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Comprehensive Module 1: Final Exam Scenario
Complete a tax return for Sherry Jackson.
Sherry Jackson (age 48, DOB: 1/27/75, SSN: 364-00-9945) is single. Her husband died on June 3, 2020.
Sherry is a paramedic. She would not like to designate $3 for the Presidential Election Campaign Fund.
Sherry was covered by a health insurance policy for the full year.
Sherry won $400 on a lottery scratch-off ticket.
Sherry has a savings account and received dividends from some stock that she owns.
a Employee’s SSN 1 Wages, tips, other compensation 2 Federal income tax withheld
364-00-9945 67650.75 9944.60
OMB No. 1545-0008 3 Social security wages 4 Social security tax withheld
67650.75 4194.35
b Employer identification number 5 Medicare wages and tips 6 Medicare tax withheld
53-0320644 67650.75 980.94
c Employer’s name address and ZIP code
FIRST EMERGENCY SERVICES, INC.
845 Lexington Ave.
Your City, Your State – Your ZIP
e Employee’s first name and initial Last name Suff.
Sherry Jackson
2604 New Circle Road
Your City, Your State – Your ZIP
f Employee’s address and ZIP code
d Control number 7 Social Security tips 8 Allocated tips
9 10 Dependent care benefits 11 Nonqualified plans
12a 14
12b
12c
12d
13 Statuary
employee Retirement
plan Third-party sick pay
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax
YS 530320644 67650.75 4282.54
18 Local wages, tips, etc. 19 Local income tax 20 Locality name
Form Wage and Tax Statement Copy B to be filed with employee’s Federal Income
W-2 20XX Tax Return
This information is being furnished to the Internal Revenue Service. If you are required to file a tax return, a negligence
penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.
Copyright
This study source © 2024, The
was downloaded by Income
1827175Tax
fromSchool, Inc. – All
cliffsnotes.com onRights Reserved
01-08-2026 16:00:03 GMT -06:00 Comp Module 1 FE Scenario - 1.1
https://www.cliffsnotes.com//study-notes/22467235
!*Comprehensive
&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
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,!*Comprehensive
&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
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CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP Payer’s RTN (optional) OMB No. 1545-0112
or foreign postal code, and telephone no.
Interest
Franklin Commerce Bank
P.O. Box 101035
1 Interest income XX Income
$ 89.33 Form 1099-INT
Your City, Your State – Your ZIP
2 Early withdrawal penalty
Copy B
PAYER’S federal identification number RECIPIENT’S identification number $
54-1438602 364-00-9945 3 Interest on U.S. Savings bonds and Treas. obligations
For Recipient
$
RECIPIENT’S name 4 Federal income tax withheld 5 Investment expenses This is important tax
information and is
Sherry Jackson being furnished to
$ $
6 Foreign tax paid 7 Foreign country or U.S. possession the Internal
Street address (including apt. no.) Revenue Service. If
2604 New Circle Road $ you are required to
file a
8 Tax-exempt interest 9 Specified private activity bond interest
return, a negligence
City or town, state or province, country and ZIP or foreign postal code penalty or other
Your City, Your State – Your ZIP sanction may be
imposed on you if
$ $ this income is
10 Market Discount 11 Bond premium
taxable and the IRS
FATCA filing determines that it
requirement has not been
$ $
□
reported.
12 Bond premium on Treasury 13 Bond premium on tax-exempt bond
obligations
$ $
Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld
bond CUSIP no. $
$
Form 1099-INT (keep for your records) www.irs.gov/form1099int Department of the Treasury – Internal Revenue Service
Copyright
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was downloaded by Income
1827175Tax
fromSchool, Inc. – All
cliffsnotes.com onRights Reserved
01-08-2026 16:00:03 GMT -06:00 Comp Module 1 FE Scenario - 1.2
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!*Comprehensive
&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
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Module 1 Final
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Exam
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M
Comprehensive Module 1: Final Exam Scenario
Complete a tax return for Sherry Jackson.
Sherry Jackson (age 48, DOB: 1/27/75, SSN: 364-00-9945) is single. Her husband died on June 3, 2020.
Sherry is a paramedic. She would not like to designate $3 for the Presidential Election Campaign Fund.
Sherry was covered by a health insurance policy for the full year.
Sherry won $400 on a lottery scratch-off ticket.
Sherry has a savings account and received dividends from some stock that she owns.
a Employee’s SSN 1 Wages, tips, other compensation 2 Federal income tax withheld
364-00-9945 67650.75 9944.60
OMB No. 1545-0008 3 Social security wages 4 Social security tax withheld
67650.75 4194.35
b Employer identification number 5 Medicare wages and tips 6 Medicare tax withheld
53-0320644 67650.75 980.94
c Employer’s name address and ZIP code
FIRST EMERGENCY SERVICES, INC.
845 Lexington Ave.
Your City, Your State – Your ZIP
e Employee’s first name and initial Last name Suff.
Sherry Jackson
2604 New Circle Road
Your City, Your State – Your ZIP
f Employee’s address and ZIP code
d Control number 7 Social Security tips 8 Allocated tips
9 10 Dependent care benefits 11 Nonqualified plans
12a 14
12b
12c
12d
13 Statuary
employee Retirement
plan Third-party sick pay
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax
YS 530320644 67650.75 4282.54
18 Local wages, tips, etc. 19 Local income tax 20 Locality name
Form Wage and Tax Statement Copy B to be filed with employee’s Federal Income
W-2 20XX Tax Return
This information is being furnished to the Internal Revenue Service. If you are required to file a tax return, a negligence
penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.
Copyright
This study source © 2024, The
was downloaded by Income
1827175Tax
fromSchool, Inc. – All
cliffsnotes.com onRights Reserved
01-08-2026 16:00:03 GMT -06:00 Comp Module 1 FE Scenario - 1.1
https://www.cliffsnotes.com//study-notes/22467235
!*Comprehensive
&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
Page 1 ofModule
510/16/2026,
1 Final 5:42:03
Exam Scenario
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Module 1 Final
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Exam
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Module 1 Final Exam Scenario Part 2.pdf10/1
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,!*Comprehensive
&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
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Module 1 Final
5:42:03
Exam
AM*&!#%#&&!%%#^#^&^!#&*^&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
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M
CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP Payer’s RTN (optional) OMB No. 1545-0112
or foreign postal code, and telephone no.
Interest
Franklin Commerce Bank
P.O. Box 101035
1 Interest income XX Income
$ 89.33 Form 1099-INT
Your City, Your State – Your ZIP
2 Early withdrawal penalty
Copy B
PAYER’S federal identification number RECIPIENT’S identification number $
54-1438602 364-00-9945 3 Interest on U.S. Savings bonds and Treas. obligations
For Recipient
$
RECIPIENT’S name 4 Federal income tax withheld 5 Investment expenses This is important tax
information and is
Sherry Jackson being furnished to
$ $
6 Foreign tax paid 7 Foreign country or U.S. possession the Internal
Street address (including apt. no.) Revenue Service. If
2604 New Circle Road $ you are required to
file a
8 Tax-exempt interest 9 Specified private activity bond interest
return, a negligence
City or town, state or province, country and ZIP or foreign postal code penalty or other
Your City, Your State – Your ZIP sanction may be
imposed on you if
$ $ this income is
10 Market Discount 11 Bond premium
taxable and the IRS
FATCA filing determines that it
requirement has not been
$ $
□
reported.
12 Bond premium on Treasury 13 Bond premium on tax-exempt bond
obligations
$ $
Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld
bond CUSIP no. $
$
Form 1099-INT (keep for your records) www.irs.gov/form1099int Department of the Treasury – Internal Revenue Service
Copyright
This study source © 2024, The
was downloaded by Income
1827175Tax
fromSchool, Inc. – All
cliffsnotes.com onRights Reserved
01-08-2026 16:00:03 GMT -06:00 Comp Module 1 FE Scenario - 1.2
https://www.cliffsnotes.com//study-notes/22467235
!*Comprehensive
&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*##(*0Comprehensive
Page 2 ofModule
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Exam Scenario
AM*&!#%#&&!%%#^#^&^!#&*^&^*#!(FG*T!^&*#*((*!#&()#_)#!*&$!*#)(!*Comprehensive
Part 2.pdf10/16/2026,
Module 1 Final
5:42:03
Exam
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