JFK Assassination System
Identification Form
Date:
10/1/201
Agency Information
AGENCY
HSCA
RECORD NUMBER:
180-10073-10093
RECORD SERIES: NUMBERED FILES
AGENCY FILE NUMBER:
004876
ORIGINATOR:
FROM:
TO:
TITLE:
RUBY, SAMUEL
RUBY, SAMUEL
DATE:
PAGES:
01/24/1978
118
SUBJECTS:
Document Information
DOCUMENT TYPE:
CLASSIFICATION:
RESTRICTIONS:
CURRENT STATUS:
DATE OF LAST REVIEW:
OPENING CRITERIA:
COMMENTS:
RUBY, SAM
RUBY, JACK, BACKGROUND, ASSOCIATES AND RELATIVES
OTHER TEXTUAL
Unclassified
3
Redact
10/25/1995
W/cover letter. Box #:102.
Released under the John F. Kennedy
Assassination Records Collection Act of
1992 (44 USC 2107 Note). Case#:NW
88326 Date: 2025
v9.1
NW 88326 Docld:32245535 Page 1
16250 Bircher Ave.
Granada Hills, ca.
91344
Ms. Donald A. Purdy, Js
Jan. 24,1978
こ
004876
I have had seven's made of my tax
returns and am enclosing the copies
the years 1967 to 1976.
and my wife have looked in.
the various paces where we
normally our
and we 
bulle now 
important papers
returns for the lyeges 1962 to 1966.
Wes of Eve proved four times since
Dallas
we
It is possible
the
of them in
that we dypating Spo
one place.
to another this for them.
anticipa
If theed be any other documents
have in my possess
You are in need of the mession and
the
course of your Investigations I will
happy to mail 
thi
Samu
to you.
Yours
by
NW 88326 Docld:32245535 Page 2
+. T
Form.
5329
Department of tho Treasury
Internal Revenue Service
Return for Individual
Retirement Savings Arrangement
(Under Sections 408 or 409 of the Internal Revenue Code)
▷ Attach to Form 1040.
1976
Only This Side of Form is
Open to Public Inspection
If you have established a retirement savings arrangement you must complete Part I and Part II and attach this
form to your individual income tax return, Form 1040. In addition: (1) if you claim a deduction on your Form 1040
for contributions to your retirement savings arrangement, complete Part III; (2) if you have made contributions in
excess of your allowable limitation for this year or prior years, complete Part IV; (3) if you are not yet age 59½
when you receive a distribution from your retirement savings arrangement which is not due to a disability, a rollover
contribution to another plan or retirement savings arrangement, or the transfer of an amount to a former spouse
under a divorce decree, you must complete Part V; (4) if you are 701 or older on the last day of the year, see in-
structions to determine if you are required to complete Part VI.
Name
SAMUEL D. Ruby
Address (Number and street) A
16250 BIRCHER ST
City or town, State and ZIP code
GRANADA
HILLS CA
If you are not required to file a Form 1040 check here
Part
Individual and Retirement Savings Information
1 Type of individual retirement savings arrangement:
(a) ☐ Individual retirement account
(b) ☐ Individual retirement annuity
(c) Individual retirement bonds
2 Were you during any part of the year an active participant in a qualified pension, profit-sharing of stock bonus
plan, including a qualified Keogh (HR 10) plan, or were you covered under a section 403(b) annuity or custodial
account or under a government retirement plan other than the Social Security or Railroad Retirement Acts?
(Volunteer firemen and military reservists see specific instructions for line 2).
Yes
#
No
If "Yes," you are not allowed a deduction for your 1976 contributions to your individual retirement-arrangement.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief it is true, correct, and complete. If prepared by a person other than the taxpayer, this declaration is based on all information
of which the préparer has any knowledge.
Your signature
Date
Preparer's signature (other than taxpayer)
95-2941449
Preparer's identification number
(see General Instruction B)
Date
13717 VANOWEN STVAN Nuys CA 9140s.
Preparer's address'and ZIP code
Form 5329
NW 88326 Docld:32245535 Page 3
ག་ད་བ་དད་པ་
Form 5329 (1976)
Partill
Your Social Security Number.
This Page Is Not Open to Public Inspection
Page 2
Attach Copy B of Form 5498 here
D322-12-7477.
3 If filed by surviving spouse or beneficiary of an individual who created this retirement savings arrangement check here ▷
and enter name and social security number of individual for whom the arrangement was established
4 Indicate your age as of the end of the year (If you checked item 3 do not complete this item):
(a)
Under age 592
(b) ☐ Age 59½ to 70%
(c)
Over age 702 (if you check item (c) complete Part VI below)
5 (a) If, during the year, you received a distribution of your entire account from a qualified pension, profit-
sharing or stock bonus plan, because either (i) you terminated employment or (ii) your employer
terminated the plan, and you transferred (rolled over) such distribution to your arrangement, check here
(b) If you checked (a) did you transfer the entire amount of the distribution (less any amounts you con-
tributed to the qualified plan-see instructions) to your arrangement within 60 days of receipt of such
distribution (or 12/31/76 if (a)(ii) applies and you received such distribution prior to 11/2/76)? .
(c) If (b) was "Yes," complete lines (i) through (iii) below:
Date of transfer to arrangement
(i)
(ii) Date distribution was made to you from the plan
•
Yes
No
Month Day Year
(iii) Name of trustee or insurance company to which the transfer was made (If bonds were purchased state "Bonds") D.
(d) (i) If within one taxable year, you received a distribution of your entire account from your employer's qualified pension,
profit-sharing or stock bonus plan because the plan was terminated by your employer did you:
(A) receive such amount on or after July 4, 1974 but prior to January 1, 1976,
(B) transfer such amount, reduced by the amount of the income tax paid on the distribution on
your 1974 or 1975 income tax return, to an arrangement and
(C) file a claim for refund of such tax paid? (Check "Yes" only if (A), (B) and (C) ALL apply.)
.
•
☐ Yes
Month Day
☐ No
Year
(ii) If (d)(i) is "Yes," and you have received such refund or credit for such tax paid enter:
(A) Date refund or credit received
•
"
(B) Date refund or amount of credit was contributed to your retirement savings arrangement .
Note: See Definition C in the Instructions concerning rollover contributions.
•
6 If, during the year, you transferred any funds from one retirement savings arrangement to another retire-
ment savings arrangement, enter the date of transfer here.
Caution: Such a transfer may be a taxable distribution.
Month
Day
Year
7 If, during the tax year covered by this form, you have entered into a prohibited transaction under section 4975 or borrowed any amount from
your retirement savings arrangement or pledged any part of your arrangement as security for a loan, check here
Note: See instructions for the tax consequences of such transactions.
Part III
Computation of Allowable Deduction
(If you have entered into a prohibited transaction under section 4975, do not complete Part III or Part
IV for the retirement savings arrangement with which you entered into such prohibited transaction.).
8 Wages, tips and other compensation from Form 1040 (if a joint return do not include compensation of spouse)
(See definition B in the instructions for the meaning of compensation.).
9 15% of line 8 or $1,500, whichever is lesser (if you are 70% or over or answered "Yes" to line 2, enter zero) .
10 Amount paid by you or on your behalf under all your retirement savings arrangements (do not include any
amounts which were considered as "rollover contributions," see lines 5 and 6, or the purchase price of any
individual retirement bonds redeemed within 12 months of their date of purchase (see instructions) or life
insurance portion of your endowment premium as reported on Form 5498 box 6) .
:
11 Allowable deduction, lesser of line 9 or line 10 (enter here and on Form 1040, line 40a)
Part IV Tax on Excess Contributions
•
12 Tax on excess contributions (see Part IV of the Specific Instructions if Part III, line 10 exceeds line 11). Enter
tax from worksheet here and on Form 1040, line 61
Part V Tax on Premature Distributions
13 Tax on premature distributions (see Part V of the Specific Instructions if you received a distribution from
your retirement savings arrangement before you have attained age 5912). Enter tax from worksheet here and
on Form 1040, line 57.
Part VI Tax on Undistributed Retirement Accounts and Annuities
(See Instructions before completing this Part.)
14 Tax based on current year distribution method, see worksheet in Instructions
15 Tax based on aggregate distribution methods, see worksheet in Instructions
16 Tax due, lesser of line 14 or 15, enter here and on Form 1040, in your total for line 62. On the dotted line to
the left of the line 62 entry space write "4974 tax,” and show the amount
NW 88326 Docid:32245535 Page 4
✰ U.S. GOVERNMENT PRINTING OFFICE: 1976-0-218-176
E.I. 13-2687299
Income
Please attach Copy B of Forms W-2 here
Sign here
Tax, Payments and Credits
Please attach Check or Money Order here
Due or Refund
Department of the Treasury-Internal Revenue Service
1040 U.S. Individual Income Tax Return 1976
For the year January 1-December 31, 1976, or other taxable year beginning
Please print or type
Filing Status
Name (If joint return, give first names and initials of both)
SAMUEL+PHYLLIS
R
Present home address (Number and street, including apartment number, or rural route).
16250 BIRCHER
City, town or post office, State and ZIP code,
GRANADA
1
Single
3
+
5
ST
HILLS CA
(Check only ONE box)
Married filing joint return (even if only one had income)
Married filing separately. If spouse is also filing give
spouse's social security number in designated space above
and enter full
name here
Unmarried Head of Household. See page 7 of instructions
to see if
you qualify ▶
Qualifying widow(er) with dependent child (Year
spouse died 19
). See page 7 of Instructions.
7 Other dependents:
(a) Name
(b) Relationship
Exemptions
This space for IRS use only.
'
Last name
by
1976 ending
19
Your social security number
322127997
For Privacy Act Notification, | Spouse's social security no.
see page 5 of Instructions. 349181420
Occu- Yours D
pation Spouse's ‣
6a Regular
S/E
S/E
Yourself Spouse Enter number of
boxes checked ☑
b First names of your dependent children who
lived with you.
SUSA
THOMAS
Enter
number
c Number of other dependents (from line 7)
d Total (add lines 6a, b, and c)
e Age 65 or older. Yourself
Blind.
Yourself
f TOTAL (add lines 6d and e)
(d) Did dependent
have income of $750
or more?
(c) Months lived in your
home. If born or died
during year, write B or D.
•
Spouse
Spouse
Enter
number
of boxes
checked
AA
(e) Amount furnished for dependent's support
By YOU. If 100%
write ALL.
By OTHERS includ-
ing dependent.
$
$
8 Presidential Election
Campaign Fund
.
Do you wish to designate $1 of your taxes for this fund?
If joint return, does your spouse wish to designate $1?
Yes
Yes
No
Note: If you check the "Yes"
box(es) it will not increase your
No
tax or reduce your refund.
9 Wages, salaries, tips, and other employee compensation
10a Dividends (16 of Instructions)
'See pages 9 and
(Attach Forms W-2. If unavail-
able, see page 6 of Instructions.)"
10b less exclusion
9
-
Balance
10c
-
12
(If gross dividends and other distributions are over $400, list in Part 1 of Schedule B.)
11 Interest income.
If $400 or less, enter total without listing in Schedule B)
If over $400, enter total and list in Part II of Schedule B)
Income other than wages, dividends, and interest (from line 37)
11
5195
12
2546
13
Total (add lines 9, 10c, 11 and 12)
13
'
7741
14
Adjustments to income (such as moving expense, etc. from line 42)
14
-0-
15a Subtract line 14 from line 13.
15a
7741
.
b Disability income exclusion (sick pay) (attach Form 2440)
15b
16
Tax Table
Schedule G
c Adjusted gross income. Subtract line 15b from line 15a, then complete Part III on back.
(If less than $8,000, see page 2 of Instructions on "Earned Income Credit.")
Tax, check if from:
15c
7741
Tax Rate Schedule X, Y or Z
Form 2555
Schedule D
OR
Form 4726
16
17a Multiply $35.00 by the number of exemptions on line 6d.
17a
IYO
18
19
b Enter 2% of line 47 but not more than $180 ($90 if box 3 is checked)
Balance. Subtract line 17c from line 16 and enter difference (but not less than zero)
Credits (from line 54)
17b
of 8
Enter
larger
of a
(If box on line 3 is checked
see page 10 of Instructions)
17c
40
18
19
20
21
Balance. Subtract line 19 from line 18 and enter difference (but not less than zero)
Other taxes (from line 62)
20
22 Total (add lines 20 and 21)
21
22
(attach Forms W-2,
23a Total Federal income tax withheld. or W-2P to front)
(include amount allowed
b 1976 estimated tax payments
(from page 2
c Earned income credit. of Instructions)
d Amount paid with Form 4868
as credit from 1975 return).
24
e Other payments (from line 66)
TOTAL (add lines 23a through e)
25
25
If line 22 is larger than line 24, enter BALANCE DUE IRS
(Check here ☐, if Form 2210 or Form 2210F is attached. See page 10 of instructions.)
If line 24 is larger than line 22, enter amount OVERPAID
26
27
28
Amount of line 26 to be credited on 1977 estimated tax 28
Amount of line 26 to be REFUNDED TO YOU :
A
A A
24
25
26
27
Pay amount on line 25 in
full with this return. Write
social security number on
check or money order and
make payable to Internal
Revenue Service.
602
322
2.2
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is
true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
23a
23b
602
23c
23d
23e
Your signature
Date
Preparer's signature (and employer's name, if any)
95-2941449
Spouse's signature (if filing jointly, BOTH must sign even if only one had income)
Identifying number (see instructions)
NW 88326 Docld:32245535 Page 5
Address (and ZIP code)
218-052-2
Date
Form 1040 (1976)
Part Income other than Wages, Dividends and Interest
29
Business income or (loss) (attach Schedule C)
30a Net gain or (loss) from sale or exchange of capital assets (attach Schedule D)
31
b 50% of capital gain distributions (not reported on Schedule D-see page 10 of Instructions).
Net gain or (loss) from Supplemental Schedule of Gains and Losses (attach Form 4797)
32a Pensions, annuities, rents, royalties, partnerships, estates or trusts, etc. (attach Schedule E)
b Fully taxable pensions and annuities (not reported on Schedule E-see page 10 of Instructions)
33 Farm income or (loss) (attach Schedule F)
.34
does apply if refund is for year in which you took the
State income tax refunds (standard deduction others see page 10 of instructions
35 Alimony received
.
)
36
Other (state nature and source-see page 11 of Instructions) .
37 Total (add lines 29 through 36). Enter here and on line 12
Page 2
29
30a
(3546
1000
30b
31
32a
32b
33
34
35
36
37
2546
Part II Adjustments to Income
38
38 Moving expense (attach Form 3903)
39
39 Employee business expense (attach Form 2106)
40a Payments to an individual retirement arrangement from attached Form 5329, Part III
b Payments to a Keogh (H.R. 10) retirement plan
40a
40b
41
Forfeited interest penalty for premature withdrawal (see page 12 of Instructions)
41
42 Total (add lines 38 through 41). Enter here and on line 14
42
Part II Tax Computation
43 Adjusted gross income (from line 15c). If you have unearned income and can be claimed as a
dependent on your parent's return, check here ☐ and see page 9 of Instructions
43
7741
44a If you itemize deductions, check here ☐, and enter total from Schedule A, line 40, and attach Schedule A
b Standard deduction-If you do not itemize deductions, check here ☐, and:
If you checked
the
box on
line
2 or 5, enter the greater of $2,100 OR 16% of line 43-but not more than $2,800
1 or 4, enter the greater of $1,700 OR 16% of line 43-but not more than $2,400
3, enter the greater of $1,050 OR 16% of line 43-but not more than $1,400
45 Subtract line 44 from line 43 and enter difference (but not less than zero)
46 Multiply total number of exemptions claimed on line 6f by $750
44
5686
45
•
46
2055
3000
47
47
Taxable income. Subtract line 46 from line 45 and enter difference (but not less than zero)
• If line 47 is $20,000 or less and you did not average your income on Schedule G, or figure your tax on Form 2555, Exemption of Income Earned Abroad, find??
your tax in Tax Table. Enter tax on line 16 and check appropriate box.
If line 47 is more than $20,000, figure your tax on the amount on line 47 by using Tax Rate Schedule X, Y, Z, or if applicable, the alternative tax from Schedule
D, income averaging from Schedule G, tax from Form 2555 or maximum tax from Form 4726. Enter tax on line 16 and check appropriate box.
Part IV Credits
48
48
Credit for the elderly (attach Schedules R & RP)
49
Credit for child care expenses (attach Form 2441)
50
Investment credit (attach Form 3468)
49
50
51
51 Foreign tax credit (attach Form 1116)
52 Contributions to candidates for public office credit (see page 12 of Instructions)
52
53
53
Work Incentive (WIN) Credit (attach Form 4874)
54 Total (add lines 48 through 53). Enter here and on line 19
Part IVER Other Taxes
54
55
56
Tax from recomputing prior-year investment credit (attach Form 4255)
Minimum tax. . Check here ☐ and attach Form 4625 *
55
56
57
Tax on premature distributions from attached Form 5329, Part V
57
58 Self-employment tax (attach Schedule SE)
58
280
59 Social security tax on tip income not reported to employer (attach Form 4137)
59
60
Uncollected employee social security tax on tips (from Forms W-2)
60
61
Excess contribution tax from attached Form 5329, Part IV
61
280
62
Total (add lines 55 through 61). Enter here and on line 21
Part VI Other Payments
62
•
63
64
Excess FICA, RRTA, or FICA/RRTA tax withheld (two or more employers-see page 13 of Instructions)
Credit for Federal tax on special fuels, nonhighway gasoline and lubricating oil (attach Form 4136)
.63
64
65
Credit from a Regulated Investment Company (attach Form 2439)
65
.66
Total (add lines 63 through 65). Enter here and on line 23e
66
U.S. GOVERNMENT PRINTING OFFICE: 1976-0-218-052
218-052-2
NW 88326 Docld:32245535 Page 6
Sched les A&B-Itemized Deductions AND
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
Dividend and Interest Income.
Attach to Form 1040. See Instructions for Schedules A and B (Form 1040).
S.+P. Ruby
Schedule A-Itemized Deductions (Schedule B on back)
Medical and Dental Expenses (not compensated by insurance
or otherwise) (See page 13 of Instructions.)
1 One half (but not more than $150) of in-
surance premiums for medical care. (Be
sure to include in line 10 below)
2 Medicine and drugs
.
3 Enter 1% of line 15c, Form 1040.
4 Subtract line 3 from line 2. Enter differ-
ence (if less than zero, enter zero)
•
5 Enter balance of insurance premiums for
medical care not entered on line 1
6. Enter other medical and dental expenses:
a Doctors, dentists, nurses, etc.
b Hospitals.
•
c Other (itemize-include hearing aids,
dentures, eyeglasses, transportation,
etc.) ▷
1941
1976
Your social security number
322/12/799
Contributions (See page 15 of Instructions for examples.)
21 a Cash contributions for which you have
receipts, cancelled checks or other
written evidence
b Other cash contributions. List donees
and amounts. ☑
sett
22 Other than cash (see page 15 of instruc-
tions for required statement)
23 Carryover from prior years .
24 Total contributions (add lines 21a through
23). Enter here and on line 37
A
100
Casualty or Theft Loss(es) (See page 15 of Instructions.)
Note: If you had more than one loss, omit lines 25 through 28
and see page 15 of Instructions for guidance.
25 Loss before insurance reimbursement
26 Insurance reimbursement
27 Subtract line 26 from line 25. Enter dif-
ference (if less than zero, enter zero)
ہے
28 Enter $100 or amount on line 27, which-
ever is smaller
.
•
•
29 Casualty or theft loss (subtract line 28
from line 27). Enter here and on line 38
Miscellaneous Deductions (See page 15 of Instructions.)
30 Alimony paid
31 Union dues.
32 Other (itemize) >
7 Total (add lines 4 through 6c)
8 Enter 3% of line 15c, Form 1040.
9 Subtract line 8 from line 7 (if less than
zero, enter zero)
10 Total (add lines 1 and 9). Enter here and
on line 34
Taxes (See page 13 of Instructions.)
11 State and local income
12 Real estate .
13 State and local gasoline (see gas tax tables)
14 General sales (see sales tax tables)
15 Personal property.
16 Other (itemize) ▷
SCH
17 Total (add lines 11 through 16). Enter
here and on line 35
1
Interest Expense (See page 14 of Instructions.)
18 Home mortgage
19 Other (itemize) ▷
Sett
20 Total (add lines 18 and 19). Enter here
and on line 36.
1128
2517
33 Total (add lines 30 through 32). Enter
here and on line 39
Summary of Itemized Deductions
34 Total medical and dental-line 10.
35 Total taxes-line 17.
36 Total interest-line 20 . . .
37 Total contributions-line 24
38 Casualty or theft loss(es)-line 29
39 Total miscellaneous-line 33.
40 Total deductions (add lines 34 through
39). Enter here and on Form 1040, line
44
1941
1128
2517
100
5686
A
* NW 88326 Docld:32245535 Page 7
218-054-1
Schedules A&B (Form 1040) 1976
Schedule B-Dividend and Interest Income
Name(s) as shown on Form 1040 (Do not enter name and social security number if shown on other side)
Part I
S.+P Ruby
Dividend Income
Note: If gross dividends (including capital gain distributions) and
other distributions on stock are $400 or less, do not complete this
part. But enter gross dividends less the sum of capital gain dis-
tributions and non-taxable distributions, if any, on Form 1040,
line 10a (see note below).
1 Gross dividends (including capital gain distributions) and other
distributions on stock. (List payers and amounts-write (H),
(W), (J), for stock held by husband, wife, or jointly)
Partill Interest Income
Page 2
Your social security number
132212 7997
Note: If interest is $400 or less, do not complete this part. But
enter amount of interest received on Form 1040, line 11.
7 Interest includes earnings from savings and loan associations,
mutual savings banks, cooperative banks, and credit unions
as well as interest on bank deposits, bonds, tax refunds, etc.
Interest also includes original issue discount on bonds and
other evidences of indebtedness (see page 16 of Instructions).
(List payers and amounts)
NOTE ON WOODLEY
BISTRO.
4959
UAL
TRANSWORLD
WORLD
17
191
17
2 Total of line 1
3 Capital gain distributions (see page 16 of
Instructions. Enter here and on Schedule D,
line 7). See note below
4 Nontaxable distribu-
tions (see page 16 of
Instructions)
•
5 Total (add lines 3 and 4)
6 Dividends before exclusion (subtract_line
5 from line 2). Enter here and on Form
1040, line 10a
•
8 Total interest income. Enter here and on
Form 1040, line 11
5195
Note: If you received capital gain distributions and do not need Schedule D to report any other gains or losses or to compute
the alternative tax, do not file that schedule. Instead, enter 50 percent of capital gain distributions on Form 1040,
line 30b.
*Part II Foreign Accounts and Foreign Trusts
1 Did you, at any time during the taxable year, have any interest in or signature or other authority over a bank,
securities, or other financial account in a foreign country (except in a U.S. military banking facility operated by a
U.S. financial institution)?
If "Yes," attach Form 4683 (For definitions, see Form 4683.)
2 Were you the grantor of, or transferor to, a foreign trust during any taxable year, which foreign trust was in
being during the current taxable year, whether or not you have any beneficial interest in such trust?
If "Yes," attach Form 4683 (For definitions, see Form 4683.)
B
☐ Yes ✓ N
Yes ✓ No
NW 88326 Docld:32245535 Page 8
U.S. GOVERNMENT PRINTING OFFICE: 1976-0-218-054
218-054-1
Deductions
SCHEDULE C
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name of proprietor
Profit or (Loss) From Business or Profession
(Sole Proprietorship)
Partnerships, Joint Ventures, etc., Must File Form 1065.
▷ Attach to Form 1040. ▷ See Instructions for Schedule C (Form 1040).
S&P Ruby
‣ SERVICE
A Principal business activity (see Schedule C Instructions) ▷.
product.
1976
Social security number
32212 7997
SNACK BAR
B Business name ▸ WOODLEY BISTRO COFFEE SHOP C Employer identification number D95-2651578
D Business address (number and street 16055 VENTURA BLUD
City, State and ZIP code D.
Encina
CA 91316
E Indicate method of accounting: (1) ☐ Cash (2) ☑ Accrual (3) ☐ Other D.
F Were you required to file Form W-3 or Form 1096 for 1978 (see Schedule C Instructions)?
If "Yes," where filed
G Was an Employer's Quarterly Federal Tax Return, Form 941, filed for this business for any quarter in 1976? :
H Method of inventory valuation D.
Income
Was there any substantial change in
the manner of determining quantities, costs, or valuations between the opening and closing inventories? (If "Yes," attach explanation)
1 Gross receipts or sales $...
Less: returns and allowances $.
2 Less: Cost of goods sold and/or operations (Schedule C-1, line 8)
3 Gross profit
4 Other income (attach schedule)
5 Total income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
7. Taxes on business and business property (explain in Schedule C-2)
Balance ‣
.2
3
4
56
7
1
Yes No
8 Rent on business property
9 Repairs (explain in Schedule C-2)
10 Salaries and wages not included on line 3, Schedule C-1 (exclude any paid to yourself)
11 Insurance
10
890
.9
11
12
12 Legal and professional fees
13
13 Commissions
14
14 Amortization (attach statement)
15 (a) Pension and profit-sharing plans (see Schedule C Instructions)
15(a)
(b) Employee benefit programs (see Schedule C Instructions)
16 Interest on business indebtedness
17 Bad debts arising from sales or services
18 Depletion.
19 Other business expenses (specify):
(b)
16
•
17
18
(a).
(b).
(c)
(d)
(e).
(f)
(g)
(h).
(i)
(i)
(k) Total other business expenses (add lines 19(a) through 19(j))
20 Total deductions (add lines 6 through 19(k))
•SCH.
19(k)
20
21 Net profit or (loss) (subtract line 20 from line 5). Enter here and on Form 1040, line 29. ALSO
enter on. Schedule SE, line 5(a).
21
3546
Less: cost of items withdrawn for personal use $..
SCHEDULE C-1.-Cost of Goods Sold and/or Operations (See Schedule C Instructions for Line 2)
1 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
2 Purchases $..
1
Balance
3 Cost of labor (do not include salary paid to yourself)
4 Materials and supplies
.
5 Other costs (attach schedule)
6 Total of lines 1 through 5
7 Less: Inventory at end of year
8 Cost of goods sold and/or operations. Enter here and on line 2 above
Did you claim a deduction for expenses of an office in your home? .
2345650
7
8
Yes
NW 88326 Docid:32245535 Page
No
218-055-1
Schedule C (Form 1040) 1976
SCHEDULE C-2.-Explanation of Lines 7 and 9
Line No.
Explanation
Amount
Line No.
Explanation
Amount
$
$
SCHEDULE C-3.-Depreciation (See Schedule C Instructions for Line 6)
If you need more space, use Form 4562.
a. Description of property
:
b. Date
acquired
c. Cost or
other basis
d. Depreciation
allowed or allowable
in prior years
1 Total additional first-year depreciation (do not include in items below).
* 2 Other depreciation:
Page 2
e. Method of
computing
depreciation
f. Life
g. Depreciation for
or rate
this year
SCH
106
3 Totals
4 Less amount of depreciation claimed in Schedule C-1, page 1
5 Balance Enter here and on page 1, line 6
SCHEDULE C-4.-Expense Account Information (See Schedule C Instructions for Schedule C-4)
Enter information with regard to yourself and your five
highest paid employees. In determining the five highest
paid employees, expense account allowances must be
added to their salaries and wages. However, the informa-
tion need not be submitted for any employee for whom
the combined amount is less than $25,000, or for your-
self if your expense account allowance plus line 21, page
1, is less than $25,000.
Name
106
Expense account
Salaries and Wages
Owner
1
2
3
4
5
Yes ☐ No (3) Employees' families at conventions or meetings?
Yes ☐ No (4) Employee or family vacations not reported on Form W-2?
Did you claim a deduction for expenses connected with:
(1) Entertainment facility (boat, resort, ranch, etc.)? .
(2) Living accommodations (except employees on business)?
U.S. GOVERNMENT PRINTING OFFICE: 1976-0-218-055
☐ Yes ☐ No
☐ Yes ☐ No
218-055-2
NW 88326 Docid:32245535 Page 10

SCHEDULE D
(Form 1040)
[Department of the Treasury
Internal Revenue Service
Capital Gains and Losses (Examples of property to be reported on this
Schedule are gains and losses on stocks, bonds, and similar investments, and gains (but not
losses) on personal assets such as a home or jewelry.)
Name(s) as shown on Form 1040
▷ Attach to Form 1040. ▷ See Instructions for Schedule D (Form 1040).
S&P
Ruby
Part Short-term Capital Gains and Losses-Assets Held Not More Than 6 Months
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date
acquired
(Mo., day, yr.)
c. Date
sold
(Mo., day, yr.)
d. Gross sales price
1976
Social security number
32212799
e. Cost or other basis,
as adjusted (see`
Instruction F) and
expense of sale
f. Gain or (loss)
(d less e)
D
I
2
Enter your share of net short-term gain or (loss) from partnerships and fiduciaries
2
3
3
Enter net gain or (loss), combine lines 1 and 2
•
4
Short-term capital loss carryover attributable to years beginning after 1969 (see Instruction I)
Net short-term gain or (loss), combine lines 3 and 4
4
5
74
Part
Long-term Capital Gains and Losses-Assets Held More Than 6 Months
INSTALLMENT SALE
5355
7
Capital gain distributions
7
8
Enter gain, if applicable, from Form 4797, line 4(a)(1) (see Instruction A)
8
9
Enter your share of net long-term gain or (loss) from partnerships and fiduciaries
9
10
Enter your share of net long-term gain from small business corporations (Subchapter S)
10
"
11 Net gain or (loss), combine lines 6 through 10
11
13
12 Long-term capital loss carryover attributable to years beginning after 1969 (see Instruction I)
Net long-term gain or (loss), combine lines 11 and 12
12
13
15039
(484
Part lll
Summary of Parts I and II (If You Have Capital Loss Carryovers From Years Beginning Before 1970, Do Not
Complete This Part. See Form 4798, Parts III, IV and V.)
14
Combine lines 5 and 13, and enter the net gain or (loss) here
14
15
If line 14 shows a gain-
a Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part IV for computation of
alternative tax). Enter zero if there is a loss or no entry on line 13
15a
b Subtract line 15a from line 14. Enter here and on Form 1040, line 30a
15b
16 If line 14 shows a loss-
}
a Enter one of the following amounts:
(i) If line 5 is zero or a net gain, enter 50% of line 14;
(ii) If line 13 is zero or a net gain, enter line 14; or,
(iii) If line 5 and line 13 are net losses, enter amount on line 5 added to 50% of amount on
line 13.
16a
b Enter here and enter as a (loss) on Form 1040, line 30a, the smallest of:
(i) The amount on line 16a;
(ii) $1,000 ($500 if married and filing a separate return); or,
(iii) Taxable income, as adjusted (see Instruction J).
NW 88326 Docld 32245535 Page 11
SEE4798.
16b
218-056-1
Page 2
Schedule D (Form 1040) 1976
[Part IV Computation of Alternative Tax (See Instruction S to See if the Alternative Tax Will Benefit You)
17 Enter amount from Form 1040, line 47
17
18
18 Enter amount from line 15a (or Form 4798, Part IV, line 8(a)) .
19 Subtract line 18 from line 17 (if line 18 exceeds line 17, do not complete the rest of this part. The Alter:
native Tax will not benefit you)
19
Note: If line 18 does not exceed $25,000 ($12,500 if married filing separately), omit lines 20 through
23 and enter zero on line 24.
20
20 Enter $25,000 ($12,500 if married filing separately)
21 Add lines 19 and 20
'
22 Tax on amount on line 17*
23 Tax on amount on line 21* .
24 Subtract line 23 from line 22
25 Tax on amount on line 19* .
22
23
26 Enter 50% of line 18 but not more than $12,500 ($6,250 if married filing separately)
21
23
24
25
25
26
27 Alternative Tax-add lines 24, 25, and 26. If smaller than the tax figured on the amount on Form 1040,
line 47, enter this alternative tax on Form 1040, line 16. Also check the Schedule D box on Form 1040,
line 16
27
*If the amount on which the tax is to be computed is $20,000 or less use the Tax Table; if more than $20,000 use Tax Rate Schedule X, Y, or Z.
Note: Enter your capital loss carryovers from 1976 to 1977:
Short-term (from Form 4798, Part II or Part V)
Long-term (from Form 4798, Part II or Part V) .
NW 88326 Docid:32245535 Page 12
Pre-1970
Post-1969
7958
484
U.S. GOVERNMENT PRINTING OFFICE: 1976-0-218-056
****
218-056-1
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service
t
Computation of Social Security Self-Employment Tax
Each self-employed person must file a Schedule SE. ▷ Attach to Form 1040.
▷ See Instructions for Schedule SE (Form 1040).
1976
If you had wages, including tips, of $15,300 or more that were subject to social security or railroad retirement taxes, do not fill in
this schedule (unless you are eligible for the Earned Income Credit). See Instructions.
If you had more than one business, combine profits and losses from all your businesses and farms on this Schedule SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
NAME OF SELF-EMPLOYED PERSON (AS SHOWN ON SOCIAL SECURITY CARD)
SAM Rub
BY
Social security number of
self-employed person 32212 7997
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.) ▷
If you have only farm income complete Parts I and III, If you have only nonfarm income complete Parts II and III.
If you have both farm and nonfarm income complete Parts I, II, and III.
Part Computation of Net Earnings from FARM Self-Employment
You may elect to compute your net farm earnings using the OPTIONAL METHOD, line 3, instead of using the Regular Method, line
2, if your gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600. However, lines 1 and
2 must be completed even if you elect to use the FARM OPTIONAL METHOD.
REGULAR METHOD
1 Net profit or (loss) from:
a Schedule F, line 54 (cash method), or line 72 (accrual method)
b Farm partnerships
la
1b
2
2 Net earnings from farm self-employment (add lines la and b)
FARM OPTIONAL METHOD
3 If gross profits
from farming' are:
a Not more than $2,400, enter two-thirds of the gross profits
b More than $2,400 and the net farm profit is less than $1,600, Enter $1,600.
3
1 Gross profits from farming are the total gross profits from Schedule F, line 28 (cash method), or line 70 (accrual
method), plus the distributive share of gross profits from farm partnerships (Schedule K-1 (Form 1065), line 14)
as explained in instructions for Schedule SE.
4 Enter here and on line 12a, the amount on line 2, or line 3 if you elect the farm optional method
Part Computation of Net Earnings from NONFARM Self-Employment
4
a Schedule C, line 21. (Enter combined amount if more than one business.)
b Partnerships, joint ventures, etc. (other than farming)
5a
3546
5b
REGULAR METHOD
5 Net profit or
(loss) from:.
c Service as a minister, member of a religious order, or a Christian Science
practitioner. (Include rental value of parsonage or rental allowance fur-
nished.) If you filed Form 4361, check here ☑ and enter zero on this
line.
d Service with a foreign government or international organization
(See Form 1040 in-
e Other structions for line 36.). Specify ►
6 Total (add lines 5a through e).
7 Enter adjustments if any (attach statement)
:
8 Adjusted net earnings or (loss) from nonfarm self-employment (line 6, as adjusted by line 7)
If line 8 is $1,600 or more OR if you do not elect to use the Nonfarm Optional Method, omit lines 9
through 11 and enter amount from line 8 on line 12b, Part III,
Note: You may use the nonfarm optional method (line 9 through line 11) only if line 8 is less than $1,600 and less
than two-thirds of your gross nonfarm profits, and you had actual net earnings from self-employment of
$400 or more for at least 2 of the 3 following years: 1973, 1974, and 1975. The nonfarm optional method
can only be used for 5 taxable years.
NONFARM OPTIONAL METHOD
9 a Maximum amount reportable, under both optional methods combined (farm and nonfarm)
b Enter amount from line 3. (If you did not elect to use the farm optional method, enter zero)
c Balance (subtract line 9b from line 9a).
2
.
10 Enter two-thirds of gross nonfarm profits or $1,600, whichever is smaller
11 Enter here and on line 12b, the amount on line 9c or line 10, whichever is smaller
Gross profits from nonfarm business are the total of the gross profits from Schedule C, line 3, plus the distribu-
tive share of gross profits from nonfarm partnerships (Schedule K-1 (Form 1065), line 14) as explained in instruc-
tions for Schedule SE. Also, include gross profits from services reported on line 5c, d, and e, as adjusted
by line 7.
*Part II Computation of Social Security Self-Employment Tax
12 Net earnings or (loss): a From farming (from line 4)
5c
5d
5e
6
3546
7
8
3546
SE
9a
$1,600 00
9b
9c
10
11
12a
b From nonfarm (from line 8, or line 11 if you elect to use the Nonfarm Optional Method)
13 Total net earnings or (loss) from self-employment reported on line 12. (If line 13 is less than $400,
you are not subject to self-employment tax. Do not fill in rest of schedule.).
12b
3546
13
3546
14 The largest amount of combined wages and self-employment earnings subject to social security or
railroad retirement taxes for 1976 is
.
14
$15,300
00
15 a Total "FICA" wages and “RRTA" compensation
b Unreported tips subject to FICA tax from Form 4137, line 9 or to RRTA
15a
15b
c Total of lines 15a and b
15c
16 Balance (subtract line 15c from line 14).
16
17 Self-employment income-line 13 or 16, whichever is smaller
17
3546
18 Self-employment tax. (If line 17 is $15,300.00, enter $1,208.70; if less, multiply the amount on line
17 by .079.) Enter here and on Form 1040, line 58.
18
280
218-060-1
NW 88326 Docld:32245535 Page 13
Form
4798
Department of the Treasury
Internal Revenue Service
Capital Loss Carryover
(Computations of Capital Loss Carryovers and Summary of Capital
Gains and Losses if Pre-1970 Capital Losses are Carried to 1976.)
▷ Attach to Form 1040.
Name(s) as shown on Form 1040
3.+P Ruby
1976
Social Security Number
32212 7997
Note: Complete Only Page 1 of This Form to Compute Your Capital Loss Carryover if Your 1975 Schedule D (Form 1040), lines
4(a) and 12(a), DO NOT SHOW A LOSS.
Part
Post-1969 Capital Loss Carryovers to 1976 (Complete this part if the amount on your 1975 Schedule D
(Form 1040), line 16(a), is larger than the loss deducted on your 1975 Form 1040, line 29a.)
Section A.-Short-term Capital Loss Carryover
1 Enter loss shown on your 1975 Schedule D (Form 1040), line 5; if none, enter zero and ignore
lines 2 through 6-then go to line 7
1
.
2 Enter gain shown on your 1975 Schedule D (Form 1040), line 13. If that line is blank or shows
a loss, enter a zero
2
3
4
5
6
3 Reduce any loss on line 1 to the extent of any gain on line 2.
4 Enter amount shown on your 1975 Form 1040, line 29a .
5 Enter smaller of line 3 or 4
6 Excess of amount on line 3 over amount on line 5
Note: The amount on line 6 is your short-term capital loss carryover from 1975 to 1976 that is attributable to years beginning
after 1969. Enter this amount on your 1976 Schedule D (Form 1040), line 4.
Section B.-Long-term Capital Loss Carryover
7
.
7 Line 4 less line 5 (Note: If you ignored lines 2 through 6, enter amount from your 1975 Form 1040, line 29a)
8 Enter loss from your 1975 Schedule D (Form 1040), line 13; if none, enter zero and ignore lines
9 through 12
8
9 Enter gain shown on your 1975 Schedule, D (Form 1040), line 5. If that line is blank or shows
a loss, enter a zero
9
10
11
12
10 Reduce any loss on line 8 to the extent of any gain on line 9
11 Multiply amount on line 7 by 2.
12 Excess of amount on line 10 over amount on line 11
Note: The amount on line 12 is your long-term capital loss carryover from 1975 to 1976 that is attributable to years beginning
after 1969. Enter this amount on your 1976 Schedule D (Form 1040), line 12.
Partill
Post-1969 Capital Loss Carryovers from 1976 to 1977 (Complete this part if the amount on your 1976
Schedule D (Form 1040), line 16a, is larger than the loss deducted on your 1976 Form 1040, line 30a.)
Section A.-Short-term Capital Loss Carryover
1 Enter loss shown on your 1976 Schedule D (Form 1040), line 5; if none, enter zero and ignore lines
2 through 6-then go to line 7
1
:
2 Enter gain shown on your 1976 Schedule D (Form 1040), line 13. If that line is blank or shows a
loss, enter a zero
2
3
4
5
6
3 Reduce any loss on line 1 to the extent of any gain on line 2
4 Enter amount shown on your 1976 Form 1040, line 30a
5 Enter smaller of line 3 or 4 ..
6 Excess of amount on line 3 over amount on line 5
Note: The amount on line 6 is your short-term capital loss carryover from 1976 to 1977 that is attributable to years beginning
after 1969. Enter this amount in the space provided on page 2 of your 1976 Schedule D (Form 1040).
Section B.-Long-term Capital Loss Carryover
7 Line 4 less line 5 (Note: If you ignored lines 2 through 6, enter amount from your 1976 Form 1040, line 30a)
7
..
8 Enter loss from your 1976 Schedule D (Form 1040), line 13; if none, enter zero and ignore lines
9 through 12
8
.
9 Enter gain shown on your 1976 Schedule D (Form 1040), line 5. If that line is blank or shows a
loss, enter a zero
9
10 Reduce any loss on line 8 to the extent of any gain on line 9
11 Multiply amount on line 7 by 2
12 Excess of amount on line 10 over amount on line 11
Note: The amount on line 12 is your long-term capital loss carryover from 1976 to 1977 that is attributable to years beginning
after 1969. Enter this amount in the space provided on page 2 of your 1976 Schedule D (Form 1040).
10
11
12
NW 88326 Docld:32245535 Page 14
Form 4798 (1976)
:
Form 4798 (1976)
Instructions
A. Who Should File.-
Do Not Complete the Rest of This Form if You Do Not Have a
Pre-1970 Capital Loss Carryover to 1976 (See Instruction A).
If your 1975 Schedule, D (Form 1040), lines 4(a) and 12(a)
show a loss: (1) use Part III, below, to determine your capital loss
carryover to 1976; (2) complete your 1976 Schedule D (Form 1040),
lines 1 through 13 to report/capital gains and losses for the current year
and any post-1969 capital loss carryovers; and (3) complete Part IV
to figure your net capital gain or (loss) for 1976 and the capital loss
limitation if necessary. Use Part V to figure capital loss carryover from
1976 to 1977 for pre-1970 losses or a combination of pre-1970 and post-
1969 losses.
B. Part IV, Line 19 or 33.-If there is a gain and a loss on the lines
mentioned in the instructions for Part IV, line 19 or 33, enter the gain
reduced by the amount of the loss. If the loss exceeds the gain enter
a zero. If there is a gain and no loss, just enter the gain.
Page
C. Part IV, Line 22 or 36.-If there is a loss and a gain on the lines
mentioned in the instructions for Part IV, line 22 or 36, enter the loss
reduced by the amount of the gain. If the gain exceeds the loss enter
a zero. If there is a loss and no gain, just enter the loss.
D. Married Taxpayers Filing Separate Returns._ If you are married
and filing a separate return the limitation for Part IV, lines 9(b)(ii)
and 27(b) is $500, increased by amounts attributable to pre-1970 short-
term capital loss components, but the combined total may not exceed
$1,000. If there is a loss in Part IV, line 2, complete Part IV, Section
E. If there is a loss in Part IV, line 5, complete Part IV, Section D.
lines 14 through 22 (assuming all the lines in Section D were not other.
wise required to be completed) ignoring the note under line 14.
E. Additional Information. -For information about capital assets,
investment interest expense deduction adjustment, alternative tax, etc.,
see the Instructions for Schedule D (Form 1040).
'
Pre-1970 and Post-1969 Capital Loss Carryovers to 1976 (Complete this part if the amount on your
Part 1975 Schedule D (Form 1040), line 16(a) or line 33, is larger than the loss deducted on your 1975
Form 1040, line 29a.)
1 Enter loss shown on your 1975 Schedule D (Form 1040), line 5; if none, enter zero and ignore
lines 2 through 20-then go to line 21.
1
(1741)
2 Enter gain shown on your 1975 Schedule D (Form 1040), line 13. If that line is blank or shows a loss enter a zero.
3 Reduce loss on line 1 to the extent of any gain on line 2.
2
0
3
74
T
Note: If line 4(a) on your 1975 Schedule D (Form 1040) is blank, IGNORE lines 4 through 11, enter
a zero on line 12-then go to line 13.
4 Combine lines 3 and 11 on your 1975 Schedule D (Form 1040).
Enter the gain; if zero or a loss, enter a zero.
4
5105.
Note: If line 4 is zero IGNORE lines 5 through 11, enter on line 12
the loss from your 1975 Schedule D (Form 1040), line 4(a)—
then go to line 13.
15; Enter any gain from your 1975 Schedule D (Form 1040), line 3.
* 6 Enter smaller of line 4 or 5.
5
6
7 Enter excess of gain on line 4 over line 6
7
8 Enter loss from your 1975 Schedule D (Form 1040), line 12(a);
otherwise, enter a zero.
8
13322
9 Reduce any gain on line 7 to the extent of any loss on line 8
10 Enter loss from your 1975. Schedule D (Form 1040), line 4(a); other-
wise enter a zero.
9
T
10
11 Add the gains on lines 6 and 9.
11
12 Reduce the loss on line 10 to the extent of any gain on line 11.
13 Pre-1970 short-term capital loss (Enter smaller of line 3 or 12).
12
13
£1707
14 Short-term capital loss attributable to years beginning after 1969 (excess of line 3 over line 13)
15 Enter any loss from line 13, above
14
16 Enter loss deducted on your 1975 Form 1040, line 29a .
15
16
(1741
17 Pre-1970 short-term loss carryover to 1976 (excess of line 15 over line 16-if line 15 does not
exceed line 16, enter zero). Enter here and in Part IV, line 2.
17
(741)
18 Enter any loss from line 14, above
18
19 Enter excess of line 16 over line 15-if line 16 does not exceed line
15, enter zero
19
.
20 Post-1969 short-term loss carryover to 1976 (excess of line 18 over line 19-if line 18 does not
exceed line 19, enter zero). Enter here and on your 1976 Schedule D (Form 1040), line 4
21 If you were required to complete Part IV of your 1975 Schedule D
20
(Form 1040), enter any loss from your 1975 Schedule D (Form
1040), line 30; otherwise, enter Zero
21
8217
22 Enter excess of line 19 over line 18-if line 19 does not exceed line
18, enter zero. (Note: If you, ignored lines 2 through 20 above, enter
amount from your 1975 Form 1040, line 29a)
22
23 Pre-1970 long-term loss carryover to 1976 (excess of line 21 over line 22-if line 21 does not
exceed line 22, enter zero). Enter here and in Part IV, line 5
24 If you were required to complete Part IV of your 1975 Schedule D
(Form 1040), enter any loss from your 1975 Schedule D (Form
1040), line 31. However, if Part IV was not required, enter any loss
from your 1975 Schedule D (Form 1040), line 13.
25 Enter excess of line 22 over line 21
does not exceed line 21, enter zero.)'.
•
24
5839
× 2 (If line 22
25
26 Post-1969 long-term loss carryover to 1976 (excess of line 24 over line 25-if line 24 does not
exceed line 25, enter zero). Enter here and on your 1976 Schedule D (Form 1040), line 12
NW 88326 Docld:32245535 Page 15
23
(8217)
26
(5839)
Form 4798 (1976)
Part IV Capital Gains and Losses
Section A.Short-term Capital Gains and Losses
1. Amount from 1976 Schedule D (Form 1040), line 5.
2 Amount from Part III, line 17.
1.
2
3. Net short-term gain or (loss), combine lines 1 and 2
3
Section B.-Long-term Capital Gains and Losses
Amount from 1976 Schedule D (Form 1040), line 13
5. Amount from Part III, line 23
4
5
6 Net long-term gain or (loss), combine lines 4 and 5
Page
(241)
€741
741
(487))
18217
6 (8701
2017
(9442)
Section C.-Summary of Sections A and B
7
Combine lines 3 and 6 and enter the net gain or (loss) here.
8 If line 7 shows a gain—
(a) Enter 50% of line 6 or 50% of line 7, whichever is smaller (see Schedule D (Form 1040), Part
IV, for computation of alternative 
tax). Enter zero if there is a loss or no entry on line 6
8(a)
(b) Subtract, line 8(a) from line 7. Enter here and on Form 1040, line 30a
9 If line 7 shows a loss-
If losses are shown on BOTH lines 5 and 6, omit lines 9(a) and (b) and go to Section D.
Otherwise, a
(a) Enter one of the following amounts:
(1) If line 3 is zero or a net gain, enter 50% of line 7;
(ii) If line 6 is zero or a net gain, enter amount from line 7; or
(iii) If line 3 and line 6 are net losses, enter amount on line 3 added to 50% of amount
on line 6.
(b) Enter here and enter as a (loss) on Form 1040, line 30a, the smallest of:
(b)
9(a)
.:(i)
The amount on line 9(a);
(ii) $1,000 (married taxpayers filing separate returns see Instruction D); or
(iii) Taxable Income, as adjusted (see Instruction J in Instructions for Schedule D (Form
1040)).
(b)
11000
Section D.-Capital Loss Limitation-Where Losses Are Shown on Both Lines 5 AND 6 of Part IV
10 Enter loss from line 3; if line 3 is zero or a gain, enter a zero.
10
12
11 Enter loss from line 6
13 Reduce loss on line 11 to the extent of the gain, if any, on line 12.
14 Combine 
amounts on 1976 Schedule D (Form 1040), lines 3 and
11
gain, if any from line 3; if line 3 is zero or a loss, enter a zero
12
13
amounts S
and if gain, enter gain; if zero or a loss, enter a zero
14
Note: If the entry on line 14 is zero, OMIT lines 15 through 21 and
enter on line 22 the loss 
shown on line 5..
15 Enter
gain, if any, from 1976 Schedule D (Form 1040), line 11
15
16 Enter smaller of amount on line 14 or line 15
16
17 Enter excess of gain on line 14 over amount on line 16
17
18 Enter loss from line 2; if line 2 is blank, enter a zero
18
19 Reduce gain, if any, on line 17 to the extent of loss, if any, on line 18 (see
Instruction 
B)
19
20 Enter loss from line 5
21 Add the gain(s) on line(s) 16 and 19
20
21
|
22 Reduce the loss on line 20 to the extent of the gain, if any, on line 21 (see Instruction C
23 Enter smaller of amount on line 22 or line 13 (if line 22 is zero, enter a zero).
24 Subtract 
amount on line 23 from the loss on line 13
25 Enter 50% of the amount on line 24.
26 Add lines 10, 23, and 25.
27. Enter here and enter as a (loss) on Form 1040, line 30a, the smallest of:
(a) Amount on line 26"
(b) $1,000 (Married taxpayers filing separate returns see Instruction D); or
22222
23
24
25
26
* (c) Taxable Income, as adjusted (see Instruction J in Instructions for Schedule D (Form 1040))
27
218-162-1
NW.88326 Docid:32245535 Page 16
NAME:
ADDRESS
S+P Ruby
MEDICAL
2 MEDICINE/DRUGS'
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5H & A INS. (½ + EXCESS)
6a DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
STATE
CALENDAR YEAR 19ª.
76
322-12-7999
SOC. SEC. NO.
DEDUCTION SCHEDULE
FEDERAL
1405.
548
CONTRIBUTIONS
21a CASH CONTRIBUTIONS
21b PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
MISC. ORGANIZED CHARITIES
POLITICAL CONTRIBUTIONS
CHURCHES
STATE
FEDERAL
22 OTHER THAN CASH
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT (LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
100
6C AMBULANCE
.LABORATORIES
TRAVEL FOR MED. 1000
MEDICARE INS.
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
20
2023
8 LESS 3% ADJ. GROSS INC.
232
9
1791
I+: (TO $150) OF H & A INS.
1501
10 TOTAL MEDICAL DED.
A 1941
7941
924
13 STATE & LOCAL GASOLINE
14 GENERAL SALES TAX
15a PERSONAL PROPERTY
8
134
15b PERSONAL PROPERTY AUTO
22
TAXES
11 STATE & LOCAL INCOME
12 REAL ESTATE
26 INSURANCE REIMBURSEMENT
27
28 ($100 LIMITATION PER CAS.)
29 TOT. CAS. OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 INCOME TAX PREPARATION
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
AUTO USE/DAMAGE
INVEST.COUNSEL & PUBS.(Sched)
EMPLOYMENT AGENCY FEES
SAFE DEPOSIT BOX
TEL. REQ. IN BUSINESS
POLITICAL CONTRIBUTIONS
16 SALES TAX AUTO
17 TOTAL TAXES
▷ 1128
INTEREST (TO WHOM PAID).
18 MORTGAGE
24821
19 INSTALLMENT LOANS
33 TOTAL MISC. DED.
35
SUMMARY OF ITEMIZED DED.
34
TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
35 TOTAL TAXES (From Line 17)
36 TOTAL INTEREST (Line 20)
37 TOTAL CONTR. (Line 24)
38 CAS. & THEFT LOSS(ES) (Line 29)
39 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM LINE 33)
20 TOTAL INTEREST.
D2517
NW88326tatDoold:32245535 No Rage: 17605
Form 101
517
40 TOTAL ITEMIZED DEDUCTIONS
ENTER ON FORM 1040 LINE 44
REMARKS
☑
100
A
STATE
FEDERAL
5686
3686
NAME. SP. Ruby
ADDRESS
1.D. NO.
OR
SOC. SEC. NO.
CALENDAR YEAR
19
76
322-12-7997
SCHEDULE OF PROFIT (OR LOSS ) FROM. BUSINESS OR PROFESSION
'PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
EMPLOYERS NO.
LABOR
TOTAL
INVENTORY AT END OF YEAR
GROSS PROFIT
GROSS INCOME
FISCAL YEAR ENDING
19
15947.
8836
8856
24001
ADVERTISING
AUTO AND TRUCK EXPENSE
BAD DEBTS
CASH SHORT
COMMISSIONS
DELIVERY
DEPRECIATION ( SCHEDULE ATTACHED
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTEREST
JANITOR SERVICE
LAUNDRY
· LEGAL AND ACCOUNTING
MAINTENANCE
OFFICE SUPPLIES. AND EXPENSE
RENT
REPAIRS
SALARIES AND
WAGES
SALARIES OFFICERS
SUPPLIES
TAXES AND LICENSES
TAXES
PAYROLL
TELEPHONE
✓ TRAVEL
UTILITIES
OTHER BUSINESS DEDUCTIONS
208.
90-0
萨
106
637
419
50
1608
13
1551
.28%
169.
.NET PROFITOR ( LOSS
NET PROFIT OR LOSS )
FEDERAL RETURN
STATE RETURN ( SEE DEPREC. SCHEDULE FOR DIFF.
PROFESSIONAL STATIONERS INC. FORM 104
LOS ANGELES, CALIF.
NW 88326 Docld:32245535 Page 18.
SCHEDULE
6456
9491
9491
945
3546
NAME
ADDRESS.
SHP Ruby
KIND OF PROPERTY
EQUIP
GOODWILL
DATE
ACQUIRED
MO
YR
6/77/2112
TOTALS
PROFESSIONAL STATIONERS INC.
CALIF.
LOS ANGELES
FORM NO 102A
I.D. NO..
OR
SOC. SEC. NO
CALENDAR YEAR 19
76
0322-12-1997 FISCAL YEAR ENDING
SCHEDULE OF DEPRECIATION / AMORTIZATION
SPEC 20%
DEP ALLOWED
PRIOR YEARS
19
REMAINING
COST
METHOD
RATE (%)
OR LIFE
(YRS)
DEPRECIATION
FOR
THIS YEAR
2112
S.L. 10YR 106
106
Add 20% Additional Depreciation on Items Purchased THIS Year.
TOTAL DEPRECIATION THIS YEAR
SCHEDULE
106
NW-88326 Docid:32245535 Page 19
J 12-1997
RUB
NAME SAMUEL & PHYLUS
or
SOC. SEC. NO. 322-12-1997
GAINS ON INSTALLMENT SALES
COFFE
DESCRIPTION OF PROPERTY
2/1/74
57
DATE ACQUIRED
TYPE OF ASSET:
1. SELLING PRICE: CASH
EE
HOP
Calendar Yr.
F/Y/E
DATE SOLD 9/2/75
NOTES
5.4
MORTGAGE TRANSFERRED
OTHER
GROSS SALES PRICE (1+2+3+4)
6. COST OR BASIS
17. LESS ACCUMULATED DEPRECIATION
PRIOR TO 1-1-62
8.
19:0
PRIOR TO 1-1-64
$10.
AFTER 12-31-61
$11.
12.
$13.
ST. LINE AFTER 12-31-63
*EXCESS OVER S/L 1-64/12-69
EXCESS OVER S/L AFTER 12-31-69
14. ADJUSTED BASIS (6-7 THRU 13)
15. EXPENSES OF SALE
16. TOTAL ADJUSTED BASIS (14 + 15)
17. TOTAL GROSS PROFIT (5 - 16)
18. TOTAL GROSS PROFIT
19. TOTAL GROSS PROFIT
V
ORDINARY
OTHER
20. CONTRACT, PRICE (1 + 2 + 4)
21 GROSS PROFIT %
:
22. PAYMENTS RECEIVED YEAR OF SALE
23
24.
25.
26.
CASH (1)
A PRINCIPAL COLLECTIONS
EXCESS MORTGAGE. OVER BASIS
OTHER (4)
27: TOTAL PAYMENTS (23 THRU 26)
28: RECOGNIZED GAIN
29. RECOGNIZED GAIN - ORDINARY
30. RECOGNIZED GAIN - OTHER
TAX-
TOTAL
ABLE ☐ PAYMENTS
YR
1975 20148
1976/19503.
LESS INT.
(TO PT. 2.
SEC. 3)
SECTION 1245
REPORTED
NONE 7418
4959 5355
BALANCE
15416
10061
4
ROFESSIONAL
LOS ANGE
NW883263132245535 Page 20 CALIF. FORM 96
1925
19
CAPITAL
SEC. 1245
SEC. 1250
$
$ 20148
48152
68300
$
$ 75228
S
%
2313
42915
238
43153
$ 2313
$22834
$683072
36.42%
20148
$
$
20148
2313
5105
ORDINARY INCOME
SECTION 1250
CAPITAL GAIN
REPORTED
BALANCE
REPORTED
BALANCE
SCHEDULE
%

"
RESIDENT
540
INDIVIDUAL
CALIFORNIA
INCOME TAX
PLACE PREADDRESSED LABEL HERE, if available. (Correct name and address, if necessary)
Enter social security number(s) only if incorrect or not shown on label.
FILING STATUS
NAME (If joint return, give first names and initials of both)
SAMUEL & PHYLLIS
-
LAST NAME
PRESENT HOME ADDRESS (Number and street, including apartment number, or
Rub
ST
HILLS
16250 BIRCHER
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
GRANADA
1
Single (Check Only One)
2 Married filing joint return (even if only one had income)
Separate return of married person-Enter spouse's
social security number and full name here
4 Head of Household-Enter name of qualifying
individual_
5 ☐ Widow(er) with dependent child (Year spouse died 197_)
EXEMPTION CREDITS
Check ✓ Calendar Year
One:
FOR
TAXABLE YEAR
1976
Fiscal Year Ending
PRIVACY NOTIFICATION
SEE PAGE 2 OF INSTRUCTIONS
Your Social Security Number,
32212
99
Spouse's Social Security Number
.1977
349 18 1420
Yours
(oral route)
CA
OCCU-
PATION
SS
Spouse's
6 Personal
If line 1 or 3 checked, enter $25
7 Dependents
If line 2, 4 or 5 checked, enter $50
Do not list the person who qualifies you as head of household
ELISA
THOMAS
6
5000
Total Number ☑
2 x $80 7100
× $8
8
00
9 600
8 Blind (see instructions) Number of blind exemptions
9 Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20
10 Wages, salaries, tips and other employee compensation Attach copy 2 of Form(s) W-2 to face of this ?
return. If unavailable, see instructions, Page 105
11 Dividends-before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540))
A 12 Interest. Enter total (if over $400, complete and attach Schedule B(540) )
◄ ATTACH COPY 2 OF FORM W-2 HERE D
Write social security number on check or money order. ATTACH HERE ▷
13 Income other than wages, dividends and interest (from line 48)
14 Total (add lines 10, 11, 12 and 13)
15 Adjustments to income (from line 55)
16 Adjusted gross income (subtract line 15 from line 14)
If you do NOT itemize deductions AND line 16 is under $15,000, find tax in Tax Table and enter on line 19.
• If you itemize deductions OR line 16 is $15,000 or more, complete lines 17 and 18.
10
011
C12
13
5195
2546
14 7741
15
16
7741
17 Deductions: Itemized (from line 63) OR STANDARD ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
18 Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
19 Tax from (check one) Tax Table
G17
5686
18 2055
Tax Rate Schedule
Income Averaging Schedule (G or G-1)
☐ 22
23 Net tax liability (subtract line 22 from line 21-if line 22 is greater than line 21, enter zero)
24 Other taxes (from line 71) . . .
23
-0-
24
25
Total tax liability (add lines 23 and 24)
25
26
27
28
Total California income tax withheld (attach W-2 or W-2P to face of this return)
Renter's credit-if you lived in rented property on March 1, 1976, complete Part 1 on page 2
1976 California estimated tax payments
: 26
☑
E 27
28
30
29 Excess California SDI tax withheld (see instructions)
Total Credits.
29.
30
30
-0
2222222
19
20
23
66
21
-0
20 Total exemption credits (from line 9, above)
21 Tax liability (subtract line 20. from line 19-if line 20 is greater than line 19, enter zero)
22 Other credits (from line 68-Including Special Low Income Tax Credit).
31 If line 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero.
Mail return to:
FRANCHISE TAX BOARD
SACRAMENTO, CA 95867
:
32 If line 25 is smaller than line 30, enter amount OVERPAID
Amount of line 32 to be REFUNDED TO YOU. Allow at least six weeks.
Mail return to:
33
FRANCHISE TAX BOARD
P.O. BOX 13-540
SACRAMENTO, CA 95813
34 Amount of line 32 to be credited on your 1977 ESTIMATED TAX
If
34
do NOT want State income tax forms and instructions mailed to you next year, check here
32
33
PAY IN FULL 31
Do not write in these spaces
P
E
M
A
R
See Instructions, Page 9
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
and belief it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
SIGN
Your signature
Date
Preparer's signature (other than taxpayer)
95 2141449
NW Boeld:32245535 Pageº21 return
Date
Address (and Zip code)
Date
Page 2 Form 540 (1976)
☐ Yes ☑No
□ Yes
☐ Yes
☐ Yes
☐ No
□ No
☐ No.
If no, you may not claim this credit
If yes, you may not claim this credit
If yes, you may not claim this credit
If yes, see page 3 of instructions
PART I Renter's Credit - All questions must be answered
-
135 Did you, on March 1, 1976, live in rented property which was your principal residence?
36 Was the property you rented exempt from property tax?
37 Did you live with any other person who claimed you as a dependent for income tax purposes?
'38. Did you or your spouse claim the homeowners' property tax exemption or receive public assistance?:
PART II Other Income
39 Business income (or loss) (attach Schedule C(540))
40 Net gain (or loss) from sale or exchange of capital assets (attach Schedule D(540)).
41 Net gain (or loss) from supplemental schedule of gains and losses (attach Schedule D-1(540)).
42. Pensions and annuities
43 Rents and royalties
44 Partnerships
45 Estates and trusts
ATTACH
SCHEDULE E
FORM (540)
46 Farm income (or loss) (attach Schedule F(540))
47 Miscellaneous income
(a) Fully taxable pensions and annuities (not reported on Schedule E(540))
(b) Alimony
………
(c) Other (state nature and source)
Enter total of lines 47(a), 47(b), and 47(c)
48 Total (add lines 39 thru 47). Enter here and on line 13.
PART III Adjustments to Income
49 "Sick pay," if included in line 10 (see instructions attach Form FTB 3805T)
50 Moving expenses (see instructions attach Form FTB 3805U)
51 Employee business expenses (See instructions attach Form FTB 3805N).
52 Military exclusion (see instructions)
53(a) Payments to an individual retirement arrangement (attach FTB 3805P)
(b) Payments to a Keogh (H.R. 10) retirement plan
:(c) Payments to a self-employed "Defined Benefit Plan"
Enter total of lines.53(a), 53(b), and 53(c)
54 Forfeited interest penalty (see instructions).
55 Total adjustments (add lines 49 thru 54). Enter here and on line 15
PART IV - Itemized Deductions
• Attach Schedule A(540) and enter sub-totals on lines 56 thru 62, below
56 Total deductible medical and dental expenses (from Schedule A(540), line 10)
57 Total taxes (from Schedule A(540), line 17). . . .
58 Total interest expense (from Schedule A(540), line 20)
59 Total contributions (from Schedule A(540), line 24)
60 Total casualty loss (from Schedule A(540), line 29).
61 Total miscellaneous deductions (from Schedule A (540), line 33)
62 Total child care and adoption expenses (from Schedule A(540), line 37)
63 Total itemized deductions (add lines 56 thru 62). Enter here and on line 17
-:
PART V Other Credits SEE INSTRUCTIONS FOR EACH CREDIT CLAIMED BELOW
64 "Other State" net income tax credit (attach copy of other state return and Schedule S(540)).
1
65 Retirement income credit (attach Schedule R(540))
66 Special low income tax credit (see special instructions).
2
67. Solar energy tax credit (see special instructions).
68 TOTAL (add lines 64 thru 67). Enter here and on line 22
PART VI Other Taxes
47a
47b
47c
39
3546
1000
གྷ-- ས
0
40
0
41
の 42
0 43
0 44
° °
Q
45
46
47
48 2546
49
☑50
©
51
52
53a
53b
53c
53
54
55
56
-194/
57
1128
58
2517
0
59
100.
60
° 61
&
62
63 5686
64
65
66
67
68
69 Tax on preference, income (see instructions attach Schedule P(540)
70 Tax on premature distributions from attached Form FTB 3805P
71 Total (add lines 69 and 70) enter here and on line 24.
PART VII
69
96
70
71
Reconciliation to Federal Return If adjusted gross income on Federal Return is different from line 16, page 1, explain below.
NW 88326 Docld;32245535 Page 22
ང་གྲྭ་རྒྱུ་ལས་ མ་ སྐུ་ལ་མཉན་ མའ་ལ་སྐམས་མ་མ་ད་་པའར་-ས་
J
AX
SCHEDULE
FORM 540
Name as shown on Form 540
CALIFORNIA
ITEMIZED DEDUCTIONS
S+P Ruby
Attach to Form 540
USE ONLY IF YOU DO NOT USE THE TAX TABLE OR TAKE THE STANDARD DEDUCTION
Medical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses,
hospital care, insurance premiums for medical
care, etc.
1. One half (but not more than $150) of Insurance
premiums for medical care.
2. Medicine and drugs.
3. Enter 1% of line 16, Form 540.
4. Subtract line 3 from line 2. Enter difference (if less
than zero, enter zero).
5. Enter balance of insurance premiums for medical care
not entered on line 1...
6. Other medical and dental expenses:
:
(a) Doctors, dentists, nurses, etc..
(b) Hospitals
(c) Other (itemize).
SCH
1941
Contributions
TAXABLE
1976
YEAR
Social Security Number
32212799
21(a). Cash contributions for which you have receipts,
canceled checks, etc.
(b). Other cash contributions. List donees and
amounts
SCH
22. Other than cash.-See instructions for required state-
ment
23. Carryover from 1974 & subsequent years - See
instructions
24. Total (Add lines 21a thru 23.
Maximum de-
100
duction may not exceed 20% of adjusted gross
income. Enter here and on Form 540, line 59).
Casualty or Theft Loss(es)
NOTE: If you had more than one loss, omit lines 25.
through 28-See instructions for guidance
25. Loss before insurance reimbursement
26. Insurance reimbursement.
27. Subtract line 26 from line 25, Enter difference
(If less than zero, enter zero)
28. Enter $100 or amount on line 27, whichever is
smaller...
29. Casualty or theft loss (subtract line 28 from
line 27. Enter here and on Form 540, line 60)
Miscellaneous Deductions
30. Alimony paid to: .
31. Employment Education Expense.
32. Union dues
Other (itemize)
7. Total (Add lines 4, 5, 6a, b, and c).
8. Enter 3% of line 16, Form 540.
9. Subtract line 8 from line 7. Enter difference (if less
than zero, enter zero).
10. Total (Add lines 1 and 9. Enter here and on Form
540, line 56).
Taxes
11. Auto license-Excess of registration and weight fees
(see instructions).
12. Real estate. .
13. State and local gasoline.
14. General Sales.
15. Personal property (Boat and Aircraft).
16. Other (itemize)..
SCH
17. Total taxes_ (Add lines 11 thru 16. Enter here and
on Form 540, line 57)
Interest Expense
18. Home mortgage:
19. Other (itemize).
Sett
20. Total-(Add lines 18 and 19. Enter here and on
Form 540, line 58).
1178
2517
33. Total (Add lines 30 through 32. Enter here and
on Form 540, line 61)
Child Care and Adoption Expense
34. Child care expenses Attach Form 3805X.
-
35. Total adoption expense. . . . .
Less 3% of line 16, Form 540. .
36. Net adoption expenses - See instructions
for maximum limitations. . . .
37. Total child care and adoption expenses
(add lines 34 and 36. Enter here and on
Form 540, line 62).
NW 88326 Docid:32245535 Page 23
SCHEDULE
B
FORM 540
Name as shown on Form 540
CALIFORNIA
DIVIDEND AND INTEREST INCOME
S&P Ruby
Attach to Form 540
PART DIVIDEND INCOME
6 Line 1-Gross Dividends and Other Distributions on
Stock If gross dividends and other distributions (including capital
gain dividends) on stock were $400 or less, do not complete
this part; but enter gross dividends (including capital gain distribu-
TAXABLE
1976
YEAR
Social Security Number
322-12-199
B
tions), less nontaxable portion, if any, on Form 540, page 1.
Do NOT deduct the $100 federal exclusion.
"Capital gain dividends" are treated as ordinary dividends for
State income tax purposes and not as capital gains as permitted
under the federal law.
1. Gross dividends and other distributions on stock-List payers and amounts-Write (H), (W), (J), for stock held by husband, wife, jointly.
:
%
2. Total dividends
3. Nontaxable distributions
4. Taxable dividends-Subtract line 3 from line 2. Enter here and on line 11, form 540
PART II-INTEREST INCOME
Interest on bonds, debentures, loans, notes, tax refunds and all
types of savings accounts including banks, credit unions and postal
savings is taxable.
Interest on the following obligations is exempt from tax:
(a) Bonds and other obligations (other than tax refunds) of the
United States, the District of Columbia and territories of
the United States. (Interest on Philippine Islands obligations
issued on or after March 24, 1934 is not exempt.)
1. Interest income-List payers and amounts..
NOTE ON WOODLEY BISTRO
UAL
TRANS WORLD
WORLD
721
(b) Bonds (but not other obligations) of California and its polit-
ical subdivisions issued after November 4, 1902.
(c) Interest on bonds of Alaska and Hawaii issued prior to their
✓ achieving statehood.
Note: If total taxable interest income was $400 or less, do
not complete this part; but enter the total amount of interest
received on Form 540, page 1.
4959
12
π
191
77
2. Total interest income. Enter here and on line 12, Form 540
NW 88326 Docld:32245535 Page 24
5195
SCHEDULE
C
FORM 540
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
TAXABLE
1976
YEAR
Attach this schedule to your income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
5.+P.
Ruby
A. Name and Address of Business
Partnerships, joint ventures, etc., must Ale on Form 565
Social Security Number
322-12-7997
B. Federal Employer I.D. No.
WOODLEY BISTRO COFFEE SHOP, 16055 VENTURA BLUD EncinoCA, 95-26515-78
C. Principal business activity (i.e., retail-hardware; wholesale-tobacco; services-legal; etc.) SERVICE -
D. Indicate method of accounting: ☐ cash; ✓ raccrual;
☐ other..
E. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)?
F. Method of inventory valuation _
COST
✓ YE
YES ☐ NO
snach вак
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐☐ YES ☐ NO If. "Yes," attach explanation.
1 Gross receipts, sales, or fees $
..Less returns and allowances $.
Less cost of items withdrawn for personal use $
2 Inventory at beginning of year (if different from last year's closing inventory, attach explanation).
3 Purchases $
4 Cost of labor (do not include salary paid to yourself).
5 Materials and supplies..
6 Other costs (explain in Schedule C-2 or attach Schedule).
Balance
se
C
.7
Total of lines 2 thru 6.
8 Inventory at end of this year..
9 Cost of goods sold (subtract line 8 from line 7).
10 Gross profit (subtract line 9 from line 1).
11 Other income (attach schedule).
12
Total Income (add lines 10 and 11).
OTHER BUSINESS DEDUCTIONS
13 Depreciation (explain in Schedule C-1 or attach Schedule)...
14 Taxes on business and business property (explain in Schedule C-2 or attach Schedule).
15. Rent on business property..
16 Repairs (explain in Schedule C-2 or attach Schedule).
17 Salaries and wages not included on line 4 (exclude any paid to yourself).
18 Insurance
* 19 Legal and professional fees.
20 Commissions
21 Amortization (attach statement).
22 Retirement plans, etc. (other than your share, see instructions).
23 Interest on business indebtedness.
24 Bad debts arising from sales or services (Not applicable if reporting on cast.
25. Depletion (attach schedule).
26 Other business expenses (explain in Schedule C-2 or attach Schedule).
27 Total of lines 13 thru 26..
basis).
28 Net profit (or loss) (subtract line 27 from line 12), Enter here and on Page 2, Form 540 or 540NR
Group and guideline class
or description of property
Date
Acquired
Cost or
other basis
sett
Depreciation
allowed (or allowable)
in prior years
Method of
computing
depreciation
3546
Life or
Rate
Depreciation
for this year
Schedule C-2
Explanation of Lines
6, 14, 16, and 26.
Schedule C-1
Depreciation
Claimed on line 13.
Sett
LINE
LINE
EXPLANATION
AMOUNT
NO.
NO..
W88 Docid:32245535 Page 25
SCHEDULE F ON REVERSE
:
106
EXPLANATION
AMOUNT
SCHEDULE
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR
S&P
Ruby
PART -Assets Held One Year or Less
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date acquired
c. Date sold
d. Gross sales
(mo., day, yr.)
(mo., day, yr.)
price
TAXABLE
*1976
YEAR
Social Security Number
322127997
a. Cost or other basis as
adjusted, cost of subse-
quent improvements (If
attach
not purchased,
explanation) and α.
pense of sale
f. Gain or loss
(d. less e.)
D
1.
2. Enter gain (or loss), if applicable, from line 17, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART IAssets Held More Than One Year But Not More Than Five Years
5.
INSTALL ment
SALE
5355
6. Enter gain (or loss), if applicable, from line 19, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7 (If gain, see 540 instructions, line 24a (Preference Income))
PART III—Assets Hold More Than Five Years
9.
5355
10. Enter gain (or loss), if applicable, from line 21, Schedule D-1 (540) (attach copy)
11. Enter your share of net gain or loss from partnerships and fiduciaries.
.12. Net gain or loss, combine lines 9, 10 and 11 (If gain, see 540 instructions, line 24a (Preference Income))
PART IV-Summary of Capital Gains and Losses
13. Enter amount from line 4
14. Enter 65% of the amount on line 8
15. Enter 50% of the amount on line 12
19.75.
16. Enter unused capital loss carryover from preceding taxable years (attach computation)
17. Combine the amounts shown on lines 13, 14, 15 and 16
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
-
3481
(15042) (1561)
19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on lines 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
(c) $1,000 ($500 in the case of a husband or wife filing a separate return)
NW-88326 Docid:32245535 Page-26-
(1000
1040
Department of the Treasury-Internal Revenue Service
US Individual Income Tax Return
For the year January 1-December 31, 1975, or other taxable year beginning
Please print or type
Name (If joint return, give first names
initials of both)
Last name
RuBy
SAMUEL & PHYLLIS R
Present home address (Number and street, including apartment number, or rural route).
16250
BIRCHER ST
HILLS CA
City, own or post office, State and ZIP code
GRANADA
Requested by
Census Bureau
for Revenue
Sharing
Filing Status
1
Single
23
5
A In what city, town, village,
etc., do you live?
LOS ANGELES
(check only ONE box)
B Do you live within the legal
limits of the city, town, etc.?
Yes
No ☐ Don't know
Married filing joint return (even if only one had income)
Married filing separately. If spouse is also filing give
spouse's social security number in designated space above
and enter full
name here
Unmarried Head of Household (See page 5 of Instructions)
Qualifying widow(er) with dependent child (Year
). See page 5 of Instructions.
spouse died 19
8 Presidential Election
Campaign Fund
Exemptions
1975, ending
Your social security number
322127997
Spouse's social security no.
349181420
Осси- Yours ▸
pation Spouse's ➤
STE
1975
19...
For Privacy Act Notification,
see page 2 of Instructions.
For IRS use only
C In what county and State do you live?
County
LOS ANGELES CA
Las
D In what township do
you live? (See page 4.)
Enter number of
6a Regular ☑ Yourself ☑ Spouse boxes checked
b First names of your dependent children who
lived with you ELISA.
THOMAS
SAS
Enter
number
c Number of other dependents (from line 27)
d Total (add lines 6a, b, and c)
e Age 65 or over.
Yourself
Yourself
Blind
.
7
Total (add lines 6d and e)
Yes
No
Yes
No
(Attach Forms W-2. If unavail.
9
Do you wish to designate $1 of your taxes for this fund?
If joint return, does your spouse wish to designate $1?.
9 Wages, salaries; tips, and other employee compensation able, see page 3 of Instructions.)
10a Dividends (Estructions) $ 17 10b Less exclusion $...
Enter
Spouse, number
2
of boxes:
Spouse checked
Y
У
Note: If you check the "Yes"
box(es) it will not increase your
tax or reduce your refund.
Tax, Payments and Credits
Please attach Check or Money Order here
Balance Due
or Refund
Please attach Copy B of Forms W-2 here ||
Income
See pages 7
17
Balance ►
10c
11
12
13
(If gross dividends and other distributions are over $400, list in Part 1 of Schedule 'B.)
If $400 or less, enter total without listing in Schedule B
Interest income.
If over $400, enter total and list in Part 1 of Schedule B
Income other than wages, dividends, and interest (from line 36)
Total (add lines 9, 10c, 11, and 12).
11
95
12
13
8867
8872
14
15
Tax Tables
Adjustments to income (such as "sick pay," moving expenses, etc. from line 42)
(If less than $8,000, see page 
8 of 
In-
Subtract line 14 from line 13' (Adjusted Gross Income) structions on "Earned Income Credit.")
If you do not itemize deductions and line 15 is under $15,000, find tax in Tables and enter on line 16a.
If you itemize deductions or line 15 is $15,000 or more, go to line 43 to figure tax.
CAUTION. If you have unearned income and can be claimed as a dependent on your parent's return, check here ☐ and see page 7 of Instructions.
16a Tax, check if from:
14
15
375
8592
Schedule D
Tax Rate Schedule X, Y, or Z
Schedule G OR
Form 4726
b Credit for personal exemptions (multiply line 6d by $30)
c Balance (subtract line 16b from line 16a).
17
Credits (from line 54)
18
Balance (subtract line 17 from line 16c)
19
Other taxes (from line 63)
20
Total (add lines 18 and 19).
17
18
19
20
g」 「 པ\ཌ」 ཀླགླ「⌘
16a
b
120
21a Total Federal income tax. withheld W-2P to front)
22
23
222
b 1975 estimated tax payments
c Earned income credit
Id Amount paid with Form 4868
e Other payments (from line 67)
Total (add lines 21a through e)
(attach Forms W-2 or
21a
(include amount allowed as
credit from 1974 return)
b
800
C
d
e
If line 20 is larger than line 22, enter BALANCE DUE IRS
(Check here ► ☐ if Form 2210, Form 2210F, or statement is attached. See page 8 of Instructions.)
If line 22 is larger than line 20, enter amount OVERPAID.
Amount of line 24 to be REFUNDED TO YOU.
24
25
26
Amount of line 24 to 'be cred-
ited on 1976 estimated tax. ►
23
24
25
202
22
22
598
598
Pay amount on line 23 in
full with this return. Write
social security number on
check or money order and
make payable to Internal
Revenue Service.
800
Sign
here
26
If all of overpayment (line 24) is to be
refunded (line 25), make no entry on line 26.
Under penalties of perjury, I declare that have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it
is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all 
information of which preparer has any knowledge.
Your signature
Date
Date
Spouse's signature (if filing jointly, BOTH must sign even if only one had income)
Preparer's signature (other than taxpayer) •
367-34-8729.
Address (and ZIP Code)
16-82510-1
NW 88326 Docld:32245535 Page 27
Form 1040 (1975)
Other
Dependents
(a) NAME
(b) Relationship
(c) Months lived in your
home. If born or died
during year, write B or D.
(G) Did de-
pendent have
income
of
$750 or more?
$
(e) Amount YOU
furnished for de-
pendent's
sup-
port. If 100%
write ALL.
Page 2
(f) Amount fur-
nished by OTHERS
including depend-
ent.
$
Employee business expense (attach Form 2106 or statement)
28
27 Total number of dependents listed in column (a). Enter here and on line 6c
Part I Income other than Wages, Dividends, and Interest
Business income or (loss) (attach Schedule C).
29a Net gain or (loss) from sale or exchange of capital assets (attach Schedule D)
29b 50% of capital gain distributions (not reported on Schedule D-see page 9 of Instructions)
30 Net gain or (loss) from Supplemental Schedule of Gains and Losses (attach Form 4797).
31a Pensions, annuities, rents, royalties, partnerships, estates or trusts, etc. (attach Schedule E).
31b Fully taxable pensions and annuities (not reported on Schedule E-see page 9 of Instructions)
Farm income or (loss) (attach Schedule F)
State income tax refunds (
32
33
34
Alimony received
35
36
37
!
does not apply if refund is for year in which you took the
standard deduction--others see page 9 of Instructions
Other (state nature and source--See page 9 of Instructions)
Total (add lines 28 through 35). Enter here and on line 12
Part 11 Adjustments to Income
"Sick pay." (attach Form 2440 or other required statement)
38 Moving expense (attach Form 3903)
39
40a Payments to a Keogh (H.R. 10) retirement plan.
28
29a (1000 I
7559
Σ
29b
30
2313
31a
31b
32
33
34
35
36
8872
37
38
39
40a
41
42
40b Payments to an individual retirement arrangement from attached Form 5329, Part III
Forfeited interest penalty for premature withdrawal-see page 10 of Instructions
Total (add lines 37 through 41). Enter here and on line 14
40b
375
41
42
375
Part III Tax Computation (Do not use this part if you use the Tax Tables to find your tax.)
43 Adjusted gross income (from line 15)
43
8592
44 (a) If you itemize deductions, check here
and attach Schedule A
and enter total from Schedule A, line 41
45
(b) If you do not itemize deductions and line 15 is $15,000 or more, check here ☐ and:
If box on line 2 or 5 is checked, enter 16% of line 15 but not more than $2,600; if box
on line 1 or 4 is checked, enter $2,300; if box on line 3 is checked, enter $1,300
Subtract line 44 from line 43
44
5735
45
2857
46
46
3000
47
47
Credits |
Multiply total number of exemptions claimed on line 7, by $750.
Taxable income. Subtract line 46 from line 45
(Figure your tax on the amount on line 47 by using Tax Rate Schedule X, Y, or Z, or if applicable, the alternative
tax from Schedule D, income averaging from Schedule G, or maximum tax from Form 4726.) Enter tax on line 16a.
48 Retirement income credit (attach Schedule R)
49 Investment credit (attach Form 3468) .
50 Foreign tax credit (attach Form 1116).
48
49
50
53 Purchase of new principal residence credit (attach Form 5405)
54 Total (add lines 48 through 53). Enter here and on line 17
Part V
Other Taxes Part IV
58 Tax on premature distributions from attached Form 5329, Part V
59 Self-employment tax (attach Schedule SE) # 408 (W) 190.
.
60 Social security tax on tip income not reported to employer (attach Form.4137).
61 Uncollected employee social security tax on tips (from Forms W-2)
62 Excess contribution tax from attached Form 5329, Part IV
63 Total (add lines 55 through 62). Enter here and on line 19
Part VI Other Payments
64 Excess FICA, RRTA, or FICA/RRTA tax withheld (two or more employers-see page 10 of Instructions).
65 Credit for Federal tax on special fuels, nonhighway gasoline and lubricating oil (attach Form 4136)
66 Credit from a Regulated Investment Company (attach Form 2439)
67 Total (add lines 64 through 66). Enter here and on line 21e
U.S. GOVERNMENT PRINTING OFFICE: 1975-0-575-050
51 Contributions to candidates for public office credit-see page 10 of Instructions
52 Work Incentive (WIN) credit (attach Form 4874)
51
52
53
54
55 Tax from recomputing prior-year investment credit (attach Form 4255) NOT USED 55
56 Tax from recomputing prior-year Work Incentive (WIN) credit (attach Schedule).
57 Minimum tax. Check here ☐, if Form 4625 is attached
101
56
57
58
59
598
60
61
62
63
598
64
65
66
67
16-82510-1
NW 88326 Docld:32245535 Page 28
Schedules A&B-Itemized Deductions AND
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
Dividend and Interest Income
Attach to Form 1040. See Instructions for Schedules A and B (Form 1040).
& PHYLLIS RUBY
Schedule A Itemized Deductions (Schedule B on back)
Medical and Dental Expenses (not compensated by insurance
or otherwise) (See page 11 of Instructions.)
1 One half (but not more than $150) of in-
surance premiums for medical care. (Be
sure to include in line 10 below)
2 Medicine and drugs
3 Enter 1% of line 15, Form 1040
4 Subtract line 3 from line 2. Enter differ-
ence (if less than zero, enter zero)
5 Enter balance of insurance premiums for
medical care not entered on line 1
6 Enter other medical and dental expenses:
a Doctors, dentists, nurses, etc.
b Hospitals.
c Other (itemize-include hearing aids,
dentures, eyeglasses, transportation,
etc.)
SCH
7 Total (add lines 4 through 6c)
8 Enter 3% of line 15, Form 1040
9 Subtract line 8 from line 7 (if less than
zero, enter zero)
-
1521
10 Total (add lines 1 and 9). Enter here and
on line 35
Taxes (See page 11 of Instructions.)
11 State and local income
.12 Real estate .
13 State and local gasoline (see gas tax tables)
14 General sales (see sales tax tables)
15 Personal property
16 Other (itemize) ►
SCH
17 Total (add lines 11 through 16). Enter
here and on line 36
1207
Interest Expense (See page 12 of Instructions.)
18 Home mortgage
19 Other (itemize)
1975
Your social security number
322 127997
Contributions (See page 12 of Instructions for examples.)
21 a Cash contributions for which you have
receipts, cancelled checks or other
written evidence
b Other cash contributions. List donees
and amounts. ►
SCH
22 Other than cash (see page 12 of instruc-
tions for required statement)
23 Carryover from prior years.
24 Total contributions (add lines 21a through
23). Enter here and on line 38.
150
Casualty or Theft Loss(es) (See page 13 of Instructions.)
Note: If you had more than one loss, omit lines 25 through 28
and see page 13 of Instructions for guidance.
25 Loss before insurance reimbursement
26 Insurance reimbursement
27 Subtract line 26 from line 25. Enter dif-
ference (if less than zero, enter zero)
28 Enter $100 or amount on line 27, which-
ever is smaller
-
29 Casualty or theft loss (subtract line 28
from line 27). Enter here and on line 39 ►
Miscellaneous Deductions (See page 13 of Instructions.)
30 Alimony paid
31 Union dues.
32 Expenses for child and dependent care
services (attach Form 2441)
33 Other (itemize)
A
1521
1207
2857
750
SCH
20 Total (add lines 18 and 19). Enter here
and on line 37 ..
2857
34 Total (add lines 30 through 33). Enter
here and on line 40
Summary of Itemized Deductions
35 Total medical and dental-line 10
36 Total taxes-line 17
.
37 Total interest-line 20
38 Total contributions-line 24
39 Casualty or theft loss(es)-line 29
40 Total miscellaneous-line 34
41 Total deductions (add lines 35 through
40). Enter here and on Form 1040, line
44
5735
NW 88326 Docld:32245535 Page 29
16-82507-1
Deductions
Y
SCHEDULE C
(Form 1040)
Department of the Treasury
Internal Revenue Service
Profit or (Loss) From Business or Profession
(Sole Proprietorship)
Name(s) as shown on Form 1040
Partnerships, Joint Ventures, etc., Must File Form 1065.
➤ Attach to Form 1040. ► See Instructions for Schedule C (Form 1040).
SAMUEL & PHYLLIS RUBY
LOAD
A Principal business activity (see Schedule C Instructions)
RUBLICE
product
1975
Social security number
322127997
SNACKBAR
Employer identification number ►
A BLUD
B Business name WOODLEY BISTRO COFFEE SHOP
D Business address (number and street) 160SS 
VENTURAB
Encino CA 91316
City, State and ZIP code ►
E Indicate method of accounting: (1) ☐ Cash (2) ☑ Accrual (3) ☐ Other ►
F Were you required to file Form W-3 or Form 1096 for 1975? (see Schedule C Instructions)
If "Yes," where filed
G Was an Employer's Quarterly Federal Tax Return, Form 941, filed for this business for any quarter in 1975?
H Method of inventory valuation
Income
95-2651578
Was there any substantial change in
the manner of determining quantities, costs, or valuations between the opening and closing inventories? (If "Yes," attach explanation)
1 Gross receipts or sales $.
Less: returns and allowances $....
2 Less: Cost of goods sold and/or operations (Schedule C-1, line 8)
3 Gross profit
4. Other income (attach schedule)
5 Total income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
7 Taxes on business and business property (explain in Schedule C-2)
8 Rent on business property
9. Repairs (explain in Schedule C-2)
Balance
1
2
3
4.
567000
C
Yes No
✓
8
9
10 Salaries and wages not included on line 3, Schedule C-1 (exclude any paid to yourself)
11 Insurance
10
11
12
12 Legal and professional fees
13
13 Commissions.
14 Amortization (attach statement)
15 (a) Pension and profit-sharing plans (see Schedule C Instructions)
(b) Employee benefit programs (see Schedule C Instructions)
16 Interest on business indebtedness
17 Bad debts arising from sales or services
18 Depletion
19 Other business expenses (specify):
14
16
17
18
ཆབར་བྱ
15(a)
(b)
(a)
(b)
(၁)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
ScH
5159
W 2400
(k) Total other business expenses (add lines 19(a) through 19(j))
20 Total deductions (add lines 6 through 19(k))
19(k)
TOTAL 20
21
21 Net profit or (loss) (subtract line 20 from line 5). Enter here and on Form 1040, line 28. ALSO
enter on Schedule SE, line 5(a) .
SCHEDULE C-1.-Cost of Goods Sold and/or Operations (See Schedule C Instructions for Line 2)
1 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
2 Purchases $...
Balance
1
7559
Less: cost of items withdrawn for personal use $.
3 Cost of labor (do not include salary paid to yourself)
4 Materials and supplies
5 Other costs (attach schedule)
6 Total of lines 1 through 5
234567
7
7 Less: Inventory at end of year
8 Cost of goods sold and/or operations. Enter here and on line 2 above
8
16-82517-1
NW 88326 Docld:32245535 Page 30

Schedule C (Form 1040) 1975
SCHEDULE C-2.-Explanation of Lines 7 and 9
Line No.
Explanation
Page
Amount
Line No.
Explanation
Amount
$
$
SCHEDULE C-3. -Depreciation (See Schedule C Instructions for Line 6) If you need more space, you may use Form 4562.
Note: If depreciation is computed by using the Class Life (ADR) System for assets placed in service after December 31, 1970, or the Guideline Class
Life System for assets placed in service before January 1, 1971, you must file Form 4832 (Class Life (ADR) System) or Form 5006 (Guideline
Class Life System). Except as otherwise expressly provided in income tax regulations sections 1.167(a)-11(b)(5)(vi) and 1.167(a)-12, the pro-
visions of Revenue Procedures 62-21 and 65-13 are not applicable for taxable years ending after December 31, 1970. (See Publication 534.)
Check box if you 'made an election this taxable year to use Class Life (ADR) System and/or Guideline Class Life System.
a. Group and guideline class
or description of property
b. Date
acquired
c. Cost or
other basis
1 Total additional first-year depreciation (do not include in items below)
2 Depreciation from Form 4832. See Note
3 Depreciation from Form 5006
4 Other depreciation:
Buildings
Furniture and fixtures .
Transportation equipment
Machinery and other equipment
Other (specify).
(
above
:).
d. Depreciation
allowed or allowable
in prior years
e. Method of
computing
depreciation
f. Life
or rate
g. Depreciation for
this year
SCH
5 Totals
6 Less amount of depreciation claimed in Schedule C-1, page 1
7 Balance-Enter here and on page 1, line 6
SCHEDULE C-4.-Expense Account Information (See Schedule C Instructions for Schedule C-4)
Enter information with regard to yourself and your five highest paid
employees. In determining the five highest paid employees, expense
account allowances must be added to their salaries and wages. How-
ever, the information need not be submitted for any employee for
whom the combined amount is less than $25,000, or for yourself if
your expense account allowance plus line 21, page 1, is less than
$25,000.
Did
you claim a deduction for expenses connected with:
(1) Entertainment facility (boat, resort, ranch, etc.)? .
Name
974
Expense account
Salaries and Wages
Owner
1
2
3
4
5
Yes ☑ No (3) Employees' families at conventions or meetings?
.
(2) Living accommodations (except employees on business)? ☐ Yes π No (4) Employee or family vacations not reported on Form W-2?
U.S. GOVERNMENT PRINTING OFFICE 1975-0 575-053
Yes
No
Yes
No
16-82517-1
NW 88326 Docid:32245535 Page 31
SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Service
Capital Gains and Losses (Examples of property to be reported on this
Schedule are gains and losses on stocks, bonds, and similar investments, and gains (but not
losses) on personal assets such as a home or jewelry.)
► See Instructions for Schedule D (Form 1040).
Name(s) as shown on Form 1040
➤ Attach to Form 1040.
SAMUEL & PHYLLIS RUBY
Part 1 Short-term Capital Gains and Losses-Assets Held Not More Than 6 Months
a. Kind of property and description
(Example, 100 shares of "Z" Co.).
b. Date
acquired
(Mo., day, yr.)
c. Date
sold
(Mo., day, yr.)
d. Gross sales price
1975
Social security number
322127997
e. Cost or other basis,
as adjusted (see
instruction F) and
expense of sale
f. Gain or (loss)
(d less e)
D
1
Enter your share of net short-term gain or (loss) from partnerships and fiduciaries
Enter not gain or (loss), combine lines 1 and 2.
Short-term capital loss component carryover from years beginning before 1970 (see Instruction I)
Short-term capital loss carryover attributable to years beginning after 1969 (see Instruction I) .
Net short-term gain or (loss), combine lines 3, 4(a) and (b)
Long-term Capital Gains and Losses-Assets Held More Than 6 Months
2
3
4(a) (
5
(b) 1741
(1741
17413
2
3
4(a)
(b)
5
Part II
6
7
Capital gain distributions.
7
8
Enter gain, if applicable, from Form 4797, line 4(a)(1) (see Instruction A).
8
SIOS
9
Enter your share of net long-term gain or (loss) from partnerships and fiduciaries
9
10
Enter your share of net long-term gain from small business corporations (Subchapter S)
11 Net gain or (loss), combine lines 6 through 10 .
10
11'
5105
12(a) Long-term capital loss component carryover from years beginning before 1970 (see Instruction I).
(b) Long-term capital loss carryover attributable to years beginning after 1969 (see Instruction 1)
13 Net long-term gain or (loss), combine lines 11, 12(a) and (b).
Part III
Summary of Parts I and II
14
15
Combine the amounts shown on lines 5 and 13, and enter the net gain or (loss) here
If line 14 shows a gain-
.
16
(a) Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part VI for computation
of alternative tax). Enter zero if there is a loss or no entry on line 13.
(b) Subtract line 15(a) from line 14. Enter here and on Form 1040, line 29a
If line 14 shows a loss-
.
If losses are shown on BOTH lines 12(a) and 13, omit lines 16(a) and (b) and go to Part IV
(see Instruction J).
➤ Otherwise,
(a) Enter one of the following amounts:
(i) If amount on line 5 is zero or a net gain, enter 50% of amount on line 14;
(ii) If amount on line 13 is zero or a net gain, enter amount on line 14; or,
(iii) If amounts on line 5 and line 13 are net losses, enter amount on line 5 added to
50% of amount on line 13. .
(b) Enter here and enter as a (loss) on Form 1040, line 29a, the smallest of:
(i) The amount on line 16(a);
(ii) $1,000 ($500 if married and filing a separate return-if a loss is shown on line
4(a) or 12(a), see instruction N for a higher limit not to exceed $1,000); or,
(iii) Taxable income; as adjusted (see Instruction M).
NW 88326. Docid:32245535 Page 32
12(a) (13322
(b) (5839
13 114056
(14056)
14 5797)
15(a)
(b)
16(a)
(b) 1/000
16-82511-1
4
ཨཱུ ;:''。
Schedule D (Form 1040) 1975
Part IV
Capital Loss Limitation-Where Losses Are Shown on Both Lines 12(a) AND 13
17 Enter loss froni line 5; if line 5 is zero or a gain, enter a zero
18 Enter loss from line 13
.
19 Enter gain, if any, from line 5; if line 5 is zero or a loss, enter a zero
20 Reduce loss on line 18 to the extent of the gain, if any, on line 19
21 Combine lines 3 and 11 and if gain, enter gain; if zero or a loss, enter a zero
Note: If the entry on line 21 is zero, OMIT lines 22 through 28, and enter on line 29 the
loss shown on line 12(a).
22 Enter gain, if any, from line 11.
23 Enter smaller of amount on line 21 or line 22.
24 Enter excess of gain on line 21 over amount on line 23
21
sio's
22222
5105
-
23 5105
24
25
26 Reduce gain, if any, on line 24 to the extent of loss, if any, on line 25 (see Instruction K)
27 Enter loss from line 12(a)...
26
-O-
27 (13322)
25 Enter loss from line 4(a); if line 4(a) is blank, enter a zero.
Page 2
17 1771
√7412
18 14056)
19
20 (140567
28
28 Add the gain(s) on line(s) 23 and 26
5105
29
29 Reduce the loss on line 27 to the extent of the gain, if any, on line 28 (see Instruction L)
30 Enter smaller of amount on line 29 or line 20 (if line 29 is zero, enter a zero) .
(8217)
30 82-172
31
31 Subtract amount on line 30 from the loss on line 20
32 Enter 50% of the amount on line 31.
33 Add lines 17, 30, and 32
34 Enter here and enter as a (loss) on Form 1040, line 29a, the smallest of:
(a) Amount on line 33;
32
33
(5839)
29207
878)
(b) $1,000 ($500 if married and filing a separate return-see Instruction N for a higher limit not to exceed $1,000); or,
(c) Taxable Income, as adjusted (see Instruction M).
34
( 1500 )
Part V
Complete Part V if You are Married Filing a Separate Return and Losses are Shown on Lines 4(a) and
14 (See Instruction N)
35 Combine lines 3 and 11 and if gain, enter gain; if zero or a loss, enter a zero.
35
Note: If the entry on line 35 is zero, OMIT lines 36 through 42, and enter on line 43 the loss shown on
line 4(a).
36
36 Enter gain, if any, from line 3
37
37 Enter smaller of amount on line 35 or line 36
38 Enter excess of gain on line 35 over amount on line 37
38
39 Enter loss from line 12(a); if line 12(a) is blank, enter a zero
39
40 Reduce the gain, if any, on line 38 to the extent of the loss, if any, on line 39 (see Instruction K)
41 Enter loss from line 4(a) .
40
41
42 Add the gain(s) on line(s) 37 and 40.
42
43 Reduce the loss on line 41 to the extent of the gain, if any, on line 42 (see Instruction L)
43
Part VI
Computation of Alternative Tax (See Instruction W to See if the Alternative Tax Will Benefit You)
44 Enter amount from Form 1040, line 47
45 Enter amount from line 15(a)
46 Subtract amount on line 45 from amount on line 44 (but not less than zero)
44
45
46
47
47 Enter smaller of amount on line 13 or line 14.
If line 47 does not exceed $50,000 ($25,000 if married filing separately), check here ►
lines 48 through 54.
and omit
48 Enter your share of certain long-term gains from partnerships, fiduciaries, and small business cor-
porations referred to as "certain subsection (d) gains" (see Instruction W).
48
49 Enter amount from line 48 or $50,000 ($25,000 if married filing separately), whichever is larger.
and omit lines 50 through 54.
If line 49 is equal to or greater than line 47, check here ►
49
50 Multiply amount on line 49 by 50%
50
51 Add amounts on lines 46 and 50
51
52 Tax on line 44 or 45, whichever is greater (use Tax Rate Schedule in instructions)
53 Tax on the amount on line 51 (use Tax Rate Schedule in instructions)
54 Subtract amount on line 53 from amount on line 52.
55 Tax on the amount on line 46 (use Tax Rate Schedule in instructions).
56 If the block on line 47 or 49 is checked, enter 50% of line 45; otherwise enter 25% of line 49.
57 Alternative Tax-add amounts on lines 54 (if applicable), 55, and 56. If smaller than the tax figured
on the amount on Form 1040, line 47, enter this alternative tax on Form 1040, line 16a
52
53
54
55
56
57
44
NW 88326 Docld:32245535 Page 33
✰ U.S. GOVERNMENT PRINTING OFFICE: 1975-0-575-054
16-82511-1
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service
Computation of Social Security Self-Employment Tax
Each self-employed person must file a Schedule SE.
Attach to Form 1040.
See Earned Income Credit Instructions on page 8 and Instructions for Schedule SE (Form 1040).
1975
If you had wages, including tips, of $14,100 or more that were subject to social security or railroad retirement taxes, do not fill in
this schedule unless you are eligible for the Earned Income Credit. See Instructions.
If you had more than one business, combine profits and losses from all your businesses and farms on this Schedule SE.
Important.―The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
NAME OF SELF-EMPLOYED PERSON (AS SHOWN ON SOCIAL SECURITY CARD)
Social security number of
SAMUEL RUBY
self-employed person 32212 7992
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.)
SNACKBAR
If you have only farm income complete Parts I and III. If you have only nonfarm income complete Parts II and III.
If you have both farm and nonfarm income complete Parts I, II, and III.
Part 1 Computation of Net Earnings from FARM Self-Employment
You may elect to compute your net farm earnings using the OPTIONAL METHOD, line 3, instead of using the Regular Method, line
2, if your gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600. However, lines 1 and
2 must be completed even if you elect to use the FARM OPTIONAL METHOD.
REGULAR METHOD
1 Net profit or (loss) from:
(a) Schedule F, line 54 (cash method), or line 74 (accrual method)
(b) Farm partnerships
2 Net earnings from farm self-employment (add lines 1(a) and (b))
FARM OPTIONAL METHOD
(a) Not more than $2,400, enter two-thirds of the gross profits
3 If gross profits
from farming' are:
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
1 Gross profits from farming are the total gross profits from Schedule F, line 28 (cash method), or line 72 (accrual
method), plus the distributive share of gross profits from farm partnerships (Schedule K-1 (Form 1065), line 14) as
explained in instructions for Schedule SE:
4 Enter here and on line 12(a), the amount on line 2, or line 3 if you elect the farm optional method
Part II Computation of Net Earnings from NONFARM Self-Employment
REGULAR METHOD
5 Net profit or
(loss) from:
(a) Schedule C, line 21. (Enter combined amount if more than one business.)
(b) Partnerships, joint ventures, etc. (other than farming) :
.
(c) Service as a minister, member of a religious order, or a Christian Science prac-
titioner. (Include rental value of parsonage or rental allowance furnished.) If you
filed Form 4361, check here ► and enter zero on this line
(See Form 1040 in-
(d) Service with a foreign government or international organization
(e) Other structions for line 35.) Specify.
6 Total (add lines 5(a) through (e))
7 Enter adjustments if any (attach statement)
8 Adjusted net earnings or (loss) from nonfarm self-employment (line 6, as adjusted by line 7)
If line 8 is $1,600 or more OR if you do not elect to use the Nonfarm Optional Method, omit lines 9 through
11 and enter amount from line 8 on line 12(b), Part III.
Note: You may use the nonfarm optional method (line 9 through line 11) only if line 8 is less than $1,600 and less
than two-thirds of your gross nonfarm profits, and you had actual net earnings from self-employment of $400 or more
for at least 2 of the 3 following years: 1972, 1973, and 1974. The nonfarm optional method can only be used for 5
taxable years.
NONFARM OPTIONAL METHOD
9 (a) Maximum amount reportable, under both optional methods combined (farm and nonfarm)
(b) Enter amount from line 3. (If you did not elect to use the farm optional method, enter zero.)
(c) Balance (subtract line 9(b) from line 9(a))
2
10 Enter two-thirds of gross nonfarm profits or $1,600, whichever is smaller
11 Enter here and on line 12(b), the amount on line 9(c) or line 10, whichever is smaller
2 Gross profits from nonfarm business are the total of the gross profits from Schedule C, line 3; plus the distributive
share of gross profits from nonfarm partnerships (Schedule K-1 (Form 1065), line 14) as explained in instructions
for Schedule SE. Also, include gross profits from services reported on lines 5(c), (d), and (e), as adjusted by line 7.
Part III Computation of Social Security Self-Employment Tax
12 Net earnings or (loss): (a) From farming (from line 4)
(b) From nonfarm (from line 8, or line 11 if you elect to use the Nonfarm Optional Method)
5159
5159
5159
SE
$1,600
00
5159
13 Total net earnings or (loss) from self-employment reported on line 12. (If Line 13 is less than $400, you are not
subject to self-employment tax. Do not fill in rest of schedule.)
5159
$14,100
14 The largest amount of combined wages and self-employment earnings subject to social security or railroad
retirement taxes for 1975 is
.
15 (a) Total "FICA" wages and "RRTA" compensation
(b) Unreported tips subject to FICA tax from Form 4137, line 9 or to RRTA.
(c) Total of lines 15(a) and (b)
16 Balance (subtract line 15(c) from line 14)
17 Self-employment income-line 13 or 16, whichever is smaller
18 Self-employment tax. (If line 17 is $14,100.00, enter $1,113.90; if less, multiply the amount on line 17
by .079.) Enter here and on Form 1040, line 59.
NW 88326 Docld:32245535 Page 34
U.S. GOVERNMENT PRINTING OFFICE: 1975-0-575-058
14100
5159
408
16-82518-3
00
00
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service
Computation of Social Security Self-Employment Tax
Each self-employed person must file a Schedule SE.
Attach to Form 1040.
See Earned Income Credit Instructions on page 8 and Instructions for Schedule SE (Form 1040).
1975
If you had wages, including tips, of $14,100 or more that were subject to social security or railroad retirement taxes, do not fill in
this schedule unless you are eligible for the Earned Income Credit. See Instructions.
If you had more than one business, combine profits and losses from all your businesses and farms on this Schedule SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
NAME OF SELF-EMPLOYED PERSON (AS SHOWN ON SOCIAL SECURITY CARD)
PHYLLIS RUBY
Social security number of
self-employed person 349 18 1420
SNACKBAR
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.)
If you have only farm income complete Parts I and III.
If you have only nonfarm income complete Parts II and III.
If you have both farm and nonfarm income complete Parts I, II, and III.
Part I Computation of Net Earnings from FARM Self-Employment
You may elect to compute your net farm earnings using the OPTIONAL METHOD, line 3, instead of using the Regular Method, line
2, if your gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600. However, lines 1 and
2 must be completed even if you elect to use the FARM OPTIONAL METHOD.
REGULAR METHOD
1 Net profit or (loss) from:
(a) Schedule F, line 54 (cash method), or line 74 (accrual method)
(b) Farm partnerships
2 Net earnings from farm self-employment (add lines 1(a) and (b)).
FARM OPTIONAL METHOD
3 If gross profits
from farming' are:
(a) Not more than $2,400, enter two-thirds of the gross profits
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
1 Gross profits from farming are the total gross profits from Schedule F, line 28 (cash method), or line 72 (accrual
method), plus the distributive share of gross profits from farm partnerships (Schedule K-1 (Form 1065), line 14) as
explained in instructions for Schedule SE.
4 Enter here and on line 12(a), the amount on line 2, or line 3 if you elect the farm optional method
Part II Computation of Net Earnings from NONFARM Self-Employment
REGULAR METHOD
5 Net profit or
(loss) from:
(a) Schedule C, line 21. (Enter combined amount if more than one business.)
(b) Partnerships, joint ventures, etc. (other than farming)
(c) Service as a minister, member of a religious order, or a Christian Science prac-
titioner. (Include rental value of parsonage or rental allowance furnished.) If you
filed Form 4361, check here ► and enter zero on this line
(d) Service with a foreign government or international organization
(e) Other structions for line 35.) Specify
(See Form 1040 in-
6 Total (add lines 5(a) through (e))
7 Enter adjustments if any (attach statement)
8 Adjusted net earnings or (loss) from nonfarm self-employment (line 6, as adjusted by line 7)
If line 8 is $1,600 or more OR if you do not elect to use the Nonfarm Optional Method, omit lines 9 through
11 and enter amount from line 8 on line 12(b), Part III.
Note: You may use the nonfarm optional method (line 9 through line 11) only if line 8 is less than $1,600 and less
than two-thirds of your gross nonfarm profits, and you had actual net earnings from self-employment of $400 or more
for at least 2 of the 3 following years: 1972, 1973, and 1974. The nonfarm optional method can only be used for 5
taxable years.
NONFARM OPTIONAL METHOD
9 (a) Maximum amount reportable, under both optional methods combined (farm and nonfarm)
(b) Enter amount from line 3. (If you did not elect to use the farm optional method, enter zero.)
(c) Balance (subtract line 9(b) from line 9(a))
2
10 Enter two-thirds of gross nonfarm profits or $1,600, whichever is smaller
11 Enter here and on line 12(b), the amount on line 9(c) or line 10, whichever is smaller
2 Gross profits from nonfarm business are the total of the gross profits from Schedule C, line 3. plus the distributive
share of gross profits from nonfarm partnerships (Schedule K-1 (Form 1065), line 14) as explained in instructions
for Schedule SE. Also, include gross profits from services reported on lines 5(c), (d), and (e), as adjusted by line 7.
Part III Computation of Social Security Self-Employment Tax
12 Net earnings or (loss): (a) From farming (from line 4)
(b) From nonfarm (from line 8, or line 11 if you elect to use the Nonfarm Optional Method) ´.
13 Total net earnings or (loss) from self-employment reported on line 12. (If Line 13 is less than $400, you are not
subject to self-employment tax. Do not fill in rest of schedule.)
.
..
14 The largest amount of combined wages and self-employment earnings subject to social security or railroad
retirement taxes for 1975 is
15 (a) Total "FICA" wages and "RRTA" compensation
(b) Unreported tips subject to FICA tax from Form 4137, line 9 or to RRTA.
(c) Total of lines 15(a) and (b)
16 Balance (subtract line 15(c) from line 14)
17 Self-employment income-line 13 or 16, whichever is smaller
18 Self-employment tax. (If line 17 is $14,100.00, enter $1,113.90; if less, multiply the amount on line 17.
by .079.) Enter here and on Form 1040, line 59 .
NW 88326 Docld:32245535 Page 35
U.S. GOVERNMENT PRINTING OFFICE: 1975-0-575-058
2400
2400
2400
SE
$1,600
00
2400
2400
$14,100
00
00
$4100
2400
190
16-82518-3
Form
4797
Department of the Treasury
Internal Revenue Service
Name(s) as shown on return
Part I
Supplemental Schedule of Gains and Losses
Sales, Exchanges and Involuntary Conversions under
Sections 1231, 1245, 1250, 1251, and 1252
To be filed with Form 1040, 1041, 1065, 1120, etc.-See Separate Instructions
SAMUEL & PHYLLIS RUBY
Ruby
Identifying number
1975
322-12-7997
Sales or Exchanges of Property Used in Trade or Business, and Involuntary Conversions
(Section 1231)
SECTION A.-Involuntary Conversions Due to Casualty and Theft (See Instruction E)
1
a. Kind of property (if necessary,
attach additional descriptive
details not shown below)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
e. Depreciation al.
lowed (or allowable)
since acquisition
f. Cost or other basis,
cost of subsequent im-
provements (if not pur-
chased, attach explana.
tion) and expense of sale
g. Gain or (loss)
(d plus e less f)
2 Combine the amounts on line 1. Enter here, and on the appropriate line as follows
(a) For all except partnership returns:
(1) If line 2 is zero or a gain, enter such amount in column g, line 3.
(2) If line 2 is a loss, enter the loss on line 5.
(b) For partnership returns: Enter the amount shown on line 2 above, on Schedule K (Form 1065), line 6.
SECTION B.-Sales or Exchanges of Property Used in Trade or Business and Certain Involuntary Conversions (Not Reportable in Sec-
tion A) (See Instruction E)
3
LINE LL
3105
4 Combine the amounts on line 3. Enter here, and on the appropriate line as follows
(a) For all except partnership returns:
5105
(1) If line 4 is a gain, enter such gain as a long-term capital gain on Schedule D (Form 1040, 1120, etc.) that is being filed. See
instruction E.
(2) If line 4 is zero or a loss, enter such amount on line 6.
(b) For partnership returns: Enter the amount shown on line 4 above, on Schedule K (Form 1065), line 7.
Part II.
Ordinary Gains and Losses
a. Kind of property (if necessary,
attach additional descriptive
details not shown below)
b. Date acquired c. Date sold
(mo., day, yr.)
d. Gross sales
(mo.. day, yr.)
price
e. Depreciation al.
lowed (or allowable)
since acquisition
f. Cost or other basis,
cost of subsequent im-
provements (if not pur-
chased, attach explana-
tion) and expense of sale.
g. Gain or (loss)
(d plus a less f)
5 Amount, if any, from line 2(a)(2)
6 Amount, if any, from line 4(a)(2)
7 Gain, if any, from page 2, line 21
8
2313,
9 Combine amounts on lines 5 through 8. Enter here, and on the appropriate line as follows
(a) For all except individual returns: Enter the gain or (loss) shown on line 9, on the line provided for on the
return (Form 1120, etc.) being filed. See instruction F for specific line reference.
(b) For individual returns:
(1) If the gain or (loss) on line 9, includes losses which are to be treated as an itemized deduction on
Schedule A (Form 1040) (see instruction F), enter the total of such loss(es) here and include on
Schedule A (Form 1040), line 29-identify as "loss from Form 4797, line 9(b)(1)"
(2) Redetermine the gain or (loss) on line 9, excluding the loss (if any) entered on line 9(b)(1). Enter here
and on Form 1040, line 30
16-82504-1
2313.
2313.
Form 4797 (1975)
NW 88326 Docld:32245535 Page 36
Form 4797 (1975)
Part III
Gain From Disposition of Property Under Sections 1245, 1250, 1251,
1252-Assets Held More than Six Months (See Separate Instructions)
Disregard lines 18 and 19 if there are no dispositions of farm property or farmland, or if this form is filed by a partnership.
10 Description of sections 1245, 1250, 1251, and 1252 property:
(A)
(B)
(C)
(D)
Date acquired
(mo., day, yr.)
Page 2
Date sold
(mo., day, yr.)
WOODLEY BISTRO COFFEESHOP 2/1/74 9/2/25
(E)
Relate lines 10(A) through 10(E) to these
columns
Property
(A)
Property
(B)
Property
(C)
Property
(D)
Property
(E)
11 Gross sales price
12 Cost or other basis and expense of sale
13 Depreciation allowed (or allowable)
14 Adjusted basis, line 12 less line 13
15 Total gain, line 11 less line 14
16 If section 1245 property:
(a) Depreciation allowed (or allowable) after ap-
plicable date (see instructions)
(b) Enter smaller of line 15 or 16(a) .
17 If section 1250 property:
(a) Enter additional depreciation atter 12/31/63
and before 1/1/70
(b) Enter additional depreciation after 12/31/69
(c) Enter smaller of line 15 or 17(5)
(d) Line 17(c) times applicable percentage (see
instruction G.4)
.
(e) Enter any excess of line 15 over line 17(b)
(f) Enter smaller of line 17(a) or 17(e)
(g) Line 17(f) times applicable percentage. (see
instruction G.4)
(h) Add lines 17(d) and 17(g)
18 If section 1251 property:
(a) If farmland, enter soil, water, and land clear-
ing expenses for current year and the four
preceding years
.
(b) If farm property other than land, subtract line
16(b) from line 15; OR, if farmland, enter
smaller of line 15 or 18(a) (see instruction
G.5)
(c) Excess deductions account (see instruction
G.5)
(d) Enter smaller of line 18(b) or 18(c)
19 If section 1252 property:
(a) Enter soil, water, and land clearing expenses
made after 12/31/69
(b) Enter amount from line 18(d), if none enter a
zero
(c) Enter any excess of line 19(a) over line 19(b)
(d) line 19(c) times applicable percentage (see
instruction G.5)
(e) Line 15 less line 19(b).
(f) Enter smaller of line 19(d) or 19(e)
INSTALLMENT
SALE
Summary of Part III Gains (Complete Property columns (A) through (E) through line 19(f) before going to line 20)
20 Total gains for all properties (add columns (A) through (E), line 15)
21 Add columns (A) through (E), lines 16(b), 17(h), 18(d), and 19(f). Enter here and on line 7
22 Subtract line 21 from line 20. Enter here and in appropriate Section in Part I (see instructions E and G.2)
U.S. GOVERNMENT PRINTING OFFICE: 1975-0-575-158
7418
2313.
5105.
16-82504-1
NW 88326 Docld:32245535 Page 37
Form
4798
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
Capital Loss Carryover
(From 1974 to 1975)
Attach to Form 1040.
& PHYLLIS RUBY
A. Who Should File.-You will need to complete either
Part 1 or Part II of this form if you have a capital loss to
carry over to 1975.
You will have a capital loss to carry to 1975 if the
amount on your 1974 Schedule D (Form 1040), line
16(a), or line 33, is LARGER THAN the loss deducted
on your 1974 Form 1040, line 29.
1975
Social Security Number
322127997
B. How to Compute Carryover.-If you have a capital
loss carryover, complete either Part I or Part II of this
form, but do not complete both.
1. Complete only Part I if lines 4(a) and 12(a) on
your 1974 Schedule D (Form 1040) DO NOT SHOW A
LOSS.
2. Complete only Part II if either (or both) line 4(a) or
line 12(a) on your 1974 Schedule D (Form 1040) shows
a loss.
Part I
Post-1969 Capital Loss Carryovers
Section A,-Short-term Capital Loss Carryover
1 Enter loss shown on your 1974 Schedule D (Form 1040), line 5; if none, enter zero and ignore
lines 2 through 6-then go to line 7
1
2 Enter gain shown on your 1974 Schedule D (Form 1040), line 13. If that line is blank or shows
a loss, enter a zero
2
3 Reduce any loss on line 1 to the extent of any gain on line 2.
4 Enter amount shown on your 1974 Form 1040, line 29
5 Enter smaller of line 3 or 4 .
6 Excess of amount on line 3 over amount on line 5
3
4
5
6
Note: The amount on line 6 is your short-term capital loss carryover from 1974 to 1975 that is attributable to years beginning
after 1969. Enter this amount on your 1975 Schedule D (Form 1040), line 4(b).
Section B.-Long-term Capital Loss Carryover
7 Line 4 less line 5 (Note: If you ignored lines 2 through 6, enter amount from your 1974. Form
1040, line 29).
7
8 Enter loss from your 1974 Schedule D (Form 1040), line 13; if none, enter zero and ignore lines
9 through 12
8
9 Enter gain shown on your 1974 Schedule D (Form 1040), line 5. If that line is blank or shows
a loss, enter a zero
9
10 Reduce any loss on line 8 to the extent of any gain on line 9
11 Multiply amount on line 7 by 2
.
.
10
11
12 Excess of amount on line 10 over amount on line 11
12
Note: The amount on line 12 is your long-term capital loss carryover from 1974 to 1975 that is attributable to years beginning
after 1969. Enter this amount on your 1975 Schedule D (Form 1040), line 12(b).
NW 88326 Docld:32245535 Page 38
Form 4798 (1975)
Pre-1970 and Post-1969 Capital Loss Carryovers
Form 4798 (1975)
Part II
Section A.-Short-term Capital Losses Identified
1
མ ཀ
1 Enter loss shown on your 1974 Schedule D (Form 1040), line 5; if none, enter zero and ignore
lines 2 through 20-then go to line 21
2 Enter gain shown on your 1974 Schedule D (Form 1040), line 13. If that line is blank or shows
a loss enter a zero
•
3 Reduce loss on line 1 to the extent of any gain on line 2.
Note: If line 4(a) on your 1974 Schedule D (Form 1040) is blank, IGNORE lines 4 through 11, enter
a zero on line 12-then go to line 13.
4 Combine lines 3 and 11 on your 1974 Schedule D (Form 1040).
Enter the gain; or if zero or a loss, enter a zero.
Note: If line 4 is zero IGNORE lines 5 through 11, enter on line 12
the loss from your 1974 Schedule D (Form 1040), line 4(a)—
then go to line 13.
5 Enter any gain from your 1974 Schedule D (Form 1040), line 3.
6 Enter smaller of line 4 or 5
7 Enter excess of gain on line 4 over line 6.
8 Enter loss from your 1974 Schedule D (Form 1040), line 12(a);
otherwise, enter a zero.
9 Reduce any gain on line 7 to the extent of any loss on line 8.
10 Enter loss from your 1974 Schedule D (Form 1040), line 4(a); other-
wise enter a zero
11 Add the gains on lines 6 and 9
"
4
56789
-
-
322
(13322)
222
Page
(2741)
0
27977
10
11
12 Reduce the loss on line 10 to the extent of any gain on line 11.
13 Pre-1970 short-term capital loss (Enter smaller of line 3 or 12)
14 Short-term capital loss attributable to years beginning after 1969 (excess of line 3 over line 13)
Section B.-Computation of Capital Loss Carryovers to 1975
12
13
14
741)
15
15 Enter any loss from line 13, above.
16 Enter loss deducted on your 1974 Form 1040, line 29.
16
1000
17 Loss carryover to 1975 (excess of line 15 over line 16-if line 15 does not exceed line 16, enter
zero). Enter here and on your 1975 Schedule D (Form 1040), line 4(a).
18
18 Enter any loss from line 14, above.
1(2341)
19 Enter excess of line 16 over line 15-if line 16 does not exceed line
19
1000
15, enter zero
.
17
1000
20 Loss carryover to 1975 (excess of line 18 over line 19-if line 18 does not exceed line 19, enter
zero). Enter here and on your 1975 Schedule D (Form 1040), line 4(b).
21 If you were required to complete Part IV of your 1974 Schedule D
(Form 1040), enter any loss from your 1974 Schedule D (Form
1040), line 30; otherwise, enter zero
.
21
20
(1741).
22 Enter excess of line 19 over line 18-if line 19 does not exceed line
18, enter zero. (Note: If you ignored lines 2 through 20 above, enter
amount from your 1974 Form 1040, line 29.)
22
23 Loss carryover to 1975 (excess of line 21 over line 22-if line 21 does not exceed line 22, enter
zero). Enter here and on 1975 Schedule D (Form 1040), line 12(a)
24 If you were required to complete Part IV of your 1974 Schedule D
(Form 1040), enter any loss from your 1974 Schedule D (Form
1040), line 31. However, if Part IV was not required, enter any loss
from your 1974 Schedule D (Form 1040), line 13
24
"/ (13322)
23
:: ::
(5839)
25 Enter excess of line 22 over line 21
does not exceed line 21, enter zero.).
x 2 (if line 22
25
26 Loss carryover to 1975 (excess of line 24 over line 25-if line 24 does not exceed line 25, enter
zero). Enter here and on your 1975 Schedule D (Form 1040), line 12(b) .
26
(5839)
NW
NW 88326 Docld:32245535 Page 39
NAME.
⚫ ADDRESS
SAMUEL & PHYLLIS RUBY
MEDICAL
2 MEDICINE/DRUGS
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5 H & A INS. (½ + EXCESS)
6a DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
322-12-7997.
STATE
CALENDAR YEAR 19
25
SOC. SEC. NO.
DEDUCTION SCHEDULE
FEDERAL
682
877
CONTRIBUTIONS
21a CASH CONTRIBUTIONS
21b PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
MISC. ORGANIZED CHARITIES
CHURCHES
STATE
FEDERAL
150
22 OTHER THAN CASH
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
6C AMBULANCE
LABORATORIES
TRAVEL FOR MED.
1000
70
MEDICARE INS.
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
8 LESS 3% ADJ. GROSS INC.
9
I+: (TO $150) OF H & A INS.
10 TOTAL MEDICAL DED.
TAXES
11 STATE & LOCAL INCOME
12 REAL ESTATE
13 STATE & LOCAL GASOLINE
14 GENERAL SALES TAX
15a PERSONAL PROPERTY
15b PERSONAL PROPERTY AUTO
16 SALES TAX AUTO
-
1629
1629
230
1359
258
1371
11559
150
1521
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT (LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
26 INSURANCE REIMBURSEMENT
27
28 ($100 LIMITATION PER CAS.)
29 TOT. CAS, OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 CHILD & DEP. CARE (Form 2441)
33 INCOME TAX PREPARATION.
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
AUTO USE/DAMAGE
INVEST. COUNSEL & PUBS.(Sched
EMPLOYMENT AGENCY FEES
932
SAFE DEPOSIT BOX
48
205
TEL. REQ. IN BUSINESS
POLITICAL CONTRIBUTIONS
22
34 TOTAL MISC. DED.
SUMMARY OF ITEMIZED DED.
17 TOTAL TAXES
1207
INTEREST (TO WHOM PAID)
18 MORTGAGE
207
2514
35 TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
36 TOTAL TAXES (From LINE 17)
37 TOTAL INTEREST (Line 20)
19 installment LOANS MISC
TRANSWORED
SBA
FEDCG
50.
38 TOTAL CONTR. (Line 24)
39 CAS. & THEFT LOSS(ES) (Line29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM LINE 34)
186
100
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON FORM 1040 LINE 45
REMARKS
20 TOTAL INTEREST
PSI
Professional Stationers, Inc.
7340 Laurel Canyon Boulevard
North Hollywood, California 91605
2857
Form 101
NW 88326 Docld:32245535 Page 40.
2857
150
750
STATE
FEDERAL
5723
5735.
SCHEDULE

EL & PHYLLIS, RUBY
MANIC SAMUELd
ADDRESS
322-12-7997
OR
SOC. SEC. NO.
SCHEDULE OF PROFIT
OR LOSS FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT
BEGINNING OF
YEAR
MERCHANDISE PURCHASED
TOTAL
LESS INVENTORY AT END OF YEAR
GROSS PROFIT
GROSS INCOME
ADVERTISING
AUTO AND
TRUCK EXPENSE
BAD DEBTS
COMMISSIONS
DELIVERY
DEPRECIATION 1 SCHEDULE BELOW )
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTEREST
JANITOR AND HAULING
LEGAL AND ACCOUNTING
OFFICE SUPPLIES AND EXPENSE
RENT
REPAIRS AND MAINTENANCE
SALARIES AND WAGES
SUPPLIES
TAXES AND LICENSES
TAXES PAYROLL
TELEPHONE AND UTILITIES
CONTRACT LABOR
NET PROFIT OR (LOSS
NET PROFIT OR (LOSS
FEDERAL
RETURN
STATE RETURN
NO.
KIND AND LOCATION OF PROPERTY
EQUIPMENT
GOOD WILL
PROFESSIONAL STATIONERS
INC
FORM
104A
LOS ANGELES, CALIF.
NW 88326 Docld:32245535 Page 41
925
CALENDAR YEAR 19.
FISCAL YEAR ENDING
EMPLOYERS NO.
9.
48924
800
24031.
24831
24831
24093
24093
OTHER BUSINESS DEDUCTIONS
99
1800
974
126
285
1107
150
4151
625
5632
240
575
168
158
444
16534
7559
SEE DEPREC. SCHEDULE FOR DIFF.
SCHEDULE OF DEPRECIATION
DATE
ACQUIRED
(+)5159(W) LYAD
YEARS
METH. OR %
COST OR
OTHER BASIS
PRIOR
DEPREC.
DEPRECIATION
THIS YEAR
2/1/24 SL 2YR 10228
2/1/24
35000
1339
SCHEDULE
974
%.
Киву.
IT SAMUEL & PHYLLIS RO
NAME
.D. or
SOC. SEC. NO.
Calendar Yr:
F/Y/E
19
2
19
DESCRIPTION OF PROPERTY
DATE ACQUIRED
GAINS ON INSTALLMENT SALES
COFFEE SHOP
2/1/74
DATE SOLD 9/2/75
TYPE OF ASSET:
1. SELLING PRICE: CASH
2.
3.
4.
5.
NOTES
MORTGAGE TRANSFERRED
OTHER
GROSS SALES PRICE (1+2+3+4)
6. COST OR BASIS
7. LESS ACCUMULATED DEPRECIATION
PRIOR TO 1-1--62
8.
9.
PRIOR TO 1-1-64
10.
AFTER 12-31-61
11.
ST. LINE AFTER 12-31-63
12.
EXCESS OVER S/L 1–64/12-69
13.
EXCESS OVER S/L AFTER 12-31-69
14. ADJUSTED BASIS (6-7 THRU 13)
15. EXPENSES OF SALE
16. TOTAL ADJUSTED BASIS (14 +15)
17. TOTAL GROSS PROFIT (5
18. TOTAL GROSS PROFIT
19. TOTAL GROSS PROFIT
-
16)
ORDINARY
OTHER
20. CONTRACT PRICE (1 + 2 + 4)
21. GROSS PROFIT %
22. PAYMENTS RECEIVED YEAR OF SALE
23.
24..
25.
26.
CASH (1)
PRINCIPAL COLLECTIONS
EXCESS MORTGAGE OVER BASIS
OTHER (4)
27. TOTAL PAYMENTS (23 THRU 26)
28. RECOGNIZED GAIN
29. RECOGNIZED GAIN
_
ORDINARY
30. RECOGNIZED GAIN - OTHER
TAX-
ABLE
YR.
1975
TOTAL
PAYMENTS
LESS INT.
(TO PT. 2.
SEC. 3)
SECTION 1245
REPORTED
NONE 7418
15416.
NW 88326 Docld:32245535 Page 42
ASIONAL STATIONERS
* ANGELES
CALLE
$
CAPITAL
SEC. 1245
SEC. 1250
$ 20148 $
48152
68300
$
$45228
2313
42915
238
43153
$
$2313
$
$22834 $
$
%
$68300 $
36.82%
%
20148
20148.
2313
5105
ORDINARY INCOME
SECTION 1250
CAPITAL GAIN
BALANCE
REPORTED
BALANCE
REPORTED
BALANCE
FORM OF
SCHEDULE
RESIDENT
540
INDIVIDUAL
CALIFORNIA
INCOME TAX
PLACE PREADDRESSED LABEL HERE, if available. (Correct name and address, if necessary).
Enter social security number(s) only if incorrect or not shown on label.
NAME (If joint return, give first names and initials of both) LAST NAME
SAMUEL
" & PHYLLIS
RUBY
PRESENT HOME ADDRESS (Number and Street, including apartment number, of rural route)
16250
BIRCHERT
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
GRANADA
FILING STATUS Check Only One:
1 ☐ Single
✓ ✓ Married filing joint return (even if only one had income)
3 ☐ Separate return of married person-Enter spouse's
social security number and full name here
4 Head of Household--Enter name of qualifying
individual _
Check ☑Calendar Year
One:
CA
EXEMPTION CREDITS
If line 1 or 3 checked, enter $25
6 Personal
7 Dependents
TAXABLE YEAR
1975
☐ Fiscal Year Ending-
1976
FOR FEDERAL PRIVACY ACT NOTIFI-
CATION SEE PAGE 2 OF INSTRUCTIONS
Your Social Security Number
32212 7997
Spouse's Social Security Number
349
OCCU-
PATION
Yours J/E
Spouse's E
18, 1920
If line 2, 4 or 5 checked, enter $50
Do not list yourself, your spouse or the person who qualifies you
as head of household. Enter name and relationship.
ELISA
THOMAS
60.00
Total Number
× $8.7 16.00
8
5 Widow(er) with dependent child (Year spouse died 197.
☐ 9
11
◄ ATTACH COPY 2 OF FORM W-2 HERE ►
17
10 Wages, salaries, tips and other employee compensation return. If unavailable, see instructions, Page 6.
Dividends-before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540) )
12 Interest. Enter total (if over $400, complete and attach Schedule B(540)):
13 Income other than wages, dividends and interest (from line 48)
14 Total (add lines 10, 11, 12 and 13)
15 Adjustments to income (from line 55)
16 Adjusted gross income (subtract line 15 from line 14)
Do not complete
lines 17 thru. 22
If line 1 or 3 is checked and line 16 is $4,000 or less, enter zero tax on line 23.
If line 2, 4, or 5 is checked and fine 16 is $8,000 or less, enter zero tax on line 23.
If you do NOT itemize deductions AND line 16 is under $15,000, find tax in Tax Table and enter on line 19.
If you itemize deductions OR line 16 is $15,000 or more, complete lines 17 and 18.
Deductions: Itemized (from line 62) OR STANDARD ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
18 Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
Blind (refer to instructions) Number of blind exemptions ►
Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20
Attach copy 2 of Form(s) W-2 to face of this
× $8
8
00
9 6600
10
11
12
12
95
13
8822
14
8984
15
16
8984
17
5735
18 3249
Write social security number on check or money order. ATTACH HERE
ATTACH FORM DE 1964 HERE
Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
22 Other credits (from line 65)
23 Net tax liability (subtract line 22 from line 21-if line 22 is greater than line 21, enter zero)
24 Tax on preference income (see instructions-attach Schedule P(540))
25 Total tax liability (add lines 23 and 24)
26 Total California income tax withheld (attach W-2 or W-2P to face of this return)
▼ 19
20
Tax from (check one) Tax Table ☐ Tax Rate Schedule ☐☐
Total exemption credits (from line 9, above)
Income Averaging Schedule (G or G-1) ☐
21
23
24
25
26
27 Renter's credit-if you lived in rented property on March 1, 1975, complete Part 1 on page 2
28 1975 California estimated tax payments
27
28
29 Excess California SDI tax withheld (attach Form DE 1964 to face of this return)
30 Total prepayment credits (add lines 26 thru 29)
29
30
30
31
If line 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero.
Pay in full and mail with return to: FRANCHISE TAX BOARD
SACRAMENTO, CA 95867
2222222
19
3.2.....
20
66
21
32 If line 25 is smaller than line 30, enter amount OVERPAID
Amount of line 32 to be REFUNDED TO YOU. Allow at least six weeks.
Mail return to:
33
FRANCHISE TAX BOARD
P.O. BOX 13-540
SACRAMENTO, CA 95813
34 Amount of line 32 to be credited on your 1976 ESTIMATED TAX
34
PAY IN FULL
31
Do not write in these spaces
32
P
33
E
M
A
ESTIMATED TAX R
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than 
taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN
Your signature
HERE
NW 88326 Docld:32245535 Page
Spouse's signature if filing a joint return
43°
Date
Preparer's signature (other than taxpayer)
Date
867-34-8729
Date
Address (and Zip code)
Page 2 Form 540 (1975)
PART 1 Renter's Credit - All questions must be answered
35 Did you, on March 1, 1975, live in rented property which was your principal residence?
36 Was the property you rented exempt from property tax?
37 Did you live with any other person who claimed you as a dependent for income tax purposes?
38 Did you or your spouse claim the homeowners' property tax exemption or receive public assistance?
PART II - Other Income
39 Business income (or loss) (attach Schedule C(540))
☐ ☐ ☐
☐ Yes
☐ Yes
☐ Yes
No
Yes ☐ No
☐ No
☐ No
If no, you may not claim this credit
If yes, you may not claim this credit
If yes, you may not claim this credit
If yes, see page 6 of instructions
39
40
7559
(1000)
44 Partnerships
40 Net gain (or loss) from sale or exchange of capital assets (attach Schedule D(540))
41 Net gain (or loss) from supplemental schedule of gains and losses (attach Schedule D-1(540))
42 Pensions and annuities
43 Rents and royalties
ATTACH
SCHEDULE E
FORM (540)
41 23/3
45 Estates and trusts
42
43
44
.45
46
46
Farm income (or loss) (attach Schedule F(540) )
47
Miscellaneous income
(a) Fully taxable pensions and annuities (not reported on Schedule E(540))
47a
47b
(b) Alimony
47c
47
48 8872
(c) Other (state nature and source)..
Enter total of lines 47(a), 47(b), and 47(c)
48 Total (add lines 39 thru 47). Enter here and on line 13
PART III-Adjustments to Income
49 "Sick pay," if included in line 10 (see instructions - attach statement)
50 Moving expenses (see instructions - attach statement)
51 Employee business expenses (see instructions - attach statement)
52 Military exclusion (see instructions) .
53 Payment as a self-employed person to a retirement plan, etc. (see instructions)
54 Forfeited interest penalty (see instructions)
55 Total adjustments (add lines 49 thru 54). Enter here and on line 15
PART IV - itemized Deductions
Attach Schedule A(540) and enter sub-totals on lines 56 thru 61, below
56 Total deductible medical and dental expenses (from Schedule A(540), line 10)
57 Total child adoption expenses (from Schedule A(540), line 13)
58 Total taxes (from Schedule A(540), line 20)
59 Total interest expense (from Schedule A(540), line 23)
60 Total contributions (from Schedule A(540), line 28)
61 Total miscellaneous deductions (from Schedule A(540), line 39)
62 Total itemized deductions (add lines 56 thru 61). Enter here and on line 17
PART V
=
- Other Credits - SEE INSTRUCTIONS FOR EACH CREDIT CLAIMED BELOW.
49
50
51
52
53
54
55
56
58
59
61
2 ཤྩ གླགན
150.
57
1203
60 150
62 5735
857
63 "Other State" net income tax credit (attach copy of other state return and Schedule S(540))
64 Retirement income credit (attach Schedule R(540)) .
65 TOTAL (add lines 63 and 64). Enter here and on line 22
PART VI - Reconciliation to Federal Return
OO
63
64
65
If adjusted gross income on Federal Return is different from line 16, page 1, explain below.
NW 88326 Docld:32245535 Page 44
DiVEX
17
TRA 375.
SCHEDULE
A
FORM 540
Name as shown on Form 540
SAMUEL
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
& PHYLLIS RUBY
TAXABLE.
1975
YEAR
Social Security Number
322-12-7992
If your adjusted gross income is $8,000 or less and your filing status is "Married, Filing Jointly," "Head of Household," or "Widow(er) With Dependent Child,"
or $4,000 or less and your filing status is "Single," or "Married, Filing Separately," do not itemize, enter zero on Form 540, line 23, and check the tax
table box.
USE ONLY IF YOU DO NOT USE THE TAX TABLE OR TAKE THE STANDARD DEDUCTION
Medical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses,
hospital care, insurance premiums for medical
care, etc.
1. One half (but not more than $150) of insurance
premiums for medical care.
2. Medicine and drugs.
3. Enter 1% of line 16, Form 540.
4. Subtract line 3 from line 2. Enter difference (if less
than zero, enter zero)..
5. Enter balance of insurance premiums for medical care
not entered on line 1.
6. Other medical and dental expenses:
(a) Doctors, dentists, nurses, etc..
(b) Hospitals
(c) Other (itemize).
Interest Expense
21. Home mortgage.
22. Other (itemize).
SCH
23. Total-(Add lines .21 and 22. Enter here and on
Form 540, line 59).
Contributions
24. Cash contributions for which you have receipts,
canceled checks, etc...
25. Other cash contributions. List donees and amounts
2857
A
7. Total (Add lines 4, 5, 6a, b, and c).
8. Enter 3% of line 16, Form 540.
9. Subtract line 8 from line 7. Enter difference (if less
than zero, enter zero)..
10. Total-(Add lines 1 and 9. Enter here and, on Form
540, line 56)..
Child Adoption Expense
11. Total expenses paid or incurred Attach itemized list
12. Enter 3% of line 16, Form 540..
13. Subtract line 12 from line 11-See instructions for
maximum limitations. (Enter here and on Form 540,
line 57).
Taxes
14. Real estate. .
15. State and local gasoline.
16. General Sales.
17. Auto license-Excess of registration and weight fees
(see instructions)..
18. Personal property (Boat and Aircraft).
19. Other (itemize)..
SCH
20. Total taxes-(Add lines 14 thru 19. Enter here and
on Form 540, line 58).
NW 88326 Docld:32245535 Page 45
1509
1207
SCH
26. Other than cash.-See instructions for required state-
ment
27. Carryover from 1974 See instructions..
28. Total (Add lines 24, 25, 26, and 27. Maximum de-
duction may not exceed 20% of adjusted gross
income. Enter here and on Form 540, line 60).
Miscellaneous Deductions
Casualty or Theft Loss(es)-See instructions
NOTE: If you had more than one loss, omit lines 29
through 33 and follow instructions for guidance.
29. Loss before insurance reimbursement:
30. Insurance reimbursement.
31. Subtract line 30 from line 29. Enter difference (if line
30 is greater than line 29, enter zero).
32. Enter $100 or amount on line 31, whichever is smaller
33. Casualty or theft loss (line 31 less line 32).
34. Alimony paid...
35. Child care-See instructions.
36. Union dues.
37. Employment education expense-See instructions
38. Other (itemize)
39. Total Add lines 33, 34, 35, 36, 37, and 38. (Enter
here and on Form 540, line 61).
150
SCHEDULE
C
FORM 540
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
Attach this schedule to your Income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
SAMUEL & PHYLLIS RuBy
A. Name and Address of Business
WOODLEY BISTRO COFFEE SHOP
TAXABLE
1925
YEAR
Partnerships, joint ventures, etc., must file on Form 565
SERVI
Social Security Number
322-12-7997
B. Federal Employer I.D. No.
95-2651578
C. Principal business activity (i.e., retail-hardware; wholesale-tobacco; services-legal; etc.). SERVICE SNACKBAR
D. Indicate method of accounting:
☐ cash;
✓ accrual; ☐ other
E. Were Forms 591, 592, 596 and 599, for the calendar year-filed (if required)? ✓ YES ☐ NO
F. Method of inventory valuation ►
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES ☐ NO If "Yes," attach explanation.
1 Gross receipts, sales, or fees $.
2 Inventory at beginning of year (if different from last year's closing inventory, attach explanation).
3 Purchases $
Less returns and allowances $.
.Less cost of items withdrawn for personal use $
4 Cost of labor (do not include salary paid to yourself).
5 Materials and supplies.
6 Other costs (explain in Schedule C-2 or attach Schedule).
Balance ►
C
7
Total of lines 2 thru 6.
8 Inventory at end of this year.
9 Cost of goods sold (subtract line 8 from line 7).
10 Gross profit (subtract line 9 from line 1)..
11 Other income (attach schedule).
12
Total Income (add lines 10 and 11).
OTHER BUSINESS DEDUCTIONS
13 Depreciation (explain in Schedule C-1 or attach Schedule)..
14 Taxes on business and business property (explain in Schedule C-2 or attach Schedule).
15 Rent on business property.
16 Repairs (explain in Schedule C-2 or attach Schedule).
17 Salaries and wages not included on line 4 (exclude any paid to yourself).
18 Insurance
19 Legal and professional fees.
20 Commissions
21 Amortization (attach statement).
22 Retirement plans, etc. (other than your share, see instructions).
23 Interest on business indebtedness..
24 Bad debts arising from sales or services (Not applicable if reporting on cash basis).
25 Depletion (attach schedule).
26 Other business expenses (explain in Schedule C-2 or attach Schedule).
27 Total of lines 13 thru 26.
28
Net profit (or loss) (subtract line 27 from line 12), Enter here and on Page 2, Form 540 or 540NR
Group and guideline class
or description of property
Date
Acquired
Cost or
other basis
Schedule C-2
Explanation of Lines
6, 14, 16, and 26.
Schedule C-1
Depreciation
Claimed on line 13.
SCH
Depreciation
allowed (or allowable)
in prior years
Method of
computing
depreciation
Life or
Rate
7559
Depreciation
for this year
LINE
NO.
EXPLANATION
LINE
AMOUNT
NO.
EXPLANATION
AMOUNT
NW 88326 Docid:32245535 Page 46
SCHEDULE
D
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR
SAMUEL
NE PHYLLIS RUBY
PART I-Assets Held One Year or Less
1.
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
1974 LOSS CARRYOVER
(20,360)
USED 1974.1000.
b. Date acquired
c. Date sold
d. Gross sales
(mo., day, yr.)
(mo., day, yr.)
price
2. Enter gain (or loss), if applicable, from line 18, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART II-Assets Held More Than One Year But Not More Than Five Years
5.
TAXABLE
1975
YEAR
Social Security Number
322127997
e. Cost or other basis as
adjusted, cost of subse-
quent improvements (if
not purchased, attach
explanation) and
pense of sale.
ex-
f.. Gain or loss
(d. less e.)
D
6. Enter gain (or loss), if applicable, from line 20, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7
PART III-Assets Held More Than Five Years
9.
5105
5105.
10. Enter gain (or loss), if applicable, from line 22, Schedule D-1 (540) (attach copy)
11. Enter your share of net gain or loss from partnerships and fiduciaries
12. Net gain or loss, combine lines 9, 10 and 11
PART IV-Summary of Capital Gains and Losses
13. Enter amount from line 4
14. Enter 65% of the amount on line 8
15. Enter 50% of the amount on line 12
16. Enter unused capital loss carryover from preceding taxable years (attach compulation)
17. Combine the amounts shown on lines 13, 14, 15 and 16
i
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
3318
(19360) (16042)
19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on lines 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
NW 88326) M32835
of a husband or wife filing a separate return)
TES
(1000)
SCHEDULE
D-1
FORM 540
Name as shown on Tax Return
SAMUEL
CALIFORNIA
SUPPLEMENTAL SCHEDULE OF GAINS AND LOSSES
(Sales or Exchanges Including Involuntary Conversions)
(Attach to Form 540, 540NR, 541 or 565)
ePHYLLIS RUBY
TAXABLE
1925
YEAR
Identifying number as shown on return'
32-2-12-7887
PART 1 Gain From Disposition of Property Under Sections 18211, 18212-18, 18219, 18220
D-1*
Lines 9 and 10 should be omitted if there are no dispositions of farm property or farm land; or, if this form is filed by a partnership.
1. Description of Sections 18211, 18212-18, 18219, and 18220 property.
WOODLEY BISTRO
COFFEE SHOP
Date acquired
(mo., day, yr.)
Date sold
(mo., day, yr.)
2/1/749/2/75
(A)
(B)
(C)
(D)
Correlate lines 1(A) through 1(D) with these columns
Property
(A)
Property
(B)
Property
(C)
Property
(D)
2. Gross sales price
3. Cost or other basis and expense of sale
4. Depreciation allowed (or allowable)
5. Adjusted basis, line 3 less line 4
6. Total gain, subtract line 5 from line 2
7. If Section 18211 property:
(a) Depreciation allowed (or allowable) after applicable date.
(See Instruction D-3)
(b) Line 6 or line 7(a), whichever is smaller
8. If Section 18212-18 property:
(a) Enter additional depreciation after 12-31-63 and before
1-1-71
(b) Enter additional depreciation after 12-31-70
(c) Enter line 6 or line 8(b), whichever is smaller
(d) Line 8(c) times applicable percentage (Instruction D-4) .
(e) Enter excess, if any, of line 6 over line 8(b)
(f) Enter line 8(a) or line 8(e), whichever is smaller
(g) Line 8(f) times applicable percentage (Instruction D-4)
(h) Add line 8(d) and line 8(g)
9. If Section 18220 property:
(a) If farm land, enter soil and water conservation expenses
for current year and four preceding years
..
(b) If farm property, other than land, subtract line 7(b) from
line 6; OR, if farm land, enter line 6 or line 9(a), which-
ever is smaller (see Instruction D-5)
•
(c) Excess deductions account (see Instruction D-5)
(d) Enter line 9(b) or line 9(c), whichever is smaller
10. If Section 18219 property:
(a) Soil and water conservation expenses made after 12-31-69
(b) Enter amount from line 9(d), if any; otherwise, enter a zero
(c) Enter excess; if any, of line 10(a) over 10(b)
(d) Line 10(c) times applicable percentage (Instruction D-5)
(e) Line 6 less line 10(b)
(f) Enter smaller of line 10(d) or line 10(e)
INSTALLMENT
SALE
SUMMARY OF PART I (Complete Property Columns (A) through (D) up to Line 10(f) before going to Line 11)
11. Enter amounts from line 6
12. Enter amounts from lines 7(b), 8(h), 9(d) and 10(f)
13. Subtract line 12 from line 11, enter here and in appropriate
Section in Part II (see Instruction D-2)
7418.
2313.
5105
14. Total of Property Columns (A) through (D), line 12. Enter here and on line 24, Part III
2313.
NW883267.Docld:32245535 Page 48
Schedule D-1(540)
PART II
Sales or Exchanges of Property Used in Trade or Business and/or Involuntary Conversions
(Section 18181-82) see Instruction E
Section A- INVOLUNTARY CONVERSIONS DUE TO CASUALTY AND THEFT
a. Kind of property (if necessary,
attach statement of descriptive
details not shown below)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
e. Depreciation allowed
(or allowable)
since acquisition
f. Cost or other basis, cost of
subsequent improvements
(if not purchased,
attach explanation) and
expense of sale
Page 2
g. Gain (or foss)
(d. plus e. less f.)
15.
16. Combine the amounts on line 15, enter here and also on the appropriate line as follows
(a) For all returns, except partnership returns: (1) If line 16 is zero or a gain, enter amount of each gain or loss, above, in
column (g) of applicable Section B-1, B-2 or B-3; (2) If line 16 is a loss, enter such amount on line 25 of Part III.
(b) For partnership returns: Enter gain(s) and loss(es) in Schedule K (Form 565). See Instruction E.
Section B SALES OR EXCHANGES OF PROPERTY USED
(Not Reportable in Section A)
-
IN TRADE OR BUSINESS AND CERTAIN INVOLUNTARY CONVERSIONS
17.
Section B-1
Property Held One Year or Less
18. Combine the amounts on line 17, enter here
Section B-2 Property Held More Than One Year But Not More Than Five Years
19.
LIN
20. Combine the amounts on line 19, enter here
21.
Section B-3
Property Held More Than Five Years
22. Combine the amounts on line 21, enter here
ގގ .
23. Combine the amounts on lines 18, 20 and 22; enter here and also on the appropriate line as follows
(a) For all returns, except partnership returns: (1) If line 23 is a gain, enter the amounts from lines 18, 20 and 22, on lineś 2, 6
and 10, respectively, of the Schedule D (Form 540), or if filing Form 541, enter amounts from lines 18, 20 and 22, on lines.
2, 7 and 11, respectively, of the Schedule D (Form 541). (2) If line 23 is a loss, enter such amount on line 26 of Part III.
(b) For partnership returns: Enter amounts on lines 18, 20 and 22, in Schedule K(565)-see Instruction E.
PART III
Ordinary Gains and Losses
a. Kind of property and how
acquired (if necessary,
attach statement of descriptive
details not shown below)
24. Gain, if any, from line 14
25. Loss, if any, from line 16
26. Loss, if any, from line 23
27.
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
e. Depreciation allowed
(or allowable)
since acquisition
f. Cost or other basis, cost of
subsequent improvements
and expense of sale
g. Gain (or loss)
(d. plus e. less f.)
2313
28. Combine lines 24 through 27, enter here and also on the appropriate line as follows
(a) For fiduciary and partnership returns: Enter the gain (or loss) shown on line 28 on the line provided for on the
return being filed-see Instruction F for specific line reference.
(b) For individual returns:
(1) If the gain (or loss) on line 28 includes losses which are to be treated as an itemized deduction on
Schedule A (Form 540 or 540NR) (see Instruction F), enter the total of such loss(es) here and on
Schedule A (Form 540 or 540NR)-Identify as loss from line 28(b)(1), Schedule D-1. (Form 540)
(2) Redetermine the gain (or loss) on line 28, excluding the loss (if any) entered on line 28(b)(1). Enter here
and on page 2 of Form 540 or Form 540NR, under "Other Income"
NW 88326-Docld:32245535 Page 49-
2-3/3
2313
1975
STATE
FEDERAL
Ruby
NAME SAMUEL & PHYLLIS RUBY
"ADDRESS
2 MEDICINE/DRUGS
MEDICAL
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5 H & A INS. (½ + EXCESS)
6a DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
322-12-7997
STATE
CALENDAR YEAR
SOC. SEC. NO.
DEDUCTION SCHEDULE
FEDERAL
682
877
CONTRIBUTIONS
121a CASH CONTRIBUTIONS
21b PARTNERSHIP SHARE
'GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
MISC. ORGANIZED CHARITIES
CHURCHES
22 OTHER THAN CASH
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
6C AMBULANCE
LABORATORIES
TRAVEL FOR MED.
1000
70
MEDICARE INS.
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
1629
1629
8 LESS 3% ADJ. GROSS INC.
9
270
1359
258
1371
I+ (TO $150) OF H & A INS.
10 TOTAL MEDICAL DED.
TAXES
11 STATE & LOCAL INCOME
12 REAL ESTATE
13 STATE & LOCAL GASOLINE
159
150.
1509
1521
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT (LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
26 INSURANCE REIMBURSEMENT
27
28 ($100 LIMITATION PER CAS.)
29 TOT. CAS. OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 CHILD & DEP. CARE (Form 2441)
33 INCOME TAX PREPARATION
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
AUTO USE/DAMAGE
INVEST.COUNSEL & PUBS. (Sched
EMPLOYMENT AGENCY FEES
932
SAFE DEPOSIT BOX
48
TEL. REQ. IN BUSINESS
14 GENERAL SALES TAX
205
POLITICAL CONTRIBUTIONS
15a PERSONAL PROPERTY
15b PERSONAL PROPERTY AUTO
22
16 SALES TAX AUTO
34 TOTAL MISC. DED.
7
100
SUMMARY OF ITEMIZED DED.
35 TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
36 TOTAL TAXES (From LINE 17)
37 TOTAL INTEREST (Line 20)
38 TOTAL CONTR. (Line 24)
39 CAS. & THEFT LOSS(ES) (Line29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM LINE 34)
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON FORM 
1040 LINE 
45
REMARKS
17 TOTAL TAXES
» 1207
207
INTEREST (TO WHOM PAID)
18 MORTGAGE
2514
19 INSTALLMENT LOANS MISC
- TRANSWORD
SBA
FEDCO
189
20 TOTAL INTEREST
PSI
Professional Stationers, Inc.
7140 Laurel Guyon Boulevard
North Hollywood, California 91605
2857 2857
Form 101
NW 88326 Docld:32245535 Page 50
150
150
150
STATE
FEDERAL
5723
5735
SCHEDULE

NAME
•
ADDRESS
RuBy
SAMUEL & PHYLLIS, RAM. I
322-12-7997
OR
SOC. SEC. NO.
SCHEDULE OF PROFIT
OR LOSS FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
TOTAL
LESS INVENTORY AT END OF YEAR
GROSS PROFIT
GROSS
INCOME
ADVERTISING
AUTO AND TRUCK EXPENSE
BAD DEBTS
COMMISSIONS
DELIVERY
DEPRECIATION ( SCHEDULE BELOW)
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE,
INTEREST
JANITOR AND HAULING
LEGAL AND ACCOUNTING
OFFICE SUPPLIES AND EXPENSE
RENT
REPAIRS AND
MAINTENANCE
SALARIES AND WAGES
SUPPLIES
TAXES AND LICENSES
TAXES PAYROLL
TELEPHONE AND UTILITIES
LINEN
ст
CONTRACT LABOR
1925
CALENDAR YEAR 19.
FISCAL YEAR ENDING
EMPLOYERS NO.
19
48929
800
24031.
24831
24831
24093
2Y093
OTHER BUSINESS DEDUCTIONS
99
1800
974
26
285
1107
150
4151
625
5632
240
575
168
158.
444
16534
7559
NET PROFIT OR
NET
(LOSS ) FEDERAL
PROFIT OR (LOSS ) STATE
RETURN
SEE DEPREC. SCHEDULE FOR DIFF.
RETURN.
NO.
KIND AND LOCATION OF PROPERTY
EQUIPMENT
GOOD WI
SCHEDULE OF DEPRECIATION
DATE
ACQUIRED
(H)5159 (W) LYAD
YEARS COST OR
METH. OR % OTHER BASIS
2/1/24 SL 7YR 10228
2/1/74
35000
PRIOR
DEPREC.
1339
DEPRECIATION
THIS YEAR
974
PROFESSIONAL STATIONERS
LOS ANGELES, CALIF.
INC FORM 10MA
NW 88326 Docld:32245535 Page 51
SCHEDULE
1
NAME
SAMUEL & PHYLA RUBY
DESCRIPTION OF PROPERTY
DATE ACQUIRED
.D. or
SEC. NO.
GAINS ON INSTALLMENT SALES.
COFFEE SHOP
2/1/74
Calendar Yr.
F/Y/E
19 25
19
-
DATE SOLD 9/2/75
TYPE OF ASSET:
1. SELLING PRICE: CASH
2.
3.
4.
5.
NOTES
MORTGAGE TRANSFERRED
OTHER
GROSS SALES PRICE (1+2+3+4)
6. COST OR BASIS
7. LESS ACCUMULATED DEPRECIATION
PRIOR TO 1-1-62
8.
9.
PRIOR TO 1-1-64
10.
AFTER 12-31-61
11.
12.
13.
ST. LINE AFTER 12-31-63
EXCESS OVER S/L 1-64/12-69
EXCESS OVER S/L AFTER 12-31-69
14. ADJUSTED BASIS (6-7 THRU 13)
15. EXPENSES OF SALE
16. TOTAL ADJUSTED BASIS (14 +15)
17. TOTAL GROSS PROFIT (5 16)
18. TOTAL GROSS PROFIT
19. TOTAL GROSS PROFIT
-
ORDINARY
_
OTHER
20. CONTRACT PRICE (1 + 2 + 4)
21. GROSS PROFIT %
22. PAYMENTS RECEIVED YEAR OF SALE
23.
24.
25.
26.
CASH (1)
PRINCIPAL COLLECTIONS
EXCESS MORTGAGE OVER BASIS
OTHER
(4)
27. TOTAL PAYMENTS (23 THRU 26)
28. RECOGNIZED GAIN
29. RECOGNIZED GAIN - ORDINARY
30. RECOGNIZED GAIN - OTHER
TAX-
ABLE
YR.
1975
TOTAL
PAYMENTS
LESS INT.
(TO PT. 2.
SEC. 3)
BALANCE
SECTION 1245
REPORTED
NONE 7418
15416.
NW 88326 Docid:32245535 Page 52
PROFESSIONAL STATION
CAPITAL
SEC. 1245
SEC. 1250
$
$ 20148
48152
$
68300
$
$ 45228
$
$
EA
$
2313
42915
238
43153
$
$ 2313 $
$22834
$68307
% 36.82%
ASS
20148
20148
2313
5105
ORDINARY INCOME
SECTION 1250
CAPITAL GAIN
REPORTED
BALANCE
REPORTED
BALANCE
%
$1040
Department of the Treasury-Internal Revenue Service
US Individual Income Tax Return
For the year January 1-December 31, 1974, or other taxable year beginning
Please print or type
Name (If joint return, give first names and initials of both)
SAMUEL
8 PHYLLIS
Last name
TRUBY
Present home address (Number and street, including apartment number or rural toute)
16250 BIRCHERST.
City, town or post office, State and ZIP code
HIP
GRANADA HILLS
Filing Status (check only one)
123
4
5
☐ ☑
Single
1974, ending
COUNTY OF
RESIDENCE
LA
1974
19.
Your social security number
322127997
Spouse's social security no.
349 18 1420
E
CA
Occu-
pation
Yours ▸
Spouse's ►
Exemptions
6a Yourself .
b Spouse
Regular / 65 or over / Blind
☑
☑
Enter
number
of boxes
checked
Married filing joint return (even if only one had income)
Married filing separately. If spouse is also filing give
spouse's social security number in designated space above
and enter full
name here ►
Unmarried Head of Household (See instructions on page 5)
c First names of your dependent children who lived with
you
ELISA
THOMAS
Enter
number
d Number of other dependents (from line 27)
7 Total exemptions claimed
Do you wish to designate $1 of your taxes for this fund?.
If joint return, does your spouse wish to designate $1?.
포.
Yes
No
"
'■
Yes
No
Note: If you check the "Yes"
box(es) it will not increase
your tax or reduce your refund.
Widow(er) with dependent child (Year spouse died 19
8 Presidential Election
Campaign Fund.
(Attach Forms W-2. If unavail.
Wages, salaries, tips, and other employee compensation able, see instructions on page 3.)
9
9
See instructions
$
11
12
13
10a Dividends (on pages 6 and 13)
Balance
(If gross dividends and other distributions are over $400, list in Part 1 of Schedule B.)
Interest income.
If $400 or less, enter total without listing in Schedule B
_If over $400, enter total and list in Part II of Schedule B.
Income other than wages, dividends, and interest (from line 38)
Total (add lines 9, 10c, 11, and 12)
10b Less exclusion $...
136
10c
11
12
13
8939
8737
14
15
Adjustments to income (such as “sick pay," moving expenses, etc. from line 43)
Subtract line 14 from line 13 (adjusted gross income)
14
15
893%
If you do not itemize deductions and line 15 is under $10,000, find tax in Tables and enter on line 16.
If you itemize deductions or line 15 is $10,000 or more, go to line 44 to figure tax.
CAUTION. If you have unearned income and can be claimed as a dependent on your parent's return, check here ☐ and see instructions on page 7.
16
Tax, check if from:
Tax Tables 1-12
Schedule D
Tax Rate Schedule X, Y, or Z'
Schedule G OR Form 4726
17
Total credits (from line 54).
18
Income tax (subtract line 17 from line 16)
19
Other taxes (from line 61)
ཋ「ཌ「ཋ「ཀྐ「8
16
48
17
18
19
20
20
Total (add lines 18 and 19)
285
785
Please attach Check or Money Order here
Balance Due
or Refund
Tax, Payments and Credits
Please attach Copy B of Forms W-2 here
Income
21a Total Federal income tax withheld (attach Forms
W-2 or W-2P to front)
.
b 1974 estimated tax payments (include amount
allowed as credit from 1973 return)
.
c Amount paid with Form 4868, Application for Automatic
Extension of Time to File U.S. Individual Income Tax Return
21a
b
Pay amount on line 23
in full with this return.
Write social security
number on check or
money order and make
payable to Internal
Revenue Service.
d Other payments (from line 65)
.
22
Total (add lines 21a, b, c, and d)
23
2222
24
*25
26
C
d
If line 20 is larger than line 22, enter BALANCE DUE IRS
(Check here ☐, if Form 2210, Form 2210F, or statement is attached. See instructions on page 7.)
If line 22 is larger than line 20, enter amount OVERPAID
Amount of line 24 to be REFUNDED TO YOU
Amount of line 24 to be cred-
ited on 1975 estimated tax. ► 26
་
22
23
785
24
25
If all of overpayment (line 24) is to be
refunded (line 25), make no entry on line 26.
Under penalties of perjury, declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief
it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he has any knowledge.
Sign
here
Date
Your signature
Spouse's signature of filing jointly, BOTH must sign even if only one had income)
NW 88326 Docid:32245535 Page 53
Preparer's signature (other than taxpayer)
Date
A 367-34-8729
Address (and ZIP Code) :- Preparer's Emp. Ident. or Soc. Sec. No.
16-83229-1
18717 VANOWEN STREET.
MAN NUYS, CA. 91403
367-34-8729
Form 1040 (1974)
(a) NAME
Other
Dependents
(b) Relationship
(c) Months lived in your
home. If born or died
during year, write B or D.
(d)
Did de-
pendent have
income
of
$750 or more?
(e) Amount YOU
furnished for de-
pendent's
sup.
pórt. If 100%
write ALL..
Page
(f) Amount
fur-
nished by OTHERS.
including depend-
ent.
28
9936
27 Total number of dependents listed in column (a). Enter here and on line 6d
Income other than Wages, Dividends, and Interest
Part I
28 Business income or (loss) (attach Schedule C)
29 Net gain or (loss) from sale or exchange of capital assets (attach Schedule D)
30 Net gain or (loss) from Supplemental Schedule of Gains and Losses (attach Form 4797)
31 Pensions, annuities, rents, royalties, partnerships, estates or trusts, etc. (attach Schedule E)
32 Farm income or (loss) (attach Schedule F)
33 Fully taxable pensions and annuities (not reported on Schedule E-see instructions on page 8)
34 50% of capital gain distributions (not reported on Schedule D-see instructions on page 8)
does not apply if refund is for year in which you took the
35 State income tax refunds standard deduction-others see instructions on page 8).
thg).
36 Alimony received
37 Other (state nature and source-see instructions on page 8)
223
29
30
31
32
33
34
35
36
38 Total (add lines 28, 29, 30, 31, 32, 33, 34, 35, 36, and 37). Enter here and on line 12
Part II Adjustments to income
37
38
8934
39 "Sick pay." (From Forms W-2 and W-2P. If not shown on Forms W-2 or W-2P, attach Form 2440 or statement.)
40 Moving expense (attach Form 3903)
39
40
41 Employee business expense (attach Form 2106 or statement).
41
42 Payments as a self-employed person to a retirement plan, etc.-see instructions on page 9
43 Total adjustments (add lines 39, 40, 41, and 42). Enter here and on line 14
Part III
42
43
Tax Computation (Do not use this part if you use Tax Tables 1–12 to find your tax.)
44 Adjusted gross income (from line 15)
44
8934
45 (a) If you itemize deductions, check here ☐ and enter total from Schedule A, line 41
and attach Schedule A
45
5590
(b) If you do not itemize deductions, check here ☐ and enter 15% of line 44, but do
NOT enter more than $2,000. ($1,000 if line 3 checked)
46 Subtract line 45 from line 44
46
47 Multiply total number of exemptions claimed on line 7, by $750
48 Taxable income. Subtract line 47 from line 46
47
3344
3000
48
244
(Figure your tax on the amount on line 48 by using Tax Rate Schedule X, Y, or Z, or if applicable, the alternative
tax from Schedule D, income averaging from Schedule G, or maximum tax from Form 4726.) Enter tax on line 16.
Part IV Credits
49 Retirement income credit (attach Schedule R)
49
50 Investment credit (attach Form 3468)
50
.
48
51 Foreign tax credit (attach Form 1116)
51
52 Credit for contributions to candidates for public office-see instructions on page 9
53 Work Incentive (WIN) credit (attach Form 4874)
52
53
54 Total credits (add lines 49, 50, 51, 52, and 53). Enter here and on line 17
Part V Other Taxes
55 Self-employment tax (attach Schedule SE)
56 Tax from recomputing prior-year investment credit (attach Form 4255)
57 Tax from recomputing prior-year Work Incentive (WIN) credit (attach schedule)
58 Minimum tax. Check here ☐, if Form 4625 is attached
54
48
H).
W).190.
55
785
56
57
58
..
59 Social security tax on tip income not reported to employer (attach Form 4137)
60 Uncollected employee social security tax on tips (from Forms W-2)
61 Total (add lines 55, 56, 57, 58, 59, and 60). Enter here and on line 19
Part VI Other Payments
59
60
61
385
62 Excess FICA tax withheld (two or more employers-see instructions on page 9)
63 Credit for Federal tax on special fuels, nonhighway gasoline and lubricating oil (attach Form 4136)
64 Credit from a Regulated Investment Company (attach Form 2439)
62
63
64
65
Total (add lines 62, 63, and 64). Enter here and on line 21d
65
Foreign
Accounts
Did you, at any time during the taxable year, have any interest in or signature or other authority over
a bank, securities, or other financial account in a foreign country (except in a U.S. military banking
facility operated by a U.S. financial institution)?
If "Yes," attach Form 4683. (For definitions, see Form 4683.)
NW 88326 Docld:32245535 Page 54
U.S. GOVERNMENT PRINTING OFFICE: 1974-0-548-047
Yes.
No
16-83229-1
Schedules A&B-Itemized Deductions AND
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
Dividend and Interest Income
Attach to Form 1040. See Instructions for Schedules A and B (Form 1040).
PHYLLIS RUBY
Schedule A-Itemized Deductions (Schedule B on back)
Medical and Dental Expenses (not compensated by insurance
or otherwise) (See instructions on page 10.)
1 One half (but not more than $150) of
insurance premiums for medical care.
(Be sure to include in line 10 below)
2 Medicine and drugs
.
3 Enter 1% of line 15, Form 1040
4 Subtract line 3 from line 2. Enter dif-
ference (if less than zero, enter zero)
5 Enter balance of insurance premiums
for medical care not entered on line 1.
6 Enter other medical and dental expenses:
a Doctors, dentists, nurses, etc.
b Hospitals
.
c Other (Itemize-include hearing aids,
dentures, eyeglasses, transportation,
etc.)
SCH
7 Total (add lines 4, 5, 6a, b, and c)
8 Enter 3% of line 15, Form 1040.
9 Subtract line 8 from line 7 (if less than
zero, enter zero)
10 Total (add lines 1 and 9). Enter here
and on line 35
Taxes (See instructions on page 10.)
11 State and local income
12 Real estate
13 State and local gasoline (see gas tax tables)
14 General sales (see sales tax tables)
15 Personal property.
16 Other (Itemize) ►
SCH
17 Total (add lines 11, 12, 13, 14, 15, and
16). Enter here and on line 36
►
1386
1974
Your social security number
322127997
Contributions (See instructions on page 11 for examples.)
21 a Cash contributions for which you
have receipts, cancelled checks, etc.
b Other cash contributions. List
donees and amounts. ►
SCH
22 Other than cash (see instructions on
☐ page 11 for required statement)
23 Carryover from prior years
24 Total contributions (add lines 21a, b,
150
22, and 23). Enter here and on line 38.
Casualty or Theft Loss(es) (See instructions on page 12.)
Note: If you had more than one loss, omit lines 25 through
28 and see instructions on page 12 for guidance.
25 Loss before insurance reimbursement .
26 Insurance reimbursement
27 Subtract line 26 from line 25. Enter
difference (if less than zero, enter
zero)
28 Enter $100 or amount on line 27,
whichever is smaller
•
29 Casualty or theft loss (subtract line 28
from line 27). Enter here and on line 39 ►
Miscellaneous Deductions (See instructions on page 12.)
30 Alimony paid
31 Union dues
32 Expenses for child and dependent care
services (attach Form 2441)
33 Other (Itemize)
1062
34 Total (add lines 30, 31, 32, and 33).
Enter here and on line 40.
Interest Expense (See instructions on page 11.)
18 Home mortgage.
19 Other (Itemize)
Summary of Itemized Deductions
35 Total medical and dental-line 10
36 Total taxes-line 17.
A
1386
1062
2.992
150
SLH
20 Total (add lines 18 and 19). Enter here
and on line 37
2992
NW 88326 Docld:32245535 Page 55
37 Total interest-line 20
38 Total contributions-line 24..
39 Casualty or theft loss(es)-line 29.
40 Total miscellaneous -line 34
41 Total deductions (add lines 35, 36, 37,
38, 39, and 40). Enter here and on
Form 1040, line 45
5390
16-83231-1
어
17
40)
of the Treasury
Revenue Service
Profit or (Loss) From Business or Profession
(Sole Proprietorship)
Partnerships, Joint Ventures, etc., Must File Form 1065.
Attach to Form 1040. See Instructions for Schedule C (Form 1040).
Name(s) as shown on Form 1040
SAM & PHYLLIS RUBY
A Principal business activity (see Schedule C Instructions) SERVICE
• WOODLEY BISTRO COFFEESHOP
B Business name ▶.
D Business address (number and street) 1605SVENTURABLVD
CA 91316,
City, State and ZIP code ENCINO
E Indicate method of accounting: (1) ☐ Cash (2) ☑ Accrual (3) ☐ Other ►
F Were you required to file Form W-3 or Form 1096 for 1974? (See Schedule C Instructions.)
If "Yes," where filed
product
1974
Social security number
322127997
SNACK BAR
Employer identification number ..
G Was an Employer's Quarterly Federal Tax Return, Form 941, filed for this business for any quarter in 1974?
H Method of inventory valuation ►
Income
Deductions
94
OST
95-2657578
Was there any substantial change in
the manner of determining quantities, costs, or valuations between the opening and closing inventories? (If "Yes," attach explanation)
1 Gross receipts or sales $
Less: returns and allowances $
2 Less: Cost of goods sold and/or operations (Schedule C-1, line 8)
3 Gross profit
4 Other income (attach schedule)
5 Total income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
7 Taxes on business and business property (explain in Schedule C-2)
8 Rent on business property
9 Repairs (explain in Schedule C-2)
Balance ►
10 Salaries and wages not included on line 3, Schedule C-1 (exclude any paid to yourself)
11 Insurance
12 Legal and professional fees
13 Commissions
14 Amortization (attach statement)
15 (a) Pension and profit-sharing plans (see Schedule C Instructions)
(b) Employee benefit programs (see Schedule C Instructions)
16 Interest on business indebtedness.
17 Bad debts arising from sales or services
18 Depletion
19 Other business expenses (specify): -
C
Yes No
☑
(a)
(b)
(၁)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(W) 2400.
(H)) 7534)
SCH:
(k) Total other business expenses (add lines 19(a) through 1971))
20 Total deductions (add lines 6 through 19)
21 Net profit or (loss) (subtract line 20 from line 5). Enter here and on Form 1040, line 28. ALSO
enter on Schedule SE, line 5(a)
9934
SCHEDULE C-1.-Cost of Goods Sold and/or Operations (See Schedule C Instructions for Line 2)
1 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
2 Purchases $.
Less: cost of items withdrawn for personal use $.
3 Cost of labor (do not include salary paid to yourself)
4 Materials and supplies
5 Other costs (attach schedule)
6 Total of lines 1 through 5
7 Less: Inventory at end of year
8 Cost of goods sold and/or operations. Enter here and on line 2 above
Balance
NW 88326 Docld:32245535 Page 56
16-
Schedule C (Form 1040) 1974
SCHEDULE C-2.-Explanation of Lines 7 and 9
Line No.
Explanation
Page 2
Amount
Line No.
Explanation
Amount
$
$
SCHEDULE C-3.—Depreciation (See Schedule C Instructions for Line 6) If you need more space, you may use Form 4562.
Note: If depreciation is computed by using the Class Life (ADR) System for assets placed in service after December 31, 1970, or the Guideline
Class Life System for assets placed in service before January 1, 1971, you must file Form 4832 (Class Life (ADR) System) or Form 5006
(Guideline Class Life System). Except as otherwise expressly provided in income tax regulations sections 1.167(a)-11(b) (5) (vi) and 1.167
(a)-12, the provisions of Revenue Procedures 62-21 and 65-13 are not applicable for taxable years ending after December 31, 1970. (See
Publication 534.)
Class Life (ADR) System and/or
Guideline Class Life System.
Check box if you made an election this taxable year to use
c. Cost or
other basis
d. Depreciation
allowed or allowable
in prior years
e. Method of
computing
depreciation
f. Life or
g. Depreciation for
rate
this year
a. Group and guideline class
or description of property
b. Date
acquired
1 Total additional first-year depreciation (do not include in items below).
2 Depreciation from Form 4832 Sce Note
3 Depreciation from Form 5006
4 Other depreciation:
Buildings .
Furniture and fixtures
Transportation equipment
Machinery and other equipment
Other (specify).
と
above
:).
SCH
1339
5 Totals
6 Less amount of depreciation claimed in Schedule C-1, page 1
7 Balance Enter here and on page 1, line 6.
SCHEDULE C-4.-Expense Account Information (See Schedule C Instructions for Schedule C-4)
Enter information with regard to yourself and your five highest paid
employees. In determining the five highest paid employees, expense
account allowances must be added to their salaries and wages. How-
ever, the information need not be submitted for any employee for
whom the combined amount is less than $25,000, or for yourself if
your expense account allowance plus line 21, page 1, is less than
$25,000.
Owner
1
Name
Expense account
1339
Salaries and Wages
2
3
4
Did you claim a deduction for expenses connected with:
5
(1) Entertainment facility (boat, resort, ranch, etc.)?
Yes
$ No (3) Employees' families at conventions or meetings?
(2) Living accommodations (except employees on business)? ☐ Yes
☐ Yes No
No (4) Employee or family vacations not reported on Form W-2? ☐ Yes No
U.S. GOVERNMENT PRINTING OFFICE: 1974-0-548-050
16-83228-1
NW-88326 Docld:32245535 Page 57
SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as
on
Capital Gains and Losses (Examples of property to be reported on
this Schedule are gains and losses on stocks, bonds, and similar investments, and gains (but
not losses) on personal assets such as a home or jewelry.)
See Instructions for Schedule D (Form 1040).
Attach to Form 1040.
SAM & PHYLLIS RUBY
Part 1
Short-term Capital Gains and Losses-
1974
Social security number
322127997
D
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date
acquired
(Mo., day, yr.)
-Assets Held Not More Than 6 Months
a. Cost or other basis,
c. Date
sold
d. Gross sales price
f. Gain or (loss)
(d less e)
(Mo., day, yr.)
as adjusted (see
instruction D) and
expense of sale
LOAN TO SUMMITEAGLE CORPORATION (10
2
3
Enter your share of net short-term gain or (loss) from partnerships and fiduciaries
Enter net gain or (loss), combine lines 1 and 2
2
3
4(a) (
(b)
5
174
2741
1382
(729)
1382.
(204
2847- (1225
1532
3062
(1174
2007
4(a) Short-term capital loss component carryover from years beginning before 1970 (see Instruction G)
Short-term capital loss carryover attributable to years beginning after 1969 (see Instruction G)
Net short-term gain or (loss), combine lines 3, 4(a) and (b) .
(b)
5
Part II
Long-term Capital Gains and Losses-Assets Held More Than 6 Months
6100 CHIEFTAIN DEXEL
100 CHIEFTAIN DEEL
100 TESORO PET
100 UNIT POPE
100 RCA
11/21/73 6/10/74
11/21/73
11/21/73
653
6/19/74 678
5/22/72 7/16/74 1622
5/15/72 9/19/74 358
2/22/73 9/23/74 1055-
7
Capital gain distributions
8
Enter gain, if applicable, from Form 4797, line 4(a)(1) (see Instruction A)
9
Enter your share of net long-term gain or (loss) from partnerships and fiduciaries.
10
11
Enter your share of net long-term gain from small business corporations (Subchapter S)
Net gain or (loss), combine lines 6 through 10
12(a) Long-term capital loss component carryover from years beginning before 1970 (see Instruction G)
(b) Long-term capital loss carryover attributable to years beginning after 1969 (see Instruction G)
13
14
15
16
Net long-term gain or (loss), combine lines 11, 12(a) and (b).
Part III. Summary of Parts I and II
:
Combine the amounts shown on lines 5 and 13, and enter the net gain or loss here.
If line 14 shows a gain-
(a) Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part VI for computation
of alternative tax). Enter zero if there is a loss or no entry on line 13.
(b) Subtract line 15(a) from line 14. Enter here and on Form 1040, line 29
If line 14 shows a loss-
If losses are shown on BOTH lines 12(a) and 13, omit lines 16(a) and (b) and go to Part IV.
See Instruction H.
Otherwise,
(a) Enter one of the following amounts:
(i) If amount on line 5 is zero or a net gain, enter 50% of amount on line 14;.
(ii) If amount on line 13 is zero or a net gain, enter amount on line 14; or,
(iii) If amounts on line 5 and line 13 are net losses, enter amount on line 5.added to
50% of amount on line 13.
(b) Enter here and enter as a (loss) on Form 1040, line 29, the smallest of:
(i) The amount on line 16(a);
(ii) $1,000 ($500 if married and filing a separate return-if a loss is shown on line
4(a) or 12(a), see instruction L for a higher limit not to exceed $1,000); or,
(iii) Taxable income, as adjusted (see Instruction K)
7
8
9
10
11
5839)
12(a) (13327 )
(b) ('
13 (19161
14 $21901
15(a)
(b)
16(a
(18983)
(b)/1/000
NW 88326 Docid:32245535 Page 58
16-83232-1
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service
Computation of Social Security Self-Employment Tax
Each self-employed person must file a Schedule SE.
Attach to Form 1040. ► See Instructions for Schedule SE (Form 1040).
1974
If you had wages, including tips, of $13,200 or more that were subject to social security taxes, do not fill in this form.
If you had more than one business, combine profits and losses from all your businesses and farms on this Schedule SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
NAME OF SELF-EMPLOYED PERSON (AS SHOWN ON SOCIAL SECURITY CARD) Social security number of
self-employed person
PHYLLIS RUBY
349 181420
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.) SNACKBAR
If you have only farm income complete Parts I and III.
If you have only nonfarm income complete Parts II and III.
If you have both farm and nonfarm income complete Parts I, II, and III.
Part I Computation of Net Earnings from FARM Self-Employment
A farmer may elect to compute net farm earnings using the OPTIONAL METHOD, line 3, instead of using the Regular Method,
line 2, if his gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600. However, lines 1 and
2 must be completed even if you elect to use the FARM OPTIONAL METHOD.
REGULAR METHOD
1 Net profit or (loss) from:
(a) Schedule F, line 54 (cash method), or line 74 (accrual method).
(b) Farm partnerships
.
2 Net earnings from farm self-employment (add lines 1(a) and (b))
FARM OPTIONAL METHOD
3 If gross profits
from farming' are:
(a) Not more than $2,400, enter two-thirds of the gross profits
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
Gross profits from farming are the total gross profits from Schedule F, line 28 (cash method), or line 72 (accrual
method), plus the distributive share of gross profits from farm partnerships (Schedule K-1 (Form 1065), line
15) as explained in instructions for Schedule SE.
4 Enter here and on line 12(a), the amount on line 2, or line 3 if you elect the farm optional method
Part II Computation of Net Earnings from NONFARM Self-Employment
REGULAR METHOD
5 Net profit or
(loss) from:
(a) Schedule C, line 21. (Enter combined amount if more than one business.)
(b) Partnerships, joint ventures, etc. (other than farming)
(c) Service as a minister, member of a religious order, or a Christian Science prac
titioner. (Include rental value of parsonage or rental allowance furnished.) If
you filed Form 4361, check here ☐ and enter zero on this line
(d) Service with a foreign government or international organization
(See Form 1040 in-
Other structions for line 37.) Specify
(e)
6 Total (add lines 5(a), (b), (c), (d), and (e)) .
7 Enter adjustments if any (attach statement)
8 Adjusted net earnings or (loss) from nonfarm self-employment (line 6, as adjusted by line 7)
If line 8 is $1,600 or more OR if you do not elect to use the Nonfarm Optional Method, omit lines 9
through 11 and enter amount from line 8 on line 12(b), Part III.
Note: You may use the nonfarm optional method (line 9 through line 11) only if line 8 is less than $1,600 and
less than two-thirds of your gross nonfarm profits, and you had actual net earnings from self-employment of
$400 or more for at least 2 of the 3 following years: 1971, 1972, and 1973. The nonfarm optional method can
only be used for 5 taxable years.
2 Gross profits from nonfarm business are the total of the gross profits from Schedule C, line 3, plus the distribu-
tive share of gross profits from nonfarm partnerships (Schedule K-1 (Form 1065), line 15) as explained in
instructions for Schedule SE. Also, include gross profits from services reported on lines 5(c), (d), and (e), as
adjusted by line 7.
NONFARM OPTIONAL METHOD
9 (a) Maximum amount reportable, under both optional methods combined (farm and nonfarm)
(b) Enter amount from line 3. (If you did not elect to use the farm optional method, enter zero.)
(c) Balance (subtract line 9(b) from line 9(a))
10 Enter two-thirds of gross nonfarm profits 2 or $1,600, whichever is smaller
11 Enter here and on line 12(b), the amount on line 9(c) or line 10, whichever is smaller
Part III Computation of Social Security Self-Employment Tax
12 Net earnings or (loss): (a) From farming (from line 4)
(b) From nonfarm (from line 8, or line 11 if you elect to use the Nonfarm Optional Method)
13 Total net earnings or (loss) from self-employment reported on line 12. (If line 13 is less than $400,
you are not subject to self-employment tax. Do not fill in rest of form.) .
14 The largest amount of combined wages and self-employment earnings subject to social security tax for 1974 is
15 (a) Total "FICA" wages as indicated on Forms W-2
(b) Unreported tips, if any, subject to FICA tax from Form 4137, line 9
(c) Total of lines 15(a) and (b)
.
16 Balance (subtract line 15(c) from line 14)
17 Self-employment income-line 13 or 16, whichever is smaller
18 If line 17 is $13,200, enter $1,042.80; if less, multiply the amount on line 17 by .079
19 Railroad employee's and railroad employee representative's adjustment from Form 4469, line 10
20 Self-employment tax (subtract line 19 from line 18). Enter here and on Form 1040, line 55
U.S. GOVERNMENT PRINTING OFFICE: 1974-0-548-055
2400
2400
2400
$1,600
SE
10
00
2Y00
2400
$13,200
00
13200
2400
190
190
16-83234-1
NW 88326 Docld:32245535 Page 59
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service.
Computation of Social Security Self-Employment Tax
Each self-employed person must file a Schedule SE.
Attach to Form 1040. ► See Instructions for Schedule SE (Form 1040).
1974
If you had wages, including tips, of $13,200 or more that were subject to social security taxes, do not fill in this form.
If you had more than one business, combine profits and losses from all your businesses and farms on this Schedule SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
NAME OF SELF-EMPLOYED PERSON (AS SHOWN ON SOCIAL SECURITY CARD) · Social security number of
self-employed person
SAMUEL RUBY
иву
322127997
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.) SNACK BAR
If you have only farm income complete Parts I and III. If you have only nonfarm income.complete Parts II and III.
you have both farm and nonfarm income complete Parts I, II, and III.
If
Part 1 Computation of Net Earnings from FARM Self-Employment
A farmer may elect to compute net farm earnings using the OPTIONAL METHOD, line 3, instead of using the Regular Method,
line 2, if his gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600. However, lines 1 and
2 must be completed even if you elect to use the FARM OPTIONAL METHOD.
REGULAR METHOD
1 Net profit or (loss) from:
2 Net earnings from farm
FARM OPTIONAL METHOD
3 if gross profits
from farming' are:
(a) Schedule F, line 54 (cash method), or line 74 (accrual method).
(b) Farm partnerships
self-employment (add lines 1(a) and (b))
(a) Not more than $2,400, enter two-thirds of the gross profits
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
'Gross profits from farming are the total gross profits from Schedule F, line 28 (cash method), or line 72 (accrual
method), plus the distributive share of gross profits from farm partnerships (Schedule K-1 (Form 1065), line
15) as explained in instructions for Schedule SE.
4 Enter here and on line 12(a), the amount on line 2, or line 3 if you elect the farm optional method
Part II Computation of Net Earnings from NONFARM Self-Employment
REGULAR METHOD
5 Net profit or
(loss) from:
(a) Schedule C, line 21. (Enter combined amount if more than one business.)
(b) Partnerships, joint ventures, etc. (other than farming)
(c) Service as a minister, member of a religious order, or a Christian Science prac-
titioner. (Include rental value of parsonage or rental allowance furnished.) If
you filed Form 4361, check here ☐ and enter zero on this line
(d) Service with a foreign government or international organization
(e)
(See Form 1040 in-
Other structions for line 37.) Specify
6 Total (add lines 5(a), (b), (c), (d), and (e)) .
7 Enter adjustments if any (attach statement)
•
8 Adjusted net earnings or (loss) from nonfarm self-employment (line 6, as adjusted by line 7)
If line 8 is $1,600 or more OR if you do not elect to use the Nonfarm Optional Method, omit lines 9
through 11 and enter amount from line 8 on line 12(b), Part III.
Note: You may use the nonfarm optional method (line 9 through line 11) only if line 8 is less than $1,600 and
less than two-thirds of your gross nonfarm profits," and you had actual net earnings from self-employment of
$400 or more for at least 2 of the 3 following years: 1971, 1972, and 1973. The nonfarm optional method can
only be used for 5 taxable years.
2 Gross profits from nonfarm business are the total of the gross profits from Schedule C, line 3, plus the distribu-
tive share of gross profits from nonfarm partnerships (Schedule K-1 (Form 1065), line 15) as explained in
instructions for Schedule SE. Also, include gross profits from services reported on lines 5(c), (d), and (e), as
adjusted by line 7.
NONFARM OPTIONAL METHOD
9 (a) Maximum amount reportable, under both optional methods combined (farm and nonfarm)
(b) Enter amount from line 3. (If you did not elect to use the farm optional method, enter zero.)
(c) Balance (subtract line 9(b) from line 9(a))
10 Enter two-thirds of gross nonfarm profits 3 or $1,600, whichever is smaller
11 Enter here and on line 12(b), the amount on line 9(c) or line 10, whichever is smaller
Part III Computation of Social Security Self-Employment Tax
12 Net earnings or (loss): (a) From farming (from line 4)
(b) From nonfarm (from line 8, or line 11 if you elect to use the Nonfarm Optional Method)
13 Total net earnings or (loss) from self-employment reported on line 12. (If line 13 is less than $400,
you are not subject to self-employment tax. Do not fill in rest of form.) .
14 The largest amount of combined wages and self-employment earnings subject to social security tax for 1974 is
15 (a) Total "FICA" wages as indicated on Forms W-2
(b) Unreported tips, if any, subject to FICA tax from Form 4137, line 9.
(c) Total of lines 15(a) and (b)
16 Balance (subtract line 15(c) from line 14)
17 Self-employment income-line 13 or 16, whichever is smaller
18 If line 17 is $13,200, enter $1,042.80; if less, multiply the amount on line 17 by .079
19 Railroad employee's and railroad employee representative's adjustment from Form 4469, line 10
20 Self-employment tax (subtract line 19 from line 18). Enter here and on Form 1040, line 55
U.S. GOVERNMENT PRINTING OFFICE 1974-0-548-055
7534
7531
say
SE
$1,600
00
7534
534
$13,200
13200
7534
595
597
16-83234-1
00
NW 88326 Docld:32245535. Page 60

3468
Department of the Treasury
Internal Revenue Service
Name
SAMUEL
Computation of Investment Credit
Attach to your tax return.
I PHYLLIS RUBY
1974
Identifying number as shown on
page 1 
of your tax return
322-12-7997
1 Qualified Investment in new and used property. (See Instructions C and D for eligible property.)
NOTE: Include your share of investment in property made by a partnership, estate, trust, small business corporation, or lessor.
Type of
property
Line
(1)
(2)
Cost or basis
Life years
(See instruction G)
(a)
3 or more but less than 5
New
(b)
5 or more but less than 7
Property
(3)
Applicable
percentage
3313
662/3
(4)
Qualified investment
(Column 2 x column 3)
(၁)
7 or more
100
Used
Property
(See Instructions for
dollar limitation)
(d)
(0)
3 or more but less than 5
5 or more but less than 7
(f)
7 or more
10228
3 Tentative investment credit-7% of line 2 (4% for public utility property)
2 Total qualified investment--Add lines 1(a) through 1(f) .
331/3
662/3
100
10228
10228
216.
4 Carryback and carryover of unused credit(s). (See instruction F and instruction for line 4-attach computation.)
5 Total-Add lines 3 and 4.
Limitation
6 (a) Individuals-Enter amount from line 16, page 1, Form 1040
(b) Estates and trusts-Enter amount from line 24 or 25, page 1, Form 1041
(c) Corporations-Enter amount from line 5, Schedule J, Form 1120
7 Less: (a) Foreign tax credit
(b) Retirement income credit (individuals only)
(c) Tax on lump-sum distributions. (See instruction 7.)
8 Total-Add lines 7(a), (b), and, (c)
9 Line 6 less line 8
10 (a) Enter amount on line 9 or $25,000, whichever is lesser. (Married persons filing separately, con-
trolled corporate groups, estates, and 
trusts, see instruction for line 10.)
(b) If line 9.exceeds line 10(a), enter 50% of the excess
11 Total-Add lines 10(a) and (b)
12 Investment credit-Amount from line 5 or line 11, whichever is lesser (enter here and on line 50,
Form 1040; line 6(b), Schedule J, Form 1120; or the 
appropriate line on other returns)
Schedule A
716
48
48
48"
48
If any part of your investment in line 1 above was made by a partnership, estate, trust, small business corporation, or lessor, complete the following:
Name
(Partnership, estate, trust, etc.)
Address
New
Property
Used
Life years
$
If property is disposed of prior to the life years used in computing the investment credit, see instruction E.
16-83238-1
NW 88326 Docld:32245535 Page 61
Form 3468 (19'
WALKNISK NON VOLEMAENDEL
Form
4798
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
Capital Loss Carryover
► (From 1973 to 1974)
Attach to Form 1040.
1042 PHYLLIS RUBY
Ruby
A. Who Should File.-You will need to complete
either Part 1 or Part II of this form if you have a capital
loss to carry over to 1974.
You will have a capital loss to carry to 1974 if the
amount on your 1973 Schedule D (Form 1040), line
16(a), or line 33, is LARGER THAN the loss deduct-
ed on your 1973 Form 1040, line 29.
1974
Social Security Number
322 12 7997
B. How to Compute Carryover.-If you have a capi-
tal loss carryover, complete either Part I or Part II of
this form, but do not complete both.
1. Complete only Part 1 if lines 4(a) and 12(a) on
your 1973 Schedule D (Form 1040) DO NOT SHOW A
LOSS.
2. Complete only Part II if either (or both) line
4(a) or line 12(a) on your 1973 Schedule. D (Form
1040) shows a loss.
Part 1
Post-1969 Capital Loss Carryovers
Section A.-Short-term Capital Loss Carryover
1 Enter loss shown on your 1973 Schedule D (Form 1040), line 5; if none, enter zero and ignore
lines 2 through 6-then go to line 7
.
1
(2741)
2 Enter gain shown on your 1973 Schedule D (Form 1040), line 13. If that line is blank or shows
a loss, enter a zero
2
3 Reduce any loss on line 1 to the extent of any gain on line 2.
4 Enter amount shown on your 1973 Form 1040, line 29
5 Enter smaller of line 3 or 4 .
6 Excess of amount on line 3 over amount on line 5
Note: The amount on line 6 is your short-term capital loss carryover from 1973 to 1974 that is attributable to years beginning
after 1969. Enter this amount on your 1974 Schedule D (Form 1040), line 4(b).
3
2741)
4
1000
5
1000
6
(1741).
Section B.-Long-term Capital Loss Carryover
7 Line 4 less line 5 (Note: If you ignored lines 2 through 6, enter amount from your 1973 Form
1040, line 29)
.
8 Enter loss from your 1973 Schedule D (Form 1040), line 13; if none, enter zero and ignore lines
9 through 12
.
.
7
8
00
9 Enter gain shown on your 1973 Schedule D (Form 1040), line 5. If that line is blank or shows
a loss, enter a zero
9
10 Reduce any loss on line 8 to the extent of any gain on line 9
11 Multiply amount on line 7 by 2
10
11
12
12 Excess of line 10 over amount on line 11
Note: The amount on line 12 is your long-term capital loss carryover from 1973 to 1974 that is attributable to years beginning
after 1969. Enter this amount on your 1974 Schedule D (Form 1040), line 12(b).
NW 88326 Docld:32245535 Page 62
Form 4798 (1974)
Pre-1970 and Post-1969 Capital Loss Carryovers
Form 4798 (1974)
Part II
Section A.-Short-term Capital Losses Identified
1 Enter loss shown on your 1973 Schedule D (Form 1040), line 5; if none, enter zero and ignore
lines 2 through 20-then go to line 21
2 Enter gain shown on your 1973 Schedule D (Form 1040), line 13. If that line is blank or shows
a loss enter a zero
3 Reduce loss on line 1 to the extent of any gain on line 2
Note: If line 4(a) on your 1973 Schedule D (Form 1040) is blank, IGNORE lines 4 through 11, enter
a zero on line 12-then go to line 13.
4 Combine lines 3 and 11 on your 1973 Schedule D (Form 1040). Enter
the gain; or if zero or a loss, enter a zero
1
2
3
4
Note: If line 4 is zero IGNORE lines 5 through 11, enter on line 12. the
loss from your 1973 Schedule D (Form 1040), line 4(a)—then go
to line 13.
5 Enter any gain from your 1973 Schedule D (Form 1040), line 3
6 Enter smaller of line 4 or 5 .
7 Enter excess of gain on line 4 over line 6
5
6
7
8 Enter loss from your 1973 Schedule D (Form 1040), line 12(a); other-
wise, enter a zero
8
9 Reduce any gain on line 7 to the extent of any loss on line 8
9
10 Enter loss from your 1973 Schedule D (Form 1040), line 4(a); other-
wise enter a zero
10
11 Add the gains on lines 6 and 9
11
12 Reduce the loss on line 10 to the extent of any gain on line 11
13 Pre-1970 short-term capital loss (Enter smaller of line 3 or 12)
14 Short-term capital loss attributable to years beginning after 1969 (excess of line 3 over line 13)
Section B. Computation of Capital Loss Carryovers to 1974
15 Enter any loss from line 13, above
16 Enter loss deducted on your 1973 Form 1040, line 29
15
16
17 Loss carryover to 1974 (excess of line 15 over line 16-if line 15 does not exceed line 16, enter
zero). Enter here and on your 1974 Schedule D (Form 1040), line 4(a)
18 Enter any loss from line 14, above
18
..
19 Enter excess of line 16 over line 15-if line 16 does not exceed line 15,
enter zero
19
ཋཀླ「ཀླ
12
13
14
20 Loss carryover to 1974 (excess of line 18 over line 19-if line 18 does not exceed line 19, enter
zero). Enter here and on your 1974 Schedule D (Form 1040), line 4(b)
21 If you were required to complete Part IV of your 1973 Schedule D
(Form 1040), enter any loss from your 1973 Schedule D (Form 1040),
line 30; otherwise, enter zero
31 (13322)
21
22 Enter excess of line 19 over line 18-if line 19 does not exceed line
18, enter zero. (Note: If you ignored lines 2 through 20 above, enter
amount from your 1973 Form 1040, line 29.) .
22
17
20
20
23 Loss carryover to 1974 (excess of line 21 over line 22-if line 21 does not exceed line 22, enter
zero). Enter here and on 1974 Schedule D (Form 1040), line 12(a)
24 If you were required to complete Part IV of your 1973 Schedule D (Form
1040), enter any loss from your 1973 Schedule D (Form 1040), line 31.
However, if Part IV was not required, enter any loss from your 1973
Schedule D (Form 1040), line 13
25 Enter excess of line 22 over line 21
exceed line 21, enter zero.)
24
x 2 (If line. 22 does not
25
26 Loss carryover to 1974 (excess of line 24 over line 25-if line 24 does not exceed line 25, enter
zero). Enter here and on your 1974 Schedule D (Form 1040), line 12(b)
NW 88326 Docld:32245535 Page 63
U.S. GOVERNMENT PRINTING OFFICE: 1974-0-548-157.
52-0781521
Page
#3 (13322)
23
26
NAME
SAM & PHYLLIS RUBY
ADDRESS
322-12-7997
D. NO.
OR
SOC. SEC. NO.
CALENDAR YEAR 19
74
SCHEDULE OF PROFIT (OR LOSS ) FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
LABOR
TOTAL
INVENTORY AT END OF YEAR
GROSS PROFIT
EMPLOYERS NO.
FISCAL YEAR ENDING
19
680841
36079
36079
8071
35279
32805
GROSS INCOME
32805
OTHER BUSINESS DEDUCTIONS
ADVERTISING
337
AUTO AND TRUCK EXPENSE
12000 MI AT 159
1800
BAD DEBTS
CASH SHORT
COMMISSIONS
DELIVERY
DEPRECIATION ( SCHEDULE ATTACHED
DUES AND
SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTEREST
JANITOR SERVICE
LAUNDRY
LEGAL AND ACCOUNTING
MAINTENANCE
OFFICE SUPPLIES AND EXPENSE
RENT
1339
16
215.
1844
241
270
47
7841
REPAIRS
SALARIES AND
WAGES
SALARIES OFFICERS
SUPPLIES
TAXES AND LICENSES
TAXES
.
PAYROLL
TELEPHONE
TRAVEL
UTILITIES
PARKING
NET PROFIT OR ( LOSS )
NET PROFIT OR LOSS )
•
991
5912
1063
588
322
45
22871
9934
FEDERAL RETURN
(+)7539
STATE RETURN ( SEE DEPREC. SCHEDULE FOR DIFF. ) W/ 2450
PROFESSIONAL STATIONERS INC.
FORM 104
NW 88326 Docfd:32245535 Page 64.
SCHEDULE
NW 88326 Docld:32245535 Page 65
NAME SAM & PHYLLIS RUBY
ADDRESS.
322-12-7997
.I.D. NO.
OR
SOC. SEC. NO.
CALENDAR YEAR 19 74
FISCAL YEAR ENDING
SCHEDULE OF DEPRECIATION / AMORTIZATION
KIND OF PROPERTY
EQUIPMENT
GOODWILL
MO
COST OR
SPEC 20%
DEP
OTHER BASIS
2/1/74/10228
4/1/74/35000
DEPRECIABLE
DEP ALLOWED
PRIOR YEARS
REMAINING
COST
METHOD
BASIS
10228
DEPRECIATION
10228
S.L 7YR 1339
TOTALS
PROFESSIONAL STATIONERS INC. LOS ANGELES
FORM NO 102A
SCHEDULE
CA
EXEMPTION CREDITS
6 Personal
7 Dependents
RESIDENT
送540季
INDIVIDUAL
CALIFORNIA
INCOME TAX
PLACE PREADDRESSED LABEL HERE, if available. (Correct name and address, if necessary)
Enter social security number(s) only if incorrect or not shown on label.
NAME (If joint return, give first deiner and initials of both)
16250
LAST NAME
RUBY
Т
SAMUEL & PHYLLIS
PRESENT HOME ADDRESS (Number and street, including apartment number, or Tural route)
BIRCHER
CITY, TOWN OR POST OFFICE, STATE AND, ZIP CODE
RANADA HILLS
FILING STATUS Check Only One:
1 ☐ Single
2
Married filing joint return (even if only one had income)
:☑M
3 ☐ Separate return of married person-Enter spouse's
social security number and full name here
4 Head of Household-Enter name of qualifying
individual.
For calendar year or
Taxable year ending-
TAXABLE YEAR
$19.74
Your Social Security Number
322
197.
7997
Spouse's Social Security Number
34918 1420
OCCU-
PATION
Yours J/E
Spouse E
If line 1 or 3 checked, enter $25
If line 2, 4 or 5 checked, enter $50
Do not list yourself, your spouse or the person who qualifies you
as head of household. Enter name and relationship.
ELISA
THOMAS
Total Number
2
× $8
8 Blind (refer to instructions) Number of blind exemptions ▸
× $8
5
Widow(er) with dependent child (Year spouse died 197) 9
Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20
8
716
966
10 Wages, salaries, tips and other employee compensation
Attach copy 2 of Form(s) W-2 to face of this
return. If unavailable, attach explanation. }
10
◄ ATTACH COPY 2 OF FORM W-2 HERE ►
11 Dividends-before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540))
12 Interest. Enter total (if over $400, complete and attach Schedule B(540))
13 Income other than wages, dividends and interest (from line 48)
14 Total (add lines 10, 11, 12 and 13)
15 Adjustments to income (from line 54)
16 Adjusted gross income (subtract line 15 from line 14)
• If you do NOT itemize deductions AND line 16 is under $10,000, find tax in Tax Table and enter on line 19.
• If you itemize deductions OR line 16 is $10,000 or more, complete lines 17 and 18.
17 Deductions: Itemized (from line 61) OR Standard ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
18 Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
ate
19 Tax from (check one) Tax Table ☐ Tax Rate Schedule
20 Total exemption credits (from line 9, above)
21 Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
22 Other credits (from line 65-Includes special low income tax credit)
23 Net tax liability (subtract line 22 from line 21-if line 22 is greater than line 21, enter zero)
Tax on preference income (see instructions-attach Schedule P(540) )
24
16 9070
17 5468
183602
19
20
21
2222322
24
25 Total tax liability (add lines 23 and 24)
25
..
26
27
Total California income tax withheld (attach Form(s) W-2 or W-2P to face of this return)
Renter's credit-if you lived in rented property on March 1, 1974, complete Part 1 on page 2
28 1974 California estimated tax payments
26
27
36
11
136
12
13
8934
14
9070
15
Income Averaging Schedule (G or G-1) ☐
ATTACH FORM DE 1964 HERE
◄ Write social security number on check or money order. ATTACH HERE ►
29 Excess California SDI tax withheld (attach Form DE 1964 to face of this return)
30 Total prepayment credits (add lines 26 thru 29). .
31 If line 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero.
Pay in full and mail with return to: FRANCHISE TAX BOARD
SACRAMENTO, CA 95887
32 If line 25 is smaller than line 30, enter amount OVERPAID
Mail return to:
FRANCHISE TAX BOARD
P.O. BOX 13-540
SACRAMENTO, CA 95813
33 Amount of line 32 to be REFUNDED. (Allow at least six weeks)
34 Amount of line 32 to be credited on your 1975 ESTIMATED TAX
30
30
-
Do not write in these spaces
-
PAY IN FULL
0.
31
P
32
0
E
M
REFUND TO YOU
34
33
ESTIMATED TAX | A
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN
Your signature
HERE
Spouse's signature-if filing a joint return
NW 88326 Docld:32245535 Page 66
Date
Date
Preparer's signature (other than taxpayer)
"
Date
13717 VANOWEN STREET 367-34-8729
Address (and Zip code) MAN MUYS, CA. 9140 Reparer's FEIN (or SSA) No.
367-34-8729
Page 2 Form 540 (1974)
PART 1- Renter's Credit
_
All questions must be answered
35 Did you, on March 1, 1974, live in rented property which was your principal residence?
35 Was the property you rented exempt from property tax?
37 Did you live with any other person who claimed you as a dependent for income tax purposes?
38 Did you or your spouse claim the homeowners' property tax exemption or receive public assistance?
PART II
-
- Other Income
39 Business income (or loss) (attach Schedule C(540))
40 Net gain (or loss) from sale or exchange of capital assets (attach Schedule D(540) )
41 Net gain (or loss) from supplemental schedule of gains and losses (attach Schedule D-1(540))
Pensions and annuities
42
43 Rents and royalties
44 Partnerships
45 Estates and trusts .
.
ATTACH
SCHEDULE E
FORM (540)
46 Farm income (or loss) (attach Schedule F(540))
47
Miscellaneous income
(a) Fully taxable pensions and annuities (not reported on Schedule E(540))
(b) Alimony
(c) Other (state nature and source)..
Enter total of fines 47(a), 47(b), and 47(c)
48 Total (add lines 39 thru 47). Enter here and on line 13
PART III Adjustments to Income
-
49 "Sick pay," if included in line 10 (see instructions - attach statement)
50 Moving expenses (see instructions - attach statement)
51 Employee business expenses (see instructions - attach statement)
52 Military exclusion (see instructions)
.
Yes
See Instructions, Page 3, for Allowable Credit
No
Yes
☐ Yes
☐ Yes
☐ No
☐ No
No
If no, you may not claim this credit
If yes, you may not claim this credit
If yes, you may not claim this credit
If yes, see page 3 of instructions
39
9934
40 1000
41
42
43
44
45
3 3 3 2 3 * 4 4
46
47a
47b
47c
47
48 8934
49
50
51
52
53
54
PART IV-Itemized Deductions
ON SEPARATE RETURNS OF MARRIED TAXPAYERS, BOTH MUST ITEMIZE
DEDUCTIONS OR BOTH MUST TAKE THE STANDARD DEDUCTION.
53 Payment as a self-employed person to a retirement plan, etc.
54 Total adjustments (add lines 49 thru 53). Enter here and on line 15
• Attach Schedule A(540) and enter sub-totals on lines 55 thru 60, below
55 Total deductible medical and dental expenses (from Schedule A(540), line 10),
56 Total child adoption expenses (from Schedule A(540), line 13)
57 Total taxes (from Schedule A(540), line 21)
.
58 Total interest expense (from Schedule A(540), line 25)
59 Total contributions (from Schedule A(540), line 29)
60 Total miscellaneous deductions (from Schedule A(540), line 40)
61 Total itemized deductions (add lines 55 thru 60). Enter here and on line 17
PART V
-
Other Credits. SEE INSTRUCTIONS FOR EACH CREDIT CLAIMED BELOW.
-
62 "Other State" net income tax credit (attach copy of other state return and Schedule S(540))
63 Retirement income credit (attach Schedule R(540))
64 (a) Special Low Income Tax Credit - If Adjusted Gross Income does not include net capital gains from assets held more than one
year and is $8,000 or less (joint return of married couple, head of household or widow(er) with dependent child) or $4,000 or
less (single or separate return of married person) enter the amount from line 21. If Adjusted. Gross Income includes Capital
Gains, complete Schedule B-1. See Page 3 of Instructions
.
(b) Enter total here from line 4, Schedule B-1. If zero or a loss, enter zero.
65 TOTAL (add lines 62 thru 64a. Enter here and on line 22
PART VI
-
64b|
55
1386.
56
57
940
58 2992
59
60
2ggགགྒགྒ
150
61 5468
62
63
83
64a
65
- Reconciliation to Federal Return - If adjusted gross income on Federal Return is different from line 16, page 1, explain below.
NW 88326 Docld:32245535 Page 67
-DIVEX 136
TAXABLE
1974
YEAR
Social Security Number
322127997
A
SCHEDULE
FORM 540
Name as shown on Form 540
SAMUEL
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
I PHYLLIS RUBY
Use only if you do not use the Tax Table or take the standard deduction.
Medical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses, hospi-
tal care, insurance premiums for medical care, etc.
1. One half (but not more than $150) of insurance
premiums for medical care
2. Medicine and drugs
.
3. Enter 1% of adjusted gross income shown on Form
540.
4. Subtract line 3 from line 2. Enter difference (if line
3 is greater than line 2, enter zero)
.
5. Enter balance of insurance premiums for medical
care not entered on line 1
6. Other medical and dental expenses:
(a) Doctors, dentists, nurses, etc.
(b) Hospitals.
(c) Other (itemize)
Interest Expense
22. Home mortgage.
23. Installment purchases
24. Other (itemize)
SCH
25. Total (Add lines 22, 23 and 24. Enter here and
on Form 540, page 2, line 58)
Contributions
26. Cash contributions for which you have receipts, can-
celed checks, etc.
.
27. Other cash contributions. List donees and amounts
2992
SCH
7. Total (Add lines 4, 5, 6a, b, and c)
8. Enter 3% of adjusted gross income shown on
Form 540
9. Subtract line 8 from line 7. Enter difference (if
line 8 is greater than line 7, enter zero)
10. Total (Add lines 1 and 9. Enter here and on
Form 540, page 2, line 55)
Child Adoption Expense
11. Total expenses paid or incurred-Attach itemized
list
12. Enter 3% of adjusted gross income shown on Form
540
13. Subtract line 12 from line 11-See instructions
for maximum limitations. (Enter here and on Form
540, page 2, line 56)
Taxes
14. Real estate
15. State and local gasoline
16. General sales
17. Auto license-Excess of registration and weight fees
(see instructions)
18. Personal property.
19. State disability insurance (SDI)--Employer private
disability plans do not qualify.
. 20. Other
1386
SCH
28. Other than cash. - See instructions for required
statement
29. Total (Add lines 26, 27 and 28. Maximum deduction
may not exceed 20% of adjusted gross income.
Enter here and on Form 540, page 2, line 59) ►
Miscellaneous Deductions
Casualty or Theft Loss(es)-See Instructions
NOTE: If you had more than one loss, omit lines 30
through 34 and follow instructions for guidance.
30. Loss before insurance reimbursement
31. Insurance reimbursement
32. Subtract line 31 from line 30. Enter difference (if
line 31 is greater than line 30, enter zero)
33. Enter $100 or amount on line 32, whichever is
smaller
34. Casualty or theft loss (line 32 less line 33).
35. Alimony paid
36. Child care See instructions
37. Union dues
38. Employment education expense-See instructions
39. Other-See instructions (itemize)
.
150
SCH
21. Total taxes - (Add lines 14 through 20. Enter here
and on Form 540, page 2, line 57)
(Rev. 1974)
NW 88326 Docld:32245535 Page 68
940
40. Total-Add lines 34, 35, 36, 37, 38 and 39. (Enter
here and on Form 540, page 2, line 60)
20
SCHEDULE
C
FORM 540
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
Attach this schedule to your income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
SAM & PHYLLIS
A. Principal business activity.
(See Instructions for "Item A.")
RUBY
SERVICE
TAXABLE
1974
YEAR
Partnerships, joint ventures, etc., must file on Form 565
-; product
Social Security Number
322127997
Snackbar.
(For example: retail-hardware; wholesal
"Wh/1000 tobacco; services-legal; manufacturing-furniture; etc.)
B. Business name. WOODLEY BISTRO COFFEEC Federal employer identification number 95-2651578
D. Business address. 1.60SSVENTURA BLVD - ENCINO
E. Indicate method of accounting:
☐ cash; ✓ accrual;
COST
other.
F. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ✓ Yes ☐ No
G. Method of inventory valuation ►..
(ZIP code)
C
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
NO. If "Yes," attach explanation.
YES
IMPORTANT-All applicable lines and schedules must be Alled in.
INCOME
1 Gross receipts or sales $
Less returns and allowances $.
2 Less: Cost of goods sold (Schedule C-1, line 29) and/or operations (attach schedule)
3 Gross profit
4 Other income (attach schedule)
5
TOTAL income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
7 Taxes on business and business property (explain in Schedule C-2)
8 Rent on business property
9 Repairs (explain in Schedule C-2)
10 Salaries and wages not included on line 24, Schedule C-1 (exclude any paid to yourself)
11 Insurance
12 Legal and professional fees.
13 Commissions.
Balance
DEDUCTIONS.
14
Amortization (attach statement)
15
(a) Pension and profit-sharing plans (see Instructions for line 15(a))
(b) Employee benefit programs (see Instructions for line 15(b))
16 Interest on business indebtedness
17 Bad debts arising from sales or services
18 Depletion
.
19 Other business expenses (specify):
(a).
(b).
(c)..
(d).
(e).
(f).
(g)..
(h) Total other business expenses (add lines 19(a) through 19(g))
20 Total deductions (add lines 6 through 19)
SCH
21 Net profit (or loss) (subtract line 20 from line 5). Enter here and on page 2, Form 540 or Form 540NR
SCHEDULE C-1. COST OF GOODS SOLD (See Schedule C Instructions for line 2)
22 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
23 Purchases $..
Less cost of items withdrawn for personal use $.
Balance
24. Cost of labor (do not include salary paid to yourself)
26 Other costs (attach schedule)
25 Materials and supplies
27 Total of lines 22 through 26
28 Less: Inventory at end of year
29 Cost of goods sold. Enter here and on line 2, above
NW 88928 Docld:32245535 Page 69
9934
Schedule C (Form 540) (Rev. 1974)
SCHEDULE C-2.
Line No.
Explanation of Lines 7 and 9
Explanation
Amount
Line No.
Explanation
Amount
$
$
Page 2
SCHEDULE C-3. DEPRECIATION (See Schedule C Instructions for line 6). NOTE: Depreciation may be computed by
using the Asset Guideline Classes specified in Federal Revenue Procedure 72-10, regardless of when assets were
placed in service. If this method is used, do NOT use the Lower Limit or the Upper Limit (ADR) Ranges. Attach
detailed statement of depreciation computation.
a. Group and guideline class
or description of property
b. Date
acquired
c. Cost or
other basis
d. Depreciation
allowed or allowable
in prior years
e. Method of
computing
depreciation
f. Life or
rate
g. Depreciation for
this year
1 Total additional first-year depreciation (do not include in items below)
2 Asset Guideline Class System (See Note above)
3 Other depreciation
Buildings
Furniture and fixtures
Transportation equipment .
Machinery and other equipment.
Other (specify)
•
Sett
1339
4 Totals
5 Less: Amount of depreciation claimed elsewhere in Schedule C-1
6 Balance-Enter here and on page 1, line 6
SCHEDULE C-4. Expense Account Information
Enter information with regard to yourself and your five
highest paid employees. In determining the five highest
paid employees, expense account allowances must be
added to their salaries and wages. However, the infor-
mation need not be submitted for any employee for
whom the combined amount is less than $10,000, or
for yourself if your expense account allowance plus
line 21, page 1 is less than $10,000.
Did
you claim a deduction for expenses connected with:
(1) Entertainment facility (boat, resort, ranch, etc.)?
Yes ✓ No
☐ Yes
(2) Living accommodations (except employees on business)?
☑ No.
NW-88326 Docid:32245535-Page 70-
(See Schedule C Instructions for Schedule C-4)
Owner
1
3
Name
1339
Expense Account
Salaries and Wages
(3) Employees' families at conventions or meetings?
☐ Yes
☑ No
(4) Employee or family vacations not reported on Form W-2?
☐ Yes
☑ No

SCHEDULE
D
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR
540 pr
SAMUEL & PHYLLIS
PART I-Assets Held One Year or Less
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
RuBy
b. Date acquired
c. Date sold
(mo.. day, yr.)
(mo., day, yr.)
d. Gross sales
price
TAXABLE
1974
YEAR
Social Security Number
322127997
e. Cost or other basis as
adjusted; cost of subse-
quent improvements (if
not purchased, attach
explanation) and ex-
pense of sale
f. Gain or loss
(d. less e.)
D
1.
LOAN TO SUMMITEAGLE CORPORATION
100 CHIEFTAINDEXEL 11/21/73 6/10/74
100 CHIESTAIN DEVEL 11/23/33 6/10/34 6533
678
2. Enter gain (or loss), if applicable, from line 18, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART II-Assets Held More Than One Year But Not More Than Five Years
5.
100TESORO PET 5/22/72 7/16/74 1622
100 UNITRODE
LUORCA
5/15/22 2/19/74 358
2/22/73
1053
1382
1382
(1000
(229)
(2433)
0225
2012 (4353
1532
3062
(4406)
6. Enter gain (or loss), if applicable, from line 20, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7
PART III-Assets Held More Than Five Years
9. •1973. LOSS CARRYOVER
(16063)
LESS,000–
10. Enter gain (or loss), if applicable, from line 22, Schedule D-1 (540) (attach copy)
11. Enter your share of net gain or loss from partnerships and fiduciaries
12. Net gain or loss, combine lines 9, 10 and 11
PART IV-Summary of Capital Gains and Losses
13. Enter amount from line 4
14. Enter 65% of the amount on line 8
15. Enter 50% of the amount on line 12.
16. Enter unused capital loss carryover from preceding taxable years (attach computation)
17. Combine the amounts shown on lines 13, 14, 15 and 16
:
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
2:
2864
(15063) (20360)
19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on lines 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
(c) $1,000 ($500 in the case of a husband or wife filing a separate return)
NW 88326 Docld:32245535 Page 71
(100)
2
CALENDAR YEAR 19
74
NAME
ADDRESS
50
SAMUEL & PHYLLIS RUBy
MEDICAL
2 MEDICINE/DRUGS
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5H & A INS. (½ + EXCESS)
ɓa DR.
Ruby
322-12-7997
SOC. SEC. NO.
DEDUCTION SCHEDULE
STATE
FEDERAL
304
CONTRIBUTIONS
21 PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
DR.
DR.
DR.
DR.
DR.
DR.
DR.
930
STATE
FEDERAL
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
750
MISC. ORGANIZED CHARITIES
POLITICAL CONTRIBUTIONS
CHURCHES
22 OTHER THAN CASH
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
6C AMBULANCE
LABORATORIES
TRAVEL FOR MED. 1000
20
MEDICARE INS.
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
1304
8 LESS 3% ADJ. GROSS INC.
268
9
1236
1
+: (TO $150) OF H & A INS.
150
10 TOTAL MEDICAL DED.
► 1386
1386
TAXES
11 STATE & LOCAL INCOME
12 REAL ESTATE
122
722
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
26 INSURANCE REIMBURSEMENT
27 Difference (not less than zero)
28 ($100 LIMITATION PER CAS.)
29 TOT. CAS. OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 CHILD & DEP. CARE (Form 2441)
33 INCOME TAX PREPARATION
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
Auto Use
Mi
INVEST.COUNSEL & PUBS.(Sched
EMPLOYMENT AGENCY FEES
SAFE DEPOSIT BOX
13 STATE & LOCAL GASOLINE
48
TEL. REQ. IN BUSINESS
14 GENERAL SALES TAX
15a PERSONAL PROPERTY
15b PERSONAL PROPERTY AUTO
197
24
16 STATE DIS. INS. H
W
SALES TAX AUTO
17 TOTAL TAXES
INTEREST (TO WHOM PAID)
18 MORTGAGE
34 TOTAL MISC. DED.
130
750
940
10152
SUMMARY OF ITEMIZED DED.
35 TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
STATE
FEDERAL
36 TOTAL TAXES (From LINE 17)
2543
-19 INSTALLMENT LOANS
MERRILLLVNIH
263
TRANS NORTO
SBA
170
16
20 TOTAL INTEREST
1992
2992
NW 88826 Decld:32245685, PagesAngeles, Calif. Form 101
37 TOTAL INTEREST (Line 20)
38 TOTAL CONTR. (Line 24)
39 CAS. & THEFT LOSS(ES) (Line29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM LINE 34)
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON 
FORM 1040 LINE 
45
REMARKS
5768
5590
7.4
STATE
FEDERAL
NAME
ADDRESS
• SAMUEL & PHYLLIS RUBY
MEDICAL
2 MEDICINE/DRUGS
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5H & AINS. (½ + EXCESS)
ɓa DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
322-12-7997
CALENDAR YEAR 19
SOC. SEC. NO.
DEDUCTION SCHEDULE
STATE
FEDERAL
CONTRIBUTIONS
21 PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
504
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
MISC. ORGANIZED CHARITIES
150
930
POLITICAL CONTRIBUTIONS
CHURCHES
22 OTHER THAN CASH
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
6C AMBULANCE
LABORATORIES
TRAVEL FOR MED. 1000
MEDICARE INS..
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
8 LESS 3% ADJ. GROSS INC.
70
1504
268
9
1236
1
+: (TO $150) OF H & A INS.
150
10 TOTAL MEDICAL DED.
1386
1386
TAXES
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
26 INSURANCE REIMBURSEMENT
27 Difference (not less than zero)
28 ($100 LIMITATION PER CAS.)
29 TOT. CAS. OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 CHILD & DEP. CARE (Form 2441)
33 INCOME TAX PREPARATION
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
Auto Use
Mi
INVEST. COUNSEL & PUBS.(Sched
11 STATE & LOCAL INCOME
12 REAL ESTATE
122
EMPLOYMENT AGENCY FEES
727
SAFE DEPOSIT BOX
13 STATE & LOCAL GASOLINE
48
TEL. REQ. IN BUSINESS
14 GENERAL SALES TAX
74%
15a PERSONAL PROPERTY
15b PERSONAL PROPERTY AUTO
24
16 STATE DIS. INS. H
W
34 TOTAL MISC. DED.
SALES TAX AUTO
17 TOTAL TAXES
INTEREST (TO WHOM PAID)
18 MORTGAGE
150
750
940
1052
SUMMARY OF ITEMIZED DED.
35 TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
STATE
FEDERAL
36 TOTAL TAXES (From LINE 17)
2343
37 TOTAL INTEREST (Line 20)
19 INSTALLMENT LOANS
38 TOTAL CONTR. (Line 24)
39 CAS. & THEFT LOSS(ES) (Line29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM 
LINE 34)
MERRILLLUNCH
263
TRANS NORD
170
SBA
16
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON FORM 1040 
LINE 
45
REMARKS
5468
5590
20 TOTAL INTEREST
1992
2992
NW 88326 CD18132245535. Page 7 ngeles, Calif. Form 101
NAME
ADDRESS
SAME PHYLLIS RUBY NO
322-12-7997
OR
SOC. SEC. NO.
CALENDAR YEAR 19
FISCAL YEAR ENDING
19
SCHEDULE OF PROFIT (OR LOSS ) FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
LABOR
EMPLOYERS NO.
680841
36079
TOTAL
INVENTORY AT
END OF YEAR
GROSS PROFIT
GROSS INCOME
36079
80721
35279
32805
32805
OTHER BUSINESS DEDUCTIONS
337
12000 MI
AT 154
1800
ADVERTISING
AUTO AND TRUCK EXPENSE
BAD DEBTS
CASH SHORT
COMMISSIONS
DELIVERY
DEPRECIATION
( SCHEDULE ATTACHED
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTEREST
JANITOR SERVICE
LAUNDRY
LEGAL AND ACCOUNTING
MAINTENANCE
OFFICE SUPPLIES AND EXPENSE
RENT
REPAIRS
SALARIES AND WAGES
SALARIES OFFICERS
SUPPLIES
TAXES AND LICENSES
TAXES
TELEPHONE
TRAVEL
PAYROLL
UTILITIES
PARKING
NET PROFIT OR LOSS 1
FEDERAL RETURN
NET PROFIT OR
LOSS
STATE
PROFESSIONAL
NW 88326 Docid:32245535 Page 74
STATIONERS INC. FORM
ANGELES CAL
104
1339
16
215.
1844
391
241
270
47
7841
991
5912
1063
388
322
45
22871
9934
(+)/539
RETURN ( SEE DEPREC. SCHEDULE FOR DIFF. (W) 2100
SCHEDULE
NW 88326 Docld:32245535 Page 75
7%
NAME SAM & PHYLLIS RUBY
ADDRESS.
322-12-7997
NO.
1.D.
OR
SOC. SEC. NO.
CALENDAR YEAR 19
FISCAL YEAR ENDING
SCHEDULE OF DEPRECIATION / AMORTIZATION.
KIND OF PROPERTY
EQUIPMENT
COST OR
SPEC 20%
DEP
OTHER BASIS
2/1/74/10228
GOODWILL
71/74/35000
DEPRECIABLE
BASIS
DEP ALLOWED
PRIOR YEARS
REMAINING
COST
METHOD
S.L
TYR 1339
TOTALS
PROFESSIONAL STATIONERS INC. LOS ANGELES
FORM NO 102A
SCHEDULE
1339
..
Loportment of the Treasury / Internal Rovonuo Sorvico
US dividical Income Tax Return
Ortho Sunuary 8-Deccant or 31, 1972, or othor Coxablo your beginning.
(17 joint com,
SLAN
first name and wilddo Initials of both)
HILLS
Including of ember, 67 resol route)
Sewing
RUBY
Lost nomo
1972, onding
4-6-75 25
1972
19
Your coslal C
349
Doty
Collen
322
WHO's number, 1] joint rem
110 11420
Ve Sol Employed
HODOWYO
Rogular / 65 or over / Clind Entor.
ப்பட்
-ci
Wing k
inity one:
aturn (ovon if only eno had income)
abei. 17 wife (husband) to alco
alcosarity numbor and frot
Exemptions
6 Yourself
7 Wife (husband).
3.
nymbor
☐ / DOHOD
chocked
First names of your dopondont childron who lived with
you Frnd, Brinn, Ellen, Thoman
a
9
Number of other dopondonts (from line 32)
10 Total exemptions claimed
(Attach Form W-2 to front.
andone child (Ent in your of douth
19
0,100, tips, and other employce componication. If unavailato, ut nation)
Por
God
[
11
120 Loss occlusion &
70.00
Balance ▷
12c
13
22 00
°
14
5,905/60
15
°
moving orponsos, etc. from lino 50)
Income)
10
17
of hin
donds and other distributions cro over $200, list in Port 1 of Schodule B.)
If $200 or tous, enter total without listing in Schedule 07
SOMO.
Lif over (280, onter total and list in Port II of Schodulo B.
amb corten wagca, diuidends, and intorost (from line 45).
Ins 11, 12, 13 and 14) .,
to incomo ( co “sick pay"
from lino 9 (onjucted (
sconto
0
If you do not Itomize doductions
ond lino 87 is under $10,000,
Wind (x in Tobics and ontor on
two 80.
Of you itomizo doduct! no et.
lino 17 to $10,000 or m
80 lino 88 80 80 80
y
could
3.4
shoot
Tonky 1-38
Celub D
Tox Roto Schcculo X, Y, or 2
Schedule G or Form 4726
10
Tollers (from lino 61)
19
nemo
(subtract lino 19 from lino 18)
20.
tort
(from line 67)
21
522 70
(3 20 and 28)
22
522 70
Income tax withhold (oftech Forms W-2
-2P (0) Wunt)
23
ct tax payments (include amount allowed
norock wom 1971 roturn) .
24
Form 4868, Application for Automatic Extension
Photo 1.3. Individual Ipromo Tax Return .
25
26
Ayato (from lino 78) .
.
661 (006 H9 23, 24, 25, and 20)
27
Pcy in full with roturn. Moto
52270
Mind 22 for than lino 27, onter BALANCE DUE IRS check or money order paysblo
D
23
Internal Ross Scrvice
DED TO YOU
29
30
python lino 22, enter amount OVERPAID
on 123timated | 38 |
during to Conable your, have any interest in or signature or othor authority
Couvillos, er efter financial account in a foreign country (Oxcept in a U.S.
20
C3y
3"
13 Reality open by a U.S. Anancial institution)?
from 4003. (for definitions, see Form 4683.)
De curn to complete Rovenue Sharing (lines 33 and 34) on next page.
Uief, gonca pozkay, I dealero that I love Camined the rotura, including accompanying scheduloo and stotomonts, and to tho bost of my knowledge and bolici
It is free, e rrect, and complots, Declaration of proparer (other than foxpoyer) is bosca on all information of which he has ony linowledgo.
Dato
Sign
Your algunsturo
[cro
Wife's (husband's) signature (if filing jointly, BOTH must sign ovon if only one had income)
EDWARD LAMBERT-
Properor's signature (oto on th
TAX CONSULTANT
17835 VENTURA BLVD., SUITE 106
Dotco
Address (CALI. Idem. cr Ses. £gy. Na.
TEL. (213) 881-7350
NW 88326 Docid:32245535 Page 76
S.S. 568-40-9527
Form 1040 (1072)
བབས་ག ༽
ཏྐ ཀཀ༧'︽︽
(b) Rolationship
(0) NAME
(c) Mentho lived in your
or diod
homo. If born
during yoar, writo B or
D.
(d) Did do.
pendont hovo
incomo of
$750 or moro?
YOU
(o) Amount
furnishod for de-
pondent's support.
If 100% writo ALL.
Pogo
(f) Amount fumlohod
by OTHERS Includ
ing dependɔnt.
$.
$
mbrepondents listed in column (a). Enter here and on line 9
(d) Township (eco instructions
c. pago U)
tion of your primal place of rat cald of your (not necesserify the came as your post office Eddress).
2 (E). County
(0) Scally. If you lived inside the boundorica of on incorpo-
dy, cts., cater its nomo; If not, choch horo ▷
Los Angeles
mure7 persons included on line 10
For IRS use only-Loovo blank
aro
ve
a roturn of their own; or, (2)
picipal pices of recidonco
" WOC Dividenda, and Intorast
Moochish Senco C)
JN3CM Q (1) freler onchongo cf capital conto (oktoch Schcdulo D)
87030071) from Supplemental Celicdulo of Coins and Loscos (attach Form 4797).
and canuitico, rants and royalties, partnorchips, co8otes or trusts, etc. (attach Schodulo E)
eixe (or loco) (attach Schodulo F)
5) Pack
8 Form
.
C) Fully Coxablo potions and annuities (not reported on Cchodulo E-sco Instructions on page 8)
31 40% of explain distributions (not reported on Schcdulo D)
12. Cato Income for refunds (caution-sco instructions on poco 0)
13 Alimony N
for (inture and source)
(35 through 44). Enter boro and on line 14
39
36
6,969 40
(1,000 00)
97
23
39
•
CO
41
42
43
44
45
5,96940
"Wel
ludo
اینجا سالم
4
°
como (ottosh Form 2440 or othor required statemont)
Fort 9909)
43
47
Boch PM 2103 er for stotomont)
forcen 690 potfromonton, clc. (coo Form 4840)
49
143, 48, 40 and 49). Put 7 horo and on lino 16
ابا عالات
(ie not ch) this part if you use You Tobics 1-12 to find your tox.)
just
Do income (for lino 17).
(*)(0) 10 some depentino, onter total from Schedule A, line 40 and attach Schedule A
(b) fan (not to deductions, ontor 15% of lino 51, but do NOT enter more
(91,C20 no 3 is chosted)
Subtract to 92 from line 53.
Multiply number of oxomptions cloimed on lino 10, by $750.
Thai Subtrect line 54 from line 53.
.
•
58 888
51
52
5,991 40
4,423.00
1,568 40
55
5,250 00
(3,68160)
(Figure your tax on the amount on line 55 by using Tax Rate Schedulo X, Y or Z, or if applicable, the alternative tax from Sched-
Davoraging from Schedulu G, or maximum tax from Form 4726.) Enter tox on line 18.
WW
two eftch Schedulo R)
38 (
Pack
113
Ven, 3409).
1116).
CO Work
bution to subidatos for public office 000 instructions on pago 9
(uttach Form 4874)
し
01 Total.c
(cd lines 56, 57, 58, 59, and E0). Enter horo and on lino 19
Miss VA YES
02 Self-employment tax (Such Schedulo SE)
.
03 Tax from rocomputing prior-year investmont credit (attach Form 4255)
03 inimest (or instructions on pago 10). Chock hero ☐, if Form 4625 is attached
123 Social security tax on tip income not reported to employor (attach Form 4137)
23 Uncelicated employee (Detal scurity tax on tips (from Forms W-2).
07_Wines 62, 63, C4, 65, and 66). Entor here and on line 21.
03 Excess PEA with (voor moro omployers-cco Instructions on page 10)
CO Crodit for Fotorul tox on spociul fuols, nonhighway gacolino and lubricating oil (attach Form 4136)
70 Crodit from a Rogulated Invostmont Company (attach Form 2439)
70
71 Total (add linics 68, 69, and 70). Entor hare and on llwo 20
D 78
US GOVERNMENT PRINTING OFFICE 1011 4040 A GPO 793 601
850288 838386 38RK
53
61
62
522 70
65
66
D
67
52270
NW 88326 Docid:32245535 Page 77
Schedules A&B-Itemized Deductions AND
(Form 1440)
Deportment of the Tronsury
Internal Rovena Servic
"
Name(o) as thown en Form 1040
3
Dividend and Interest Income
▷ Attach to Form 1040.
"
1
Javilion Barbge
Adulo Itomized Poductions (Schedule 8 on back)
COMPU
1972
Your cocial security number.
322 12
7927
by Insuranco Contributions.-Cash-including cheeks, monoy orders, ctc.
(Itomize-see instructions on page 11 for examploo.)
dr, doctor, dentists, nursos,
for modle: I enro, ctc.
hospital c, En jeg
2 no r
94'0) of In
470
Dro. (Do
:)
3N
(
Om for
Bater boro)
•
Entor belange of insurance premiums for
randical care ontored on line 1.
Nomize othoracical and dental ox-
ponse Incert Douring olds, denturos,
oyogle 300, leportation, otc
}
10 Total cash contributions .
19 Other than cosh (000 instructions on
page 12 for roquired statement). Entor
total for such items hore .
20 Carryover from prior years.
21 Total contributions (Add lines 18, 19, and
20. Enter here and on line 35, below.) ▷
Intoroot oxpenso.
22 Homo mortgage
23 Installmont purchasos.
24 Other (Itomizo)
"Total
4, 8,0).
Enter of 17, Form 1040
Subtro
em Enter diffor
oneo (7 locs th 2016, ontor zaro).
°
And on the 85.)
kontol on-
38x10. Enter horo
D
150.00
Hool CARD
22 Stato and fosal pooling (se gap tax tablos)
23 Conere saka (que calco, tax tablos) .
14 Stato il local incomo,
24 Personal property
10 Other:
200.00
29 Total interest oxponco (Add linco 22,
23 and 24. Entor hero and on line 36,
bolow.)
D
3.23200
Casualty or theft loss(C3)
Soe instructions on page 12. NOTE: If
you had more than one casualty or
thaft loss occurrence, OMIT lines 26
through 29 and soe page 12 of the
instructions for guidanco.
26 Loss before odjustments.
27 Insurance roimbursement
28 $100 limitation.
29 Add lines 27 and 28
30 Casualty or theft loss. (Excess of lino
26 over line 29. Enter here and on line
37, below.)
D
31 Child and depondont care expenses
from Form 2441. (Enter here and on
line 38, below.).
$100 00
D
Miscellancous deductions for alimony,
union dues, etc. (soo instructions on
page 13).
841 00
17 Total (DAC (Add lince 88 through 10..
Enter horo R on lino 34, below.).
D
32 Total miscellancous Coductions (Entor
. D
hore and on line 39, below.) .
Summary of Itomized Doductions
Total deductible mcdical and dental organces (from linɔ 10)
24 Total tax (7m line 37)
80 Total contributions (from line 21).
36 Total intorost expense (frum line 25).
37 Casualty, and theft loss (os) (from line 30).
A
150 00
841.00
200 00
3,232 00
20 Child and doporident cure expenses (from line 31).
39 Total miscellaneous deductions (from line 32).
40 TOTAL ITEMIZED DEDUCTIONS. (Add lines 33 through 39. Enter here and on Form 1040, line 52. S/A D
4,423 00
NW 88326 Docld:32245535 Page 78
IDENTIFICA.. UN NO. 322-12-1997
SCHEDULE OF DEDUCTIONS
STATE
CONTRIBUTIONS
CHURCHES
050
YEAR ENDED.
FEDERAL & STATE
100@
NAME
ADDRESS.
Svea un ver
Rusy
SCHEMAR NO..
CAP OF MENGAL INDELINGS
NO MEDISHES
563 NOU. 1998 INME
FEDERAL
3/CUNTISTY}
KINK GE
R3
MEDICAL
APPLIANCES.
EXPENJES
MRSED BY INSURANCE
ADJ, QLD SOMS.
66)
2000 IN 08
COMMUNITY CHEST/UNITED CRUSADE
SALVATION ARMY/GOODWILL INDUSTRIES
RED CROSS
XMAS & EASTER SEALS
HEART FUND/CANCER FUND
PARTNERSHIP RETURN
PAYROLL DEDUCTION
CITY OF HOPE
$1
OTHER ORGANIZED CHARITIES:
TOTAL CONTRIBUTIONS
INTEREST (TO WHOM PAID)
MORTGAGE LOAN OLONIAL ME
INSTALLMENT LOAN
KAY ARBA FIN.
ARE THEIR A
Was View at
7000
2014 1
FEDERAL & STATE
245940
40@
24007
TOTAL INTEREST
MISCELLANEOUS DEDUCTIONS
ALIMONY (EXPLAIN)
SAFE DEPOSIT BOX FEE
UNION DUES
SMALL TOOLS (GOOD 1 YEAR)
TOOLS DEPRECIATION
SAFETY EQUIPMENT
UNIFORMS (NOT GEN. WEAR)
LAUNDRY & CLEANING
AUTO
MILEAGE (10
TELEPHONE EXPENSE (NOT REIMB.)
EMPLOYMENT AGENCY FOGO
PUDERAL
OTATU
DUES & SUBSCRIPTIONG
G (LOCO DEG. VOL
MINOUTO
63600 636 10
INCOME TAX PREPARATION
CHILD CARE
OTHERS:
TOTAL MISC. DEDUCTIONS
CASUALTY LOSSES (EXPLAIN)
PAX
д д 口口
(0) EAB. O
сел. обро
CITY INSURANCE"
TAX
OYNERS:
Д д
Д
OD
_YOYAL TAXES (4) 02. 047.00
NW 88326 Docld:32245535 Page 7
18326 Docks PUERT
SUB TOTAL
LESS REIMBURSED BY INS.
SUB TOTAL
IFSS $100 00 FOR EACH CASUALTY
FEDERAL & STATE
FEDERAL & STATE
TOTAL CASUALTY LOSSES
FEDERAL
STATE
TOTAL DEDUCTIONS RAW
17835 VENTURA BOULEVARD, SUITE 106
ENCINO, CALIFORNIA 91316
SCHEDULE C
(Form 1040)
Department of the Treasury
Internal Rovonue Servico
Profit (or Loss) From Business or Profession
▷ Attach to Form 1040.
(Sole Proprietorship)
▷ Partnerships, joint ventures, otc., must file Form 1065.
Naine(s) as shown on Form 1040
Somel and Phyllis Ruby
A Princied puck uctivity...
; product
1972
Social security number
322 12 7997
(For oxamplo: rotail-hardware; wholesalo-tobacco; sorvices--logal; manufacturing-furnituro; ctc.)
Food Servico
(c)
..
Bruck Bor
Jus
¨5410"Fak¨´Nuyo¨Blva,
C Employer Identification Number
Busin, (imb and ctreot)
City, und 21 do
Van Nuyo, California¨
Indic accoung: (1) caoh; (2) ☐ accrual; (3) ☐ other.
required to filp Form 1096 for 1972? (See Schedula C Instructions)
EM______
F Were
☐ YES ☐ NO. If "Yes," where filed? ▷
01 this inces located within the boundaries of the city, town, ctc., indicated? YES
old you this busing the and of 1978? YES ☐ NO.
Dewy mochain 1078 did you own this busine? 12.
☐ NO.
7 Was on Employor's Quarterly Fodoral Tax Roturn, Form 941, Allod for this businood for any quartor in 1972? ☐ YES ☑ NO.
IMPORTANT All coplicablo lincs and schedulca must be filled in.
3. Greco receipts or solco S..
_ Loco roturno and allowances $.
12 Loo: Gout of goods cold and/or operations (Schedule C-1, line 8)
8 Gress profit
4 Chor Ireento(at)hodulo)
B
AL
Inoma (non 3 and 4)
In Occulo C-2)
you on chicos proporty (Oxplain in Eshodulo C-3)
Rosas preporty
Repain (oxplain in Sehodula C-3)
Setorica and wage included on lina 3, Schedulo C-8 (oxclude any paid to yourself)
33 Insuranc
A.
12 Legal as proicosional food
10 Commingb
24 Anerlisation (oftech sectoment)
10 (0) Ponsica and profit-sharing plans (0) Schodule C Instructions)
(4) Employd benefits programs (see Schedule C Instructions)
20 intron businoco Indebtedness
87 crising from bales or servicop
10 Doplatint
20 coxon (spcelfy):
Balance ▷
SCHEDULE
ATTACHED
C
(u):
(b).
(c)
(d).
(b)
(1)
(g)
(h)
20
• (10).
(1)
(m).
(n)).
(0)
(p) Total other businoso exponses (add linos 19(a) through 19(0))
Total deductions (add linos 6 through 19).
21 Net profit (or loss) (subtract line 20 from line 5). Enter here and on line 35, Form 1040. ALSO enter on
Schedulo SE, line 1
NW 88326-Doeld:32245535 Page 80
6,969 40

Samvol and Phyllio Ruby
1972
Inc
Logo: Solos Tox
Good Credo Cold
Daging Inventory
SUPPLEMENT TO SCHEDULE C
Moat
Bchor/goc
#Rical Available
Lous! Ending inventory
Grood Income
Papasco
•RODC
Accorracisy
Portosa
1.
Tolofican
*Advoeding
Miccollcucoup/topolre
Equipont
Toro/licensed"
Hongery
Auto
Lincn
Donationd
$45,499.72
383.47 $45,116.25
$
800.00
4.491.98
16,463.08
2,923.29
3,102.44
$27,780.79
800.00
$ 1,728.82
100.00
3,877.93
26,980.79
$18,135.46
323.42
190.00
127.45
25.00
254.15
382.25
214.51
12.15
425.29
000
61.94
14.65
7,737.56
Newspapers
NET INCOME
Long
Depreciation
NET INCOME
$10,397.90
3,428,50
6,969.40
DEPRECIATION
Benipmont
4-70
$10,000.00
$4,000.00
5 Yr. SL
$2,000.00
Govont not to
Compoto
5,000.00
2,000.00
2 Yr. SL
1,000.00
Leasehold Imp.
(Balance of Lease)
3,000.00
957.00
7 Yr. SL
428.50
$3,428.50
NW 88326 Docld:32245535, Page 81
SCHEDULE SE
(Form 1040)
Deportment of the Treasury
Internal Rovenuo Servic
Computation of Social Security Self-Employment Tax
▷ Each self-omployed person must fit a Schodulo SE.
▷ Attach to Form 1040.
1972
▷ If you had wages, including tips, of $9,000 or moro that woro subject to social security taxes, do not fill in this pago.
▷ If you had more than on business, combing profits and lessos from all your businesses and farms on this Schodule SE.
Important. The self-employment Income reported bolow will be credited to your social security record and used in figuring social security benefits. :
OFS SHOWN) ON COCIAL CZCURITY CARD)
Sombod Re
Cecial cecurity number
al coll-employed porcen
322 12 7997
Business cethitic subject to self-employment tax (gresory store, restaurant, farm, etc.) ▷
Computation of Not Earnings from BUSINESS Self-Employment (other than farming)
7 Net profit (o less) shown in Schedulo C (Form 1040), line 21. (Enter combined amount if more than one
B
"*
4.
•
12 Notino (1030) Oncluded corvieos or courecs Included on line 1 .
Opocky oculor our
Not comingoer 1000) from business colf-cmploymont (Subtract lino 2 from line 1, and onter hore and
ien llao ((a), bolow.)
| Computation of Not Earnings from FARM Self-Employment
6,969 40
6,969 40
SE
A firmer may olcat to computo not farm carnings using the OPTIONAL METHOD (lino 6, below) INSTEAD OF THE REGULAR
OD (lino 0,Solow) 17 Ria gross profits ora: (1) $2,469 or loss, or (2) more than $2,400 and net profits are less than $1,600.
your gre33 proits from forming are not mero than $2,400 and you elect to use the optional method, you need not complete lines
3.and 5. t
Computation under Regular Mothed
40 Not form profit (or loss) from:
(a) Senodulo F, line 54 (cash method), or line 74 (accrual method)
(b) Farm partnerships
Its Not coming from scmployment from forming. Add linos 4(a) and (b) .
**
Contation undor Optional Mcdied
O reprom towing are:
((0)
;;
12/490, ontor two-thirds of the gross profits.
(6) Morov 62,400 tho not form preft to loco thon $1,600, antor $1,600
- profit frem forming are the total of the gross profito from Schodulo F, lino 28 (cash
c) or no 2 (accrual mothed), plus the distributivo share of gross profit from form
303 omplained in Instructions for Schodulo SE.
Enter hero ondion Ilmo 8(b), below, tho amount on line 5 (or line 6, if you use the optional
method)
Computation of Social Security Self-Employment Tax
8 Net earnings (or loss) from self-employment-
(a) From business (other than farming) from line 3, above
(b) From farming (from line 7, above) '.
(c) From payinorships, joint ventures, etc, (other than farming)
(d) From, corvico as a minister, membor of a religious ordor, or a Christian Science practitioner. If you
filed Porn 4361, chock hora [ and ontor zoro on this line
.
(0) Premi Skylen with a forulon governwont or international organization
((7) Other (director's foolote.). Specify
0 Votal not pingo (or fono) from solf employment reported on line 8.
(07 lino () to Kou than $400, you are not cubjoct to coll-Omployment tos. Do not fill in root of pago.)
10 The largoot amount of combined wages and self-employmont earnings subject
to social cocurity tax for 1972 is
11 (a) Total "FICA" wagos as indicated on Form W-2.
(b) Unreported tips, if any, subject to FICA tax from
Form 4137, lino 9.
(c) Total of lines 11(a) and 11(b)
12 Dalanco (subtract lino 11(c) from line 10).
13 Self-employment income--line 9 or 12, whichever is smaller.
14 If line 13 to $9,000, ontor $675.00; if less, multiply the amount on line 13 by .075.
0
$9,000
00
6,969 40
6,969 40
522 70
+
i
85 Railroad Chipleyco's and railroad employoo representative's adjustment for hospital insurance benefits
tox from Fort 4469.
30 Golf-employment tax (subtract line 15 from lino 14). Enter here and on Form 1040, line 62
522 70
NW 88326 Docld:32245535 Page 82
.
SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Servico
Capital Gains and Losses
▷ Attach to Form 1040. ▷ Examples of property to be reported on this Schedule are
goins and losses on stocks, bonds, and similar investments, and gains (but not losses)
on personal assets such as a home or jewelry.
Name(s) as shown on Form 1040
Soul on Phyllin Ruby
Chol-forn Cupitol Gains and Lossos--Assots Mold Not More Than 6 Months
UK 7 preporty and consription
(15,800 oharco
"".)
b. Moty
Ocquired.
Entor lottor
Dymbol (coo
inctruction
c. Co., doy, yr.
(Put doto said abovo
dotted lino and dato
acquired below
dotted lino)
d Gross anlos prico
1972
Social security number
322 12 7997
o. Cost or other bosis,
as adjusted (000
instruction E) and
Oxpence of solo
D
8. Coin (or loos)
(d loca o).
SCHEDULE ATTACHED
Entor your chare of not chort-term coin (or loss) from partnerships and fiduciarios
Entorno coin (or 1900), combino linos 1 and 2.
4(0) Short-timepital 1900 component carryover from yours beginning boforo 1970 (seo Instruction H)
(436) Short-form capital loco carryover attributable to yours beginning oftor 1969 (soo Instruction H)
Nog postcoln (or loss), comblo linas 3, 4(0) and 4(b) .
| Longform Capital Gains and Lossos-Assots Hold More Than 6 Months
Capital gain distributions
Butor (oppileablo'from line 4(0)(1), Form 4797 (coo Instruction A)
(4,496 00)
4,296 00
2
3
4(0)
4(6)
•
ព
200 00
7
0
g
10
22
Entor your chora of not long-term goin (or loss) from partnerships and fiduciarios
Entor your choro of not long-term gain from small business corporations (Subchapter S).
Not gain (Cr less), combing lines 6 through 10
10
11
.
13
12(0) Long-term capital loss component carryover from years beginning before 1970 (see Instruction H)
12(b) Long-term capital loco carryover attributable to years boginning after 1969 (see Instruction H).
Net long-term gain (or loss), combine lines 11, 12(a) and 12(b)
Past Summary of Parts I and II
12(a) (14,522 007
12(b)
°
13
14
ចិន
Combine the amounts shown on lines 5 and 13, and enter the net gain or loss here.
If line 14 shows a pain,
14
(14,322 00)
(a) Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part VI for computation
of alternativo tax). Enter zero if there is a loss or no entry on line 13.
15(0)
.
15(b)
16
(b) Subtract line 15(a) from line 14. Enter here and on line 36, Form 1040.
If no 30 chow a loo
▷ Omit linos 16(0) and 16(b) and go to Part IV if looses are shown on BOTH lines 12(a) and 13.
Sou Incéruction
▷ Othorwico,
(0) Entor ono of the following amounto:
"
(1) If amount on line 5 is zoro or a not goin, onter 50% of amount on line 14;
(ii) If amount on line 13 is zoro or a not gain, enter amount on line 14; or,
(iii), If amounts on line 5 and line 13 are not losses, enter amount on line 5 added to
50% of amount on line 13.
(b) Enter here and enter as a (loss) on line 36, Form 1040, the smaller of:
(i) The amount on line 16(a);
(ii) $1,000 ($500 if married and filing a separate return-if a loss is shown on line
4(a) or 12(a), see instruction M for a higher limit not to exceed $1,000); or,
(iii) Taxable income, as adjusted (see Instruction 1)
NW 88326-Docid:32245535 Page 83
Carrvover
16(a)
1,000 00
16(b)(
(13,322.00)
J
D. and PHYLLIS RUBY
PiGE
SALESMAN WEIS. VOISIN and N
Co.,
WEEKLY WORK PLAN/TIME REPORT
NUMBER
CONTRACT
WEEK ENDING
:
accueings
Present
Customer
Mavel And
AMOUNT
APPLIC
NET
REMASE DATE
PRICE
NET SALE PRICE
PRICE
SoD
COMMENTS ANI
EXPENSE
HR +CLUSOTES GA
62/12
- 73-05% ! | | 5mm
Go34 M1771 3165,29 1-6-72 3103. Br
(60300)
Come Del
су
954 04% -7000 749 1-97-70 1547.62 1-17-77-1514:00 Th
FAVEL CORR CONV.
09
51-37-0-1547.62
Des. 75- 17% ST 3,000 71% 13:27-71 23-21.43 1-17-72 2.352.95 7414
04-75% 15.000 561/ 12:30-71 02886.00 1-6-72 29 51%
1800575-77 593,2 1-19-7365 5
V
PL: Corelli Sto 2014 1-19-112 45240 2-2-2 411 212
Co. Wes. Sh. 15½ 1-19-74 30842 2-9-72 3287 lis
St. Sh. 232-9.73 477791/2
11/267-7-72 83472 2-11-72 2069 2 (29)
(1420)
BY PFD 1/2 Sh. 1844 2-11-73 19142 3-13-72 1931 1974
dosh, 182-7-42 37412 3-13-72 372-19
2012-12-29 363 3-13-7 21685 11½ (4/629)
Voll
04
За
H
1203
2.5
100 SM. 11½ 12-12-12 11742 3-13-72 9/11 9 (7630)
KEST Jal
TOTALS
NW 88326, Docld:32245535. Page 84
Sus D. and RYLLIS RUBY
WEEKLY WORK PLAN/TIME REPORT
SALESMAN
WEIS VOISINA CO., INC.
CUSTOMER
NAME
RITIES
Fresent
Customer
SHARES
NUMBER
CONTRACT
PURCHASE
PRIE
ATION
DATE
SRILD
WEEK ENDING PAGE
REVENUE
BOOKED
NET SPIEST PRICE
PRICE
COMMENTS AN
EXPENSE
HR LOSS NOTES G
111 he's 17-972 755854-29-73 "1985" 164/4
212514-78-72 1161 5.22% 10:32 5% (1032)
ค. ปี 2 |
5.75% $2,000 5724-28-72 1161 5.22.7 11167 55
5. Cafe Comel
45
-6.752 8 56 924-28-73 4643- 5-22-74303 53 (340)
5113-13-71 30.330 7.17-73 36032 18%
L
ST100
19th 7-10-22 10122 8-24-70 10522-10%
12 8-16-73 1835 8:24-72 2033 203/44
19
8-24-77-2 20612 9-6-72 3732
☐
Bangs
31/12/5/72-732835 9-18-72 1950 1978 (885)
Cambrives 511 10 27/1996-3-23 28092 9-18-72 1913 1912 (896)
GENT WAS
80
1483 7-13-73 1173% 10-5.72 1145- 145/8 (47)
Math Clear Mrs.
100 149 9-18-72
1489 10-11-72 1519 15/2
༧''
Was.
Turbo f. - Missi (STT pess 1453 19-18-7 | | 14.89 10-11-72 153 15%
"briserved the
NW 88326 Docld:32245535 Page-85-
Vol 3-31-71 1182
1-17-72 107-30 11
(28)
(2900)
234
And
SAMUEL D. and PHYLLIS FUBY
WEEKLY WORK PLAN/TIME REPOR I
SALESMAN
BACHE and C. 1972
a.
CUSTOMER
NAME
Customer
Present
NUMBER
CONTRACT
Planned
PREM
ENTL
TEL
CoMaNDTIES
REVENUE
BOOKED
PURONGE DATE
APRUDRATION
SOLD PRICE
TRAMASA
PRICE ON
CALI.
COMM
HRS
EXPEN
+
HR CONT
3.67 1.1.2-2
38
36.7 1.12-74
3.82
Ra Ifa.
(67.50)
224
12-1-71
13-21-72 1
2 123 1.6.72 123/
1237/
24.05 1-18-72 075.00
101.201-24-72 102.70
24.652-2-72
25.15
2490 2.7-722 3.5.60
24.93 2072 3510
123.00 2-8-72 131.90
25.10 3-7-72 25.20
11.79 3-7-22
(1390)
(30.00)
73
86
150
123
11.-19-22
Papa Ketua Cite 1-6-72
1-20-722
☑
13-3-72
12
12.8-72
W
11-26-7411
13-8-781
12.05.
SEAM
141-72 MB. 33714 3.15.72 3314
13-2-2111
27.303-1672 27.75
321-72 51 B. 317.00 3-24.72 345.00
43-23 1
26.44 4-19-72 25.10
for
(4602 OCD)
(1992) 40s
G.00 Foll VINAMICIAL PUBLICATION'S
15.00 FOR ADAMS KEATAR
2.00 Ep. FINGER REPAC
TOTALS
NW 88326 Docid:32245535 Page 86
DIUIDUNT
40
INDIVIDUAL
CALIFORNIA
INCOME TAX
arar year 1972, or other taxable year beginning
NAME(S) AND IN(S)
SAK
TAXABLE YKAD
1972
1972, onding
1973
LAST NAME
RUDY
Including sportmont number, er rural route)
," California_
ZIP CODE
OCCU-
PATION
Your social security number
322 12 7997
Wife's number, it
349 16 1420
Yours Self Employed
W180'0 Housewifo
9. Expo-03 not lict yourself, your spouse or person who qualifice you as head of household
DADB (losed and/or if different from yours)
ALLATIONSHIP
End, Brinn, Elloa, Thomas...
return Enter puso's secial
y number and Wra como here.
-Enter
..Number ▷ 5
6. Dilad (refer to instructions)
Number of blind exemptions claimed ▷ 6
0.
ericano Gempisto Part 1, page 2
7. Total dopondont ac3 Elind oxomptons (add lines 5 and 6)
7
10.
(Attach Copy 2 of Form(s) 17-2 to
3.0, 3, 3, 3, and other employes compensation. freat. If available, ces explanation)
nor total (If over $500, comploto and attach Schodule B(540))
total (If our $500, comploto and attach Schodule (B(540))
uidends and Introst (from page 2, line 41)
4.11. Imp offer Om
02
(0, 0, 10 cnd 11);
مانة
8
7000
g
10
22100"
11
5.969160
12
6.065140
2. lino 47)
13
34
(no 10 from in 12)
14
6,061 40
W
1 AND 10 is under $10, and tor in Tor Table and octor on lino 17.
101 Codesto CA Ino 14 is $10,000 or more completes 18 and 16.
2,000 100
10. Notions C ploudard deduction (from page 2, line 56)
15
10. (subarcet lino 15 from no 14). Figure your tox on this cmsunt by using the appropriate Fox Rate
otro Enter tax on 87
10
4,06160
Tax Tablo,
☑Tox Roto Schedule 02
☐ Schaduto 'C(540)
17
32100
6.
"
10.
Olago-$25. Married couple or head of houschold £50
-Total on line 7 above, h × $8
18
19
50700
32 00
20. Te (add is 18 and 19)
20
20
80.
Cubtract liz) 20 from lino 17)
12. Ce
from pago 2, line 59)
29. Not
(subtract line 22 from lino 21)
25. Total
24. Tan on Erfurted incorde (see instructions-attach Schedule P(540))
(add lines 23 and 24)
26. Total California inceto Co pithhold (attcch Form(s) W-2 c? DE-2P to front)
27. 1072 Cafes fox payments
26
27
28
23. Excoco Galliumla, 891 tox withhold (attach Form DE 1964fcco of return)
29. Total paymen03 (udd finos 26, 27 and 28)
29. If 110 25 to larger thigh lino 29, entor CALANCE DUE.
St.-if lino 29 is larger than line 25, enter OVERPAVIMENT.
Pay in full Mail payment with return to
Franchise Tax Board, Sacramento, CA 95367.
Coil return to P.O. Box 13-540,
Sacramento, CA 95813.
22. Lino 9 tot (u) 03. (Allow at locot'ch weeks for your refund)
(b) Credited on 1973 estimated tax
D
D
21
24
25
22223
O
29
<
30
▷ 31
Sign ▷
Nore
Under penalties of perjury, declare that I have comined this return, Including escompanying schedules and statements, and to the best of my kno
Collef it is true, correct and complote. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any imowledge.
EDWARD L. LAMBERT
TAX.CONSULTANT.
Do cot write ta these spess
P
E
Your signature-if Oling Jointly, BOTH must sign
Dato
YSS VENTURA
ENCINO, CALIF. 91316.
Spouse's signaturo
Dato
Data
A
TEL 7213) 881-7350
NW-88326 Docld:32245535-Page 87-
S.S. 56840-9527
2 Form 543 (1972)
God of Houscheld-If claimed, answer the following questions
Chcel ☐ Nover married
נכס
☐ Widow(or) Dato,
(Soo Instructions)
Legal soparation (interlocutory docroo doos not qualify) Date
☐ Final diverco/dissolution Date_
Individual who qualified you as head of household (Do not list this individual as a dopondont on pago 1, Ilno 5):
Age Did this person qualify as your dopondont for
Did this porcon reside in your home for the entire taxable year? _ If not, explain circumstanci
Year: 1977
Rolationship_
(for 33)
(loss)
in (or foss) from
Schou
of one
(646)
of capital ossct) (citoch Schodulo D1540)).
not goin (or loss
pimental Cohodule of Gains and Losses (aftich Schodule D-1(540))
lines 30 (a) and (b). :༢。
alec danuiting.
C
(PCR)
s
101 Panda (ur lose) (otton Schedulo™ (540))
(a) Fully foxable pensions and annuities (not reported on Schodulo E)
(5)) Alimony.
(c) Other (state ecture and cource)
(14) Yol lolous Incon (add lines 40(a), (b) and (c))
94 Entor for on pago 1. no 11
༥. ༩༨ ?
10 Included in la(see Instructions-attach statement)
conson (sed indiretto) statement)
Coloss of
..
insta st
pay only (and Instructions for 8, page P'>
on to a tirement plan, ctç.¨
(ir
hero and on page 1, Ɔ 10°
99
6,969 40
34
(1,000 (00)
35
36
37
38
39
40
41
28
5,969 (3
43
47
42
2 3 3 3 9 5
43
24
44
45
Doduction Onceparate returca cl ccrried taxpayers both must Romize deductions or both must take the standard deduction
codulo A (210) and enter sub totals on lines 43 through 53, bolew
al caponco (from Schedulo A (40), line 10)
duction drum) (m Schedule A (540), line 15).
Siren Schoula A (540), linɔ 23)
utions (feld A (540), Ikó 25)
58 sponso (from Sodule A (5), line 29)
Tous Cuction (from Schoule A (540), lina 37)
deductions (add fines 40 through 53)
(g() fico (oductiuis, onter a standard deduction cl
shigle or marric person filing separate return
C) of oudoor mori 3 couple filing join& roturn
Cosuctions Ch 54) 03 deduction (no 55). Enter Core and on pago 1, line 15
for
48
49
50
51
52
53
54
20000 00
55
59
56
Tax PC to Another State-Attach copy of "other state" return-and Retirement Income Credit
fved from sources within State of
and also taxable by California A
Andivated pro pecin (from pol; linɔ 14)
(clicbility (ach ringo,
B
C
cat (3 (79))
(100%) x line C (connot excood ton paid other stato
bit
57
58
97 and 8. Enty hero and co pago 1, line 22
59
ancilation to Federal Return-If adjusted gross income on Federal Return is different from line 14, page 1, explain below
NW 88326 Docid:32245535 Page 88″
04250-400 0-72 1D. COOM ①A COP
A
Samuel and Phyllia Ruby
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Ford $40
Dy chole bouti
13 or fate a seduction
00 expert returns of a pond and wife,
compte by Insurcaco "cr otherwise) for
(C3, Costers, Contato, nervos, heapt
print for
TAXABLE
19
12
YEAR
Cali g c
322 12 7997
if one spouse itemizos deductions, the other may not use the Tax Table or clot
the standard deduction. If you choose to itemize your deductions, completo in
appropriate items below.
Contibutions
caro, c
22. Cash-Including checks, money orders, etc.
(itomize)
22
10 of
3
9 from 2. Entor Koronce
COLLECTO, GOT 2070).,.
4
Ence of insure() prosiums for medical
8
5 G
5
23
24
200.00
.D 25
23. Total cash contributions
24. Other than cash (see instructions). Entor total
here
.
29. TothAdd lines 23 and 24. Maximum deduction
may not exceed 20% of adjusted gross income.
Enter here and on Form 540, page 2)
Interest Expens
20. Momo mortgago
27. Installmont purchacoo
0000
20. Otor (itemize).
0
V. Enter differe
for w
9
10. Enter foro and on
150.00
10
20. To
Add lines 26, 27 and 28. Enter hore and
on Form 540, page 2)
27
222
•
20
*། །
......
3,232.00
29
Miscolomons Deductions
1
Casucity or Thoft Loss(os)-Soo Instructions
11
NOTE: If you had more than one casualty or theft
1036 occurrence, omit lines 30 through 33 and follow
instructions for guidance.
20. L933 Doloro adjustmontą
31. Incurenço reimburcomont
شاهی
19
32. $100 Imitation
93. Add lines 31 and 32
34. Casualty or theft loss. (Line 30 loss line 33)
34
3=233
39
$100.00
39
.
14
35. Child Caro-Sec instructions.
35
od
15
16
30. Oor--For education, alimony, union duos, etc.
-S30 Instructions
36
and gokat
17
10
Lovato
19
22
20
1. 14 rough 20. Cator
horo con Fcm £49, pc30 (2)
شاه
(D.v. 1972)
NW-88326 Docld:32245535-Page-89-
21
841.00
07. Total miscollanoous deduction--Add Ilnoo 34, 35
and 30. (Entor hore and on Form 540, pogo 2) ▷
37
Schedulo D on rovorio
SCHEDULE
Li
PORM 540
17
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Solo Proprietorships)
1 schedule to your form, Dorm DCO COND
How
10 Ruby'
TAXADLE
19 72
YEAR
".
Pannorbica, joint vontures, ote, must me on form [20]
Social Security Nunicor
322
127997
Food Servico
1 Ulcer
Balup for:"
Ongel: Bor
cross..
; product
(for ossomlo rotail-hardware; wholocalo-tobacco; sorvicos-logul, manufacturing-furnituro; otc.)
5618 Vou Nuya Blvd.
hodespunting,
891, 72, 400 and
sle
this
C. Fodorol omployor identification numbor...
Van Nuys, California
ecch; ☐ Czerval; ☐ other.
for the color year flod (if required)?
undaries of city, town, plc. indicated?
of the toneblo yoar?
Yes
No
.12.
my menths of the sumablo your did you own this businos?
applicable (lobe and conduce must ba.fd in.
Greipt for solo
A
(ZIP God)
☑ Yos
Yes
No
☐
Cof goods.cold (Schodule C-1, lino
Locs returns and allowances 8.
and/or operations (attach schodulo)
Balance ▷
SCHEDULE-
ATTACHED
༦ ༣༩༡
SAN
(uld finde 3 and 4)
Jeton?
in Seli ulo C-2).
burhoods
property (oxplain in Schodulo C-3)
on buptive property
Calodulo" C-3)
190
198
bion and tyøges ties included on line 3, Schodulo C-1 (oxclude any paid to yourself)
121 Tad profopional foes.
14ction (statomont)
100 Coaston and profit-sharing pland (see Instructions for lino 15(a))
NC
38
Caloyco how
on bucknow
ཌ
wearem (che Instructions for line 150))
bran
delis arting from sales corvicos
Sien
Row
(c)
(0)
(9)
(0)
3
20
(0).
(p) Total other business expenses (add lines 19(a) through 19(0))
Total deductions (add lines 6 through 19)
21 Net profit (or loss) (subtract line 20 from line 5). Enter here and on page 2, Form 540 or Form 540NR
(Qov. 1972)
NW-88326 Docid:32245535 Page 90 --
یورتر و
6,969 40
Pago 1

OCHDULE
40
CALIFORNIA
CAPITAL GAINS AND LOSSES
Astash to Form 503 or BAGNA
co to ropart gains and losses on stocks, bonds and cimilar investmonto
on (but not lagros) on porconal accons such as a homo er lcwolry.
[ Than One Ye
2,100 ( 7"
(a)
b. Dato 01
(100 (777)
c. Date cotd
(Co., day, yv.)
d. Gress sales
prico
SCHEDULE ATTACHED
TAXADLE
1942
YEAR
075
322 12799
c. Cast or cther basis as
adjusted, cost c7cb-
quent improve (if
not purchased, attach
amplonatio.) cad ot-
ponse of
1. Gala, toss.
(0: 100$ 0.).
..
(4,490.00)
4.2.00...
(cs from partnerships and Aduciaries
Nussd), short tohm Capital fat conyover from proceding taxable year (attach statement)
locs,)
(inc 1, 2 and 3
Your [ Not Moro Than Five Years
· 200.00
I lon
Codulo (6) (540) (encich copy)
from part
IMCG and 7
י.
Vivo Yoers *
hips and fiduciaries
OpSchodulo D.1*1540) (attach copy)
pornorchid and fiduciarios
corryover frei procoding taxeble yours (attach statomoni)
001 and
el 422. Dr.
abs and i
on line 49
own cinco 14, 15 on to
Lochows a coin, ontor haro and on page 2, Part II of form 540 or 540NR
Of line 17 shows a loss, cater here and on page 2, Part II of Form 540 or 540NR the smallest of:
(c) empunt on line 17
(b) slid turable income for the taxable year (computed without regard to gains or lossos from sale or exchange
of capital assota)
(c) $1,000 ($500 in the cacy of a husband or wito Alling a coparato return)
NW-88326 Docid:32245535 Page 91
(1,000.00)
Tarryover (13,322.00)
4
7-13-72
#1040
Department of the Treasury
Internal Revenue Service
US Individual Income Tax Return
For the year January 1-December 31, 1971. or other taxable year beginning
Please print or type
First name and initial (If joint return, use first names and middle initials of both:
SAMUEL AND PHYLLIS
Present home address (Number and street, including apartment number, or rural route)
16250 Bircher Street
City, town or post office, State and ZIP code
Granada Hills, California
Filing Status-check only one:
1 ☐ Single
2 ☑ Married filing jointly (even if only one had income)
Married filing separately and spouse is also filing.
3
456
Please attach Copy B of Form W-2 to back
Income
ㅁㅁㅁ
Give spuse's social security number in
space ai ove and enter first name here >
Unmarried Head of Household
Surviving widow(er) with dependent child
Married filing separately and spouse is not filing
Last name..
RUBY
Exemptions
7 Yourself
1971, ending
Occu-
1971
19
Your social security number
322 12 7997
Spouse's social security number
349 18 1420
Yours Self Employed
Housewife
pation
Spouse's
Regular/65 or over / Blind
Enter
number
of boxes
checked
8 Spouse: applies only if item)
2 or 6 is checked,
9 First names of your dependent children who lived with
you Fred, Brian, Elisa
Thomas'
10 Number of other dependents (from line 33)
11 Total exemptions claimed.
12 Wages, salaries, tips, etc. (Attach Forms W-2 to back. If unavailable, attach explanation)
☐ (If gross dividends and other distributions are over $100, list in Part 1 of Schedule B.) ·
14 Interest. If $100 or less, enter total without listing in Schedule B
If over $100, enter total and list in Part II of Schedule Bi
15 Income other than wages, dividends, and interest (from line: 40)
16 Total (add lines 12, 13c, 14 and 15)
12
Enter
number
13a Dividends (pages 5) $ 42.50
13b Less exclusion $.... 2.50
42
13c
Balance
14
178 36
15
6.35033
16
6.529 12
17
17 Adjustments to income (such as "sick pay," moving expense, etc. from line 45)
18 Adjusted gross income (subtract line 17 from line 16) .
18
6,529 19
> See page 3 of instructions for rules under which the IRS will figure your tax.
If you do not itemize deductions and line 18 is under $10,000, find tax in Tables and enter on line 19.
If you itemize deductions or line 18 is $10,000 or more, go to line 46 to figure tax.
19 Tax (Check if from: ☐ Tax Tables 1-13, ☐ Tax Rate Sch. X, Y, or Z, ☐ Sch. D, ☐ Sch. G or ☐ Form 4726).
20 Total credits (from line 54)
21 Income tax (subtract line 20 from line 19)
22 Other taxes (from line 60)
23 Total (add lines 21 and 22)
ཐ་གླ་བ་སྨ
55127
23
55127
24 Total Federal income tax withheld (attach Forms W-2 or W-2P to back)
.25 1971 Estimated tax payments (include 1970 overpayment allowed as a credit)
26. Other payments (from line 64).
24
.25
26
27 Total (add lines 24, 25, and 26)
27
28 If line 23 is larger than line 27, enter BALANCE DUE Pay in full with return. Make check or money
order payable to Internal Revenue Service
28
551 27
29
Write soc. sec. no. on Check or Money Order. Attach here
Foreign
Sign
Your signature
here
Accounts
Bal. Due
or Refund
Tax, Payments and Credits
29 If line 27 is larger than line 23, enter OVERPAYMENT
30 Line 29 to be: (a) REFUNDED Allow at least six weeks
for your refund check
(b) Credited on 1972 estimated tax
31 Did you, at any time during the taxable year, have any interest in or signature or other author.
ity over a bank, securities, or other financial account in a foreign country (except in a U.S.
military banking facility operated by a U.S. financial institution)?
If "Yes," attach Form 4683. (For definitions, see Form 4683.)
Yes
No
Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and best
it is true, correct, and complete.
Date
EDWARD L. LAMBERT
Signature of prepare other wan batadion
all information of which he, bas, any knowledge.
100.
'Address
☐ VENTURA BLVD., SUITE 510
ENCINO_CALIE 91316
THL (213) 981 4020
Date
Spouse's signature (if filing jointly, BOTH must sign even if only one had income)
NW 88326 Docld:32245535 Page 92
Page 2 Form 1040 (1971)
Attach Copy B of Form W-2 here. D.
PART I.-Additional Exemptions (Complete only for other dependents claimed on line 10).
32 (a) NAME
(b) Relationship
ich Months lived in your home:
It born or died during year,
white or D
(d) Did de.
pendent have
income of
$675 or more?
(e) Amount YOU fur-
nished for dependent's
support. If 100 write
ALL..
(1) Amount furnished
by OTHERS includ.
ing dependent.
$
$
33. Total number of dependents listed above. Enter here and on line 10.
PART II.-Income other than Wages, Dividends, and Interest
34 Business income or (loss) (attach Schedule C) .
35 Net gain or (loss) from sale or exchange of capital assets (attach Schedule D)
36 Net gain or (loss) from Supplemental Schedule of Gains and Losses (attach Form 4797):
37 Pensions and annuities, rents and royalties, partnerships, estates or trusts, etc. (attach Schedule E).
38 Farm income or (loss) (attach Schedule F)
39 Miscel- (a) Fully taxable pensions and annuities not reported on Schedule E-
laneous
income
.
see structions on page /
(b) 50% of capital gain distributions (not reported on Scheilule D)
(c) State income tax refunds (caution-see instructions on page 7)
(d) Alimony.
(e) Other (state nature and source).
wwwww
7,350 33
(1,000 00)
(f) Total miscellaneous income (add lines 39(a), (b), (c), (d) and (e))
39
40
6,350 00
40 Total (add lines 34, 35, 36, 37, 38, and 39). Enter here and on line 15
PART III. Adjustments to Income
41 "Sick pay if included in line 12 (attach Form 2440 or other required statement)
42 Moving expense (attach Form 3903)
43 Employee business expense (attach Form 2106 or other statement)
41
42
43
44 Payments as a self-employed person to a retirement plan, etc. (altach Form 2950SE)
45 Total adjustments (add lines 41, 42, 43, and 44). Enter here and on line 17
44
45.
PART IV. Tax Computation (Do not use this part if you use Tax Tables 1-13 to find your tax.)
46 Adjusted gross income (from line 18)
46
6529 19
47 (a) If you iternize deductions, enter total from Schedule A, line 32 and attach Schedule A
(b) If you do not itemize deductions, and line 46 is:
47
4,010 99
(1) $10,000 or more but less than $11,538.43, enter 13% of line 46
(2) $11,538.43 or more, enter $1,500.
Note: deduction under (1) or (2) is limited to $750 if married and filing separately.
48 Subtract line 47 from line 46
50 Taxable income. Subtract line 49 from line 48
48
2,518 20
49 Multiply total number of exemptions claimed on line 11, by $675.
49
4.050 00
-0-
50
(Figure your tax on the amount on line 50 by using Tax Rate Schedule X, Y or Z, or if applicable, the alternative.
tax from Schedule D, income averaging from Schedule G, or maximum tax from Form 4726.) Enter tax on line 19.
PART V.-Credits
51 Retirement income credit (attach Schedule R)
52 Investment credit (attach Form 3468)
53 Foreign tax credit (attach Form 1116)
51
52
53.
54
54 Total credits (add lines 51, 52, and 53). Enter here and on line 20
PART VI.-Other Taxes
55 Self-employment tax (attach Schedule SE)
56 Tax from recomputing prior-year investment credit (attach Form 4255)
57 Minimum tax (see instructions on page 8). Check here ☐, if Form 4625 is attached
58 Social security tax on unreported tip income (attach Form 4137)
55
551 27:
56
57
58
59
60
551 27
59 Uncollected employee social security tax on tips (from Forms W-2)
60 Total (add lines 55, 56, 57, 58, and 59). Enter here and on line 22
PART VII. Other Payments
61 Excess FICA tax withheld (two or more employers--see instructions on page 8).
61'
62 Credit for Ferleral tax on special fuels, nonhighway gasoline and lubricating oil (attach Form 4136)
63 Regulated Investment Company Credit (attach Form 2439)
621
63
64 Total (add lines 61, 62, and 63). Enter here and on line 26
641
94 1149524
NW 88326 Docld:32245535 Page 93.
Schedules A&B-Itemized Deductions AND
(Form 1040)
Department of the Treasury
Internal Revenge Service
Name(s) as shown on Form 1040
Dividend and Interest Income
▷ Attach to Form 1040.
Samuel and Phyllis Ruby
Schedule A-Itemized Deductions (Schedule B on back).
1971
Your social security number
322 127997
Medical and dental expenses (not compensated by insurance Contributions.-Cash-including checks, money orders, etc.
or otherwise) for medicine and drugs, doctors, dentists, nurses, (Itemize-see instructions on page 10 for
hospital care, insurance premiums for medical care, etc.
examples)
1 One half (but not more than $150) of in-
surance premiums for medical care. (Be
sure to include in line 10 below)
2 Medicine and drugs.
3 Enter 1% of line 18, Form 1040.
4 Subtract line 3 from line 2. Enter differ-
ence (if less than zero, enter zero) .
5 Enter balance of insurance premiums for
medical care not entered on line 1
6 Itemize other medical and dental ex-
penses. Include hearing aids, dentures,
eyeglasses, transportation, etc.
18 Total cash contributions
19 Other than cash (see instructions on
page 10 for required statement). Enter
total for such items here.
20 Carryover from prior years
21 Total contributions (Add lines 18,
19, and 20. Enter here and on line 29,
below.)
Interest expense.
22 Home mortgage.
23 Installment purchases.
24 Other (Itemize).
7 Total (add lines 4, 5, and 6)
8 Enter 3% of line 18, Form 1040
9 Subtract line 8 from line 7. Enter differ-
ence (if less than zero, enter zero)
10 Total deductible medical and dental ex-
penses (Add lines 1 and 9. Enter here
and on line 27, below.)
Taxes.
11 Real estate
12 State and local gasoline (see gas tax tables)
13 General sales (see sales tax tables).
14 State and local income.
15 Personal property
16 Other
17 Total taxes (Add lines 11 through 16.
Enter here and on line 28, below.)
150 00
25 Total interest expense (Add lines 22,
23, and 24. Enter here and on line 30,
below.)
Miscellaneous deductions for child care,
alimony, union dues, casualty losses, etc.
(see instructions on page 10).
2,617 68
743:31
26 Total miscellaneous deductions (Enter
here and on line 31, below.):
500 00
Summary of Itemized Deductions
27 Total deductible medical and dental expenses (from line 10)
28 Total taxes (from line 17).
30 Total interest expense (from line 25)
31 Total miscellaneous deductions (from line 26).
32 TOTAL ITEMIZED DEDUCTIONS. (Add lines 27 through 31. Enter here and on Form 1040, line 47.)
A
150100
743 31
2,617 68
500100
4,010.99
29 Total contributions (from line 21).
NW 88326 Docld:32245535 Page 94
SAMUEL & PHYLIES RURY
NAME.
ADDRESS.
SCHEDULE NO..
MEDICAL
1. ONE HALF OF MEDICAL INSURANCE
(NOT OVER $130.00)
2. DRUGS AND MEDICINES
3. LESS: 1% OF ADJ. GROSS INCOME
4. NET DRUGS AND MEDICINES
5. DOCTORS/DENTISTS
DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
MEDICARE
HOSPITAL
322-12-7997
IDENTIFICATION NO..
SCHEDULE OF DEDUCTIONS
STATE
15000
CONTRIBUTIONS
CHURCHES
FEDERAL
100
YEAR ENDED.
FEDERAL & STATE
COMMUNITY CHEST/UNITED CRUSADE
SALVATION ARMY/GOODWILL INDUSTRIES
RED CROSS
XMAS & EASTER SEALS
HEART FUND/CANCER FUND
PARTNERSHIP RETURN
PAYROLL DEDUCTION
OTHER ORGANIZED CHARITIES:
TOTAL CONTRIBUTIONS
INTEREST (TO WHOM PAID)
MORTGAGE LOAN
COLOM MTC
INSTALLMENT LOAN
FEDERAL & STATE.
261768
LABORATORY
BALANCE OF MEDICAL INSURANCE
NOT DEDUCTIBLE ON TOP LINE'
TRAVEL FOR MEDICAL
AMBULANCE:
GLASSES
HEARING AID
PROSTHETIC APPLIANCES
MEDICAL EXPENSES
LESS: REIMBURSED BY INSURANCE
6. TOTAL
7. LESS: 3% OF ADJ. GROSS INCOME
8. BALANCE (NOT LESS THAN ZERO)
9. TOTAL MEDICAL DEDUCTIONS
(LINE 1 PLUS LINE 8)
TAXES
AUTO LICENSE (LESS REG. FEE)
SALES TAX
SALES TAX AUTO
REAL ESTATE TAX
15000 15000
FEDERAL
10000
STATE
10000
533157831
TOTAL INTEREST 2617 68
MISCELLANEOUS DEDUCTIONS
ALIMONY (EXPLAIN)
SAFE DEPOSIT BOX FEE
UNION DUES
SMALI. TOOLS (GOOD 1 YEAR)
TOOLS DEPRECIATION
SAFETY EQUIPMENT
UNIFORMS (NOT GEN. WEAR)
LAUNDRY & CLEANING
AUTO
MILEAGE @
TELEPHONE EXPENSE (NOT REIMB.)
EMPLOYMENT AGENCY FEES
DUES & SUBSCRIPTIONS.
INCOME TAX PREPARATION
OTHERS
FEDERAL & STATE
PERSONAL PROPERTY TAX
STATE INCOME TAX
x x x x
GAS TAX 1000
GAL. @ 50 © GAL.
7000
7000
DISABILITY INSURANCE
MISC. TAX
OTHERS:
x x
x x
TOTAL MISC. DEDUCTIONS
CASUALTY LOSSES (EXPLAIN)
BORONG VOKE DAMAGE
2-71
SUB TOTAL
LESS REIMBURSED BY INS.
SUB TOTAL
LESS $100.00 FOR EACH CASUALTY
TOTAL CASUALTY LOSSES
FEDERAL & STATE
31000
310000
Wooo SBP FORHETE
600.00
1000
5000
FEDERAL
STATE
TOTAL TAXES 7431.31743?)
NW188326 Dogld;32245535 Page 25
TOTAL DEDUCTIONS
401099 601099
16633 VENTURA ROULEVARD
SLITE 510
ENCINO
CALIFORNIA Q1316
JULE C
m 1040)
Profit (or Loss) From Business or Profession
(Sole Proprietorship)
▷ Partnerships, joint ventures, etc., must file on Form 1065.
▷ Attach to Form 1040.
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
Samuel and Phyllis Ruby
19716
322
Social security number
12 7997
: product
(For example: retail-hardware; wholesale tobacco; services-legal; manufacturing-furniture; etc.)
Food Service
A Principal business activity ..
(See separate instructions)
Snack Bar
B Business name
5418 Van Nuys Blvd.
D Business address
E Indicate method of accounting: (1) ✓ cash; (2) ☐ accrua!;
C Employer Identification Number.
Van Nuys, California 91401
(3) other.
(ZIP code)
F Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES
☑ NO. If "Yes," attach explanation.
G Were you required to file Forms 1096 and 1099 or 1087 for the calendar year 1971? (See "Item G" in separate instructions for Schedule C.)
☐ YES ☑ NO.
If "Yes," where were they filed?
1
Gross receipts or gross sales $.
... Less: Returns and allowances $
2 Inventory at beginning of year (if different from last year's closing inventory
attach explanation)
3
Merchandise purchased $...
less cost of any items.
withdrawn from business for personal use $.
4
Cost of labor (do not include salary paid to yourself)
5
Material and supplies
6
Other costs (explain in Schedule C-1)
7
8
9
Total of lines 2 through 6
Inventory at end of this year .
Cost of goods sold and/or operations (subtract line 8 from line 7).
10 Gross profit (subtract line 9 from line 1)
OTHER BUSINESS DEDUCTIONS
11 Depreciation (explain in Schedule C-2)
12 Taxes on business and business property (explain in Schedule C-1).
13 Rent on business property
14 Repairs (explain in Schedule C-1)
15 Salaries and wages not included on line 4 (exclude any paid to yourself)
16 Insurance
17. Legal and professional fees
18 Commissions
19 Amortization (attach statement)
20 (a) Pension and profit-sharing plans (See Instructions)..
(b) Employee benefit programs (See Instructions)
21 Interest on business indebtedness
22 Bad debts arising from sales or services
23 Depletion.:
24 Other business expenses (explain in Schedule C-1)
25
Total of lines 11 through 24
26 Net profit (or loss) (subtract line 25 from line 10). Enter here and on line 34, Form 1040. ALSO enter on
Schedule SE, Part I, line 1
Line No.
.
SCHEDULE C-1. EXPLANATION OF LINES 6, 12, 14, AND 24
Lina No.
Explanation
Amount
$
Explanation
NW 88326 Docld:32245535 Page 96
SCHEDULE
ATTACHED
7,350
Amount
$
Samuel and Phyllis Ruby
Income
Less: Sales Tax
SUPPLEMENT TO SCHEDULE
$43,479.18
174.63
$43,304.55
Cost of Goods Sold
Beginning inventory
Purchases
Beverage/milk
Groceries.
800.
4,980.70
15,169.50
Meat
2,570.35
Bakery/bread
2,815.62
Total Available
$26,336.17
Less: Ending inventory
800.00
25,536.17
Adjusted Gross Profit
$17,768.38
Expenses
Casual labor
Rent.
Payroll
Telephone
Insurance
Advertising
Accounting
Miscellaneous
Equipment
Maintenance/repairs
Taxes/licenses.
Hosiery
Auto
Linen
Donations
Less: Depreciation
NET PROFIT
Equipment
Covenant not
to Compete
Leasehold Imp.
(Bal. of Lease)
DEPRECIATION:
4/70
$10,000.00
$2,000.00
5 Yr. SL
5,000.00
3,000.00
1,000.00.
428.50
5 Yr. SL
7 Yr. SL
NW 88326 Docld:32245535 Page 97
48.12
1,459.87
3,640.03
$148.00
190.50
43.70
175.00
27.04
74.03
136.19
558.06
130.04
317.14
17.83
24.00
6.989.55
$10,778.83
(3,428.50)
$ 7,350.33,
$2,000.00
1,000.00
428.50
$3,428.50
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service
Computation of Social Security Self-Employment Tax |
▷ Each self-employed person must file a Schedule SE.
▷ Attach to Form 1040.
1971
If you had wages, including tips, of $7.800 or more that were subject to social security taxes, do not fill in this page.
If you had more than one business, combine profits and losses from all your businesses and farms on this Schedule SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
Name of self-employed person (as shown on social security card)
Samuel Ruby
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.) ►
Social security number
of self-employed person
127997
322
Part Computation of Net Earnings from BUSINESS Self-Employment (other than farming)
1 Net profit (or loss) shown in Schedule C (Form 1040), line 26. (Enter combined amount if more than one
business.)
7,350 33
2 Net income (or loss) from excluded services or sources included on line 1
Specify excluded services or sources
Computation of Net Earnings from FARM Self-Employment
3. Net earnings (or loss) from business self-employment (Subtract line 2 from line 1, and enter here and
on line 8(a). Part III below.)
Pärtill
7,350 33
SE
A farmer may elect to compute net farm earnings using the OPTIONAL METHOD (line 6, below) INSTEAD OF THE REGULAR.
METHOD (line 5, below) if his gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600.
If your gross profits from farming are not more than $2,400 and you elect to use the optional method, you need not complete
lines 4 and 5.
Computation under Regular Method
4 Net farm profit (or loss) from:
(a) Schedule F, line 52 (cash method), or line 71 (accrual method).
(b) Farm partnerships
5 Net earnings from self-employment from farming. Add lines 4(a) and (b)
Computation under Optional Method
6 If gross profits from farming are:**
(a) Not more than $2,400, enter two-thirds of the gross profits
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
*Note.-Gross profits from farming are the total of the gross profits from Schedule F, line 28 (cash
method), or line 69 (accrual method), plus the distributive share of gross profit from farm
partnerships as explained in instructions for Schedule SE.
7 Enter here and on line 8(b), Part III, below, the amount on line 5 (or line 6, if you use the optional
method)
Part Computation of Social Security Self-Employment Tax
8 Net earnings (or loss) from self-employment-..
(a) From business (other than farming) from line 3, Part I, above
(b) From farming (from line 7, Part II, above)
(c) From partnerships, joint ventures, etc. (other than farming)
(d) From service as a minister, member of a religious order, or a Christian Science practitioner. If you
filed Form 4361, check here ☐ and enter zero on this line..
(e) From service with a foreign government or international organization
(f) Other (director's fees, etc.). Specify
9 Total net earnings (or loss) from self-employment reported on line 8
(If line 9 is less than $400, you are not subject to self-employment tax. Do not fill in rest of page.)
10 The largest amount of combined wages and self-employment earnings subject
to social security tax is
11 (a) Total "FICA" wages as indicated on Form W-2
(b) Unreported tips, if any, subject to FICA tax from
Form 4137, line 9
(c) Total of lines 11(a) and 11(b).
12 Balance (subtract line 11(c) from line 10).
13 Self-employment income-line 9 or 12, whichever is smaller
14 If line 13 is $7,800, enter $585.00; if less, multiply the amount on line 13 by .075
$7,800
00
$7,350 33
7,350 33
15 Railroad employee's and railroad employee representative's adjustment for hospital insurance benefits
tax from Form 4469
7,350 33.
551 27
16 Self-employment tax (subtract line 15 from line 14). Enter here and on Form 1040, line 55
55127
NW 88326 Docld:32245535 Page 98
www.
SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Service
Capital Gains and Losses
Attach to. Form 1040. Examples of property to be reported on this Schedule are
gains and losses on stocks, bonds, and similar investments, and gains (but not losses)
on personal assets such as a home or jewelry.
Name(s) as shown on Form 1040
Samuel and Phyllis Ruby
Partile Short-term Capital Gains and Losses-Assets Held Not More Than 6 Months
a. Kind of property and description
(Example, 100 shares of "Z" Co)
h. How
acquired.
Enter letter
symbol (see
instructions)
c. Mo., day, yr.
(Put date sold above
dotted line and date
acquired bel
dotted line,
d. Gross sales price
1971
Social security number
3.2 12 +7997
a. Cost or other basis,
as adjusted, cost of sub:
sequent improvements
(if not purchase-t, attach
explanation) and ex-
ponse of sale
f. Gain or (loss)
(d less e)
SCHEDULE ATTACHED
(1,248 00)
2
3
Enter your share of net short-term gain or (loss) from partnerships and fiduciaries
Enter net gain or (loss), combine lines 1 and 2.
ས
3
4(a)
Short-term capital loss component carryover from years beginning before 1970 (see Instruction H) 4(a).
4(b) Short-term capital loss carryover attributable to years beginning after 1969 (see Instruction H)
5
6
Net short-term gain or (loss), combine lines 3, 4(a) and 4(b)
Part Long-term Capital Gains and Losses-Assets Held More Than 6 Months
4(b)
5
7
Capital gain distributions.
8
9
Enter gain if applicable from line 4(a)(1), Form 4797 (see Instruction A)
10
Enter your share of net long-term gain or (loss) from partnerships and fiduciaries
11
Enter your share of net long-term gain from small business corporations (Subchapter S)
Net gain or (loss), combine lines 6 through 10 ..
7
8
9
10
11
13
Net long term gain or (loss), combine lines 11, 12(a) and 12(b)
Pärtill Summary of Parts I and II
12(a) Long-term capital loss component carryover from years beginning before 1970 (see Instruction H).
12(b) Long-term capital loss carryover attributable to years beginning after 1969 (see Instruction H).
12(a) (14,274 00)
12(b)
13
(14,274 00)
14
$15
Combine the amounts shown on lines 5 and 13, and enter the net gain (loss) here
If line 14 shows a gain-
14
(15,522 00)
(a) Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part VI for computation of
alternative tax). Enter zero if there is a loss or no entry on line 13.
15(a)
(b) Subtract line 15(a) from line 14. Enter here and on line 35, Form 1040
15(b)
16
If line 14 shows a loss-See Instruction 1.
▷ Omit lines 16(a) and 16(b) and go to Part IV if losses are shown on lines 12(a) and 13.
▷ Otherwise,
(a) Enter one of the following amounts:
( (ii) If amount on line 13 is zero or a net gain, enter amount on line 14; or,
(i) If amount on line 5 is zero or a net gain, enter 50% of amount on line 14;
(iii) If amounts on line 5 and line 13 are net losses, enter amount on line 5 added to
50% of amount on line 13.
16(a)
(b) Enter here and on line 35, Form 1040, the smaller of:
(i) The amount on line 16(a);
(ii) $1,000 ($500 if married and filing a separate return--if losses are shown on lines
4(a) and 5, see Instruction K for a higher limit not to exceed $1,000); or,
(iii) Taxable income, as adjusted (see instruction J)
Carry
16(b) ( 1,000 100)
(1-1)($14,522.00)
NW 88326 Docld:32245535 Page 99
SALESMAN Bached
C
CUSTOMER
NAME
TYPE
BUSINESS
Description requir
Transhmer Compe 13-15-70
Veoton Co. 150-12-31-78
Tyler Corp. cool-6-71
·ller Corp, 501-6-71
CS. AM Fletc/pr701-19-71
Equity Fineline 3001-22-74
Pet Plic
1-3-71-31077-2933--
WEEKLY WORK PLAN/TIME REPORT
Phyllis NOTHER 4 Stoc
NUMBER
CONTRACT
✓ Planned
PREM
INTL
TEL
PRO
APPLICATION
REVENUE
BOOKED
A
CALL
COMMENTS AND
HRS
ONE TIME MONTHLY HR]
EXPENSE
NOTES
Gainorlices
Interest Paid va
174-
1-6-71 3218 3,100
218-
1-19-713,132-2,257-
275
1-19-71 777 715-
61-
1-227-4075-3,591-
479-
2-3-714,303 3776-
522-
Trysler Corpyc- 23-14
216-7/2,772
125
idway Inc. 300-2-4-71
2-1776-1999-1930
69-
10 Inc
200/2-3-7
2-26-20-2190-2,3-2
38-
jeasco34803002-17-70
3-4-71-2414-3,5.36-
(122)
0.112y Serv (VP0502-16.71
3-4-71 514-538
(14-)
2. Key Serv. 2002-16-74
Bucky Fried Ch.2003-4-71
ng Tiger 103-12-71
uble Pict-3-11-76
bia Bichon 503-11-71
3-4-11-2112-2,071-
68-
3-10-71-438-3776-
541-
3-12-7-4113-4155-
(52-)
3-26-7/2,4043463-
1554)
3-26-7) 723-870-
(47)
Jabech/ Air Graft:300 3:26-71
4-6-713314-3,445
(76-)
STALS
NW 88326 Docld:32245535 Page 100

SALESMAN Bach & C
CUSTOMER
NAME
TYPE
BUSINESS
S. D, RubyYT
WEEKLY WORK FLAN/TIME REPORT
Phyllis All
CONTRACT
Planned
PREM
INTL
TEL
PRO
APPLICATION
WEEK ENDING
WEEKEN
REVENUE
BOOKED
CALL
HRS
COMMENTS AND
EXPENSE
NOTES
+
ONE TIME MONTHLY HP:
Description
Acquitie
1/25 Nat Gen C-41-200-3-9-71
Is Nat. 16. 13-401003-9-7;
Engravidity Spe 2-24-77
its Locus Theaton 4-30-17
its. Nithi Wstling 2004-6-71
Es Nith Wst Iiring 506-1-71
Lts Whittaker Coxpico 5-14-71
its Whitted in Corp 200-5-14-71
Republic Corp 2006-4-71
Solitron Devices 100-4-671
Resorts Tutnatia 6-4-71
1 ts N, thist T7.2008-24-71
23/1255-335
5-14-0741- EL
5-14-7 480-50
6-1-71-23162041
6-4-71-3535 2.755-
72-
(370-)
275-
580-
6-4-71 352 1938
42
6-1-76-457-556-
(98-)
8-2-1-7
19
(171)
8-24-71-13034-1645-
(6/1-)
8-24-7/1-304 1952
(648-7
8-12
8-24-171-1443--2,422-
(979)
11-10-7-3,411-16,4445
(1037)
TOTALS
NW 88326 Docld:32245535 Page 101
SALESMAN. Bar/104
321/10
CUSTOMER
NAME
Description
Zpomer
Present
TYPE
BUSINESS
Pate
Ctr. May Sugar 1/11-12-71
CarMar, Plywood 111-10-71
S, D.RUBY.
WEEKLY WORK PLAN/TIME REPORT
Com NUMBER
CONTRACT
Planned
PREM
INTL
TEL
PRO
APPLICATION
WEEK ENDING
REVENUE
CALL
BOOKED
HRS.
COMMENTS AND
EXPENSE
ONE TIME
MONTHLY HR:
NOTES
+
Duty E
Garverless
11-19-71 493
11-12-7141-
K2 72
ذكذ
ساتان
Fr. Mar Plywood 11-11-76
4-10-791-
LT. May Suger 2 11-23-71
11-24-19 510
503
23
dr. May Sugar 11126-77
11-30-7-517
༣.༡/
* Fr. May Sugar 1 11-29-7)
12-1-715.23 529
(3-)
+ Mar Plyton 1 11-23-71
LY Plywood
12-1-71-89-
(65)
ix May11 Suppl 12-3-71
12-3-715.28 534
(351-)
1x. May11 Sugr + 12-5-771
12-10-71 5.33
535
218-
14 May-11-Sigar 4 12-1477
1214-7 58
5.19
(3052)
Li. May-11-Sugar 2 12-15-71
12-15-76.05
235
(367)
TOTAL ST. LOTS
TOTALS
NW 88326 Docld:32245535 Page 102
(Samuel
12.4
CALL
HRS
COMMENTS AND
WEEKLY WORK PLAN/TIME REPORT
SALESMAN-Morrill Lynch Piece25:11 EEK ENDING
CUSTOMER
NAME
CONTRACT
Planned
PREM
INTL
TEL
TYPE
BUSINESS
Nati
Cescription Acquired
Aeral Research
PRO
APPLICATION
REVENUE
BOOKED
ONE TIME MONTHLY HR
11-9-77223
Vleis, voisin & Co., Inc
at'l Gen'l Corp 5000 9-15-74
any Sub 93-4.
"at'/Gen / Corp
SAMiel D. Ruby (^n/
10.4-71 3023-3937-
+
EXPENSE
NOTES
Gainor (Los)
(08-)
31-
314 Sub93-487-5 9-14-71
16-8-71 3051-1317
34.
15000
Pan Amer, Airways (10-8-71
212-9
186-45070.
2675-27-13
(38-)
36 Amer Airways
5000 9-14-71
11-4-71 275
186 4.500
27
Condes Corp
Lat./Gen'l Corp
1-93-50% 5000
0x sub73407
0910-13-71
11-18-7-2716-2610
11-19-71
12-17-71/6037- 5880-
106-3
157-
TOTOL
Lor
(124800)
NW.88326 Docld:32245535 Page 103
SCHEDULE
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
SHORT-TERM-ASSETS HELD NOT MORE THAN 6 MONTHS
1.
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo.. day, yr.)
d. Grass sales price:
TAXABLE
1971
YEAR
322
Social Security Number
7997
e. Cost or other basis, as
adjusted. cost of
subsequent improvements
(if not purchased.
attach explanation)
and expense of sale
f. Gain or loss
(d less e)
SCHEDULE ATTACHED:
2. Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3. Enter net gain (or loss), combine lines 1 and 2.
4. Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
5. Net short-term gain (or loss), combine lines 3 and 4
LONG-TERM-ASSETS HELD MORE THAN 6 MONTHS
6.
(1,248.00)
7. Enter gain if applicable from line 4, Schedule D-1 (Form 540) (attach copy).
8. Enter your share of net long-term gain (or loss) from partnerships and fiduciaries
9. Net gain (or loss), combine lines 6 through 8
10. Enter unused long-term capital loss carryover from preceding taxable years (attach statement).
11. Net long-term gain (or loss), combine lines 9 and 10
12. Combine the amounts shown on lines 5 and 11, and enter the net gain (or loss) here.
13. If line 12 shows a gain-
(a) Enter 50% of line 11 or 50% of line 12, whichever is smaller. Enter zero if there is a loss or no entry on line 11
(b) Subtract line 13(a) from line 12. Enter here and on line 32, Form 540 (line 33, Form 540NR)
14. If line 12 shows a loss-
(a) Add lines 4 and 10 (if lines 4 and 10 are blank, enter a zero here and on lines 14(b) and 14(c) and go to
line 14(d)).
(b) Combine lines 3 and 9-if gain, enter gain; if loss, enter zero:
(c) Enter smallest of (i) line 14(a) less line 14(b); (ii) the amount of taxable income on Form 540 or 540NR,
computed without capital gains and or losses-determine this figure via a side computation; or (iii) $1,000
(d) Combine lines 3 and 9-if loss, enter loss; if gain, enter zero here and on line 14(e) and go to line 14(f)
(e) Enter smallest of (i) the amount of taxable income on Form 540 or 540NR, computed without capital gains
and or losses, less line 14(c)-determine this figure via a side computation; (ii) $1,000 ($500 if married and
filing separately); (iii) if line 3 is zero or shows a gain, 50% of line 14(d); (iv) if line 9 is zero or shows a
gain, amount on line 14(d); or (v) if lines 3 and 9 show losses, line 3 added to 50% of line 9
(f) Enter here, and on line 32, Form 540 (line 33, Form 540NR), the sum of lines 14(c) and 14(e)-(Do not
enter an amount greater than $1,000)
(14.274,00)
(15.522.00)
( 1,000.00)
Carryover (1-1). ($14,572.00)
Sen Instructions on Back
NW 88326 Docld:32245535 Page 104
ATTACH REMITTANCE HERE.
FORM
540
RESIDENT
CALIFORNIA
INDIVIDUAL INCOME TAX RETURN
TAXABLE
1971
YEAR
For Calendar Year 1971
or Fiscal Year Begun
FIRST NAME(S) AND INITIAL(S)
SAMUEL AND PHYLLIS
Please
Type
PRESENT HOME ADDRESS (Number and street, or rural route)
or
16250 Bircher Street
Print
CITY, TOWN OR POST OFFICE
Granada Hills
OQ NOT WRITE ON THIS LINE
1971 and Ended
1972
Your social security number
LAST NAME
RUBY
322
12 7997
349
Your occupation
Spouse's social security number
18 1420
Spouse's occupation
Self Employed
STATE
COUNTY
ZIP CODE
California
Los Angeles
S
C
M
B
P
NAME AND ADDRESS OF EMPLOYER AT TIME OF FILING
Self Employed
FILING STATUS-Check Only One:
1. ☐ Single
2. ☑Married, filing joint return
BLIND and/or DEPENDENT EXEMPTIONS:
Claim your appropriate
exemption on line 16
5. Blind
☐ Yourself
3. ☐ Married, filing separate return-If this item checked, enter spouse's
social security number in space above and enter first name
here
4. ☐ Unmarried "head of household"-Complete Part I, page 2
Income
Your spouse -Enter number of boxes checked >
5
RELATIONSHIP
6. Dependents--Do not list yourself, your spouse, or person who qualifies you
as head of household NAME (and address if different from yours)
Fred, Brian Elisa, Thomas
7. Total blind and dependent exemptions (add lines 5 and 6)
8. Wages, salaries, tips, etc. (before payroll deductions) if more than two employers, attach list
Employer's name
Where employed (city and state)
Enter
number
6
4
7
4
Do not write
in this coloss
00
8
9. Dividends. Enter total here (complete and attach Schedule B (540), if total is over $100)
10. Interest. Enter total here (complete and attach Schedule B (540), if total is over $100)
11. Other income (from page 2, line 40)
12. Total (add lines 8, 9, 10 and 11)
13. Adjustments to Income (from page 2, line 46)
9.
4250
10
178 86.
11
6,350 33
12
6,571 69
13
14. Adjusted gross income (subtract line 13 from line 12)
14
6,571 69
If you do not itemize deductions AND line 14 is under $10,000, find your tax in Tax Table in instructions. Enter tax on line 15.
• If you itemize deductions OR line 14 is $10,000 or more, go to Part IV on page 2 to figure tax. Enter tax on line 15.
15. Tax from (check one): ☐ Tax Table, ☑Tax Computation (page 2, Part IV) or ☐ Schedule G (540), line 21
16. Personal Exemption. Single-$25. Married couple or head of household--$50
15
25.60
16
50.00
17. Multiply total number of exemptions on line 7 above, by $8
17
32.00
Your
Tax,
18. Total exemptions (add lines 16 and 17)
and
Credits
19. Tax liability (subtract line 18 from line 15-not less than zero)
20. Other credits (from page 2, line 62)
21. Net tax (subtract line 20 from line 19)
22. Tax forgiveness-20% of line 21 (use Part V on page 2, if reporting income on Schedule D (540))
NOTE: You must file your return and pay any tax due (line 27) by the due date to be entitled to this forgiveness
23. Net tax liability (subtract line 22 from line 21-if $1.00 or less, enter zero)
24. Tax on preference income (see instructions) check here ☐, if Schedule P (540) is altached
25. Total tax liability (add lines 23 and 24)
812222
82.00.
19
-None--
20
24
23
222
°
25
Balance:
Due or
Refund
28. Overpayment-if any (subtract line 25 from line 26)
26. 1971 California estimated tax payment (include 1970 overpayment allowed as a credit)
27. Balance due--if any (subtract line 26 from line 25)
PAY IN FULL WITH RETURN
OVERPAYMENT
29. Portion of line 28 you wish to apply on 1972 estimated tax
30. Refund-if any (subtract line 29 from line 28).
REFUND
22223
26 ►
27
None
°
28
29
30
Sign ▷
Your signature if filing jointly, BOTH must sign
Date
Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
ELAYARD L. LAMBERT
SULLENT.
Do not write in these spaces
T
here
Signature of prepare other than; taxpayer, SUITE 5101
SADE 91316
Р
I
Spouse's signature
Date
Address
402 Date
Enter Your Social Security No. on Your Chock or Money Order. Make Remittance Payable to
FRANCHISE TAX BOARD - Mail to FRANCHISE TAX BOARD, SACRAMENTO, CALIFORNIA 95867
NW 88326 Docid:32245535 Page 105
Form 540 1971 Page 2
PART Head of Household-If claimed, answer the following questions (See Instructions)
Check ☐ Never married.
one: ☐ Widow(er)
Date.
Individual who qualified you as head of household:
Name..
Is this person married?.
the calendar year 1971?..
☐ Legal separation (interlocutory decree does not qualify) Date..
☐ Final divorce/dissolution
Age. Gross income $.
Date
Relationship
If
yes, did he or she file a joint return with spouse?
Did this person reside in your home for the entire taxable year?
How much did you contribute? $.
Total amount necessary to maintain household $
PART I-Other Income
31. Business income (or loss) (attach Schedule C (540))
32. Net gain for loss) from sale or exchange of capital assets (attach Schedule D (540))
33. Net gain (or loss) from Supplemental Schedule of Gains and Losses (attach Schedule D-1 (540))
34. Pensions and annuities...
35. Rents and royalties
36. Partnerships
37. Estates and trusts
Attach
Schedule E
(Form 540)
38. Farm income (or loss) (attach Schedule F (540))
39. Miscel
laneous
Income
(a) Fully taxable pensions and annuities (not reported on Schedule O
(b) Alimony
.
(c) Other (state nature and source)..
(d) Total miscellaneous income add lines 39(a), (b) and (c)
40. Total (add lines 31 through 39). Enter here and on page 1, line 11
PART III-Adjustments to Income.
41. "Sick pay" if included in line 8 (see instructions-attach statement)
42. Moving expenses (see instructions-attach statement)
43. Employee business expense (see instructions-attach statement)
44. Military exclusion (see instructions for line 8)
45. Payments as a self-employed person to a retirement plan, etc., (attach Federal Form 2950SE)
46. Total adjustments (add lines 41 through 45). Enter here and on page 1, line 13
PART IV-Tax Computation-Do not use this part if you use the Tax Table to find your tax
47. Adjusted gross income (from page 1, line 14)
48. (a) If you itemize deductions, enter total from Schedule A (540), line 32, and attach Schedule A
(b) if you do not itemize deductions, and line 14 is $10,000 or more, enter
(1) $1,000, if single, or married person filing separate return
(2) $2,000, if head of household; or married couple filing joint return
19. Taxable income (subtract line 48 from line 47).
appropriate Tax Rate Schedule in instructions. Enter tax on page 1, line 15
Did this person qualify as your dependent for
If not, explain circumstances.
31
°
7,350 33
32 °
(1,000 00)
33
34 °
35 °
36 °
37
ww wwww ww
38
39
40
6,350 33
41
°
42
°
43
44
0
45
6
46
47
6,571 69
.48
4,010.00
Figure your tax on this amount by using
2,560 70
49
PART V-Tax Forgiveness
Complete all fines below. However, if you used the income averaging method to compute your tax on line 15. omit lines 50,
51 and 52, enter on line 53 the amount shown on line 41 of Schedule G. (540), and complete lines 54. 55 and 56.
50. Taxable income from line 49 above, or page 1, line 14 if Tax Table used
50
51. Amount (if any) entered on Schedule D (540), line 13(a)
51
52. Adjusted taxable income (subtract line 51 from line 50)
53. Adjusted tax (use same method as used for determining tax on page 1, line 15)
54. Add lines 18 and 20, page 1, and enter total here
$5. Adjusted net tax (subtract line 54 from line 53)
54
55
56
SSSSSSS
52
53
56: 20% of line 55. Enter here and on page 1, line 22
PART VI-Credit for Net Income Tax Paid to Another State-Attach copy of "other state" return -and Retirement Income Credit
57. Income derived from sources within State of
and also taxable by California
57
58. California adjusted gross income (from page 1, line 14)
59. California tax liability (from page 1, line 19).
58
59
50 Credit limitation-line 57 ÷ line 58
% (100% maximum) × line 59 (cannot exceed tax paid other state)
60
°
61 0
62
51. Retirement income credit (attach Schedule R (540)).
52. Total (add lines 60 and 61). Enter here and on page 1, line 20
PART VII-Reconciliation to Federal Return-If adjusted gross income on Federal Return is different from line 14, pag: 1, explain below
NW 88326 Docid:32245535 Page 106
1772.400 6.71 12 0CCM (①A OSP
SCHEDULE
FORM 540
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
TAXABLE
19 71
YEAR
Name as shown on Form 540
Samuel and Phyllis Ruby
Itemized vs. Standard Deduction-You have a choice between two deduction
methods. You can either itemize your deductions or take a standard deduction as
explained in the 540 Instructions. On separate returns of a husband and wife,
Social Security Number
322
27997
if one spouse itemizes deductions, the other may not use the Tax Table or cla
the standard deduction. If you choose to itemize your deductions; complete tr
appropriate items below.
Medical and dental expenses (not compensated by insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospital care, insurance
premiums for medical care, etc.
"
1. One half (but not more than $150) of insurance premiums for medical care.
2. Medicine and drugs
3. Enter 1% of adjusted gross income shown on Form 540
4. Subtract line 3 from line 2. Enter difference (if less than zero, enter zero)
5. Enter balance of insurance premiums for medical care not entered on line 1
6. Other medical and dental expenses (attach itemized list)
7. Total-(Add lines 4, 5 and 6)
8. Enter 3% of adjusted gross income shown on Form 540
9. Subtract line 8 from line 7. Enter difference (if less than zero, enter zero)
10. Total--(Add lines 1 and 9)
Child Adoption Expense
11. Total expenses paid or incurred-Attach itemized list
12. Enter 3% of adjusted gross income shown on Form 540
13. Subtract line 12 from line 11-See instructions for maximum limitations
Taxes
14. Real estate
15. State and local gasoline
18. General sales
17. Auto license-Excess of registration and weight fees (see instructions)
18. Personal property
19. State disability insurance (SDI)-Employer private disability plans do not qualify
20. Other. (specify) ..
21. Total taxes-(Add lines 14 through 20)
.2
3
4
5
6
8
A
A'
1
9
10
150 po
11
123
14
15
16
17
456782222
18
19
20
21
743-31
22. Cash-Including checks, money orders, etc. (itemize)
Contributions
23. Total cash contributions
24. Other than cash (see instructions). Enter total here
25. Total Add lines 23 and 24-Maximum deduction may not exceed 20% of adjusted gross income
Interest Expanse
28. Home mortgage
27. Installment purchases
28. Other (itemize)
29. Total Add lines 26, 27 and 28)
Miscellaneous Deductions
30. For child care, alimony, union dues, casualty losses, etc.--See instructions (itemize)
A
31. Total miscellaneous deductions
32. Total deductions (Add lines 10, 13, 21, 25, 29 and 31). Enter total here and on form 540, page 2; in space provided
Rev. 1971)
NW 88326 Docld:32245535 Page 107
Schedule B on reverso
224
.22
23
25
322
24
A
26
27
28
29
2,617 681
30
31
500 00
S
.32
4,010 99
ག་ད་ཡིན་ན་་་་་་་་་གཅུ་ངོ་ཤེསཔ་༢༡་ལྡན་ཅན་དན་གནས་
SCHEDULE
FORM 540
** CALIFORNIA >
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
Attach this schedule to your income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
TAXABLE
1971
YEAR
Partnerships, joint ventures, etc., must file on Form 365
Social Security Number
12. 7997
322
A. Principal business activity.
Food Service
;product
B. Business name.
.D. Business location 5418 Van Nuys Blvd.
Snack Bar
(For example: retail-hardware; wholesale-tobacco; services-legal; manufacturing-furniture; etc.)
C. Federal employer identification number:
Van Nuys, California 01401
(Number and street or rural route)
(City-post office)
(State)
E. Indicate method of accounting: ☐ cash;
accrual; ☐ other (describe)
(ZIP code)
F. Was there any substantial change in the manner of determining quantities, costs or valuations between the opening and closing
inventories? ☐ Yes ☐ No. If "yes," attach explanation.
G. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ☐ Yes
1. Gross receipts or gross sales $
Less: Returns and allowances $
2. Inventory at beginning of year (If different than last year's closing inventory attach.
explanation)
3. Merchandise purchased $
drawn from business for personal use $
4. Cost of labor (do not include salary paid to yourself)
5. Material and supplies
6. Other costs (explain in Schedule C-1)
7.
Total of lines 2 through 6.
8. Inventory at end of this year.
less cost of any items with-
9. Cost of goods sold and/or operations (subtract line 8 from line 7)
10. Gross profit (subtract line 9 from line 1)
OTHER BUSINESS DEDUCTIONS
11. Depreciation (explain in Schedule C-2)
12. Taxes on business and business property (explain in Schedule C-1)
13. Rent on business property
14. Repairs (explain in Schedule C-1)
15. Salaries and wages not included on line 4 (exclude any paid to yourself)
16. Insurance
17. Legal and professional fees
18. Commissions
19. Amortization (attach statement)
20. (a) Pension and profit-sharing plans (see instructions)
(b) Employee benefit programs (see instructions)
21. Interest on business indebtedness
22. Bad debts arising from sales or services
23. Depletion of mines, oil and gas wells, timber, etc. (attach schedule)
24. Other business expenses (explain in Schedule C-1)
25.
Total of lines 11 through 24
☑ No
26. Net profit (or loss) (subtract line 25 from line 10). Enter here and on page 2, Form 540 or 540NR
SCHEDULE C-1. EXPLANATION OF LINES 6, 12, 14, AND 24
SCHEDULE
ATTACHED
7,350133
Line No.
Explanation
Rev. 1971)
NW 88326 Docld:32245535 Page 108
Amount
Line No.
Explanation
$
Amount
Page 1
1040
Department of the Treasury-Internal Revenue Service
US Individual Income Tax Return
For the year January 1-December 31, 1973, or other taxable year beginning
Please print or type
Name (If joint return, give first names and initials of both)
SAMUEL & PHYLLIS
Last name
BuB
BIRCHER ST
Present home address (Number and street, including apartment number, or rural route)
16250
City, town or post office, State and ZIP code
GRANADA HILLS CALIF
Filing Status-check only one:
1 ☐ Single
2 Married filing joint return (even if only one had income)
☑
3 ☐ Married filing separately. If spouse is also filing give
spouse's social security number in designated space above
and enter full name here
4
Unmarried Head of Household
5
Exemptions
6a Yourself .
7
b Spouse
1973, ending
COUNTY OF
RESIDENCE
1973
19....
Your social security number
32212799 2
Spouse's social security no.
LOS ANGELES 349:18 1420
Occu-
pation
Yours ▸
Spouse's
SIE
HW.
Regular / 65 or over / Blind
B
Enter
number
of boxes
checked
c First names of your dependent children who lived with
you THOMAS
ELISA - FRED
d Number of other dependents (from line 27)
Total exemptions claimed
Enter
number ▷
Widow(er) with dependent child (Year spouse died 19
8 Presidential Election Campaign Fund. Check if you wish to designate $1 of your taxes for this fund. If joint return,
check ☐ if spouse wishes to designate $1. Note: This will not increase your tax or reduce your refund. See note below.
(Attach Forms W-2. If
9 Wages, salaries, tips, and other employee compensation. unavailable, attach explanation)
9
10a Dividends on page 6.5) $ 92
See instructions
10b Less exclusion $92-, Balance D
10c
-
10d (Gross amount received, if different from line 10a
$.
.
11 Interest income
11
12
13
Income other than wages, dividends, and interest (from line 38)
Total (add lines 9, 10c, 11, and 12)
12
13
"
14
15
Adjustments to income (such as “sick pay," moving expenses, etc. from line 43)
Subtract line 14 from line 13 (adjusted gross income)
14
15
"
348
16196
16541.
16541
If you do not itemize deductions and line 15 is under $10,000, find tax in Tables and enter on line 16.
If you itemize deductions or line 15 is $10,000 or more, go to line 44 to figure tax.
CAUTION. If you have unearned income and can be claimed as a dependent on your parent's return, check here ▷
16 Tax, check if from:
Schedule D
Tax Tables 1-12
Schedule G
Total credits (from line 54)
and see instructions on page 7.
Tax Rate Schedule X, Y, or Z
Form 4726 OR Form 4972
16
1095
17
17
18
Income tax (subtract line 17 from line 16)
18
1095
19
19.
20
Other taxes (from line 61)
Total (add lines 18 and 19)
"
20
396
149.1
Please attach Copy B of Forms W-2 here]
Tax, Payments and Credits
Balance Due
or Refund
Write soc. sec. no. on Check or Money Order. Attach here]
Income
21a Total Federal income tax withheld (attach Forms
W-2 or W-2P to front) .
b 1973 estimated tax payments (include amount
allowed as credit from 1972 return)
21a
b
c Amount paid with Form 4868, Application for Automatic
Extension of Time to File U.S. Individual Income Tax Return
C
d Other payments (from line 65)
d
22
Total (add lines 21a, b, c, and d)
23
24
25
.
Pay in full with return. Make
check or money order payable
If line 20 is larger than line 22, enter BALANCE DUE IRS to Internal Revenue Service
(Check here ☐, if Form 2210, Form 2210F, or statement is attached. See instructions on page 8.)
If line 22 is larger than line 20, enter amount OVERPAID
Amount of line 24 to be REFUNDED TO YOU
.
26 Amount of line 24 to be credited on 1974 esti-
mated tax.
26
A
22
23
1491
24
25
Note: 1972 Presidential Election Campaign Fund Designation.-Check ☐ if you did not designate $1 of your taxes on your
1972 return, but now wish to do so. If joint return, check ☐ if spouse did not designate on 1972 return but now wishes to do so.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief
It is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he has any knowledge.
Sign
here
Date
Preparer's signature (other than taxpayer)
Your signature
Spouse's signature (if filing jointly, BOTH must sign even if only one had income).
Address (and ZIP Code)
Date
367-34-8729
Preparer's Emp. Ident. or Soc. Sec. No.
16-82337-2
3717 VANOWEN STREET
VAN NUYS, CA. 91403
NW 88326 Docld:32245535 Page 109
-
367-34-6729
Form 1040 (1973)
Other
Dependents
(a) NAME
"
(b) Relationship
(c) Months lived in your
home. If born or died
during year, write B or D.
(d) Did
-de-
pendent have
income
.of
$750 or more?
(e) Amount YOU
furnished for de-
pendent's sup-
port. །f 100%
write ALL.
(f)
Page
Amount
fur-
nished by. OTHERS
including depen-
dent.
$
27 Total number of dependents listed in column (a). Enter here and on line 6d
Partil Income other than Wages, Dividends, and Interest
28 Business income or (loss) (attach Schedule C)
29 Net gain or (loss) from sale or exchange of capital assets (attach Schedule D)
28
4948
29
30
30 Net gain or (loss) from Supplemental Schedule of Gains and Losses (attach Form 4797)
12248
31
31 Pensions, annuities, rents, royalties, partnerships, estates or trusts, etc. (attach Schedule E).
32 Farm income or (loss) (attach Schedule F)
32
¡does
33 Fully taxable pensions and annuities (not reported on Schedule E-see instructions on page 8)..
34 50% of capital gain distributions (not reported on Schedule D)
35 State income tax refunds (stand not apply if refund is for year in which you took the
36 Alimony received
33
34
the)
35
36
37
37 Other (state nature and source) ►
38 Total (add lines 28, 29, 30, 31, 32, 33, 34, 35, 36, and 37). Enter here and on line 12
Part Adjustments to Income
38 16196
39 "Sick pay." (From Forms W-2 and W-2P. If not shown on Forms W-2 or W-2P, attach Form 2440 or statement.)
40 Moving expense (attach Form 3903)
39
40
41
41 Employee business expense (attach Form 2106 or statement)
42 Payments as a self-employed person to a retirement plan, etc. (see Form 4848) :
43 Total adjustments (add lines 39, 40, 41, and 42). Enter here and on line 14
42
43
Pärt Tax Computation (Do not use this part if you use Tax Tables 1-12 to find your tax.)
44 Adjusted gross income (from line 15)
44
45 (a) If you itemize deductions, enter total from Schedule A, line 41 and attach Schedule A
(b) If you do not itemize deductions, enter 15% of line 44, but do NOT enter more than
$2,000. ($1,000 if line 3 checked).
45
16541
5165
46 11376
47
3750
46 Subtract line 45 from line 44.
47 Multiply total number of exemptions claimed on line 7, by $750
48 Taxable income. Subtract line 47 from line 46
48
(Figure your tax on the amount on line 48 by using Tax Rate Schedule X, Y, or Z, or if
applicable, the alternative tax from Schedule D, income averaging from Schedule G, max-
imum tax from Form 4726, or special averaging from Form 4972.) Enter tax on line 16.
Part IV Credits
49 Retirement income credit (attach Schedule R).
7626
50 Investment credit (attach Form 3468)
51 Foreign tax credit (attach Form 1116)
:
52 Credit for contributions to candidates for public office-see instructions on page 9
53 Work Incentive (WIN) credit (attach Form 4874)
54 Total credits (add lines 49, 50, 51, 52, and 53). Enter here and on line 17
Part V Other Taxes
55 Self-employment tax (attach Schedule SE)
56 Ṭax from recomputing prior-year investment credit (attach Form 4255)
57 Tax from recomputing prior-year Work Incentive (WIN) credit (attach schedule)
58 Minimum tax. Check here ☐, if Form 4625 is attached
59 Social security tax on tip income not reported to employer (attach Form 4137).
60 Uncollected employee social security tax on tips (from Forms W-2)
61 Total (add lines 55, 56, 57, 58, 59, and 60). Enter here and on line 19
Part VI Other Payments
62 Excess FICA tax withheld (two or more employers-see instructions on page 9)
49
50
51
52
53
54
55
396
56
57
58
59
60
61
396
62
63 Credit for Federal tax on special fuels, nonhighway gasoline and lubricating oil (attach Form
4136)
63
64
64 Credit from a Regulated Investment Company (attach Form 2439)
65
Total (add lines 62, 63, and 64). Enter here and on line 21d
65
Foreign
Accounts
Did you, at any time during the taxable year, have any interest in or signature or other authority over
a bank, securities, or other financial account in a foreign country (except in a U.S. military banking
facility operated by a U.S. financial institution)?
If "Yes," attach Form 4683. (For definitions, see Form 4683.)
NW 88326 Docld:32245535 Page 110
U.S. GOVERNMENT PRINTING OFFICE: 1973-0-500-047
Yes
No
16-82337-1

SCHEDULE A
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
j
Itemized Deductions
▷ Attach to Form 1040.
& PHYLLIS RUBY
Medical and Dental Expenses (not compensated by insurance
or otherwise) for medicine and drugs, doctors, dentists,
nurses, hospital care, insurance premiums for medical care,
etc.
1 One half (but not more than $150) of
insurance premiums for medical care.
(Be sure to include in line 10 below)
2 Medicine and drugs
.
3 Enter 1% of line 15, Form 1040
4 Subtract line 3 from line 2. Enter dif-
ference (if less than zero, enter zero)
5 Enter balance of insurance premiums
for medical care not entered on line 1
6 Enter other medical and dental expenses:
a Doctors, dentists, etc. .
b Hospitals
•
c Other (Itemize-include hearing aids,
dentures, eyeglasses, transportation,
etc.)
150
475
730
1
1973
Your social security number
322127997.
Contributions (See instructions on page 11 for examples.)
21 a Cash contributions for which you
have receipts, cancelled checks, etc.
b Other cash contributions. List
donees and amounts. ▷
23 Carryover from prior years
150
22 Other than cash (see instructions on
page 12 for required statement)
60
24 Total contributions (add lines 21a, b,
22, and 23). Enter here and on line
38.
150
Casualty or Theft Loss(es) (See instructions on page 12.)
Note: If you had more than one loss, omit lines 25 through
28 and see instructions on page 12 for guidance.
25 Loss before insurance reimbursement.
26 Insurance reimbursement
27 Subtract line 26 from line 25. Enter
difference (if less than zero, enter
zero)
.
28 Enter $100 or amount on line 27,
whichever is smaller .
29 Casualty or theft loss (subtract line 28 from
line 27). Enter here and on line 39. D
Miscellaneous Deductions (See instructions on page 12.)
30 Alimony paid
32 Expenses for child and dependent care
services (attach Form 2441)
33 Other (Itemize) ▷
7 Total (add lines 4, 5, 6a, b, and c)
8 Enter 3% of line 15, Form 1040.
1265.
496
9 Subtract line 8 from line 7 (if less than
zero, enter zero)
769
31 Union dues.
10 Total (add lines 1 and 9). Enter here
and on line 35
919.
Taxes
11 State and local income
12 Real estate
13 State and local gasoline (see gas tax tables)
14 General sales (see sales tax tables)
.
15 Personal property
16 Other (Itemize)
SCH
.17 Total (add lines 11, 12, 13, 14, 15, and
16). Enter here and on line 36
Interest Expense
18 Home mortgage.
19 Other (Itemize)
SCH
20 Total (add lines 18 and 19). Enter here
and on line 37
34 Total (add lines 30, 31, 32, and 33).
Enter here and on line 40.
A
Summary of Itemized Deductions
927
35 Total medical and dental-line 10
3169.
36. Total taxes-line 17 .
37 Total interest-line 20
38 Total contributions-line 24.
39 Casualty or theft loss(es)-line 29.
40 Total miscellaneous-line 34
41 Total deductions (add lines 35, 36, 37,
38, 39, and 40). Enter here and on
Form 1040, line 45
U.S. GOVERNMENT PRINTING OFFICE: 1973-0-500-049
A
919.
927
3169.
150
5165
16-82343-3
NW 88326 Docld:32245535 Page 111
SCHEDULE C
(Form 1040)
Department of the Treasury
Internal Revenue Service
Profit or (Loss) From Business or Profession
(Sole Proprietorship)
▷ Attach to Form 1040. ▷ Partnerships, joint ventures, etc., must file Form 1065.
Name(s) as shown on Form 1040
SAMUEL & PHYLLIS RUBY
A Principal business activity (see Schedule C Instructions) D. SNACKBAR
"SNACK AR
B Business name D.
D Business address (number and street) D.
_; product .
1973
Social security number
322127997
Food
.C Employer identification number ▷.
5418VAN Nuys BLVD
City, State and ZIP code ▷ VAN Nuys.
CA
Accrual (3) ☐ Other ☑
E Indicate method of accounting:
(1) ☑ Cash
(2)
FRESNO
F Were you required to file Form W-3 or Form 1096 for 1973? (See Schedule C Instructions.)
If "Yes," where filed ▷
CA
G. Was an Employer's Quarterly Federal Tax Return, Form 941 filed for this business for any quarter in 1973?
H Method of inventory valuation
Income
Deductions
LOST
Was there any substantial change in
the manner of determining quantities, costs, or valuations between the opening and closing inventories? (If "Yes," attach explanation) .
1 Gross receipts or sales $.
Less: returns and allowances $.
2 Less: Cost of goods sold and/or operations (Schedule C-1, line 8)
3 Gross profit
•
4 Other income (attach schedule)
5 Total income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
7 Taxes on business and business property (explain in Schedule C-2)
8 Rent on business property
9 Repairs (explain in Schedule C-2)
Balance ▷
yoursen.
10 Salaries and wages not included on line 3, Schedule C-1 (exclude any paid to yourself)
11 Insurance
12, Legal and professional fees
13 Commissions
14 Amortization (attach statement)
15 (a) Pension and profit-sharing plans (see Schedule C Instructions)
(b) Employee benefit programs (see Schedule C Instructions) .
16 Interest on business indebtedness
17 Bad debts arising from sales or services
18 Depletion.
19 Other business expenses (specify):
C
Yes
No
(h)
@ £ £ € 0 € @ € € € £ ĕ
(a)
(b)
(c)
(d)
(e)
(f)
(i)
(i)
(k) Total other business expenses (add lines 19(a) through 19(j))
20 Total deductions (add lines 6 through 19)
•
.
andon
Form 1040, line
21 Net profit or (loss) (subtract line 20 from line 5). Enter here and
enter on Schedule SE, line 5(a)
SCHEDULE C-1.-Cost of Goods Sold and/or Operations. (See Schedule C Instructions for Line 2)
.
1 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
2 Purchases $
Less: cost of items withdrawn for personal use $.
3 Cost of labor (do not include salary paid to yourself)
4 Materials and supplies
5 Other costs (attach schedule)
6 Total of lines 1 through 5
7 Less: Inventory at end of year
8 Cost of goods sold and/or operations. Enter here and on line 2 above
Balance >>>
4948
NWV 88326 Docid:32245535 Page 112
16-82344-1
Schedule C (Form 1040) 1973
SCHEDULE C-2.-Explanation of Lines 7 and 9
Line No.
Explanation
Page 2
Amount
Line No.
Explanation
Amount
$
$
SCHEDULE C-3.-Depreciation (See Schedule C Instructions for Line 6) If you need more space, you may use Form 4562.
Note: If depreciation is computed by using the Class Life (ADR) System for assets placed in service after December 31, 1970, or the Guideline
Class Life System for assets placed in service before January 1, 1971, you must file Form 4832 (Class Life (ADR) System) or Form 5006
(Guideline Class Life System). Except as otherwise expressly provided in income tax regulations sections 1.167(a)-11(b)(5)(vi) and 1.167
(a)-12, the provisions of Revenue Procedures 62-21 and 65-13 are not applicable for taxable years ending after December 31, 1970.
Check box if you made an election this taxable year to use Class Life (ADR) System and/or
Guideline Class Life System.
a. Group and guideline class
or description of property
b. Date
acquired
c. Cost or
other basis
d. Depreciation
allowed or allowable
in prior years
1 Total additional first-year depreciation (do not include in items below).
2 Depreciation from Form 4832
above
3 Depreciation from Form 5006 See Note
4 Other depreciation:
Buildings .
Furniture, and fixtures
Transportation, equipment
Machinery and other equipment.
Other (specify).
e. Method of
computing
depreciation
f. Life or
rate
g. Depreciation for
this year
5 Totals
6 Less amount of depreciation claimed in Schedule C-1, page 1
7 Balance-Enter here and on page 1, line 6
SUMMARY OF DEPRECIATION (Other Than Additional First-Year Depreciation)
Straight line
Declining balance
1 Depreciation from
Form 4832
2 Depreciation from
Form 5006
3 Other
2000.
-
Sum of the
years-digits
Units of
production
Other (specify)
Total:
SCHEDULE C-4.-Expense Account Information (See Schedule C Instructions for Schedule C-4)
Enter information with regard to yourself and your five highest paid
employees. In determining the five highest paid employees, expense
account allowances must be added to their salaries and wages. How-
ever, the information need not be submitted for any employee for
whom the combined amount is less than $10,000, or for yourself if
your expense account allowance plus line 21, page 1, is less than
$10,000.
ין
Did you claim a deduction for expenses connected with:
(1) Entertainment facility (boat, resort, ranch, etc.)?
Owner
1
2
3
4
5
Name
Expense account
☐ Yes ☑ No (3) Employees' families at conventions or meetings?
2000
Salaries and Wages
☐ Yes ☑ No
(2) Living accommodations (except employees on business)? ☐ Yes ☑ No (4) Employee or family vacations not reported on Form W-2? ☐ Yes ✓ No
NW 88326 Doold:32245535 Page 113
U.S. GOVERNMENT PRINTING OFFICE: 1973-0-500-050
16-82344-1
SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Service
Capital Gains and Losses
Attach to Form 1040. Examples of property to be reported on this Schedule are
gains and losses on stocks, bonds, and similar investments, and gains (but not losses)
on personal assets such as a home or jewelry.
Name(s) as shown on Form 1040
4L & PHYLLIS
SAMUEL
RuBy
1973
Social security number
322127997
Part I Short-term Capital Gains and Losses-Assets Held Not More Than 6 Months
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. How
acquired.
Enter letter
symbol (see
instruction
D)
YOU INTERNATIONAL REC A
400
c. Mo., day, yr.
(Put date sold above
dotted line and date
acquired below
dotted line)
2/22/73
d. Gross sales price
1/17/73 3218
4/3/73
e. Cost or other basis,
as adjusted (see
instruction E) and
expense of sale
f. Gain or (loss)
(d less e)
3729 (511)
100 LEVITZ
A
10/11/72 1281
100 POTTER INST
6/29/73
A
100 ESSEX INTER
A
3/19/73
6/29/73.
4/3/73 1392
348
2799 (1516)
695 (349)
1759 (367)
Enter your share of net short-term gain or (loss) from partnerships and fiduciaries
2
3
;
Enter net gain or (loss), combine lines 1 and 2
4(a)
4(b)
5
Partill
Short-term capital loss component carryover from years beginning before 1970 (see Instruction H)
Short-term capital loss carryover attributable to years beginning after 1969 (see Instruction H)
Net short-term gain or (loss), combine lines 3, 4(a) and 4(b)
Long-term Capital Gains and Losses-Assets Held More Than 6 Months
2
3 2741
4(a)
4(b)
5
(2741)
7
Capital gain distributions
8
Enter gain, if applicable, from line 4(a)(1), Form 4797 (see Instruction A)
9
: Enter your share of net long-term gain or (loss) from partnerships and fiduciaries
10
11
Enter your share of net long-term gain from small business corporations (Subchapter S).
Net gain or (loss), combine lines 6 through 10
12(a) Long-term capital loss component carryover from years beginning before 1970 (see Instruction H)
12(b) Long-term capital loss carryover attributable to years beginning after 1969 (see Instruction H)
13
Part Summary of Parts I and II
7
8
9
10
11
12(a) (13322
12(b)
Net long-term gain or (loss), combine lines 11, 12(a) and 12(b)
13 (13322
14
15
Combine the amounts shown on lines 5 and 13, and enter the net gain or loss here.
If line 14 shows a gain―
14
16063).
(a) Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part VI for computation
of alternative tax). Enter zero if there is a loss or no entry on line 13.
15(a)
(b) Subtract line 15(a) from line 14. Enter here and on line 29, Form 1040
15(b)
16
If line 14 shows a loss-
▷ Omit lines 16(a) and 16(b) and go to Part IV if losses are shown on BOTH lines 12(a) and 13.
See Instruction I.
▷ Otherwise,
(a) Enter one of the following amounts:
(i) If amount on line 5 is zero or a net gain, enter 50% of amount on line 14;
(ii) If amount on line 13 is zero or a net gain, enter amount on line 14; or,
(iii) If amounts on line 5 and line 13 are net losses, enter amount on line 5 added to
50% of amount on line 13. .
16(a)
(16063
(b) Enter here and enter as a (loss) on line 29, Form 1040, the smallest of:
(i) The amount on line 16(a);
(ii) $1,000 ($500 if married and filing a separate return-if a loss is shown on line
4(a) or 12(a), see instruction M for a higher limit not to exceed $1,000); or,
(iii) Taxable income, as adjusted (see Instruction' L)
| 16(b) (1000
NW 88326-Docid:32245535 Page 114
16-82339-1
Schedule D (Form 1040) 1973
Part IV
Capital Loss Limitation-Where Losses Are Shown on Both Lines 12(a) AND 13
17 Enter loss from line 5; if line 5 is zero or a gain, enter a zero
18 Enter loss from line 13
.
19 Enter gain, if any, from line 5; if line 5 is zero or a loss, enter a zero
20 Reduce loss on line 18 to the extent of the gain, if any, on line 19
21 Combine lines 3 and 11 and if gain, enter gain; if zero or a loss, enter a zero
NOTE: If the entry on line 21 is zero, OMIT lines 22 through 28, and enter on line 29 the
loss shown on line 12(a).
22 Enter gain, if any, from line 11.
23 Enter smaller of amount on line 21 or line 22
21
Page
17 (2741)
18 332
19
20 13322
22
23
24
24 Enter excess of gain on line 21 over amount on line 23
25
25 Enter loss from line 4(a); if line 4(a) is blank, enter a zero
26 Reduce gain, if any, on line 24 to the extent of loss, if any, on line 25 (see Instruction J)
27 Enter loss from line 12(a)
28 Add the gain(s) on line(s) 23 and 26
26
27
28
.
29 Reduce the loss on line 27 to the extent of the gain, if any, on line 28 (see Instruction K)
30 Enter smaller of amount on line 29 or line 20 (if line 29 is zero, enter a zero).
29
2
31 Subtract amount on line 30 from the loss on line 20
32 Enter 50% of the amount on line 31
33 Add lines 17, 30, and 32.
34 Enter here and enter as a (loss) on line 29, Form 1040, the smallest of:
(a) Amount on line 33;
(b) $1,000 ($500 if married and filing a separate return-see Instruction M for a higher limit not to exceed $1,000); or,
(c) Taxable Income, as adjusted (see Instruction L)
30 133
31
32
-
33 16063
3411000
*Part V Complete Part V if You are Married Filing a Separate Return and Losses are Shown on Lines 4(a) and
14. (See Instruction M).
35 Combine lines 3 and 11 and if gain, enter gain; if zero or a loss, enter a zero.
NOTE: If the entry on line 35 is zero, OMIT lines 36 through 42, and enter on line 43 the loss shown on line 4(a).
36 Enter gain, if any, from line 3
37 Enter smaller of amount on line 35 or line 36
.
38 Enter excess of gain on line 35 over amount on line 37
39 Enter loss from line 12(a); if line 12(a) is blank, enter a zero
35
36
37
38
39
40 Reduce the gain, if any, on line 38 to the extent of the loss, if any, on line 39 (see Instruction J) .
41 Enter loss from line 4(a)
40
41
•
42 Add the gain(s) on line(s) 37 and 40.
43 Reduce the loss on line 41 to the extent of the gain, if any, on line 42 (see Instruction K)
Part VI Computation of Alternative Tax (See Instruction V to See if the Alternative Tax Will Benefit You) ..
42
43
44. Enter amount from line 48, Form 1040
44
45 Enter amount from line 15(a)
46 Subtract amount on line 45 from amount on line 44 (but not less than zero)
47 Enter smaller of amount on line 13 or line 14.
45
46
47
.
If line 47 does not exceed $50,000 ($25,000 if married filing separately), check here ▷
omit lines 48 through 54.
and
48 Enter long-term gains from certain contracts and installment sales referred to as "certain subsec-
tion (d) gains" (see Instruction V)
48
49 Enter amount from line 48 or $50,000 ($25,000 if married filing separately), whichever is larger
49
.'
If line 49 is equal to or greater than line 47, check here ☐ and omit lines 50 through 54.
50 Multiply amount on line 49 by 50%
50
51 Add amounts on lines 46 and 50
52 Tax on line 44 or 45, whichever is greater (use Tax Rate Schedule in instructions)
53 Tax on the amount on line 51 (use Tax Rate Schedule in instructions)
54 Subtract amount on line 53 from amount on line 52.
55 Tax on the amount on line 46 (use Tax Rate Schedule in instructions)
56 If the block on line 47 or 49 is checked, enter 50% of line 45; otherwise enter 25% of line 49.
57 Alternative Tax-add amounts on lines 54 (if applicable), 55, and 56. If smaller than the tax figured
on the amount on line 48, Form 1040, enter this alternative tax on line 16, Form 1040
56
40
57
51
52
53
54
55
NW 88326 Docid:32245535 Page 115.
U.S. GOVERNMENT PRINTING OFFICE: 1973-0-500-051
16-82339-1
SCHEDULE G
(Form 1040)
Department of the Treasury.
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
Income Averaging
See instructions on pages 3 and 4.
Attach to Form 1040.
& PHYLLIS RUBY
Taxable Income and Adjustments
•
1 Taxable income (see instruction 1)
2 Income earned outside of the United
States or within U.S. possessions and ex-
cluded under sections 911 and 931
3 Excess community income and certain
amounts received by owner-employees
subject to a penalty under section 72(m)
(5). See instruction 3.
4 Accumulation distributions subject to sec-
tion 668(a). See Form 4970
•
5 Adjusted taxable income or base period
income. (Line 1 plus line 2, less lines 3
and 4.) If less than zero, enter zero
Computation of Averagable Income
(a)
Computation year
1973
7626.
7626
6 Adjusted taxable income from line 5, column (a)
(b)
1st preceding base
period year
7 30% of the sum of line 5, columns (b), (c), (d), and (e).
8 Averagable income (line 6 less line 7)
1972
(c)"
2d preceding base
period year
1971
1973
Your social security number
322127997
(d)
3d preceding base
period year
1970
(e)
4th preceding base
period year
1969
67626-
7
7626
8
Complete the remaining parts of this form only if line 8 is more than $3,000. If $3,000 or
less, you do not qualify for income averaging. Do not fill in rest of form.
G
Computation of Tax
9
9
Amount from line 7 .
7.·་་,‛་་་་་་་་་ ་ ་ ་ ་ ་ ་ ་་་་
10
1525
10 20% of line 8
11
1525
11 Total (add lines 9 and 10)
12 Amount from line 3, column (a), less any income subject to a penalty under section 72(m) (5)
which was included in line 3
12
13
13 Total (add lines 11 and 12)
1525
14
219
14 Tax on amount on line 13
15
15 Tax on amount on line 11
16 Tax on amount on line 9.
17 Difference (line 15 less line 16).
18 Multiply the amount on line 17 by 4
219
16
.
17
219
18
876
19 Total (add lines 14 and 18)
•
19 1095
20 Tax on income subject to the penalty under section 72(m) (5) which was included in line 3
21 Tax (add lines 19 and 20). Enter here and on Form 1040, line 16. Also check Schedule G box on
Form 1040, line 16
20
..
20
21
1095
NW 88326 Docid:32245535 Page 116-
16-82358-1
SCHEDULE SE
(Form 1040)
Department of the Treasury
Internal Revenue Service
Computation of Social Security Self-Employment Tax
▷ Each self-employed person must file a Schedule SE.
▷ Attach to Form 1040.
1973
If you had wages, including tips, of $10,800 or more that were subject to social security taxes, do not fill in this form.
If you had more than one business, combine profits and losses from all your businesses and farms 
on this Schedule 
SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
NAME OF SELF-EMPLOYED PERSON (AS SHOWN ON SOCIAL SECURITY CARD)
• SAMUEL RUBY
Social security number
of self-employed person
322127997.
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.) DSNACK BAR
✪ If you have only farm income complete Parts I and III.
①If you have only nonfarm income complete Parts II and III.
○ If you have both farm and nonfarm income complete Parts I, II, and III.
Part Computation of Net Earnings from FARM Self-Employment
SE
A farmer may elect to compute net farm earnings using the OPTIONAL METHOD, line 3, instead of using the Regular Method,
line 2, if his gross profits are: (1) $2,400 or less, or (2) more than 
$2,400 and net profits are less than $1,600. However, lines
1 and 2 must be completed even if you elect to use the FARM OPTIONAL 
METHOD.
1 REGULAR METHOD-Net profit or (loss) from:
(a) Schedule F, line 54 (cash method), or line 74 (accrual method)
(b) Farm partnerships
•
2 Net earnings from farm self-employment (add lines 1(a) and 1(b))
3 FARM OPTIONAL METHOD If gross profits from farming are: 14
(a) Not more than $2,400, enter two-thirds of the gross profits.
•
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
1 Gross profits from farming are the total gross profits from Schedule F, line 28 (cash method),
or line 72 (accrual method), plus the distributive share of gross profits from farm 
partnerships
(Schedule K-1 (Form 1065), line 15) as explained in instructions for Schedule 
SĖ.
Enter here and on line 12(a), the amount on line 2, or line 3 if you elect the farm optional method
Partell Computation of Net Earnings from NONFARM Self-Employment
5 REGULAR METHOD Net profit or (loss) from:
(a) Schedule C, line 21. (Enter combined amount if more than one business.)
(b) Partnerships, joint ventures, etc. (other than farming)
((c) Service as a minister, member of a religious order, or a Christian Science practitioner. (Include
rental value of parsonage or rental allowance furnished.) If you filed Form 4361, check here
and enter zero on this line :
(d) Service with a foreign government or international organization
(e) Other (director's fees, etc.). Specify
Total (add lines 5(a), 5(b), 5(c), 5(d), and 5(e))
7 Enter other adjustments (attach statement)
8 Adjusted net earnings or (loss) from nonfarm self-employment (line 6, as adjusted by line 7)
If line 8 is $1,600 or more OR if you do not elect to use the Nonfarm Optional Method, omit lines 9 through 11 and enter
amount from line 8 on line 12(b), Part III.
Note: You may use the nonfarm optional method (line 9 through line 11) only if line 8 is less than
$1,600 and less than two-thirds of your gross nonfarm profits, 
and you had actual net earn-
ings from self-employment of $400 or more for at least 2 of the 3 following years: 1970, 
1971,
and 1972. The nonfarm optional method can only be used for 5 taxable years.
* Gross profits from nonfarm business are the total of the gross profits from Schedule C, line 3,
plus the distributive share of gross profits from nonfarm partnerships (Schedule K-1 
(Form
1065), line 15) as explained in instructions for Schedule SE. Also, include gross profits from
I services reported on lines 5(c), 5(d), and 5(e), as adjusted by line 7.
9 NONFARM OPTIONAL METHOD:
(a) Maximum amount reportable, under both optional methods combined (farm and nonfarm)
(b) Enter amount from line 3. (If you did not elect to use the farm optional method, enter zero.)
(c) Balance (subtract line 9(b) from line 9(a))
10 Enter two-thirds of gross nonfarm profits 2 or $1,600, whichever is smaller
.11 Enter here and on line 12(b), the amount on line 9(c) or line 10, whichever is smaller.
4948
4948
4948
$1,600
00
NW 88326 Docld:32245535 Page 117
16-82342-1
:
Schedule SE (Form 1040) 1973
Part II
Computation of Social Security Self-Employment Tax
12 Net earnings or (loss):
(a) From farming (from line 4) .
(b) From nonfarm (from line 8, or line 11 if you elect to use the Nonfarm Optional Method)
13 Total net earnings or (loss) from self-employment reported on line 12. (If line 13 is less than $400,
you are not subject to self-employment tax. Do not fill in rest of form.).
14 The largest amount of combined wages and self-employment earnings sub-
ject to social security tax for 1973 is
15 (a) Total "FICA" wages as indicated on Forms W-2
(b) Unreported tips, if any, subject to FICA tax from
Form 4137, line 9.
(c) Total of lines 15(a) and 15(b) .
16 Balance (subtract line 15(c) from line 14).
17 Self-employment income-line 13 or 16, whichever is smaller.
$10,800
00
4948
4948
10800
4948
396
396
18 If line 17 is $10,800, enter $864.00; if less, multiply the amount on line 17 by .08.
19 Railroad employee's and railroad employee representative's adjustment for hospital insurance bene-
fits tax from Form 4469
20 Self-employment tax (subtract line 19 from line 18). Enter here and on Form 1040, line 55.
You may use this space to make any needed computations
NW 88326 Docid:32245535 Page 118
Page 2
✰U.S. GOVERNMENT PRINTING OFFICE: 1973-0-500-055
16-82342-1
J
Form
4797
Department of the Treasury.
Internal Revenue Service
Name
Part
Supplemental Schedule of Gains and Losses
Sales, Exchanges and Involuntary Conversions under Sections 1231, 1245, 1250, etc.
To be filed with Form 1040, 1041, 1065, 1120, etc.-See Instruction A
SAMUEL & PHYLLIS
RUB
BY
1973
Identifying number as shown on page 1
of your return
322-12-7997
Sales or Exchanges of Property Used in Trade or Business and/or Involuntary Conversions
(Section 1231)
SECTION A.-Involuntary Conversions Due to Casualty and Theft (See Instruction D)
a. Kind of property (if necessary,
attach statement of descriptive
details not shown below)
1'
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
e. Depreciation al-
lowed (or allowable)
since acquisition
f. Cost or other basis,
cost of subsequent im-
provements (if not pur-
chased, attach explana-
tion) and expense of sale
g. Gain or (loss)
(d plus e less f)
2 Combine the amounts on line 1, enter here and also on the appropriate line as follows
(a) For all returns, except partnership returns:
(1) If line 2 is zero or a gain, enter such amount in column g, line 3.
(2) If line 2 is a loss, enter the loss on line 5.
(b) For partnership returns: Enter the amount shown on line 2, on line 6, Schedule K (Form 1065).
SECTION B. Sales or Exchanges of Property Used in Trade or Business and Certain Involuntary Conversions (Not Reportable
in Section A) (See Instruction D)
3
4 Combine the amounts on line 3, enter here and also on the appropriate line as follows.
(a) For all returns, except partnership returns:
(1) If line 4 is a gain, enter such gain as a long-term capital gain on the Schedule D (Form 1040, 1120, etc.) that is
being filed-see instruction D.
(2) If line 4 is zero or a loss, enter such amount on line 6.
(b) For partnership returns: Enter the amount shown on line 4, on line 7, Schedule K (Form 1065).
Part II
Ordinary Gains and Losses
a. Kind of property and how acquired
(If necessary, attach statement of de-
scriptive details not shown below)
b. Date acquired
(mo., day, yr.)
5 Amount, if any, from line 2(a)(2)
6 Amount, if any, from line 4(a)(2)
7 Gain, if any, from line 21
c. Date sold
(mo., day, yr.)
d. Gross sales
price
e. Depreciation al-
lowed (or allowable)
since acquisition
f. Cost or other basis,
cost of subsequent
improvements and
expense of sale
g. Gain or (loss)
(d plus e less f)
12248
8
9. Combine lines 5 through 8, enter here and also on the appropriate line as follows
(a) For all returns, except individual returns: Enter the gain or (loss) shown on line 9, on the line provided
for on the return (Form 1120, etc.) being filed-see instruction E, for specific line reference.
(b) For individual returns:
(1) If the gain or (loss) on line 9, includes losses which are to be treated as an itemized deduction on
Schedule A (Form 1040) (see instruction E), enter the total of such loss(es) here and include on
line 29, Schedule A (Form 1040)-identify as loss from line 9(b)(1), Form 4797
(2) Redetermine the gain or (loss) on line 9, excluding the loss (if any) entered on line 9(b)(1). Enter
here and on line 30, Form 1040 .
12248.
12248.
NW 88326 Docld:32245535 Page 119
16-82348-1
Form 4797 (1973)
Page
*Part III Gain From Disposition of Property Under Sections 1245, 1250,
1251, 1252-Assets Held More than Six Months (See Instruction F)
Lines 18 and 19 should be omitted if there are no dispositions of farm property or farmland; or, if this form is filed by a partnership.
10 Description of sections 1245, 1250, 1251, and 1252 property:
SNACK BAR
Date acquired
(mo., day, yr.)
4/70
Date sold
(mo., day, yr.)
8/13/73
(A)
(B)
(c)
(D)
(E)
Correlate lines 10(A) through 10(E)
with these columns
11 Gross sales price
12 Cost or other basis and expense of sale
13 Depreciation allowed (or allowable)
14 Adjusted basis, line 12 less line 13.
15 Total gain, subtract line 14 from line 11
16 If section 1245 property:
(a) Depreciation allowed (or allowable) after
applicable date (see instructions)
"
Property
(A)
Property
(B)
Property
(C)
Property
(D)
Property
(E)
28000-
28138.
12386
15752
12248.
12386
-
(b) Line 15 or line 16(a), whichever is smaller 12248
17 If section 1250 property:
(a) Enter additional depreciation after
12/31/63 and before 1/1/70.
(b) Enter additional depreciation after
12/31/69 .
(c) Enter line 15 or line 17(b), whichever is
smaller.
(d) Line 17(c) times applicable percentage
(see instruction F.4)
(e) Enter excess, if any, of line 15 over
line 17(b)
(f) Enter line 17(a) or line 17(e), whichever
is smaller
(g) Line 17(f) times applicable percentage
(see instruction F.4)
(h) Add line 17(d) and line 17(g) .
18 If section 1251 property:
(a) If farmland, enter soil, water, and land
clearing expenses for current year and
the four preceding years
(b) If farm property, other than land, sub-
tract line 16(b) from line 15; OR, if farm-
land, enter line 15 or line 18(a), which-
ever is smaller (see instruction F.5)
(c) Excess deductions account (see instruc-
tion F.5)
(d) Enter line 18(b) or line 18(c), whichever
is smaller
19 If section 1252 property:
(a) Enter soil, water, and land clearing ex-
penses made after 12/31/69 .
(b) Enter amount from line 18(d), if any;
otherwise, enter a zero .
"
(c) Enter excess, if any, of line 19(a) over
line 19(b)
.
.
(d) Line 19(c) times applicable percentage
(see instruction F.5)
(e) Line 15 less line 19(b)
(f) Enter smaller of line 19(d) or line 19(e)
Summary of Part III Gains (Complete Property columns (A) through (E) up to line 19(f), before going to line 20)
20 Total of Property columns (A) through (E), line 15 .
.
21 Total of Property columns (A) through (E), lines 16(b), 17(h), 18(d), and 19(f). Enter here and on line 7.
22 Subtract line 21 from line 20. Enter here and in appropriate Section in Part I (see instructions D and F.2)
12248
12-248
NW 88326 Docld:32245535 Page 120
U.S. GOVERNMENT PRINTING OFFICE:1973-0-500-154
16-82348-1

Form
4798
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
SAMUEL
Capital Loss Carryover
(From 1972 to 1973)
▷ Attach to Form 1040.
& PHYLLIS
RuBy
A. Who Should File.-You will need to complete
either Part I or Part II of this form if you have a capital
loss to carryover to 1973.
You will have a capital loss carryover to 1973 if the
amount on line 16(a), or on line 33, of Schedule D.
(Form 1040) for 1972 is LARGER THAN the loss de-
ducted on line 36, Form 1040 for 1972.
1973
Social Security Number
322127997
B. How to Compute Carryover.-If you have a cap.
ital loss carryover, complete either Part 1 or Part II, but
do not complete both.
1. Complete only Part 1 if lines 4(a) and 12(a),
Schedule D (Form 1040) for 1972, DO NOT SHOW
A LOSS.
2. Complete only Part II if either (or both) line 4(a)
or 12(a), Schedule D (Form 1040) for 1972,
shows a loss.
Part I
Post-1969 Capital Loss Carryovers
Section A.-Short-term Capital Loss Carryover
1 Enter loss from line 5, Schedule D (Form 1040) for 1972; however, if such line is blank or shows
a gain, check this block ☐, and OMIT lines 1 through 6 (because no short-term capital loss carry-
over exists) and enter the amount from line 36, Form 1040 for 1972 on line 7-then go to line 8
2 Enter gain from line 13, Schedule D (Form 1040) for 1972; however, if such line is blank or shows
a loss, enter a zero
3 Reduce loss, if any, on line 1 to extent of gain, if any, on line 2
4 Enter amount from line 36, Form 1040 for 1972
5 Enter smaller of amount on line 3 or line 4.
::
6 Excess of amount on line 3 over amount on line 5
1
.
2.
3
4
5
6
Note: The amount on line 6 is your short-term capital loss carryover from 1972 to 1973 that is attributable to years
beginning after 1969. Enter this amount on line 4(b), Schedule D (Form 1040) 
for 1973.
Section B.-Long-term Capital Loss Carryover
7 Line 4 less line 5 (unless you checked the block on line 1, and followed the line 1 instruction)
7
.
8 Enter loss from line 13, Schedule D (Form 1040) for 1972; however, if such line is blank or shows
a gain, check this block ☐, and OMIT lines 8 through 12, because no long-term capital loss carry.
8
00
over exists. .
9 Enter gain from line 5, Schedule D (Form 1040) for 1972; however, if such line is blank or shows
a loss, enter a zero
9
10 Reduce loss on line 8 to extent of gain, if any, on line 9
11 Multiply the amount on line. 7 by 2
10
11
12 Excess of amount on line 10 over amount on line 11
12
Note: The amount on line 12 is your long-term capital loss carryover from 1972 to 1973 that is attributable to years beginning
after 1969. Enter this amount on line 12(b), Schedule D (Form 1040) for 1973.
NW 88326 Docld:32245535 Page 121
1
Form 4798 (1973)
Part 1
Pre-1970 and Post-1969 Capital Loss Carryovers
Section A. Short-term Capital Losses Identified
1 Enter loss from line 5, Schedule D (Form 1040) for 1972; however, if such line is blank or shows
a gain, check this block ☑):B and OMIT lines 1 through 20 (because no short-term capital loss carry-
over exists), complete line 21, enter loss from line 36, Form 1040 for 1972 on line 22—then go to
line 23
2 Enter gain from line 13, Schedule D (Form 1040) for 1972; however, if such line is blank or shows
a loss enter a zero
3 Reduce the loss on line 1 to the extent of the gain, if any, on line 2
Note: If line 4(a), Schedule D (Form 1040) for 1972 is blank, OMIT lines
4 through 11, enter a zero on line 12—then go to line 13.
4 Combine lines 3 and 11, Schedule D (Form 1040) for 1972 and if gain,
enter gain; if zero or a loss, enter a zero.
4
Note: If line 4 is zero, OMIT lines 5 through 11, enter on line 12 the loss
from line 4(a), Schedule D (Form 1040) for 1972—then go to line
13.
5 Enter gain, if any, from line 3, Schedule D (Form 1040) for 1972 .
6 Enter smaller of amount on line 4 or line 5
7 Enter excess of gain on line 4 over amount on line 6.
5
6
•
7
8 Enter loss from line 12(a), Schedule D (Form 1040) for 1972; otherwise,
enter a zero
8
9 Reduce the gain, if any, on line 7 to the extent of the loss, if any, on line 8
10 Enter loss from line 4(a), Schedule D (Form 1040) for 1972; otherwise,
enter a zero.
11 Add the gain(s) on line(s) 6 and 9
9
10
11
1
3
23
Page 2
12
12 Reduce the loss on line 10 to the extent of the gain, if any, on line 11
13
13 Pre:1970 short-term capital loss (enter smaller of amount on line 3 or on line 12)
14 Short-term capital loss attributable to years beginning after 1969 (excess of line 3 over line 13)
Section B.-Computation of Capital Loss Carryovers to 1973
14
15 Enter loss, if any, from line 13 above.
15
16
16 Enter loss deducted on line 36, Form 1040 for 1972
17 Loss carryover to 1973 (excess of line 15 over line 16-If line 15 does not exceed line 16, enter
zero). Enter here and on line 4(a), Schedule D (Form 1040) for 1973 .
17
18
18 Enter loss, if any, from line 14 above.
19 Enter excess of line 16 over line 15-if line 16 does not exceed line 15,
enter zero .
19
20 Loss carryover to 1973 (excess of line 18 over line 19-If line 18 does not exceed line 19, enter
zero). Enter here and on line 4(b), Schedule D (Form 1040) for 1973
20
21 If you were required to complete Part IV, Schedule D (Form 1040) for
1972, enter loss, if any, from line 30, Schedule D (Form 1040) for 1972.
Otherwise, enter zero
21
15/322
22 Enter excess of line 19 over line 18-if line 19 does not exceed line 18,
enter zero (unless you checked the block on line 1, and followed the
line 1 instructions)
22
1000
:
23 Loss carryover to 1973 (excess of line 21 over line 22-if line 21 does not exceed line 22, enter
zero). Enter here and on line 12(a), Schedule D (Form 1040) for 1973 .
24 If you were required to complete Part IV, Schedule D (Form 1040) for
1972, enter loss, if any, from line 31, Schedule D (Form 1040) for 1972.
Otherwise, enter loss, if any, from line 13, Schedule D (Form 1040) for 1972
25 Enter excess of line 22 over line 21 D...
22 does not exceed line 21, enter zero.).
24
i
× 2 (If line
-
25
0
-
26 Loss carryover to 1973 (excess of line 24 over line 25-if line 24 does not exceed line 25, enter
zero). Enter here and on line 12(b), Schedule D (Form 1040) for 1973 .
NW 88326 Docld:32245535 Page 122
✰ U.S. GOVERNMENT PRINTING OFFICE: 1973-0-500-156
36-2603-697
23
(13322)
26
CALENDAR YEAR 19
73
SOC. SEC. NO.
NAME
N
ADDRESS
SAMUEL & PHYLLIS: RUBY 97.
322-12-7997
DEDUCTION SCHEDULE
MEDICAL
MEDICINE/DRUGS
LESS 1% A.G.I. (Line 18-1040)
NET MED/DRUGS
H & A INS. (½½ + EXCESS)
DR.
DR.
DR.
DR.
DR.
DR.
.DR.
DR.
PROSTHETIC APPLIANCES
HEARING AID
FEDERAL
STATE
475.
730
HOSPITAL
AMBULANCE
LABORATORIES
TRAVEL FOR MED. 1000
60
MEDICARE INS.
GLASSES
MEDICAL EXPENSES
1265
12-65
LESS REIMBURSED BY INS.
LESS 3% ADJ. GROSS INC.
495
499
769
766
+ ½ (TO $150) OF H & A INS.
150
150
10 TOTAL MEDICAL DED.
919
916
TAXES
* REAL ESTATE
601
STATE & LOCAL GASOLINE
GENERAL SALES TAX
218
STATE & LOCAL INCOME
X X X X X
✅ PERSONAL PROPERTY
- PERSONAL PROPERTY AUTO
STATE DISABILITY INS.
SALES TAX AUTO
CONTRIBUTIONS
PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
MISC. ORGANIZED CHARITIES
POLITICAL CONTRIBUTIONS.
CHURCHES
FEDERAL
STATE
150
OTHER THAN CASH.
CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT LOSS(ES)
LOSS BEFORE ADJUSTMENT
INSURANCE REIMBURSEMENT
$100 LIMITATION (PER CASUALTY)
29 TOT. CAS. OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
INCOME TAX PREPARATION
UNION/PROFESSIONAL DUES
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
AUTO USE DAMAGE
4446
ALIMONY (SCHEDULE)
INVEST.COUNSEL & PUBS. (SCHED)
EMPLOYMENT AGENCY FEES
SAFE DEPOSIT BOX
TEL. REQ. IN BUSINESS
CHILD & DEP. CARE (Form 2441)
<
180
1934 TOTAL MISC. DED.
17 TOTAL TAXES
2/27
INTEREST (TO WHOM PAID)
MORTGAGE
2570
SBA
INSTALLMENT LOANS
ST THRIFT
BAYAREA
19. MERRILL LUNCH
WEIS VOISIN
22.
157.
62
352
9.
SUMMARY OF ITEMIZED DEDUCT.
35
TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
* 36 TOTAL TAXES (FROM LINE 17)
37 TOTAL INTEREST (Line 20)
38 TOTAL CONTR. (Line 24)
39 CAS.& THEFT LOSS(ES) (Line 29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM 
LINE 34)
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON 
FORM. 1040 LINE 
45
REMARKS
20 TOTAL INTEREST
D 3169.
3169
NW-88376 Doeld:32245535nPageAles, Calif. Form 101
N.
FEDERAL
STATE
▷ 5165
16
73
CALENDAR YEAR 19
FISCAL YEAR ENDING
NAME: SAMUEL & PHYLLIS RUBY
ADDRESS
I.D.
OR
SOC. SEC. NO.
322-12-7997
SCHEDULE OF PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
EMPLOYERS N.O.
800
19336
LABOR
TOTAL
INVENTORY AT END OF YEAR
GROSS PROFIT
GROSS INCOME
ADVERTISING
AUTO AND TRUCK EXPENSE
BAD DEBTS
CASH SHORT
COMMISSIONS
DELIVERY
DEPRECIATION (. SCHEDULE ATTACHED
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTEREST
JANITOR SERVICE
LAUNDRY
LEGAL AND ACCOUNTING
MAINTENANCE
OFFICE SUPPLIES AND EXPENSE
RENT
REPAIRS
SALARIES AND WAGES
SALARIES OFFICERS
SUPPLIES
TAXES AND LICENSES
TAXES
PAYROLL
19.
33636
20136
0
20136
13300
13500
OTHER BUSINESS DEDUCTIONS
TST
550
TELEPHONE
TRAVEL
UTILITIES
SALES TAX INCLUDED.
NET PROFITOR ( LOSS
NET PROFIT OR
LOSS )
FEDERAL RETURN
STATE RETURN ( SEE DEPREC. SCHEDULE FOR DIFF. )
PROFESSIONAL STATIONERS INC. FORM 104
LOS ANGELES, CALIF.
NW 88326 Docid:32245535 Page 124
2000
257
120
600
53
1060
2487
192
480
91
STT
8552
पपठ
SCHEDULE
NAME
ADDRESS.
SAMUEL & PHYLLIS RUBY
322-12-7997
I.D. NO.
OR
SOC. SEC. NO.
CALENDAR YEAR 1973
FISCAL YEAR ENDING
SCHEDULE OF DEPRECIATION / AMORTIZATION
19
KIND OF PROPERTY
MO
DATE
ACQUIRED
YR
FOODWILL
EQUIPMENT
COVENENT NOT TO
COMPETE
LEASEHOLD Imp.
4/70/10000
4/70 10000
4/70/5000
Yho 3000
TOTALS
5 J
PROFESSIONAL STATIONERS INC.
CALIF.
LOS ANGELES ..
FORM NO 102A
SPEC 20%'
DEP
1 5 3
10386
DEP ALLOWED
PRIOR YEARS
REMAINING
COST
METHOD
6000
3000
1386
7 5 7
RATE (%)
OR LIFE
(YRS)
DEPRECIATION
FOR
THIS YEAR
SL. SYR 1167
S.L. SYR 583
S.L. 7YR 250
Add 20% Additional Depreciation on Items Purchased THIS Year.
TOTAL DEPRECIATION THIS YEAR
SCHEDULE
2000
NW 88326 Docid:32245535 Page 125
RESIDENT
540
INDIVIDUAL
CALIFORNIA
INCOME TAX
For the year January 1-December 31, 1973, or other taxable year beginning
FIRST NAME(S) AND INITIAL(S)
Please
Туре
or
Print
SAMUEL & PHYLLIS
LAST NAME
Ruby.
PRESENT HOME ADDRESS (Number and street, including apartment number or rural route)
16250
BIRCHER ST
HILLS
CALIF
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
GRANADA
Filing Status Check Only One
1.
Single
-
2. ✓ Married filing joint return
3. ☐ Married filing separate return-Enter spouse's full
name
Head of Household-Enter name of qualifying
individual
Exemption Credits
1973, ending.
OCCU-
TAXABLE YEAR
1973
19.
Your Social Security Number
322 127997
Spouse's Social Security Number
34918142
Yours S/E
PATION Spouse's
If line 1 or 3 checked, enter $25
6. Personal Exemption:
Dependents Do not list person who qualifies you as head of household.
If line 2, 4 or 5 checked, enter $50
7.
Name (include last name and/or address if different from yours Relationship
THOMAS
ELISA
"FRED"
Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20' below.
Total Number
3
X $8
721
5. ☐ Widow(er) with dependent child. Enter year spouse
died 19.
8.
Blind (refer to instructions) Number of blind exemptions ▷
X $8
8
9.
9/28
.Income
10
11
12
345
92
ATTACH COPY 2 OF FORM W-2 HERE D
Attach copy 2 of Form(s) W-2 to front, ).
10. Wages, salaries, tips and other employee compensation if unavailable, attach explanation
11. Dividends before federal exclusion. Capital gain dividends must be included at 100%
12. Interest. (See instructions for taxability of federal, state and municipal bonds)
13. Income other than wages, dividends and interest (from line 50)
14. Total (add lines 10, 11, 12 and 13)
15. **Adjustments to income (from line 56)
16. Adjusted gross income (subtract line 15 from line 14)
13 16/96
1416633
21. Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
Your
Tax
ATTACH FORM DE1964 HERE
Write social security number on check or money
order. ATTACH HERE ▷
A and
Credits
24.
25.
Special tax credit-from line 75 (see Instructions, page 2, for allowable credit)
Net Tax liability (subtract line 24 from line 23-if line 24 is greater than liner 23, enter zero)
26. Tax on preference income (see instructions-attach Schedule P(540))
15
1616633
⚫
о
If you do NOT itemize deductions AND line 16 is under 10,000, find tax in Tax Table and enter on line 19.
If you itemize deductions OR line 16 is $10,000 or more, complete lines 17 and 18.
17.
Deductions: Itemized (from line 63) OR Standard ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
18. Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
17
5162
18
1771
19. Tax-If an averaging method is used, check appropriate box ☐ Schedule G, or ☐ Schedule G-1.
20. Total exemption credits (from line 9, above)
20
22. Other credits (from line 66)
23. Net tax (subtract line 22 from line 21-if line 22 is greater than line 21 enter zero)
27. Total tax liability (add lines 25 and 26)
222222222
19
249
21
74
175
125
53
23
24
25
1.2-2
26
27
122
Your
Pre-
payment
Credits
28. Renter's credit-if you lived in rented property on March 1, 1973, Complete Part I on page 2
29. Total California income tax withheld (attach Form(s) W-2 or W-2P to face of return).
30. 1973 California estimated tax payments (include amount allowable as a credit from 1972 return)
31. Excess California SDI tax withheld (attach Form DE 1964 to face of return)
32. Total prepayment credits (add lines 28 through 31)
28
29
30
31
Balance
Due
33. If line 27 is equal to or larger than line 32, enter amount of BALANCE DUE
Pay in full and mail with return to: Franchise Tax Board, Sacramento, CA 95867
34. If line 32 is larger than line 27, enter amount OVERPAID
33
32
33
122
Do not write in these spaces
34
.or
Refund
35.
36.
Mail return to: Franchise Tax Board, P.O. Box 13-540, Sacramento, CA 95813
Amount of line 34 to be REFUNDED. (allow at least six weeks for your refund)
Amount of line 34 to be credited on your 1974 estimated tax
35
36
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all 
information of which he has any knowledge.
WE
Р
E
M
A
SIGN
Your signature
HERE
Wife's signature-if filing a joint return
Date
Preparer's signature (other than taxpayer)
.Date
Address (and Zip code)
*Date
NW 88326 Docld:32245535 Page 126
367-34-8729
Preparer's Employer Identification (or SSA) Number
13717 VANOWEN STREET
YAN NUYS, CA. 91403
357-34-8729.
Page 2 Form 540 (1973)
PART
"
Renter's Credit All questions must be answered
12+
See Instructions, Page 2, for Allowable Credit
46.
Partnerships
37. Did you, on March 1, 1973, live in rented property which was your principal residence?
38. Was the property you rented exempt from property, tax?
39. Did you live with any other person who claimed you as a dependent for income tax purposes?
40. Did you or your spouse claim the homeowners' property tax exemption or receive public assistance?.
PART 1 Other Income
41. Business income (or loss) (attach Schedule C(540))
42. Net gain (or loss) from sale or exchange of capital assets (attach Schedule D(540))
43. Net gain (or loss) from supplemental schedule of gains and losses (attach Schedule D-1(540))
44.
Pensions and annuities
45. Rents and royalties.
Attach
Schedule E
Form (540)
Yes
No
Yes
☐ No
If no, you may not claim this credit
If yes, you may not claim this credit
Yes
☐ No
Yes
☐ No
If yes, you may not claim this credit
If yes, see page 2 of instructions
41
4948
42 (1000)
43
13248
44
45
46
47
47. Estates and trusts
48. Farm income (or loss) (attach Schedule F(540))
48
Miscel-
(a) Fully taxable pensions and annuities (not reported on Schedule E(540))
(b) Alimony
(a)
49. laneous
income
(c) Other (state nature and source).
 ེ⇨
(b)
(c)
49
Enter total of lines 49(a), (b) and (c)
50 16196
50. Total (add lines 41 through 49). Enter here and on line 13.
PART III - Adjustments to Income
51. "Sick pay", if included in line 10 (see instructions-attach statement)
52. Moving expenses (see instructions-attach statement)
53. Employee business expenses (see instructions-attach statement)
54. Military exclusion (see instructions)
55. Payment as a self-employed person to a retirement plan, etc.
56. Total adjustments (add lines 51 through 55). Enter here and on line 15
PART IV Itemized Deductions
ON SEPARATE RETURNS OF MARRIED TAXPAYERS, BOTH MUST ITEMIZE
DEDUCTIONS OR BOTH MUST TAKE THE STANDARD DEDUCTION.
Attach Schedule A(540) and enter sub-totals on lines 57 through 62, below
57. Total deductible medical and dental expenses (from Schedule A(540), line 10)
58. Total child adoption expenses (from Schedule A(540), line 13)
59. Total taxes (from Schedule A(540), line 21)
60. Total interest expense (from Schedule A(540), line 25)
61. Total contributions. (from Schedule A(540), line 29)
62. Totals miscellaneous deductions (from Schedule A(540), line 40)
63. Total itemized deductions (add lines 57 through 62). Enter here and on line 17
PART V Other Credits SEE INSTRUCTIONS FOR EACH CREDIT CLAIMED BELOW
64. "Other State" net income tax credit (attach copy of other state return and Schedule S(540))
65. Retirement income credit (attach Schedule R(540))
66. Total (add lines 64 and 65). Enter here and on line 22
!
51
52
53
54
55
56
57.
918
58
0
59
927
60
3169
61
150
62
63 5162
64
65
66
PART VI - Special Tax Credit - If you report net gains from capital assets held more than one year on Schedule D(540), complete all lines below.
"
67. Taxable income from line 18 (or line 16 if Tax Table used)
68. Amount of gain or loss (if any) entered on Schedule D(540), line 14
All other taxpayers enter "Net Tax" from line 23 on line 74 and complete line 75.
67
68
69. Amount of gain or loss (if any) entered on Schedule D(540), line 15
69
(1000)
70. Combine lines 68 and 69 and enter total here. If zero or a loss, enter zero
71. Adjusted taxable income (subtract line 70 from line 67)
72. Adjusted tax (use same method as used for determining tax on line 19)
'73. Add lines 20 and 22, and enter total here
74. Adjusted net tax (subtract line 73 from line 72)
75. Special tax credit-Determine allowable credit using Table on page 2 of instructions. Enter here and on line 24
22233
7.0
71
72
73
74
175
75
53
NW 88326 Doeld:32245535 Page-127-
13714-400 5-73 10,000M ①A OSP
SCHEDULE
A
'FORM 540
Name as shown on Form 540
SAMUEL
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
& PHYLLIS
Itemized vs. Standard Deduction-You have a choice between two deduction
methods. You can either itemize your deductions or take a standard deduction as
explained in the 540 Instructions. On separate returns of a husband and wife,
Medical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses, hospi-
tal care, insurance premiums for medical care, etc.
1. One half (but not more than $150) of insurance
premiums for medical care
2. Medicine and drugs
3. Enter 1% of adjusted gross income shown on Form
540.
4. Subtract line 3 from line 2. Enter difference (if line
3. is greater than line 2, enter zero)
150
RUBY
TAXABLE
1973
YEAR
Social Security Number
322127997
if one spouse itemizes deductions, the other may not use the Tax Table or claim
the standard deduction. If you choose to itemize your deductions, complete the
appropriate items below.
Interest Expense
22. Home mortgage.
23. Installment purchases
24. Other (itemize)
SCH
25. Total (Add lines 22, 23 and 24. Enter here and
on Form 540,- page 2)
Contributions
26. Cash contributions for which you have receipts, can-
celed checks, etc.
:
5. Enter balance of insurance premiums for medical
care not entered on line 1 :
475
6. Other medical and dental expenses;
(a) Doctors, dentists, etc..
(b) Hospitals.
( (c) Other (itemize).
730
27. Other cash contributions. List donees and amounts
60
3169
150
Total (Add lines 4, 5, 6a, b, and c)
1263
8. Enter 3% of adjusted gross income shown on
Form 540
9. Subtract line 8 from line 7. Enter difference (if
line 8 is greater than line 7, enter zero)
499
766
10. Total (Add lines 1 and 9. Enter here and on
Form 540, page 2)
916
Child Adoption Expense
11. Total expenses paid or incurred-Attach itemized
list
,"12. Enter 3% of adjusted gross income shown on Form
540
13. Subtract line 12 from line 11-See instructions
for maximum limitations. (Enter here and on Form
540, page 2)
'Taxes (See tables on reverse)
14. Real estate
15. State and local gasoline
16. General sales
17. Auto license-Excess of registration and weight fees
(see instructions)
18. Personal property
19. State disability insurance (SDI)-Employer private
disability plans do not qualify
-
28. Other than cash. See instructions for required
statement
29. Total (Add lines 26, 27 and 28. Maximum deduction
may not exceed 20% of adjusted gross income.
Enter here and on Form 540, page 2)
Miscellaneous Deductions
Casualty or Theft Loss(es)-See Instructions
NOTE: If you had more than one loss, omit lines 30
through 34 and follow instructions for guidance.
30. Loss before insurance reimbursement
31. Insurance reimbursement
32. Subtract line 31 from line 30. Enter difference. (if
line 31 is greater than line 30, enter zero)
33. Enter $100 or amount on line 32, whichever is
smaller
:
34. Casualty or theft loss (line 32 less line 33).
35. Alimony paid
36. Child care-See instructions
37. Union dues
38. Employment education expense-See instructions
39. Other-See instructions (itemize) ..
150
20. Other
21. Total taxes-(Add lines 14 through 20. Enter here
and on Form 540, page 2)
(Rev. 1973)
NW 88326 Docld:32245535 Page 128
927
40. Total Add lines 34, 35, 36, 37, 38 and 39. (Enter
here and on Form 540, page 2)
A
SCHEDULE
C
*FORM 540
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
Attach this schedulo to your income tax return, Form 540 or 540NE
Name as shown on Form 540 or 540NB
"SAMMEL CPHYLLIS
EPHYLLIS 
RUBY
A. Principal business activity..
(See Instructions for "Item A.")
✓ B. Business name
SNACK
BAR
TAXABLE
1973
YEAR
Partnerships, joint ventures, etc., must filo on Form 565
Social Security Number
_; product_
322127997
Food
(For example: retail-hardware; wholesale-tobacco; services-legal; manufacturing-furniture; etc.)
SNACK BAR
C. Federal employer identification number...
D. Business address 5418 VAN Nuys BLUS
E. Indicate method of accounting: H cash; accrual; ☐ other.
-
employer Ways CALIF
F. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ☑ Yes
G. Method of inventory valuation D.
COST
☐ No
(ZIP code)
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES. ☐ NO.. If "Yes," attach explanation.
IMPORTANT-All applicable lines and schedules must be filled in.
INCOME
DEDUCTIONS
1 Gross receipts or sales $
Less returns and allowances $
2 Less: Cost of goods sold (Schedule C-1, line 29) and/or operations (attach schedule)
3 Gross profit
4 Other income (attach schedule)
5
TOTAL income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
17 Taxes on business and business property (explain Schedule C-2)
8 Rent on business property
9 Repairs (explain in Schedule C-2)
10 Salaries and wages not included on line 24, Schedule C-1 (exclude any paid to yourself)
11 Insurance
12 Legal and professional fees
13 Commissions ..
14 Amortization (attach statement)
15 (a) Pension and profit-sharing plans (see Instructions for line 15(a))
(b) Employee benefit programs (see Instructions for line 15(b))
16 Interest on business indebtedness
17 Bad debts arising from sales or services
18 Depletion
19 Other business expenses (specify):
Balance ▷
(b).
(c).
(d).
(e).
(f)..
(g).
(h) Total other business expenses (add lines 19(a) through 19(g))
20 Total deductions (add lines 6 through 19)
SCHEDULE
21 Net profit (or loss) (subtract line 20 from line 5). Enter here and on page 2, Form 540 or Form 540NR
SCHEDULE C-1. COST OF GOODS SOLD (See Schedule C Instructions for line 2)
22 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
23 Purchases $
Less cost of
items withdrawn for personal use $.
24 Cost of labor (do not include salary paid to yourself)
25 Materials and supplies
26 Other costs (attach schedule)
27 Total of lines 22 through 26
28 Less: Inventory at end of year
29 Cost of goods sold. Enter here and on line 2, above
NW883263 Docld:32245535 Page 129
Balance ▷
4948
Schedule C (Form 540) (Rev. 1973)
SCHEDULE C-2.
Line No.
Page 2
Explanation of Lines 7 and 9
Explanation
Amount
Line No.
Explanation
Amount
$
$
SCHEDULE C-3.
DEPRECIATION (See Schedule C Instructions for line 6). NOTE: Depreciation may be computed by
using the Asset Guideline Classes specified in Federal Revenue Procedure 72-10, regardless of when assets were
placed in service. If this method is used, do NOT use the Lower Limit or the Upper Limit (ADR) Ranges. Attach
detailed statement of depreciation computation.
a. Group and guideline class
or description of property
b. Date
acquired
c. Cost or
other basis
d. Depreciation
allowed or allowable
in prior years
e. Method of
computing
depreciation
f. Life or g. Depreciation for
rate
this year
■ Total additional first-year depreciation (do not include in items below)
2 Asset Guideline Class System (See Note above)
3 Other depreciation
Buildings
Furniture and fixtures
Transportation equipment.
Machinery and other equipment.
Other (specify)
4. Totals
.5 Less: Amount of depreciation claimed elsewhere in Schedule C-1
6 Balance-Enter here and on page 1, line 6
Summary
Straight line
7 Line 2, above
8 Other
•
2070
Declining balance
Sum of the
years-digits
Units of
production
Other (specify)
Total
2000
SCHEDULE C-4. Expense Account Information
Enter information with regard to yourself and your five
highest paid employees. In determining the five highest
paid employees, expense account allowances must be
added to their salaries and wages. However, the infor-
mation need not be submitted for any employee for
whom the combined amount is less than $10,000, or
for yourself if your expense account allowance plus
line 21, page 1 is less than $10,000.
Did
you claim a deduction for expenses connected with:
(1) Entertainment facility (boat, resort, ranch, etc.)?
Yes ✓ No
No
(2) Living accommodations (except employees on business)?
Yes
NW 88326 Docld:32245535 Page 130
(See Schedule C Instructions for Schedule C-4)
Owner
ย
2
3
4
5
Name
Expense Account
Salaries and Wages
(3) Employees' families at conventions or meetings?
☐ Yes
✓ No
(4) Employee or family vacations not reported on Form W-2?
Yes
No
13719-400 5-73 2,000M ①▲ OSP

SCHEDULE
,FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR
SAMUEL & PHYLLIS RUBY
PART 1-Assets Held One Year or Less
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
•1. LOD INTER RECTIFIER
400
* 100 LEVITZ
1000
POTTER INST
100 ESSEX INT
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
1/17/73 2/22/73 3218
TAXABLE
1973
YEAR
Social Security Number
322127897
e. Cost or other basis as
adjusted, cost of subse-
quent improvements (if
not purchased, attach
explanation) and
pense of sale
3729
ex-
f. Gain or loss
(d. less e.)
)ތ.
10/11/72 4/3/73
3/19/73 6/29/73
1281
2797
348
695
4/3/73 6/29/73 1392
1739
347.
(3672
2. Enter gain (or loss), if applicable, from line 18, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART II Assets Held More Than One Year But Not More Than Five Years
5.
(2741)
6. Enter gain (or loss), if applicable, from line 20, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7
PART III Assets Held More Than Five Years
9.
?
10. Enter gain (or loss), if applicable, from line 22, Schedule D-1 (540) (attach copy)
11. Enter your share of gain or loss from partnerships and fiduciaries
12. Net gain or loss, combine lines 9, 10 and 11
PART IV
13. Enter amount from line 4
Summary of Capital Gains and Losses
15. Enter 50% of the amount on line 12 1972 LOSS. 1.4.3.22.
14: Enter 65% of the amount on line 8
-
1000
16. Enter unused capital loss carryover from preceding taxable years (attach computation)
17. Combine the amounts shown on lines 13, 14, 15 and 16
.
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
2741)
(13323) (16063)
19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on line 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
(c) $1,000 ($500 in the case of a husband or wife filing a separate return).
NW 88326 Docld:32245535 Page 131
(1000)
SCHEDULE
D-1
FORM 540
Name as shown on Tax Return
SAMUEL
CALIFORNIA
SUPPLEMENTAL SCHEDULE OF GAINS AND LOSSES
(Sales or Exchanges Including Involuntary Conversions)
(Attach to Form 540, 540NR, 541 or 565)
LPHYLLIS RUBY
TAXABLE
1973
YEAR
Identifying number as shown on return
322-12-7997
PART I Gain From Disposition of Property Under Sections 18211, 18212-18, 18219, 18220
Lines 9 and 10 should be omitted if there are no dispositions of farm property or farm land; or, if this form is filed by a partnership.
1. Description of Sections 18211, 18212-18, 18219, and 18220 property.
SNACK
BAR
Date acquired
(mo., day, yr.)
4/70
Date sold
(mo.. day, yr.)
8/13/73
(A)
(B)
(C)
(D)
Property
(A)
Property
(B)
Property
(C)
Property
(D)
4. Depreciation allowed (or allowable)
5. Adjusted basis, line 3 less line 4
Correlate lines, 1(A) through 1(D) with these columns
2. Gross sales price
3. Cost or other basis and expense of sale
28000
28138.
12386 -
15752-
6. Total gain, subtract line 5 from line 2
12248.
7. If Section 18211 property:
(a) Depreciation allowed (or allowable) after applicable date.
(See Instruction D-3)
(b) Line 6 or line 7(a), whichever is smaller
12386
12248.
8. If Section 18212-18 property:
(a) Enter additional depreciation after 12-31-63 and before
1-1-71
(b) Enter additional depreciation after 12-31-70
(c) Enter line 6 or line 8(b), whichever is smaller
(d) Line 8(c) times applicable percentage (Instruction D-4)
(e) Enter excess, if any, of line 6 over line 8(b)
(f) Enter line 8(a) or line 8(e), whichever is smaller
_ ` (g) Line 8(f) times applicable percentage (Instruction D-4)
(h) Add line 8(d) and line 8(g)
9. If Section 18220 property:
(a) If farm land, enter soil and water conservation expenses
for current year and four preceding years
•
(b) If farm property, other than land, subtract line 7(b) from
line 6; OR, if farm land, enter line 6 or line 9(a), which-
ever is smaller (see Instruction D-5)
(c) Excess deductions account (see Instruction D-5)
(d) Enter line: 9(b) or line 9(c), whichever is smaller
10. If Section 18219 property:
(a) Soil and water conservation expenses made after 12-31-69
(b) Enter amount from line 9(d), if any; otherwise, enter a zero
(c) Enter excess, if any, of line 10(a) over 10(b)
•
(d) Line 10(c) times applicable percentage (Instruction D-5)
(e) Line 6 less line 10(b)
(f) Enter smaller of line 10(d) or line 10(e)
SUMMARY OF PART I
17
(Complete Property Columns (A) through (D) up to Line 10(f) before going to Line 11).
11. Enter amounts from line 6
12. Enter amounts from lines 7(b), 8(h), 9(d) and 10(f)
13. Subtract line 12 from line 11, enter here and in appropriate
Section in Part II (see Instruction D-2)
12248
12248
14. Total of Property Columns (A) through (D), line 12. Enter here and on line 24, Part III
(REV. 1973)
NW 88326 Docid:32245535 Page 132
12248-
Schedule D-1(540)
PART II
Sales or Exchanges of Property Used in Trade or Business and/or Involuntary Conversions
✓ (Section 18181-82) see Instruction E
Section A - INVOLUNTARY CONVERSIONS DUE TO CASUALTY AND THEFT
15.
a. Kind of property (if necessary,
attach statement of descriptive
details not shown below)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
e. Depreciation allowed
(or allowable).
since acquisition
f. Cost or other basis, cost of
subsequent improvements
(if not purchased,
attach explanation) and
expense of sale
Page 2
g. Gain (or loss)
(d. plus e. less f.)
16 is zero or a gain, enter amount of each gain or loss, above, in
(2) If line 16 is a loss, enter such amount on line 25 of Part III.
Schedule K (Form 565). See Instruction E.
16. Combine the amounts on line 15, enter here and also on the appropriate line as follows
(a) For all returns, except partnership returns: (1) If line
column (g) of applicable Section B-1, B-2 or B-3;
(b) For partnership returns: Enter gain(s) and loss(es) in
Section B SALES OR EXCHANGES OF PROPERTY USED
(Not Reportable in Section A)
IN TRADE OR BUSINESS AND CERTAIN INVOLUNTARY CONVERSIONS
17.
Section B-1
Property Held One Year or Less
18. Combine the amounts on line 17, enter here
Section B-2 Property Held More Than One Year But Not More Than Five Years
19.
20. Combine the amounts on line 19, enter here
21.
Section B-3 Property Held More Than Five Years
22. Combine the amounts on line 21, enter here
23. Combine the amounts on lines 18, 20 and 22; enter here and also on the appropriate line as follows
(a) For all returns, except partnership returns: (1) If line 23 is a gain, enter the amounts from lines 18, 20 and 22, on lines 2, 6
and 10, respectively, of the Schedule D (Form 540 or 541) that is being filed. (2) If line 23 is a loss, enter such amount on
line 26 of Part III.
(b) For partnership returns: Enter amounts on lines 18, 20 and 22, in Schedule K(565)—see Instruction E.
PART II!
Ordinary Gains and Losses
a. Kind of property and how
acquired (if necessary,
attach statement of descriptive
details not shown below)
24. Gain, if any, from line 14
25. Loss, if any, from line 16
b. Date acquired
(mo., day, yr.)
c. Date sold
d. Gross sales
(mo., day, yr.)
⚫price
e. Depreciation allowed
(or allowable)
since acquisition
f. Cost or other basis, cost of
subsequent improvements
and expense of sale
g. Gain (or loss)
(d. plus e. less f.)
12248
26. Loss, if any, from line 23
27.
28. Combine lines 24 through 27, enter here and also on the appropriate line as follows
(a) For fiduciary and partnership returns: Enter the gain (or loss) shown on line 28 on the line provided for on the
return being filed-see Instruction F for specific line reference.
(b) For individual returns:
(1) If the gain (or loss) on line 28 includes losses which are to be treated as an itemized deduction on
Schedule A (Form 540 or 540NR) (see Instruction F), enter the total of such loss(es) here and on
Schedule A (Form 540 or 540NR)-Identify as loss from line 28(b)(1), Schedule D-1 (Form 540) ..
(2) Redetermine the gain (or loss) on line 28, excluding the loss (if any) entered on line 28(b)(1). Enter here
and on page 2 of Form 540 or Form 540NR, under "Other Income"
NW 88326 Docld:32245535 Page 133
12248-
12248.
13722-400 5-73 2.500M ①D OSP
Form
1040
US
Department of the Treasury I Internal Revenue Service
Individual Income Tax Return
1970, ending
Last name
For the year January 1-December 31, 1970, or other taxable year beginning
First name and initial (If joint return, use first names and middle initials of both)
Please print or type |
- SAMUEL AND PHYLLIS
Present home address (Number and street or rural route)
16250 Bircher
City, town or post office, State and ZIP code
Granada Hills, California
Filing Status-check only one:
had income
*1 ☐ Single; 2 ☑Married filing jointly (even if only one)
3 ☐ Married filing separately and spouse is also filing.
If this item checked give spouse's social security number in
space above and enter
4
5
first name here >
Unmarried Head of Household
Surviving widow(er) with dependent child
6 ☐ Married filing separately and spouse is not filing
Please attach Copy B of Form W-2 to back
Income
RUBY
Exemptions
7 Yourself
Regular
☑
(applies only if item) ☑
.
8 Spouse (2 or 6 is checked)
1970
19.
Your social security number
322 12 7997
Spouse's social security number
349 18 1420
Yours Self-Emp.
pation Spouse's Housewife
Occu-
65 or over / Blind
Enter
number
of boxes
checked
9 First names of your dependent children who lived with
Fred, Brian, Elisa,
you
Thomas
10 Number of other dependents (from line 34) .
11 Total exemptions claimed
12 Wages, salaries, tips, etc. (Attach Forms W-2 to back. If unavailable, attach explanation).
12
12
Enter
4
number >>>
46
13a Dividends (and instr.) $.
see pages 5
20.60
13b Less exclusion $
20.60
Balance.
13c
(Also list in Part 1 of Schedule B, if gross dividends and other distributions are over $100)
14 Interest. Enter total here (also list in Part II of Schedule B, if total is over $100).
14
15
15 Income other than wages, dividends, and interest (from line 40)
7,284 97
16
7.284 97
16 Total (add lines 12, 1804 and 15)
17
17 Adjustments to income (such as sign pa
' moving expense, etc. from line 45)
18 Adjusted gross income, subtract line
See page 2 of instructions for rules unde
18
7,284 97
the
If you do not itemize deductions and line 18 is under
If you itemize deductions or line 18 is $10,000
19
jedule D ☐, or Schedule G ☐ ))
11753
20
20
Surcharge
Tax and
Bal. Due
Please attach Check or Money Order here
Payments and Credits
or Refund
Sign
here
We tax.
Willigt arour tax and surcharge.
10,000 pax in Tables. Enter tax on line 19.
46
nedolok, Y, or Z
19 Tax (Check if from: Tax Tables 1-15 ☐, Tax Rates
20 Tax surcharge. See Tax Surcharge Tables A, B and C in instructions.
ment income credit, use Schedule R to figure surcharge.)
21 Total (add lines 19 and 20)
22 Total credits (from line 55)
23 Income tax (subtract line 22 from line 21).
24 Other taxes (from line 61)
25 Total (add lines 23 and 24).
26 Total Federal income tax withheld (attach Forms W-2 to back)
27 1970 Estimated tax payments (include 1969 overpayment allowed as a credit)
28 Other payments (from line 65).
29 Total (add lines 26, 27, and 28)
ou claim retire!
COPY
23
117 53
24
538 20
25
26
27
28
30 If line 25 is larger than line 29, enter BALANCE DUE. Pay in full with return .
29
65573
Make check or money
order payable to inter-
nal Revenue Service.
30
655 73
31
; (b) Refunded ▷
$
31 If line 29 is larger than line 25, enter OVERPAYMENT.
32. Line 31 to be: (a) Credited on 1971 estimated tax $
Under penalties of perjury, I declare that i have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief
It is true, correct, and complete.
Date
Your signature
Signature of preparer other than taxpayer, based on
all information of which he has any knowledge.
Date
Spouse's signature (if filing jointly, BOTH must sign even if only one had income)
Address
16633 VENTURA BLVD.
ENCINO, CALIF. 91316
LAMBERT-MARKELL
18-81168-1
NW 88326 Docld:32245535 Page 134
Page 2 Form 1040 (1970)
Foreign Accounts
(check.
appropriate box)
Attach Copy B of Form W-2 here. ▷
Did you, at any time during the taxable year, have any interest in or signature or other authority over
a bank, securities, or other financial account in a foreign country (except in a U.S. military banking
facility operated by a U.S. financial institution)?.
If "Yes," attach Form 4683. (For definitions, see Form 4683.)'
•
PART I.-Additional Exemptions (Complete only for other dependents claimed on line 10)
33 (a) NAME
→
wowich
(b) Relation-
ship
(c) Months lived in your
home. If born or died
during year write "B"
OF "D"
(d) Did depend
ent have income
of $625 or more?
(e) Amount YOU furnished
for dependent's support, if
100% write "ALL'
☐ Yes
☐ No.
(f) Amount furnished
by OTHERS includ-
ing dependent.
$
34 Total number of dependents listed above. Enter here and on line 10.
ገ
PART II. Income other than Wages, Dividends, and Interest
35 Business income (or loss) (attach Schedule C).
・ハ
36 Sale or exchange of property (attach Schedule D)..
37 Pensions and annuities, rents and royalties, partnerships, estates or trusts, etc. (attach Schedule E).
38 Farm income (or loss) (attach Schedule F)
39 Miscellaneous income (state nature and source)
+
40 Total (add lines 35, 36, 37, 38, and 39). Enter here and on line 15
PART III. Adjustments to Income
41 "Sick pay" if included in line 12 (attach Form 2440 or other required statement)
42 Moving expense (attach Form 3903) .
43 Employee business expense (attach Form 2106 or other statement)
44 Payments as a self-employed person to a retirement plan, etc. (attach Form 2950SE)
45 Total adjustments (add lines 41, 42, 43, and 44). Enter here and on line 17 .
PART IV Tax Computation
46 Adjusted gross income (from line 18):
47 (a) If you itemize deductions, enter total from Schedule A, line 22
(b) If you do not itemize deductions, and line 46 is $10,000 or more, enter
$1,000 ($500 if married and filing separately)
48 Subtract line 47 from line 46.
40
39
2 w wwww
41
42
43
44
45
8,284 97
(1,000 00)
7.284 197
46
7.284 97
47
2.74544
48
4.539 53
49
49 Multiply total number of exemptions claimed on line 11, by $625.
3.700 00
50 Taxable income. Subtract line 49 from line 48. (Figure your tax on this amount by using Tax Rate
Schedule X, Y; or Z unless the alternative tax or income averaging is applicable.) Enter tax on line 51
51 Tax. Enter here and on line 19.
50
51
839 53
11753
PART V.-Credits
52 Retirement income credit (attach Schedule R)
53 Investment credit (attach Form 3468)
54 Foreign tax credit (attach Form 1116)
55 Total credits (add lines 52, 53, and 54). Enter here and on line 22
PART VI Other Taxes
56 Self-employment tax (attach Schedule SE) .
57 Tax from recomputing prior-year investment credit (attach Form 4255)
58 Minimum tax. See instructions on page 7. Check here ☐, if Form 4625 is attached
59 Social security tax on unreported tip income (attach Form 4137).
60 Uncollected employee social security tax on tips (from Forms W-2).
61 Total (add lines 56, 57, 58, 59, and 60). Enter here and on line 24
PART VII. Other Payments
62 Excess F.I.C.A. tax withheld (two or more employers-see instructions on page 7)
63 Credit for Federal tax on gasoline, special fuels, and lubricating oil (attach Form 4136)
64 Regulated Investment Company Credit (attach Form 2439)
65 Total (add lines 62, 63, and 64). Enter here and on line 28
NW 88326 Docld:32245535 Page 135
✰✰✰U.S. GOVERNMENT PRINTING OFFICE:1970-0-370-040
52
53
54
55
56
538 20
57
58
59
60
61
538 20
62
63
64
65
94-1149624
16-81168-1
Schedules A&B-Itemized Deductions AND
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
"
Dividend and Interest Income
▷ Attach to Form 1040.
Samuel and Phyllis Ruby
Schedule A-Itemized Deductions (Schedule B on back)
Medical and dental expenses (not compensated by insurance
or otherwise) for medicine and drugs, doctors, dentists, nurses,
hospital care, insurance premiums for medical care, etc.
1 One half (but not more than $150) of In-
surance premiums for medical care.
2 Medicine and drugs
•
3 Enter 1% of line 18, Form 1040.
4 Subtract line 3 from line 2. Enter differ-
ence (if less than zero, enter zero) .
5 Itemize other medical and dental ex-
penses. Include hearing aids, dentures,
eyeglasses, transportation, balance of in-
surance premiums for medical care not
entered on line 1, etc.
1970
Your Social Security Number
322 12 7997
Contributions. Cash-including checks, money orders, etc.
(Itemize-see instructions on page 8 for
examples)
11 Total cash contributions
.
12 Other than cash (see instructions on
page 8 for required statement). Enter
total for such items here .
13 Carryover from prior years (see in-
structions on page 8).
14 Total contributions (Add lines 11,
12, and 13. Enter here and on line
19, below. See instructions on page 8
for limitation)
Interest expense-Home mortgage
Installment purchases.
Other (Itemize).
280 00
6 Total (add lines 4 and 5).
7 Enter 3% of line 18, Form 1040
8 Subtract line 7 from line 6. Enter differ.
ence (if less than zero, enter zero) .
9 Total deductible medical and dental ex-
penses (Add lines 1 and 8. Enter here and
on line 17, below.).
Taxes. Real estate .
•
State and local gasoline (see gas tax tables)
General sales (see sales tax tables) .
State and local income .
Personal property.
15 Total Interest expense (Enter here and
on line 20, below.) .
15000 Miscellaneous deductions for child care,
alimony, union dues, casualty losses, etc.
(see instructions on page 8).
10 Total taxes (Enter here and on line 18,
below.)
1.552 18
6631261
16 Total miscellaneous deductions (Enter
here and on line 21, below.).
100 00
Summary of Itemized Deductions
17 Total deductible medical and dental expenses (from line 9)
18 Total taxes (from line 10)
19 Total contributions (from line 14).
150 00
663 26
280 00
20 Total interest expense (from line 15).
21 Total miscellaneous deductions (from line 16).
22 TOTAL ITEMIZED DEDUCTIONS. (Add lines 17 through 21. Enter here and on Form 1040, line 47) S/A
1,552 18
100 00
2.745 44
16-81169-1
NW 88326 Docld:32245535 Page 136
NAME
Samuel and Phyllis Ruby
ADDRESS.
16250 Bircher
SCHEDULE NO...
MEDICAL
1. ONE HALF OF MEDICAL INSURANCE
(NOT OVER $150.00)
2. DRUGS AND MEDICINES
3. LESS: 1% OF ADJ. GROSS INCOME
4. NET DRUGS AND MEDICINES
5. DOCTORS/DENTISTS
DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
LIDENTIFICATION NO. 322-12-7997
Granada Hills, California
SCHEDULE OF DEDUCTIONS
FEDERAL
STATE
150 00 150 00
CONTRIBUTIONS
CHURCHES
COMMUNITY CHEST/UNITED CRUSADE
YEAR ENDED. 1970
SALVATION ARMY/GOODWILL INDUSTRIES
RED CROSS
XMAS & EASTER SEALS
HEART FUND/CANCER FUND
PARTNERSHIP RETURN
PAYROLL DEDUCTION
FEDERAL & STATE
150 00
OTHER ORGANIZED CHARITIES:
100 00
Boy Scouts
Girl Scouts
15 00
15 00
TOTAL CONTRIBUTIONS
280 00
0
INTEREST (TO WHOM PAID)
MORTGAGE LOAN
Colonial Mtg. Co.
FEDERAL & STATE
1,133 10
MEDICARE
HOSPITAL
.LABORATORY
* BALANCE OF MEDICAL INSURANCE
NOT DEDUCTIBLE ON TOP LINE
TRAVEL FOR MEDICAL
AMBULANCE
GLASSES
HEARING AID
PROSTHETIC APPLIANCES
MEDICAL EXPENSES
LESS: REIMBURSED BY INSURANCE
6. TOTAL
7. LESS: 3% OF ADJ. GROSS INCOME
8. BALANCE (NOT LESS THAN ZERO)
9. TOTAL MEDICAL DEDUCTIONS
(LINE 1 PLUS LINE 8)
TAXES
AUTO LICENSE (LESS REG. FEE)
150 00
FEDERAL
4200
150 00
STATE
42 00
170 00
SALES TAX
+ Large Items
170 00
SALES TAX AUTO
REAL ESTATE TAX
311 26
311 26
PERSONAL PROPERTY TAX
STATE INCOME TAX
x x x x
GAS TAX 2000GAL. @ .07. C GAL.
140 00 140 00
INSTALLMENT LOAN
Goodbody Co..
Bache Co.
First Thrift
Transworld.
120 32
119 12
89 10
51 44.
Revolving Charges (6%)
39 10
TOTAL INTEREST
1,552 18
MISCELLANEOUS DEDUCTIONS
FEDERAL & STATE
ALIMONY (EXPLAIN)
SAFE DEPOSIT BOX FEE
UNION DUES
SMALL TOOLS (GOOD 1 YEAR)
TOOLS DEPRECIATION
SAFETY EQUIPMENT
UNIFORMS (NOT GEN. WEAR)
LAUNDRY & CLEANING
AUTO
MILEAGE (m)
TELEPHONE EXPENSE (NOT REIMB.)
EMPLOYMENT AGENCY FEES
DUES & SUBSCRIPTIONS
INCOME TAX PREPARATION
OTHERS Financial Publ.
TOTAL MISC. DEDUCTIONS
CASUALTY LOSSES (EXPLAIN)
50 00
5000
100 00
FEDERAL & STATE
DISABILITY INSURANCE
MISC. TAX
OTHERS:
x x
x x
SUB TOTAL
LESS REIMBURSED BY INS.
SUB TOTAL
LESS $100.00 FOR EACH CASUALTY
TOTAL CASUALTY LOSSES
FEDERAL
STATE
TOTAL TAXES
663 26 66326
TOTAL DEDUCTIONS 2,745 1142,745 44
t
LAMBERT-MARKELL 16633 VENTURA BLVD. * ENCINO, CALIF. 98140
NW 88326 Docld:32245535 Page 137.
SCHEDULE C
(Form 1040)*
Department of the Treasury
Internal Revenue Service
Profit (or Loss) From Business or Profession
Name as shown on Form 1040
3
(Sole Proprietorship)
▷ Partnerships, joint ventures, etc., must file on Form 1065.
▷ Attach to Form 1040.
Samuel and Phyllis Ruby.
A Principal business activity
(See separate instructions)
B Business name
D Business address
Food
Snack Bar
product
1970
Social security number
322 12 7997
(For example: retail-hardware; wholesale-tobacco; services--legal; manufacturing-furniture; etc.)
5418 Van Nuys Boulevard.
C Employer Identification Number
E Indicate method of accounting: (1) ☑ cash; (2) ☐ accrual; (3) ☐ other.
95-2651578
91401
(ZIP code)
Van Nuys, California
F Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES ☑ NO. If "Yes," attach explanation.
G Were you required
to file Forms 1096 and 1099 or 1087 for the calendar year 1970? (See "Item G" in separate instructions for Schedule C.)
☐ YES ☑ NO. If "Yes," where were they filed?
וי
1
.Gross receipts or gross sales $..
Less: Returns and allowances $.
2 Inventory at beginning of year; (if different from last year's closing inventory
attach explanation)
3 Merchandise purchased $.
less cost of any items
withdrawn from business for personal use $.
4
Cost of labor (do not include salary paid to yourself)
5
Material and supplies
6
Other costs (explain in Schedule C-1)
7
8
9
Total of lines 2 through 6
Inventory at end of this year
Cost of goods sold and/or operations (subtract line 8 from line 7)
10 Gross profit (subtract line 9 from line 1)
OTHER BUSINESS DEDUCTIONS
11 Depreciation (explain in Schedule C-2).
12 Taxes on business and business property (explain in Schedule C-1)
13 Rent on business property
14 Repairs (explain in Schedule C-1)
15 Salaries and wages not included on line 4 (exclude any paid to yourself)
16 Insurance
17 Legal and professional fees
18 Commissions
19 Amortization (attach statement)
20 Retirement plans, etc. (other than contributions made on your behalf-see separate
instructions)
21 Interest on business indebtedness
22 Bad debts arising from sales or services
23 Depletion
24 Other business expenses (explain in Schedule C-1)
25
Total of lines 11 through 24.
26 Net profit (or loss) (subtract line 25 from line 10). Enter here and on line 35, Form 1040. ALSO enter on
Schedule SE, Part I, line 1 .
Line No.
SCHEDULE
ATTACHED
* SCHEDULE C-1. EXPLANATION OF LINES 6, 12, 14, AND 24
9,284 97
C
Explanation
Amount
Line No.
Explanation
Amount.
NW 88326 Docld:32245535 Page 138
18-81171-1
SCHEDULE SE
(Form 1040).
Department of the Treasury
Internal Revenue Service
Computation of Social Security Self-Employment Tax
▷ Each self-employed person must file a separate Schedule SE
▷ Attach to Form 1040.
1970
> If you had wages, including tips, of $7,800 or more that were subject to social security taxes, do not fill in this page.
▷ If you had more than one business, combine profits (or losses) from all of your businesses and farms on this Schedule SE.
Important. The self-employment income reported below will be credited to your social security record and used in figuring social security benefits.
Name of self-employed person (as shown on social security card)
Social security number
Samuel Ruby
Check applicable block
1 ☑ Male 2 ☐ Female
322 12 7997
Business activities subject to self-employment tax (grocery store, restaurant, farm, etc.) ►
Part Computation of Net Earnings from BUSINESS Self-Employment (other than farming)
1. Net profit (or loss) shown in Schedule C (Form 1040), line 26. (Enter combined amount if more than one business.).
2 Net income (or loss) from excluded services or sources: included on line 1
Specify excluded services or sources......
8,284 97
3
Net earnings (or loss) from business self-employment (Subtract line 2 from line 1, and enter here and on line 1(a),
Part III, below.) :.
Part Computation of Net Earnings from FARM Self-Employment
SE
A farmer may elect to compute net farm earnings using the OPTIONAL METHOD (line 3, below) INSTEAD OF THE REGULAR METHOD (line 2, below)
if his gross profits are: (1) $2,400 or less, or (2) more than $2,400 and net profits are less than $1,600. If your gross profits from farming are
not more than $2,400 and you elect to use the optional method, you need not complete lines 1 and 2.
Computation under Regular Method
1 Net farm profit (or loss) from:
(a) Schedule F, line 52 (cash method), or line 69 (accrual method)
(b) Farm partnerships.
2 Net earnings from self-employment from farming. Add lines 1(a) and (b)
Computation under Optional Method
3 If gross profits from farming are:*
(a) Not more than $2,400, enter two-thirds of the gross profits
(b) More than $2,400 and the net farm profit is less than $1,600, enter $1,600
*Note. Gross profits from farming are the total of the gross profits from Schedule F, line 28 (cash method), or line
67 (accrual method), plus the distributive share of gross profit from farm partnerships as explained in instruc-
tions for Schedule SE.
4 Enter here and on line 1(b), Part III, below, the amount on line 2 (or line 3, if you use the optional method)
Part III Computation of Social Security Self-Employment Tax
1
Net earnings (or loss) from self-employment-
(b) From farming (from line 4, Part II, above)
☐ (a) From business (other than farming-from line 3, Part 1, above)
(c) From partnerships, joint ventures, etc. (other than farming)
(d) From service as a minister, member of a religious order, or a Christian Science practitioner. If you filed Form
4361, check here ☐ and enter zero on this line
i
(e) From service with a foreign government or international organization
(f) Other (director's fees, etc.). Specify
2 Total net earnings (or loss) from self-employment reported on line 1
3
(if line 2 is less than $400, you are not subject to self-employment tax. Do not fill in rest of page.)
The largest amount of combined wages and self-employment earnings subject to social
security tax is
4 (a) Total "FICA" wages as indicated on Form W-2
(b) Unreported tips, if any, subject to FICA tax from Form 4137,
line 9
(c) Total of lines 4(a) and 4(b)
5 Balance (subtract line 4(c) from line 3)
6. Self-employment income-line 2 or 5, whichever is smaller
$7,800
00
7
If line 6 is $7,800, enter $538.20; if less, multiply the amount on line 6 by .069
8 Railroad employee's and railroad employee representative's adjustment for hospital insurance benefits tax from
Form 4469.
9 Self-employment tax (subtract line 8 from line 7). Enter here and on Form 1040, line 56
NW 88326 Docld:32245535 Page 139
8,284 97
8,284 97
7,800 00
538 20
538120
16-81171-1
OPO
Samuel and Phyllis Ruby
Income:
Less: Sales Tax
SUPPLEMENT TO SCHEDULE C
Beginning inventory
Purchases. Beverages/milk
Groceries
Meat
Bakery/bread
Less Ending inventory
Adjusted Gross Profit
Expenses:
Rent
Payroll
Payroll taxes
Travel to employees
Miscellaneous expense
Interest.
Accounting.
Telephone
Repairs
Insurance
Linen
Auto
-
Office
3,000 M.
Cleaning/maintenance
Depreciation
Net Profit
Equipment
4/70
Covenant Not To
Compete
Leasehold Imp.
(7 Yr. Balance Lease)
NW 88326 Docld:32245535 Page 140
DEPRECIATION
$10,000.00
$32.657.34
153.39
$32.503.95
1.988.55
8,761.69
1,893.83
2,412.82
$15.056.89
800.00
14.256.89
$18.247.06
1,172.16
2,046.30
202.92
215.00
219.40
419.10
225.00
78.45
121.40
150.00.
21.00
360.00
360.00
50.00
3,321.36
:( 8,962.09)
9,284.97
5 Yr..
$2,000.00
5,000.00
5 Yr.
3,000.00
7 Yr.
1,000.00
428.50
April-December, 1970
$4,428.50

SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name(s) as shown on Form 1040
Sales or Exchanges of Property
➤ Attach to Form 1040.
Samuel and Phyllis Ruby
1970
Social Security Number
7997
322 12
Part Capital Assets-Short-term capital gains and losses- -assets held not more than 6 months
a. Kind of prop-
erty. Indicate
security, real
estate, or other
(specify)
c. How
ac.
b. Description
(Examples: 100 sh. of
"Z" Co., 2 story brick,
etc.)
quired.
Enter
letter
symbol
(see
Instr.)
d. Date
acquired
e. Date sold
f. Gross sales
((mo., day, yr.) (mo., day, yr.)
price
g. Depreciation
allowed (or
allowable) since
acquisition
h. Cost or other
basis, cost of
subsequent improve-
Iments (if not
purchased, attach
explanation) and
expense of sale
D
i. Gain (or loss)
(f plus
g less h)
1
"SCHEDULE ATTACHED
2 Enter your share of net short-term gain (or loss) from partnerships and fiduciaries.
3
Enter net gain (or loss) from lines 1 and 2
4
Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
5 Net short-term gain (or loss) from lines 3 and 4
Long-term capital gains and losses assets held more than 6 months
6
(15,274.00)
7. Capital gain distributions.
8. Enter gain from Part VII, line 47 or line 51(a), whichever applicable
9 Enter your share of net long-term gain (or loss) from partnerships and fiduciaries
10 Enter your share of net long-term gain from small business corporations (Subchapter S)
11 Net gain (or loss) from lines 6 through 10
12 Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
13 Net long-term gain (or loss) from lines 11 and 12..
14 Combine the amounts shown on lines 5 and 13, and enter the net gain (or loss) here
15 If line 14 shows a gain―
(a) Enter 50% of line 13 or 50% of line 14, whichever is smaller (see Part IV for computation of alternative
tax). Enter zero if there is a loss or no entry on line 13
(b) Subtract line 15(a) from line 14. Enter here and on line 17, Part II
16 If line 14 shows a loss-
(a) Add lines 4 and 12 (if lines 4 and 12 are blank, enter a zero here and on lines 16(b) and 16(c) and go
to line 16(d)).
(b) Combine lines 3 and 11-if gain, enter gain; if loss, enter zero
(c) Enter smallest of (i) line 16(a) less line 16(b); (ii) line 48, Form 1040 (line 18, Form 1040 if tax
table used) disregarding capital gains and/or losses-determine this figure via a side computation;
or (iii) $1,000 .
(d) Combine lines 3 and 11-If loss, enter loss; if gain, enter zero here and on line 16(e),
and go to line 16(f)
(e) Enter smallest of (i) line 48, Form 1040 (line 18, Form 1040 if tax table used) disregarding capital
gains and/or losses, less line 16(c)-determine this figure via a side computation; (ii) $1,000 ($500
If married and filing separately); (iii) if line 3 is zero or shows a gain, 50% of line 16(d); (iv) if line
11 is zero or shows a gain, amount on line 16(d); or, (v) if lines 3 and 11 show losses, line 3 added
to 50% of line 11.
•
•
Do
(f) Enter here, and on line 17, Part II, the sum of lines 16(c) and 16 yvonot enter an amounte
Car
than $1,000) .
Part Summary of Schedule D Gains and Losses
17 Net gain (or loss) from line 15(b) or 16(f), Part I
18 Net gain (or loss) from line 22, Part III
19 Total net gain (or loss), combine lines 17 and 18. Enter here and on line 36, Form 1040
(15,274.00)
greater
( 1,000.00)
NW 88326 Docld:32245535 Page 141
070-18 – |
370-046
Samuel and Phyllis Ruby
NW 88326 Docld:32245535 Page 142
Shares
Description
SUPPLEMENT TO SCHEDULE D
Sale Price
Purchase Price
Gain
(Loss)
Trans America Inc.
Tool Research and Eng.
Nat'l Health Ent.
Botany Ind.
Datatron Processing
Castleton Ind.
Computer Equipment
Computer Equipment
Computer Inv.
$1,738.00
3,147.00
984.00
857.00
$
$1,681.00
58.00
4,534.00
(
1,387.00)
615.00
1,724.00
(
1,109.00)
541.00
1,105.00
(
564.00)
336.00
529.00
(
193.00)
814.00
1,479.00
665.00)
492.00
1,219.00
727.00)
2,463.00
( 1,479.00)
1,648.00
791.00)
(
831.00)
(
702.00)
967.00
535.00)
482.00)
361.00)
25.00
5.00
38.00
38.00
830.00
492.00
432.00
358.00
200
200
100
100
100
200
100
100
100
100
Computer Inv.
100
Adams Russell
100
Cinerama Inc.
100
Summit Org.
100
Summit Org.
100
Itel Corp.
100
Asamere Oil Co., Ltd.
1,512.00
100
Saxon Ind.
2,078.00
100
Saxon Ind.
100
Telex Corp.
100
Telex Corp.
100
Salem Corp.
100
3 Units
200
1,107.00
100
100
100
1,661.00
1,194.00
840.00
[111
Equity Funding Corp.
General Mtg. Invest.
Nat'l Health Enterprises
Botany Industries
Computer Equip.
Technicolor Inc.
480.00
1,685.00
2,078.00
1,980.00
1,980.00
1,193.00
2,250.00
3,301.00
517.00
456.00
1,403.00
NET LOSS
840.00
1,660.00
1,507.00
2,041.00
2,041.00
289.00)
2,269.00
2,269.00
. 289.00)
1,495.00
302.00)
2,584.00
3,011.00
3,499.00
1,105.00
1,219.00
2,465.00
334.00)
290.00
( 2,392.00)
589.00)
763.00)
( 1,062.00)
($15,274.00)
N
*FORM
540
RESIDENT
CALIFORNIA
INDIVIDUAL INCOME TAX RETURN
TAXABLE
1970
YEAR
Please
FIRST NAME(S) AND INITIAL(S)
Type PRESENT HOME ADDRESS (Number and street, or rural route)
or
For Calendar Year 1970 or Fiscal Year Begun
1970 and Ended
1971
LAST NAME
Your social security number
S
SAMUEL AND PHYLLIS
RUBY
32212 7997
C
COUNTY
Spouse's social security number
ง
16250 Bircher
Los Angeles
STATE
California
B
P
A
Print CITY, TOWN OR POST OFFICE
Granada Hills.
NAME AND ADDRESS OF EMPLOYER AT TIME OF FILING
Self-Employed
ZIP CODE
34918 1420M
Your occupation
91344 Self-Employed
NAME AND ADDRESS ON 1969 CALIFORNIA RETURN. IF SAME AS ABOVE, WRITE "SAME". IF NONE FILED,
GIVE REASON.
11346 Montgomery Avenue
Filing Status
(check one)
1.
Single
2. X
Married, filing joint return
Income
Employer's name
Spouse's occupation
Housewife
Adjusted gross income on 1970 Federal
Return $ 8,284.97
If different from line 11, below, explain
in Part VII, page 2.
Granada Hills, Calif.
3.
4.
Married, filing separate return--spouse's name:.
Unmarried "head of household" - Complete Part 1, page 2
If joint return,
5. Wages, salaries, tips, etc. (before payroll deductions) if more than two employers, attach schedule
Where employed (city and state)
5
Include all
income of
both husband
and wife
8. Dividends. Enter total here (also list in Schedule B (540), Part I, if total is over $100)
6°
20 60
7. Interest. Enter total here (also list in Schedule B (540), Part II, if total is over $100)
7 •
8. Other income (from page 2, line 30)
9. Total (add lines 5, 6, 7 and 8)
10. Adjustments to Income (from page 2, line 35)
8
8,284 97
9
8,305 57
10
ATTACH REMITTANCE HERE
11. Adjusted gross income (subtract line 10 from line 9)
11
8.30557
Your
.Tax,
and
Credits
15. Total other credits (from page 2, line 49)
16. Net tax liability (subtract line 15 from line 14-If $1.00 or less, enter. "zero")
If you do not itemize deductions AND line 11 is under $10,000, find your tax in Tax Table in instructions. Enter tax on line 12.
If you itemize deductions OR line 11 is $10,000 or more, go to Part IV on page 2 to figure tax.
12. Tax from (check one): Tax Table ☐, Tax Computation (page 2, Part IV) ☑, or Schedule G. (540) ☐
13. Exemption credits (from page 2, line 43)
14. Tax liability (subtract line 13 from line 12)
12
23456
5100
8200
13
14
None
15
16
None
Balance
17: 1970 California estimated tax payment or credit from 1969 (if any). If none, enter "zero"
18. Balance due-if any (subtract line 17 from line 16)
Due or
Rofund
19. Overpayment-if any (subtract line 16 from line 17)
PAY IN FULL WITH RETURN
OVERPAYMENT
20. Portion of line 19 you wish to apply on 1971 estimated tax
21. Refund-if any (subtract line 20 from line 19)
REFUND
28222
17
None
18
•
19
°
20
21
Do not write in these spaces
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
T
Sign ▸
P
Your signature if filing jointly, BOTH must sign
Date
Signature of preparer other than taxpayer
here
Spouse's signature,
Date
Addred AMBERT-MARKELL...
1
Date
16633 VENTURA BLVD.
ENGINO, CALIF.. 91316
ז
e Make Remittance Payable to FRANCHISE TAX BOARD-Mail to
FRANCHISE TAX BOARD, SACRAMENTO, CALIFORNIA 95814.
NW 88326 +Docid:32245535 Page 143
Form 540 1970 Page 2
PART 1-Head of Household-If claimed, answer the following questions
Final divorce/dissolution
Check
one:
Never married
Date...
Individual who qualified you as head of household:
Name...
Is this person married?.
the calendar year 1970?...
(See Instructions)
Widow(er)
Separate maintenance
Date...
Date..
..Relationship.
_. If
yes, did he or she file a joint return with spouse?
✓ Did this person reside in your home for the entire taxable year?..
How much did you contribute $..
Total amount necessary to maintain household $.
PART I Other Income
22. Business income (or loss) (attach Schedule C (540))
23. Sale or exchange of property (attach Schedule D (540))
24. Pensions and annuities.
25. Rents and royalties
26. Partnerships
27. Estates or trusts
Attach
Schedule E
(Form 540)
]
28. Farm income (or loss) (attach Schedule F (540))
29. Miscellaneous income (state nature and source)..
30. Total (add lines 22 through 29). Enter here and on page 1, line 8
PART III-Adjustments to Income
31. "Sick pay" if included on page 1, line 5 (attach statement).
32. Moving expenses (attach statement)
33. Employee business expense (attach statement)
34. Military exclusion (maximum $1,000-$500 if separate return of husband or wife)
35. Total adjustments (add lines 31 through 34). Enter here and on page 1, line 10
PART IV-Tax Computation-If you do not use Tax Table or Income Averaging (Schedule G (540))
36. Adjusted gross income (from page 1, line 11)
37. If you itemize deductions, enter total from Schedule A (540), line 31
If you do not itemize deductions, and line 36 is $10,000 or more, enter
(a) $1,000, if single, or married person filing separate return
(b) $2,000, if head of household, or married couple filing joint return
38. Taxable income (subtract line 37 from line 36)
39. Tax from Tax Rate Schedule in Instructions. Enter here and on page 1, line 12
PART V Exemption' Credits
40. Single-$25. Married couple or head of household--$50
41. Blind ☐ Yourself ☐ Your spouse-$8 for each box checked.
42. Dependents-Do not list yourself, your spouse, or person who qualifies you as head of household
NAME (and address if different from yours).
Fred, Brian, Elisa,
Thomas
Gross income $.
_Age__
Did this person qualify as your dependent for
If not, explain circumstances
RELATIONSHIP
children
2322222
24
25
26
27
28
•
8,284 97
(1,000 00)
29
•
30
7.284 97
31.
32 ⚫
33 °
34
°
35
36
36
7.30557
37
2.74544
38
4,539 33
39
51 00
40
5000
41°
Number of dependents listed.
× $8
42
32 00
°
43
82 00
43. Total exemption credits (add lines 40, 41 and 42). Enter here and on page 1, line 13
PART VI-Credit for Net Income Tax Paid to Another State-Attach copy of "other state" return-and Retirement Income Credit
44. Income derived from sources within State of
and also taxable by California
44
45. California adjusted gross income (from page 1, line 11)
46. California tax liability (from page 1, line 14)
47. Credit limitation-line 44 line 45
48. Retirement income credit (attach Schedule R (540))
45
46
% (100%* maximum) × line 46 (cannot exceed tax paid other state)
47
•
48
°
49
49. Total (add lines 47 and 48). Enter here and on page 1, line 15
PART VII Reconciliation to Federal Return-If adjusted gross income on Federal return is different from line 11, page 1, explain below
Dividend Exclusion
NW 88326 Docld:32245535 Page 144
45149-400 7-70 13,000M ①A OSP
SCHEDULE
LAL
FORM 540
Name as shown on Form 540
Samuel and Phyllis Ruby
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
Itemized vs. Standard Deduction-You have a choice between two deduction
methods. You can either itemize your deductions or take a standard deduction as
explained in the 540 Instructions. On separate returns of a husband and wife,
TAXABLE
19 70
YEAR
Social Security Number
322
12
7997
if one spouse itemizes deductions, the other may not use the Tax Table or claim
the standard deduction. If you choose to itemize your deductions, complete the
appropriate items below.
Medical and dental expenses (not compensated by insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospital care, insurance
premiums for medical care, etc.
1. One half (but not more than $150) of insurance premiums for medical care
2. Medicine and drugs
3. Enter 1% of adjusted gross income shown on Form 540
2
3
4
1
569
_ 4: Subtract line 3 from line 2 (if less than zero, enter zero)
premiums
5. Other medical and dental expenses. Include balance of insurance premiums for medical care not
deducted on line 1 (attach schedule)
6. Total-(Add lines 4 and 5)
. .
7. Enter 3% of adjusted gross income shown on Form 540
8. Subtract line. 7 from line 6 (if less than zero, enter zero)
9. Total-(Add lines 1 and 8)
Child Adoption Expense
10. Total expenses paid or incurred-Attach itemized list
11. Enter 3% of adjusted gross income shown on Form 540
12. Subtract line 11 from line 10-See instructions for maximum limitations
Taxes
13. Real estate
14. State and local gasoline
15. General sales
16. Auto license-Excess of registration and weight fees (see instructions)
17. Personal property
18. State disability insurance (SDI)-Employer private disability plans do not qualify
19. Other (specify)
20. Total taxes---(Add lines 13 through 19)
21. Cash--Including checks, money orders, etc. (itemize)
Contributions
22. Total cash contributions
23. Other than cash (see instructions). Enter total here
24. Total Add lines 22 and 23-Maximum deduction may not exceed 20% of adjusted gross income
Interest Expense
25. Home mortgage
26. Installment purchases
27. Other (itemize)
28. Total-(Add lines 25, 26 and 27)
Miscellaneous Deductions
29. For child care, alimony, union dues, casualty losses, etc.-See instructions (itemize)..
8
9
150 00
10
11
12
17
19
14
31561122
18
20
663 26
21
24
22
222
23
280 00
A
25
26
27
22
28
23
29
1,552 18
30. Total miscellaneous deductions
30
100 00
31. Total deductions (Add lines 9, 12, 20, 24, 28 and 30). Enter total here and on Form 540, page 2, in space provided S/A
31
2,74544
(Rev. 1970)
NW 88326° Docid:32245535 Page 145
Schedule B on reverse
SCHEDULE
C
FORM 540
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
Attach this schedule to your income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
Food
A. Principal business activity..
Snack Bar
B. Business name
TAXABLE
19_70
YEAR
Partnerships, joint ventures, etc., must file on Form 565
; product__
Social Security Number
322 12 7997
(For example: rotail-hardware; wholesale-tobacco; services-legal; manufacturing-furniture; etc.) 25-
D. Business location 5418 Van Nuys Boulevard
(Number and street or rural route)
accrual;
C. Federal employer identification number 26.51.578
Van Nuys, California 91401
(City-post office)
other
(describe)..
E. Indicate method of accounting: ☑ cash;
F. Was there any substantial change in the manner of determining
inventories? ☐ Yes ☑ No. If "yes," attach explanation.
(State)
(ZIP code)
quantities, costs or valuations between the opening and closing
☑ No
G. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)?
1. Gross receipts or gross sales $
☐ Yes
Less: Returns and allowances $.
2. Inventory at beginning of year (If different than last year's closing inventory attach
explanation)
3. Merchandise purchased $.
drawn from business for personal use $
4. Cost of labor (do not include salary paid to yourself)
5. Material and supplies
6. Other costs (explain in Schedule C-1)
7.
Total of lines 2 through 6
8. Inventory at end of this year.
less cost of any items with-
9. Cost of goods sold and/or operations (subtract line 8 from line 7)
10. Gross profit (subtract line 9 from line 1)
OTHER BUSINESS DEDUCTIONS
11. Depreciation (explain in Schedule C-2)
12. Taxes on business and business property (explain in Schedule C-1)
13. Rent on business property
14. Repairs (explain in Schedule C-1)
15. Salaries and wages not included on line 4 (exclude any paid to yourself)
16. Insurance.
17. Legal and professional fees
18. Commissions .
19. Amortization (attach statement)
20. Retirement plans, etc. (other than your share)
21. Interest on business indebtedness
22. Bad debts arising from sales or service.
23. Losses of business property (attach statement)
24. Depletion of mines, oil and gas wells, timber, etc. (attach schedule)
25. Other business expenses (explain in Schedule C-1)
26.
Total of lines 11 through 25
.
27. Net profit (or loss) (subtract line 26 from line 10). Enter here and on page 2, Part II, Form 540 or 540NR $
SCHEDULE C-1. EXPLANATION OF LINES 6, 12, 14, AND 25
SCHEDULE
ATTACHED
9,284 97
Line No.
Explanation
(Rev. 1970)
NW 88326 Docld:32245535 Page 146
Amount
Line No.
Explanation
Amount
Page 1
SCHEDULE
FORM 540
CALIFORNIA
SALES OR EXCHANGES OF PROPERTY
Attach to Form 540 or 540NR
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
Part I-CAPITAL ASSETS
SHORT-TERM--ASSETS HELD NOT MORE THAN 6 MONTHS
a. Kind of property (if necessary,
attach statement of descriptive
details not shown below)
.L
b. Date acquired
c. Date sold
(mo., day, yr.)
' (mo., day, yr.)
d. Gross sales price
TAXABLE
$1.970
YEAR
Social Security Number.
322 12 7997
e. Depreciation allowed
(or allowable)
since acquisition
(attach schedule)
f. Cost or other basis,
cost of subsequent
improvements (if not
purchased, attach
explanation) and
expense of sale
g. Gain or loss
(d plus e less'f)
SCHEDULE ATTACHED
2. Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3. Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
4. Net short-term gain (or loss) from lines 1, 2 and 3
#k
LONG-TERM ASSETS HELD MORE THAN 6 MONTHS
5. Enter gain (if any) from line 16, Part II
(15.274.00)
6. Enter your share of net long-term gain (or loss) from partnerships and fiduciaries
7. Enter unused long-term capital loss carryover from preceding taxable years (attach statement)·
8. Net long-term gain (or loss) from lines 5, 6 and 7
9. Combine the amounts shown on lines 4 and 8 and enter the net gain (or loss) here
10. If line 9 shows a GAIN, enter 50% of line 8 or 50% of line 9, whichever is smaller. (Enter zero if there is a
loss or no entry on line 8)”.
11. Subtract line 10 from line 9, Enter here and on line 17, Part III
12. If line 9 shows a LOSS, enter here and on line 17, Part III the smallest of the following:
(a) the amount on line 9; (b) the amount of taxable income on Form 540 or 540NR, computed without capital
gains and losses; or (c) $1,000
Carryover Loss (14,274.00).
Part II-SALE OR EXCHANGE OF PROPERTY UNDER SECTIONS 18181-82
13. Enter gain (if any) from line 22, Part IV
14. Enter gain (if any) from line 25, Part IV
(15,274.00)
( 1,000.00)
15. Enter your share of gain (or loss) of Section 18181-82 items, from partnerships and fiduciaries
16. Net gain (or loss). If GAIN; enter on line 5, Part 1; if LOSS, enter on line 29, Part V
PART III-TOTAL NET GAIN OR LOSS FROM SALES OR EXCHANGES OF PROPERTY
17. Net gain (or loss) from line 10 or 11, Part I
18. Net gain (or loss) from line 31, Part IV
19. Total net gain (or loss)-Combine lines 17 and 18. Enter here and on Form 540 or Form 540NR, page 2, Part
II, line 23.
(Rev. 1970)
NW 88326 Docld:32245535 Page 147
(Schedule continued on reverse)
Page 1
IRS
1040
Combined
1 with Form
* 1040A
4101 Sepulveda
787-0211
Department of the Treasury
989-2700
Internal Revenue Service
US Individual Income Tax Return
For the year January 1-December 31, 1969, or other taxable year beginning.
First namo and initial (If joint return, use first names and middle initials of both)
95
1969
1969, ending
19.
Last name
Your social security number
Please print or type
Home address (Number, and street or rural route)
City, town or post office, State and ZIP code
Your occupation
Spouso's social security number
Enter below name and address used on your return for 1968 (if same as above write "Same"). If none filed, give
reason...If changing from separate to joint or joint to separate returns, enter 1968 names and addresses.
Spouse's occupation
Your present employer and address
Your
Filing
Status-
(Check
only one)
123
ㅁㅁㅁ
Single
Married filing joint return (even if only one had income)
If this item checked give spouse's social security number in space provided
above and enter first name here
Check boxes for exemptions which apply
7a Yourself.
.
7b Spouse (only if her (his) income is included in this return or she (he) had no income)
8 First names of your dependent children who lived with you
4
Unmarried Head of Household
5
Surviving widow(er) with dependent child
Married filing separate return and spouse is also filing a return.
6
Married filing separate return and spouse
is not required to file
Rs 65 or over
Blind
Enter
number
of boxes
checked >>
Please attach Copy B of Form W-2 here
Your Income
Your Exemptions
Please attach Check or Money Order here
Balance Due Your Credits
or Refund
-Your Tax and
Surcharge
Sign
here
9 OTHER
DEPENDENTS
(a) NAME-Enter figure 1 in the last
column to right for each name listed
(if more space is needed, use other side)
(b) Relation
ship?
No Months lived
Inyour home? See
page 3 of instr.
(d) $600
or more
income?
Enter number
(e) Support you
furnished. If 100%
write "ALL."
►
(f) Support furnished
by dependent and
others
$
10 Total exemptions from lines 7, 8, and 9 above.
11 Wages, salaries, tips, etc. Attach Forms W-2. If unavailable, explain on back
.11
(If over $100, Less 12b Exclusion $ 200 Balance 12c
12a Dividends (Total before $.
46-
exclusion)
list in Sch. B)
13
Interest (If over $100, list in Schedule B, Part II)
0
13 1,637
14
Adjusted Gross Income ▸
15c
90%.
Other income from Schedule C ☐, Schedule D ☐, Schedule E ☐, Schedule F
14
(Add lines 11 thru 14)
15a Total $ 16.37
(see back)
Less 15b Adjustments $
730
A If line 15c is $5,000 or more, go to Schedule T, to figure tax and surcharge. (Omit lines 16a and 16b.)
B. Also go to Schedule T, to figure tax and surcharge if you itemize deductions; or claim retirement income credit, foreign tax credit, or
investment credit; or if you owe self-employment tax or tax from recomputing prior year investment credit. (Omit lines 16a and 16b.)
C If neither A nor B applies use Tax Tables instead of Schedule T. Complete lines 16a, 16b, and 16c. See paragraph D on back for
☐☐ rules under which the IRS will figure your tax and surcharge.
16a Tax from Tax Table: A ☐, B ☐, or C ☐ (check one)
.
16b Tax surcharge on amount on line 16a (see Page 10 of instr.)
16a
16b
+
16c Total add lines 16a and 16b OR enter amount from Schedule T (Form 1040), line 11. 16c
17 Total Federal income tax withheld (attach Forms W-2)
17
19
20
21
18 Excess F.I.C.A. tax withheld (two or more employers-see page 5 of instr.)
☐ Nonhighway Federal gasoline tax-Form 4136, ☐ Reg. Inv.-Form 2439
1969 Estimated tax payments (include 1968 overpayment allowed as a credit)
Total (add lines 17, 18, 19, and 20)
18
.
19
20
90-
Make check or
money order pay-
able to Internal
Revenue Service.
211
90
22 If line 16c is larger than line 21,
222
23
If line 21 is larger than line 16c,
enter BALANCE DUE
22
-▷ enter OVERPAYMENT
23
; (b) Refunded ▷ $
90
90
24 Line 23 to be: (a) Credited on 1970 estimated tax ▷ $
Under penalties of perjury, I declare that i have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it
is true,, correct, and complete.
Your signature
Date
Spouse's signature (If filing jointly, BOTH must sign even if only one had income)
NW-88326 Docid:32245535 Page 148
Signature of preparer other than taxpayer, based on
all information of which he has any knowledge.
Date
Addross
16-
石
SCHEDULE. D
(Form 1040)
U.S. Treasury Department
Internal Revenue Service
Gains and Losses From Sales or Exchanges
of Property
Name as shown on page 1 of Form 1040
Attach this schedule to your income tax return, Form 1040
1968
Social Security. Number
Part CAPITAL ASSETS-Short-term capital gains and losses-assets held not more than 6 months
a. Kind of prop-
orty. Indicate
security, real
estate, or other
(Specify)
c. How
ac-
b. Description
(Examples: 100 sh. of
"Z" Co., 2 story brick,
quired.
Enter
letter
d. Date
acquired
etc.)
(See
instr.)
e. Date sold
symbol (mo., day, yr.) (mo.. day, yr.)
See Schedule
f. Gross sales
price
g. Depreciation
allowed (or
allowable) since
acquisition
Attacke
h. Cost or other
basis, cast of
subsequent improve-
ments (if not
purchased, attach
explanation) and
expense of sale
1. Gain or lo25
(f'plus g less h)
(6359)
2 Enter your share of net short-term gain (or loss) from partnerships and fiduciaries.
3. Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
4 Net short-term gain (or loss) from lines 1, 2, and 3.
Long-term capital gains and losses-assets held more than 6 months (12 months or more for certain livestock)
5 Enter gain from Part II, line 3'.
76,352
Total long-term gross sales price.
6a Enter your share of net long-term gain (or loss) from partnerships and fiduciaries.
6b Enter your share of net long-term gain from small business corporations (Subchapter S).
7 Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
8 Capital gain dividends (see Form 1040 Instructions, page 5).
Net long-term gain (or loss) from lines 5, 6a, 6b, 7, and 8
10 Combine the amounts shown on lines 4 and 9, and enter the net gain (or loss) here
11 If fine 10 shows a GAIN-Enter 50% of line 9 or 50% of line 10, whichever is smaller.
entry on line 9.) (See reverse side for computation of alternative tax.) .
(Enter zero if there is a loss or no
£2 Subtract. line 11 from line 10. Enter here and in Part IV, line 1, on reverse side
13 if line 10 shows a LOSS Enter here and in Part IV, line 1, the smallest of the following: (a) the amount on line 10; (b)
the amount on Form 1040, page 1, e11b, computed without regard to capital gains or lesses; or (c) $1,000 LING 3
Part 11-GAIN FROM DISPOSITION OF DEPRECIABLE PROPERTY UNDER SECTIONS 1245 1250
assets held more than 6 months (see instructions for definitions)
Where double headings appear, use the first heading for section 1245 and the second heading for section 1250.
a. Kind of property and how acquired (if necessary, attach statement
of descriptive details not shown below-write 1245 or 1250
- to Indicate type of asset)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mn., day, yr.)
d. Gross sales price
(6,357-)
16,359
e. Cost or other basis, cost of
subsequent improvements (if
not purchased, attach expla
cation) and expense of sale
f. Depreciation allowed (or allowable) since acquisition
t-1. Prior to January 1, 1962
.OR
Prior to January 1, 1964
1-2. After December 31, 1961
OR -
After December 31, 1933
g. Adjusted basis
(e less sum of 1-1 and f-2)
h. Total gain
(d less )
Ordinary gain
(lesser of 1-2 or h)
OR
(see instructions)
1. Other gain
(h less )
2 Total ordinary gain.
Enter here and in Part IV, line 2, on reverse side.
13 Total other gain. Enter here and in Part I, line 5; however, if the gains do not exceed the losses when this amount is
combined with other gains and losses from section 1231 property enter the total of column in Part III, line 1.
NW 88326 Docld:32245535 Page 149
SCHEDULE T
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name (as shown on Form 1040)
Tax Computation
Tax Computation
Attach this schedule to your income tax return, Form 1040
1969
Social Security Number
3
5
1
Your adjusted gross income (from line 15c, Form 1040)
2
Note. If your adjusted gross income is less than $5,000 and you choose to take the standard deduction
instead of itemizing your deductions, omit lines 2, 3, 4, and 5. Find your tax in the tables on pages 10-12
in the instructions and enter it in line 6a instead of making a percentage rate computation.
Enter on the line at the right the amount of your deduction figured under one of the following
methods:
- If you itemize deductions, enter the total from Schedule A (Form 1040), line 14
'OR
- Figure your standard deduction as follows:
(a) Enter 10 percent of line 1 ‘but“.
not more than $1,000 ($500 if
married and filing separately).
(b) Enter the sum of: $200 ($100 if
$
907
Enter the larger of (a) or (b) on the
line at the right. If your spouse files
a separate return, determine your
deduction in the same manner that
she (he) has.
1392-
RELIMINARY
* married and filing separately)
plus $100 for each exemption
claimed in line, 10 of Form 1040,
but do not enter more than
$1,000 ($500 if married and
filing separately)
Subtract the amount on line 2 from the amount on line 1 and enter the balance here.
Enter number of exemptions claimed on line 10, Form 1040, 6 Multiply this number by $600, and
enter the amount on this line .
..
Subtract the amount on line 4 from the amount on line 3 and enter the balance here. This is your
taxable income .
6a Tax: Use the appropriate Tax Rate Schedule on page 9 of instructions to figure your tax on the amount on
line 5.
•
(Check if tax is from: Tax Table ☐, Tax Rate Schedule ☐, Schedule D ☐, or Schedule G ☐ )
6b Tax surcharge. If line 6a is less than $7.30, find surcharge from tables on page 10 of instructions. If line 6a
is $730 or more, multiply amount on line 6a by .05 and enter result. (If you claim retirement income
credit. use Schedule R (Form 1040) to figure surcharge.)
6c Total (add lines 6a and 6b) .
Special credits
7a Retirement income credit .
F
:
7b Investment credit.
7c Foreign tax credit
7d Total (add lines 7a, 7b, and 7c)
3600
8
Income tax (subtract line 7d from line 6c)
9 Self-employment tax (from Schedule SE (Form 1040), line 13).
10 Tax from recomputing prior-year investment credit (attach statement)
11 Total tax (add lines 8, 9, and 10). Enter here and on line 16c, Form 1040 (make no entries on line 16a
or 16b, Form 1040)
NW 88326 Doeld:32245535 Page 130
✰ U.S. GOVERNMENT PRINTING OFFICE:1969-0-337-051

SCHEDULE B
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name (as shown on page 1 of Form 1040)
Dividends and Interest
Income Schedule
Attach this schedule to your income tax return, Form 1040
PART -Dividends Income
$
1969
Social Security Number
1 Gross dividends and other distributions on stock (list payers and amounts-write (H), (W), (J), for stock
held by husband, wife, or jointly)
PRELIMINARY PROOF
Total line 1
1
2 Capital gain distributions (see
page 5 of instructions)
3 Nontaxable distributions (see
page 5 of instructions)
4. Total (add lines 2 and 3) .
5 Dividends before exclusion (line 1 less 4-not
less than zero). Enter here and on Form 1040;
line 12, in space provided.
PART II—Interest Income (list payers and amounts below)
Earnings from savings and loan associations and credit unions
Liberty Federal Savings
H
☐
از
44
Other Interest (on bank deposits, bonds, tax refunds, etc.)
NW-88326 Doeld:32245535-Page=151
(W) Central Natural /zzuk
* Clucago
лой
513
Total interest income. Enter here and on line 13.
1,637
1
j
SCHEDULE A
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name (as shown on Form 1040)
"
Itemized Deductions
Attach this schedule to your income tax return, Form 1040
Itemized Deductions-You have a choice between two
deduction methods. You can either itemize your actual
deductions or take a standard deduction. Deductions may be
itemized for charitable and other contributions, interest ex-
pense, medical expense, certain taxes, casualty losses, child
care, and other items described in the instructions on
back. If you take the standard deduction, you will get an
Medical and dental expense (not compensated by insurance
or otherwise) for medicine and drugs, doctors, dentists, nurses,
hospital care, medical insurance premiums, etc.
1 One half of insurance premiums for medi-
cal care (but not more than $150)
2 Medicine and drugs
3 Enter 1% of line 15c, Form 1040 .
4 Subtract line 3 from line 2 (not less than
zero).
5 Itemize other medical, dental expenses
(Include balance of insurance premiums
not deducted on line 1) .
+50
48
9
39
G5
1969
Social Security Number
amount equal to 10 percent of the income you report on line
15c of Form 1040, but not less than $200 plus $100 for
each exemption claimed on line 10 of Form 1040 (subtract
$100 if married and filing separately). The maximum
standard deduction is $1,000 ($500 if married and filing
separately). If you choose to itemize your deductions, fill
• in the appropriate spaces below.
Contributions. Cash-including checks, money orders, etc.
(Itemize) BOY &
Girl Scouts of Amer
Catholic C
15
18
Dr. Strauss
Dr. Mentel
Dr. Robinson
Hosp, Ins Pro,
Dr. Reis
RELIMINARY PROOF
11a Total cash contributions
40
11b
Other than cash (see instructions for
required statement). Enter total of
such items here.
200
11c Carryover from prior years (see in-
structions on back) .
11d Total contributions (add lines 11a,
60
11b, and 11c-see instructions for
limitation)
42
40
Interest expense-Home mortgage
406
Installment purchases
Other (Itemize)
25
Dr. Fox (Eye, Exam
(Brian, Fredy.
Weiner
(4 pair Eptical
6 Total (add lines 4 and 5) .
7 Enter 3% of line 15c, Form 1040 .
8 Subtract Ane 7 from line 6.
Auto Loan Devon Bk.
120
75
Sang)
Sears
15
(25)
92-
939
27
912
12 Total interest expense
135
-
Miscellaneous deductions for child care,
9 Total (line 1 plus line 8)
Taxes. Real estate. . .
State and local gasoline
State and local income
Personal property.
10 Total taxes
- 1062
alimony, union dues, casualty losses, etc.
See instructions. 1965
22
General sales (See page 15 of instructions)
108
Income Tax Preparation
25
1301
13 Total miscellaneous
14 Total deductions (add lines 9, 10, 11d, 12, and 13-enter on Schedule T (Form 1040), line 2). D
NW 88326 Doçia 322455
25
1392-
16--1
1969
Samuel
&
hyllis Kuby
11346 MONTGOMERY, "
Granada HILLS, CALIF..
attached to and made part of U.S. Individual
FORM 1040, 1969.
Income Tax
SHARES DESCRIPTION
•E.F. HUTTON and Co.
12:00 MERCANTILE INDUSTRIES
200 BOTANY INDUSTRIES
200 MIDWESTERN FINANCIAL
MIDWESTERN FINANCIAL
200
200
VTR, INC.
MCDONNELL & Co..
100
WESTBURY FASHIONS
100
DATE
DATE
PURCHA
All Stocks:
Acquired, A.
SALE
ACQUIRED SOLD PRICE PRICE (6055)
11-68
284
10-68 1-69 3303-2994- 309-
2.69 4,010- 3,726-
10-68 2-69 1,466-1,832- (366)
10-68 2.69 4 1,416 -1,832 (416-)
3.69 5.69 5,325= 4,458 867-
8-682-69
"
943-853-90-
IMPERIAL CORP. & AMER. 8-68 6-69 1,672-1,749 (77)
GOOD BODY & CO.
100 VOLUME MERCHANDISE
• 300 PENNSYLVANIA ENG. CORP.
200 BOTANY INDUSTRIES
200 CINERAMA, INC.
200 HENRY'S DRIVE. IN
200 PENTRON ELECTRONICS CO.
100 POLYCHROME CORR
1200 NYTRONICS, INC.
11-68 1-69 2,563 2,645 82-
12-68 1-69 4.646-3,809 837
11-68 2-69 4,010- 3,726 284
1-69 2·69 2,627-2,438 -189-
2.69 10-69 2,463 828- 1,635)
10-69.10.69 875- 873 2-
3.69 10.69 1,672- 2,002 (330)
1-69 11-69 3,320- 4,660- (1,340-)
COGAN- BERLIND-WEILL - LEVITT
100 HELENE CURTIS INDUSTRIES 12-68 10-69 1,338-2153- (815-)
100 ALLIED ARTISTS PICTS
100 VANGUARD INT., INC.
100 TELEVISION Mfg. AMER
100 NYTRONICS, INC.
100 DIVERSIFIED IND.
BACHE + Co.
__
3-69 10-69 1,078-1,257- (179)
9-68 10-69
12-68 10-69
671-1,219- (548)
362- 739 (377)
6-69 11-69 1,647-1989- (342)
6-69 12-69 1722-2,431- (709)
100 UNITED PIECE + DVE WKS. 8.68 1-69 2.314-2,343 (29)
8
100 SIBONEY CORP.
100 SIBONEY CORP
Hoo MIDWESTERN FINANCIAL
609-
1-692-69
588 21-
1-69 2-69 609-
600 9.
8-68 2-69 2,932 4220 (1,288-
100 GENERAL BATTERY & CERAMIC 1-69 5.1.9 1,623-1484-139-
100 GSC ENTERPRISES, INC.
2.69 5-69
979-739-
240
100 IMPERIAL CORP of AMER. 8-68 6-69 1,573 1,749 (176-)
200 GENERAL BATTERY + CERAMIC
100 TOOL RESEACEH & ENG.
Too NYTRONICS
TOTAL
6-69 10-69 3.394-2,893 501-
6-69 10-69 2,464-2,267 197-
2-69 12-69 1276- 3059 (173)
64, 902- 68, 155 (6,357)
NW-88326-Docid:32245535-Page-153-
59.
Jamve!
amoy
11346 MONTGOMERY
GRANADA HILLS, CALIC
To be attached and made
。 part of U.S. Individual Income Tax Form 1040
The below listed expenses are in connection with Schedule D
C INTEREST PAID ON MARGIN ACCOUNTS
BACHE & Co.
MCDONNELL & Co.
COGAN-BERLIND - WEILL - LEVITT.
GOOD BODY & Co.
E. F. HUTTON + Co.
137
145-
74
176
51-
TOTAL INTEREST
583
1969
O
BOOKS, PERIODICALS & SERVICES
AUTO EXPENSE 6000 MILES.
5,000
MUES
LESS PERSONAL
BUSINESS MILES at 10/1000 MILES
88326 Docld:32245535 Page 154
47
100
TOTAL EXPENSES
730
$1040
Combined
with Form
1040A
Department of the Treasury I Internal Revenue Service
US Individual Income Tax Return
For the year January 1-December 31, 1969, or other taxable year beginning.
Please print or type
00 322-12-7997
SAMUEL & PHYLLIS RUBY
11346 MONTGOMERY AVE
GRANADA HILLS, CALIF 91344
1969, ending.
1969
19
349-18-1420 D036 Your social security number
Enter below name and address used on your return for 1968 (if same as above write "Sam"); If none filed, give
reason. If changing from separate to joint or joint to separate returns, enter 1968 names and addresses.
"Samuel & PHYLLIS RUBY-6123 NIHOYNE CHICAGO, 111 60645.
Name and address of employer at time of filing
Your
Filing
Status
(Check
only one)
Please attach Copy B of Form W-2 to back
Your Income
Your Exemptions
Balance Due Your Credits
Please attach Check or Money Order here
or. Refund
Your Tax and
Surcharge
12.3
Single
SELF.
2 ☑ Married filing joint return (even if only one had income)
Married filing separate return and spouse is also filing a return..
If this item checked give spouse's social security number in space provided
above and enter first name here
Check boxes for exemptions which apply
7a Yourself
7b Spouse (applies only if line 2 or line 6 is checked)
8 First names of your dependent children who lived with you
FRED-BRIAN-ELISA-THOMAS
9 OTHER
DEPENDENTS
(a) HAME Enter figure 1 in the last
column to right for each name listed
(if more space is needed, use other sida).
4
5
322/12/1
12/7997
Your occupation
Sif- EMPLOYED
Spouse's social security number
349 18 1420
Spouse's occupation
Hseit
Unmarried Head of Household
Surviving widow(er) with dependent child
Married filing separate return and spouse
is not filing a return
Regular
65 or over
Blind
Enter
number
of boxes
checked 2
Enter number A
(o) Support you
furnished. If 100%
write "ALL"
(f) Support furnished
by dependent and
others
$
(b)
Relationship
(c) Months lived'
in your home. See
Instructions, B-2.
(d) $500
or more
income?
$
on 1040-11
[See item 2] 12b Less Exclusion $ 2000-
Balance B 12c
0
13
16374
14
907-
10 Total exemptions from lines 7, 8, and 9 above.
11 Wages, salaries, tips, etc. (Attach Form W-2 to back. If unavailable, explain on back) 11
12a Dividends [Total before] $46-
exclusion
13 Interest (Enter total here and if over $100, also list in Schedule B, Part II)
14 Other income: Total from attached schedules (check schedules used -C ☐, DEO, F□).
f Add lines 11.1.
15a Total 12c.. 13 & 14 $ 16,37
See
15b Less Adjustments 1040-1 $ 730-
•
Adjusted
Gross
Income 15c
1 6
If line 15c is $5,000 or more, go to Schedule T, to figure tax and surcharge. (Omit lines 16 and 17.)
Go to Sch. T to figure tax and surcharge if you itemize deductions; or claim retirement income credit, foreign tax credit, or invest-
ment credit; or if you owe self-employment tax or tax from recomputing prior year investment credit. (Omit lines 16 and 17.).
If neither of above two items applies, go to Tax Tables instead of Sch. T..Complete lines 16, 17, & 18.
16 Tax from Tax Table (see tables on T-2 and T-3).
16
17 Tax surcharge on line 16 (see T-1 for tax surcharge tables) . 17
See 1040-1 for rules under
which the IRS will figure
your tax and surcharge.
18
19
Enter total of lines 16 and 17 OR amount from Schedule T, line 18, if applicable (check
if from Tax Table A ☐, B ☐ ☐ ☐ ; Tax Rate Sch, ☐, Sch. D ☐ or Sch. G .
Total Federal income tax withheld (attach Forms W-2 to back)
18
19
20 Excess F.I.C.A. tax withheld (two or more employers--see R-2)
21
☐ Nonhighway Federal gasoline tax, Form 4136; ☐ Reg. Inv., Form 2439
2222
20
22 1969 Estimated tax payments (include 1968 overpayment allowed as a credit)
Total (add lines 19, 20, 21, and 22)
23
24 If line 18 is larger than line 23, enter BALANCE DUE. Pay in full with return-
25 If line 23 is larger than line 18, enter OVERPAYMENT
**
26 Line 25 to be: (a) Credited on 1970 estimated tax - $
90
23
24
25
; (b) Refunded ▷- $
Make check or
money order pay-
able ta Internal
Revenue Service.
Go
да!
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the 'best of my knowledge and belief it
Is true, correct, and complete.
Sign
here
Your signature
Spouse's signature (if filing jointly, BOTH must sign even if only one had income)
NW/88326 Docid:32245535 Page 155
Date
Signature of preparer other than taxpayer, based on
all information of which he has any knowledge.
Date
Address
SCHEDULE A
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name as shown on Form 1040
Itemized Deductions
✓ See instructions on A-1 and A-2.
▷ If you use this schedule, attach it to Ferm 1040.
Samuel & PHYLLIS Ruby
Medical and dental expenses (not compensated by insurance
or otherwise) for medicine and drugs, doctors, dentists, nurses,
hospital care, insurance premiums for medical care, etc.
1 One half of Insurance premiums for mak
cal care (but not more than $150) .
2 Medicine and drugs.
°
.
3 Enter 1% of line 15c, Form 1040
4. Subtract line 3 from line 2. Enter differ-
ence (if less than zero, enter zero)
"
"
•
5 Itemize other medical and dental ex-
penses (include balance of insurance
premiums for medical care not deducted
on line 1)
· HOSP. INS. PREMS.
De. REIS.
De. STRAUSS
1969
Social Security Number.
322127997
Contributions. -Cash-Including checks, money orders, etc,
(Itemize)..
Boy Scouts & AMER
12
150
48
GIRL SCOUTS & AMER.
15
9
W
39 - CATHOLIC CHARITIES.
10
200
40
-
60.
11 Total cash contributions
42
De MENDEL
406
12 Other than cash (see instructions on
A-1 for required statement). Enter
total for such items here
De ROBINSON
25
13 Carryover from prior years (see in-
structions on A-2) .
De. Fox (EYE EXAM)
(FRED, BRIAN, SAMILL
75-
WEINER OPTICAL
92
(4 pair GLASSES)
14 Total contributions (add lines 11,
12, and 13-see instructions on A-2.
for limitation)
•
Interest expense-Home mortgage
Installiment purchases !
Other (Itemize)
AUTO LOAN DEVON BANK
SEARS
6 Total (add lines 4 and 5)
7 Enter 3% of line 15c, Form 1040.
8 Subtract line 7 from line 6. Enter differ-
.
ence (if less than zero, enter zero)
9 Total deductible medical and dental ex-
937
27
912
1,062-
15 Total interest expense
Miscellaneous deductions for child care,
alimony, union dues, casualty losses, etc.
(see instructions on A-2).
1968 INCOME TAX PREPARATION
penses (add lines 1 and 8)
Taxes. -Real estate .
22
State and local gasoline
708
General sales (see sales tax tables)
State and local income
Personal property.
10 Total taxes
NW 88326 Docld:32245535 Page 156
130
16 Total miscellaneous deductions
17 TOTAL ITEMIZED DEDUCTIONS (add
lines 9, 10, 14, 15, and 16-enter
here and on Schedule T, line 2).
40.
720
1500
135
25
4392
SCHEDULE B
(Form 1040)
Department of the Treasury.
Internal Revenue Service
Name as shown on Form 1040
SAMUELT
Dividend and Interest Income
See instructions on B-1
If you use this schedule, attach it to Form 1040
'PHYLLIS RUBY
PART Dividend Income
1. Gross dividends and other distributions on stock (list payers
and amounts-write (H), (W), (J), for stock held by hus-
band, wife, or jointly)
1969
Social Security Number
302 12 7997
PART IInterest Income
1 Earnings from savings and loan associations and credit
unions (list payers and amounts)
(W) LIBERTY FEDERAL SAVINES
SLOAN Assoc. & CHGO
((W)
(W)
(W)
".
.:
-525
395
1-28
45
2 Other Interest on bank deposits, bonds.:
tax refunds, etc. (list payers and amounts)
(W) CENTRAL NAT'L Bx & CH GO
513
2 Total of line 1.
3 Capital gain distri-
butions (see instruc-
tions on B-1).
4 Nontaxable distribu-
tions (see instruc-
tions on B-1).
5 Total (add lines 3 and 4)
•
6 Dividends before exclusion (subtract
line 5 from line 2). Enter here and on
Form 1040, line 12a
3 Total interest income. Enter here and
on Form 1040, line 13
NW 88326 Docld:32245535 Page 157
1,637
1
1
1
SCHEDULE D
(Form 1040)
Department of the Treasury
Internal Revenue Service
Name as shown on Form 1040
Sales or Exchanges of Property
See instructions on D-1 and D-2
If you use this schedule, attach it to Form 1040.
。 SAMUEL + PHYLLIS RUBY
T
1969
Social Security Number
32212 7997
Part I-CAPITAL ASSETS-Short-term capital gains and losses-assets held not more than 6 months
a. Kind of prop-
erty.. Indicate
security, real
estate, or other
(Specify)
c. How
ac:
b. Description
(Examples: 100 sh. of
quired.
Enter
"Z Co., 2 story brick,
jetter
etc.)
symbol
(Sea
instr.)
d. Date
acquired
(mo., day, yr.)
e. Date sold
(mo., day, yr.)
1. Gross sales
price
g. Depreciation
allowed (or
allowable) since
acquisition
SEE
SCHEDULE
ATTACHED
h. Cost or other
basis, cost of
subsequent improve.
menis (if not
purchased, attach
explanation) and
expense of sale
i. Gain or loss
(f plús g'less h)
(6,359-)
•1635
3570)
2 Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3 Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
4 Net short-term gain (or loss) from lines 1, 2, and 3
Long-term capital gains and losses--assets held more than 6 months (12 months or more for certain livestock)
5 Enter gain from Part II, line 3
Total long-term gross sales price..
бa Enter your share of net long-term gain (or loss) from partnerships and fiduciaries.
6b Enter your share of net long-term gain from small business corporations (Subchapter S).
7
Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
8 Capital gain dividends
9
Net long-term gain (or loss) from lines 5, 6a, 6b, 7, and 8
10 Combine the amounts shown on lines 4 and 9, and enter the net gain (or loss) here.
11 IF LINE 10 SHOWS A GAIN-Enter 50% of line 9 or 50% of line 10, whichever is smaller.
or no entry on line 9.) (See reverse side for computation of alternative tax.). :
12 Subtract line 11 from line 10. Enter here and in Part IV, line 1, on reverse side
(6.359-
(Enter zero if there is a loss
(6,359-)
P., (tine 15c,
13 IF LINE 10 SHOWS A LOSS-Enter here and in Part IV, line 1, the smallest of: (a) line 10; (b) line 3, Sch.
Form 1040, if tax table used) computed without capital gains or losses; or (c) $1,000.
Part II-GAIN FROM DISPOSITION OF DEPRECIABLE PROPERTY UNDER SECTIONS 1245 AND 1250-
assets held more than 6 months (see instructions on D-1 for definitions)
Where double headings appear, use the first heading for section 1245 and the second heading for section 1250.
a. Kind of property and how acquired (if necessary, attach statement
of descriptive details not shown balow-write 1245 or 1250
to indicate type of asset)
b. Date acquired
(mo., day, yr.).
c. Date sold
(mo:, day, y:.)
d. Gross sales price
D
e. Cost or other basis, cost of
subsequent improvements (if
not purchased,' attach expla
nation) and expense of sale
f. Depreciation allowed (or allowable) since acquisition
f-1. Prior to January 1, 1962
-- OR
Prior to January 1, 1964
1-2. After December 31, 1961
--OR--
After December 31, 1963
g. Adjusted basis
h. Total gain.
(e less sum of t-1 and f-2)
(d less g)
i. Ordinary gain
(lesser of 1-2 o: h)
OR--
(see instructions)
2 Total ordinary gain.
Enter here and in Part IV, line 2, on reverse side.
3 Total other gain. Enter here and in Part I, line 5; however, if the gains do not exceed the losses when this amount is
combined' with other gains and losses from section 1231 property enter the total of column j in Part III, line 1.
NW 88326 Docid:32245535 Page 158
Other gain
(h less i)
INS
ded by the
ons. This is
Jule T. Also
1
If 8 or more
there isnotax,
10% my
Mini-
ULE T
1040)
of the Treasury
enue Service
A
shown on Form 1040
Tax Computation
If no entry is made on line 14, line 16, or line 17, keep this for your records
If entry is made on line 14, line 16, or line 17, attach 
to form 1040
SAMUEL & PHYLLIS RUBY
adjusted gross income (from line 15c, Form 1040)
1969
Social Security Number
322127997
907
If your adjusted gross income is less than $5,000 and you choose to take the standard deduction
ad of itemizing your deductions, omit lines 2, 
3, 4, and 5. Find your tax in the appropriate table
B on T-2 or C on T-3), Enter tax on line 
6 below.
er on the line at the right the amount of your deduction figured under one of the following
nods:
you itemize deductions, enter the total from Schedule A, line 17
OR
gure your standard deduction as follows:
(1) Enter 10 percent of line 1 but do not
enter more than $1,000 ($500 if
married and filing separately)
(2) Enter the sum of: $200 ($100 if
married and filing separately) plus
$100 for each exemption claimed in
line 10 of Form 1040, but do not
✓enter more than $1,000 ($500 if
married and filing separately).
$
$
Enter the larger of b(1)
or b(2) on the line at the
right. If your spouse files
a separate return, deter-
mine your deduction in
the same manner that
she (he) has.
Multiply this number by $600, and
tract the amount on line 2 from the amount on line 1 and enter the balance here.
er number of exemptions claimed on line 10, Form 1040,
er the amount here
>tract the amount on line 4 from the amount on line 3 and enter the balance here. This is your
able income. Figure tax on this amount by using the appropriate Tax Rate Schedule (I, 
II, or II) on
1. Enter tax on line 6 below
ou claim the retirement income credit, enter amount from Schedule R, line 12, here
otract line 7 from line 6
:
•
< surcharge. If line 8 is less than $735, find surcharge from tax surcharge tables on T-1. If line 8 is
35 or more, multiply amount on line 8 
by .10 and enter result here'
tal (Add lines 6 and 9)
tirement income credit from Schedule R, line 17 (attach Schedule R).
vestment credit (attach Form 3468).
reign tax credit (attach Form 1116).
tal credits (add lines 11, 12, and 13)
•
.
•
..
come tax (subtract line 14 from line 10)
elf-employment tax (attach Schedule SE)
°
a
°
°
ax from recomputing prior-year investment credit (attach Form 4255)
°
°
°
°
A
otal tax (add lines 15, 16, and 17). Enter here and on line 18, Form 1040 (make no entry on line 16
r17, Form 1040). Attach Sch. T to Form 1040 
only if you made an entry on line 14, 16, or 17 above.
he Averaging. If your income has
ased substantially this year, it may
'your advantage to figure your tax
e surcharge under the "averaging
od." Obtain Schedule G from an
nál Revenue Service office for full
native Tax. It will usually be to
advantage to use the alternative tax
ir net long-term capital gain exceeds
net short-term capital loss, or if you
a net long-term capital gain only, and
are filing (a) a separate return with
ole income exceeding $26,000, or
'
(b) a joint return, or as a surviving hus-
band or wife, with taxable income ex-
ceeding $52,000, or (c) as a head of
household with taxable incorne exceeding
$38,000.
Line 9-Tax Surcharge.-The rate for
the calendar year 1969 is 10 percent.
The tax surcharge is an addition to the
regular income tax. See the Tax Sur-
charge Tables on T-1.
Credit for Foreign Taxes and Tax-Free
Covenant Bonds.-You may claim these
credits only if you itemize deductions.
1,392-
3,600
0
1
1
0
0
Ο
1
To claim tax-free covenant bonds credit,
enter the amount of credit above line
14, and write "covenant bonds" to left
of the entry.
Line 16--Self-Employment Tax.-Enter
amount shown on line 9, Part III, Schedule
SE.
Line 17-Tax From Recomputing Prior
Year Investment Credit. Enter
amount by which the credit taken in a
prior year or years exceeds the credit as
recomputed due to early disposition of
property. Attach Form 4255.
NW 88326 Docld:32245535 Page 159
00100001000010000 10000 10000 10000 10000 10000 10000 10000 10000 10000 10000 10000 1000+
000000 00¯¯ ¯¯¯¯ 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 00
4
4063
20
1222
50
57
14
31
39
)6
14
11
19
33
26
.39 39
the
T-3
10000 10000 10000 10000 10000 10000 10000 1000000 2000064-0
11
NW-88326 Docld:32245535 Page 160
Good bodya.co 1970
Dividends
20.60%
Interest
18.24
83
84
7
323
809
845
276
276
348
0
269
16

NW-88326 Docid:32245535 Page 161
36-2586182
The Stanley-Oliver Mfg. Co.
1001 S. California Ave.
Chicago, Ill. 60612
Type or print EMPLOYER'S identification number, name, and address above.
WAGE AND TAX STATEMENT
1968
Copy C-For employee's records
SOCIAL SECURITY INFORMATION
tax withheld's
paid in 1968 4
FEDERAL INCOME TAX INFORMATION
Federal income tax
withheld
Wages paid subject to with-
holding in 19681
Other compensa-
F.I.C.A. employee Total F.I.C.A. wages
tion paid in 1968.2
156.00
2,250.00
EMPLOYEE'S social security number DD
322 12 7997
Samuel D. Ruby
6123 N. Hoyne Ave.
Chicago, Ill. 60645
Type or print EMPLOYEE'S name and address (including ZIP code) above.
FORM W-2-U.S. Treasury Department, Internal Revenue Service
99.00
2,250.00
or sick pay exclusion.
1 Includes tips reported by employee. Amount is before payroll deductions
2 Add this item to wages in figuring the amount to be reported as wages
and salaries on your income tax return.
8 The social security (F.I.C.A.) rate of 4.4% includes 6% for Hospital
Insurance Benefits and 3.8% for old-age, survivors, and disability insurance.
4 Includes tips reported by employee. If your wages were subject to social
security taxes, but are not shown, these wages are the same as wages shown,
under "Federal Income Tax Information," but not more than $7,800.
Uncollected Employee Tax on Tips
Please attach Check or Money Order here - -
Please attach Copy B of Form W-2 here
1040
Please print or type | Form
U.S.Indiv`U.S. Treasury Department, Internal Revenue Service
Income Tax Return for the year January 1-December 31, 1968,
or other taxable year beginning.
· First namo and Initial (If joint return, use first names and middle initials of both)
Samuel and Phyllis
Home address (Number and street or rural route)
6123 N.
Heyne
Illinois
City, town or post office, and State
icago
1968, ending
Ruby
Last name
ZIP code
19........
60645
Enter below name and address used on your return for 1967 (if same as above, write "Same"). If none filed, give
reason. If changing from separate to joint or joint to separate returns, enter 1967 names and addresses.
Same
Your present employer and address
1968
Your social security number
322127997
Your occupation
Self-employed
Spouse's social security number
344 181420
Spouse's occupation
Housewife
Self-employed
Your Exemptions Regular 65 or over
2a Yourself .
2b Spouse
☑
Your Filing Status-check only one:
1a ☐ Single
1c
1b ☑ Married filing joint return (even if only one had income)
Married filing separately. If spouse is also filing a return,
enter her (his) social security number in space provided above
and give first name here
1d ☐ Unmarried. Head of Household
Blind
Enter
number
of boxes
checked ►
3a First names of your dependent children who lived with
you Freid, Brian
Elisa
Thomas
Enter
number ‣
3b Number of other dependents (from page 2, Part 1, line 3)
4 Total exemptions claimed
6
le ☐ Surviving widow(er) with dependent child
Income
5
If joint re-
6
turn include
all income
of both
husband
and wife
Wages, salaries, tips, etc. If not shown on attached Forms W-2 attach explanation
Other income (from page 2, Part II, line 8)
5
3,250 00
6
5/869 40
7
Total (add lines 5 and 6)
7
5119460
8
Adjustments to income (from page 2, Part III, line 5)
8
71685
9
Total income ("adjusted gross income") (subtract line 8 from line 7)
9
402
Find tax
from table
10
If you do not itemize deductions and line 9 is under $5,000, find tax in tables on
pages 12-14 of instructions. Omit lines 11a, b, c, or d. Enter tax on line 12a.
10
-OR-
11a If you itemize deductions, enter total from page 2, Part IV, line 17
Figure tax
using tax
If you do not itemize deductions, and line 9 is $5,000 or more enter the larger of:
(1) 10 percent of line 9; OR (2) $200 ($100 if married and filing separate return) (11a
plus $100 for each exemption claimed on line 4, above.
Deduction under (1) or (2) limited to $1,000 ($500 if married and filing separately).
74026
rate
schedules
11b Subtract line 11a from line 9. Enter balance on this line"
11c Multiply total number of exemptions on line 4, above, by $600
11b
6-662131
11c
3,600/00
11d Subtract line 11c from line 11b. Enter balance on this line. (Figure your tax on this 11d
amount by using tax rate schedule on page 11 of instructions.) Enter tax on line 12a.
12a Tax (Check if from: Tax Table ☐, Tax Rate Schedule ☑, Sch. D ☐, or Sch. G ☐ ) 12a
12b Tax surcharge. If line 12a is less than $734, find surcharge from tables on page 10 of instruc-
tions. If line 12a is $734 or more, multiply amount on line 12a by .075 and enter result. (If 12b
you claim retirement income credit, use Schedule B (Form 1040) to figure surcharge.)
12c Total (add lines 12a and 12b)
3,06231
46059
260103
12c
48659
13 Total credits (from page 2, Part V, line 4)
13
☐
14a Income tax (subtract line 13 from line 12c)
14a
475
Your
Tax,
Credits,
14b Tax from recomputing prior year investment credit (attach statement)
14b
15 Self-employment tax (Schedule C-3 or F-1)
15
16
Total tax (add lines 14a, 14b, and 15)
16
and
Pay-
17
Total Federal income tax withheld (attach Forms W-2)
18
ments
Excess F.I.C.A. tax withheld (two or more employers-see page 5 of instr.)
17
18
15606
19
20
☐ Nonhighway Federal gasoline tax-Form 4136, ☐ Reg. Inv.-Form 2439 19
1968 Estimated tax payments (include 1967 overpayment allowed as a credit) 20
21
Total (add lines 17, 18, 19, and 20)
21
22
If payments (line 21) are less than tax (line 16), enter Balance Due. Pay in full with this return
22
4/75/04
Make check or
money order pay-
able to Internal
Revenue Service.
15600
31904
Balance
23
If payments (line 21) are larger than tax (line 16), enter Overpayment
23
Due or
Refund
24
25
Amount of line 23 you wish credited to 1969 Estimated Tax
Subtract line 24 from 23. Apply to: ☐ U.S. Savings Bonds, with excess refunded or ☐ Refund only
Under penalties of perjury, 1 doclaro that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is
true, correct, and comploto. If proparod by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
24
25
Sign
here
Your signaturo
Dato
Spouse's signaturo (if filing jointly, BOTH must sign even if only one had income)
NW 88326 Docld:32245535 Page 162
Signature of proparer other than taxpayer
Addross
Dato
659-10-80189-8
Part Exemptions
Complete only for dependents claimed on line 3b, page 1
(a) NAME (If more space is needed attach schedule)
(b) Relationship
(c) Months lived in your
home. If born or died dur
ing year write "B" or "D"
(d) Did depend-
ent have income
of $600 or more?
1
2
Form
(e) Amount YOU furnished
for dependent's support,"
If 100% write "ALL"
1040-1968--Pago
(f) Amount furnished
by OTHERS includ.
ing dependent.
$.
P
Enter here and on page 1, line 3b.
3 Total number of dependents listed above.
Part Income from sources other than wages, etc.
la Gross dividends and other distributions on stock (list payers
and amounts-write (H), (W), (J), for stock held by husband, wife, or
jointly)
Sun Elect
Coburn
20,00 Heu
52.50
Partive Itemized deductions-Use only if you do not use
tax table or standard deduction.
Medical and dental expense (not compensated by insurance or
otherwise) Attach itemized list.
1 One-half of insurance premiums for medi-
cal care (but not more than $150) .
Ind. 15.00
Ferg 41.58 2 Total cost of medicine and drugs
Atlas 20.00 Eastern Hue 12. 57 3 Enter 1% of line 9, page 1
Diversified Metals
ALL (IF)
Total line la
lb Exclusion (see instructions).
1c Capital gain distributions
(see page 5 of instructions).
1d Nontaxable distributions
(see page 5 of instructions).
100100
•
•
'
6.00 4 Subtract line 3 from line 2 (not less than zero)
5 Other medical, dental expenses (include
balance of insurance premiums for medi.
cal care not deductible on line 1)
167 53 6 Total (add lines 4 and 5)
7 Enter 3% of line 9, page 1
.
8 Subtract line 7 from line 6 (not less than zero)
9 Total (add lines 1 and 8) .
Contributions.-Cash-including checks, money orders, etc.
(itemize)
If Taxable dividends (line la less line le-
le Total (add lines 1b, 1c, and 1d).
not less than zero)
Interest (list payers and amounts below)
►
700100
67155
Earnings from savings and loan assoc. and credit unions.
Other interest (on bank deposits, bonds, tax refunds, etc.)..
Devon Ban
2 Total interest income.
3. Pensions and annuities, rents and royalties, part-
nerships, estates or trusts, etc. (attach Sch. B).
4 Business income or loss (attach Schedule C) .
5 Sale or exchange of property (attach Schedule D)
6 Farm income or loss (attach Schedule F) .
Miscellaneous income (state nature and source)
Business
• Oliver J. Isenberg.
7 Total miscellaneous income.
8 TOTAL (add lines 1f, 2, 3, 4, 5, 6, and 7)
Enter here and on page 1, line 6.
Part Adjustments to income
1 "Sick pay" if included in line 5, page 1 (at-
tach Form 2440 or other required statement) .
12 Moving expes /? ex
expenses (attach 
Form 3903).
3 Employee business expense (attach-Form
2106 or other statement)
4 Payments by self-employed persons to re-
tirement plans, etc. (attach Form 2950SE).
5 TOTAL ADJUSTMENTS (lines 1 through 4).
Enter here and on page 1, line 8
A
.
1560
10 Total cash contributions
11 Other than cash (see instructions for required
statement). Enter total of such items here.
12 Carryover from prior years (see page 7 of instr.)
13 Total contributions (add lines 10, 11,
and 12-see instructions for limitation) ▷
Taxes. Real estate
State and local gasoline
General sales (see page 15 of instructions)
State and local income.
Personal property
14 Total taxes.
Interest expense.-Home Mortgage
.
503622 Installment purchases
750.00
Other (Itemize)
15 Total interest expense
•
"
•
A
A
750 00 Miscellaneous deductions.-(see page 8 of instructions)
•
5569/40
16 Total miscellaneous
•
➤
17 TOTAL DEDUCTIONS (add lines 9, 13, 14,
15, and 16). Enter here and on page 1, line 11a. ▷
PAVA Credits
716831 Retirement income credit (Schedule B)
2 Investment credit (Form 3468).
3 Foreign tax credit (Form 1116).
4 TOTAL CREDITS (for page 1, line 13)
•
A
7/683 EXPENSE ACCOUNTS If you had an expense allowance or charged
expenses to your employer, check here ☐ and see page 6 of instructions,
✰✰✰✰U.S. GOVERNMENT PRINTING OFFICE 1968-O-290-001
ructions
660-10-60180-1
NW 88326 Docld:32245535 Page 163
PREPARED BY.
DATE..
CHECKED:
FOOTINGS BY..
EXTENSIONS BY
SENIOR..
Samuel and Phyllis Ruby
16123. N. Hoyne
Chicago, Illinois
To be attached to and made a
- Income Tax Form 1040, 1968
Part III
part of U.S. Incividual
The below listed expenses are in connection with
my Schedule D
Interest paid on margin accou
to:
Mc Donald
13107
EF. Hutton,
1538
Rothschild
Bache
2884
7929
Total Interest
25458
Book, Periodiak and Services
Auto
Miles Traveled
Less Persona
Business
at 10¢
Telephone
Rent - Use of 1/4 of room
13775
☐
6000
4500
1500
15000
9600.
72.00'
Desk and Book Case
$165.00 at 10 years
L6SEL
Total, Expenses
Adjustment.
714.83
T
NW-88326 Docid:32245535 Page 164
PREPARED BY.
DATE.
CHECKED:
FOOTINGS BY.
EXTENSIONS BY..
SENIOR ____
Samuel and Phyllis Ruby
6123
W. Hoyne
Chicago, Illinois
To be attached to and made a part of U.S. Incividual
Income Tax Form 1040, 1968.
Part III
The below listed expenses are in connection
my Schedule D.
Interest paid on margin accoun
to:
Mc Donald
13107
EF Hutton,
1538
Rothschild
2884
Bache
7929
Total Interest
25458
12775
Book, Periodiak and Services
Miles Travelled
Auto
Less Persona
Business
at 10¢
Telephone
- Rent - Use of 1/4 of room
6000
4500
1500
15000
Desk and Book Case
$165.00 at 10 years
Total Expenses!
NW 88326 Docld:32245535 Page 165
9600
7200
16502
714.83.
(Adjustments to THONG)
SCHEDULE D
(Form 1040)
U.S. Treasury Department
Internal Revenue Service
Gains and Losses From Sales or Exchanges
of Property
Name as shown on page 1 of Form 1040
Attach this schedule to your income tax return, Form 1040
Samuel and Phyllis
Ruby
1968
Social Security Number
322 127997
Part I-CAPITAL ASSETS-Short-term capital gains and losses-assets held not more than 6 months
a. Kind of prop.
erty. Indicate
security, real
estate, or other
(Specify)
b. Description
(Examples: 100 sh. of
"Z" Co., 2 story brick,
etc.)
c. How
ac-
quired.
Enter
letter
d. Date
acquired
e. Date sold
symbo! (mo., day, yr.) (mo., day, yr.)
(See
instr.)
f. Gross sales
price
g. Depreciation
allowed (or
allowable) since
acquisition
h. Cost or other
basis, cost of
subsequent improve-
ments (if not
purchased, attach
explanation) and
expense of sale
i. Gain or loss
(f plus g less h)
Sec Schedule Attached
5036.22
°
5036-22
2 Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3 Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
4 Net short-term gain (or loss) from lines 1, 2, and 3
•
Long-term capital gains and losses-assets held more than 6 months (12 months or more for certain livestock)
5 Enter gain from Part II, line 3.
Total long-term gross sales price.
6a Enter your share of net long-term gain (or loss) from partnerships and fiduciaries.
6b Enter your share of net long-term gain from small business corporations (Subchapter S) .
7 Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
8
Capital gain dividends (see Form 1040 Instructions, page 5).
9
Net long-term gain (or loss) from lines 5, 6a, 6b, 7, and 8.
10 Combine the amounts shown on lines 4 and 9, and enter the net gain (or loss) here
5036.23
(Enter zero if there is a loss or no
5.036.22
11 If line 10 shows a GAIN-Enter 50% of line 9 or 50% of line 10, whichever is smaller.
entry on line 9.) (See reverse side for computation of alternative tax.) .
12 Subtract line 11 from line 10. Enter here and in Part IV, line 1, on reverse side
13 If line 10 shows a LOSS-Enter here and in Part IV, line 1, the smallest of the following: (a) the amount on line 10; (b)
the amount on Form 1040, page 1, line 11b, computed without regard to capital gains or losses; or (c) $1,000.
Part II GAIN FROM DISPOSITION OF DEPRECIABLE PROPERTY UNDER SECTIONS 1245 AND 1250-
assets held more than 6 months (see instructions for definitions)
Where double headings appear, use the first heading for section 1245 and the second heading for section 1250.
a. Kind of property and how acquired (if necessary, attach statement
of descriptive details not shown below-write 1245 or 1250
to Indicate type of asset)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales price
о
D
e. Cost or other basis, cost of
subsequent improvements (if
not purchased, attach expla
nation) and expense of sale
1
f. Depreciation allowed (or allowable) since acquisition
f-1. Prior to January 1, 1962
OR
f-2. After December 31, 1961
OR
g. Adjusted basis
h. Total gain
(e less sum of f-1 and f-2)
(d less g)
Prior to January 1, 1964
After December 31, 1963
f. Ordinary gain
(lesser of f-2 or h)
-- OR -
(see instructions)
2 Total ordinary gain.
Enter here and in Part IV, line 2, on reverse side.
3 Total other gain. Enter here and in Part I, line 5; however, if the gains do not exceed the losses when this amount is.
'combined with other gains and losses from section 1231 property enter the total of column ) in Part III, line 1
•
NW 88326 Docid:32245535 Page 166
j. Other gain
(h less i)
1040
Please print or type.
U.S. Individual U.S. Treasury Dep
t Internal Revenue Service
phapp
·Income Tax Return for the year January 1-December 31, 1967,
or other taxable year beginning
First name and initial (if joint return, use first names and middle initials of both)
Samuel and Phyllis
Home address (Number and street or rural route)
6123 N. Houne.
City, town or post office, and State
Chicago, Illinois
1967, ending
Last name
Ruby
ZIP code
Enter below name and address used on your return for 1966 (if same as above, write "Same"). If none filed, give reason.
from separate to joint or joint to separate 
returns, enter 1966 names and addresses.
•Same
19........
1967
Your social security number
322 12 7997
Your occupation
Engineer
Spouse's social security number
349 18 1420
If changing Spouse's occupation
Housewife
Your present employer and address Stanley - Oliver Mfg. Co. Chicago, Illinois
Spouse's present employer and address, if joint retorn
Your Filing Status-check only one:
la ☐ Single
ic
1b ☑ Married filing joint return (even if only one had income)
Married filing separately. If spouse is also 
filing a return
,
enter her (his) social security number in space provided above
and give first name here
ld ☐ Unmarried Head of Household
le ☐ Surviving widow(er) with dependent child
Income
Your Exemptions Regular 65 or over
2a Yourself
2b Spouse "
•
Blind
Enter
number
of boxes
checked
3a First names of your dependent children who lived with
you: Fred, Brian,
Elisa, Thomas
Enter
number
4
3b Number of other dependents (from page 2, Part 1, line 3)
4 Total exemptions claimed
5
Piease attach Copy B of Form W-2 here
If joint re-
turn include
6
Wages, salaries, tips, etc. If not shown on attached Forms W-2 attach explanation
Other income (from page 2, Part II, line 8)
5
6
6.1.7.5336)
.00
7
all income
of both
husband
and wife
7
Total (add lines 5 and 6)
674664
8
Adjustments to income (from page 2, Part III, line 5)
8
9
Total income (subtract line 8 from line 7)
19
Find tax
from table
10 If you do not itemize deductions and line 9 is less than $5,000, find your tax from
Enter tax on line 12.
tables in instructions. Do not use 
lines 11a, b, c, or d.
10
-OR-
11a If you itemize deductions, enter total from page 2, Part IV, line 17
Figure tax
using tax
rata
If you do not itemize deductions, and line 9 is $5,000 or more enter the larger of:
OR (2) $200 ($
100 if married and filing separate return)
(1) 10 percent of line 9;
plus $100 for each exemption claimed on line 4, above.
Deduction under (1) or (2) limited to $1,000 ($500 if married and filing separately).
11b Subtract line 11a from line 9
lla
1,186 28.
11b
schedules
11c Multiply total number of exemptions on line 4, above, by $600
11c
556036
360000
11d Subtract line.lic from line 11b. Enter balance on this line. (Figure your tax on this
amount by using tax rate schedule on page 
11 of instructions.) Enter tax on line 12.
11d
196036
12 Tax (from either Tax Table, see line 10, or Tax Rate Schedule, see lines lla-11d)
13 Total credits (from page 2, Part V, line 4)
14a Income tax (subtract line 13 from line 12)
12
28805
13
14a
228805
_ Your
14b Tax from recomputing prior year investment credit (attach statement)
14b
Tax,
Credits,
15
Self-employment tax (Schedule C-3 or F-1)
15
16
Total tax (add lines 14a, 14b, and 15)
16
28805
Please attach Check or Money Order here
and
17
Total Federal income tax withheld (attach Forms W-2)
17
Pay-
ments
18
Excess F.I.C.A. tax withheld (two or more employers-see page 5 of instr.)
18
19
☐ Nonhighway Federal gasoline tax-Form 4136, ☐ Reg. Inv.-Form 2439 19
20
1967 Estimated tax payments (include 1966 overpayment allowed as a credit)
2222
34460
20
21
Total (add lines 17, 18, 19, and 20)
21
34960
22
If payments (line 21) are less than tax (line 16); enter Balance Due. Pay in full with this return
22
Balance
23
If payments (line 21) are larger than tax (line 16), enter Overpayment
23
61/55
Due or
Refund
24
Amount of line 23 you wish credited to 1968 Estimated Tax
24
25
Your signature
here
Subtract line 24 from 23. Apply to: ☐ U.S. Savings Bonds, with excess refunded or ☑ Refund only 25
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, 
and to the best of 
my knowledge and bolief it is
true, correct, and complete. If prepared by a 
person other than taxpayer, his declaration is based on all information of which he has any knowledge.
Sign
Date
Spouse's signature (if filing jointly, BOTH must sign even if only one had Income)
Signature of preparer other than taxpayer
97+11 77: K
Address
Dato
689-16-79828-1
6/55
NW 88326 Docid:32245535 Page 167
19°
SCHEDULE. D
(Form 1040)
U.S. Treasury Department
Internal Revenue Service
Gains and Losses From Sales or Exchanges
of Property
Attach this schedule to your income tax return, Form 1040
Name and address as shown on page 1 of Form 1040
Samuel and Phyllis Ruby, 6123 NV. House, Chicago, Illinois
Hayne,
Part I-CAPITAL ASSETS-Short-term capital gains and losses assets held not more than 6 months
a. Kind of prop-
arty. Indicate
security, real
estate, or other
(Specify)
b. Description
(Examples: 100 sh. of
"Z" Co., 2 story brick,
etc.)
c. How
BC-
quired.
Enter
letter
d. Date
acquired
(See
instr.)
e. Date sold
1. Gross sales
. price
Stock
Stock
symbol (mo., day, yr.) (mo., day, yr.)
Zero Mfg A 9-29-6710-16-673-93592
Pike Coup A 9-27-67 10-16-67 2.600,25
g. Depreciation
allowed (or
allowable) since
acquisition
h. Cost or other
basis, cost of
subsequent improve-
ments (if not
purchased, attach
explanation) and
expense of sale
1967
1. Gain or loss
(f plus g less h)
4483.26
2694.81
( 54734)
(94.56)
2 Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3 Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
4 Nét short-term gain (or loss) from lines 1, 2, and 3..
Long-term capital gains and losses-assets held more than 6 months (12 months or more for certain livestock)
412-659-67 553856
5 Enter gain from Part II, line 3.
Steck
Stock
Stock
| Beth Steel
AME
Jupiter
A 6-63
9-67 2,269.95
A 4-63 10-67 559.73
(64.90)
5,504.07
7,873.50
53725
34.44
396.45
22.48
Total long-term gross sales price.
6 Enter the full amount of your share of net long-term gain (or loss) from partnerships and fiduciaries
7 Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
8 Capital gain dividends (see Form 1040 Instructions, page 6)
9 Net long-term gain (or loss) from lines 5, 6, 7, and 8.
10 Combine the amounts shown on lines 4 and 9, and enter the net gain (or loss) here.
11 If line 10 shows a GAIN-Enter 50% of line 9 or 50% of line 10, whichever is smaller.
entry on line: 9.) (See reverse side for computation of alternative tax.) .
12 Subtract line 11 from line 10. Enter here and in Part IV; line 1, on reverse side .
453.42
(188.48)
(Enter zero if there is a loss or no
10:
(b)
13 If line 10 shows a LOSS Enter here and in Part IV, line 1, the smallest of the following: (a) the amount on line
the amount on page 1, line 11b, Form 1040, computed without regard to capital gains and losses; or (c)-$1,000.
Part II GAIN FROM DISPOSITION OF DEPRECIABLE PROPERTY UNDER SECTIONS 1245 AND 1250-
assets held more than 6 months (see instructions for definitions)
Where double headings appear, use the first heading for section 1245 and the second heading for section 1250.
a. Kind of property and how acquired (if necessary, attach statement
of descriptive details not shown below-write 1245 or 1250
to indicate type of asset)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales price
188.48)
D
e. Cost or other basis, cost of
subsequent improvements (if
not purchased, attach expla-.
nation) and expense of sale
1
f. Depreciation allowed (or allowable) since acquisition
g. Adjusted basis
Prior to January 1, 1964
1-1. Prior to January 1, 1962 f-2. After December 31, 1961
OR-
OR
After December 31, 1963
(e less sum of f-1 and f-2)
h. Total gain
(d less g)
1. Ordinary gain
(lesser of f-2 or h)
-OR-
(see instructions).
2 Total ordinary gain.
Enter here and in Part IV, line 2, on reverse side.
о
3 Total other gain. Enter here and in Part I, line 5; however, if the gains do not exceed the losses when this amount is
combined with other gains and losses from section 1231 property enter the total of column j in Part III, line 1.
NW 88326 Doeld 32245535 Page 168
J. Other gain
(h less i)
16-79725-1
Partal Exemptions
Complete only for dependents claimed on line 3b, page 1
(a) NAME (if more space is needed attach schedule)
(b) Relationship
(c) Months lived in your
home. If born or died dur-
ing year write "B" or "D"
(d) Did depend-
ent have income
of $500 or more?
Form 1040-1967-Page 2
(f) Amount furnished
by OTHERS Includ-
Ing dependent..
(e) Amount YOU furnished
for dependent's support,
If 100% write "ALL
1
2
3 Total number of dependents listed above.
Enter here and on page 1, line 3b
Pan
$.
►
Income from sources other than wages, etc. ☐ Itemized deductions-Use only if you do not use
1a. Gross dividends and other distributions on stock (list payers
and amounts-write (H), (W), (J), for stock held by husband, wife, 'or
jointly)
Bethlehem Steel (H.)
Amer, Mich.
d
•Found. (H)
Total line la
1b Exclusion (see instructions).
1c Capital gain distributions
(see page 6 of instructions).
100/00
tax table or standard deduction.
Medical and dental expense (not compensated by insurance or
otherwise) Attach itemized list.
•
•
1 One-half (but not more than $150) of in-
168.75
surance premiums for medical care
67.50 2 Total cost of medicine and drugs
3 Enter 1% of line 9, page 1
4 Subtract line 3 from line 2 (not less than zero)
5 Other medical, dental expenses (include
balance of insurance premiums for medi-
cal care not deductible on line 1)
236256 Total (add lines 4 and 5)
.
7 Enter 3% of line 9, page 1
8 Subtract line 7 from line 6 (not less than zero)
9 Total (add lines 1 and 8).
71472
686172
686122
20241
48431
59903
Contributions. Cash-including checks, money orders, etc.
(itemize).
Misc Charities.
ld Nontaxable distributions
(see page 6 of instructions).
le Total (add-lines 1b, 1c, and 1d)
1f Taxable dividends (line la less line le-
not less than zero)
Interest (list payers and amounts below)
136 2
Earnings from savings and loan assoc. and credit unions.
Other interest (banks, bonds, tax refunds, etc.)
1st Natl. Bant of Lincolns
48.87
10 Total cash contributions
11 Other than cash (see instructions for required.
statement). Enter total of such items here.
12 Carryover from prior years (see page 8 of Instr.)
13 Total contributions (add lines 10, 11,
and 12-see instructions for limitation) ▷
Taxes. Real estate .
25:00
16.00.
20.00
6100
2 Total interest income
3 Pensions and annuities, rents and royalties, part-
nerships, estatos or trusts, etc. (attach Sch. B).
4 Business Income or loss (attach Schedule C).
5 Sale or exchange of property (attach Schodule D).
6 Farm income or loss (attach Schedule F).
Miscellaneous income (state nature and source)
State and local gasoline
4000
General sales (see page 15 of instructions)
175.00
State and local income.
Personal property
14 Total taxes.
21500
Interest expense. -Home Mortgage.
188 48 Other (item
(itemize)
• Reynolds
Freehling
Misc.
15 Total interest expense
210.87
4.38
3900
25425
57.00
7 Total miscellaneous income
8 TOTAL (add lines 1f, 2, 3, 4, 5, 6, and 7)
Enter here and on page 1, line 6.
Part Adjustments to income
1 "Sick pay" if included in line 5, page 1 (at-
tach Form 2440 or other required statement).
2 Moving expenses (attach Form 3903).
3 Employee business expense (attach Form
2106 or other statement)
4 Payments by self-employed persons to re-
tirement plans, etc. (attach Form 2950SE).
5 TOTAL ADJUSTMENTS (lines 1 through 4).
Enter here and on page 1, line 8
A
•
(336
Miscellaneous deductions.-(see page 9 of Instructions)
Wook Tools
16 Total miscellaneous
17 TOTAL DEDUCTIONS (add lines 9, 13, 14,
15, and 16). Enter here and on page 1, line 11a. ▷
PEV Credits
1 Retirement income credit (Schedule B)
2 Investment credit (Form 3468)
3 Foreign tax credit (Form 1116).
.
5700
1,186/28
.4 TOTAL CREDITS (for page 1, line 13).
EXPENSE ACCOUNTS-If you had an expense allowance or charged
expenses to your employer, check here ☐ and see page 7 
of Instructions.
U.S. GOVERNMENT PRINTING OFFICE: 1957-0-200-001
050-10-70823-1
-NW-88326 Docid:32245535 Page-169
NW-88326 Docid 32245535. Page 170
36-2586182
The Stanley-Oliver Mfg. Co.
1001 S. California Ave.
Chicago, Ill. 60612
Type or print. EMPLOYER'S identification number, name, and address above.
FEDERAL INCOME TAX INFORMATION
WAGE AND TAX STATEMENT
1967
Copy C-For employee's: records
SOCIAL SECURITY INFORMATION
F.I.C.A. employee Total F.I.C.A: wages
Federal income tax
withheld
Wages paid subject to with-
holding in 1967
Other compensa:
tion paid in 1967
tax withheld
6,750.00.
349,60.
Type or print EMPLOYEE'S social security number
L
Samuel D. Ruby
6123 N. Hoyne Ave.
Chicago, Ill. 60645
322 127997
Type or print EMPLOYEE'S name and address (including ZIP code) above.
FORM W-2-U.S. Treasury Department, Internal Revenue Service
paid in 1967
290.40 6,600.00
tions or "sick pay" exclusion.
Includes tips reported by employee. This amount is before payroll deduc.
Add this item to wages in figuring the amount-to-be-reported as wages
and salaries on your income tax return.
3 The social security (F.I.C.A.) rate of 4.4% includes .5% for Hospital
Insurance Benefits and 3.9% for old-age,. survivors, and disability insurance.
Includes tips reported by employee. If your wages were subject to social
under "Federal Income Tax Information,'
security taxes, but are not shown, these wages are the same as wages shown
but not more than $6,600.
Uncollected Employee Tax on Tips
16-79067-1

Agency: HSCA
Reference copy, JFK Collection: HSCA (RG 233)
JFK ASSASSINATION COLLECTION
IDENTIFICATION FORM
Record Number: 7310093
Record Series:
NUMBERED FILES
004876
Agency File Number: 0
Originator: Citizen Ruby, Sanuel
Ruby., Samuel.
From: Ruby-
To:
R
K
Title:
K
Date: 1-24-78
Pages: 169
Subjects:
1.
3.
.. Ruby, Sam.
Income Tax Returns.
R
R
Ruby Jock Background Associates and Relatives
4.
5.
6.
Document Type: Other Textual
Classification:
S T
Restrictions: Open 14 1B 1C 21 3
Current Status: 0 P I
Date of Lest Review: / /93
Opening Criteria:
Comments:
w/ cover letter
4/
Box #: 102
NW 88326 Docid:32245535 Page 171
Folder Title:
☑
5 D
R
R
R
Reference copy, JFK Collection:
HSCA (RG 233)
REGIDENT
540
INDIVIDUAL
CALIFORNIA
INCOME TAX
LACE PREADDRESSED LABEL HERE, If available. (Correct name and address, if necessary)
Inter social security number(s) only if incorrect or not shown on label.
NAME (If joint return, give first names and initials of both)
SAMUEL & PHYLLIS
LAST NAME
Ruby
PRESENT HOME ADDRESS (Number and street, including apartment number, or rural route)
16250 BIRCHER
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
GRANADA
1 ☐ Single (Check Only One)
Married filing joint return (even if only one had income)
ST
HILLS
CA
EXEMPTION CREDITS
6 Personal
7 Dependents
TAXABLE YEAR
1976
Check ✓ Calendar Year
☐ Fiscal Year Ending
One:
FOR
PRIVACY NOTIFICATION
SEE PAGE 2 OF INSTRUCTIONS
Your Social Security
Social Security
Yours
OCCU.
PATION
Spouse's S
S
1977
00
FILING STATUS
☐
Separate return of married person-Enter spouse's
social security number and full name here
Head of Household-Enter name of qualifying
individual
If line 1 or 3 checked, enter $25
If line 2, 4 or 5 checked, enter $50
Do not list the person who qualifies you as head of household
ELISA
THOMAS
Total Number
8 Blind (see instructions) Number of blind exemptions
× $8
5 ☐ Widow(er) with dependent child (Year spouse died 197_) W 9 Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20
10 Wages, salaries, tips and other employee compensation Attach copy 2 of Form(s) W-2 to face of this ?
return. If unavailable, see instructions, Page 10 S
11 Dividends-before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540))
A 12 Interest. Enter total (if over $400, complete and attach Schedule B(540))
◄ ATTACH COPY 2 OF FORM W-2 HERE D
social security number on check or money order. ATTACH HERE ►
13 Income other than wages, dividends and interest (from line 48)
14 Total (add lines 10, 11, 12 and 13)
15 Adjustments to income (from line 55)
16 Adjusted gross income (subtract line 15 from line 14)
If you do NOT itemize deductions AND line 16 is under $15,000, find tax in Tax Table and enter on line 19.
If you itemize deductions OR line 16 is $15,000 or more, complete lines 17 and 18.
17 Deductions: Itemized (from line 63) OR STANDARD ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
18 Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
19 Tax from (check one)
Tax Table
20 Total exemption credits (from line 9, above)
Tax Rate Schedule
21 Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
22 Other credits (from line 68-Including Special Low Income Tax Credit).
2 x $80 7100
9/163/00
8
00
10
e 11
8
Ф
2123456
5195
2546
147741
7741
2222222
17
5686
18 2055
Income Averaging Schedule (G or G-1).
19
20
23
65
21
-0
미 22
23
0 0
24
25
Bet.com
25
Total tax liability (add lines 23 and 24)
26
27
28
Total California income tax withheld (attach W-2 or W-2P to face of this return)
Renter's credit-if you lived in rented property on March 1, 1976, complete Part 1 on page 2
1976 California estimated tax payments
26
: 27
28
30
29 Excess California SDI tax withheld (see instructions)
Total Credits.
2222
29
23 Net tax liability (subtract line 22 from line 21-if line 22 is greater than line 21, enter zero)
24 Other taxes (from line 71) . . .
31 If line 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero.
Mail return to:
FRANCHISE TAX BOARD
SACRAMENTO, CA 95867
32 If line 25 is smaller than line 30, enter amount OVERPAID
Amount of line 32 to be REFUNDED TO YOU. Allow at least six weeks.
Mail return to:
33
FRANCHISE TAX BOARD
P.O. BOX 13-540
SACRAMENTO, CA 95813
34 Amount of line 32 to be credited on your 1977 ESTIMATED TAX
.34
If you do NOT want State income tax forms and instructions mailed to you next year, check here
30
-0
--
PAY IN FULL
→ 四 31
Do not write in these spaces
32
-0-
P
E
聯 33
0
M
A
R
See Instructions, Page 9
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
and belief it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
SIGN
Your signature
88326 Docid:32245535 Page 172
Date
碼
Preparer's signature father
Date
Reference copy, JFK Collection:
HSCA (RG 233)
☐ Yes ☑No
□ Yes
☐ Yes
☐ Yes
☐ No.
☐ No
☐ No
PART 1 - Renter's Credit - All questions must be answered
35 Did you, on March 1, 1976, live in rented property which was your principal residence?
36 was the property you rented exempt from property tax?
37 Did you live with any other person who claimed you as a dependent for income tax purposes?
38 Did you or your spouse claim the homeowners' property tax exemption or receive public assistance?.
PART II Other Income
39 Business income (or loss) (attach Schedule C(540)) .
40 Net gain (or loss) from sale or exchange of capital assets (attach Schedule D(5401).
41 Net gain (or loss) from supplemental schedule of gains and losses (attach Schedule D-1 (540)).
42 Pensions and annuities
43 Rents and royalties
44 Partnerships
45 Estates and trusts
ATTACH
SCHEDULE E
FORM (540)
46 Farm income (or loss) (attach Schedule F(540)).
47 Miscellaneous income
(a) Fully taxable pensions and annuities (not reported on Schedule E(540))
(b) Alimony
(c) Other (state nature and source)
Enter total of lines 47(a), 47(b), and 47(c)
48 Total (add lines 39 thru 47). Enter here and on line 13.
-
PART III Adjustments to Income
49 "Sick pay," if included in line 10 (see instructions attach Form FTB 3805T)
50 Moving expenses (see instructions attach Form FTB 3805U)
51 Employee business expenses (See instructions attach Form FTB 3805N)
52 Military exclusion (see instructions) .
53(a) Payments to an individual retirement arrangement (attach FTB 3805P)
(b) Payments to a Keogh (H.R. 10) retirement plan.
(c) Payments to a self-employed "Defined Benefit Plan'
Enter total of lines 53(a), 53(b), and 53(c) .
54 Forfeited interest penalty (see instructions).
55 Total adjustments (add lines 49 thru 54). Enter here and on line 15
PART IV
-
Itemized Deductions
• Attach Schedule A(540) and enter sub-totals on lines 56 thru 62, below
56 Total deductible medical and dental expenses (from Schedule A(540), line 10)
57 Total taxes (from Schedule A(540), line 17). . . . .
58 Total interest expense (from Schedule A(540), line 20)
59 Total contributions (from Schedule A(540), line 24)
60 Total casualty loss (from Schedule A(540), line 29).
61 Total miscellaneous deductions (from Schedule A(540), line 33).
62 Total child care and adoption expenses (from Schedule A(540), line 37)
63 Total itemized deductions (add lines 56 thru 62). Enter here and on line 17
PART V
-
Other Credits - SEE INSTRUCTIONS FOR EACH CREDIT CLAIMED BELOW
Page-2-Form 540 (1976)..
If no, you may not claim this credit
If yes, you may not claim this credit
If yes, you may not claim this credit
If yes, see page 3 of instructions
39
40
3546
· 1000)
གྷབྷུཀྑུསྶུ ཙྩུ བྷཱུ བྷཱུ
41
'42
43
44
45
46
47a
47b
47c
47
48 2546
50
225
49
◉51
52
53a
53b
53c
53
54
4
55
>>
56
1941
57
1128
58
2517
• 59
100
60
61
&
62
☑
635686
64 "Other State" net income tax credit (attach copy of other state return and Schedule S(540)).
65 Retirement income credit (attach Schedule R(540))
66 Special low income tax credit (see special instructions).
67 Solar energy tax credit (see special instructions).
68 TOTAL (add lines 64 thru 67). Enter here and on line 22
PART VI-Other Taxes
69 Tax on preference income (see instructions - attach Schedule P(540)
70 Tax on premature distributions from attached Form FTB 3805P
64
65
66
67
68
69
70
71
Reconciliation to Federal Return
If adjusted gross income on Federal Return is different from line 16, page 1, explain below.
71 Total (add lines 69 and 70) enter here and on line 24. . .
PART VII
NW 88326 Docld:32245535 Page 173
Reference copy, JFK Collection:
HSCA (RG 233)
SCHEDULE
FORM 540
Name as shown on Form 540
CALIFORNIA
ITEMIZED DEDUCTIONS
S&P Ruby
Attach to Form 540
USE ONLY IF YOU DO NOT USE THE TAX TABLE OR TAKE THE STANDARD DEDUCTION
TAXABLE
1976
YEAR
Social Security Number.
Madical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses,
hospital care, Insurance premiums for medical
care, etc.
1. One half (but not more than $150) of insurance
premiums for medical care
2. Medicine and drugs..
3. Enter 1% of line 16, Form 540.
4. Subtract line 3 from line 2. Enter difference (if less
than zero, enter zero).
5. Enter balance of insurance premiums for medical care
not entered on line 1.
6. Other medical and dental expenses:
(a) Doctors, dentists, nurses, etc..
(b) Hospitals
(c) Other (itemize).
SCH
1941
Contributions
21(a). Cash contributions for which you have receipts,
canceled checks, etc.
(b). Other cash contributions. List donees and
amounts
SCH
22. Other than cash.-See instructions for required state-
ment
23. Carryover from 1974 & subsequent years
instructions
24. Total (Add lines 21a thru 23.
See
Maximum de-
100
duction may not exceed 20% of adjusted gross
income. Enter here and on Form 540, line 59)
Casualty or Theft Loss(es)
NOTE: If you had more than one loss, omit lines 25
through 28-See instructions for guidance
25. Loss before insurance reimbursement
26. Insurance reimbursement
27. Subtract line 26 from line 25, Enter difference
(If less than zero, enter zero)
28. Enter $100 or amount on line 27, whichever is
smaller
29. Casualty or theft loss (subtract line 28 from
line 27. Enter here and on Form 540, line 60)
Miscellaneous Deductions
30. Alimony paid to: ......
31. Employment Education Expense..
32. Union dues
Other (itemize)
7. Total (Add lines 4, 5, 6a, b, and c).
8. Enter 3% of line 16, Form 540.
9. Subtract line 8 from line 7. Enter difference (if less
than zero, enter zero)..
10. Total (Add lines 1 and 9. Enter here and on Form
540, line 56).
Taxes
11. Auto license-Excess of registration and weight fees
(see instructions).
12. Real estate. .
13. State and local gasoline.
14. General Sales.
15. Personal property (Boat and Aircraft).
16. Other (itemize).
SCH
17. Total taxes (Add lines 11 thru 16. Enter here and
on Form 540, line 57)
Interest Expense
18. Home mortgage..
19. Other (itemize).
Sett
20. Total-(Add lines 18 and 19. Enter here and on
Form 540, line 58).
NW 88326 Docld:32245535 Page 174
1178
2517
33. Total (Add lines 30 through 32. Enter here and
on Form 540, line 61)
Child Care and Adoption Expense
34. Child care expenses - Attach Form 3805X.
35. Total adoption expense. . . .
Less 3% of line 16, Form 540. .
36. Net adoption expenses - See instructions
for maximum limitations. . . .
37. Total child care and adoption expenses
(add lines 34 and 36. Enter here and on
Form 540, line 62).
C
A
Reference copy, JFK Collection: ESCA (RG 233)
SCHEDULE
B
FORM 540
lame as shown on Form 540
CALIFORNIA
DIVIDEND AND INTEREST INCOME
S&P Ruby
Attach to Form 540
PART I-DIVIDEND INCOME
Line 1-Gross Dividends and Other Distributions on
tock If gross dividends and other distributions (including capital
ain dividends) on stock were $400 or less, do not complete
his part; but enter gross dividends (including capital gain distribu-
TAXABLE
1976
YEAR
Social Security Number
B
tions), less nontaxable portion, if any, on Form 540, page 1.
Do NOT deduct the $100 federal exclusion.
"Capital gain dividends" are treated as ordinary dividends for
State income tax purposes and not as capital gains as permitted
under the federal law.
Gross dividends and other distributions on stock-List payers and amounts-Write (H), (W), (J), for stock held by husband, wife, jointly.
Total dividends
Nontaxable distributions
.
Taxable dividends Subtract line 3 from line 2. Enter here and on line 11, form 540
PART II-INTEREST INCOME
Interest on bonds, debentures, loans, notes, tax refunds and all
pes of savings accounts including banks, credit unions and postal
avings is taxable.
Interest on the following obligations is exempt from tax:
(a) Bonds and other obligations (other than tax refunds) of the
United States, the District of Columbia and territories of
the United States. (Interest on Philippine Islands obligations
issued on or after March 24, 1934 is not exempt.)
Interest income-List payers and amounts..
(b) Bonds (but not other obligations) of California and its polit-
ical subdivisions issued after November 4, 1902.
(c) Interest on bonds of Alaska and Hawaii issued prior to their
achieving statehood.
Note: If total taxable interest income was $400 or less, do
not complete this part; but enter the total amount of interest
received on Form 540, page 1.
NOTE ON
UAL
WOODL
ODLEY
BISTRO
TRANS WORLD
WORLD
4959
1
☐
191
17
. Total Interest Income. Enter here and on line 12, Form 540
NW 88326 Docld:32245535 Page 175
5195
SCHEDULE
C
FORM 540
Reference copy, JFK Collection:
HSCA (RG 233)
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
TAXABLE
1976
YEAR
tach this schedule to your income tax return, Form 540 or 540NR
me as shown on Form 540 or 540NR
5.+P.
Ruby
Name and Address of Business
Partnerships, joint ventures, etc., must file on
Form 563
Social Security Number
B. Federal Employer 1.D. No.
DOODLEY BISTRO COFFEE SHOP, 1605S VENTURA BLUD EncinoCA, 95-26515-78
Principal business activity (i.e., retail-hardware; wholesale-tobacco; services-legal; etc.) SERVICE
Indicate method of accounting: ☐ cash; ☑ accrual;
☐ other...
Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ✓ YES ☐ NO
Method of inventory valuation ►………...
COST
☑
Snach
BAR
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES ☐ NO If. "Yes," attach explanation.
1 Gross receipts, sales, or fees $..
_Less returns and allowances $..
_Less cost of items withdrawn for personal use $.
2 Inventory at beginning of year (if different from last year's closing inventory, attach explanation).
3 Purchases $
4 Cost of labor (do not include salary paid to yourself).
5 Materials and supplies..
6 Other costs (explain in Schedule C-2 or attach Schedule).
Balance ►
C
7
Total of lines 2 thru 6.
8 Inventory at end of this year.
9 Cost of goods sold (subtract line 8 from line 7).
O Gross profit (subtract line 9 from line 1).
1 Other income (attach schedule)..
2
Total Income (add lines 10 and 11).
OTHER BUSINESS DEDUCTIONS
'3 Depreciation (explain in Schedule C-1 or attach Schedule)..
4 Taxes on business and business property (explain in Schedule C-2 or attach Schedule).
15 Rent on business property..
16 Repairs (explain in Schedule C-2 or attach Schedule).
17 Salaries and wages not included on line 4 (exclude any paid to yourself).
18 Insurance
19 Legal and professional fees.
20 Commissions
21 Amortization (attach statement)
22 Retirement plans, etc. (other than your share, see instructions)
23 Interest on business indebtedness..
24 Bad debts arising from sales or services (Not applicable if reporting on cast. basis).
25 Depletion (attach schedule)..
26 Other business expenses (explain in Schedule C-2 or attach Schedule).
27
Total of lines 13 thru 26.
28 Net profit (or loss) (subtract line 27 from line 12), Enter here and on Page 2, Form 540 or 540NR
Group and guideline class
or description of property
Date
Acquired
Cost or
other basis
sett
Depreciation
allowed (or allowable)
in prior years
Method of
computing
depreciation
☑
3546
Life or
Rate
Depreciation
for this year
Schedule C-2
Explanation of Lines
6, 14, 16, and 26.
Schedule C-1
Depreciation
Claimed on line 13.
LINE
NO.
Sett
EXPLANATION
AMOUNT
LINE
NO.
NW-88326-Doeld:32245535-Page-176
106
EXPLANATION
AMOUNT
Reference copy, JFK Collection:
HSCA (RG 233)
SCHEDE
D
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR
S&P Ruby
PART -Assets Held One Year or Less
1.
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo.. day, yr.)
d. Gross sales
price
2. Enter gain (or loss), if applicable, from line 17, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships. and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART Assets Hold More Than One Year But Not More Than Five Years
5.
INSTALLMENT
SALE
TAXABLE
1976
YEAR
Social Security Number.
a. Cost or other basis as
adjusted, cost of subse-
quent improvements (if
not purchased, attach
explanation) and α
pense of sale
f. Gain or loss
(d. less e.)
5355
6. Enter gain (or loss), if applicable, from line 19, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7 (If gain, see 540 instructions, line 24a (Preference Income))
PART III-Assets Hold More Than Five Years
9.
5355
D
10. Enter gain (or loss), if applicable, from line 21, Schedule D-1 (540) (attach copy)
11. Enter your share of net gain or loss from partnerships and fiduciaries
12. Net gain or loss, combine lines 9, 10 and 11 (If gain, see 540 instructions, line 24a (Preference Income))
PART IV-Summary of Capital Gains and Losses
13. Enter amount from line 4
14. Enter 65% of the amount on line 8
15. Enter 50% of the amount on line 12
16. Enter unused capital loss carryover from preceding taxable
17. Combine the amounts shown on lines 13, 14, 15 and 16
25.
ats (attach computation)
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
3481
(15042) (1561)
19. If line. 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on lines 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
(c) $1,000 ($500 in the case of a husband or wife filing a separate return)
NW 88326 Docld:32245535 Page 177
(1000)
Reference copy,
JFK Collection:
ESCA (RG 233)
RESIDENT
540
INDIVIDUAL
CALIFORNIA
INCOME TAX
PLACE PREADDRESSED LABEL HERE, if available. (Correct name and address, if necessary)
Enter social security number(s) only if incorrect or not shown on label.
NAME (If joint return, give first names and initials of both) LAST NAME
5.
AMUEL & PHYLLIS
RUBY
PRESENT HOME ADDRESS (Number and Street, including apartment number of rural route)
16250
BIRCHER
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
GRANADA
FILING STATUS-Check Only One:
1 ☐ Single
Check ✓ Calendar Year
One:
T
HILLS
CA
§ If line 1 or 3 checked, enter $25
✓ Married filing joint return (even if only one had income)
3 ☐ Separate return of married person-Enter spouse's
social security number and full name here
4 ☐ Head of Household---Enter name of qualifying
individual
5 Widow(er) with dependent child (Year spouse died 197.
◄ ATTACH COPY 2 OF FORM W-2 HERE ►
EXEMPTION CREDITS
6 Personal
TAXABLE YEAR
1975
☐☐ Fiscal Year Ending.
1976
FOR FEDERAL PRIVACY ACT NOTIFI-
CATION SEE PAGE 2 OF INSTRUCTIONS
Your Social Security Numbe
Spouse's Social Security Number
349
OCCU-
PATION
If line 2, 4 or 5 checked, enter $50
Yours
Spouse's
18
1920
S/E
7 Dependents Do not list yourself, your spouse or the person who qualifies you
as head of household. Enter name and relationship.
ELISA
THOMAS
Total Number
8 Blind (refer to instructions) Number of blind exemptions ►
2
× $8●
× $8
9 Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20
10 Wages, salaries, tips and other employee compensation Attach copy 2 of Form(s) W-2 to face of this )
{ 
return. If unavailable, see instructions, Page 61
Dividends-before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540) )
12 Interest. Enter total (if over $400, complete and attach Schedule 8(540))
11
13 Income other than wages, dividends and interest (from line 48)
14 Total (add fines 10, 11, 12 and 13)
15 Adjustments to income (from line 55)
16 Adjusted gross income (subtract line 15 from line 14)
If line 1 or 3 is checked and line 16 is $4,000 or less, enter zero tax on line 23.
If line 2, 4, or 5 is checked and line 16 is $8,000 or less, enter zero tax on line 23.
Do not complete
i lines 17 thru 22
If you do NOT itemize deductions AND line 16 is under $15,000, find tax in Tax Table and enter on line 19.
If you itemize deductions OR line 16 is $15,000 or more, complete lines 17 and 18.
Deductions: Itemized (from line 62) OR STANDARD ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
Tax from (check one) Tax Table ☐
Income Averaging Schedule (G or G-1) ☐
17
18
▼ 19
Tax Rate Schedule
20
Total exemption credits (from line 9, above)
21
22
Other credits (from line 65)
Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
23 Net tax liability (subtract line 22 from line 21-if line 22 is greater than line 21, enter zero)
24 Tax on preference income (see instructions-attach Schedule P(540))
25 Total tax liability (add lines 23 and 24)
26 Total California income tax withheld (attach W-2 or W-2P to face of this return)
10
0 1 2 3 4 5
650 00
181
9
-0
16.00
00
66 00
17
رو
11
12
13
14
"8822
8984
8984
15
☐ 16
5735
17
❤ 183249
19
3.2
20
66
21
2222322
24
25
( 26
27 Renter's credit-if you lived in rented property on March 1, 1975, complete Part 1 on page 2
28 1975 California estimated tax payments
送 27
28
Write social security number on check or money order. ATTACH HERE
ATTACH FORM DE 1964 HERE
29 Excess California SDI tax withheld (attach Form DE 1964 to face of this return)
30 Total prepayment credits (add lines 26 thru 29)
31
32
If line 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero.
Pay in full and mail with return to: FRANCHISE TAX BOARD
SACRAMENTO, CA 95867
If line 25 is smaller than line 30, enter amount OVERPAID
33 Amount of line 32 to be REFUNDED TO YOU. Allow at least six weeks.
Mail return to:
FRANCHISE TAX BOARD
P.O. BOX 13-540
SACRAMENTO, CA 95813
34 Amount of line 32 to be credited on your 1976 ESTIMATED TAX
34
29
32
鹽 33
30
PAY IN FULL 31
Do not write in these spaces
P
E
M
A
ESTIMATED TAX R
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than 
taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN
Your signature
Date
HERE
NW 88326 Docid:32245535 Pagën 78oint return
Date
Preparer's signature (other than taxpayer)
Date
Reference copy, JFK Collection:
HSCA (RG 233)
SCHEDULE
FORM 540
Name as shown on Form 540
SAMUEL
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
& PHYLLIS RUBY
TAXABLE
1975
YEAR
Social Security Number
If your adjusted gross income is $8,000 or less and your filing status is "Married, Filing Jointly." "Head of Household," or "Widow(er) With Dependent Child,"
or $4,000 or less and your filing status is "Single," or "Married, Filing Separately," do not itemize, enter zero on Form 540, line 23, and check the tax
table box.
USE ONLY IF YOU DO NOT USE THE TAX TABLE OR TAKE THE STANDARD DEDUCTION
Medical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses,
hospital care, insurance premiums for medical
care, etc.
1. One half (but not more than $150) of insurance
premiums for medical care
•
2. Medicine and drugs
3. Enter 1% of line 16, Form 540
4. Subtract line 3 from line 2. Enter difference (if less
than zero, enter zero)
5. Enter balance of insurance premiums for medical care
not entered on line 1..
6. Other medical and dental expenses:
(a) Doctors, dentists, nurses, etc.
(b) Hospitals
(c) Other (itemize)..
Interest Expense
21. Home mortgage
22. Other (itemize).
SCH
23. Total-(Add lines 21 and 22. Enter here and on
Form 540, line 59)
Contributions
24. Cash contributions for which you have receipts,
canceled checks, etc.
25. Other cash contributions. List donees and amounts
2857
A
7. Total (Add lines 4, 5, 6a, b, and c).
8. Enter 3% of line 16, Form 540
9. Subtract line 8 from line 7. Enter difference (if less
than zero, enter zero).
10. Total-(Add lines 1 and 9. Enter here and, on Form
540, line 56).
Child Adoption Expense
11. Total expenses paid or incurred-Attach itemized list
12. Enter 3% of line 16, Form 540.
13. Subtract line 12 from line 11-See instructions for
maximum limitations. (Enter here and on Form 540,
line 57)..
Taxes
14. Real estate.
15. State and local gasoline.
16. General Sales.
17. Auto license-Excess of registration and weight fees
(see instructions).
18. Personal property (Boat and Aircraft).
19. Other (itemize)..
SCH
20. Total taxes-(Add lines 14 thru 19. Enter here and
Form 540 line
NW 88325 Bold! 32245535 Page 179
1509
1207
SCH
26. Other than cash.-See instructions for required state.
ment
27. Carryover from 1974-See instructions.
28. Total-(Add lines 24, 25, 26, and 27. Maximum de-
duction may not exceed 20% of adjusted gross
income. Enter here and on Form 540, line 60).
Miscellaneous Deductions
Casualty or Theft Loss(es)-See instructions
NOTE: If you had more than one loss, omit lines 29.
through 33 and follow instructions for guidance.
29. Loss before insurance reimbursement.
30. Insurance reimbursement
31. Subtract line 30 from line 29. Enter difference (if line
30 is greater than line 29, enter zero).
32. Enter $100 or amount on line 31, whichever is smaller
33. Casualty or theft loss (line 31 less line 32).
34. Alimony paid..
35. Child care-See instructions.
36. Union dues..
37. Employment education expense-See instructions.
38. Other (itemize)
39. Total Add lines 33, 34, 35, 36, 37, and 38. (Enter
here and on Form 540, line 61).
150
SCHEDULE
C
FORM 540
Reference copy, JFK Collection:
HSCA (RG 233)
L
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
TAXABLE
1925
YEAR
(Sole Proprietorships)
Attach this schedule to your Income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
SAMUEL & PHYLLIS RUBY
A. Name and Address of Business
WOODLEY BISTRO (OFFEE SHOP
Partnerships, joint ventures, ofc., must ale on Form 565
Social Security Number
B. Federal Employer I.D. No.
95-2651878
C. Principal business activity (.e., retai-hardware; wholesale-tobacco; Services (ga), etc.) SERVICE SNAL51BBR
D. Indicate method of accounting: ☐ cash; ✓ accrual;
☐ other....
E. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ✓ YES ☐ NO
F. Method of inventory valuation
COST
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES ☐ NO If "Yes," attach explanation.
1 Gross receipts, sales, or fees $.
... Less returns and allowances $
Less cost of items withdrawn for personal use $
2 Inventory at beginning of year (if different from last year's closing inventory, attach explanation).
3 Purchases $..
4 Cost of labor (do not include salary paid to yourself)
5 Materials and supplies.
6 Other costs (explain in Schedule C-2 or attach Schedule)..
Balance ►
C
7
Total of lines 2 thru 6.
8 inventory at end of this year.
9 Cost of goods sold (subtract line 8 from line 7).
10 Gross profit (subtract line 9 from line 1)
11 Other income (attach schedule).
12
Total Income (add lines 10 and 11)
OTHER BUSINESS DEDUCTIONS
13 Depreciation (explain in Schedule C-1 or attach Schedule)
14 Taxes on business and business property (explain in Schedule C-2 or attach Schedule).
15 Rent on business property
16 Repairs (explain in Schedule C-2 or attach Schedule)
17 Salaries and wages not included on line 4 (exclude any paid to yourself)
18 Insurance
19 Legal and professional fees.
20 Commissions
21 Amortization (attach statement)
22 Retirement plans, etc. (other than your share, see instructions)
23 Interest on business indebtedness.
24 Bad debts arising from sales or services (Not applicable if reporting on cash basis).
25 Depletion (attach schedule).
26 Other business expenses (explain in Schedule C-2 or attach Schedule).
27 Total of lines 13 thru 26.
28 Net profit (or loss) (subtract line 27 from line 12), Enter here and on Page 2, Form 540 or 540NR
Group and guideline class
or description of property
Date
Acquired
Cost or
other basis.
Depreciation
allowed (or allowable)
in prior years
Schedule C-2
Explanation of Lines
6, 14, 16, and 26.
Schedule C-1
Depreciation
Claimed on line 13.
LINE
NO.
SCH
Method of
computing
depreciation
Life or
Rate
7559
Depreciation
for this year
EXPLANATION
AMOUNT
LINE
NO.
EXPLANATION
AMOUNT
NW 88326 Docid:32245535 Page 180°

SCHEDULE
D
FORM 540
Reference copy, JFK Collection: HSCA (RG 233)
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 540NR/
SAMUEL
IRT
2 PHYLLIS RUBY
PART I-Assets Held One Year or Less
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date acquired
(mo.. day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
TAXABLE
1975
YEAR
Social Security Number
e. Cost or other basis as
adjusted, cost of subse-
quent improvements (if
not purchased. attach
explanation) and
pense of sale
ex-
f. Gain or loss
(d. less e.)
1.
1974 LOSS CARRYOVER
(20,360)
USED 1974 1000.
2. Enter gain (or loss), if applicable, from line 18, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART II-Assets Held More Than One Year But Not More Than Five Years
5.
6. Enter gain (or loss), if applicable, from line 20, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7
PART III-Assets Held More Than Five Years
9.
5105
5105
D
10. Enter gain (or loss), if applicable, from line 22, Schedule D-1 (540) (attach copy)
11. Enter your share of net gain or loss from partnerships and fiduciaries
12. Net gain or loss, combine lines 9, 10 and 11
PART IV-Summary of Capital Gains and Losses
13. Enter amount from line 4
14. Enter 65% of the amount on line 8
15. Enter 50% of the amount on line 12
16. Enter unused capital loss carryover from preceding taxable years (attach compulation)
17. Combine the amounts shown on lines 13, 14, 15 and 16
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
3318
(9360)(16042)
19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on lines 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
NW 88326 bb@M:32245585 Page 181a husband or wife filing a separate return)
(1000)
Reference copy, JFK Collection: ESCA (RG 233)
SCHEDULE
D-1
FORM 540
Name as shown on Tax Return
SAMUEL
CALIFORNIA
SUPPLEMENTAL SCHEDULE OF GAINS AND LOSSES
(Sales or Exchanges Including Involuntary Conversions)
(Attach to Form 540, 540NR, 541 or 565)
PHYLLIS RUBY
TAXABLE
1925
YEAR
Identifying number as shown on return
PART I Gain From Disposition of Property Under Sections 18211, 18212-18, 18219, 18220
D-1
Lines 9 and 10 should be omitted if there are no dispositions of farm property or farm land; or, if this form is filed by a partnership.
1. Description of Sections 18211, 18212-18, 18219, and 18220 property.
Date acquired
(mo., day, yr.)
Date sold
(mo., day, yr.)
2/1/749/2/78
(A)
WOODLEY BISTRO
• COFFEE SHOP
(B)
(C)
(D)
Correlate lines 1(A) through 1(D) with these columns
Property
(A)
Property
(B)
Property
(C)
Property
(D)
2. Gross sales price
3. Cost or other basis and expense of sale
4. Depreciation allowed (or allowable)
5. Adjusted basis, line 3 less line 41
6. Total gain, subtract line 5 from line 2
7. If Section 18211 property:
(a) Depreciation allowed (or allowable) after applicable date.
(See Instruction D-3)
(b) Line 6 or line 7(a), whichever is smaller
8. If Section 18212-18 property:
(a) Enter additional depreciation after 12-31-63 and before
1-1-71.
(b) Enter additional depreciation after 12-31-70
(c) Enter line 6 or line 8(b), whichever is smaller
(d) Line 8(c) times applicable percentage (Instruction D-4)
(e) Enter excess, if any, of line 6 over line 8(b)
(f) Enter line 8(a) or line 8(e), whichever is smaller
(g) Line 8(f) times applicable percentage (Instruction D-4)
(h) Add line 8(d) and line 8(g)
9. If Section 18220 property:
(a) If farm land, enter soil and water conservation expenses
for current year and four preceding years
(b) If farm property, other than land, subtract line 7(b) from
line 6; OR, if farm land, enter line 6 or line 9(a), which-
ever is smaller (see Instruction D-5)
(c) Excess deductions account (see Instruction D-5)
(d) Enter line 9(b) or line 9(c), whichever is smaller
10. If Section 18219 property:
(a) Soil and water conservation expenses made after 12-31-69
(b) Enter amount from line 9(d), if any; otherwise, enter a zero
(c) Enter excess, if any, of line 10(a) over 10(b)
(d) Line 10(c) times applicable percentage (Instruction D-5)
(e) Line 6 less line 10(b)
(f) Enter smaller of line 10(d) or line 10(e)
INSTALLMENT
SALE
SUMMARY OF PART I (Complete Property Columns (A) through (D) up to Line 10(f) before going to Line 11)
11. Enter amounts from line 6
.
12. Enter amounts from lines 7(b), 8(h), 9(d) and 10(f)
13. Subtract line 12 from line 11, enter here and in appropriate
7418
2313.
5105
14. Total of Property Columns (A) through (D), line 12. Enter here and on line 24, Part III
Section in Part II (see Instruction D-2)
NW-88326 Docld:32245535-Page 182-
2313.
NAME
ADDRESS
MEDICAL
Reference copy, JFK Collection:
SAMUEL & PHYLLIS KUB
2 MEDICINE/DRUGS
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5 H & A INS. (½ + EXCESS)
ɓa DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
ву
HSCA (RG 233)
CALENDAR YEAR
19 15
SOC. SEC. NO.
DEDUCTION SCHEDULE
STATE
FEDERAL
682
877
CONTRIBUTIONS
21a CASH CONTRIBUTIONS
21b PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
MISC. ORGANIZED CHARITIES
CHURCHES
STATE
FEDERAL
150
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
6C AMBULANCE
LABORATORIES
TRAVEL FOR MED.
10777
70
MEDICARE INS.
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
1629
1629
8 LESS 3% ADJ. GROSS INC.
9
220
1359
1+ ½ (TO $150) OF H & A INS
1371
150
10 TOTAL MEDICAL DED.
$ 1507
1521
TAXES
11 STATE & LOCAL INCOME
22 OTHER THAN CASH
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT (LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
26 INSURANCE REIMBURSEMENT
27
26 ($100 LIMITATION PER.CAS.)
29 TOLCAS OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 CHILD & DEP. CARE (Form 2441)
33 INCOME TAX PREPARATION
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
AUTO USE/DAMAGE
INVEST.COUNSEL & PUBS. (Sched
EMPLOYMENT AGENCY FEES
12 REAL ESTATE
932
SAFE DEPOSIT BOX
13 STATE & LOCAL GASOLINE
48
TEL. REQ. IN BUSINESS
14 GENERAL SALES TAX
205
POLITICAL CONTRIBUTIONS
15a PERSONAL PROPERTY
15b PERSONAL PROPERTY AUTO
22
16 SALES TAX AUTO
34 TOTAL MISC. DED.
150.
750
17 TOTAL TAXES
1207
1207
SUMMARY OF ITEMIZED DED.
35 TOT DEDUCTIBLE MEDICAL & DENTAL
EXPENSES FROM LINE 101
STATE
FEDERAL
INTEREST (TO WHOM PAID)
36 TOTAL TAXES (From LINE 17)
18 MORTGAGE
2514
19 INSTALLMENT LOANS MISC
TRANSWOrep
SBA
FEDCG
ގ
189
7
100
37 TOTAL INTEREST (Line 20)
38 TOTAL CONTR. (Line 24)
39 CAS. & THEFT LOSS(ES) (Line29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS (FROM LINE 34)
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON FORM 1040 LINE 45
REMARKS
2852 2857
20 TOTAL INTEREST
PSI
Professional Stationers, Inc
7:10 inpassade
Form 191
NW 88326 Docld:32245535 Page 183
57231
5735.
SCHEDULE
NAME
Reference copy, JFK Collection:
• SAMUEL & PHYLLIS, RUBY
NO.
OR
SOC. SEC. NO.
ADDRESS
ESCA (RG 233)
CALENDAR YEAR 19.
FISCAL YEAR ENDING
SCHEDULE OF PROFIT
OR LOSS FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
EMPLOYERS NO.
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
TOTAL
LESS INVENTORY AT
GROSS PROFIT
HOSS INCOME
END OF
YEAR
ADVERTISING
AND TRUCK EXPENSE
84D. D. BTS
COMMISSIONS
DELIVERY
DEPRECIATION 1 SCHEDULE BLLO
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTERESI
JANITOR AND HAUL IN.
LEGAL AND ACCOUNT INI.
OFFICE SUPPLIES AND
1 XPENSE
RENT
REPAIRS AND
MAINTENANCE
SALARIES AND WAGES
SUPPLIES
TAXES AND LICENSES
TAXES PAYROLL
TELEPHONE AND UTILITIES.
LINEN
CONTRACT LABOR
48929
800
24031.
24831
24831
24093
24093
OTHER BUSINESS DEDUCTIONS
99
1800
974
92%
285
1107
150
4151
625
5632
240
575
168
158
444
16534
2559
NET PROFIT OR ILOSS
FEDERAL
RETURN
NE 1
PROFIT OR
(LOSS
STATE
RETURN
SEE DEPREC. SCHEDULE FOR DIFF.
NO.
KIND AND LOCATION OF PROPERTY
EQUIPMENT
GOOD WILL
SCHEDULE OF DEPRECIATION
DATE
(+)5159 (W) LYDD
YEARS COST OR
ACQUIRED METH. OR % OTHER BASIS
2/1/24 S.L 7YR 10228
2/1/24
35000
PRIOR
DEPREC.
1339
DEPRECIATION
THIS YEAR
974
PROFESSIONAL
LOS ANGELES,
STATIONERS INC
CALIF.
FORM
104A
NW 88326 Docld:32245535 Page 184
SCHEDULE.
Reference copy,
JFK Collection: HSCA (RG 233)
.:
RESIDENT
540
INDIVIDUAL
CALIFORNIA
INCOME TAX
PLACE PREADDRESSED LABEL HERE, if available. (Correct name and address, if necessary)
Enter social security number(s) only if incorrect or not shown on label.
NAME (I joint return, give first of her and initials of both)
AMUEL & PHYLLIS
LAST NAME
'RUBY
PRESENT HOME ADDRESS (Number and street, including apartment number, or Tural route)
16250
BIRCHER ST
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
FILING STATUS Check Only One:
Са
For calendar year or
Taxable year ending_
TAXABLE YEAR
1974
Your Social Security Number
Spouse's Social Security Number
OCCU-
Yours
Je
PATION Spouse
TRANADA
HILLS
EXEMPTION CREDITS
If line 1 or 3 checked, enter $25
1 ☐ Single
6 Personal
Married filing joint return (even if only one had income) 7 Dependents
-
If line 2, 4 or 5 checked, enter $50
Do not list yourself, your spouse or the person who qualifies you
as head of household. Enter name and relationship.
ELISA
THOMAS
197.
2
3 ☐ Separate return of married person-Enter spouse's
social security number and full name here
4 ☐ Head of Household-Enter name of qualifying
individual
Total Number
2
× $8
116
5 ☐ Widow(er) with dependent child (Year spouse died 197_) |9
8 Blind (refer to instructions) Number of blind exemptions ►
Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20
10 Wages, salaries, tips and other employee compensation | return. If unavailable, attach explanation.
}
× $8
8
966
Attach copy 2 of Form(s) W-2 to face of this
10
ATTACH COPY 2 OF FORM W-2 HERE
11 Dividends before federal exclusion. Enter total (if over $400, complete and attach Schedule B(540))
12 Interest. Enter total (if over $400, complete and attach Schedule B(540))
13 Income other than wages, dividends and interest (from line 48)
14 Total (add lines 10, 11, 12 and 13)
15 Adjustments to income (from line 54)
11
136
12
13 8934
16 Adjusted gross income (subtract line 15 from line 14)
•
.
If you do NOT itemize deductions AND line 16 is under $10,000, find tax in Tax Table and enter on line 19.
If you itemize deductions OR line 16 is $10,000 or more, complete lines 17 and 18.
17 Deductions: Itemized (from line 61) OR Standard ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked)
18 Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
19 Tax from (check one) Tax Table ☐
Tax Rate Schedule
Income Averaging Schedule (G or G-1) ☐
14 4070
15
18 9070
17 5468
183602
36
19
Write social security number on check or money order. ATTACH HERE ►
ATTACH FORM DE 1964 HERE
20 Total exemption credits (from line 9, above)
21
.
Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
22 Other credits (from line 65-Includes special low income tax credit)
23 Net tax liability (subtract line 22 from line 21-if line 22 is greater than line 21, enter zero)
24
Tax on preference income (see instructions-attach Schedule P(540))
25
Total tax liability (add lines 23 and 24)
22223 22
20
21
-
24
25
26
27
Total California income tax withheld (attach Form(s) W-2 or W-2P to face of this return)
Renter's credit-if you lived in rented property on March 1, 1974, complete Part 1 on page 2
28 1974 California estimated tax payments
26
27
29 Excess California SDI tax withheld (attach Form DE 1964 to face of this return)
30 Total prepayment credits (add lines 26 thru 29). .
30
31 If line 25 is larger than line 30, enter BALANCE DUE. If it is equal to line 30, enter zero.
Pay in full and mail with return to: FRANCHISE TAX BOARD
SACRAMENTO, CA 95867
32 If line 25. is smaller than line 30, enter amount OVERPAID
Mail return to:
FRANCHISE TAX BOARD
P.O. BOX 13-540
SACRAMENTO, CA 95813
33 Amount of line 32 to be REFUNDED. (Allow at least six weeks)
34 Amount of line 32 to be credited on your 1975 ESTIMATED TAX
32
REFUND TO YOU >>>
34
33
•
0.
PAY IN FULL
31
Do not write in these spaces
P
E
M
✓ ESTIMATED TAX A
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN
Your signature
Data
NW 88.32245535-Page 185 return
Data
Preparer's signature (other than taxpayer)
3717 VANOWEN STREE
Date
Address (and Zip codes :MAN BUYS, CA. 914 Preparer's FEIN (or SSA) No.
767.348700
هستند
Reference copy,
JFK Collection:
HSCA (RG 233)
TAXABLE
1974
YEAR
Social Security Number
SCHEDULE
FORM 540
Name as shown on Form 540
SAMUEL
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
Į PHYLLIS RUBY
Ruby
Use only if you do not use the Tax Table or take the standard deduction.
Medical and dental expenses (not compensated by insurance or otherwise) for
medicine and drugs, doctors, dentists, nurses, hospi-
tal care, insurance premiums for medical care, etc.
1. One half (but not more than $150) of insurance
premiums for medical care
2. Medicine and drugs
3. Enter 1% of adjusted gross income shown on Form
540.
4. Subtract line 3 from line 2. Enter difference (if line
3 is greater than line 2, enter zero)
5. Enter balance of insurance premiums for medical
care not entered on line 1
6. Other medical and dental expenses:
(a) Doctors, dentists, nurses, etc.
(b) Hospitals.
(c) Other (itemize)
interest Expense
22. Home mortgage.
23. Installment purchases
24. Other (itemize)
·SCH
25. Total (Add lines 22, 23 and 24. Enter here and
on Form 540, page 2, line 58)
Contributions
26. Cash contributions for which you have receipts, can-
celed checks, etc.
27. Other cash contributions. List donees and amounts
2992
SCH
7. Total (Add lines 4, 5, 6a, b, and c)
8. Enter 3% of adjusted gross income shown on
Form 540
9. Subtract line 8 from line 7. Enter difference (if
line 8 is greater than line 7, enter zero)
10. Total (Add lines 1 and 9. Enter here and on
Form 540, page 2, line 55)
Child Adoption Expense
11. Total expenses paid or incurred-Attach itemized
list
12. Enter 3% of adjusted gross income shown on Form
540
13. Subtract line 12 from line 11-See instructions
for maximum limitations. (Enter here and on Form
540, page 2, line 56)
Taxes
14. Real estate
15. State and local gasoline
16. General sales
17. Auto license-Excess of registration and weight fees
(see instructions)
18. Personal property
19. State disability insurance (SDI)-Employer private
disability plans do not qualify
20. Other
SCH
1386
SCH
28. Other than cash. See instructions for required
statement
29. Total-(Add lines 26, 27 and 28. Maximum deduction
may not exceed 20% of adjusted gross income.
Enter here and on Form 540, page 2, line 59)
Miscellaneous Deductions
Casualty or Theft Loss(es)-See Instructions
NOTE: If you had more than one loss, omit lines 30
through 34 and follow instructions for guidance.
30. Loss before insurance reimbursement
31. Insurance reimbursement
32. Subtract line 31 from line 30. Enter difference (if
line 31 is greater than line 30, enter zero)
33. Enter $100 or amount on line 32, whichever is
smaller
34. Casualty or theft loss (line 32 less line 33).
35. Alimony paid
36. Child care-See instructions
37. Union dues
38. Employment education expense-See instructions
39. Other-See instructions (itemize) .
150
21. Total taxes (Add lines 14 through 20. Enter here
and on Form 540, page 2, line 57).
NW 88326 Docid:32245535 Page 186
940
40. Total Add lines 34, 35, 36, 37, 38 and 39. (Enter
here and on Form 540, page 2, line 60)
་
.
SCHEDULE
C
FORM 540
Reference copy, JFK Collection: HSCA (RG 233) ">
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
TAXABLE
1974
YEAR
(Sole Proprietorships)
-
Attach this schedule to your income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
AM & PHYLLIS RUBY
A. Principal business activity.
(See Instructions for "Item A.")
B. Business name..
SERVICE
Partnerships, joint ventures, etc., must Ale on Form 565
Social Security Number
_; product
SNACKBAR.
(For example: retail-hardware; wholesale tobacco; services-legal; manufacturing-furniture; etc.)
"SHOP"
WOODLEY BISTRO COFFEES. Federal employer identification number 95-2651578
D. Business address 160SSVENTURA BLVD. ENCINO...
E. Indicate method of accounting:
-
☐ cash; ✓ accrual; ☐ other..
COST
F. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ☑ Yes
G. Method of inventory valuation ▶
CA 91316
☐ No
(ZIP code)
C
Was there any substantial change in the manner of determining quantities, costs, or valuations between the opening and closing inventories?
☐ YES
NO. If "Yes," attach explanation.
☑NO
1 Gross receipts or sales $.
IMPORTANT-All applicable lines and schedules must be Allod in.
INCOME
DEDUCTIONS
Less returns and allowances $.
2 Less: Cost of goods sold (Schedule C-1, line 29) and/or operations (attach schedule)
3 Gross profit
4 Other income (attach schedule)
5
TOTAL income (add lines 3 and 4)
6 Depreciation (explain in Schedule C-3)
7 Taxes on business and business property (explain in Schedule C-2)
8 Rent on business property
9 Repairs (explain in Schedule C-2)
10 Salaries and wages not included on line 24, Schedule C-1 (exclude any paid to yourself)
11 Insurance
12 Legal and professional fees
13 Commissions.
14
Amortization (attach statement)
15 (a) Pension and profit-sharing plans (see Instructions for line 15(a))
(b) Employee benefit programs (see Instructions for line 15(b))
16 Interest on business indebtedness
.
17 Bad debts arising from sales or services
18 Depletion
19 Other business expenses (specify):
Balance
(a).
(b).
(c).
(d).
(e).
(f).
(g).
(h) Total other business expenses (add lines 19(a) through 19(g))
20 Total deductions (add lines 6 through 19)
Sett
21 Net profit (or loss) (subtract line 20 from line 5). Enter here and on page 2, Form 540 or Form 540NR
SCHEDULE C-1. COST OF GOODS SOLD (See Schedule C Instructions for line 2)
22 Inventory at beginning of year (if different from last year's closing inventory, attach explanation)
23 Purchases $.....
Less cost of items withdrawn for personal use $.
24 Cost of labor (do not include salary paid to yourself)
25 Materials and supplies
26 Other costs (attach schedule)
27 Total of lines 22 through 26
28 Less: Inventory at end of year
29 Cost of goods sold. Enter here and on line 2, above
NW-88326 Docld:32245535 Page 187
•
Balance ►
9934
SCHEDULE
D
FORM 540
Reference copy, JFK Collection: HSCA (RG 233)
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 pr 540NR
SAMUEL & PHYLLIS RUBY
PART |--Assets Held One Year or Less
1.
a. Kind of property and description
b. Date acquired
(mo.. day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales
price
(Example, 100 shares of "Z" Co.)
6/10/24
TAXABLE
1974
YEAR
Social Security Number
e. Cost or other basis as
adjusted, cost of subse-
quent improvements (if
purchased, attach
explanation) and ex.
pense of sale
not
f. Gain or loss
(d. less e.)
11000.
D
LOANTOSUMMIT EAGLE CORPORAtion
1.00 CHIEFTAINDEXEL 11/21/73
100 CHIEFTAIN DEVEL 11/21/73 6/19/74
653
1382
(229
678
1382
(204
2. Enter gain (or loss), if applicable, from line 18, Schedule D-1 (540) (attach copy)
3. Enter your share of net gain or loss from partnerships and fiduciaries
4. Net gain or loss, combine lines 1, 2 and 3
PART 1-Assets Held More Than One Year But Not More Than Five Years
5.
100 TESORO PET 5/22/72 7/16/74 1622
100 UNITRODE
LOORCA
9174 358
174 1053
5/15/22
2/22/73
1/22374
2817
.1532
3062
(2433).
02205
6. Enter gain (or loss), if applicable, from line 20, Schedule D-1 (540) (attach copy)
7. Enter your share of net gain or loss from partnerships and fiduciaries
8. Net gain or loss, combine lines 5, 6 and 7
PART III-Assets Held More Than Five Years
9.
1973. LOSS. CARRYOVER.
(16063)
LESS1000
10. Enter gain (or loss), if applicable, from line 22, Schedule D-1 (540) (attach copy)
11. Enter your share of net gain or loss from partnerships and fiduciaries
12. Net gain or loss, combine lines 9, 10 and 11
PART IV-
-Summary of Capital Gains and Losses
13. Enter amount from line 4
14. Enter 65% of the amount on line 8
15. Enter 50% of the amount on line 12 .
16. Enter unused capital loss carryover from preceding taxable years (attach computation)
17. Combine the amounts shown on lines 13, 14, 15 and 16
18. If line 17 shows a gain, enter here and on page 2, Part II of Form 540 or 540NR
2433
2864
(4406)
(15063) (20360)
19. If line 17 shows a loss, enter here and on page 2, Part II of Form 540 or 540NR the smallest of:
(a) amount on lines 17;
(b) the taxable income for the taxable year (computed without regard to gains or losses from sale or exchange
of capital assets; or
(c) $1,000 ($500 in the case of a husband or wife filing a separate return)
NW-88326-Beeld:32245535-Page-188-
(1100)
NAME
ADDRESS
•
Reference copy, JFK Collection: ESCA (RG 233)
• SAMUEL & PHYLLIS RUBY
Ruby
CALENDAR YEAR 19
74
SOC. SEC. NO.
MEDICAL
2 MEDICINE/DRUGS
3 LESS 1% A.G.I. (Line 18 - 1040)
4 NET MED/DRUGS
5 H & A INS. (½ + EXCESS)
ɓa DR.
DR.
DR.
DR.
DR.
DR.
DR.
DR.
6b HOSPITAL
PROSTHETIC APPLIANCES
HEARING AID
6C AMBULANCE
LABORATORIES
TRAVEL FOR MED. 1000
MEDICARE INS.
GLASSES
7 MEDICAL EXPENSES
LESS REIMBURSED BY INS.
8 LESS 3% ADJ. GROSS INC.
+ (TO $1.50) OF H & A INS
10 TOTAL MEDICAL DED.
TAXES
11 STATE & LOCAL INCOME
12 REAL ESTATE
13 STATE & LOCAL GASOLINE
14 GENERAL SALES TAX
15 a PERSONAL PROPERTY
15b PERSONAL PROPERTY AUTO
16 STATE DIS. INS. H
W
SALES TAX AUTO
17 TOTAL TAXES
INTEREST (TO WHOM PAID)
18 MORTGAGE
STATE
A 1386
19 INSTALLMENT LOANS
MERRILLLUNCH
TRANS1107
SBA
DEDUCTION SCHEDULE
FEDERAL
CONTRIBUTIONS
21 PARTNERSHIP SHARE
GIRL/BOY SCOUTS
HEART FUND/CANCER FUND
STATE
FEDERAL
504
RED CROSS/UNITED FUND
XMAS & EASTER SEALS
150
MISC. ORGANIZED CHARITIES
930
POLITICAL CONTRIBUTIONS
CHURCHES
22 OTHER THAN CASH
70
1304
268
12350
1386
23 CARRY OVER FROM PRIOR YRS.
24 TOTAL CONTRIBUTIONS
CASUALTY OR THEFT LOSS(ES)
25 LOSS BEFORE ADJUSTMENT
26 INSURANCE REIMBURSEMENT
27 Difference (not less than zero)
28 ($100 LIMITATION PER CAS.)
29 TOT. CAS. OR THEFT LOSS
MISCELLANEOUS DEDUCTIONS
30 ALIMONY
31 UNION/PROFESSIONAL DUES
32 CHILD & DEP. CARE (Form 2441)
33 INCOME TAX PREPARATION
UNIFORMS/PROTEC. CLOTHING
SMALL TOOLS AND SUPPLIES
LAUNDRY AND CLEANING
Auto Use
Mi
INVEST.COUNSEL & PUBS. (Sched
EMPLOYMENT AGENCY FLES
SAFE DEPOSIT BOX
122
722
48
TEL. REQ. IN BUSINESS
147
24
34 TOTAL MISC. DED.
150
750
940
1062
SUMMARY OF ITEMIZED DED.
35 TOT. DEDUCTIBLE MEDICAL & DENTAL
EXPENSES (FROM LINE 10)
STATE
FEDERAL
36 TOTAL TAXES (From LINE 17)
2343
NW8832632245535 Page 18992+
263.
37 TOTAL INTEREST (Line 20)
38 TOTAL CONTR. (Line 24)
39 CAS. & THEFT LOSS(ES) (Line29)
40 TOTAL MISCELLANEOUS
DEDUCTIONS 
(FROM 
LINE 34)
170
16
2992
41 TOTAL ITEMIZED DEDUCTIONS
ENTER ON FORM 1040 LINE 45
REMARKS
3468
15590
Reference copy, JFK Collection:
NAME
SAML PHYLLIS RUBY
Ruby.
ADDRESS
OR
NO.
SOC. SEC. NO.
HSCA (RG 233)
CALENDAR YEAR
SCHEDULE OF PROFIT (OR LOSS ) FROM BUSINESS OR PROFESSION
PRINCIPAL BUSINESS ACTIVITY
BUSINESS NAME
BUSINESS ADDRESS
TOTAL RECEIPTS
INVENTORY AT BEGINNING OF YEAR
MERCHANDISE PURCHASED
LABOR
TOTAL
INVENTORY AT END OF YEAR
GROSS PROFIT
EMPLOYERS NO.
19 >
74
FISCAL YEAR ENDING
19
68084
36079
36079
6072
35279
32805
GROSS INCOME
32805
OTHER BUSINESS DEDUCTIONS
ADVERTISING
337
AUTO AND
TRUCK EXPENSE
12000 M1
AT 154
1800
BAD DEBTS
CASH SHORT
COMMISSIONS
DELIVERY
DEPRECIATION ( SCHEDULE ATTACHED ,
DUES AND SUBSCRIPTIONS
ENTERTAINMENT AND PROMOTIONAL
INSURANCE
INTEREST
JANITOR SERVICE
LAUNDRY
LEGAL AND ACCOUNTING
MAINTENANCE
OFFICE SUPPLIES AND EXPENSE
RENT
REPAIRS
SALARIES AND WAGES
SALARIES OFFICERS
SUPPLIES
TAXES AND LICENSES
TAXES
PAYROLL
TELEPHONE
TRAVEL
UTILITIES
PARKING
NET PROFIT
OR (LOSS
)
FEDERAL RETURN
NET PROFIT OR
LOSS
1339
16
215
1844
24T
270
42
7841
991
5912
1063
588
322
45
22871
9939
(H)7539
STATE RETURN ( SEE DEPREC. SCHEDULE FOR DIFF. KW) 2400
NW 88326 Decld:32245535° Page 190™
104
SCHEDULE

NW 88326 Docid:32245535 Page 191
NAME
MybLis
may
ADDRESS
KIND OF PROPERTY
EQUIPMENT
I.D. NO.
OR
SOC. SEC. NO.
CALENDAR YEAR 19
FISCAL YEAR ENDING
SCHEDULE OF DEPRECIATION / AMORTIZATION
COST OR
SPEC 20%
DEP
OTHER BASIS
2/1/74/10228
GOODWILL
71/74/35000
DEPRECIABLE
BASIS
DEP ALLOWED
PRIOR YEARS
10228
REMAINING
COST
METHOD
RATE (%)
OR LIFE
S.L
7YR 1339
TOTALS
PROFESSIONAL STATIONERS INC.
LOS ANGELES, CALIF. FORM NO 102A
SCHEDULE
Reference copy, JFK Collection: ESCA (RG 233)
RESIDENT'
Reference copy, JFK Collection: HSCA (RG 233)
INDIVIDUAL
CALIFORNIA
LICONE TAX
car 1972, or other taxable year beginning
NE(C) AND
AL(5) |
TAXABLE YEAR
1972
1972, ending
1973
'
LAST NAME
RUBY
Your social sy
1 direct, dedit epartment number, or rural routo)
Wire's numbt
162.AL
ll, California
Pay
filing point return
4, ficcto return-Enter spouse's social
number and first name here
ZIP CODE
Yours
OCCU-
Self Lopio
PATION Wife's Housewi
9. Dependents-Do not fist yourself, your spouse or person who qualifies you as head of household
NAME (Include last carce and/or address if different from yours)
Fred, Brian, Elisa, Thomas..
NELATIONSHIP
-Enter
_ Number 5
Number of blind exemptions claimed ▷ 6-
☐
of Marscheld--Complete Part 1, page 2
7. Total dependent and blind exemptions (add lines 5 and 6)
7
0. Ellad (refer to instructions)
(C. 2 dl Form(3) 1/2 to
$500, and tech due (10))
Lid (if over $500, complete and attach Schedule (B(540))
ty Cuffs and Ext (from pago 2, line 41)
2010 al 11)
cap!)
0
70%
0
10
11
12
247)
13
fubtract In 10 from as 12)
14
6,057
อ
0 Mb
Card
14 is under $10,00), Und tato Ke Fable and enter on in 17.
6 or more com
19 and 16.
2,000
(from page 2, line 56)
15
13. to
(subtracting 15 frem [
r tax on
14), Figure your tax on this cmount by using the appropriate Tox Roto
17
10
4,052):
x Tablo,
☐ Tax Noto Schedule ()
☐ Schedule 'G(540)
17
Sag-$25. Married couple or head of household-050
Total on line 7 above, & × $8
10
19
50100
32100
20. Tel (add lines 18 and 19)
20
20
rite social scouri
on diet (7
1. Th
Cubtract line 20 from line 17)
22.07 eats (from page 2, line 59)
23. fet cxy (subtract line 22 from lino 21)
24. Tax on preference income (see instructions-attach Schedule P(540))
25. Tola! to Hality (add lines 23 and 24)
17**
26. Total California income tax withhold (attech Form(s) W-2 or DE-2P to front)
27. 1072 California estimated tax payments
.
20. Exce Ballforale SDI tax withhold (attach Form DE 1964 to face of return)
23. Total payments (add lines 26, 27 and 28)
80. If line 25 is larger than line 29, entor CALANCE DUE.
31. If line 29 is larger than line 25, enter OVERPAYMENT.
22
26
27
28
Poy in full. Mail payment with return to
Franchise Tax Board, Sacramento, CA 95867.
Mall return to P.O. Box 13-540,
Sacramento, CA 95813.
32. Line 31 to to (a) REFUNDED. (Allow at least six weeks for your refund)
(b) Credited on 1973 estimated tax
21
23
24
25
22222
°
29
30
→ 31
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belle? It is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
EDWARD L. LAMBERT
Sign D
Your signature if filing Jointly, BOTH must sign
NW 88326 Docld:32245535 Page 192
Date
TAX.CONSULIANT.
V
A BLVD
Do not write in these sp
P
E
SCHEDULE
FORD
Sal c. Thyllda Ruby
Reference copy, JFK Collection: HSCA (RG 233)
CALIFORNIA
ITEMIZED BEDUCTIONS
Mob to form 5:3
AXABLE
19 72
YEAR
Serial
T
La .
D of a
tfolio
11 auction
nis,
(m) (7
1.
caro, ct).
if one spouse itemizes deductions, the other may not use the Tax Table or clai
the standard deduction. If you choose to itemize your deductions, completo (
appropriate items below.
Cc..bibutions
22. Cash-Including checks, money orders, etc.
(itomize)
22
22
} {
by
13 prom
3.1% of adjusted race ch ja on
Form 840
4. She line 3 free 2. Enter bronce
1773, UN
78
2
3
-
P
23. Total cach contributions
23
5
11. Other than cash (sco instructions). Enter total
Bord.
24
63. Todd lines 23 and 24. Maximum deduction
may not exceed 20% of justed gross income.
word and on Form 5-10, p 2).
203,07
25
3
3 73
9
1 and 0. Enter
1 ca
150.00
10
W
mortgago
27. It purchases
21. Other (Itemize)
1
20. Total-(Add lines 26, 27 and 28. Enter here and
on Form 540, page 2)
3 Deductions. i
Casucity or Theft Loss(os)-Soo instructions
23
27
28
29
223
3,232.00
11
12
NOTE: If you had more than one casually or theft
Ic occurrence, omit lines 30 through 33 and follow
insauctions for guidance.
30. Loss before adjustments
7
31. Insurance reimbursement
for Luxing (Brendon Form
540, page 2)
ཐ་
13
32. $100 limitation
33. Add lines 31 and 32
34. Casualty or theft loss. (Line 30 less line 33)
34
33233
30
31
$100.00
Real estate
State and local
10. Canoral sclos
14
15
16
GGS
35. Child Caro-See instructions
35
30. Other-For education, alimony, union dues, etc.
-Sea instructions
36
Auto license-Excess of reglabation and weight
foes (see Instructiona)
Personal property
* State Cisability
18
(1)
private
19
20
disability prompto not caly
Other
41. Total taxes-(Add linos 14 through 20. Entor
1
here and on form 540, pago 2)
NW 88326 Docld:32245535 Page 193
21
841.00
37. Total miscellaneous deductions--Add llnes 34, 35
and 36, (Entor hero and on Form 540, pago 2) D
37
SCHEDULE
FOM 540
Reference copy, JFK Collection: HSCA (RG 233)
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Selo Propriatorships)
PCP 040N3
1. Ruby'
19 72
C
YEA?
Portmorchips, (plm) vontoro, eta, much les form.
Social Security
11
Pied Servico
;
product
(for examples retail-hardware; wholesale-tobacco; services -legaly manufacturing--furniture; clc.)
tin for "HA
Snack Bur
5410 Van Nuyo Blvd.
2. Desin me
Guiness address..
G. Federal employer identification number..
Van Nuys, California
In method of accounting: ☐ cash; ☐ accrual; ☐ other.
Wecs Teams 591,592, 626 and 520, for the calendar year filed (if required)?
is the business located within boundaries of the city, town, etc. indicated?
Did you own this busines at the end of the taxable year?
Nowy month of the taxable year did you own this business?
.12.
Yes
No
theppil
and ku mor? La lled in.
Con returns and allowances $
(Collo C-1, lino C) and/or operations (attach schodulo)
tation (att
property (Schudo C-3)
Saulo C-3)
12. Included on line 3, Schedule C-1 (andid, any paid to yourself)
fbes.
statomani)
()trupsion and probationing plans (see instructions for line 15(G))
_ployed by programa (90) Intructions for line 15())
en bulb
•1 debis arting from salts services
11 Dection
(i).
0
(m)
(n).
(o).
1 3 0 0 0 0 0 6 6 Q € = £ € 39
(b).
(c).
(d)
(0)
(09).
(g).
(b).
(c)..
(1)..
B B
Calanco D>
SCHEDUL
20
(p) Total other business expenses (add lines 19(a) through 19(0))
Total deductions (add lines 6 through 19)
21. Net profit (or loss) (subtract line 20 from line 5). Enter here and on page 2, Form 540 or Form 540NR
NW 88326 Docld:32245535 Page 194
(ZIP corto)
Yos ☐ N
Yes ☐ K
6,969 40
SCHEDULE
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
are gains (but not losses) on personal assets such as 
a home or jewelry.
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
SHORT-TERM-ASSETS HELD NOT MORE THAN 6 MONTHS
1.
a. Kind of property and descriation
(Example, 100 shares of "Z" Ca
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo.. day, yr.)
d Gss sales price
TAXABLE
1971
YEAR
Social Security Number
e. Cost or other bis, as
adjusted. cost of
subsequent improvements.
(if not purchased.
attach explanation)
and expense of sale
f. Gain or loss
(3 less e)
SCHEDULE ATTACHE
2. Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3. Enter net gain (or loss), combine lines 1 and 2
•
4. Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
5. Net short-term gain (or loss), combine lines 3 and 4
LONG-TERM-ASSETS HELD MORE THAN 6 MONTHS
6.
(1.248.00)
7. Enter gain if applicable from line 4, Schedule D-1 (Form 540) (attach copy)
8. Enter your share of net long-term gain (or loss) from partnerships and fiduciaries
9. Net gain (or loss), combine lines 6. through 8
.
10. Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
11. Net long-term gain (or loss), combine lines 9 and 10
12. Combine the amounts shown on lines 5 and 11, and enter the net gain (or loss) here
13. If line 12 shows a gain-
(a) Enter 50% of line 11 or 50% of line 12, whichever is smaller. Enter zero if there is a loss or no entry on line 11
(b) Subtract line 13(a) from line 12. Enter here and on line 32, Form 540 (line 33, Form 540NR)
14. If line 12 shows a loss-
(a) Add lines 4 and 10 (if lines 4 and 10 are blank, enter a zero here and on lines 14(b) and 14(c) and go to
line 14(d))
.
(b) Combine lines 3 and 9-if gain, enter gain; if loss, enter zero
•
(c) Enter smallest of (i) line 14(a) less line 14(b); (ii) the amount of taxable income on Form 540 or 540NR,
computed without capital gains and or losses--determine this figure via a side computation; or (iii) $1,000
(d) Combine lines 3 and 9-if loss, enter loss; if gain, enter zero here and on line 14(e) and go to line 
14(f)
(e) Enter smallest of (i) the amount of taxable income on Form 540 or 540NR, computed without capital gains
and or losses, less line 14(c)-determine this figure via a side computation; (ii) $1,000 ($500 if married and
filing separately); (iii) if line 3 is zero or shows a gain, 50% of line 14(d); (iv) if line 9 is zero or 
shows 
a
gain, amount on line 14(); or (v) if lines 3 and 9 show losses, line 3 added to 50% of 
line 9
(f) Enter here, and on line 32. Form 540 (line 33, Form 540NR), the sum of lines 14(c) and 14(e)-(Do not
enter an amount greater than $1,000).
.
(14,274,00).
(15.522.00).
( 1,000.00)
Carryover (1-1) ($14,572.00)
NW 88326 Docld:32245535 Page 195
Son Instructions on Back
SCHEDULE
FORM 540
CALIFORNIA
ITEMIZED DEDUCTIONS
Attach to Form 540
TAXABLE
19 71
YEAR
Name as shown on Form 540
Samuel and Phyllis Ruby
itemized vs. Standard Deduction_You have a choice between two deduction
methods. You can either itemize your deductions or take a standard 
deduction as
explained in the 540 Instructions. On separate returns of a husband 
and wife
,
Social Security Number
if one spouse itemizes deductions. the other may not use the Tax Table or
the standard deduction. If you choose to itemize your deductions, complete r
appropriate items below.
Medical and dental expenses (not compensated by insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospital care, insurance
premiums for medical care, etc.
1. One half (but not more than $150) of insurance premiums for medical care
2. Medicine and drugs
3. Enter 1% of adjusted gross income shown on Form 540
4. Subtract line 3 from line 2. Enter difference (if less than zero, enter zero)
5. Enter balance of insurance premiums for medical care not entered on line 1
6. Other medical and dental expenses (attach itemized list)
7. Total_(Add lines 4, 5 and 6)
8. Enter 3% of adjusted gross income shown on Form 540
9. Subtract line 8 from line 7. Enter difference (if less than zero, enter zero)
10. Total--(Add lines 1 and 9)
Child Adoption Expense
11. Total expenses paid or incurred-Attach itemized list
12. Enter 3% of adjusted gross income shown on Form 540
13. Subtract line 12 from line 11-See instructions for maximum limitations
Taxes
14. Real estate
15. State and local gasoline
18. General sales
17. Auto license-Excess of registration and weight fees (see instructions)
18. Personal property
19. State disability insurance (SDI)-Employer private disability plans do not qualify
20. Other (specify) ..
21. Total taxes-(Add lines 14 through 20)
23456
A
1
00
9
10
150 00
=22
11
12
13
45678222
14
15
16
17
18
19
20
21
743 31
Contributions
22. Cash-Including checks, money orders, etc. (itemize)
23. Total cash contributions
24. Other than cash (see instructions). Enter total here
25. Total Add lines 23 and 24-Maximum deduction may not exceed 20% of adjusted gross income
Interest Expense
28. Home mortgage
27. Installment purchases
28. Other (itemize)
29. Total Add lines 26, 27 and 28)
Miscellaneous Deductions
30. For child care, alimony, union dues, casualty losses, etc.-See instructions (itemize)
31. Total miscellaneous deductions
32. Total deductions - (Add lines 10, 13, 21, 25, 29 and 31). Enter total here and on Form 540, page 2, in space provided
NW 88326, Docld:32245535 Page 196
Schedule A on reversa
22
222
23
24
25
A
228
26
27
28
29
2,617 68
30
30
31
S/
32
500 ho
4,010 99
SCHEDULE
FORM 540
CALIFORNIA >
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
(Sole Proprietorships)
Attach this schedule to your income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
TAXABLE
1971
YEAR
Partnerships, joint ventures, etc., must file on Form 56
Social Security Number
; product
For example: retail-hardware; wholesale-toborco; services-legal; manufacturing-furniture; etc.)
C. Federal employer identification number.
Van Mivs, California 
91401
(City-post office)
(State
(ZIP code
A. Principal business activity
Food Service
B. Business name
Snack Bar
D. Business location
5418 Van Nuys Blvd.
Number and street or rural route)
E. Indicate method of accounting: ☑ cash; ☐ accrual; ☐ other (describe)
F. Was there any substantial change in the manner of determining quantities, costs or valuations between the opening and closing
inventories? Yes ☐ No. If "yes," attach explanation.
G. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ☐ Yes
1. Gross receipts or gross sales $
Less: Returns and allowances $
2. Inventory at beginning of year (If different than last year's closing inventory attach
explanation)
.
3. Merchandise purchased $
drawn from business for personal use $
4. Cost of labor (do not include salary paid to yourself)
5. Material and supplies
6. Other costs (explain in Schedule C-1)
7.
Total of lines 2 through 6 .
8. Inventory at end of this year.
less cost of any items with-
9. Cost of goods sold and/or operations (subtract line 8 from line 7)
10. Gross profit (subtract line 9 from line 1)
OTHER BUSINESS DEDUCTIONS
11. Depreciation (explain in Schedule C-2) .
12. Taxes on business and business property (explain in Schedule C-1)
13. Rent on business property
14. Repairs (explain in Schedule C-1)
15. Salaries and wages not included on line 4 (exclude any paid to yourself)
16. Insurance
17. Legal and professional fees
18. Commissions
19. Amortization (attach statement)
20. (a) Pension and profit-sharing plans (see instructions)
(b) Employee benefit programs (see instructions)
21. Interest on business indebtedness
•
22. Bad debts arising from sales or services
23. Depletion of mines, oil and gas wells, timber, etc. (attach schedule)
24. Other business expenses (explain in Schedule C-1)
25.
Total of lines 11 through 24
☑ No
26. Net profit (or loss) (subtract line 25 from line 10). Enter here and on page: 2, Form 540 or 540NR
SCHEDULE C-1. EXPLANATION OF LINES 6, 12, 14, AND 24
SCHEDULE
ATTACHED
$
7,350 33
Line No.
Explanation
W88326 'Docld:32245535 Page 197
Amount
$
Line No.
Explanation
Amount
Page
1
SCHEDULE
FORM 540
CALIFORNIA
CAPITAL GAINS AND LOSSES
Attach to Form 540 or 540NR
Use this schedule to report gains and losses on stocks, bonds and similar investments,
and gains (but not losses) on personal assets such as a home or jewelry.
Name as shown on Form 540 or 54CNR
Samuel and Phyllis Puby
SHORT-TERM-ASSETS HELD NOT MORE THAN 6 MONTHS.
a. Kind of property and description
(Example, 100 shares of "Z" Co.)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo.. day, yr.)
Gss sales price
TAXABLE
1971
YEAR
Social Security Number
e. Cost or other b. is, as
adjusted. cost of
subsequent improvements.
(if not purchased.
attach explanation)
and expense of sale
f. Gain or loss
(3 less e)
1.
SCHEDULE ATTACHED
2. Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3. Enter net gain (or loss), combine lines and 2
•
4. Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
5. Net short-term gain (or loss), combine lines 3 and 4
LONG-TERM-ASSETS HELD MORE THAN 6 MONTHS
6.
7. Enter gain if applicable from line 4, Schedule D-1 (Form 540) (attach copy)
8. Enter your share of net long-term gain (or loss) from partnerships and fiduciaries
9. Net gain (or loss), combine lines 6 through 8
10. Enter unused long-term capital loss carryover from preceding taxable years (oftach statement)
11. Net long-term gain (or loss), combine lines 9 and 10
12. Combine the amounts shown on lines 5 and 11, and enter the net gain (or loss) here
13. If line 12 shows a gain-
:
(1,248.00)
(14,274,00).
(15.522.00).
(a) Enter 50% of line 11 or 50% of line 12, whichever is smaller. Enter zero if there is a loss or no entry on line 11
(b) Subtract line 13(a) from line 12. Enter here and on line 32, Form 540 (line 33, Form 540NR)
14. If line 12 shows a loss-
(a) Add lines 4 and 10 (if lines 4 and 10 are blank, enter a zero here and on lines 14(b) and 14(c) and go to
line 14(d))
(b) Combine lines 3 and 9-if gain, enter gain; if loss, enter zero
•
(c) Enter smallest of (i) line 14(a) less line 14(b); (ii) the amount of taxable income on Form 540 or 540NR,
computed without capital gains and or losses-determine this figure via a side computation; or (iii) $1,000
(d) Combine lines 3 and 9-if loss, enter loss; if gain, enter zero here and on line 14(e) and go to line 14(f)
(e) Enter smallest of (i) the amount of taxable income on Form 540 or 540NR, computed without capital gains
and or losses, less line 14(c)-determine this figure via a side computation; (ii) $1,000 ($500 if married and
filing separately); (iii) if line 3 is zero or shows a gain, 50% of line 14(d); (iv) if line 9 is zero or shows a
gain, amount on line 14(d); or (v) if lines 3 and 9 show losses, line 3 added to 50% of line 9
(f) Enter here, and on line 32, Form 540 (line 33, Form 540NR), the sum of lines 14(c) and 14(e)-(Do not
enter an amount greater than $1,000)
.
( 1,000.00)
Carryover (1-1) ($14,512.00)
Son Instructions on Back
NW 88326 Docld:32245535 Page 198
RESIDENT
540
BEAL
3324
(KG BUSI
TAXABLE YEAR
OF
THE
Reference copy, Jrk collection:
INDIVIDUAL
CALIFORNIA
1973
INCOME TAX
19.
1973, ending.
Your Social Security Number
or the year January 1-December 31, 1973, or other taxable year beginning
FIRST NAME(S) AND INITIAL(S)
ease
int
SAMUEL & PHYLLIS
LAST NAME
PRESENT HOME ADDRESS (Number and street, including apartment number or rural route)
16250
BIRCHER
HILLS
CITY, TOWN OR POST OFFICE, STATE AND ZIP CODE
GRANADA
ling Status Check Only One
1. ☐ Single
.
2. ☑ Married filing joint return
3. ☐ Married filing separate return-Enter spouse's full
name
4. ☐ Head of Household-Enter name of qualifying
individual
RUBY
ST
CALIF
OCCU-
PATION
Yours
Exemption Credits If line 1 or 3 checked, enter $25
"Spouse's Social Security Number
S/E
Spouse's HW.
6. Personal Exemption: line 2, 4 or 5 checked. enter $50
Dependents. Do not list person who qualifies you as head of household.
Name (include last name and/or address if different from yours Relationship
7.
THOMAS
ELISA
6
5.0
FRED
Total Number
3
5. ☐ Widow(er) with dependent child. Enter year spouse 8.
died 19..........
Blind (refer to instructions) Number of blind exemptions!
X $8
X $8
7
8
124
9.
9/24
Income
10
11
92
12
345
13
6/96
AI חיי הרוח וורייר
◄ ATTACH COPY 2 OF FORM W-2 HERE ►
Write social security number on check or money order. ATTACH HERE ►
Total exemption credits (add lines 6, 7 and 8) Enter here and on line 20 below
Attach copy 2 of Form(s) W-2 to front, )
10. Wages, salaries, tips and other employee compensation if unavailable, attach explanation
11. Dividends-before federal exclusion. Capital gain dividends must be included at 100%
12. Interest. (See instructions for taxability of federal, state and municipal bonds)
13. Income other than wages, dividends and interest (from line 50)
14. Total (add lines 10, 11, 12 and 13)
15. Adjustments to income (from line 56)
16. Adjusted gross income (subtract line 15 from line 14)
•
If you do NOT itemize deductions AND line 16 is under 10,000, find tax in Tax Table and enter on line 19.
• If you itemize deductions OR line 16 is $10,000 or more, complete lines 17 and 18.
14 16633
15
16 16633
5162
18 11471
17. Deductions: Itemized (from line 63) OR Standard ($1,000 if line 1 or 3 checked-$2,000 if line 2, 4 or 5 checked) 17
18. Taxable income (subtract line 17 from line 16) Compute tax from Tax Rate Schedule-Enter tax on line 19
19. Tax-If an averaging method is used, check appropriate box ☐ Schedule G, or ☐ Schedule G-1
20. Total exemption credits (from line 9, above)
•
21. Tax liability (subtract line 20 from line 19-if line 20 is greater than line 19, enter zero)
22. Other credits (from line 66)
222222222
19
249
20
21
74
175
Your
Tax
and
Credits
23. Net tax (subtract line 22 from line 21-if line 22 is greater than line 21 enter zero)
24. Special tax credit-from line 75 (see Instructions, page 2, for allowable crédit)
23
24
25.
26.
Net Tax liability (subtract line 24 from line 29-if line 24 is greater than line 23, enter zero)
Tax on preference income (see instructions-attach Schedule P(540))
25
135
53
122
26
:
27.
Total tax liability (add lines 25 and 26)
27
122
28.
Your
29.
Renter's credit-if you lived in rented property on March 1, 1973, complete Part I on page 2
Total California income tax withheld (attach Form(s) W-2 or W-2P to face of return).
28
29
Pre-
30.
payment
Credits
31.
1973 California estimated tax payments (include amount allowable as a credit from 1972 return)
Excess California SDI tax withheld (attach Form DE 1964 to face of return)
32. Total prepayment credits (add lines 28 through 31)
30
31
32
33
33
122
Do not write in these spaces
Balance
Due
or
Refund
33. If line 27 is equal to or larger than line 32, enter amount of BALANCE DUE
Pay in full and mail with return to: Franchise Tax Board, Sacramento, CA 95867
34. If line 32 is larger than line 27, enter amount OVERPAID
Mail return to: Franchise Tax Board, P.O. Box 13-540, Sacramento, CA 95813
35. Amount of line 34 to be REFUNDED. (allow at least $/x weeks for your refund)
Amount of line 34 to be credited on your 1974 estimated tax
36.
•
34
35
36
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all 
information of which he has any knowledge.
SIGN
Your signature
HERE
NW 88326 Docld32245335-Page 19greturn
P
E
M
A
Date
Preparer's signature (other than taxpayer)
Date
Date
Address (and Zip code)
15717
Preparer's Employer Identification (or SSA) Number
MAIN STREET
Reference copy, JFK Collection: ESCA (RG 233)
SCHEDULE
0-1
FORM 540
Name as shown on Tax Return
SAMUEL
CALIFORNIA
SUPPLEMENTAL SCHEDULE OF GAINS AND LOSSES
(Sales or Exchanges Including Involuntary Conversions)
(Attach to Form 540, 540NR, 541 or 565)
PHYLLIS RUBY
TAXABLE
1973
YEAR
Identifying number as shown on return
PART I Gain From Disposition of Property Under Sections 18211, 18212-18, 18219, 18220
Lines 9 and 10 should be omitted if there are no dispositions of farm property or farm land; or, if this form is filed by a partnership.
1. Description of Sections 18211, 18212-18, 18219, and 18220 property.
Date acquired
(mo.. day, yr.)
Date sold
(mo., day, yr.)
(A)
(B)
SNACK
BAR
(C)
(D)
Correlate lines 1(A) through 1(D) with these columns
2. Gross sales price
•
3. Cost or other basis and expense of sale
4. Depreciation allowed (or allowable)
5. Adjusted basis, line 3 less line 4
Property
(A)
28000-
28138
-
12386
15756
6. Total gain, subtract line 5 from line 2
12248.
7. If Section 18211 property:
(a) Depreciation allowed (or allowable) after applicable date.
(See Instruction D-3)
(b) Line 6 or line 7(a), whichever is smaller
12386
12248.
4/70
8/13/73
Property
(B)
Property
(C)
Property
(D)
8. If Section 18212-18 property:
(a) Enter additional depreciation after 12-31-63 and before
1-1-71
(b) Enter additional depreciation after 12-31-70
(c) Enter line 6 or line 8(b), whichever is smaller
(d) Line 8(c) times applicable percentage (Instruction D-4)
(e) Enter excess, if any, of line 6 over line 8(b)
(f) Enter line 8(a) or line 8(e), whichever is smaller
(g) Line 8(f) times applicable percentage (Instruction D-4)
(h) Add line 8(d) and line 8(g)
9. If Section 18220 property:
(a) If farm land, enter soil and water conservation expenses
for current year and four preceding years
(b) If farm property, other than land, subtract line 7(b) from
line 6; OR, if farm land, enter line 6 or line 9(a), which-
ever is smaller (see Instruction D-5)
(c) Excess deductions account (see Instruction D-5)
(d) Enter line 9(b) or line 9(c), whichever is smaller
10. If Section 18219 property:
(a) Soil and water conservation expenses made after 12-31-69
(b) Enter amount from line 9(d), if any; otherwise, enter a zero
(c) Enter excess, if any, of line 10(a) over 10(b)
•
(d) Line 10(c) times applicable percentage (Instruction D-5)
(e) Line 6 less line 10(b)
(f) Enter smaller of line 10(d) or line 10(e)
SUMMARY OF PART I (Complete Property Columns (A) through (D) up to Line 10(f) before going to Line 11)
11. Enter amounts from line 6
12. Enter amounts from lines 7(b), 8(h), 9(d) and 10(f)
13. Subtract line 12 from line 11, enter here and in appropriate
Section in Part II (see Instruction D-2)
12248
12248
14. Total of Property Columns (A) through (D), line 12. Enter here and on line 24, Part III
NW-88326 Docld:32245535 Page 200-
12248-

ATTACH REMITTANCE HERE
FORM
540
RESIDENT
i
Reference copy, JFK Collection: HSCA (RG 233)
CALIFORNIA
INDIVIDUAL INCOME TAX RETURN
TAXABLE
1970
YEAR
Please
FIRST NAME(S) AND INITIAL(S)
Type PRESENT HOME ADDRESS (Number and street, or rural route)
or
Print
For Calendar Year 1970 or Fiscal Year Begun
1970 and Ended
1971
SAMUEL AND PHYLLIS
LAST NAME
RUBY
Your social security number
S
C
COUNTY
Spouse's social security number
་
16250 Bircher
Los Angeles
M
STATE
ZIP CODE
California
Your occupation
91344
Self-Employed
B
P
A
CITY, TOWN OR POST OFFICE
Granada Hills
NAME AND ADDRESS OF EMPLOYER AT TIME OF FILING
Self-Employed
NAME AND ADDRESS ON 1969 CALIFORNIA RETURN. IF SAME AS ABOVE, WRITE "SAME". IF NONE FILED,
GIVE REASON.
11346 Montgomery Avenue
Filing Status
1.
Single
(check one)
2.
✗ Married, filing joint return
Income
If joint return,
Granada Hills, Calif.
3.
4.
Spouse's occupation
Housewife
Adjusted gross income on 1970 Federal
Return $ 8.284.97
If different from line 11. below, explain
in Part VII. page 2.
Married, filing separate return-spouse's name:
Unmarried "head of household" -Complete Part I, page 2
5. Wages, salaries, tips, etc. (before payroll deductions) if more than two employers, attach schedule
Employer's name
Where employed (city and state)
5
Include all
Income of
both husband
8. Dividends. Enter total here (also list in Schedule B (540), Part I, if total is over $100)
6
•
20 60
and wife
7. Interest. Enter total here (also list in Schedule B (540), Part II, if total is over $100)
7
8. Other income (from page 2, line 30)
9. Total (add lines 5, 6, 7 and 8)
10. Adjustments to Income (from page 2, line 35)
8
8,28497
9
8.305 7
10
11. Adjusted gross income (subtract line 10 from line 9)
11
.
8.30557
Your
Tax,
and
Credits
If you do not itemize deductions AND line 11 is under $10,000, find your tax in Tax Table in instructions. Enter tax on line 12.
If you itemize deductions OR fine 11 is $10,000 or more, go to Part IV on page 2 to figure tax.
12. Tax from (check one): Tax Table ☐, Tax Computation (page 2, Part IV) ☑, or Schedule G (540) ☐
13. Exemption credits (from page 2, line 43)
14. Tax liability (subtract line 13 from line 12)
12
15. Total other credits (from page 2, line 49)
15
16. Net tax liability (subtract line 15 from line 14-If $1.00 or less, enter "zero")
16
23456
5100
8200
13
None
14
None
Balance
Due or
Refund
17. 1970 California estimated tax payment or credit from 1969 (if any). If none, enter "zero"
18. Balance due-If any (subtract line 17 from line 16)
17 ►
None
PAY IN FULL WITH RETURN
18
•
.
19. Overpayment-if any (subtract line 16 from line 17)
20. Portion of line 19 you wish to apply on 1971 estimated tax
21. Refund-if any (subtract line 20 from line 19)
OVERPAYMENT
19
20▸>
REFUND
21-
Do not write in these spaces
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and
belief it is true, correct and complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
T
Sign ▷
P
Your signature if filing Jointly, BOTH must sign
Date
Signature of preparer other than taxpayer
here
Spouse's signature
Date
Addres AMBERT-MARKEL...
1
16633 VENTURA BLVD.
• Make Remittance Payable to FRANCHISE TAX BOARD-Mail to
FRANCHISE TAX BOARD, SACRAMENTO, CALIFORNIA 95814.
NW 88326 Docld:32245535 Page 201
ENCINO, CALIF. 91316
T
SCHEDULE
A
FORM 540
Reference copy, JFK Collection: HSCA (RG 233)
CALIFORNIA
ITEMIZED DEDUCTIONS
TAXABLE
19 70
YEAR
Attach to Form 540
Name as shown on Form 540
Samuel and Phyllis Ruby
Itemized vs. Standard Deduction--You have a choice between two deduction
methods. You can either itemize your deductions or take a standard deduction as
explained in the 540 Instructions. On separate returns of a husband and wife,
Social Security Number
if one spouse itemizes deductions, the other may not use the Tax Table or claim
the standard deduction. If you choose to itemize your deductions, complete the
appropriate items below.
Medical and dental expenses (not compensated by insurance or otherwise) for medicine and drugs, doctors, dentists, nurses, hospital care, insurance.
premiums for medical care, etc.
1. One half (but not more than $150) of insurance premiums for medical care
2. Medicine and drugs.
2
3. Enter 1% of adjusted gross income shown on Form 540
34
4. Subtract line 3 from line 2 (if less than zero, enter zero)
5. Other medical and dental expenses. Include balance of insurance premiums for nedical care not
deducted on line 1 (attach schedule)
6. Total-(Add lines 4 and 5)
7. Enter 3% of adjusted gross income shown on Form 540
8. Subtract line 7 from line 6 (if less than zero, enter zero)
9. Total-(Add lines 1 and 8)
Child Adoption Expense
10. Total expenses paid or incurred-Attach itemized list
11. Enter 3% of adjusted gross income shown on Form 540
12. Subtract line 11 from line 10-See instructions for maximum limitations
Taxes
13. Real estate
14. State and local gasoline
15. General sales
16. Auto license-Excess of registration and weight fees (see instructions)
17. Personal property.
18. State disability insurance (SD!)-Employer private disability plans do not qualify
19. Other (specify)
20. Total taxes--(Add lines 13 through 19)
4
5
69
21. Cash-Including checks, money orders, etc. (itemize)
Contributions
22. Total cash contributions
23. Other than cash (see instructions). Enter total here
24. Total Add lines 22 and 23-Maximum deduction may not exceed 20% of adjusted gross income
Interest Expense
25. Home mortgage
26. Installment purchases
27. Other (itemize)
28. Total (Add lines 25, 26 and 27)
Miscellaneous Deductions
29. For child care, alimony, union dues, casualty losses, etc.-See instructions (itemize).
A
8
9
150 00
10
2
11
12
15
13
14
3456
16
17
18
19
20
663 26
21
22
222
23
24
280 00
27
222
25
26
28
1,552 18
23
A
29
29
30. Total miscellaneous deductions
30
100 00
31. Total deductions (Add lines 9, 12, 20, 24, 28 and 30). Enter total here and on Form 540, page 2, in space provided S/A.
NW 88326. Docld:32245535 Page 202
31
7445/14
Schedule
SCHEDULE
C
FORM 540
L
Reference copy, JFK Collection: ESCA (RG 233)
CALIFORNIA
PROFIT (OR LOSS) FROM BUSINESS OR PROFESSION
.AXABLE
19-70
YEAR
(Sole Proprietorships)
Attach this schedule to your Income tax return, Form 540 or 540NR
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
Food
A. Principal business activity...
Snack Bar
B. Business name
Partnerships, joint ventures, etc., must file on Form 565
Social Security Number
_; product....
(For example: retail-hardware; wholesale-tobacco; services-legal; manufacturing-furniture; etc.)
D. Business location 5418 Van Nuys Boulevard
(Number and street or rural route)
E. Indicate method of accounting: ☑ cash; ☐ accrual;
C. Federal employer identification number 26.51 578....
Van Nuys, California 91401
(City-post office)
other
(describe).....
(State)
(ZIP code)
quantities, costs or valuations between the opening and closing
F. Was there any substantial change in the manner of determining
inventories? ☐ Yes ☑ No. If "yes," attach explanation.
G. Were Forms 591, 592, 596 and 599, for the calendar year filed (if required)? ☐ Yes
1. Gross receipts or gross sales $.
Less: Returns and allowances $.
2. Inventory at beginning of year (If different than last year's closing inventory attach
explanation)
3. Merchandise purchased $
drawn from business for personal use $
4. Cost of labor (do not include salary paid to yourself)
5. Material and supplies
6. Other costs (explain in Schedule C-1)
7.
Total of lines 2 through 6
8. Inventory at end of this year.
less cost of any items with-
9. Cost of goods sold and/or operations (subtract line 8 from line 7)
10. Gross profit (subtract line 9 from line 1)
OTHER BUSINESS DEDUCTIONS
11. Depreciation (explain in Schedule C-2) .
12. Taxes on business and business property (explain in Schedule C-1)
13. Rent on business property
14. Repairs (explain in Schedule C-1)
:
15. Salaries and wages not included on line 4 (exclude any paid to yourself)
16. Insurance
17. Legal and professional fees
18. Commissions.
19. Amortization (attach statement)
20. Retirement plans, etc. (other than your share)
21. Interest on business indebtedness
•
22. Bad debts arising from sales or service. .
23. Losses of business property (attach statement)
24. Depletion of mines, oil and gas wells, timber, etc. (attach schedule)
25. Other business expenses (explain in Schedule C-1)
26.
Total of lines 11 through 25
☑ No.
27. Net profit (or loss) (subtract line 26 from line 10). Enter here and on page 2, Part II, Form 540 or 540NR $
SCHEDULE C-1. EXPLANATION OF LINES 6, 12, 14, AND 25
SCHEDULE
ATTACHED
9.284 97
Line No.
Explanation
NW 88326 Docld:32245535 Page 203
Amount
Line No.
Explanation
$.
Amount
PAGO
1
SCHEDULE
D
FORM 540
1.
Reference copy, JFK Collection:
CALIFORNIA
SALES OR EXCHANGES OF PROPERTY
Attach to Form 540 or 540NR
HSCA (RG 233)
TAXABLE
1970
YEAR
Name as shown on Form 540 or 540NR
Samuel and Phyllis Ruby
Part I-CAPITAL ASSETS
SHORT-TERM-ASSETS HELD NOT MORE THAN 6 MONTHS
a. Kind of property (if necessary,
attach statement of descriptive
details not shown below)
b. Date acquired
(mo., day, yr.)
c. Date sold
(mo., day, yr.)
d. Gross sales price
1.
Social Security Number.
e. Depreciation allowed
(or allowable)
since acquisition
(attach schedule)
f. Cost or other basis,
cost of subsequent
improvements (if not
purchased, attach
explanation) and
expense of sale
0. Gain or loss
(d plus e less f)
SCHEDULE ATTACHED
2. Enter your share of net short-term gain (or loss) from partnerships and fiduciaries
3. Enter unused short-term capital loss carryover from preceding taxable years (attach statement)
4. Net short-term gain (or loss) from lines 1, 2 and 3
LONG-TERM-ASSETS HELD MORE THAN 6 MONTHS
5. Enter gain (if any) from line 16, Part II
(15.274.00)
6. Enter your share of net long-term gain (or loss) from partnerships and fiduciaries
7. Enter unused long-term capital loss carryover from preceding taxable years (attach statement)
8. Net long-term gain (or loss) from lines 5, 6 and 7
9. Combine the amounts shown on lines 4 and 8 and enter the net gain (or loss) here
10. If line 9 shows a GAIN, enter 50% of line 8 or 50% of line 9, whichever is smaller. (Enter zero if there is a
loss or no entry on line 8)
11. Subtract line 10 from line 9, Enter here and on line 17, Part III
12. If line 9 shows a LOSS, enter here and on line 17, Part III the smallest of the following:
(a) the amount on line 9; (b) the amount of taxable income on Form 540 or 540NR, computed without capital
gains and losses; or (c) $1,000
Carryover Loss (14,274.00).
Part II-SALE OR EXCHANGE OF PROPERTY UNDER SECTIONS 18181-82
13. Enter gain (if any) from line 22, Part IV
14. Enter gain (if any) from line 25, Part IV
(15,274.00)
( 1,000.00)
15. Enter your share of gain (or loss) of Section 18181-82 items from partnerships and fiduciaries
16. Net gain (or loss). If GAIN, enter on line 5, Part 1; if LOSS, enter on line 29, Part V
PART III-TOTAL NET GAIN OR LOSS FROM SALES OR EXCHANGES OF PROPERTY
17. Net gain (or loss) from line 10 or 11, Part 1
18. Net gain (or loss) from line 31, Part IV
.
19. Total net gain (or loss)-Combine lines 17 and 18. Enter here and on Form 540 or Form 540NR, page 2, Part
II, line 23
NW-88026) Docld:32245535 Page 204
(Schedule continued or reve.CA)
__
Page 1
(c)
SCHEDULE E -- SHAREHOLDERS SHARE OF INCOME AND CREDITS
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
(a) GEORGE MARCUS.
(b)
(c)
130/ MIAMI GARDENS DR, N.MIAMI, FLA, 33162
EARL RUBY".
4380 STONEY RIVER DR, BIRMINGHAM, MICH 48010
(d)
(e)
Amount taxabl
PAGE 4
(2)
Social Security
Number
.(3).
Number of
Shares
(4)
Amou
be used
tributi
ine
03639
320338
38038
7500
Droo
Reference copy, JFK Collection:
ESCA (RG 233)
NW18832
(a)
(b)
(c)
(d)
(e).
(f)
(g)
(h)
(i)
(j)
SCHEDULE E -- SHAREHOLDERS SHARE OF INCOME AND CREDITS
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
GEORGE
1301
MARCUS
MIAMI GARDENS DR, N.MIAMI, FLA, 33162
EARL RUBY.
4380 STONEY RIVER DR, BIRMINGHAM, MICH 48010
Amount taxable as ordinary
Income (schedule K. line 9
U:8: 1120-8)
Distri
va Incor
(a) $ 32,036.39
(b) 32.03438
(e)
(f)
(h)
(!)
PAGE 4
(2)
Social Security
Number
.(3)
Number of
Shares
32380,38
32380.38
32380
7500.
7500
Reference copy, JFK Collection:
HSCA (RG 233)
SCHEDULE - SHAREHOLDERS SHARE OF INCOME AND CREDITS
(if additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
(2)
Social Security
Number
(a)..EARL
RUBY
1860 STONY RIVER DR. BIRM.MI
(b). ESTATE OF GEORGE MARCUS
60 W. WARNINGTON #1150 CHICAGO, IL 60602
(c)
(d).
(e)
(f)
(g)
(h)
(i)
(j)
(3)
Number of
Shares
(4)
Amount taxable as ordinary
income (schedule K, total of
lines 4 and 8, U.S. 1120-S)
7,500
46.840,04
7,500
46,840.05
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 34 or
on page 2, schedule 2, line 43)
difference between column 4
and column 5
(See instructions)
(7)
Enter here and on form
MI-1040, page 1, line 22
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(See instructions)
Enter here
(8)
and on form
MI-1040, each shareholder's
proportionate share of Single
business tax paid.
(See instructions).
(a)
46,840.04
(b)
46,840.05
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
NW 88326 Docld:32245535 Page 207
PAGE 3 OF S
Reference copy, JFK Collection:
ESCA (RG 233)
;
SCHEDULE F SHAREHOLDERS SHARE OF INCOME AND CREDITS
-
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
(2)
Social Security
Number
(a). AL RUBY
4380 STONEY RIVER.
(b). STATE
BIRM., MI
OF GEORGE MARCUS
LG W. WASHINGTON HIED CHICAGO ILL. 60602
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(3)
Number of
Shares
500
500
(4)
Amount taxable as ordinary
income (schedule K, total of
lines 4 and 8, U.S. 1120-S)
19,730.16
19,730.15
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
(a)
19,730.16
(b) 19.730.15
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 34 or
on page 2, schedule 2, line 43)
difference between column 4
and column 5
(See instructions)
(7)
Enter here and on form
MI-1040, page 1, line 22
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(See instructions)
46.61
46.61
(8).
Enter here and on form
MI-1040, each shareholder's
proportionate share of Single
business tax paid.
(See instructions)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
NW 88326 Docld:32245535 Page 208
Reference copy, JFK Collection:
ESCA (RG 233)
D-1040 (NR)
CITY OF
DETROIT
First Name and initial
CITY OF DETROIT INCOME TAX
INDIVIDUAL RETURN-NONRESIDENT
or other taxable year beginning
Earl R. and Marge
PLEASE
Last Name
Ruby
1976, ending
PRINT
.OR
TYPE
(If joint return of husband and wife, use first names and middle initials of both)
Home Address (Number and Street or Rural Route)
1976
19
Your Social Security Number
Your Occupation
Sales
EXTENSION NUMBEI
UMBEI
If you are an EMPLOY
enter your Federal EMPL()
Identification No. here:
Spouse's Social Security Number
State
Michigan
Postal Zip Code
48221
APP.
Spouse's Occupation
Housewife
IP
FP
OA.
18135 Livernois
City, Town or Post Office.
Detroit,
A.
If married, is spouse filing a separate return? ☐ YES
Attach Copy of Form DW-2 or W-2 Here
B.
☑ NO. If yes, enter spouse's first name...
Enter the name and address used on your return for 1975 (If the same as above write "Same". If different, indicate date
moved.) If none filed, give reason.
Same
SCHEDULE A.- EXEMPTIONS
1. YOURSELF
SPOUSE
2. Enter first names of each of your DEPENDENT CHILDREN who lived with you:
3.
OTHER
DEPENDENTS
NAME
Enter figure 1 in the last column to
right for each name listed
Auditor
Regular
65 or over
Blind
Enter
number of
☑
☐ ☐
exemptions
checked
Enter Ro.
Relationship
Months lived in
your home during
1976
ESCA (RG 233)
Reference copy,
JFK Collection:
2
4. Total exemptions from lines 1, 2 and 3; enter here and on line 15 below.
INCOME
(If joint return, include all income of both husband and wife)
5. Enter GROSS income from employers for wages, salaries, commissions, tips, etc. - indicate (W) for wife
6.
Employer's Name
COBO CLEANERS
TOTALS
Total wages reported
on DW-2 or W-2
Where employed (City and State)
INC.
.. DETROIT, MICH.
$
164,200.00
16,500,00
f
Detroit Income Tax
Withheld
97000
11000
WAGES, ETC.. EARNED
IN DETROIT
82.100
100,00
8,250,00
350100
90...
63172
4.481100
00
Attach Check or Money Order Here
COBO - RUMAR SALES, INC. DETROIT, MICH.
180, 700,00
7. Rental income (or loss) from tangible property in the City of Detroit - from page 2, Schedule B, line 4
8. Other income (or loss) from partnerships, etc. - from page 2, Schedule F, line 4...
1,080.00
9. Gain (or loss) from sale or exchange of tangible property in the City of Detroit - from page 3, Schedule E, line 10.
10. Net profit (or loss) from business from page 3, Schedule C, line 8
11. Income (or loss) - TRUSTS AND ESTATES ONLY- from page 4, Schedule G, line 7 (see instructions for exemption to enter on line 15)
Total (add lines 6 through 11 of last column)
12.
13. Less: Deductions from page 2, Schedule M, line 5 (if none, enter zero).
14.
Total (line 12 less line 13)
15. Less Amount for Exemptions: Enter number of exemptions from line 4 above
16.
TOTAL INCOME SUBJECT TO TAX
17. CITY OF DETROIT TAX: Multiply line 16 by .005 (½%).
PAYMENTS AND CREDITS
18. a. Tax withheld by employer - from line 6 above - ATTACH Forms DW-2 or W-2.
19.
b. Payments and credits on 1976 Declaration of Estimated Detroit Income Tax
c. Other Credits - explain in attached statement (See Instructions)
TOTAL Add Lines 18a, b, and c
TAX DUE OR REFUND
95,462172
95,462,72
2
and multiply by $600.
$. 1,200,00
94,262172
$.
47131
1,080,00
$.
4,080,00
608 169
20. If your payments (line 19) are larger than your tax (line 17), enter amount of OVERPAYMENT
21. Check box if you wish overpayment on line 20 to be: (A) ☐ Credited on 1977 Estimated Tax or (B) ☑ Refunded.
22. If your tax (line 17) is larger than your payments (line 19) enter amount of BALANCE DUE Pay in full with this return. • $
Make check payable to: "TREASURER, CITY OF DETROIT." A balance due of less than one dollar ($1.00) need not be paid.
I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct and
complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN HERE
SIGN
HERE
(Taxpayer's signature and date)
(Signature of preparer other than taxpayer)
(Date)
SIGN HERE.
(Spouse's signature and date) (If joint return, BOTH HUSBAND AND WIFE MUST SIGN)
GORDON L HOLLANDER, P.C.
CERTIFIED PUBLIC ACCOUNTANT
NW 88326 Docid:24245595 Finage28epartment, Treasury Division, 104 City-County 1ST ROAD26
DETUDAIS ALLIST DE BLER DV ADDI
Mich. Dept. of Treasury
C-8000K ☐
Schedule of Partners or Shareholders-
Partnership, Subchapter S Corp., Professional Corp.
See instructions on reverse side
1
Name:
Cobo-Rumar Sales, Inc.
2 Account Number:
38-1812707
EAR SUMMARY
3 Total Number of Partners or Shareholders...
4 Total Number of Qualified Partners or Shareholders from Part II-enter here and on C-8000, line 60a.. 4
QUALIFIED PARTNERS OR SHAREHOLDERS
PAR
NAME AND ADDRESS
Earl Ruby
4380 Stoney River; Birm.
1976
B SOCIAL
SECURITY NO.
C % D SHAREHOLDER'S
Time SALARY
E
%
PARTNER'S or SHAREHOLDER'S
Own. F Share of Bus. Inc. | G Share of SBT Paid
100%
18,000 00 100%
| 00
100
%
100
%
1 00
100
09
%
80
00
%
| 00
00
29
%
| 00
b°
%
100
_
_|
%
1 00
%
| 00.
00
%
| 00
6°
%
| 00
100
80
%
100
29
%
100
100
29
%
00
bi
%
| 00
00
%
| 00
%
100
00
AS
%
100
%
100
100
[PART NON-QUALIFIED PARTNERS OR SHAREHOLDERS. If more space is needed submit separate schedule and enter totals on line 7.
100
29
%
100
8
| 00
100
%
1.00
| 00
100
8
29
%
| 00
00
| 00
| 00
29
%
100
8
| 00
69
%
100
100
00
29
%
| 00
100
100
%
10
00
| 00
100
১৭
%
100
8
100
100
6°
%
| 00
1.00
100
8
%
100
100
NW 88326 Doold:32245535 iPage 210m)
| 00
%
00
8l
00
7
100
☑
1.00
1.00
Reference copy, JFK Collection:
ESCA (RG 233)

MANUELLO
Calendar Year
OR FISCAL YEAR
Beginning
Ending
DAVE
1976
☑ INDIVIDUAL (Check)
☐ FIDUCIARY One)
Mo.
Day
Yr.
09
30
76
19.
19.
Retroactive Date
If this return is for an Estate, give Probate.
File No.
County
THIS NUMBER WHEN SUBMITTING PAYMENT, OR IN CORRESPON
RUBY EARL & MARGIE
18135 LIVERNOIS AVE
DETROIT MI
FOR OFFICE USE ONLY
698855
i
48221
Husband's Social Security No.
698855
Intangible Account Number
007 82
Type
County
City
POSTED:
K
с
Date of Death
76 12
File Date
AUDITED:
Wife's Social Security No.
Employer Identification No.
Reference copy, JFK Collection:
TIL
TT
ESCA (RG 233)
LINE
NO.
Computation of Tax Due
1. Accounts and Notes Receivable (non-income producing only)
2. Less Accounts and Notes Payable
3. Balance Taxable @ 1/10th of 1%
4. Accounts and Notes Receivable (income producing only)
5. Less Accounts and Notes Payable (use only that portion, if any, not used in Line 2)
6. Balance Taxable
7. Income applicable to balance
8. Tax 32% of income (Line 7) or 1/10th of 1% of Balance (Line 6), whichever is greater.
9. Stocks and Bonds Schedule A, Column 9.
10. Mortgages and Land Contracts Schedule B, Column 8.
LINE
AMOUNT
TAX
NO.
1.
2.
4.
5.
6.
- 2 3 4 5 6 7
7.
8.
9.
237623
10.
11. Annuities ----- Schedule C, Column 9.
11.
12. Beneficiary Return (attach copy hereto)
12.
13.
TOTAL
13.
2,376.23
14.
15.
Less Statutory deduction ($175.00 or $350.00 by husbands and wives filing joint return).
BALANCE DUE
350 00
14.
15.
2.026.23
16. Cash on Hand or in Transit as of retroactive date (include cash in safety deposit boxes)
17. Bank Deposits in Banks Located Outside of Michigan
18. Savings in Building and Loan Ass'ns. Located Outside of Michigan
19. TOTAL
20. TAX @ 20¢ per $1000.00 of Line 19
16.
or Withdrawn from Mich.
Banks or Ass'ns. after
RETROACTIVE DATE.
17.
18.
19.
20.
21.
22.
23.
24.
TOTAL TAX DUE (Line 15 plus Line 20)
21.
2,02623
Less Advance Payment of Tax
22.
TOTAL TAX DUE
Penalties & Interest; Penalty
23.
2,026.23
%, S.
; Interest
%
Months, S.
24.
25.
2,02623
25. TOTAL AMOUNT DUE WITH THIS RETURN (Due on or before April 30).
Or Four Months after End of Authorized Fiscal Year
Make Remittance Payable To: 'STATE OF MICHIGAN' Write your Intangible Account No. on your check.
Mail To: MICHIGAN DEPARTMENT OF TREASURY, TREASURY BUILDING, LANSING, MICHIGAN 48922
Business or Profession of Taxpayer:
SALES
Year of Last Return Filed:
1975
Amount Single Business Tax Paid:
Address of Last Return:
Check which Method your return is Computed by.
☑ RETROACTIVE DATE
SAME
MONTHLY AVERAGE
I declare under the penalties imposed by Act No. 301 P.A. of 1939, as Amended.
that this return, incluiting any monompanying behartules and statements has been
examined by me and to the best of my knowledge and belief is a true, correct
and complete return.
Prepared By:
GORDON L HOLLANDER, P.C.
CERTIFIED PUBLIC ACCOUNTANT
NW-88326 Docid:3224353M MILE ROAD
Single Business Tax Account No.:
Telephone Number:
863.0400
NOTE: If this return is from a Trustee, attach a list of Names and
Addresses of Beneficiaries and Date of Creation of Trust.
Signature
Signature
Title: (State whether Individual, Owner, Executor, Administrator, Trustee, etc.)
► Attach State Copy of Form W-2 Here<
MICHIGAN INDIVIDUAL INCOME TAX RETURN
for 1975, or taxable year beginning
▼ First name and initial (if joint return, use first names and initials of both)
Please Print or Type
Earl R. and Marge
Home address (number and street or rural route)
18135 Livernois
City, town or post office, and State
Detroit, Michigan
Residency Status during tax year:
☑ Resident
Filing Status:
A ☐ Single
☐ Non-resident
B ☑ Married, filing jointly
☐ Married, filing separately (see instructions, page 2)
Name of Spouse
Last name
Ruby
1975, ending
19
ZIP code
48221
Part-year resident, from
1. Exemptions:
to
Your social security number.
Your occupation
Sales
Spouse's social security no.
Spouse's occupation
(a) Enter here the number of exemptions claimed on your
federal income tax return..
(b) Special exemption for paraplegics & quadriplegics. [Instructions]
(c) TOTAL EXEMPTIONS, add lines 1(a) and 1(b).
4
AP
4
Do you wish to designate $2.00 of your taxes for this fund? +2
If joint return, does your spouse wish to designate $2.00?.....
YES ☑ NO
☐ YES ☑ NO
NOTE: If you check the 'YES' boxes
it will not increase your tax
reduce your refund.
or
(Give spouse's Soc. Sec. No. in the space provided)
STATE
2.
CAMPAIGN FUND
3. Adjusted gross income as defined in the Internal Revenue Code and which should be reported on Federal Form 1040,
Attach copies of any Federal schedules 
that indicate a loss or deduction
line 15, or 1040 A, line 12 from gross income. (See page 5 of the instructions)
4. Additions to adjusted gross income, (from page 2, line 35).
5. Total, add lines 3 and 4. .
$3.
178,036/18
4:
5.
178,03618
6-
6. Subtractions from adjusted gross income, (from page 2, line 44).
7. Subtract line 6 from line 5
8. Residents multiply exemptions claimed on line 1 by $1,500.00 (part-year and nonresident allowance from line 48)
9. Income subject to tax (subtract line 8 from line 7)..
10. Tax: multiply line 9 by 4.37% (.0437).
8
178,036/18
6000 00
9.
172,036 18
10.
7,51798.
CREDITS (See instructions - pages 7-10)
11. Income tax paid to Michigan cities.
411·
AMOUNT PAID
100/89
CREDIT
lla.
2009
12. Contributions to Michigan colleges & universities (attach receipts). 12
13. Income tax paid to another state (attach copy of return).
14. Total credits (add lines 11a, 12a, and 13a), enter total here.
15. Income tax, subtract line 14 from line 10 (if line 14 is greater than line 10, enter 'NONE')
16. Credits from any MI-1040 CR form. (see page 9 of instructions).
12a..
13.
13a
14.
2009
15
7.49789
16
Attach Check or Money Order Here ◄
18. Enter 1975 homestead property tax or amount from line 59
19. Tax not eligible for credit, enter 3.5% (.035) of line 17..
20. Subtract line 19 from line 18, if line 19 is greater, enter 'NONE'
21. Property tax credit, 60% (.60) of line 20, ($500.00 maximum)
22. Personal property tax paid on inventory. 22
Do not complete lines 17 thru 21 if you have claimed a credit on line 16.
17. Household income from line 56
17
18
19.
20.
X 39% (.39). .
22
21.
22.
23
24. Michigan estimated tax payments
24
2,157150
4,000
00
25
PAYMENTS
23. Michigan tax withheld (attach State copy of W-2).
25. 1974 overpayment credited to 1975.
26. Add lines 16, 22, 23, 24, and 25,/or lines 21, 22, 23, 24, and 25
27. If line 26 is less than line 15, enter BALANCE OF TAX DUE HERE.
28. If line 26 is greater than line 15, enter AMOUNT OVERPAID.
29. Amount of line 28 to be REFUNDED TO YOU..
30. Amount of line 28 to be credited to 1976 estimated tax.
30
This return is due April 15, 1976 or on the 15th day of the fourth month after the close of your tax year.
Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and
statements, and to the best of my knowledge and belief it is true. correct and complete. If prepared by a 
person
.
other than the taxpayer, his declaration is based on all information of which he has any knowledge.
Sign
Your signature
NW 88926 Docid:32245535.
Date
1:32245535 Page 213 BOTH must sign even if only one had income)
26.
PAY
27
6,15750
34039
28.
29
REFUND
NOTE: If all of overpayment (line 28) is to be
refunded (line 29), make no entry on line 30.
OFFICE USE
GORDUN" I "HOLLANDER, F.C.
CERTIFIED PUBLIC ACCOUNTANT
WEST TFM
Date
Reference copy, JFK Collection:
ESCA (RG 233)
!
pre expected in 1976
2. Exemptions (number of allowable exemptions times $1.500.00).
3. Subtract line 2 from line 1. (This is your estimated taxable income)
4. Estimated tax (line 3 times .046 or 4.6%).
5. LESS: Total estimated tax credit for Michigan City income taxes, personal property tax on inventories.
Michigan homestead property taxes and contributions to Michigan colleges and universities
6. Subtract line 5 from line 4. Enter here and on line 1 below
MICHIGAN DECLARATION OF ESTIMATED INCOME TAX FOR INDIVIDUALS- 1976
FORM
MICHIGAN
MI-1040-ES
For calendar year 1976 or fiscal year ending.
19.
THE
GREAT
Lant
STATE OF MICHIGAN
Department of Treasury
STATE
First name and initial (if joint declaration, use names and initials of both)
Last name
Please
print
Address (number and street)
or type
City, State, and ZIP code
1. Your estimate of 1976 income tax
2. Estimated income tax withheld and to be withheld during entire year of 1976 .
3. ESTIMATED TAX (line I less line 2). (If less than $100, no declaration is required).
4. COMPUTATION OF INSTALLMENT. Check proper box below and enter amount indicated.
If this declaration is (☐ April 15, 1976, enter 1/4 of line 3;
☐ September 15, 1976, enter 1/2 of line 3)
(☐ June 15, 1976, enter 1/3 of line 3;
☐ Jan. 15, 1977, enter amount on line 3
due to be filed on:
5. If you had an overpayment on your 1975 income tax return which you elected to have applied as a
credit against your 1976 estimated tax, enter the amount here.
6. To apply entire overpayment credit to this installment and any excess to the next, enter here the amount on line 5. To spread
credit evenly.to each installment, divide it by number of installments and enter results here.
7. Amount to be paid with this declaration at time of filing (line 4 less line 6).
8. Note: The payment of the estimated tax (line 3 less any 1975 overpayment credit) with this return eliminates the filing of
quarterly estimates. Enter lump sum payment here.
I have examined this declaration and to the best of my knowledge it is correct.
Your social security number
Spouse's social security number
Signature(s).
Date...
19....
If joint estimate, both husband and wife must sign
MICHIGAN DECLARATION OF ESTIMATED INCOME TAX FOR INDIVIDUALS- 1976
MICHIGAN
For calendar year 1976 or fiscal year ending.
19.
THE
GREAT
STATE
STATE OF MICHIGAN
Department of Treasury
FORM
MI-1040-ES
Your social security number
Please
print
or type
First name and initial (if joint declaration, use names and initials of both)
Earl R. and Marge
Address (number and street)
18135 Livernois
City, State, and ZIP code
Detroit, Michigan
1. Your estimate of 1976 income tax
48221
Last name
Ruby
2. Estimated income tax withheld and to be withheld during entire year of 1976
3. ESTIMATED TAX (line 1 less line 2). (If less than $100, no declaration is required).
4. COMPUTATION OF INSTALLMENT. Check proper box below and enter amount indicated.
Spouse's social security number
5,600.00
5.600.00
If this declaration is
due to be filed on:
☑ April 15. 1976, enter 1/4 of line 3;
☐ June 15, 1976, enter 1/3 of line 3;
☐ September 15, 1976, enter 1/2 of line 3)
1,400.00
☐ Jan. 15, 1977, enter amount on line 3.
5. If you had an overpayment on your 1975 income tax return which you elected to have applied as a
credit against your 1976 estimated tax, enter the amount here..
6. To apply entire overpayment credit to this installment and any excess to the next, enter here the amount on line 5. To
spread credit evenly to each installment, divide it by number of installments and enter results here.
7. Amount to be paid with this declaration at time of filing (line 4 less line 6)..
8. Note: The payment of the estimated tax (line 3 less any 1975 overpayment credit) with this return eliminates the filing
of quarterly estimates. Enter lump sum payment here
NW 88322245535
ion and to the best of my knowledge it is correct.
Date
1,400.00
19.
ESCA (RG 233)
Reference copy, JFK Collection:
PLEASE
PRINT
OR
D-1040 (NR)
CITY OF
DETROIT
First Name and Initial
CITY OF DETROIT INCOME TAX
INDIVIDUAL RETURN NONRESIDENT
or other taxable year beginning.
Earl R. and Marge
Last Name
Ruby
-
1975, ending
(If joint return of husband and wife, use first names and middle initials of both).
Home Address (Number and Street or Rural Route)
1975
19
Your Social Security Number
Your Occupation
Sales
EXTENSION NUMBEI
If you are an
EMPLO
enter your Federal EMPLO
Identification No. here:
Spouse's Social Security Number
TYPE
18135 Livernois
City, Town or Post Office
'
State
Detroit, Michigan
Postal Zip Code
48221
APP.
Spouse's Occupation
IP
FP
OA.
A.
If married, is spouse filing a separate return? ☐ YES
☑ NO. If yes, enter spouse's first name.
00
Attach Copy of Form DW-2 or W-2 Here
B.
Enter the name and address used on your return for 1974 (If the same as above write "Same". If different, indicate date
moved.) If none filed, give reason.
Same
SCHEDULE A EXEMPTIONS
1. YOURSELF
SPOUSE
2. Enter first names of each of your DEPENDENT CHILDREN who lived with you:
Denise, Joyce
3.
OTHER
DEPENDENTS
NAME
Enter figure 1 in the last column to
right for each name listed
Auditor
Regular
☑
☑
ㅁㅁ:
65 or over
Blind
Enter
number of
exemptions
checked
Enter
Relationship
Months lived in
your home during.
1975
4. Total exemptions from lines 1, 2 and 3; enter here and on line 15 below.
INCOME
(If joint return, include all income of both husband and wife)
Total wages reported
5. Enter GROSS income from employers for wages, salaries, commissions, tips, etc. - indicate (W) for wife
Employer's Name
Cobo
6.
CLEANERS, INC.
Where employed (City and State)
DET, MICH.
on DW-2 or W-2
$.
70,000'00
TOTALS
Detroit Income Tax
Withheld
22900
.........
501011
3390
00
WAGES, ETC. EARNED
IN DETROIT
35,000,00
8,25050
43,250100
....
39613
7,508100
16.50000
86,500.00
7. Rental income (or loss) from tangible property in the City of Detroit - from page 2, Schedule B, line 4.
8. Other income (or loss) from partnerships, etc. - from page 2, Schedule F, line 4.
9. Gain (or loss) from sale or exchange of tangible property in the City of Detroit - from page 3, Schedule E, line 10.
10. Net profit (or loss) from business - from page 3, Schedule C, line 8
11. Income (or loss) - TRUSTS AND ESTATES ONLY— from page 4, Schedule G, line 7 (see instructions for exemption to enter on line 15)
Total (add lines 6 through 11 of last column)
12.
13. Less:
14.
Deductions from page 2, Schedule M, line 5 (if none, enter zero).
Total (line 12 less line 13)
16.
4
and multiply. by $600.
46,154,13
46,154' 13.
2,400,00
43,754113
Attach Check or Money Order Here
15. Less Amount for Exemptions: Enter number of exemptions from line 4 above
TOTAL INCOME SUBJECT TO TAX
17. CITY OF DETROIT TAX: Multiply line 16 by .005 (½%).
PAYMENTS AND CREDITS
18. a. Tax withheld by employer - from line 6 above - ATTACH Forms DW-2 or W-2.
19.
b. Payments and credits on 1975 Declaration of Estimated Detroit Income Tax
c. Other Credits - explain in attached statement (See Instructions)
TOTAL Add Lines 13a, b, and c
TAX DUE OR REFUND
20. If your payments (line 19) are larger than your tax (line 17), enter amount of OVERPAYMENT
218.77
$.
33900
I
33900
$.
120123
21. Check box if you wish overpayment on line 20 to be: (A) ☐ Credited on 1976 Estimated Tax or (B) ✓ Refunded.
22. If your tax (line 17) is larger than your payments (line 19) enter amount of BALANCE DUE Pay in full with this return... $.
Make check payable to: "TREASURER, CITY OF DETROIT." A balance due of less than one dollar ($1.00) need not be paid.
SIGN
HERE
(Taxpayer's signature and date)
SIGN HERE
I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct and
complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN HERE
GORDON L. HOLLANDER, P.C.
NW 88326 Docid:32245535 Rage21ate) (If joint return, BOTH HUSBAND AND WIFE MUST SIGN) CERTIFIED PUBLIC ACCOUNTANT‍)
(Signature of preparer other than taxpayer)
(Date)
ESCA (RG 233)
Reference copy, JFK Collection:
1 1 1
"
***Litl UT TREASUNT
Revenue Division
THIS NUMBER WHEN SUBMITTING PAYMENT, OR IN CORRESPONE
نار..
El
INTANGIBLES TAX RETURN
Calendar Year 19.
OR FISCAL YEAR
Beginning.
Ending_
19.
19.
Individual.
Partnership_
Check
Michigan Corporation
One
Foreign Corporation
Fiduciary
MONTH
DAY
YEAR
11
30
75
RUBY EARL & MARGIE
18135 LIVERNOIS AVE
DETROIT ΜΙ
DO NOT WRITE ABOVE THIS LINE
69885i
5
ESCA (RG 233)
་
48221
RETROACTIVE DATE
Line Computation of Tax Due
No.
1. Accounts and Notes Receivable (non-income producing only)_
2. Less Accounts and Notes Payable.
3. Balance Taxable @ 1/10th of 1%-
4. Accounts and Notes Receivable (income producing only)_
5. Less Accounts and Notes Payable (use only that portion, if any, not used in Line 2).
6. Balance Taxable
7. Income applicable to balance.
8. Tax @ 32% of Income (Line 7) or 1/10 of 1% of Balance (Line 6), whichever is greater..
9. Stocks and Bonds. Schedule A, Column 9.-
10. Mortgages and Land Contracts Schedule B, Column 8.
698855
007
82
75
12
ACCOUNT NO.
TYPE
COUNTY
CITY
. K
C
FILE DATE
AMOUNT
POSTED
FILED
✓ IF THIS RETURN IS FO
County.
File No.
ESTATE GIVE PROBA
Date of Death.
Line
ΤΑ
No.
1.
2.
3.
4.
5.
6.
Reference copy, JFK Collection:
☐☐
| | ||
7.
1
8.
9.
2952
K
10.
11. Annuities ----- Schedule C, Column 9.
11
12. Beneficiary Return (attach copy hereto)
12.
29528
13.
14.
TOTAL
13.
15.
16. Cash on Hand or in Transit as of retroactive date (include cash in safety deposit boxes).
17. Bank Deposits in Banks Located Outside of Michigan.
18. Savings in Building and Loan Ass'ns. Located Outside of Michigan.
or Withdrawn from Mich.
Banks or Ass'ns. after
Less Statutory deduction ($175.00 or $350.00 by husbands and wives filing joint return)
BALANCE DUE
35
14.
15.
16.
17.
18.
RETROACTIVE DATE.
19. TOTAL
20. TAX @ 40¢ per $1000.00 of Line 19_
21.
TOTAL TAX DUE (Line 15 plus Line 20).
22.
Less Advance Payment of Tax
23.
TOTAL TAX DUE
2
24.
Penalties & Interest; Penalty
25.
TOTAL AMOUNT DUE
19.
20.
21
260287
22.
260287
23.
%, $
Interest_
-%-
Months,
24.
25.
26028-
MAKE REMITTANCE PAYABLE TO STATE OF MICHIGAN
Please forward Remittance for Amount Shown Here on or before April 30.
To: MICHIGAN DEPARTMENT OF TREASURY, LANSING, MICH. 48922
(or four months after end of authorized fiscal year)
IMPORTANT Be Sure to Answer the following Question When Applicable.
1. Business or Profession of Taxpayer_
2. Give year of last return filed.
1974
SALES
Address of Last Return.
SAME
SAME
3. Check here if return is computed on a Retroactive Date Method.
863-0400
_Phone No..
4. If taxpayer is a corporation give State and Date of Incorporation.
_or Monthly Average Method
Federal Employers Identification Number_
5. If this is the return of a Trustee attach list of names and addresses of beneficiaries and date of creation of trust.
6. If this is a Business Return a copy of the Balance Sheet as of the close of the Tax Year must be attached.
1 declare under the penalties Imposed by Art No. 301 P. A. of 1939, as Amended, that this return, Including any accompanying schedules and statements (has been examined by
and to the best of my knowledge and belief is a true, correct and complete return.
Return Prepared by_
GORDON L. HOLLANDER, P.C.__
CERTIFIED PUBLIC ACCOUNTANT
NW 88326, Docid:32245535 P5216EST TEN MILE ROAD
Social Security Number
Signed
Signed
TiAt-
SCHEDULE SHAREHOLDERS SHARE OF INCOME AND CREDITS
(if additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
(2)
Social Security
Number
(a). EARL
RUBY
11300 этому RIVER DR. BIRM.MI
(b). ESTATE OF GEORGE MARCUS
60 W. WARNINGTON #1150 CHICAGO, IL 60602
(c)
(d).
(e)
(f)
(g)
(h)
(i)
(j)
(3)
Number of
Shares
(4)
Amount taxable as ordinary
income (schedule K, total of
lines 4 and 8, U.S. 1120-S)
7,500
46,840,04
7,500
46.840.05
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6.
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 34 or
on page 2, schedule 2, line 43)
-difference between column 4
and column 5
(See instructions)
(7)
pro-
Enter here and on form
MI-1040, page 1, line 22
each shareholder's
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(See instructions)
(8)
Enter here and on form
MI-1040, each shareholder's
proportionate share of Single
business tax paid.
(See instructions)
(a)
46.840.04
(b)
46,840.05
(c)
(d).
(e)
(f)
(g)
(h)
(i)
(j).
NW 88326 Docld:32245535 Page 216
PAGE 3 OF S
Reference copy, JFK Collection:
ESCA (RG 233)
► Attach State Copy of Form W-2 Here ◄
MICHIGAN INDIVIDUAL INCOME TAX RETURN
Please Print or Type
for 1975, or taxable year beginning
First name and initial (if joint return, use first names and initials of both)
Earl R. and Marge
Home address (number and street or rural route)
18135 Livernois
City, town or post office, and State
Detroit, Michigan
Residency Status during tax year:
☑ Resident
0 Filing Status:
A
Single
☐ Non-resident
B ☑ Married, filing jointly
C ☐ Married, filing separately (see instructions, page 2)
Last name
Ruby
1975, ending
19
ZIP code
48221
Part-year resident, from
1. Exemptions:
to
Your social security number_
Your occupation
Sales
Spouse's social security no.
Spouse's occupation
(a) Enter here the number of exemptions claimed on your
federal income tax return..
(b) Special exemption for paraplegics & quadriplegics. [Instructions]
(c) TOTAL EXEMPTIONS, add lines 1(a) and 1(b).
4.
Name of Spouse
2.
(Give spouse's Soc. Sec. No. in the space provided)
STATE
Do you wish to designate $2.00 of your taxes for this fund?
$2
CAMPAIGN FUND
If joint return, does your spouse wish to designate $2.00?.....
YES ☑ NO
YES ☑ NO
NOTE: If you check the 'YES' boxes
it will not increase your tax
reduce your refund.
or
3. Adjusted gross income as defined in the Internal Revenue Code and which should be reported on Federal Form 1040,
Attach copies of any Federal schedules 
that indicate a loss or deduction
line 15, or 1040 A, line 12 from gross income. (See page 5 of the instructions)
4. Additions to adjusted gross income, (from page 2, line 35).
5. Total, add lines 3 and 4...
6. Subtractions from adjusted gross income, (from page 2, line 44).
7. Subtract line 6 from line 5
8. Residents multiply exemptions claimed on line 1 by $1,500.00 (part-year and nonresident allowance from line 48)
Income subject to tax (subtract line 8 from line 7)..
10. Tax: multiply line 9 by 4.37% (.0437).
3.
178,036/18
4
5.
178,036 18
6
03618
+8'
9.
172,036 18
10.
7,51798
CREDITS (See instructions - pages 7-10)
11. Income tax paid to Michigan cities.
AMOUNT PAID
100/89
CREDIT
lla.
2009
12. Contributions to Michigan colleges & universities (attach receipts). 12
13. Income tax paid to another state (attach copy of return). .
14. Total credits (add lines 11a, 12a, and 13a), enter total here.
15. Income tax, subtract line 14 from line 10 (if line 14 is greater than line 10, enter 'NONE')
16. Credits from any MI-1040 CR form. (see page 9 of instructions)
12a.
13.
13a.
14.
20/09
15
7.49789
16
► Attach Check or Money Order Here ◄
Do not complete lines 17 thru 21 if you have claimed a credit on line 16.
17. Household income from line 56
€17
18. Enter 1975 homestead property tax or amount from line 59
19. Tax not eligible for credit, enter 3.5% (.035) of line 17..
18
19.
20.
X 39% (.39).
22
21.
22.
20. Subtract line 19 from line 18, if line 19 is greater, enter 'NONE'
21. Property tax credit, 60% (.60) of line 20, ($500.00 maximum)
22. Personal property tax paid on inventory. 22
PAYMENTS
23. Michigan tax withheld (attach State copy of W-2).
24. Michigan estimated tax payments
25. 1974 overpayment credited to 1975.
26. Add lines 16, 22, 23, 24, and 25,/or lines 21, 22, 23, 24, and 25
27. If line 26 is less than line 15, enter BALANCE OF TAX DUE HERE.
28. If line 26 is greater than line 15, enter AMOUNT OVERPAID
29. Amount of line 28 to be REFUNDED TO YOU...
30. Amount of line 28 to be credited to 1976 estimated tax.
30
23
24
998
25
This return is due April 15, 1976 or on the 15th day of the fourth month after the close of your tax year.
Under penalties of perjury. I declare that I have examined this return, including accompanying 
schedules and
statements, and to the best of my knowledge and belief it is true. correct and complete. If prepared 
by a person
other than the taxpayer, his declaration is based on all information of which he has any knowledge
.
2,157150
4,0.
00
000
PAY
26.
27
6,15750
1,340/39
28.
29
REFUND
......
NOTE: If all of overpayment (line 28) is to be
refunded (line 29), make no entry on line 30.
OFFICE USE
Date
Signature of preparer other than taxpayer
Date
Sign
Here
Your signature
NW 88326 Docid 32245535 rep 17. BOTH must sign even if only one had income)
CERTIFIED PUBLIC ACCOUNTANT
122
"
Mail return and
19675
WEST TEN MILE ROAD Drawer H, Lansing 48904
Reference copy, JFK Collection:
ESCA (RG 233)
3.
00
Attach Copy of Form DW-2 or W-2 Here
D-1040 (NR)
CITY OF
DETROIT
First Name and Initial
CITY OF DETROIT INCOME TAX
INDIVIDUAL RETURN
or other taxable year beginning.
Earl R. and Marge
PLEASE
PRINT
OR
Last Name
Ruby
NONRESIDENT
1975, ending
(If joint return of husband and wife, use first names and middle initials of both)
Home Address (Number and Street or Rural Route)
1975
19.
Your Social Security Number
Your Occupation
Sales
EXTENSION NUMBE
If you are an
enter your Federal EMPLO
Identification No. here:
EMPLO
Spouse's Social Security Number
TYPE
18135 Livernois
City, Town or Post Office
State
Detroit, Michigan
Postal Zip Code
48221
APP.
Spouse's Occupation
IP
FP
OA.
A.
If married, is spouse filing a separate return?
☐ YES
☑ NO. If yes, enter spouse's first name...
B.
Enter the name and address used on your return for 1974 (If the same as above write "Same". If different, indicate date
moved.) If none filed, give reason.
Same
SCHEDULE A
-
EXEMPTIONS
• 1. YOURSELF
SPOUSE
2. Enter first names of each of your DEPENDENT CHILDREN who lived with you:
Denise, Joyce
OTHER
DEPENDENTS
NAME
Enter figure 1 in the last column to
right for each name listed
ESCA (RG 233)
Reference copy, JFK Collection:
Auditor
Regular
☑
65 or over
Blind
Enter
number of
exemptions
checked
☑
Enter Ma.
Relationship
Months lived in
your home during
1975
4. Total exemptions from lines 1, 2 and 3; enter here and on line 15 below.
INCOME
(If joint return, include all income of both husband and wife) `
5. Enter GROSS income from employers for wages, salaries, commissions, tips, etc. - indicate (W) for wife
Employer's Name
6.
Coso
CLEANERS, INC.
Where employed (City and State)
DET, MICH.
TOTALS
Total wages reported
on DW-2 or W-2
lf
70 00000
16.50000
86,500,00
7. Rental income (or loss) from tangible property in the City of Detroit - from page 2, Schedule B, line 4.
8. Other income (or loss) from partnerships, etc. — from page 2, Schedule F, line 4.
Detroit Income Tax
Withheld
22900
110105
33900
9. Gain (or loss) from sale or exchange of tangible property in the City of Detroit - from page 3, Schedule E, line 10.
10. Net profit (or loss) from business - from page 3, Schedule C, line 8
....
11. Income (or loss) - TRUSTS AND ESTATES ONLY- from page 4, Schedule G, line 7 (see instructions for exemption to enter on line 15)
12.
Total (add lines 6 through 11 of last column)
13. Less: Deductions from page 2, Schedule M, line 5 (if none, enter zero).
Total (line 12 less line 13)
14.
15. Less Amount for Exemptions: Enter number of exemptions from line 4 above
TOTAL INCOME SUBJECT TO TAX
16.
17. CITY OF DETROIT TAX: Multiply line 16 by .005 (1%).
PAYMENTS AND CREDITS
18. a. Tax withheld by employer - from line 6 above - ATTACH Forms DW-2 or W-2.
b. Payments and credits on 1975 Declaration of Estimated Detroit Income Tax
4
and multiply by $600.
4
WAGES, ETC. EARNED
IN DETROIT
35,000,00
8,250600
43,250100
396,13
3,508100
46,154,13
1
46,154113
2,400,00
43,754113
$
218.77
33900
|
Attach Check or Money Order Here
c. Other Credits
-
explain in attached statement (See Instructions)
19.
TOTAL Add Lines 13a, b, and c
TAX DUE OR REFUND
33900
$
120123
20. If your payments (line 19) are larger than your tax (line 17), enter amount of OVERPAYMENT
21. Check box if you wish overpayment on line 20 to be: (A) ☐ Credited on 1976 Estimated Tax or (B) ☑ Refunded.
22. If your tax (line 17) is larger than your payments (line 19) enter amount of BALANCE DUE Pay in full with this return...
Make check payable to: "TREASURER, CITY OF DETROIT." A balance due of less than one dollar ($1.00) need not be paid.
I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct and
complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN HERE
SIGN
HERE
SIGN HERE
19
(Signature of preparer other than taxpayer)
(Date)
(Taxpayer's signature and date)
GORDON L HOLLANDER, P.C..
(Spouse's signature and date) (if joint return, BOTH HUSBAND AND WIFE MUST SIGN) CERTIFIED PUBLIC ACCOUNTANT)
NW 88326 Docid:32745575; Faun&618epartment, Treasury Division, 104 City-C 1967 WESTEN MILER 48226
"
og tapered in 19/6
2. Exemptions (number of allowable exemptions times $1,500.00)
3. Subtract line 2 from line 1. (This is your estimated taxable income)
4. Estimated tax (line 3 times .046 or 4.6%).
5. LESS: Total estimated tax credit for Michigan City income taxes. personal property tax on inventories,
Michigan homestead property taxes and contributions to Michigan colleges and universities.
6. Subtract line 5 from line 4. Enter here and on line 1 below
MICHIGAN DECLARATION OF ESTIMATED INCOME TAX FOR INDIVIDUALS- 1976
FORM
MI-1040-ES
MICHIGAN
For calendar year 1976 or fiscal year ending.
19--
STATE OF MICHIGAN
Department of Treasury
THE
GREAT
LAVE
STATE
First name and initial (if joint declaration, use names and initials of both)
Please
print
Address (number and street)
or type
City, State, and ZIP code
Last name
1. Your estimate of 1976 income tax
2. Estimated income tax withheld and to be withheld during entire year of 1976
3. ESTIMATED TAX (line 1 less line 2). (If less than $100, no declaration is required).
4. COMPUTATION OF INSTALLMENT. Check proper box below and enter amount indicated.
☐ September 15, 1976, enter 1/2 of line 3
If this declaration is
due to be filed on:
☐ April 15, 1976, enter 1/4 of line 3;
☐ June 15, 1976, enter 1/3 of line 3;
☐ Jan. 15, 1977, enter amount on line 3
5. If you had an overpayment on your 1975 income tax return which you elected to have applied as a
credit against your 1976 estimated tax, enter the amount here.
6. To apply entire overpayment credit to this installment and any excess to the next, enter here the amount on line 5. To spread
credit evenly to each installment, divide it by number of installments and enter results here..
7. Amount to be paid with this declaration at time of filing (line 4 less line 6).
8. Note: The payment of the estimated tax (line 3 less any 1975 overpayment credit) with this return eliminates the filing of
quarterly estimates. Enter lump sum payment here
I have examined this declaration and to the best of my knowledge it is correct.
Signature(s).
Your social security number
Spouse's social security number
Date...
19.
If joint estimate, both husband and wife must sign
MICHIGAN DECLARATION OF ESTIMATED INCOME TAX FOR INDIVIDUALS- 1976
MICHIGAN
For calendar year 1976 or fiscal year ending.
19-
THE
GREAT
STATE
STATE OF MICHIGAN
Department of Treasury
FORM
MI-1040-ES
Your social security number
Please
print
or type
First name and initial (if joint declaration, use names and initials of both)
Earl R. and Marge
Address (number and street)
18135 Livernois
City, State, and ZIP code
Detroit, Michigan
1. Your estimate of 1976 income tax
48221
Last name
Ruby
2. Estimated income tax withheld and to be withheld during entire year of 1976
3. ESTIMATED TAX (line 1 less line 2). (If less than $100, no declaration is required).
Spouse's social security number
5,600.00
5,600.00
☐ September 15, 1976, enter 1/2 of line 3)
1,400.00
June 15, 1976, enter 1/3 of line 3;
☐ Jan. 15, 1977, enter amount on line 3
4. COMPUTATION OF INSTALLMENT. Check proper box below and enter amount indicated.
If this declaration is (☑ April 15, 1976, enter 1/4 of line 3;
due to be filed on:
5. If you had an overpayment on your 1975 income tax return which you elected to have applied as a
credit against your 1976 estimated tax, enter the amount here.
6. To apply entire overpayment credit to this installment and any excess to the next, enter here the amount on line 5. To
spread credit evenly to each installment, divide it by number of installments and enter results here.
7. Amount to be paid with this declaration at time of filing (line 4 less line 6).
8. Note: The payment of the estimated tax (line 3 less any 1975 overpayment credit) with this return eliminates the filing
of quarterly estimates. Enter lump sum payment here
I have examined this declaration and to the best of my knowledge it is correct.
1,400.00
NW 88326tDocld:32245535.. Page 219...
hand and wife must cian
Date....
19.
ESCA (RG 233)
Reference copy, JFK Collection:
Lif UT TREASUNT
Revenue Division
INTANGIBLES TAX RETURN
Calendar Year 19.
OR FISCAL YEAR
Beginning.
19.
Ending.
19.
Individual_
Partnership.
Check
Michigan Corporation
One
Foreign Corporation
Fiduciary
MONTH
DAY
YEAR
30
75
نادر
THIS NUMBER WHEN SUBMITTING PAYMENT, OR IN CORRESPOND
El
RUBY EARL & MARGIE
18135 LIVERNOIS AVE
DETROIT MI
DO NOT WRITE ABOVE THIS LINE
b
8855
48221
AMOUNT
POSTED
FILED
IF THIS RETURN IS FOI
County_
File No.
ESTATE GIVE PROBA
Date of Death.
Linel
TA
No.
698855
007 82
75
12
ACCOUNT NO.
TYPE
COUNTY
CITY
K
C
FILE DATE
RETROACTIVE DATE
Line Computation of Tax Due
No.
1. Accounts and Notes Receivable (non-income producing only)_
2. Less Accounts and Notes Payable.
3. Balance Taxable @ 1/10th of 1%.
4. Accounts and Notes Receivable (income producing only)_
5. Less Accounts and Notes Payable (use only that portion, if any, not used in Line 2)_
6. Balance Taxable
7. Income applicable to balance.
8. Tax @ 32% of Income (Line 7) or 1/10 of 1% of Balance (Line 6), whichever is greater..
9. Stocks and Bonds Schedule A, Column 9.
10. Mortgages and Land Contracts Schedule B, Column 8.
11. Annuities Schedule C, Column 9.
12. Beneficiary Return (attach copy hereto)
1.
2.
23
3.
4.
5.
6
7.
8.
9.
° =
=
10.
2915
ESCA (RG 233)
i .
Kill
Reference copy, JFK Collection:
☐☐
| | || |
11.
12.
2/95.
13.
13.
TOTAL
14.
15.
BALANCE DUE
16. Cash on Hand or in Transit as of retroactive date (include cash in safety deposit boxes).
17. Bank Deposits in Banks Located Outside of Michigan_
18. Savings in Building and Loan Ass'ns. Located Outside of Michigan
or Withdrawn from Mich.
Banks or Ass'ns. after
RETROACTIVE DATE.
Less Statutory deduction ($175.00 or $350.00 by husbands and wives filing joint return)
14.
15.
19. TOTAL
20. TAX @ 40¢ per $1000.00 of Line 19.
21.
22.
23.
24.
25.
TOTAL TAX DUE (Line 15 plus Line 20)
Less Advance Payment of Tax
TOTAL TAX DUE.
Penalties & Interest; Penalty
TOTAL AMOUNT DUE
16.
17.
18.
19.
%, $
Interest_
%
Months, $
222222
20.
260287
21
260287
23.
24.
2602
25.
4567
MAKE REMITTANCE PAYABLE TO STATE OF MICHIGAN
Please forward Remittance for Amount Shown Here on or before April 30.
To: MICHIGAN DEPARTMENT OF TREASURY, LANSING, MICH. 48922
(or four months after end of authorized fiscal year)
IMPORTANT Be Sure to Answer the following Question When Applicable.
1. Business or Profession of Taxpayer._
2. Give year of last return filed.
1974
SALES
Address of Last Return.
SAME
SAME
3. Check here if return is computed on a Retroactive Date Method.
4. If taxpayer is a corporation give State and Date of Incorporation...
Phone No...
863-0400
Lor Monthly Average Method
Federal Employers Identification Number_
5. If this is the return of a Trustee attach list of names and addresses of beneficiaries and date of creation of trust.
6. If this is a Business Return a copy of the Balance Sheet as of the close of the Tax Year must be attached.
I declare under the penalties imposed by Act No. 301 P. A. of 1939, as Amended, that this return, including any accompanying schedules and
and to the best of my knowledge and belief is a true, correct and complete return.
Return Prepared by_
GORDON L. HOLLANDER, P.C. _
CERTIFIED PUBLIC ACCOUNTANT
19675 WEST TEN MILE ROAD
NW 88326r.Docld:32245535c Rage ELD MICHIGAN
MOOr
Social Security Number
Signed
Signed
Title
Cint
whethe toditabl
m
- Sieme
been examined by 1

(1)
SCHEDULE F SHAREHOLDERS SHARE OF INCOME AND CREDITS
(if additional space is needed, attach schedule).
Name and Address of Each Shareholder
(2)
Social Security
Number
(a). EARL
RUBY
WARD STONY RIVER DR. BIRM.MI
(b). ESTATE OF GEORGE MARCUS
60 W. WARMINGTON #1150 CHICAGO, IL 60602
(c) .
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(3)
Number of
Shares
(4)
Amount taxable as ordinary
income (schedule K, total of
lines 4 and 8, U.S. 1120-S)
7,500
46.840.04
7,500
46,840.05
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 34 or
on page 2, schedule 2, line 43)
difference between column 4
and column 5
(See instructions)
(7)
Enter here and on form
MI-1040, page 1, line 22
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(See instructions)
Enter
(8)
here and on
form
MI-1040, each shareholder's
proportionate share of Single
business tax paid.
(See instructions)
(a) 46,840.04
(b)
46,840.05
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
NW 88326 Docld:32245535 Page 221
PAGE 3 OF S
Reference copy, JFK Collection:
ESCA (RG 233)
SCHEDULE F - SHAREHOLDERS SHARE OF INCOME AND CREDITS
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder -
(2)
Social Security
Number
(3)
Number of
Shares
(4)
Amount taxable as ordinary
income (schedule K, total of
lines 4 and 8, U.S. 1120-S)
(a). RUBY
4380 STONEY RIVER, BIRM. MI
(b).SSTATE OF GEORGE MARCUS
LG W. WASHINGTON LIED CHICAGO ILL. 60602
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
500
19.730.16
500
19,730.15
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 34 or
on page 2, schedule 2, line 43)
difference between column 4
and column 5
(See instructions)
(7)
Enter here and on form
MI-1040, page 1, line 22
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(See instructions)
(8).
Enter here and on form
MI-1040, each shareholder's
proportionate share of Single
business tax paid.
(See instructions)
(a) 19,730.16
(b) 19.730.15
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
NW 88326 Docld:32245535 Page 222
46.61
46.61
PAGE OFF
R
Reference copy, JFK Collection:
ESCA (RG 233)
Mich. Dept. of Treasury
C-8000M
1
Name:
PART
Schedule of Partners or Shareholders-
Partnership, Subchapter S Corp., Professional Corp.
See instructions on reverse side
Cobo-Rumar Sales, Inc.
2 Account Number:
38-1812707
SUMMARY
3 Total Number of Partners or Shareholders...
4 Total Number of Qualified Partners or Shareholders from Part II-enter here and on C-8000, line 60a.
QUALIFIED PARTNERS OR SHAREHOLDERS
HART
A
NAME AND ADDRESS
Earl Ruby
4380 Stoney River; Birm.
1976
B SOCIAL
SECURITY NO.
C % D SHAREHOLDER'S E %
Time
SALARY
PARTNER'S or SHAREHOLDER'S
Own. F Share of Bus. Inc. | G Share of SBT Paid:
100%
18,000 00 100%
| 00
| 00
90
%
00
%
| 00
100
80
%
| 00
%
|00
100
%
| 00
%
100
00
%
100
%
100
8
29
%
| 00
%
| 00
| 00
6°
%
100
8
%
100
| 00
%
| 00
%
| 00
100'
AS
%
] 00
%
100
| 00
| 00
00
%
100
| 00
%
[PARTIH NON-QUALIFIED PARTNERS OR SHAREHOLDERS. If more space is needed submit separate schedule and enter totals on line 7.
|00
89
%
100
|00
1 00
%
| 00
100'
| 00
29
%
| 00
|00
100
%
| 00
100
00
%
00
1 00
| 00
59
%
100
100
8
|00
%
100
100
| 00
29.
%
| 00
100
8
100
bi
%
100
100
100
%
1.00
00
| 00
TOTALS (Part II and Part III)
NW-88326-Docld:32245535 Page 223
7
00
88
bi bi
%
100
00
%
100
100
Reference copy, JFK Collection:
ESCA (RG 233)
men. Dept. of Treasury
0-0000X
-
Schedule of Partners or Shareholders-
Partnership, Subchapter S Corp., Professional Corp.
See instructions on reverse side
1 Name:
Cobo Cleaners, Inc.
2 Account Number:
38-1806433.
SUMMARY
3 Total Number of Partners or Shareholders..
4 Total Number of Qualified Partners or Shareholders from Part II-enter here and on C-8000, line 60a.
QUALIFIED PARTNERS OR SHAREHOLDERS
PART
A
NAME AND ADDRESS
Earl Ruby
4380 Stoney River; Birm.
1976 ☐
B SOCIAL
C % D SHAREHOLDER'S E %
SECURITY NO.
Time
SALARY
PARTNER'S or SHAREHOLDER'S
Own. F Share of Bus. Inc. G Share of SBT Paid
100%
144,600 00 10%
100
| 00
29
%
| 00
6°
%
00
| 00
00
%
00
29
%
1 00
| 00
80
6°
%
100
%
100
|00
8
6°
%
100
29
%
100
100
5°
%
100
%
| 00
29
89
%
100
100°
%
100
1 00
%
| 00
29
%
00
| 00
%
100
A°
%
100
100
%
00
%
| 00
| 00
PARK NON-QUALIFIED PARTNERS OR SHAREHOLDERS. If more space is needed submit separate schedule and enter totals on line 7.
| 00
%
| 00
1.00
00
29
%
| 00
00
| 00
100
29
%
| 00
00
| 00
6°
%
100
00
| 00
69
%
| 00
| 00
| 00
6°
%
100
8
|00
00
%
1 00
100
00
5°
%
| 00
100
| 00
A°
%
100
100
8
8
| 00 %
| 00
|00
100
TOTALS (Part II and Part III)
100
: NW-88326-Bocld:32245535 Page 224
bi bi
%
%
100
88
00
1.00
100
31
Reference copy, JFK Collection:
ESCA (RG 233)
inn. Dept. of Treasury
海口
C-0000K☐
Schedule of Partners or Shareholders-
Partnership, Subchapter S Corp., Professional Corp.
See instructions on reverse side
1 Name:
PART
Cobo Cleaners, Inc.
SUMMARY
2 Account Number:
38-1806433.
3 Total Number of Partners or Shareholders:.
4 Total Number of Qualified Partners or Shareholders from Part II-enter here and on C-8000, line 60a.
QUALIFIED PARTNERS OR SHAREHOLDERS
PART
NAME AND ADDRESS
Earl Ruby
4380 Stoney River; Birm.
1976 ☐
B SOCIAL
C % D SHAREHOLDER'S E %
SECURITY NO.
Time
SALARY
PARTNER'S or SHAREHOLDER'S
Own. F Share of Bus. Inc. G Share of SBT Paid
100%
144,600 00 10%
100
100
29
%
00
69
%
00
00
AS
%
100.
g
29
%
|00
|00
00
29
%
| 00
%
100
00
6°
%
| 00
29
%
00
110011
6°
%
| 00
69
%
100
00
6°
%
| 00
%
| 00
|00
29
%
| 00
29
%
| 00
| 00
%
| 00
%
00
| 00
100
%
00
100
%
PARTHI NON-QUALIFIED PARTNERS OR SHAREHOLDERS. If more space is needed submit separate schedule and enter totals on line 7.
100
8
29
%
| 00
00
| 00
%
100
| 00
100
8
6°
%
| 00
100
| 00
A°
%
| 00
| 00
00
%
| 00
100
100
100
|00
6°
%
00
| 00
6°
%
00
00
6°
%
| 00
100
| 00
80
29
%
|00
100
| 00
ག%
A°
100
| 00
N TOTALS (Part II and Part III)
NW-88326-Docld:32245535 Page 225
100
88
00
bibi
%
1 00
%
| 00
88
100
100
DACE 4 AE/
Reference copy, JFK Collection:
ESCA (RG 233)
men. Dept. of Treasury
COOK
Schedule of Partners or Shareholders—
Partnership, Subchapter S Corp., Professional Corp.
See instructions on reverse side
1
Name:
Cobo Cleaners, Inc.
PART
SUMMARY
2 Account Number:
38-1806433
1976☐
PART
NAME AND ADDRESS
Earl Ruby
(4+380 Stoney River; Birm.
3 Total Number of Partners or Shareholders.
4 Total Number of Qualified Partners or Shareholders from Part II-enter here and on C-8000, line 60a.
QUALIFIED PARTNERS OR SHAREHOLDERS
B SOCIAL
SECURITY NO.
SALARY
C % D SHAREHOLDER'S E %
Time
PARTNER'S or SHAREHOLDER'S
Own. F Share of Bus. Inc. G Share of SBT Paid
100%
144,600 00 10%
100
|| 00.
%
| 00
29
%
| 00
00
%
100
89
%
00
| 00
%
| 00
%
100
00
5°
%
| .00
6°
%
| 00
_ +
00
%
00
29
%
| 00
| 00
6°
%
100
%
100
100
%
100
00
69
%
| 00
100
%
%
00
PART NON-QUALIFIED PARTNERS OR SHAREHOLDERS. If more space is needed submit separate schedule and enter totals on line 7.
00
29
%
00
100
00
%
00
| 0
00
%
|00
| 00
00
29
%
100
30
00
100
%
100
| 00
| 00
90
69
%
100
| 00
100
29
%
00
00
| 00
bi
%
00
| 00
| 00
29
%
100
80
00
00
%
100
00
| 00
%
100
00
00
| 00
%
| 00
|00
| 00
TOTALS
NW 88326 Docid 3243)
100
88
%
100
%
| 00
88
100
100
W
л
Reference copy, JFK Collection:
ESCA (RG 233)
▸ Attach Check or Money Order Here <
Attach State Copy of Form W-2 Here<
Please Print or Type <
. STATE
Department of Treasury
for 1973. or taxable year beginning
First name and initial (if joint return, use first names and initials of both)
EARL
AND MARGE
Home address (number and street or rural route)
LIVERNOIS
1973. ending
19
Last name
RUBY
Your social security number
Your occupation
SALES
Spouse's social security no.
City, town or post office, and State
MICHIGAN
Were you a Michigan resident prior to July 1, 1972? ☑ Yes ☐ No
2. Filling status check one.
☑ Married Filing Jointly
Single
ZIP code
48221
1. Exemptions-Enter here total number of exemptions claimed on your
1973 Federal income tax return.
✓ Resident (full year)
☐ Married Filing Separately Name of Spouse
-
Give spouse's social security no. in space provided
Part-year from
☐ Nonresident
3. Adjusted gross income as defined in the Internal Revenue Code and which should be reported on Federal Form 1040,
Attach copies of any Federal schedules that indicate a loss or deduction
Line 15 or 1040A, Line 12 from gross income. (See page 5 of the instructions)
4. Additions (from page 2, line 36)
5. Add lines 3 and 4
to
3
1041633/07
507
5.
120.
7.
130,706 02
8
3,60
9.
27.10.
10.
4.957/2
CREDIT
6. Subtractions (from page 2, line 44).
7. Balance line(5 less line 6)..
8. Residents multiply exemptions claimed on line 1 by $1200.00.
Part-year and nonresident allowance from line 48.
9. Income subject to tax (line 7 less line 8)..
10. Tax: multiply line 9 by .039 (3.9%)
CREDITS
11. Income tax paid to Michigan cities
12. Contributions to Michigan colleges and universities (attach receipts).. 12
AMOUNT PAID
2749
(See pages 8, 9, and 10 of the instructions)
192159 11a.
12a.
13. Income tax paid to another state (attach copy of return)..
14. Total credits (add lines 11a, 12a, and 13a,) enter total here
13.
15. Subtract line 14 from line 10 (If line 14 is greater than line 10, enter NONE)
Homestead property tax relief lines 16 thru 20 senior citizens, veterans and blind persons see form MI-1040CR.
16. Enter 1973 homestead property tax or line 51.
17. Household Income from line 58..
16
18. Enter 3.5% (.035) of Household Income shown on line 17.
18.
19. Difference between line 16 and line 18 (If line 18 is greater
than line 16, enter NONE)....
19.
20.
13 a.
45
14.
15.
27/99
4029/77
20. Enter 60% of line 19 (Maximum $500.00)
21. Credit from MI-1040CR (attach form MI-1040CR).
22. Personal property tax paid on inventory..
23. Inventory tax credit 25% of line 22.
PAYMENTS
24. Michigan tax withheld (attach State copy of W-2).
25. Michigan estimated tax payments.
26. 1972 overpayment credited to 1973.
27. Add line 20 or 21 to lines 23, 24, 25, and 26
(s)
21
23.
2.26620
809
28. If line 27 is less than line 15, enter BALANCE OF TAX DUE HERE PAY IN FULL WITH RETURN.
29. If line 27 is greater than line 15, enter OVERPAYMENT HERE..
30. Amount of line 29 you wish to apply to your estimated tax payments.
31. Amount to be REFUNDED (subtract line 30 from line 29)
695100
27.
2.941
1.96
29.
20380
This return is due April 15, 1974 or on the 15th day of the fourth month after the close of your tax year.
Under penalties of perjury. I declare that have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it
is true, correct and complete. If prepared by a person, other than taxpayer, his declaration is based on all'information of which he has any knowledge.
Sign
Here
Your signature
Date
Signature of preparer, other than taxpayer.
Spouse's signature (if filing jointly. BOTH must sign even if only one had income)
Make checks payable to "State of Michigan." Mail return and payment to
-
NW 88326 Docld:32245535 Page 227
GORDON HOLLANDER, P.C.
17350 TEN MILE ROAD
SOUTHFIELD, MICHIGAN 48075
MichCERTIFIED PUBLIC ACCOUNTANTsing, Michigan 48904
Date
.
In 197
2. Exemptions (number of allowable exemptions times $1.500.00)
3. Subtract line 2 from the 1. (This is your estimated taxable income)
4. Estimated tax (line 3 times .039 or 3.9%)...
5. LESS: Total estimated tax credit for Michigan City income taxes, personal property tax on inventories,
Michigan homestead property taxes and contributions to Michigan colleges and universities..
6. Subtract line 5 from line 4. Enter here and on line i below
MICHIGAN DECLARATION OF ESTIMATED INCOME TAX FOR INDIVIDUALS, 1974
C
For calendar year 1974 or fiscal year ending.
GREAT
LAKE
STATE
First name and initial (if joint declaration, use names and initials of both)
Last name
19.
STATE OF MICHIGAN
Department of Treasury
FORM
MI-1040-ES
Your social security number
Please Address (number and street).
print
or type!
City, State, and ZIP code
1. Your estimate of 1974 income tax..
2. Estimated income tax withheld and to be withheld during entire year of 1974
☐ September 16, 1974, enter 1/2 of line 3
3. ESTIMATED TAX (line 1 less line 2). (If less than $100, no declaration is required).
4. COMPUTATION OF INSTALLMENT. Check proper box below and enter amount indicated.
If this declaration is ☐ April 15, 1974, enter 1/4 of line 3;
due to be filed on: ☐ June 17, 1974, enter 1/3 of line 3;
5. If you had an overpayment on your 1973 income tax return which you elected to have applied as a
credit against your 1974 estimated tax, enter the amount here....
Jan. 15, 1975, enter amount on line 3
6. To apply entire overpayment credit to this installment and any excess to the next, enter here the amount on line 5. To spread
credit evenly to each installment, divide it by number of installments and enter results here.
7. Amount to be paid with this declaration at time of filing (line 4 less line 6)..
3. Note: The payment of the estimated tax (line 3 less any 1973 overpayment credit) with this return eliminates the filing of
quarterly estimates. Enter lump sum payment here
I have examined this declaration and to the best of my knowledge it is correct.
Signature(s).
Spouse's social security number
Date...
19.
If joint estimate, both husband and wife must sign
MICHIGAN DECLARATION OF ESTIMATED INCOME TAX FOR INDIVIDUALS- 1974
MICHIGAN
For calendar year 1974 or fiscal year ending.
19.
THE
STATE OF MICHIGAN
Department of Treasury
FORM
MI-1040-ES
STATE
Please
print
or type
First name and initial (if joint declaration, use names and initials of both).
EARL
AND
Address (number and street)
18135
City, State, and ZIP code.
MARGE
LIVERNOIS
MICHIGAN
DETROIT,
1. Your estimate of 1974 income tax.
Last name
RUBY
48221
2. Estimated income tax withheld and to be withheld during entire year of 1974
3. ESTIMATED TAX (line 1 less line 2). (If less than $100, no declaration is required).
4. COMPUTATION OF INSTALLMENT. Check proper box below and enter amount indicated.
If this declaration is ✓ April 15, 1974, enter 1/4 of line 3;
☐ June 17, 1974, enter 1/3 of line 3;
☐ September 16, 1974, enter 1/2 of line 3)
due to be filed on:
☐ Jan. 15, 1975, enter amount on line 3.
5. If you had an overpayment on your 1973 income tax return which you elected to have applied as a
credit against your 1974 estimated tax, enter the amount here..
6. To apply entire overpayment credit to this installment and any excess to the next, enter here the amount on line 5. To
spread credit evenly to each installment, divide it by number of installments and enter results here....
7. Amount to be paid with this declaration at time of filing (line 4 less line 6)..
Your social security number
Spouse's social security number
2,000.00
2.000.00
500.00
00.00
8. Note: The payment of the estimated tax (line 3 less any 1973 overpayment credit) with this return eliminates the filing
of quarterly estimates. Enter lump sum payment here.
I have examined this declaration and to the best of my knowledge it is correct.
Signature(s).
Date...
19.
NW 88326 Docld:32245535sPage 228 husband and wife must sign
Attach Copy of Form DV-2 or VI-2 Here
Attach Check or Money Order Here
or other raxable year beginning
Name and initial
4 F704298
joint retur
_
1973, ending..
Last Name
home Address (N
RUBY EARL & MARGE
City, Town or Posi
18135 LIVERNOIS
DETROIT, MI
48221
5)
e
Your Social Security Number
EXTENSION NUMBER
Your Occupation
Spouse's Social Security Number
if you are an EMPLOYER
jenter your Federal EMPLOYER
identification No. here:
Spouse's Occupation
A.
if married, is spouse filing a separate return? YES
☐ NO.
If yes, enter spouse's first name..
.
3. Enter the name and address used on your return for 1972 (If the same as above write "Same". If different, indicate date
moved.) If none filed, give reason.
3.
SAME
SCHEDULE - EXEMPTIONS
1. YOURSELF
SPOUSE
2. Enter first names of each of your DEPENDENT CHILDREN who lived with you:
OTHER
DEPENDENTS
NAME
Enter figure 1 in the last column to
right for each name listed
4. Total exemptions from lines 1, 2 and 3; enter here and on line 15 below.
Auditor
Regular
65 or over
Blind
☐ ☐
APP.
OA.
Enter
number of
exemptions
checked
Enter No.
Relationship.
Months lived in
your home curing
1973
5. Enter GROSS income from employers for wages, salaries, commissions, tips, etc. - indicate (W) for wife
Employer's Name
ó.
Total wages reported
on DW-2 or W-2
INCOME (If joint return, include all income of both husband and wife)
Where employed (City and State)
Detroit Income Tax
Withheld
WAGES, ETC. EARNED
IN DETROIT
S0.35 O
S.
120 3.0
CLEANERS, INC.
AUMS SALES INC. DET, MI
TOTALS
7. Rental income (or loss) from tangible property in the City of Detroit - from page 2, Schedule B, line 4
8. Other income (or loss) from partnerships, etc. - from page 2, Schedule F, line 4.
9. Gain (or loss) from sale or exchange of tangible property in the City of Detroit - from page 3, Schedule E, line 10.
10. Net profit (or loss) from business from page 3, Schedule C, line 8
11. Income (or loss) - TRUSTS AND ESTATES ONLY- from page 4, Schedule G, line 7 (see instructions for exemption to enter on line 15)
Total (add lines 6 through 11 of last column)..
12.
13. Less:
14.
Deductions from page 2, Schedule M, line 5 (if none, enter zero).
Total (line 12 less line 13)
15. Less Amount for Exemptions: Enter number of exemptions from line 4 above
16.
TOTAL INCOME SUBJECT TO TAX
17. CITY OF DETROIT TAX: Multiply line 16 by .005 (½%)
PAYMENTS AND CREDITS
16. a. Tax withheld by employer from line 6 above - ATTACH Forms DW-2 or W-2.
19.
20.
b. Payments and credits on 1973 Declaration of Estimated Detroit Income Tax.
c. Other Credits - explain in attached statement (See Instructions)
TOTAL Add Lines 18a, b, and c
TAX DUE OR REFUND
3
and multiply by $600
your payments (line 19) are larger than your tax (line 17), enter amount of OVERPAYMENT
21. Check box if you wish overpayment on line 20 to be: (A) ☐ Credited on 1974 Estimated Tax or (B) (✓ Refunded.
303/27
185106
1
22. If your tax (line 17) is larger than your payments (line 19) enter amount of BALANCE DUE Pay in full with this return. • S
Make check payable to: "TREASURER, CITY OF DETROIT." A balance due of less than one dollar ($1.00) need not be paid.
declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and belief it is true, correct and
complete. If prepared by a person other than taxpayer, his declaration is based on all information of which he has any knowledge.
SIGN HERE..
SIGN
SIGN HERE
(Taxpayer's signature and date)
(Signature of preparer other than taxpayer)
GORDON L. HOLLANDER, P.C.
(Spouse's signature and date) (If joint return, BOTH HUSBAND AND WIFE MUST SIGN)
CERTIFIED PUBLIC ACCOUNTANT
MAIL TO: City Treasurer, 104 City-County Building, Detroit 178402 ROAD
RETURNS MUST BE FILED BY APRIL 30SOUYAFIELD, MICHIGAN 48075
NW 88326 Docid:32245535 Page 229
(Date)
Revenue Division:
...TCDLES TAX REURN
Ofender Year 1978
THIS NUMBER WHEN SUBMITTING PAYMENT, OR IN CORRESPONDENCE
OR FISCAL YEAR
ginning.
Ending_
19
19.
RUBY EARL & MARGIE
Individuai
18135 LIVERNOIS
Partnership.
Check
DETROIT MI
Michigan Corporation
One
Foreign Corporation
Fiduciary
MONTH
DAY
YEAR
30
73
698855
1007
DO NOT WRITE ABOVE THIS LINE
AVE
48221
693355
POSTED
Y
FILED
IF THIS RETURN IS FOR AN
ESTATE GIVE PROBATE
County_
8-2
N
73
12
File No.
TYPE
COUNTY
CITY
K
C
FILE DATE
Date of Death_
AMOUNT
Linel
No.
TAX
No.
RETROACTIVE DATE
Computation of Tax Due
ACCOUNT NO.
1. Accounts and Notes Receivable (non-income producing only)_
2. Less Accounts and Notes Payable.
3. Balance Taxable @ 1/10th of 1%-
4. Accounts and Notes Receivable (income producing only)_
5. Less Accounts and Notes Payable (use only that portion, if any, not used in Line 2)_
6. Salance Taxable
7. Income applicable to balance.
6. Tax @32% of Income (Line 7) or 1/10 of 1% of Balance (Line 6), whichever is greater.
9. Stocks and Bonds. Schedule A, Column 9.
10. Mortgages and Land Contracts... Schedule B, Column 8.
11. Annuities. Schedule C, Column 9.
12. Beneficiary Return (attach copy hereto)
13.
TOTAL
----
14.
15.
Luss Statutory deduction ($175.00 or $350.00 by husbands and wives filing joint return)
BALANCE DUE
16. Cash on Hand or in Transit as of retroactive date (include cash in safery deposit boxes).
17. Bank Deposits in Banks Located Outside of Michigan_
16. Savings in Building and Loan Ass'ns. Located Outside of Michigan_
19. TOTAL
20. TAX @40 per $1000.00 of Line 19.
or Withdrawn from Mich.
Banks or Ass'ns. after
RETROACTIVE DATE.
21.
22.
23.
24.
25.
TOTAL TAX DUE (Line 15 plus Line 20)
Less Advance Payment of Tax
TOTAL TAX DUE
Penalties & Interest; Penalty
TOTAL AMOUNT DUE
%, $
Interest_
%.
Months, $
1:1
2.
3.
2
5.
ό
7.
8.
26169
9
10.
11.
15.
19.
20.
21.
22.
23
24.
25.
2 2 2 2 2
MAKE REMITTANCE PAYABLE TO STATE OF MICHIGAN
Please forward Remittance for Amount Shown Here on or before April 30.
To: MICHIGAN DEPARTMENT OF TREASURY, LANSING, MICH. 48922
(or four months after end of authorized fiscal year)
IMPORTANT -Be Sure to Answer the following Question When Applicable.
SALES
i. Business or Profession of Taxpayer_
2. Give year of last return filed.
1972
Address of Last Return_
SAME
_or Monthly Average Method_
3. Check here if return is computed on a Retroactive Date Method
Phone No.
4. If taxpayer is a corporation give State and Date of Incorporation.
Federal Employers Identification Number_
5. If this is the return of a Trustee attach list of names and addresses of beneficiaries and date of creation of trust.
6. If this is a Business Return a copy of the Balance Sheet as of the close of the Tax Year must be attached.
I declare under the penalties imposed by Act No. 301 P. A. of 1939, as Amended, that this return, including any accompanying
and to the best of my knowledge and belief is a true, correct and complete return.
Return Prepared by.
GORDON L. HOLLANDER, P.C.
CERTIFIED PUBLIC ACCOUNTANT
17350 TEN MILE ROAD
SOUTHFIELD, MICHIGAN 48075-
NW 88326 Docld:32245535 Page 230N REVERSE SIDE
Address_
Social Security Number
Signed
Signed
Title
and statements has been examined by.
State whether Individual Owner, Member of
Administrator, Trustee, etc., or ve W
"

of D-15-01-J Rev. 8-73)
A.
TOTAL DETROIT INCOME EXPECTED IN 1974
3.
EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
TAX COMPUTATION SCI
C. ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE 8)
S
S
S
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 15 OF DECLARATION BELOW
$
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending..
19.
1974
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
ADDRESS
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER:
CORPORATION
PARTNERSHIP
CITY
STATE
POSTAL ZIP CODE
1
OTHER
THIS
1a. Your 1973 Detroit Income Tax S.
1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 1b less line 2)
S.
$.
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1974-1/4; ☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2; ☐ Jan. 31, 1975-100%
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credit
$
FOR
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$
YOUR
RECORDS.
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
OFFICE OF THE CITY TREASURER
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
-
INCOME TAX DIVISION
This declaration of estimated tax is not a Tax Return.
DATE
D-1040-ES
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending..
CLEANCES, INC.
NAME(S)
(PRINT OR TYPE).
ADDRESS
CITY
DOCUMENT LOCATOR NUMBER
15-185 LIVER NOIS
STATE
MICHIGAN
YOUR SOCIAL SECURITY NUMBER
19........
1972
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
CORPORATION
PARTNERSHIP
SPOUSE'S SOCIAL SECURITY NUMBER.
POSTAL ZIP CODE
4001
☐ OTHER
$.
°
S
1). As
ia. Your 1973 Detroit Income Tax $ 1,580.53 1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 1b less line 2)
4. Computation of installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☑ Apr. 30, 1974-1/4; ☐☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2; Jan. 31, 1975-100%
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
1,600/00
S
°
$
Yooja
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
1 CERTIFY THAT THIS IS A CORRECT DECLARATION.
Signature of Taxpayer. Spouse also if joint declaration.
This declaration of estimated tax is not a Tax Return.
DATE
NW 88326 Docid:32245535 Page 231
1570
1972
1971
1973
dnding of year
fo matulabatre or sale
Cedule)
3 Temi
$ Loss Inventory at end of your
7 Co of goods cola (anber)
and on
ction
2. Social security number
3. Titlo
Ima
voted to
busines
comb
Ionicera (enter here and on line 12, page 1).
RESERVE METHOD (Se instruction 15,
Amount adder to reserve
4. Current year's
provision
3. Recoveries
3. Sales on account
2. Tunta
5. Amount shad
tomy
DEPRECIATION (Sce instruction 21) Note: If depreciation is computed by using the Clap Live (ADR) Syrtam
1970, or the Guideline Class Life 
System for assets placed in service Sefore 1971, you must Me Form 4032 (
(Gun Class Life System) with your return. Except as otherwise expressly provided in regulations section 11107(a)
hd regulationstion 
1.167(a)-12, the 
provisions of Revenue Procedures 62-21 and 05-13 are not applicable for taxable years chain
Check box(as) you made an election this taxable year to use Class Life (ADR) System and/or
07
deline
2. Dato
acquired
Guideline Sites Life System. Se
3. Cost or
other basis
4. Depreciation
allowed or allowable
in prior years
5. Method of
6. LITS
computing depreciation
1 Total additional first-year depreciation (do not include in items below).
2 Depreciation from Form 4332.
& Depreciation from Form 5006.
4 Omer appreciation:
Buildings.
Furniture and fixtures
Transportation equipment
Nachinery and other equipment
Outer (specify).
Totals
Loss amount of depreciation claimed in Schedule A
anco-enter here and on line 21, page 1
SUMMARY OF DEPRECIATION (other than additional first-year depreciation)
1 Depreciation from Form 4832.
Depreciation from Form 5003
Straight line
Declining balance
Sum of the
years.digits
Units so
production
Other (specify)
TAX COMPUTATION (Sec instructions)
1 Taxable income (line 28, page 1).
2 (g) Enter 48% of line 1 (members of controlled groups, see instructions)
(b) Subtract $6,500 and enter difference
3 Not long-term capital gain reduced by not short-term capital loss (from line 9(b), page 1)
4 Subtract. $25,000. (Statutory minimum.)
6,500.00
Dolance (line 3 less line 4) (see instructions)
Enter 30% of line 5 (see instructions)
7 Income tax (line 2 of line 6, whichever is lesser). Enter here and on line 29, page 1
NW 88326 Docid:32245535 Page 232
25.000000
1.
(one 20, pag. 1)
macy donated a dividends out of cummings and points of the
imposed on certain capital gains (hd 81, peso 1)
undistributed taxable income
2 OP
STRONS
2. Scat security
calidad distribe
dividend die
exable as ordinary income (Do not include amounts shown on line 6)
to taxable so long-term capital gains (after tax)*
Actual dividend distributions taxable as ordinary income and qualifying for dividend exclusion
7 Nondividond tributions
Bhalted taxable income-taxable as ordinary income or (lost).
Undioributed taxable income-taxable as long-term capital gain (after vaxņa
das sus ba patified re to what amount of bit pro man share of long-term capital gains ray cucitly on subcration (4) coin. S-
NPMENT INDEDTERNESS:
Investment interest expense.
(Not Investment income or (loss).
(pences over rental income
attributable to net lease property
ess of nox long-term capital gains
over not short-term capital losses
abutable to investment property
coated depreciation of:
(_) Low-income rental housing
(2) Other real property
(3) Personal property subject to a
mot lease.
(5) Amortization of
rifted pollution control facilities
Bate Incorporated
(2) Railroad rolling stock
(3) On-the-job training facts
(4) Child care facilition
(c) Reserve for losses on bad debts of
financial Institutions.
(4) Excess percentage depletion
() long-term capital gain (after tex)
12 HNVESTMENT CREDIT PROPERTY:
Basis of
Investment
property
Dost of
investment
properly
(a) 3 or more but less than 5 your
(b) 5 or more but less than 7 years.
(c) 7 or more years.
(d) 3 or mora but less than 5
(a) 5 or more but less than 7 years.
(4) 7 or more years
COMPLETE A SEPARATE SCHEDULE K-1 FOR EACH SHAREHOLDER-File Copy A with Form
eider, and keep Copy C for your records.
JOWE 1966
the corporation at the end of the taxable year own, directly or in-
directly, 50% or more of the voting stock of a domestic corpora-
Yes☐ No. (For rules of attribution, see section 257 (c).)
the answer is "Yes," attach a schedule showing:
(E) me, address, and employer identification number; and
(b) percentage owned,
Did the corporation during the taxable year have any contracts or cub-
contracts subject to the Renegotiation Act of 1951? ☐ Yes ☐ No.
"Yes," enter the aggregate gross dollar amount billed during the
year
1 Amount of taxable income or (loss) for: 1970
1971
..........; 1972
4850567
Refer to page 7 of instructions and state the principal;
Business activity
Product or service
05.67
Were you a member of a controlled group subject to
the provisions of sections 1561 or 1582? .
L Did you claim a deduction for expenses connected with ong
(1) Entertainment facility (boat, resort, ranch, etc.)?.
(2) Living cocommodations (except employees of Dub
iness)? .
(3) Employees' familles at conventions of meetings?
(2) Employee of family vacations not reported on
Form W-27.
M Did you le all required Forms 1099, 1000 and 10377
N Did the corporation, at any time during the taxable
your, have any interest in or signature or other authority
over a bank, securities, or other financial cccount i
a foreign country? ..
_
Yes
if "Yes," attach Form 4088. (For definitions, sce Form (288)
Answer only if (1) this is the first 11208 return filed sine guar
to be treated as a small business corporation and (2) the o
was in existence for the taxable year prior to the election and
ment credit property:
Was an agreement filed under section 1.47-4(b) of the
Regulations?
NW 88326 Docid:32245535 Page 233
D
of 15+ (Rev. 3-73)
TAX COMPUTATIO
A.
TOTAL DETROIT INCOME EXPECTED IN 1974
EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
C.
ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE 3)
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
S
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1 OF DECLARATION BELOW
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending.
19.
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
ADDRESS
CITY
STATE
SPOUSE'S SOCIAL SECURITY NUMBER!
POSTAL ZIP CODE
S
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
CORPORATION
PARTNERSHIP
OTHER
KEEP
THIS
1a. Your 1973 Detroit Income Tax $.
1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 1b less line 2)
$
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1974-1/4; ☐☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2; ☐ Jan. 31, 1975-100%
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credit
$.
$
FOR
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
OFFICE OF THE CITY TREASURER
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
-
INCOME TAX DIVISION
This declaration of estimated tax is not a Tax Return.
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
DATE
D-1040-ES
SALES, Dile.
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending..
NAME(S) (PRINT OR TYPE)
19.
1974
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
INDIVIDUAL
ADDRESS
10:15 LIVERNNS
SPOUSE'S SOCIAL SECURITY NUMBER
CORPORATION
CITY-
PARTNERSHIP
D
STATE
MICHIGAN
POSTAL ZIP CODE
OTHER
1a. Your 1973 Detroit Income Tax $ 219.04
$.
DOCUMENT LOCATOR NUMBER
.; 1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 1b less line 2)
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1974-1/4; ☐☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2; ☐ Jan. 31, 1975-100%
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credi>
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
0
S
S
°
S
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
1 CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 234
DATE
(b)
(c)
(a)
(e)
(f)
(g)
(h)
(i)
(1)
space is needed,
sontoduto)
Name and Address of Each Shareholder
(2)
Social Security
Number
Number of
Shares
(6)
Amount to be used by shareholder on
income (schedule K, total
of lines 4 and 8,
1120-S)
U.S.
line 5, or page 2. schedule 3.
line 6
The 35 or On
4. SCHOULI
line 43) difference between column
4 and column 5 (saa instructions}
(a) $
36 707-35
$
38.7478r
$
(b)
301-6234
38,307 36
(c)
(d)
(e)
(i)
(g)
(h)
(i)
(j)
NW 88326 Docld:32245535 Page 235
C of D-15-DIT-) (Rev. 8-73)
A.
TOTAL DETROIT INCOME EXPECTED IN 1974
3.
EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
TAX COMPUTATION SCHIDE
C. ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE 8)
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1b OF DECLARATION BELOW
D-1040-ES
$
S
S
$
CITY
STATE
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending..
19.
1974
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
ADDRESS
SPOUSE'S SOCIAL SECURITY NUMBER:
POSTAL ZIP CODE
INDIVIDUAL
CORPORATION
0000
PARTNERSHIP
OTHER
1a. Your 1973 Detroit Income Tax's..
1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
S.
THIS
3. ESTIMATED TAX (line 1b less line 2)
$.
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
Apr. 30, 1974-1/4; ☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2; ☐ Jan. 31, 1975-100%
$.
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credit
$
5. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
FOR
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
This declaration of estimated tax is not a Tax Return.
OFFICE OF THE CITY TREASURER
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
INCOME TAX DIVISION
:
DATE
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
D-1040-ES
NAME(S)
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending.
(PRINT OR TYPE),
19.
YOUR SOCIAL SECURITY NUMBER
CLEANC40
INC.
ADDRESS
16165
CITY
STATE
MICHIGAN
SPOUSE'S SOCIAL SECURITY NUMBER
POSTAL ZIP CODE
48001
DOCUMENT LOCATOR NUMBER
LIVER NOIS
1a. Your 1973 Detroit Income Tax $ 1,580.53
1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 1b less line 2)
4. Computation of installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☑Apr. 30, 1974-1/4; ☐ June 30, 1974-1/3; Sept. 30, 1974-1/2; ☐ Jan. 31, 1975-100%
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
1974
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
CORPORATION
☐ PARTNERSHIP
OTHER
S.
$.
S.
°
$
$.
Hoojan
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
1. CERTIFY THAT THIS IS A CORRECT DECLARATION.
Signature of Taxpayer. Spouse also if joint declaration.
This declaration of estimated tax is not a Tax Return.
DATE
NW 88326 Docld:32245535 Page 236
(+73)
TAX COMPUTATION SCHEDULE
A
TOTAL DETROIT INCOME EXPECTED IN 1974
2.
EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
C.
ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE 8)
0.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½2 OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1 OF DECLARATION BELOW
S
D-1040-15
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending..
19.
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
ADDRESS
INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER
CORPORATION
CITY
STATE
PARTNERSHIP
POSTAL ZIP CODE
OTHER
1a. Your 1973 Detroit Income Tax S.
THIS
1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 15 less line 2)
$.
$.
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1974-1/4; ☐☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2; ☐ Jan. 31, 1975-100%
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credit
$.
$
FOR
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
OFFICE OF THE CITY TREASURER
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
-
INCOME TAX DIVISION
:
This declaration of estimated tax is not a Tax Return.
DATE
D-1040-38
NAME(S)
SALES
Tile.
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1974 or Fiscal Year Ending..
(PRINT OR TYPE)
ADDRESS
LIVERNAIS
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
19........
1974
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
'
YOUR SOCIAL SECURITY NUMBER
CITY-
STATE
'
MICHIGAN
POSTAL ZIP CODE
COD
SPOUSE'S SOCIAL SECURITY NUMBER!
ODOO
1a. Your 1973 Detroit Income Tax $. 219.04
..;
CORPORATION
PARTNERSHIP
OTHER
$.
3.
DOCUMENT LOCATOR NUMBER
1b. Your Estimate of 1974 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1974.
3. ESTIMATED TAX (line 1b less line 2).
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1974-1/4; ☐☐ June 30, 1974-1/3; ☐ Sept. 30, 1974-1/2;
5. Less: Amount of overpayment on 1973 return which you elected to claim as a credi>
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
Jan. 31, 1975-100%
S
$.
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
1 CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 237
DATE
SCHEDULE F
-
SHAREHOLDERS SHARE OF INCOME AND CREDITS
(If additional space is needed, attach schedula)
(1)
Name and Address of Each Shareholder
(a)
RUBY
4380
STOWEY RIVER, BIRM.
MICH.
(b)
Of
GEORGE MARCUS
69 W. WASHINGTON AH1150
CHICAGO
#LL.60232
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(2)
Social Security
Number
(3)
Number of
Shares
759
7,500
(4)
Amount taxable as ordinary
income (schedule K, total
of lines 4 and 8, U.S.
1120-S)
(5)
Distributive income from
page 1, line 5, or page 2,
schedule B, line 6
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 37 or
on page 2, schedule 2, line 46)
difference between column 4
and column 5 (see instructions)
(7)
Enter here and on form
MI-1040, page 1, line 25
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(see instructions)
(a) $
9,169.69
9,169.69
(b)
9.169.69
9,169.69
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(!)
NW 88326 Docld:32245535 Page 238
040-25
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
TAX COMPUTATION SCHEDULE
C of D-15-DIT-J (Rev. 8-74)
.A.
TOTAL DETROIT INCOME EXPECTED IN 1975
B: EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
C. ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE B)
S
S
$
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1b OF DECLARATION BELOW
$
1975
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
1975
19.
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
1
ADDRESS
CITY
CHECK TYPE OF DECLARATION
INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ☐ CORPORATION
PARTNERSHIP
STATE
POSTAL ZIP CODE
ㅁㅁㅁㅁ
☐ OTHER
KEEP
1a. Your 1974 Detroit Income Tax $.
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
$
1
THIS
3. ESTIMATED TAX (line 1b less line 2)
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
Apr. 30, 1975-1/4; June 30, 1975-1/3; Sept. 30, 1975-1/2; ☐ Jan. 31, 1976-100%
$.
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
$
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
FOR
$.
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
FINANCE DEPARTMENT INCOME TAX DIVISION
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
This declaration of estimated tax is not a Tax Return.
DATE
D-1040-ES
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
NAME(S)
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
(PRINT OR TYPE)
19.
1975
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
Cobo
-
CITY
DETROIT.
DOCUMENT LOCATOR NUMBER
367.39;
RUMAR
SALES, INC.
ADDRESS 18135 LIVERNOIS
STATE
MICHIGAN
1a. Your 1974 Detroit Income Tax $....
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2)
SPOUSE'S SOCIAL SECURITY NUMBER
☐ INDIVIDUAL
✓ CORPORATION
PARTNERSHIP
POSTAL ZIP CODE
48221
☐ OTHER
$.
4001
$
400
00
☑ Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3;
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
Sept. 30, 1975-1/2;
10
00
Jan. 31, 1976-100%
$.
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$
0100
$.
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
I CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 239
DATE
_
SCHEDULE F SHAREHOLDERS SHARE OF INCOME AND CREDITS
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
RUBY
STONEY RIVER DR. BIRM. MI 48010
(a)
4380
(b)
ESTATE
OF GEORGE
69 W. WASHINGTON
#1150
MARCUS
CHICAGO, ILL LOGOR
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(2)
Social Security
Number
(3)
Number of
Shares
7,500
7,500
(4)
Amount taxable as ordinary
income (schedule K, total
of lines 4 and 8, U.S.
1120-S)
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
36, 331.38
36.331.37
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 37 or
on page 2, schedule 2, line 46)
difference between column 4
and column 5 (see instructions)
(7)
Enter here and on form
MI-1040, page 1, line 25
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(see instructions)
9194
9194
(a) $
36,331.38
(b)
36, 331.37
(c)
(d)
(e)
(f)
(g)
(h)
(i).
(j)
NW 88326 Docid:32245535 Page 240
DAST 2
་
4

Cor 0-15-DIT.J
Rev. 8-74;
CHY OF
DECERNATION OF ESTRATED
TAX COMPUTATION SCHEDULE
མ་
1973
TOTAL DETROIT INCOME EXPECTED IN 1975
В
EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
c. ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE B)
$
$
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
$
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1 OF DECLARATION BELOW
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year. 1975 or Fiscal Year Ending
1975
19
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
ADDRESS
CITY
STATE
POSTAL ZIP CODE
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ☐ CORPORATION
☐ PARTNERSHIP
☐ OTHER
KEEP
1a. Your 1974 Detroit Income Tax $..
1b. Your Estimate of 1975 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
$.
THIS
3. ESTIMATED TAX (line 1b less line 2)
4. Computation of installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
I
COPY
لسا
Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2;
Jan. 31, 1976-100%
5.
Less: Amount of overpayment on 1974 return which you elected to claim as a credit
$
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
FOR
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
This declaration of estimated tax is not a Tax Return.
FINANCE DEPARTMENT - INCOME TAX DIVISION
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
DATE
D-1040-ES
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
NAME(S)
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
(PRINT OR TYPE)
19
1975
YOUR SOCIAL SECURITY NUMBER
܆܇
CLEANCE
INC.
ADDRESS 1813.5
LiveRnOIS
CITY
STROIT
STATE
MICHIGAN
SPOUSE'S SOCIAL SECURITY NUMBERİ
POSTAL ZIP CODE
48221
☐ ☐
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
CORPORATION
PARTNERSHIP
OTHER
DOCUMENT LOCATOR NUMBER
1a. Your 1974 Detroit Income Tax $ 1,46%26
1b. Your Estimate of 1975 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975
3. ESTIMATED TAX (line 1b less line 2)
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; ☐ Jan. 31, 1976–100%
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$.
1,65
$
130174
26986
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
I CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 241
DATE
SCHEDULE A CHAREHOLDERS SHARE OF INCOME AND CREDITS.
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
RUBY
OF
4380 STONEY RIVER BIRM.
(a)
(b)
MICH.
640265 MARCUS
69 W. WASHINGTONA-1150. CHICAGO
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
(2)
Social Security
Number
(3)
Number of
Shares
7809
7,500
(4)
Amount taxable as ordinary
income (schedule K, total
of lines 4 and 8, U.S.
1120-S)
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 37 or
on page 2, schedule 2, line 46)
difference between column 4
and column 5 (see instructions)
(7)
Enter here and on form
MI-1040, page 1, line 25
each shareholder's pro-
portionate share of per-
sonai property taxes
paid on inventories or
the credit for franchise
fees paid.
(see instructions)
(a) $
9,169.69
(b)
9169.69
9.169.69
9,169.69
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(j)
NW 88326 Docld:32245535 Page 242
✓-
C of D-15-DIT-J (Rev. 8.74)
CITY OF DURROIT DECLARATION OF ESTIMATED INCOME TAX
TAX COMPUTATION SCHEDULE
1973
A. TOTAL DETROIT INCOME EXPECTED IN 1975
$
$
1
B.
EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
C.
ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE B)
$
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1b OF DECLARATION BELOW
$
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
19.
1975
YOUR SOCIAL SECURITY NUMBER
NAME(S)
(PRINT OR TYPE)
ADDRESS
CITY
STATE
POSTAL ZIP CODE
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ☐ CORPORATION
☐ PARTNERSHIP
OTHER
KEEP
THIS
la: Your 1974 Detroit Income Tax $..
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2)
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1975-1/4; June 30, 1975-1/3;
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
Sept. 30, 1975-1/2;
FOR
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
Jan. 31, 1976-100%
$.
$
$.
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
FINANCE DEPARTMENT - INCOME TAX DIVISION
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
This declaration of estimated tax is not a Tax Return.
DATE
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending..
19.
YOUR SOCIAL SECURITY NUMBER
SALES
INS.
+
(PRINT OR TYPE)
Coso - RUMAR
D-1040-ES
NAME(S)
ADDRESS
CITY
18135 LIVERNOIS
DETROIT.
DOCUMENT LOCATOR NUMBER
STATE
MICHIGAN
1a. Your 1974 Detroit Income Tax $ 367.39,
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2).
1975
CHECK TYPE OF DECLARATION
INDIVIDUAL
✓ CORPORATION
SPOUSE'S SOCIAL SECURITY NUMBER
POSTAL ZIP CODE
48701
☐ PARTNERSHIP
☐ OTHER
$
400,00
$.
400100
$.
100,00
Jan. 31, 1976-100%
•
$
$.
10000
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
Sept. 30, 1975-1/2;
☑ Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3;
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
I CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint decturation.
NW 88326 Docid:32245535 Page 243
DATE
SCHEDULE F
SHAREHOLDERS SHARE OF INCOME AND CREDITS
(If additional space is needed, attach schedule)
(1)
Name and Address of Each Shareholder
(a)
EN
4380
RUBY
STONEY RIVER DR. BIRM. MI 48010
(b) ESTATE OF GEORGE
69 W. WASHINGTON #1150
MARCUS
CHICAGO, ILL COLOR
(c)
(d)
(e)
(f)
(g)
(h)
(i)
(!)
(2)
Social Security
Number
(3)
Number of
Shares
7,500
7,500
(4)
Amount taxable as ordinary
income (schedule K, total
of lines 4 and 8, U.S.
1120-S)
(5)
Distributive Income from
page 1, line 5, or page 2,
schedule B, line 6
(6)
Amount to be used by share-
holder on MI-1040 (enter on
page 2, schedule 1, line 37 or
on page 2, schedule 2, line 46)
difference between column 4
and column 5 (see instructions)
(7)
Enter here and on form
MI-1040, page 1, line 25
each shareholder's pro-
portionate share of per-
sonal property taxes
paid on inventories or
the credit for franchise
fees paid.
(see instructions)
(a) $
36,331.38
36,331.38
(b)
36, 331.37
36331.37
(c)
(d)
(e)
(f)
(g)
(h)
(i)
9194
9194
(j)
NW 88326 Docld:32245535 Page 244
DIGT 2
4
of D-15-DIT.) Rev. 8-74;
CITY OF DERROT DECLARATION OF
ESTRATED INCOME
TAX COMPUTATION SCHEDULE
1. TOTAL DETROIT INCOME EXPECTED IN 1975
B. EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
C.
ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE B)
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 16 OF DECLARATION BELOW
$
1976
S
1
$
$
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending..
1975
19
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
INDIVIDUAL
ADDRESS
CITY
STATE
POSTAL ZIP CODE
SPOUSE'S SOCIAL SECURITY NUMBER ☐ CORPORATION
☐ PARTNERSHIP
☐ OTHER
KEEP
1a. Your 1974 Detroit Income Tax $.
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
THIS
3. ESTIMATED TAX (line 1b less line 2) .
COPY
4. Computation of installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; Jan. 31, 1976-100%
6.
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$
FOR
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
This declaration of estimated tax is not a Tax Return.
FINANCE DEPARTMENT - INCOME TAX DIVISION
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
DATE
D-1040-ES
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
19.
1975
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
CLEANBE
INC.
ADDRESS
978135
LiveRNOIS
SPOUSE'S SOCIAL SECURITY NUMBER
CITY
CAROIT
STATE
MICHIGAN
POSTANKS 201
ZIP CODE
0000
CHECK TYPE OF DECLARATION
INDIVIDUAL
CORPORATION
PARTNERSHIP
OTHER
DOCUMENT LOCATOR NUMBER
1a. Your 1974. Detroit Income Tax $ 1,469.26
1b. Your Estimate of 1975 Detroit Income Tax
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2).
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☑Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; ☐ Jan. 31, 1976–100%
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$.
$.
$.
$
130174
269
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
I CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 245
DATE
CITY OF DENOM DICTANATION OF ESTIMATED
TAX COMPUTATION SCHEDULE
TAK
1975
C of D-15-DIT-) (Rev. 8-74).
A.
TOTAL DETROIT INCOME EXPECTED IN 1975
B. EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
C. ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE B)
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1b OF DECLARATION BELOW
$
$
$
1
1
i
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
1975
19
'
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
1
ADDRESS
CITY
STATE
POSTAL ZIP CODE
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ☐ CORPORATION
☐ PARTNERSHIP
☐ OTHER'
KEEP 1a. Your 1974 Detroit Income Tax $.
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
$.
THIS
3. ESTIMATED TAX (line 1b less line 2)
$.
COPY
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; ☐ Jan. 31, 1976–100%
5. Less: Amount of overpayment on 1974 return. which you elected to claim as a credit
$.
$
FOR
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5). . . .
$.
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
This declaration of estimated tax is not a Tax Return.
FINANCE DEPARTMENT - INCOME TAX DIVISION
DATE
D-1040-ES
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
Ỷ DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending:
19.
1975
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
ADDRESS
18135
CITY
MARUBY
LIVERNOIS
STATE
INC.
POSTAL ZIP CODE
DETROIT
MICHIGAN
48221
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ✓ CORPORATION
☐ PARTNERSHIP
☐ OTHER
1
DOCUMENT. LOCATOR NUMBER
1a. Your 1974 Detroit Income Tax $ 98.22,
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2)
$.
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; ☐ Jan. 31, 1976-100%
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$.
$
10
100
6783
3817
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
1 CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 246
DATE
40-25
C of D-15-DIT-) (Rev. 8-74)
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME
TAX COMPUTATION SCHEDULE
A.
TOTAL DETROIT INCOME EXPECTED IN 1975
B. EXEMPTIONS ($600.00 FOR EACH EXEMPTION)
$
S
1975
$
1
C.
ESTIMATED DETROIT TAXABLE INCOME (LINE A LESS LINE B)
D.
ESTIMATED DETROIT INCOME TAX-NONRESIDENT INDIVIDUALS ENTER ½ OF 1% OF LINE C.
ALL OTHER TAXPAYERS ENTER 2% OF LINE C. ENTER TAX HERE AND ON LINE 1b OF DECLARATION BELOW
$
D-1040-ES
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending.
19.
1975
'
NAME(S)
(PRINT OR TYPE)
YOUR SOCIAL SECURITY NUMBER
CHECK TYPE OF DECLARATION
1
I
ADDRESS
CITY
STATE
POSTAL ZIP CODE
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ☐ CORPORATION
☐ PARTNERSHIP
OTHER
KEEP
1a. Your 1974 Detroit Income Tax $..
THIS
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2)
;
$
COPY
4. Computation of installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
☐ Apr. 30, 1975-1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; Jan. 31, 1976-100%
S.
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
$
FOR
YOUR
RECORDS
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
MAKE REMITTANCE PAYABLE TO "TREASURER, CITY OF DETROIT"
AND MAIL WITH DECLARATION TO:
FINANCE DEPARTMENT - INCOME TAX DIVISION
104 CITY-COUNTY BUILDING
DETROIT, MICHIGAN 48226
This declaration of estimated tax is not a Tax Return.
DATE
D-1040-ES
DETACH ON PERFORATION AND SEND FORM BELOW WITH YOUR REMITTANCE
NAME(S)
MARUBY INC.
CITY OF DETROIT DECLARATION OF ESTIMATED INCOME TAX
For Calendar Year 1975 or Fiscal Year Ending:
(PRINT OR TYPE)
19.
1975
YOUR SOCIAL SECURITY NUMBER
ADDRESS
18135
LIVERNOIS
CHECK TYPE OF DECLARATION
☐ INDIVIDUAL
SPOUSE'S SOCIAL SECURITY NUMBER ☑ CORPORATION
CITY
PARTNERSHIP
DETOOT
STATE
.98.22.
MICHIGAN
1a. Your 1974 Detroit Income Tax $.
1b. Your Estimate of 1975 Detroit Income Tax.
2. Amount of Detroit Income Tax to be withheld or other credit expected in 1975.
3. ESTIMATED TAX (line 1b less line 2)
POSTAL ZIP CODE
48221
☐ OTHER
10
$.
DOCUMENT LOCATOR NUMBER
4. Computation of Installment: Check Due Date of declaration below and enter portion of line 3 as indicated:
100
☐ Apr. 30, 1975–1/4; ☐ June 30, 1975-1/3; ☐ Sept. 30, 1975-1/2; ☐ Jan. 31, 1976-100%
$
$
5. Less: Amount of overpayment on 1974 return which you elected to claim as a credit
6. AMOUNT TO BE PAID WITH THIS DECLARATION (line 4 less line 5).
61
3817
IF YOU ARE AN EMPLOYER, ENTER EMPLOYER IDENTIFICATION NUMBER
I CERTIFY THAT THIS IS A CORRECT DECLARATION.
This declaration of estimated tax is not a Tax Return.
Signature of Taxpayer. Spouse also if joint declaration.
NW 88326 Docld:32245535 Page 247
DATE