Employer: CompanyOne Address: 1111 Place Road City: One City State: California Zip code: 11112 Employer’ s FED ID number: 33-01XXX22 Dependent: Tara Petersan SSN: 001-XX-XX00 DOB: 12 / 29 / 2004 Child Care Costs: $ 10,320 Child Care Provider: fabulous daycarecenter Address: 121 Place Road City: One City State: California Zip code: 11111 Identifying number: 33-XXXX011 Life Change Events Home Sale: Primary residence sale price $ 520,000 cost basis( incurred three years prior) $ 300,000