1040 U.S.

Individual Income Tax Return 2023

Department of the Treasury—Internal Revenue Service
Form

OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2023, or other tax year beginning , 2023, ending , 20 See separate instructions.
Your first name and middle initial Last name Your social security number
SHELBY L PALMER 6 3 9 3 6 9 5 3 8
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
7770 PIPERS LN 104 Check here if you, or your
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3
to go to this fund. Checking a
SANANTONIO TX 78251 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse

Filing Status X Single Head of household (HOH)

Married filing jointly (even if only one had income)
Check only
one box. Married filing separately (MFS) Qualifying surviving spouse (QSS)
If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child’s name if the
qualifying person is a child but not your dependent:

Digital At any time during 2023, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell,
Assets exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) Yes X No
Standard Someone can claim: You as a dependent Your spouse as a dependent
Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1959 Are blind Spouse: Was born before January 2, 1959 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) Check the box if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more
than four
dependents,
see instructions
and check
here . .

Income 1a Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . . . . . . . 1a 0

b Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . . . 1b 0
Attach Form(s)
W-2 here. Also c Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . . 1c 0
attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d 0
W-2G and
1099-R if tax e Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . . 1e 0
was withheld. f Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . . 1f 0
If you did not g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . . 1g 0
get a Form
W-2, see
h Other earned income (see instructions) . . . . . . . . . . . . . . . . . . 1h 0
instructions. i Nontaxable combat pay election (see instructions) . . . . . . . 1i 0
z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . 1z 0
Attach Sch. B 2a Tax-exempt interest . . . 2a 0 b Taxable interest . . . . . 2b 0
if required. 3a Qualified dividends . . . 3a 0 b Ordinary dividends . . . . . 3b 0
4a IRA distributions . . . . 4a 0 b Taxable amount . . . . . . 4b 0
Standard
Deduction for— 5a Pensions and annuities . . 5a 0 b Taxable amount . . . . . . 5b
• Single or 6a Social security benefits . . 6a 0 b Taxable amount . . . . . . 6b 0
Married filing
separately, c If you elect to use the lump-sum election method, check here (see instructions) . . . . .
$13,850 7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . 7 0
• Married filing
jointly or 8 Additional income from Schedule 1, line 10 . . . . . . . . . . . . . . . . . 8 67,036
Qualifying
surviving spouse, 9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . . 9 67,036
$27,700 10 Adjustments to income from Schedule 1, line 26 . . . . . . . . . . . . . . . 10 36,545
• Head of
household, 11 Subtract line 10 from line 9. This is your adjusted gross income . . . . . . . . . . 11 30,491
$20,800
12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 13,850
• If you checked
any box under 13 Qualified business income deduction from Form 8995 or Form 8995-A . . . . . . . . . 13 3,328
Standard
Deduction, 14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 17,178
see instructions.
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income . . . . . 15 13,313
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2023)
Form 1040 (2023) Page 2

Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 1,379
Credits 17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17 0
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 1,379
19 Child tax credit or credit for other dependents from Schedule 8812 . . . . . . . . . . 19 0
20 Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . 20 0
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 1,379
23 Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . . . 23 9,472
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . . 24 10,851
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 0
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b 0
c Other forms (see instructions) . . . . . . . . . . . . . 25c 0
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 0
If you have a 26 2023 estimated tax payments and amount applied from 2022 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . 27 0
attach Sch. EIC.
28 Additional child tax credit from Schedule 8812 . . . . . . . . 28 0
29 American opportunity credit from Form 8863, line 8 . . . . . . . 29 0
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3, line 15 . . . . . . . . . . . . 31 17,998
32 Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits . . 32 17,998
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . . 33 17,998
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 7,147
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a 7,147
Direct deposit? b Routing number 0 4 1 2 1 5 6 6 3 c Type: X Checking Savings
See instructions.
d Account number 1 3 4 5 1 0 2 8 6 1 9 1 9
36 Amount of line 34 you want applied to your 2024 estimated tax . . . 36 0
Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions . . . . . . . . 37 0
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38 0
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . . Yes. Complete below. No
Designee’s Phone Personal identification
name no. number (PIN)

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

Phone no. Email address

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid Self-employed
Preparer
Firm’s name Phone no.
Use Only
Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2023)
SCHEDULE 1 OMB No. 1545-0074
Additional Income and Adjustments to Income
(Form 1040)
Department of the Treasury
Attach to Form 1040, 1040-SR, or 1040-NR. 2023
Attachment
Go to www.irs.gov/Form1040 for instructions and the latest information.
Internal Revenue Service Sequence No. 01
Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
SHELBY L PALMER 639369538
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . 1 0
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a 0
b Date of original divorce or separation agreement (see instructions):
3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . . . 3 67,036
4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income:
a Net operating loss . . . . . . . . . . . . . . . . . . . 8a ( )
b Gambling . . . . . . . . . . . . . . . . . . . . . . 8b 0
c Cancellation of debt . . . . . . . . . . . . . . . . . . 8c 0
d Foreign earned income exclusion from Form 2555 . . . . . . . 8d ( )
e Income from Form 8853 . . . . . . . . . . . . . . . . . 8e
f Income from Form 8889 . . . . . . . . . . . . . . . . . 8f 0
g Alaska Permanent Fund dividends . . . . . . . . . . . . . 8g 0
h Jury duty pay . . . . . . . . . . . . . . . . . . . . . 8h 0
i Prizes and awards . . . . . . . . . . . . . . . . . . . 8i 0
j Activity not engaged in for profit income . . . . . . . . . . . 8j 0
k Stock options . . . . . . . . . . . . . . . . . . . . . 8k 0
l Income from the rental of personal property if you engaged in the rental
for profit but were not in the business of renting such property . . . 8l 0
m Olympic and Paralympic medals and USOC prize money (see
instructions) . . . . . . . . . . . . . . . . . . . . . 8m 0
n Section 951(a) inclusion (see instructions) . . . . . . . . . . 8n 0
o Section 951A(a) inclusion (see instructions) . . . . . . . . . . 8o 0
p Section 461(l) excess business loss adjustment . . . . . . . . 8p
q Taxable distributions from an ABLE account (see instructions) . . . 8q 0
r Scholarship and fellowship grants not reported on Form W-2 . . . 8r
s Nontaxable amount of Medicaid waiver payments included on Form
1040, line 1a or 1d . . . . . . . . . . . . . . . . . . . 8s ( 0)
t Pension or annuity from a nonqualifed deferred compensation plan or
a nongovernmental section 457 plan . . . . . . . . . . . . 8t 0
u Wages earned while incarcerated . . . . . . . . . . . . . 8u 0
z Other income. List type and amount:
8z
9 Total other income. Add lines 8a through 8z . . . . . . . . . . . . . . . . . . 9 0
10 Combine lines 1 through 7 and 9. This is your additional income. Enter here and on Form
1040, 1040-SR, or 1040-NR, line 8 . . . . . . . . . . . . . . . . . . . . . 10 67,036
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040) 2023
Schedule 1 (Form 1040) 2023 Page 2

Part II Adjustments to Income

11 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 0
12 Certain business expenses of reservists, performing artists, and fee-basis government
officials. Attach Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . 13 0
14 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . 14
15 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . 15 4,736
16 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . 16 31,809
17 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . 17 0
18 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . 18 0
19a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19a 0
b Recipient’s SSN . . . . . . . . . . . . . . . . . . . . . .
c Date of original divorce or separation agreement (see instructions):
20 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 0
21 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . 22
23 Archer MSA deduction . . . . . . . . . . . . . . . . . . . . . . . . . 23
24 Other adjustments:
a Jury duty pay (see instructions) . . . . . . . . . . . . . . 24a 0
b Deductible expenses related to income reported on line 8l from the
rental of personal property engaged in for profit . . . . . . . . 24b 0
c Nontaxable amount of the value of Olympic and Paralympic medals
and USOC prize money reported on line 8m . . . . . . . . . . 24c 0
d Reforestation amortization and expenses . . . . . . . . . . . 24d 0
e Repayment of supplemental unemployment benefits under the Trade
Act of 1974 . . . . . . . . . . . . . . . . . . . . . . 24e 0
f Contributions to section 501(c)(18)(D) pension plans . . . . . . . 24f 0
g Contributions by certain chaplains to section 403(b) plans . . . . 24g 0
h Attorney fees and court costs for actions involving certain unlawful
discrimination claims (see instructions) . . . . . . . . . . . . 24h 0
i Attorney fees and court costs you paid in connection with an award
from the IRS for information you provided that helped the IRS detect
tax law violations . . . . . . . . . . . . . . . . . . . 24i 0
j Housing deduction from Form 2555 . . . . . . . . . . . . . 24j
k Excess deductions of section 67(e) expenses from Schedule K-1 (Form
1041) . . . . . . . . . . . . . . . . . . . . . . . . 24k
z Other adjustments. List type and amount:
24z
25 Total other adjustments. Add lines 24a through 24z . . . . . . . . . . . . . . . 25 0
26 Add lines 11 through 23 and 25. These are your adjustments to income. Enter here and on
Form 1040, 1040-SR, or 1040-NR, line 10 . . . . . . . . . . . . . . . . . . 26 36,545
Schedule 1 (Form 1040) 2023
SCHEDULE 2 OMB No. 1545-0074
Additional Taxes
(Form 1040)
Department of the Treasury
Attach to Form 1040, 1040-SR, or 1040-NR. 2023
Attachment
Go to www.irs.gov/Form1040 for instructions and the latest information.
Internal Revenue Service Sequence No. 02
Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
SHELBY L PALMER 639369538
Part I Tax
1 Alternative minimum tax. Attach Form 6251 . . . . . . . . . . . . . . . . 1
2 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . 2
3 Add lines 1 and 2. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 17 . . 3 0
Part II Other Taxes
4 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . 4 9,472

5 Social security and Medicare tax on unreported tip income.

Attach Form 4137 . . . . . . . . . . . . . . . . . . 5
6 Uncollected social security and Medicare tax on wages. Attach
Form 8919 . . . . . . . . . . . . . . . . . . . . . 6
7 Total additional social security and Medicare tax. Add lines 5 and 6 . . . . . . 7 0

8 Additional tax on IRAs or other tax-favored accounts. Attach Form 5329 if required.
If not required, check here . . . . . . . . . . . . . . . . . . . . . 8
9 Household employment taxes. Attach Schedule H . . . . . . . . . . . . . 9
10 Repayment of first-time homebuyer credit. Attach Form 5405 if required . . . . . 10
11 Additional Medicare Tax. Attach Form 8959 . . . . . . . . . . . . . . . . 11
12 Net investment income tax. Attach Form 8960 . . . . . . . . . . . . . . . 12
13 Uncollected social security and Medicare or RRTA tax on tips or group-term life
insurance from Form W-2, box 12 . . . . . . . . . . . . . . . . . . . . 13 0

14 Interest on tax due on installment income from the sale of certain residential lots
and timeshares . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Interest on the deferred tax on gain from certain installment sales with a sales price
over $150,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Recapture of low-income housing credit. Attach Form 8611 . . . . . . . . . . 16
(continued on page 2)
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71478U Schedule 2 (Form 1040) 2023
Schedule 2 (Form 1040) 2023 Page 2

Part II Other Taxes (continued)

17 Other additional taxes:
a Recapture of other credits. List type, form number, and amount:
17a
b Recapture of federal mortgage subsidy, if you sold your home
see instructions . . . . . . . . . . . . . . . . . . . 17b
c Additional tax on HSA distributions. Attach Form 8889 . . . . 17c
d Additional tax on an HSA because you didn’t remain an eligible
individual. Attach Form 8889 . . . . . . . . . . . . . . 17d
e Additional tax on Archer MSA distributions. Attach Form 8853 . 17e
f Additional tax on Medicare Advantage MSA distributions. Attach
Form 8853 . . . . . . . . . . . . . . . . . . . . . 17f
g Recapture of a charitable contribution deduction related to a
fractional interest in tangible personal property . . . . . . . 17g
h Income you received from a nonqualified deferred compensation
plan that fails to meet the requirements of section 409A . . . 17h
i Compensation you received from a nonqualified deferred
compensation plan described in section 457A . . . . . . . 17i
j Section 72(m)(5) excess benefits tax . . . . . . . . . . . 17j
k Golden parachute payments . . . . . . . . . . . . . . 17k
l Tax on accumulation distribution of trusts . . . . . . . . . 17l
m Excise tax on insider stock compensation from an expatriated
corporation . . . . . . . . . . . . . . . . . . . . . 17m
n Look-back interest under section 167(g) or 460(b) from Form
8697 or 8866 . . . . . . . . . . . . . . . . . . . . 17n
o Tax on non-effectively connected income for any part of the
year you were a nonresident alien from Form 1040-NR . . . . 17o
p Any interest from Form 8621, line 16f, relating to distributions
from, and dispositions of, stock of a section 1291 fund . . . . 17p
q Any interest from Form 8621, line 24 . . . . . . . . . . . 17q
z Any other taxes. List type and amount:
17z
18 Total additional taxes. Add lines 17a through 17z . . . . . . . . . . . . . . 18 0

19 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . 19

20 Section 965 net tax liability installment from Form 965-A . . . 20
21 Add lines 4, 7 through 16, and 18. These are your total other taxes. Enter here and
on Form 1040 or 1040-SR, line 23, or Form 1040-NR, line 23b . . . . . . . . . 21 9,472
Schedule 2 (Form 1040) 2023
SCHEDULE 3 OMB No. 1545-0074
Additional Credits and Payments
2023
(Form 1040)
Attach to Form 1040, 1040-SR, or 1040-NR.
Department of the Treasury Attachment
Go to www.irs.gov/Form1040 for instructions and the latest information.
Internal Revenue Service Sequence No. 03
Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
SHELBY L PALMER 639369538
Part I Nonrefundable Credits
1 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . 1 0

2 Credit for child and dependent care expenses from Form 2441, line 11. Attach
Form 2441 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0

3 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . . . 3 0

4 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . . 4 0

5a Residential clean energy credit from Form 5695, line 15 . . . . . . . . . . . 5a 0

b Energy efficient home improvement credit from Form 5695, line 32 . . . . . . 5b 0

6 Other nonrefundable credits:

a General business credit. Attach Form 3800 . . . . . . . . 6a 0

b Credit for prior year minimum tax. Attach Form 8801 . . . . 6b

c Adoption credit. Attach Form 8839 . . . . . . . . . . . . 6c 0

d Credit for the elderly or disabled. Attach Schedule R . . . . . 6d 0

e Reserved for future use . . . . . . . . . . . . . . . . 6e 0

f Clean vehicle credit. Attach Form 8936 . . . . . . . . . . 6f 0

g Mortgage interest credit. Attach Form 8396 . . . . . . . . 6g 0

h District of Columbia first-time homebuyer credit. Attach Form 8859 6h 0

i Qualified electric vehicle credit. Attach Form 8834 . . . . . 6i 0

j Alternative fuel vehicle refueling property credit. Attach Form 8911 6j 0

k Credit to holders of tax credit bonds. Attach Form 8912 . . . 6k 0

l Amount on Form 8978, line 14. See instructions . . . . . . 6l 0

m Credit for previously owned clean vehicles. Attach Form 8936 . 6m 0

z Other nonrefundable credits. List type and amount:

6z 0

7 Total other nonrefundable credits. Add lines 6a through 6z . . . . . . . . . . 7 0

8 Add lines 1 through 4, 5a, 5b, and 7. Enter here and on Form 1040, 1040-SR, or
1040-NR, line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 0

(continued on page 2)
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71480G Schedule 3 (Form 1040) 2023
Schedule 3 (Form 1040) 2023 Page 2

Part II Other Payments and Refundable Credits

9 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . 9 0

10 Amount paid with request for extension to file (see instructions) . . . . . . . . 10 17,998

11 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . . . . 11 0

12 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . . . . 12 0

13 Other payments or refundable credits:

a Form 2439 . . . . . . . . . . . . . . . . . . . . . 13a 0

b Credit for repayment of amounts included in income from earlier

years . . . . . . . . . . . . . . . . . . . . . . . . 13b 0

c Elective payment election amount from Form 3800, Part III, line
6, column (i) . . . . . . . . . . . . . . . . . . . . . 13c 0

d Deferred amount of net 965 tax liability (see instructions) . . . 13d 0

z Other payments or refundable credits. List type and amount:

13z 0

14 Total other payments or refundable credits. Add lines 13a through 13z . . . . . 14 0

15 Add lines 9 through 12 and 14. Enter here and on Form 1040, 1040-SR, or 1040-NR,
line 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 17,998
Schedule 3 (Form 1040) 2023
SCHEDULE C Profit or Loss From Business OMB No. 1545-0074
(Form 1040)
Department of the Treasury
(Sole Proprietorship)
Attach to Form 1040, 1040-SR, 1040-SS, 1040-NR, or 1041; partnerships must generally file Form 1065. 2023
Attachment
Internal Revenue Service Go to www.irs.gov/ScheduleC for instructions and the latest information. Sequence No. 09
Name of proprietor Social security number (SSN)
SHELBY L PALMER 639369538
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
DOORDASH 4 4 5 3 2 0
C Business name. If no separate business name, leave blank. D Employer ID number (EIN) (see instr.)
SHELBYS RETAILER
E Business address (including suite or room no.) 13999 OLD BLANCO RD
City, town or post office, state, and ZIP code SAN ANTONIO TX
F Accounting method: (1) Cash (2) X Accrual (3) Other (specify)
G Did you “materially participate” in the operation of this business during 2023? If “No,” see instructions for limit on losses . X Yes No
H If you started or acquired this business during 2023, check here . . . . . . . . . . . . . . . . . . X
I Did you make any payments in 2023 that would require you to file Form(s) 1099? See instructions . . . . . . . . X Yes No
J If “Yes,” did you or will you file required Form(s) 1099? . . . . . . . . . . . . . . . . . . . . . X Yes No
Part I Income
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on
Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . 1 62,563
2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . 2 0
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3 62,563
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4 0
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5 62,563
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . 6 35,088
7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . 7 97,651
Part II Expenses. Enter expenses for business use of your home only on line 30.
8 Advertising . . . . . 8 0 18 Office expense (see instructions) . 18 3,000
9 Car and truck expenses 19 Pension and profit-sharing plans . 19 0
(see instructions) . . . 9 17,815 20 Rent or lease (see instructions):
10 Commissions and fees . 10 1,000 a Vehicles, machinery, and equipment 20a 7,800
11 Contract labor (see instructions) 11 0 b Other business property . . . 20b 0
12 Depletion . . . . . 12 21 Repairs and maintenance . . . 21 0
13 Depreciation and section 179 22 Supplies (not included in Part III) . 22 0
expense deduction (not
included in Part III) (see 23 Taxes and licenses . . . . . 23 0
instructions) . . . . 13 24 Travel and meals:
14 Employee benefit programs a Travel . . . . . . . . . 24a 0
(other than on line 19) . 14 0 b Deductible meals (see instructions) 24b 1,000
15 Insurance (other than health) 15 0 25 Utilities . . . . . . . . 25 0
16 Interest (see instructions): 26 Wages (less employment credits) 26 0
a Mortgage (paid to banks, etc.) 16a 27a Other expenses (from line 48) . . 27a
b Other . . . . . . 16b b Energy efficient commercial bldgs
17 Legal and professional services 17 0 deduction (attach Form 7205) . . 27b
28 Total expenses before expenses for business use of home. Add lines 8 through 27b . . . . . . . 28 30,615
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29 67,036
30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method. See instructions.
Simplified method filers only: Enter the total square footage of (a) your home: 0
and (b) the part of your home used for business: 0 . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30

}
31 Net profit or (loss). Subtract line 30 from line 29.
• If a profit, enter on both Schedule 1 (Form 1040), line 3, and on Schedule SE, line 2. (If you
checked the box on line 1, see instructions.) Estates and trusts, enter on Form 1041, line 3. 31 67,036
• If a loss, you must go to line 32.

}
32 If you have a loss, check the box that describes your investment in this activity. See instructions.

• If you checked 32a, enter the loss on both Schedule 1 (Form 1040), line 3, and on Schedule
SE, line 2. (If you checked the box on line 1, see the line 31 instructions.) Estates and trusts, enter on 32a X All investment is at risk.
Form 1041, line 3. 32b Some investment is not
• If you checked 32b, you must attach Form 6198. Your loss may be limited. at risk.
For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11334P Schedule C (Form 1040) 2023
Schedule C (Form 1040) 2023 Page 2
Part III Cost of Goods Sold (see instructions)

33 Method(s) used to
value closing inventory: a Cost b Lower of cost or market c Other (attach explanation)
34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory?
If “Yes,” attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No

35 Inventory at beginning of year. If different from last year’s closing inventory, attach explanation . . . 35

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36 0

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37 0

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38 0

39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 0

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40 0

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41 0

42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 . . . . . . 42 0
Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and
are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must file
Form 4562.

43 When did you place your vehicle in service for business purposes? (month/day/year) 0 8 / 0 1 /2 0 2 3

44 Of the total number of miles you drove your vehicle during 2023, enter the number of miles you used your vehicle for:

a Business 27,000 b Commuting (see instructions) 0 c Other 0

45 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . . Yes X No

46 Do you (or your spouse) have another vehicle available for personal use?. . . . . . . . . . . . . . X Yes No

47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes X No

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No

Part V Other Expenses. List below business expenses not included on lines 8–26, line 27b, or line 30.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48

Schedule C (Form 1040) 2023
SCHEDULE SE OMB No. 1545-0074
(Form 1040) Self-Employment Tax
Department of the Treasury
Attach to Form 1040, 1040-SR, 1040-SS, or 1040-NR. 2023
Attachment
Internal Revenue Service Go to www.irs.gov/ScheduleSE for instructions and the latest information. Sequence No. 17
Name of person with self-employment income (as shown on Form 1040, 1040-SR, 1040-SS, or 1040-NR) Social security number of person
SHELBY L PALMER with self-employment income 639369538
Part I Self-Employment Tax
Note: If your only income subject to self-employment tax is church employee income, see instructions for how to report your income
and the definition of church employee income.
A If you are a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361, but you had
$400 or more of other net earnings from self-employment, check here and continue with Part I . . . . . . . . .
Skip lines 1a and 1b if you use the farm optional method in Part II. See instructions.
1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065),
box 14, code A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a 0
b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve
Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code AQ 1b ( 0)
Skip line 2 if you use the nonfarm optional method in Part II. See instructions.
2 Net profit or (loss) from Schedule C, line 31; and Schedule K-1 (Form 1065), box 14, code A (other than
farming). See instructions for other income to report or if you are a minister or member of a religious order 2 67,036
3 Combine lines 1a, 1b, and 2 . . . . . . . . . . . . . . . . . . . . . . . . . 3 67,036
4a If line 3 is more than zero, multiply line 3 by 92.35% (0.9235). Otherwise, enter amount from line 3 . 4a 61,908
Note: If line 4a is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions.
b If you elect one or both of the optional methods, enter the total of lines 15 and 17 here . . . . . 4b 0
c Combine lines 4a and 4b. If less than $400, stop; you don’t owe self-employment tax. Exception: If
less than $400 and you had church employee income, enter -0- and continue . . . . . . . . 4c 61,908
5a Enter your church employee income from Form W-2. See instructions for
definition of church employee income . . . . . . . . . . . . . 5a 0
b Multiply line 5a by 92.35% (0.9235). If less than $100, enter -0- . . . . . . . . . . . . . 5b 0
6 Add lines 4c and 5b . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 61,908
7 Maximum amount of combined wages and self-employment earnings subject to social security tax or
the 6.2% portion of the 7.65% railroad retirement (tier 1) tax for 2023 . . . . . . . . . . . 7 160,200
8a Total social security wages and tips (total of boxes 3 and 7 on Form(s) W-2)
and railroad retirement (tier 1) compensation. If $160,200 or more, skip lines
8b through 10, and go to line 11 . . . . . . . . . . . . . . . 8a 0
b Unreported tips subject to social security tax from Form 4137, line 10 . . . 8b 0
c Wages subject to social security tax from Form 8919, line 10 . . . . . . 8c 0
d Add lines 8a, 8b, and 8c . . . . . . . . . . . . . . . . . . . . . . . . . . 8d 0
9 Subtract line 8d from line 7. If zero or less, enter -0- here and on line 10 and go to line 11 . . . . 9 160,200
10 Multiply the smaller of line 6 or line 9 by 12.4% (0.124) . . . . . . . . . . . . . . . . 10 7,677
11 Multiply line 6 by 2.9% (0.029) . . . . . . . . . . . . . . . . . . . . . . . . 11 1,795
12 Self-employment tax. Add lines 10 and 11. Enter here and on Schedule 2 (Form 1040), line 4, or
Form 1040-SS, Part I, line 3 . . . . . . . . . . . . . . . . . . . . . . . . 12 9,472
13 Deduction for one-half of self-employment tax.
Multiply line 12 by 50% (0.50). Enter here and on Schedule 1 (Form 1040),
line 15 . . . . . . . . . . . . . . . . . . . . . . . . 13 4,736
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 11358Z Schedule SE (Form 1040) 2023
Schedule SE (Form 1040) 2023 Page 2
Part II Optional Methods To Figure Net Earnings (see instructions)
Farm Optional Method. You may use this method only if (a) your gross farm income1 wasn’t more than
$9,840, or (b) your net farm profits2 were less than $7,103.
14 Maximum income for optional methods . . . . . . . . . . . . . . . . . . . . . 14 6,560
15 Enter the smaller of: two-thirds (2/3) of gross farm income1 (not less than zero) or $6,560. Also, include
this amount on line 4b above . . . . . . . . . . . . . . . . . . . . . . . . 15 0
Nonfarm Optional Method. You may use this method only if (a) your net nonfarm profits3 were less than $7,103
and also less than 72.189% of your gross nonfarm income,4 and (b) you had net earnings from self-employment
of at least $400 in 2 of the prior 3 years. Caution: You may use this method no more than five times.
16 Subtract line 15 from line 14 . . . . . . . . . . . . . . . . . . . . . . . . . 16 0
17 Enter the smaller of: two-thirds (2/3) of gross nonfarm income4 (not less than zero) or the amount on
line 16. Also, include this amount on line 4b above . . . . . . . . . . . . . . . . . 17 0
1 3
From Sch. F, line 9; and Sch. K-1 (Form 1065), box 14, code B. From Sch. C, line 31; and Sch. K-1 (Form 1065), box 14, code A.
2 4
From Sch. F, line 34; and Sch. K-1 (Form 1065), box 14, code A—minus the amount From Sch. C, line 7; and Sch. K-1 (Form 1065), box 14, code C.
you would have entered on line 1b had you not used the optional method.
Schedule SE (Form 1040) 2023
Form 8995 Qualified Business Income Deduction OMB No. 1545-2294

Simplified Computation
Attach to your tax return.
2023
Department of the Treasury Attachment
Internal Revenue Service Go to www.irs.gov/Form8995 for instructions and the latest information. Sequence No. 55
Name(s) shown on return Your taxpayer identification number
SHELBY L PALMER 639369538
Note. You can claim the qualified business income deduction only if you have qualified business income from a qualified trade or
business, real estate investment trust dividends, publicly traded partnership income, or a domestic production activities deduction
passed through from an agricultural or horticultural cooperative. See instructions.
Use this form if your taxable income, before your qualified business income deduction, is at or below $182,100 ($364,200 if married
filing jointly), and you aren’t a patron of an agricultural or horticultural cooperative.

1 (a) Trade, business, or aggregation name (b) Taxpayer (c) Qualified business
identification number income or (loss)

i SHELBYS RETAILER 639369538 76,987

ii

iii

iv

v
2 Total qualified business income or (loss). Combine lines 1i through 1v,
column (c) . . . . . . . . . . . . . . . . . . . . . . 2 76,987
3 Qualified business net (loss) carryforward from the prior year . . . . . . . 3 ( 0 )
4 Total qualified business income. Combine lines 2 and 3. If zero or less, enter -0- 4 76,987
5 Qualified business income component. Multiply line 4 by 20% (0.20) . . . . . . . . . . . 5 15,397
6 Qualified REIT dividends and publicly traded partnership (PTP) income or (loss)
(see instructions) . . . . . . . . . . . . . . . . . . . . 6 0
7 Qualified REIT dividends and qualified PTP (loss) carryforward from the prior
year . . . . . . . . . . . . . . . . . . . . . . . . . 7 ( 0 )
8 Total qualified REIT dividends and PTP income. Combine lines 6 and 7. If zero
or less, enter -0- . . . . . . . . . . . . . . . . . . . . 8 0
9 REIT and PTP component. Multiply line 8 by 20% (0.20) . . . . . . . . . . . . . . . 9 0
10 Qualified business income deduction before the income limitation. Add lines 5 and 9 . . . . . . 10 15,397
11 Taxable income before qualified business income deduction (see instructions) 11 16,641
12 Enter your net capital gain, if any, increased by any qualified dividends
(see instructions) . . . . . . . . . . . . . . . . . . . . 12 0
13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . 13 16,641
14 Income limitation. Multiply line 13 by 20% (0.20) . . . . . . . . . . . . . . . . . . 14 3,328
15 Qualified business income deduction. Enter the smaller of line 10 or line 14. Also enter this amount on
the applicable line of your return (see instructions) . . . . . . . . . . . . . . . . . 15 3,328
16 Total qualified business (loss) carryforward. Combine lines 2 and 3. If greater than zero, enter -0- . . 16 ( 0 )
17 Total qualified REIT dividends and PTP (loss) carryforward. Combine lines 6 and 7. If greater than
zero, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 ( 0 )
For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 37806C Form 8995 (2023)