4Ps
1040EZ Tax Form
Directions: A 1040EZ Tax Form must be included in your Senior Portfolio. Refer to the Overview, Timeline and Assembly Handout to determine where to place this form. You may include a personal, real 1040EZ Tax Form or you may use this form to obtain information to use when filling out the tax form. Read all directions on the actual tax form carefully. Use black or blue ink on your final copy. Completely and accurately fill out the tax form. Here is information you can use to fill out the 1040EZ Tax Form. Assume you are single with no children. Here is last year’s W-2 form that was given to you by your employer. You worked in sales part-time at a local retail store. Besides the wages, you earned $122.74 interest on savings in the bank. Using the following W-2 form, file a 1040EZ income tax return for yourself and place it into your senior portfolio. Rather than using your “real” SSN, use the once indicated below.
a Control number
22222
Void
For Official Use Only OMB No. 1545-0008
b Employer’s identification number 1 Wages, tips, other compensation 2 Federal income tax withheld
91-8512589
c Employer’s name, address, and ZIP code
15,000.00
3 Social security wages
1,275.32
4 Social security tax withheld
15,000.00 Macy’s Department Store 123 Capital Mall Boulevard Olympia, WA 98502
d Employee’s social security number 5 Medicare wages and tips
1,012.36
6 Medicare tax withheld
13,643.92
7 Social security tips
289.24
8 allocated tips
9 Advance EIC payment
10 Dependent care benefits
123-45-6789
e Employee’s name (first, middle initial, last) 11 Nonqualified plans 12 Benefits included in box 1
Student Name Student Address City State Zip
13 See Instrs. for box 13 14 Other
15 Statutory Deceased Pension Legal Employee plan rep
942 Subtotal Deferred Emp compensation
21 Local income tax
f Employee’s address and ZIP code
16 State Employer’s state I.D. No. 17 State wages, tips, etc. 18 State income tax 19 Locality Name 20 Local wages, tips, etc.
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