Irs Form 1040A – Fill Out and Use This PDF

Form

Department of the Treasury—Internal Revenue Service

1040A

U.S. Individual Income Tax Return (99)

2017

IRS Use Only—Do not write or staple in this space.

Your first name and initial

Last name

OMB No. 1545-0074

Your social security number

If a joint return, spouse’s first name and initial

Last name

Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions.

Apt. no.

▲ Make sure the SSN(s) above

and on line 6c are correct.

City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

Presidential Election Campaign

Check here if you, or your spouse if filing

jointly, want $3 to go to this fund. Checking

Foreign country name

Foreign province/state/county

Foreign postal code

a box below will not change your tax or

refund.

You

Spouse

Filing

1

Single

4

Head of household (with qualifying person). (See instructions.)

status

2

Married filing jointly (even if only one had income)

If the qualifying person is a child but not your dependent,

3

Married filing separately. Enter spouse’s SSN above and

enter this child’s name here. ▶

Check only

one box.

full name here. ▶

5

Qualifying widow(er) (see instructions)

Exemptions

6a

Yourself.

If someone can claim you as a dependent, do not check

}

Boxes

box 6a.

checked on

6a and 6b

b

Spouse

No. of children

on 6c who:

c

Dependents:

(4) ✓ if child under

(2) Dependent’s social

(3) Dependent’s

• lived with

age 17 qualifying for

If more than six

you

security number

relationship to you

child tax credit (see

(1) First name

Last name

dependents, see

instructions)

• did not live

instructions.

with you due to

divorce or

separation (see

instructions)

Dependents

on 6c not

entered above

Add numbers

on lines

d Total number of exemptions claimed.

above ▶

Adjusted

16

Educator expenses (see instructions).

16

gross

17

IRA deduction (see instructions).

17

income

18

Student loan interest deduction (see instructions).

18

19

Reserved for future use.

19

20

Add lines 16 through 19. These are your total adjustments.

20

21

Subtract line 20 from line 15. This is your adjusted gross income.

▶ 21

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 11327A Form 1040A (2017)

Form 1040A (2017)

Page 2

Tax, credits,

22

Enter the amount from line 21 (adjusted gross income).

22

Check

You were born before January 2, 1953,

Blind

23a

Total boxes

and

if:

{

Spouse was born before January 2, 1953,

Blind }checked ▶ 23a

payments

b

If you are married filing separately and your spouse itemizes

deductions, check here

▶ 23b

Standard

Deduction

24

Enter your standard deduction.

24

for—

• People who

25

Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-.

25

check any

26

Exemptions. Multiply $4,050 by the number on line 6d.

26

box on line

23a or 23b or

27

Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.

who can be

This is your taxable income.

27

claimed as a

▶

dependent,

see

28

Tax, including any alternative minimum tax (see instructions).

28

instructions.

29

Excess advance premium tax credit repayment. Attach

• All others:

Form 8962.

29

Single or

Married filing

30

Add lines 28 and 29.

30

separately,

$6,350

31

Credit for child and dependent care expenses. Attach

Married filing

Form 2441.

31

jointly or

32

Credit for the elderly or the disabled. Attach

Qualifying

widow(er),

Schedule R.

32

$12,700

Head of

33

Education credits from Form 8863, line 19.

33

household,

34

Retirement savings contributions credit. Attach Form 8880.

34

$9,350

35

Child tax credit. Attach Schedule 8812, if required.

35

36

Add lines 31 through 35. These are your total credits.

36

37

Subtract line 36 from line 30. If line 36 is more than line 30, enter -0-.

37

38

Health care: individual responsibility (see instructions). Full-year coverage

38

39

Add line 37 and line 38. This is your total tax.

39

40

Federal income tax withheld from Forms W-2 and 1099.

40

41

2017 estimated tax payments and amount applied

If you have

from 2016 return.

41

a qualifying

child, attach

42a

Earned income credit (EIC).

42a

Schedule

EIC.

b

Nontaxable combat pay election. 42b

43

Additional child tax credit. Attach Schedule 8812.

43

44

American opportunity credit from Form 8863, line 8.

44

45

Net premium tax credit. Attach Form 8962.

45

46

Add lines 40, 41, 42a, 43, 44, and 45. These are your total payments.

▶

46

Refund

47

If line 46 is more than line 39, subtract line 39 from line 46.

This is the amount you overpaid.

47

Direct

48a

Amount of line 47 you want refunded to you. If Form 8888 is attached, check here ▶

48a

deposit?

▶ b

Routing

▶ c Type:

Checking

Savings