2023 1040 Cole McCauley

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CLIENT'S COPY
Direct Deposit/Debit Report
Name: COLE P. MCCAULEY ID Number: 254-97-2593
Debit/Deposit
Unit Form Name of Financial Institution Account Type Routing Number Account Number Date Amount
FED 1040 BANK OF AMERICA CHECKING 061000052 334040965691 DEPOSIT 1,173.
GA 500 BANK OF AMERICA CHECKING 061000052 334040965691 DEPOSIT 395.
303481 04-01-23
Two-Year Comparison Worksheet 2023
Name(s) as shown on return Social security number
COLE P. MCCAULEY 254-97-2593
2022 Filing Status SINGLE SINGLE
2023 Filing Status
2022 Tax Bracket 12.0% 2023 Tax Bracket 10.0%
Tax Year Tax Year Increase

Description
2022 2023 (Decrease)
WAGES, SALARIES, AND TIPS 34,451. 13,846. -20,605.

SCHEDULE B - TAXABLE INTEREST 11. 33. 22.
SCHEDULE B - QUALIFIED DIVIDENDS 187. 195. 8.
SCHEDULE B - ORDINARY DIVIDENDS 187. 195. 8.
OTHER INCOME 0. 642. 642.
TOTAL INCOME 34,649. 14,716. -19,933.
ADJUSTED GROSS INCOME 34,649. 14,716. -19,933.
STANDARD DEDUCTION 12,950. 13,850. 900.

TOTAL DEDUCTIONS 12,950. 13,850. 900.
TAXABLE INCOME 21,699. 866. -20,833.
TAX 2,378. 66. -2,312.

TAX BEFORE CREDITS 2,378. 66. -2,312.
FORM 8863 (EDUCATION CREDITS) 0. 66. 66.

TAX AFTER NON-REFUNDABLE CREDITS 2,378. 0. -2,378.
TOTAL TAX 2,378. 0. -2,378.
FED. INCOME TAX WITHHELD, FORM W-2 2,815. 941. -1,874.

SCHEDULE EIC (EARNED INCOME CREDIT) 0. 223. 223.
NET PREMIUM TAX CREDIT 0. 9. 9.
TOTAL PAYMENTS 2,815. 1,173. -1,642.
TAX OVERPAID 437. 1,173. 736.

AMOUNT REFUNDED 437. 1,173. 736.
GEORGIA STATE RETURN

TAXABLE INCOME 26,549. 6,616. -19,933.
TAX 1,354. 213. -1,141.
NON-REFUNDABLE CREDITS 0. 8. 8.
PAYMENTS 1,619. 600. -1,019.
AMOUNT REFUNDED 265. 395. 130.
326301 04-01-23
HENNING, DOWDY & JONES, LLC
750 HAMMOND DRIVE
BUILDING 1, SUITE 200
SANDY SPRINGS, GA 30328
July 11, 2024
COLE P. MCCAULEY
4391 paran place
ATLANTA, GA 30327
Dear COLE:
Enclosed are your 2023 income tax returns.
Specific filing instructions are as follows.
FEDERAL INCOME TAX RETURN:
This return has been prepared for electronic filing and the practitioner PIN program has been elected.
Please sign and return Form 8879 to our office. We will then transmit your return electronically to the
IRS. If after three weeks you have not received your refund, you may contact the IRS at 1-800-829-4477.
No payment is required as you are due a refund in the amount of $1,173.
Your refund will be deposited directly into your account ending in 5691. Refer to Form 1040 on the Direct
Deposit/Debit Report for complete account information.
GEORGIA INCOME TAX RETURN:
This return has been prepared for electronic filing. If you wish to have it transmitted electronically to the
GA DOR, please sign, date, and return Form GA 8453 to our office. We will then submit your electronic
return to the GA DOR. Do not mail the paper copy of the return to the GA DOR.
No payment is required as you are to receive a refund in the amount of $395.
Your refund will be deposited directly into your account ending in 5691. Refer to Form 500 on the Direct
Deposit/Debit Report for complete account information.
Your copies of the returns are enclosed for your files. We suggest that you retain these copies
indefinitely.
Sincerely,
Kelly Dowdy, CPA

Form 8879
(Rev. January 2021)
IRS e-file Signature Authorization
OMB No. 1545-0074
Department of the Treasury | ERO must obtain and retain completed Form 8879.
Internal Revenue Service | Go to www.irs.gov/Form8879 for the latest information.
Submission Identification Number (SID)

=
Taxpayer's name Social security number
COLE P. MCCAULEY 254 97 2593
----
----
Spouse's name Spouse's social security number
----
----
Part I Tax Return Information - Tax Year Ending December 31, 2023 (Enter year you are authorizing.)
Enter whole dollars only on lines 1 through 5.
Note: Form 1040-SS filers use line 4 only. Leave lines 1, 2, 3, and 5 blank.
1 Adjusted gross income ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 14,716.
2 Total tax ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2
3 Federal income tax withheld from Form(s) W-2 and Form(s) 1099 ~~~~~~~~~~~~~~~~~~~~~~~ 3 941.
4 Amount you want refunded to you ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4 1,173.
5 Amount you owe 5
Part II Taxpayer Declaration and Signature Authorization (Be sure you get and keep a copy of your return)
Under penalties of perjury, I declare that I have examined a copy of the income tax return (original or amended) I am now authorizing, and to the best of my knowledge
and belief, it is true, correct, and complete. I further declare that the amounts in Part I above are the amounts from the income tax return (original or amended) I am now
authorizing. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send my return to the IRS and to receive from the IRS
(a) an acknowledgement of receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any
refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial
institution account indicated in the tax preparation software for payment of my federal taxes owed on this return and/or a payment of estimated tax, and the financial
institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the
authorization. To revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 . Payment cancellation requests must be received no
later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes
to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I further acknowledge that the personal identification number
(PIN) below is my signature for the income tax return (original or amended) I am now authorizing and, if applicable, my Electronic Funds Withdrawal Consent.
Taxpayer's PIN: check one box only
X I authorize HENNING, DOWDY & JONES, LLC to enter or generate my PIN 6 2 5 9 3 as my
ERO firm name Enter five digits, but
signature on the income tax return (original or amended) I am now authorizing. don't enter all zeros
I will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. Check this box only if you are
entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.
Your signature | Date | 07/11/2024
Spouse's PIN: check one box only

I authorize to enter or generate my PIN as my
ERO firm name Enter five digits, but
signature on the income tax return (original or amended) I am now authorizing. don't enter all zeros
will enter my PIN as my signature on the income tax return (original or amended) I am now authorizing. Check this box only if you
are entering your own PIN and your return is filed using the Practitioner PIN method. The ERO must complete Part III below.
Spouse's signature | Date |
Practitioner PIN Method Returns Only - continue below

Part III Certification and Authentication - Practitioner PIN Method Only
ERO's EFIN/PIN. Enter your six-digit EFIN followed by your five-digit self-selected PIN. 5 8 2 1 0 1 9 2 3 3 8
Don't enter all zeros
I certify that the above numeric entry is my PIN, which is my signature for the electronic individual income tax return (original or amended) I am now
authorized to file for tax year indicated above for the taxpayer(s) indicated above. I confirm that I am submitting this return in accordance with the
requirements of the Practitioner PIN method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns.
ERO's signature | Date |
319995 04-01-23 ERO Must Retain This Form - See Instructions

Don't Submit This Form to the IRS Unless Requested To Do So
LHA For Paperwork Reduction Act Notice, see your tax return instructions. Form 8879 (Rev. 01-2021)
Tax Year 2023 e-file Jurat/Disclosure
for Form 1040 or 1040NR
using Practitioner PIN method
(with or without Electronic Funds Withdrawal)
ERO Declaration
I declare that the information contained in this electronic tax return is the information furnished to me by the taxpayer. If the
taxpayer furnished me a completed tax return, I declare that the information contained in this electronic tax return is identical
to that contained in the return provided by the taxpayer. If the furnished return was signed by a paid preparer, I declare I have
entered the paid preparer's identifying information in the appropriate portion of this electronic return. If I am the paid preparer,
under the penalties of perjury I declare that I have examined this electronic return, and to the best of my knowledge and belief,
it is true, correct, and complete. This declaration is based on all information of which I have any knowledge.
ERO Signature
I am signing this Tax Return by entering my PIN below.
ERO's PIN 58210192338

(enter EFIN plus 5 self-selected numerics)
Taxpayer Declarations
Perjury Statement
Perjury Statement (1040 and 1040NR)
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to
the best of my knowledge and belief, they are true, correct and complete. Declaration of preparer (other than the taxpayer) is
based on all information of which the preparer has any knowledge.
Perjury Statement (104X)

Under penalties of perjury, I declare that I have filed an original return and that I have examined this amended return,
including accompanying schedules and statements, and to the best of my knowledge and belief, this amended return is true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information about which the preparer has
any knowledge.
Consent to Disclosure
I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send my return/form
to IRS and to receive the following information from IRS: a) an acknowledgment of receipt or reason for rejection of transmission;
b) the reason for any delay in processing or refund; and, c) the date of any refund.
Electronic Funds Withdrawal Consent

If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal
(direct debit) entry to the financial institution account indicated in the tax preparation software for payment of my Federal taxes
owed on this return and/or payment of estimated tax, and the financial institution to debit the entry to this account. This
authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To
revoke (cancel) a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior
to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of
taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment.
I am signing this Tax Return and Electronic Funds Withdrawal Consent, if applicable, by entering my Self-Select
PIN below.
Taxpayer's PIN: 62593 Date 07112024
Spouse's PIN:
319986 04-01-23
Department of the Treasury - Internal Revenue Service
Form
1040 U.S. Individual Income Tax Return 2023 OMB No. 1545-0074
IRS Use Only - Do not write or staple in this space.
For the year Jan. 1 - Dec. 31, 2023, or other tax year beginning , ending See separate instructions.
" "
Your first name and middle initial Last name Your social security number
COLE P. MCCAULEY 254 97 2593
" "
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
Check here if you, or your
4391 PARAN PLACE spouse if filing jointly, want $3 to
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code go to this fund. Checking a box
ATLANTA GA30327 below will not change your tax or
refund.
Foreign country name Foreign province/state/county Foreign postal code You Spouse
Filing Status X Single Head of household (HOH)

Check only Married filing jointly (even if only one had income)
one box. Married filing separately (MFS) Qualifying surviving spouse (QSS)
If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child's name if the qualifying person is
a child but not your dependent
Digital At any time during 2023, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell,
Assets exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) Yes X 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, 1959 Are blind Spouse: Was born before January 2, 1959 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4) Check the box if qualifies for (see instr.):
If more Child tax credit Credit for other dependents
than four
(1) First name Last name
depend-
ents, see
instr. and
check
here
STMT 1
1 a Total amount from Form(s) W-2, box 1 (see instructions) ~~~~~~~~~~~~~~~~~~~ 1a 13,846.
Income
b Household employee wages not reported on Form(s) W-2 ~~~~~~~~~~~~~~~~~~ 1b
Attach Form(s)
W-2 here. Also c Tip income not reported on line 1a (see instructions) ~~~~~~~~~~~~~~~~~~~~~ 1c
attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) ~~~~~~~~~~ 1d
W-2G and
1099-R if tax e Taxable dependent care benefits from Form 2441, line 26 ~~~~~~~~~~~~~~~~~~ 1e
was withheld. f Employer-provided adoption benefits from Form 8839, line 29 ~~~~~~~~~~~~~~~~ 1f
If you did not g Wages from Form 8919, line 6 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1g
get a Form
W-2, see h Other earned income (see instructions) 1h
instructions. i Nontaxable combat pay election (see instructions) ~~~~~~~
1i
z Add lines 1a through 1h 1z 13,846.
Attach 2 a Tax-exempt interest ~~~ 2a b Taxable interest ~~~~~~ 2b 33.
Sch. B if 195. b Ordinary dividends ~~~~~ 195.
3 a Qualified dividends ~~~~ 3a 3b
required.
4 a IRA distributions ~~~~~ 4a b Taxable amount ~~~~~~ 4b
5 a Pensions and annuities ~~ 5a b Taxable amount ~~~~~~ 5b
Standard
Deduction for - 6 a Social security benefits ~~ 6a b Taxable amount 6b
¥ Single or Married c If you elect to use the lump-sum election method, check here (see instructions) ~~~~~
filing separately,
$13,850 7 Capital gain or (loss). Attach Schedule D if required. If not required, check here ~~~~~ 7
¥ Married filing 8 Additional income from Schedule 1, line 10 ~~~~~~~~~~~~~~~~~~~~~~~~~ 8 642.
jointly or
Qualifying 9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income ~~~~~~~~~~~~~ 9 14,716.
surviving spouse,
$27,700 10 Adjustments to income from Schedule 1, line 26 ~~~~~~~~~~~~~~~~~~~~~~ 10
11 Subtract line 10 from line 9. This is your adjusted gross income ~~~~~~~~~~~~~~ 11 14,716.
¥ Head of
household,
$20,800 12 Standard deduction or itemized deductions (from Schedule A) ~~~~~~~~~~~~~~ 12 13,850.
¥ If you checked 13 Qualified business income deduction from Form 8995 or Form 8995-A ~~~~~~~~~~~~ 13
any box under
Standard 14 Add lines 12 and 13 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14 13,850.
Deduction,
see instructions. 15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income ~~~~~~ 15 866.
LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2023)
313921 12-04-23
Form 1040 (2023) COLE P. MCCAULEY 254-97-2593 STMT 3 Page 2
Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 16 66.
Credits 17 Amount from Schedule 2, line 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17
18 Add lines 16 and 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 18 66.
19 Child tax credit or credit for other dependents from Schedule 8812 ~~~~~~~~~~~~~ 19
20 Amount from Schedule 3, line 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 20 66.
21 Add lines 19 and 20 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 21 66.
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 21 ~~~~~~~~~~~~ 23
24 Add lines 22 and 23. This is your total tax 24 0.
Payments 25 Federal income tax withheld from:
SEE STATEMENT 4
a Form(s) W-2 ~~~~~~~~~~~~~~~~~~~~~~~~ 25a 941.
b Form(s) 1099 ~~~~~~~~~~~~~~~~~~~~~~~~ 25b
c Other forms (see instructions) ~~~~~~~~~~~~~~~~ 25c
d Add lines 25a through 25c ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 25d 941.
If you have a 26 2023 estimated tax payments and amount applied from 2022 return 26
qualifying child,
27 Earned income credit (EIC) ~~~~~~~~~~~~~~~~~ 27 223.
attach Sch. EIC.
28 Additional child tax credit from Schedule 8812 ~~~~~~~ 28
29 American opportunity credit from Form 8863, line 8 ~~~~~ 29
30 Reserved for future use ~~~~~~~~~~~~~~~~~~~ 30
31 Amount from Schedule 3, line 15 ~~~~~~~~~~~~~~ 31 9.
32 Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits ~~~ 32 232.
33 Add lines 25d, 26, and 32. These are your total payments 33 1,173.
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid 34 1,173.
35 a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here 35a 1,173.
Direct deposit? b Routing number 061000052 c Type: X Checking Savings
d Account number 334040965691
See instructions.
36 Amount of line 34 you want applied to your 2024 estimated tax 36

Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions ~~~~~~~~~~ 37
38 Estimated tax penalty (see instructions) 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X Yes. Complete below. No
Designee's Phone Personal identification
name KELLY DOWDY, CPA no. 404-705-4589 number (PIN) 92338

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
Here (see inst.)
MARKETING
Spouse's signature. If a joint return, both must sign. Date Spouse's occupation If the IRS sent your spouse
Joint return?
an Identity Protection PIN,
See instructions.
Keep a copy for enter it here (see inst.)
your records.
Phone no. Email address
Paid Preparer's name Preparer's signature Date PTIN
Preparer Check if:

Use Only KELLY DOWDY, CPA P00071067 Self-employed
Phone no.
Firm's
name HENNING, DOWDY & JONES, LLC 404-705-4589
750 HAMMOND DR NE BLDG 1 SUITE 200 Firm's EIN
Firm's
address SANDY SPRINGS, GA 30328 46-0733218
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2023)
313922 12-04-23
OMB No. 1545-0074
SCHEDULE 1
Additional Income and Adjustments to Income
(Form 1040)
Department of the Treasury

Attach to Form 1040, 1040-SR, or 1040-NR. 2023
Attachment
Internal Revenue Service 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)
3 Business income or (loss). Attach Schedule C ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3
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:
a Net operating loss ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8a ( )
b Gambling ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8b
c Cancellation of debt ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8c
d Foreign earned income exclusion from Form 2555 ~~~~~~~~~~~~~~~ 8d ( )
e Income from Form 8853 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8e
f Income from Form 8889 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8f
g Alaska Permanent Fund dividends ~~~~~~~~~~~~~~~~~~~~~~ 8g
h Jury duty pay ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8h
i Prizes and awards ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8i
j Activity not engaged in for profit income ~~~~~~~~~~~~~~~~~~~~ 8j
k Stock options ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8k
l Income from the rental of personal property if you engaged in
the rental for profit but were not in the business of renting such
property ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8l
m Olympic and Paralympic medals and USOC prize money (see
instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8m
n Section 951(a) inclusion (see instructions) ~~~~~~~~~~~~~~~~~~~ 8n
o Section 951A(a) inclusion (see instructions) ~~~~~~~~~~~~~~~~~~ 8o
p Section 461(l) excess business loss adjustment ~~~~~~~~~~~~~~~~ 8p
q Taxable distributions from an ABLE account (see instructions) ~~~~~~~~~ 8q
r Scholarship and fellowship grants not reported on Form W-2 ~~~~~~~~~~ 8r
s Nontaxable amount of Medicaid waiver payments included on Form
1040, line 1a or 1d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8s ( )
t Pension or annuity from a nonqualifed deferred compensation plan or
a nongovernmental section 457 plan ~~~~~~~~~~~~~~~~~~~~~ 8t
u Wages earned while incarcerated ~~~~~~~~~~~~~~~~~~~~~~~ 8u
z Other income. List type and amount:
PERFORMAN PREDICTIONS 8z 642.

642.
9 Total other income. Add lines 8a through 8z ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 9 642.
10 Combine lines 1 through 7 and 9. This is your additional income. Enter here and on Form
1040, 1040-SR, or 1040-NR, line 8 10 642.
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040) 2023
LHA 314141 12-14-23

Schedule 1 (Form 1040) 2023 Page 2
Part II Adjustments to Income
11 Educator expenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11
12 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach
Form 2106 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 12
13 Health savings account deduction. Attach Form 8889 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13
14 Moving expenses for members of the Armed Forces. Attach Form 3903 ~~~~~~~~~~~~~~~~~~~ 14
15 Deductible part of self-employment tax. Attach Schedule SE ~~~~~~~~~~~~~~~~~~~~~~~~ 15
16 Self-employed SEP, SIMPLE, and qualified plans ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 16
17 Self-employed health insurance deduction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17
18 Penalty on early withdrawal of savings ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 18
" "
19 a Alimony paid 19a
b Recipient's SSN ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
c Date of original divorce or separation agreement (see instructions):
20 IRA deduction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 20
21 Student loan interest deduction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 21
22 Reserved for future use ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 22
23 Archer MSA deduction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 23
24 Other adjustments:
a Jury duty pay (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~ 24a
b Deductible expenses related to income reported on line 8l from
the rental of personal property engaged in for profit ~~~~~~~~~~~~~~ 24b
c Nontaxable amount of the value of Olympic and Paralympic
medals and USOC prize money reported on line 8m ~~~~~~~~~~~~~~ 24c
d Reforestation amortization and expenses ~~~~~~~~~~~~~~~~~~~ 24d
e Repayment of supplemental unemployment benefits under the
Trade Act of 1974 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 24e
f Contributions to section 501(c)(18)(D) pension plans ~~~~~~~~~~~~~ 24f
g Contributions by certain chaplains to section 403(b) plans ~~~~~~~~~~ 24g
h Attorney fees and court costs for actions involving certain
unlawful discrimination claims (see instructions) ~~~~~~~~~~~~~~~~ 24h
i Attorney fees and court costs you paid in connection with an
award from the IRS for information you provided that helped the
IRS detect tax law violations ~~~~~~~~~~~~~~~~~~~~~~~~~ 24i
j Housing deduction from Form 2555 ~~~~~~~~~~~~~~~~~~~~~~ 24j
k Excess deductions of section 67(e) expenses from Schedule K-1
(Form 1041) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 24k
z Other adjustments. List type and amount:
24z
25 Total other adjustments. Add lines 24a through 24z ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 25
26 Add lines 11 through 23 and 25. These are your adjustments to income. Enter here and on
Form 1040, 1040-SR, or 1040-NR, line 10 26
Schedule 1 (Form 1040) 2023
314142 12-14-23
SCHEDULE 3 OMB No. 1545-0074
Additional Credits and Payments
(Form 1040)

Attach to Form 1040, 1040-SR, or 1040-NR. 202303
Attachment
Internal Revenue Service Go to www.irs.gov /Form1040 for instructions and the latest information. Sequence No.
Part I Nonrefundable Credits
1 Foreign tax credit. Attach Form 1116 if required ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1
2 Credit for child and dependent care expenses from Form 2441, line 11. Attach
Form 2441 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2
3 Education credits from Form 8863, line 19 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 66.
4 Retirement savings contributions credit. Attach Form 8880 ~~~~~~~~~~~~~~~~~~~~~~~~ 4
5a Residential clean energy credit from Form 5695, line 15 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 5a
b Energy efficient home improvement credit from Form 5695, line 32 5b
6 Other nonrefundable credits:
a General business credit. Attach Form 3800 ~~~~~~~~~~~~~~~~ 6a
b Credit for prior year minimum tax. Attach Form 8801 ~~~~~~~~~~~ 6b
c Adoption credit. Attach Form 8839 ~~~~~~~~~~~~~~~~~~~~ 6c
d Credit for the elderly or disabled. Attach Schedule R ~~~~~~~~~~~ 6d
e Reserved for future use ~~~~~~~~~~~~~~~~~~~~~~~~~~ 6e
f Clean vehicle credit. Attach Form 8936 ~~~~~~~~~~~~~~~~~~ 6f
g Mortgage interest credit. Attach Form 8396 ~~~~~~~~~~~~~~~~ 6g
h District of Columbia first-time homebuyer credit. Attach Form 8859 ~~~~ 6h
i Qualified electric vehicle credit. Attach Form 8834 ~~~~~~~~~~~~~ 6i
j Alternative fuel vehicle refueling property credit. Attach Form 8911 ~~~~~ 6j
k Credit to holders of tax credit bonds. Attach Form 8912 ~~~~~~~~~~ 6k
l Amount on Form 8978, line 14. See instructions ~~~~~~~~~~~~~~ 6l
m Credit for previously owned clean vehicles. Attach Form 8936 ~~~~~~~ 6m
z Other nonrefundable credits. List type and amount:
6z
7 Total other nonrefundable credits. Add lines 6a through 6z ~~~~~~~~~~~~~~~~~~~~~~~~ 7
8 Add lines 1 through 4, 5a, 5b, and 7. Enter here and on Form 1040, 1040-SR, or
1040-NR, line 20 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8 66.
(continued on page 2)
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 3 (Form 1040) 2023
LHA 314161 12-14-23

Schedule 3 (Form 1040) 2023 Page 2
Part II Other Payments and Refundable Credits
9 Net premium tax credit. Attach Form 8962 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 9 9.
10 Amount paid with request for extension to file (see instructions) ~~~~~~~~~~~~~~~~~~~~~~ 10
11 Excess social security and tier 1 RRTA tax withheld ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11
12 Credit for federal tax on fuels. Attach Form 4136 12
13 Other payments or refundable credits:
a Form 2439 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13a
b Credit for repayment of amounts included in income from earlier
years ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13b
c Elective payment election amount from Form 3800, Part III, line
6, column (i) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13c
d Deferred amount of net 965 tax liability (see instructions) ~~~~~~~~~ 13d
z Other payments or refundable credits. List type and amount:
13z
14 Total other payments or refundable credits. Add lines 13a through 13z ~~~~~~~~~~~~~~~~~~ 14
15 Add lines 9 through 12 and 14. Enter here and on Form 1040, 1040-SR, or 1040-NR,
line 31 15 9.
Schedule 3 (Form 1040) 2023
314162 12-14-23
Underpayment of Estimated Tax by
2210
OMB No.1545-0140
Form
Individuals, Estates, and Trusts
Attach to Form 1040, 1040-SR, 1040-NR, or 1041. 2023
Attachment
Internal Revenue Service
Go to www.irs.gov/Form2210 for instructions and the latest information. Sequence No. 06
Name(s) shown on tax return Identifying number
Do You Have To File Form 2210?

Yes
Complete lines 1 through 7 below. Is line 4 or line 7 less than | Don't file Form 2210. You don't owe a penalty.
$1,000?
No
L
Complete lines 8 and 9 below. Is line 6 equal to or more than Yes You don't owe a penalty. Don't file Form 2210 unless box E in
|
line 9? Part II applies, then file page 1 of Form 2210.
No
L
Yes You must file Form 2210. Does box B, C, or D in Part II apply?
You may owe a penalty. Does any box in Part II below apply? |
No Yes
No | You must figure your penalty.
L L
Don't file Form 2210. You aren't required to figure your You aren't required to figure your penalty because the IRS will
penalty because the IRS will figure it and send you a bill for any figure it and send you a bill for any unpaid amount. If you want to
unpaid amount. If you want to figure it, you may use Part III figure it, you may use Part III as a worksheet and enter your
as a worksheet and enter your penalty amount on your tax penalty amount on your tax return, but file only page 1 of
return, but don't file Form 2210. Form 2210.
Part I Required Annual Payment

1 Enter your 2023 tax after credits from Form 1040, 1040-SR, or 1040-NR, line 22. (See the
instructions if not filing Form 1040.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1
2 Other taxes, including self-employment tax and, if applicable, Additional Medicare Tax and/or Net
Investment Income Tax (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2
3 Other payments and refundable credits (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 ( 232. )
4 Current year tax. Combine lines 1, 2, and 3. If less than $1,000, stop; you don't owe a penalty. Don't file Form 2210 ~~~~ 4 0.
5 Multiply line 4 by 90% (0.90) ~~~~~~~~~~~~~~~~~~~~~~~~~ 5
6 Withholding taxes. Don't include estimated tax payments. See instructions ~~~~~~~~~~~~~~~~~~~~~~ 6 941.
7 Subtract line 6 from line 4. If less than $1,000, stop; you don't owe a penalty. Don't file Form 2210 ~~~~~~~~~~~ 7 0.
8 Maximum required annual payment based on prior year's tax (see instructions) ~~~~~~~~~~~~~~~~~~~~ 8
9 Required annual payment. Enter the smaller of line 5 or line 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 9
Next: Is line 9 more than line 6?
No. You don't owe a penalty. Don't file Form 2210 unless box E below applies.
Yes. You may owe a penalty, but don't file Form 2210 unless one or more boxes in Part II below applies.
¥ If box B, C, or D applies, you must figure your penalty and file Form 2210.
¥ If box A or E applies (but not B, C, or D), file only page 1 of Form 2210. You aren't required to figure your penalty; the IRS will figure it and send you
a bill for any unpaid amount. If you want to figure your penalty, you may use Part III as a worksheet and enter your penalty on your tax return, but
file only page 1 of Form 2210.
Part II Reasons for Filing. Check applicable boxes. If none apply, don't file Form 2210.
A You request a waiver (see instructions) of your entire penalty. You must check this box and file page 1 of Form 2210, but you
aren't required to figure your penalty.
B You request a waiver (see instructions) of part of your penalty. You must figure your penalty and waiver amount and file Form 2210.
C Your income varied during the year and your penalty is reduced or eliminated when figured using the annualized income installment method. You must
figure the penalty using Schedule AI and file Form 2210.
D Your penalty is lower when figured by treating the federal income tax withheld from your income as paid on the dates it was actually withheld, instead of in
equal amounts on the payment due dates. You must figure your penalty and file Form 2210.
E You filed or are filing a joint return for either 2022 or 2023, but not for both years, and line 8 above is smaller than line 5 above. You must file page 1 of
Form 2210, but you aren't required to figure your penalty (unless box B, C, or D applies).
For Paperwork Reduction Act Notice, see separate instructions. Form 2210 (2023)
LHA 312501 01-11-24

SCHEDULE B Interest and Ordinary Dividends OMB No. 1545-0074
(Form 1040)
Internal Revenue Service
Attach to Form 1040 or 1040-SR.
Go to www.irs.gov/ScheduleB for instructions and the latest information.
2023
Attachment
08
Sequence No.
Name(s) shown on return Your social security number
COLE P. MCCAULEY
Part I 1 List name of payer. If any interest is from a seller-financed mortgage and the buyer used the
" "
254 97 2593
Amount
property as a personal residence, see the instructions and list this interest first. Also, show that
Interest
buyer's social security number and address:
1 33.
Note: If you
received a Form
1099-INT,
Form 1099-OID,
or substitute
statement from
a brokerage firm,
list the firm's
name as the
payer and enter
the total interest
shown on that 2 Add the amounts on line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 33.
form.
3 Excludable interest on series EE and I U.S. savings bonds issued after 1989.
Attach Form 8815 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3
4 Subtract line 3 from line 2. Enter the result here and on Form 1040 or 1040-SR, line 2b 4 33.
Note: If line 4 is over $1,500, you must complete Part III. Amount
Part II 5 List name of payer:
SCHWAB 1738 195.
Ordinary
Dividends
5
Note: If you
received a Form
1099-DIV or
substitute
statement from
a brokerage firm,
list the firm's
name as the
payer and enter
the ordinary
dividends shown
on that form.
6 Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR, line 3b 6 195.
Note: If line 6 is over $1,500, you must complete Part III.
Part III You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a
Yes No
Foreign foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust.
Accounts 7a At any time during 2023, did you have a financial interest in or signature authority over a financial account (such
and Trusts as a bank account, securities account, or brokerage account) located in a foreign country? See instructions ~~~
Caution: If
required, failure to file
If "Yes," are you required to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR),
FinCEN Form 114 may to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing
result in substantial
penalties. Additionally,
requirements and exceptions to those requirements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
you may be required b If you are required to file FinCEN Form 114, list the name(s) of the foreign country(-ies) where the financial
to file Form 8938,
Statement of Specified account(s) is (are) located ~~~~~~~~
Foreign Financial
Assets. See instr.
8 During 2023, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust?
327501 11-03-23 If "Yes," you may have to file Form 3520. See instructions
LHA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule B (Form 1040) 2023
Interest and Dividend Summary
Name: COLE P. MCCAULEY FEIN/SSN: 254-97-2593
Interest on U.S. Tax-Exempt Private Activity Market Original Issue Ordinary Qualified
Payer Interest Savings Bonds Interest Interest Discount Discount (OID) Dividends Dividends
A 1 33.
B SCHWAB 1738 195. 195.
C
Totals 33. 195. 195.
Capital Gain Unrecaptured Section 1202 Collectibles Section 199A Investment Federal Tax State Tax Foreign Tax
Distributions Section 1250 Gain Gain Dividends Expenses Withheld Withheld Paid
Totals
330191 04-01-23
Qualified Dividends and Capital Gain Tax Worksheet - Line 16 Keep for Your Records
Name(s) shown on return Your SSN

Before you begin: u See the earlier instructions for line 16 to see if you can use this worksheet to figure your tax.
u Before completing this worksheet, complete Form 1040 or 1040-SR through line 15.
u If you don't have to file Schedule D and you received capital gain distributions, be sure you
checked the box on Form 1040 or 1040-SR, line 7.
1. Enter the amount from Form 1040 or 1040-SR, line 15. However, if you are filing Form
2555 (relating to foreign earned income), enter the amount from
line 3 of the Foreign Earned Income Tax Worksheet ~~~~~~~~~~~~~ 1. 866.
2. Enter the amount from Form 1040 or 1040-SR,
line 3a* ~~~~~~~~~~~~~~~~~~~ 2. 195.
p
3. Are you filing Schedule D?*
n
m
Yes. Enter the smaller of line 15 or 16 of
n
Schedule D. If either line 15 or 16 is
~ 3. 0.
n
blank or a loss, enter -0-.
o
X No. Enter the amount from Form 1040 or
1040-SR, line 7.
4. Add lines 2 and 3 ~~~~~~~~~~~~~~ 4. 195.

5. Subtract line 4 from line 1. If zero or less, enter -0- ~~~~~~~~~~~~~ 5. 671.
p
n
6. Enter:
m
$ 44,625 if single or married filing separately,
n
o
$ 89,250 if married filing jointly or qualifying surviving spouse, ~~~ 6. 44,625.
$ 59,750 if head of household.
7. Enter the smaller of line 1 or line 6 ~~~~~~~~~~~~~~~~~~~~~ 7. 866.
9. Subtract line 8 from line 7. This amount is taxed at 0% ~~~~~~~~~~~ 9. 195.
11. Enter the amount from line 9 ~~~~~~~~~~~~~~~~~~~~~~~~ 11. 195.
12. Subtract line 11 from line 10 ~~~~~~~~~~~~~~~~~~~~~~~~ 12. 0.
p
n
13. Enter:
n
$ 492,300 if single,
m
n
$ 276,900 if married filing separately, ~~~ 13. 492,300.
n
o
$ 553,850 if married filing jointly or qualifying surviving spouse,
$ 523,050 if head of household.
14. Enter the smaller of line 1 or line 13 ~~~~~~~~~~~~~~~~~~~~ 14. 866.
15. Add lines 5 and 9 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15. 866.
16. Subtract line 15 from line 14. If zero or less, enter -0- ~~~~~~~~~~~~ 16. 0.
17. Enter the smaller of line 12 or line 16 ~~~~~~~~~~~~~~~~~~~~ 17. 0.
18. Multiply line 17 by 15% (0.15) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 18. 0.
19. Add lines 9 and 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 19. 195.
20. Subtract line 19 from line 10 ~~~~~~~~~~~~~~~~~~~~~~~~ 20. 0.
21. Multiply line 20 by 20% (0.20) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 21. 0.
22. Figure the tax on the amount on line 5. If the amount on line 5 is less than $100,000, use the Tax Table to
figure the tax. If the amount on line 5 is $100,000 or more, use the Tax Computation Worksheet ~~~~~~ 22. 66.
23. Add lines 18, 21, and 22 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 23. 66.
24. Figure the tax on the amount on line 1. If the amount on line 1 is less than $100,000, use the Tax Table to
figure the tax. If the amount on line 1 is $100,000 or more, use the Tax Computation Worksheet ~~~~~~ 24. 86.
25. Tax on all taxable income. Enter the smaller of line 23 or line 24. Also include this amount on the entry space
on Form 1040 or 1040-SR, line 16. If you are filing Form 2555, don't enter this amount on the entry space on
Form 1040 or 1040-SR, line 16. Instead, enter it on line 4 of the Foreign Earned Income Tax Worksheet ~~ 25. 66.
* If you are filing Form 2555, see the footnote in the Foreign Earned Income Tax Worksheet before completing this line.
310451 01-02-24
DOES NOT APPLY
6251 Alternative Minimum Tax - Individuals OMB No. 1545-0074
Form
Department of the Treasury Attach to Form 1040, 1040-SR, or 1040-NR. 2023

Attachment
COLE P. MCCAULEY
Part I Alternative Minimum Taxable Income
" "
254 97 2593
1 Enter the amount from Form 1040 or 1040-SR, line 15, if more than zero. If Form 1040 or 1040-SR, line 15,
is zero, subtract line 14 of Form 1040 or 1040-SR from line 11 of Form 1040 or 1040-SR and enter the result
here. (If less than zero, enter as a negative amount.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 866.
2 a If filing Schedule A (Form 1040), enter the taxes from Schedule A, line 7; otherwise, enter the amount from
Form 1040 or 1040-SR, line 12 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2a 13,850.
b Tax refund from Schedule 1 (Form 1040), line 1 or line 8z ~~~~~~~~~~~~~~~~~~~~~~~~~~ 2b
c Investment interest expense (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~ 2c
d Depletion (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2d
e Net operating loss deduction from Schedule 1 (Form 1040), line 8a. Enter as a positive amount ~~~~~~~~ 2e
f Alternative tax net operating loss deduction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2f
g Interest from specified private activity bonds exempt from the regular tax ~~~~~~~~~~~~~~~~~~ 2g
h Qualified small business stock, see instructions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2h
i Exercise of incentive stock options (excess of AMT income over regular tax income) ~~~~~~~~~~~~~ 2i
j Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A) ~~~~~~~~~~~~~~~~~ 2j
k Disposition of property (difference between AMT and regular tax gain or loss) ~~~~~~~~~~~~~~~~ 2k
l Depreciation on assets placed in service after 1986 (difference between regular tax and AMT) ~~~~~~~~ 2l
m Passive activities (difference between AMT and regular tax income or loss) ~~~~~~~~~~~~~~~~~ 2m
n Loss limitations (difference between AMT and regular tax income or loss) ~~~~~~~~~~~~~~~~~~ 2n
o Circulation costs (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~~ 2o
p Long-term contracts (difference between AMT and regular tax income) ~~~~~~~~~~~~~~~~~~~ 2p
q Mining costs (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2q
r Research and experimental costs (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~ 2r
s Income from certain installment sales before January 1, 1987 ~~~~~~~~~~~~~~~~~~~~~~~~ 2s
t Intangible drilling costs preference ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2t
3 Other adjustments, including income-based related adjustments ~~~~~~~~~~~~~~~~~~~~~~~ 3
4 Alternative minimum taxable income. Combine lines 1 through 3. (If married filing separately and line 4 is
more than $831,150, see instructions.) 4 14,716.
Part II Alternative Minimum Tax (AMT)
5 Exemption.
p
IF your filing status is ... AND line 4 is not over ... THEN enter on line 5 ...
n
n
m
Single or head of household ~~~~~~~~ $578,150 ~~~~~~~~~~ $81,300
n
n
Married filing jointly or qualifying surviving spouse 1,156,300 ~~~~~~~~~~ 126,500 ~ 5 81,300.
o
Married filing separately ~~~~~~~~~~ 578,150 ~~~~~~~~~~ 63,250
If line 4 is over the amount shown above for your filing status, see instructions.
6 Subtract line 5 from line 4. If more than zero, go to line 7. If zero or less, enter -0- here and on lines 7, 9, and
11, and go to line 10 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6 0.
p
n
7 ¥ If you are filing Form 2555, see instructions for the amount to enter.
n
¥ If you reported capital gain distributions directly on Form 1040 or 1040-SR, line 7; you reported
m
qualified dividends on Form 1040 or 1040-SR, line 3a; or you had a gain on both lines 15 and
n
16 of Schedule D (Form 1040) (as refigured for the AMT, if necessary), complete Part III on the 0.
~ 7
n
back and enter the amount from line 40 here.
o
¥ All others: If line 6 is $220,700 or less ($110,350 or less if married filing separately), multiply
line 6 by 26% (0.26). Otherwise, multiply line 6 by 28% (0.28) and subtract $4,414 ($2,207 if
married filing separately) from the result.
8 Alternative minimum tax foreign tax credit (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~ 8
9 Tentative minimum tax. Subtract line 8 from line 7 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 9 0.
10 Add Form 1040 or 1040-SR, line 16 (minus any tax from Form 4972), and Schedule 2 (Form 1040), line 2.
Subtract from the result Schedule 3 (Form 1040), line 1 and any negative amount reported on Form 8978,
line 14 (treated as a positive number). If zero or less, enter -0-. If you used Schedule J to figure your tax on
Form 1040 or 1040-SR, line 16, refigure that tax without using Schedule J before completing this line. See
instructions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 10 66.
11 AMT. Subtract line 10 from line 9. If zero or less, enter -0-. Enter here and on Schedule 2 (Form 1040), line 1 11 0.
LHA For Paperwork Reduction Act Notice, see your tax return instructions. 319481 12-09-23 Form 6251 (2023)
Form 6251 (2023) COLE P. MCCAULEY 254-97-2593 Page 2
Part III Tax Computation Using Maximum Capital Gains Rates
Complete Part III only if you are required to do so by line 7 or by the Foreign Earned Income Tax Worksheet in the instructions.
12 Enter the amount from Form 6251, line 6. If you are filing Form 2555, enter the amount from line 3 of the
worksheet in the instructions for line 7 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 12
13 Enter the amount from line 4 of the Qualified Dividends and Capital Gain Tax Worksheet in the Instructions
for Form 1040 or the amount from line 13 of the Schedule D Tax Worksheet in the Instructions for Schedule
D (Form 1040), whichever applies (as refigured for the AMT, necessary). See instructions. If you are filing
Form 2555, see instructions for the amount to enter ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13
14 Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT, if necessary). See
instructions. If you are filing Form 2555, see instructions for the amount to enter ~~~~~~~~~~~~~~~~ 14
15 If you did not complete a Schedule D Tax Worksheet for the regular tax or the AMT, enter the amount
from line 13. Otherwise, add lines 13 and 14, and enter the smaller of that result or the amount from line
10 of the Schedule D Tax Worksheet (as refigured for the AMT, if necessary). If you are filing Form 2555, see
instructions for the amount to enter ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15
16 Enter the smaller of line 12 or line 15 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 16
17 Subtract line 16 from line 12 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17
18 If line 17 is $220,700 or less ($110,350 or less if married filing separately), multiply line 17 by 26% (0.26).
Otherwise, multiply line 17 by 28% (0.28) and subtract $4,414 ($2,207 if married filing separately) from the result 18
p
19 Enter:
m
¥ $89,250 if married filing jointly or qualifying surviving spouse,
o
¥ $44,625 if single or married filing separately, or ~~~~~~~~~~~~~~~~~~~~~~ 19
¥ $59,750 if head of household.
20 Enter the amount from line 5 of the Qualified Dividends and Capital Gain Tax Worksheet or the amount from
line 14 of the Schedule D Tax Worksheet, whichever applies (as figured for the regular tax). If you did not
complete either worksheet for the regular tax, enter the amount from Form 1040 or 1040-SR, line 15; if
zero or less, enter -0-. If you are filing Form 2555, see instructions for the amount to enter ~~~~~~~~~~~ 20
21 Subtract line 20 from line 19. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 21
23 Enter the smaller of line 21 or line 22. This amount is taxed at 0% ~~~~~~~~~~~~~~~~~~~~~~~ 23
p
25 Enter:
n
m
¥ $492,300 if single,
n
¥ $276,900 if married filing separately, ~~~~~~~~~~~~~~~~~~~~ 25
o
¥ $553,850 if married filing jointly or qualifying surviving spouse, or
¥ $523,050 if head of household.
26 Enter the amount from line 21 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 26
27 Enter the amount from line 5 of the Qualified Dividends and Capital Gain Tax Worksheet or the amount from
line 21 of the Schedule D Tax Worksheet, whichever applies (as figured for the regular tax). If you did not
complete either worksheet for the regular tax, enter the amount from Form 1040 or 1040-SR, line 15; if
zero or less, enter -0-. If you are filing Form 2555, see instructions for the amount to enter ~~~~~~~~~~~ 27
28 Add line 26 and line 27 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 28
29 Subtract line 28 from line 25. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 29
31 Multiply line 30 by 15% (0.15) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 31
32 Add lines 23 and 30 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 32
If lines 32 and 12 are the same, skip lines 33 through 37 and go to line 38. Otherwise, go to line 33.
34 Multiply line 33 by 20% (0.20) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 34
If line 14 is zero or blank, skip lines 35 through 37 and go to line 38. Otherwise, go to line 35.
35 Add lines 17, 32, and 33 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 35
37 Multiply line 36 by 25% (0.25) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 37
38 Add lines 18, 31, 34, and 37 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 38
39 If line 12 is $220,700 or less ($110,350 or less if married filing separately), multiply line 12 by 26% (0.26).
Otherwise, multiply line 12 by 28% (0.28) and subtract $4,414 ($2,207 if married filing separately) from the result 39
40 Enter the smaller of line 38 or line 39 here and on line 7. If you are filing Form 2555, do not enter this
amount on line 7. Instead, enter it on line 4 of the worksheet in the instructions for line 7 40
319591 12-09-23 Form 6251 (2023)
EIC Worksheet A - 2023 EIC
Name(s) shown on return
Keep for Your Records
Your Social Security number
0
Before you begin: Be sure you are using the correct worksheet. Use this worksheet only if you answered
"No" to Step 5, question 2. Otherwise, use Worksheet B.
Part 1 1. Enter your earned income from Step 5. ~~~~~~~~~ 1 13,846.
All Filers Using 2. Look up the amount on line 1 above in the EIC Table (right after
Worksheet A Worksheet B) to find the credit. Be sure you use the correct column
for your filing status and the number of qualifying children you have
who have a valid SSN as defined earlier. Enter the credit here. ~~~~~~~~~~~~~ 2 292.
If line 2 is zero,
STOP You can't take the credit.
Enter "No" on the dotted line next to Form 1040 or 1040-SR, line 27.
3. Enter the amount from Form 1040 or 1040-SR, line 11. ~ 3 14,716.
4. Are the amounts on lines 3 and 1 the same?
Yes. Skip line 5; enter the amount from line 2 on line 6.
X No. Go to line 5.
Part 2 5. If you have:

¥ No qualifying children who have a valid SSN, is the amount on
line 3 less than $9,800 ($16,370 if married filing jointly)?
Filers Who
¥ 1 or more qualifying children who have a valid SSN, is the amount
Answered
on line 3 less than $21,560 ($28,120 if married filing jointly)?
"No" On
Line 4
Yes. Leave line 5 blank; enter the amount from line 2 on line 6.
X No. Look up the amount on line 3 in the EIC Table to find the credit. Be sure
you use the correct column for your filing status and the number of
qualifying children you have who have a valid SSN. Enter the credit here. ~ 5 223.
Look at the amounts on lines 5 and 2.

Then, enter the smaller amount on line 6.
Part 3 6. This is your earned income credit. ~~~~~~~~~~~~~~~~~~~~~~~~~ 6 223.

Enter this amount on
Form 1040 or 1040-SR,
Your Earned
line 27.
Income Credit
0
Reminder -
If you have a qualifying child, complete and attach Schedule EIC.
321522 01-02-24
Schedule EIC - Earned Income Worksheet
Name(s) shown on return Your Social Security Number
Step 5: Earned Income

Taxable Earned Income
1. Enter the amount from Form 1040 or 1040-SR, line 1z ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1. 13,846.
2. Enter the Medicaid waiver payment amounts excluded from income on Schedule 1 (Form 1040), line 8s,
unless you choose to include these amounts in earned income,
in which case enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2.
3. Subtract line 2 from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. 13,846.
4. Enter all of your nontaxable combat pay if you elect to include it in earned income. Also enter the amount of your
nontaxable combat pay on line 1i of Form 1040 or 1040-SR ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4.
5. Add lines 3 and 4. This is your earned income* ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. 13,846.
321524
04-01-23
8863 Education Credits OMB No. 1545-0074
2023
Form
(American Opportunity and Lifetime Learning Credits)
Department of the Treasury Attach to Form 1040 or 1040-SR. Attachment
! Complete a separate Part III on page 2 for each student for whom you're claiming either credit before you complete Parts I and II.
CAUTION
Part I Refundable American Opportunity Credit
1 After completing Part III for each student, enter the total of all amounts from all Parts III, line 30 ~~~~~~~ 1
2 Enter: $180,000 if married filing jointly; $90,000 if single, head of
household, or qualifying surviving spouse ~~~~~~~~~~~~~~~~ 2
3 Enter the amount from Form 1040 or 1040-SR, line 11. But if you're filing
Form 2555 or 4563, or you're excluding income from Puerto Rico, see
Pub. 970 for the amount to enter instead ~~~~~~~~~~~~~~~~ 3
4 Subtract line 3 from line 2. If zero or less, stop; you can't take any
education credit ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4
5 Enter: $20,000 if married filing jointly; $10,000 if single, head of household,
or qualifying surviving spouse ~~~~~~~~~~~~~~~~~~~~~~ 5
p
n
6 If line 4 is:
m
n
¥ Equal to or more than line 5, enter 1.000 on line 6 ~~~~~~~~~~~~~~~~
o
¥ Less than line 5, divide line 4 by line 5. Enter the result as a decimal (rounded to ~~~~~~~~ 6
at least three places) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7 Multiply line 1 by line 6. Caution: If you were under age 24 at the end of the year and meet the
conditions described in the instructions, you can't take the refundable American opportunity
credit; skip line 8, enter the amount from line 7 on line 9, and check this box ~~~~~~~~~~~~~ 7
8 Refundable American opportunity credit. Multiply line 7 by 40% (0.40). Enter the amount here and
on Form 1040 or 1040-SR, line 29. Then go to line 9 below 8
Part II Nonrefundable Education Credits
9 Subtract line 8 from line 7. Enter here and on line 2 of the Credit Limit Worksheet (see instructions) ~~~~~ 9
10 After completing Part III for each student, enter the total of all amounts from all Parts III, line 31.
If zero, skip lines 11 through 17, enter -0- on line 18, and go to line 19 ~~~~~~~~~~~~~~~~~~~ 10 11,488.
11 Enter the smaller of line 10 or $10,000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11 10,000.
12 Multiply line 11 by 20% (0.20) 12 2,000.
13 Enter: $180,000 if married filing jointly; $90,000 if single, head of
household, or qualifying surviving spouse ~~~~~~~~~~~~~~~~ 13 90,000.
14 Enter the amount from Form 1040 or 1040-SR, line 11. But if you're filing
Form 2555 or 4563, or you're excluding income from Puerto Rico, see Pub.
970 for the amount to enter instead ~~~~~~~~~~~~~~~~~~~ 14 14,716.
15 Subtract line 14 from line 13. If zero or less, skip lines 16 and 17, enter -0-
on line 18, and go to line 19 ~~~~~~~~~~~~~~~~~~~~~~~ 15 75,284.
16 Enter: $20,000 if married filing jointly; $10,000 if single, head of household,
or qualifying surviving spouse ~~~~~~~~~~~~~~~~~~~~~~ 16 10,000.
17 If line 15 is:
¥ Equal to or more than line 16, enter 1.000 on line 17 and go to line 18
¥ Less than line 16, divide line 15 by line 16. Enter the result as a decimal (rounded to at least three
places) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17 1.000
18 Multiply line 12 by line 17. Enter here and on line 1 of the Credit Limit Worksheet (see instructions) ~~~~~ 18 2,000.
19 Nonrefundable education credits. Enter the amount from line 7 of the Credit Limit Worksheet
SEE STATEMENT 5
(see instructions) here and on Schedule 3 (Form 1040), line 3 19 66.
For Paperwork Reduction Act Notice, see your tax return instructions. Form 8863 (2023)
LHA 303511 01-05-24

Form 8863 (2023) Page 2
! Complete Part III for each student for whom you're claiming either the American opportunity credit or lifetime learning
CAUTION credit. Use additional copies of page 2 as needed for each student.
Part III Student and Educational Institution Information. See instructions.

20 Student name (as shown on page 1 of your tax return) 21 Student social security number (as shown on page 1 of your tax return)

22 Educational institution information (see instructions)
a. Name of first educational institution b. Name of second educational institution (if any)
ACCELERATE ATLANTA LLC

(1) Address. Number and street (or P.O. box). City, town or post (1) Address. Number and street (or P.O. box). City, town or post
office, state, and ZIP code. If a foreign address, see instructions. office, state, and ZIP code. If a foreign address, see instructions.
2 DUNWOODY PARK SOUTH

ATLANTA, GA 30338
(2) Did the student receive Form 1098-T (2) Did the student receive Form 1098-T
from this institution for 2023? X Yes No from this institution for 2023? Yes No
(3) Did the student receive Form 1098-T (3) Did the student receive Form 1098-T
from this institution for 2022 with box Yes X No from this institution for 2022 with box Yes No
7 checked? 7 checked?
(4) Enter the institution's employer identification number (EIN) (4) Enter the institution's employer identification number
if you're claiming the American opportunity credit or if you (EIN) if you're claiming the American opportunity credit or
checked "Yes" in (2) or (3). You can get the EIN from Form if you checked "Yes" in (2) or (3). You can get the EIN
1098-T or from the institution. from Form 1098-T or from the institution.
23 Has the American opportunity credit been claimed for this

student for any 4 prior tax years? Yes - Stop!
Go to line 31 for this student. X No - Go to line 24.
24 Was the student enrolled at least half-time for at least one
academic period that began or is treated as having begun in
2023 at an eligible educational institution in a program X Yes - Go to line 25. No - Stop! Go to line 31
leading towards a postsecondary degree, certificate, or for this student.
other recognized postsecondary educational credential?
See instructions.
25 Did the student complete the first 4 years of postsecondary Yes - Stop!
education before 2023? See instructions. Go to line 31 for this X No - Go to line 26.
student.
26 Was the student convicted, before the end of 2023, of a Yes - Stop!
X No - Complete lines 27
felony for possession or distribution of a controlled Go to line 31 for this
through 30 for this student.
substance? student.
! You can't take the American opportunity credit and the lifetime learning credit for the same student in the same year. If
CAUTION you complete lines 27 through 30 for this student, don't complete line 31.
American Opportunity Credit

27 Adjusted qualified education expenses (see instructions). Don't enter more than $4,000 ~~~~~~~~~ 27
28 Subtract $2,000 from line 27. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 28
29 Multiply line 28 by 25% (0.25) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 29
30 If line 28 is zero, enter the amount from line 27. Otherwise, add $2,000 to the amount on line 29 and
enter the result. Skip line 31. Include the total of all amounts from all Parts III, line 30, on Part I, line 1 30
Lifetime Learning Credit
31 Adjusted qualified education expenses (see instructions). Include the total of all amounts from all Parts
III, line 31, on Part II, line 10 31 11,488.
Form 8863 (2023)
303512 01-05-24
8867 Paid Preparer's Due Diligence Checklist OMB No. 1545-0074
Form
(Rev. November 2023)
Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC), Child Tax Credit (CTC) (including the Additional
Child Tax Credit (ACTC) and Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS.
Department of the Treasury Attachment
2023
Taxpayer name(s) shown on return Taxpayer identification number

Preparer's name Preparer tax identification number
KELLY DOWDY, CPA P00071067
Part I Due Diligence Requirements
Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I-V
for the benefit(s) claimed (check all that apply). X EIC CTC/ACTC/ODC AOTC HOH
1 Did you complete the return based on information for the applicable tax year provided by the taxpayer or Yes No N/A
reasonably obtained by you? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X
2 If credits are claimed on the return, did you complete the applicable EIC and/or CTC/ACTC/ODC
worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-PR, 1040-SS or Schedule 8812 (Form 1040)
instructions, and/or the AOTC worksheet found in the Form 8863 instructions, or your own worksheet(s) that
provides the same information, and all related forms and schedules for each credit claimed? ~~~~~~~~~~~~~ X
3 Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of
the following.
¥ Interview the taxpayer, ask questions, and contemporaneously document the taxpayer's responses to
determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.
¥ Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of any credit(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X
4 Did any information provided by the taxpayer or a third party for use in preparing the return, or
information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If " Yes,"
answer questions 4a and 4b. If " No," go to question 5.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X
a Did you make reasonable inquiries to determine the correct, complete, and consistent information? ~~~~~~~~~
b Did you contemporaneously document your inquiries? (Documentation should include the questions
you asked, whom you asked, when you asked, the information that was provided, and the impact the
information had on your preparation of the return.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5 Did you satisfy the record retention requirement? To meet the record retention requirement, you must
keep a copy of your documentation referenced in question 4b, a copy of this Form 8867, a copy of any
applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to figure
the amount(s) of the credit(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X
List those documents provided by the taxpayer, if any, that you relied on:
6 Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
credit(s) and/or HOH filing status and the amount(s) of any credit(s) claimed on the return if his/her
return is selected for audit? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X
7 Did you ask the taxpayer if any of these credits were disallowed or reduced in a previous year? ~~~~~~~~~~~ X
(If credits were disallowed or reduced, go to question 7a; if not, go to question 8.)
a Did you complete the required recertification Form 8862? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8 If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete and
correct Schedule C (Form 1040)? X
For Paperwork Reduction Act Notice, see separate instructions. Form 8867 (Rev. 11-2023)
320501 01-05-24
LHA
Form 8867 (Rev. 11-2023) COLE P. MCCAULEY 254-97-2593 Page 2
Part II Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
9a Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children Yes No N/A
claimed, or is eligible to claim the EIC without a qualifying child? (If the taxpayer is claiming the EIC
and does not have a qualifying child, go to question 10.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ X
b Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer
has supported the child the entire year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
c Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of
more than one person (tiebreaker rules)?
Part III Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC, or ODC, go
to Part IV.)
10 Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer's dependent who is Yes No N/A
a citizen, national, or resident of the United States? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
11 Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the child has not lived
with the taxpayer for over half of the year, even if the taxpayer has supported the child, unless the child's
custodial parent has released a claim to exemption for the child? ~~~~~~~~~~~~~~~~~~~~~~~~~~
12 Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or
separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar
statement to the return?
Part IV Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
13 Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified Yes No
tuition and related expenses for the claimed AOTC?
Part V Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)
14 Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year Yes No
and provided more than half of the cost of keeping up a home for the year for a qualifying person?
Part VI Eligibility Certification
You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing
status on the return of the taxpayer identified above if you:
A. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer's responses on the return or
in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of the credit(s);
B. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable
credit(s) claimed and HOH filing status, if claimed;
C. Submit Form 8867 in the manner required; and
D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under
Document Retention.
1. A copy of this Form 8867.
2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
3. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer's eligibility for the
credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was
obtained.
5. A record of any additional information you relied upon, including questions you asked and the taxpayer's responses, to
determine the taxpayer's eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
If you have not complied with all due diligence requirements, you may have to pay a penalty for each failure to
comply related to a claim of an applicable credit or HOH filing status (see instructions for more information).
15 Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and Yes No
complete? X
Form 8867 (Rev. 11-2023)
320502 01-05-24
8962 Premium Tax Credit (PTC)
OMB No. 1545-0074
Form
Department of the Treasury Attach to Form 1040, 1040-SR, or 1040-NR. 2023
Attachment
Name shown on your return Your social security number
A. You cannot take the PTC if your filing status is married filing separately unless you qualify for an exception. If you qualify, check the box
Part I Annual and Monthly Contribution Amount
1 Tax family size. Enter your tax family size. See instructions 1 1
2a Modified AGI. Enter your modified AGI. See instructions ~~~~~~~~~~~ 2a 14,716.
b Enter the total of your dependents' modified AGI. See instructions ~~~~~ 2b
3 Household income. Add the amounts on lines 2a and 2b ~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 14,716.
4 Federal poverty line. Enter the federal poverty line amount from Table 1-1, 1-2, or 1-3. See instructions. Check the
appropriate box for the federal poverty table used.
a Alaska b Hawaii c X Other 48 states and DC 4 13,590.
5 Household income as a percentage of federal poverty line (see instructions) ~~~~~~~~~~~~~~~~~ 5 108 %
6 Reserved for future use ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7 Applicable figure. Using your line 5 percentage, locate your "applicable figure" on the table in the instructions 7
8a Annual contribution amount. Multiply ln 3 by b Monthly contribution amount. Divide line 8a
ln 7. Round to nearest whole dollar amount 8a by 12. Round to nearest whole dollar amount 8b
Part II Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit
9 Are you allocating policy amounts with another taxpayer or do you want to use the alternative calculation for year of marriage? See instructions.
Yes. Skip to Part IV, Allocation of Policy Amounts, or Part V, Alternative Calculation for Year of Marriage. X No. Continue to line 10.
10 See the instructions to determine if you can use line 11 or must complete lines 12 through 23.
Yes. Continue to line 11. Compute your annual PTC. Then skip lines 12-23 X No. Continue to lines 12-23. Compute
and continue to line 24. your monthly PTC and continue to line 24.
(a) Annual enrollment (b) Annual applicable (c) Annual (d) Annual maximum (e) Annual premium (f) Annual advance
Annual premiums (Form(s) SLCSP premium contribution premium assistance tax credit allowed payment of PTC
Calculation 1095-A, line 33A) (Form(s) 1095-A, amount (subtract (c) from (b); (smaller of (a) or (d)) (Form(s) 1095-A,
line 33B) (line 8a) if zero or less, enter -0-) line 33C)
11 Annual Totals
(a) Monthly enrollment (b) Monthly (c) Monthly (d) Monthly maximum (e) Monthly premium (f) Monthly advance
premiums (Form(s) applicable SLCSP contribution amount premium assistance tax credit allowed payment of PTC
Monthly 1095-A, lines 21-32, premium (Form(s) (amount from line 8b (subtract (c) from (smaller of (a) or (d)) (Form(s) 1095-A,
Calculation column A) 1095-A, lines 21-32, or alternative marriage (b); if zero or lines 21-32,
column B) monthly calculation) less, enter -0-) column C)
12 January
13 February
14 March
15 April
16 May
17 June
18 July
19 August
20 September
21 October
22 November
23 December 431. 351. 351. 351. 342.
24 Total premium tax credit. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total here ~~ 24 351.
25 Advance payment of PTC. Enter the amount from line 11(f) or add lines 12(f) through 23(f) and enter the total here ~~ 25 342.
26 Net premium tax credit. If line 24 is greater than line 25, subtract line 25 from line 24. Enter the difference here and
on Schedule 3 (Form 1040), line 9. If line 24 equals line 25, enter -0-. Stop here. If line 25 is greater than line 24,
leave this line blank and continue to line 27 26 9.
Part III Repayment of Excess Advance Payment of the Premium Tax Credit
27 Excess advance payment of PTC. If line 25 is greater than line 24, subtract line 24 from line 25. Enter the difference here ~~ 27
28 Repayment limitation (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 28
29 Excess advance premium tax credit repayment. Enter the smaller of line 27 or line 28 here and on Schedule 2
(Form 1040), line 2 29
For Paperwork Reduction Act Notice, see your tax return instructions. Form 8962 (2023)
321611 12-07-23
LHA
Form 8962 (2023) COLE P. MCCAULEY 254-97-2593 Page 2
Part IV Allocation of Policy Amounts
Complete the following information for up to four policy amount allocations. See instructions for allocation details.
Allocation 1
30 (a) Policy Number (Form 1095-A, line 2) (b) SSN of other taxpayer (c) Allocation start month (d) Allocation stop month
Allocation percentage
(e) Premium Percentage (f) SLCSP Percentage (g) Advance Payment of the PTC
applied to monthly
Percentage
amounts
Allocation 2
applied to monthly
Percentage
amounts
Allocation 3
applied to monthly
Percentage
amounts
Allocation 4
applied to monthly
Percentage
amounts
34 Have you completed all policy amount allocations?

Yes. Multiply the amounts on Form 1095-A by the allocation percentages entered by policy. Add all allocated policy amounts and non-
allocated policy amounts from Forms 1095-A, if any, to compute a combined total for each month. Enter the combined total for each month on
lines 12-23, columns (a), (b), and (f). Compute the amounts for lines 12-23, columns (c)-(e), and continue to line 24.
No. See the instructions to report additional policy amount allocations.

Part V Alternative Calculation for Year of Marriage
Complete line(s) 35 and/or 36 to elect the alternative calculation for year of marriage. For eligibility to make the election, see the instructions for line 9.
To complete line(s) 35 and/or 36 and compute the amounts for lines 12-23, see the instructions for this Part V.
35 Alternative entries (a) Alternative family size (b) Alternative monthly (c) Alternative start month (d) Alternative stop month
for your SSN contribution amount
36 Alternative entries (a) Alternative family size (b) Alternative monthly (c) Alternative start month (d) Alternative stop month
for your spouse's contribution amount
SSN
Form 8962 (2023)
321612 12-07-23
}}}}}}}}}}}}}}}} }}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 1040 WAGES RECEIVED AND TAXES WITHHELD STATEMENT 1
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
FEDERAL STATE CITY

T AMOUNT TAX TAX SDI FICA MEDICARE
S EMPLOYER'S NAME PAID WITHHELD WITHHELD TAX W/H TAX TAX
} }}}}}}}}}}}}}}} }}}}}}}}}} }}}}}}}}}} }}}}}}}}} }}}}}}} }}}}}}} }}}}}}}
T ZENITH MEDIA SERVICES
INC 13,846. 941. 600. 905. 212.
}}}}}}}}}} }}}}}}}}}} }}}}}}}}} }}}}}}} }}}}}}} }}}}}}}

TOTALS 13,846. 941. 600. 905. 212.
~~~~~~~~~~ ~~~~~~~~~~ ~~~~~~~~~ ~~~~~~~ ~~~~~~~ ~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 1040 QUALIFIED DIVIDENDS STATEMENT 2
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ORDINARY QUALIFIED
NAME OF PAYER DIVIDENDS DIVIDENDS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}
SCHWAB 1738 195. 195.
}}}}}}}}}}}}}}
TOTAL INCLUDED IN FORM 1040, LINE 3A 195.
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 1040 TAX STATEMENT 3
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
DESCRIPTION AMOUNT
}}}}}}}}}}} }}}}}}}}}}}}}}
FROM QUALIFIED DIVIDENDS AND CAPITAL GAIN WORKSHEET 66.
}}}}}}}}}}}}}}
TOTAL TO FORM 1040, LINE 16 66.
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 1040 FEDERAL INCOME TAX WITHHELD - FORM(S) W-2 STATEMENT 4
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
T
S DESCRIPTION AMOUNT
- }}}}}}}}}}} }}}}}}}}}}}}}}
T ZENITH MEDIA SERVICES INC 941.
}}}}}}}}}}}}}}
TOTAL TO FORM 1040, LINE 25A 941.
~~~~~~~~~~~~~~
STATEMENT(S) 1, 2, 3, 4
}}}}}}}}}}}}}}}} }}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 8863 CREDIT LIMIT WORKSHEET STATEMENT 5
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
1 ENTER THE AMOUNT FROM FORM 8863, LINE 18 2,000.
2 ENTER THE AMOUNT FROM FORM 8863, LINE 9
3 ADD LINES 1 AND 2 2,000.
4 ENTER THE AMOUNT FROM: FORM 1040 OR 1040-SR, LINE 18 66.
5 ENTER THE TOTAL OF YOUR CREDITS FROM:

SCHEDULE 3 (FORM 1040 OR 1040-SR), LINES 1, 2,
6D AND 6L
6 SUBTRACT LINE 5 FROM LINE 4 66.
7 ENTER THE SMALLER OF LINE 3 OR LINE 6 HERE AND ON

FORM 8863, LINE 19 66.
~~~~~~~~~~
STATEMENT(S) 5
PLEASE DO ERO MUST RETAIN THIS FORM.
NOT MAIL! DO NOT SUBMIT THIS FORM TO
GEORGIA DEPARTMENT OF REVENUE
UNLESS REQUESTED TO DO SO.
IRS DCN OR SUBMISSION ID
GA-8453
2023
GEORGIA INDIVIDUAL INCOME TAX DECLARATION FOR ELECTRONIC FILING
SUMMARY OF AGREEMENT BETWEEN TAXPAYER AND ERO OR PAID PREPARER
Amended Return
First Name and Initial Last Name Social Security Number
If Joint Return, Spouse's First Name and Initial Spouse's Last Name Spouse's Social Security Number
Home Address (number and street) Apt Number Daytime Telephone Number
4391 PARAN PLACE
City, Town or Post Office State ZIP Code
ATLANTA GA 30327
PART I TAX RETURN INFORMATION
1. Federal Adjusted Gross Income (Form 500 or Form 500X, Line 8; Form 500EZ, Line 1) ~~~~~~~~~~~~~~ 1. 14,716
2. Georgia Taxable Income (Form 500 or Form 500X, Line 15c; Form 500EZ, Line 3) ~~~~~~~~~~~~~~~~~ 2. 6,616
3. Net Georgia Tax (Form 500 or Form 500X, Line 22; Form 500EZ, Line 6) ~~~~~~~~~~~~~~~~~~~~~ 3. 205
4. Balance Due (Form 500, Line 44; Form 500X, Line 37; Form 500EZ, Line 23) ~~~~~~~~~~~~~~~~~~~ 4.
5. Refund (Form 500, Line 45; Form 500X, Line 38; Form 500EZ, Line 24) ~~~~~~~~~~~~~~~~~~~~~~ 5. 395
PART II DECLARATION OF TAXPAYER(S)

Under penalties of perjury, I declare that the information I have provided to my Electronic Return Originator (ERO) and/or Online Service Provider
and/or Transmitter and the amounts shown in Part I agree with the amounts shown on the corresponding lines of the electronic portion of my 2023
Georgia Income Tax Return. I declare that I have examined my tax return, including accompanying schedules and statements, and to the best of my
knowledge and belief, my return is true, correct and complete. I consent that the electronic portion of my return may be sent by my ERO/Online
Service Provider/Transmitter.
SIGN
HERE TAXPAYER'S SIGNATURE Date SPOUSE'S SIGNATURE (if joint return, both must sign) Date
COLE P. MCCAULEY
PRINT NAME EMAIL ADDRESS
PART III DECLARATION OF ELECTRONIC RETURNS ORIGINATOR AND PAID PREPARER
I DECLARE THAT I HAVE REVIEWED THE ABOVE TAXPAYER'S RETURN AND THAT THE ENTRIES ON THE GA-8453 ARE COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE.
ERO's Signature Date
ERO's
Firm's Name HENNING, DOWDY & JONES, LLC X
Check also if paid preparer
Use
Address 750 HAMMOND DR NE BLDG 1 SUITE 200 FEIN/PTIN 46-0733218
Only
City, State, & ZIP Code SANDY SPRINGS, GA 30328 SSN/TIN P00071067
IF PREPARED BY ANY PERSON OTHER THAN THE TAXPAYER, THIS DECLARATION IS BASED ON ALL INFORMATION OF WHICH THE
PREPARER HAS ANY KNOWLEDGE.
Paid Preparer's Signature Date
Paid
Firm's Name FID/TIN
Preparer's
Use Only Address SSN/TIN
City, State, & ZIP Code
GA-8453 (REV 05/05/23)
KEEP A COPY WITH YOUR RECORDS
399061 08-22-23
CCH 01 150
Georgia Form 500(Rev. 08/30/23)
Individual Income Tax Return
Georgia Department of Revenue
2023 (Approved software version)
Page 1
Fiscal Year
Beginning 01/01/2023 STATE GA
ISSUED
YOUR DRIVER'S
Fiscal Year
Ending 12/31/2023 LICENSE/STATE ID 057697062
YOUR FIRST NAME MI YOUR SOCIAL SECURITY NUMBER

1. COLE P 254-97-2593
LAST NAME (For Name Change See IT-511 Tax Booklet) SUFFIX
MCCAULEY
SPOUSE'S FIRST NAME MI SPOUSE'S SOCIAL SECURITY NUMBER

DEPARTMENT USE ONLY
LAST NAME SUFFIX
CHECK IF ADDRESS
ADDRESS (NUMBER AND STREET or P.O. BOX) (Use 2nd address line for Apt, Suite or Building Number) HAS CHANGED
2. 4391 PARAN PLACE
CITY (Please insert a space if the city has multiple names) STATE ZIP CODE
3. ATLANTA GA 30327
(COUNTRY IF FOREIGN)
Residency Status
4. Enter your Residency Status with the appropriate number ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. 1
1. FULL-YEAR RESIDENT 2. PART-YEAR RESIDENT TO 3. NONRESIDENT
Omit Lines 9 thru 14 and use Form 500 Schedule 3 if you are a part-year or nonresident filer.
Filing Status
5. Enter Filing Status with appropriate letter (See IT- 511 Tax Booklet) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. A
A. Single B. Married filing joint C. Married filing separate (Spouse's social security number must be entered above) D. Head of Household or Qualifying Surviving Spouse
6. Number of exemptions (Check appropriate box(es) and enter total in 6c.) 6a. Yourself X 6b. Spouse 6c. 1
7a. Number of Qualified Dependents* 7b. Number of Unborn Dependents 7c. Total Number of Dependents
*Enter details on Line 7d., and DO NOT include yourself, spouse and/or your unborn dependents. See IT-511 Tax Booklet.
345001 10-18-23 All Pages (1-5) are required for processing

Georgia Form 500
Georgia Department of Revenue YOUR SOCIAL SECURITY NUMBER
2023 254-97-2593
Page 2
7d. Qualified Dependents. (If you have more than 4 dependents, attach a list of additional dependents).
First Name, MI. Last Name
Social Security Number Relationship to You
INCOME COMPUTATIONS
If amount on line 8, 9, 10, 13 or 15 is negative, use the minus sign (-). Example -3456.
8. Federal adjusted gross income (From Federal Form 1040) ~~~~~~~~~~~~~ 8. 14716
(Do not use FEDERAL TAXABLE INCOME) If the amount on Line 8 is $40,000 or more, or your gross income is less than your
W-2s you must include a copy of your Federal Form 1040 Pages 1, 2, and Schedule 1.
9. Adjustments from Form 500 Schedule 1 (See IT-511 Tax Booklet) ~~~~~~~~~ 9.
10. Georgia adjusted gross income (Net total of Line 8 and Line 9) ~~~~~~~~~~ 10. 14716
11. Standard Deduction (Do not use FEDERAL STANDARD DEDUCTION) ~~~~~~~ 11a. 5400
(See IT-511 Tax Booklet)
b. Self: 65 or over? Blind? Total x 1,300= ~~~~~~~ 11b.
Spouse: 65 or over? Blind?
c. Total Standard Deduction (Line 11a + Line 11b) ~~~~~~~~~~~~~~~ 11c. 5400
Use EITHER Line 11c OR Line 12c (Do not write on both lines)
12. Total Itemized Deductions used in computing Federal Taxable Income. If you use itemized deductions, you must include Federal Schedule A.
a. Federal Itemized Deductions (Schedule A - Form 1040) ~~~~~~~~~~~ 12a.
b. Less adjustments: (See IT-511 Tax Booklet) ~~~~~~~~~~~~~~~~~ 12b.
c. Georgia Total Itemized Deductions ~~~~~~~~~~~~~~~~~~~~~ 12c.
13. Subtract either Line 11c or Line 12c from Line 10; enter balance ~~~~~~~~~ 13. 9316
345002 10-18-23
All Pages (1-5) are required for processing

Georgia Form 500
2023 254-97-2593
Page 3
14a. Enter the number from Line 6c. 1 Multiply by $2,700 for filing status A or D 14a. 2700
or multiply by $3,700 for filing status B or C
14b. Enter the number from Line 7c. Multiply by $3,000 ~~~~~~~~~ 14b.
14c. Add Lines 14a. and 14b. Enter total ~~~~~~~~~~~~~~~~~~~~ 14c. 2700
15a. Income before GA NOL (Line 13 less Line 14c or Schedule 3, Line 14) ~~~ 15a. 6616
15b. Georgia NOL utilized (Cannot exceed Line 15a or the amount after
applying the 80% limitation, see IT-511 Tax Booklet for more information) ~~ 15b.
15c. Georgia Taxable Income (Line 15a less Line 15b) ~~~~~~~~~~~~~~ 15c. 6616
16. Tax (Use Tax Rate Schedule in the IT-511 Tax Booklet) ~~~~~~~~~~~ 16. 213
17. Low Income Credit 17a. 1 17b. 8 ~~~~~~~~~ 17c. 8

STMT 1
18. Other State(s) Tax Credit (Include a copy of the other state(s) return) ~~~~ 18.
19. Credits used from IND-CR Summary Worksheet ~~~~~~~~~~~~~~ 19.
20. Total Credits Used from Schedule 2 Georgia Tax Credits (must be filed 20.
electronically)
21. Total Credits Used (sum of Lines 17-20) cannot exceed Line 16 ~~~~~~~ 21. 8
22. Balance (Line 16 less Line 21) if zero or less than zero, enter zero ~~~~~~ 22. 205
INCOME STATEMENT DETAILS Only enter income on which Georgia tax was withheld. Enter income from W-2s, 1099s, and G2-As on Line 4
GA Wages/Income. For other income statements complete Line 4 using the income reported from Form G2-RP Line 12 or 13; Form G2-LP Line
11, or for Form G2-FL enter zero.
(INCOME STATEMENT A) (INCOME STATEMENT B) (INCOME STATEMENT C)

1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE:
X W-2 G2-A G2-LP W-2 G2-A G2-LP W-2 G2-A G2-LP
1099 G2-FL G2-RP 1099 G2-FL G2-RP 1099 G2-FL G2-RP
2. EMPLOYER/PAYER FEDERAL 2. EMPLOYER/PAYER FEDERAL 2. EMPLOYER/PAYER FEDERAL
ID NUMBER (FEIN) X SSN ID NUMBER (FEIN) SSN ID NUMBER (FEIN) SSN
133736241
3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID

2035023N
4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. GA WAGES / INCOME

13846
5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. GA TAX WITHHELD

600
PLEASE COMPLETE INCOME STATEMENT DETAILS ON PAGE 4.

345011 10-18-23

CCH 01 1019 -150 2023 GA 004 T1 23 0
Georgia Form 500
2023 254-97-2593
Page 4
(INCOME STATEMENT D) (INCOME STATEMENT E) (INCOME STATEMENT F)
1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE: 1. WITHHOLDING TYPE:
W-2 G2-A G2-LP W-2 G2-A G2-LP W-2 G2-A G2-LP
1099 G2-FL G2-RP 1099 G2-FL G2-RP 1099 G2-FL G2-RP
2. EMPLOYER/PAYER FEDERAL 2. EMPLOYER/PAYER FEDERAL 2. EMPLOYER/PAYER FEDERAL
ID NUMBER (FEIN) SSN ID NUMBER (FEIN) SSN ID NUMBER (FEIN) SSN
3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID 3. EMPLOYER/PAYER STATE WITHHOLDING ID
4. GA WAGES / INCOME 4. GA WAGES / INCOME 4. GA WAGES / INCOME
5. GA TAX WITHHELD 5. GA TAX WITHHELD 5. GA TAX WITHHELD
23. Georgia Income Tax Withheld on Wages and 1099s ~~~~~~~~~~~ 23. 600
(Enter Tax Withheld Only and include W-2s and/or 1099s)
24. Other Georgia Income Tax Withheld ~~~~~~~~~~~~~~~~~~~ 24.
(Must include G2-A, G2-FL, G2-LP and/or G2-RP)
25. Estimated Tax paid for 2023 and Form IT-560 ~~~~~~~~~~~~~~ 25.
26. Schedule 2B Refundable Tax Credits ~~~~~~~~~~~~~~~~~~~ 26.

(Cannot be claimed unless filed electronically)
27. Total prepayment credits (Add Lines 23, 24, 25 and 26) ~~~~~~~~~~ 27. 600
28. If Line 22 exceeds Line 27, subtract Line 27 from Line 22 and enter
balance due ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 28.
29. If Line 27 exceeds Line 22, subtract Line 22 from Line 27 and enter
overpayment ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 29. 395
30. Amount to be credited to 2024 ESTIMATED TAX ~~~~~~~~~~~ 30.
31. Georgia Wildlife Conservation Fund (No gift of less than $1.00) ~~~~~ 31.
32. Georgia Fund for Children and Elderly (No gift of less than $1.00) ~~~~ 32.
33. Georgia Cancer Research Fund (No gift of less than $1.00) ~~~~~~~ 33.
34. Georgia Land Conservation Program (No gift of less than $1.00) ~~~~~ 34.
35. Georgia National Guard Foundation (No gift of less than $1.00) ~~~~~ 35.
36. Dog & Cat Sterilization Fund (No gift of less than $1.00) ~~~~~~~~~ 36.
37. Saving the Cure Fund (No gift of less than $1.00) ~~~~~~~~~~~~ 37.
38. Realizing Educational Achievement Can Happen (REACH) Program ~~~~ 38.
(No gift of less than $1.00) 345012 10-18-23

Georgia Form 500
2023 Page 254-97-2593
5
39. Public Safety Memorial Grant (No gift of less than $1.00) ~~~~~~~~~~~ 39.
40. Disabled Veteran's Scholarship Fund (No gift of less than $1.00) ~~~~~~~~ 40.
41. Form 500 UET (Estimated tax penalty) X 500 UET exception attached ~~ 41.
42. Penalty: Late Payment and/or Late Filing ~~~~~~~~~~~~~~~~~~~~ 42.
43. Interest ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 43.
44. (If you owe) Add Lines 28, 31 thru 43 ~~~~~~~~~~~~~~~~~~~~~ 44.
MAKE CHECK PAYABLE TO GEORGIA DEPARTMENT OF REVENUE
Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER,
PO BOX 740399 ATLANTA, GA 30374-0399
45. (If you are due a refund) Subtract the sum of Lines 30 thru 43 from Line 29
THIS IS YOUR REFUND ~~~~~~~~~~~~~~~~~~~~~~~~~~ 45. 395
Refund Due Mail To: GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER,
PO BOX 740380 ATLANTA, GA 30374-0380
If you do not enter Direct Deposit information or if you are a first time filer you will be issued a paper check.
45a. Direct Deposit (U.S. Accounts Only) Type: Checking X Savings
Routing Account
Number
061000052 Number 334040965691
Mail page 1-5 and any applicable schedules, forms, and documentation. DO NOT staple pages
I/We declare under the penalties of perjury that I/we have examined this return (including accompanying schedules and statements) and to the best of my/our knowledge
and belief, it is true, correct, and complete. If prepared by a person other than the taxpayer(s), this declaration is based on all information of which the preparer has knowledge.
Taxpayer's Signature (Check box if deceased) Spouse's Signature (Check box if deceased)
Taxpayer's Date of Death Spouse's Date of Death
Taxpayer's Signature Date Taxpayer's Phone Number Spouse's Signature Date
By providing my e-mail address I am authorizing the Georgia Department of Revenue to electronically notify me at the below e-mail address regarding any updates to
my account(s).
Taxpayer's E-mail Address X
I authorize DOR to discuss this return
with the named preparer.
Preparer's Phone Number

404-705-4589
Signature of Preparer
Name of Preparer Other Than Taxpayer Preparer's FEIN
KELLY DOWDY, CPA 46-0733218
Preparer's Firm Name Preparer's SSN/PTIN/SIDN

HENNING, DOWDY & JONES, L P00071067
345013 10-18-23

}}}}}}}}}}}}}}}} }}}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
GA 500 LOW INCOME CREDIT WORKSHEET STATEMENT 1
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
1. FEDERAL ADJUSTED GROSS INCOME 14,716.

2. ENTER THE NUMBER OF TOTAL EXEMPTIONS. EXEMPTIONS ARE SELF,
SPOUSE AND NATURAL OR LEGALLY ADOPTED CHILDREN. 1
3. ENTER 1 IF YOU OR YOUR SPOUSE IS 65 OR OLDER; ENTER 2 IF
YOU AND YOUR SPOUSE ARE 65 OR OLDER.
YOU 65 OR OLDER [ ]
SPOUSE 65 OR OLDER [ ]
}}}}}}}}}}}}}}
4. ADD LINES 2 AND 3. 1
5. BASE CREDIT (FROM CHART) X 8.
}}}}}}}}}}}}}}
6. MULTIPLY LINE 4 BY LINE 5. TOTAL TO FORM 500, LINE 17C. 8.
~~~~~~~~~~~~~~
STATEMENT(S) 1
500 UET Rev. (09/15/20) Page 1
Underpayment of Estimated Tax
by Individuals/Fiduciary
Georgia Department of Revenue
Taxpayer Services Division
Meets Exception 4 for
an estate of a decedent
For tax years 2019 and later (Attach this form to Form 500 or 501) or a testamentary trust
HOW TO FIGURE YOUR UNDERPAYMENT
(Complete Lines 1 through 6)
YOUR FIRST NAME SOCIAL SECURITY OR I.D. NUMBER
COLE P. 254 97 2593
LAST NAME
MCCAULEY
1. Tax (from Form 500 Line 16 or Form 501 Line 8) 1. 213
2. Credits Used (from Form 500 Line 21 and Line 26 or Form 501 Line 9c and Line 11c) 2. 8
3. Balance Due (Line 1 less Line 2) 3. 205
4. Enter 100% of the Immediately Preceding Year's Tax (return must be for a 12-month period) 4. 1354
5. Enter 70% of the Amount Shown on Line 3 5. 144
See instructions for COVID-19 adjustments. DUE DATE OF INSTALLMENTS
6. Divide amount on Line 4 by the number of APRIL 15, 2023 JUNE 15, 2023 SEPT. 15, 2023 JAN. 15, 2024
installments required for the year (See Instruction
B), enter the results in appropriate columns ~~~~~~ 6. 339 339 339 337
7. Divide amount on Line 5 by the number of
installments required for the year (See Instruction
B), enter the results in the appropriate column ~~~~~ 7. 36 36 36 36
8. Enter the lesser of Line 6 or Line 7 for each period
in the appropriate column ~~~~~~~~~~~~~~ 8. 36 36 36 36
9. Amounts paid on estimate for each period and
tax withheld (withheld treated equally paid for each quarter) 9. 150 150 150 150
10. Overpayment of previous installment
(See Instruction E) ~~~~~~~~~~~~~~~~~ 10. 114 228 342
11. Total of Line 9 and Line 10 ~~~~~~~~~~~~~ 11. 150 264 378 492
12. Underpayment (Line 8 less Line 11) or
Overpayment (Line 11 less Line 8) 12. -114 -228 -342 -456
EXCEPTIONS WHICH AVOID THE PENALTY (See Instruction D)
(Farmers and fishermen see Instruction G for special exception)
13. Total amount paid and withheld from Jan. 1, through the installment
date indicated (withheld treated equally paid for each quarter) 13. 150 300 450 600
14. Exception 1. - Tax on prior years income using
current year rates and exemptions ~~~~~~~~~~ 14.
15. Exception 2. - Tax on annualized current year
Not
income ~~~~~~~~~~~~~~~~~~~~~~ 15.
16. Exception 3. - Tax on current year's income
Applicable
over 3, 5, 8, month periods 16.
HOW TO FIGURE THE PENALTY
(Complete Lines 17 through 21 for installments not avoided by an exception)
17. Amount of underpayment (from Line 12) ~~~~~~~ 17.
18. Date of payment or April 15, 2024 whichever is
earlier (See Instruction F) ~~~~~~~~~~~~~~ 18.
19. Number of days from due date of installment
to date shown on Line 18 ~~~~~~~~~~~~~~ 19.
20. Penalty (9 percent a year on amount shown on
345121 05-03-23
Line 17 for the number of days shown on Line 19) ~~~ 20.
21. Penalty (Add amounts on Line 20) show this
amount in the space provided on Form 500 / 501 21. 0
CCH 01 150

2023 1040 Cole McCauley

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Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency

Name: COLE P. MCCAULEY ID Number: 254-97-2593

FED 1040 BANK OF AMERICA CHECKING 061000052 334040965691 DEPOSIT 1,173.

GA 500 BANK OF AMERICA CHECKING 061000052 334040965691 DEPOSIT 395.

Tax Year Tax Year Increase

WAGES, SALARIES, AND TIPS 34,451. 13,846. -20,605.

ADJUSTED GROSS INCOME 34,649. 14,716. -19,933.

STANDARD DEDUCTION 12,950. 13,850. 900.

TAX 2,378. 66. -2,312.

FORM 8863 (EDUCATION CREDITS) 0. 66. 66.

TOTAL TAX 2,378. 0. -2,378.

FED. INCOME TAX WITHHELD, FORM W-2 2,815. 941. -1,874.

TAX OVERPAID 437. 1,173. 736.

GEORGIA STATE RETURN

July 11, 2024

Enclosed are your 2023 income tax returns.

Specific filing instructions are as follows.

FEDERAL INCOME TAX RETURN:

No payment is required as you are due a refund in the amount of $1,173.

GEORGIA INCOME TAX RETURN:

No payment is required as you are to receive a refund in the amount of $395.

Kelly Dowdy, CPA

Submission Identification Number (SID)

Your signature | Date | 07/11/2024

Spouse's PIN: check one box only

Spouse's signature | Date |

Practitioner PIN Method Returns Only - continue below

ERO's signature | Date |

319995 04-01-23 ERO Must Retain This Form - See Instructions

ERO's PIN 58210192338

Perjury Statement (104X)

Electronic Funds Withdrawal Consent

Taxpayer's PIN: 62593 Date 07112024

Filing Status X Single Head of household (HOH)

36 Amount of line 34 you want applied to your 2024 estimated tax  36

name KELLY DOWDY, CPA no. 404-705-4589 number (PIN) 92338

Phone no. Email address

Paid Preparer's name Preparer's signature Date PTIN

Preparer Check if:

Department of the Treasury

PERFORMAN PREDICTIONS 8z 642.

LHA 314141 12-14-23

Department of the Treasury

LHA 314161 12-14-23

COLE P. MCCAULEY 254-97-2593

Do You Have To File Form 2210?

Part I Required Annual Payment

LHA 312501 01-11-24

Totals 33. 195. 195.

Name(s) shown on return Your SSN

4. Add lines 2 and 3 ~~~~~~~~~~~~~~ 4. 195.

6251 Alternative Minimum Tax - Individuals OMB No. 1545-0074

Department of the Treasury Attach to Form 1040, 1040-SR, or 1040-NR. 2023

Part 1 1. Enter your earned income from Step 5. ~~~~~~~~~ 1 13,846.

4. Are the amounts on lines 3 and 1 the same?

Yes. Skip line 5; enter the amount from line 2 on line 6.

Part 2 5. If you have:

Look at the amounts on lines 5 and 2.

Part 3 6. This is your earned income credit. ~~~~~~~~~~~~~~~~~~~~~~~~~ 6 223.

36 Amount of line 34 you want applied to your 2024 estimated tax 36