Dear I lonorable Mayor and Members of the Council,
My name is Douaa Megahed, the wife of the recently deceased Galal Salem Namatalla and the recent owner of the land on 4021 Somerset Boulevard.
My husband passed away on April 25, 2021 after years of struggling against pancreatic cancer. After his passing, I found a letter from City of Bellflowers, So I decided to visit the City Hall to inquire about the situation regarding the property, and was surprised to find that I owed $33,440.14 for the cleaning of the lot. In the beginning of 2018, my family and I moved to Riverside County, where my husband was diagnosed with pancreatic cancer in September of 2018. Due to our relocation, we were not able to receive the letters sent to our Downey residence until we moved back near the end of 2020. At that time, he was scheduled for a big surgery and multiple radiation sessions shortly afterwards, so he wasn't able to deal with any of the issues regarding the property. Until his passing, I was not involved in any business, my husband was the one who took care of everything until he had his fetal disease, so I had no experience when it came time for me to handle everything.
The main source of income for my family was my husband's work, so after his passing we lost most of our income. I will attach a copy of our most recent tax return for the year of 2021, in addition to the W-2 we received from his job for the 4 months he was a live. I have four children, two of which are in college and two in high school.
After my visit to the City Hall, I began communicating with the Assistant City Attorney, Timothy E. Campen. I attempted to resolve this issue as effectively as I could considering the circumstances I was in. I offered 4,000 at the beginning. and then offered 15,000 to solve the
problem completely. I received a letter that I was offered 10,000 but it never happened. I don't know where the 10,000 offers come from.
I ani currently willing to pay up to half of the original value. I am not able to pay the full amount, and I do not want a lien on the property as it is my childrens' inheritance.
After looking into the expenses listed for the work done on the property, I made some comparisons to try and make sense of the incredibly high values. I was charged $10,950.00 for the fence (144 ft plus the 16 ft gate opening, 3f1: high, 2 rail white vinyl). The same material and quality with 3 rails and 4 ft high was $127 for 8 ft at Home Depot. As a result, the price for the material would have come out to be $2,286. In addition to the labor, the job should not have exceeded $5,000. The same goes for the wood chips. I was charged $11,792 for installation of the wood chips, but when calculated, the price did not exceed $5,000. In addition, I was charged $8,950 for "clear and grub." I want to clarify that the land was flat, with only weeds to be cleared. I will attach all the documents that prove my estimated price.
I will attach the 2021 tax return and all income sources that belong to my husband in this year, and my major expenses during the year, including my kids tuition and our mortgage. My husband received a W2 for the 4 months he was alive and I received a 1099 MISC for him as a death benefit for a surviving spouse; the total for both is $60,352. This amount will not be in my income next year. ,Both W2 are one time payments.
I sincerely hope that you consider these facts when coming to a decision, and that we come to an agreeable solution soon.
Thank you very much,
Douaa Megahed
DECEASED GALAL SALEM 04-25-2021
Dopartmonl of the Troasury-Infornot tievenue asivii; "" 040 U.S. Individual Income Tax Return G>�2 OMB No, 1545-0074 f IRS Um Only -Do not wme of stapio In this sps;a.
Filing Status U Single XU Married filing Jointly U Married filing separately (MFS) U Head of household (HOH) U Qualrlying widower) (OW) Chock only 11 you checked [lie MFS box, enter the name of your spouse. If you checked the HOH or OW box, ontor the child's name if the one box. qualifying person Is a child but not your dependent ► Your first namo and middle initial Last name Your.
GALAL SALEM
If joint return, spouse's first name and middle Initial Last name Spou ber
DOUAA MEGAHED
Home address (number and street). If you have a P.O, box, see instructions. Apt. no. Presidential Election Campaign 9241 LUBEC ST Check here d you, or your
spouse 6 filing jointly, want S3
City, town, or post elf ica. If you have a foreign address, also complete spaces below, State ZIP code to go to this fund. Checking a DOWNE Y I CA 90240 box below will not change
Foreign country name Foreign provincelstate/county Foreign postal code your tax or refund.
You Spouse
At any time during 2021, did you receive, self, exchange, or otherwise dispose of any financial interest in any virtual currency? Yes No Standard Someone can claim:11 You as a dependent 0 Your spouse as a dependent Deduction 11 Spouse itemizes on a separate return or you were a dual -status alien AgelBlindness You: Were born before January 2, 1957 Are blind Spouse: Was born before January 2, 1957 1 Is blind Dependents (see instructions): (2) Social security (3) Relationship (4) / ,f quabf es for Cndo mst):
radafor other
(1) First name Lest name number to you Child tax credit dependants a more AHMED SALEM
O
edAN
Hepnents, AYA SALEM
ane ckcGons
h MAHMOUD SALEM ON
here ► FIMOHAMED SALEM ON
1 Wages, Salaries, tips, etc. Attach Form(s) W-2 .... I 1 4 2 411 Attach 2a Tax-exempt interest 2a b Taxable interest .......... . ... . . 21b Sch. B if
required. 3a Qualified dividends ......., 3a b Ordinary dividends 3b 4a IRA distributions .. , , , , 4a b Taxable amount , ,,, , ,,, , , , , , , , , 4b Standard Sa Pensions and annuities 5a b Taxable amount , , ,,,,, , , , , , , , , , 5b Deduction for- 6a Social security benefits 6a b Taxable amount , , , , , , , , , , , , , ,i -_I, -,t 6b • Single or Married 7 Capital gain or (loss). Attach Schedule D it required. If not required, check here . . . .......... 10,I_ 7 !ding separately, 8 Other income from Schedule 1, line 10 .... ..... 8 43,028 S12.550 ....................................
• Married filing 9 Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income ..................... ► 9 85,439 tlyar
QuaJil in 10 Adjustments to income from Schedule 1, line 26 ...................................... 10 ptralAymg
..................
widow(er), 11 Subtract line 10 from line 9. This is your adjusted gross income ,,,,, , , , , , , , , , , ► 11 85,439 525,100 12a Standard deduction or itemized deductions (from Schedule A) . , , , , 112al 26, 5 36 • Head of
household, b Chardableoontr,butIensdyou take the standard deduction (sooiastructions)...... 2b sla.eoa c Add fines 12a and 12b ......................................................... 12c 26, 536 •If you checked
any box under 13 Qualified business income deduction from Form 8995 or Form 8995-A 13 1,710 standard14 Add limes 12c and 13 284246
Deduet�an........................................................... 14 see instructions. 15 Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- ................... 11-51 57,193 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
FD,, 21 104051 BWF 1040 Form Software Copyright 1996- 2022 HRB Tax Group, Inc.
Form 104U (2021)
Form 1040 (2021) SALEM M
16 Tex (seo Inslrucllons). Check if any Irom Form(s), 1 UIJ814 2U4972 3LJ 6 463
17 Amount from Schedule 2, line 3 . . . . .... . .... . .. . .. . .... . ........................ I ...... 17 18 Add llnou16 and 17................................................................. 18 6 463
19 Nonrefundable child lax credit or credit for other dependents from Schedule 8012 . . .. . ...... . ... . . 19 500
20 Amount from Schedule 3, line ............................. .......................... 20 3 500
21 Add lines 19 and 20................................................................ 21 4 000
22 Subtract line 21 from line 18. Il zero or loss, enter -0- ...... , , , , . .......................... 22 2 463
23 Other taxes, Including self-employment tax, from Schedule 2, line 21 , ,, , , , , , , , , , , , , , , , , , , , , , , , , 23 24 Add linos 22 and 23. This is your total tax ........................ ...................... ► 24 2 463
25 Federal income lax withhold from:
Phone no. 562-396-8665
a Forni(s) W-2 ................................................. 25a 93
b Form(s)1099 ................................................. 25b
c Other forms (see instructions) ... . ....... . ........ . .. . ............ 25c
Check if:
dAdd fines 25a through 25c ............................... . ............................ 25d 93
26 2021 estimated tax payments and amount applied from 2020 return ........ . .. . ................. l.1c havea .....
.
a Earned income credit (EIC) .................................... . 27a 26 05-23-2022P02074350
ch,ld. aft
ach
Bch. EIC. Check here if you were born after January 1, 1998, and before Self-empfayed
Preparer
Firm's name ►HRB TAX GROUP INC
January 2, 2004, and you satisfy all the other requirements for Phone no.562-923-9761
Use Only
taxpayers who are at least age 18, to claim the EIC. See instructions .. ►� b Nontaxable combat pay election ............ 27b
DOWNEY CA 90241
c Prior year (2019) earned income ............ 27c
28 Refundable child rax detlit or addmonaf child tax credo from Schedule 8872 ............................................ 26 4 500
.
29 American opportunity credit from Form 8883, line a ......................... 29 1 000
30 Recovery rebate credit. See instructions ......................... . . .... . . 30 31 Amount from Schedule 3, line 15 .............................. . ... 31 32 Add lines 27a and 28 through 31. These are your total other payments and refundable credits ..... ► 32 5500
33 Add lines 25d, 26, and 32. These are your total payments .... . ... . . ......... . .... . ......... )133 5 5 93
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid .......... 34 3 130
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here ..... ► 0 35a 3 130
Direct deposit? ► b Routing number ► c Type: ® Checking 0 Savings See instructions.► of Account number
36 Amount of line 34 you want applied to your 2022 estimated tax ..... ► 36 Amount 37 Amount you owe. Subtract line 33 from line 24. For details on how to pay, see instructions ... , . , , . 0, 1 37 You Owe 38 Estimated tax penalty (see instructions) ....................... ► 1 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
idenuhcation
name ► HRB TAX GROUP INC no. 11-562-923-9761 number(PIN) 0 - SIgn Under perwms of perjury. I declare that t have examined this retum and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, Sign
Para carred, am corn ieta. Declaration of preparar (other than taxpayer] is based on all information of which preparer has any knowledge.
Go to www.irs.gov/Form104O for instructions and the latest information. Form 1040 (2021) FDA 21 104052 BWF1040 Form Software Copyright i9ge-2022HRBTax Group. Inc.
Your signature
Date
Your occupation
If the IRS sent you an Identity
Jeini return?Protection
Seeinsvuuicns.k
FILING AS SURVIVING
PHYSICIAN
PIN, enter -
ithem (see inst.) ►
Keep a copy for
Spouse's signature. If a joint retum, both must sign.
Date
Spouse's occupation
If the IRS sent your spouse an Idenliry
your ragas,
OME MAKER
Protection PIN, enter
it hero (son jn,;Q ►
Phone no. 562-396-8665
Email address GDAAMM@ YAHOO. COM
Preparers name
Preparer's signature
Date
PTIN
Check if:
Paid
DOUAA MEGAHED
IDOUAA MEGAHED
05-23-2022P02074350
Self-empfayed
Preparer
Firm's name ►HRB TAX GROUP INC
Phone no.562-923-9761
Use Only
Frm'saddress 01,7841 FIRESTONE BLVD
DOWNEY CA 90241
Firm'sEIN► 431871840
Go to www.irs.gov/Form104O for instructions and the latest information. Form 1040 (2021) FDA 21 104052 BWF1040 Form Software Copyright i9ge-2022HRBTax Group. Inc.
LINA U£NEFIT
PAYMENTS, INC. LLTCU
goo COTTAGE GROVE ROAD
IIANTFORU Cr 06152
GALAL SALEM
737 NAVAJO DR
RIVERSIDE CA 92507
IMPORTANT: See Reverse side for Important Information.
Keep this copy for your records
031867
C2017H 12 -1S. -XII
Dept. of Treasury - Internal Revenue Service w2FACF
This information Is being furnished to the Internal Revenue Ser-Jce 2021Y.
Form W-2
Wage and Tax
fu,—I-1 Inforrnatgn beinfu,—I-1to the Internal
Revenue S4-". Ilyou.1.,equired to fir. U.
tanLol number
Statement
rnurn a negligence petwhy or other sanctlun may
be Imposed an you dthh income b ta..bk and
OMB No. 15450006
yaufadto report R
Employer's ldeMiocatlon Number{EINI
1 Wages, tip% other compensation
2 Feder.IImao t.awhhh.M
06-1252418
39,012.83
.00
Emlayer+ name, address and ZIP coda
3 S -i -I security wages
4 5acial.ecurltyiaxwtthheld
50862G3 LK 0962900
LINA BENEFIT
PAYMENTS, INC. LLTCU
S hledl... w.gesandtlps
6 Medicaretaxwethheld
900 COTTAGE GROVE ROAD
HARTFORD CT 06152
.00
.00
7 5osw1 securhy t Ips
8 Alk"—tedtlpa
.l secur6y number
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10 Dependentcare benefu
F
EMP eei -1 —a,dmnlal Lan name
11 Nonqu.hfied plans
13 12 Saatrsnructionsfar Boxll
GALAL SALEM
t
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V❑Mck-P.arttr ❑Buram
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Suttnory
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,
❑ Empbyte
737 NAVAJO DR
14 0thtf
RIVERSIDE CA 92507
Em la ee'sadd,essand ZIP code
15 State) Empby,,'-wel.D.No.
16 Stattip%e wag.%
17 State Income tax
18 tw.i..qe%
19 Locallmom"
20 locality risme
CA... l 81584450.......
39:012.$3
........ .
031867
C2017H 12 -1S. -XII
Dept. of Treasury - Internal Revenue Service w2FACF
This information Is being furnished to the Internal Revenue Ser-Jce
INTI ILII III I Ill III I IIIA II II 11111!1 III ! II )III
LINA BENEFIT PAYMENTS, INC
t 900 C@ 17AGL'' GROVE RD
LUFCU
MAR"1TORD, C"I' {)6152
000004000374
DOUAA MEGAHED
9241 LUBEC STREET
DOWNEY, CA 90240
Instructions for Recipient
Recipient's tnpeyef identllicationnumbr r(INI. For your pra[action, this form may show only the last ,our d+gila of your social mcuruy number 155NI, irWivitluet tazpJyor itlmlr0auon number IITINh adopuon laaperur itlennliwnon number IATtN1. or emplpyaridanlihution numbu MIN;. Howwer, the payer hes ,.parted your eompl". TIN to the IRS.
Account number. May shorn an account or other unique number the payer assigned to distinguish your account.
FATCA riling raquinment d the FATCA filing requirement boa is checked that pryer amp 9 on this Form t099 to sa 'sfy 4f account r ning raguvemenl under chapter 4 of "a Intorno! RevOng.
Code You may also hate • filing requirement Seo the Imauctions for Form 9939.
Amounts shown may be subjexd to wlfymployment f5Ej tax. Individuals should sat the Instruction, far Schedule SE IFarm 1040], Curporationc, tiducrauas, or partnerships must mpon the amounts on tho appropriate line of cher, ux felurne.
Form 1099-flodsc Irtcorrect7 It lhls corm is incorrect or has been issued in error, conLct she Payer If you cannot get rho form rorrecad. crtach on explanetion to your tea [.turn and report your income sonedly Bwr ]. Repan rents Irani real nlYl• an Schedule E tForm 10401 howovn[, report rami on Schedule C IFarm 10401 it ytru provided irgnirtcard services to that tenant, sold real estate as a business, or retired personal property as a busman m.:S" Pub. 527.
9th 2. Repan rorah,es freer D.I. gas. or mineral prop.nies; copyrights: and palems an Schedule E (Fortis 10401. Ho"an'0 report payments far a waning mtmast as espleined in the Schedule E (Form 1040} ;raud
triorrt For royalt.es on limber. coal, and iron are, Fee Pub. 544.
Hoa 3. Gener49y.,•po<t this amaunl on the 'other income- line of Schedule 1 tFnrm 10401 and Identify the pay -1. The ama„nt shown maybe payments reuivad as the barwliciery o1 a deceased smploYee. canoes. anutls. lJxeble damagee. laden gaming prohts.o, other taxable income. See Pub. 525. If it Is
va9e u br.sa i%zscorne. report thlsarrrourtl an Schedule C at F (Form 10401.
BOX
I. Sna,vs Wakup wahnpld'nq Or witOhold+r+g can Indian pantsrW carob! a. Genarall Y, a P•Yar must backup wMhho 4 ,f roo 6d tat tumnh yam T1N. S.a Form W.9 and Pub. 505 for more information.
Repots this --ad on Yon irtenme tax r"n as taa mthheld.
PAYER'S name. street address, ory or town, state or provinrm, country, GP or 1Oru9 and W.Pil One rw.
LINA BENEFIT PAYMENTS, INC
900 COTTAGE GROVE RD PI11y)
LLTCU l o v o
HARTFORD.CT 06152
RECIPIENTS
PAYER CODE'.: 0210
02/01/2022
IF YOU HAVE QUESTIONS CONTACT:
PHONE: $00-148-7468
Boa 6, 5howa tha amount paid to a fishing boat sew member wl[o is considered by the .peace, 10 be sellamployad. Solrsmployedmdiv[duah must report eh..Munl on Schedule C (Form 10401 See Pub. 334
Boa 6, Fur andrviduala,ropun on S0ad,.Ie C (Fwm 10401.
Bax 7. It ,Chocked, consumer products tataring 15,000 or mote wee sold to You fa moats. On a buyssa. a depositwmmasion,or Other bears. Generally, rapers troy income from Your sale of Now prodrna an Schedule C (Form 10401. �L
Boa S. Showa aubsLtoo ptymems in Ila, at d—donde or trig -ria capl1 nl*rest .a r—Ol by your bila, On your behalf as a result of a loan of your feaunlies. Report on ItN'ather incamP line of Schedule 1 (Form 1040)
Boa 9. Report this amount on Schedule F IForm 10401.
Be. 10, Showa gram prawads paid 10 an attomey in connection with feat "prices, Report "Ohio ,sae big pen ea income on yourritium. W in the trade
Boz 11. Shows lho (mount Paid for rhe purchase of 0'u for resale from any person engag or buemam o1 Latching Clsh. See the inanudlona nor YOvr Iia ,alum tW ,appnrr,g Ihia Ir,cama.
Hex 12. May shrew current year deferrals as • nonsmPloysunder a non I"811haddelerred caanpensaban INOOCI plan that is subteen to the roqu.romcne, of section 409A plusany wrninga on current and pilot year deferrals.
Hex 13. Shows your total compensation of exam golden Parachute p.vmemssubied to a 20'baause fax. Sue your tea return ind,uctrom for where to report.
Boz 14. Snows Income as a nomnipbyae under an NOOC Oran char tlaef nm mets the ,agudertanlF of section 409A. Any amount included In box 12 )hat is currently taxable la tlsa Indudad m aha box, Report 11iiiamount as income on your tax return. This income is also W01110 to a subHamial ■dd4ietial lax 10 be reported on Form 10x0, 10405R, 0r 1040.I�R. See the rnatrudionf for Your Pse ,Nunn.
Bose. 15.17. Show slate Or local income lea wthhald Iron the payment& Future developments. For the fairst Inlormatlon about dwolopments railed to Form I099JNISC Jeff its Instrurhons, such as legislation uN isd shot they were published, go to wsvw.lrs.pev/Form 1099MtSe Free File. Go to wwwim,gavlFrueFduta sato if you quality for n 0n onhna federal lax Preparation - to -filing. old dead deposit or payment options.
coda, 1 Rents
S
2 Royalties
3 Otherincome
s 21.338.83
5 Fishing boat proceeds
OMB No. 154540115
2021
Form 1099-MISC
4 Federal income tax withheld
6 Medical and health care payments
06-1252418 s '
RECIFIENTS,lame. Ripe address Lnowli'9 apt no 1, racy or laver, sane Or provinu, w trv, end 7 Peva, mode diroct miss B Substitute payments in lieu of ZIP a foreign Postal code totaling $5,000 or more of dividendsor interest DOUAA MEGAHED /1Y`��1 {�/7 �//�{ consumer products ❑
9241 LUBEC STREET f J lam' S recipient ler rows. 5
DOWNEY,CA 902411 LL// 9 Cropinsuranceprocegds 10 Gloss proceeds paid soan s � attorney
i t o s
1 t Fish purchased for resale 12 Section 409A deferrals Accountnumber (see instructions) LJ! 1K_ '
TRACKING i=: 726029775
Form 1099-MISC {heepfaryotlrrecords)
1 HB021 3.000
FArCAhling 13 Excess golden parachute 114 Nonquaivgaaarcrrea [equl.eMott payments compensation
S $
7 j 15 State tax withheld 16 Stato/Payer's state no
Miscellaneous
Information
Copy B
For Recipient
This is important tax
information and is
being furnished to
the IRS. If you are
required to file a
return, a negligence
penalty or other
sanction may be
imposed on you if
this income is
taxable and the IRS
determines that it
has not been
reported.
17 State income
5 I CA 18)58UM I s
www,irs.gov/Forrn1099MISC Department of the Treasury• Internal RevenueSdiVlCO cr.
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This is important tax information and is being furnished Eo the Internal Revenue Service r�C Cf tnnyn PC]lii r,W. inJ [a[Ir{JIGM �um4.,
Caldomia Nartnslate UnivarIldy
9700 West saran Dnve
Elk Grove. CA 95757
916 686 7400
r]LFAE W..' W.N,6cllon r0 91 VOEMrS :l.wrel tllnl,ltltu,n 90-0791579
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Department of M 're&ery . Internal Revenue ytr^r
Copy a
Far Student
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Your eligible education expenses reported to the IRS were computed based on amounts received for tuition and fees, less scholarships. However, you may not claim arty more qualified expenses for the Lifetime Learning Credit than you have already paid for.
This crel}t applies to tuition and fees for undergraduate, graduate, and conbnu,ng-educatron course work EduCa too expenses are eligible for the Lifetime Learning credit A famify can cialrn on its tax return a .^.red, equal to 20 percent of 510,000 educabonal expenses. so the maximum benefit is 52.000 each tax year.
NOTE E1,g,ble education expenses are offset by scholarships, grants. and other tax-free tuition bene^is For Example the line item for the L,febma Learning Credit can be found on line 49 of Form 1040 and Line 31 of Form 1040A You will also need to submit Form 8863 with your tax return. Tax forms are available at www IRS goy
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FILERS carne, shod address, Illy or term, province 1x utute, ZIP or laagn pos" r-K1tr, and toloplwnn n1AFA ur
I
UNIVERf1ITY OF CALIFORNIA IRVINE
TAX REPORTING OFFICE
UC IRVINE CAbtpUS BILLNQ & COLLEC1tION5
IRVINE, CA 92697
949-924-2455 call Cantor 1389-220-2540
:R'S Federal 1donlificaliorr no. STUDENTS taxpayot dentllWilon no. 952226406
IDENTS name, street address, city a Iowa, province of stale, country.
ZIP or foreign postal code
AYA GALAL SALIM
737 NAVAJO DRIVE
RIVERSIDE, CA 92507
Payrowds recd i id fa
%oliiod tuition and related
exporrsw
15952.72
Adjustments made for a
prior yeen
Adjustments to SclwlershyE
or grads for a Aria year
OMB No. 1545.1574
2021
Form 1098-T
6 Schdarshipsorgrarts
6000.00
Check Gus box it Ula
amount in box 1
includes amounts for an
academic period
beginning January -
March 2022
El
ice PmvidedAccount Number 8 Check Kai bast half-lkrm sILO Miii �9 Check if a graduate shldeal � 14 Mrs. ConlydG ural} reimbJrefurd
81403127
Copy
For Studer
This is fmportaf=
tax informaboi
and is berm
furnished to the --
Internal Revenuc--
Ser Ace.
IRS Form 1098.7 A college or university that received qualified tuition and related expenses on your behalf is required to file Form 1098-T, above, with the Informal Revenue Service QRS). copy d Form 103&T must be fumished to you. The nfonnabon being reported to the IRS verifies your onroVmerd with regard to certain etigibiNy criteria for the Amenran Oppodunl y Tax Croda, she lletme Learfung lax Credit. Hanover, the enruyment information by eseif does not establish eligibility for rhe weds.
Box 1. Indicates the total payments received for qualified luition and related expenses less any related reimbursements of refunds. 5= 2. Bax 2 s na Lager used and wait be blank.
Sox 3. Bax 3 ¢ no forger used and vd1 be blank.
Box 4. Indirares arty ai shnent made for a prior year for qualdted lution and related expenses that were reported on a prior year Form 1098-7. This amount may reduce any allowable education credit you may train for the prior year. See form 8863 or Pub. 970 for more information.
Box 5. Indcases the talar of all scholarships or grants administered and processed by the, eligible educational inslilution. The amount of scholarships or grants for the calendar year [including Biose not reported by the nstaubm) may reduce the amount of arty education credit you may claire for the year. See Form 8861 for how to report these amounts.
Box S- IndKNdm an adprirne d to scWarshrps or grants for a prior year. This amount may affect the amount of any allwrable educalion cit dd you may dans for the poor year. See Form &M3 for hon to report these amounts.
Box 7_ If this Pox is checked, the amount in Bar 1 includes amounts for an academic period beginning January4larch 2022. Soe Pub. 970 for how fo roped these amounts.
Box 8. Irdwtes vfiether your vlxxA considers you fo have carried at least one -had the normal fuH-time workload for your course of study for an aradomic term during fax year 2021, If you viefe as fer,� a half -Wm ctudew for 21 leag one academic term re during 2021, you ed ono of the requirements for the Amuncan Opportunity Credd. You do not have to reel the mAdoad requremerrl to qualify for the Lifebrne Learning Credd.
Box S. Indrale; wheth" your school considers you to have been enrolled in a program leading to a graduate degree, graduate -level certificate, or other recognized graduale-level educational credential dung tax yeas 2021. 8 you were enrolled in a graduate program, you are not eligible for the American Opportunity Crede, but you may qualify for the Lifetime Learning Credit.
Box 10. Indicates the total around or winiburserr¢nts or refunds of quabfwd tuition and related expenses made by an insurer. The amount of reimbursements or refunds for rhe calendar year may reduce the arnarrd or any aliovral le educalon Cradd you may Claim for the year.
BACKGROUND INFORMATION
The Taxpayer Relief Act of 1997 (TRA97) established two educabon tax credits: the Nope Tax Credit (cumandy modified as the American OppartunityCredit by the American Recoveryand Reinvestment Act of 2009) for students who are enrolled In one of the first four years of postsecondary education and are carrying at least a half-time worldoad while pursuing an undergraduate degree, certificate, or other recognized credential; and the Lifetime Learning Tax Credit for students who lake one or more Gasses from a college of unrverr,Ry to pursue an undergraduate or graduate degree, certificate, other recognized credential, or to acquire or improve job skills
To claim the American OppoRunity (Nope) or L09time Leaming Tax Credit, use IRS Form 8863, Education Credits. If you are claimed as a dependent by maanother b ther
P[including your parent(s)j, you cannot claim the American Opportunity Tax Credit, Lifetime Learing Tax Credit. However, the person claiming y Y entitled to the credit on his or her tax return. Resources: For more Information see IRS Publication 970: Tax Benefits for Higher Education and IRS Notice 97 �:
provides consumer guidance on Education Tax Incentives. These documents and IRS Form 8863 and is available at www.rs gov or by calling the IRS at 1-8004529-1 040 For additional 1098-T information and instructions from your college or university go to vncw.lwl0981.ccni MR 1 U1 LTUwMTctNDk5YyO4NzNhLTBmZTY3ZmMwMGE2NAAQAKi05XtggGllhBve%26 DSQvJ... 111
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Loan Statement y ��
CCLNLAR .na,wt,.•,•a.•r, .,a°Ih..rl"R. PO Box 77404 Statement Date: 05/02/22 w�n.aW..16,n.,d,.lIFY111 Ewing, NJ 08628 —
STATEMENT ENCLOSED Account Number:
Payment Due Date 06/01/22
Amount Due $5,231.48
11 ppymenl is recafvod aeW QW17122, V00 491ers ron "lee d,arged + 0642977 000530381 DEP201 0929465 110 AF12PB CT
GALAL SALEM
9241 LUBEC ST
DOWNEY CA 90240-3007
tit,ylrltl�rr,,,llrurlrrllrrrullulrlrr,lll„Il��t�lr
9241 LUBEC:S1
DOWNEY. CA 90240-3007
Outstanding Principal
$569,697.60
Escrow Balance
$1,219.42
Maturity Date
August 2045
Interest Rate
3.6250%
Prepayment Penalty
NONE
Deferred Balance
$70,453.94
05'02122 05!02!22 o5/2022 PAYMT - THANK YOU
Customer Servicelpay By Phone: 855.839.6253
Webslte: httpsjf www.loanadministration.com
'Qualified Written Requests, notlflc011Ons of error, or requests for information conoerrslrig your ban must be
directed to PO Box 77423 Ewing NJ 08628
Loan Set Up on Automatic PaymentlACH'
YES
•II your atxount,s setup on Automatic YaymanVACH as etdcated abova, your account will continue to draft as schedufad.
$6,460.42
Principal
$1,303.82
$8,663.48
$1,720.96
Interest
Escrow (for Taxes and Insurance)
$2,206.70
Escrow (Taxes and insurance)
$0.00
Other
Current Payment Due 06/01/22
$5,231.48
Total Fees Charged Since Last Statement
$0.00
Overdue Amount
$0.00
Total Amount Due
$5,231.48
85,231.48
Now's a great time to explore your home loan options with Citi. See how refinancing could help you save on monthly payments, secure a lower interest rate, shorten the term of your loan and more. You can even tap into your home's equity to make home improvements, consolidate higher -rate debt or fund a large purchase. If you're looking to purchase a new home, we can also assist you with financing options, Call 1-866-674-3084 (Speech and Hearing Impaired customers, dial 711) and mention offer code 14853-1, or visit citi.com/mortgage_ to view current rates and calculators. Citi is an equal housing lender.
NMLS ff412915.
See Reverse Side For Additional Important Information Please return this portion Make with
your
r payment MO
Galal Salem , , -Ill VW- ,,,,,,,,,nJ r yu4rvzlvnL l b1mZ.1 rsLmMwmUL2NAAQAKj05XtggGlth9ve%2BDSQvJ... 111 ISO
Paid Since Last Statement
Paid Year to Date
$1,299.89
$6,460.42
Principal
$1,724.89
$8,663.48
Interest
$2,206.70
$10,839.32
Escrow (Taxes and insurance)
$9.00
Other
$0.00
$0.00
$0.00
Fees
$0,00
$0.00
'Unapplied Funds
$5,231.48
$25,963.22
Total
IMPORTANT MESSAGES
85,231.48
Now's a great time to explore your home loan options with Citi. See how refinancing could help you save on monthly payments, secure a lower interest rate, shorten the term of your loan and more. You can even tap into your home's equity to make home improvements, consolidate higher -rate debt or fund a large purchase. If you're looking to purchase a new home, we can also assist you with financing options, Call 1-866-674-3084 (Speech and Hearing Impaired customers, dial 711) and mention offer code 14853-1, or visit citi.com/mortgage_ to view current rates and calculators. Citi is an equal housing lender.
NMLS ff412915.
See Reverse Side For Additional Important Information Please return this portion Make with
your
r payment MO
Galal Salem , , -Ill VW- ,,,,,,,,,nJ r yu4rvzlvnL l b1mZ.1 rsLmMwmUL2NAAQAKj05XtggGlth9ve%2BDSQvJ... 111 ISO
Launch Servicing. LI.0
PO BOX 91910
Sioux Falls, 5D 57109.1910
AHMED SALEM
9241 LUBEC STREET
DOWNEY, CA 90240
RE: ACCOUNT NUMBER -
LAUNCI-1
July 29, 2021
DEAR AHMED SALEM,
Our records reflect your loan(s) entered repayment. We have established a repayment schedule that will meet the conditions and terms of your Loan Credit Agreement(s). If your loan(s) have future scheduled disbursements, your repayment terms will be adjusted and you will be notified after each disbursement. Your loan(s) entered repayment on 07/2812021. with a payment due date of 08/11/2021 and will be due on the same day of each month thereafter.
Total Amount
to be Repaid
Loan # Interest Rate �ate?d Total Balance
Unpaid
np pal Capital zed at Repayment
Balance at Interest
Repayment
171282 0.000°/0 $37.322.54 $OAO $31,322.50
interest
Payable
$0.00 $37.322.50
Your repayment schedule is as follows and is based on the assumption that all payments will be made on your scheduled due dates and using the interest rate stated above.
e rest
Number of Pa menu Pa ment Amount"
n techange during ngethe lrepayment termXThe final t
rest R ate; T al paymentamounttwill be
8 1 � $4,146.98 calculated based on the remaining loan balance at the time of the final payment.
Unpaid Principal Balance at Repayment: The anticipated unpaid principal balance as of the date the loan enters repayment prior to any capitalized interest.
npaid as of the date the loan enters repayment will be capitalized (added Estimated Capitalized Interest: Any interest u
to the principal balancej, interest then begins accruing an the increased principal balance (Total Balance at Repayment).
Total Balance at Repayment: The anticipated unpaid balance (principal and capitalized interest) as of the date the loan enters repayment,
ill be paid over the life of the loan if all payments are received on the Interest Payable: The amount of interest that w
scheduled due dates assuming does not change.
ng the interest rate
nation of the Total Balance at Repayment plus the Interest Payable over Total Amount to Be Repaid: This is the combi
eceived on the schedule due date and the interest rate does not change. the life of the loan assuming the payments are r
Is needed to pay the loan in full assuming the interest rate does not Number of Payments: The number of paymen
change; all payments are received on the due date and for the amount due. .--wu imzvir i uTz l UWMTctNDk5YyO4NzNh!_TBinZTY3ZMMwMGE2NAAQAK)OSXlggGllh9ve%,2$Q$QvJ... 111
Curren) Account
Current Account information; (08/16121 -09115121 )
Studellt name: SALEM, AYA GALAL
FALL 2021 QUARTER Registration Fees, Paid
ZOT Account Summary _
mount due this billing cyclo:
$0.00
By 0-9115121 or before, after all conditions
re mot
Past Due Balance
1 $0.00
Current ChargeslDe3iits
r
$0'00
Current Payments/Credits
$0.00
Future Charges/Debits
$0'00
Futurc Payments -/Credits
$0.00
For questions contact. Campus Billing Services: [email protected], [948j UCl•B1LL (824.2455)
Account Balance
$fl'UO
Past Due Transactions (description) Trans. Fnue pate Unpaid [Trans Date Paid Dept.
FDescription Reference amount
HS -00
�ST�UDEN�T HEALTH CENTER ���F2386017 $5.00 08115!21 $D•fl4 1 00/25/21 Fog/92121 S SIT
Total: $O.DO
Current Transactions or Credits (description) Trans. npaidorReference Que QatEFIU napplied
Paid or Dept. Description Amount
Trans Date Applied �� III
���GfSTRAR FALL 2021 QUARTER 042441 $5.245.75 09/15121 $0.00 08112/2? 09/12/21 RE �E-PAYMENT
EGISTRATION FEES
T 9479A5 $5,250.75 CR $0.00
112121 09/12/21 CASHIER TO ZOTACCOUN ���
09 �� Total. $0.00
Future Transactions (description) Trans. Due Date Unpaid or Paid or Qescriptian Reference Amount Unapplied
FTransDate Applied Dept
Total: 50.00
Account Balance $0.00
page 7 of 2
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