1. Electronic Filing Instructions for your 2011 Federal Tax Return
Important: Your taxes are not finished until all required steps are completed.
Declaration Control Number: Accepted: 01/22/2012
norma J buchanon
p.o. box 501
forreston, IL 61030
|
Balance | Your federal tax return (Form 1040A) shows a refund due to you in the
Due/ | amount of $8,234.00. Applicable fees were deducted from your original
Refund | refund amount of $8,234.00. Your refund is now $8,176.10. Because you
| chose to have your TurboTax fees deducted from your refund, you will
| receive e-mail from the University National Bank of Saint Paul, MN,
| which handles this transaction. The IRS estimates that you can expect
| your tax refund to be direct deposited into your account on or around
| 02/01/2012. This is only an estimate. The account information you
| entered - Account Number: 50002194 Routing Transit Number: 271184425.
|
______________________________________________________________________________________
|
Where's My | Before you call the Internal Revenue Service with questions about
Refund? | your refund, give them 7 to 14 days processing time from the date
| your return is accepted. If then you have not received your refund,
| or the amount is not what you expected, contact the Internal Revenue
| Service directly at 1-800-829-4477. You can also check www.irs.gov
| and select the "Where's my refund?" link.
|
______________________________________________________________________________________
|
No | No signature form is required since you signed your return
Signature | electronically.
Document |
Needed |
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your federal return
Keep |
|
______________________________________________________________________________________
|
2011 | Adjusted Gross Income $ 24,094.00
Federal | Taxable Income $ 4,494.00
Tax | Total Tax $ 0.00
Return | Total Payments/Credits $ 8,234.00
Summary | Amount to be Refunded $ 8,234.00
| Effective Tax Rate -21.20%
|
______________________________________________________________________________________
Page 1 of 1

2. Hi norma,
We just want to thank you for using TurboTax this year! It's our goal to make
your taxes easy and accurate, year after year.
With TurboTax Federal Free Edition:
- Your filed return has 100% guaranteed accurate calculations*
- You received a printed copy of your return with supporting documents for your
records
Many happy returns from TurboTax.

3. Form Department of the Treasury—Internal Revenue Service
1040A U.S. Individual Income Tax Return (99) 2011 IRS Use Only—Do not write or staple in this space.
Your first name and initial Last name OMB No. 1545-0074
Your social security number
norma J buchanon 329-50-5462
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
▲
p.o. box 501 and on line 6c are correct.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign
forreston IL 61030 Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign country name Foreign province/county Foreign postal code a box below will not change your tax or
refund. You Spouse
Filing 1 Single 4 Head of household (with qualifying person). (See instructions.)
status 2 Married filing jointly (even if only one had income) If the qualifying person is a child but not your dependent,
Check only 3 Married filing separately. Enter spouse’s SSN above and enter this child’s name here. ▶
one box. full name here. ▶ 5 Qualifying widow(er) with dependent child (see instructions)
}
Exemptions 6a Yourself. If someone can claim you as a dependent, do not check Boxes
checked on
box 6a. 6a and 6b 1
b Spouse No. of children
on 6c who:
c Dependents: (4) ✓ if child under
(2) Dependent’s social (3) Dependent’s • lived with
age 17 qualifying for
If more than six you 2
security number relationship to you child tax credit (see
dependents, see (1) First name Last name instructions) • did not live
instructions. with you due to
xavier Z taylor 324-96-0331 Grandchild divorce or
ethan A watson 335-08-3033 Grandchild separation (see
instructions)
Dependents
on 6c not
entered above
Add numbers
on lines
d Total number of exemptions claimed. above ▶ 3
Income
7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7 24,094.
Attach
Form(s) W-2 8a Taxable interest. Attach Schedule B if required. 8a
here. Also b Tax-exempt interest. Do not include on line 8a. 8b
attach
Form(s) 9a Ordinary dividends. Attach Schedule B if required. 9a
1099-R if tax b Qualified dividends (see instructions). 9b
was 10 Capital gain distributions (see instructions). 10
withheld. 11a IRA 11b Taxable amount
If you did not distributions. 11a (see instructions). 11b
get a W-2, see 12a Pensions and 12b Taxable amount
instructions.
annuities. 12a (see instructions). 12b
Enclose, but do
not attach, any
payment. Also,
13 Unemployment compensation and Alaska Permanent Fund dividends. 13
please use Form 14a Social security 14b Taxable amount
1040-V.
benefits. 14a (see instructions). 14b
15 Add lines 7 through 14b (far right column). This is your total income. ▶ 15 24,094.
Adjusted
gross 16 Educator expenses (see instructions). 16
income 17 IRA deduction (see instructions). 17
18 Student loan interest deduction (see instructions). 18
19 Tuition and fees. Attach Form 8917. 19
20 Add lines 16 through 19. These are your total adjustments. 20
21 Subtract line 20 from line 15. This is your adjusted gross income. ▶ 21 24,094.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. BAA Form 1040A (2011)
REV 12/01/11 TTO

4. Form 1040A (2011) Page 2
Tax, credits, 22 Enter the amount from line 21 (adjusted gross income). 22 24,094.
and
payments
23a Check
if: {
You were born before January 2, 1947,
Spouse was born before January 2, 1947,
Blind Total boxes
Blind checked ▶ 23a }
b If you are married filing separately and your spouse itemizes
Standard deductions, check here ▶ 23b
Deduction
for— 24 Enter your standard deduction. 24 8,500.
• People who 25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 25 15,594.
check any
box on line 26 Exemptions. Multiply $3,700 by the number on line 6d. 26 11,100.
23a or 23b or
who can be 27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.
claimed as a This is your taxable income. ▶ 27 4,494.
dependent,
see 28 Tax, including any alternative minimum tax (see instructions). 28 448.
instructions.
29 Credit for child and dependent care expenses. Attach
• All others:
Single or Form 2441. 29
Married filing 30 Credit for the elderly or the disabled. Attach
separately,
$5,800 Schedule R. 30
Married filing 31 Education credits from Form 8863, line 23. 31
jointly or
Qualifying 32 Retirement savings contributions credit. Attach
widow(er),
$11,600 Form 8880. 32
Head of 33 Child tax credit (see instructions). 33 448.
household,
$8,500 34 Add lines 29 through 33. These are your total credits. 34 448.
35 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is
your total tax. 35 0.
36 Federal income tax withheld from Forms W-2 and
1099. 36 3,125.
If you have
37 2011 estimated tax payments and amount applied
a qualifying from 2010 return. 37
child, attach 38a Earned income credit (EIC). 38a 3,557.
Schedule
EIC. b Nontaxable combat pay
election. 38b
39 Additional child tax credit. Attach Form 8812. 39 1,552.
40 American opportunity credit from Form 8863, line 14. 40
41 Add lines 36, 37, 38a, 39, and 40. These are your total payments. ▶ 41 8,234.
42 If line 41 is more than line 35, subtract line 35 from line 41.
Refund This is the amount you overpaid. 42 8,234.
Direct 43a Amount of line 42 you want refunded to you. If Form 8888 is attached, check here ▶ 43a 8,234.
deposit?
See ▶ b
Routing ▶ c Type: Checking Savings
instructions number 2 7 1 1 8 4 4 2 5
and fill in
43b, 43c, ▶ d
Account
and 43d or number 5 0 0 0 2 1 9 4
Form 8888. 44 Amount of line 42 you want applied to your
2012 estimated tax. 44
Amount 45 Amount you owe. Subtract line 41 from line 35. For details on how to pay,
you owe see instructions. ▶ 45
46 Estimated tax penalty (see instructions). 46
Third party Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete the following. No
designee Designee’s
name ▶
Phone
no. ▶
Personal identification
number (PIN) ▶
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
Sign and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other
here than the taxpayer) is based on all information of which the preparer has any knowledge.
Your signature Date Your occupation Daytime phone number
Joint return?
▲
See page 13. cashier (815)742-2174
Keep a copy Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protection
for your PIN, enter it
records. here (see inst.)
Print/type preparer's name Preparer’s signature Date PTIN
Paid Check ▶ if
self-employed
preparer Firm's name ▶ Firm's EIN ▶
SELF PREPARED
use only Firm's address ▶ Phone no.
REV 12/01/11 TTO Form 1040A (2011)

5. SCHEDULE EIC Earned Income Credit 1040A ◀
OMB No. 1545-0074
(Form 1040A or 1040)
2011
..........
Qualifying Child Information 1040
Department of the Treasury Complete and attach to Form 1040A or 1040 EIC Attachment
Internal Revenue Service (99) only if you have a qualifying child. Sequence No. 43
Name(s) shown on return Your social security number
norma J buchanon 329-50-5462
• See the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, to make
Before you begin: sure that (a) you can take the EIC, and (b) you have a qualifying child.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card.
Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s
social security card is not correct, call the Social Security Administration at 1-800-772-1213.
▲
• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See page 2 for details.
!
CAUTION • It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.
Qualifying Child Information Child 1 Child 2 Child 3
1 Child’s name First name Last name First name Last name First name Last name
If you have more than three qualifying
children, you only have to list three to get
the maximum credit. xavier Z taylor ethan A watson
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040A, lines 38a
and 38b, or Form 1040, lines 64a and 64b,
unless the child was born and died in
2011. If your child was born and died in
2011 and did not have an SSN, enter
“Died” on this line and attach a copy of
the child’s birth certificate, death
certificate, or hospital medical records. 324-96-0331 335-08-3033
3 Child’s year of birth
Year 1 9 9 9 Year 2 0 0 8 Year
If born after 1992 and the child was If born after 1992 and the child was If born after 1992 and the child was
younger than you (or your spouse, if younger than you (or your spouse, if younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b;
go to line 5. go to line 5. go to line 5.
4 a Was the child under age 24 at the end of
2011, a student, and younger than you (or Yes. No. Yes. No. Yes. No.
your spouse, if filing jointly)?
Go to line 5. Go to line 4b. Go to line 5. Go to line 4b. Go to line 5. Go to line 4b.
b Was the child permanently and totally
disabled during any part of 2011?
Yes. No. Yes. No. Yes. No.
Go to The child is not a Go to The child is not a Go to The child is not a
line 5. qualifying child. line 5. qualifying child. line 5. qualifying child.
5 Child’s relationship to you
(for example, son, daughter, grandchild,
niece, nephew, foster child, etc.) Grandchild Grandchild
6 Number of months child lived
with you in the United States
during 2011
• If the child lived with you for more than
half of 2011 but less than 7 months,
enter “7.”
• If the child was born or died in 2011 and 12 months 12 months months
your home was the child’s home for the
entire time he or she was alive during Do not enter more than 12 Do not enter more than 12 Do not enter more than 12
2011, enter “12.” months. months. months.
Schedule EIC (Form 1040A or 1040) 2011
For Paperwork Reduction Act Notice, see your tax BAA REV 11/22/11 TTO
return instructions.

6. 8812 Additional Child Tax Credit 1040
◀
OMB No. 1545-0074
2011
Form 1040A
1040NR
Department of the Treasury
8812 Attachment
Internal Revenue Service (99) Complete and attach to Form 1040, Form 1040A, or Form 1040NR. Sequence No. 47
Name(s) shown on return Your social security number
norma J buchanon 329-50-5462
}
Part I All Filers
1 1040 filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040, line 51).
1040A filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040A, line 33). 1 2,000.
1040NR filers: Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040NR, line 48).
If you used Pub. 972, enter the amount from line 8 of the Child Tax Credit Worksheet in the publication.
2 Enter the amount from Form 1040, line 51, Form 1040A, line 33, or Form 1040NR, line 48 . . . . . . 2 448.
3 Subtract line 2 from line 1. If zero, stop; you cannot take this credit . . . . . . . . . . . . . 3 1,552.
4a Earned income (see instructions on back) . . . . . . . . . . . . 4a 24,094.
b Nontaxable combat pay (see instructions on
back) . . . . . . . . . . . . . 4b
5 Is the amount on line 4a more than $3,000?
No. Leave line 5 blank and enter -0- on line 6.
Yes. Subtract $3,000 from the amount on line 4a. Enter the result . . . 5 21,094.
6 Multiply the amount on line 5 by 15% (.15) and enter the result . . . . . . . . . . . . . . 6 3,164.
Next. Do you have three or more qualifying children?
No. If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the smaller of
line 3 or line 6 on line 13.
Yes. If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on line 13.
Otherwise, go to line 7.
Part II Certain Filers Who Have Three or More Qualifying Children
7 Withheld social security and Medicare taxes from Form(s) W-2, boxes 4 and 6.
If married filing jointly, include your spouse’s amounts with yours. If you
}
worked for a railroad, see instructions on back . . . . . . . . . . 7
8 1040 filers: Enter the total of the amounts from Form 1040, lines
27 and 57, plus any taxes that you identified using code
“UT” and entered on line 60.
1040A filers: Enter -0-. 8
1040NR filers: Enter the total of the amounts from Form 1040NR, lines
27 and 55, plus any taxes that you identified using code
“UT” and entered on line 59.
}
9 Add lines 7 and 8 . . . . . . . . . . . . . . . . . . . 9
10 1040 filers: Enter the total of the amounts from Form 1040, lines
64a and 69.
1040A filers: Enter the total of the amount from Form 1040A, line
38a, plus any excess social security and tier 1 RRTA 10
taxes withheld that you entered to the left of line 41
(see instructions on back).
1040NR filers: Enter the amount from Form 1040NR, line 65.
11 Subtract line 10 from line 9. If zero or less, enter -0- . . . . . . . . . . . . . . . . . 11
12 Enter the larger of line 6 or line 11 . . . . . . . . . . . . . . . . . . . . . . 12
Next, enter the smaller of line 3 or line 12 on line 13.
Part III Additional Child Tax Credit
13 This is your additional child tax credit . . . . . . . . . . . . . . . . . . . 13 1,552.
Enter this amount on
Form 1040, line 65,
1040 Form 1040A, line 39, or
1040A Form 1040NR, line 63.
1040NR ◀
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 11/22/11 TTO Form 8812 (2011)

7. We Need Your Consent to Use Your Tax Information
The IRS requires that we obtain your consent to use specific information in your tax return to determine
if you can use this payment method.
Protecting Your Privacy
Because you have selected this payment option, Intuit, the maker of TurboTax software, needs to check
a few items in your return to determine whether you can pay your fees from your refund. For example,
you must reside in the U.S. and your refund must be large enough to make the payment.
We’re asking your permission to perform these checks and providing some important information to
you as required by the IRS. To agree, simply enter your name(s) and the date in the boxes below after
reading the consent and select "I Agree".
I authorize Intuit, the maker of TurboTax, to use the information provided in this 2011 return to
determine whether a portion of the refund can be used to pay for tax preparation.
IRS regulations require the following statements:
"Federal law requires this consent form be provided you you. Unless authorized by law, we cannot use,
without your consent, your tax return information for purposes other than the preparation and filing of
your tax return.
You are not required to complete this form. If we obtain your signature on this form by conditioning our
services on your consent, your consent will not be valid. Your consent is valid for the amount of time
that you specify. If you do not specify the duration of your consent, your consent is valid for one year."
norma buchanon
Taxpayer’s First Name Taxpayer’s Last Name
Spouse’s First Name Spouse’s Last name
(if applicable) (if applicable)
Please type the date below:
01/22/2012
Date
If you believe your tax return information has been disclosed or used improperly in a manner
unauthorized by law or without your permission, you may contact the Treasury Inspector General for
Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.

8. Finally, We Need Your Consent to Disclose Your Tax Information
Before we continue with processing your payment by transferring money from your tax refund, we
need to ask for your permission again, this time to forward certain of your information to University National
Bank of St. Paul, MN (’BANK’) and to Santa Barbara Tax Processing Group, LLC, (’SBTPG’), the
administrator and servicer of your tax refund transfer. To consent, type your first and last name and
today’s date in the boxes below.
How this protects your privacy
Because you are choosing to pay for your tax preparation with money from your refund, Intuit, the
maker of TurboTax software, needs to send a limited amount of personal information from your tax
return information, (such as your identifying information, deposit information, and refund amount)
to BANK and to SBTPG, the administrator and servicer of payment for tax preparation services
from your tax refund. Your information is sent via a secure SSL encrypted transmission for the
sole purpose of refund processing tax preparation service payment. BANK and SBTPG are
contractually obligated to protect the confidentiality of your information.
We’re asking your permission to disclose that information, and also providing some important
information to you as required by the IRS. To agree, simply enter your name(s) and the date in the
boxes below after reading this consent and select "I Agree".
I authorize Intuit, the maker of TurboTax, to disclose to BANK and SBTPG that portion of
my 2011 tax return information that is necessary to enable BANK and SBTPG to process my
refund and pay for my tax preparation.
IRS regulations require the following statements:
"Federal law requires this consent form be provided to you. Unless authorized by law, we cannot
disclose, without your consent, your tax return information to third parties for purposes other than the
preparation and filing of your tax return. If you consent to the disclosure of your tax return information,
Federal law may not protect your tax return information from further use or distribution.
You are not required to complete this form. If we obtain your signature on this form by conditioning our
services on your consent, your consent will not be valid. If you agree to the disclosure of your tax
return information, your consent is valid for the amount of time that you specify. If you do not specify
the duration of your consent, your consent is valid for one year."
norma buchanon
Please type the date below:
01/22/2012
Date
If you believe your tax return information has been disclosed or used improperly in a manner
unauthorized by law or without your permission, you may contact the Treasury Inspector General for
Tax Administration (TIGTA) by telephone at 1-800-366-4484, or by email at complaints@tigta.treas.gov.
sbia1301.SCR 12/01/11

9. ELECTRONIC POSTMARK - CERTIFICATION OF ELECTRONIC FILING
Taxpayer: norma J buchanon
Primary SSN: 329-50-5462
Federal Return Submitted: January 22, 2012 04:48 PM PST
Federal Return Acceptance Date: 01/22/2012
The Intuit Electronic Postmark shows the date and time Intuit received your federal tax return. The Intuit
Electronic Postmark documents the filing date of your income tax return, and the electronic postmark
information should be kept on file with your tax return and other tax-related documentation.
There are two important aspects of the Intuit Electronic Postmark:
1. THE INTUIT ELECTRONIC POSTMARK.
The electronic postmark shows the date and time Intuit received the federal return, and is deemed the
filing date if the date of the electronic postmark is on or before the date prescribed for filing of the
federal individual income tax return.
TIMELY FILING:
For your federal return to be considered filed on time, your return must be postmarked on or before
midnight April 17, 2012. Intuit’s electronic postmark is issued in the Pacific Time (PT) zone. If you are
not filing in the PT zone, you will need to add or subtract hours from the Intuit Electronic Postmark time
to determine your local postmark time. For example, if you are filing in the Eastern Time (ET) zone and
you electronically file your return at 9 AM on April 17, 2012, your Intuit electronic postmark will indicate
April 17, 2012, 6 AM. If your federal tax return is rejected, the IRS still considers it filed on time if the
electronic postmark is on or before April 17, 2012, and a corrected return is submitted and accepted
before April 22, 2012. If your return is submitted after April 22, 2012, a new time stamp is issued to
reflect that your return was submitted after the IRS deadline and, consequently, is no longer considered
to have been filed on time.
If you request an automatic six-month extension, your return must be electronically postmarked by
midnight October 15, 2012. If your federal tax return is rejected, the IRS will still consider it filed on time
if the electronic postmark is on or before October 15, 2012, and the corrected return is submitted and
accepted by October 20, 2012.
2. THE ACCEPTANCE DATE.
Once the IRS accepts the electronically filed return, the acceptance date will be provided by the Intuit
Electronic Filing Center. This date is proof that the IRS accepted the electronically filed return.

10. Electronic Filing Instructions for your 2011 Illinois Tax Return
Important: Your taxes are not finished until all required steps are completed.
norma J buchanon
p.o. box 501
forreston, IL 61030
|
Balance | Your Illinois state tax return (Form IL-1040) shows a refund due to
Due/ | you in the amount of $442.00. Your tax refund should be direct
Refund | deposited into your account within 7 to 14 days after your return is
| accepted. The account information you entered - Account Number:
| 50002194 Routing Transit Number: 271184425.
|
______________________________________________________________________________________
|
Where's My | Before you call the Illinois Department of Revenue with questions
Refund? | about your refund, give them 7 to 14 days processing time from the
| date your return is accepted. If then you have not received your
| refund, or the amount is not what you expected, contact the Illinois
| Department of Revenue directly at 1-217-782-3336. From outside of
| Illinois use 1-800-732-8866. You can also visit the Illinois
| Department of Revenue web site at www.ILtax.com.
|
______________________________________________________________________________________
|
No | No signature form is required since you signed your return
Signature | electronically.
Document |
Needed |
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your state and federal returns
Keep | Copies of Forms W-2, W-2G, and 1099-R
| Copies of other states' tax returns, if applicable
|
______________________________________________________________________________________
|
2011 | Taxable Income $ 18,094.00
Illinois | Total Tax $ 905.00
Tax | Total Payments/Credits $ 1,347.00
Return | Amount to be Refunded $ 442.00
Summary |
|
______________________________________________________________________________________
Page 1 of 1

11. Illinois Department of Revenue
2011 Form IL-1040
Individual Income Tax Return or for fiscal year ending /
tax.illinois.gov
Do not write above this line.
Step 1: Personal Information
329-50-5462
norma J buchanon
p.o. box 501
forreston IL 61030
C Filing status (see instructions)
Single or head of household Married filing jointly Married filing separately Widowed
D Check if same-sex civil union return (see instructions)
Step 2:1 Federal adjusted gross income from your U.S. 1040, Line 37; U.S. 1040A, Line 21; or (Whole dollars only)
U.S. 1040EZ, Line 4 1 24,094 .00
Income
2 Federally tax-exempt interest and dividend income from your U.S. 1040 or 1040A, Line 8b;
or U.S. 1040EZ 2 .00
3 Other additions. Attach Schedule M. 3 .00
Staple W-2 and 1099 forms here
4 Total income. Add Lines 1 through 3. 4 24,094 .00
Step 3: 5
Social Security benefits and certain retirement plan income
received if included in Line 1. Attach Page 1 of federal return.
Base
5 .00
Income 6
Illinois Income Tax overpayment included in U.S. 1040, Line 10 6 .00
7
Other subtractions. Attach Schedule M. 7 .00
Check if Line 7 includes any amount from Schedule 1299-C.
8 Add Lines 5, 6, and 7. This is the total of your subtractions. 8 .00
9 Illinois base income. Subtract Line 8 from Line 4. 9 24,094 .00
Step 4: 10 a Number of exemptions from your federal return 3 x $2,000 a 6,000 .00
Exemptions
b If someone can claim you as a dependent, see instructions. x $2,000 b .00
c Check if 65 or older: You + Spouse = x $1,000 c .00
d Check if legally blind: You + Spouse = x $1,000 d .00
Exemption allowance. Add Lines a through d. 10 6,000 .00
Step 5: 11 Residents: Net income. Subtract Line 10 from Line 9. Skip Line 12. 11 18,094 .00
Net 12 Nonresidents and part-year residents:
Check the box that applies to you during 2011
Income Nonresident Part-year resident, and
write the Illinois base income from Schedule NR. Attach Schedule NR. 12 .00
Step 6:
13 Residents: Multiply Line 11 by 5% (.05).
Nonresidents and part-year residents: Write the tax from Schedule NR. 13 905 .00
Tax
14 Recapture of investment tax credits. Attach Schedule 4255. 14 .00
15 Income tax. Add Lines 13 and 14. Cannot be less than zero. 15 905 .00
Staple your check
Step 7: 16 Income tax paid to another state while an Illinois resident.
Attach Schedule CR. 16 .00
Tax After
Non- 17 Property tax and K-12 education expense credit amount from
refundable Schedule ICR. Attach Schedule ICR. 17 .00
Credits 18 Credit amount from Schedule 1299-C. Attach Schedule 1299-C. 18 .00
19 Add Lines 16, 17, and 18. This is the total of your credits. Cannot
exceed the tax amount on Line 15. 19 0 .00
20 Tax after nonrefundable credits. Subtract Line 19 from Line 15. 20 905 .00
ID: 3WM REV 12/23/11 TTO
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
IL-1040 front (R-12/11) this information is required. Failure to provide information could result in a penalty.

12. 21 Tax after nonrefundable credits from Page 1, Line 20 21 905 .00
22 Household employment tax. See instructions.
Step 8:
22 .00
Other 23 Use tax on internet, mail order, or other out-of-state purchases from
UT Worksheet or UT Table in the instructions. Do not leave blank.
Taxes 23 0 .00
24 Total Tax. Add Lines 21, 22, and 23. 24 905 .00
9:
Step 25 Illinois Income Tax withheld. Attach W-2 and 1099 forms. 25 1,169 .00
Payments 26 Estimated payments from Forms IL-1040-ES and IL-505-I,
and
including overpayment applied from 2010 return 26 .00
Refundable
27 Pass-through entity tax payments. Attach Schedule K-1-P or K-1-T. 27 .00
Credit
28 Earned Income Credit from Schedule ICR. Attach Schedule ICR. 28 178 .00
29 Total payments and refundable credit. Add Lines 25 through 28. 29 1,347 .00
Step 10: 30 Overpayment. If Line 29 is greater than Line 24, subtract Line 24 from Line 29. 30 442 .00
Result 31 Underpayment. If Line 24 is greater than Line 29, subtract Line 29 from Line 24. 31 .00
Step 11: 32 Late-payment penalty for underpayment of estimated tax. 32 .00
a Check if at least two-thirds of your federal gross income is from farming.
Underpayment
of Estimated Tax
b Check if you or your spouse are 65 or older and permanently
Penalty and
living in a nursing home.
Donations c Check if your income was not received evenly during the year and
you annualized your income on Form IL-2210. Attach Form IL-2210.
33 Voluntary charitable donations. Attach Schedule G. 33 .00
34 Total penalty and donations. Add Lines 32 and 33. 34 .00
Step 12: 35 If you have an overpayment on Line 30 and this amount is greater than
Line 34, subtract Line 34 from Line 30. This is your remaining overpayment. 35 442 .00
Refund or
Amount You 36 Amount from Line 35 you want refunded to you 36 442 .00
Owe
37 Complete to direct deposit your refund
Routing number 2 7 1 1 8 4 4 2 5 Checking or Savings
Account number 5 0 0 0 2 1 9 4
38 Subtract Line 36 from Line 35. This amount will be applied to your 2012 estimated tax. 38 0 .00
39 If you have an underpayment on Line 31, add Lines 31 and 34. or
If you have an overpayment on Line 30 and this amount is less than Line 34,
subtract Line 30 from Line 34. This is the amount you owe. 39 .00
Step 13: Under penalties of perjury, I state that I have examined this return, and, to the best of my knowledge, it is true, correct, and
complete.
Sign and
Date (815)742-2174
Your signature Date Daytime phone number Your spouse’s signature Date
Self-Prepared
Paid preparer’s signature Date Preparer’s phone number Preparer’s FEIN, SSN, or PTIN
Third Party
Check, and complete below, if you want to allow another person to discuss this return with the Illinois Department
Designee
of Revenue.
Designee’s Designee’s
Name (please print) Phone number
Form 1099-G
Next year (in January 2013), we will no longer automatically mail 1099-G forms. Instead, we ask that you get this
Information
information from our website. Check the box if you still want us to mail you a paper Form 1099-G next year.
If no payment enclosed, mail to: If payment enclosed, mail to:
ILLINOIS DEPARTMENT OF REVENUE ILLINOIS DEPARTMENT OF REVENUE
PO BOX 1040 SPRINGFIELD IL 62726-0001
GALESBURG IL 61402-1040
ID: 3WM REV 12/23/11 TTO
IL-1040 back (R-12/11) DR AP RR DC

13. Illinois Department of Revenue
2011 Schedule ICR Illinois Credits
Attach to your Form IL-1040 IL Attachment No. 23
Read this information first You must complete IL-1040 through Line 15 and Schedule CR, if
Complete this schedule only if you are eligible for the applicable, before completing this schedule.
Illinois Property Tax Credit The total amount of Illinois Property Tax Credit and K-12
K-12 Education Expense Credit Education Expense Credit cannot exceed tax. Only the
Earned Income Credit may exceed tax.
Earned Income Credit (EIC)
Step 1: Provide the following information
norma J buchanon 3 2 9 – 5 0 – 5 4 6 2
Your name as shown on your Form IL‑1040 Your Social Security number
Step 2: Figure your nonrefundable credit
1 Write the amount of tax from your IL-1040, Line 15. 1 905.00
2 Write the amount of credit for tax paid to other states from your IL-1040, Line 16. 2 .00
3 Subtract Line 2 from Line 1. 3 905.00
Section A - Illinois Property Tax Credit (See instructions for directions on how to obtain your property number)
4 a rite the total amount of Illinois Property Tax paid during the
W
year for the real estate that includes your principal residence.
tax 4a .00
b Write the property number for the
property listed above. 4b
c Write the property number for an
adjoining lot, if included in Line 4a. 4c
d Write the property number for another
adjoining lot, if included in Line 4a. 4d
e rite the portion of your tax bill that is deductible as a business
W
expense on U.S. income tax forms or schedules, even
if you did not take the federal deduction. 4e .00
f Subtract Line 4e from Line 4a. 4f .00
g ultiply Line 4f by 5% (.05).
M 4g .00
5 Compare Lines 3 and 4g, and write the lesser amount here. 5 0.00
6 Subtract Line 5 from Line 3. 6 905 .00
Section B - K-12 Education Expense Credit
You must complete the K-12 Education Expense Credit Worksheet on the back
of this schedule and attach any receipt you received from your student’s school.
7 a Write the total amount of K-12 education expenses from Line 13
of the worksheet on the back of this schedule. 7a .00
b You may not take a credit for the first $250 paid. 7b 250.00
c Subtract Line 7b from Line 7a. If the result is negative, enter “zero.” 7c .00
d Multiply Line 7c by 25% (.25). Compare the result and $500, and
write the lesser amount here. 7d .00
8 Compare Lines 6 and 7d, and write the lesser amount here. 8 .00
Section C - Total Nonrefundable Credit
9 Add Lines 5 and 8. This is your nonrefundable credit amount. Write this amount on
Form IL-1040, Line 17. 9 0.00
ID: 3WM REV 12/22/11 TTO Continued on Page 2
IL-1040 Schedule ICR (R-12/11) Page 1 of 4

14. Schedule ICR — Page 2
Step 3: Figure your refundable credit
Earned Income Credit
10 a Write the amount of federal EIC as shown on your
U.S. 1040, Line 64a; U.S. 1040A, Line 38a; or
U.S. 1040EZ, Line 8a. 10a 3,557 .00
b Multiply the amount on Line 10a by 5% (.05). 10b 178 .00
c Illinois residents: Write 1.0.
Nonresidents and part-year residents: Write the decimal from
Schedule-NR, Line 48. 10c 1.0000
d Multiply Line 10b by the decimal on Line 10c. 10d 178 .00
11 Write the amount from Line 10d here. This is your Illinois
Earned Income Credit. Write this amount on Form IL-1040, Line 28. 11 178 .00
Section B Continued - K-12 Education Expense Credit Worksheet (continued from Step 2, Section B)
You must complete this section and attach any receipt you received from your student’s school.
12 Complete the following information for each of your qualifying students. If a student attended more than one qualifying school during the
calendar year, please list separately. If you need more space, attach a separate piece of paper following this format.
A B C D E F
Student’s name Social Security number
Grade School name School city Total tuition,
(K-12 only) (IL K-12 schools only or write (IL cities only) book/lab fees
“home school,” if applicable)
a - -
b - -
c - -
d - -
e - -
f - -
g - -
h - -
i - -
j - -
13 Add the amounts in Column F for Lines 12a through 12j (and the amounts from Column F of any
additional pages you attached). This is the total amount of your qualified education expenses for
this year. Write this amount here and on Step 2, Line 7a of this schedule. 13 .00
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
Page 2 of 4 ID: 3WM REV 12/22/11 TTO this information is required. Failure to provide information could result in a penalty. IL-1040 Schedule ICR (R-12/11)