1040 U.S.

Individual Income Tax Return 2023

Form Department of the Treasury—Internal Revenue Service

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
Sayesta Anwar 660 48 4772
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
179 Ingleside Ave B2 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
White Sulphur Springs WV 249862539 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse

Filing Status 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 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 18,524.
b Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . . . 1b
Attach Form(s)
W-2 here. Also c Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . . 1c
attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d
W-2G and
1099-R if tax e Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . . 1e
was withheld. f Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . . 1f
If you did not g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . . 1g
get a Form
W-2, see
h Other earned income (see instructions) . . . . . . . . . . . . . . . . . . 1h 0.
instructions. i Nontaxable combat pay election (see instructions) . . . . . . . 1i
z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . 1z 18,524.
Attach Sch. B 2a Tax-exempt interest . . . 2a b Taxable interest . . . . . 2b
if required. 3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b
Standard
Deduction for— 5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b
• Single or 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b
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
• Married filing
jointly or 8 Additional income from Schedule 1, line 10 . . . . . . . . . . . . . . . . . 8
Qualifying
surviving spouse, 9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . . 9 18,524.
$27,700 10 Adjustments to income from Schedule 1, line 26 . . . . . . . . . . . . . . . 10
• Head of
household, 11 Subtract line 10 from line 9. This is your adjusted gross income . . . . . . . . . . 11 18,524.
$20,800
• If you checked
12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 13,850.
any box under 13 Qualified business income deduction from Form 8995 or Form 8995-A . . . . . . . . . 13
Standard
Deduction, 14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 13,850.
see instructions.
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income . . . . . 15 4,674.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. 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 . . 16 468.
Credits 17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 468.
19 Child tax credit or credit for other dependents from Schedule 8812 . . . . . . . . . . 19
20 Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . 20
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 468.
23 Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . . . 23 0.
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . . 24 468.
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 2,327.
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 2,327.
If you have a 26 2023 estimated tax payments and amount applied from 2022 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . 27
attach Sch. EIC.
28 Additional child tax credit from Schedule 8812 . . . . . . . . 28
29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3, line 15 . . . . . . . . . . . . 31
32 Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits . . 32
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . . 33 2,327.
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 1,859.
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a 1,859.
Direct deposit? b Routing number 0 5 1 5 0 3 1 7 4 c Type: Checking Savings
See instructions.
d Account number 0 0 8 9 2 6 7 4 6 1 2 8
36 Amount of line 34 you want applied to your 2024 estimated tax . . . 36
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
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . . 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? trainee (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. (935)411-8049 Email address

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid Self-employed
Preparer
Firm’s name Self-Prepared Phone no.
Use Only
Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040 for instructions and the latest information. BAA REV 03/04/24 Intuit.cg.cfp.sp Form 1040 (2023)
 :(679,5*,1,$
,7
3(5621$/,1&20(7$;5(7851 2023
SOCIAL Deceased **SPOUSE’S Deceased
SECURITY SOCIAL SECURITY
NUMBER 660484772 Date of Death* NUMBER Date of Death*
YOUR
LAST NAME SUFFIX FIRST MI
ANWAR NAME SAYESTA
SPOUSE’S
SPOUSE’S
SUFFIX FIRST MI
LAST NAME
NAME

FIRST LINE SECOND LINE

OF ADDRESS 179 INGLESIDE AVE APT B2 OF ADDRESS

CITY STATE ZIP CODE

WHITE SULPHUR SPRINGS WV 249862539
TELEPHONE EXTENDED
EMAIL DUE DATE
NUMBER 9354118049 MARKSAMSON520@GMAIL.COM MM/DD/YYYY
* ONLY INLCLUDE A DECEASED TAXPAYER AND THEIR DATE OF DEATH IF IT OCCURRED IN THIS TAX YEAR. FOR THE NEXT TWO YEARS, PLEASE LIST THEM BELOW ON THE SURVIVING SPOUSE EXPEMPTION.

AMENDED RETURN NONRESIDENT SPECIAL NONRESIDENT/PART YEAR RESIDENT FORM WV-8379 FI LED AS AN INJURED SPOUSE

FILING STATUS X 1 SINGLE 2 HEAD OF 3 MARRIED, 4 MARRIED, FILING SEPARATE 5 WIDOW(ER) WITH
(CHECK ONE) HOUSEHOLD FILING JOINT **Enter spouse’s SS# and name in the boxes above DEPENDENT CHILD

EXEMPTIONS
(a <2856(/) To claim an exemption for yourself, enter 1. If someone can claim you as a dependent, leave box (a) blank.) (a) 1
(b 63286( To claim an exemption for your spouse, enter 1. They may not be claimed as an exemption by anyone else. (b)

(F '(3(1'(176 List your dependents. If over four dependents, continue on Schedule DP on page 49. (QWHUWRWDOQXPEHURIGHSHQGHQWV (c)

Dependent First name Dependent Last name Social Security Number Date of Birth (MM DD YYYY)

(G 6859,9,1*63286( (See page 21) Decedents SSN Year Spouse Died:

(d)

(e 7RWDO([HPSWLRQV (add boxes a, b, c, and d). Enter here and on line 6 below. If box e is zero, enter $500 on line 6 below. (e) 1

1. Federal Adjusted Gross Income or income to claim senior citizen tax credit from Schedule SCTC-A 1 18524 .00

2. Additions to income (line 59 of Schedule M)............................................................................................. 2 .00

3. Subtractions from income (line 50 of Schedule M).................................................................................... 3 .00

4. West Virginia Adjusted Gross Income (line 1 plus line 2 minus line 3)...................................................... 4 18524 .00

5. Low-Income Earned Income Exclusion (see worksheet on page 29)........................................................ 5 .00

1 x $2,000 ........................................
6. Total Exemptions as shown above on Exemption Box (e) ________ 6 2000 .00

7. West Virginia Taxable Income (line 4 minus lines 5 & 6) IF LESS THAN ZERO, ENTER ZERO ............ 7 16524 .00

8. Income Tax Due (Check One) ................................................................................................................. 8 .00

442
X Tax Table Rate Schedule Nonresident/Part-year resident
calculation schedule
TAX DEPT USE ONLY MUST INCLUDE WITHHOLDING
PAY
PLAN
COR SCTC NRSR HEPTC FORMS WITH THIS RETURN
(W-2s, 1099s, Etc.)
*T O 4 0 2 0 2 3 0 1*
–1–
1555 REV 02/22/24 INTUIT.CG.CFP.SP
 PRIMARY LAST NAME ANWAR SOCIAL SECURITY NUMBER 660484772
9. Credits from Tax Credit Recap Schedule (see schedule on page 5 ) ............................................................ 9 .00

10. Total Income Tax Due. Line 8 minus 9. If line 9 is greater than line 8, enter 0 10
442 .00

11. Overpayment previously refunded or credited (amended return only) ........................................................... 11 .00
Penalty Due &+(&.,)5(48(67,1*:$,9(52548$/,),(')$50(5
12. West Virginia Use Tax Due on out-of-state purchases
(See Schedule UT on page 44). X CHECK IF NO USE TAX DUE ............... 12 .00

13. Add lines 10 through 12. This is your total amount due.................................................................................. 13 442 .00

Check if withholding from NRSR 741 .00

14. West Virginia Income Tax Withheld (See instructions page 23) (Nonresident Sale of Real Estate) 14

15. Estimated Tax Payments and Payments with Schedule 4868 ....................................................................... 15 0 .00

16. Non-Family Adoption Tax Credit, if applicable (include Schedule WV NFA-1) ................................................ 16 .00

17. Senior Citizen Tax Credit for property tax paid (include Schedule SCTC-A) .................................................. 17 .00

18. Homestead Excess Property Tax Credit for property tax paid (include Schedule HEPTC-1 and Class 2 receipt) 18 .00

19. Build WV Property Value Adjustment Refundable Tax Credit ........................................................................... 19 .00

20. Amount paid with original return (amended return only) ................................................................................ 20 .00

21. Payments and Refundable Credits (add lines 14 through 20) ....................................................................... 21 741 .00

%DODQFH'XH(line 13 minus line 21). If Line 21 is greater than line 13, complete line 23 ... PAY THIS AMOUNT 22 .00
23. Line 21 minus line 13. This is your overpayment ......................................................................................... 23 299 .00
24. Indicate donations from line 24. Enter below and enter the sum of columns 24A, 24B, and 24C on Line 24
24A. 24B. 24C.
CHILDREN’S TRUST 4WV DEPT. OF VETERANS STATE VETERANS
FUND ASSISTANCE CEMETERY 24 .00

25. Amount of Overpayment to be credited to your 2024 estimated tax............................................................... 25 .00

26. Refund due to you (line 23 minus line 24 and line 25).............................................................. REFUND 26 299 .00
'LUHFW'HSRVLW
RI5HIXQG X CHECKING SAVINGS 051503174 008926746128
ROUTING NUMBER ACCOUNT NUMBER
3/($6(5(9,(:<285$&&2817,1)250$7,21)25$&&85$&<,1&255(&7$&&2817,1)250$7,210$<5(68/7,1$5(7851('3$<0(17&+$5*(

I authorize the Tax Division to discuss my return with my preparer YES NO

Under penalty of perjury, I declare that I have examined this return, 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 Date Telephone Number

Preparer: Check
HERE if client is
requesting NOT
WRH¿OH
SELF-PREPARED
Preparer’s EIN Signature of preparer other than above Date Telephone Number

SELF-PREPARED
Preparer’s Printed Name Preparer’s Firm

)255()81'0$,/727+,6$''5(66 )25%$/$1&('8(0$,/727+,6$''5(66
WV TAX DIVISION WV TAX DIVISION
P.O. BOX 1071 P.O. BOX 3694
CHARLESTON, WV 25324-1071 CHARLESTON, WV 25336-3694
3D\PHQW2SWLRQV5HWXUQV¿OHGZLWKDEDODQFHRIWD[GXHPD\SD\WKURXJKDQ\RIWKHIROORZLQJPHWKRGV
• Check or Money Order payable to the WV Tax Division - Enclose check or money order with your return.
• Electronic Payment - May be made by visiting mytaxes.wvtax.gov and clicking on “Pay Personal Income Tax”. *T O 4 0 2 0 2 3 0 2*
REV 02/22/24 INTUIT.CG.CFP.SP
1555 –2–