town or post offce,Ifyou have a foreign address, sea instructions. State ZlPcade Presidential Ne art Beach checking box below ref vnnot CA 92660 change your tax orrrefund. . Election Campaign ' Check here it you, or your spouse if filingjoinlly, want 83 to go to this fund? (see instructions).......... .► []You spouse FilingStatus 1 Single 4 Head of household (with justifying person). (See Instructions.) If thequalifyingpersonIsac ild 2 Married 86ngjoinoy (even ifonly one had income) but not your dependent, enter this child's Check only 3 Marred firing separately. Enter spouse's SSN above &full name here ► nnn hns name here. ► 5 n qualiNn0 widower) will dependent child (see instructions) Exemptions 6a Yourself. If someone can claim you as a de endent, do not check box so...... , y dependent, on 6Boxaa nd6bchocked oand 6b . 1 bSp0U5¢ .................... No. of children No. c Dependants: (2) Deppendent's (3) Dependent's (4) if on se who: •uvad socialsecunty relationship qualdring for with you . . number to you child child 1 First name Last name see Ins"% li did not live with you dueto divorce orationp) see (1name) . If more than eOopondanteea n not entered above. four dependents, See lOSlrUCli00s. Add numbers es F d Total number of exemptions claimed ...... .... above - .. ► 1l 7 Wages, salaries, tips, etc. Attach Forms) W-2 ......................... Income 8 a Taxable Interest. Attach Schedule B if required ...................... . b Tax-exempt interest. Do not include on line 8a ........ 8 b.53 . Attach Form(s) 9 a Ordinary dividends. Attach Schedule B if required ...................... s) ................... 9 b 18 . W-2 here. Also b qualified dividends (see insu. 111i Forms 10 Taxable refunds,credits,oroffsets of state and local income taxes(see instructions) ............. 9 tax and withheld. 11 Alimony received ........................................ 12 Business Income or (loss). Attach Schedule C or C-EZ ..................... you 13 Capital gain or hiss). An Sell Difregd. If not mild,, ck here ............... ► El g -2, g el I see nsstrutru ctions. 14 Other gains or (losses). Attach Form 4797 ........................... 15 a IRA distributions....... 15a b Taxable amount (see lnstrs) .. 16a Pensions and annuities .. 16a J b Taxable amount (see instrs) .. 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E .... Enclose, but do 18 Farm Income or (loss). Attach Schedule F ....................... . .. ation ent 19 not attach, any 20a Soda sell security benefas.pens....I 20 aI I b Taxable amount (see Inslrs) .. payment. Also, please use Form 1090A. 21 Otherincome------------------------------------- 22 Add the amounts in the far right column for lines 7 through 21. This Is your total Income. . ►l 7 25,687. 8 a 272. 18. 9a 123. 10 11 12 13 170. 14 15b 16b 17 8 807. 20 b 21 22 27,077. co CUUUULui enpenaea (aev umuwuwoy ..... , , , . . Adjusted 24 Certain business expenses of reservists, performing artists, and fee -basis Gross government officials. Attach Form 2106or2106•EZ........... 24 Income 25 Health savings account deduction. Attach Form 8889 ..... 25 26 Moving expenses. Attach Form 3903.............. 26 27 One-half of self-employment tax. Attach Schedule SE ..... 27 28 Self-employed SEP, SIMPLE, and qualified plans ....... 28 29 Self-employed health insurance deduction (see instructions) ....... 29 30 Penalty on early withdrawal of savings ............. 30 31 a Alimony paid b Recipient's SSN... ► 31 a 32 IRA deduction (see instructions) ................ 32 33 Student loan Interest deduction (see Instructions) ...... 33 34 Tuition and fees deduction. Attach Form 8917 ......... 34 35 Domestic production activities deduction. Attach Form $903 . . . . . . . . 35 36 Add lines 23- 31a and 32. 35.................................... 37 Subtract line 36 from line 22. This is your adjusted gross Income ............. 108. 3.08. . ► 36 37 26,969. BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. FDIAgt 12 10/13/08 Form 1040 (2008) s 0 Fnrm 9ndn f2nnm Vnnr cca ,T Taw 3T2-92-A563 Pnne2 Tax and 38 Amount from line 37 (adjusted gross income) ...... , ............. . Credits 39a Check _r ]You were born before January 2, 1944, e Blind. Total boxes If: l Spouse was born before January 2, 1944, Blind, checked ► 39a 38 26,969. to If your spouse Itemizes on a separate return, or you were a dual -status alien, see instts and ck here ► 39 b DeductioStandard n L c Check if standard deduction includes real estate taxes or disaster loss (see instructions)..... ► 39c for— 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ............ • People who 41 Subtract line 40 from line 38.................................. checked any box on line 39a, 39b, 42 If line 38 is over$119,975, or you provided housing to a Midwestern displaced Individual, see instructions. or39c or who Otherwise, multiply$3,500 by the total number of exemphons claimed on line 6d ............... _ 40 5,450. 41 21,519. 42 3,500. can be claimed 43 Taxable income. Subtract line 42 from line 41. as a dependent, If line 42 is more than line 41, enter-0. ........ ...................... see Instructions. 44 Tax (see instrs). Check if any tax Is from: a Form(s) 6814 BForm 43 18 03.9. •All others: b 4972...... . ......... 44 2,273. 45 0 . 45 Alternative minimum tax (see instructions). Attach Form 6251 ................ Single or Marded Sing separately, 46 Add lines 44 and 45..................................... ► fili$5,450 47 Foreign tax credit. Attach Form 11161f required ........ 47 46 2 273 . Married filing 48 Credit for child and dependent care expenses. Attach Form2441 ..... 48 Jointly or 49 Credit for the elderly or the disabled. Attach Schedule R .... 49 Qualifying 50 Education credits. Attach Form 8863.............. 50 widow(er), $10,900 51 Retirement savings contributions credit. Attach Form 8880 ... 51 Head of 52 Child tax credit (see Instructions). Attach Form 8901 if requned ...... 52 household, 53 Credits from Form: a Q 8396 b ❑ 8839 c ❑ 5695 ... 53 $8,000 54 Other cis from Farm: a Q 3800 b ❑ 8801 c 54 1_ 65 55 Add lines 47 through 54. These are your total credits ..................... 56 2,273. 56 Subtract line 55 from line 46. If line 55 is more than line 46, enter-0 . . . . . . . . . . . . . . ► 57 Self-employment tax. Attach Schedule SE ............. ................ Other 58 Unreported social security and Medicare tax from Form: a []4137 b ❑8919 ............. 57 58 59 Taxes 59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 53291f required ........... 60 Additional taxes: a QAEIC payments b L_I Household employment taxes. Attach Schedule H ...... 60 61 2,273. 61 Add lines 56.60. This is your total tax ............................... ► Payments 62 Federal income lax withheld from Forms W-2 and 1099 .... 62 63 2908 es8malad tax payments and amount applied from 2007 return .... 63 If you have a L qualifying 64 a Earned income credit(EIC).. . ............... 64a child, attach bNontaxablecombatpaydechon...►I646i Schedule Elo. 65 Excess social security and Der I RRTA tax withhold (see inshuclions) . 65 3,260. 66 Additional child tax credit. Attach Form 8812 .......... 66 67 Amount paid with request for extension to file (see instructions) ... 67 68 Credits from Form: a Q 2439 b ❑ 4136 c ❑ 8801 d ❑ 8885 68 69 First-time homebuyer credit. Attach Form 5405......... 1 69 302. 70 Recovery rebate credit (see worksheel) ............ 70 _ . . . . . . . . . . . . ► 71 71 Add lines 62 through 70. These are our total payments . . . . . . . . . . . . 3,560. Refund 72 If line 71 is more than line 61, subtract One 61 from line 71. This is the amount you overpaid........ Direct deposit? 73a Amount of line 72 you want refunded to ou. If Form 8888 is attached, check here . ► See Instructions ► b Routing number ..... 322282001 ► c T e: Checking X❑ Savings and fill in 73b, ► d Account number ..... 40054315170 8 73c, and 73d or Form 8888. 74 Amount of line 72 you want applied to your 2009 estimated tax . ►1 74 72 1,287. 73 a 1,287. _ Amount 75 Amount you owe. Subtract line 71 from line 61. For details on how to pay, see inslmchons .........► 75 You Owe 76 Estimated tax penalty see instructions ............ 176 Third Party Do you want to allow another person to discuss this return wmhthe IRS (see InsWctions)?...... UYes. Complete the following. UNo DeslBnee'e Phone Pcraanal Identification Designee name ► no numbar(PINI ► Under penalhes orperjury, I dedare that 1 have examined cow return and accompanying schedules and statements, and to the best army knowledge and Sign belief,theyarelme,cored,andcomplete Deduction of preparer(other than taxpayer) is based on all Information of which preparer has any knowledge Here Your signature Data Youroccupation Daytime phone number Joint return? See Instructions. Marketing Coordinator Keep acopy Spouse's signature. if a Joint return, both must sign. Data Spouse's occupation for your records. Date Preparers SSN or PTIN Preparers ' Paid signature self-employedCheck l( Preparer's Fin'sname Self -Prepared (o Dore it Use Only sd yemployed),� SIN Form 1040 (2008) FDIA0112 10/13/08 SCHEDULE D (Form 1040) I Capital Gains and Losses Attach to Form 1040 or Form 1040NR. See Instructions for Schedule D (Form 1040). DepartmentR,of the Treosury � Use Schedule D-1 to list additional transactions for lines 1 and 8. Inlemal Revanueservlm (99) OMa No 1545.0074 11: Nema(s) shown on fetum Your social security number Vanessa J Taw 312-92-8563 rt'I Short -Term Capital Gains and Losses — Assets Held One Year or Less (a) Desmpuan of properly (Example: 100 shares XYZ Co (b) Date acquired (Mo, day, yr) (C) Dale sold (Mo. day, yr) (d) sales pace (see instructions) (e) Cast or other bass (see instructions) (f) Gain or (loss) Subtract (a) froln(d) 1 2 3 4 5 6 7 Enter your short -tern totals, if any, from Schedule D-1, fine 2.... 2 Total short-term sales price amounts. Add lines 1 and 2 in column(d) ............................. 3 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824 .......... 4 Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 ...... 5 Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover WorksheetIn the Instructions ........................................... 6 Net short-term capital gain or (loss). Combine lines 1 through 6In column f ................... 7 II' Long -Term Capital Gains and Losses —Assets Held More Than One Year (a) Desmptim of Treasury(Fxampio: 0 shores XYL Co (b) Date acquired (Mo. day, yr) (C) Dale sold (Mo, day, yr) (d) sales price (see instructions) (a) Cost of olherbssis (see instructions) (f) Gain or (loss) Subtract(a) front (d) 8 Global Gross Class A 03/10/91 10/10 08 3,000.00 2,830.00 170.00 9 10 11 12 13 14 15 Enter your long-term totals, if any, from Schedule D-1, line 9 ... 9 Total long-term sales price amounts. Add lines 8 and 9 In column (d) ............................. 10 3,000. Gain from Form 4797, Part l; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 4684, 6781, and 8824........................................... Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 ...... Capital gain distributions. See insirs............................................ Long-term capital loss carryover. Enter the amount, if any, from line 15 of your Capital Loss Carryover Worksheetin the Instructions ........................................... Net long-term capital gain or (loss). Combine lines 8 through 14 in column (f). Then go to Part III on page 2 11 12 13 14 15 170. BAA For Paperwork Reduction Act Notice, see Form 1040 or Form 1040NR instructions. Schedule D (Form 1040) 2008 FDIA0612 11108108 Schedule D (Form 1040)2008 Vanessa J Taw 312-92-8563 Page 2 III Summary 16 Combine lines 7 and 15 and enter the result ................................... If line 16 Is: • A gain, enter the amount from line 16 on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 17 below. • A loss, skip lines 17 through 20 below. Then go to line 21. Also be sure to complete line 22. • Zero, skip lines 17 through 21 below and enter-0- on Form 1040, line 13, or Form 1040NR, line 14. Then to go line 22. 17 Are lines 15 and 16 both gains? © Yes. Go to line 18. No. Skip lines 18 through 21, and go to line 22. 18 Enter the amount, if any, from line 7 of the 28% Rate Gain Worksheet in the instructions ............. ► 19 Enter the amount, if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet In theInstructions ................................................. . 20 Are lines 18 and 19 both zero or blank? ® Yes. Complete Form 1040 through line 43, or Form 1040NR through line 40 Then complete the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions for Form 1040 (or In the Instructions for Form 104ONR), Do not complete lines 21 and 22 below. No. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the Schedule D Tax Worksheet in the Instructions. Do not complete lines 21 and 22 below. 21 If line 16 Is a loss, enter here and on Form 1040, line 13, or Form 1040NR, line 14, the smaller of: • Thelossonline16or ........ • ($3,000), or if marded filing separately, ($1,500) Note. When figuring which amount is smaller, treat both amounts as positive numbers. 22 Do you have qualified dividends on Form 1040, line 9b, or Form 1040NR, line 10b? ❑ Yes. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the Qualified Dividends and Capital Gain Tax Worksheet In the Instructions for Form 1040 (or In the Instructions for Form 1040NR). ❑ No. Complete the rest of Form 1040 or Form 1040NR. Schedule D (Form 1040) 2008 FOIA0812 11/08108 0 Recovery Rebate Credit Worksheet 2008 ► Keep for your records Name(s) Shown on Return Social Security Number Vanessa J Taw 312-92-8563 Before you begin: • See the printed instructions for Form 1040, line 70 to find out if you can take this credit. • If you received Notice 1378, have it available. The notice shows the amount of your economic stimulus payment, which you will need to fill in line 28 below. If you do not have Notice 1378, you can find the amount of your economic stimulus payment on www.irs.gov. 1 Can you, or your spouse if filing a joint return, be claimed as a dependent on another person's return? No. Go to line 2. Yes. You cannot take the credit. Stop here. 2 Does your tax return include a valid social security number for you and, if filing a joint return, your s ousa? I X I Yes. Skip lines 3 and 4 and go to line 5. No. Go to line 3. 3 Are You filing a joint return for 2008? Yes. Go to line 4. No. You cannot take the credit. Stop here. 4 Were either you or your spouse a member of the U.S. Armed Forces at any time during 2008? 8 Yes. Go to line 5. No. You cannot take the credit. Stop here. 5 Enter the amount from Form 1040, line 56 .......................... 2,273. 6 Enter the amount from Form 1040, line 52 ......................... . 7 Add lines 5and 6........................................ 2,273. 8 Enter $600 ($1,200 If married filing jointly) .......................... 600. 9 Enter the smaller of line 7 or line 8.............................. . 10 Is the amount on line 9 at least $300 ($600 if married filing jointly)? QX Yes. If you have at least one qualifying child for whom you entered a valid social security number` on Form 1040, line 6c, column (2), and checked the box in column (4), or have at least one qualifying child with a valid social security number" for whom you completed Form 8901, go to line 11. Otherwise, skip lines 11 through 21 and enter the amount from line 9 on line 22. Q No. If line 7 Is more than zero, go to line 11. Otherwise, skip line 11 and go to line 12. 11 Is your gross income" more than the amount shown below for your filing status? a Program calculated gross income ............... . b Adjustment to gross income ................... . c Gross income ........................... . • Single or married filing separately — $8,950 • Married filing jointly — $17,900 • Head of household — $11,500 • Qualifying widow(er) — $14,400 eNo. Go to line 12. Yes. Skip lines 12 through 18 and go to line 19. 12 Enter the amount from Form 1040, line 20a......................... . 13 Enter the amount of any nontaxable veterans' disability or death benefits you received In 2008........................................ . 14 A,rree You filing Form 8812? Yes. Skip line 15. Enter on line 16 the amount from Form 8812, line 4a. No. Go to line 15. 15 Are you filing Form 2555 or 2555-EZ to exclude foreign earned income, or using one of the optional methods to figure your net earnings from self-employment on Schedule SE, or are you a church employee or member of the clergy? Yes. Fill out the Earned Income Worksheet In Pub. 972 and enter on line 16 the amount from line 8 of that worksheet. Q No. Go to line 16. 3- 0 0 Vanessa J Taw 312-92-8563 16 Earned Income. If you did not already enter an amount on this line as instructed on lines 14 or 15, complete Worksheet B on page 51 in the printed instructions and enter the amount from Worksheet B, line 4b. (If you (or your spouse, if filing jointly) had nontaxable combat pay, did not file Form 8812, and did not enter an amount on Form 1040, line 64b, add your (and your spouse's) nontaxable combat pay to the amount on this line.) a Program calculated earned income ............... . b Adjustment to earned income ................... c Earned income ........................................ 17 Qualifying income. Add lines 12,13 and 16. ....................... . 18 Is line 17 at least $3,000? BNo. Skip lines 19 through 21 and enter the amount from line 9 on line 22. Yes. Go to line 19. 19 Enter $300 ($600 If married filing jointly) .......................... . 20 Enter the larger of line 9 or line 19 .............................. . 21 Multiply $300 by the number of qualifying children for whom you entered a valid social security number* on: • Form 1040, line 6c, column (2), and checked the box in column (4), or • Form 8901, column (b).................................. . Page 2 22 Add lines 20 and 21....................................... 600. 23 Enter the amount from Form 1040, line 38 .......................... 26,969. 24 Enter $75,000 ($150,000 if married filing jointly) ....................... 75,000. 25 Is the amount on line 23 more than the amount on line 24? eNo. Skip line 26. Enter the amount from line 22 on line 27 below. Yes. Subtract line 24 from line 23 .......................... . 26 Multiply line 25 by 5% (.05).................................. . 27 Subtract line 26 from line 22. If zero or less, enter 0 (zero) ................. 600. 28 Enter the amount, if any, of the economic stimulus payment you received (before offset) as shown on Notice 1378 or www.irs.gov. If you received more than one payment, enter the total of all payments you received as shown on all Notices 1378 or on www.irs.gov. If filing a joint return, include your spouse's payment as shown on your spouse's Notice 1378 or on www.irs.gov. If you filed a joint return for 2007 and received an economic stimulus payment, you and your spouse are each treated as having received half of the payment ........... 300. 29 Recovery rebate credit. Subtract line 28 from line 27. If zero or less, enter -0- (zero). Enter the result here and, if more than zero, on Form 1040, line 70. If you entered an amount on line 13 above, enter "Won the dotted line to the left of Form 1040, line 70. If you (or your spouse, if filing jointly) had nontaxable combat pay, did not file Form 8812, and did not enter an amount on Form 1040, line 64b, enter "NCP" to the left of Form 1040, line 70. If line 28 is more than line 27, you do not have to pay back the difference ............... 300. * A valid social security number is not required for a qualifying child If you filed a joint return AND either you or your spouse was a member of the U.S. Armed Forces at any time during 2008. "* Your gross income Includes the total of the following amounts: Form 1040, lines 7, 8a, 9a, 10, 11, 13 (if you were not required to file Schedule D), 15b, 16b, 19, 20b, and 21 (excluding any negative amounts); Schedule C, line 7; Schedule C-EZ, line 1; Schedule E, lines 3 and 4; Schedule F, line 11; Form 4835, line 7; Schedule K-1 (Form 1065), box 14, codes B and C; Schedule K-1 (Form 1065-B), box 9, code K-2; Schedule K-1 (Form 1120S), box 14, code B. But do not include on this line any amount for which you claimed the foreign earned income exclusion or the housing exclusion on Form 2555 or2555-EZ. Your gross income also includes the total of all gains from Schedule D, lines 1, 8, and 13; Schedule D-1, lines 1 and 8; Form 4684, line 14, and column (c) of lines 35 and 40; Form 4797, lines 2, 10, and 30; Form 6252, lines 24 and 35; Form 6781, lines 1 and 12; Form 8824, lines 14, 23, 35, and 36; and Form 2439, line 1a. But subtract from this total any section 1202 exclusion, any section 1045 or section 1397B rollover, any exclusion of gain from DC Zone assets or qualified community assets, and any section 121 exclusion shown on Schedule D or Form 4797. Vanessa J Taw 312-92-8563 Page Note: Based on the information on your 2007 tax return, the estimated amount of rebate that you received was: Basic Credit ......................................... 300. Child Credit ............................................ 0. Reduction Due to Adjusted Gross Income Limitation .................... . Total Estimated Rebate .................................... 300. i Form 1040 Qualified Dividends and Capital Gain Tax Worksheet 2008 Line 44 Keep for your records Name(s) Shown on Return I Social Security Number 1 Enter the amount from Form 1040, line 43 ......... 1 18,019. 2 Enter the amount from Form 1040, line 915 ............ 2 18. 3 Are you filing Schedule D? XQ Yes. Enter the smaller of line 15 or 16 of Schedule D. If either line 15 or 16 is a loss, enter-0- .. 3 170. 0 No. Entertheamount from Form 1040, line 13. 4 Add lines 2 and 3 ......... 4 188. 5 If you are claiming Investment Interest expense on Form 4952, enter the amount from line 4g.Otherwise enter -0-.... 5 0. 6 Subtract line 5 from line 4. If zero or less, enter-0...... 6 188. 7 Subtract line 6 from line 1. If zero or less, enter-0...... 7 17,831. 8 Enter the smaller of: • The amount on line 1 or • $32,550 if single or married filing sep, $65,100 if married filing jointly or 8 18,019. qualifying widow(er), or $43,650 if head of household. 9 Is the amount on line 7 equal to or more than the amount on line 8? RX Yes. Skip lines 9 and 10; go to line 11. No. Enter the amount from line 7 ........... 9 17,831. 10 Subract line 9 from line 8 ................... 10 188. 11 Are the amounts on lines 6 and 10 the same? BX Yes. Skip lines 11 through 14; go to line 15 No. Enter the smaller of line 1 or line 6 ....... 11 12 Enter the amt from line 10 (if line 10 is blank, enter 0) ... 12 13 Subtract line 12 from line 11.................. 13 14 Multiply line 13 by 15% (.15)................................ 14 15 Figure the tax on the amount on line 7. Use the Tax Table or Tax Computation Worksheet, whichever applies................................15 2,273. 16 Add lines 14 and 15..................................... 16 2,273. 17 Figure the tax on the amount on line 1. Use the Tax Table or Tax Computation Worksheet, whichever applies................................17 2,303. 18 Tax on all taxable Income. Enter the smaller of line 16 or line 17 here and on Form 1040, line 44...................................... 18 2,273. Tax Payments Worksheet 2008 ► Keep for your records Name(s) Shown on Return I Social Security Number Vanessa J Taw 312-92-8563 Estimated Tax Payments for 2008 (If more than 4 payments for any state or locality, see Tax Help) Federal State Local Date Amount Date Amount ID Date Amount ID 1 04/15/08 04/15/08 04/15/08 2 06/16/08 06/16/08 06/16/08 3 09/15/08 09/15/08 09/15/08 4 01/15/09 01/15/09 01/15/09 5 Tot Estimated Payments .. . Tax Payments Other Than Withholding (If multiple states, see Tax Help) Federal State ID Local ID 6 Overpayments applied to 2008 .... 7 Credited by estates and trusts .... 8 Totals Lines 1 through 7 ...... 9 2008 extensions ............ _ _ 1 Taxes Withheld From: Federal State Local 10 Forms W-2...................... 11 Forms W-2G .................... 12 Forms 1099-R ................... 13 Forms 1099-MISC and 1099-G........... 14 Schedules K-1 .................... 15 Farms 1099-INT, DIV and OID 16 Social Security and Railroad 17 Farm 1099-B ....... 18a Other withholding .... b Other withholding .... c Other withholding .... 19 Total Withholding Lines 10 20 Total Tax Payments for 2008 . . ........... Benefits ... St Loc _ St Loc _ St Loc _ St Loc through 18c... ........... 3,260. 302. 132. 1 1 I 3,260.. 302. 132. 3,260. 302. 132. Prior Year Taxes Paid In 2008 (If multiple states or localities, see Tax Help) State ID Local ID 21 Tax paid with 2007 extensions 22 2007 estimated tax paid after 23 Balance due paid with 2007 24 Other (amended returns, Installment ............... 12/31/07 .......... return ............. payments, etc) . . _ _ _ Form 1040 Student Loan Interest Deduction Worksheet 2008 Line 33 ► Keep for your records Name(s) Shown on Return Social Security Number Vanessa J Taw 312-92-8563 1 Enter the total interest you paid in 2008 on qualified student loans .......... 1 108. (see Form 1040 instructions). 2 Enter the smaller of line 1 or$2,500........................... 2 108. 27,077. 3 Modified AGI ........................................ 3 Note: If line 3 is $70,000 or more if single, head of household, or qualifying widow(er) or $145,000 or more if married filing jointly, stop here. You cannot take the deduction. 4 Enter: $55,000 If single, head of household, or qualifying widow(er); $115,000 if married filing jointly .............................. 4 55,000. 5 Subtract line 4 from line 3. If zero or less, enter -0- here and on line 7, skip line 6, and go on to line 8................................. 5 0. 6 Divide line 5 by $15,000 or $30,000 If married filing jointly. Enter the result as a decimal (rounded to at least three places) ............ 6 0. 7 Multiply line 2 by line 6.................................. 7 8 Student loan interest deduction. Subtract line 7 from line 2. Enter the result here and on Form 1040, line 33. Do not include this amount in figuring any other deduction on your return (such as on Schedule A, C. E, etc.) .......... 8 108. Modified AGI is the amount from Form 1040, line 22, increased by any excludable income from Puerto Rico, or of bona fide residents of American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands, and foreign earned income/housing exclusion, and decreased by amounts on Form 1040, lines 23 through 32 and any write-in amount next to line 36, not including the Foreign housing deduction on line A of the Other Adjustments to Income Smart Worksheet. • Federal Carryover Worksheet 2008 Keep for your records Name(s) Shown on Return I Social Security Number Vanessa J Taw 312-92-8563 2007 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 With- held/Pmts (a) Paid With Return M Total Over- payment (g) Applied Amount CA 123. 123.' Totals .. 123. 123. Other Tax and Income Information 2007 2008 1 Filing status ............................. 2 Number of exemptions for blind or over 65 (0 - 4)......... 3 Itemized deductions after limitation ................. 4 Check box if required to itemize deductions ............ 5 Adjusted gross income ....................... 6 Tax liability for Form 2210 or Form 2210-F ............ 7 Alternative minimum tax ....................... 8 Federal overpayment applied to next year estimated tax..... 1 2 3 4�- 5 6 7 8 1 Single 1 Single 123. 434. 6,080. 26,969. 0. 1,973. 0. QuickZoom to the IRA Information Worksheet for IRA Information (see Tax Help) ....... ► Excess Contributions 2007 2008 9 a Taxpayer's excess Archer MSA contributions as of 12/31 ... b Spouse's excess Archer MSA contributions as of 12/31 .... 10 a Taxpayers excess Coverdell ESA contributions as of 12/31... b Spouse's excess Coverdell ESA contributions as of 12/31.... 11 a Taxpayer's excess HSA contributions as of 12/31 ........ b Spouse's excess HSA contributions as of 12131 ......... 9 a b 10 a b 11 a b Loss and Expense Carryovers 2007 2008 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 2008... b 2007... c 2006... d 2005... e 2004... f 2003... 12 a b 13 a b 14 a b 15 a b 16 a b c d e f I I Federal Carryover Worksheet page 2 Vanessa J Taw 2008 312-92-8563 Loss and Expense Carryovers (cont'd) 2007 2008 17 AMT Nonrecap'd net Sec 1231 losses from: a 2008... b 2007... c 2006... d 2005... e 2004... f 2003... Credit Carryovers 17 a b c d e f 2008 2007 18 General business credit ....................... 19 Adoption credit from: a 2008 ................. b 2007................. c 2006................. d 2005................. e 2004................. f 2003 ................. 20 Mortgage interest credit from: a 2008 ............ b 2007............ c 2006............ d 2005............ 21 Credit for prior year minimum tax .................. 22 District of Columbia first-time homebuyer credit.......... 23 Residential energy efficient property credit ............ 24 Amount overpaid less earned income credit............ Other Carryovers 25 Section 179 ex ense deduction disallowed ............ 26 Excess a Taxpayer (Form 2555, line 46) ....... foreign b Taxpayer (Form 2555, line 48) ....... housing c Spouse (Form 2555, line 46) ........ deduction: d Spouse (Form 2555, line 48) ........ 18 19 a b c d e f 20 a b c d 21 22 23 24 25 26 a b c d I I I 2008 F 793 . 2007 Federal Carryover Worksheet page 3 2008 Vanessa J Taw 312-92-8563 Charitable Contribution Carryovers 27 2007 Carryover of charitable contributions from: a 2007 .............. b 2006 .............. c 2005 ............. d 2004 ............. e 2003 .............. Other Property Capital Gain (a) 50% (b) 30% (c) 30% (d) 20% 28 2008 Carryover of charitable contributions from: a 2008 .............. b 2007 .............. c 2006 .............. d 2005 .............. e 2004 .............. Other Property Capital Gain (a) 50% (b) 30% (c) 30% (d) 20% Estimated Rebate Due to Economic Stimulus Act of 2008 29 Total estimated economic stimulus rebate calculated on your 2007 tax return ........ 300. 2007 State Capital Lass Carryovers (For users not transferring from the prior year) State ID Short-term Capital Loss for State AMT Short-term Capital Loss for State Long-term Capital Loss for State AMT Long-term Capital Loss for State Capital Loss (combined) for State AMT Capital Loss (combined) for State • IRA Information Worksheet 2008 ► Keep for your records Name(s) Shown on Return Vanessa J Taw Social Security Number 312-92-8563 Part l Traditional IRA Taxpayer Spouse 1 2 3 Basis and Value Total basis in traditional IRAs ................... Year-end value on 12/31/2008................... Basis carryover as of 12/31/2008 ................. 4 5 Excess Contributions Excess contributions as of 12/31/2007 .............. Carryover of excess contributions to 12131/2008 . . . . . . . . . rP-a—rt-1-1-71 Roth IRA Taxpayer Spouse 6 7 8 9 Basis (Contribution and Conversion History) Basis in Roth IRA contributions .................. Basis in Roth IRA conversions ................... Contribution basis carryover as of 12/31/2008 .......... Conversion basis carryover as of 12/31/2008 ......... . Soo. 500. 10 11 Excess Contributions Excess contributions as of 12/31/2007 .............. Carryover of excess contributions to 12/31/2008........ . FP—ar-t-11-1---1 Traditional IRA Basis Detail Taxpayer Spouse 12 13 14 1s 16 17 Basis for 2007 and earlier years .................. . Adjustment due to return of excess contributions ......... . Rollover of nontaxable portion of a qualified retirement plan ... . Basis received from former spouse due to divorce or inherited.. . Basis transferred to former spouse due to divorce ........ . Adjusted total basis in Traditional IRAs ............... . PartIV Traditional IRA Year-end Value Detail Taxpayer Spouse 18 19 20 21 Enter the combined value of all traditional IRAs (including SIMPLE IRAs) on 12/31/08 (See Help) ......... . If any amounts were recharacterized either to or from any traditional IRA, enter the net amounts recharacterized after 12/31/08 (See Help) ......................... . Enter the total amount of any traditional IRA distributions that you rolled over, or intend to roll over, to another traditional IRA, but the rollover was (or will be) made after 12/31/08 .... . Check this box if you converted all of the traditional IRAs you had in 2008 to Roth IRAs in 2008................... 0 0 0 ! IRA Information Worksheet 2008 ► Keep for your records Page 2 Name(s) Shown on Return Social Security Number Vanessa J Taw 312-92-8563 rp—ar—t—T-71 Roth IRA Contribution and Conversion Balances Taxpayer Spouse 22 Opened a Roth IRA before 2004 .................. Yes= No Q Yes= No Q 2007 Balances (Basis . Before 2008 Transactions) 23 Cumulative regular Roth IRA contributions, including rollovers from Roth 401(k) and Roth 403(b) .................. 24 Cumulative pre 2004 conversions -taxable and nontaxable .... 25 2004 conversion contributions taxable at conversion ........ 26 2004 conversion contributions not taxable at conversion ...... 27 2005 conversion contributions taxable at conversion ........ 28 2005 conversion contributions not taxable at conversion ...... 29 2006 conversion contributions taxable at conversion ........ 30 2006 conversion contributions not taxable at conversion ..... . 31 2007 conversion contributions taxable at conversion ....... . 32 2007 conversion contributions not taxable at conversion ..... . 2008 Transactions -Contributions Taxpayer Spouse 33 Regular Roth IRA contributions .................... 500. 34 Rollover from Roth 401(k) and Roth 403(b) ............ . 35 Conversion contributions taxable at conversion .......... . 36 Conversion contributions not taxable at conversion ........ . 37 Repayments of qualified Roth reservist distributions ....... . 38 Repayment of basis from prior year hurricane distributions.... . 2008 Transactions - Distributions 39 Distributions from regular Roth IRA contributions and from rollovers from Roth 401(k) and Roth 403(b) 40 Distributions from cumulative pre 2004 conversions 41 Distributions from 2004 conversions taxable at conversion .... . 42 Distributions from 2004 conversions not taxable at conversion.. . 43 Distributions from 2005 conversions taxable at conversion .... . 44 Distributions from 2005 conversions not taxable at conversion.. . 45 Distributions from 2006 conversions taxable at conversion .... . 46 Distributions from 2006 conversions not taxable at conversion.. . 47 Distributions from 2007 conversions taxable at conversion .... . 48 Distributions from 2007 conversions not taxable at conversion.. . 49 Distributions from 2008 conversions taxable at conversion .... . s0 Distributions from 2008 conversions not taxable at conversion.. . Yes No Yes No 51 Did you have any open Roth IRA accounts on 12/31/08 ...... Q Q Q Balance carryover to 2009 (Basis . After 2008 Transactions) 52 Cumulative regular Roth IRA contributions, including rollovers from Roth 401(k) and Roth 403(b) .................. 500. 53 Cumulative pre 2005 conversions - taxable and nontaxable 54 2005 conversion contributions taxable at conversion ....... . 55 2005 conversion contributions not taxable at conversion ..... . 56 2006 conversion contributions taxable at conversion ....... . 57 2006 conversion contributions not taxable at conversion ..... . 58 2007 conversion contributions taxable at conversion ....... . 59 2007 conversion contributions not taxable at conversion ..... . 60 2008 conversion contributions taxable at conversion ....... . 61 2008 conversion contributions not taxable at conversion ..... . IRA Information Worksheet 2008 ► Keep for your records Page 3 Name(s) Shown on Return Vanessa J Taw Social Security Number 312-92-8563 Part VI Roth IRA Basis Adjustments Taxpayer Spouse 62 63 64 65 66 67 68 69 70 71 72 73 Received From Former Spouse due to Divorce or Inheritance Cumulative regular Roth IRA contributions, including rollovers from Roth 401(k) and Roth 403(b) .................. Cumulative pre 2004 conversions - taxable and nontaxable .... 2004 conversion contributions taxable at conversion ........ 2004 conversion contributions not taxable at conversion ..... . 2005 conversion contributions taxable at conversion ....... . 2005 conversion contributions not taxable at conversion ..... . 2006 conversion contributions taxable at conversion ....... . 2006 conversion contributions not taxable at conversion ..... . 2007 conversion contributions taxable at conversion ....... . 2007 conversion contributions not taxable at conversion ..... . 2008 conversion contributions taxable at conversion ....... . 2008 conversion contributions not taxable at conversion ..... . 74 75 76 77 78 79 80 81 82 83 84 85 Transferred To Former Spouse due to Divorce Cumulative regular Roth IRA contributions, including rollovers from Roth 401(k) and Roth 403(b) ................. . Cumulative pre 2004 conversions - taxable and nontaxable ... . 2004 conversion contributions taxable at conversion ....... . 2004 conversion contributions not taxable at conversion ..... . 2005 conversion contributions taxable at conversion ....... . 2005 conversion contributions not taxable at conversion ..... . 2006 conversion contributions taxable at conversion ....... . 2006 conversion contributions not taxable at conversion ..... . 2007 conversion contributions taxable at conversion ....... . 2007 conversion contributions not taxable at conversion ..... . 2008 conversion contributions taxable at conversion ....... . 2008 conversion contributions not taxable at conversion ..... . • Santa Barbara Bank & Trust Refund Processing Agreement ('Agreement') Name: Vanessa J Taw Social Security No.: 312-92-8563 This Agreement contains important terms, conditions and disclosures about the processing of your refund by Santa Barbara Bank & Trust, a division of Pacific Capital Bank, N.A. ('SBBT'). Read this Agreement carefully before accepting its terms and conditions, and print a copy and/or retain this Information electronically for future reference. 1. Use Of Pronouns. As used in this Agreement, the words'you' and 'your refer to the applicant or both the applicant and joint applicant if the 2008 federal Income lax return is a joint return (individually and collectively, 'Applicant'). The words 'we,' 'us' and'our refer to SBBT. 2. Authorization to Release Personal Information. You authorize the Internal Revenue Service ('IRS') to disclose any Information to SBBT related to the funding of your 2008 tax refund. You also authorize Intuit, as the transmitter of your electronically filed tax return, to disclose your tax return and contact Information to SBBT for use in connection with the refund processing services being provided pursuant to this Agreement. Neither Intuit nor SBBT will disclose or use your lax return Information for any other purpose, except as permitted by law. SBBT will not use your tax information or contact Information for any marketing purpose. To view the SBBT Privacy Policy applicable to this Agreement, see Section 12 below. 3, No Requirement To Have SBBT Process Your Refund In Order To File Electronically. You understand that SBBT charges a refund processing fee to deduct Intuit's fees from your refund. You further understand that your tax year 2008 federal Income tax return can be filed electronically, and your IRS refund direct deposited, without using SBBT's refund processing service by, Instead, paying the applicable TurboTax filing fees to Intuit by credit or debit card at the time you file your 2008 federal income tax return. 4. Summary of Terms Expected Federal Refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,287.00 Less SBBT Refund Processing Fee .............................................. $ 29.95 Less Electronic Filing Transmission Fee and/or Service Fee for web users .......................... $ 79.90 Less Additional Products and Services Purchased ...................................... $ ExpectedProceeds (1)................................................... $ 1,177.15 (1) This Is only an estimate. The amount will be reduced by any applicable sales taxes. 5. Temporary Deposit Account Authorization. You hereby authorize SBBT to establish a temporary deposit account ('Deposit Account') for the purpose of receiving your tax year 2008 federal Income tax refund from the IRS. SBBT must receive an acknowledgement from the IRS that your return has been electronically filed and accepted for proes sing'afore the Deposit Account can be opened. You authorize SBBT to deduct I your Deposit Account the following amounts: (1) the SBBT refund processing fee; (ii) the fees and charges related to the preparation, Processing and lransmissfon of your tax return; and, (III) amounts to pay for additional products and servfces purchased plus applicable taxes. You authorize SBBT to disburse the balance of the Deposit Account to you after making all authorized deductions or payments. 6. Acknowledgements. (a) You understand that: (1) SBBT cannot guarantee the amount of your tax year 2008 federal Income tax refund or the date It will be Issued, and (II) SBBT Is not affiliated with the transmitter of the tax return (Intuit) and does not warrant the accuracy of the software used to prepare the tax return. (b) You agree that Intuit Is not acting as your agent and is not under any fiduciary duty with respect to the processing of your refund by SBBT. 7. Truth in Savings Disclosure. The Deposit Account is being opened for the purpose of receiving your (both spouses If this is ajointly filed return) tax year 2008 federal lax refund. There Is no cost to you for opening the Deposit Account. No other deposits may be made to the Deposit Account. No withdrawals will be allowed from the Deposit Account until all fees, charges, disbursements and payments authorized by this Agreement have been paid. No Interest is pa able on the deposit; thus, the annual percentage yield and Interest rate are 0%. The Deposit Account will be closed after all authorized deductions have been made and any remaining balance has been disbursed to you. Questions or concerns about the Deposit Account should be directed to: SANTA BARBARA BANK & TRUST, attn: Refund Processing Department, P.O. Box 1030, Solana Beach, CA 92075, or to SBBT via the Internet at http://cisc.sbbtral.com. 8. Direct Deposit Information. The balance of your refund will be disbursed to you electronically by ACH Direct Deposit to your personal bank account designated below. If a joint return is filed, the bank account may be a joint account or the Individual account of either spouse. DIRECT DEPOSIT ACCOUNT TYPE: Checking ©Savings RTN#: 322282001 ACCOUNT#: 400543151708 Note: To Insure that there are no delays In receiving your refund, please contact your financial Institution to confirm that you are using the correct RTN (routing) and account number. If you or your representative enter your personal bank account information incorrectly and your deposit is returned to MT. the refund balance minus $5 SBBT handling fee will be disbursed to you via an SBBT cashier's check mailed to the address on your tax return. If the direct deposit is not returned to SBBT, you will be responsible for the loss. aTAPP SBIA0912 10/31/08 Vanessa J Taw 312-92-8563 9. Electronic Fund Transfers: The Federal Electronic Fund Transfer Act provides you with certain rights and obligations regarding the funds that will be electronically deposited Into and transferred from your Deposit Account with SBBT. If SBBT does not complete an electronic fund transfer to or from the Deposit Account on time or in the correct amount according to this Agreement, SBBT will be liable for your losses or damages. There are some exceptions, however. SBBT will not be liable, for instance, If: through no fault of SBBT, you do not have enough available funds In the Deposit Account to make the transfer; circumstances beyond SBBT's control (such as fire, flood, water damage, power failure, strike, labor dispute, computer breakdown, civil unrest, governmental action, acts of terrorism, telephone line disruption or a natural disaster) delay the transfer despite reasonable precautions taken by SBBT; the funds in the Deposit Account are subject to legal process or are otherwise not available for withdrawal; the Information supplied by you or a third party is Incorrect, Incomplete, ambiguous or untimely; or, SBBT has reason to believe the transaction may not be authorized by you. If you believe that there is an error or if you have a question about your Deposit Account, you will write to Santa Barbara Bank & Trust, P.O. Box 1030, Solana Beach, California 92075, or call SBBT at 818-717-7228, or communicate with it via the Internet by logging on to http://cisc.sbbtrtal.com, and provide SBBT with your name, a description or explanation of the error, and the dollar amount of the suspected error or the transfer you are unsure about SBBT will determine whether the error occurred within 10 business days after it hears from you and will correct any error promptly. SBBT will tell you the results within three business days after completing its investigation. If SBBT decides that there was no error, it will send you a written explanation. You may ask for copies of the documents that SBBT used In its Investigation. SBBT's business days are Monday through Friday, excluding holidays. 10. Compensation. In addition to any fees paid directly by you to Intuit, SBBT will Pay a portion of SBBT's refund processing fee to Intuit In consideration of and pursuant to their agreement relating to Intuit's provision of var ray programming, testing, data processing, transmission, systems maintenance, status reporting and other software, technical and communications service. 11. Governing Law. The enforcement and Interpretation of this Agreement and the transactions contemplated herein shall be governed by the laws of the Slate of California applicable to contracts executed and to be performed entirely in the State of California by residents of the State of California without regard to the conflicts of laws, and, to the extent applicable, by the laws of the United States of America, including the Electronic Signatures In Global and National Commerce Act. 12. Santa Barbara Bank & Trust Privacy Policy. Privacy Policy. To help the government fight the funding of terrorism and money laundering, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. SBBT will obtain information from and about you in connection with the opening of the Deposit Account. Federal law requires SBBT to provide you with this statement. In this Privacy Polley, 'Confidential Information' means non-public personally Identifiable information about you. This notice applies only to Individuals who are using, or have used In the past, SBBT's refund processing services. SBBT may change (add to, delete or amend) the terms of this Privacy Policy at any time, giving you such notice as may then be required by law. Confidential Information SBBT collects. We collect Confidential Information from you, Intuit and the IRS in connection with your refund processing in order to identify You, set up your temporary Deposit Account, and process your refund. This may include Information such as your name, address, date of birth, social security number and personal bank account information. SBBT also collects Information from the IRS concerning your refund deposit. Information SBBT shares and with whom. We may disclose your Confidential Information to nonaffiliated third parties as permitted by law. However, we will not use or disclose your Confidential Information that we receive from Intuit or the IRS for marketing purposes. We also may disclose Confidential Information with your consent. Security procedures SBBT uses to protect your Confidential Information. Inside SBBT, your information is accessible only to employees who need the Information In order to process your product request or answer your questions. SBBT has a formal Code of Ethics and train Its employees on their responsibility to maintain the privacy of your Confidential Information. SBBT also maintains physical, electronic and procedural safeguards that comply with federal standards to guard your Confidential Information. Questions? If you have any questions regarding this Privacy Policy, please call 800-717-7228. YOUR AGREEMENT By selecting the'l agree' button in TurboTax: (i) You authorize SBBT to receive your 2008 federal tax refund from the IRS and to make the deductions from your refund described in the Agreement, (li) You agree to receive all Communications electronically in accordance with the 'Consent to Conduct Business Electronically' section of the License Agreement for Tax Year 2008 TurboTax(R) Software and Services, as the term 'Communications' is defined therein, (III) You consent to the release of your 2008 refund deposit information and application information as described in Section 2 of this Agreement, and (Iv) You acknowledge that you have reviewed, and agree to be bound by, the Agreement's terms and conditions. You understand that, If you change your lax year 2008 federal tax return Information Ina way that affects the amount of your refund, you must review and accept the Agreement again. If this is a joint return, selecting 'I agree' indicates that both spouses agree to ye bound by the terns and conditions of the Agreement. RTAPP SDIA0912 10131/08 ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING TAXPAYER: Vanessa J Taw PRIMARY SSN: 312-92-8563 FEDERAL RETURN SUBMITTED: April 07, 2009 09:20 PM PDT FEDERAL RETURN ACCEPTANCE DATE: 04/07/2009 The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The Intuit Electronic Postmark documents the filing date of your income tax return, and the electronic postmark information should be kept on file with your tax return and other tax -related documentation. There are two important aspects of the Intuit Electronic Postmark: 1. THE INTUIT ELECTRONIC POSTMARK. The electronic postmark shows the date and time Intuit received the federal return, and is deemed the filing date if the date of the electronic postmark is on or before the date prescribed for filing of the federal individual income tax return. TIMELY FILING: For your federal return to be considered filed on time, your return must be postmarked on or before midnight April 15, 2009. Intuit's electronic postmark is issued in the Pacific Time (PT) zone. If you are not filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark time to determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone and you electronically file your return at 9 AM on April 15, 2009, your Intuit electronic postmark will indicate April 15, 2009, 6 AM. If your federal tax return is rejected, the IRS still considers it filed on time if the electronic postmark is on or before April 15, 2009, and a corrected return is submitted and accepted before April 20, 2009. If your return is submitted after April 20, 2009, a new time stamp is issued to reflect that your return was submitted after the IRS deadline and, consequently, is no longer considered to have been filed on time. If you request an automatic six-month extension, your return must be electronically postmarked by midnight October 15, 2009. If your federal tax return is rejected, the IRS will still consider it filed on time if the electronic postmark is on or before October 15, 2009, and the corrected return is submitted and accepted by October 20, 2009. 2. THE ACCEPTANCE DATE. Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return. FDIU0401 10102MB Vanessa J Taw 312-92-8563 SMART WORKSHEET FOR: Form 1040: Individual Tax Return Tax Smart Worksheet ATax ........................................... 2,273. Check If from: 1 Tax table ................................................. 2 Tax Computation Worksheet (see instructions) ........................... . 3 Schedule D Tax Worksheet...................................... . 4 Qualified Dividends and Capital Gain Tax Worksheet ........................ X 5 Schedule .............................................. 6 Form8615.............................................. 7 Foreign Earned Income Tax Worksheet ............................... . B Additional tax from Form 8814 ............................ . C Additional tax from Form 4972 ............................ . D Tax from additional Form(s) 4972 .......................... . E Recapture tax from Form 8863 ............................. F IRC Section 197(f)(9)(B)(ii) election for an additional tax ............... G Tax. Add lines A through F. Enter the result here and on line 44 .......... 2,273. MART WORKSHEET FOR: Schedule D: Capital Gains & Losses A Is a statement with stock sale detail being attached Instead of entering detail? .............................. ►QYes QNo If yes, Form 8453 Is required to be mailed to IRS when electronically filing. B Sort sales by date sold in Parts I and II? ...................... ►QYes QNo KEEP FOR YOUR RECORDS Electronic Filing Instructions for your 2008 California Tax Return Important: Your taxes are not finished until all required steps are completed. �� V / I Declaration Control Number: 00-440043-99519-9 Accepted: 04/07/2009 Vanessa J Taw 676 Alderwood Drive Newport Beach, CA 92660 1 Balance 1 Your California state tax return (Form 540) shows you have elected to Due/ 1 pay your balance due of $11.00 by Direct Debit. Your tax payment of Refund 1 $11.00 will be withdrawn from this account: Account Number: 400543151708, Routing Transit Number: 322282001, Elected Date of Withdrawal: 04/08/2009. To inquire about the status of your Direct 1 Debit call the Franchise Tax Board directly at 1-916-845-0353. I What YOU 1 Sign and date Form 8453-OL within 1 day of acceptance. Need to I Sign I Do Not I Do not mail a paper copy of your tax return. Since you filed Mail I electronically, the Franchise Tax Board already has your return. What You I Your Electronic Filing Instructions (this form) Needto I - Form 8453-OL and attachment(s) Keep I Printed copy of your state and federal returns 2008 1 1 Taxable Income $ 22,083.00 California 1 Total Tax $ 313.00 Tax 1 Total Payments/Credits $ 302.00 Return I Payment Due $ 11.00 Summary 1 Effective Tax Rate 4.0% Page 1 of 1 os1 Declaration Control Number DCN f DO NOT MAIL THIS FORM TO THE FTB 00 — 440043 — 99519 — F9 I Dale Accepted 04/07/2009 TAXA13LE YEAR California Online e-file Return Authorization FORM 2008 for Individuals 8453-OL Your first name and Initial Lest name Your SSN or rrlN VANESSA J TAW 312-92-8563 If joint return.spouse's/ReP's first name and initial Lastname Spouse's/RaP's SSN or rrIN Address (including number and street, PC Box, or PMB no.) Apt. no./Ste. no. Daytime telephone number 676 ALDERWOOD DRIVE city State ZIP Code NEWPORT BEACH CA 92660 Part I Tax Return Information (whole dollars only) California adjusted gross Income. (Form 540, line 17; Form 540 2EZ, line 16; Long Form 540NR, line 21; or Short Form 540NR, line 21)............................................. 1 25,775. 2 Refund or No Amount Due. (Form 540, line 66; Form 540 2EZ, line 28; Long Form 540NR, line 73: or Short Form 540NR, line 73)............................................. 2 3 Amount you owe. (Form 540, line 62; Form 540 2EZ, line 27; Long Form 540NR, line 69; or Short Form 540NR, line 69)................................................... 3 Part II Settle Your Account Electronically for Taxable Year 2008 (Due 04115109) Direct Deposit of Refund Electronic Funds Withdrawal 5 a Amount 5 b Withdrawal Date(MMIDD/YYYY) 04/08/2009 Part [I[ Make Estimated Tax Payments for Taxable Year 2009 These are not installment payments for the current amount you owe. First Payment Due 4/15/09 Second Payment Due 6115/09 Third Payment Due 9/15/09 Fourth Payment Due 1115/10 6 Amount ..................... 7 Withdrawal Date ............... . Part IV Banking Information (Have you verified your banking information?) 8 Amount of refund to be directly deposited to account below 12 The remaining amount of my refund for direct deposit 9 Routing number 322282001 13 Routing number 10 Account number 4005433.51708 14 Account number 11 Type of account: n Checking n Savings 15 Type of account: n Checking [, Savings Part V Declaration of Taxpayer(s) I authorize my account to be settled as designated in Part II. If I check box 4,1 declare that the direct deposit refund Information in Part IV agrees with the authorization stated on my return. I authorize an electronic funds withdrawal for the amount listed on line 5a and any estimated payment amounts listed on line 6 from the account listed on lines 9, 10, and 11. If I have filed ajoint return, this is an irrevocable appointment of the other spouse/RDP as an agent to receive the refund or authorize an electronic funds withdrawal. Under penalties o(ppe try, Idedare that the infamatonlprovided to the Franchise Tax Board(F1'B),either directly ortitroughafilesollwere, including my name, address, and social secunly number (SSN or Individualtaxpayer Identification number (ITIN), and the amounts shown in Part I above, agrees with the information and amounts shown on the cartesponding lines of m9 2008 Caliromia income tax return. TO tits best arm9knowledge andbelief, my return is We, carecb and complete. If I am filing a balance due return, I understand That if the FTB does not receive full and timely payment of my tax IiabiGty, Iranian liable fa the tax Lability and all applicable Interest and penalties. I aulhaize my remm and accompanying schedules and slatemenl, he transmitted to the FTB directly or Through the edits so0ware. If the processing of my return or refund is delayed, I aulhartze the FTB to disclose to me, either dtrec0y or through the e•fI a software, the reason(,) for the delay or the dale when the refund was sent Sign Here V9ltl It Is unlawful to forge a spouse'srRDP's signature. For Privacy Notice, get form FTB 1131. FTB 8453-0L C2 (2008) CAEAS201 12112/08 Notice, got form FTI3 1131. CAIA3912 12105108 nia Resident FORM AYE ATTACH FEDERAL RETURN P 312-92-8563 TAW 08 AC VANESSA J TAW A R RP 676 ALDERWOOD DRIVE NEWPORT BEACH CA 92660 01 1 37 0 408 0 APE 0 06 0 38 0 409 0 FS 0 09 0 39 0 410 0 3800 0 10 0 40 0 411 0 3803 0 12 25688 41 0 412 0 SCHG1 0 14 1194 42 0 413 0 5870A 0 16 0 43 0 414 0 5805 5805F 0 17 25775 45 0 61 0 TPID 18 3692 46 0 62 11 FN 20 472 47 0 63 0 DESIGNEE 0 23 0 48 11 64 0 25 0 49 0 66 0 26 0 400 0 67 0 27 0 401 0 68 0 28 60 402 0 31 0 403 0 32 0 404 0 33 0 405 0 34 313 406 0 36 302 407 0 PH Filing Status 1 Single 4 Head of household (with qualifying person). (see instructions) 2 Marred/01)flmgjoindy(see Instructions). 5 Qualifying mdow(er) with dependent H N child, Enter year spouse1ROP died . 3 Marded(RDP filing separately. Enter spouse's(RDP's SSN or [FIN above and full name here... If your California filing status is different from your federal f4ing status, check the box here ............• 6 If someone can claim you (or your spouselRDP)as a dependent, check the box here (see instructions) .......• 6 Exemptions 7 Personal: 11 you checked 1, 3, or above, enter in the box. if you checked 2 or 5, enter 2 in the box. If you checked the box on line 6, see the instructions ....................... 7 $ Wholo dottnn Doty 99. 8 Blind: if you(oryour spouse/RDP) are visually impaired, enter l; if both are visually impaired, enter2 .. Nx$99= 8x$99= $ 9 Senior. If you (or your spousefRDP) are 65 or older, enter 1; if both are 65 or older, enter 2 .... , • 9x $99 = $ 10 Dependents: Enter name and relationship. Do not Include yourself oryourspouselRDP. Total dependent exemptions* 10 Qx$309=$ 11 Exemption amount: Add line 7 through line 10. Transfer this amount to line 21 ........... , 11 $ 99 . Taxable Income 12 State wages from your Form(s) W-2, box 16, or CA Sch, W-2 CG, line 3 ...... • 12 25, 688. 13 Enter federal adjusted gross Income from Form 1040, line 37; Form 1040A, line 21; Form 1040EZ, line 4...... 13 26., 969 . 14 California adjustments— subtractions. Enter the amount from Schedule CA (540), line 37, column B ...... • 14 1,194. 15 Subtract line 14 from line 13. If less than zero, enter the result in parentheses (see instructions) ......... 15 25,775. 16 California adjustments — additions. Enter the amount from Schedule CA(540), line 37, column C . . . . . . . . • 16 17 California adjusted gross income. Combine line 15 and line 16 .............. . ....... • 17 25,775. 18 Enter the larger of your CA standard deduction OR your CA itemized deductions ............. • 18 3,692. 19 Subtract line 18 from line l7. This is our taxable income. if less than zero, enter -0............... 19 22,083. Tax 20 Tax. Check box if from: Tax Table Tax Rate Schedule FTB3800 FTB 3803... • 20 472. 21 Exempdon credits. Enter the amount from line 11.Ifyour federal AGl is more than $163,187 (see inslrs)...... 21 99. 22 Subtract line 21 from line 20. if less than zero, enter -0........................... 22 373. 23 Tax. (see instructions) Check box if from: ❑ Schedule G-1 ❑ Form FIB 5870A ........ @) 23 24 Add line 22 and line 23. Continue to Side 2 ............................... 24 373. 0� 3101086 r' Your Nome. VANESSA J TAW YcurSBNcrrrph 312-92-8563 Special 25 Credit Code amount .... ► 25 Credits 26 Credit Code amount .... ► 26 27 To claim more than two credits (see instructions).......... • 27 28 Nonrefundable renter's credit (see Instructions) .......... • 28 60 . 29 Add line 25 through line 28. These are your total credits .................... 29 60. 30 Subtract line 29 from line 24. If less than zero, enter .0. ......................... 30 313. Other Taxes 31 Alternative minimum tax. Attach Schedule P (540) ......... • 31 0. 32 Mental Health Services Tax (see Instructions) ........... • 32 33 Other taxes and credit recapture (see instructions) • 33 34 Add line 30, line 31, line 32, and line 33. This Is your tax ............... .• 34 313. Payments 36 California Income tax withheld (see Instructions) .......... • 36 302. 37 2008 CA estimated lax and other payments (see Instructions)......... • 37 38 Real estate withholding. (Form(s) 592-8, 593, and 594) (see instructions) .... • 38 39 Excess SDI (see Instructions) ................... • 39 Child and Dependent Care Expenses Credit (see instructions). Attach form FTB 3506. • 40 • 41 942 • 43 44 Add line 36, line 37, line 38, line 39, and line 43. These are your total payments (see instructions) ........................................ 44 302. Overpaid Tax] 45 Overpaid tax. If line 44 is more than line 34, subtract line 34 from line 44 ............ 45 Tax Due 46 Amount of line 45 applied to 2009 estimated tax ....................... • 46 47 Overpaid tax available this year. Subtract line 46 from line 45 ................• 47 46 Tax due. If line 44 Is Jess than line 34. subtract line 44 from line 34.............. . 48 11. CA Seniors Special Fund (sea instruction) .. ► 400 CA Peace Officer Memorial Foundation Fund jO' 408 AWeimer's Dismse/Reioted Disorders Fund 10401 CA Military Family Relief Fund. . . . . . `409 CA Fund for Senior Citizens . ........ ► 402 CA Sea Otter Fund .......... It'410 Rare and Endangered Species Preservation Program ........ ► 403 CA Ovarian Cancer Research Fund . . . 411 State Children's Trust Fund for the Prevention of Child Abuse....... . CA Municipal SheiterSpoyNeuter Fund .... �412 CA Breast Cancer Research Fund ..... ►405 CA Cancer Research Fund ....... !413 CA FlreSghlers' Mommol Fund ....... ► 406 ALS/Lw Gehries Disease Research Fund 10'414 Emergency Food For Families Fund . .... . ► 407 are YOU Uwe rKAKUKIOM I OVMKY, rV V. sit..... ans.nr+mcu, v.. a•rw,-vvve . Interest and 63 Interest, late return penalties, and late paantpenalties .. ............ . 63 Penalties 64 Underpayment of estimated tax. Check box: u FTB 5805 attached ❑ FTB 5805F attached .. • 64 65 Total amount due (see Instructions). Enclose, but do not staple, any payment ........ 65 11 . Refund and 66 REFUND OR NO AMOUNT DUE. Subtract line 49 and line 61from line 47 (see instructions). Mail to: Direct Deposit FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0009 ...... , • 66 Fill in the information to authorize direct deposit of your refund Into one or two accounts. Do not attach a voided check or a deposit slip (see instructions). Have you verified the routing and account numbers? Use whole dollars only. All or the following amount of my refund (line 66) Is authorized for direct deposit Into the account shown below: Checking Savings • Routing number • Type • Account number • 67 Direct deposit amount The remaining amount of my refund (line 66 is authorized for direct deposit into the account shown below: Checking NSavfngs • RoutinG number •Type •Account number • 68 Direct deposit amount IMPORTANT. Seethe Instructions to rind culifyou should attach a copyofyourcmnplete federal return Under penalties of penury, I declare that l have Sign examined this return. Including accompanying schedules and statements. and to the best of my knowledge and belief, it is true, coned, and complete. Here it"Yoursignaluro Spouse's/RDP's signature (if a)olnt return, both must sign) It is unlawful to fame a spmse'eIRDP's signature. Jolnlrelum? (See inslrudlons.) Paid preparers signature (declaration of preparer Is based mall information of which preparar has any knowledge) Flnn's name (oryours Flrm's address Preparer's SSN/PTIN Do you went to allow another person to discuss this return with us (see instructions)? .................... ...•uYes uNo Print Third Pady Dosleneo's Noma Telephone Number Side 2 Form 540 C1 2008 0 51 3102086 r' CAIA3912 12105roe 0 LJ TAXABLE YEAR SCHEDULE 2008 California Adjustments — Residents CA (540) Important: Attach this schedule behind Form 540, Side 2 as a supporting California schedule. Namo(s) as shown on return SSN or ITIN VANESSA J TAW 312-92-8563 Part I Income Adjustment Schedule Federal Amounts Subtractions Additions 1 A (taxable amounts from B See instructions IC See instructions Section A — Income your federal return) I 7 Wages, salaries, tips, etc. See Instructions before making an I entry In column B or C ...................... 7 25,687. I 8 Taxable interest income ..................... 8 272. 264. 9 Ordinary dividends. See instructions (b) 18. 9 a 18. I 10 Taxable refunds, credits, offsets of state and local income taxes ....... 10 123. 123. 11 Alimony received ......................... 11 1 12 Business income or Boss) ....................... 12 13 Capital gain or (loss). See Instructions .............. 13 170, I 14 Other gains or (losses) ...................... 14 15 Total IRA distributions. See instructions ...(a) 15b I 16 Total pensions and annuities. See instructions (a) 16b 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc ..... 17 I 18 Farm Income or (loss) ...................... 18 19 Unemployment compensation. Enter the same amount in column A and column B ..................... 19 807. 807. _ 20 Social security benefits ........ (a) 20 to I 21 Other Income, la a California lottery winnings a NOL from FTB 3805D, 3805Z, b Iti_ b Disaster loss carryover from FTB 3805V 3806, 3807, or 3809 21 c! i c c Federal NOL (Form 1040, line 21) f Other (describe) d Idl d NOL carryover from FTB 3805V --je If 22 Total. Combine line 7 through line 21 in column A. Add line 7 through line 21f In column B and column C. Go to Section B ... 22 Itl4lIV11 G - /1YrYJ 23 Educator expenses ........................ 23 24 Certain business expenses of reservists, performing artists, and fee -basis government officials ................ 24 25 Health savings account deduction ................ 25 26 Moving expenses ........................ 26 27 One-half of self-employment tax ................. 27 28 Self-employed SEP, SIMPLE, and qualified plans ........ 28 29 Self-employed health insurance deduction ............ 29 30 Penally on early withdrawal of savings .............. 30 31 a Alimony paid. b Reclplent's: SSN...... Last name ... 31 32 IRAdeduction .......................... 32 33 Student loan Interest deduction .................. 33 34 Tuition and fees deduction .................... 34 35 Domestic production activities deduction ............. 35 36 Add line 23 through line 31a and line 32 through line 35 In columns A, B, and C. See lnsus ............................. 36 108. 37 Total. Subtract line 36 from line 22 In columns A, B, and C. See Instructions ......................... 37 26,969. 1 For Privacy Notice, got form FTS 1131. 051 I7731084 CAtA4012 12/12108 Schedule CA (540) 2008 Side 1 VANESSA J TAW 312-92-8563 Part 11 Adjustments to Federal Itemized Deductions 38 Federal Itemized deductions. Add the amounts on federal Schedule A (Form 1040), lines 4, 9, 15, 19, 20, 27, and 28..................................................... 38 434. 39 Enter total of federal Schedule A (Form 1040), line 5 (State Disability Insurance, and state and local Income tax, or General Sales Tax) and line 8 (foreign Income taxes only). See Instructions ................. 39 434. 40 Subtract line 39 from line 38............................................ 40 41 Other adjustments including California lottery losses. See instructions. Specify . . 41 42 Combine line 40 and line 41............................................ 42 0. 43 Is your federal AGI (Form 540, line 13) more than the amount shown below for your filing status? Single or married/RDP filing separately ................ $163,187 Head of household .......................... $244,785 Manied/RDP filing jointly or qualifying widower) ........... $326,379 No. Transfer the amount online 42 to line 43. Yes. Complete the Itemized Deductions Worksheet in the Instructions for Schedule CA (540), line 43 ....... 43 0 . 44 Enter the larger of the amount on line 43 or your standard deduction listed below Single or married/RDP filing separately ................. $3,692 Manied/RDP filing Jointly, head of household, or qualifying widower) .. $7,384 Transfer the amount on line 44 to Form 540, line 18 ............................... Side 2 Schedule CA (540) 2008 p� 7732084 r— CATA4012 12A2108 Interest and Dividend 2008 Adjustments Worksheet Name as Shown on Return Social Security Number Vanessa J Taw 312-92-8563 Interest Income Adjustments (B) (C) Subtractions Additions 1 Bonds or obligations of the United States or any of itsterritories' ............................... . 2 Loans made in an enterprise zone ................... . 3 Interest on obligations of District of Columbia issued after December 27, 1973 ............. i ............. . 4 Interest on state, county, city, town or other local government bonds issued by or in a state other than California .......... . 5 California Interest adjustments from K-1's ............... . 6 Interest earned from Health Savings Account ............. . 7 Interest from Ottoman Turkish Empire Settlement Payments .... . 8 Interest Income from children between the ages of 14 and 18, and students underage 24 ....................... . 9 Exempt dividends from mutual fund that has at least 50% of its assets Invested In U.S./California municipal obligations and were included in column A ..................... . 10 Exempt dividends from other states or that do not meet 50% rule.. . 11 Other adjustments (Itemize): a •- --------------------------------- --------------------------------- b •- c•- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - d ---—----——- Total adj—ustm—ents--from taxable---—interest---—Income.---Enter---here--an--d on Schedule CA (540/540NR), line 8.................. . Dividend Income Adjustments I (B) I (C) Subtractions Additions 12 Controlled foreign corporation dividends ................ . 13 Regulated Investment company (RIC) capital gains ......... . 14 Distributions of pre-1987 earnings from S Corporations ....... . 15 California dividend adjustments from K-1's .............. . 16 Dividend income from children between the ages of 14 and 18, and students underage 24 ....................... . 17 Other adjustments (itemize): a•- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b •- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - c •- d --------------------------------- --------------------------------- Total adjustments from taxable dividend income. Enter here and on Schedule CA (540/540NR), line 9.................. . * Do not make adjustments in either column B or column C for the amount of interest you earned on Federal National Mortgage Association (Fannie Mae) Bonds, Government National Mortgage Association (Ginnie Mae) Bonds, and Federal Home Loan Mortgage Corporations (FHLMC) securities. California law is the same as federal law for these types of interest income. CAIW3001.SCR 1221108 Name(s) Shown on Return Vanessa J Taw Social Security Number 312-92-8563 Income 2007 2008 Difference % Form 540 and 540NR Filers: Federal adjusted gross income ..... California adjustments .......... Form 540 2EZ Filers: Total income ............... . 6,080. 26,969. 20,889. 343.57 2,753. -1, 194. -3, 947. -143.37 Adjusted Gross Income......... 8,833. 25,775. 16,942. 191.80 Standard or Itemized Deduction ... 3,516. 3,692. 176. 5.01 Taxable Income .............. 5,317. 22,083. 1.6,766. 315.33 Tax ..................... Exemption credits ............. Tax less exemption credits ........ Schedule G-1 and Form 5870Atax .. . Tax before credits ............. Credits ................... Tax after credits .............. Alternative minimum tax ......... Other taxes and lRCinterest ....... 53. 472. 419. 790.57 94. 99. 5. 5.32 0. 373. 373. 0. 373. 373. 60. 60. 0. 313. 33.3. 0. 0. 0. o. 0. 0. Total Tax After Credits ......... 0. 313. 313. Withholding ................ Estimated payments ........... Other payments .............. Total Payments .............. Usetax ................... Contributions ............... Form 5805/5805F penalty ........ Other penalties and interest ...... . Applied to next year's estimated tax ... 123. 302. 179. 145.53 123. 302. 179. 145.53 0. 0. Amount Refund .............. Amount Due ................ 123. -123. -100.00 11. 11. Vanessa J Taw 312-92-8563 SMART WORKSHEET FOR: Form 540: California Resident Income Tax Return Form 540 California Income Tax Withheld Smart Worksheet A California income tax withheld from the Tax Payments Worksheet ......... 302. B Real estate and other withholding from Form(s) 592-13, 593-B and 594 entered on the federal Tax Payments Worksheet and included on line A ..... . Note: Make sure that the amount on line B is reported on the federal Tax Payments Worksheet or you will not get the state Income tax deduction on your federal Schedule A. C California Income tax withheld for line 36. Subtract line B from line A ........ 302. SMART WORKSHEET FOR: Interest and Dividend Adjustments Wks Tax Exempt Interest Dividends Smart Worksheet A California state tax exempt dividends from Federal Schedule B .............. 26. B Exempt dividends where at least 50% of assets invested in U.S./California municipal obligations ..................................... 26. C Exempt dividends that do not meet 50% rule (A - B) .................... 0. D Out of state exempt dividends from Federal Schedule B .................. E Exempt dividends additions per California tax law, line 10 below. (C + D) ........ 0. KEEP FOR YOUR RECORDS L Vanessa J Taw We Need Your Consent to Use Your Tax Information The IRS requires that we obtain your consent to use specific information in your tax return to determine if you can use this payment method. Protecting Your Privacy Because you have selected this payment option, Intuit, the maker of TurboTax software, needs to check a few items in your return to determine whether you can pay your fees from your refund. For example, you must reside in the U.S. and your refund must be large enough to make the payment. We're asking your permission to perform these checks and providing some important information to you as required by the IRS. To agree, simply enter your name(s) and the date in the boxes below after reading the consent and select "I Agree". I authorize Intuit, the maker of TurboTax, to use the information provided in this 2008 return to determine whether a portion of the refund can be used to pay for tax preparation. IRS regulations require the following statements: "Federal law requires this consent form be provided to you. Unless authorized by law, we cannot use, without your consent, your tax return information for purposes other than the preparation and filing of your tax return. You are not required to complete this form. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. Your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year." Vanessa Taw Vanessa J Taw Please type the date below: 04/07/2009 Date If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov. 312-92-8563 MUSE SSIA1001 10/15/08 :-1 Vanessa J Taw We Need Your Consent to Disclose Your Tax Information In order to process your payment and protect your privacy, we need to obtain your consent again, this time to send Information in your tax return to Santa Barbara Bank & Trust, a division of Pacific Capital Bank, N.A. ("SBBT"). SBBT will facilitate this service for you. Protecting Your Privacy Because you have selected to pay your fees from your refund, Intuit, the maker of TurboTax software, needs to send a limited amount of personal information from your tax return, such as your identifying information, deposit information and refund amount to SBBT. Your information is sent via a secure SSL encrypted transmission forthe sole purpose of providing you with this service. SBBT is contractually obligated to protect the confidentiality of your information. We're asking your permission to disclose that information, and also providing some important information to you as required by the IRS. To agree, simply enter your name(s) and date in the boxes below after reading this consent and select "I Agree". I authorize Intuit, the maker of TurboTax, to disclose to Santa Barbara Bank & Trust that portion of my 2008 tax return information that is necessary to enable Santa Barbara Bank & Trust to process and pay my fees from my refund. IRS regulations require the following statements: "Federal law requires this consent form be provided to you. Unless authorized by law, we cannot disclose, without your consent, your tax return information to third parties for purposes other than the preparation and filing of your tax return. If you consent to the disclosure of your tax return Information, Federal law may not protect your tax return information from further use or distribution. You are not required to complete this form. If we obtain your signature on this form by conditioning our services on your consent, your consent will not be valid. If you agree to the disclosure of your tax return information, your consent is valid for the amount of time that you specify. If you do not specify the duration of your consent, your consent is valid for one year." Vanessa Taw Vanessa J Taw Please type the date below: 04/07/2009 Date If you believe your tax return information has been disclosed or used improperly in a manner unauthorized by law or without your permission, you may contact the Treasury Inspector General for Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov. 312-92-6563 FDISCLOS SBIA1301 10115/08 41 Label (Sea Instructions.) Usethe IRS label. Otherwise, please print ortype. Presidential Election Campaign Filing Status Check only Department of the Treasury — Internal Revenue service first name City, town orpom office. MI Lest name J Taw name MI Last name treat) If you have a P.O. box. see instruction Drive i have a forelon address. see [actuations. Check here if you, or your spouse if filingjointly, want $3 to go to Ihl 1Firingjoingy 2 (even if only one had income) 3ling separately. Enter spouse's SSN above &full namehere. ► sip-7�-a�oa Spouso's social security number You must enter your social security It number(s) above. ?(see instructions)... .... . . . . ► LJYou LSpouse 4 LJ 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 ► Exemptions 6a bSpouse X Yourself. If someone can claim you as a dependent, do not check box 6a....... Y P ...... ............................ . .. . .... I Boxes checked on ea and III,. No. or children 1 If more than c Dependents: 1 First name Last name (2) Dependent's social security number (3) Dependent's relationship to you (4) if qualifying chledicorchfild (see mstm) 1711 on Cc who: • lived With You renal Iluo with you duo to rations ration (Boo lnatn) . (sea pn tm) Oapendonls on ea not entered above . four dependents, see Instructions. Add numbers of Total number of exemptions claimed ........ ......bovo08... ► 1 Income Attach Forms) W2 here. Also attach Forms 111-213 and 1099-R If tax was withheld. If you did not guaW,2 see Instructions. Enclose, but do not attach, any payment. Also, Pp lease use Form 1040.11. 7 Wages, salaries, tips, etc. Attach Forms) W-2 ......................... 8 a Taxable Interest. Attach Schedule B if required ........................ b Tax-exempt interest. Do not Include on line 8a ........ 6 b 53 . 9 a Ordinary dividends. Attach Schedule B if required ....................... b Qualified dividends (see instrs) ................... 9 b 18 . 10 Taxable refunds, credits, or offsets of state and local income taxes (see instructions) ............. 11 Alimony received ........................................ 12 Business Income or (loss). Attach Schedule C or C-F2..................... 13 Capital gain or(loss). Alt Sch D if regd. if not regd, ck here ............... ►� 14 Other gains or (losses). Attach Form 4797 ........................... 15a IRA distributions....... 15a b Taxable amount (see lnstrs) .. 16a Pensions and annuities .. 16a bTaxable amount (see lnstrs) .. 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E .... 18 Farm Income or (loss). Attach Schedule F ........................... 19 Unemployment compensation ............ ................... 20 a Social security benefits...... I20al b Taxable amount (see instrs) .. 21 Olherincome______________________________ 22 Add the amounts in the far richt column for lines 7 through 21. This is vour total Income.. ► 7 25,687. 8 a 272. _ 18. 9a _ 123. 10 11 12 13 170. 14 15b 16b 17 18 19 807. 20b 21 22 1 27,077. 23 Educator expenses (see instructions) ............ Adjusted 24 Certain business expenses ofreservists, pedormingg artists, and fee -basis Gross government officials. Attach Form 2106 or 2106-EZ........... Income 25 Health savings account deduction. Attach Form 8889 ..... 26 Moving expenses. Attach Form 3903.............. 27 One-half of self-employment tax. Attach Schedule SE ..... 28 Self-employed SEP, SIMPLE, and qualified plans ....... 29 Self-employed health insurance deduction (see instructions) ....... 30 Penalty on early withdrawal of savings ............ 31 a Alimony paid b Recipiem's SSN... ► 32 IRA deduction (see instructions) ................ 33 Student loan Interest deduction (see Instructions) ....... 34 Tuition and fees deduction. Attach Form 8917 ......... 35 Domestic production acbvides deduction. Attach Form 8903........ 36 Add lines 23-31a and 32.35.................................... 37 Subtract line 36 from line 22. This is your adjusted gross Income zs 108. 24 25 26 27 28 29 30 31 a 32 33 108. 34 35 ..............► 36 37 1 26,969. SAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see Instructions. FDIAot12 10113108 Form 1040 (2008) »o_oo_ooro o.__I Tax and 38 Amount from line 37 (adjusted gross Income) ......................... were bom before January 2, 1944, e Blind. Total boxes Credits 39a Check r To if: 1 Spouse was born before January 2, 1944, Bltnd. checked ► 39a 38 26,969. Standard b if your spouse itemizes on a separate return, or you were a dual -status alien, see lnstrs and ck here ► 39b Deduction cCheck if standard deduction includes real estate taxes or disaster loss (see instructions)..... ► 39c for— 40 Itemized deductions (from Schedule A) oryour standard deduction (see left margin) ............ • People who 41 Subtract line 40 from line 38.................................. checked any box on line 39a, 39b, 42 If line 38 is over$119,975, or you provided housing to a Midwestern displaced individual, see instructions. or39corwho Otherwise, multiply $3,500 by the total number of exemptions claimed on line 6d ............... _ 40 5,450. 41 21,519. 3,500. — 42 can be claimed 43 Taxable Income. Subtract Una 42 from line 41. as a dependent, If line 42 is more than line 41, enter-0. ........ ...................... see Instructions. 44 Tax (see Instrs). Check if any tax is from: a B Form(s) 8814 43 18,019. • All others: b Form 4972 ................ 44 2,273. 45 0. 45 Alternative minimum tax (see instructions). Attach Form 6251 ................ Single or Married 46 Add lines 44 and 45..................................... ► filing separately, $5,450 47 Foreign tax credit. Attach Form 1116 if required ........ 47 46 2,273. Married filing 48 Credit for child and dependent care expenses. Attach Form 2441 ..... 48 jointly or 49 Credit for the elderly or the disabled. Attach Schedule R .... 49 Qualifying 50 Education credits. Attach Form 8863.............. 50 widow(er), $10,900 51 Retirement savings contributions credit Attach Form 8880 ... 51 Head of 52 Child tax credit (see inslmCiions). Attach Form 8901 if required ...... 52 household, 53 Credits from Form: a Q 8396 b ❑ 8839 c ❑ 5695 ... 53 $8,000 54 Other as from Form: a ❑ 3800 to ❑ 8801 c ❑ 54 55 55 Add lines 47 through 54. These are your total credits ..................... 56 2,273. 56 Subtract line 55 from line 46. If line 55 Is more than line 46, enter-0 . ............ .. ► 57 Self-employment tax. Attach Schedule SE ............. ............... Other 58 Unreported social security and Medicare lax from Form: a ❑4137 b []8919 ............. 57 58 59 Taxes 59 Additional lax on IRAs, other qualified retirement p-tons, etc. Attach Form 5329 drequaed ........... 60 Additional taxes: a QAEIC payments b u Household employment taxes. Attach Schedule H ...... 60 61 2,2737 61 Add lines 56.60. This is your total tax ...............................► Payments 62 Federal Income tax withheld from Forms W-2 and 1099 .... 62 63 2008 ---mated tax payments and amount applied from 2007 return .... 63 If you have a L qualifying 64a Earned Income credit (EIC).................. 64a child,attach If Nontaxable combat pay election ...► 6410 Schedule EIC. 65 Excess social security and far l RRTA tax withheld (see instructions) . 65 3,260. 66 Additional child tax credit. Attach Form 8812 .......... 66 67 Amount paid with request for extension to file (see instructions) ...... 67 68 Credits from Form: a ❑ 2439 to Q 4136 c ❑ 88DI d ❑ 8885 68 69 First-time homebuyer credit. Attach Form 5405......... 69 300. 70 Recovery rebate credit (see worksheet) ............ 70 ,�„� ► 71 71 Add lines 62 through 70. These are our total payments ........................ 3,560. Refund 72 If line 71 is more than line 61,subtract Ene 61 from line 71. This is the amount you overpaid........ Direct deposit? 73a Amount of line 72 you want refunded to ou. If Form 8888 is attached, check here .. ► See Instructions � b Routing number ..... 322282003- c T e: Checking ® Savings and fill In73b, ► of Account number .....14005433.51708 73c, and 73d or Form 8888. 74 Amount of line 72 you want applied to your 2009 estimated tax . ► 74 72 1,287. 73a 1,28 . _ Amount 75 Amount you owe. Subtract line 71 from line 61' For details on how to pay, see instructions ........ .► 75 You Owe 76 Estimated tax penalty (see instructions) ............ 76 1_ Third Party Do you want to allow another person to discuss this return with the IRS (see Instructions)? U Yes. Complete the following. UNo Designee's Phone Personal Identificationilneinnna .,ern no ► numberrPIN) ► unaurpart-".mPuirmy.,...a,o,,,o„„a.ee.a��„�o,..��„o,,,��, e, �„ uwv.nyn. 1; a..�.,,.,.�.,.....�............�...................�...........�...,.............y..'1- Sign belief, Iheynretrue,canect, old complete. Declaration of preparer(oiher tier taxpayer)isbased on ell lnronnehen efwhlMpreparer has any know edge Here Yourslgnature Date Youroccupetion Daytime phone number Joint return? , See Instructions. I IMarketinq Coordinator Ke8a pa copy Spouse's signature. If a Joint return, both must sign Date Spouse's ocpahon for your records. 0._ Paid signature Preparer's Finn's name (orvours- Use Only selyempioysd),� or PTIN Form 1040 (2008) FDIA0112 103108 SCHEDULE D (Form 1040) I Capital Gains and Losses Department of the Transu 'Attach to Form 1040 or Form 1040NR. See Instructions for Schedule D (Form 1040). Internal awanuo Service (as) � Use Schedule D-1 to list additional transactions for lines 1 and B. OMB No. 1545.0074 11: Narrate) shown an return Your social security number Vanannn ,T Taw 312-92-8563 Part TiShort-Term Capital Gains and Losses — Assets Held One Year or Less (a)Desc"Ion of property(Exampis: ,property %Y2 Co (b) Data acquired (Mo. day, yr) (C)Date sold (Mo, day, yr) (d)saies price (see instructions) (a) Cast or otherbasis (seolnstructlons) (f) Gain or (loss) subtract (a) from(d) 1 2 3 4 5 6 7 Enter your short -tern totals, If any, from Schedule D-1, line 2 .... 2 Total short-term sales price amounts. Add lines 1 and 2I1 column(d)............................ 3 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824 .......... 4 Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 ...... 5 Short-term capital loss caryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover Worksheet in the instructions ........................................... 6 Net short-term capital gain or (loss). Combine lines 1 through 6 in column f .... . .............. 7 Part II Long -Term Capital Gains and Losses — Assets Held More Than One Year (a) Description of prepmty(Fxampls. 10D aharas (Parents) Co (b) Date acquired (Mo, day, yr) (c) Date sold (Mo. day, yr) (d) sales price (sea Instructions) (e) Cost or otherbasis (see instructions) (f) Gain or (loss) subtract (a) fom(d) 8 Global Gross Class A 03/10/91 10/10/08 3,000.00 2,830.00 170.00 9 Enter your long-term totals, If any, from Schedule D-1, line 9 ... 9 10 Total long-term sales price amounts. Add lines 8 and 9 in column(d) ........ . .................... 10 3 000. 11 Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss) from Forms 4684, 6781, and 8824............................................ 12 Not long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 ...... 13 Capital gain distributions. See Instrs..... ....................................... 14 Long-term capital loss carryover. Enter the amount, if any, from line 15 of your Capital Loss Carryover Worksheet In the Instructions .......................... . ................ 15 Net long-term capital gain or (loss). Combine lines 8 through 14 in column (f). Then go to Part III on page 2 11 12 13 14 1s 170. BAA For Paperwork Reduction Act Notice, see Form 1040 or Form 1040NR Instructions. Schedule D (Form 1040) 2008 FDIA0612 11/08108 0 Schedule D(Form 1040)2008 Vanessa J Taw 312-92-8563 Page °Part III Summary 16 Combine Ilnes 7 and 15 and enter the result .................................. . If line 16 Is: • A gain, enterthe amount from line 16 on Form 1040, line 13, or Form 1040NR, line 14. Then go to line 17 below. • A loss, skip lines 17 through 20 below. Then go to line 21. Also be sure to complete line 22. • Zero, skip lines 17 through 21 below and enter-0- on Form 1040, line 13, or Form 1040NR, line 14. Then to go line 22. 17 Are lines 15 and 16 both gains? QYes. Go to line 18. No. Skip lines 18 through 21, and go to line 22. 18 Enter the amount, if any, from line 7 of the 28% Rate Gain Worksheet in the Instructions........... . 19 Enter the amount, if any, from line 18 of the Unrecaptured Section 1250 Gain Worksheet in theinstructions ................................................. . 20 Are lines 18 and 19 both zeroor blank? X� Yes. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the Qualified Dividends, and Capital Gain Tax Worksheet in the Instructions for Form 1040 (or -in the Instructions for Form 1040NR). Do not complete lines 21 and 22 below. ❑ No. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the Schedule D Tax Worksheet in the Instructions. Do not complete lines 21 and 22 below. 21 If line 16 is a loss, enter here and on Form 1040, line 13, or Form 1040NR, line 14, the smaller of: • The loss on line 16 or L • ($3,000), or If marded filing separately, ($1,500) J Note. When figuring which amount is smaller, treat both amounts as positive numbers. 22 Do you have qualified dividends on Form 1040, line 9b, or Form 1040NR, line 10b? Yes. Complete Form 1040 through line 43, or Form 1040NR through line 40. Then complete the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions for Form 1040 (or in the Instructions for Form 1040NR). ❑ No. Complete the rest of Form 1040 or Form 1040NR. Schedule D (Form 1040) 2008 FDIA0612 11/08/08 C_1 • Santa Barbara Bank & Trust Refund Processing Agreement ('Agreement') Name: Vanessa J Taw Social Security No.: 312-92-8563 This Agreement contains Important terms, conditions and disclosures about the processing of your refund by Santa Barbara Bank & Trust, a division of Pacific Capital Bank, N.A. ('SBBT'). Read this Agreement carefully before accepting Its terns and conditions, and print a copy and/or retain this information electronically for ffuture reference. 1. Use Of Pronouns. As used in this Agreement, the words 'you' and 'your refer to the applicant or both the applicant and joint applicant if the 2008 federal income tax return is a joint return (individually and collectively, 'Applicant'). The words 'we, 'us' and'oue referto SBBT. 2. Authorization to Release Personal Information. You authorize the Internal Revenue Service ('IRS') to disclose any Information to SBBT related to the funding of your 2008 tax refund. You also authorize Intuit, as the transmitter of your electronically filed tax return, to disclose your tax return and contact Information to SBBT for use in connection with the refund processing services being provided pursuant to this A reement. Neither Intuit nor SBBT will disclose or use your lax return Information for any other purpose, except as permitted by law. SBBT will not use your tax Information or contact Information for any marketing purpose. To view the SBBT Privacy Policy applicable to this Agreement, see Section 12 below. 3. No Requirement To Have SBBT Process Your Refund In Order To File Electronically. You understand that SBBT charges a refund Precessing fee to deduct Intuit's fees from your refund. You further understand that your tax year 2008 federal Income tax return can be flied electronically, and your IRS refund direct deposited, without using SBBT's refund processing service by, Instead, paying the applicable TurboTax filing fees to Intuit by credit or debit card at the time you file your 2008 federal income tax return. 4. Summary of Terms Expected Federal Refund ................................................... $ 1,287.00 Less SBBT Refund Processing Fee .............................................. $ 29.95 Less Electronic Filing Transmission Fee and/or Service Fee for web users .......................... $ 79.9 0 Less Additional Products and Services Purchased ...................................... $ ExpectedProceeds (1) ................................................... $ 1,177.1 (1) This is only an estimate. The amount will be reduced by any applicable sales taxes. 5. Temporary Deposit Account Authorization. You hereby authorize SBBT to establish a temporary deposit account ('Deposit Account') for the purpose of receiving your tax year 2008 fedeml Income tax refund from the IRS. SBBT must receive an acknowledgement from the IRS that your return has been electronically filed and accepted for processing before the Deposit Account can be opened. You authorize SBBT to deduct from your Deposit Account the following amounts: (I) the SBBT refund processing fee; (iq the fees and charges related to the preparation, processing and transmission of your tax return; and, (III) amounts to pay for additional products and services purchased plus applicable taxes. You authorize SBBT to disburse the balance of the Deposit Account to you after making all authorized deductions or payments. 6. Acknowledgements. (a) You understand that: (1) SBBT cannot guarantee the amount of your tax year 2008 federal Income tax refund or the dale it will be Issued, and (11) SBBT is not affiliated with the transmitter of the tax return (Intuit and does not warrant the accuracy of the software used to prepare the tax return. (b) You agree that Intuit Is not acting as your agent; is not under any fiduciary duty with respect to the processing of your refund by SBBT. 7. Truth In Savings Disclosure. The Deposit Account is being opened for the purpose of receiving your (both spouses if this is ajointly filed return) tax year 2008 federal lax refund. There Is no cost to you for opening the Deposit Account. No other deposits may be made to the Deposit Account. No withdrawals will be allowed from the Deposit Account until all fees, charges, disbursements and payments authorized by this Agreement have been paid. No Interest is payable on the deposit; thus, the annual percentage yield and Interest rate are 0%. The Deposit Account will be closed after all authorized deductions have been made and any remaining balance has been disbursed to you. Questions or concerns about the Deposit Account should be directed to: SANTA BARBARA BANK & TRUST, sun: Refund Processing Department, P.O. Box 1030. Solana Beach, CA 92075, or to SBBT via the Internet at http://cisc.sbbtral.com. 8. Direct Deposit Information. The balance of your refund will be disbursed to you electronically by ACH Direct Deposit to your personal bank account designated below. If a joint return is filed, the bank account may be a joint account or the individual account of either spouse. DIRECT DEPOSIT ACCOUNT TYPE: Checking ]savings RTN#: 322282001_ ACCOUNT#: 400543151708 _____- Note: To Insure that there are no delays In receiving your refund, please contact your financial institutlon to confirm that you are using the correct RTN (routing) and account number. If you or your representative enter your personal bank account Information Incorrectly and your deposit is returned to SBBT, the refund balance minus $5 SBBT handling fee will be disbursed to you via an SBBT cashlel's check mailed to the address on your tax return. If the direct deposit is not returned to SBBT, you will be responsible for the loss. aTAPP SSIA0912 10/31/08 0 Vanessa J Taw 312-92-8563 9. Electronic Fund Transfers: The Federal Electronic Fund Transfer Act provides you with certain rights and obligations regarding the funds that will be electronically deposited Into and transferred from your Deposit Account with SBBT. If SBBT does not complete an electronic fund transfer to or from the Deposit Account on time or In the correct amount according to this Agreement, SBBT will be liable for your losses or damagges. There are some exceptions, however. SBBT will not be liable, for instance, if: through no fault of SBBT, you do not have enough avallable funds In the Deposit Account to make the transfer; circumstances beyond SBBT's control (such as fire, flood, water damage, power failure, strike, labor dispute, computer breakdown, civil unrest, governmental action, acts of terrorism, telephone line disruption or a natural disaster) delay the transfer despite reasonable precautions taken by SBBT; the funds in the Deposit Account are subject to legal process or are otherwise not available for withdrawal; the information supplied by you or a thud party is Incorrect, incomplete, ambiguous or untimely; or, SBBT has reason to believe the transaction may not be authorized by you. If you believe that there is an error or if you have a question about your Deposit Account, you will write to Santa Barbara Bank & Trust, P.O. Box 1030, Solana Beach, California 92076, or call SBBT at 818-717-7228, or communicate with it via the Internet by logging on to http://cisc.sbbtrtal.com, and provide SBBT with your name, a description or explanation of the error, and the dollar amount of the suspected error or the transfer you are unsure about. SBBT will determine whether the error occurred within 10 business days after it hears from you and will correct any error promptly. SBBT will tell you the results within three business days after completing Its Investigation. If SBBT decides that there was no error, it will send you a written explanation. You may ask for copies of the documents that SBBT used In Its Investigation. SBBT's business days are Monday through Friday, excluding holidays. 10. Compensation. In addition to any fees paid directly by you to Intuit, SBBT will pay a portion of SBBT's refund processing fee to Intuit in consideration of and pursuant to their agreement relating to Intuit's provision of various programming, testing, data processing, transmission, systems maintenance, status reporting and other software, technical and communications service. 11. Governing Law. The enforcement and Interpretation of this Agreement and the transactions contemplated herein shall be governed by the laws of the State of California applicable to contracts executed and to be performed entirely in the State of California by residents of the State of California, without regard to the conflicts of laws, and, to the extent applicable, by the laws of the United States of America, Including the Electronic Signatures In Global and National Commerce Act. 12. Santa Barbara Bank & Trust Privacy Policy. Privacy Policy. 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FDIU0401 10/02/08 • Sy • THE IRVINE COMPANY APARTMENT COMMUNITIES May 28, 2008 City of Newport c/o Raul Gomez LDM Associates, INC. 10722 Arrow Route, Suite 822 Rancho Cucamonga, CA 91730 Re: Villa Point I (Off Site Baywood) Annual Affordability Monitoring Summary Report Dear Mr. Gomez, Enclosed you will find the 2008 Annual Affordability Summary Report and the Certification of Continued Household Eligibility form for each resident on the Villa Point I program. If you have any questions, or require additional information; please contact me at your earliest convenience at (949) 720-5690. Sincerely, A (� �l Jason Di Antonio, BMR Compliance Manager Attachments: Annual Affordability Monitoring Summary Report Documentation for eac - 110 Innovation Drive, In .L/ W Yflw\ CITY OF NEWPORT BEACH PLANNING DEPARTMENT FO April 17, 2008 odSO The Irvine Company Apartment Communities Attn: Jason DiAntonio, BMR Compliance Manager U " VILLA POINT I 110 Innovation Drive Irvine, California 92617 Re: Transmittal -of 2008 Income Limits and Maximum Rents Villa Point I— (Off Site Baywood) Dear Mr. Di Antonio: This correspondence transmits the revised income limits and maximum rents as they apply to the Villa Point (Off -site) Baywood Apartments. Adherence to these income limits and rents will provide conformance with the City of Newport Beach and U.S. Department of Housing and Urban Development's (HUD) affordability requirements. (1) 14 of the 28 affordable units must be rented to families or individuals that meet HUD's low-income standards (80% of area median income). This may be accomplished by renting the units to Section 8 Certificate or Voucher holders. When Section 8 tenants are not available, two -bedroom units may currently be rented for no more than $1,595 per month to individuals whose total household income does not exceed low income standard (see enclosed income limit chart). In addition, the resting 14 two -bedroom units must be rented to families or individuals that does not exceed the median -income category (100% of area median), adjusted for family size. Again, this may be accomplished by renting the units to Section 8 Certificate holders or Voucher holders. Alternatively if no Section 8 holders are available, the units may be rented for no more 95% of 30% of the qualify income, adjusted by family size. (2) Based on the HUD Orange County median income of $84,100, and adjustments for family size, the maximum rents that can be charged are as follows: Unit Size Maximum Rent Income Limit Section 8 Section 8 2 Bedrooms (OCHA) (OCHA) 3300 Newport Boulevard • Post Office Box 1768 • Newport Beach, California 92658-8915 Telephone: (949) 644-3200 • Fax: (949) 644-3229 • www.city.newport-beach.ca.us Irvine Apartments/ Jason DiAntonio Villa Point I (Off -site Baywood Apartments) Transmittal of Revised Income and Rent Limits April 17, 2008 2 Bedrooms (HUD) Non- Section 8 FMR 2 Persons: $59,500 voucher holders @ ($1,595)* 3 Persons: $66 950 lower income 4 Persons: $74,400 2 Bedrooms 2 Persons: $1,598 2 Persons: $67,300 (median income 3 Persons: $1,798 3 Persons: $75,700 units) 4 Persons: $1,997 4 Persons: $84,100 *with utilities: Gas/Elec & Refrigerator HUD's policy for two -bedroom units is that they must not be occupied by one individual or a married couple. It is HUD's position that housing assistance funds are very limited, and should be used to house people as efficiently as possible. This policy should be applied to all two - bedroom units. Individuals or families occupying a unit in this development shall enter into a rental agreement, the terms of which includes a requirement for the submission of verification information regarding the income of the occupants. Additionally, a rental agreement provision shall also be included that provides for termination of the tenancy in the event of misrepresentations, as described in the affordable housing agreement with the City. Information verifying tenant income at the time of initial occupancy and for each yearly re -certification thereafter, shall be maintained in the tenant's individual file. Rental rates may be adjusted periodically to reflect published changes in the Section 8 Fair Market Rents (FMRs) and applicable revised income limits. Notice of proposed rent increases must be given to tenants in writing at least 30 days prior to the effective date of the increase, or in conformance with applicable state law, whichever is longer. A copy of the written rent increase notification must also be maintained in your records for compliance with HUD requirements. To simplify monitoring and minimize paperwork, the City is requesting that the following forms be submitted annually to the City: A. For units occupied by tenants with Section 8 certificates or vouchers, please provide the City with a copy of the Section 8 Rental Agreement. B. For the remaining units, not occupied by Section 8 tenants, each new tenant must submit a copy of their most recent signed income tax form, and be eligibility qualified. Retain a copy of their income tax form in their file, and forward a photocopy of each of the new rental agreements to the City. C. For the remaining units, not occupied by Section 8 tenants, each continuing tenant must complete and return to you a "Certification of Continued Household Eligibility" form for the annual reporting period. A copy of this form is attached Irvine Apartments/ Jason DiAntonio Villa Point I (Off -site Baywood Apartments) Transmittal of Revised Income and Rent Limits April 17, 2008 for your duplication and distribution. Forward a copy of the Certification form to the City for each continuing tenant. D. An Annual Affordability Monitoring Summary Report form is attached for your completion. Transfer the requested information from your tenant submissions, and return this form to the City. The City of Newport Beach has retained the services of LDM Associates, Inc. for performance of its annual affordable housing compliance. Please submit the above requested documentation by May 30th, 2008 to: City of Newport c/o Raul Gomez LDM Associates, INC. 10722 Arrow Route, Suite 822 Rancho Cucamonga, CA 91730 The aforementioned income limits and rents are in accordance with the Affordable Housing Agreement dated January 31, 1990. If you have any questions, or require any additional information, please contact me at your earliest convenience at (909) 476-9696 ex.109. Sincerely, Raul Gomez,, Affor�sing Consultant Attachments: HUD Orange County Income Limits Table County of Orange Housing Affordability Table Certification of Continued Household Eligibility Annual Affordability Monitoring Summary Report Form HUD - ORANGE COUNTY INCOME LIMITS April 2008 NUMBER OF PERSONS IN FAMILY COUNTY STANDARD 1 2 3 4 5 6 7 8 Extremely low Income 19,550 22,300 25,100 27,900 30,150 32,350 34,600 36,850 ORANGE (30% of Area Median Income) County Area Very low income Very loof moodea 32,550 37,200 41,850 46,500 50,200 53,950 57,650 61,400 median: w an Income) $84,100 Lower income 52,100 59,500 66,950 74,400 80,350 86,300 92,250 98,200 (80% of Area Median Income) Median income (100°% of Area Median Income) 58,900 67,300 75,700 84,100 90,800 97,600 104,300 111,000 Moderate Income 70,600 $0,700 90,800 100,900 109,000 117,000 125,100 133,200 (120%of Area Median Income) 0 • VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income" of the undersigned individual(s) was $ ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ per month. • Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age Signature Signature Signature Date: IRVINE APARTMENT COMPANY BOND SUMMARY APRIL 2008 MOVE -INS APRIL 2008 RE -CERTIFICATIONS Affordable Housinc I_AW. Villa Points # APT. RESIDI NAME 9 281 Linda hl ! 315 Heili $ 323 Stull $: 333 Cott 337 Rew 344 Hek 345 MCGo% 353 Dumitrc 356 Sisson(I 513 Cole $: 656 North 4 743 Hick 783 Mel oza 936 VACA MEDIAN- Villa Points # APT. RESIDI NAME $ 325 Trai 335 Pouls 346 Conn 347 Ma I( 517 Galbai 676 Hadfif 735 1s Mathre $ 744 Jone 745 Ha hi 782 VACA 838 Gomez $1 912 Scoffil 913 Kawl 915 Haghig Total number of apartme # of property deemed Inc # of property deemed Inc TTP = Total Tenant Payr 2008 ANNUAL AFFORDABILITY MONITORING SUMMARY REPORT Apartment Name; Villa Point II (Off -site Newport North Address: Apartments) Unit # Tenant Name Unit Size Move -in Date Monthly Rent Family Household income Size 1 Br. $ $ 2 Br. $ $ Br. $ $ 4 Br. $ $ 5 Br. $ $ 6 B` $ $ 7 Br. $ $ 6 Br. $ $ 9 Br. $ $ 10 Br. $ $ Br. $ $ 12 Br. $ $ 13 Br. $ $ 14 Sr. $ $ 15 Br. $ $ 16 Br. $ $ 17 Br. $ $ 2008 ANNUAL AFFORDABILITY MONITORING SUMMARY REPORT Apartment Name: Villa Point 11(Off-site Newport North Address: Apartments) Unit # Tenant Name T-unitsize I Move -in Date Monthly Rent Family Household Income Size 18 Br. I I $ $ • • N VILLA POINT I (Off -site Baywood Apartments) Unit No. °8 f CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 8'No,• or) per month. Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): l_i(Dk d_e)20-" q)011 'd8 Signature Signature Signatturee Date: NOUBiNG & COMMUNITY SERVTCIIS DEPARTMENT —o ORMGE COUNTY HOUSXNG AUTHORITY �� M 1770 N. BftO WAY . SANTq qNA, CA 42706 10 http!p://www.ochouGlnp,org '9ttro 02/22/2008 Irvine Apartment Communities Tiare Lindahl C/o The Bays Apts 10355 1 Baywood Dr 281 Baywood Dr Newport Beach CA 92660 Newport Beach, CA 92660 Dear Irvine Apartment Communities: This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $8S0.00 Previous Housing Assistance Payment $515.00 Previous Rent to Owner $1,365.00 Tenant's New Share Rent $870.00 New Housing Assistant Payment $495.00 New Contract Rent $1,365.00 IMPORTANT NOTICE - P)Ci NDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed, AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except For the changes shown above. These changes will become effective 04/01/2008. If you have questions please call Frances Nguyen at (71.4) 480 2753. HAPPY Software, Inc, M02/22/2008 • S VILLA POINT I (Off -site Baywood Apartments) h i Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) [Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ per month. /rr mY Por-h crn * Total Annual Eligible nco i cludes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age J1XI Signature Signature Signature Date:%/t/ 9 RING & COMMUNITY SERvicES ]DEPARTMENT o , . "dh ORANGE COUNTY HOUSING AUTHORITY a ro 1770 N. BROAD WAY • SANTA ANA, CA 92706 9 httpt//www.achousing.org 03/26/2008 Irvine Apartment Communities Joyce E. Heilig C/o The Bays Apts 6700 1 Baywood Dr 315 Baywood Dr Newport Beach CA 92660 Newport Beach, CA 92660 Dear Irvine Apartment Communities: This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $650.00 Previous Housing Assistance Payment $715.00 Previous Rent to owner $1,365.00 Tenant's New Share Rent $115,00 New housing Assistant Payment $10250.00 New Contract Rent $1,365.00 IWORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of. the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 04/01/2008. .If you have questions please ealJ Yvomme Taylor at (714) 480-2709. HAPPY Software, Inc. Yro312612ao6 9,% kt • VILLA POINT I (Off -site Baywood Apartments) Unit No. 5�Z3 _ CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $'.tllr 192 ; and, 3. During 2007, my total cnonthly rent payment to Villa Point I (Off -site Baywood bO Apartments) was $ _, J-, 00 per month. MCA 'f'Ofcrlatj .� O• ryk0 . * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or .pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age ii%t(`+ 5S*4o Or— Signatturre Date: /g /) O r 0 . HOUSING & COMMUNITY SU' RVICES ABPARTMBNT � ORANGE COUNTYHOUSING AMHORITY 1770 N. aROADWAY • SANTA ANA, CA 92706 httPi//www.ochousing.orq 06/29/2007 Irvine Apartment Communities C/o The Bays Apts 1 Baywood Dr Newport Beach CA 92660 Dear Irvine Apartment Communities: This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share Previous Housing Assistance Payment Previous Rent to Owner Tenant's New Share Rent New Housing Assistant Payment New Contract Rent Julie W Stull 6689 323 Baywood Dr Newport Beach, CA 92660 $543.00 $732.00 $1,275.00 $570.00 $795.00 $1065.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (now contract rent you requested). The effective date, the OCHA and tenant portions of the rent will be adjusted accordingly by Leasing staff, you will receive a separate notice when completed. AMENDMENT TO ROUSING ASSISTANCE PAYMENT'S CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 08/01/2007. If you have questions please call Adrienne Ponce at 714 480-2825. HAPPY Software, Inc, AP0612912007 f V VILLA POINT I (Off -site Baywood Apartments) Unit No. 3,Z r CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) INVe certify to the management of Villa Point 1 (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 4 S-6 D . o n per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age 1 RA4-J ) 6si Signature Signature Date: S , 07, Dg f 4 11040 Department of the Tine —In mal Revenue Service G,1oo� U.S. Individual Income Tax Return //�/ IRS Use On" not %mao le In thl For the year Jan. 7—Dec. 31. 2007, or other tax year beginning ,ending tlMB No. 1545,0074 Label L Yourfirstname M.1. Last name SuffixYour socialsecurity number (an A B AN M TRAN ) 621-72-8380 elshmtlons an pose 12.)E If a joint return, spouse's first name M.I. Lastname Suffix , Spouse's social security number Use the IRS L ' label. Home address (number and street). If you have a P.O. box, see page 12. Apt no. . Ycu must enter . tl� R 325 BAYWOOD DR ourSSN s above. please print or type. City, town or post office, state, and ZIP code. If you have a foreign address, seepage 12. Checking a box below will not Presidential I E INEWPORT BEACH CA 92660 change your tax or refund. Election Campaign ► Check -here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 12) ► ❑ You ❑ Spouse 1 ❑ Single 4 LX f Head of household (with qualifying person). (See page 13.) Filing Status 2 ❑ Marred filing jointly (even if only one had income) If the qualifying person is a child but not your dependent, 3 ❑ Marred filing separately. Enter spouse's SSN above enter this child's name here. and full name here. ► Check only ► Mrstname Last name SSN one box. Firstname Last name 5 ❑ Qualifying widower) with dependent child (see page 14) Boxes decked 6a ❑X Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . . . . on 6a and 6b 1 Exemptions b ❑ Spouse _ No. of children c Dependents: (2)Dependents (3) Dependents on6cwho: (t �Wg *lived with you 3 social security number relatonsh)p to add not We with aeddl(seepapIS) 1 First name Lastname you you due to divorce If more than four KIM TRAN 621-72-8383 Daughter ❑ orsepantioo 0 dependents, see JULIE TRAN 622-74-7719 Daughter ® (seepagels) Dependents on 6cnot page ib. BRANDON TRAN 608-29 8612 Son ® entered above 0 ❑ Add numbers on 4 d Total number of exemptions claimed . . . . . . . . . . . . . . . . . . . . . . . . fines above 0. Income Attach Form(s) W2 here. Also attach Forms W-20 And 1902-R If tax was withheld. If you di d not gat a W sea page , Enclose, but do not attach, any payment. Also, please use Form1040V. 7 Be b 9a b 10 11 12 13 14 15a 16a 17 18 19 20a 21 22 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . Taxable interest. Attach Schedule B if required . . . . . . . . . Tax-exempt interest Do not include on line 8a . . . . . . . . . 8b Ordinary dividends. Attach Schedule B ifyequired . . . . . . . . . Qualified dividends (see page 19). . . . . . . . . . Taxable refunds, credits, or offsets of stale and local income taxes (see page 20) . . . . . . Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Business Income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . . . Capital gain or (loss). Attach Schedule D f required. if not required, check here 10, ❑ Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . IRA distributions 16a b Taxable amount (see page 21) Pensions and annuities . . . . 16a b Taxable amount (see page 22) Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . .. Unemployment compensation . . . . . . . . . .. . . . . . . . . Social security benefits . . . . . I 20a � J b Taxable amount (see page 24) Other Income. List type and amount (see page 24) ____________________________________ Add the amounts in the far right column for lines 7 through 21. This is yourtotal income . ► 7 39,530 Is 29 1T- °; `^ 9a 10 11 12 13 14 15b 16b 17 18 19 20b 0 21 22 39.55 Adjusted Gross Income 23 24 26 26 27 28 29 30 31a 32 33 34 36 36 37 Educator expenses (see page 26) . . . . . . . . . . . . . . Certain business expenses of reservists, performing artists, and fee -basis government officials. Attach Form 2106 or 2106-EZ . . . Health savings account deduction. Attach Form 8889 . . . . . . Moving expenses. Attach Form 3903 . . . . . . . . . . . . One-half of self-employment tax. Attach Schedule SE . . . . . Self-employed SEP, SIMPLE, and qualified plans . . . . . . . Self-employed health insurance deduction (see page 26) . . . . Penalty on early withdrawal of savings . . . . . . . . . . . . Alimony paid b Recipient's SSN ► IRA deduction (see page 27) . . . . . . . . . . . Student loan interest deduction (see page 30) . . . . . . Tuition and fees deduction. Attach Form 8917. . . . . . . . . Domestic production activities deduction. Attach Form 8903. Add lines 23 through 31a and 32 through 35 . . . . . . . . . Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . . . . . . . . 23-'; _ - - 2.0001 24_; 25 26 27 28 29 30 31a 32 2000 33 34 35 . . . . . . ► 36 3T 37,5591 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 83. (HTA) ' Form 1040 (2oD7) %/A K; RA TDO R91_7An Pane l Tax 38 Amount from One 37 (adjusted gross income). . . . . . . . . .. . . . . . . and 39a Check ❑ You were bom before January 2, 1943, ❑ Blind. Total boxes CreditsIf.{❑ Spouse was bom before January 2, 1943, ❑Blind. }checked ► 39a Standard b If your spouse Itemizes on a separate return or you were a dual -status alien, see page 31 and check here ► 39b for —on for— 40 itemized deductions (from Schedule A) or your standard deduction (see left margin) is People who 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . checked any 42 If line 38 Is $117,300 or less, multiply $3,400 by the totalnumberof exemptions claimed on line box on line 39a or 39b or 6d. If line 38 is over $117,300. see the worksheet on page 33 . . . . . . . . . . . . . . . . . who can be 43 Taxable Income. Subtract line 42 from line 41. If line 42 is more than line 41, enter-0- . . .... claimed as a 44 Tax (see page33). Check if any tax is from: a ❑ Form(s) 8814 b ❑ Form 4972 c ❑ Form($) 8889 dependent see page 31. 45 Alternative minimum tax (see page 36). Attach Form 6251 . . . . . . . . . . . . .. . . • All others: 46 Add lines 44 and 45 . . . . . . . . . . . . . . . . . . . . . . ► 38 37.5591 " . 40 7,850 41 29.70 lw• �' " 42 113,600 43 16109 44 1 859 45 46 1 859 Single or 47 Credit for chill and dependent care expenses. Attach Form 2441 . . . . 47 Monied filing 48 Credit for the elderly or the disabled. Attach Scheduld R . . . . . . . . 48 separately, 49 Education credits. Attach Form 8863 49 Married filing 50 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . 50 jointly or 51 Foreign tax credit. Attach Form 1116If required . . . . . . . . . . . 51 Qualifying 52 Child tax credit (see page 39). Attach Form 8901 if required . 62 1 659 widow(er), . . . . . $10.700 53 Retirement savinc s contributions credit. Attach Form 8880 . . . . . . 53 200 Head of 64 Credits from: a Form 8396 b ❑ Form 8869 c ❑ Form 8839 64 household, 65 Other credits: a ❑ Form 3800 b ❑ Form 8801 c ❑Form 56 $7,850 56 Add lines 47 through 55. These are your total credits . . . . . . . . . . . . . . . . . . . 67 Subtract line 56 from line 46. If line 56 is more than line 46, enter-0- . ► - ' - 1.8591 56 57 0 58 Self-employment tax. Attach Schedule BE . . . . . . . . . . . . . . . . . . Other 59 Unreported social security and Medicare tax from: a ❑ Form 4137 b ❑ Form 8919 58 59 60 Taxes 60 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . . . Si Advance eamed income credit payments from Form(s) W-2, box 9 . . . . . . . . . . . . . . 61 62 62 Household employment taxes. Attach Schedule H . . . . . . . . . . . . . . . . . . . . . 63 Add lines 57 through 62. This is your total tax . _ . ► 63 0 Payments 64 Federal income tax withheld from Forms W2 and 1099 . . . . . . . 64 2,522 65 65 2007 estimated tax payments and amount applied from 2006 return . . . If youhavea Bea Earned income credit (EIC) . . . . . . . qualifying b Nontaxable combat pay election. - •' <;•.,.. 66a - 67 child, attach 67 Excess social security and tier 1 RRTA tax withheld (see page 59) . . . . Schedule EIC. 168 Additional child tax credit. Attach Form 8812 . . . . . . . . . . . . 69 Amount paid with re uest for extension to file (see page 59) . . . . 70 Payments from: a Forrn 2439 b ❑Form 4136 a ❑Form 8885 71 Refundable credit for prior year minimum tax from Form 8801, line 27. _ - '- 68 341 69 70 71 . ► 72 Add lines 64. 65, 66a, and 67 through 71. These are your total payments 72 2.8631 Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid . . 74a Amount of line 73 you want refunded to you. If Form 88,88 is attached check here. ► ❑ Direct deposit? ► b Routing number 322281992 I ► c Type: �X Checking ❑Savings'`""r See page 50 and fill in 74b, ► d Account number 1000011504292005- 74c, and 74d, or Form 8888. 75 Amount of line 73 you want applied to your 2008 estimated tax . . . ► 1 75 73 2,863 74a 2,863 ^ 0 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see p77e 60 . . . . . You Owe 77 Estimated tax penalty61 Th;rA Dnrfu Do you want to allow another person to discuss this return with the IRS (see page 61)? ❑X Yes. Complete the following. ❑ No Designee ' g Designee's Phone Personal identification 19707 name ► DONNY VU no. ► (714) 265-5401 number (PIN) D. Sian 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 Here belief, theyAm We, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Joint return? Yo Date Your000upation Daytime phone number See page 13. 2/2/2008 REP 949 706-1818 Keep a copy foryour Spouse's sigma a Jolnt return, both must sign. Date Spouse's occupation -' `-.1 y.,,r - �, records.1- ;16: - Preparer's Date Preparers SSN or-PTIN Paid signature 2020D8 Check It selfem P00443630 Preparer's Use Only Firm's name FUT E ANCIAL SERVICES INC. EIN yours if self-employed), ' 14291 EUCLID ST STE D110 Phone no. 20-4491759 14 265-5401 address, and ZIP code GARDEN GROVE state CA zip code 92843 Form 1040 (20o7) VILLA POINT I (Off -site Baywood Apartments) Unit No.33� CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, t e_Total Annual Eligible Income* of the undersigned individual(s) was $ a' �006 _; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ �`0 per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age Signature Signature Date: - O VILLA POINT I (Off -site Baywood Apartments) Unit No.,jf�'�) 5 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ and, 3. During 2007, my total rto thly rent payment to Villa Point I (Off -site Baywood Apartments) was $ IL per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Agee Signature(s) of Income Earning Household Member(s): ignature Signature Signature Date: 5 � q C) V VILLA POINT I (Off -site Baywood Apartments) Unit No. 337 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ 1/.5 ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ t�� S = --� per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age /W, X LII i 1 Signature(s) of Income Earning Household Member(s): Date: Signature Signature Signature I • • VILLA POINT I (Off -site Baywood Apartments) Unit No. XqV CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ 701 (Pq S ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ / qRS per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Signature Signature Signature Date: ^0 7S Department of the Treasury — Internal Revenue Service 2007 U.S. Individual Income Tax Return the Year Jan 1 - Dec 31. 2007. or other fax Year treginninq , 2007, eni it Label Your first name mi ustname (see i-Inc6om') Mohammed H Helal Use the It a joint return, spouse's first name MI Last name IRS label. Shereen A Hamodeh Otherwise, Home address (number and street). If you have a P.O. box, see Instructions. Apartment no. or type. print 2633 E. La Palma Ave. 133 City. town or oast office. It You have a foreign address, see instructions. Stale LP code Presidential JAnaheim CA 92806 Election 0. Campaign 11i, Check here if you, or your spouse if filing jointly, want$3 to go to this fund? (see instructions) ................ Do not write 260-87-6415 Spouse's social security number You must enter your social security number(s) above. You ❑ Spouse Filing Status 1N Single 4 U Head of household (with qualifying person). (See 9 2 Married filing jointly(even if only one had interne) instructions.) If the qualifying person is a chi d but not your dependent, enter this child's Check only 3 Married filing separately. Enter spouse's SSN above & full name here. one box name here 5 n Qualifying widow(er) with dependent child (see instructions) Exemptions 6oxea checked 2 If more than four dependents, see instructions. 6. a Yourself. If someone can claim you as a dependent, do not check box 6a ............ on 6a and 6b bSpouse ..............................(.................................. No. of chili 2)Dependent's (3)Dependent's (4) ,f on 6c who: lived c Dependents: social security relatienshlp lifying chi d yO° ' number to you taxu� tild �i� did not First name Last name (sea mstrs) Iiva with ro A at M Hilal 626-43-6586 Dau hter % ore=paaraa Muhanad M Hilal 326-06-2043 Son R Dependent Dependent ee not on 6 en entered ab( Add numbe an lines ofexemotions claimed ............................... above... Iran 2 u in rn we . 7 Wages, salaries, tips, etc. Attach Form(s) W2......................................... Income Be Taxable interest. Attach Schedule B if required .................... ............... b Tax-exempt interest. Do not include on line 8a .............. L 8bJ Attach Forms) 9a Ordinary dividends. Attach Schedule B if required ....................................... W-2 here. Also b Qualified dividends (see instrs).................................. I 9bi attach Forms 10 Taxable refunds, credits, or offsets of state and local income taxes (see Instructions) .................... If taxwaswithheld. 11 Alimony received.................................................................. III and 1099•R ' . 12 Business Income or (loss). Attach Schedule C or C-EZ .............................. If you did not I 13 Capital gain or (loss). Aft ScSellD if read. If not refill, ck here .......................... 0- ❑ get see Instructions. 14 Other gains or (losses). Attach Form 4797............................................. 15a IRA distributions ............ I 15aJ bTaxable amount (see instrs) .. 16a Pensions and annuities ...... 16a bTaxable amount (see instrs) .. 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E .. Enclose, but do 18 Farm income or (loss). Attach Schedule F.............................................. not attach, any 19 Unemployment compensation......................................................... payment Also, 20a Social security benefits ........... 120al b Taxable amount (see instrs) .. pplease use Foftn10404. 21 Other income _________________ ____ 22 Add the amounts in the far right column for lines 7 through 21. This is your total income. i 8a ; 9a 10 11 12 19 O18 . 13 14 15b 16b 17 18 19 20b 22 19 Ol6 . 23 Educator expenses (see instructions) ....................... Adjusted 24 Certain business expenses of reservists, performing artists, and fee -basis Gross government officials. Attach Form 2106 or 2106-F2 .................... Income 25 Health savings account deduction. Attach Form 8889 ........ 26 Moving expenses. Attach Form 3903 ....................... 27 One-half of self-employment tax. Attach Schedule SE........ 28 Self-employed SEP, SIMPLE, and qualified plans............ 29 Self-employed health insurance deduction (see instructions) ............. 30 Penalty on early withdrawal of savings ..................... 31 a Alimony paid b Recipient's SSN .... . 32 IRA deduction (see instructions) ........................... 33 Student loan interest deduction (see instructions)............ 34 Tuition and fees deduction. Attach Form 8917 ............... 35 Domestic production activities deduction. Attach Form 8903 .............. [a 24 25 26 27 28 29 30 31 32 33 34 35 36 Add Imes23.31a and 32-35........................................................... 37 Subtract line 36 from line 22. This is your adjusted gross income ..................... . ...� BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. FDIA0112 12IM07 Form 1040 (2007) 1-71 Lt-7q F,yrm �Mlr r9f11171 MnhammpA R Rplal a Ahprppn A Ramnciph 260-87-6415 Pace Tax and 38 Amount from line 37 (adjusted gross income) .......................................... Credits 39a Check r e You were born before January 2, 1943, a Blind. Total boxes if: 1 born before was bobefore January 2, 1943, Blind. checked I" 39a 38 17,674. Standard b If your spouse itemizes on a separate return, or you were a dual -status alien, see instrs and ck here 0' 39b Deduction 40 Itemized deductions (from Schedule A) oryour standard deduction (see left margin) ..................... 40 10,700. 41 6,974. foPeople who 41 Subtract line 40 from line 38.......................................................... checked any box 42 If line 38 is $117,300 or less, multiply $3,400 by the total number of exemptions on line 39a or claimed on line 6d. If line 38 is over $117,300, see the instructions ........ .............. 39b or who can 43 Taxable Income. Subtract line 42 from line 41. be claimed as a If line 42 is more than line 41, enter-0........................................................ dependent, see 44 Tax (see instrs)Check if any tax is from: a Form(s) 8814 b ❑ Form 4972 Instructions. c. 8 Forms) 8889 ......................... 42 13,600. 43 0. 44 0. 45 • All others: 45 Alternative minimum tax (see instructions). Attach Form 6251 ........................... 46 0. Single or Married 46 Add lines 44 and 45................................................................ 0- filingg separately, 47 Credit for child and dependent care expenses. Attach Form 2441 .......... 47 $5,350 48 Credit for the elderly or the disabled. Attach Schedule R ..... 48 Married filing 49 Education credits. Attach Form 8863 ....................... 49 jointly or 50 Residential energy credits. Attach Form 5695 ............... 50 Qualifying wldow(er), 51 Foreigntax credit. Attach Form 1116 if required red ............. 51 9 - $10,700 52 Child tax credit (see instructions). Attach Form 8901 if required ........... 52 0. ' Head of 53 Retirement savings contributions credit. Attach Form 8880 ... 53 household, 54 Credits from: a ❑ Form 8396 b ❑ Form 8859 c ❑ Form 8839 .. 54 $7,850 55 Other credits: a ❑ '3g00"0 b ❑ a°s01 c ❑ Form 55 56 Add lines 47 through 55. These are your total credits ....................... ........... 56 0. 57 0. 57 Subtract line 56 from line 46. If line 56 is more than line 46, enter-0................... 0- 58 Self-employment tax. Attach Schedule SE ........................................... .......... Other 59 Unreported social security and Medicare tax from: a ❑ Form 4137 b ❑ Form 8919 .................. 58 2 1687. 59 60 Taxes 60 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required ................... 61 61 Advance earned income credit payments from Form(s) W-2, box 9 ....................... 62 62 Household employment taxes. Attach Schedule H....................................... 63 2.687. 63 Add lines 57-62. This is your total tax ...................................................... " Payments 64 Federal income tax withheld from Forms W-2 and 1099 ...... 65 2007 estimated tax payments and amount applied from 20f15 return ........ If you have a qualifying 66aEarned Income credit (EIC)........ ....................... child, attach b Nontaxable combat pay election ..... 66b Schedule EIC. 67 Excess social security and for 1 RRTA tax withheld (see instructions)....... 64 65 66a 4,656. 67 68 889. 68 Additional child tax credit. Attach Form 8812 ... ............ 69 69 Amount paid with request for extension to file (see instructions ...... 70 Payments from: a ❑ Form 2439 b ❑ Form 4136 c b Form 05 70 F71 71 Refundable credit for prior year minimum tax from Form 8801, line 27 ...... 72 Add Ilnes 64, 61. 66a, and 6/ through 71. Theso are ou'tot.1 a mants............................................................ 72 5 545. Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid ............. Direct deposit? 74a Amount of line 73 you want refunded to ou. If Form 8888 is attached, check here .. ❑ See instructions ► b Routing number ........ XXXXXXXXX ► c T e: Checking ❑ Savings and fill in 74b, ► d Account number ....... XXXXXXXXXXXXXXXXX 74c, and 74d or Form8888. 75 Amount of line 73 youwant applied tg your20DSestimated tax ........ 11"75 73 74a 2,858. 2 858 . 76 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see instructions ............... You Owe 77 Estimated tax penaltysee instructions .................... 77 Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? .......... U Yes. Complete the tollowing. -U-no Designees Phone Per I( Idenld'icanon ► Designee name► no. ► number (PIM Under penalties of perjury, 1 declare That 1 have ez mined ins return and accompanying schedules and statements, and to the best of my Knowledge and Sign belief, they are true, comecl, and complete, Decl ton of preparer (other than taxpayer) is based on all Information of which preparer has any knowledge. Here Your signature Date Your occupation Daytime phone number Joint return? ^ See instructions. 7-0 sales (213) 604-0612 Keep a copy po e's signature. If a joint return, both ust sign. Date Spouse's occupation s for Your records. housewife Paid Preparees Use Only or Form 1040 (2007) FDIA0112 12/06/07 SCHEDULE C Profit or Loss From Business OMB No. 1545-0074 (Form 1040) (Sole Proprietorship) 2007 Department of Ore Treasury ► Partnerships, jioint ventures, etc, must file Form 1D65 or 1065-B. Attachment Internal mevenue service (99) 'Attach to Form 1040,1046NR, or 1041. ►See Instructions for Schedule C (Form 1040). sequence No. 09 Name of proprietor Social security number(SSN) Mohammed H Helal 260-87-6415 A Principal business or profession, Including product or service (see instructions) B Errtercode from Instructions wholesale & distribution of apparel ►424300 C Business name. If no separate business name, leave blank. D Employer ID number (EIN), If any Ayat inc 102-0808552 E Business address pneluding suite or room no.)►2335 Lon Beach Blvd. ___________________________. City, town or post office, state, and ZIP code------5--------_ ____ Long Beach CA 90806 F Accounting method: (1) X Cash (2) Lj Accrual (3) Lj Other (specify) ► _ _ _ _ _ _ _ _ _ _ _ _ _ G Did you 'materially participate' in the operation of this business during 2007? If'No,' see instructions for limit on losses. . X�Yes No H If you started or acquired this business during 2007. check here.......................................................... ... ► 1 Gross receipts or sales. Caution. If this income was reported to you on Form W-2 and the '❑ 1 24,500. 'Statutory employee' box on that form was checked, see the instructions and check here............ 2 Returns and allowances................................................................................ 2 3 Subtract line 2 from line 1.............................................................................. 3 24,500. 4 Cost of goods sold (from line 42 on page 2).............................................................. 4 5 Gross profit Subtract line 4 from line 3................................................................... 5 24,500. 6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) ............................................ ............................... 6 7 Gross income. Add lines 5 and 6...................................................................... 7 24,500. ' %1 FYnancom Pnfcr pvneneec fnr hi ucinpcc ,see of vnur hnmp nnly nn fine 30. 8 Advertising .................... 9 Car and truck expenses (see Instructions .............. 10 Commissions and fees ......... 11 Contract labor (see Instructions) .............. 12 Depletion ..................... 13 Depreciation and section 179 expense deduction Zt Included inPart III) e Instructions) .............. 14 Employee benefit pro rams (other than on line 1913 ......... 15 Insurance (other than health) ... 16 Interest: a Mortgage (paid to banks, etc) ........ bOther......................... 17 Legal & professional services ... 117 8 18 Office expense ......................... 19 Pension and profit-sharing plans 20 Rent or lease (see instructions): a Vehicles, machinery, and equipment ..... b Other business property ................. 21 Repairs and maintenance ............... 22 Supplies (not included in Part III) ........ 23 Taxes and licenses ..................... 24 Travel, meals, and entertainment: a Travel ................................. b Deductible meals and entertainment (see instructions) ....................... 25 Utilities ................................ 26 Wages (less employment credits) ........ 27 Other expenses (from line 48 on page 2)................................ 18 9 19 20a 10 11 1,000. 20b 3,252. 21 12 22 13 23 350. 24a 14 24b 15 25 16a 26 27 880. 16b 28 Total expenses before expenses for business use of home. Add lines 8 through 27 in columns ............. ► 29 Tentative profit (loss). Subtract line 28 from line 7........................................................ 30 Expenses for business use of your home. Attach Forth 8829............................................... 31 Net profit or (loss). Subtract line 30 from line 29. • If a pprofit, enter on both Form 1040, line 12, and Schedule SE, line 2 or on Form 1040NR, line 13 (statutory employees, see instructions). Estates and trusts, enter on Form 1041, line 3. T .............. 28 5,482. 29 19,018. 30 131 1 19,018. • if a loss, you must go to line 32. J 32 If you have a loss, check the box that describes your investment in this activity (see instructions). —1 • If yyou checked 32a, enter the loss on both Form 1040, line 12, and Schedule SE, line 2, or on Form All investment is 1040NR, line 13 (statutory employees, see Instructions). Estates and trusts, enter on Form 1041, line 3. 32a ©at risk. Some investment • if you checked 32b you must attach Form 6198. Your loss may be limited. 32b n is not at risk. SAA For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule C (Form 1040) 2007 FDIZD112 O6I15ro7 2 33 Method(s) used to value closing inventory: a U Cost b U Lower of cost or market c U Other (attach explanation) 34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If 'Yes,' attach explanation......................................................................................... ❑ Yes X❑ No 35 Inventory at beginning of year. If different from last year's closing inventory, attachexplanation..................................................................................... 36 Purchases less cost of items withdrawn for personal use ................................................. 37 Cost of labor. Do not include any amounts paid to yourself ................................................ 38 Materials and supplies................................................................................. 39 Other costs........................................................................................... 40 Add lines 35 through 39................................................................................ 41 Inventory at end of year............................................................................... oods sold. Subtract TOO IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must file Form 4562. 43 When did you place your vehicle in service for business purposes? (month, day, year) ►_ _ _ _ _ _ _ _ _ -- 44 Of the total number of miles you drove your vehicle during 2007, enter the number of miles you used your vehicle for: a Business b Commuting (see instructions) —________—_ cOther 45 Do you (or your spouse) have another vehicle available for personal use? ............................................. ❑ Yes ❑ No 46 Was your vehicle available for personal use during off -duty hours? .................................................... ❑ Yes ❑ No 47a Do you have evidence to support your deduction?.................................................................... ❑ Yes ❑ No written? included an lines 8 telephone------------------------------------------------- Enter here Schedule C (Form 1040) 2007 FDIZ0112 06/15/07 Fottn 8812 Additional Child Tax Credit OMB No'1545.0074 2007 IntaVI nevenue theService ry Complete and attach to Form ]040, Form 1040A, or Form 104ONR. Attachment /� Sequence No. 47 Name(s) shown on return Your social security number Mohammed H Helal & Shereen A Hamodeh 260-87-6415 Part 1 I All Filers 1 Enter the amount from line 1 of your Child Tax Credit Worksheet in the Form 1040, Form 1040A or Form 104ONR instructions. If you used our 972, enter the amount from line 8 of the worksheet on page 4 of the publication....................................................................................... 1 2,000. 2 Enter the amount from Form 1040, line 52, Form 1040A, line 32, or Form 104ONR, line 47 ................... 2 0. 3 Subtract line 2 from line 1. If zero, stop; you cannot take this credit ....................................... 4a Enter your total earned income (see instructions) .... ..........................I 4al 17,674 b Nontaxable combat pay (see instructions I 4bl 5 Is 8 the line more than Yes. Subtract$11 750 from the amounton line 4a. Enter the result...... .... No. Leave line 5 blank and enter -0- on line 6. 5 5 924. 6 Multiply the amount on line 5 by 15% (.15) and enter the result ............................................ Next. Do you have three or more qualifying children? © No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the smaller of line 3 or line 6 on line 13. ❑ Yes. If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on line 13. Otherwise, go to line 7. 7 Withheld social security and Medicare taxes from Form(s). W-2, boxes 4 and 6. If married filing Jointly, include your spouse's amounts with yours. If you worked for a railroad, see the instructions ............................................ 8 1040 filers: Enter the total of the amounts from Form 1040, lines 27 and 59, plus any taxes that you identified using code 'Ur and entered on the dotted line next to line 63. 1040A filers: Enter -0-. 104ONR filers: Enter the total of the amounts from Form 104ONR, line 54, plus any taxes that you identified using code UT' and entered on the dotted line next to line 58. _ 9 Add lines 7 and 8........................................................... 10 1040 filers: Enter the total of the amounts from Form 1040, lines 66a and 67. 1040A filers: Enter the total of the amount from Form 1040A, line 40a, plus any excess social security and tier 1 RRTA taxes withheld that you entered to the left of line 42 (see instructions). 104ONR fliers: Enter the amount from Form 104ONR, line 61. 11 Subtract line 10 from line 9. if zero or less, enter-0...................................................... 12 Enter the larger of line 6 or line 11..................................................................... Next, enter the smaller of line 3 or line 12 on line 13. 13 This is your additional child tax credit.................................................................. Enter this amount on Form 1040, line 68, or Form 1040A, line 41, or Form 104ONR, line 62. SAA For Paperwork Reduction Act Notice, see Instructions. FDIA3001 11/09/07 Form 8812 (2007) • SCHEDULE SE (Form 1040) Ithe nto nt of Revenue Sernce Trwsury Name of poison with selkn Self -Employment Tax ► Attach to Form 1040. ► See Instructions for Schedule SE Income (as shown on Form Who Must File Schedule SE You must file Schedule SE if., Social security number of person with self-employment income ► 2007 • You had net earnings from self-employment from other than church employee income (line 4 of Short Schedule SE or line 4c of Long Schedule SE) of $400 or more, or • You had church employee income of $108.28 or more. Income from services you performed as a minister or a member of a religious order is not church employee income (see Instructions). Note. Even if you had a loss or a small amount of income from self-employment, it may be to your benefit to file Schedule SE and use elther'optional method' in Part II of Long Schedule SE (see instructions). Exception. If your only self-employment income was from earnings as a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361 and received IRS approval not to be taxed on those eamings, do not file Schedule SE. Instead, write 'Exempt — Form 4361' on Form 1040, line 58. May 1 Use Short Schedule SE or Must I Use Long Schedule SE? Note. Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SE, above. Did you receive wanes or tips in 2007? No Are you a minister, member of a religious order, or Christian Science practitioner who received IRS approval not to be taxed on earnings from these sources, but you owe self-employment tax on other earnings? Are you using one of the optional methods to figure your net earnings (see instructions)? No Did you receive church employee income reported on Form W-2 of $108.28 or more? No You may use Short Schedule SE below Was the total of your wages and tips subject to social securil or railroad retirement tax plus yyour net earnings from self-employment more than $97,500? Yes Did you receive tips subject to social securit or Medicare tax that you did not report to your employer. Did you report any wages on Form 8919, Uncollected f Social Security and Medicare Tax on Wages? You must use Section A — Short Schedule SE. Caution. Read above to see if you can use Short Schedule SE. 1 Net farm profit or (loss) from Schedule F, line 36, and farm partnerships, Schedule K-1 (Form 1065), box14, code A........................................................................................ 2 Net profit or (loss) from Schedule C, line 31; Schedule C-FZ, line 3; Schedule K-1 (Form 1065), box 14 code A (other than farming); and Schedule K-1 (Form 1065-B), box 9, code A. Ministers and members of religious orders, see instructions for amounts to report on this line. See instructions for other income to report ........ 3 Combine lines 1 and 2................................................................................. 4 Net earnings from self-employment Multiply tine 3 by 92.35% (.9235). If less than $400, do not file i this schedule; you do not owe self-employment tax ..................................................... 5 Self-employment tax. If the amount on line 4 is: • $97,500 or less, multiply line 4 by 15.3% (.153). Enter the result here and on Form 1040, line 58. • More than $97,500, multi pplyy line 4 by 2.9% (.029). Then, add $12,090 to the result. Enter the ""' total here and on Form 1040, line 58. — 6 Deduction for one-half of self-employment tax. Multiply line 5 by 50"/o (.5). Enter the result here and on Form 1 , line 27 ....................... a % SAA For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule SE (Form 1040) 2007 I'DIA1101 11/02/07 SCHEDULE EIC Earned Income Credit OMB No. IM-0074 (Form 1040A or 1040) Qualifying Child Information 2007 eeparbnent of the Treasury Complete and attach to Form 1040A or 1040 Attachment Internal Revenue service only 1f you have a qualifying child. Sequence No. 43 Names) shown on return Your social security number Mohammed H Helal & Shereen A Hamodeh 260-87-6415 YOU Be/OIBeforebe in: See the instructions for Form 1040A, lines 40a and 40b, or Form 1040, lines 66a and Y 9 66b, to make sure that (a) you can take the EIC and (b) you have a qualifying child. • If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details. CAUTION! • It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child. • Be sure the child's name on line 1 and social security number (SSN) on line 2 agree with the child's social security. card. Otherwise, at the time we process your return, we may reduce or disallow our EIC. If the name or SSN on the child's social security card is not correct, call the Social Security Administration at 1.800.772.1213. Qualifying Child Information Child 1 Child 2 1 Child's name First name Last name Fast name Last name If you have more than two qualifying children, you only have to list two to get the maximum credit ............... A at M Hilal Muhanad M Hilal 2 Child's SSN The child must have an SSN as defined in the Form 1040A or Form 1040 instructions unless the child was born and died in 2007. If your child was born and died in 2007 and did not have an SSN, enter'Dled' on this line and attach a copy of the child's birth certificate ................................. 626-43-6586 326-06-2043 3 Child'syearofbirth Year 2004 Year 2006 If born after 1988, skip lines 4a If born after 1-9 skip lines 4a and 4b; go to line 5. and 4b; o to line 5. 4 If the child was born before 1989 — a Was the child under age 24 at the end of 2007 and ❑ Yes. ❑ No. ❑ Yes. ❑ No. a student? ............................... y........... Go to line 5. Continue. Go to fine 5. Continue. Was the child permanently and totally disabled ❑ Yes. ❑ No. ❑ Yes. ❑ No. during any part of 2007? ............................... Continue. The child is not a Confine. The child is not a qualifying child. qualifying child. 5 Child's relationship to you (for example, son, daughter, grandchild, niece, nephew, foster child, etc)....................................... Dau hter Son 6 Number of months child lived with you in the United States during 2007 • If the child lived with you for more than half of 2007 but less than 7 months, enter'T. • If the child was born or died in 2007 and your home was the child's home for the entire time he or she was alive during 2007, enter '12 ..................... 12 months 12 months Do not enter more than 12 months. Do not enter more than 12 months. TIP You may also be able to take the additional child tax credit if your child (a) was underage 17 at the end of 2007, and (b) is a U.S. citizen or resident alien. For more details, see the instructions for line 41 of Form 1040A or line 68 of Form 1040. BAA For Paperwork Reduction Act Notice, see Form 1040A or 1040 instructions. Schedule EIC (Form 1040A or 1040) 2007 FDIA7401 10116W Mohammed H Helal & Shereen A Hamodeh 260-87-6415 SMART WORKSHEET FOR: Form 1040: Individual Tax Return Tax Smart Worksheet ATax.............................................................................. 0. Check if from: 1 Tax table...................................................................................... X 2 Tax Computation Worksheet (see instructions) ............................................... 3 Schedule D Tax Worksheet................................................................... 4 Qualified Dividends and Capital Gain Tax Worksheet......................................... 5 Schedule J................................................................................... 6 Form 8615.................................................................................... 7 Foreign Earned Income Tax Worksheet...................................................... B Additional tax from Form 8814.................................................. C Additional tax from Form 4972.................................................. D Tax from additional Form(s) 4972............................................... E Recapture tax from Form 8863.................................................. F IRC Section 197(f)(9)(B)(ii) election for an additional tax ....................... G Tax. Add lines A through F. Enter the result here and on line44............... 0. KEEP FOR YOUR RECORDS • 1! VILLA POINT I (Off -site Baywood Apartments) Unit No. S CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher,'income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) .71 was $ —r olTe ; and, 3� During 2007, my total month])Vent payment to Villa Point I (Off -site Baywood Apartments) was $ per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date, indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Date: �,. Ignalur Signature Signature 05/09/2008 08:30 19497487488 WATERMARK • PAGE 01/01 Ila. 411 VILLA POINT I (Off -site Baywood Apartments) Unit No. 2t.0 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of Section 8 aertincate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned istare the only income eaming occupant($) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ ?2q 0 &j Q _; and, 3. During 2007, my total monthly rent payment to Villa Point Koff --site Baywood Apartments) was $ ) 410 per month. Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(g) of Income Earning Household Member(s): Member(s): Name Age o si nature _ — ...... Signature Signature ., . ,' Dater I PAYERrly, OWW. ZIP retie, end lelephene number HILLIS CORPORATION HILLIS CORPORATION 403 HELIOTROPE, SUITE C CORONA DEL MAR CA 92625 CONNER Form Section 409A Income L :D rf chocked �3lO) 5°17- 33�frf 1 Rants OMNo. 15eE•01 2 Royalties 19 $ _ 200' F MiscellIncome Other emomc r4hlntl boat pmcoods Nonemptoyee canpensaoon 'lb state lax velulhold ---------- your records.) For Mod & nesllll care payments This is I Incom SuasbWa palnnenL^"• in lieu loam, I)eln$Jfl 9nter ofdiv,4anM pr Server crop In,vrance proceeds regt return, 9laWayer's state no. 1K state Income S 37106.23 -------------------- Deportment of the Treasury — IntornW Rovcnuo Service VILLA POINT I (Off -site Baywood Apartments) Unit No. 39 7 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $• L464 UU6, oo ; and; 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 11Ap110_ per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Date: // zo2 signature d VILLA POINT I (Off -site Baywood Apartments) Unit No. 353 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) INVe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ 34000 ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1i La 5- o .0 per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Member(s): Name /60 Age Signature(s) of Income Earning Household Member(s): Signature 1° L'�P' �> Signature Signature Date: May 3o t19 12:12p W-)�� � • �t p.1 Label *n. Ma nxn e3" g1,omo11M%) VTOAXCA u o lo.rc nxarn, We mo IRS label. Otherwise, Waoand<Mealt ease printor type. 0. BID) rJOr. vwn m W I'Motdenttal XCIRMU Elec-ccommpanign JP tbedt we Filing Status 1 only Exemptions UBnng lately Wendt to go to US fudi (see i 13%MK mash ................ ' � B onlyane bJd inrroma) EMx FpmAe's S6N atgw i loll aeannhota 5 I 1 taxan Rvwmrlalw,motcw 6A someone can claim you as a dependent, do not chack box Q............ YotasetL If h � �r �nxn or P_S..I..(4J a oocid sceud relp_faM1ah( tua eMn 1 an�"aean � d 1 oa It more than ��__ {,-•„�,wi, four dependents, See WnSbucuarr•nvnars dTotal number Ofoxo Uanaelalm6d............... ik ,.. ►' 7, 7 Wages, salarias, tips. ale. Attach Fmm(s) W-2 ............... • . , , ... • ................. Income Be Taxable Interest, Attach Schedule B If required ....... . ......... . ... . ............... . .. bTax-exempt Interest. Do riot Include on fine Ba ............. �— AAttxdr Ftme(s) 9a Ordirmry dividends. Attach Schedule B If regolred ........ • .. . .. . ... .. ...... • , . , .. r -2Itac, Ahe b Boalifits tlWk h (ne Wei) ..................:. attach Fare .... � � ..... • • 9b WffiaindIMN 1a Tanhlemhod%cW1b,aregtetsofslateandlocalirmm�eleas(sheifdruallont)..I.................. iftax wo withheld. 11 Alimonyredelved..........................................................•....... NN7yoo 12 Susiness Income of loss). Mach Schedule 0 Or CU........,.."".................. 9etaWdPut 73 Coldipainor(ImlAttSabDuragd,Itnot rmd,dtbae ..............•.•........'0 bw Illihuctbas, 14 Mar gains or posses). Attach Form 4797. ....... . ..... . ................. .. ......... 15a IRA d181ributIonS,............ 1sa b7axaae amount (see Insks Ica PenSIMrS and aimitles I .. •. • 76A bTaxable amount (see Insbs) ,. 17 Rental real oStata, royalties, partnerships, S corporallons, trustsl etc. Attach Soheduhl E.. Enalam but do 13 Farm income or (loss). Attach Schedule F .................... . ................... . • nit Nual. airy 19 tlnemploymentcompersaUon+,.............................. ..................... PpUtnmpf.a�Alm,?gaSodelsaeurltyhonatUs�...�......`2aai IbTaxable amount see10154S ForoiulW4•Y, 21 at* Wiemla — _ 22 Add quo amounts In the far IItLbWnm far IinFS I M � n 77 • TI1M fa'Pur Secil Incamo. � 7 3a 94 .,...,.. "F " 10 77 12 13 14 15b 76h 17 1a 79 2nb 22 23 Educalarwieenses(MIMIX+atiom).... Adjusted 2/ IO,glom bnolaess eW30 of molstr, POMMrap d414 aml I*bW Gross Oernmntortklals.Attach Form 2106or2106•Ei. ................ Income 25 Health savings account deduction. Attach Form BB69........ 26 Moving expenses. Mach Form 3903 . ... . . . . ...... . . .. 27 One-half of so$emplayment tax. Atach Schedule SE....... 25 SelM1empfoyed SEP, SIMPLE, And gUagged plans, ..., ..... 2e SaH.atAPkyed UedN lAfurahaededttdbn (Joe lfabudionJ)............. 90 Penalty an early wilhdmmfofsaving&................... S1aAllmonypaW bftpbarSSSN.,.,' ••• 32 IRA deduction (see Insbuclfi ns)t............ 33 Slueem loan Irxera% eaauotnon (Asa hynnleN(M)........... 34 Tuition and fees deduction, Attach Form 8917... . . . ..... . . . 36 DOWAtla predee1105 MMdcJ detlamlen. Ahaeh Fain 8A03............ 36 Add lirxaZ3.31aaad32.3S.,..,. .................. 37 Subtract line 36 from tine M Thtu tc your ul*d Groan raceme 23 29 4..} izri, 9 710 27 9 710 'A.tY^ 29 3o :7 i uia%in S1a ;.: •.' .................... . 35 37 b 7 9 DAA For olsclosvro, MvacY Acts and Paperwork Rrtduchion Act Notice, flee insfnr.ction& MADIM MOW form Idea (4e7) Ham ao 08 12f12P W . M 0 P.2 Tax and 38 Amount from line 37 (adjualed gross lrlAome)....................................... , Credits 39A ChaeR You were born bofore Jamey 2, 190, Bl lid, Total boxes If L USpouso w= horn before January?., 1%3, Blind. checked ► 39a 39 �y StRnd r1d b N yaer apauae Ikrnfne on a separate corn m you here a dlwtsiah: alkn, see ioshs and ck icele. ► 39b M4chon 4a ItteniYeddodudlens(komSaWilleA)oryeurstandard deduction (smkltmorpin)..................... e Paoptewho 47 Subtract Ine40 from lhre38�................................................... checked any box 42 If line 38IS $117 200 or Imes, multiply S3 400 by the labil rmmber of exemptions on the 390 or claimed an Ikle ?K . If line 36 is over $11�/,300, W iho lndlructiom .... . ...............1, 39b or who can 43 T "1'rplwma, S ftact Nde 42 from line 41. be claimed AS2 ItIno42iItmmelhmInic47,attcr4.............. ........ dependent, See m TaX (see instts). ChBdk if Any tax iA fYOm: 0 eFAfm(6) 8614 b FArm histrucham, a 497l, Form(A)8809.............. to 40 41 3,400 42 43 a2.740 44 45 • P41 others: A5 Ahornativm A4'ndrrumtax Into- hmbuctlo". Attach Form M........................... 46 oingioorMartled 46 Ad4bras44And 45......................................... fi50Sepnratoly, 47 CrMitforthlldand dependemtoRmvpmmAttach Form Z441.......... 47 335500 40 Credit for the elderly or ft dfsAbled. Attach 9ehcdula R . , .. 40 "uy Married Ming 49 Etfucafon credits. Attach Form 8863 ........... . ....... . .. 49 folntir or p 50 Residential energy credits. At" Form 6M .............. 50QtMt widow( er), 51 Foreign tax credit, Attach Form 1116 if raqulraa............ 510,70i1 52 f1dN14+xmad l (eaa inmdcl om). Atfab tArm 89711f rcqulrM .......... 52 Head of 53 Rofrement savkgs conhibuflxls credit. Attach Form 8880.,. 10 houdohold 54 LYcdlMfmlm A lixm8396 b{]Faro88S9 cQF4rMMD,. 54 $7,800 0 Duff awits: a e�h""",p b��ai c ❑Fam 64 FS � �• "b 5fi 56 Add lines 47 throu0h 55. These lire your %&d dh,erRe.................................. 57 57 Sub(YaAt 111* 56 from line 46, If Ikm 56IS more than line 46 enter-0•................. ► 50 SeI(d7rlphiinonttax AlWSel"fe82.................................................... ther' O59 UnleporkdsxlalsaurirydndMadtgrelatftom a [jPorm41S7 bOFormMI9.................: �0 B9 G0 Taxes 60 AddllioncltMonIlk, othRgoallhedretkemontpWnsetc, AltdmhfixinS 9ifrequirrd................... 61 61 Advance earned income credit payments from Form(s) W.2, box 9 .... . . .... . .. . ........ 92 62 HarYsehdld employment tuxes. Attach Schedule M...................................1, _--------..__.63 Add11M R-fa This ItYear iotaltax.................................. .................. I" Payments 64 Fddoral iAaome lax wiPolseM from Foma W,2 and 1099..... , 64 R'c'h---F esfinetedtaxpaymenuanA4Nbudtapplidtrom2186te1pfl,....... 66a Eatlted inaanacreord(Et) ..........................,.... O6eattach bt4antaxibleedlnbApoyeleahon..... "' Gab EM t' ;�MuleCIO, 67 Men sOElal3=11yandfaf89TAtmtwilhhrld(seoilstruclions)...... 67 68 Additional child tax aw L Attach Form 8812............... 60 69 AYmurd paid wNb request for cAmlon to fie (sac Inshuallohs .. , ..... , . 70 Mrnentafrorn: a aForm2lin b,C]farn14136 a L]Fmm8889 70 71 Refundahloemit for pftywrhihinimuxhnmFan M,linen..... 71 72 itiddllmi!L Kmt.aada?thmgh71, Y. •se 3D Refund d11M R nmate lAae In 6; Sunned line 63 MM bad M Tab b ale ammmtyou eVIIIMid............... Direct deposit? 7 N Amaunt of Ilm 73 you want refunded to rou, Ir Form MW is attached. chock hero.. ► See Instruction ► b Routing number.,...... e e Checklll0 Savings ON flit in Ab, . dAceoanI number....... 74c, and 74d or Form SM. 75 AmwnfntNne)SfbuwntapWed etm7a08rrfeWYAt.n....,,. 75 Arnount 76 Amunlyouwa,Sobtmctline 121ramOnetW,Fofd4Wlsonhovrldpar amhuWclktn............... o You Owe 77 Fatlmaled tax pan& (ser: instructions) ............... . �77 Third party Do you want farAewannlhHpafsonlodisaasthis talrnWltlldn:0(Seelasbactlats)7.......... IM Yes. Col Designee a°e�°"°°y . under ppaer��yeIppm of p.r)ry, I dodw OW I hen enmimml ft realm and ncoo"wyelp� nluMh see MAtta�,pph and ty Mn Sign bdW. li my a� dw, wreck, end cooft D e4m ml Of pMperdr eWkr Im la"w) h ha�edan ra Inraaawm al -hldl More Ywr alhNmm ue. Yar ra7ganon Joint return? See kmteudfons. R SELF EMPLOYED IOr�vrair00w�rordl;-., w5poax's aiq,dMa, d slam ratan. hem mlae elph, Oebr T.pauwS oragMkm Paid PFeparer's Use Only rowliz. lavolu amptlim phma, mamba May 30 08 12212P td 9 ScHr;;Du4r; C I 0 Pro10fit or Moss From Sushipss (Form 1040) (Sole PmprietvRbip} k-Attaah fo Panel 1MW94D. %194 Dr Dwlmz nm..Il no"pente 8 oudnmoaaess u4nutWlewtw° na1�P_D. bW[ 464 ray, foam w Pont °cxa, eN zlr code NORM CA. 90f F Accounting method: (1) �'dsh (q Accrual (A G Did you'materialiy porlicipate' In the operation of this twsiness P.3 OWN.. IIrtFZOOVA A 1f 00,I Form104r& � rfJ 09 W'Al owye.V"PpW 445-82-3183 6 smsraoa°InmM.tetaU°Itc 464390 D Fmp1W relm,m6°rpH)A1wW Other (specRY)► 2Dp77 if Wo see iltstntdiar for l mi! on fosaee. ^ X�Ynn ......... ............... 1 Gross reaolph or sales, Cauft. It this IncoRfe was reparled too an Form W-2 and the n 'StatgitRy ampWj%W box on that form was tlfeeked, see fie hGtruWofa end eheck here.. , ..... , .. P. 1 2 Roturr>9arfaallowonces.............................................................................. 2 3 Subtract line 2 from One I....... ...................................................................... 3 4 Cast of goods sold (if= lino 42 do page p .... . .............. . ................... I ............... I .... 4 S GrassprofitSubtract ino4from line 3................................................ ..............� 6 Other Income, Including federal and state gasoline: or fuel tax creditor refund tw (sIrnkuoUone)................................................................................... e 8 AdvntWIlrg................... 8 Car and Irstruucli expenses 10 Commkalor'. And leas........ 11 Contras�t( lapp� ee Wltuolions) ........... . . 12 Depletion 11. 1,.. 111111•.-..1. 13 De rpr�allon and section 174 exwan5e detluefien �not Included In Part III) seelnstructions)............. 14 Nmployoa bonellt rams (olherlhan on fine WIT., 15 Insurance (other men heath).. 10 Interest, a meting (Pahl to bahs, eta)....... hOther ........................ 18 Office expense ......................... 19 peroloh and profit•shorkty plans 7.300 2a Rent or lease (sea isfruatian5)! a Vehicles, machlnary, AM aquwnem..... b other bueinase property :................ 21 Repafrs and maintenance ............... 22 Sapplles(rlotlncludedinPart 01)..,.,,,, 29 Taxes oW 80ehses..................... 24 Navel, me tv, and entertainment: a Tfav4................................ b Deductible meals and entertainment (sea Instructions) ....................... 25 1/91RIaL............................... 28 Wages (199Y ampbymnnt eredhs)........ 27 Other expenses Qrom Ona 48 on -- page 2).......................... expenses before expenses for business use of home. Add lWs 8 (hmtlgh 27 in e01uf ...... . . . .... . 29 Tentative protY (loss). Subtract line 28 from line 7..................................... . . ..... . . . . ....... 30 EWnso3 for business use of your home. Attach Form U29. ............................................. 31 Netproliit or(fees), Subtract line 30 from lwm 29. e If R profit, antr'r on both Fare 11140, inn12, and Sehadule SF.RM2 or an Ferns 10 014%(me 13 (4tatutoy athployaas, see instructions). Estates and trusts, enter on Form 1041,line, ............. e if a lass, yuu mor go le Iron 3E. 32 It you have a loss, check the box that desenD= your wwos mart in this activity (see Instructions). • If Yyna�!f eh#&W 32a, ynlar tnlr loss on both Form 1W, IWe 12, and Schedule 912, Ilre $ ar on Form 1o4aNR' Vne la (alufulay employees, we inst(uctlor 1.), E talo9 and mats, enter tm Farts r041, Ilne 0. • If you cheeW 92b. you must unach yaps e190. Your Wz may be limifod._ Forpapnrwotk FDIZ411ZL aNlyde'i 5 filjw so- 7— 250 1,150 9.710 51,790 51,790 All Invgelnxln! Is 32a ❑ at risk. (porm 1040) Na>l 30 09 1221$p W J • p.4 33 Method(p) used to value dosing Invwttary: a L f Cost b U Lowor of cost or madeet c u OOW (attach explanation) 94 Was thank any change In daterminkg quanUl as, c4oNs, or vatuatio a eetrn en opening and clot f g lnvnrdory7 ifWt, attach exp wtion...................................................... I .................... ... ,...... DYon ❑No 35 ItweMory at 6egMning of year. If different from last years closing ine Tory, _- attach explans on .................. ............... �J 36 Purchases less Cost of Items witherm" for personal use............................................�...� 27 Cost of tacar. 6a not Include any amamLa paid to yeorsetf............................................... 39 Motefmis and suppllr_a..............................................I... ..... ................... I 39 Other CoM ......................................................................................... 40 Add lim*35 Uwugh 3R.............................................................................. 41 inventory atend ofynot.............................................................................. Miff-f7,f Information On Your Vehicle. Complete this pert only if you are claiming car or truck a1 p¢nses on Mae 9 and ate not required to file Fenn 451A for this buslnnr. Son the instructions for Itnd to tp find out If you mull file Form 46Q. 43 When did you place your vehleta In service for business purposas4 (month, day. yeao — ---^ 44 Of the total number of miles you drove your vehide during 2007, enter the numbnr of mikm you trwd your vehicle for. a Business — IS Commuting (•MInstrucUbns) ----- 00ther .--^„______ As Oo yuu tar your xpousu) have onottior vehicle avaNablefor personal mS............ DYon []No 46 Was your vehicle available for personal Ise durim off -duty hours? ............................. ............ I • .... , . , 0yes E]No 41.11 Do you nave eviderim to puppotlyaw deductbn2............................................ I.................... DYes []No PROMOxxON I_�IV_I_M3-.,_..----------------..^ —_ 300 TELEPAQN"--..-.,--------------------------- --------- F350 ---- - -- ----- --- - - - - ----------- ---- -- --- - -- - --------- --_-- ---------_---T... ------------------------------------------------------ x , 3.50 FDROI12L OQ1509 Mat$ 30 08 12:12P W • 9 • P.5 VtVwLmnlnIea Tamury—hda, rdevn, ry kh Label ) A7•IA-1rWZA WMTAMG •620-34-5870 (Fn,v helrvclhhe iJs0lllo h a pAnt MUM. samne's VIM MM ad 1•aR nNM ( i1 'Spaase'i iociM tWaiYrvMntlir IRS lapel. `•„ i:,.' :" l., ,. ....,.,. Othom". Hw uld�(hmidwaxFaftaIfyvnlem4P.o.ue,ix, 4m4KIWrK AVIWV�m Yournustenter your plP..asa print social security or type. 353 BAYWOOD DRIVE Y number(s) above, A camppaiw Cagn 10� 0hech here d you, aryara• sppdga It tllipg iomt¢, u803 to go to this fuadf (sea ipstrudlons) ............. . . . You pause Filing5t0tus 1 Single 4 X MW ofhousanotd (with alifying rson). (see instructions.) If the qualityn9 perwls a chlfd 2 tdanied1111npjoinl(Y(av,rl$onryanahaakcatm) butnotyol.ItdependaxltenlcrNlLachlkf3 ehoo, on(Y onebo;. Exemptions 3 M'''gir� Ftlinp Pwat i%Fjiler =e-%39N above& full name here ► - namemm..F 5 Qru4 wld with utchild rdelnswcr'tam Ba [g YourselL If someone can claim you as a dependent, do00%dledt box 154.. , , , , , , • , • • on GiiA 1 tlmore thanend tour dependents, see lrtrWt:liorrr. IsS ouva....... .......... ......... .........I.,.....................,...... ,.... Waal cMld>•i .Ii;1Depondent'S (fit tkpendent's (4) ij : eenho: C Dependents: Fociy security roletiortship tynd ngmWr to you docfh dvaee 1) Firstnerne Last name VIM' BRANDON M WWAT.OG 61.0-13-1102 SON F» oan XWOB I SB.ELTON 602-63-4146 SON, DmAN `t"' on<+ iMrndrhovi Add he.Cbar! d Total rnrmixr of era ors claimed , 'Z!r 3 InOemC 7 WAW., salalles, UPS, etc. Attach ParmU) W2 ........................................ 8aTmablelrdetest. Attach Srhedulal3lfrequired,,,.... ,•............. .. 7 5 240. fla ate. b Tax R"pt Int"t, od net Include on line 8a ........... . . I Rb Adadh 1'"04) W-2hem.Aho attackFam Ittatwaswdhhold gal Ordinary dividends. Attach Schedule 8 If required ...................... . .. . bnudlbaddWldcndc(smIwIrc)................................. 1 91314iinr 10 Tamblotdundactodlla,orolfuhWsfalcandlocallncomclaes(meln�hl&itons)... 11 Alhnonyfecetved................................................................... 78 72 Hyou did not got a W$ sve inshadbar, 12 6usatess inconla or floss), Attxh ScberWte C or C E7. . . . . . ........................... 73 Ibplfal gda aQoss). AltSdh fy ff regd. H not rdgd, dt hcrc............ I ... , ........ F- ❑ 14 Other gWm or (tomes). Attach Form 4707. . ........................................... 73 74 15b 15m IRA distributions............ Lisal bTaxable 8mohmt (sae btslm) ., 7 b 16a Pensions and annuities ...... 116al Wrawbh amount (sea instrc) .. 17 17 Rental real estate, royalf1 s, pannetshtpo, S corporation, trust, eta. Attach Schedule E.. 18 EWIM hhA do not ntdchany � °nL�aO' a(sea pme t fatm 1914N, 18 Farm Income or (foss), Attach Schedule, F...................... , 1. ... I ................ to Unampleymentcomponsatiorr........•................... ... SAaSeclillneuillifWafpa...........12021 IbTarmWeamount ainstrs. 7t1 DlAai hkmme_—__—___— __ — 79 20b Adjusted Gross Income 23 24 25 26 27 28 29 3o 3faAtlmdlypaM 92 33 94 35 38 37 Educator w"Mes (Sea InSINChens)..................... %s Mnanbusinasls�pns dresenktr pctarmingardsls,and fde•Wt govurnmmtoHMab.Nlxhfam2109ar2t08EZ ................... 24 Heahh savings account deduction. Attach Form St389... - Moving expenses. Attach Form 3M , , .................... 29 One-half of sell -employment tax. Attach Schedule SE...... , 2T SelPotriptoyed SEP, SIMPLE, and qualified plans........... 28 SaH•tmPPoyatlMnidt(nsurmcadcdre0al(momsMcuont)•..........,. 24 Penalty an early vAmdfawalofswkvgs swkvgz .................... 30 hBxipim0S9N.... 37a IRA deduction (see Instructions). 32, Student loan interest deduction (sea hmtruclic,............ 33 Tuition and fees deduction. Attach Form 8917.. Don4tk Predation sativitlas daltctm Mkeh Feml W........... . . 3S AAdlien 22-214edp2,a9•................................--.................. Suctract line 36 from line 22.111is I% gr:tad 'income . . ....rs Mi' x" nvtgp aN,t7.. �jfd..... x .......... . ....... " 87 7 166. SAAfor Diselopunt,pWvaeyAct; =dPapmymkReduction Act Hadco.Sea lnXWueBons. Pnvorra. 12aw Form 1e10(20D7) VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management, of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, th< Total Annual Eligible Income* of the undersigned individual(s) was $ j ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 4/0, 00 per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age 11�hlt-- Sissies--- y4 Signature(s) of Income Earning Household Member(s): Signature Date: 5/�g HOU"G & COMMUNITY SERVICES DEPARTMENT 4 1104# ORANGE COUNTY HOUSING AUTHORITY 1770 N. BROADWAY - SANTA ANA, CA 92706 http!//-Ww.ochauring.org 6)n 07/24/2007 Irvine Apartment Communities Leslie H. Sisson C/o The Bays Apts 6690 1 Baywood Dr 356 Baywood Dr Newport Beach CA 92660 Newport Beach, CA 92660 Dear Irvine Apartment Communities: This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $410.00 Previous Housing Assistance Payment $955.00 Previous Rent to Owner $1,365.00 Tenant's New Share Rent $197.00 New Housing Assistant Payment $1,168,00 New Contract Rent $1,365.00 IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested). The effective date, the OCHA and tenant portions of the rent will be adjusted accordingly by Leasing staff; you will receive a separate notice when completed. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 09/01/2007. If you have questions please call Adrienne Ponce at 714 480-2825. HAPPY Software, Inc. AP07124/2007 VILLA POINT 1(Off--site Baywood Apartments) Unit No. iE 3 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ Iir�_; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Ba.)RVood Apartments) was $ ANgy %�_ per month. —Pe,%Ir, �-Oe 1Sr aos * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental ro'' property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Inc Member(s):mousehold Name Age ra1Y1�1��-_ r Signature(s) of Incomes Earning` in --Household Member(s): Signature Signature Signature Date: L.�e.� es HOUSING & COMIIIUNITY SERVICES DEPARTMENT ` ORANGE COUNTY HOUSING AUTHORITY r, 177D N. BROADWAY . SANTA ANA, CA 92.70.E http!//WWW.CchovSing.drg ra 12/04/2007 Irvine Apartment Communities Vivian J Cole C/o The Bays Apts 6695 1 Baywood Dr 513 Baywood Dr Newport Beach CA 92660 Newport Beach, CA 92660 Dear Irvine Apartment Communities. - This letter is to inform. you of a CHANGE IN RENT as follows: Previous Tenant Share $237.00 Previous blousing Assistance Payment ' $1,088.00 Previous Rent to Owner $19325.00 Tenant's New Share Rent $243.00 New Housing Assistant Payment $1,082.00 New Contract Rent $11325.00- IMPORTANT NOTICE - PENDING RENT INCREASES: The above contract -rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed, AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the housing Assistance Payment Contract •signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 02/01/2008, If you have questions please call Yvohne Taylor at (714) 480-2709. a� HAPPY Software, Inc. Yr12/04/2007 VILLA POINT I (Off -site Baywood Apartments) Unit No. 519- CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ O Q ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1c,�JSL per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): Date: dl Signature Signature Ignature 8 r� . VILLA POINT I (Off-sitg Baywood Apartments) I Unit No. .6 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) Me certify to the management of Villa Point I (Off -site Baywood Apartments) that: The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007 the Total Annual Eligible Income" of the undersigned individual(s) 00 was-$ and, 3. During 2007, my total mo thly rent payment to Villa Point I (Off -site Baywood Apartments) was $ _ �Z per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Age Signature SIggn+nature Date: v ILOVING & COMMUNITY SH89ICRS DEPARTMENT ORANGE COUM HOUSING ALUORM 1770 N. 13ROADWAY • SANTA ANAL CA 92706 https//www.achouning.org if p 03/24/2008 Irvine Apartment Communities Dawn Bender U lolk) C/o The Bays Apts 6740 1 Baywood Dr 656 Alderwood Dr Newport Beach CA 92660 Newport Beach, CA 92660 Dear Irvine Apartment Communities: This letter is to inform you of a CHANGE IN RENT as follows: Previous Tenant Share $333.00 Previous Housing Assistance Payment $10007.00 Previous Rent to Owner $1,340.00 Tenant's New Share Rent $88.00 New Housing Assistant Payment $1452.00 New Contract pent $19340.00 I1 WORTANT NOTICE - PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is complcted. AMENDMENT TO HOUSING ASSISTANCE PAYMENTS CONTRACT: The contents of the Housing Assistance Payment Contract signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 04/01/2008. If you have questions please call Yvonne Taylor at (714) 480-2709. HAPPY SoRware, Inc. Yr03/24/2008 a . 4. VILLA POINT I (Off -site Baywood Apartments) Unit No. (Qi� CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) INVe certify to the management of Villa Point I (Off -site Baywood Apartments) that: The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the T8&1 Annual Eligible Income, ofthie,undersigned individual(s) was $ (01,—; and, - 3. During 2007, my total,)nonthly ren, _ t payment to Villa Point I (Off -site Baywood Apartments) was $ 115 I�Jl��vv— per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided infon-nation in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach{ California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Name Age ( Signatures) of Income Earning Household Member(s): � 11Li:j Signature Date: �� 3° Employea's name, address, and ZIP Katie A Hadfleld 1171 Corella Newport Beach, CA 92660 15State Em layer's elate ID number 16 Slate wages, bps, elm 2007 CA _ 23429434 _______9041.60 3e-2099803 Form Wage and TeX 17stnte Income tax 18 Local wages, tips, elm W-2 Statement ____-_ 105.53 --------9041.60 Coppy 2-To Be Filed -- Wllh Employee's 19 Local Income tax 20 Locality name Slate, City, or Local -___-_-__ 54.25 CA SDI Income Tax Return. - - - - - - - - - - - Departmonto the reasury— ntemma even—uo8e ce 204720f10itl1/1, a+e•ara Z/2�PMC� hployee's name, address, and ZIP Katie A Hadfield 1171 Colette Newport Beach, CA 92660 2007 38-2099803 Fonn Wage and Ta W-2 Statement Copy 2 - To Be Filed With Employee's State, City, or Local Income Tax Ret6rn. il0 number 16 State wages, Ups, elm ----------- ------0 tax 18 Local wages, n e, etc 105.531_______�041.60 19 Local income lax NLocalllyname ----_---_ 54.25 CASDI 41er11, Iocurale, vlsu nm Ins vvnu one FAST,. Use at wwwAs,govyefile, FIT,. Employee Reference Copy 2 Wage and Tax `� 200 Statement Copy Cfor em I ce's records, OMB Na 1san:000s If Controlnumber Dept Carp. Employeruseonly 0000000436VNH 3010 WRBO A 242 o Employer's name, address, and MP code CORINTHIAN COLLEGES INC 6 HUTTON CENTER ,SUITE 400 SANTA ANA, CA 92707 eN Employee's name, address, and LP code TYLER R HADFIELD 676 ALDERWOOD DR NEWPORT BEACH, CA 92660 If m oyes number a Empoyeca SSA num er 33-0717312 529-35-4723 1 Wegea, tips, other comp. 2 Federal income tax withheld 52431.68 4345005 3 $=lot security wages 4 Social security tax withhold 52431.68 3250.76 Medicare wages and tips 5 Medlcaretaxwithheld 52431.68 760.26 7 auchd security tips 6 Allocated tips a Advance EIC payment 10 Dependent care benefits 11 NonquslRied plans 12a c`oo nl ru ono or ox3.10 14 Other 4740.56 125 INS tzb 12o 12d 1 314.57 CA SDI 13 Stat emp Rotpan Id parry Slckpay r 15 Slate Empioyar'setate to no. 16 Statewages, lips, eta CA 428.2562 0 1 52431.68 17 State incometax IULocal wages, lips, eta 904.90 IV Local income tax 20 Looailty name 52431 VNH 13010 IWR80 I A a name, address, and LP code HIAN COLLEGES INC ON CENTER ,SUITE 400 ANA, CA 92707 :!41 r1G1.1 s Empi ers eD io number s Empmyae-anA number 33.0 173 2 529.35.4723 7 Socials curity tips a Allocated tips s vanes payment 10 Dependent care benefits rhlianqua a pane 124 See Instruction. for box C1 3.10 14 other 2 s 4740.5 1251NS 12o 314.57 CA SDI 13Stalemp Rat plan rdpartyeick An Employ 's name, address and ZIP code TYLER R HADFIELD 676 ALDERWOOD DR NEWP'RT BEACH, CA 92660 Metals E loyer'satate to nal6 State wage0. lips, eta CA ge-2562 0 62431.68 17 State Inc me lax 904.90 IS Local wages, tips, eta li Localin ometax 20Locailtyname a eral Filing Copy Wage and Tax W .2. zuu/ vv-z ana CAI'11V1NUZs bUIv11v1At1Y 1is',summary section' is included with yal�.2 to help describe this ortion .in more detail. The reverse side 11R'ludes general information that you may also find helppful. The following reflects your final pay stub, plus any adjustments made by your employer. OROSS PAY' 52,431.68 SOCIAL SECURITY 3,250.76 TAX WITHHELD BOX 04 OF W-2 FED. INCOME 4,345.05 MEDICARE TAX 760.26 TAX WITHHELD WITHHELD BOX 02 OF W-2 BOX 06 OF W-2 STATE INCOME TAX 904.90 SUI/SDI 314.57 BOX 17 OF W-2 BOX 14 OF W-2 LOCAL INCOME TAX 0.00 BOX 19 OF W-2 To change your employee W-4 profile information file a new W-4 with your payroll department TYLER R HADFIELD Social Security Numbers29-35-4723 676 ALDERWOOD DR Taxable Marital Status: MARRIED NEWPORT BEACH, CA 92660 Exemptions/Allowances: Federal:4 State: 4 Local: 0 O 20o7 ADP. INC ♦-Fold arM Datech Nere -a Wages, line, other comp. 2 Federal Income tax wahhel 52431.68 4345.05 Social security wages 14 Social security tax wllhheh 0000000436VNH 13010 IWR801 A o Employer's name, address, and LP code CORINTHIAN COLLEGES INC 6 HUTTON CENTER ,SUITE 400 SANTA ANA, CA 92707 4740.56 125 INS 314.57 CASDI TYLER R HADFIELD 676 ALDERWOOD DR NEWPORT BEACH, CA 92660 vA. slate rmng•vopy -2 Wage and•Tax 'Statement Copy 2to ba tlled with employee's State Incon 1 Wages, tips, other comp. 2 Federalincametaxwahhem 52431.68 4345.05 3 Social eecuritywa oe 4 Secret security taxwilhheld 524�1.68 3250.76 5 Medicare wages and tips 6 MedicaretaxwRhhald 52431.68 760.26 d Controlnumbcr OepL Corp. Employeruseoniy 0000000436VNH 3010 WR80 A 241 c Employer's name, address, and ZIP coda CORINTHIAN COLLEGES INC 6 HUTTON CENTER ,SUITE 400 SANTA ANA, CA 92707 4740.56 125 INS 314.57 CA SDI TYLER R HADFIELD 676 ALDERWOOD DR NEWPORT BEACH, CA 92660 or Local rmmg I Wage and Tax "Statement I WO,.malneww'w CIN ner, care VILLA POINT I (Off -site Baywood Apartments) Unit No. `735 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ pia t o24(0 • a� ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 1170 per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -income Earning Household Member(s): i Name Age J Signature(s) of Income Earning Household Member(s): Date: Signature To Date Earnings I Year To Date Deductions AM.Year AM. National Account Services Regular Pay 16M•56 on,dena n,w�ex.rnw M+m Lunch Penalty 12.00 203.22 Overtime - 1.Sx vacation Pay 96.00 003.001063 - IANC Sick Pay 96.O1i Floating Holiday 96.00 Holiday Pay 384.00 Pqi Naas 653•75 Subjective Bonus puarffrly 92A0 01N-y COE BBHb 114.00 Ortly Economic Occupancy Bonus 64.00 Social Security No.: 047.90-5091 Medial Status Single Exemphon$1Al10Mnces. Fai 1/0 State' 1/0 _ _.._ ___. ._____...� tvmnes hos. omlercompensahon 2Federal iiwe Irvine Apartment Communities Irvine,pCA Innovation CHARLES J. PYILIK i3 SmNarY RNrenmi ThyM1pvry 140mer 735 ALOERNOOD DR. andmra Man . oxy CA -SDI 105.63 El NEWPORT BEACH. CA 92660 ❑ 1857.98 a _Wn hek 1091.48 mheld 255.27 CA 439:=" 1rbu4.os -- ._. Form W-2 Wage and Tax Statement Employee's Depy rento - For theTre EMPLOYEE'S RECORDS. Revers (See Servicobco e Employee oionisb 2007 thepartmenl of Revenue awrye if you Revenue Service. a tax reormaaonlsbeince penalty r to Copy the Internal Revenue Service li you are required toile atax relum,aneghgence penalty or ether sanction may be imposed on you it this Income is taxable and you fail to report d. OMB No 1545.00D0 Receive a Discount on TurboTax online Products and Free H2 Download at <http://www.probusiness.com/turbotax> 2007 State Copy2•To Be Filed Wllh Employee'sS ate, Clly or Local lncomo7ax ...�.., . Form W-2 Wage and Tax Statement Filing Copy Return DepadmeLtotihe Treab ryTTnve sahon e2-L..ry lcomcome lax mthhold Irvine Apartment Communities 110 Innovation Drive Irvine, CA 92617 CHARLES J. PYTLIK 735 ALDERNOOD DR. NEWPORT BEACH, CA 92660 007 Form W-2 Irvine Apartment Communities 110 Innovation Drive Irvine, CA 92617 CHARLES J. PYTLIK 735 ALDERNOOD DR. NENPORT BEACH, CA 92660 Federal copyB CA -SDI 105.63 tax 120 L liry name with Employee's FEDERAL Tax Return. asury. Internal Revenue Service aeuocarea uv� ____._. ____.... 17604.53 109 . 9 Advance ElG Payment 5Mediarevra, 17604.53 6Nsdicara tax wim255.27 CA -SDI 105.63 t9 Localincome Wx 2D Locaht 57 National Account Services aN,onaemw.w.aenl 003.000839 . IAHC Social Security No 049.80.1456 Mahal Status Single ExamptionslAll:n ances Federal: 0/0 Shaw nin Year To Date,Earnings Regular Pay - Lunch Penalty overtire - 1.5x Vacation Pay Sick Pay Floating Holiday Holiday Pay - ENPLOYEE'REFFRRN. 80fill Ppi. Bonus ' Subjective Bonus Quarterly QIN.Y,.COE BOW Qrtly Ewm nic occupancy Bonus 20915:07 55.15 2".77 699.19: ,407.23 88.24 697.44 354.51 1046.07 188.00 171.00 131.00 Year To Date Deductions Pretax Medical Plan Pretax Dental Plan Pre -Tax Vision Care 352.00 22.00 22.00 a Eoployeessoclal security number 049.80-1456 bEmployer Menbfice6on number (EIN) 20.0397577 75otia1 severity bps - - 1 Wages, tips, other compensation - 24601.67 2Federallresmataxwthlbeld 3044.98 c Employers name, address, end ZIPeOde, Irvine Apartment Communities 110 Innovation Drive Irvine, CA 92617 0Amcated bps asocial security Moos _ 24601.67 4Socialsewmytaxwthheld 1525.30 9 Advance SIC payment 5 Medicare wages and bps 24601.67 6 Medicare tax w,thheld 356.72 10 Dependent care benefit i2a Sea instruction for box 12 A2b s Employees first name and Initial Lastnama Suif, 11 Nonqualaw plans 12c 12d LEE A. NATURE - 735 ALDERfAIOD OR. NEWPORT BEACH, CA 92660 13 steutory .aaurtmet Th arty eaWoysa Wen atdiaay 14 Other CA -SDI 147.61 ❑ •❑ ❑ IEm o eas address and ZIP code i55pe Employers Sete lDNo 185tt wages, bps, etc CA 4394236-4 24601.67 17 Sata income tax 457..72 , 18 Lgcol wages, bps, otF 79 Local income mz 20 Locality name 2007 Form W-2 Wage and Tax Statement Employee's copy c-For EMPLOYEES RECORDS. (See Nobce10Ertployeeon WM) Departmentof the Treasury -Internal Revenue Service This mforma6on is being fumtshed to Copy the Internal Revenue Service If you are required to file a tax return, a negligence penalty or OMB No. 1545,0008 other sanction may be Imposed on you If this income is taxable and you fail to report it Receive a Discount on TurboTax Onlirle.Products and FreeW2 Download at<http://www,probusiness.cog/turbotax> 2007 State Copy 2- To Be Filed With Employee's State, City or Local Income Tax Cn.m IAf O raL.nn nnA Tnr Q!-itn„ e t CiI4nM rnnv .. _...___._. i_.__-r OMB No 1545-M I - -ram - ••w -_i rev^, nv- aFmployee'ssocalsecuraynumber In Employer Identification number(EIN) 7 Social seventy tips 1 Wages, tips, other win sebon 2 Federal (MOtax withheld 049.80.1456 20.0397577 1601.67 3044.98 C Employers name. address, and ZIP code 8Altocatud lips 3 Secret secudty, vngas 4 Swlal county tox withheld Irvine Apartment Communities 110 Innovation Drive Irvine, CA 92617 24601.67 159.30 9 Advance EIC payment 5 Medicare wages and bps 24601.67 6 Medcare tax wmMld 355.72 10 Dependent care benefits 12a See Instructions for box 12 12b e Employee's rim name and Initial Last name Soft, ll Nonqualihw plans 120 12d LEE A. NATHRE 735 ALDEMM DR. NEWPORT BEACH. CA 92660 13 Sta lon Rce emett Third -party wiled. Wan slcxpay 14 Other CA -SDI 147.61 ❑ ❑ ❑ fEm o ee'saddress and ZIP code 1C Nelms FmNnvelc 6larwln Nn'Ifl dab wanPS L,I5. I1M.. 17 Sh1IB hILOr11910Y 18Lowlwaees. bps. etc. 191-ocalincometax 120 Locality name VILLA POINT 1(Off-site Baywood Apartments) Unit No. `7 13 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was$ IO •g98' ;and; �- P.MW6 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 110 ` per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification -is -made -under -penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Name Age vi�-�o�,, u ql-Glf-s Signature(s) of Income Earning Household Member(s): Signature Z Signature Date: �/� -/ LR 11 VILLA POINT I (Off -site Baywood Apartments) Unit No. CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individuals) was $ ; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ 6 C`)C`)` o per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non income Earning Household Member(s): Name Age Signature(s) of Income Earning Household Member(s): I� signature Signature Signature Date: �-. - as —o� VILLA POINT I (Off -site Baywood Apartments) Unit No. I CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was•$ ;and, 3. During 2007, my total mo thly rent gayment to Villa Point I (Off -site Baywood Apartments) was $ 1 & per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age ., - Aq Signature Signaat]uurree�lJ/�►Ity���,-r L�A_'S�gneAe ' ` "l Data: .4 — a ` o C • • VILLA POINT 1(Off-site Baywood Apartments) Unit No. -73'3 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) INVe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ IcL D o E) mom; and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ J S '—' per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age Sig ure Signature Signature Date: HOUSING & COMMUNITY SERVICES DEPARTMENT a ` ORANGE GOM HOUSING AMHORITY 1770 N. BROADWAY . SANTA ANA, CA 92706 http:/Iwww.ochousing.org �pp1` 05/07/2008 Irvine Apartment Communities Rose L. Melgoza C/o The Bays Apts 1195 l Baywood Dr 783 Alderwood Newport Beach CA 92660 Newport Beach, CA 92660 Dear Irvine Apartment Communities: This letter is to inform you of a CHANGE IN RENT as follows: Previous Tonant Share $330.00 Previous Housing Assistance Payment $985.00 Previous Rent to Owner $13315.00 Tenant's New Share Rent $208.00 New housing Assistant Payment $1,107.00 Now Contract Rent $1,315.00 IMPORTANT NOTICE-1PENDING RENT INCREASES: The above contract rent amount may not reflect a pending rent increase (new contract rent you requested.) You will receive a separate notice with adjusted owner portion from your Field Representative when the rent increase is completed. AMENDMENT TO HOUSING ASSISTANCE 1P,AYM.UNTS CONTRACT: The contents of the housing Assistance Payment Contract Signed on 08/01/2007 shall prevail except for the changes shown above. These changes will become effective 07101/2008. If you have questions please call Yvonne Taylor at (734) 480-2709. HAPPY Software, Inc. YT0510712008 0 0 VILLA POINT I (Off -site Baywood Apartments) Unit No. Y59 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ _ and, 3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ `4 'i 75-, 7 per month. Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned',acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age ..auaww Date: VILLA POINT 1(Off-site Baywood Apartments) Unit No.-1 CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (tor tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) IMe certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ t000, CEO ; and, 3. During 2007, my total monthly rent payment to Villa Point 1 (Off -site Baywood Apartments) was $ 15C0. 00 per month. * Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Eaming Household Signature(s) of Income Earning Household Member(s): Member(s): Name Age Signature (b�-t hey Scc. -ekc 2'`1 Signature Mot soy1 Signature Date: • it VILLA POINT I (Off -site Baywood Apartments) Unit No. 91 a CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, 2. During 2007, the Total Annual Eligible Income* of the undersigned individual(s) was $ S0,n0n.o0 ; and, 3. During 2007, my total monthly rent payment to Villa Point I •(Off -site Baywood Apartments) was $ J�q q00 per month. " Total Annual Eligible Income includes: wages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: Names and Ages of Non -Income Earning Household Member(s): Name Age MOM W, 51 v Signature(s) of Income Earning Household Member(s): _ I . Signature Signature •, • VILLA POINT I (Off -site Baywood Apartments) Unit No-9/ - &a7 ir/OOc/ CERTIFICATION OF CONTINUED HOUSEHOLD ELIGIBILITY (For tenants not in possession of a Section 8 certificate or voucher, income documentation must be obtained.) I/We certify to the management of Villa Point I (Off -site Baywood Apartments) that: 1. The undersigned is/are the only income earning occupant(s) of the above indicated leased premises; and, r-2. During 2007, the Total Eligible Income` of the undersigned individual(s) 0 was•$.• and, L/ �3. During 2007, my total monthly rent payment to Villa Point I (Off -site Baywood Apartments) was $ I t � per month. C: TStal7CnnuaY� IE Igiblewom i cfu1 �k✓ages, tips, overtime, bonuses, commissions, net income from a business or rental property, interest and dividends, social security payments, retirement fund or pension payments and distributions, disability benefits, workers' compensation and disability pay, severance pay, alimony, child support, all regular and special pay and allowances of a member of the Armed Forces (to exclude hostile fire allowance). The undersigned acknowledge(s) that Villa Point I (Off -site Baywood Apartments) and the City of Newport Beach are relying on the accuracy of the provided information in the leasing of an apartment to the undersigned; and in conferring on the undersigned the monetary benefits of the Agreement which restricts the rents collectible for occupancy of the above indicated leased premises. The undersigned consents to the delivery of a copy of this Certification of Continued Household Eligibility to the City of Newport Beach. This Certification is made under penalty of perjury in Newport Beach, California on the date indicated below: \ I Names and Ages of Non -Income Earning Household Member(s): Name Signature(s) of Income Earning Household Member(s): Age .104 AS "w M .IP 4 T Signatures r t� Ignature Signature tz fO p ulj eh .1?y r 1 r-4—,VIGuJ G2 P 71 11A Tiriv So M 16 Ar & Date: Qrn ]iA AAA,`?,-, -,/ r TENANT INC +' CERTIFICATIOr7 eective Date: (��p 0' fiat Certification ❑ Recertification 1P Other it,CL. D/yyyy i j r;, :.51 i RtAlilt7 =15EVI _b�!IVIEYI DA�e� ; Property Name: Bavwood Expansion County: Orange BIN #: N/A Address: 1 Bavwood Drive N'ewortt Beach CA�.92660UMniltt%# Bedrooms: •�'.1--'~ •L:; �i{.'• -04R8WWtb---,o.N63uq1mrb/e�r::pl?& W1a�FF ;jG`.� ":'`,:-'%Y.}�:+,r«:,!'Ra.a ''":''s'ii7:.. 7�•i. HH Mbr # Last Name First Name & Middle Initial Relationship to Head of Household Date of Birth (MMIDD/YYYY) FIT Student or N) Social Security or Alien Reg. No. HEAD Oq rS 2 t, ' OL'--�eo 03 3 4 5 6 7 yy 'i:.' "ll lY{%,J ' .nla{[LL•ll':ViYll'1 ; i .l�G_ 'J.Yv�,= ti' 44. 7—{Yyv7'Pr •ti: HH Mbr # (A) Eto ent or Wa es (B) Soc. Securi/Pensions (C) Public Assistance (D) Other Income rat N) I r TOTALS $ `t j� !12, 1 $ is $ Add totals from (A) through (D), above TOTAL INCONE (E): $ 2 . RZ ,t� �' :i<"Mn 4i, i� / �' 1•1fR.SFiT�t'1d; "ryRi:., fm, 'rY 'i. e, 9"�i+1. Nr�•t.,,i5': ''t!rt., ' �:.t �'rx .i�ti'R\ ��'•r'L�;,`,i .i .'..;i;sf 3r:'x6,,17�..i';.; y,x �ti�vwy r,�g�r) Hshld (F) (G) (II) n) Mbr # e of Asset C/I Cash Value of Asset ual Income from Asset t C h vr" ` TOTALS: $ ' •O Enter Column (H) Total Passbook Rate If over $5000 $— X 2.00% = (J) Imputed Income Enter the greater of the total of column I, or J: imputed income TOTAL INCOME FROM ASSETS (K) $ $ $ (L) Total Annual Household Income from all Sources (Add (E) + (K)] $ \X:;$�t4.,, , r�ir ^:..wv4: ...:{ ."i`,{�"• Y�.c... _ ._ ,;y. .. lYl'l'�il�t�5«y.7�ty";'''^its+v`�?'lf. ti. The information on this form will be used to determine maximum income eligibility. I/we have provided for each person(s) set forth in Part II acceptable verification of current anticipated annual income. Uwe agree to notify the landlord immediately upon any member of the household moving out of the unit or any new member raving in. Uwe agree to notify the landlord immediately upon any member becondng a full time student. Under penalties of perjury, Uwe certify that the infomution presented in this Certification is true and accurate to the best of my/our knowledge and belief. The undersigned further understands that providing false representations herein constitutes an act of fraud. False, misleading or incomplete information may result in the termination of the lease agreement. Signature Signature (Date) Signature (Date) (Date) Signature (Date) 17, TOTAL ANNUAL HOUSEHOLD INCOME FROM ALL SOURCES: �3 From item (L) on page 1 $ ( J Current Income Limit per Family Size: Household Income at Move -in: tECERTIFICATION ONLY: Current Income Limit x 140%: Household Income exceeds 140%at reccrtifica_tii n: ❑ Yes t?7,Io Household Size at Move -in: +Tenant FtI Paid Rent_ Rent Assistance: $ Utility Allowance $ `'I Other non -optional charges: $ \\ GROSS RENT FOR UNCf: (Tenant paid rent plus Utility Allowance & Unit Meets Rent Restriction at: other non -optional charges) $ ❑ 60% 0 50% 0 40% 0 30% Q for Maximum Rent Limit this unit: $ WA Mtm *Student Explanation: ARE ALL OCCUPANTS FULL TIME STUDENTS? If yes, Enter student explanation* 1 TANF assistance / (also attach documentation) 2 Job Training Program yes •�tr _0 3 Single parent/dependent child �/-'�_'' 4 Married/joint return Enter 1-4 a. Mark the program(s) hsted below (a. through e.) for which this household's unit will be counted toward the property's occupancy requirements. Under each program marked, indicate the household's income status as established by this cerlificatioon�/recertifrcation. Tax Credit ❑ I b. HOME ❑ I c. Tax Exempt ❑ I d. AMP ❑ I C. L pr51 , (Name oJPragram) See Part V above. kk Income Status ❑ 550%AMGI ❑ 560%AMGI ❑ 580%AMGI ❑ OI** was .Income Stews ❑ 50%AMGI ❑ 60%AMGI ❑ 80%AMGI ❑ 01** over -income Income Status ❑ 50%AMGI ❑ 800/9AMGI t7 ❑ OI** ❑ �y ♦kw_.�_.J'' .R'.��'•4 ity 'll'GN� Y�SPJ��/.�.ar.7,4`Y _�':::,-i'�.F.riJ,2�+�'i`e lt� .� •.1,•.(-.,r Based on the representations herein and upon the proofs and documentation required to be submitted, the individual(s) named in Part 11 of this Tenant Income Certification is/are eligible under the provisions of Section 42 of the Internal Revenue Code, as amended, and the Land Use Restriction Agreement (if plic le), to live in a unit in this Project. rya s SId1fUREOFOWNER/REPRESENTATIVE ATE Tenant Income Certification (February 2004) va.vvl� W./)�.,V AVV�JL VLIL\L LL'L\iALLVl� r households whose'combined net assets do n*ced $5,000. replete only one form per household; include of children. Household Development Name: Complete all that apply for 1 through 4: 1. My/our assets include: (A) Cash Value* sN . (B) (A*B) Int Annual Rate Income Source r $ �4 Savings Account $ Cash on Hand $ Certificates of Deposit $ Stocks $ IRA Accounts $ Keogh Accounts S Equity in real estate S Lump Sum Receipts Unit No. 2;U (A) (B) Cash Inc Value* Rate $ $ $ S S S S S We Insurance Policies (excluding Term) $ Other RetirementlPension Foods not named above: S Personal propertyheld as as investment** : $ Other (list): (A*B) Annual Income Source T Checking Account $ Safety Deposit Box $ Money market fundi $ Bonds $ 401KAecounts $ Must Funds $ Land Contracts $ Capital investments PLEASENOTBe Certain funds (a.&, Retire nau, Pension, Tmt) may or maynotbe (fully) accessible to you. Include only those amounts which ate. *Crib value is defined as market value minus the cost of converting the asset to cash, such as broker's fees, settlement costs, outstanding toms, early withdrawal pea etc **PeaoW property held as an investment any include, but is not limited to, gem or coin collections, art antique cats, etc. lb not include necessary personal property: as, but not necessarily limited to, household furniture, daily-useautos. clothing, assets ofan active business, or q=W equipment for use by the disabled. 2. ❑ 4. ❑ Within the past two (2) years, Uwe have sold or given away assets (including cash, real estate, etc.) for more than $1,000 below t fair market value (FMV). Those amounts* are included above and are equal to a total of: $- (*9 difference between FMV and the amount received, for each asset on which this occurred). Uwe have not sold or given away assets (including cash, real estate, etc.) for less then fair market value during the past two (2) years, Uwe do not have any assets at this time. The fenUy assets (as defined In 24 CPR 813.102) above do not exceed $5,000 and the annual income from the net family assets Is s� This amount is included in total gross annual Income. Under penalty of perjury, Uwe certify that the information presented in this certification is true and accurate to the best of my/our knowledge. undersigned further understands) that providing false representations herein constitutes an act of fraud. False, misleading or incomplete informa i nyresult in the temunation of a lease agreement Applicont/Teiaut Date Appllcent/Tenant Date Applicant/Tenant Date Applicant/Tarant Date Unde $5,000 Asset Certification (Septa 2 1 4,332.91 x 12• _ 51,994.92 #+ 0• 100• x 6• _ 600.00 *+ 0• 51,994.92 + 600.00 + 52,594.92 *+ 0• # 1.7r526.24 4• _ 42381.56 *+ 4,381.56 x 12• = 52,578.72 *+ EMPLOYMENT VEIRUICATION TO' (Name& address of employer) I -A use RE: c71A iinne 10Wa APPsm+srcnent Name I hereby at f dee roleeae of my XXX-xx- a5(a ( , 13' p SodaleaamyNumber Unt (if'�f r%pnpd) I_1411Pat 10 Data The htdividual Teemed dire d1Jcae Ia an tly Icintgenant of a causingProgram that Progthat required verification of mmme. The Informotion provided winremain ewnklcntlif toeattefra�nofthat stated por =only. Your prumpt tssPonse Is crucial and grwityappredated. pot 3Rjoidt t f 1 rir•�r �-t J Return PwmTat V7Ai(- •- (`qcc) 10V11- vat — ^�•PLPAN COMPLETE THIS FORM ENTIRELY, NOTING -WA-OR -NONEe WHERE APPLICABLE Empbyee tvama: 1 7 �•� Job'litle: 1'CQaw PresaMlyEmployed: You Data F2t6t Employed �f Now- Last Dayafpmptoymerrt . 4 l CurromOro"Mages/Salary:Sy�J (CIRCLEONE) hourly weeky &MAk(y %amWi1*nft4t� nomht, yearly AVerhgeifofmguluhours per wook:, Year-tadateasmirv!-1154,w,•Ja .1.2001thru.�_) 1J1((�a/2odg OvarlkneRate:5 d parhour AvoiegefiofavKrnehourspvrwosk: CAIL- ^y -i-A411; n Shf@DlaatanaolRate; S bla perhour Avereaef ofshiftdiffoAntlarhouraparwoakAlk„ --k% Aw\ Cemmtealuns,boluses,tips, other. S-AL&(CIR(XEONE) .hourly weekly bPAakly se�mMnatlhy monNy yaady e- •0 List any ontlelpaWd change In the employee's ram of pay within the nod 12 morrths: t1& O V+U Elfogtivo dale: If the employm's ands iswasonal or sporadic, please Addlbonalremarks! K— Vt." Alas 4 Emp"# Printed Name Da .' Empbypr(Qxrparty]NatnettntlAtldraee� • '�� w ► VKwvL�S'1't� fro-- T:55- 2)- Phorla# pot E•mall NqM, Sm6n 1001 orTidc 18 ordo U.B. Codcrml= haorimlrgl OIP=ts mAkdvAllrul falecsLventads or misrcptowntttions tuany I)gattmcmorAgenoy or the United Stapsu tuanymatta within itsjudafictkm. Employment Verification (Septembor2000) 0 39VC1 €F0KAcLt21a ZT099680TE Eb:bT 000Z/L0/90 e }i �,._ ,I�,i bi .: a.i r'•-'.T✓+. %.�I:�e61:F's :'r.;.,� ``,1'J:dre -_-_-.!r'.,; r.x '';,"9 "•n- _ -:S r"t.}T .1'., i:;. `�/-,.• •'. - � m o'�@CSC3tEmen�te Y'EazcSi'n''•'i},:'� '" '':1.' _ _ _'?n ,r';t: •p-, :'}1• t:}`_ __'l y11: 4q'),4'v -n Y]"� :'•r- :';}:e=•.>;•;•?_C'_ '(i; �iy- .:}yq'�, °e...;' _ R h'�Me; m.. '��,Empldyee� IDr.Payspl9:•her3od'ii"'"pri;.^;•.`�ayr611 ,'v-; ":"PaybaCe"'P$,, `G'F6up/.Lv�„ Ctienk,;Ndmlie$";. J:` 'Ip - !"� -?... 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EY OR PARTY WITHDUTATTORNEY (Name, state barnomber, andeddross): I. 1287 FOR COURT USE ONLY nne Honey, SBN:h b46647' Offices of Stxanne I. Honey City Blvd. W., Suite 1700 nge, CA 92868-2914 EPHONE NO.: (714) 938-3858 FAX NO: ^ ATTORNEY FOR (Noma): Zanne Porat i M , OR COURT OF CALIFORNIA, COUNTY OF Orange F $� UPERtCRCpv ETaooREss:341 The City Dr. INGADDRESS: P. 0. Box ox ND Orange, UX �tO/g ��EORN/q ZIP ODE: CA492668-3205 A170 � ANCH NAME: Family Law Division pt,pN SLgT R 3 ;�(�Q'N R AGE OF IONER: Am Porat@rk oftheCuxt 6Y O• MONROE NDENT: Suzanne Porat JUDGMENT i ® Dissolution Legal separation Nullity CASE NUMBER U Status only 99DO11024 0 Reserving jurisdiction over termination of marital status Judgment on reserved issues Date marital status ends: 1. U• This judgment U contains personal conduct restraining orders = modifies existing restraining orders. The restraining orders are contained on page(s) of attachment. They expire on (date): 2. This proceeding was heard as follows: ® default or uncontested = by declaration under Fam. Code, § 2336 0 contested a. Date:3/27/01 Dept.: L-69 Rm.: b. Judicial officer (name): David S. Weinberg Temporaryjudge c. ® Petitioner present in court ® Attorney present in court (name): Ron Cordova d. ® Respondent present in court ® Attorney present in court (name): Suanne Honey e. Claimant present in court (name): 0 Attorney present In court (name): f. Other (specify name): 3. The court acquired jurisdiction of the respondent on(date): 11/24/99 = Respondent was served with process ® Respondent appeared 4. THE COURT ORDERS, GOOD CAUSE APPEARING: a. Judgment of dissolution be entered. Marital status is terminated and the parties are restored to the status of unmarried persons (1) XD on the following date (specify): APR 13 Z001 (2) 0 on a date to be determined on noticed motion of either party or on stipulation. b. 0 Judgment of legal separation be entered. c. 0 Judgment of nullity be entered. The parties are declared to be unmarried persons on the ground of (specify): d• H This judgment shall be entered nunc pro tunc as of (date): e. Judgment on reserved Issues. f ® Wife's 0 Husband's former name be restored (specify): Suzanne Marie Joska g. © Jurisdiction is reserved over all other issues and all present orders remain in effect except as provided below. h. 0 This judgment contains provisions for child support or family support. Both parties shall complete and file with the court a Child Support Case Registry Form (form 1285.92) within 10 days of the date of this judgment. The parents shall 'notify the court of any change in the information submitted within 10 days of the change by filing an updated form. The forms Otice of Rights and Responsibilities (form 1285.78) and Information Sheet on Changing a Child Support Order (form 129.79) are attached. (Contlnued on reverse) Nm Adopted for Mandatory Use JUDGMENT �,�y/ Family Code Judicial Couev. ofCalifornia1,1m4 ii; Lick`!�' §§ 2340, 2343, 2341 Rule 1287 (Rev. July 1,1398) (Family Law) 0 7. Each party shall be entitie_i to one 10-minute telepho':i-e call eVcry 48 hnurs 47:.:;:a the ma: or chili &.ring the otter yarty's custodial period. ::f the child. is not in when the paean:; calls, the custodial parent will ensure that the child retarns the call prior to going to sleep that night. The minor child shall be free to call eithe— parent at env tinge the child wishes. Meither party shall ir.tarfere in any way lith the child's tel�!p"one calls. s',r�•vr�Ps Fees 8. Each party shall pay .•.slher own attorneys °'ses and costs incurred in this action. Cia-.1d Support 9, continuing until furthc- order of Court or u ii the child masrias, •dies, is emancipated, reaches age 19, or reaches age 18 and io not a full-time high scrool stu?ent residing with a pa_er: u'..icnever occurs first. 10. The parties acknoViaedge that `hey are £ally informed of their rights pu:tsua_= to the California Statewide Unii02:m Child Support Guideline and that ".h`s stip.11alced award is heir_g agreed to StiiCholt coercion or duir"8s. T-�z '.erne:; C•'clare that the agreement is in the best interest of the chil@n:�n involved• and their needs will be ariequ=t=-_}- r.:at by the stipulated amount. The right to s;:_pert now beer_ assigned to the county pursuant to Section _1477 of the i4=3ia;-e and J AiTAL 1✓cF 'T TO F'2MINGS Art) GR--,2R AFTE i '.TEARING �� alk SUSIMCOURTOFCALIFORNIA, COUNTOFORANGE FILED SUPERIOR COURT OF CALIFORNIA COUNTY Or ORANGE STIPULATION AND ORDER:. ❑ ON EX PARTE HEARING LANIORr.'IJXduSTICECENTER P< ON ORDER TO SHOW CAUSE MAY 21 2004 ❑ ON REVIEW HEARING CouR ❑ FORJUDGMENTALM SLATECIe'Ra the ❑ FOR JUDGMENT ON RESERVED ISSUES A stipulation for Judgment does not replace the formal, typed Judgment. Pg _ of msent)(not lfre*ept) represented by A (present) (not present) represented by The mattcruoVor hearing t are continued to , 20 at in Dept. Notice is w ved (), a given by THE ❑ , X 0 009 TE AND AGREE that: �4POUSAL SUPP T: (Husb) (Wife) shall pay (Hush) (Wife) S per (WEEK) (MONTH) payable S o and $ of each (WEEK) (MONTH) commencing and continuing u further order of the the remarria of the payee, the death of either party, or 20_ whichever ccurs first. CH D SUP T: (Father/Mother) shall (Father/Mother) child support of S per (WEEK) (MONTH) pa able on and on ofeach MONTH) commencing and continuing unti rther order of the court or a child marries, ies, is emancipated, reaches 19, or reaches 18 and is no longer a ful 1me high school stude tchever occurs first. d Support must be proportional for each child. Support calculati printout is attac 1. We agree that we are ful informed of rights regarding child suppo 2. We make this agreem t freely w' ut coercion or duress and the ds of our children will be stipulated amount. 3. This agreement is in the best interests of the child(ren). 4. The right to support has not been assigned to any county at application for -public 5. A wage assignment shall issue. CUSTODYNISITATION: shall be ordered pursuant to the mediation on and attached hereto. ig Division of Prope : See additional pages attached. Petitioner Attorney for Respondent SIGNATURE OF PARTIES by this pending. reached by the parties We have read the entire stipulation and agreement. We understand it fully and request the court to make our stipulation and agreement the Court's order. We understand that willful failure to comply with the provisions of this order maybe a contempt of court and may be punished b7fimnd imprisonment. We waive all further notice of this order. Petitioner IT IS SO ORDERED Date Forcourtuse Only 519(R3/03) , Judge/Commissioner of the Superior Court INCOME CERTIFICATION NAME: Qu--IAVInP �� () TELEPRONENUMBER:tb&Lfof:su-M37 Re, Initial Certification BIN H ❑ Recertification ��& G Other Unit YES Nn $MONTHLY GROSS INCOME ❑ Uwe am self employed. (List nature of self employment) (use pg income from business) ❑ I/we have ajob and receive wages, salary, overtime pay, commissions, fees, tips, bonuses, and/or otter compensation: List the businesses and/or companies that pay you: Name of Employ U 2) $ 3) $ ❑ Vwe receive cash contnbutions of gifts including rent or utility payments, on an ongoing basis from persons not living with me. $ ❑ Vwe receive unemployment benefits. ❑ Uwe receive Veteran's Administration, GI Bill, or National Guard/Military benefits/income. p Uwe receive periodic social security payments. $ ❑ The household receives unearned income from family members age 17 or under (example: Social Security, Trust Fund disbursements, etc ). S ❑ Itwe receive Supplemental Security Income (SSI). $ ❑ Uwc receive disability or death benefits other than Social Security. $ ❑ Vwe receive Public Assistance Income (examples: TANF, AFDC) $ 13 Awe am entitled to receive child support payments. $ 0 • 0 ❑ p'� Uwc am currently receiving child support payments. $ If yes, from how many persons do you receive support? ❑ p� We am/= currently making efforts to collect child support owed tome. List efforts being made to collect child support: ❑ I/we receive alimony/spousal support payments ❑ Uwe receive periodic payments from trusts, annuities, inheritance, retirement funds or pensions, insurance policies, or lottery winnings. If yea, list sources: 1) $ 2) $ ❑ Uwe receive income from real or personal property. (use = coined income) ❑ Uwe have a checking account(s). If yes, list bnk(s) 1)CS -1,5 .�{ ACCOUNT NUMBER INTERESTRATE Rzz Y R . g' O .�o _% CASH VALUE $ $ 2) ❑ ❑ Uwe have a savings acw s) ACCOUNT NUMBER INTEITSTRATE CASH VALUE r 1) If des, lis bank(s),� �� �_ /t o �% $ _,_ , 1 2) % $ ❑ Ef Vwe have a revocable trust(s) Ifyes,listbank(s) 1) ❑ Vwe own real estate. , If yes, provide description: $ ❑ / Vwe own stocks, bonds, or Treasury Bills If yes, list sources bank names 1) 2) _% $ ❑ Vivo have Certificates of Deposit (CD) or Money Market Account(s). If yes, list sources/bank names 1) _% $ 2) _% $ ❑ Vwe have an IRA/Lump Sum Penskm/Keogh ACCount/40IK. If yes, list bank(s) 1) _% S 2) _% $ ❑ Vwe have a whole life insurance policy. If yes, how many policies $ ❑ Uwe have cash on hand. $ ❑ Vwe have disposed ofassets(i.e. gave away money/assets) for less than the fair market value in the past 2 years. If yes, list items and date disposed: 1) $ r ❑ Student financial aid (public or private, not including student loans) $ STUDENTSTATUS YES NO ❑ Does the household consist of persons who are all full-time students ( Examples: Collcge[University, trade school, etc.)? ❑ Does your household anticipate becoming a full-time student household in the next 12 months? ❑ ❑ If you answered yes to either of the previous two questions are you: ❑ Receiving assistance under Title IV of the Social Security Act (AFDGfANF) ❑ • Enrolled in ajob training program receiving assistance through the Job Ire Training Participation Act QTPA) or other similar program ❑ Marred and filing a joint tax return ❑ Single parent with a dependant child or children and neither you nor your child ren are dependent of another individual UnintrWN TIPBOF PERJURY, I URTPYTRAT APP A'110NOR1EMMAU rr OPTiIE tBAS¢` OREEar¢M. P EAME OF APPLIC�'/fENANT SIGN, T WI SSEDBY( IGt ATUREOFOWNER/REPRF. ') U115 RUBAND ACCURATE TO TfIBBPSPOPMY/ODRMiOwLEDOE TNEOND¢HPrONEDFUR110;R FAisE, FD51.P lDINGORiNCOaRt.¢fE INFORAfA N LL�R/rESULTINTBEDENLV.OP NA DATE DATE Q C/ BE MARKET RENT UNIT 6 THE ill E COMPAW APPLICATION TO RENT Sy�APARTMEW r COMMUNITIES (AND RECEIPT FOR APPLICATION SCREENING FEE) Room complete this farm entirely In Ink, notm,, WA' or'mme' where applicable Do not use while out. The Information you provide Ml be vedirm prior 1 TICACs apprmnal to rant an apartment to you h an apartment community owned by either The Irvine Company, IMne Apartment Communes, LP. or Irvin Commercial Pmpedy Company (collectively,'Cwner). yb. 1.Yk' IleanCHisf , + � ',r - -,-• - - dl:,a:a:..�s1u:�..°.++(`.� , �,; a Commuolry: Atltlress. yam, •rilkens0a PMIAPPdm No (UM FLs kldb latl[) J,A,. Dab aide SOWI iky NumOer �. j{���� •. Natl7dW &(A •a •leidtldwd daM'Cd a'. A-t ..:,•� :'�??ri. ".n Y,• " (tast,FM,MMMlnWa) (Loot, Flet MtlEb I." (LaM, FkM seeds meal) (i.n.Fkst,MWdie IrWap (Last, FM Mgdb In" (Lsst,Fms Mquloln AwkrsnYS PlesentAddmss. Own / Phdi O.Ya F. A ddmeS� ReM T. Deudmd famay home Atudcdfam05•Mmc Apanmenl. MdMWy Payments To d0you makepaymOnlsi PrerentL lom's Numo6Addrnss prone ImmndbW Prior Address (Nless than ayr at above) F-1 Own MomblYPayment 04", imm Rent a To Immodlab Pdol LaMbsds N. mss• Phowa Do wuawnaP Yes F7 No NmnW.f Pets Typo: B.ed Aduk PeMeipM. 2: OCDD Itfe� ':Y•' «,"! % ::'q)i%'�M""d:t<sM • fi`Y° "7 •t •.iY^s+d:' '_(�" 7— .,re Ouagans(LaA FIrstlagdbindal) VVI aY I (LaAFkAMWdbinaH Oaq of BNb SSN: (tall Irsl, qdb In Oa of Ym (Last FaA Middle Me) Dale of BlM SSN: ISSN (L ,FM.ModbinWH Dandom (Last, FM MWEb In WI) Dab of B%b SSN: SSN• . 3Pt Ib @nf niit r' 1:'<`Rff .i ...1_` `v 4.. .f�i1M< '•JM1 "F'• Empbyerpt 9 mpbyed. maim olbusbess)ausbcu Addreu (gtlWrq LPCode) s Phom °r Typoof Business Poskbn Fom 20 Suporwsar bye Plw a y hT �eac y3�i t uca i'o a p ayp41 ,�- _. r awppnimusl ProHdal wYSWb. CanWA 100, Phawa aOY` Imomo ImnwdWWP Em y' Ad cu(in I�LP Cod• a) F. T. Me 4:fF7liil Dhe p•barikaMpmnch(bdud0 ,slob) i C- cM t% —L72 Sdano3.ou.o Savkps• ba karq/sc m 0 b al ; a / -/YJ BaMnm aLs s va lm vOwrated for bonkminq pmhabnt [] oYw CauMyaM SlalowhOro fried.` Waal yeaR_ Hawyoue"rhadanypublb yes [114 Whatyearr_ pens,Wdpmontsart repant wsussioubnY! Haw yvuewr beeneviecda Nawyouawrdefauhodonaleaui rl Yes �No Hawywererbean wnvktaa ofehbrcYdul Yes No e /In 4rvobod an oecnaa awbstpmpoM.pouom. powmmdntorkials,ertlutMwhedhmmu, pkwldmpa.Ol SO%0! 60%IXImN;si In afns r�.•/.pbawwlYY:(torsluimiodNrsaa r Re.(( RBIs n_" gQq 7�Ryay' or35 H DI tit pea L FUM1rr.NmrpMmnumbeu C7 1 ' o �/ Nm -gz 'By pmvidingane-mall address lam eluding toreeeJvo amaa from The twine Courmanyand Hs affiliates YZ aNq-pPMraUa�b ReM 1 �-n �e ARV connParvir APARTMENT COKAMUNiT1E5 B Reason for relocation: Ah A(ILAJ 1 r-L46 IAA, sd- 1 7. How many vehicles do you owri ? I �2 MabA Tear Lkpnma Make yearWines Note: Parking of recreational vehicles, boats or frailers is not permitted In the Community. 8. Do you have Renters Insurance? ❑yea No 9. Consent to Verification of Credit and Other Information: lam maBm Dds AppllmWnwlunbrpyl0r bapurpOseetoNNnlnp TICACY apprevalb remanapaNronibiM apannbmmmmunily¢Iwwnabaw Iad,nerleapa mmNlnpbo Nolimb credo ant sees, Kornai unkind C d to m In 11 W aM csponXare to ont TICAC, owner, and de:R reepodiw empbyms and agents (mpe0dwly. eb'fICAC PedkS), b wirty the aNrt and erve Wommdon preHded M coo b bb Application and b abbk oeda remnx N,coOrn w consumer reports. fand aber reports fmm gedX I ahra q apenas, knanl sorties 0uMm mknoto. bars(IndIn abaroants. W wb. local. bymmanotrr Deer o.rasst'enes. or WoimaWnrebtbgbINOde ApppcNbn I enk nontaWTN;AI Parties b prevba bfomatbn mnWned b Uds Apprwslbn b wrbvs bcal sbk War fedcrel powmmem peneks, NKludbpwXM1od bmuabn, vadom lax eNoreamem apondex 1 mderetardaW r I kue ma aparbbm, llq TICAC Pidks ¢Ws haw a mNnW.mdpM b review mY nW p WOrmNbn,paYmem M1bbry. omupanrybhbry0rd otlrerlNo�malbnb bb Applbalbnror WmousmtalM b mY Leau aMrorforacauntrenawbabtluMp and aXer tlb bllnof mytaau. 1 berebyrekase end Inq Aarnaett Tbo IMne Company.Irvbe PpaNneNCammuNss, LP .Irvine CammelWl PmpeM CompanY.Tho Xvee CompanYApartmam CommuMks, be. and alof 1M1ebrespeGlbo oremm.OmObYms and apenla. Irem any am aO Tbbirty,kpN gometlugsard surds, bgtlbp atlomoK Im; arisae outoftlw wrrrNun aMbr vu oltb Homblbn mmaNM b NOAppbpalbm bWtlbp eb rekab almN WomuSm bebermmex 1wananttluabfttheateff tXropplordon. 9anWomuaonnlanrob des is dlibn(bC Waq robe, bbo Wbmal s be rnaroWmndbon)bwe,f M Appmtoror and mnetl t of to dab of this AmllatlOn r arry bbrmaXon prevbed M me b tlebmllnetl b Oa fate, mN folio aWomem wtl be pmuMs far tlapprenl Of my Apprx:Nbn or blmWmn N my Luau wM Owror. I apmo b ro1ryTICAC X any of tlYt bbmutbn predtlM b bb Apptlmdon OM1ardei tluMp die APppmbonpmmtt or duM1Q my bnanry. I also uMarsbM MNTCACwDrebin WSApppO.naon, abnp wXh anyatlbrbknnabonpreNded byma, wM1euerorrotmts Apppcmbn b eppowtl. Anon- funtlablo Applleatlon Sereanlnp Fee ofS]5.00(as Itemized below)Is roqukedfrom each Applicant to process this Application and to check the Information provided. A separate Application to Rent must be signed by each Applicant who will Occupy the apartment before this Appllanon will be considered by TICAC. AN APPLICATION SCREENING FEE WILL NOT Be CHARGED FOR RECERTIFICATIONS � I I enmetlab bebw, TICAC remhed 3]500 rmm me undcrsbmM ApppMmtb mnrombnwahppplbrRe Appilplbnb RentanamrtmeNfmm Owror. TM above amoumbbbo uaotl baaoen ApPXmnlwph rmamabaedX M1bbryaM odbrbacNpround lNamolbn TboameuntclumodbXambedas 1. AWN coals olemdhmport, unlmMtloblrorlevimbnluarN,aMlorodrorsOmonaq mpoW 2 Cgstb obbin,pmmu aM wMy sewonllp lNommWn(may bdudo slags lima wd aXwrrebkd msb) p Toblfee MaWW(maymtoxa d$MKrApptl 01 The Irvine C�Wany Apartment eMn-ap000tonblwo Wv i1T65 2