Blank Sample Tax Return Transcript PDF Form Edit Document

Blank Sample Tax Return Transcript PDF Form

A Sample Tax Return Transcript is a document that provides a summary of a taxpayer's return information as filed with the IRS. This transcript includes details such as income, deductions, and tax liabilities for a specific tax year. Understanding this form is essential for verifying tax information or preparing for audits.

To fill out the form, please click the button below.

Edit Document
Jump Links

The Sample Tax Return Transcript form is a crucial document that provides a detailed overview of your tax return information as reported to the Internal Revenue Service (IRS). This form includes essential data such as your Social Security Number (SSN), filing status, and the income you reported for the tax period ending December 31, 2017. It highlights various income sources, including wages, business income, and any deductions or credits you claimed. Adjustments to your income are also detailed, giving you a clear picture of your adjusted gross income. Additionally, the form outlines your tax liabilities, payments made, and any amounts owed or refunds due. Understanding this document can empower you to manage your tax affairs effectively and ensure compliance with tax regulations. Whether you need it for loan applications, financial planning, or verifying your tax status, the Sample Tax Return Transcript serves as a vital resource for navigating your financial landscape.

Sample - Sample Tax Return Transcript Form

Page 1 of 6

This Product Contains Sensitive Taxpayer Data

Tax Return Transcript

 

Request Date:

08-09-2018

 

Response Date:

08-09-2018

 

Tracking Number:

100200235179

 

Customer File Number:

0987654321

SSN Provided:

XXX-XX-5084

 

Tax Period Ending: Dec. 31, 2017

The following items reflect the amount as shown on the return (PR), and the amount as adjusted (PC), if applicable. They do not show subsequent activity on the account.

SSN:

 

XXX-XX-5084

SPOUSE SSN:

 

 

NAME(S) SHOWN ON RETURN: DRAK

ADDRESS:

 

123 DA

FILING STATUS:

Single

FORM NUMBER:

 

1040

CYCLE POSTED:

20181005

RECEIVED DATE:

Jan.15, 2018

REMITTANCE:

 

$0.00

EXEMPTION NUMBER:

1

DEPENDENT 1

N ME CTRL:

 

DEPENDENT 1

SSN:

 

DEPENDENT 2

N ME CTRL:

 

DEPENDENT 2

SSN:

 

DEPENDENT 3

N ME CTRL:

 

DEPENDENT 3

N:

 

DEPENDENT 4

N ME CTRL:

 

DEPENDENT 4

N:

 

PTIN:

 

 

PREPARER EIN:

 

Income

WAGES, SALARIES, TIPS, ETC:

$13,000.00

TAXABLE INTEREST INCOME: SCH B:

$0.00

TAX-EXEMPT INTEREST:

$0.00

ORDINARY DIVIDEND INCOME: SCH B:

$0.00

QUALIFIED DIVIDENDS:

$0.00

REFUNDS OF STATE/LOCAL TAXES:

$0.00

8/9/2018

Page 2 of 6

ALIMONY RECEIVED:

 

$0.00

BUSINESS INCOME OR LOSS (Schedule C):

 

$2,500.00

BUSINESS INCOME OR LOSS: SCH C PER COMPUTER:

 

$2,500.00

CAPITAL GAIN OR LOSS: (Schedule D):

 

$0.00

CAPITAL GAINS OR LOSS: SCH D PER COMPUTER:

 

$0.00

OTHER GAINS OR LOSSES (Form 4797):

 

$0.00

TOTAL IRA DISTRIBUTIONS:

 

$0.00

TAXABLE IRA DISTRIBUTIONS:

 

$0.00

TOTAL PENSIONS AND ANNUITIES:

 

$0.00

SAMPLE

$0.00

TAXABLE PENSION/ANNUITY AMOUNT:

 

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

 

$0.00

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

 

$0.00

RENT/ROYALTY INCOME/LOSS PER COMPUTER:

 

$0.00

ESTATE/TRUST INCOME/LOSS PER COMPUTER:

 

$0.00

PARTNERSHIP/S-CORP INCOME/LOSS PER COMPUTER:

 

$0.00

FARM INCOME OR LOSS (Schedule F):

 

$0.00

FARM INCOME OR LOSS (Schedule F) PER COMPUTER:

 

$0.00

UNEMPLOYMENT COMPENSATION:

 

$0.00

TOTAL SOCIAL SECURITY BENEFITS:

 

$0.00

TAXABLE SOCIAL SECURITY BENEFITS:

 

$0.00

TAXABLE SOCIAL SECURITY BENEFITS PER COM UTER:

 

$0.00

OTHER INCOME:

 

$0.00

SCHEDULE EIC SE INCOME PER COMPUTER:

 

$2,323.00

SCHEDULE EIC EARNED INCOME PER COMPUTER:

$15,323.00

SCH EIC DISQUALIFIED INC COMPUTER:

 

$0.00

TOTAL INCOME:

$15,500.00

TOTAL INCOME PER COMPUTER:

$15,500.00

Adjustments to Income

EDUCATOR EXPENSES:

 

$0.00

EDUCATOR EXPENSES PER CO PUTER:

$0.00

RESERVIST AND OTHER

BUSINESS EXPENSE:

$0.00

HEALTH

VINGS

CCT

DEDUCTION:

$0.00

HEALTH S VINGS

CCT

DEDUCTION PER CO PTR:

$0.00

MOVING EXPENSES: F3903:

$0.00

SELF EMPLOYMENT T X DEDUCTION:

$177.00

SELF EMPLOYMENT T X DEDUCTION PER COMPUTER:

$177.00

ELF EMPLOYMENT T X DEDUCTION VERIFIED:

$0.00

KEOGH/ EP CONTRIBUTION DEDUCTION:

$0.00

ELF-EMP HE LTH INS DEDUCTION:

$0.00

EARLY WITHDRAWAL OF

AVINGS PENALTY:

$0.00

ALIMONY PAID

N:

 

 

ALIMONY PAID:

 

 

$0.00

IRA DEDUCTION:

 

 

$0.00

IRA DEDUCTION PER COMPUTER:

$0.00

STUDENT LOAN INTEREST DEDUCTION:

$0.00

STUDENT LOAN INTEREST DEDUCTION PER COMPUTER:

$0.00

STUDENT LOAN INTEREST DEDUCTION VERIFIED:

$0.00

TUITION AND FEES DEDUCTION:

$0.00

TUITION AND FEES DEDUCTION PER COMPUTER:

$0.00

DOMESTIC PRODUCTION ACTIVITIES DEDUCTION:

$0.00

8/9/2018

Page 3 of 6

DOMESTIC PRODUCTION ACTIVITIES DEDUCTION PER COMPUTER:

 

$0.00

OTHER ADJUSTMENTS:

 

 

$0.00

ARCHER MSA DEDUCTION:

 

$0.00

ARCHER MSA DEDUCTION PER COMPUTER:

 

$0.00

TOTAL ADJUSTMENTS:

 

 

$177.00

TOTAL ADJUSTMENTS PER COMPUTER:

 

$177.00

ADJUSTED GROSS INCOME:

$15,323.00

ADJUSTED GROSS INCOME PER COMPUTER:

$15,323.00

SAMPLE

 

Tax and Credits

 

 

65-OR-OVER:

 

 

NO

BLIND:

 

 

 

 

NO

SPOUSE 65-OR-OVER:

 

 

NO

SPOUSE BLIND:

 

 

NO

STANDARD DEDUCTION PER COMPUTER:

 

$4,850.00

ADDITIONAL STANDARD DEDUCTION PER COMPUTER:

 

$0.00

TAX TABLE INCOME PER COMPUTER:

$10,473.00

EXEMPTION AMOUNT PER COMPUTER:

 

$3,100.00

TAXABLE INCOME:

 

 

$7,373.00

TAXABLE INCOME PER COMPUTER:

 

$7,373.00

TOTAL POSITIVE INCOME PER COMPUTER:

$15,500.00

TENTATIVE TAX:

 

 

$749.00

TENTATIVE TAX PER COMPUTER:

 

$749.00

FORM 8814 ADDITIONAL TAX AMOUNT:

 

$0.00

TAX ON INCOME LESS SOC SEC INCOME PER COM UTER:

 

$0.00

FORM 6251 ALTERNATIVE MINIMUM TAX:

 

$0.00

FORM 6251 ALTERNATIVE INI UM TAX PER CO UTER:

 

$0.00

FOREIGN TAX CREDIT:

 

$0.00

FOREIGN TAX CREDIT PER CO PUTER:

 

$0.00

FOREIGN INCOME EXCLUSION PER CO PUTER:

 

$0.00

FOREIGN INCOME EXCLUSION TAX PER CO PUTER:

 

$0.00

EXCESS ADVANCE PREMIUM TAX CREDIT REPAY ENT OUNT:

 

$0.00

EXCESS

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

 

$0.00

CHILD & DEPENDENT C RE CREDIT:

 

$0.00

CHILD & DEPENDENT C RE CREDIT PER COMPUTER:

 

$0.00

CREDIT FOR ELDERLY

ND DIS BLED:

 

$0.00

CREDIT FOR ELDERLY

ND DIS BLED PER COMPUTER:

 

$0.00

EDUCATION CREDIT:

 

 

$0.00

EDUCATION CREDIT PER COMPUTER:

 

$0.00

GRO EDUC TION CREDIT PER COMPUTER:

 

$0.00

RETIREMENT

AVINGS CNTRB CREDIT:

 

$0.00

RETIREMENT

AVINGS CNTRB CREDIT PER COMPUTER:

 

$0.00

PRIM RET

 

AV CNTRB: F8880 LN6A:

 

$0.00

EC RET

AV CNTRB: F8880 LN6B:

 

$0.00

TOTAL RETIREMENT

AVINGS CONTRIBUTION: F8880 CMPTR:

 

$0.00

RESIDENTIAL ENERGY CREDIT:

 

$0.00

RESIDENTIAL ENERGY CREDIT PER COMPUTER:

 

$0.00

CHILD TAX CREDIT:

 

 

$0.00

CHILD TAX CREDIT PER COMPUTER:

 

$0.00

ADOPTION CREDIT: F8839:

 

$0.00

ADOPTION CREDIT PER COMPUTER:

 

$0.00

8/9/2018

Page 4 of 6

FORM 8396 MORTGAGE CERTIFICATE CREDIT:

$0.00

FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER:

$0.00

F3800, F8801 AND OTHER CREDIT AMOUNT:

$0.00

FORM 3800 GENERAL BUSINESS CREDITS:

$0.00

FORM 3800 GENERAL BUSINESS CREDITS PER COMPUTER:

$0.00

PRIOR YR MIN TAX CREDIT: F8801:

$0.00

PRIOR YR MIN TAX CREDIT: F8801 PER COMPUTER:

$0.00

F8936

ELECTRIC MOTOR VEHICLE CREDIT AMOUNT:

$0.00

F8936

ELECTRIC MOTOR VEHICLE CREDIT PER COMPUTER:

$0.00

SAMPLE

$0.00

F8910

ALTERNATIVE MOTOR VEHICLE CREDIT AMOUNT:

F8910

ALTERNATIVE MOTOR VEHICLE CREDIT PER COMPUTER:

$0.00

OTHER CREDITS:

$0.00

TOTAL CREDITS:

$0.00

TOTAL CREDITS PER COMPUTER:

$0.00

INCOME TAX AFTER CREDITS PER COMPUTER:

$749.00

Other Taxes

SE TAX:

 

$354.00

SE TAX PER COMPUTER:

 

$354.00

SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS:

 

$0.00

SOCIAL SECURITY AND MEDICARE TAX ON UNRE ORTED TI

ER COM UTER:

$0.00

TAX ON QUALIFIED PLANS F5329 (PR):

 

$0.00

TAX ON QUALIFIED PLANS F5329 PER COM UTER:

 

$0.00

IRAF TAX PER COMPUTER:

 

$0.00

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

 

$1,103.00

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

 

$1,103.00

OTHER TAXES PER COMPUTER:

 

$0.00

UNPAID FICA ON REPORTED TIPS:

 

$0.00

OTHER TAXES:

 

$0.00

RECAPTURE TAX: F8611:

 

$0.00

HOUSEHOLD EMPLOYMENT TAXES:

 

$0.00

HOUSEHOLD EMPLOYMENT TAXES PER CO PUTER:

 

$0.00

HEALTH C RE RESPONSIBILITY PEN LTY:

 

$0.00

HEALTH C RE RESPONSIBILITY PEN LTY VERIFIED:

 

$0.00

HEALTH COVER GE REC PTURE: F8885:

 

$0.00

RECAPTURE T XES:

 

$0.00

TOTAL SSESSMENT PER COMPUTER:

 

$1,103.00

TOTAL T X LI BILITY TP FIGURES:

 

$1,103.00

TOTAL T X LI BILITY TP FIGURES PER COMPUTER:

 

$1,103.00

Payments

FEDERAL INCOME TAX WITHHELD:

$1,000.00

HEALTH CARE: INDIVIDUAL RESPONSIBILITY:

$0.00

HEALTH CARE FULL-YEAR COVERAGE INDICATOR:

0

E TIMATED TAX

PAYMENT :

$0.00

OTHER PAYMENT CREDIT:

$0.00

REFUNDABLE EDUCATION CREDIT:

$0.00

REFUNDABLE EDUCATION CREDIT PER COMPUTER:

$0.00

REFUNDABLE EDUCATION CREDIT VERIFIED:

$0.00

EARNED INCOME CREDIT:

$0.00

EARNED INCOME CREDIT PER COMPUTER:

$0.00

EARNED INCOME CREDIT NONTAXABLE COMBAT PAY:

$0.00

8/9/2018

Page 5 of 6

SCHEDULE 8812

NONTAXABLE COMBAT PAY:

$0.00

EXCESS SOCIAL

SECURITY & RRTA TAX WITHHELD:

$0.00

SCHEDULE 8812

TOT SS/MEDICARE WITHHELD:

$0.00

SCHEDULE 8812

ADDITIONAL CHILD TAX CREDIT:

$0.00

SCHEDULE 8812

ADDITIONAL CHILD TAX CREDIT PER COMPUTER:

$0.00

SCHEDULE 8812

ADDITIONAL CHILD TAX CREDIT VERIFIED:

$0.00

AMOUNT PAID WITH FORM 4868:

$0.00

FORM 2439 REGULATED INVESTMENT COMPANY CREDIT:

$0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS:

$0.00

SAMPLE

$0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS PER COMPUTER:

HEALTH COVERAGE TX CR: F8885:

$0.00

PREMIUM TAX CREDIT AMOUNT:

$0.00

PREMIUM TAX CREDIT VERIFIED AMOUNT:

$0.00

PRIMARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT:

$0.00

SECONDARY NAP

FIRST TIME HOME BUYER INSTALLMENT AMT:

$0.00

FIRST TIME HOMEBUYER CREDIT REPAYMENT AMOUNT:

$0.00

FORM 5405 TOTAL HOMEBUYERS CREDIT REPAYMENT PER COMPUTER:

$0.00

SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER:

$0.00

SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER (2):

$0.00

FORM 2439 AND

OTHER CREDITS:

$0.00

TOTAL PAYMENTS:

$1,000.00

TOTAL PAYMENTS PER COMPUTER:

$1,000.00

Refund or Amount Owed

AMOUNT YOU OWE:

$103.00

APPLIED TO NEXT YEAR'S ESTIMATED TAX:

$0.00

ESTIMATED TAX PENALTY:

$0.00

TAX ON INCOME LESS STATE REFUND PER CO UTER:

$0.00

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

$103.00

BAL DUE/OVER PYMT USING CO PUTER FIGURES:

$103.00

FORM 8888 TOTAL REFUND PER CO PUTER:

$0.00

Third Party Designee

THIRD P RTY DESIGNEE ID NU BER:

 

AUTHORIZ TION INDIC TOR:

0

THIRD RTY DESIGNEE N ME:

 

Schedule C--Profit or Loss From Business

OCIAL

ECURITY NUMBER:

 

EMPLOYER

ID NUMBER:

 

BU INE

NAME:

 

DE CRIPTION OF BU INE /PROFESSION:

DRAK

NAICS CODE:

000000

ACCT MTHD:

 

FIR T TIME CHEDULE C FILED:

N

TATUTORY EMPLOYEE IND:

N

INCOME

GROSS RECEIPTS OR SALES:

$2,700.00

RETURNS AND ALLOWANCES:

$0.00

NET GROSS RECEIPTS:

$0.00

COST OF GOODS SOLD:

$0.00

SCHEDULE C FORM 1099 REQUIRED:

NONE

8/9/2018

Page 6 of 6

SCHEDULE C FORM 1099 FILED:

NONE

OTHER INCOME:

$0.00

EXPENSES

CAR AND TRUCK EXPENSES:

$0.00

DEPRECIATION:

$0.00

INSURANCE (OTHER THAN HEALTH):

$0.00

MORTGAGE INTEREST:

$0.00

LEGAL AND PROFESSIONAL SERVICES:

$0.00

SAMPLE

$0.00

REPAIRS AND MAINTENANCE:

TRAVEL:

$0.00

MEALS AND ENTERTAINMENT:

$0.00

WAGES:

$0.00

OTHER EXPENSES:

$0.00

TOTAL EXPENSES:

$200.00

EXP FOR BUSINESS USE OF HOME:

$0.00

SCH C NET PROFIT OR LOSS PER COMPUTER:

$2,500.00

AT RISK CD:

 

OFFICE EXPENSE AMOUNT:

$0.00

UTILITIES EXPENSE AMOUNT:

$0.00

COST OF GOODS SOLD

INVENTORY

AT

BEGINNING OF

YEAR:

$0.00

INVENTORY

AT

END OF YEAR:

 

$0.00

Schedule SE--Self-Employment Tax

SSN OF SELF-EMPLOYED TAXPAYER:

XXX-XX-5084

NET FARM PROFIT/LOSS: SCH F:

$0.00

CONSERVATION RESERVE PROGRAM PAY ENTS:

$0.00

NET NONFARM PROFIT/LOSS:

$2,500.00

TOTAL SE INCOME:

$2,500.00

SE QUARTERS COVERED:

4

TOTAL SE TAX PER COMPUTER:

$353.12

SE INCOME COMPUTER VERIFIED:

$0.00

SE INCOME PER COMPUTER:

$2,308.00

TOTAL NET E RNINGS PER CO PUTER:

$2,308.00

LONG FORM ONLY

TENTATIVE

CHURCH RNINGS:

$0.00

TOTAL SOC

SEC & RR W GES:

$0.00

E

T X

COMPUTER:

$286.19

E MEDIC RE INCOME PER COMPUTER:

$2,308.00

E MEDICARE TAX PER COMPUTER:

$66.93

E FARM OPTION METHOD U ED:

0

E OPTIONAL METHOD INCOME:

$0.00

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

PART III - ALLOWABLE EDUCATION CREDITS

GROSS EDUCATION CR PER COMPUTER:

$0.00

TOTAL EDUCATION CREDIT AMOUNT:

$0.00

TOTAL EDUCATION CREDIT AMOUNT PER COMPUTER:

$0.00

 

 

This Product Contains Sensitive Taxpayer Data

 

 

 

 

 

 

8/9/2018

Document Breakdown

Fact Name Description
Request Date The request for the tax return transcript was made on August 9, 2018.
Response Date The response to the request was also dated August 9, 2018.
Tax Period Ending This transcript reflects information for the tax period ending December 31, 2017.
Filing Status The taxpayer's filing status is recorded as Single.
Total Income The total income reported on the transcript is $15,500.00.
Adjusted Gross Income The adjusted gross income is shown as $15,323.00.
Total Payments Total payments made by the taxpayer amount to $1,000.00.
Amount Owed The taxpayer owes $103.00 as indicated on the transcript.
Tax Form Number The tax return transcript is based on Form 1040.
Third Party Designee No third-party designee is authorized according to this transcript.

Check out Other Forms

Misconceptions

Understanding the Sample Tax Return Transcript form is crucial for taxpayers. However, several misconceptions can lead to confusion. Below are eight common misconceptions along with clarifications.

  • Misconception 1: The Sample Tax Return Transcript shows all account activity.
  • This form only reflects the amounts as shown on the return and any adjustments made. It does not include subsequent activity on the account.

  • Misconception 2: The information is available to anyone.
  • The Sample Tax Return Transcript contains sensitive taxpayer data and is not accessible to the general public. Only authorized individuals can obtain it.

  • Misconception 3: The form is the same as a tax return.
  • While the transcript summarizes the information from the tax return, it is not a substitute for the actual tax return itself.

  • Misconception 4: All tax transcripts are identical.
  • There are different types of tax transcripts, such as Return Transcripts and Account Transcripts, each serving distinct purposes.

  • Misconception 5: You can use the transcript to file your taxes.
  • The Sample Tax Return Transcript is not intended for filing. It serves as a summary for reference purposes only.

  • Misconception 6: The transcript includes future tax liabilities.
  • The Sample Tax Return Transcript does not project future tax liabilities. It only provides information based on past filings.

  • Misconception 7: You can obtain a transcript instantly.
  • While some transcripts can be requested online, processing times may vary. It's important to allow adequate time for retrieval.

  • Misconception 8: The information is always accurate and final.
  • While the transcript is based on official records, errors can occur. Always verify the information against your records.

Documents used along the form

When dealing with your tax return, the Sample Tax Return Transcript form is just one piece of the puzzle. There are several other forms and documents that you might encounter during the tax preparation process. Each of these documents serves a specific purpose and can help clarify your financial situation or provide necessary information to the IRS. Here’s a list of commonly used forms that often accompany the tax return transcript.

  • Form 1040: This is the standard individual income tax return form used by U.S. taxpayers to report their income, deductions, and credits. It summarizes your financial situation for the tax year.
  • Schedule A: If you choose to itemize your deductions instead of taking the standard deduction, this form allows you to list various deductible expenses, such as mortgage interest, property taxes, and medical expenses.
  • Schedule C: For self-employed individuals, this form reports income and expenses from a business. It helps calculate your net profit or loss.
  • Form W-2: Employers provide this form to employees, detailing their annual wages and the taxes withheld. It’s essential for accurately reporting income on your tax return.
  • Form 1099: This series of forms reports various types of income other than wages, salaries, or tips. Different versions exist for specific types of income, such as freelance work or interest income.
  • Form 8862: If you’ve previously been denied the Earned Income Tax Credit (EITC), this form allows you to claim it again by proving your eligibility.
  • Form 8888: This form is used to allocate your tax refund to different accounts, such as savings or checking accounts, or to purchase U.S. savings bonds.
  • Form 4506-T: This form allows you to request a transcript of your tax return from the IRS, which can be useful for verifying income when applying for loans or mortgages.
  • Trailer Bill of Sale Form: To facilitate trailer ownership transfers, consult our complete guide on the trailer bill of sale to ensure proper documentation and compliance.
  • Form 1040-X: If you need to amend your tax return after filing, this form is used to make corrections or updates to your original return.

Understanding these forms can simplify your tax filing process and ensure you have everything you need for a smooth experience. Whether you're filing your taxes for the first time or are a seasoned filer, having the right documents at hand is crucial for accuracy and compliance.