Electronic Filing Instructions For Your 2020 Federal Tax Return

Electronic Filing Instructions for your 2020 Federal Tax Return
Important: Your taxes are not finished until all required steps are completed.
Peter A LaFontaine
1224 Ben Avon
Batavia, OH 45103-1094
|
Balance | Your federal tax return (Form 1040) shows a balance due of $432.00.
Due/ | Mail your completed Form 1040-V with included payment made payable to
Refund | the United States Treasury by May 17, 2021. Make sure you sign your
| check and write your social security number and "Form 1040-V" on the
| check.
|
______________________________________________________________________________________
|
What You | Your return shows a balance due of $432.00. Mail your completed Form
Need to | 1040-V with included payment of $432.00 made payable to United States
Mail | Treasury by May 17, 2021.
|
| Mail to:
| Internal Revenue Service
| P.O. Box 802501
| Cincinnati, OH 45280-2501
|
| Do not mail Form 1040-V with payment until your return has been
| ACCEPTED for electronic filing by the IRS. If your return still
| hasn't been accepted by May 17, 2021, don't wait. Go ahead and mail
| in form 1040-V with your payment.
|
______________________________________________________________________________________
|
What You | Your Electronic Filing Instructions (this form)
Need to | Printed copy of your federal return
Keep |
|
______________________________________________________________________________________
|
Other | Identity Theft Affidavit for Peter (Form 14039)
Forms to |
Mail | Mail this form to:
| Internal Revenue Service
| Ogden, Utah 84201-0025
|
______________________________________________________________________________________
|
2020 | Adjusted Gross Income $ 2,807.00
Federal | Taxable Income $ 0.00
Tax | Total Tax $ 432.00
Return | Payment Due $ 432.00
Summary | Effective Tax Rate 0.00%
|
______________________________________________________________________________________
Page 1 of 1
Hi Peter,
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2020
TO PAY YOUR TAXES DUE BY CHECK, MAIL THIS FORM TO THE ADDRESS LISTED BELOW.
Form 1040-V 2020

I Detach Here and Mail With Your Payment and Return I
Department of the Treasury
Internal Revenue Service (99) 2020 Form 1040-V Payment Voucher
G Use this voucher when making a payment with Form 1040.
G Do not staple this voucher or your payment to Form 1040.
G Make your check or money order payable to the 'United States Treasury.' Enter the amount
G Write your social security number (SSN) on your check or money order. of your payment. . . . . . . . . G 432.
REV 07/28/21 TTO 1555
PETER A LAFONTAINE INTERNAL REVENUE SERVICE

P.O. BOX 802501
1224 BEN AVON CINCINNATI, OH 45280-2501
BATAVIA OH 45103-1094
035609554 ZL LAFO 30 0 202012 610

1040 U.S. Individual Income Tax Return 2020 (99)
Form Department of the Treasury—Internal Revenue Service
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying
one box.
person is a child but not your dependent a
Your first name and middle initial Last name Your social security number
Peter A LaFontaine 035-60-9554
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
1224 Ben Avon Check here if you, or your
spouse if filing jointly, want $3
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
to go to this fund. Checking a
Batavia OH 451031094 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse
At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes No
Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien
Age/Blindness You: Were born before January 2, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check
here a
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . 1
Attach 2a Tax-exempt interest . . . 2a 2b 0.
b Taxable interest . . . . .
Sch. B if
required.
3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b 0.
4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b
5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b
Standard 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b
Deduction for—
7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . a 7 -4.
• Single or
Married filing 8 Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . 8 3,057.
separately,
$12,400 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . a 9 3,053.
• Married filing 10 Adjustments to income:
jointly or
Qualifying a From Schedule 1, line 22 . . . . . . . . . . . . . . 10a 216.
widow(er),
$24,800
b Charitable contributions if you take the standard deduction. See instructions 10b 30.
• Head of c Add lines 10a and 10b. These are your total adjustments to income . . . . . . . . a 10c 246.
household,
$18,650 11 Subtract line 10c from line 9. This is your adjusted gross income . . . . . . . . . a 11 2,807.
• If you checked 12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 3,191.
any box under
Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . . . . . . 13 0.
Deduction,
see instructions.
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 3,191.
15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- . . . . . . . . . 15 0.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2020)
Form 1040 (2020) Page 2
16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 0.
17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 0.
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . 19
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 0.
23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . 23 432.
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . a 24 432.
25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d
• If you have a 26 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . No. . 27
attach Sch. EIC.
• If you have 28 Additional child tax credit. Attach Schedule 8812 . . . . . . . 28
nontaxable 29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
combat pay,
see instructions. 30 Recovery rebate credit. See instructions . . . . . . . . . . 30
31 Amount from Schedule 3, line 13 . . . . . . . . . . . . 31
32 Add lines 27 through 31. These are your total other payments and refundable credits . . . a 32
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . a 33
34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34
Refund
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . a 35a
Direct deposit? ab Routing number X X X X X X X X X a c Type: Checking Savings
See instructions. a
d Account number X X X X X X X X X X X X X X X X X
36 Amount of line 34 you want applied to your 2021 estimated tax . . a 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe now . . . . . . . . . . a 37 432.
You Owe Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
For details on 2020. See Schedule 3, line 12e, and its instructions for details.
how to pay, see
instructions. 38 Estimated tax penalty (see instructions) . . . . . . . . . a 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . a Yes. Complete below. No
Designee’s Phone Personal identification
name a no. a number (PIN) a
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
Sign 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 If the IRS sent you an Identity
Protection PIN, enter it here
F
Joint return? Self-Employed/ Disabled (see inst.) a 0 5 2 9 9 0

See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.) a
Phone no. (239)316-8648 Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid Self-employed
Preparer Firm’s name a Self-Prepared Phone no.
Use Only Firm’s address a Firm’s EIN a
Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 07/28/21 TTO Form 1040 (2020)
SCHEDULE 1 OMB No. 1545-0074
Additional Income and Adjustments to Income
(Form 1040)
a Attach to Form 1040, 1040-SR, or 1040-NR. 2020
Attachment
Internal Revenue Service a Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 01
Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . 1
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b Date of original divorce or separation agreement (see instructions) a
3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . 3 3,057.
4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income. List type and amount a
8
9 Combine lines 1 through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR,
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3,057.
Part II Adjustments to Income
10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government
officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . 12
13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . 13
14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . 14 216.
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . 15
16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . 16
17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . 17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient’s SSN . . . . . . . . . . . . . . . . . . . . a
c Date of original divorce or separation agreement (see instructions) a
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees deduction. Attach Form 8917 . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and
on Form 1040, 1040-SR, or 1040-NR, line 10a . . . . . . . . . . . . . . . 22 216.
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 07/28/21 TTO Schedule 1 (Form 1040) 2020
Additional Taxes
(Form 1040)
Attachment
Part I Tax
1 Alternative minimum tax. Attach Form 6251 . . . . . . . . . . . . . . . . 1
2 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . 2
3 Add lines 1 and 2. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 17 . . 3
Part II Other Taxes
4 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . 4 432.
5 Unreported social security and Medicare tax from Form: a 4137 b 8919 . 5
6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored
accounts. Attach Form 5329 if required . . . . . . . . . . . . . . . . . . 6
7a Household employment taxes. Attach Schedule H . . . . . . . . . . . . . 7a
b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if
required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b
8 Taxes from: a Form 8959 b Form 8960
c Instructions; enter code(s) 8
9 Section 965 net tax liability installment from Form 965-A . . . 9
10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form
1040 or 1040-SR, line 23, or Form 1040-NR, line 23b . . . . . . . . . . . . 10 432.
SCHEDULE C Profit or Loss From Business OMB No. 1545-0074
2020
(Form 1040) (Sole Proprietorship)
a Go to www.irs.gov/ScheduleC for instructions and the latest information.
Department of the Treasury Attachment
Internal Revenue Service (99) a Attach to Form 1040, 1040-SR, 1040-NR, or 1041; partnerships generally must file Form 1065. Sequence No. 09
Name of proprietor Social security number (SSN)
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
Web Design a 9 9 9 9 9 9
C Business name. If no separate business name, leave blank. D Employer ID number (EIN) (see instr.)
Lotus Health LLC
E Business address (including suite or room no.) a 1224 BEN AVON
City, town or post office, state, and ZIP code Mason, OH 45040
F Accounting method: (1) Cash (2) Accrual (3) Other (specify) a
G Did you “materially participate” in the operation of this business during 2020? If “No,” see instructions for limit on losses . Yes No
H If you started or acquired this business during 2020, check here . . . . . . . . . . . . . . . . . a
I Did you make any payments in 2020 that would require you to file Form(s) 1099? See instructions . . . . . . . . Yes No
J If “Yes,” did you or will you file required Form(s) 1099? . . . . . . . . . . . . . . . . . . . . . Yes No
Part I Income
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on
Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . a 1 1,000.
2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3 1,000.
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5 1,000.
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . 6
7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . a 7 1,000.
Part II Expenses. Enter expenses for business use of your home only on line 30.
8 Advertising . . . . . 8 18 Office expense (see instructions) 18
9 Car and truck expenses (see 19 Pension and profit-sharing plans . 19
instructions) . . . . . 9 20 Rent or lease (see instructions):
10 Commissions and fees . 10 a Vehicles, machinery, and equipment 20a
11 Contract labor (see instructions) 11 b Other business property . . . 20b
12 Depletion . . . . . 12 21 Repairs and maintenance . . . 21
13 Depreciation and section 179 22 Supplies (not included in Part III) . 22
expense deduction (not
included in Part III) (see 23 Taxes and licenses . . . . . 23
instructions) . . . . . 13 24 Travel and meals:
14 Employee benefit programs a Travel . . . . . . . . . 24a
(other than on line 19) . . 14 b Deductible meals (see
15 Insurance (other than health) 15 instructions) . . . . . . . 24b
16 Interest (see instructions): 25 Utilities . . . . . . . . 25
a Mortgage (paid to banks, etc.) 16a 26 Wages (less employment credits) . 26
b Other . . . . . . 16b 27a Other expenses (from line 48) . . 27a 3,300.
17 Legal and professional services
17 b Reserved for future use . . . 27b
28 Total expenses before expenses for business use of home. Add lines 8 through 27a . . . . . . a 28 3,300.
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29 -2,300.
30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method. See instructions.
Simplified method filers only: Enter the total square footage of (a) your home:
and (b) the part of your home used for business: . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30
}
31 Net profit or (loss). Subtract line 30 from line 29.
• If a profit, enter on both Schedule 1 (Form 1040), line 3, and on Schedule SE, line 2. (If you
checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3. 31 0.
• If a loss, you must go to line 32.
}
32 If you have a loss, check the box that describes your investment in this activity. See instructions.
• If you checked 32a, enter the loss on both Schedule 1 (Form 1040), line 3, and on Schedule
SE, line 2. (If you checked the box on line 1, see the line 31 instructions). Estates and trusts, enter on 32a All investment is at risk.
Form 1041, line 3. 32b Some investment is not
at risk.
• If you checked 32b, you must attach Form 6198. Your loss may be limited.
For Paperwork Reduction Act Notice, see the separate instructions. BAA REV 07/28/21 TTO Schedule C (Form 1040) 2020
Schedule C (Form 1040) 2020 Page 2
Part III Cost of Goods Sold (see instructions)
33 Method(s) used to
value closing inventory: a Cost b Lower of cost or market c Other (attach explanation)
34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory?
If “Yes,” attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
35 Inventory at beginning of year. If different from last year’s closing inventory, attach explanation . . . 35
36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36
37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37
38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38
39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40
41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41
42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 . . . . . . 42
Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9
and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must
file Form 4562.
43 When did you place your vehicle in service for business purposes? (month/day/year) a
44 Of the total number of miles you drove your vehicle during 2020, enter the number of miles you used your vehicle for:
a Business b Commuting (see instructions) c Other
45 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . . Yes No
46 Do you (or your spouse) have another vehicle available for personal use?. . . . . . . . . . . . . . Yes No
47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes No
b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Part V Other Expenses. List below business expenses not included on lines 8–26 or line 30.
Startup Costs 3,300.
48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48 3,300.

REV 07/28/21 TTO Schedule C (Form 1040) 2020
2020
E-Commerce a 4 5 4 1 1 0
I Luv Kickz 8 3 3 6 4 4 7 4 8
E Business address (including suite or room no.) a 1224 Ben Avon
City, town or post office, state, and ZIP code Batavia, OH 45103-1094
Part I Income
Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . a 1 23,618.
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3 23,618.
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4 2,650.
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5 20,968.
7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . a 7 20,968.
8 Advertising . . . . . 8 100. 18 Office expense (see instructions) 18 150.
instructions) . . . . . 9 1,797. 20 Rent or lease (see instructions):
11 Contract labor (see instructions) 11 b Other business property . . . 20b
13 Depreciation and section 179 22 Supplies (not included in Part III) . 22 7,220.
included in Part III) (see 23 Taxes and licenses . . . . . 23 39.
16 Interest (see instructions): 25 Utilities . . . . . . . . 25 170.
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29 7,512.
Simplified method filers only: Enter the total square footage of (a) your home: 100
and (b) the part of your home used for business: 25 . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30 125.
}
checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3. 31 7,387.
}
at risk.
35 Inventory at beginning of year. If different from last year’s closing inventory, attach explanation . . . 35 2,500.
36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36 2,500.
37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37 0.
38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38 50.
39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 100.
40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40 5,150.
41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41 2,500.
42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 .
. . . . . 42 2,650.
file Form 4562.
43 When did you place your vehicle in service for business purposes? (month/day/year) a 11/11/2017
a Business 480 b Commuting (see instructions) c Other 0

Credit Cards 3,500.
Domains, Shopify Fees 360.
eBay 120.

2020
Web Design a 5 4 1 5 1 0
Lotus Health LLC
E Business address (including suite or room no.) a 1224 Ben Avon
City, town or post office, state, and ZIP code Batavia, OH 45103-1094
Part I Income
Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . a 1
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5
7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . a 7
8 Advertising . . . . . 8 18 Office expense (see instructions) 18
instructions) . . . . . 9 20 Rent or lease (see instructions):
11 Contract labor (see instructions) 11 1,000. b Other business property . . . 20b
13 Depreciation and section 179 22 Supplies (not included in Part III) . 22
included in Part III) (see 23 Taxes and licenses . . . . . 23
16 Interest (see instructions): 25 Utilities . . . . . . . . 25
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29 -4,330.
Simplified method filers only: Enter the total square footage of (a) your home: 100
and (b) the part of your home used for business: 25 . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30
}
checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3. 31 -4,330.
}
at risk.
35 Inventory at beginning of year. If different from last year’s closing inventory, attach explanation . . . 35
36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36
37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37
38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38
39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40
41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41
42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 . . . . . . 42
file Form 4562.
43 When did you place your vehicle in service for business purposes? (month/day/year) a
a Business b Commuting (see instructions) c Other

Tools, Templates, Stock Photos 30.
Startup Costs 3,300.

SCHEDULE D OMB No. 1545-0074
(Form 1040)
Capital Gains and Losses
a
a Attach to Form 1040, 1040-SR, or 1040-NR.
Go to www.irs.gov/ScheduleD for instructions and the latest information.
2020
Internal Revenue Service (99) a Use Form 8949 to list your transactions for lines 1b, 2, 3, 8b, 9, and 10. Sequence No. 12
Name(s) shown on return Your social security number

Did you dispose of any investment(s) in a qualified opportunity fund during the tax year? Yes No
If “Yes,” attach Form 8949 and see its instructions for additional requirements for reporting your gain or loss.
Part I Short-Term Capital Gains and Losses—Generally Assets Held One Year or Less (see instructions)
See instructions for how to figure the amounts to enter on the (g) (h) Gain or (loss)
lines below. (d) (e) Adjustments Subtract column (e)
Proceeds Cost to gain or loss from from column (d) and
This form may be easier to complete if you round off cents to (sales price) (or other basis) Form(s) 8949, Part I, combine the result
whole dollars. line 2, column (g) with column (g)
1a Totals for all short-term transactions reported on Form

1099-B for which basis was reported to the IRS and for
which you have no adjustments (see instructions).
However, if you choose to report all these transactions
on Form 8949, leave this line blank and go to line 1b .
1b Totals for all transactions reported on Form(s) 8949 with
Box A checked . . . . . . . . . . . . . 2,538. 2,453. 15. 100.
2 Totals for all transactions reported on Form(s) 8949 with
Box B checked . . . . . . . . . . . . . 0. 100. -100.
Box C checked . . . . . . . . . . . . .
4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4684, 6781, and 8824 . . 4
5 Net short-term gain or (loss) from partnerships, S corporations, estates, and trusts from
Schedule(s) K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Short-term capital loss carryover. Enter the amount, if any, from line 8 of your Capital Loss Carryover
Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . . 6 ( )
7 Net short-term capital gain or (loss). Combine lines 1a through 6 in column (h). If you have any long-
term capital gains or losses, go to Part II below. Otherwise, go to Part III on the back . . . . . . 7 0.
Part II Long-Term Capital Gains and Losses—Generally Assets Held More Than One Year (see instructions)
See instructions for how to figure the amounts to enter on the (g) (h) Gain or (loss)
lines below. (d) (e) Adjustments Subtract column (e)
Proceeds Cost to gain or loss from from column (d) and
This form may be easier to complete if you round off cents to (sales price) (or other basis) Form(s) 8949, Part II, combine the result
whole dollars. line 2, column (g) with column (g)
8a Totals for all long-term transactions reported on Form

1099-B for which basis was reported to the IRS and for
which you have no adjustments (see instructions).
However, if you choose to report all these transactions
on Form 8949, leave this line blank and go to line 8b .
8b Totals for all transactions reported on Form(s) 8949 with
Box D checked . . . . . . . . . . . . .
Box E checked . . . . . . . . . . . . .
Box F checked . . . . . . . . . . . . . . 0. 4. -4.
11 Gain from Form 4797, Part I; long-term gain from Forms 2439 and 6252; and long-term gain or (loss)
from Forms 4684, 6781, and 8824 . . . . . . . . . . . . . . . . . . . . . . . 11
12 Net long-term gain or (loss) from partnerships, S corporations, estates, and trusts from Schedule(s) K-1 12
13 Capital gain distributions. See the instructions . . . . . . . . . . . . . . . . . . . 13
14 Long-term capital loss carryover. Enter the amount, if any, from line 13 of your Capital Loss Carryover
Worksheet in the instructions . . . . . . . . . . . . . . . . . . . . . . . . 14 ( )
15 Net long-term capital gain or (loss). Combine lines 8a through 14 in column (h). Then, go to Part III
on the back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 -4.
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 07/28/21 TTO Schedule D (Form 1040) 2020
Schedule D (Form 1040) 2020 Page 2
Part III Summary
16 Combine lines 7 and 15 and enter the result . . . . . . . . . . . . . . . . . . 16 -4.
• If line 16 is a gain, enter the amount from line 16 on Form 1040, 1040-SR, or 1040-NR, line 7.
Then, go to line 17 below.
• If line 16 is a loss, skip lines 17 through 20 below. Then, go to line 21. Also be sure to complete
line 22.
• If line 16 is zero, skip lines 17 through 21 below and enter -0- on Form 1040, 1040-SR, or
1040-NR, line 7. Then, go to line 22.
17 Are lines 15 and 16 both gains?

Yes. Go to line 18.
No. Skip lines 18 through 21, and go to line 22.
18 If you are required to complete the 28% Rate Gain Worksheet (see instructions), enter the
amount, if any, from line 7 of that worksheet . . . . . . . . . . . . . . . . . a 18
19 If you are required to complete the Unrecaptured Section 1250 Gain Worksheet (see
instructions), enter the amount, if any, from line 18 of that worksheet . . . . . . . . . a 19
20 Are lines 18 and 19 both zero or blank and are you not filing Form 4952?
Yes. Complete the Qualified Dividends and Capital Gain Tax Worksheet in the instructions
for Forms 1040 and 1040-SR, line 16. Don’t complete lines 21 and 22 below.
No. Complete the Schedule D Tax Worksheet in the instructions. Don’t complete lines 21
and 22 below.
21 If line 16 is a loss, enter here and on Form 1040, 1040-SR, or 1040-NR, line 7, the smaller of:
• The loss on line 16; or

• ($3,000), or if married filing separately, ($1,500) } . . . . . . . . . . . . . . . 21 ( 4. )
Note: When figuring which amount is smaller, treat both amounts as positive numbers.
22 Do you have qualified dividends on Form 1040, 1040-SR, or 1040-NR, line 3a?
Yes. Complete the Qualified Dividends and Capital Gain Tax Worksheet in the instructions
for Forms 1040 and 1040-SR, line 16.
No. Complete the rest of Form 1040, 1040-SR, or 1040-NR.
REV 07/28/21 TTO Schedule D (Form 1040) 2020

8949 Sales and Other Dispositions of Capital Assets
OMB No. 1545-0074
2020
Form
a Go to www.irs.gov/Form8949 for instructions and the latest information.
a File with your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Internal Revenue Service Sequence No. 12A
Name(s) shown on return Social security number or taxpayer identification number
Before you check Box A, B, or C below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute
statement will have the same information as Form 1099-B. Either will show whether your basis (usually your cost) was reported to the IRS by your
broker and may even tell you which box to check.
Part I Short-Term. Transactions involving capital assets you held 1 year or less are generally short-term (see
instructions). For long-term transactions, see page 2.
Note: You may aggregate all short-term transactions reported on Form(s) 1099-B showing basis was
reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on
Schedule D, line 1a; you aren’t required to report these transactions on Form 8949 (see instructions).
You must check Box A, B, or C below. Check only one box. If more than one box applies for your short-term transactions,
complete a separate Form 8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page
for one or more of the boxes, complete as many forms with the same box checked as you need.
(A) Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see Note above)
(B) Short-term transactions reported on Form(s) 1099-B showing basis wasn’t reported to the IRS
(C) Short-term transactions not reported to you on Form 1099-B
Adjustment, if any, to gain or loss.
1 (e) If you enter an amount in column (g), (h)
(c) (d) Cost or other basis. enter a code in column (f). Gain or (loss).
(a) (b) See the separate instructions.
Date sold or Proceeds See the Note below Subtract column (e)
Description of property Date acquired
disposed of (sales price) and see Column (e) from column (d) and
(Example: 100 sh. XYZ Co.) (Mo., day, yr.)
(Mo., day, yr.) (see instructions) in the separate (f) (g) combine the result
instructions Code(s) from Amount of with column (g)
instructions adjustment
00901B105 AIM IMMUNOTECH INC. 1 05/14/20 05/26/20 2. 3. -1.
00973E409 AKERS BIOSCIENCES INC. COMMON STOCK 4 05/14/20 05/26/20 14. 21. -7.
02376R102 AMERICAN AIRLINES GROUP INC. C OMMON STOCK 5 VARIOUS 05/27/20 56. 53. 3.
05156X884 AURORA CANNABIS INC. COMMON SH ARES 5 05/19/20 05/21/20 82. 74. 8.
05156X884 AURORA CANNABIS INC. COMMON SH ARES 2 05/21/20 05/28/20 31. 33. W 2. 0.
05156X884 AURORA CANNABIS INC. COMMON SH ARES 5 05/21/20 06/09/20 78. 82. W 4. 0.
05156X884 AURORA CANNABIS INC. COMMON SH ARES 1 05/21/20 07/16/20 12. 17. -5.
05156X884 AURORA CANNABIS INC. COMMON SH ARES 14 VARIOUS 07/20/20 166. 216. -50.
127097103 CABOT OIL & GAS CORP. 1 05/29/20 06/01/20 19. 20. -1.
185860202 CLEVELAND BIOLABS, INC. COMMON STOCK 5 05/14/20 05/14/20 11. 11. 0.
185860202 CLEVELAND BIOLABS, INC. COMMON STOCK 4 05/14/20 05/19/20 9. 8. 1.
222070203 COTY INC 3 05/15/20 05/21/20 10. 10. 0.
222070203 COTY INC 32 06/01/20 06/02/20 136. 127. 9.
22576C101 CRESCENT POINT ENERGY CORP. 20 05/20/20 06/01/20 27. 31. -4.
2 Totals. Add the amounts in columns (d), (e), (g), and (h) (subtract
negative amounts). Enter each total here and include on your
Schedule D, line 1b (if Box A above is checked), line 2 (if Box B
above is checked), or line 3 (if Box C above is checked) a 653. 706. 6. -47.
Note: If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an
adjustment in column (g) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment.
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 07/28/21 TTO Form 8949 (2020)
OMB No. 1545-0074
2020
Form
247361702 DELTA AIR LINES, INC. 2 05/21/20 05/27/20 51. 46. 5.
25065K104 DESTINATION XL GROUP INC COMMO N STOCK 50 05/29/20 06/01/20 21. 24. -3.
262077100 DRIVE SHACK INC. 25 VARIOUS 05/26/20 48. 50. -2.
33938J106 FLEXION THERAPEUTICS, INC. COM MON STOCK 4 05/22/20 05/26/20 39. 39. 0.
345370860 FORD MOTOR COMPANY 9 VARIOUS 05/27/20 53. 48. 5.
345370860 FORD MOTOR COMPANY 29 VARIOUS 05/29/20 165. 166. W 4. 3.
345370860 FORD MOTOR COMPANY 5 06/01/20 06/02/20 29. 30. W 0. -1.
345370860 FORD MOTOR COMPANY 5 06/01/20 06/09/20 37. 30. 7.
345370860 FORD MOTOR COMPANY 5 06/01/20 06/11/20 31. 30. 1.
366554103 GARRISON CAPITAL INC. COMMON S TOCK 5 05/14/20 05/19/20 12. 11. 1.
37045V100 GENERAL MOTORS COMPANY 3 VARIOUS 06/04/20 87. 84. 3.
399473107 GROUPON, INC. COMMON STOCK 25 VARIOUS 05/21/20 31. 30. 1.
40434H104 HTG MOLECULAR DIAGNOSTICS, INC . COMMON STOCK 73 VARIOUS 05/26/20 40. 41. W 0. -1.
42237K300 HEAT BIOLOGICS, INC. COMMON ST OCK 30 05/19/20 05/21/20 21. 23. -2.
above is checked), or line 3 (if Box C above is checked) a 665. 652. 4. 17.
OMB No. 1545-0074
2020
Form
500600101 KOPIN CORPORATION COMMON STOCK 1 05/13/20 05/14/20 1. 1. 0.
565849106 MARATHON OIL CORPORATION 5 05/29/20 06/01/20 26. 28. -2.
56585W401 MARATHON PATENT GROUP, INC. CO MMON STOCK 45 VARIOUS 05/26/20 32. 37. -5.
649604501 NEW YORK MORTGAGE TRUST, INC. COMMON STOCK 7 06/15/20 07/20/20 17. 21. -4.
665531109 NORTHERN OIL AND GAS, INC. COM MON STOCK 85 VARIOUS 06/04/20 71. 75. W 5. 1.
665531109 NORTHERN OIL AND GAS, INC. COM MON STOCK 165 VARIOUS 06/09/20 214. 137. 77.
67011N105 NOVUS THERAPEUTICS, INC. COMMO N STOCK 2 05/14/20 05/26/20 2. 2. 0.
68620A104 ORGANOVO HOLDINGS, INC. COMMON STOCK 33 VARIOUS 05/18/20 17. 22. -5.
68620P101 ORGANIGRAM HOLDINGS INC. COMMO N SHARES 30 05/15/20 05/19/20 46. 39. 7.
68620P101 ORGANIGRAM HOLDINGS INC. COMMO N SHARES 57 VARIOUS 05/27/20 92. 91. 1.
708160106 PENNEY J C CORP INC COMMON STO CK 144 VARIOUS 05/15/20 39. 28. 11.
72765Q882 PLATINUM GROUP METALS LTD. 22 05/15/20 05/21/20 33. 30. 3.
72919P202 PLUG POWER, INC. COMMON STOCK 2 05/18/20 05/19/20 8. 8. 0.
74980D100 RTW RETAILWINDS INC COMMON STO CK 100 05/29/20 06/01/20 40. 46. -6.
above is checked), or line 3 (if Box C above is checked) a 638. 565. 5. 78.
OMB No. 1545-0074
2020
Form
767292105 RIOT BLOCKCHAIN, INC. COMMON STOCK 10 05/14/20 05/14/20 22. 23. -1.
767292105 RIOT BLOCKCHAIN, INC. COMMON STOCK 10 05/14/20 05/21/20 24. 23. 1.
86730L109 SUNDIAL GROWERS INC. COMMON SH ARES 100 VARIOUS 05/22/20 97. 60. 37.
86730L109 SUNDIAL GROWERS INC. COMMON SH ARES 33 VARIOUS 05/28/20 29. 30. -1.
88338N107 THERAPEUTICSMD, INC. COMMON ST OCK 25 05/20/20 05/21/20 30. 29. 1.
91232N207 UNITED STATES OIL FUND, LP 4 05/26/20 06/01/20 103. 103. 0.
91822J103 VBI VACCINES, INC. NEW COMMON STOCK (CANADA) 55 VARIOUS 05/21/20 130. 120. 10.
960908309 WESTPORT FUEL SYSTEMS INC COMM ON SHARES 25 05/20/20 05/26/20 35. 33. 2.
G4863A108 INTERNATIONAL GAME TECHNOLOGY PLC 3 05/22/20 05/26/20 25. 23. 2.
H8817H100 TRANSOCEAN LTD. 61 VARIOUS 05/19/20 87. 86. 1.
above is checked), or line 3 (if Box C above is checked) a 582. 530. 52.
Form 8949 (2020) Attachment Sequence No. 12A Page 2
Name(s) shown on return. Name and SSN or taxpayer identification no. not required if shown on other side Social security number or taxpayer identification number
Before you check Box D, E, or F below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute
Part II Long-Term. Transactions involving capital assets you held more than 1 year are generally long-term (see
instructions). For short-term transactions, see page 1.
Note: You may aggregate all long-term transactions reported on Form(s) 1099-B showing basis was reported
to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line
8a; you aren’t required to report these transactions on Form 8949 (see instructions).
You must check Box D, E, or F below. Check only one box. If more than one box applies for your long-term transactions, complete
a separate Form 8949, page 2, for each applicable box. If you have more long-term transactions than will fit on this page for one or
more of the boxes, complete as many forms with the same box checked as you need.
(D) Long-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see Note above)
(E) Long-term transactions reported on Form(s) 1099-B showing basis wasn’t reported to the IRS
(F) Long-term transactions not reported to you on Form 1099-B
165167743 CHESAPEAKE ENERGY CORP COMMON STOCK 0 01/30/18 04/27/20 0. 4. -4.
Schedule D, line 8b (if Box D above is checked), line 9 (if Box E
above is checked), or line 10 (if Box F above is checked) a 0. 4. -4.
Note: If you checked Box D above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an
REV 07/28/21 TTO Form 8949 (2020)
OMB No. 1545-0074
2020
Form
ABLE 01/15/20 06/29/20 0. 100. -100.
above is checked), or line 3 (if Box C above is checked) a 0. 100. -100.
SCHEDULE SE
Self-Employment Tax
OMB No. 1545-0074
2020
(Form 1040)
a Go to www.irs.gov/ScheduleSE for instructions and the latest information.
Sequence No. 17
a Attach to Form 1040, 1040-SR, or 1040-NR.
Internal Revenue Service (99)
Name of person with self-employment income (as shown on Form 1040, 1040-SR, or 1040-NR) Social security number of person
Peter A LaFontaine with self-employment income a 035-60-9554
Part I Self-Employment Tax
Note: If your only income subject to self-employment tax is church employee income, see instructions for how to report your income
and the definition of church employee income.
A If you are a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361, but you had
$400 or more of other net earnings from self-employment, check here and continue with Part I . . . . . . . . a
Skip lines 1a and 1b if you use the farm optional method in Part II. See instructions.
1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065),
box 14, code A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve
Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code AH 1b ( )
Skip line 2 if you use the nonfarm optional method in Part II. See instructions.
2 Net profit or (loss) from Schedule C, line 31; and Schedule K-1 (Form 1065), box 14, code A (other than
farming). See instructions for other income to report or if you are a minister or member of a religious order 2 3,057.
3 Combine lines 1a, 1b, and 2 . . . . . . . . . . . . . . . . . . . . . . . . . 3 3,057.
4a If line 3 is more than zero, multiply line 3 by 92.35% (0.9235). Otherwise, enter amount from line 3 . 4a 2,823.
Note: If line 4a is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions.
b If you elect one or both of the optional methods, enter the total of lines 15 and 17 here . . . . . 4b
c Combine lines 4a and 4b. If less than $400, stop; you don’t owe self-employment tax. Exception: If
less than $400 and you had church employee income, enter -0- and continue . . . . . . . a 4c 2,823.
5a Enter your church employee income from Form W-2. See instructions for
definition of church employee income . . . . . . . . . . . . . 5a
b Multiply line 5a by 92.35% (0.9235). If less than $100, enter -0- . . . . . . . . . . . . . 5b 0.
6 Add lines 4c and 5b . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2,823.
7 Maximum amount of combined wages and self-employment earnings subject to social security tax or
the 6.2% portion of the 7.65% railroad retirement (tier 1) tax for 2020 . . . . . . . . . . . 7 137,700
8a Total social security wages and tips (total of boxes 3 and 7 on Form(s) W-2)
and railroad retirement (tier 1) compensation. If $137,700 or more, skip lines
8b through 10, and go to line 11 . . . . . . . . . . . . . . . 8a
b Unreported tips subject to social security tax from Form 4137, line 10 . . . 8b
c Wages subject to social security tax from Form 8919, line 10 . . . . . . 8c
d Add lines 8a, 8b, and 8c . . . . . . . . . . . . . . . . . . . . . . . . . . 8d
9 Subtract line 8d from line 7. If zero or less, enter -0- here and on line 10 and go to line 11 . . . a 9 137,700.
10 Multiply the smaller of line 6 or line 9 by 12.4% (0.124) . . . . . . . . . . . . . . . . 10 350.
11 Multiply line 6 by 2.9% (0.029) . . . . . . . . . . . . . . . . . . . . . . . . 11 82.
12 Self-employment tax. Add lines 10 and 11. Enter here and on Schedule 2 (Form 1040), line 4 . . 12 432.
13 Deduction for one-half of self-employment tax.
Multiply line 12 by 50% (0.50). Enter here and on Schedule 1 (Form 1040),
line 14 . . . . . . . . . . . . . . . . . . . . . . . . 13 216.
Part II Optional Methods To Figure Net Earnings (see instructions)
Farm Optional Method. You may use this method only if (a) your gross farm income1 wasn’t more than
$8,460, or (b) your net farm profits2 were less than $6,107.
14 Maximum income for optional methods . . . . . . . . . . . . . . . . . . . . . 14 5,640
15 Enter the smaller of: two-thirds (2/3) of gross farm income1 (not less than zero) or $5,640. Also, include
this amount on line 4b above . . . . . . . . . . . . . . . . . . . . . . . . 15
Nonfarm Optional Method. You may use this method only if (a) your net nonfarm profits3 were less than $6,107
and also less than 72.189% of your gross nonfarm income,4 and (b) you had net earnings from self-employment
of at least $400 in 2 of the prior 3 years. Caution: You may use this method no more than five times.
16 Subtract line 15 from line 14 . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Enter the smaller of: two-thirds (2/3) of gross nonfarm income4 (not less than zero) or the amount on
line 16. Also, include this amount on line 4b above . . . . . . . . . . . . . . . . . 17
1 3
From Sch. F, line 9; and Sch. K-1 (Form 1065), box 14, code B. From Sch. C, line 31; and Sch. K-1 (Form 1065), box 14, code A.
2 4
From Sch. F, line 34; and Sch. K-1 (Form 1065), box 14, code A—minus the amount From Sch. C, line 7; and Sch. K-1 (Form 1065), box 14, code C.
you would have entered on line 1b had you not used the optional method.
For Paperwork Reduction Act Notice, see your tax return instructions. BAA REV 07/28/21 TTO Schedule SE (Form 1040) 2020
Schedule SE (Form 1040) 2020 Attachment Sequence No. 17 Page 2
Part III Maximum Deferral of Self-Employment Tax Payments
If line 4c is zero, skip lines 18 through 20, and enter -0- on line 21.
18 Enter the portion of line 3 that can be attributed to March 27, 2020, through December 31, 2020 . . 18 0.
19 If line 18 is more than zero, multiply line 18 by 92.35% (0.9235); otherwise, enter the amount from line 18 19
20 Enter the portion of lines 15 and 17 that can be attributed to March 27, 2020, through December 31,
2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Combine lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . 21
If line 5b is zero, skip line 22 and enter -0- on line 23.
22 Enter the portion of line 5a that can be attributed to March 27, 2020, through December 31, 2020 . . 22
23 Multiply line 22 by 92.35% (0.9235) . . . . . . . . . . . . . . . . . . . . . . 23 0.
24 Add lines 21 and 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 0.
25 Enter the smaller of line 9 or line 24 . . . . . . . . . . . . . . . . . . . . . . 25 0.
26 Multiply line 25 by 6.2% (0.062). Enter here and see the instructions for line 12e of Schedule 3 (Form
1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 0.
BAA REV 07/28/21 TTO Schedule SE (Form 1040) 2020
Form 6198
(Rev. December 2020)
At-Risk Limitations OMB No. 1545-0712
a Attach to your tax return.

Attachment
Department of the Treasury 31
Internal Revenue Service
a Go to www.irs.gov/Form6198 for instructions and the latest information. Sequence No.
Name(s) shown on return Identifying number
Description of activity (see instructions)
Sch C Lotus Health LLC
Part I Current Year Profit (Loss) From the Activity, Including Prior Year Nondeductible Amounts.
See instructions.
1 Ordinary income (loss) from the activity (see instructions) . . . . . . . . . . . . . . . 1 -2,300.
2 Gain (loss) from the sale or other disposition of assets used in the activity (or of your interest in the
activity) that you are reporting on:
a Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b Form 4797 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
c Other form or schedule . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
3 Other income and gains from the activity, from Schedule K-1 (Form 1065) or Schedule K-1 (Form
1120-S), that were not included on lines 1 through 2c . . . . . . . . . . . . . . . . 3
4 Other deductions and losses from the activity, including investment interest expense allowed from
Form 4952, that were not included on lines 1 through 2c . . . . . . . . . . . . . . . 4 ( )
5 Current year profit (loss) from the activity. Combine lines 1 through 4. See the instructions before
completing the rest of this form . . . . . . . . . . . . . . . . . . . . . . . 5 -2,300.
Part II Simplified Computation of Amount at Risk. See the instructions before completing this part.
6 Adjusted basis (as defined in section 1011) in the activity (or in your interest in the activity) on the first
day of the tax year. Do not enter less than zero . . . . . . . . . . . . . . . . . . 6
7 Increases for the tax year (see instructions) . . . . . . . . . . . . . . . . . . . . 7
8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Decreases for the tax year (see instructions) . . . . . . . . . . . . . . . . . . . 9
10a Subtract line 9 from line 8 . . . . . . . . . . . . . . . . a 10a
b If line 10a is more than zero, enter that amount here and go to line 20 (or complete Part III).
Otherwise, enter -0- and see Pub. 925 for information on the recapture rules . . . . . . . . 10b
Part III Detailed Computation of Amount at Risk. If you completed Part III of Form 6198 for the prior year, see
the instructions.
11 Investment in the activity (or in your interest in the activity) at the effective date. Do not enter less than
zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Increases at effective date . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Add lines 11 and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Decreases at effective date . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Amount at risk (check box that applies):
}
a At effective date. Subtract line 14 from line 13. Do not enter less than zero.
b From your prior year Form 6198, line 19b. Do not enter the amount from line 10b of 15
your prior year form.
16 Increases since (check box that applies):
a Effective date b The end of your prior year . . . . . . . . . . . . . . . . 16
17 Add lines 15 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Decreases since (check box that applies):
a Effective date b The end of your prior year . . . . . . . . . . . . . . . . 18
19a Subtract line 18 from line 17 . . . . . . . . . . . . . . . a 19a
b If line 19a is more than zero, enter that amount here and go to line 20. Otherwise, enter -0- and see
Pub. 925 for information on the recapture rules . . . . . . . . . . . . . . . . . . 19b
Part IV Deductible Loss
20 Amount at risk. Enter the larger of line 10b or line 19b . . . . . . . . . . . . . . . 20
21 Deductible loss. Enter the smaller of the line 5 loss (treated as a positive number) or line 20. See the
instructions to find out how to report any deductible loss and any carryover . . . . . . . . . 21 ( )
Note: If the loss is from a passive activity, see the Instructions for Form 8582, Passive Activity Loss Limitations, or the
Instructions for Form 8810, Corporate Passive Activity Loss and Credit Limitations, to find out if the loss is allowed under
the passive activity rules. If only part of the loss is subject to the passive activity loss rules, report only that part on Form
8582 or Form 8810, whichever applies.
For Paperwork Reduction Act Notice, see the Instructions for Form 6198. BAA REV 07/28/21 TTO Form 6198 (Rev. 12-2020)
Form 8995 Qualified Business Income Deduction OMB No. 1545-2294
Simplified Computation
a Attach
to your tax return.
2020
Name(s) shown on return Your taxpayer identification number

Note. You can claim the qualified business income deduction only if you have qualified business income from a qualified trade or
business, real estate investment trust dividends, publicly traded partnership income, or a domestic production activities deduction
passed through from an agricultural or horticultural cooperative. See instructions.
Use this form if your taxable income, before your qualified business income deduction, is at or below $163,300 ($326,600 if married
filing jointly), and you aren’t a patron of an agricultural or horticultural cooperative.
1 (a) Trade, business, or aggregation name (b) Taxpayer (c) Qualified business
identification number income or (loss)
i Lotus Health LLC 035-60-9554 0.
ii I Luv Kickz 83-3644748 7,171.
iii Lotus Health LLC 035-60-9554 -4,330.
iv
2 Total qualified business income or (loss). Combine lines 1i through 1v,

column (c) . . . . . . . . . . . . . . . . . . . . . . 2 2,841.
3 Qualified business net (loss) carryforward from the prior year . . . . . . . 3 ( )
4 Total qualified business income. Combine lines 2 and 3. If zero or less, enter -0- 4 2,841.
5 Qualified business income component. Multiply line 4 by 20% (0.20) . . . . . . . . . . . 5 568.
6 Qualified REIT dividends and publicly traded partnership (PTP) income or (loss)
(see instructions) . . . . . . . . . . . . . . . . . . . . 6
7 Qualified REIT dividends and qualified PTP (loss) carryforward from the prior
year . . . . . . . . . . . . . . . . . . . . . . . . . 7 ( )
8 Total qualified REIT dividends and PTP income. Combine lines 6 and 7. If zero
or less, enter -0- . . . . . . . . . . . . . . . . . . . . 8
9 REIT and PTP component. Multiply line 8 by 20% (0.20) . . . . . . . . . . . . . . . 9
10 Qualified business income deduction before the income limitation. Add lines 5 and 9 . . . . . . 10 568.
11 Taxable income before qualified business income deduction . . . . . . 11 0.
12 Net capital gain (see instructions) . . . . . . . . . . . . . . . 12 0.
13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . 13 0.
14 Income limitation. Multiply line 13 by 20% (0.20) . . . . . . . . . . . . . . . . . . 14 0.
15 Qualified business income deduction. Enter the lesser of line 10 or line 14. Also enter this amount on
the applicable line of your return . . . . . . . . . . . . . . . . . . . . . . a 15 0.
16 Total qualified business (loss) carryforward. Combine lines 2 and 3. If greater than zero, enter -0- . . 16 ( 0. )
17 Total qualified REIT dividends and PTP (loss) carryforward. Combine lines 6 and 7. If greater than
zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 ( 0. )
For Privacy Act and Paperwork Reduction Act Notice, see instructions. REV 07/28/21 TTO Form 8995 (2020)
Form 14039 Department of the Treasury - Internal Revenue Service OMB Number
(December 2020) Identity Theft Affidavit 1545-2139
Complete this form if you need the IRS to mark an account to identify questionable activity.
Section A - Check the following boxes in this section that apply to the specific situation you are reporting (Required for all filers)
1. I am submitting this Form 14039 for myself
2. This Form 14039 is submitted in response to a ‘Notice’ or ‘Letter’ received from the IRS
• Please provide ‘Notice’ or ‘Letter’ number(s) on the line to the right
• Please check box 1 in Section B and see special mailing and faxing instructions on reverse side of this form.
3. I am submitting this Form 14039 on behalf of my ‘dependent child or dependent relative’
• Please complete Section E on reverse side of this form.
4. I am submitting this Form 14039 on behalf of another person (other than my dependent child or dependent relative)
• Please complete Section E on reverse side of this form.
Section B – Reason For Filing This Form (Required)
Check only ONE of the following boxes that apply to the person listed in Section C below. If the taxpayer in ‘Section C’ has previously
submitted a Form 14039 to the IRS on the same affected tax year(s), there’s no need to submit another Form 14039.
1. Someone used my information to file taxes, including being incorrectly claimed as a dependent
2. I don’t know if someone used my information to file taxes, but I’m a victim of identity theft
Please provide an explanation of the identity theft issue, how you became aware of it and provide relevant dates.
If needed, please attach additional information and/or pages to this form.
Data leak
Section C – Name and Contact Information of Identity Theft Victim (Required)

Victim’s last name First name Middle Taxpayer Identification Number
initial (Please provide 9-digit Social Security Number)
LaFontaine Peter A 035-60-9554

Current mailing address (apartment or suite number and street, or P.O. Box) If deceased, please provide last known address
1224 Ben Avon
Current city State ZIP code
Batavia OH 45103-1094
Tax Year(s) you experienced identity theft (If not known, enter ‘Unknown’ in one box below) What is the last year you filed a
return
NRF
Address used on last filed tax return (If different than ‘Current’) Names used on last filed tax return (If different than ‘Current’)
City (on last tax return filed) State ZIP code
Telephone number with area code (Optional) If deceased, please indicate ‘Deceased’ Best time(s) to call
Home telephone number (239) 316-8648 Cell phone number (239)316-8648 Evening
Language in which you would like to be contacted English Spanish
Section D – Penalty of Perjury Statement and Signature (Required)
Under penalty of perjury, I declare that, to the best of my knowledge and belief, the information entered on this Form 14039 is true, correct,
complete, and made in good faith.
Signature of taxpayer, or representative, conservator, parent or guardian Date signed
Submit this completed form to either the mailing address or the FAX number provided on the reverse side of this form.
www.irs.gov REV 07/28/21 TTO Form 14039 (Rev. 12-2020)
Page 2
Section E – Representative, Conservator, Parent or Guardian Information (Required if completing Form 14039 on someone else’s behalf)
Check only ONE of the following five boxes next to the reason you are submitting this form
1. The taxpayer is deceased and I am the surviving spouse
• No attachments are required, including death certificate.
2. The taxpayer is deceased and I am the court-appointed or certified personal representative
• Attach a copy of the court certificate showing your appointment.
3. The taxpayer is deceased and a court-appointed or certified personal representative has not been appointed
• Attach copy of death certificate or formal notification from a government office informing next of kin of the decedent’s death.
• Indicate your relationship to decedent: Child Parent/Legal Guardian Other
4. The taxpayer is unable to complete this form and I am the appointed conservator or have Power of Attorney/Declaration
of Representative authorization per IRS Form 2848
• Attach a copy of documentation showing your appointment as conservator or POA authorization.
• If you have an IRS issued Centralized Authorization File (CAF) number, enter the nine-digit number:
5. The person is my dependent child or my dependent relative

By checking this box and signing below you are indicating that you are an authorized representative, as parent, guardian or legal
guardian, to file a legal document on the dependent’s behalf.
• Indicate your relationship to person: Parent/Legal Guardian Fiduciary Relationship per IRS Form 56
Power of Attorney Other
Representative's name
Last name First name Middle initial
Representative’s current mailing address (City, town or post office, state, and ZIP code)
Representative’s telephone number
Instructions for Submitting this Form

Submit this completed and signed form to the IRS via Mail or FAX to specialized IRS processing areas dedicated to assist you.
In Section C of this form, be sure to include the Social Security Number in the ‘Taxpayer Identification Number’ field.
Help us avoid delays:
• Choose one method of submitting this form either by Mail or by FAX, not both.
• Please provide clear and readable photocopies of any additional information you may choose to provide.
• Note that ‘tax returns’ may not be submitted to either the mailing address or FAX number.
Submitting by Mail Submitting by FAX
• If you checked Box 1 in Section B in response to a notice or • If you checked Box 1 in Section B of Form 14039 and are
letter received from the IRS, return this form and if possible, a submitting this form in response to a notice or letter received
copy of the notice or letter to the address contained in the from the IRS. If it provides a FAX number, you should send
notice or letter. there.
• If you checked Box 1 in Section B of Form 14039, are unable If no FAX number is shown on the notice or letter, please follow
to file your tax return electronically because the primary and/ the mailing instructions on the notice or letter.
or secondary SSN was misused, attach this Form 14039 to the • Include a cover sheet marked ‘Confidential’.
back of your paper tax return and submit to the IRS location
where you normally file your tax return. • If you checked Box 2 in Section B of Form 14039 (no current
tax-related issue), FAX this form toll-free to:
• If you’ve already filed your paper return, please submit this
Form 14039 to the IRS location where you normally file. Refer to 855-807-5720
the ‘Where Do You File’ section of your return instructions or visit
IRS.gov and input the search term ‘Where to File’.
• If you checked Box 2 in Section B of Form 14039 (no current
tax-related issue), mail this form to:
Internal Revenue Service
Fresno, CA 93888-0025
Privacy Act and Paperwork Reduction Notice
Our legal authority to request the information is 26 U.S.C. 6001. The primary purpose of the form is to provide a method of reporting identity theft issues to the IRS so that the IRS may document situations where individuals are or may be
victims of identity theft. Additional purposes include the use in the determination of proper tax liability and to relieve taxpayer burden. The information may be disclosed only as provided by 26 U.S.C. 6103. Providing the information on this
form is voluntary. However, if you do not provide the information it may be more difficult to assist you in resolving your identity theft issue. If you are a potential victim of identity theft and do not provide the required substantiation
information, we may not be able to place a marker on your account to assist with future protection. If you are a victim of identity theft and do not provide the required information, it may be difficult for IRS to determine your correct tax
liability. If you intentionally provide false information, you may be subject to criminal penalties. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a
valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return
information are confidential, as required by section 6103. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we
would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send this form to this
address. Instead, see the form for filing instructions. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information
subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.
www.irs.gov REV 07/28/21 TTO Form 14039 (Rev. 12-2020)

Section 1.263(a)-1(f)
GAttach to your income tax return
Name(s) Shown on Return Identification Number

Tax Year: 2020

Section 1.263(a)-1(f)
De Minimis Safe Harbor Election
The taxpayer elects to make the de minimis safe harbor election under the Regulation 1.263(a)-1(f)
Name: Peter A LaFontaine

Address: 1224 Ben Avon, Batavia OH 451031094
Identification Number: 035-60-9554
fdiv9801.SCR 11/15/17
Electronic Filing Instructions for your 2020 Ohio Tax Return
Important: Your taxes are not finished until all required steps are completed.
Peter A LaFontaine
1224 Ben Avon
Batavia, OH 45103-1094
|
Balance | Your Ohio state tax return (Form IT 1040) shows that you have no
Due/ | balance due nor a refund due to you: DO NOT mail a payment or expect
Refund | to receive a refund from the Ohio Department of Taxation.
|
______________________________________________________________________________________
|
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 |
|
______________________________________________________________________________________
|
2020 | Taxable Income $ 2,807.00
Ohio | No Refund or Amount Due $ 0.00
Tax |
Return |
Summary |
|
______________________________________________________________________________________
Page 1 of 1
Do not staple or paper clip. 0033 2020 Ohio IT 1040
hio Department of
Taxation
Individual Income Tax Return
Use only black ink/UPPERCASE letters. 20000133
08 24 21 Sequence No. 1
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REV 04/06/21 TTO Rev. 9/9/20. IT 1040 – page 1 of 2

0033 2020 Ohio IT 1040
Individual Income Tax Return
SSN 035 60 9554
20000233 Sequence No. 2
D$PRXQWIURPOLQHRQSDJH ........................................................................................................ 7a. 2807 00
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17. Amended return only±DPRXQWSUHYLRXVO\SDLGZLWKRULJLQDODQGRUDPHQGHGUHWXUQ .............................17. 00
Total Ohio tax payments (add lines 14, 15, 16 and 17) ............................................................................ 00
Amended return only±RYHUSD\PHQWSUHYLRXVO\UHTXHVWHGRQRULJLQDODQGRUDPHQGHGUHWXUQ .............. 00
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REV 04/06/21 TTO Rev. 9/9/20. IT 1040 – page 2 of 2

0033
2020 Ohio Schedule A
Income Adjustments
Use only black ink/UPPERCASE letters.
20000333
Primary taxpayer’s SSN
Sequence No. 3
08 24 21 035 60 9554
Additions
(Add the following if not included on Ohio IT 1040, line 1)
1. Non-Ohio state or local government interest and dividends....................................................................... 1. 00

2. Certain Ohio pass-through entity taxes paid .............................................................................................. 2. 00
2KLRSODQIXQGVXVHGIRUQRQTXDOL¿HGH[SHQVHV ............................................................................... 3. 00
4. Losses from sale or disposition of Ohio public obligations ......................................................................... 4. 00
5. Nonmedical withdrawals from a medical savings account ......................................................................... 5. 00
6. Reimbursement of expenses previously deducted on an Ohio income tax return ..................................... 6. 00
Federal
7. Internal Revenue Code 168(k) and 179 depreciation expense addback ................................................... 7. 00
8. Exempt federal interest and dividends subject to state taxation ................................................................ 8. 00
9. Federal conformity additions ...................................................................................................................... 9. 00
10. Total additions (add lines 1 through 9 ONLY). Enter here and on Ohio IT 1040, line 2a ..............10. 00
Deductions
(Deduct the following if included on Ohio IT 1040, line 1)
11. Business income deduction – Ohio Schedule IT BUS, line 11 ................................................................. 11. 00
12. Employee compensation earned in Ohio by residents of neighboring states............................................. 12. 00
7D[DEOHUHIXQGVFUHGLWVRURႇVHWVRIVWDWHDQGORFDOLQFRPHWD[HVIHGHUDO6FKHGXOHOLQH .. 13. 00
7D[DEOH6RFLDO6HFXULW\EHQH¿WVIHGHUDODQG65OLQHE .................................................... 14. 00
&HUWDLQUDLOURDGUHWLUHPHQWEHQH¿WV .......................................................................................................... 15. 00
16. Interest income from Ohio public obligations and purchase obligations; gains from the
disposition of Ohio public obligations; or income from a transfer agreement ........................................... 16. 00
17. Amounts contributed to an Ohio county's individual development account program ............................... 17. 00
18. Amounts contributed to STABLE account: Ohio's ABLE plan .................................................................. 18. 0 00
19. Income earned in Ohio by a qualifying out-of-state business or employee for disaster
work conducted during a disaster response period .................................................................................. 19. 00
Federal
20. Federal interest and dividends exempt from state taxation ...................................................................... 20. 00
21. Deduction of prior year 168(k) and 179 depreciation addbacks ............................................................... 21. 00
22. Refund or reimbursements from the federal 1040, Schedule 1, line 8 for federal
itemized deductions claimed on a prior year return.................................................................................. 22. 00
REV 04/06/21 TTO Rev. 9/9/20. Schedule A – page 1 of 2

0033
2020 Ohio Schedule A
Income Adjustments
Primary taxpayer’s SSN
20000433
035 60 9554 Sequence No. 4
23. Repayment of income reported in a prior year ......................................................................................... 23. 00

24. Wage expense not deducted based on the federal work opportunity tax credit ....................................... 24. 00
25. Federal conformity deductions ................................................................................................................... 25. 00

Uniformed Services
26. Military pay received by Ohio residents while stationed outside Ohio....................................................... 26. 00
27. Compensation earned by nonresident military servicemembers and their civilian spouses ...................... 27. 00
28. Uniformed services retirement income ..................................................................................................... 28. 00
29. Military injury relief fund grants and veteran’s disability severance payments .................................................. 29. 00
&HUWDLQ2KLR1DWLRQDO*XDUGUHLPEXUVHPHQWVDQGEHQH¿WV..................................................................... 30. 00
Education
31. Amounts contributed to Ohio CollegeAdvantage: Ohio’s 529 Plan .......................................................... 31. 00
32. Pell/Ohio College Opportunity taxable grant amounts used to pay room and board ............................... 32. 00
33. Ohio educator expenses in excess of federal deduction .......................................................................... 33. 00
Medical
'LVDELOLW\EHQH¿WV ..................................................................................................................................... 34. 00

6XUYLYRUEHQH¿WV ....................................................................................................................................... 35. 00
36. Unreimbursed medical and health care expenses (see instructions for worksheet; include a copy) ..... 36. 00
37. Medical savings account contributions/earnings (see instructions for worksheet; include a copy) ........ 37. 00
4XDOL¿HGRUJDQGRQRUH[SHQVHV .............................................................................................................. 38. 00
39. Total deductions (add lines 11 through 38 ONLY). Enter here and on Ohio IT 1040, line 2b...............39. 0 00
REV 04/06/21 TTO Rev. 9/9/20. Schedule A – page 2 of 2

Forms Ohio
IT 1040 - SD 100 Electronic Filing 2020
Perjury Statement Acceptance
Under penalties of perjury, I declare that to the best of my knowledge and belief, the Ohio income
tax return and if applicable, the Ohio school district income tax return are true, correct and
complete. I also declare under penalties of perjury that if I am filing a return with my spouse, I am
authorized to make this declaration on his/her behalf and to file the return for both of us.
X Taxpayer’s acceptance of the above Perjury Statement

Spouse’s acceptance of the above Perjury Statement
1040 U.S. Individual Income Tax Return 2020 (99)
Form Department of the Treasury—Internal Revenue Service
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying
one box.
person is a child but not your dependent a
Your first name and middle initial Last name Your social security number
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
1224 Ben Avon Check here if you, or your
spouse if filing jointly, want $3
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code
to go to this fund. Checking a
Batavia OH 451031094 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse
At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes No
Standard Someone can claim: You as a dependent Your spouse as a dependent

Deduction Spouse itemizes on a separate return or you were a dual-status alien
Age/Blindness You: Were born before January 2, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check
here a
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . 1
Attach 2a Tax-exempt interest . . . 2a 2b 0.
b Taxable interest . . . . .
Sch. B if
required.
3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b 0.
4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b
5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b
Standard 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b
Deduction for—
7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . a 7 -4.
• Single or
Married filing 8 Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . 8 3,057.
separately,
$12,400 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . a 9 3,053.
• Married filing 10 Adjustments to income:
jointly or
Qualifying a From Schedule 1, line 22 . . . . . . . . . . . . . . 10a 216.
widow(er),
$24,800
b Charitable contributions if you take the standard deduction. See instructions 10b 30.
• Head of c Add lines 10a and 10b. These are your total adjustments to income . . . . . . . . a 10c 246.
household,
$18,650 11 Subtract line 10c from line 9. This is your adjusted gross income . . . . . . . . . a 11 2,807.
• If you checked 12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 3,191.
any box under
Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . . . . . . 13 0.
Deduction,
see instructions.
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 3,191.
15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- . . . . . . . . . 15 0.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2020)
Form 1040 (2020) Page 2
16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 0.
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 0.
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . 19
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 0.
23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . 23 432.
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . a 24 432.
25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d
• If you have a 26 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . No. . 27
attach Sch. EIC.
• If you have 28 Additional child tax credit. Attach Schedule 8812 . . . . . . . 28
nontaxable 29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
combat pay,
see instructions. 30 Recovery rebate credit. See instructions . . . . . . . . . . 30
31 Amount from Schedule 3, line 13 . . . . . . . . . . . . 31
32 Add lines 27 through 31. These are your total other payments and refundable credits . . . a 32
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . a 33
34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34
Refund
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . a 35a
Direct deposit? ab Routing number X X X X X X X X X a c Type: Checking Savings
See instructions. a
d Account number X X X X X X X X X X X X X X X X X
36 Amount of line 34 you want applied to your 2021 estimated tax . . a 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe now . . . . . . . . . . a 37 432.
You Owe Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
For details on 2020. See Schedule 3, line 12e, and its instructions for details.
how to pay, see
instructions. 38 Estimated tax penalty (see instructions) . . . . . . . . . a 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . a Yes. Complete below. No
Designee’s Phone Personal identification
name a no. a number (PIN) a
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
Sign 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 If the IRS sent you an Identity
Protection PIN, enter it here
F
Joint return? Self-Employed/ Disabled (see inst.) a 0 5 2 9 9 0

See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.) a
Phone no. (239)316-8648 Email address
Preparer’s name Preparer’s signature Date PTIN Check if:
Paid Self-employed
Preparer Firm’s name a Self-Prepared Phone no.
Use Only Firm’s address a Firm’s EIN a
Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 07/28/21 TTO Form 1040 (2020)
Additional Income and Adjustments to Income
(Form 1040)
Attachment
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . 1
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b Date of original divorce or separation agreement (see instructions) a
3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . 3 3,057.
4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income. List type and amount a
8
9 Combine lines 1 through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR,
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3,057.
Part II Adjustments to Income
10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government
officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . 12
13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . 13
14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . 14 216.
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . 15
16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . 16
17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . 17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient’s SSN . . . . . . . . . . . . . . . . . . . . a
c Date of original divorce or separation agreement (see instructions) a
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees deduction. Attach Form 8917 . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and
on Form 1040, 1040-SR, or 1040-NR, line 10a . . . . . . . . . . . . . . . 22 216.
Additional Taxes
(Form 1040)
Attachment
Part I Tax
1 Alternative minimum tax. Attach Form 6251 . . . . . . . . . . . . . . . . 1
2 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . 2
3 Add lines 1 and 2. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 17 . . 3
Part II Other Taxes
4 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . 4 432.
5 Unreported social security and Medicare tax from Form: a 4137 b 8919 . 5
6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored
accounts. Attach Form 5329 if required . . . . . . . . . . . . . . . . . . 6
7a Household employment taxes. Attach Schedule H . . . . . . . . . . . . . 7a
b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if
required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b
8 Taxes from: a Form 8959 b Form 8960
c Instructions; enter code(s) 8
9 Section 965 net tax liability installment from Form 965-A . . . 9
10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form
1040 or 1040-SR, line 23, or Form 1040-NR, line 23b . . . . . . . . . . . . 10 432.

Electronic Filing Instructions For Your 2020 Federal Tax Return

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Electronic Filing Instructions For Your 2020 Federal Tax Return

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Electronic Filing Instructions for your 2020 Federal Tax Return

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Form 1040-V 2020

PETER A LAFONTAINE INTERNAL REVENUE SERVICE

035609554 ZL LAFO 30 0 202012 610

Standard Someone can claim: You as a dependent Your spouse as a dependent

Joint return? Self-Employed/ Disabled (see inst.) a 0 5 2 9 9 0

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41

a Business b Commuting (see instructions) c Other

47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes No

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Startup Costs 3,300.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48 3,300.

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36 2,500.

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37 0.

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38 50.

39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 100.

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40 5,150.

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41 2,500.

a Business 480 b Commuting (see instructions) c Other 0

47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes No

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Credit Cards 3,500.

Domains, Shopify Fees 360.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48 3,980.

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41

a Business b Commuting (see instructions) c Other

47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes No

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Tools, Templates, Stock Photos 30.

Startup Costs 3,300.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48 3,330.

Name(s) shown on return Your social security number

1a Totals for all short-term transactions reported on Form

8a Totals for all long-term transactions reported on Form

Part III Summary

16 Combine lines 7 and 15 and enter the result . . . . . . . . . . . . . . . . . . 16 -4.

17 Are lines 15 and 16 both gains?

• The loss on line 16; or

No. Complete the rest of Form 1040, 1040-SR, or 1040-NR.

REV 07/28/21 TTO Schedule D (Form 1040) 2020

00901B105 AIM IMMUNOTECH INC. 1 05/14/20 05/26/20 2. 3. -1.

185860202 CLEVELAND BIOLABS, INC. COMMON STOCK 4 05/14/20 05/19/20 9. 8. 1.

222070203 COTY INC 3 05/15/20 05/21/20 10. 10. 0.

222070203 COTY INC 32 06/01/20 06/02/20 136. 127. 9.

247361702 DELTA AIR LINES, INC. 2 05/21/20 05/27/20 51. 46. 5.

262077100 DRIVE SHACK INC. 25 VARIOUS 05/26/20 48. 50. -2.

345370860 FORD MOTOR COMPANY 9 VARIOUS 05/27/20 53. 48. 5.

345370860 FORD MOTOR COMPANY 29 VARIOUS 05/29/20 165. 166. W 4. 3.

345370860 FORD MOTOR COMPANY 5 06/01/20 06/02/20 29. 30. W 0. -1.

345370860 FORD MOTOR COMPANY 5 06/01/20 06/09/20 37. 30. 7.

345370860 FORD MOTOR COMPANY 5 06/01/20 06/11/20 31. 30. 1.

37045V100 GENERAL MOTORS COMPANY 3 VARIOUS 06/04/20 87. 84. 3.

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,QWHUHVWSHQDOW\RQXQGHUSD\PHQWRIHVWLPDWHGWD[include Ohio IT/SD 2210) ........................................11. 00

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