Form
Department of the Treasury—Internal Revenue Service
1040A
Label
(See page 19.)
L A B E L H E R E
U.S. Individual Income Tax Return
Your first name and initial Last name
(99)
1999
IRS Use Only—Do not write or staple in this space. OMB No. 1545-0085 Your social security number
If a joint return, spouse’s first name and initial
Last name
Spouse’s social security number
Use the IRS label.
Otherwise, please print or type.
Home address (number and street). If you have a P.O. box, see page 20.
Apt. no.
IMPORTANT!
City, town or post office, state, and ZIP code. If you have a foreign address, see page 20.
You must enter your SSN(s) above. Yes No Note. Checking “Yes” will not change your tax or reduce your refund.
Presidential Election Campaign Fund (See page 20.)
Do you want $3 to go to this fund? If a joint return, does your spouse want $3 to go to this fund?
Filing status
Check only one box.
1 2 3 4 5 6a b c
Single Married filing joint return (even if only one had income) Married filing separate return. Enter spouse’s social security number above and full name here. Head of household (with qualifying person). (See page 21.) If the qualifying person is a child but not your dependent, enter this child’s name here. Qualifying widow(er) with dependent child (year spouse died 19 ). (See page 22.)
Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax return, do not check box 6a. Spouse Dependents: (1) First name Last name (2) Dependent’s social security number (3) Dependent’s relationship to you (4) if qualifying child for child tax credit (see page 23)
No. of boxes checked on 6a and 6b No. of your children on 6c who: ● lived with you ● did not live with you due to divorce or separation (see page 24) Dependents on 6c not entered above Add numbers entered on lines above
Exemptions
If more than seven dependents, see page 22.
d Total number of exemptions claimed.
Income
Attach Copy B of your Form(s) W-2 here. Also attach Form(s) 1099-R if tax was withheld.
If you did not get a W-2, see page 25. Enclose, but do not staple, any payment.
7 8a b 9 10a
Wages, salaries, tips, etc. Attach Form(s) W-2.
7
Taxable interest. Attach Schedule 1 if required. 8a Tax-exempt interest. DO NOT include on line 8a. 8b Ordinary dividends. Attach Schedule 1 if required. 9 Total IRA 10b Taxable amount distributions. (see page 25). 10a 10b 11a Total pensions 11b Taxable amount and annuities. (see page 26). 11a 11b 12 Unemployment compensation, qualified state tuition program earnings, and Alaska Permanent Fund dividends. 12 13a Social security 13b Taxable amount benefits. (see page 28). 13a 13b 14 15 16 17 18 Add lines 7 through 13b (far right column). This is your total income. IRA deduction (see page 30). 15 Student loan interest deduction (see page 30). 16 Add lines 15 and 16. These are your total adjustments. Subtract line 17 from line 14. This is your adjusted gross income.
Cat. No. 11327A
14
Adjusted gross income
17 18
Form 1040A (1999)
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 53.
Form 1040A (1999)
Page 2
Taxable income
19
Enter the amount from line 18.
if: You were 65 or older Spouse was 65 or older Blind Blind Enter number of boxes checked 20a
19
20a Check
b If you are married filing separately and your spouse itemizes deductions, see page 32 and check here 20b Enter the standard deduction for your filing status. But see page 33 if you checked any box on line 20a or 20b OR if someone can claim you as a dependent. ● Single—$4,300 ● Married filing jointly or Qualifying widow(er)—$7,200 21 ● Head of household—$6,350 ● Married filing separately—$3,600 22 Subtract line 21 from line 19. If line 21 is more than line 19, enter -0-. 22 23 Multiply $2,750 by the total number of exemptions claimed on line 6d. 23 24 Subtract line 23 from line 22. If line 23 is more than line 22, enter -0-. This is your taxable income. 24 25 Find the tax on the amount on line 24 (see page 34). 25 26 Credit for child and dependent care expenses. Attach Schedule 2. 26 27 Credit for the elderly or the disabled. Attach Schedule 3. 27 28 Child tax credit (see page 35). 28 29 Education credits. Attach Form 8863. 29 30 Adoption credit. Attach Form 8839. 30 31 Add lines 26 through 30. These are your total credits. 31 32 Subtract line 31 from line 25. If line 31 is more than line 25, enter -0-. 32 33 Advance earned income credit payments from Form(s) W-2. 33 34 Add lines 32 and 33. This is your total tax. 34 35 Total Federal income tax withheld from Forms W-2 and 1099. 35 36 1999 estimated tax payments and amount applied from 1998 return. 36 37a Earned income credit. Attach Schedule EIC if you have a qualifying child. 37a b Nontaxable earned income: and type amount 38 Additional child tax credit. Attach Form 8812. 38 39 39 Add lines 35, 36, 37a, and 38. These are your total payments. 40 If line 39 is more than line 34, subtract line 34 from line 39. 40 This is the amount you overpaid. 41a Amount of line 40 you want refunded to you. 41a Routing b c Type: Checking Savings number d Account
number
21
Tax, credits, and payments
Refund
Have it directly deposited! See page 47 and fill in 41b, 41c, and 41d.
42
Amount you owe Sign here
Joint return? See page 20. Keep a copy for your records.
43 44
Amount of line 40 you want applied to your 2000 estimated tax. 42 If line 34 is more than line 39, subtract line 39 from line 34. This is the amount you owe. For details on how to pay, see page 48. Estimated tax penalty (see page 48). 44
43
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 accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxpayer) is based on all information of which the preparer has any knowledge. Daytime telephone Your signature Date Your occupation number (optional) ( ) Spouse’s signature. If joint return, BOTH must sign. Date Date Spouse’s occupation
Paid preparer’s use only
Preparer’s signature Firm’s name (or yours if self-employed) and address
Check if self-employed
Preparer’s SSN or PTIN
EIN ZIP code
Form 1040A (1999)