2009 Supporting Documents
Forms 1099-INT:
Source Fed Tax With Interest Income
Nationwide Life Ins Co 0.00 1693.12
Union Bank   451.21
TOTAL   2144.33
Form 1099-DIV:
Source Fed Tax With Qualified Dividends Ordinary Dividends Nondividend Distributions Notes:
National Financial Svcs 0.00 5313.70 5321.66 2.06 Reported on two different forms
Forms 1099-R:
Source Fed Tax With Employee Contributions / Insurance Premiums Taxable Amount Gross Distribution Notes:
Genworth Life Insurance 0.00 767.46 1437.88 2205.34  
Office of Personnel Mgmt 0.00 1807.32 Unknown 9888.00 Missing at time of original filing
TOTAL     11325.88 12093.34 Assumes OPM taxable 100%
Form SSA-1099:
Source Fed Tax With Paid by check / direct deposit Medicare Part B Premiums Deducted Net Benefits
Social Security Admin 0.00 8892.00 1156.80 10048.80