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1040 Department of the Treasury—Internal Revenue Service (99)

2020
Form

U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only–Do not write or staple in this space.
Filing Status Single X Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child's name if the qualifying
one box.
person is a child but not your dependent.

Your first name and middle initial Last name Your social security number

Dean A Gluesenkamp
If joint return, spouse's first name and middle initial Last name Spouse's social security number

Kristina M Perez
Home address (number and street). If you have a P.O box, see instructions. Apt. no.
Check here if you, or your
spouse if filing jointly, want $3
City, town or post office .If you have a foreign address, also complete spaces below. State ZIP code to go to this fund.Checking a
box below will not change
Washougal WA 98671 your tax or refund.
Foreign country name Foreign province/state/county Foreign postal code
You Spouse

At anytime during 2020, did you receive, sell, send, exchange, or otherwise acquire financial interest in any virtual currency? 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, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind

Dependents (see instructions): (2) Social security (3) Relationship (4)  if qualifies for (see instructions):
number to you
(1) First name Last name Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check

Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 1 68,533

Client Copy
Attach
2a
Tax-exempt interest . . 2a b Taxable interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b 92
Sch.B if
3a
Qualified dividends . . . 3a b Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . 3b
required.
4a
IRA distributions . . . . . 4a b Taxable amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b
5a Pensions and annuities 5a b Taxable amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5b
6a Soc. sec. ben. ........ 6a b Taxable amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6b
7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  7
• Single or
Married filing
8 Other income from Schedule 1, line 9 ...................................................................... 8 19,143
separately, 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  9 87,768
$12,400
• Married filing
10 Adjustments to income:
jointly or
Qualifying
a From Schedule 1, line 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10a 0
widow(er), b Charitable contributions if you take the standard deduction. See instructions 10b 187
$24,800
• Head of
c Add line 10a and 10b. These are your total adjustments to income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10c 187
household,
$18,650
11 Subtract line 10c from line 9. This is your adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  11 87,581
• If you checked 12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 24,800
any box under
13 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3,829
14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 28,629
see instructions.
15 Subtract line 14 from line 11. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 58,952
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2020)

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Form 1040 (2020) Dean A Gluesenkamp & Kristina M Perez Page 2

16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972
3 ................................................................................................ 16 6,682
17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 6,682
19 Child tax credit or credit for other dependents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Amount from Schedule 3, line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 6,682
23 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  .. 24 6,682
25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25a 14,463
b Form(s) 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25d 14,463
26 2020 estimated tax payments and amount applied from 2019 return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
• If you have a
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
attach Sch. EIC.
28 Additional child tax credit. Attach Schedule 8812 . . . . . . . . . . . . . . . . . . . 28
• If you have
nontaxable 29 American opportunity credit from Form 8863, line 8 . . . . . . . . . . . . . . . . 29
combat pay, see
instructions. 30 Recovery rebate credit. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 0
31 Amount from Schedule 3, line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
32 Add lines 27 through 31. These are your total other payments and refundable credits . . . . . . .  32
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  33 14,463
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . . . . . 34 7,781
Direct deposit? 35a Amount of line 34 you want refunded to ou. If Form 8888 is attached, check here . . . . . . .  35a 7,781
See instructions b Routing number  c Type: X Checking Savings

t Copy
d Account number
36 Amount of line 34 y estimated tax  36
Amount 37 Subtract line 33 from l u owe now . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  37
You Owe Note: Schedule H an , ay not represent all of the taxes you owe for
For details on 2020. See Schedule 3, line 12e, and its instructions for details.
how to pay, see
instructions. 38 Estimated tax penalty (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . .  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 number
name  Holly McCall no.  503-477-4396 (PIN) 

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here If the IRS sent you an Identity
Your signature Date Your occupation Protection PIN, enter it here
Joint return?
See instructions. Business Owner (see inst.)
Keep a copy for If the IRS sent your spouse an
Spouse's signature. If a joint return, both must sign. Date Spouse's occupation Identity Protection PIN, enter it here
your records.
Director (see inst.)

Phone no. Email address

Preparer's name Preparer's signature Date PTIN Check if:

Paid Holly McCall Holly McCall 10/28/22 ********* X Self-employed

Preparer Firm's name  McCall Tax & Bookkeeping Services, Inc. Phone no. 503-477-4396
Use Only 5311 SE Powell Blvd Ste 101
Firm's address  Portland OR 97206-2951 Firm's EIN 

Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2020)

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SCHEDULE 1 Additional Income and Adjustments to Income OMB No. 1545-0074

(Form 1040)

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

2020
Attachment
Internal Revenue Service  Go to for instructions and the latest information. Sequence No. 01
Name(s) shown on Form 1040,1040-SR, or 1040-NR Your social security number

Dean A Gluesenkamp & Kristina M Perez

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 19,143
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income. List type and amount  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
...... ....................................................................................................................... 8
9 Combine lines 1 through 8. Enter here and on Form 1040, 1040-SR, or 1040-NR, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 19,143
Part II Adjustments to Income
10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government
officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Client Copy
16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient's SSN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
c Date of original divorce or separation agreement (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees deduction. Attach Form 8917 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and
on Form 1040, 1040-SR, or 1040-NR, line 10a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040) 2020

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SCHEDULE E Supplemental Income and Loss OMB No. 1545-0074

(Form 1040)

Department of the Treasury

(From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.)
 Attach to Form 1040, 1040-SR, 1040-NR, or 1041. 2020
Attachment
Internal Revenue Service (99)  Go to for instructions and the latest information. Sequence No. 13
Name(s) shown on return Your social security number

Dean A Gluesenkamp & Kristina M Perez

Part I Income or Loss From Rental Real Estate and Royalties Note: If you are in the business of renting personal property, use
Schedule C. See instructions. If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40.
A Did you make any payments in 2020 that would require you to file Form(s) 1099? See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
B If "Yes," did you or will you file required Form(s) 1099? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
1a Physical address of each property (street, city, state, ZIP code)
A 1506 NE Lomard St, Portland, OR 97211
B
C
1b Type of Property 2 For each rental real estate property listed
QJV
(from list below) above, report the number of fair rental and
personal use days. Check the QJV box only
A 7
. ......................... if you meet the requirements to file as a
A 366
B . ......................... qualified joint venture. See instructions. B
C C
Type of Property:
1 Single Family Residence 3 Vacation/Short-Term Rental 5 Land 7 Self-Rental
2 Multi-Family Residence 4 Commercial 6 Royalties 8 Other (describe)
Income: Properties: A B C
3 Rents received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 49,899
4 Royalties received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Expenses:

Client Copy
5 Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Auto and travel (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Cleaning and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Legal and other professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Management fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Mortgage interest paid to banks, etc. (see instructions) . . . . . . . . . . . . . . . . . . . . 12 21,656
13 Other interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 12,983
14 Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 5,498
17 Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Depreciation expense or depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 13,008
19 Other (list)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Total expenses. Add lines 5 through 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 53,145
21 Subtract line 20 from line 3 (rents) and/or 4 (royalties). If
result is a (loss), see instructions to find out if you must
file Form 6198 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 -3,246
22 Deductible rental real estate loss after limitation, if any,
on Form 8582 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 ( 3,246)( )( )
23a Total of all amounts reported on line 3 for all rental properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23a 49,899
b Total of all amounts reported on line 4 for all royalty properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23b
c Total of all amounts reported on line 12 for all properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23c 21,656
d Total of all amounts reported on line 18 for all properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23d 13,008
e Total of all amounts reported on line 20 for all properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23e 53,145
24 Income. Add positive amounts shown on line 21. Do not include any losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 0
25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here . . . . . . . . . . . . . . 25 ( 3,246)
26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result
here. If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on
Schedule 1 (Form 1040), line 5. Otherwise, include this amount in the total on line 41 on page 2 ........................ 26 -3,246
For Paperwork Reduction Act Notice, see the separate instructions. Schedule E (Form 1040) 2020
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Schedule E (Form 1040) 2020 Attachment Sequence No. 13 Page 2

Name(s) shown on return. Do not enter name and social security number if shown on other side. Your social security number

Dean A Gluesenkamp & Kristina M Perez

Caution: The IRS compares amounts reported on your tax return with amounts shown on Schedule(s) K-1.
Part II Income or Loss From Partnerships and S Corporations – Note: If you report a loss, receive a distribution, dispose of
stock, or receive a loan repayment from an S corporation, you must check the box in column (e) on line 28 and attach the required basis
computation. If you report a loss from an at-risk activity for which any amount is not at risk, you must check the box in column (f) on
line 28 and attach Form 6198. See instructions.
27 Are you reporting any loss not allowed in a prior year due to the at-risk or basis limitations, a prior year unallowed loss from a
passive activity (if that loss was not reported on Form 8582), or unreimbursed partnership expenses? If you answered “Yes,”
see instructions before completing this section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
(b) Enter for (c) Check if (d) Employer (e) Check if (f) Check if
28 (a) Name partnership; foreign identification basis computation any amount is
for S corporation partnership number is required not at risk

A Deans Car Care Inc S X

B Deans Car Care Inc S X
C
D
Passive Income and Loss Nonpassive Income and Loss
(g) Passive loss allowed (h) Passive income (i) Nonpassive loss allowed (j) Section 179 expense (k) Nonpassive income
(attach Form 8582 if required) from Schedule K-1 (see Schedule K-1) deduction from Form 4562 from Schedule K-1

A 0 11,002
B 0 11,387
C
D
29a Totals 22,389
b Totals

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30 Add columns (h) and (k) of line 29a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 22,389
31 Add columns (g), (i), and (j) of line 29b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 ( 0)
32 Total partnership and S corporation income or (loss). Combine lines 30 and 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 22,389
Part III Income or Loss From Estates and Trusts
(b) Employer
33 (a) Name
identification number

A
B
Passive Income and Loss Nonpassive Income and Loss
(c) Passive deduction or loss allowed (d) Passive income (e) Deduction or loss (f) Other income from
(attach Form 8582 if required) from Schedule K-1 from Schedule K-1 Schedule K-1

A
B
34a Totals
b Totals
35 Add columns (d) and (f) of line 34a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
36 Add columns (c) and (e) of line 34b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 ( )
37 Combine lines 35 and 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Part IV Income or Loss From Real Estate Mortgage Investment Conduits (REMICs)—Residual Holder
(c) Excess inclusion from
(b) Employer (d) Taxable income (net loss) (e) Income from
38 (a) Name
identification number
Schedules Q, line 2c
from Schedules Q, line 1b Schedules Q, line 3b
(see instructions)

39 Combine columns (d) and (e) only. Enter the result here and include in the total on line 41 below . . . . . . . . . . . . . . . . . . . . . . 39
Part V Summary
40 Net farm rental income or (loss) from Form 4835. Also, complete line 42 below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
41 Combine lines 26, 32, 37, 39, and 40. Enter the result here and on Schedule 1 (Form 1040), line 5 . . . . . . . . . . . . . . . . .  41 19,143
42 Reconciliation of farming and fishing income. Enter your gross
farming and fishing income reported on Form 4835, line 7; Schedule K-1
(Form 1065), box 14, code B; Schedule K-1 (Form 1120-S), box 17, code
AD; and Schedule K-1 (Form 1041), box 14, code F. See instructions . . . . . . . . . . . . . . . . 42
43 If you were a real estate professional
(see instructions), enter the net income or (loss) you reported anywhere on Form
1040, Form 1040-SR, or Form 1040-NR from all rental real estate activities in which
you materially participated under the passive activity loss rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
DAA Schedule E (Form 1040) 2020
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Form 8995 Qualified Business Income Deduction OMB No. 1545-2294

Simplified Computation 2020

Department of the Treasury  Attach to your tax return. Attachment
Internal Revenue Service  Go to for instructions and the latest information. Sequence No. 55
Name(s) shown on return Your taxpayer identification number
Dean A Gluesenkamp & Kristina M Perez
Note. You can claim the qualified business income deduction if you have qualified business income from a qualified trade or
business, real estate investment trust dividends, publicly traded partnership income, or a domestic production activities deduction
passed through from an agricultural cooperative. See instructions.
Use this form if your taxable income, before your qualified business income deduction, is at or below $163,300 ($326,600 if married
filing jointly), and you aren't a patron of an agricultural or horticultural cooperative.
1 (a) Trade, business, or aggregation name (b) Taxpayer (c) Qualified business
identification number income or (loss)

i Lombard St -3,246
ii Deans Car Care Inc 11,002
iii Deans Car Care Inc 11,387
iv

2 Total qualified business income or (loss). Combine lines 1i through 1v,

Client Copy
column (c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 19,143
3 Qualified business net (loss) carryforward from the prior year . . . . . . . . . . . . . . . . . . . . . . . 3 ( )
4 Total qualified business income. Combine lines 2 and 3. If zero or less, enter -0- . . 4 19,143
5 Qualified business income component. Multiply line 4 by 20% (0.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3,829
6 Qualified REIT dividends and publicly traded partnership (PTP) income or (loss)
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Qualified REIT dividends and qualified PTP (loss) carryforward from the prior
year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ( )
8 Total qualified REIT dividends and PTP income. Combine lines 6 and 7. If zero
or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 0
9 REIT and PTP component. Multiply line 8 by 20% (0.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Qualified business income deduction before the income limitation. Add lines 5 and 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3,829
11 Taxable income before qualified business income deduction . . . . . . . . . . . . . . . . . . . . . . . . 11 62,781
12 Net capital gain (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 62,781
14 Income limitation. Multiply line 13 by 20% (0.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 12,556
15 Qualified business income deduction. Enter the lesser of line 10 or line 14. Also enter this amount on
the applicable line of your return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  15 3,829
16 Total qualified business (loss) carryforward. Combine lines 2 and 3. If greater than zero, enter -0- . . . . . . . . . . . . . . . . . . . 16 ( 0)
17 Total qualified REIT dividends and PTP (loss) carryforward. Combine lines 6 and 7. If greater than
zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 ( )
For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8995 (2020)

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Form 1040 Tax Return Reconciliation Worksheet 2020

Filing Status: 1 Single X 2 Married filing jointly 3 Married filing separately 4 Head of household* 5 Qualifying widow(er)*

MFS spouse name: *Qualifying person that is a child but not a dependent:

Taxpayer first name and initial Last name Taxpayer social security number

Dean A Gluesenkamp
If a joint return, spouse's first name and initial Last name Spouse's social security number
Kristina M Perez
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign

Taxpayer Spouse

City, town or post office, state, and ZIP code.

Washougal WA 98671
Foreign country name Foreign province/state/county Foreign postal code

At anytime during 2020, did you receive, sell, send, exchange, or otherwise acquire financial interest in any virtual currency? Yes X No
6a X Taxpayer. If someone can claim you as a dependent, do not check box 6a Boxes checked on 6a and 6b . . . . . . . . . . . . . 2
b X Spouse Children on 6c who lived with you . . . . . . . . . .
Children on 6c who did not live with you . . . . .

Dependents on 6c not entered above . . . . . . .

Total. Add lines above 2

6c Dependents:  if qualifies for
First name Last name Social security number Relationship to you Child tax credit Other dependents If more than four

dependents,

 here

7 7 68,533

Client Copy
Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income 8a Taxable interest. Attach Schedule B if required ...................................................... 8a 92
(Schedule 1) b Tax-exempt interest. Do not include on line 8a . . . . . . . . . . . . . . . . . . . . 8b
9a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9a
b Qualified dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b
10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Capital gain or (loss). Attach Schedule D if required. If not required, check here  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Other gains or (losses). Attach Form 4797 ........................................................... 14
15a IRA distributions . . . . . . . . . . . . . . 15a b Taxable amount . . . . . . . . . . . . . 15b
16a Pensions and annuities . . . . . . 16a b Taxable amount . . . . . . . . . . . . . 16b
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . . . . . . . . 17 19,143
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20a Social security benefits . . . . . . . . . . 20a b Taxable amount . . . . . . . . . . . . . 20b
21 Other income. List type and amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Combine the amounts in the far right column for lines 7 through 21. This is your total income . .  22 87,768
23 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Adjusted 24 Certain business expenses of reservists, performing artists, and
Gross fee-basis government officials. Attach Form 2106 or 2106-EZ . . . . . 24
Income 25 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . 25
(Schedule 1) 26 Moving expenses. Attach Form 3903 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE . . . . . . 27
28 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . 28
29 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . . . . . 29
30 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
31a Alimony paid b Recipient's SSN  31a
32 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
33 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
34 Tuition and fees. Attach Form 8917 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
35 Charitable contributions if you take the standard deduction . . . . . . . . 35 187
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 187
37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  37 87,581
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Form 1040 Tax Return Reconciliation Worksheet, Page 2 2020

Name Dean A Gluesenkamp & Kristina M Perez Tp TIN
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 87,581
Tax and
Credits
(Schedules 2, 3)
39a Check
if: {
You were born before January 2,1956,
Spouse was born before January 2,1956,
Blind.
Blind.
Total boxes
checked  } 39a
b If your spouse itemizes on a separate return or you were a dual-status alien, check here  39b
Standard
Deduction 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . . . . . . . . . . . 40 24,800
for— 41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 62,781
• People who
check any
42 Qualified business income deduction (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 3,829
box on line 43 Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 58,952
39a or 39b or
who can be 44 (see instr.). Check if any from: Form(s)
8814
Form
4972 . ........................ 44 6,682
claimed as a
dependent,
45 Alternative minimum tax (see instructions). Attach Form 6251 .....................................
45
see 46 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
instructions.
• All others:
47 Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  47 6,682
Single or 48 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . . . . . . . . 48
Married filing
separately, 49 Credit for child and dependent care expenses. Attach Form 2441 . . . 49
$12,400
50 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Married filing
jointly or 51 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . 51
Qualifying
widow(er), 52 Child tax credit/credit for other dependents . . . . . . . . . . . . . . . . . . . . . . . . . . 52
$24,800 Residential energy credits. Attach Form 5695 . . . . . . . . . . . . . . . . . . . . . . . 53
53
Head of
household, 54 Other credits from Form: 3800 8801 54
$18,650
55 Add lines 48 through 54. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
56 Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . .  56 6,682
Other Taxes 57 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
(Schedule 2) 58 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . . . . . . . . . . . 58
59 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . . . . . . . . . 59
60a Household employment taxes from Schedule H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60a

Client Copy
b First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60b
61 Taxes from: Form 8959 Form 8960 Instructions; enter code(s) 61
62 Section 965 net tax liability installment from Form 965-A . . . . . . . . . . . . . . . . . . . 62
63 Add lines 56 through 61. This is your ..........................................................  63 6,682
64 Federal income tax withheld from: 64
a Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64a 14,463
b Form(s) 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64b
c Other forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64c
65 2020 estimated tax payments and amount applied from 2019 return . . . . . . . . . 65
Payments 66a Earned income credit (EIC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66a
(Schedule 3) b Nontaxable combat pay election . . 66b
67 Additional child tax credit. Attach Schedule 8812 . . . . . . . . . . . . . . . . . . . . . . 67
68 American opportunity credit from Form 8863, line 8 . . . . . . . . . . . . . . . . 68
69 Recovery rebate credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 0
70 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . 70
71 Amount paid with request for extension to file . . . . . . . . . . . . . . . . . . . . . . 71
72 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . . . . . . . 72
73 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . . . . . . . . . 73
74 Credits: Form 2439 8885
Sch H & Form 7202 Sch H & SE Filers 74
Other
75 Add lines 64 (a-c), 65, 66a, 67 through 74. These are your  75 14,463
Refund 76 If line 75 is more than line 63, subtract line 63 from line 75. This is the amount you overpaid . . . . . . 76 7,781
77a Amount of line 76 you want refunded to you. If Form 8888 is attached, check here . . . . . . . .  77a 7,781
 b Routing numbe  c Type: X Checking Savings
 d Account number
78 Amount of line 76 you want applied to your 2021 estimated tax  78
Amount 79 Amount you owe. Subtract line 75 from line 63. For details on how to pay, see instructions ...  79
You Owe 80 Estimated tax penalty (see instructions) 80
Int/Pen Date filed Int Fail to file Fail to pay Total

Third Party Do you want to allow another person to discuss this return with the IRS (see instructions)? X Yes. Complete below. No Personal identification no. (PIN)

Designee Designee's Name

 Holly McCall Phone no.  503-477-4396
Taxpayer Daytime phone number Taxpayer: Occupation Business Owner IRS Identity Protection PIN
Other Info
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Taxpayer Spouse Email address

18014 10/28/2022 3:22 PM

Form 1040 Shareholder's Basis Worksheet Page 1 2020

Name Taxpayer Identification Number
Dean A Gluesenkamp
Name of Entity Deans Car Care Inc EIN
Passive Activity Type Not Passive K1 Unit 1
Shareholder Stock Basis
1. Beginning of year stock basis. Per IRC 1367(a)(2) do not enter an amount below zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 6,235
Increases to stock basis
2. Capital contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Ordinary business income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 11,002
4. Net rental real estate income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Other net rental income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Interest, dividends and royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
7. Net capital gains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Net section 1231 gain and ordinary business gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Tax-exempt interest and other tax-exempt income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. 104,734
10. Other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.
11. Excess of deductions for depletion over basis of property (other than oil and gas) . . . . . . . . . . . . . . . . 11.
12. Other increases to stock basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Total increases to stock basis. Combine lines 2 through 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. 115,736
14. Add line 1 and line 13 and enter the result here . . . . . . . . . . . . . 14. 121,971
Decreases to stock basis
15. Distributions allowed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. 55,739
16. Subtract line 15 from line 14. If zero or less, enter - 0 - 16. 66,232
17. Losses and deductions applied against stock basis. (See Shareholder Basis Worksheet Page 2) 17. 672
18. Other decreases to stock basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.

Client Copy
19. Amount used to restore loan basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. Total decreases (other than distributions) to stock basis. Combine lines 17 through 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. 672
21. (Subtract line 20 from line 16). Per IRC 1367(a)(2) do not enter an amount below zero . . . . . . . 21. 65,560
Shareholder Loan Basis
22. Beginning of year loan basis. Per IRC 1367(b)(2)(A) do not enter an amount below zero ........ 22.
23. Loans to corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
24. Loan basis restored from line 19 above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
25. Other increases to loan basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25.
26. Loan repayments from line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.
27. Combine lines 22 through 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. 0
28. Losses and deductions applied against loan basis. (See Shareholder Basis Worksheet Page 2) . 28.
29. Other decreases to loan basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.
30. Total decreases to loan basis. Add lines 28 and 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30. 0
31. (Subtract line 30 from line 27). Per IRC 1367(b)(2)(A) do not enter an amount below zero . . . . . 31. 0
32. (Add lines 21 and line 31) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32. 65,560
Gain Recognized on Excess Distributions
33. Property distributions reported in Box 16, Code D, Schedule K-1 (1120S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33. 55,739
34. Stock basis before distributions and loss items (line 14) less gain from the entire disposition of stock reported on line 18. . . 34. 121,971
35. (Subtract line 34 from line 33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35. 0
Sch D/8949, short-term capital gain Sch D/8949, long-term capital gain

Gain Recognized on Repayment of Shareholder Loan

36. Loan basis at beginning of tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.
37. Basis restored - amount used in prior years to offset losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.
38. Loan basis before loan repayment. Add line 36 and line 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.
39. Face amount of shareholder loan at beginning of tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39.
40. Loan repayments to shareholder during tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.
41. Nontaxable return of loan basis. Divide line 38 by line 39 and multiply the result by line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.
42. (Subtract line 41 from line 40) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42.
Sch D/8949, short-term capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sch D/8949, long-term capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ordinary income on Schedule E page 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18014 10/28/2022 3:22 PM

Form 1040 Shareholder's Basis Worksheet Page 2 2020

Name Dean A Gluesenkamp Id No.
Deans Car Care Inc
Entity Name EIN Passive Activity Type Not Passive K1 Unit 1
Basis reduced by nondeductible items before loss and deduction items
Loss Allocated to Shareholder Stock and Loan Basis
Suspended Current Total Allowed Disallowed Allowed Disallowed Loss Total
Losses Year Loss Loss Percent Stock Loss Stock Loss Percent Loan Loss Carryforward Allowed Loss
Nondeductible noncapital exp
& oil/gas depletion deduction: 580 580 1.0000 580 580
Losses and deductions:
Ordinary business loss
Net rental real estate loss
Other net rental loss
Short-term capital loss
Long-term capital loss
28% capital loss
Section 1231 loss
4797 - Ordinary loss
Other portfolio loss
1256 contracts and straddles
Other losses - Schedule E
Other losses - 1040 Sch 1
Section 179 expense
Cash contributions 92 92 1.0000 92 92
Cash contributions (30%)
Noncash contributions (50%)
Noncash contributions (30%)
Cap gain prop 50% org (30%)
Cap gain prop (20%)
Portfolio deductions (other)
Investment interest expense
Depletion
Deductions-royalty income
Section 59(e)(2) expenditures
Preproductive period exp.
Reforestation expense ded.
Other deductions
Foreign taxes
Total losses and deductions 92 92 1.0000 92 92
Total nonded and deductible items 672 672 672 672
18014 10/28/2022 3:22 PM

Form 1040 Shareholder's Basis Worksheet Page 1 2020

Name Taxpayer Identification Number
Kristina M Perez
Name of Entity Deans Car Care Inc EIN
Passive Activity Type Not Passive K1 Unit 2
Shareholder Stock Basis
1. Beginning of year stock basis. Per IRC 1367(a)(2) do not enter an amount below zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0
Increases to stock basis
2. Capital contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Ordinary business income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 11,387
4. Net rental real estate income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Other net rental income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Interest, dividends and royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
7. Net capital gains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Net section 1231 gain and ordinary business gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Tax-exempt interest and other tax-exempt income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. 108,402
10. Other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.
11. Excess of deductions for depletion over basis of property (other than oil and gas) . . . . . . . . . . . . . . . . 11.
12. Other increases to stock basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Total increases to stock basis. Combine lines 2 through 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. 119,789
14. Add line 1 and line 13 and enter the result here . . . . . . . . . . . . . 14. 119,789
Decreases to stock basis
15. Distributions allowed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. 57,692
16. Subtract line 15 from line 14. If zero or less, enter - 0 - 16. 62,097
17. Losses and deductions applied against stock basis. (See Shareholder Basis Worksheet Page 2) 17. 695
18. Other decreases to stock basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.

Client Copy
19. Amount used to restore loan basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. Total decreases (other than distributions) to stock basis. Combine lines 17 through 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. 695
21. (Subtract line 20 from line 16). Per IRC 1367(a)(2) do not enter an amount below zero . . . . . . . 21. 61,402
Shareholder Loan Basis
22. Beginning of year loan basis. Per IRC 1367(b)(2)(A) do not enter an amount below zero ........ 22.
23. Loans to corporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
24. Loan basis restored from line 19 above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
25. Other increases to loan basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25.
26. Loan repayments from line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.
27. Combine lines 22 through 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. 0
28. Losses and deductions applied against loan basis. (See Shareholder Basis Worksheet Page 2) . 28.
29. Other decreases to loan basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.
30. Total decreases to loan basis. Add lines 28 and 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30. 0
31. (Subtract line 30 from line 27). Per IRC 1367(b)(2)(A) do not enter an amount below zero . . . . . 31. 0
32. (Add lines 21 and line 31) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32. 61,402
Gain Recognized on Excess Distributions
33. Property distributions reported in Box 16, Code D, Schedule K-1 (1120S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33. 57,692
34. Stock basis before distributions and loss items (line 14) less gain from the entire disposition of stock reported on line 18. . . 34. 119,789
35. (Subtract line 34 from line 33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35. 0
Sch D/8949, short-term capital gain Sch D/8949, long-term capital gain

Gain Recognized on Repayment of Shareholder Loan

36. Loan basis at beginning of tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.
37. Basis restored - amount used in prior years to offset losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.
38. Loan basis before loan repayment. Add line 36 and line 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.
39. Face amount of shareholder loan at beginning of tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39.
40. Loan repayments to shareholder during tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.
41. Nontaxable return of loan basis. Divide line 38 by line 39 and multiply the result by line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.
42. (Subtract line 41 from line 40) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42.
Sch D/8949, short-term capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sch D/8949, long-term capital gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ordinary income on Schedule E page 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18014 10/28/2022 3:22 PM

Form 1040 Shareholder's Basis Worksheet Page 2 2020

Name Kristina M Perez Id No.
Deans Car Care Inc
Entity Name EIN Passive Activity Type Not Passive K1 Unit 2
Basis reduced by nondeductible items before loss and deduction items
Loss Allocated to Shareholder Stock and Loan Basis
Suspended Current Total Allowed Disallowed Allowed Disallowed Loss Total
Losses Year Loss Loss Percent Stock Loss Stock Loss Percent Loan Loss Carryforward Allowed Loss
Nondeductible noncapital exp
& oil/gas depletion deduction: 600 600 1.0000 600 600
Losses and deductions:
Ordinary business loss
Net rental real estate loss
Other net rental loss
Short-term capital loss
Long-term capital loss
28% capital loss
Section 1231 loss
4797 - Ordinary loss
Other portfolio loss
1256 contracts and straddles
Other losses - Schedule E
Other losses - 1040 Sch 1
Section 179 expense
Cash contributions 95 95 1.0000 95 95
Cash contributions (30%)
Noncash contributions (50%)
Noncash contributions (30%)
Cap gain prop 50% org (30%)
Cap gain prop (20%)
Portfolio deductions (other)
Investment interest expense
Depletion
Deductions-royalty income
Section 59(e)(2) expenditures
Preproductive period exp.
Reforestation expense ded.
Other deductions
Foreign taxes
Total losses and deductions 95 95 1.0000 95 95
Total nonded and deductible items 695 695 695 695
18014 10/28/2022 3:22 PM

Form 1040 K-1 Reconciliation Worksheet - Sch E, B, D, Form 4797 2020

Name Dean A Gluesenkamp Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 1
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Ordinary business income/-loss 11,002 11,002

Net rental real estate income/-loss
Other net rental income/-loss
Guaranteed payments
Section 179 expense
Disallowed Section 179 expense
Depletion
Section 59(e)(2) expenditures
Preproductive period expense
Reforestation expense deduct
Other deductions
Unreimbursed expenses
Other inc/loss - Schedule E
Debt financed acquisition
Dependent care benefits

11,002 11,002

Royalties
Deductions-royalty income
Depletion

Interest Income
Tax-exempt interest income
Dividend Income
Qualified dividends (1040, Page 2)

Short-term capital gain/-loss

Long-term capital gain/-loss
28% capital gain/-loss
1256 contracts and straddles

4797 Part I
4797 Part II
Section 179/280F recapture
18014 10/28/2022 3:22 PM

Form 1040 K-1 Reconciliation Worksheet - Form 1040, Sch A, Form 4952 2020
Name Dean A Gluesenkamp Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 1
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Other portfolio income/-loss

Other income/-loss
Penalty on early withdrawal

Federal income tax withheld

Undistributed capital gains credit
Recapture of low-income housing cr
Recapture of indian employment cr
Recapture of employ child care cr
Recapture of new markets cr
Recapture of alt motor vehicle cr
Recapture of alt fuel veh refueling cr

Cash contributions 92 92
Cash contributions (30%)
Noncash contributions (50%)
Noncash contributions (30%)
Cap gain prop 50% org (30%)
Cap gain prop (20%)
Portfolio deductions (other)
Real estate taxes
State and local tax withheld paid
Foreign taxes
Investment int from 4952

Investment interest expense

Investment income adjustment
Investment expenses
18014 10/28/2022 3:22 PM

Form 1040 K-1 Reconciliation Worksheet - Form 4684, Sch SE, Misc, Credits 2020
Name Dean A Gluesenkamp Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 1
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Form 4684 lt loss trade/business

Form 4684 lt loss income producing
Form 4684 long-term gain
Form 4684 st loss income producing

Net earnings from self-employ

Gross farming or fishing inc
Gross nonfarm income

Self-employed medical insurance

Shareholder med ins not on Form W2
Other tax-exempt income 104,734 104,734
Nondeductible expenses 580 580
Cash & market security distrib
Property distributions 55,739 55,739
Repayment of shareholder loans
Dependent care benefits (Form 2441)
18014 10/28/2022 3:22 PM

Form 1040 K-1 Reconciliation Worksheet - Sch E, B, D, Form 4797 2020

Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Ordinary business income/-loss 11,387 11,387

Net rental real estate income/-loss
Other net rental income/-loss
Guaranteed payments
Section 179 expense
Disallowed Section 179 expense
Depletion
Section 59(e)(2) expenditures
Preproductive period expense
Reforestation expense deduct
Other deductions
Unreimbursed expenses
Other inc/loss - Schedule E
Debt financed acquisition
Dependent care benefits

11,387 11,387

Royalties
Deductions-royalty income
Depletion

Interest Income
Tax-exempt interest income
Dividend Income
Qualified dividends (1040, Page 2)

Short-term capital gain/-loss

Long-term capital gain/-loss
28% capital gain/-loss
1256 contracts and straddles

4797 Part I
4797 Part II
Section 179/280F recapture
18014 10/28/2022 3:22 PM

Form 1040 K-1 Reconciliation Worksheet - Form 1040, Sch A, Form 4952 2020
Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Other portfolio income/-loss

Other income/-loss
Penalty on early withdrawal

Federal income tax withheld

Undistributed capital gains credit
Recapture of low-income housing cr
Recapture of indian employment cr
Recapture of employ child care cr
Recapture of new markets cr
Recapture of alt motor vehicle cr
Recapture of alt fuel veh refueling cr

Cash contributions 95 95
Cash contributions (30%)
Noncash contributions (50%)
Noncash contributions (30%)
Cap gain prop 50% org (30%)
Cap gain prop (20%)
Portfolio deductions (other)
Real estate taxes
State and local tax withheld paid
Foreign taxes
Investment int from 4952

Investment interest expense

Investment income adjustment
Investment expenses
18014 10/28/2022 3:22 PM

Form 1040 K-1 Reconciliation Worksheet - Form 4684, Sch SE, Misc, Credits 2020
Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Form 4684 lt loss trade/business

Form 4684 lt loss income producing
Form 4684 long-term gain
Form 4684 st loss income producing

Net earnings from self-employ

Gross farming or fishing inc
Gross nonfarm income

Self-employed medical insurance

Shareholder med ins not on Form W2
Other tax-exempt income 108,402 108,402
Nondeductible expenses 600 600
Cash & market security distrib
Property distributions 57,692 57,692
Repayment of shareholder loans
Dependent care benefits (Form 2441)
18014 10/28/2022 3:22 PM

Form 1040 Passive Activity Deduction Worksheet 2020

Name Taxpayer Identification Number
Dean A Gluesenkamp & Kristina M Perez
Activity Lombard St Form Sch E Unit 1
Type Rental real estate w/active participation Entire Disposition of Activity

Regular Tax Loss Calculations

Prior Year Current Year Current Year Suspended Losses
Suspended Losses Generated Utilized To Next Year
Operating 3,246 3,246
Short-term capital loss
Long-term capital loss
28% rate capital loss
Section 1231 loss
Ordinary business loss
Other Losses - 1040 Schedule 1
Commercial revitalization

Alternative Minimum Tax Loss Calculations

Prior Year Current Year Current Year Suspended Losses
Suspended Losses Generated Utilized To Next Year
Operating 3,246 3,246
Short-term capital loss
Long-term capital loss
28% rate capital loss

Client Copy
Section 1231 loss
Ordinary business loss
Other Losses - 1040 Schedule 1
Commercial revitalization
18014 10/28/2022 3:22 PM

Schedule E Qualified Business Income Calculation Worksheet 2020

Name Taxpayer Identification Number
Dean A Gluesenkamp & Kristina M Perez
Property Description Form/Schedule Unit
Lombard St E 1
1. Schedule E, Page 1, Net rental real estate income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. -3,246
Additions for qualified business income:
2. Form 4797, Ordinary income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
Prior year suspended losses utilized this year:
3. Passive suspended losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
4. At-Risk suspended losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Section 179 expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Total additions to net profit or (loss). Add lines 2 through 5. .......................................................... 6.

Subtractions for qualified business income

7. Form 4797, Ordinary loss (includes share of net 1231 loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.
10. Total subtraction to net profit or (loss). Add lines 7 through 9. ......................................................... 10.

11. Qualified business income for this activity. Line 1 plus line 6 less line 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. -3,246

Client Copy
Beginning of Year End of Year
Carryovers: Pre -2018 After 2017 Allowed loss Pre -2018 After 2017 QBI Portion of
Passive activity: (A) (B) (C) (D) (E) Allowed Losses
Operating
Form 4797, Part II
Section 1231 loss
At-Risk:
Operating
Form 4797, Part II
Section 1231 loss
Section 179 expense
Other:
Section 179 expense

Amount to Form 8995, line 3 or Schedule C (Form 8995-A), line 2 qualified business loss carryforward
18014 10/28/2022 3:22 PM

Schedule E K-1 Reconciliation Worksheet - Qualified Business Income 2020

Name Dean A Gluesenkamp Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 1
Activity Passive Activity Type Not Passive Entire disposition of activity
Screen K1QBI QBI Items from Basis Limit At-risk Limit Passive Qualified Prior Year Suspended QBI Losses Allowed
Amount Schedule K-1 Adjustment Adjustment Limitation Business Income Passive / 179 Basis At-risk
Ordinary business inc/-loss 11,002 11,002 11,002
Net rental real estate inc/-loss
Other net rental income/-loss
Royalties
Section 1231 gain (loss)
Section 179 expense
Disallowed Section 179 exp
Other income (loss)
Other income/-loss Form 1040
Reserved
Other deductions
4797 ordinary income / -loss
Depletion
UPE + Debt financed acquisit
Deductible part of SE tax
Self-employed health insurance
Self-employed qualified plans
Ordinary gains on distribution
11,002
Form 8995 or 8995-A Qualified business net (loss) carryforward from prior years
Form 8995, line 3 or Form 8995-A (Schedule C), line 2

Pre -TCJA Post- TCJA Pre -TCJA Post - TCJA Pre -TCJA Post- TCJA
Suspended Loss Carryforwards Passive Passive Basis Basis At-Risk At-Risk Other carryovers
Ordinary business loss
Net rental real estate loss
Other net rental loss
Section 179 expense
Depletion
Section 59(e)(2) expenditure
Preproductive period exp
Reforestation expense ded
Other deductions
Other losses - Schedule E
Dependent care expense
4797 - Ordinary loss
Other losses - 1040 Sch 1
Section 1231 loss
18014 10/28/2022 3:22 PM

Schedule E K-1 Reconciliation Worksheet - Qualified Business Income 2020

Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Screen K1QBI QBI Items from Basis Limit At-risk Limit Passive Qualified Prior Year Suspended QBI Losses Allowed
Amount Schedule K-1 Adjustment Adjustment Limitation Business Income Passive / 179 Basis At-risk
Ordinary business inc/-loss 11,387 11,387 11,387
Net rental real estate inc/-loss
Other net rental income/-loss
Royalties
Section 1231 gain (loss)
Section 179 expense
Disallowed Section 179 exp
Other income (loss)
Other income/-loss Form 1040
Reserved
Other deductions
4797 ordinary income / -loss
Depletion
UPE + Debt financed acquisit
Deductible part of SE tax
Self-employed health insurance
Self-employed qualified plans
Ordinary gains on distribution
11,387
Form 8995 or 8995-A Qualified business net (loss) carryforward from prior years
Form 8995, line 3 or Form 8995-A (Schedule C), line 2

Pre -TCJA Post- TCJA Pre -TCJA Post - TCJA Pre -TCJA Post- TCJA
Suspended Loss Carryforwards Passive Passive Basis Basis At-Risk At-Risk Other carryovers
Ordinary business loss
Net rental real estate loss
Other net rental loss
Section 179 expense
Depletion
Section 59(e)(2) expenditure
Preproductive period exp
Reforestation expense ded
Other deductions
Other losses - Schedule E
Dependent care expense
4797 - Ordinary loss
Other losses - 1040 Sch 1
Section 1231 loss
18014 10/28/2022 3:22 PM

Form 1040 Rent and Royalty Reconciliation 2020

Name Taxpayer identification number
Dean A Gluesenkamp & Kristina M Perez
Property description Unit 1 Ownership Percentage
Lombard St T, S, J J Business Use Percentage
Passive type: Active participation State OR Personal Use Percentage
1. Physical address: 2. Property Use Information:
Street . . . . . . . . . . . . . . . . 1506 NE Lomard St Fair Rental Days . . . . . . . . . . . . . . . . . . . . . .366
City, state, zip . . . . . . . . . . Portland OR 97211 Personal Use Days . . . . . . . . . . . . . . . . . . .
Property type: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Self-Rental QJV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Column A Column B Column C (Column A - B - C)

Vacation
Total Nonbusiness Home / Personal Income / Expenses
Income: Income/Expense Expenses Use Expenses Reported on Schedule E
3. Rents received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,899 49,899
4. Royalties received . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expenses:
5. Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Auto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Auto and travel (total) . . . . . . . . . . . . . . . . . . . . . . . .
7. Cleaning and maintenance . . . . . . . . . . . . . . . . . .
8. Commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Legal and other professional fees . . . . . . . . . . .
11. Management fees . . . . . . . . . . . . . . . . . . . . . . . . . . .

Client Copy
Mortgage interest from 1098 . . . . . . . . . . . . . . . . 21,656
Refinancing points on 1098 . . . . . . . . . . . . . . . . .
12. Mortgage interest paid to banks, etc. . . . . . . . . 21,656 21,656
Other mortgage interest . . . . . . . . . . . . . . . . . . . . .
Other interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,983
Refinancing points . . . . . . . . . . . . . . . . . . . . . . . . . . .
Qualified mortgage insurance . . . . . . . . . . . . . . .
13. Other interest (total) . . . . . . . . . . . . . . . . . . . . . . . . . 12,983 12,983
14. Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15. Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Real estate taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . .
All other taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,498
16. Taxes (total) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,498 5,498
17. Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18. Depreciation expense or depletion . . . . . . . . . . 13,008 13,008
19. Other (list)

20. Total expenses. Add lines 5 through 19 . . . . . . . 53,145 53,145

21. Income or (loss) from rental or royalty properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3,246
18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Federal Statements

Deans Car Care Inc

Form W-2, Box 12
Description Amount
Employee salary reduction Section 408(p) contributions $ 1,263
Total $ 1,263

Deans Car Care Inc

Form W-2, Box 14 - Other

Description Amount
Statewide Transit Tax: OR $ 41
Total $ 41

Client Copy
18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Federal Statements

Deans Car Care Inc

Form W-2, Box 12
Description Amount
Employee salary reduction Section 408(p) contributions $ 4,888
Total $ 4,888

Deans Car Care Inc

Form W-2, Box 14 - Other

Description Amount
Statewide Transit Tax: OR $ 28
Total $ 28

Client Copy
 18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Federal Asset Report
FYE: 12/31/2020 Lombard St

Date Bus Sec Basis

Asset Description In Service Cost % 179 Bonus for Depr PerConv Meth Prior Current

Prior MACRS:
1 Building 2/28/18 474,884 474,884 39 MM S/L 22,831 12,176
3 Improvements 2/28/18 32,450 32,450 39 MM S/L 1,560 832
507,334 507,334 24,391 13,008

Other Depreciation:
2 Land 2/28/18 344,685 344,685 0 -- Land 0 0
Total Other Depreciation 344,685 344,685 0 0

Total ACRS and Other Depreciation 344,685 344,685 0 0

Grand Totals 852,019 852,019 24,391 13,008

Less: Dispositions and Transfers 0 0 0 0
Less: Start-up/Org Expense 0 0 0 0
Net Grand Totals 852,019 852,019 24,391 13,008

Client Copy
18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Bonus Depreciation Report
FYE: 12/31/2020 Lombard St

Date In Tax Bus Tax Sec Current Prior Tax - Basis

Asset Property Description Service Cost Pct 179 Exp Bonus Bonus for Depr
3 Improvements 2/28/18 32,450 0 0 0 32,450

Grand Total 32,450 0 0 0 32,450

Client Copy
 18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
AMT Asset Report
FYE: 12/31/2020 Lombard St

Date Bus Sec Basis

Asset Description In Service Cost % 179 Bonus for Depr PerConv Meth Prior Current

Prior MACRS:
1 Building 2/28/18 474,884 474,884 39 MM S/L 22,831 12,176
3 Improvements 2/28/18 32,450 32,450 39 MM S/L 1,560 832
507,334 507,334 24,391 13,008

Other Depreciation:
2 Land 2/28/18 0 0 0 HY 0 0
Total Other Depreciation 0 0 0 0

Total ACRS and Other Depreciation 0 0 0 0

Grand Totals 507,334 507,334 24,391 13,008

Less: Dispositions and Transfers 0 0 0 0
Net Grand Totals 507,334 507,334 24,391 13,008

Client Copy
 18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Depreciation Adjustment Report
FYE: 12/31/2020 All Business Activities

AMT
Adjustments/
Form Unit Asset Description Tax AMT Preferences

MACRS Adjustments:
E 1 1 Building 12,176 12,176 0
E 1 3 Improvements 832 832 0
13,008 13,008 0

Client Copy
 18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Future Depreciation Report FYE: 12/31/21
FYE: 12/31/2020 Lombard St

Date In
Asset Description Service Cost Tax AMT

Prior MACRS:
1 Building 2/28/18 474,884 12,177 12,177
3 Improvements 2/28/18 32,450 832 832
507,334 13,009 13,009

Other Depreciation:
2 Land 2/28/18 344,685 0 0
Total Other Depreciation 344,685 0 0

Total ACRS and Other Depreciation 344,685 0 0

Grand Totals 852,019 13,009 13,009

Client Copy
18014 10/28/2022 3:22 PM

Form 1040 K1 Detail Summary Report, Page 1 2020

Name Taxpayer identification number
Dean A Gluesenkamp & Kristina M Perez
Activity
Passthrough Entity Name EIN Entity Type Passive Activity Type Disposed
A Deans Car Care Inc S Corporation Not Passive
B Deans Car Care Inc S Corporation Not Passive
C
D
Form / Schedule / Worksheet
Form 1040: A B C D
Other Income: Totals:
Other portfolio income (loss) Form 1040, Sch 1, Line 8

Other income (loss) - 1040, Sch 1 Form 1040, Sch 1, Line 8

Net operating loss carryover - regular Form 1040, Sch 1, Line 8

Net operating loss carryover - AMT Form 6251, Line 2f

Prior Year Basis Items Form 1040, Sch 1, Line 8

Basis Adjustment Form 1040, Sch 1, Line 8

Prior Year At-Risk Items Form 1040, Sch 1, Line 8

At-risk adjustment Form 1040, Sch 1, Line 8

PAL adjustment Form 1040, Sch 1, Line 8

PTP adjustment Form 1040, Sch 1, Line 8

Self-employed health insurance deduction:

Self-employed medical insurance Form 1040, Sch 1, Line 16
SE Health Ins Ded Wrk, Line 1
Basis Adjustment Form 1040, Sch 1, Line 16
SE Health Ins Ded Wrk, Line 1
At-risk adjustment Form 1040, Sch 1, Line 16

Client Copy
SE Health Ins Ded Wrk, Line 1
Penalty for early withdrawal of savings:
Penalty for early withdrawal Form 1040, Sch 1, Line 17

Prior Year Basis Losses Form 1040, Sch 1, Line 17

Basis Adjustment Form 1040, Sch 1, Line 17

Prior Year At-Risk Losses Form 1040, Sch 1, Line 17

At-risk adjustment Form 1040, Sch 1, Line 17

Federal income tax withheld

Back up withholding Form 1040, Line 25c

Trust paid fed estimated tax

Form 4562:
Section 179 expenses Form 4562, line 6

Prior Year Basis Losses Form 4562, line 6

Basis Adjustment Form 4562, line 6

Prior Year At-Risk Losses Form 4562, line 6

At-risk adjustment Form 4562, line 6

Section 179 carryover Form 4562, line 10

Business income - basis adjustment Form 4562, line 11

Business income - At-risk adjustment Form 4562, line 11

Miscellaneous Items:
Section 179 exp ded allow in PY Form 4797, Part IV, Line 33

Section 179 recomputed depreciation Form 4797, Part IV, Line 34

Section 280F expense in PY Form 4797, Part IV, Line 33

Section 280F recomputed depreciation Form 4797, Part IV, Line 34

Qualified Business Income Deduction Information:

Section 199A REIT dividends Form 8995, Line 6
Form 8995-A, Line 28
18014 10/28/2022 3:22 PM

Form
1040 K1 Detail Summary Report, Page 3 2020
Name Taxpayer identification number
Dean A Gluesenkamp & Kristina M Perez
Passthrough Entity Name EIN Entity Type Passive Activity Type Disposed
A Deans Car Care Inc S Corporation Not Passive
B Deans Car Care Inc S Corporation Not Passive
C
D
Form / Schedule / Worksheet A B C D
Schedule B: Totals:
Interest Schedule B, Line 1

Tax-exempt interest Form 1040, Line 2a

Ordinary dividends Schedule B, Line 5

Qualified dividends Form 1040, Line 2a

Schedule A:
Medical and dental:
Shareholder medical ins - no W2 Schedule A, line 1

Basis adjustment Schedule A, line 1

At-risk adjustment Schedule A, line 1

Taxes:
State/local withholding taxes Schedule A, line 5a

State/local w/h - Sch K1 Basis Adj Schedule A, line 5a

State/local w/h - Sch K1 At-Risk Adj Schedule A, line 5a

Real estate taxes Schedule A, line 5b

RE tax - Sch K1 Basis Adj Schedule A, line 5b

RE tax - Sch K1 At-Risk Adj Schedule A, line 5b

Total foreign taxes paid/accrued

Client Copy
Schedule A, line 6

Foreign taxes - K1 Basis Adj Schedule A, line 6

Foreign taxes - K1 At-Risk Adj Schedule A, line 6

Gifts to Charity:
Cash contributions 92 95 187 Schedule A, line 11

Cash contrib Basis Adj Schedule A, line 11

Cash contrib Risk Adj Schedule A, line 11

Cash contributions (30%) Schedule A, line 11

30% Cash contrib Basis Adj Schedule A, line 11

30% Cash contrib Risk Adj Schedule A, line 11

Noncash contribution (50%) Schedule A, line 12

50% Noncash contrib Basis Adj Schedule A, line 12

50% Noncash contrib Risk Adj Schedule A, line 12

Noncash contribution (30%) Schedule A, line 12

30% Noncash contrib Basis Adj Schedule A, line 12

30% Noncash contrib Risk Adj Schedule A, line 12

50% Cap Gain (30%) Schedule A, line 12

50% Cap Gain 30% Basis Adj Schedule A, line 12

50% Cap Gain 30% Risk Adj Schedule A, line 12

Capital gain property (20%) Schedule A, line 12

20% Contrib Basis Adj Schedule A, line 12

20% Contrib Risk Adj Schedule A, line 12

Other Itemized Deductions:

Portfolio deduction not misc Schedule A, line 16

Basis Adjustment Schedule A, line 16

At-Risk Adjustment Schedule A, line 16

Estate tax deduction Schedule A, line 16

Excess deductions - 67(e) expense Form 1040, Sch 1, line 22

Excess deductions - other itemized Schedule A, line 16

18014 10/28/2022 3:22 PM

Form 1040 Salaries & Wages Report 2020

Name Taxpayer Identification Number
Dean A Gluesenkamp & Kristina M Perez
T/S Employer Federal Wages Federal Withheld Soc Sec Wages
A T Deans Car Care Inc 40,837 4,872 42,100
B S Deans Car Care Inc 27,696 9,591 32,583
C
D
E
F
G
H
I
J
K
L
M

Taxpayer 40,837 4,872 42,100

Spouse 27,696 9,591 32,583
Totals 68,533 14,463 74,683

Soc Sec Withheld Medicare Wages Medicare Withheld Soc Sec Tips Allocated Tips Dep Care Ben Other, Box 14
A 2,610 42,100 610 41
B 2,020 32,583 472 28

Client Copy
C
D
E
F
G
H
I
J
K
L
M

Taxpayer 2,610 42,100 610 41

Spouse 2,020 32,583 472 28
Totals 4,630 74,683 1,082 69
State State Wages State Withheld Name of Locality Local Wages Local Withheld
A OR 40,837 3,340
B OR 27,696 2,875
C
D
E
F
G
H
I
J
K
L
M

Taxpayer 40,837 3,340

Spouse 27,696 2,875
Totals 68,533 6,215
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Form 1040 Two Year Comparison Report - Schedule E Page 1 2019 & 2020
Name Taxpayer identification number
Dean A Gluesenkamp & Kristina M Perez
Property description Unit
Lombard St 1

Income 2019 2020 Differences

1. Total rents and royalties received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 53,700 49,899 -3,801
Expenses
2. Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Auto and travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
4. Cleaning and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Commissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
7. Legal and other professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Management fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Mortgage interest paid to banks, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. 22,133 21,656 -477
10. Other interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. 13,453 12,983 -470
11. Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. 5,296 5,498 202
14. Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.
15. Depreciation expense or depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. 13,009 13,008 -1
16. Other expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.
17. Total expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. 53,891 53,145 -746

Client Copy
Profit/(loss)
18. Income or (loss) from rental real estate or royalty properties . . 18. -191 -3,246 -3,055
19. Deductible rental real estate loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. -191 -3,246 -3,055

Carryover
20. Vacation home operating expenses carryover to next year . . . . . . . . 20.
21. Vacation home excess casualty & depreciation carryover to next yr 21.
18014 10/28/2022 3:22 PM

Form 1040 TPW - EIP 3 and Recovery Rebate Credit Worksheet 2020 & 2021
Name Tax a er Identification Number
Dean A Gluesenkamp & Kristina M Perez
2019 2020 2021
A. Filing Status MFJ MFJ
B. Adjusted gross income (AGI) 87,581 87,581
C. Is AGI on line B greater or equal to $80,000 ($160,000 MFJ/QW;
$120,000 HH)? Yes Stop here. No go to D No Yes X No Yes X No Yes
D. Can taxpayer or spouse, if filing a joint return, be claimed as a
dependent on another person's return? No go to E. Yes Stop here No Yes X No Yes X No Yes
E. Does the taxpayer, and spouse if filing jointly, have a valid social
security number? Yes skip line F and go to line 1. No, go to line F Yes No X Yes No X Yes No
F. Were either taxpayer or spouse a member of the U.S. Armed Forces
at any time during the tax year? Yes go to line 1. No, Stop here Yes No Yes No Yes No

2019 2020 2021

1. Adjusted gross income (AGI) from the return . . . . . . . . . . . . . . . . 1. 87,581 87,581
2. Economic impact payment (EIP) based upon filing
status. Enter $1,400 ($2,800 if MFJ) . . . . . . . . . . . . . . . . . . . . . . . . 2. 2,800 2,800
Note: Tp/Sp who died on/after 1/1/21 are eligible for EIP3
3. Number of dependents with valid identification number . . . . . . 3.
4. Enter $1,400 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 1,400 1,400
5. EIP for dependents with valid identification

Client Copy
number. Multiply line 4 by line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Total EIP before AGI limits. Add line 2 and 5 . . . . . . . . . . . . . . . 6. 2,800 2,800
7. Phaseout limit based upon filing status. Enter
$75,000 ($150,000 MF/QWJ; $112,500 HH) . . . . . . . . . . . . . . . . . 7. 150,000 150,000
8. Subtract line 7 from line 1. If less than zero, enter -0- . . . . . . 8. 0 0
9. Enter $80,000 ($160,000 MFJ/QW; $120,000 HH) . . . . . . . . . . . 9. 160,000 160,000
10. Subtract line 7 from line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. 10,000 10,000
11. EIP reduction percentage. Divide line 8 by line 10 . . . . . . . . . 11. 0.00 0.00
12. EIP reduction amount. Multiply line 6 by line 11 . . . . . . . . . . . 12.
13. Projected EIP. Subtract line 12 from line 6. If less
than zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. 2,800 2,800
14. Enter the amount from line 13 of the year used to calculate . 14. 2,800
15. Recovery rebate credit for 2021. Subtract line 14 from 2020 Tax Return
line 13. If zero or less, enter -0-. Enter the result here
and on Tax Projection Worksheet line 82 . . . . . . . . . . . . . . . . . . . . 15. 0
18014 10/28/2022 3:22 PM

Form 1040 Tax Return History Report - Page 1 2020

Name Dean A Gluesenkamp & Kristina M Perez Taxpayer Identification Number
2018 2019 2020 2021 Projected
Filing Status MFJ MFJ MFJ MFJ
Salaries and wages . . . . . . . . . . . . . . . . . . . 38,121 39,382 68,533 68,533
Interest income . . . . . . . . . . . . . . . . . . . . . . . . 92 92
Dividend income . . . . . . . . . . . . . . . . . . . . . . .
Business income/loss . . . . . . . . . . . . . . . . 16,748
Capital gains/losses . . . . . . . . . . . . . . . . . .
Other gains/losses . . . . . . . . . . . . . . . . . . .
IRA distributions, pensions, annuities . .
Rent, royalty, farm rental income . . . . . . 5,507 -191 -3,246 19,143
Partnership/S corp income . . . . . . . . . . . . 60,983 56,900 22,389 *
Estate or trust income . . . . . . . . . . . . . . . . . *

Farm income/loss . . . . . . . . . . . . . . . . . . . . .
Other income/loss . . . . . . . . . . . . . . . . . . . . . 478
Total income . . . . . . . . . . . . . . . . . . . . . . . . 121,837 96,091 87,768 87,768
Total adjustments . . . . . . . . . . . . . . . . . . . . . 1,183 ** 187 ** 187
Adjusted gross income . . . . . . . . . . . . . . 120,654 96,091 87,581 87,581
Allowable itemized deductions . . . . 24,137 23,649 23,117 23,117
Standard deduction . . . . . . . . . . . . . . . . . . . . 24,000 24,400 24,800 25,100
Itemized or standard deduction taken 24,137 24,400 24,800 25,100
Exemptions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable income before Qual Bus Inc Ded 96,517 71,691 62,781 62,481
Qual Bus Inc Ded 16,411 11,342 3,829
Taxable income . . . . . . . . . . . . . . . . . . . . . . 80,106 60,349 58,952 62,481
* Amts in the projected col generate from the federal Tax Projection Wrk (TPW); this field is incl in the total Sch E income/loss amt on the TPW. ** Incl Charitable Contribution w/standard deduction.
18014 10/28/2022 3:22 PM

Form 1040 Tax Return History Report - Page 2 2020

Name Dean A Gluesenkamp & Kristina M Perez Taxpayer Identification Number
2018 2019 2020 2021 Projected
Taxable income . . . . . . . . . . . . . . . . . . . . . . . 80,106 60,349 58,952 62,481
Tax on taxable income and Form 8962 . 9,507 6,851 6,682 7,100
Alternative minimum tax . . . . . . . . . . . . . . . . .
Total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net tax liability . . . . . . . . . . . . . . . . . . . . . . . . . 9,507 6,851 6,682 7,100
Self-employment taxes . . . . . . . . . . . . . . . . . 2,366
Other taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,416
Total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,289 6,851 6,682 7,100
Income tax withheld . . . . . . . . . . . . . . . . . . . . . 8,839 14,080 14,463 14,463
Estimated tax payments . . . . . . . . . . . . . . . . .
Other payments . . . . . . . . . . . . . . . . . . . . . . . . .
Total payments . . . . . . . . . . . . . . . . . . . . . . . . . 8,839 14,080 14,463 14,463
Total due/-refund . . . . . . . . . . . . . . . . . . . . . . . 5,450 -7,229 -7,781 -7,363
Penalties and interest . . . . . . . . . . . . . . . . . . . 67
Net tax due/-refund . . . . . . . . . . . . . . . . . . . . . 5,517 -7,229 -7,781 -7,363
Refund applied to estimated tax payments
Refund received . . . . . . . . . . . . . . . . . . . . . . . . . -7,229 -7,781
Marginal tax rate . . . . . . . . . . . . . . . . . . . . . . . % % 22.0 % 12.0 % 12.0 % 12.0 %
Effective tax rate . . . . . . . . . . . . . . . . . . . . . . . % % 18.0 % 11.0 % 11.0 % 11.0 %
18014 10/28/2022 3:22 PM

Form 1040 Reconciliation Worksheet - Taxable Income & Tax 2020

Name Tax a er Identification Number
Dean A Gluesenkamp & Kristina M Perez

Tax brackets are rates applied to specific levels of taxable income. Various rates apply to different portions of the total taxable income. Type of income,
further determines the rate applied. Marginal Tax Rate is the tax paid on the highest level of taxable income. This worksheet details how tax is calculated on
ordinary income and capital gain income, the percentage of taxable income, marginal tax rate and the tax method used.

Filing Status Married filing jointly Tax Pct Total Tax (ln 27) divided Total Taxable Income (ln 19) 11.0 %
Tax Method Tax tables
Tax using ordinary and capital gains rates exceeds tax using only ordinary rates. Taxable income is taxed only using ordinary rates:
Tax using capital gains rates Tax using Ordinary rates Tax savings

Marginal Amount of Income

Taxable Amount Tax Rate Tax on Taxable Income Marginal Tax Rate - Income Range to Next Tax Bracket
Ordinary Income . . . . . . 58,952 12.0 % 6,682 $19,750 - $80,250 21,298
Capital Income . . . . . . . %
Capital Income - 1250 . %
Capital Income - 1202 . %

*Tax on taxable ordinary income under $100,000 is determined using IRS Tax Tables that impose the same amount of tax on taxable income within $50
intervals. Therefore, the column (b) Tax may not be calculated as column (a) times the applicable line tax rate.

Income taxed at ordinary rates (a) Taxable Income (b) Tax*

1. 10% rate . . . Maximum 1a. 19,750 1b. 1,978

Client Copy
. . . . . . . . .taxable
. . . . . . .income
. . . . . . per
. . . .this
. . . .bracket:
. . . . . . .$19,750
............................................
2. 12% rate . . . Maximum
. . . . . . . . .taxable
. . . . . . .income
. . . . . . per
. . . .this
. . . .bracket:
. . . . . . .$60,500
............................................ 2a. 39,202 2b. 4,704
3. 22% rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a. 3b.
4. 24% rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a. 4b.
5. 32% rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5a. 5b.
6. 35% rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a. 6b.
7. 37% rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7a. 7b.
8. Total ordinary taxable income and ordinary tax. Add lines 1 through 7 . . . . . . . . . . . . . . . . 8a. 58,952 8b. 6,682
Income taxed at capital gains rates
9. 0% capital gains rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9a. 9b.
10. 15% capital gains rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10a. 10b.
11. 20% capital gains rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11a. 11b.
12. 25% capital gains rate . . . . . . . . . . . . . . . . . . . . .Unrecaptured
. . . . . . . . . . .Section
. . . . . . .1250
. . . . Gain
........................... 12a. 12b.
13. 28% capital gains rate . . . . . . . . . . . . . . . . . . . . .Small business stock, collectibles
................................................. 13a. 13b.
14. Total taxable capital gains and capital gains tax. Add lines 9 through 13 14a. 14b.

Total taxable income

15. Total ordinary taxable income. Enter the amount from line 8a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. 58,952
16. Total capital gains taxable income. Enter the amount from line 14a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.
17. Add lines 15 and 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. 58,952
18. Enter the net foreign exclusion amount from the Foreign Earned Income Tax Worksheet, line 2c. . . . . . . . . . . . . . . . . . . . . . . . . . 18.
19. Taxable income reported on 1040, line 11b, (1040NR, line 41, or 1040NR-EZ, line 14). Subtract line 18 from line 17. . . . . 19. 58,952
Total tax
20. Total ordinary tax. Enter the amount from line 8b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. 6,682
21. Total capital gains tax. Enter the amount from line 14b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.
22. Tax on child's interest and dividend. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.
23. Tax on lump-sum distribution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
24. Other taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
25. Add lines 20 through 24. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. 6,682
26. Enter the tax allocated to the net exclusion amount from the Foreign Earned Income Tax Worksheet, line 5. . . . . . . . . . . . . . . 26.
27. Total tax reported on 1040, line 12b, (1040NR, line 42, or 1040NR-EZ, line 15). Subtract line 26 from line 25. . . . . . . . . . . . . 27. 6,682
18014 10/28/2022 3:22 PM

Oregon Individual Return Summary

Tax Year 2020

DEAN A GLUESENKAMP KRISTINA M PEREZ

Income, Adjustments, and Deductions

Total income .................................................................................................................... 76,674
Additions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Subtractions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76,674
Itemized X or Standard deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,182
Other deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,697
Taxable income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57,795
Tax, Payments, and Credits
Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,352
Installment sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,352
Nonrefundable credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
Net income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,984
Income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,215
Estimate and extension payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Refundable credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,215
Amount due/-refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -2,231

Client Copy
Overpayment applied to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oregon 529 plan deposit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
Net amt due/-refund before int/pen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -2,231
Amount Due /-Refund
Underpayment of estimates penalty ............................................................................................
Late filing interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Failure to file penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Failure to pay penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net amount due/-refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -2,231

Miscellaneous Information 2021 Estimates

Tax form ............... 40N 1st qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Residency type, taxpayer . NONRESIDENT 2nd qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Residency type, spouse NONRESIDENT 3rd qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Direct debit withdrawal date . . . . . . . . . . . . . . . . . 4th qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amended return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total estimates .........................................
Nonresident/Part-year percentage . . . . . . . . . . . . . 87.500 % ..........
Marginal tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.750 %
Effective tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.893 %
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2020 Form OR-40-N Office use only

Page 1 of 5, 150-101-048 Oregon Department of Revenue 00542001011022
(Rev. 08-25-20 ver. 01)
Oregon Individual Income Tax Return for Nonresidents

Submit original form—do not submit photocopy

Fiscal year ending: Space for 2-D barcode—do not write in box below

Amended return. If amending for an NOL,

tax year the NOL was generated:
Calculated using “as if” federal return.

Short-year tax election. Federal disaster relief.

X Extension filed. Federal Form 8886.

Form OR-24. Military. Employment exception.

First name Initial Last name Social Security no. (SSN)

First time using Applied
this SSN (see for ITIN
Deceased
instructions)
DEAN A GLUESENKAMP
Spouse’s first name Initial Spouse’s last name Spouse’s SSN
First time using Applied
this SSN (see for ITIN

Client C
Deceased
instructions)
KRISTINA M PEREZ
Current mailing address Date of birth (mm/dd/yyyy) Spouse’s date of birth

**/**/1985 **/**/1988
City State ZIP code Country Phone

WASHOUGAL WA 98671
Filing status (check only one box)
Exemptions Total
1. Single. 6a. Credits for yourself: X Regular Severely disabled .. 6a. 1

2. X Married filing jointly. Check box if someone else can claim you as a dependent.

3. Married filing separately (enter spouse’s information ). 6b. Credits for spouse: X Regular Severely disabled .. 6b. 1

4. Head of household (with qualifying dependent). Check box if someone else can claim your spouse as a dependent.

5. Qualifying widow(er) with dependent child.

Dependents. List your dependents in order from youngest to oldest. If more than four, check this box and include Schedule OR-ADD-DEP
with your return.
Dependent's date Check if child with
First name Last name Code* Dependent's SSN of birth (mm/dd/yyyy) qualifying disability

*Dependent relationship code (see instructions).

6c. Total number of dependents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6c. 0
6d. Total number of dependent children with a qualifying disability (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6d. 0
6e. Total exemptions. Add 6a through 6d ................................................................................................. Total. 6e. 2
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2020 Form OR-40-N

Page 2 of 5, 150-101-048 Oregon Department of Revenue 00542001021022
(Rev. 08-25-20 ver. 01)
Name SSN
DEAN A GLUESENKAMP
Note: Reprint page 1 if you make changes to this page.

Income Federal column (F) Oregon column (S)

7. Wages, salaries, and other pay for work from federal Form 1040 or
1040-SR, line 1. Include all Forms W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7F. 68,533.00 7S. 68,533.00
8. Interest income from Form 1040 or 1040-SR, line 2b . . . . . . . . . . . . . . . . . . . . . 8F. 92.00 8S.
9. Dividend income from Form 1040 or 1040-SR, line 3b . . . . . . . . . . . . . . . . . . . 9F. 9S.
10. State and local income tax refunds from federal Schedule 1, line 1 . . . . . . 10F. 10S.
11. Alimony received from federal Schedule 1, line 2a . . . . . . . . . . . . . . . . . . . . . . . 11F. 11S.
12. Business income or loss from federal Schedule 1, line 3 . . . . . . . . . . . . . . . . . 12F. 12S.
13. Capital gain or loss from Form 1040 or 1040-SR, line 7 . . . . . . . . . . . . . . . . . . 13F. 13S.
14. Other gains or losses from federal Schedule 1, line 4 . . . . . . . . . . . . . . . . . . . . 14F. 14S.
15. IRA distributions from Form 1040 or 1040-SR, line 4b . . . . . . . . . . . . . . . . . . . 15F. 15S.
16. Pensions and annuities from Form 1040 or 1040-SR, line 5b . . . . . . . . . . . . 16F. 16S.
17. Schedule E income or loss from federal Schedule 1, line 5 . . . . . . . . . . . . . . 17F. 19,143.00 17S. 8,141.00
18. Farm income or loss from federal Schedule 1, line 6 . . . . . . . . . . . . . . . . . . . . . 18F. 18S.
19. Social Security benefits from Form 1040 or 1040-SR, line 6b; and unem-
ployment and other income from federal Schedule 1, lines 7 and 8 . . . . . . 19F. 19S.
20. Total income. Add lines 7 through 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20F. 87,768.00 20S. 76,674.00

Adjustments
21. IRA or SEP and SIMPLE contributions, from federal Schedule 1,
Client Copy
lines 15 and 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22. Education deductions from federal Schedule 1, lines 10, 20, and 21 . . . . .
21F.
22F.
21S.
22S.
23. Moving expenses from federal Schedule 1, line 13 . . . . . . . . . . . . . . . . . . . . . . . 23F. 0.00 23S. 0.00
24. Deduction for self-employment tax from federal Schedule 1, line 14 . . . . . 24F. 24S.
25. Self-employed health insurance deduction from federal
Schedule 1, line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25F. 0.00 25S. 0.00
26. Alimony paid from federal Schedule 1, line 18a . . . . . . . . . . . . . . . . . . . . . . . . . . 26F. 26S.
27. Total adjustments from Schedule OR-ASC-NP, section 1 . . . . . . . . . . . . . . . . 27F. 187.00 27S. 0.00
28. Total adjustments. Add lines 21 through 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28F. 187.00 28S.
29. Income after adjustments. Line 20 minus line 28 . . . . . . . . . . . . . . . . . . . . . . . . . 29F. 87,581.00 29S. 76,674.00

Additions
30. Total additions from Schedule OR-ASC-NP, section 2 . . . . . . . . . . . . . . . . . . . 30F. 30S.
31. Income after additions. Add lines 29 and 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31F. 87,581.00 31S. 76,674.00

Subtractions
32. Social Security and tier 1 Railroad Retirement Board benefits included
on line 19F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32F.
33. Total subtractions from Schedule OR-ASC-NP, section 3 . . . . . . . . . . . . . . . . 33F. 33S.
34. Income after subtractions. Line 31 minus lines 32 and 33 . . . . . . . . . . . . . . . . 34F. 87,581.00 34S. 76,674.00
35. Oregon percentage (see instructions; not more than 100.0%) . . . . . . . . . . 35. 87.5 %

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2020 Form OR-40-N

Page 3 of 5, 150-101-048 Oregon Department of Revenue 00542001031022
(Rev. 08-25-20 ver. 01)
Name SSN
DEAN A GLUESENKAMP
Note: Reprint page 1 if you make changes to this page.

Deductions and modifications

36. Amount from line 34S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36. 76,674.00
37. Oregon itemized deductions. Enter your Oregon itemized deductions from Schedule OR-A, line 23. If you
are not itemizing your deductions, enter 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37. 18,494.00
38. Standard deduction. Enter your standard deduction (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.

You were: 38a. 65 or older 38b. Blind Your spouse was: 38c. 65 or older 38d. Blind

39. Enter the larger of line 37 or 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39. 18,494.00

40. 2020 federal tax liability. See instructions for the correct amount: $0-$6,950 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40. 3,082.00
41. Total modifications from Schedule OR-ASC-NP, section 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.
42. Deductions and modifications multiplied by the Oregon percentage (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . 42. 18,879.00
43. Charitable art donation (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43.
44. Total deductions and modifications. Add lines 42 and 43 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44. 18,879.00
45. Oregon taxable income. Line 36 minus line 44. If line 44 is more than line 36, enter 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . 45. 57,795.00

Oregon tax
4,352.00

Client Copy
46. Tax. Check the appropriate box if you’re using an alternative method to calculate your tax (see instructions). ... 46.

46a. Schedule OR-FIA-40-N 46b. Worksheet FCG 46c. X Schedule OR-PTE-NR

47. Interest on certain installment sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.

48. Total tax before credits. Add lines 46 and 47 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48. 4,352.00

Standard and carryforward credits

49. Exemption credit (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49. 368.00
50. Total standard credits from Schedule OR-ASC-NP, section 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.
51. Total standard credits. Add lines 49 and 50 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51. 368.00
52. Tax minus standard credits. Line 48 minus line 51. If line 51 is more than line 48, enter 0 . . . . . . . . . . . . . . . . . . . . . . . 52. 3,984.00
53. Total carryforward credits claimed this year from Schedule OR-ASC-NP, section 6. Line 53 can’t be more
than line 52 (see Schedules OR-ASC and OR-ASC-NP Instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.
54. Tax after standard and carryforward credits. Line 52 minus line 53 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54. 3,984.00

Payments and refundable credits

55. Oregon income tax withheld. Include a copy of Forms W-2 and 1099 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55. 6,215.00
56. Amount applied from your prior year’s tax refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56.
57. Estimated tax payments for 2020. Include all payments you made prior to the filing date of this return,
including real estate transactions. Do not include the amount you already reported on line 56 . . . . . . . . . . . . . . . . . . . 57.
58. Tax payments from a pass-through entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58.
59. Earned income credit (see instructions) ........................................................................... 59.
60. Reserved

61. Total refundable credits from Schedule OR-ASC-NP, section 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61.

62. Total payments and refundable credits. Add lines 55 through 61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62. 6,215.00

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2020 Form OR-40-N

Page 4 of 5, 150-101-048 Oregon Department of Revenue 00542001041022
(Rev. 08-25-20 ver. 01)
Name SSN

DEAN A GLUESENKAMP
Note: Reprint page 1 if you make changes to this page.

Tax to pay or refund

63. Overpayment of tax. If line 54 is less than line 62, you overpaid. Line 62 minus line 54 . . . . . . . . . . . . . . . . . . . . . . . . . 63. 2,231.00
64. Net tax. If line 54 is more than line 62, you have tax to pay. Line 54 minus line 62 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64.
65. Penalty and interest for filing or paying late (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65.
66. Interest on underpayment of estimated tax. Include Form OR-10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66.

Exception number from Form OR-10, line 1: 66a. Check box if you annualized: 66b.

67. Total penalty and interest due. Add lines 65 and 66. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67.
68. Net tax including penalty and interest. Line 64 plus line 67 . . . . . . . . . . . . . . . . . . . . This is the amount you owe. 68. 0.00
69. Overpayment less penalty and interest. Line 63 minus line 67 . . . . . . . . . . . . . . . . . . . . . . . . . . This is your refund. 69. 2,231.00
70. Estimated tax. Fill in the portion of line 69 you want applied to your open estimated tax account . . . . . . . . . . . . . . . . . 70.
71. Charitable checkoff donations from Schedule OR-DONATE, line 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71.
72. Oregon 529 college savings plan deposits from Schedule OR-529 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72.
73. Total. Add lines 70 through 72. The total can’t be more than your refund on line 69 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73.
74. Net refund. Line 69 minus line 73 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . This is your net refund. 74. 2,231.00

Direct deposit

Client Copy
75. For direct deposit of your refund, see instructions. Check the box if the final deposit destination is outside the United States:

Type of account: X Checking or Savings

Routing number:

Account number:

Reserved

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2020 Form OR-40-N

Page 5 of 5, 150-101-048 Oregon Department of Revenue 00542001051022
(Rev. 08-25-20 ver. 01)
Name SSN
DEAN A GLUESENKAMP
Note: Reprint page 1 if you make changes to this page.

Sign here. Under penalty of false swearing, I declare that the information in this return is true, correct, and complete.
Your signature Date

X
Spouse’s signature (if filing jointly, both must sign) Date

X
Signature of preparer other than taxpayer Preparer phone Preparer license number, if professionally prepared

X HOLLY MCCALL 503-477-4396 ********

Preparer address City State ZIP code

5311 SE POWELL BLVD STE 101 PORTLAND OR 97206-2951

Signing this return does not grant your preparer the right to represent you or make decisions on your behalf. For more information, see the instructions for
the form on our website.

Important: Include a copy of your federal Form 1040, 1040-SR, 1040-X, 1040-NR, or 1040-NR-EZ. Without this information, we may adjust your
return.

Make your payment (if you have an amount due on line 68)
• Online payments: Visit our website at www.oregon.gov/dor.
• Mailing your payment: Make your check or money order payable to the Oregon Department of Revenue. Write “2020 Oregon Form OR-40-N”

Client Copy
and the last four digits of your SSN or ITIN on your check or money order. Include your payment with this return. Don’t use the Form OR-40-V
payment voucher unless you’re sending us a separate payment.

Send in your return

• Non-2-D barcode. If the 2-D barcode area on the front of this return is blank:
– Mail tax-due returns to: Oregon Department of Revenue, PO Box 14555, Salem OR 97309-0940.
– Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14700, Salem OR 97309-0930.
• 2-D barcode. If the 2-D barcode area on the front of this return is filled in:
– Mail tax-due returns to: Oregon Department of Revenue, PO Box 14720, Salem OR 97309-0463.
– Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14710, Salem OR 97309-0460.

Amended statement. Complete this section only if you’re amending your 2020 return or filing with a new SSN.

If filing an amended return, use this space to explain what you’re changing. Include the return line numbers and the reason for each change. If your
filing status has changed, explain why. Include all supporting forms and schedules when you file your amended return, even if you haven’t changed
anything on them.

If filing with a new SSN, enter your former identification number.

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2020 Schedule OR-A Office use only

Page 1 of 1, 150-101-007 Oregon Department of Revenue 19482001011022
(Rev. 08-13-20 ver. 01)
Oregon Itemized Deductions

Submit original form—do not submit photocopy

First name Initial Last name Social Security number (SSN)
DEAN A GLUESENKAMP
Spouse’s first name Initial Spouse’s last name Spouse’s SSN
KRISTINA M PEREZ

Read instructions carefully before completing this schedule.

Medical and dental expenses
Caution! Don’t include expenses reimbursed or paid by others.
1. Medical and dental expenses (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Federal adjusted gross income (AGI). Enter the amount
from Form OR-40, line 7 or Form OR-40-N or OR-40-P,
line 29F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. AGI threshold. Multiply line 2 by 7.5% (0.075) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
4. Medical and dental expense deduction. Subtract line 3
from line 1. If line 3 is more than line 1, enter 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.

Taxes you paid

5. State and local income taxes. Don’t include Oregon

Client Copy
income tax! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Real estate taxes (see instructions) . . . . . . . . . . . . . . . . . . . . 6. 5,564.00
7. Personal property taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Total income and property taxes. Add lines 5 through 8.
Don’t enter more than $10,000 ($5,000 if married filing separately) ............. 9. 5,564.00
10. Other taxes. List type and amount:
10.
11. Taxes paid deduction. Add lines 9 and 10 ....................................................................... 11. 5,564.00

Interest you paid

12. Mortgage interest and points reported to you on federal Form 1098 . . . . . . . . . . . . . . . . 12. 12,930.00
13. Mortgage interest not reported to you on federal Form 1098 . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Points not reported to you on federal Form 1098 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.
15. Mortgage insurance premiums (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.
16. Investment interest, (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.
17. Interest paid deduction. Add lines 12 through 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. 12,930.00

Gifts to charity
18. Gifts by cash or check (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.
19. Gifts other than by cash or check, (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. Carryover from prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.
21. Total gifts to charity. Add lines 18 through 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.

Other miscellaneous deductions

22. List type and amount. Important! Don’t include employee business expenses, tax preparation fees,
or other deductions subject to the 2 percent of AGI limitation (see instructions).
22.

Oregon itemized deductions

23. Add lines 4, 11, 17, 21, and 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. 18,494.00
Enter the amount from line 23 on Form OR-40, line 16; Form OR-40-N or OR-40-P, line 37.

—You must include this schedule with your Oregon income tax return—
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2020 Schedule OR-ASC-NP Office use only

Page 1 of 2, 150-101-064 Oregon Department of Revenue 15632001011022
(Rev. 08-17-20 ver. 01)
Oregon Adjustments for Form OR-40-N and Form OR-40-P Filers

Submit original form—do not submit photocopy.

First name Initial Last name Social Security number (SSN)
DEAN A GLUESENKAMP
Spouse’s first name Initial Spouse’s last name Spouse’s SSN
KRISTINA M PEREZ
Use Schedule OR-ASC-NP to claim any of the following items that aren’t included on Form OR-40-N or Form OR-40-P:
• Adjustments. • Modifications. • Carryforward credits.
• Additions. • Standard credits. • Refundable credits.
• Subtractions.

Identify the code you’re claiming and enter the information requested in the corresponding section. Enter the total from each section
on the line indicated for Form OR-40-N or OR-40-P.

For more information, refer to the instructions, Publication OR-CODES, or Publication OR-17.

Section 1: Adjustments (codes 002–099)

Code Amount in column Amount in column

1a. 007 1b. 187.00 1c.

1d. 1e. 1f.

Client Copy
1g. 1h. 1i.
1j. 1k. 1l.
Enter totals
1m. 1n. 1o. on Form OR-40-N or
Total 187.00 Total OR-40-P, lines 27F and 27S.

Section 2: Additions (codes 103–165)

Code Amount in column Amount in column

2a. 2b. 2c.

2d. 2e. 2f.
2g. 2h. 2i.
2j. 2k. 2l.
Enter totals
2m. 2n. 2o. on Form OR-40-N or
Total Total OR-40-P, lines 30F and 30S.

Section 3: Subtractions (codes 300–361)

Code Amount in column Amount in column

3a. 3b. 3c.

3d. 3e. 3f.
3g. 3h. 3i.
3j. 3k. 3l.
Enter totals
3m. 3n. 3o. on Form OR-40-N or
Total Total OR-40-P, lines 33F and 33S.

–You must include this schedule with your Oregon income tax return–
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18014 10/28/2022 3:22 PM

2020 Schedule OR-ASC-NP

Page 2 of 2, 150-101-064 Oregon Department of Revenue 15632001021022
(Rev. 08-17-20 ver. 01)
Name SSN
DEAN A GLUESENKAMP
Section 4: Modifications (codes 600–699)
Code Amount

4a. 4b.
4c. 4d.
4e. 4f.
4g. 4h.
4i. 4j.
Enter total
on Form OR-40-N or
OR-40-P, line 41

Section 5: Standard credits (codes 800–834)

State abbreviation
Code Amount (if claiming code 802 or 815)

5a. 5b. 5c.

5d. 5e. 5f.
5g. 5h. 5i.
5j. 5k. 5l.
5m. 5n. 5o.
Enter total
on Form OR-40-N, line 50;

Client Copy
or OR-40-P, line 49

Section 6: Carryforward credits (codes 835–889)

Code Amount from prior year Amount awarded this year Total used this year
6a. 6b. 6c. 6d.
6e. 6f. 6g. 6h.
6i. 6j. 6k. 6l.
6m. 6n. 6o. 6p.
6q. 6r. 6s. 6t.
Enter total
on Form OR-40-N, line 53; or
OR-40-P, line 52

Section 7: Refundable credits (codes 890–899)

Code Amount
7a. 7b.
7c. 7d.
7e. 7f.
Enter total
on Form OR-40-N, line
61; or OR-40-P, line 60

—You must include this schedule with your Oregon income tax return—
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18014 10/28/2022 3:22 PM

2020 Schedule OR-PTE-NR Office use only

Page 1 of 2, 150-101-367 Oregon Department of Revenue 18142001011022
(Rev. 07-28-20, ver. 01)
Qualified Business Income Reduced
Tax Rate Schedule for Oregon Nonresidents
Submit original form–do not submit photocopy
First name Initial Last name Social Security number (SSN)
DEAN A GLUESENKAMP
Spouse's first name if joint return Initial Spouse's last name Spouse’s SSN if joint return
KRISTINA M PEREZ

To qualify for the reduced tax rate, you must complete both sections and submit this form with your Oregon Form OR-40-N.

Section A—Qualifying business information

List each qualifying sole proprietorship (SP), S corporation (SC), or partnership (P) along with the business code number (or NAICS
code), number of qualifying employees, entity type, nonpassive income (or loss), and Section 179 expenses attributable to each
qualifying business. Only list businesses that qualify. See instructions for more information.
Business code no. No. of qualifying employees
1. Qualifying business name FEIN
DEANS CAR CARE INC 7
Entity type: a. Nonpassive loss b. Section 179 expense c. Nonpassive income
SC (SP, SC, or P only) 11,387.00
FEIN Business code no. No. of qualifying employees
2. Qualifying business name
DEANS CAR CARE INC 7

Client y
Entity type: a. Nonpassive loss ense c. Nonpassive income
SC (SP, SC, or P only)

Qualifying business name usines No. of qualifying employees

3.

Entity type: a. Nonpassive loss b. Section 179 expense c. Nonpassive income

(SP, SC, or P only)

Qualifying business name FEIN Business code no. No. of qualifying employees
4.

Entity type: a. Nonpassive loss b. Section 179 expense c. Nonpassive income

(SP, SC, or P only)

Business code no. No. of qualifying employees

5. Qualifying business name FEIN

Entity type: a. Nonpassive loss b. Section 179 expense c. Nonpassive income

(SP, SC, or P only)

6. Total for each column a. Nonpassive loss total b. Section 179 expense total c. Nonpassive income total
(a), (b), and (c): 11,387.00

7. Enter the amount from line 6c .................................. 7. 11,387.00

8. Add lines 6a and 6b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.

9. Line 7 minus line 8 ............................................... 9. 11,387.00

If line 9 is 0 or less, you can’t use the reduced tax rate. Return to the Form OR-40-N, line 46, and complete the rest of the form. If
line 9 is more than 0, enter this amount on line 2b of the Tax worksheet in Section B on page 2.

–You must include this schedule with your Oregon Form OR-40-N–

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18014 10/28/2022 3:22 PM
DEAN A GLUESENKAMP KRISTINA M PEREZ

2020 Schedule OR-PTE-NR

Page 2 of 2, 150-101-367 Oregon Department of Revenue 18142001021022
(Rev. 07-28-20, ver. 01)

Use the following worksheet to calculate your tax. See the instructions for information on completing the worksheet.

Section B—Tax worksheet

Complete each applicable line to determine your tax.

1. Enter Oregon taxable income from Form OR-40-N, line 45 . . . . . 1a. 57,795.00
2. Enter the total qualifying income from line 9 of Section A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b. 11,387.00

3. Line 1a minus line 2b. Don’t enter less than 0 . . . . . . . . . . . . . . . . . . 3a. 46,408.00
4. Enter the amount of the depreciation addition from
Form OR-40-N, line 30S, that is attributable to qualifying
businesses on lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a. 4b.
5. Line 3a minus line 4a. Don’t enter less than 0 . . . . . . . . . . . . . . . . . . 5a. 46,408.00
6. Line 2b plus line 4b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6b. 11,387.00
7. Enter the amount of the depreciation subtraction from
Form OR-40-N, line 33S, that is attributable to qualifying
businesses on lines 7a and 7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7a. 7b.
8. Line 5a plus line 7a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8a. 46,408.00
9. Line 6b minus line 7b. Don’t enter less than 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b. 11,387.00
10. Tax for income on line 8a (see instructions).
This is your tax on nonqualifying income. . . . . . . . . . . . . . . . . . . . . . 10a. 3,555.00

Client Copy
11. Tax for income on line 9b using tax rate chart B in the instructions.
This is your tax on qualifying income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11b. 797.00
12. Line 10a plus line 11b.
This is your total tax with the reduced rate for
qualifying income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a. 4,352.00
13. Tax for income on line 1a (see instructions) . . . . . . . . . . . . . . . . . . 13a. 4,551.00
14. Enter the lesser of line 12a or line 13a . . . . . . . . . . . . . . . . . . . . . . . . 14a. 4,352.00

If line 12a is less than 13a, enter the amount from line 14a on line 46 of Form OR-40-N and check box 46c. If line 13a is less than 12a,
it isn't more beneficial for you to use the reduced tax rate. Enter the amount from line 13a on line 46 of Form OR-40-N and complete
the rest of the return.

Note: You can’t amend to revoke or make the election after your original return is filed unless you file an amended return on or before
the original due date of April 15, 2021, or if filing on extension, October 15, 2021. If you amend after the due date for the return,
including extensions, you must use the tax on line 12a of the Tax worksheet even if line 13a is less.

–You must include this schedule with your Oregon Form OR-40-N–

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18014 10/28/2022 3:22 PM

Form 40 Oregon Federal Tax Liability Worksheet 2020

Name Taxpayer Identification Number

DEAN A GLUESENKAMP KRISTINA M PEREZ

Part A: Federal Tax Subtraction

1. Federal tax liability after credits * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 6,682

2. Excess advance premium tax credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Subtract line 2 from line 1. If zero or less, enter zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 6,682
4. Tax on qualified retirement plans and any recapture taxes included on the federal return * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Add lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 6,682
6. Refundable education credit * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
7. Total premium tax credit * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
8. Sum of all 2020 tax rebates (economic stimulus payments) received from the federal government . . . . . . . . . . . . . . . . . . . . . 8. 3,600
9. Add lines 6, 7 and 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. 3,600
10. Subtract line 9 from line 5. If zero or less, enter zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. 3,082
11. Maximum allowable tax liability subtraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 6,950
12. Enter the smaller of line 10 or 11 here, this is the federal tax liability subtraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 3,082
Part B: Federal Tax Paid for a Prior Year

1. Maximum allowable tax liability subtraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0

2. Federal tax liability subtraction from Part A, line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 0
3. Subtract line 2 from line 1. If zero or less, enter zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 0

Client Copy
4. Federal tax paid in 2020 for a prior year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Enter the smaller of line 3 or 4 here and on Form OR-ASC (subtraction code 309) or
Form OR-ASC-NP (modification code 602) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 0
Part C: Foreign tax subtraction

1. Maximum allowable tax liability subtraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0

2. Federal tax liability subtraction from Part A, line 11 plus Part B line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 0
3. Subtract line 2 from line 1. If zero or less, enter zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 0
4. Foreign tax paid, but not more than $3,000 ($1,500 if married/RDP filing separately) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Enter the smaller of line 3 or line 4 here and on Form OR-ASC (subtraction code 311) or
Form OR-ASC-NP (modification code 603) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 0
* For registered domestic partner returns the amount of federal tax liability comes from the return filed with the IRS not the "As if" return.
18014 10/28/2022 3:22 PM

Form 40 Oregon K-1 Reconciliation Worksheet - Schedule E, B, D, Form 4797

(For part-year and nonresident taxpayers)
2020
Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Ordinary business income or -loss 11,387 11,387

Net rental real estate income or -loss
Other net rental income or -loss
Guaranteed payments
Section 179 expense
Disallowed Section 179 expense
Depletion
Section 59(e)(2) expenditures
Preproductive period expense
Reforestation expense deduction
Other deductions
Unreimbursed expenses
Other income or loss - Schedule E
Debt financed acquisition
Dependent care benefits

11,387 11,387

Royalties
Deductions-royalty income
Depletion

Interest Income
Tax-exempt interest income
Dividend Income
Qualified dividends (1040, Page 2)

Short-term capital gain or -loss

Long-term capital gain or -loss
28% capital loss
Section 1256 contracts and straddles

Form 4797 Part I

Form 4797 Part II
Sections 179 and 280F recapture
18014 10/28/2022 3:22 PM

Form 40 Oregon K-1 Reconciliation Worksheet - Form 1040, Schedule A, Form 4952, 8903
(For part-year and nonresident taxpayers)
2020
Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Other portfolio income/-loss

Other income/-loss
Penalty on early withdrawal

Federal income tax withheld

Undistributed capital gains credit
Recapture of low-income housing cr
Recapture of indian employment cr
Recapture of employ child care cr
Recapture of new markets cr
Recapture of alt motor vehicle cr
Recapture of alt fuel veh refueling cr

Cash contributions (50%/60%) 95 95

Cash contributions (30%)
Noncash contributions (50%)
Noncash contributions (30%)
Cap gain prop 50% org (30%)
Cap gain prop (20%)
Portfolio deductions (other)
Real estate taxes
State and local tax withheld paid
Foreign taxes
Investment int from 4952

Investment interest expense

Investment income adjustment
Investment expenses
18014 10/28/2022 3:22 PM

Form 40 Oregon K-1 Reconciliation Worksheet - Form 4684, Schedule SE, Misc, Credits
(For part-year and nonresident taxpayers)
2020
Name Kristina M Perez Taxpayer Identification Number
Entity Name Deans Car Care Inc EIN Entity Type S Corporation Screen K1 K1 Unit 2
Activity Passive Activity Type Not Passive Entire disposition of activity
Current Year PY Suspended Disallowed PY Suspended Disallowed PY Suspended Disallowed Tax
Amount Basis Loss Basis Limitation At-risk Loss At-risk Limitation Passive Loss Loss Limitation Return

Form 4684 Lt loss trade/business

Form 4684 Lt loss income producing
Form 4684 long-term gain
Form 4684 St loss income producing

Net earnings from self-employment

Gross farming or fishing income
Gross nonfarm income

Self-employed medical insurance

Shareholder med ins not on Form W2
Other tax-exempt income 108,402 108,402
Nondeductible expenses 600 600
Cash and marketable security distrib
Property distributions 57,692 57,692
Repayment of shareholder loans
Dependent care benefits (Form 2441)
18014 10/28/2022 3:22 PM

Form 40 Oregon Form 8582 Worksheet 2020

Name Taxpayer Identification Number

DEAN A GLUESENKAMP KRISTINA M PEREZ

Part I 2020 Passive Activity Loss

Caution: Complete Worksheets 1, 2, and 3 on page 2 before completing Part I.
Rental Real Estate Activities With Active Participation (For the definition of active participation, see
Special Allowance for Rental Real Estate Activities in the instructions.)
1a Activities with net income (enter the amount from Worksheet 1,
column (a)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b Activities with net loss (enter the amount from Worksheet 1, column
(b)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b ( 3,246)
c Prior years unallowed losses (enter the amount from Worksheet 1,
column (c)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c ( )
d Combine lines 1a, 1b, and 1c 1d -3,246
Commercial Revitalization Deductions From Rental Real Estate Activities
2a Commercial revitalization deductions from Worksheet 2, column (a) . . . . . . . . . . . . . . . . . . 2a ( )
b Prior year unallowed commercial revitalization deductions from
Worksheet 2, column (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b ( )
c Add lines 2a and 2b 2c (
All Other Passive Activities
3a Activities with net income (enter the amount from Worksheet 3,
column (a)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a
b Activities with net loss (enter the amount from Worksheet 3,

Client Copy
column (b)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3b ( )
c Prior years unallowed losses (enter the amount from Worksheet 3,
column (c)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3c ( )
d Combine lines 3a, 3b, and 3c 3d
4 Combine lines 1d, 2c, and 3d. If this line is zero or more, stop here and include this form with
your return; all losses are allowed, including any prior year unallowed losses entered on line 1c,
2b, or 3c. Report the losses on the forms and schedules normally used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 -3,246
If line 4 is a loss and: • Line 1d is a loss, go to Part II.
•
Line 2c is a loss (and line 1d is zero or more), skip Part II and go to Part III.
•
Line 3d is a loss (and lines 1d and 2c are zero or more), skip Parts II and III and go to line 15.
Caution: If your filing status is married filing separately and you lived with your spouse at any time during the year, do not complete
Part II or Part III. Instead, go to line 15.
Part II Special Allowance for Rental Real Estate Activities With Active Participation
Note: Enter all numbers in Part II as positive amounts. See page 8 of the instructions for an example.
5 Enter the smaller of the loss on line 1d or the loss on line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3,246
6 Enter $150,000. If married filing separately, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 6 150,000
7 Enter modified adjusted gross income, but not less than zero (see instructions) . . . . . . 7 90,827
Note: If line 7 is greater than or equal to line 6, skip lines 8 and
9, enter -0- on line 10. Otherwise, go to line 8.
8 Subtract line 7 from line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 59,173
9 Multiply line 8 by 50% (.5). Do not enter more that $25,000. If married filing separately, see page 8 . . . . . . . . . . . . . . . . . . . 9 25,000
10 Enter the smaller of line 5 or line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3,246
If line 2c is a loss, go to Part III. Otherwise, go to line 15.
Part III Special Allowance for Commercial Revitalization Deductions From Rental Real Estate Activities
Note: Enter all numbers in Part III as positive amounts. See the example for Part II on page 8 of the instructions.
11 Enter $25,000 reduced the amount, if any, online 10. If married filing separately, see instructions. . . . . . . . . . . . . . . . . . . . . . 11
12 Enter the loss from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Reduce line 12 by the amount on line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Enter the smallest of line 2c (treated as a positive amount), line 11, or line 13 14
Part IV Total Losses Allowed
15 Add the income, if any, on lines 1a and 3a and enter the total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Total losses allowed from all passive activities for 2020. Add lines 10, 14, and 15. See
instructions to find out how to report the losses on your tax return 16 3,246
For Paperwork Reduction Act Notice, see instructions. Form 8582 (2020)
DAA
18014 10/28/2022 3:22 PM

Form 40 Oregon Form 8582 Worksheet, Page 2 2020

Name Taxpayer Identification Number

DEAN A GLUESENKAMP KRISTINA M PEREZ

Worksheet 1—For Form 8582, Lines 1a, 1b, and 1c
Current year Prior years Overall gain or loss
Name of activity
(a) Net income (b) Net loss (c) Unallowed
(d) Gain (e) Loss
(line 1a) (line 1b) loss (line 1c)
Lombard St
3,246 3,246

Total. Enter on Form 8582, lines 1a, 1b,

and 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  3,246
Worksheet 2—For Form 8582, Lines 2a and 2b
Name of activity (a) Current year (b) Prior year (c) Overall loss
deductions (line 2a) unallowed deductions (line 2b)

Total. Enter on Form 8582, lines 2a and

2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Client Copy
Worksheet 3—For Form 8582, Lines 3a, 3b, and 3c
Current year Prior years Overall gain or loss
Name of activity
(a) Net income (b) Net loss (c) Unallowed
(d) Gain (e) Loss
(line 3a) (line 3b) loss (line 3c)

Total. Enter on Form 8582, lines 3a, 3b,

and 3c .................................. 
Worksheet 4—Use this worksheet if an amount is shown on Form 8582, line 10 or 14
Name of activity Form or schedule (c) Special (d) Subtract
and line number (a) Loss (b) Ratio allowance column (c) from
Form 8582 Line 10 to be reported on column (a)
Lombard St
Sch E1 3,246 1.0000 3,246

Total ............................................................  3,246 1.00 3,246

Worksheet 5—Allocation of Unallowed Losses

Name of activity
(a) Loss (b) Ratio (c) Unallowed loss

Total ...................................................................................  1.00

18014 10/28/2022 3:22 PM

Form 40 Oregon Form 8582 Worksheet, Page 3 2020

Name Taxpayer Identification Number

DEAN A GLUESENKAMP KRISTINA M PEREZ

Worksheet 6—Allowed Losses

Name of activity
(a) Loss (b) Unallowed loss (c) Allowed loss

Total 
Worksheet 7—Activities With Losses Reported on Two or More Forms or Schedules
Name of activity: (a) (b) (c) Ratio (d) Unallowed (e) Allowed loss
loss
Form or schedule and line number
to be reported on (see
instructions): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1a Net loss plus prior year unallowed
loss from form or schedule . . . . . . . . . . . . . . . . . . 
b Net income from form or
schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

c Subtract line 1b from line 1a. If zero or less, enter -0-

Form or schedule and line number
to be reported on (see
Client Copy 

instructions): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1a Net loss plus prior year unallowed
loss from form or schedule . . . . . . . . . . . . . . . . . . 
b Net income from form or
schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

c Subtract line 1b from line 1a. If zero or less, enter -0- 

Form or schedule and line number
to be reported on (see
instructions): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1a Net loss plus prior year unallowed
loss from form or schedule . . . . . . . . . . . . . . . . . . 
b Net income from form or
schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

c Subtract line 1b from line 1a. If zero or less, enter -0- 

Total  1.00
18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
Oregon Statements

Form 40N - Other Adjustments

Federal Oregon
Code Description Amount Amount
007 Standard deduction charitable cont $ 187 $ 0
Total $ 187 $ 0

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 18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
OR Asset Report
FYE: 12/31/2020 Lombard St

Date Basis OR OR Federal Difference

Asset Description In Service Cost for Depr Prior Current Current Fed - OR

Prior MACRS:
1 Building 2/28/18 474,884 474,884 22,831 12,176 12,176 0
3 Improvements 2/28/18 32,450 32,450 1,560 832 832 0
507,334 507,334 24,391 13,008 13,008 0

Other Depreciation:
2 Land 2/28/18 344,685 344,685 0 0 0 0
Total Other Depreciation 344,685 344,685 0 0 0 0

Total ACRS and Other Depreciation 344,685 344,685 0 0 0 0

Grand Totals 852,019 852,019 24,391 13,008 13,008 0

Less: Dispositions 0 0 0 0 0 0
Less: Start-up/Org Expense 0 0 0 0 0 0
Net Grand Totals 852,019 852,019 24,391 13,008 13,008 0

Client Copy
 18014 Gluesenkamp, Dean A & Kristina M 10/28/2022 3:21 PM
OR Future Depreciation Report FYE: 12/31/21
FYE: 12/31/2020 Lombard St

Date In
Asset Description Service Cost OR

Prior MACRS:
1 Building 2/28/18 474,884 12,177
3 Improvements 2/28/18 32,450 832
507,334 13,009

Other Depreciation:
2 Land 2/28/18 344,685 0
Total Other Depreciation 344,685 0

Total ACRS and Other Depreciation 344,685 0

Grand Totals 852,019 13,009

Client Copy
18014 10/28/2022 3:22 PM

Form 40 Oregon Interest and Dividend Reconciliation Report 2020

Name Taxpayer Identification Number

DEAN A GLUESENKAMP
Description Resident Amount PY/NR Amount
TAXABLE INTEREST INCOME
ADVANTIS CREDIT UNION 11 0
CONSOLIDATED FEDERAL CREDIT UNION 81 0
TOTAL TAXABLE INTEREST INCOME.................. 92 0

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Page 1 Of 1
Summary Resident Amount PY/NR Amount
TOTAL TAXABLE INTEREST INCOME 92 0

Note: Report does not include income from Form 8814 or allocated instate amounts from Form 8621.
18014 10/28/2022 3:22 PM

Form 40N Oregon Nonresident Two Year Comparison Report 2019 & 2020
Name Taxpayer Identification Number

DEAN A GLUESENKAMP KRISTINA M PEREZ

2019 2020 Differences
96,091 87,581 -8,510
Income

1. Total federal income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.

2. Total Oregon income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 39,191 76,674 37,483
3. Income allocation factor 3. 40.80 % 87.50 %
4. Oregon source income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 39,191 76,674 37,483
5. Itemized or standard deduction . . . . . . . . . . . . . . . . . . . . . . . . 5. 18,587 18,494 -93
6. Other deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. 6,800 3,082 -3,718
7. Deductions before allocation . . . . . . . . . . . . . . . . . . . . . . . . 7. 25,387 21,576 -3,811
8. Deductions after allocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 10,358 18,879 8,521
9. Other deductions not allocated . . . . . . . . . . . . . . . . . . . . . . . . . 9.
Tax

10. Total deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. 10,358 18,879 8,521

11. Taxable income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 28,833 57,795 28,962
12. Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 2,097 4,352 2,255
13. Other taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Nonrefundable credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. 168 368 200
15. Net tax 15. 1,929 3,984 2,055
16. Income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. 5,928 6,215 287
17. Other payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.
18. Estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.
Payments

19. Refundable credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 962 -962

20. Total payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. 6,890 6,215 -675

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21. Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.
22. Penalties and interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.
23. Net tax due/-refund 23. -4,961 -2,231 2,730
18014 10/28/2022 3:22 PM

COMBINED TAX RETURN

FOR INDIVIDUALS FORM SP-2020
Multnomah County
Business Income Tax 2020 CALENDAR YEAR
City of Portland DUE DATE: APRIL 15, 2021
Business License Tax
TAX YEAR
From: 1/1/2020 to 12/31/2020
ACCOUNT # SOCIAL SECURITY #

XFEDERAL EXTENSION CEASED BUSINESS

AMENDED RETURN OFFICIAL USE ONLY
NAME NAICS
PEREZ GLUSENKAMP ENTERPRISES LLC 532400
MAILING ADDRESS Check if changed CITY STATE/PROV ZIP CODE
1506 NE LOMBARD ST PORTLAND OR 97211
EXEMPTION

Exempt - Multnomah County Only Exempt - City of Portland Only X Exempt - Both Jurisdictions

Total Gross Business Income: 49,899 If over $50,000 attach statement with explanation

PART I - BUSINESS INCOME

For lines 1 through 5 below, the same number will generally be entered in both columns. Multnomah County City of Portland
1. Net Income or (Loss) from Federal Schedule C (Attach Schedule Cs) . . . . . . . . . . . . . 1M 1P
2. Taxes Based On or Measured by Net Income Add-Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2M 2P
3. Net Income or (Loss) from Federal Schedule E, D, etc. (Attach E, D, etc.) . . . . . . . . . 3M 3P

Client Copy
4. Subtract Deductible SE Tax (see instructions for additions & subtractions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4M 4P
5. Adjusted Net Income (sum of lines 1 through 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5M 5P
6. Owner's Compensation Deduction (see instructions) (# owners ) ........... 6M ( ) 6P ( )
7. Subject Net Income (line 5 minus line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7M 7P

PART II - MULTNOMAH COUNTY BUSINESS INCOME TAX

8a. Multnomah County Gross Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8a

8b. Total Gross Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8b
8c. Apportionment Percentage (line 8a/8b, cannot be more than 1.0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8c
9. Multnomah County Apportioned Net Income (line 7M x line 8c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10. Net Operating Loss Deduction (max 75% of line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  10 ( )
11. Income Subject to Tax (line 9 minus line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12. Multnomah County Business Income Tax (line 11 x tax rate of 2%) MINIMUM $100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13. 
Prepayments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 ( 100 )
14. Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16. Balance Due or (Overpayment) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 (100)
17. Reserved

Page 1 of 2, SP-2020 Rev. 12/21/2020

18014 10/28/2022 3:22 PM
PEREZ GLUSENKAMP ENTERPRISES LLC
7P

PART III - CITY OF PORTLAND BUSINESS LICENSE TAX

18a. Portland Gross Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a

18b. Total Gross Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18b
18c. Apportionment Percentage (line 18a/18b, cannot be more than 1.0) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18c
19. Portland Apportioned Net Income (line 7P x line 18c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20. Net Operating Loss Deduction (max 75% of line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  20 ( )
21. Income Subject to Tax (line 19 minus line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22. Portland Business License Tax (line 21 x tax rate of 2.6%) MINIMUM $100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
22a. Heavy Vehicle Use Tax (HVT) (see HVT Schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22a
22b. Reserved
22c. Residential Rental Registration Fee (see Schedule R) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22c
22d. Reserved
23. 
Prepayments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 ( 100 )
24. Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
25. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
26. Balance Due or (Overpayment) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 (100)
PART IV - TAX DUE / REFUND

27. If the sum of line 16 and line 26 is negative, this is the amount you overpaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 ( 200 )
27a. Amount from line 27 you want refunded to you . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27a ( 200 )
For direct deposit of your refund, file your tax return online at PRO.Portland.gov.
27b. Amount from line 27 you want applied to tax year 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . 27b ( )
28. If the sum of line 16 and line 26 is positive, this is the amount you owe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Client Copy
Make check payable to City of Portland. Check #

PART V - SIGNATURE

The undersigned declares that the information given on this report is true. The undersigned is authorized to act as a representative of
the filer. Filers of incomplete returns may be subject to civil penalties of up to $500.

Signature of TaxFiler Date

TaxFiler Email TaxFiler Phone Number

Signature of Preparer HOLLY MCCALL Date 10/28/22

Preparer's Name MCCALL TAX & BOOKKEEPING SERVICES, INC. Preparer Phone Number 503-477-4396

Mail completed tax return (with supporting tax pages and payment, if applicable) to:
Revenue Division
111 SW Columbia St. Suite 600
Portland, OR 97201-5840
Phone (503) 823-5157 FAX (503) 823-5192 TDD (503) 823-6868

Page 2 of 2, SP-2020 Rev. 12/21/2020

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Oregon Combined Report For Individuals (SP) Return Summary

Tax Year 2020
DEAN A GLUESENKAMP KRISTINA M PEREZ

Portland Multnomah

Total income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income subject to tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 100
Late filing interest and penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Balance due/ -overpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -100 -100
Total balance due/ -refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -200
Overpayment applied to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net amount due/-refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -200

Client Copy

2021 Estimates

1st qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2nd qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3rd qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4th qtr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total estimates .......................................