Form

1040 Department of the Treasury—Internal Revenue Service

U.S. Individual Income Tax Return

(99)
2014 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2014, or other tax year beginning , 2014, ending , 20 See separate instructions.
Your first name and initial Last name Your social security number

Trishla Shah 390-96-2558

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above
c
and on line 6c are correct.
8927 Willmon Way
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign
Windcrest TX 78239 Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign country name Foreign province/state/county Foreign postal code
a box below will not change your tax or
refund. You Spouse

1 Single 4 Head of household (with qualifying person). (See instructions.) If

Filing Status
2 Married filing jointly (even if only one had income) the qualifying person is a child but not your dependent, enter this
Check only one 3 Married filing separately. Enter spouse’s SSN above child’s name here. a
box. and full name here. a 5 Qualifying widow(er) with dependent child

Exemptions 6a
b
Yourself. If someone can claim you as a dependent, do not check box 6a .
Spouse . . . . . . . . . . . . . . . . . . . .
.
.
.
.
.
.
.
.
} Boxes checked
on 6a and 6b
No. of children
1
c Dependents: (2) Dependent’s (3) Dependent’s (4)  if child under age 17 on 6c who:
social security number relationship to you qualifying for child tax credit • lived with you
(1) First name Last name (see instructions) • did not live with
you due to divorce
or separation
If more than four (see instructions)
dependents, see Dependents on 6c
instructions and not entered above
check here a Add numbers on
d Total number of exemptions claimed . . . . . . . . . . . . . . . . . lines above a 1
7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7 35,590.
Income
8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a 125.
b Tax-exempt interest. Do not include on line 8a . . . 8b
Attach Form(s)
9a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a
W-2 here. Also
attach Forms b Qualified dividends . . . . . . . . . . . 9b
W-2G and 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10
1099-R if tax 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11
was withheld.
12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12
13 Capital gain or (loss). Attach Schedule D if required. If not required, check here a 13
If you did not 14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14
get a W-2,
see instructions. 15a IRA distributions . 15a b Taxable amount . . . 15b
ROLLOVER 16a Pensions and annuities 16a 9,811. b Taxable amount . . . 16b 8,761.
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . 19
20a Social security benefits 20a b Taxable amount . . . 20b
21 Other income. List type and amount 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income a 22 44,476.
23 Educator expenses . . . . . . . . . . . 23
Adjusted 24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24
Income 25 Health savings account deduction. Attach Form 8889 . 25
26 Moving expenses. Attach Form 3903 . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE . 27
28 Self-employed SEP, SIMPLE, and qualified plans . . 28
29 Self-employed health insurance deduction . . . . 29
30 Penalty on early withdrawal of savings . . . . . . 30
31a Alimony paid b Recipient’s SSN a 31a
32 IRA deduction . . . . . . . . . . . . . 32 1,050.
33 Student loan interest deduction . . . . . . . . 33 63.
34 Tuition and fees. Attach Form 8917 . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903 35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 1,113.
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . a 37 43,363.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA REV 12/31/14 Intuit.cg.cfp.sp Form 1040 (2014)
Form 1040 (2014) Page 2
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . 38 43,363.
Tax and
Credits
39a Check
if:
{ You were born before January 2, 1950,
Spouse was born before January 2, 1950,
Blind.
Blind.
} Total boxes
checked a 39a
b If your spouse itemizes on a separate return or you were a dual-status alien, check here a 39b
Standard 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . 40 6,200.
Deduction 37,163.
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41
• People who 42 Exemptions. If line 38 is $152,525 or less, multiply $3,950 by the number on line 6d. Otherwise, see instructions 42 3,950.
check any
box on line 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . 43 33,213.
39a or 39b or 44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44 4,530.
who can be
claimed as a 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . 45
dependent,
see 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . 46
instructions. 47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . a 47 4,530.
• All others:
48 Foreign tax credit. Attach Form 1116 if required . . . . 48
Single or
Married filing 49 Credit for child and dependent care expenses. Attach Form 2441 49
separately,
$6,200 50 Education credits from Form 8863, line 19 . . . . . 50
Married filing 51 Retirement savings contributions credit. Attach Form 8880 51
jointly or
Qualifying 52 Child tax credit. Attach Schedule 8812, if required . . . 52
widow(er), 53 Residential energy credits. Attach Form 5695 . . . . 53
$12,400
Head of 54 Other credits from Form: a 3800 b 8801 c 54
household, 55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . 55
$9,100
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . a 56 4,530.
57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . 57
Other 58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 58
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . 59 605.
Taxes 60a Household employment taxes from Schedule H . . . . . . . . . . . . . . 60a
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . 60b
61 Health care: individual responsibility (see instructions) Full-year coverage . . . . . 61
62 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 62
63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . a 63 5,135.
Payments 64 Federal income tax withheld from Forms W-2 and 1099 . . 64 5,664.
65 2014 estimated tax payments and amount applied from 2013 return 65
If you have a
66a Earned income credit (EIC) . . . . . . . . . . 66a
qualifying
child, attach b Nontaxable combat pay election 66b
Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 . . . . . 67
68 American opportunity credit from Form 8863, line 8 . . . 68
69 Net premium tax credit. Attach Form 8962 . . . . . . 69
70 Amount paid with request for extension to file . . . . . 70
71 Excess social security and tier 1 RRTA tax withheld . 71. . .
72 Credit for federal tax on fuels. Attach Form 4136 . 72. . .
73 Credits from Form: a 2439 b Reserved c Reserved d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . a 74 5,664.
Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 75 529.
76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . a 76a 529.
a
bRouting number 2 7 5 9 7 9 0 7 6 a c Type: Checking Savings
Direct deposit?
See a dAccount number 5 3 9 5 6 3 0 3
instructions.
77 Amount of line 75 you want applied to your 2015 estimated tax a 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions a 78
You Owe 79 Estimated tax penalty (see instructions) . . . . . . . 79
Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No
Designee’s Phone Personal identification
Designee name a no. a number (PIN) a

Sign 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 belief,
they are true, correct, and complete. Declaration 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
F

Joint return? See

instructions. Disability Rights (414)202-3135
Keep a copy for Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protection
your records. PIN, enter it
here (see inst.)
Print/Type preparer’s name Preparer’s signature Date PTIN
Paid Check if
self-employed
Preparer
Use Only Firm’s name a Self-Prepared Firm's EIN a

Firm’s address a Phone no.

www.irs.gov/form1040 REV 12/31/14 Intuit.cg.cfp.sp Form 1040 (2014)
Form 5329 Additional Taxes on Qualified Plans OMB No. 1545-0074

(Including IRAs) and Other Tax-Favored Accounts

2014
a Attach to Form 1040 or Form 1040NR.
Department of the Treasury Attachment
Internal Revenue Service (99) a Information about Form 5329 and its separate instructions is at www.irs.gov/form5329. Sequence No. 29
Name of individual subject to additional tax. If married filing jointly, see instructions. Your social security number
Trishla Shah 390-96-2558
Home address (number and street), or P.O. box if mail is not delivered to your home Apt. no.

Fill in Your Address Only F City, town or post office, state, and ZIP code. If you have a foreign address, also complete
If You Are Filing This the spaces below (see instructions).
Form by Itself and Not If this is an amended
With Your Tax Return return, check here a
Foreign country name Foreign province/state/county Foreign postal code

If you only owe the additional 10% tax on early distributions, you may be able to report this tax directly on Form 1040, line 59, or
Form 1040NR, line 57, without filing Form 5329. See the instructions for Form 1040, line 59, or for Form 1040NR, line 57.
Part I Additional Tax on Early Distributions
Complete this part if you took a taxable distribution before you reached age 59½ from a qualified retirement plan (including an
IRA) or modified endowment contract (unless you are reporting this tax directly on Form 1040 or Form 1040NR—see above). You
may also have to complete this part to indicate that you qualify for an exception to the additional tax on early distributions or for
certain Roth IRA distributions (see instructions).
1 Early distributions included in income. For Roth IRA distributions, see instructions . . . . . . 1 8,761.
2 Early distributions included on line 1 that are not subject to the additional tax (see instructions).
Enter the appropriate exception number from the instructions: 05 . . . . . . . . . 2 2,716.
3 Amount subject to additional tax. Subtract line 2 from line 1 . . . . . . . . . . . . . 3 6,045.
4 Additional tax. Enter 10% (.10) of line 3. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 4 605.
Caution: If any part of the amount on line 3 was a distribution from a SIMPLE IRA, you may have
to include 25% of that amount on line 4 instead of 10% (see instructions).
Part II Additional Tax on Certain Distributions From Education Accounts
Complete this part if you included an amount in income, on Form 1040 or Form 1040NR, line 21, from a Coverdell
education savings account (ESA) or a qualified tuition program (QTP).
5 Distributions included in income from Coverdell ESAs and QTPs . . . . . . . . . . . . 5
6 Distributions included on line 5 that are not subject to the additional tax (see instructions) . . . 6
7 Amount subject to additional tax. Subtract line 6 from line 5 . . . . . . . . . . . . . 7
8 Additional tax. Enter 10% (.10) of line 7. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 8
Part III Additional Tax on Excess Contributions to Traditional IRAs
Complete this part if you contributed more to your traditional IRAs for 2014 than is allowable or you had an amount on line
17 of your 2013 Form 5329.
9 Enter your excess contributions from line 16 of your 2013 Form 5329 (see instructions). If zero, go to line 15 9
10 If your traditional IRA contributions for 2014 are less than your
maximum allowable contribution, see instructions. Otherwise, enter -0- 10
11 2014 traditional IRA distributions included in income (see instructions) . 11
12 2014 distributions of prior year excess contributions (see instructions) . 12
13 Add lines 10, 11, and 12 . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Prior year excess contributions. Subtract line 13 from line 9. If zero or less, enter -0- . . . . . 14
15 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 15
16 Total excess contributions. Add lines 14 and 15 . . . . . . . . . . . . . . . . . 16
17 Additional tax. Enter 6% (.06) of the smaller of line 16 or the value of your traditional IRAs on December 31, 2014
(including 2014 contributions made in 2015). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 . 17
Part IV Additional Tax on Excess Contributions to Roth IRAs
Complete this part if you contributed more to your Roth IRAs for 2014 than is allowable or you had an amount on line 25 of your 2013 Form 5329.
18 Enter your excess contributions from line 24 of your 2013 Form 5329 (see instructions). If zero, go to line 23 18
19 If your Roth IRA contributions for 2014 are less than your maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . 19
20 2014 distributions from your Roth IRAs (see instructions) . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Prior year excess contributions. Subtract line 21 from line 18. If zero or less, enter -0- . . . . . 22
23 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 23
24 Total excess contributions. Add lines 22 and 23 . . . . . . . . . . . . . . . . . 24
25 Additional tax. Enter 6% (.06) of the smaller of line 24 or the value of your Roth IRAs on December 31, 2014
(including 2014 contributions made in 2015). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 25
For Privacy Act and Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 01/07/15 Intuit.cg.cfp.sp Form 5329 (2014)
Form 5329 (2014) Page 2
Part V Additional Tax on Excess Contributions to Coverdell ESAs
Complete this part if the contributions to your Coverdell ESAs for 2014 were more than is allowable or you had an amount
on line 33 of your 2013 Form 5329.
26 Enter the excess contributions from line 32 of your 2013 Form 5329 (see instructions). If zero, go to line 31 26
27 If the contributions to your Coverdell ESAs for 2014 were less than the
maximum allowable contribution, see instructions. Otherwise, enter -0- 27
28 2014 distributions from your Coverdell ESAs (see instructions) . . . 28
29 Add lines 27 and 28 . . . . . . . . . . . . . . . . . . . . . . . . . . 29
30 Prior year excess contributions. Subtract line 29 from line 26. If zero or less, enter -0- . . . . . 30
31 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 31
32 Total excess contributions. Add lines 30 and 31 . . . . . . . . . . . . . . . . . 32
33 Additional tax. Enter 6% (.06) of the smaller of line 32 or the value of your Coverdell ESAs on
December 31, 2014 (including 2014 contributions made in 2015). Include this amount on Form
1040, line 59, or Form 1040NR, line 57 . . . . . . . . . . . . . . . . . . . . 33
Part VI Additional Tax on Excess Contributions to Archer MSAs
Complete this part if you or your employer contributed more to your Archer MSAs for 2014 than is allowable or you had an
amount on line 41 of your 2013 Form 5329.
34 Enter the excess contributions from line 40 of your 2013 Form 5329 (see instructions). If zero, go to line 39 34
35 If the contributions to your Archer MSAs for 2014 are less than the
maximum allowable contribution, see instructions. Otherwise, enter -0- 35
36 2014 distributions from your Archer MSAs from Form 8853, line 8 . . 36
37 Add lines 35 and 36 . . . . . . . . . . . . . . . . . . . . . . . . . . 37
38 Prior year excess contributions. Subtract line 37 from line 34. If zero or less, enter -0- . . . . . 38
39 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 39
40 Total excess contributions. Add lines 38 and 39 . . . . . . . . . . . . . . . . . 40
41 Additional tax. Enter 6% (.06) of the smaller of line 40 or the value of your Archer MSAs on
December 31, 2014 (including 2014 contributions made in 2015). Include this amount on Form
1040, line 59, or Form 1040NR, line 57 . . . . . . . . . . . . . . . . . . . . 41
Part VII Additional Tax on Excess Contributions to Health Savings Accounts (HSAs)
Complete this part if you, someone on your behalf, or your employer contributed more to your HSAs for 2014 than is
allowable or you had an amount on line 49 of your 2013 Form 5329.
42 Enter the excess contributions from line 48 of your 2013 Form 5329. If zero, go to line 47 . . . 42
43 If the contributions to your HSAs for 2014 are less than the maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . 43
44 2014 distributions from your HSAs from Form 8889, line 16 . . . . 44
45 Add lines 43 and 44 . . . . . . . . . . . . . . . . . . . . . . . . . . 45
46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0- . . . . . 46
47 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 47
48 Total excess contributions. Add lines 46 and 47 . . . . . . . . . . . . . . . . . 48
49 Additional tax. Enter 6% (.06) of the smaller of line 48 or the value of your HSAs on December 31, 2014
(including 2014 contributions made in 2015). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 49
Part VIII Additional Tax on Excess Accumulation in Qualified Retirement Plans (Including IRAs)
Complete this part if you did not receive the minimum required distribution from your qualified retirement plan.
50 Minimum required distribution for 2014 (see instructions) . . . . . . . . . . . . . . 50
51 Amount actually distributed to you in 2014 . . . . . . . . . . . . . . . . . . . 51
52 Subtract line 51 from line 50. If zero or less, enter -0- . . . . . . . . . . . . . . . 52
53 Additional tax. Enter 50% (.50) of line 52. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 53
Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my
Sign Here Only If You knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which
preparer has any knowledge.
Are Filing This Form by
Itself and Not With Your
F

Tax Return
Your signature Date
Print/Type preparer’s name Preparer's signature Date PTIN
Paid Check if
self-employed
Preparer
Firm’s name a Firm's EIN a
Use Only
Firm's address a Phone no.
Form 5329 (2014)
REV 01/07/15 Intuit.cg.cfp.sp
 1NPR For the year Jan. 1-Dec. 31, 2014, or other tax year
2014
Nonresident & part-year resident
Wisconsin income tax beginning , 2014 ending , 20 .
Check here if this is an amended return Complete form using BLACK INK
DO NOT STAPLE

Your legal last name Legal first name M.I. Your social security number
SHAH TRISHLA 390962558
If a joint return, spouse’s legal last name Spouse’s legal first name M.I. Spouse’s social security number

Home address (number and street). If you have a PO Box, see page 7 Apt. no. Tax district
8927 WILLMON WAY Check below then fill in either the name of Wisconsin city,
City or post office State Zip code village, or town, and the county in which you lived at the
end of 2014 or before leaving Wisconsin (nonresidents
WINDCREST TX 78239 leave blank).
Filing status Special X City Village Town
conditions City, village,
X Single
or town BROOKFIELD
PAPER CLIP withholding statements here

Married filing joint return

Legal last name
(even if only one had income) County of WAUKESHA
Married filing separate return.
Legal first name M.I.
Fill in spouse’s SSN above School district number See page 41 0714
and full name here ................
Head of household (with
qualifying person), (see page 8).
Also, check here if married....

Resident status Check the status that applies

You Spouse
Full-year resident of Wisconsin
Nonresident of Wisconsin; state of residence (2-letter state abbreviation)
X Part-year resident of Wisconsin from 01 01 2014 to 12 03 2014 Note: Complete residence questionnaire, page 49.
mm dd yyyy mm dd yyyy

Print numbers like this  NO COMMAS

Income Not like this  NO CENTS A. Federal column B. Wisconsin column

1 Wages, salaries, tips, etc. (see page 10) . . . . . . . . . . . . . . . . . . . . . . . . . 1 35590 .00 35590 .00
2 Taxable interest (see page 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 125 .00 0 .00
3 Ordinary dividends (see page 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 .00 0 .00
4 Taxable refunds, credits, or offsets of state and local income taxes
(from federal Form 1040, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .00 Not taxable
5 Alimony received (see page 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 .00 0 .00
PAPER CLIP check or money order here

6 Business income or (loss) (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . 6 .00 .00

7 Capital gain or (loss) (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 .00 .00
8 Other gains or (losses) (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 .00 .00
9 IRA distributions (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 .00 0 .00
10 Pensions and annuities (see page 13) . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 8761 .00 0 .00
11 Rental real estate, royalties, partnerships, S corporations, trusts, etc.
(see page 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 .00 .00
12 Farm income or (loss) (see page 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 .00 .00
13 Unemployment compensation (see page 15) . . . . . . . . . . . . . . . . . . . . . 13 .00 0 .00
14 Social security benefits (see page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 .00 Not taxable
15 Other income (see pages 16-22). Enclose Schedule M MEDICAL CA 15
. . . . . . . . . . . . . .00 -778 .00
44476 .00 34812 .00
I-050i

16 Add lines 1 through 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

INTUIT REV 11/24/14 INTUIT.CG.CFP.SP

2014 Form 1NPR Name TRISHLA SHAH SSN 390962558 Page 2 of 4
Adjustments to Income A. Federal column B. Wisconsin column
17 Reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Not deductible for Wisconsin
18 Certain business expenses of reservists, performing artists, and
fee-basis government officials (see page 22) . . . . . . . . . . . . . . . . . . . . . 18 .00 .00
19 Health savings account deduction (see page 22) . . . . . . . . . . . . . . . . . . 19 .00 .00
20 Moving expenses (see page 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 .00 .00
21 Deductible part of self-employment tax (see page 22). . . . . . . . . . . . . . . . 21 .00 .00
22 Self-employed SEP, SIMPLE, and qualified plans (see page 22) . . . . . . 22 .00 .00
23 Self-employed health insurance deduction (see page 23) . . . . . . . . . . . . 23 .00 .00
24 Penalty on early withdrawal of savings (see page 23) . . . . . . . . . . . . . . . . 24 .00 0 .00
25 Alimony paid (see page 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 .00 .00
26 IRA deduction (see page 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 1050 .00 0 .00
27 Student loan interest deduction (see page 23) . . . . . . . . . . . . . . . . . . . . 27 63 .00 63 .00
28 Reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Not deductible for Wisconsin
29 Domestic production activities deduction (see page 23) . . . . . . . . . . . . . 29 Not deductible for Wisconsin
30 Other adjustments included in Form 1040, line 36 (see page 23)
(list type and amount) 30 .00 .00
31 Total adjustments to income. Add lines 17 through 30 . . . . . . . . . . . . . . 31 1113 .00 63 .00
Adjusted Gross Income
32 Wisconsin income. Subtract line 31, column B from line 16, column B . . 32 34749 .00
33 Federal income. Subtract line 31, column A from line 16, column A . . . . 33 43363 .00
34 Divide line 32 by line 33. Carry the decimal to four places. If amount
on line 32 is more than amount on line 33, fill in 1.0000. (See page 23) . 34 .8014
Tax Computation
35 Fill in the larger of Wisconsin income from line 32, column B or federal income from line 33,
column A. But, if Wisconsin income from line 32 is zero or less, fill in 0 (zero) . . . . . . . . . . . . . . 35 43363 .00
36a If you (or your spouse) can be claimed as a dependent on anyone else’s return, check here
and see the “Exception” in the instructions for line 36c on page 24 . . . . . . . . . . . . . . . . . . . . . . . 36a
36b Aliens (see page 24 to determine if you must check line 36b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36b
36c Find the standard deduction for amount on line 33 using table on page 39 . . . . . . . . . . . . . . . . . 36c 6634 .00
37 Subtract line 36c from line 35. If line 36c is more than line 35, fill in 0 (zero) . . . . . . . . . . . . . . . . 37 36729 .00
38 Exemptions (Caution: see page 24)
a Fill in exemptions from your federal return 1 x $700 . . .38a 700 .00
b Check if 65 or older You + Spouse = x $250 . . 38b .00
c Add lines 38a and 38b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38c 700 .00
39 Subtract line 38c from line 37. If line 38c is more than line 37, fill in 0 (zero) . . . . . . . . . . . . . . . . . 39 36029 .00
40 Tax (see table on page 42) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 1966 .00
41 Itemized deduction credit. Complete Schedule 1 (page 4, Form 1NPR) . . . . 41 0 .00
42 School property tax credits (part-year and full-year residents only)
a Rent paid in 2014–heat included
Rent paid in 2014–heat not included
.00
2463 .00 } Find credit from
table page 26 . . . . 42a 74 .00
Find credit from
b Property taxes paid on home in 2014 .00 table page 27 . . . . 42b .00
43 Add credits on lines 41, 42a, and 42b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 74 .00
44 Subtract line 43 from line 40. If line 43 is more than line 40, fill in 0 (zero) . . . . . . . . . . . . . . . . . . 44 1892 .00
45 Fill in ratio from line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 .8014
46 Multiply line 44 by ratio on line 45 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 1516 .00

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 2014 Form 1NPR Page 3 of 4
Name(s) shown on Form 1NPR Your social security number
TRISHLA SHAH 390962558
47 Fill in amount from line 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 1516 .00
48 Armed forces member credit. (Full-year Wisconsin residents only) . . . . 48 .00
49 Working families tax credit. (Full-year Wisconsin residents only) . . . . . . 49 .00
50 Certain nonrefundable credits from line 11 of Schedule CR . . . . . . . . . . . 50 .00
51 Add lines 48 through 50 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 .00
52 Subtract line 51 from line 47. If line 51 is more than line 47, fill in 0 (zero) . . . . . . . . . . . . . . . . . . . 52 1516 .00
53 Alternative minimum tax. Enclose Schedule MT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 0 .00
54 Add lines 52 and 53 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 1516 .00
55 Married couple credit. Complete Schedule 2 (page 4, Form 1NPR) . . . . 55 .00
56 Other credits from Schedule CR, line 34. Enclose Schedule CR . . . . . . 56 .00
57 Net income tax paid to another state. Enclose Schedule OS . . . 57 .00
58 Add lines 55, 56, and 57 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 .00
59 Subtract line 58 from line 54. If line 58 is more than line 54, fill in 0 (zero). This is your net tax . . 59 1516 .00
60 Sales and use tax due on Internet, mail order, or other out-of-state purchases (see page 30) . . . 60 .00
If you certify that no sales or use tax is due, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . X
61 Donations (decreases refund or increases amount owed)
a Endangered resources .00 f Firefighters memorial . . . . . . . .00
b Packers football stadium .00 g Military family relief . . . . . . . . .00
c Cancer research . . . . . . .00 h Second Harvest/Feeding Amer. .00
d Veterans
. . . .trust fund .00 i Red Cross WI Disaster Relief .00
e Multiple
. . . . . .
sclerosis .00 j Special Olympics Wisconsin . .00
Total (add lines a through j) . . . 61k .00
62 Penalties on IRAs, other retirement plans, MSAs, etc. (see page 31) 605 .00 x .33 = 62 200 .00
63 Credit repayments and other penalties (see page 31) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 .00
64 Add lines 59 through 63 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 1716 .00

Payments and Credits

65 Wisconsin income tax withheld. Enclose readable withholding statements . . 65 2189 .00
66 2014 Wisconsin estimated tax paid and amount applied from 2013 return . . 66 .00
67 Earned income credit. (Full-year Wisconsin residents only)
Number of qualifying children
Federal credit . . . . . . . . . . . . . . . . . . . . . .00 x % = 67 .00
68 Farmland preservation credit. a. Schedule FC, line 18 . . . . . . . . . . . . . . . 68a .00
b. Schedule FC-A, line 13 . . . . . . . . . . . . . 68b .00
69 Repayment credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 .00
70 Homestead credit. (Full-year Wisconsin residents only) . . . . . . . . . . . . . . . 70 .00
71 Eligible veterans and surviving spouses property tax credit . . . . . . . . . . . . 71 .00
72 Refundable credits from Schedule CR, line 38 . . . . . . . . . . . . . . . . . . . . . . 72 .00
73 AMENDED RETURN ONLY – amount previously paid (see page 34) . . . . . . 73 .00
74 Add lines 65 through 73 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 2189 .00
75 AMENDED RETURN ONLY – amounts previously refunded (see page 34) . 75 .00
76 Subtract line 75 from line 74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 2189 .00
I-050ai

INTUIT REV 11/24/14 INTUIT.CG.CFP.SP

 Paper clip a copy of your federal income
2014 Form 1NPR tax return and schedules to this return. SSN 390962558 Page 4 of 4
Refund or Amount You Owe
77 If line 76 is more than line 64, subtract line 64 from line 76. This is the AMOUNT OVERPAID . . . 77 473 .00
78 Amount of line 77 you want REFUNDED TO YOU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 473 .00
79 Amount of line 77 to be APPLIED TO YOUR 2015 ESTIMATED TAX . . . . 79 0 .00
80 If line 76 is less than line 64, subtract line 76 from line 64 . . . . This is the AMOUNT YOU OWE  80 .00
81 Underpayment interest. Fill in exception code – see Sch. U  81 .00
Also include on line 80 (see page 36).

Third Do you want to allow another person to discuss this return with the department (see page 36)? Yes Complete the following. X No
Party Designee’s Phone
Personal
identification
Designee name no. number (PIN)

Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.
Your signature Spouse’s signature (if filing jointly, BOTH must sign) Date
Sign
here
For Department
Mail your return to: Wisconsin Department of Revenue Use Only
(if tax is due) (if refund or no tax due) (if amended return) C
PO Box 268 PO Box 59 PO Box 8991
Madison WI 53790-0001 Madison WI 53785-0001 Madison WI 53708-8991

Schedule 1 – Wisconsin Itemized Deduction Credit (see line 41 instructions)

1 Medical and dental expenses from line 4, federal Schedule A. See instructions for exceptions . . . . 1 .00
2 Interest paid from lines 10‑12 and 14, federal Schedule A. See instructions for exceptions . . . . . . . 2 .00
3 Gifts to charity from line 19, federal Schedule A. See instructions for exceptions . . . . . . . . . . . . . . 3 3005 .00
4 Casualty losses from line 20, federal Schedule A only if the loss is directly related to a
federally-declared disaster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .00
5 Add lines 1 through 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3005 .00
6a Wisconsin standard deduction from Form 1NPR, line 36c . . . . . . . . . . . . . . . 6a 6634 .00
6b Ratio from Form 1NPR, line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6b .8014
6c Multiply line 6a by ratio on line 6b. Fill in the result on line 6c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6c 5316 .00
7 Subtract line 6c from line 5. If line 6c is more than line 5, fill in 0 (zero) . . . . . . . . . . . . . . . . . . . . . . 7 0 .00
8 Rate of credit is .05 (5%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 x .05
9 Multiply line 7 by line 8. Fill in here and on line 41 of Form 1NPR . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 0 .00

Schedule 2 – Married Couple Credit May be claimed only when both spouses have earned income taxable by Wisconsin.
(A) YOURSELF (B) YOUR SPOUSE
1 Wages, salaries, tips, etc., included in column B of line 1 on Form 1NPR.
Do not include deferred compensation (even though reported on a W‑2) or
taxable scholarships or fellowships not reported on a W‑2 . . . . . . . . . . . . . . 1 .00 .00
2 Net profit or (loss) from self-employment from federal Schedules C, C-EZ,
and F (Form 1040), Schedule K-1 (Form 1065), and any other taxable self-
employment or earned income included in column B on Form 1NPR . . . . . . 2 .00 .00
3 Combine lines 1 and 2. This is your total Wisconsin earned income. . . . . . . 3 .00 .00
4 Add amounts on Form 1NPR, lines 18, 22, 26, and 30, column B. Fill in the
total of these adjustments that apply to your or your spouse’s earned income. 4 .00 .00
5 Subtract line 4 from line 3. This is your qualified earned income. . . . . . . . . . 5 .00 .00
6 Compare the amount in columns (A) and (B) of line 5. Fill in the
smaller amount here. If more than $16,000, fill in $16,000. . . . . . . . . . . . . . . . . . . . . . . . . . . 6 .00
7 Rate of credit is .03 (3%). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 x .03
8 Multiply line 6 by line 7. Round the result and fill in here and on line 55 of Form 1NPR.
Do not fill in more than $480. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 .00

INTUIT REV 11/24/14 INTUIT.CG.CFP.SP

 LEGAL RESIDENCE (DOMICILE) QUESTIONNAIRE
Your answers to these questions will be used to determine your legal residence. Certain types of income are either taxable or nontaxable
to Wisconsin based upon whether you were a legal resident of Wisconsin at the time you received such income. Form 1NPR may be
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to submit additional information, enclose an additional sheet describing your particular circumstances.

NAME(S) TRISHLA SHAH SOCIAL SECURITY NUMBER 390962558

Please 9RQH ,IPDUULHG¿OLQJMRLQWUHWXUQFKHFNRQHER[IRUHDFKVSRXVH

You Spouse
Full-year Wisconsin resident; did not change domicile from Wisconsin during 2014.
X Changed legal residence from Wisconsin during 2014; have not moved back to Wisconsin.
Changed legal residence from Wisconsin during or before 2014; have moved back to Wisconsin.
Changed legal residence to Wisconsin from (state) on (date) during
2014; no previous Wisconsin residency. If you check this box, do not complete the rest of the questionnaire.
Was a nonresident of Wisconsin for all of 2014. Resident of
(Nonresident alien; please indicate country)

If you changed your legal residence from Wisconsin during 2013 or 2014 and you did not previously complete a questionnaire
for that change, answer the following questions.
1. a. On what date did you move from Wisconsin?
b. When you moved from Wisconsin, did you intend to move back to Wisconsin? If yes, when?
c. If you moved back to Wisconsin, indicate date and explain the circumstances under which you moved back to Wisconsin.

2. Did you establish a legal residence in another state? If yes, in which state and on what date?

3. After establishing legal residency in the new state, list the dates you were in Wisconsin.
4. When were you physically present in your new state of legal residence (please list dates)?
5. Did your spouse and dependent children (if any) move to your new state of legal residence? If yes, when?
6. a. On what date did you begin working in your new state of legal residence?
b. Was your job permanent, temporary, or seasonal? Check one and explain

7. In your new state of legal residence, referred to in question 2, did you:

a. Register to vote? If yes, when? If no, why not?
b. Purchase a home? If yes, when? If no, why not?
c. Obtain a driver’s license? If yes, when? If no, why not?
d. Register an auto or other vehicle? If yes, when? If no, why not?
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8. Since changing your legal residence from Wisconsin, have you:
a. Performed services for income in Wisconsin? If yes, when?
b. Purchased/renewed Wisconsin auto license plates? If yes, when?
c. Renewed a Wisconsin driver’s license? If yes, when?
d. Voted in Wisconsin, in person or by absentee ballot? If yes, when?
e. Attended or sent your children to Wisconsin schools? If yes, when?
  I 3XUFKDVHGD:LVFRQVLQUHVLGHQWKXQWLQJ¿VKLQJRUWUDSSLQJOLFHQVH" ,I\HVZKHQ"
Type of license? County purchased in?
g. Listed Wisconsin as your state of legal residence for purposes of your auto insurance?
h. Listed Wisconsin as your state of legal residence for purposes of your will?
i. Listed Wisconsin as your state of legal residence for purposes of any legal proceedings? If yes, when?
j. Obtained or renewed any Wisconsin trade or professional licenses or union memberships? If yes, when?
9. If you answered “yes” to any of the questions 8a through 8j, please explain why you have taken such action.

10. Did you or your spouse own the real estate you occupied as your home while living in Wisconsin? If yes, have you
disposed of it? If yes, when? If you still own the Wisconsin home, what use do you make of it and
how often?
11. If you established a legal residence in a new state but are using a Wisconsin address on your 2014 tax returns, please explain.
I-151 Legal Residence Questionnaire
REV 11/12/14 INTUIT.CG.CFP.SP
INTUIT
SCHEDULE
Wisconsin
M Form 1NPR –
Additions to and Subtractions from Income 2014
Department of Revenue
Name Social security number

TRISHLA SHAH 390962558

See the instructions for line 15 of Form 1NPR for further information on the additions and subtractions
that may be necessary to compute Wisconsin income.

Additions to Income
1 Income from line 21 of federal Form 1040 Nonresidents – fill in any other income
from line 21 of federal Form 1040 that you received from Wisconsin sources.
Part-year and full-year residents – Figure the amount of any other income from
line 21 of federal Form 1040 you received while a Wisconsin resident. Add to that
figure any other income you received from Wisconsin sources while a nonresident
(Note: If the amount you would enter on line 1 is a negative number, enter the
amount on line 19 as a positive number instead.) . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 .00
2 Farmland preservation credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 .00
3 Enterprise zone jobs credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 .00
4 Development zones credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 .00
5 Technology zones credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 .00
6 Manufacturing investment credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 .00
7 Economic development tax credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 .00
8 Jobs tax credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 .00
9 Woody biomass harvesting and processing credit . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 .00
10 Community rehabilitation program credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 .00
11 Research expense credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 .00
12 Manufacturing / Agriculture credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 .00
13 Federal net operating loss carryover (only if included on line 1 or 31 of this schedule) . . 13 .00
14 Passive foreign investment company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 .00
15 Addition for certain expenses paid to related entities . . . . . . . . . . . . . . . . . . . . . . . . 15 .00
16 Distributions from EdVest and Tomorrow’s Scholar accounts . . . . . . . . . . . . . . . . . . 16 .00
17 Addition for difference in federal and Wisconsin basis of assets . . . . . . . . . . . . . . . . 17 .00

18 Add lines 1 through 17. This is your total additions to income . . . . . . . . . . . . . . . . . . 18 .00

Now go to page 2  

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I-053i
2014 Schedule M Page 2 of 2
Name Social security number

TRISHLA SHAH 390962558

Subtractions from Income
19 See line 1 on page 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 .00
20 Farm loss carryover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 .00
21 Recoveries of federal itemized deductions (only if included on line 1 or 19 of this schedule) . 21 .00
22 Wisconsin net operating loss carryforward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 .00
23 Medical care insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 778 .00
24 Long-term care insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 .00
25 Retirement income exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 .00
26 Amounts not taxable by Wisconsin (only if included in column B of Form 1NPR or
line 1 or 19 of this schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 .00
27 Adoption expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 .00
28 Tuition and fee expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 .00
29 Contributions to a Wisconsin state-sponsored college savings program . . . . . . . . . . 29 .00
30 Child and dependent care expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 .00
31 Distributions from Wisconsin state-sponsored college tuition program
(only if included on line 1 or 19 of this schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 .00
32 Sale of business assets or assets used in farming to a related person . . . . . . . . . . . 32 .00
33 Repayment of income previously taxed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 .00
34 Human organ donation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 .00
35 ATV corridors (only if included in column B of Form 1NPR or
line 1 or 19 of this schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 .00
36 Subtraction for certain expenses paid to related entities . . . . . . . . . . . . . . . . . . . . . . 36 .00
37 Interest, rental payments, intangible expenses, and management fees, reported
as income by a related entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 .00
38 Sales of certain insurance policies (only if included in column B of Form 1NPR or
line 1 or 19 of this schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 .00
39 Relocated business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 .00
40 Job creation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 .00
41 Combat zone related death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 .00
42 Private school tuition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 .00
43 Physician or psychiatrist grant (only if included in column B of Form 1NPR or
line 1 or 19 of this schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 .00
44 Subtraction for difference in federal and Wisconsin basis of assets . . . . . . . . . . . . . 44 .00
45 Add lines 19 through 44. This is your total subtractions from income . . . . . . . . . . . . 45 778 .00
46 Fill in the amount from line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 .00
47 If line 45 is more than line 46, subtract line 46 from line 45. Fill in here and on
line 15, column B, of Form 1NPR and put a minus sign ( - ) in front of the number . . . 47 -778 .00
48 If line 46 is more than line 45, subtract line 45 from line 46. Fill in here and on
line 15, column B, of Form 1NPR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 .00

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 Form
1040 Department of the Treasury—Internal Revenue Service

U.S. Individual Income Tax Return

(99)
2014 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2014, or other tax year beginning , 2014, ending , 20 See separate instructions.
Your first name and initial Last name Your social security number

Trishla Shah 390-96-2558

If a joint return, spouse’s first name and initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above
c
and on line 6c are correct.
8927 Willmon Way
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign
Windcrest TX 78239 Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign country name Foreign province/state/county Foreign postal code
a box below will not change your tax or
refund. You Spouse

1 Single 4 Head of household (with qualifying person). (See instructions.) If

Filing Status
2 Married filing jointly (even if only one had income) the qualifying person is a child but not your dependent, enter this
Check only one 3 Married filing separately. Enter spouse’s SSN above child’s name here. a
box. and full name here. a 5 Qualifying widow(er) with dependent child

Exemptions 6a
b
Yourself. If someone can claim you as a dependent, do not check box 6a .
Spouse . . . . . . . . . . . . . . . . . . . .
.
.
.
.
.
.
.
.
} Boxes checked
on 6a and 6b
No. of children
1
c Dependents: (2) Dependent’s (3) Dependent’s (4)  if child under age 17 on 6c who:
social security number relationship to you qualifying for child tax credit • lived with you
(1) First name Last name (see instructions) • did not live with
you due to divorce
or separation
If more than four (see instructions)
dependents, see Dependents on 6c
instructions and not entered above
check here a Add numbers on
d Total number of exemptions claimed . . . . . . . . . . . . . . . . . lines above a 1
7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7 35,590.
Income
8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a 125.
b Tax-exempt interest. Do not include on line 8a . . . 8b
Attach Form(s)
9a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a
W-2 here. Also
attach Forms b Qualified dividends . . . . . . . . . . . 9b
W-2G and 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10
1099-R if tax 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11
was withheld.
12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12
13 Capital gain or (loss). Attach Schedule D if required. If not required, check here a 13
If you did not 14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14
get a W-2,
see instructions. 15a IRA distributions . 15a b Taxable amount . . . 15b
ROLLOVER 16a Pensions and annuities 16a 9,811. b Taxable amount . . . 16b 8,761.
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . 19
20a Social security benefits 20a b Taxable amount . . . 20b
21 Other income. List type and amount 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income a 22 44,476.
23 Educator expenses . . . . . . . . . . . 23
Adjusted 24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ 24
Income 25 Health savings account deduction. Attach Form 8889 . 25
26 Moving expenses. Attach Form 3903 . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE . 27
28 Self-employed SEP, SIMPLE, and qualified plans . . 28
29 Self-employed health insurance deduction . . . . 29
30 Penalty on early withdrawal of savings . . . . . . 30
31a Alimony paid b Recipient’s SSN a 31a
32 IRA deduction . . . . . . . . . . . . . 32 1,050.
33 Student loan interest deduction . . . . . . . . 33 63.
34 Tuition and fees. Attach Form 8917 . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903 35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 1,113.
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . a 37 43,363.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA REV 12/31/14 Intuit.cg.cfp.sp Form 1040 (2014)
Form 1040 (2014) Page 2
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . 38 43,363.
Tax and
Credits
39a Check
if:
{ You were born before January 2, 1950,
Spouse was born before January 2, 1950,
Blind.
Blind.
} Total boxes
checked a 39a
b If your spouse itemizes on a separate return or you were a dual-status alien, check here a 39b
Standard 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . 40 6,200.
Deduction 37,163.
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41
• People who 42 Exemptions. If line 38 is $152,525 or less, multiply $3,950 by the number on line 6d. Otherwise, see instructions 42 3,950.
check any
box on line 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . 43 33,213.
39a or 39b or 44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 44 4,530.
who can be
claimed as a 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . 45
dependent,
see 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . 46
instructions. 47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . a 47 4,530.
• All others:
48 Foreign tax credit. Attach Form 1116 if required . . . . 48
Single or
Married filing 49 Credit for child and dependent care expenses. Attach Form 2441 49
separately,
$6,200 50 Education credits from Form 8863, line 19 . . . . . 50
Married filing 51 Retirement savings contributions credit. Attach Form 8880 51
jointly or
Qualifying 52 Child tax credit. Attach Schedule 8812, if required . . . 52
widow(er), 53 Residential energy credits. Attach Form 5695 . . . . 53
$12,400
Head of 54 Other credits from Form: a 3800 b 8801 c 54
household, 55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . 55
$9,100
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . a 56 4,530.
57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . 57
Other 58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 58
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . 59 605.
Taxes 60a Household employment taxes from Schedule H . . . . . . . . . . . . . . 60a
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . 60b
61 Health care: individual responsibility (see instructions) Full-year coverage . . . . . 61
62 Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) 62
63 Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . a 63 5,135.
Payments 64 Federal income tax withheld from Forms W-2 and 1099 . . 64 5,664.
65 2014 estimated tax payments and amount applied from 2013 return 65
If you have a
66a Earned income credit (EIC) . . . . . . . . . . 66a
qualifying
child, attach b Nontaxable combat pay election 66b
Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 . . . . . 67
68 American opportunity credit from Form 8863, line 8 . . . 68
69 Net premium tax credit. Attach Form 8962 . . . . . . 69
70 Amount paid with request for extension to file . . . . . 70
71 Excess social security and tier 1 RRTA tax withheld . 71. . .
72 Credit for federal tax on fuels. Attach Form 4136 . 72. . .
73 Credits from Form: a 2439 b Reserved c Reserved d 73
74 Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . a 74 5,664.
Refund 75 If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid 75 529.
76a Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . a 76a 529.
a
bRouting number 2 7 5 9 7 9 0 7 6 a c Type: Checking Savings
Direct deposit?
See a dAccount number 5 3 9 5 6 3 0 3
instructions.
77 Amount of line 75 you want applied to your 2015 estimated tax a 77
Amount 78 Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions a 78
You Owe 79 Estimated tax penalty (see instructions) . . . . . . . 79
Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No
Designee’s Phone Personal identification
Designee name a no. a number (PIN) a

Sign 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 belief,
they are true, correct, and complete. Declaration 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
F

Joint return? See

instructions. Disability Rights (414)202-3135
Keep a copy for Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protection
your records. PIN, enter it
here (see inst.)
Print/Type preparer’s name Preparer’s signature Date PTIN
Paid Check if
self-employed
Preparer
Use Only Firm’s name a Self-Prepared Firm's EIN a

Firm’s address a Phone no.

www.irs.gov/form1040 REV 12/31/14 Intuit.cg.cfp.sp Form 1040 (2014)
Form 5329 Additional Taxes on Qualified Plans OMB No. 1545-0074

(Including IRAs) and Other Tax-Favored Accounts

2014
a Attach to Form 1040 or Form 1040NR.
Department of the Treasury Attachment
Internal Revenue Service (99) a Information about Form 5329 and its separate instructions is at www.irs.gov/form5329. Sequence No. 29
Name of individual subject to additional tax. If married filing jointly, see instructions. Your social security number
Trishla Shah 390-96-2558
Home address (number and street), or P.O. box if mail is not delivered to your home Apt. no.

Fill in Your Address Only F City, town or post office, state, and ZIP code. If you have a foreign address, also complete
If You Are Filing This the spaces below (see instructions).
Form by Itself and Not If this is an amended
With Your Tax Return return, check here a
Foreign country name Foreign province/state/county Foreign postal code

If you only owe the additional 10% tax on early distributions, you may be able to report this tax directly on Form 1040, line 59, or
Form 1040NR, line 57, without filing Form 5329. See the instructions for Form 1040, line 59, or for Form 1040NR, line 57.
Part I Additional Tax on Early Distributions
Complete this part if you took a taxable distribution before you reached age 59½ from a qualified retirement plan (including an
IRA) or modified endowment contract (unless you are reporting this tax directly on Form 1040 or Form 1040NR—see above). You
may also have to complete this part to indicate that you qualify for an exception to the additional tax on early distributions or for
certain Roth IRA distributions (see instructions).
1 Early distributions included in income. For Roth IRA distributions, see instructions . . . . . . 1 8,761.
2 Early distributions included on line 1 that are not subject to the additional tax (see instructions).
Enter the appropriate exception number from the instructions: 05 . . . . . . . . . 2 2,716.
3 Amount subject to additional tax. Subtract line 2 from line 1 . . . . . . . . . . . . . 3 6,045.
4 Additional tax. Enter 10% (.10) of line 3. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 4 605.
Caution: If any part of the amount on line 3 was a distribution from a SIMPLE IRA, you may have
to include 25% of that amount on line 4 instead of 10% (see instructions).
Part II Additional Tax on Certain Distributions From Education Accounts
Complete this part if you included an amount in income, on Form 1040 or Form 1040NR, line 21, from a Coverdell
education savings account (ESA) or a qualified tuition program (QTP).
5 Distributions included in income from Coverdell ESAs and QTPs . . . . . . . . . . . . 5
6 Distributions included on line 5 that are not subject to the additional tax (see instructions) . . . 6
7 Amount subject to additional tax. Subtract line 6 from line 5 . . . . . . . . . . . . . 7
8 Additional tax. Enter 10% (.10) of line 7. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 8
Part III Additional Tax on Excess Contributions to Traditional IRAs
Complete this part if you contributed more to your traditional IRAs for 2014 than is allowable or you had an amount on line
17 of your 2013 Form 5329.
9 Enter your excess contributions from line 16 of your 2013 Form 5329 (see instructions). If zero, go to line 15 9
10 If your traditional IRA contributions for 2014 are less than your
maximum allowable contribution, see instructions. Otherwise, enter -0- 10
11 2014 traditional IRA distributions included in income (see instructions) . 11
12 2014 distributions of prior year excess contributions (see instructions) . 12
13 Add lines 10, 11, and 12 . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Prior year excess contributions. Subtract line 13 from line 9. If zero or less, enter -0- . . . . . 14
15 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 15
16 Total excess contributions. Add lines 14 and 15 . . . . . . . . . . . . . . . . . 16
17 Additional tax. Enter 6% (.06) of the smaller of line 16 or the value of your traditional IRAs on December 31, 2014
(including 2014 contributions made in 2015). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 . 17
Part IV Additional Tax on Excess Contributions to Roth IRAs
Complete this part if you contributed more to your Roth IRAs for 2014 than is allowable or you had an amount on line 25 of your 2013 Form 5329.
18 Enter your excess contributions from line 24 of your 2013 Form 5329 (see instructions). If zero, go to line 23 18
19 If your Roth IRA contributions for 2014 are less than your maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . 19
20 2014 distributions from your Roth IRAs (see instructions) . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Prior year excess contributions. Subtract line 21 from line 18. If zero or less, enter -0- . . . . . 22
23 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 23
24 Total excess contributions. Add lines 22 and 23 . . . . . . . . . . . . . . . . . 24
25 Additional tax. Enter 6% (.06) of the smaller of line 24 or the value of your Roth IRAs on December 31, 2014
(including 2014 contributions made in 2015). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 25
For Privacy Act and Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 01/07/15 Intuit.cg.cfp.sp Form 5329 (2014)
Form 5329 (2014) Page 2
Part V Additional Tax on Excess Contributions to Coverdell ESAs
Complete this part if the contributions to your Coverdell ESAs for 2014 were more than is allowable or you had an amount
on line 33 of your 2013 Form 5329.
26 Enter the excess contributions from line 32 of your 2013 Form 5329 (see instructions). If zero, go to line 31 26
27 If the contributions to your Coverdell ESAs for 2014 were less than the
maximum allowable contribution, see instructions. Otherwise, enter -0- 27
28 2014 distributions from your Coverdell ESAs (see instructions) . . . 28
29 Add lines 27 and 28 . . . . . . . . . . . . . . . . . . . . . . . . . . 29
30 Prior year excess contributions. Subtract line 29 from line 26. If zero or less, enter -0- . . . . . 30
31 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 31
32 Total excess contributions. Add lines 30 and 31 . . . . . . . . . . . . . . . . . 32
33 Additional tax. Enter 6% (.06) of the smaller of line 32 or the value of your Coverdell ESAs on
December 31, 2014 (including 2014 contributions made in 2015). Include this amount on Form
1040, line 59, or Form 1040NR, line 57 . . . . . . . . . . . . . . . . . . . . 33
Part VI Additional Tax on Excess Contributions to Archer MSAs
Complete this part if you or your employer contributed more to your Archer MSAs for 2014 than is allowable or you had an
amount on line 41 of your 2013 Form 5329.
34 Enter the excess contributions from line 40 of your 2013 Form 5329 (see instructions). If zero, go to line 39 34
35 If the contributions to your Archer MSAs for 2014 are less than the
maximum allowable contribution, see instructions. Otherwise, enter -0- 35
36 2014 distributions from your Archer MSAs from Form 8853, line 8 . . 36
37 Add lines 35 and 36 . . . . . . . . . . . . . . . . . . . . . . . . . . 37
38 Prior year excess contributions. Subtract line 37 from line 34. If zero or less, enter -0- . . . . . 38
39 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 39
40 Total excess contributions. Add lines 38 and 39 . . . . . . . . . . . . . . . . . 40
41 Additional tax. Enter 6% (.06) of the smaller of line 40 or the value of your Archer MSAs on
December 31, 2014 (including 2014 contributions made in 2015). Include this amount on Form
1040, line 59, or Form 1040NR, line 57 . . . . . . . . . . . . . . . . . . . . 41
Part VII Additional Tax on Excess Contributions to Health Savings Accounts (HSAs)
Complete this part if you, someone on your behalf, or your employer contributed more to your HSAs for 2014 than is
allowable or you had an amount on line 49 of your 2013 Form 5329.
42 Enter the excess contributions from line 48 of your 2013 Form 5329. If zero, go to line 47 . . . 42
43 If the contributions to your HSAs for 2014 are less than the maximum
allowable contribution, see instructions. Otherwise, enter -0- . . . . 43
44 2014 distributions from your HSAs from Form 8889, line 16 . . . . 44
45 Add lines 43 and 44 . . . . . . . . . . . . . . . . . . . . . . . . . . 45
46 Prior year excess contributions. Subtract line 45 from line 42. If zero or less, enter -0- . . . . . 46
47 Excess contributions for 2014 (see instructions) . . . . . . . . . . . . . . . . . 47
48 Total excess contributions. Add lines 46 and 47 . . . . . . . . . . . . . . . . . 48
49 Additional tax. Enter 6% (.06) of the smaller of line 48 or the value of your HSAs on December 31, 2014
(including 2014 contributions made in 2015). Include this amount on Form 1040, line 59, or Form 1040NR, line 57 49
Part VIII Additional Tax on Excess Accumulation in Qualified Retirement Plans (Including IRAs)
Complete this part if you did not receive the minimum required distribution from your qualified retirement plan.
50 Minimum required distribution for 2014 (see instructions) . . . . . . . . . . . . . . 50
51 Amount actually distributed to you in 2014 . . . . . . . . . . . . . . . . . . . 51
52 Subtract line 51 from line 50. If zero or less, enter -0- . . . . . . . . . . . . . . . 52
53 Additional tax. Enter 50% (.50) of line 52. Include this amount on Form 1040, line 59, or Form 1040NR, line 57 53
Under penalties of perjury, I declare that I have examined this form, including accompanying attachments, and to the best of my
Sign Here Only If You knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which
preparer has any knowledge.
Are Filing This Form by
Itself and Not With Your
F

Tax Return
Your signature Date
Print/Type preparer’s name Preparer's signature Date PTIN
Paid Check if
self-employed
Preparer
Firm’s name a Firm's EIN a
Use Only
Firm's address a Phone no.
Form 5329 (2014)
REV 01/07/15 Intuit.cg.cfp.sp