1040 U.S. Individual Income Tax Return

Transcription

1 Form epartment of the Treasury - Internal Revenue Service 040 U.S. Individual Income Tax Return Lael instructions) Use the IRS lael. Otherwise, please print or type. L L H R Presidential lection ampaign Filing Status heck only one ox. xemptions If more than four dependents, see instructions. For the year Jan. -ec. 3, 200, or other tax year eginning Your first name and initial peter If a joint return, spouse's first name and initial MY, Last name Last name Home address (numer and street). If you have a P.O. ox, see instructions., 200, ending, 20 ity, town or post office, state, and ZIP code. If you have a foreign address, see instructions. pt. no. OM No Your social security numer Spouse's social security numer heck here if you, or your spouse if filing jointly, want $3 to go to this fund (see instructions) You Spouse Single 4 Head of household (with qualifying person). instructions) If 2 X Married filing jointly (even if only one had income) the qualifying person is a child ut not your dependent, enter 3 Married filing separately. nter spouse's SSN aove this child's name here. 6a c 200 IRS Use Only - o not write or staple in this space. You must enter your SSN(s) aove. hecking a ox elow will not change your tax or refund. and full name here. Qualifying widow(er) with dependent child instructions) X Yourself. If someone can claim you as a dependent, do not check ox 6a oxes checked 2 on 6a and 6 X Spouse } No. of children (4) X if qualifying child ependents: (3) ependent's on 6c who: (2) ependent's relationship to for child () First name Last name social security numer you lived with you tax credit 3 did not live with you due to divorce or separation 0 (see instructions) --Son X Son X --Son X ependents on 6c not entered aove 0 Income ttach Form(s) W-2 here. lso attach Forms W-2G and 099-R if tax was withheld. If you did not get a W-2, see instructions. nclose, ut do not attach, any payment. lso, please use Form 040-V. djusted Gross Income d Total numer of exemptions claimed Wages, salaries, tips, etc. ttach Form(s) W a Taxale interest. ttach Schedule if required a Tax-exempt interest. o not include on line 8a ,40 9a Ordinary dividends. ttach Schedule if required a Qualified dividends (see instructions) Taxale refunds, credits, or offsets of state and local income taxes (see instructions) limony received usiness income or (loss). ttach Schedule or -Z apital gain or (loss). ttach Schedule if required. If not required, check here Other gains or (losses). ttach Form a IR distriutions..... a Taxale amount (see instructions) 6a Pensions and annuities.. 6a Taxale amount (see instructions) 6 7 Rental real estate, royalties, partnerships, S corporations, trusts, etc. ttach Schedule Farm income or (loss). ttach Schedule F Unemployment compensation a Social security enefits.. 20a Taxale amount (see instructions) 20 2 Other income. List type and amount (see instructions) dd the amounts in the far right column for lines 7 through 2. This is your total income ducator expenses (see instructions) ertain usiness expenses of reservists, performing artists, and fee-asis government officials. ttach Form 206 or 206-Z Health savings account deduction. ttach Form Moving expenses. ttach Form One-half of self-employment tax. ttach Schedule S Self-employed SP, SIMPL, and qualified plans Self-employed health insurance deduction (see instructions) Penalty on early withdrawal of savings a limony paid Recipient's SSN 3a IR deduction (see instructions) Student loan interest deduction (see instructions) Tuition and fees deduction (see instructions) omestic production activities deduction. ttach Form dd lines 23 through 3a and 32 through Sutract line 36 from line 22. This is your adjusted gross income For isclosure, Privacy ct, and Paperwork Reduction ct Notice, see instructions dd numers on lines aove 02,00 3,0 0,0 0,0 Form 040 (200)

2 Form 040 (200) Tax and redits Standard eduction for - People who checked any ox on line 39a or 39 or who can e claimed as a dependent, See instr. ll others: Single or Married filing separately, $,000 Married filing jointly or Qualifying widow(er), $0,000 Head of household, $7,300 Other Taxes Payments If you have a qualifying child, attach Schedule I. Refund irect deposit? See instructions and fill in 73, 73c, and 73d. mount You Owe Third Party esignee Sign Here Joint return? See instructions Keep a copy for your records. Paid Preparer's Use Only 38 mount from line 37 (adjusted gross income) a heck You were orn efore January 2, 94, lind. Total oxes if: { Spouse was orn efore January 2, 94, lind. } checked 39a 0 If your spouse itemizes on a seperate return or you were a dual-status alien, see instructions and check here Itemized deductions (from Schedule ) or your standard deduction (see left margin) Sutract line 40 from line If line 38 is over $09,47, or you provided housing to a person displaced y Hurricane Katrina, see instructions. Otherwise, multiply $3,200 y the total numer of exemptions claimed on line 6d Taxale income. Sutract line 42 from line 4. If line 42 is more than line 4, enter Tax (see instructions). heck if any tax is from: a Form(s) 884 Form lternative minimum tax (see instructions). ttach Form dd lines 44 and Foreign tax credit. ttach Form 6 if required redit for child and dependent care expenses. ttach Form redit for the elderly or the disaled. ttach Schedule R ducation credits. ttach Form Retirement savings contriutions credit. ttach Form hild tax credit (see instructions). ttach Form 890 if required.. 2 3,00 3 doption credit. ttach Form redits from: a Form 8396 Form Other credits. heck applicale ox(es): Form 880 c Form 6 dd lines 47 through. These are your total credits Sutract line 6 from line 46. If line 6 is more than line 46, enter Self-employment tax. ttach Schedule S Social security and Medicare tax on tip income not reported to employer. ttach Form dditional tax on IRs, other qualified retirement plans, etc. ttach Form 329 if required dvance earned income credit payments from Form(s) W Household employment taxes. ttach Schedule H dd lines 7 through 62. This is your total tax Federal income tax withheld from Forms W-2 and , estimated tax payments and amount applied from 2004 return a arned income credit (I) a Nontaxale comat pay election xcess social security and tier RRT tax withheld (see instr.) dditional child tax credit. ttach Form mount paid with request for extension to file (see instructions) Payments from: a Form 2439 Form 436 c Form dd lines 64, 6, 66a, and 67 through 7 These are your total payments a d a Form 3800 If line 7 is more than line 63, sutract line 63 from line 7. This is the amount you overpaid mount of line 72 you want refunded to you Routing numer ccount numer 74 mount of line 72 you want applied to your 2006 estimated tax 74 7 mount you owe. Sutract line 7 from line 63. For details on how to pay, see instructions 7 76 stimated tax penalty (see instructions) esignee's name Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the est of my knowledge and elief, they are true, correct, and complete. eclaration of preparer (other than taxpayer) is ased on all information of which preparer has any knowledge. Your signature Spouse's signature. If a joint return, oth must sign. Preparer's signature Firm's name (or yours if self-employed), address, and ZIP code c Type: hecking Savings o you want to allow another person to discuss this return with the IRS (see instructions)? Phone no. Your occupation Spouse's occupation heck if self-employed IN Phone no a Yes. omplete the following. Personal identification numer (PIN) aytime phone numer Preparer's SSN or PTIN Page 2 0,0 23,40 8,70 6,00 6,70 9,76. 9,76. 3,00 6,76. 6,76. 6,00 9,239. 9,239. No Form 040 (200)

3 SHULS & (Form 040) epartment of the Treasury Internal Revenue Service ttach to Form 04 Name(s) shown on Form 040 Medical and ental xpenses Taxes You Paid Interest You Paid (Schedule is on page 2) aution. o not include expenses reimursed or paid y others. Medical and dental expenses (see instructions) nter amount from Form 040, line Multiply line 2 y 7.% (.07) , Sutract line 3 from line. If line 3 is more than line, enter State and local (check only one ox): a Income taxes, or General sales taxes (see instructions) } Real estate taxes (see instructions) Personal property taxes Other taxes. List type and amount 8 9 dd lines through X Schedule - Itemized eductions Home mortgage interest and points reported to you on Form 098 Home mortgage interest not reported to you on Form 098. If paid to the person from whom you ought the home, see instructions and show that person's name, identifying no., and address See Instructions for Schedules & (Form 040). 0, ,90 7,70,0 30 9,70 OM No ttachment Sequence No. 07 Your social security numer 9,0 Note. Personal interest is not deductile. Gifts to harity If you made a gift and got a enefit for it, see instructions. 2 Points not reported to you on Form 098. See instructions for special rules Investment interest. ttach Form 492 if required dd lines 0 through a Gifts y cash or check. If you made any gift of $20 or more, see instructions Gifts y cash or check after ugust 27, 200, that you elect to treat as qualified contriutions (see instr.) Other than y cash or check. If any gift of $20 or more, see instructions. You must attach Form 8283 if over $ arryover from prior year dd lines a, 6, and asualty and Theft Losses 9 asualty or theft loss(es). ttach Form Jo xpenses and ertain Miscellaneous eductions 2 22 Other expenses -- investment, safe deposit ox, etc. List 23 type and amount dd lines 20 through nter amount from Form 040, line Multiply line 24 y 2% (.02) Sutract line 2 from line 23. If line 2 is more than line 23, enter Unreimursed employee expenses -- jo travel, union dues, jo education, etc. ttach Form 206 or 206-Z if required. Tax preparation fees Other - from list in the instr. List type and amount Other Miscellaneous eductions 27 Total 28 Is Form 040, line 38, over $4,90 (over $72,97 if married filing separately)? Itemized X } No. Your deduction is not limited. dd the amounts in the far right column eductions for lines 4 through 27. lso, enter this amount on Form 040, line 4 28 Yes. Your deduction may e limited. See instructions for the amount to enter. For Paperwork Reduction ct Notice, see instructions If you elect to itemize deductions even though they are less than your standard deduction, check here 2 a ,90 9,70 4,60 23,40 Schedule (Form 040) 200

4 Schedules & (Form 040) 200 Name(s) shown on Form 04 o not enter name and social security numer if shown on page one. Part I Interest instructions and the instructions for Form 040, line 8a.) Schedule - Interest and Ordinary ividends List name of payer. If any interest is from a seller-financed mortgage and the uyer used the property as a personal residence, see instructions and list this interest first. lso, show that uyer's social security numer and address OM No Your social security numer Page 2 ttachment Sequence No. 08 mount Universal Savings 3,0 2,40 Note. If you received a Form 099-INT, Form 099-OI, or sustitute statement from a rokerage firm, list the firm's name as the payer and enter the total interest shown on that form. Part II Ordinary ividends instructions and the instructions for Form 040, line 9a.) Sutotal,0 Tax-xempt Interest 2,40 3,0 2 dd the amounts on line xcludale interest on series and I U.S. savings onds issued after 989. ttach Form Sutract line 3 from line 2. nter the result here and on Form 040, line 8a Note. If line 4 is over $,00, you must complete Part III. List name of payer mount 3,0 Note. If you received a Form 099-IV or sustitute statement from a rokerage firm, list the firm's name as the payer and enter the ordinary dividends shown on that form. Part III Foreign ccounts and Trusts 6 dd the amounts on line. nter the total here and on Form 040, line 9a Note. If line 6 is over $,00, you must complete Part III. You must complete this part if you (a) had over $,00 of taxale interest or ordinary dividends; or () had a foreign account; or (c) received a distriution from, or were a grantor of, or a transferor to, a foreign trust. 7a 8 t any time during 200, did you have an interest in or a signature or other authority over a financial account in a foreign country, such as a ank account, securities account, or other financial account? See instructions for exceptions and filing requirements for Form T F uring 200, did you receive a distriution from, or were you the grantor of, or transferor to, a foreign trust? If "Yes," you may have to file Form 32 See instructions For Paperwork Reduction ct Notice, see instructions. Schedule (Form 040) 200 If "Yes," enter the name of the foreign country 07/7/2007 0:4:2M 6 Yes No X X

5 Noncash haritale ontriutions Form 8283 OM No (Rev. ecemer 200) ttach to your tax return if you claimed a total deduction of over $00 for all contriuted property. ttachment epartment of the Treasury Internal Revenue Service See separate instructions. Sequence No. Name(s) shown on your income tax return Identifying numer Note: Figure the amount of your contriution deduction efore completing this form. See your tax return instructions. Section. onated Property of $,000 or Less and ertain Pulicly Traded Securities - List in this section only items (or groups of similar items) for which you claimed a deduction of $,000 or less. lso, list certain pulicly traded securities even if the deduction is more than $,000 (see instructions). Part I Information on onated Property - If you need more space, attach a statement. (a) Name and address of the donee organization lakeville community college () escription of donated property (For a donated vehicle, enter the year, make, model, condition, and mileage.) stock Note: If the amount you claimed as a deduction for an item is $00 or less, you do not have to complete columns (d), (e), and (f). (c) of the contriution (d) acquired y donor (mo., yr.) (e) How acquired y donor (f) onor's cost or adjusted asis (g) Fair market value (see instructions) (h) Method used to determine the fair market value 09/7/200 /200 PURHS 30 70PULILY TR Part II Partial Interests and Restricted Use Property - omplete lines 2a through 2e if you gave less than an entire interest in a property listed in Part I. omplete lines 3a through 3c if conditions were placed on a contriution listed in Part I; also attach the required statement (see instructions). 2a nter the letter from Part I that identifies the property for which you gave less than an entire interest. If Part II applies to more than one property, attach a separate statement. Total amount claimed as a deduction for the property listed in Part I: () For this tax year. (2) For any prior tax years. c Name and address of each organization to which any such contriution was made in a prior year (complete only if different from the donee organization aove): Name of charitale organization (donee) ddress (numer, street, and room or suite no.) ity or town, state, and ZIP code d e For tangile property, enter the place where the property is located or kept Name of any person, other than the donee organization, having actual possession of the property 3a Is there a restriction, either temporary or permanent, on the donee's right to use or dispose of the donated Yes No property? id you give to anyone (other than the donee organization or another organization participating with the donee organization in cooperative fundraising) the right to the income from the donated property or to the possession of the property, including the right to vote donated securities, to acquire the property y purchase or otherwise, or to designate the person having such income, possession, or right to acquire? c Is there a restriction limiting the donated property for a particular use? For Paperwork Reduction ct Notice, see instructions. Form 8283 (Rev ) 07/7/2007 0:4:2M

6 Form 8283 (Rev ) Name(s) shown on your income tax return Identifying numer Section. onated Property Over $,000 (xcept ertain Pulicly Traded Securities) - List in this section only items (or groups of similar items) for which you claimed a deduction of more than $,000 per item or group (except contriutions of certain pulicly traded securities reported in Section ). n appraisal is generally required for property listed in Section (see instructions). Part I Information on onated Property - To e completed y the taxpayer and/or appraiser. 4 heck the ox that descries the type of property donated: Qualified onservation ontriution Other Real state Securities *rt includes paintings, sculptures, watercolors, prints, drawings, ceramics, antiques, decorative arts, textiles, carpets, silver, rare manuscripts, historical memorailia, and other similar ojects. **ollectiles include coins, stamps, ooks, gems, jewelry, sports memorailia, dolls, etc., ut not art as defined aove. Note: If your total art contriution was $20,000 or more, you must attach a complete copy of the signed appraisal. If your deduction for any donated property was more than $00,000, you must attach a qualified appraisal of the property. See instructions. (a) escription of donated property (if you need more space, attach a separate statement) (d) acquired y donor (mo., yr.) Part II rt* (contriution of $20,000 or more) rt* (contriution of less than $20,000) ollectiles** (e) How acquired y donor (f) onor's cost or adjusted asis Intellectual Property () If tangile property was donated, give a rief summary of the overall physical condition of the property at the time of the gift (g) For argain sales, enter amount received (h) mount claimed as a deduction See instructions (c) ppraised fair market value (i) verage trading price of securities Taxpayer (onor) Statement - List each item included in Part I aove that the appraisal identifies as having a value of $00 or less. See instructions. I declare that the following item(s) included in Part I aove has to the est of my knowledge and elief an appraised value of not more than $00 (per item). nter identifying letter from Part I and descrie the specific item. See instructions. quipment Other Page 2 Signature of taxpayer (donor) Part III eclaration of ppraiser I declare that I am not the donor, the donee, a party to the transaction in which the donor acquired the property, employed y, or related to any of the foregoing persons, or married to any person who is related to any of the foregoing persons. nd, if regularly used y the donor, donee, or party to the transaction, I performed the majority of my appraisals during my tax year for other persons. lso, I declare that I hold myself out to the pulic as an appraiser or perform appraisals on a regular asis; and that ecause of my qualifications as descried in the appraisal, I am qualified to make appraisals of the type of property eing valued. I certify that the appraisal fees were not ased on a percentage of the appraised property value. Furthermore, I understand that a false or fraudulent overstatement of the property value as descried in the qualified appraisal or this Form 8283 may suject me to the penalty under section 670(a) (aiding and aetting the understatement of tax liaility). I affirm that I have not een arred from presenting evidence or testimony y the Office of Professional Responsiility. Sign Here Signature Title usiness address (including room or suite no.) Identifying numer ity or town, state, and ZIP code Part IV onee cknowledgment - To e completed y the charitale organization. This charitale organization acknowledges that it is a qualified organization under section 70(c) and that it received the donated property as descried in Section, Part I, aove on the following date Furthermore, this organization affirms that in the event it sells, exchanges, or otherwise disposes of the property descried in Section, Part I (or any portion thereof) within 2 years after the date of receipt, it will file Form 8282, onee Information Return, with the IRS and give the donor a copy of that form. This acknowledgment does not represent agreement with the claimed fair market value. oes the organization intend to use the property for an unrelated use? Yes No Name of charitale organization (donee) mployer identification numer ddress (numer, street, and room or suite no.) ity or town, state, and ZIP code uthorized signature Title 07/7/2007 0:4:2M