EFG Tax Return(s)

Transcription

1 Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency specifications. When using Acrobat 5.x products, uncheck the "Shrink oversized pages to paper size" and uncheck the "Expand small pages to paper size" options, in the Adobe "Print" dialog. When using Acrobat 6.x and later products versions, select "None" in the "Page Scaling" selection box in the Adobe "Print" dialog Tax Return(s) Prepared for CLIENT CODE: Account Number Release Number Prepared by NAME ADDRESS CITY AND STATE Processing Date: Time: 02/26/ :46:1 Special Instructions Messages EFG

2 ELECTRONIC FILING Return Information Form: 1 Sheet: 1 Box: 30 { This return has been disqualified from electronic filing for the following reason(s): (40001) Form: 1 Sheet: 1 Box: 40 { Form 104 Taxpayer s (or spouse s) first and/or last name has not been entered. (4000) Form: 1 Sheet: 1 Box: 44 { Form 104 The filing status is "Married Filing Separate", and the spouse s name has not been entered on Interview Form 1 or it has been overridden on Line 3 of the government form. (40015) Form: 1 Sheet: 1 Box: 46 { Form 104 Taxpayer s (or spouse s, if applicable) social security number is missing or invalid. TAX EXEMPT, APPLIED FOR and NRA are not valid for electronic filing. (40011) Form: 1 Sheet: 1 Box: 61 { Form 104 Taxpayer s home address, state or ZIP code has not been entered. NONE is a valid entry for the street address. (40010) Form: 1 Sheet: 1 Box: 63 { Form 104 The city field has not been entered or is less than the minimum number of characters required (3). (40275) Form: 1 Sheet: 1 Box: 65 { Form 104 The ZIP code is not within the valid range of ZIP codes for the state. (40210) Form: Alt Filing { Form Electronic Return Originator (ERO) information is incomplete or invalid. Check your Office Manager for completeness and do not enter a ZIP code on the same line with the city and state. To ensure correct formatting of the city and state, the state must be spelled correctly, or the standard U.S. Postal state abbreviation must be used. If entering information on Interview Form 3, do not enter partial information. (40008) ,

3 Return Information { Form Declaration Control Number (DCN) is incomplete or invalid. Ensure the Electronic Filing Identification Number (EFIN) has been entered in the Office Manager under Configure Applications/Tax Preparation/Alternative Filing Options. Whenever ERO override information is entered on either Interview Form 3 or Interview Form EF-1, the EFIN must be entered in Box 81 of Interview Form EF-1. (40012) { Form 104 Incomplete or invalid information has been entered in the Paid Preparer s Use Only section on page 2 of Form 1040 or 1040A OR page 1 of Form 1040EZ. If entering information on Interview Form 3, do not enter partial information. (40064) { Electronic Filing. notification has been selected for this return, however a taxpayer address has not been entered. If you do not want the taxpayer notified via when the return is accepted by the IRS please change the customer notification option on Interview Form EF-1, Box 42. (48284) { Electronic Filing. notification has been selected for this return, however a preparer address has not been entered on Interview Form EF-1, Box 85 or in Office Manager. If you do not want the taxpayer notified via when the return is accepted by the IRS please change the customer notification option on Interview Form EF-1, Box 42. (48285) CAUTION Form: KS 40 { Kansas. Please include the school district number and/or the county abbreviation on Interview Form KS1. Kansas requires this information be entered in the appropriate spaces on the Kansas income tax return. The correct school district number and/or county abbreviation to be entered should be the one where the taxpayer resided on 12/31/06. (20774) INFORMATIONAL Form: 1 Sheet: 1 Box: 46 { Form 104 Spouse s social security number is missing. (30100) Form: 1 Sheet: 1 Box: 51 { Form 104 Taxpayer s date of birth is missing. (30101) Form: Form 1040 { Schedule A. Total itemized deductions calculated to be $26. Schedule A is not advantageous for regular tax purposes. (31432) ,

4 Form: Form 1040 Return Information { Electronic Filing. Electronic filing has been requested for this return. The IRS requires all negative numbers to print with minus signs when filing electronically. In this return, a request was made to print with parenthesis either on Interview Form 2 or in Office Manager. This option was not used in this return. (30853) { Form Alternative minimum taxable income is $ (33201) { Form 104 Electronic filing has been requested for this return. The IRS requires all returns to be dollar rounded when filing electronically. Either Interview Form 2 or the Office Manager file has requested pennies. This option was not used in this return. (35003) Form: Form 1040A { Form 1040A. The taxpayer qualifies for filing Form 1040A. Enter a code "2" on Interview Form 4, Box 30 for preparation of Form 1040A. If this box is left blank, Form 1040 will be prepared. (36785) Form: Sch A { Schedule A. The ZIP code entered on Interview Form 1, Box 65 or Interview Form A-2, Box 116 did not return a local sales tax rate from the ZIP code table for the automatic state and local general sales tax calculation. Please verify the ZIP code entered is correct. (32554) ,

5 Form: Form 1040 Return Information { At the time of this release, forms included in this return may be classified as either Prior Year, Preliminary, Approval Pending, or Final Update in Process. Prior Year - The program update is based upon the prior year tax forms. Forms produced with this classification are for reference only and should NOT be filed. Preliminary - The program update is based upon preliminary forms received from the taxing authority. Further changes are expected. Forms produced with this classification are for reference only and should NOT be filed. Approval Pending - Approval Pending forms are identified by the code "AP" in the lower right hand corner of the government form. The form has been submitted to the taxing authority for scanning verification and requires taxing authority approval before it can be filed. Final Update in Process - Final development, testing and/or release of the program has not been completed. This form classification will ONLY be identified on the ProSystem fx website. Please review calculations on these forms thoroughly prior to filing. For form-by-form release information details, please review the Forms Release Status section of the ProSystem fx website, prosystemfxsupport.tax.cchgroup.com/pfxcurrent.nsf/i. (35005) Form: KS 40 { Kansas. Taxpayer s Daytime/Work Telephone number is missing. (32831) ,

6 2006 Return Summary FEDERAL KANSAS ADJUSTED GROSS INCOME ITEMIZED OR STANDARD DEDUCTION -5,15-3,00 EXEMPTIONS -3,30-2,25 TAXABLE INCOME TAX INCOME TAX WITHHELD CREDIT FOR FEDERAL TELEPHONE EXCISE TAX -3 AMOUNT DUE <REFUND> -3 ADDITIONAL INFORMATION: FEDERAL TAX BRACKET AVERAGE TAX RATE - 00% MARGINAL TAX RATE - 0% KANSAS TAX BRACKET - 00% /

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8 06I:00123:V1 Input Listing Page 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1, Sheet #1, Entity 1 Box Cnt 3 30: "KS", 42: " ", 70: "7"

9 Form 1040 U.S. Individual Income Tax Return 2006 Label (See instructions on page 16.) Use the IRS L A B E L () IRS Use Only - Do not write or staple in this space. OMB No For the year Jan. 1-Dec. 31, 2006, or other tax year beginning, 2006, ending, 20 Your first name and initial Last name Your social security number If a joint return, spouse s first name and initial Last name " " " " ; ; Spouse s social security number label. Home address (number and street). If you have a P.O. box, see page 16. Apt. no. H You must enter Otherwise, E your SSN(s) above. please print R City, town or post office, state, and ZIP code. If you have a foreign address, see page 16. or type. E Checking a box below will not change your tax or refund. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 16) You Spouse 1 Single 4 Head of household (with qualifying person). If the qualifying Filing Status 2 Married filing jointly (even if only one had income) person is a child but not your dependent, enter this child s 3 X Check only Married filing separately. Enter spouse s SSN above name here. one box. and full name here. 5 Qualifying widow(er) with dependent child (see page 17) Boxes checked 6a X Yourself. If someone can claim you as a dependent, do not check box 6a ~~~~~~~~~~~~~~~~ on 6a and 6b Exemptions b Spouse pmo 1 No. of children (4) if qualifying child tax credit for on 6c who: (3) Dependent s u c Dependents: (2) Dependent s social security number child relationship to lived with you (1) First name Last name you (see page 1) did not live with you B due to divorce or separation (see page 20) If more than four dependents, see page 1. Income Attach Form(s) W-2 here. Also attach Forms W-2G and 10-R if tax was withheld. If you did not get a W-2, see page 23. Enclose, but do not attach, any payment. Also, please use Form 1040-V. Adjusted Gross Income Dependents on 6c not entered above Add numbers on lines d Total number of exemptions claimed above 7 Wages, salaries, tips, etc. Attach Form(s) W-2 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 8a b a b 15a 16a a 21 Taxable interest. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt interest. Do not include on line 8a ~~~~~~~~~~~ 8b Ordinary dividends. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~ Qualified dividends (see page 23) ~~~~~~~~~~~~~~~~~ Taxable refunds, credits, or offsets of state and local income taxes~~~~~~~~~~~~~~~~~~ 10 Alimony received ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Business income or (loss). Attach Schedule C or C-EZ ~~~~~~~~~~~~~~~~~~~~~~~ Capital gain or (loss). Attach Schedule D if required. If not required, check here ~~~~~~~ Other gains or (losses). Attach Form 477 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ IRA distributions Pensions and annuities ~~~~~~~ 15a ~~~~ 16a Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F b b Taxable amount (see page 25) b Taxable amount (see page 26) 8a a b 16b ~~~~~~~~ 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unemployment compensation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Social security benefits ~~~~ 20a b Taxable amount (see page 27) Other income. List type and amount (see page 2) 22 Add the amounts in the far right column for lines 7 through 21. This is your total income a Archer MSA deduction. Attach Form 8853 ~~~~~~~~~~~~~ 23 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ ~~~~~~~~~~~~~~~~~ 24 Health savings account deduction. Attach Form 888 ~~~~~~~~ Moving expenses. Attach Form 303 ~~~~~~~~~~~~~~~ One-half of self-employment tax. Attach Schedule SE ~~~~~~~~ Self-employed SEP, SIMPLE, and qualified plans ~~~~~~~~~~ Self-employed health insurance deduction (see page 2) ~~~~~~~ Penalty on early withdrawal of savings ~~~~~~~~~~~~~~~ Alimony paid b Recipient s SSN IRA deduction (see page 31) ~~~~~~~~~~~~~~~~~~~ Student loan interest deduction (see page 33) ~~~~~~~~~~~ Jury duty pay you gave to your employer~~~~~~~~~~~~~~ Domestic production activities deduction. Attach Form 803 ~~~~~ 36 Add lines 23 through 31a and 32 through 35 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 36 from line 22. This is your adjusted gross income LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 8 Form 1040 (2006) a b

10 Form 1040 (2006) Page 2 Tax and 38 Amount from line 37 (adjusted gross income) 38 Credits 3a Check You were born before January 2, 142, Blind.p if: rqs mo Total boxes Standard Deduction for - Spouse was born before January 2, 142, Blind. checked ~ 3a b If your spouse itemizes on a separate return or you were a dual-status alien, see page 34 and check here ~~ 3b People who checked any 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ~~~~~~~~~~~ 40 5,15 box on line 3a or 3b or who 41 Subtract line 40 from line 38 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 41-5,15 can be claimed as a dependent. 42 If line 38 is over $112,875, or you provided housing to a person displaced by Hurricane Katrina, see page 36. Otherwise, multiply $3,300 by the total number of exemptions claimed on line 6d ~~~~~~~~ 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- ~~~~~~~~~~~ All others: 44 Tax. Check if any tax is from: a Form(s) 8814 b Form 472 ~~~~~~~~~~~~~~~~~~ Single or Married filing 45 Alternative minimum tax. Attach Form 6251 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ separately, $5, Add lines 44 and Foreign tax credit. Attach Form 1116 if required ~~~~~~~~~~~~~ 47 Married filing jointly or 48 Credit for child and dependent care expenses. Attach Form 2441 ~~~~~~ 48 Qualifying widow(er), 4 Credit for the elderly or the disabled. Attach Schedule R ~~~~~~~~~~ 4 $10, Education credits. Attach Form 8863 ~~~~~~~~~~~~~~~~~~ 50 Head of household, 51 Retirement savings contributions credit. Attach Form 8880 ~~~~~~~~ 51 $7, Residential energy credits. Attach Form 565 ~~~~~~~~~~~~~~ 52 Other Taxes Payments 64 If you have a qualifying child, attach Schedule EIC. 65 Child tax credit (see page 42). Attach Form 801 if required ~~~~~~~~ Credits from: a Form 836 b Form 883 c Form 885 Other credits: a Form 3800 b Form 8801 c Form Add lines 47 through 55. These are your total credits~~~~~~~~~~~~~~~~~~~~~~~~~~ 56 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- Self-employment tax. Attach Schedule SE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 58 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 ~~~~~~~~~ Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 532 if required ~~~~~~~~~~ Advance earned income credit payments from Form(s) W-2, box ~~~~~~~~~~~~~~~~~~~~ Household employment taxes. Attach Schedule H ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 57 through 62. This is your total tax 66a Earned income credit (EIC) Federal income tax withheld from Forms W-2 and 10 ~~~~~~~~~~ estimated tax payments and amount applied from 2005 return ~~~~ b Nontaxable combat pay election ~~~ 66b Excess social security and tier 1 RRTA tax withheld (see page 60) ~~~~~ Additional child tax credit. Attach Form 8812~~~~~~~~~~~~~~~ Amount paid with request for extension to file (see page 60) ~~~~~~~~ Payments from: a Form 243 b Form 4136 c Form 8885 Credit for federal telephone excise tax paid. Attach Form 813 if required ~~ 72 Add lines 64, 65, 66a, and 67 through 71. These are your total payments 72 Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid~~~~~~~~~ 73 Direct deposit? 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here 74a See page 61 Routing Account and fill in 74b, b number c Type: Checking Savings d number 74c, and 74d, or Form Amount of line 73 you want applied to your 2007 estimated tax 75 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see page 62 ~~~~~~~~~ 76 You Owe 77 Estimated tax penalty (see page 62) 77 Third Party Do you want to allow another person to discuss this return with the IRS (see page 63)? Yes. Complete the following. No Designee s Phone Personal identification Designee name no. number (PIN) 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, Sign and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Daytime phone number Here Date Your occupation Joint return? See page 17. Keep a copy = Spouse s signature. If a joint return, bothmust sign. Date Spouse s occupation for your records. Paid Preparer s Use Only Date Preparer s Check if selfsignature employed = EIN Firm s name (or yours if self-employed), address, and ZIP code = a Preparer s SSN or PTIN ADDRESS Phone no , NAME CITY AND STATE

11 K KANSAS INDIVIDUAL INCOME TAX (Rev. /06) and/or FOOD SALES TAX REFUND kk Name or address has changed? Taxpayer or (spouse if filing joint) died during this tax year Taxpayer was engaged in commercial farming/fishing in 2006 Filing an amended individual income return. Note: This form cannot be used for tax years prior to Filing Status: Residency Status: Exemptions: Reason for amended return: Single Resident Amended Kansas only Married filing joint (Even if only one had income) Nonresident or Part-Year resident (Complete Schedule S, Part B.) Number of exemptions claimed on 2006 federal return Filing Head of Household Amended Federal return Married filing separate From Total Kansas exemptions Adjustment by IRS Head of Household X 1 X 1 To 1. Federal adjusted gross income Other credits ~~~~ 0 2. UNDERPAYMENT ~~ Modifications ~~~~ Total tax credits ~~~ 0 3 Interest ~~~~~~ 0 Kansas adjusted gross income 17. Income tax balance after credits 31. Penalty ~~~~~~ 4. Standard or itemized deductions Use Tax Due ~~~~ 32. Estimated tax penalty ~ Exemption allowance ~ 1. Total Tax Balance ~~ 33. AMOUNT YOU OWE ~ 2 Kansas income tax withheld 525 Total deductions ~~~ form W-2, 10 or K-1 ~~ 34. OVERPAYMENT ~~~ Taxable income ~~~ 21. Estimated tax paid ~~ 35. CREDIT FORWARD ~~ 8.. Tax ~~~~~~~~ 22. Amount paid with KS extension 36. CHICKADEE CHECKOFF Nonresident allocation percent 23. Earned income credit ~ 1 Nonresident tax ~~~ 24. Refundable portion of tax credits RESEARCH FUND ~~ 11. KS tax on lump sum distriubutions (Residents only) 12. TOTAL INCOME TAX ~ original return ~~~~ 4 REFUND ~~~~~~ 13. Credit for taxes paid to 14. Credit for child & dependent care expenses ~~~~~ ~~ 25. FOOD SALES TAX REFUND ~ RELIEF FUND ~~~~ 26. Payments remitted with 27. Overpayment from original other states~~~~~ return (Subtraction only) ~~ 28. Total refundable credits 37. SENIOR CITIZENS MEALS ON WHEELS PROGRAM 38. BREAST CANCER 3. MILITARY EMERGENCY I authorize the Director of Taxation or the Director s designee to discuss my return and attachments with my preparer. I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return. Taxpayer Signature Date Preparer Name Preparer PTIN OR Spouse Signature Date Preparer Phone Number Preparer EIN / SSN kk F o r O f f i c e U s e O n l y

12 Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency specifications. When using Acrobat 5.x products, uncheck the "Shrink oversized pages to paper size" and uncheck the "Expand small pages to paper size" options, in the Adobe "Print" dialog. When using Acrobat 6.x and later products versions, select "None" in the "Page Scaling" selection box in the Adobe "Print" dialog. CLIENT S COPY

13 Form 1040 U.S. Individual Income Tax Return 2006 Label (See instructions on page 16.) Use the IRS L A B E L () IRS Use Only - Do not write or staple in this space. OMB No For the year Jan. 1-Dec. 31, 2006, or other tax year beginning, 2006, ending, 20 Your first name and initial Last name Your social security number If a joint return, spouse s first name and initial Last name " " " " ; ; Spouse s social security number label. Home address (number and street). If you have a P.O. box, see page 16. Apt. no. H You must enter Otherwise, E your SSN(s) above. please print R City, town or post office, state, and ZIP code. If you have a foreign address, see page 16. or type. E Checking a box below will not change your tax or refund. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 16) You Spouse 1 Single 4 Head of household (with qualifying person). If the qualifying Filing Status 2 Married filing jointly (even if only one had income) person is a child but not your dependent, enter this child s 3 X Check only Married filing separately. Enter spouse s SSN above name here. one box. and full name here. 5 Qualifying widow(er) with dependent child (see page 17) Boxes checked 6a X Yourself. If someone can claim you as a dependent, do not check box 6a ~~~~~~~~~~~~~~~~ on 6a and 6b Exemptions b Spouse pmo 1 No. of children (4) if qualifying child tax credit for on 6c who: (3) Dependent s u c Dependents: (2) Dependent s social security number child relationship to lived with you (1) First name Last name you (see page 1) did not live with you B due to divorce or separation (see page 20) If more than four dependents, see page 1. Income Attach Form(s) W-2 here. Also attach Forms W-2G and 10-R if tax was withheld. If you did not get a W-2, see page 23. Enclose, but do not attach, any payment. Also, please use Form 1040-V. Adjusted Gross Income Dependents on 6c not entered above Add numbers on lines d Total number of exemptions claimed above 7 Wages, salaries, tips, etc. Attach Form(s) W-2 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 8a b a b 15a 16a a 21 Taxable interest. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt interest. Do not include on line 8a ~~~~~~~~~~~ 8b Ordinary dividends. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~ Qualified dividends (see page 23) ~~~~~~~~~~~~~~~~~ Taxable refunds, credits, or offsets of state and local income taxes~~~~~~~~~~~~~~~~~~ 10 Alimony received ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Business income or (loss). Attach Schedule C or C-EZ ~~~~~~~~~~~~~~~~~~~~~~~ Capital gain or (loss). Attach Schedule D if required. If not required, check here ~~~~~~~ Other gains or (losses). Attach Form 477 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ IRA distributions Pensions and annuities ~~~~~~~ 15a ~~~~ 16a Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F b b Taxable amount (see page 25) b Taxable amount (see page 26) 8a a b 16b ~~~~~~~~ 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unemployment compensation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Social security benefits ~~~~ 20a b Taxable amount (see page 27) Other income. List type and amount (see page 2) 22 Add the amounts in the far right column for lines 7 through 21. This is your total income a Archer MSA deduction. Attach Form 8853 ~~~~~~~~~~~~~ 23 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ ~~~~~~~~~~~~~~~~~ 24 Health savings account deduction. Attach Form 888 ~~~~~~~~ Moving expenses. Attach Form 303 ~~~~~~~~~~~~~~~ One-half of self-employment tax. Attach Schedule SE ~~~~~~~~ Self-employed SEP, SIMPLE, and qualified plans ~~~~~~~~~~ Self-employed health insurance deduction (see page 2) ~~~~~~~ Penalty on early withdrawal of savings ~~~~~~~~~~~~~~~ Alimony paid b Recipient s SSN IRA deduction (see page 31) ~~~~~~~~~~~~~~~~~~~ Student loan interest deduction (see page 33) ~~~~~~~~~~~ Jury duty pay you gave to your employer~~~~~~~~~~~~~~ Domestic production activities deduction. Attach Form 803 ~~~~~ 36 Add lines 23 through 31a and 32 through 35 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 36 from line 22. This is your adjusted gross income LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 8 Form 1040 (2006) a b

14 Form 1040 (2006) Page 2 Tax and 38 Amount from line 37 (adjusted gross income) 38 Credits 3a Check You were born before January 2, 142, Blind.p if: rqs mo Total boxes Standard Deduction for - Spouse was born before January 2, 142, Blind. checked ~ 3a b If your spouse itemizes on a separate return or you were a dual-status alien, see page 34 and check here ~~ 3b People who checked any 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ~~~~~~~~~~~ 40 5,15 box on line 3a or 3b or who 41 Subtract line 40 from line 38 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 41-5,15 can be claimed as a dependent. 42 If line 38 is over $112,875, or you provided housing to a person displaced by Hurricane Katrina, see page 36. Otherwise, multiply $3,300 by the total number of exemptions claimed on line 6d ~~~~~~~~ 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- ~~~~~~~~~~~ All others: 44 Tax. Check if any tax is from: a Form(s) 8814 b Form 472 ~~~~~~~~~~~~~~~~~~ Single or Married filing 45 Alternative minimum tax. Attach Form 6251 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ separately, $5, Add lines 44 and Foreign tax credit. Attach Form 1116 if required ~~~~~~~~~~~~~ 47 Married filing jointly or 48 Credit for child and dependent care expenses. Attach Form 2441 ~~~~~~ 48 Qualifying widow(er), 4 Credit for the elderly or the disabled. Attach Schedule R ~~~~~~~~~~ 4 $10, Education credits. Attach Form 8863 ~~~~~~~~~~~~~~~~~~ 50 Head of household, 51 Retirement savings contributions credit. Attach Form 8880 ~~~~~~~~ 51 $7, Residential energy credits. Attach Form 565 ~~~~~~~~~~~~~~ 52 Other Taxes Payments 64 If you have a qualifying child, attach Schedule EIC. 65 Child tax credit (see page 42). Attach Form 801 if required ~~~~~~~~ Credits from: a Form 836 b Form 883 c Form 885 Other credits: a Form 3800 b Form 8801 c Form Add lines 47 through 55. These are your total credits~~~~~~~~~~~~~~~~~~~~~~~~~~ 56 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- Self-employment tax. Attach Schedule SE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 58 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 ~~~~~~~~~ Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 532 if required ~~~~~~~~~~ Advance earned income credit payments from Form(s) W-2, box ~~~~~~~~~~~~~~~~~~~~ Household employment taxes. Attach Schedule H ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 57 through 62. This is your total tax 66a Earned income credit (EIC) Federal income tax withheld from Forms W-2 and 10 ~~~~~~~~~~ estimated tax payments and amount applied from 2005 return ~~~~ b Nontaxable combat pay election ~~~ 66b Excess social security and tier 1 RRTA tax withheld (see page 60) ~~~~~ Additional child tax credit. Attach Form 8812~~~~~~~~~~~~~~~ Amount paid with request for extension to file (see page 60) ~~~~~~~~ Payments from: a Form 243 b Form 4136 c Form 8885 Credit for federal telephone excise tax paid. Attach Form 813 if required ~~ 72 Add lines 64, 65, 66a, and 67 through 71. These are your total payments 72 Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid~~~~~~~~~ 73 Direct deposit? 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here 74a See page 61 Routing Account and fill in 74b, b number c Type: Checking Savings d number 74c, and 74d, or Form Amount of line 73 you want applied to your 2007 estimated tax 75 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see page 62 ~~~~~~~~~ 76 You Owe 77 Estimated tax penalty (see page 62) 77 Third Party Do you want to allow another person to discuss this return with the IRS (see page 63)? Yes. Complete the following. No Designee s Phone Personal identification Designee name no. number (PIN) 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, Sign and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Daytime phone number Here Date Your occupation Joint return? See page 17. Keep a copy = Spouse s signature. If a joint return, bothmust sign. Date Spouse s occupation for your records. Paid Preparer s Use Only Date Preparer s Check if selfsignature employed = EIN Firm s name (or yours if self-employed), address, and ZIP code = a Preparer s SSN or PTIN ADDRESS Phone no , NAME CITY AND STATE

15 K KANSAS INDIVIDUAL INCOME TAX (Rev. /06) and/or FOOD SALES TAX REFUND kk Name or address has changed? Taxpayer or (spouse if filing joint) died during this tax year Taxpayer was engaged in commercial farming/fishing in 2006 Filing an amended individual income return. Note: This form cannot be used for tax years prior to Filing Status: Residency Status: Exemptions: Reason for amended return: Single Resident Amended Kansas only Married filing joint (Even if only one had income) Nonresident or Part-Year resident (Complete Schedule S, Part B.) Number of exemptions claimed on 2006 federal return Filing Head of Household Amended Federal return Married filing separate From Total Kansas exemptions Adjustment by IRS Head of Household X 1 X 1 To 1. Federal adjusted gross income Other credits ~~~~ 0 2. UNDERPAYMENT ~~ Modifications ~~~~ Total tax credits ~~~ 0 3 Interest ~~~~~~ 0 Kansas adjusted gross income 17. Income tax balance after credits 31. Penalty ~~~~~~ 4. Standard or itemized deductions Use Tax Due ~~~~ 32. Estimated tax penalty ~ Exemption allowance ~ 1. Total Tax Balance ~~ 33. AMOUNT YOU OWE ~ 2 Kansas income tax withheld 525 Total deductions ~~~ form W-2, 10 or K-1 ~~ 34. OVERPAYMENT ~~~ Taxable income ~~~ 21. Estimated tax paid ~~ 35. CREDIT FORWARD ~~ 8.. Tax ~~~~~~~~ 22. Amount paid with KS extension 36. CHICKADEE CHECKOFF Nonresident allocation percent 23. Earned income credit ~ 1 Nonresident tax ~~~ 24. Refundable portion of tax credits RESEARCH FUND ~~ 11. KS tax on lump sum distriubutions (Residents only) 12. TOTAL INCOME TAX ~ original return ~~~~ 4 REFUND ~~~~~~ 13. Credit for taxes paid to 14. Credit for child & dependent care expenses ~~~~~ ~~ 25. FOOD SALES TAX REFUND ~ RELIEF FUND ~~~~ 26. Payments remitted with 27. Overpayment from original other states~~~~~ return (Subtraction only) ~~ 28. Total refundable credits 37. SENIOR CITIZENS MEALS ON WHEELS PROGRAM 38. BREAST CANCER 3. MILITARY EMERGENCY I authorize the Director of Taxation or the Director s designee to discuss my return and attachments with my preparer. I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return. Taxpayer Signature Date Preparer Name Preparer PTIN OR Spouse Signature Date Preparer Phone Number Preparer EIN / SSN kk F o r O f f i c e U s e O n l y

16 Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency specifications. When using Acrobat 5.x products, uncheck the "Shrink oversized pages to paper size" and uncheck the "Expand small pages to paper size" options, in the Adobe "Print" dialog. When using Acrobat 6.x and later products versions, select "None" in the "Page Scaling" selection box in the Adobe "Print" dialog. GOVERNMENT COPY

17 Form 1040 U.S. Individual Income Tax Return 2006 Label (See instructions on page 16.) Use the IRS L A B E L () IRS Use Only - Do not write or staple in this space. OMB No For the year Jan. 1-Dec. 31, 2006, or other tax year beginning, 2006, ending, 20 Your first name and initial Last name Your social security number If a joint return, spouse s first name and initial Last name " " " " ; ; Spouse s social security number label. Home address (number and street). If you have a P.O. box, see page 16. Apt. no. H You must enter Otherwise, E your SSN(s) above. please print R City, town or post office, state, and ZIP code. If you have a foreign address, see page 16. or type. E Checking a box below will not change your tax or refund. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 16) You Spouse 1 Single 4 Head of household (with qualifying person). If the qualifying Filing Status 2 Married filing jointly (even if only one had income) person is a child but not your dependent, enter this child s 3 X Check only Married filing separately. Enter spouse s SSN above name here. one box. and full name here. 5 Qualifying widow(er) with dependent child (see page 17) Boxes checked 6a X Yourself. If someone can claim you as a dependent, do not check box 6a ~~~~~~~~~~~~~~~~ on 6a and 6b Exemptions b Spouse pmo 1 No. of children (4) if qualifying child tax credit for on 6c who: (3) Dependent s u c Dependents: (2) Dependent s social security number child relationship to lived with you (1) First name Last name you (see page 1) did not live with you B due to divorce or separation (see page 20) If more than four dependents, see page 1. Income Attach Form(s) W-2 here. Also attach Forms W-2G and 10-R if tax was withheld. If you did not get a W-2, see page 23. Enclose, but do not attach, any payment. Also, please use Form 1040-V. Adjusted Gross Income Dependents on 6c not entered above Add numbers on lines d Total number of exemptions claimed above 7 Wages, salaries, tips, etc. Attach Form(s) W-2 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 8a b a b 15a 16a a 21 Taxable interest. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt interest. Do not include on line 8a ~~~~~~~~~~~ 8b Ordinary dividends. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~ Qualified dividends (see page 23) ~~~~~~~~~~~~~~~~~ Taxable refunds, credits, or offsets of state and local income taxes~~~~~~~~~~~~~~~~~~ 10 Alimony received ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Business income or (loss). Attach Schedule C or C-EZ ~~~~~~~~~~~~~~~~~~~~~~~ Capital gain or (loss). Attach Schedule D if required. If not required, check here ~~~~~~~ Other gains or (losses). Attach Form 477 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ IRA distributions Pensions and annuities ~~~~~~~ 15a ~~~~ 16a Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F b b Taxable amount (see page 25) b Taxable amount (see page 26) 8a a b 16b ~~~~~~~~ 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unemployment compensation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Social security benefits ~~~~ 20a b Taxable amount (see page 27) Other income. List type and amount (see page 2) 22 Add the amounts in the far right column for lines 7 through 21. This is your total income a Archer MSA deduction. Attach Form 8853 ~~~~~~~~~~~~~ 23 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ ~~~~~~~~~~~~~~~~~ 24 Health savings account deduction. Attach Form 888 ~~~~~~~~ Moving expenses. Attach Form 303 ~~~~~~~~~~~~~~~ One-half of self-employment tax. Attach Schedule SE ~~~~~~~~ Self-employed SEP, SIMPLE, and qualified plans ~~~~~~~~~~ Self-employed health insurance deduction (see page 2) ~~~~~~~ Penalty on early withdrawal of savings ~~~~~~~~~~~~~~~ Alimony paid b Recipient s SSN IRA deduction (see page 31) ~~~~~~~~~~~~~~~~~~~ Student loan interest deduction (see page 33) ~~~~~~~~~~~ Jury duty pay you gave to your employer~~~~~~~~~~~~~~ Domestic production activities deduction. Attach Form 803 ~~~~~ 36 Add lines 23 through 31a and 32 through 35 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 36 from line 22. This is your adjusted gross income LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 8 Form 1040 (2006) a b

18 Form 1040 (2006) Page 2 Tax and 38 Amount from line 37 (adjusted gross income) 38 Credits 3a Check You were born before January 2, 142, Blind.p if: rqs mo Total boxes Standard Deduction for - Spouse was born before January 2, 142, Blind. checked ~ 3a b If your spouse itemizes on a separate return or you were a dual-status alien, see page 34 and check here ~~ 3b People who checked any 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ~~~~~~~~~~~ 40 5,15 box on line 3a or 3b or who 41 Subtract line 40 from line 38 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 41-5,15 can be claimed as a dependent. 42 If line 38 is over $112,875, or you provided housing to a person displaced by Hurricane Katrina, see page 36. Otherwise, multiply $3,300 by the total number of exemptions claimed on line 6d ~~~~~~~~ 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- ~~~~~~~~~~~ All others: 44 Tax. Check if any tax is from: a Form(s) 8814 b Form 472 ~~~~~~~~~~~~~~~~~~ Single or Married filing 45 Alternative minimum tax. Attach Form 6251 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ separately, $5, Add lines 44 and Foreign tax credit. Attach Form 1116 if required ~~~~~~~~~~~~~ 47 Married filing jointly or 48 Credit for child and dependent care expenses. Attach Form 2441 ~~~~~~ 48 Qualifying widow(er), 4 Credit for the elderly or the disabled. Attach Schedule R ~~~~~~~~~~ 4 $10, Education credits. Attach Form 8863 ~~~~~~~~~~~~~~~~~~ 50 Head of household, 51 Retirement savings contributions credit. Attach Form 8880 ~~~~~~~~ 51 $7, Residential energy credits. Attach Form 565 ~~~~~~~~~~~~~~ 52 Other Taxes Payments 64 If you have a qualifying child, attach Schedule EIC. 65 Child tax credit (see page 42). Attach Form 801 if required ~~~~~~~~ Credits from: a Form 836 b Form 883 c Form 885 Other credits: a Form 3800 b Form 8801 c Form Add lines 47 through 55. These are your total credits~~~~~~~~~~~~~~~~~~~~~~~~~~ 56 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- Self-employment tax. Attach Schedule SE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 58 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 ~~~~~~~~~ Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 532 if required ~~~~~~~~~~ Advance earned income credit payments from Form(s) W-2, box ~~~~~~~~~~~~~~~~~~~~ Household employment taxes. Attach Schedule H ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 57 through 62. This is your total tax 66a Earned income credit (EIC) Federal income tax withheld from Forms W-2 and 10 ~~~~~~~~~~ estimated tax payments and amount applied from 2005 return ~~~~ b Nontaxable combat pay election ~~~ 66b Excess social security and tier 1 RRTA tax withheld (see page 60) ~~~~~ Additional child tax credit. Attach Form 8812~~~~~~~~~~~~~~~ Amount paid with request for extension to file (see page 60) ~~~~~~~~ Payments from: a Form 243 b Form 4136 c Form 8885 Credit for federal telephone excise tax paid. Attach Form 813 if required ~~ 72 Add lines 64, 65, 66a, and 67 through 71. These are your total payments 72 Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid~~~~~~~~~ 73 Direct deposit? 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here 74a See page 61 Routing Account and fill in 74b, b number c Type: Checking Savings d number 74c, and 74d, or Form Amount of line 73 you want applied to your 2007 estimated tax 75 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see page 62 ~~~~~~~~~ 76 You Owe 77 Estimated tax penalty (see page 62) 77 Third Party Do you want to allow another person to discuss this return with the IRS (see page 63)? Yes. Complete the following. No Designee s Phone Personal identification Designee name no. number (PIN) 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, Sign and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Daytime phone number Here Date Your occupation Joint return? See page 17. Keep a copy = Spouse s signature. If a joint return, bothmust sign. Date Spouse s occupation for your records. Paid Preparer s Use Only Date Preparer s Check if selfsignature employed = EIN Firm s name (or yours if self-employed), address, and ZIP code = a Preparer s SSN or PTIN ADDRESS Phone no , NAME CITY AND STATE

19 Caution: Forms printed from within Adobe Acrobat products may not meet IRS or state taxing agency specifications. When using Acrobat 5.x products, uncheck the "Shrink oversized pages to paper size" and uncheck the "Expand small pages to paper size" options, in the Adobe "Print" dialog. When using Acrobat 6.x and later products versions, select "None" in the "Page Scaling" selection box in the Adobe "Print" dialog. STATE COPY

20 K KANSAS INDIVIDUAL INCOME TAX (Rev. /06) and/or FOOD SALES TAX REFUND kk Name or address has changed? Taxpayer or (spouse if filing joint) died during this tax year Taxpayer was engaged in commercial farming/fishing in 2006 Filing an amended individual income return. Note: This form cannot be used for tax years prior to Filing Status: Residency Status: Exemptions: Reason for amended return: Single Resident Amended Kansas only Married filing joint (Even if only one had income) Nonresident or Part-Year resident (Complete Schedule S, Part B.) Number of exemptions claimed on 2006 federal return Filing Head of Household Amended Federal return Married filing separate From Total Kansas exemptions Adjustment by IRS Head of Household X 1 X 1 To 1. Federal adjusted gross income Other credits ~~~~ 0 2. UNDERPAYMENT ~~ Modifications ~~~~ Total tax credits ~~~ 0 3 Interest ~~~~~~ 0 Kansas adjusted gross income 17. Income tax balance after credits 31. Penalty ~~~~~~ 4. Standard or itemized deductions Use Tax Due ~~~~ 32. Estimated tax penalty ~ Exemption allowance ~ 1. Total Tax Balance ~~ 33. AMOUNT YOU OWE ~ 2 Kansas income tax withheld 525 Total deductions ~~~ form W-2, 10 or K-1 ~~ 34. OVERPAYMENT ~~~ Taxable income ~~~ 21. Estimated tax paid ~~ 35. CREDIT FORWARD ~~ 8.. Tax ~~~~~~~~ 22. Amount paid with KS extension 36. CHICKADEE CHECKOFF Nonresident allocation percent 23. Earned income credit ~ 1 Nonresident tax ~~~ 24. Refundable portion of tax credits RESEARCH FUND ~~ 11. KS tax on lump sum distriubutions (Residents only) 12. TOTAL INCOME TAX ~ original return ~~~~ 4 REFUND ~~~~~~ 13. Credit for taxes paid to 14. Credit for child & dependent care expenses ~~~~~ ~~ 25. FOOD SALES TAX REFUND ~ RELIEF FUND ~~~~ 26. Payments remitted with 27. Overpayment from original other states~~~~~ return (Subtraction only) ~~ 28. Total refundable credits 37. SENIOR CITIZENS MEALS ON WHEELS PROGRAM 38. BREAST CANCER 3. MILITARY EMERGENCY I authorize the Director of Taxation or the Director s designee to discuss my return and attachments with my preparer. I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return. Taxpayer Signature Date Preparer Name Preparer PTIN OR Spouse Signature Date Preparer Phone Number Preparer EIN / SSN kk F o r O f f i c e U s e O n l y

21 Form 1040 U.S. Individual Income Tax Return 2006 Label (See instructions on page 16.) Use the IRS L A B E L () IRS Use Only - Do not write or staple in this space. OMB No For the year Jan. 1-Dec. 31, 2006, or other tax year beginning, 2006, ending, 20 Your first name and initial Last name Your social security number If a joint return, spouse s first name and initial Last name " " " " ; ; Spouse s social security number label. Home address (number and street). If you have a P.O. box, see page 16. Apt. no. H You must enter Otherwise, E your SSN(s) above. please print R City, town or post office, state, and ZIP code. If you have a foreign address, see page 16. or type. E Checking a box below will not change your tax or refund. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 16) You Spouse 1 Single 4 Head of household (with qualifying person). If the qualifying Filing Status 2 Married filing jointly (even if only one had income) person is a child but not your dependent, enter this child s 3 X Check only Married filing separately. Enter spouse s SSN above name here. one box. and full name here. 5 Qualifying widow(er) with dependent child (see page 17) Boxes checked 6a X Yourself. If someone can claim you as a dependent, do not check box 6a ~~~~~~~~~~~~~~~~ on 6a and 6b Exemptions b Spouse pmo 1 No. of children (4) if qualifying child tax credit for on 6c who: (3) Dependent s u c Dependents: (2) Dependent s social security number child relationship to lived with you (1) First name Last name you (see page 1) did not live with you B due to divorce or separation (see page 20) If more than four dependents, see page 1. Income Attach Form(s) W-2 here. Also attach Forms W-2G and 10-R if tax was withheld. If you did not get a W-2, see page 23. Enclose, but do not attach, any payment. Also, please use Form 1040-V. Adjusted Gross Income Dependents on 6c not entered above Add numbers on lines d Total number of exemptions claimed above 7 Wages, salaries, tips, etc. Attach Form(s) W-2 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 8a b a b 15a 16a a 21 Taxable interest. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt interest. Do not include on line 8a ~~~~~~~~~~~ 8b Ordinary dividends. Attach Schedule B if required ~~~~~~~~~~~~~~~~~~~~~~~~~ Qualified dividends (see page 23) ~~~~~~~~~~~~~~~~~ Taxable refunds, credits, or offsets of state and local income taxes~~~~~~~~~~~~~~~~~~ 10 Alimony received ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Business income or (loss). Attach Schedule C or C-EZ ~~~~~~~~~~~~~~~~~~~~~~~ Capital gain or (loss). Attach Schedule D if required. If not required, check here ~~~~~~~ Other gains or (losses). Attach Form 477 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ IRA distributions Pensions and annuities ~~~~~~~ 15a ~~~~ 16a Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F b b Taxable amount (see page 25) b Taxable amount (see page 26) 8a a b 16b ~~~~~~~~ 17 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unemployment compensation ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Social security benefits ~~~~ 20a b Taxable amount (see page 27) Other income. List type and amount (see page 2) 22 Add the amounts in the far right column for lines 7 through 21. This is your total income a Archer MSA deduction. Attach Form 8853 ~~~~~~~~~~~~~ 23 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ ~~~~~~~~~~~~~~~~~ 24 Health savings account deduction. Attach Form 888 ~~~~~~~~ Moving expenses. Attach Form 303 ~~~~~~~~~~~~~~~ One-half of self-employment tax. Attach Schedule SE ~~~~~~~~ Self-employed SEP, SIMPLE, and qualified plans ~~~~~~~~~~ Self-employed health insurance deduction (see page 2) ~~~~~~~ Penalty on early withdrawal of savings ~~~~~~~~~~~~~~~ Alimony paid b Recipient s SSN IRA deduction (see page 31) ~~~~~~~~~~~~~~~~~~~ Student loan interest deduction (see page 33) ~~~~~~~~~~~ Jury duty pay you gave to your employer~~~~~~~~~~~~~~ Domestic production activities deduction. Attach Form 803 ~~~~~ 36 Add lines 23 through 31a and 32 through 35 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 36 from line 22. This is your adjusted gross income LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 8 Form 1040 (2006) a b

22 Form 1040 (2006) Page 2 Tax and 38 Amount from line 37 (adjusted gross income) 38 Credits 3a Check You were born before January 2, 142, Blind.p if: rqs mo Total boxes Standard Deduction for - Spouse was born before January 2, 142, Blind. checked ~ 3a b If your spouse itemizes on a separate return or you were a dual-status alien, see page 34 and check here ~~ 3b People who checked any 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ~~~~~~~~~~~ 40 5,15 box on line 3a or 3b or who 41 Subtract line 40 from line 38 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 41-5,15 can be claimed as a dependent. 42 If line 38 is over $112,875, or you provided housing to a person displaced by Hurricane Katrina, see page 36. Otherwise, multiply $3,300 by the total number of exemptions claimed on line 6d ~~~~~~~~ 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- ~~~~~~~~~~~ All others: 44 Tax. Check if any tax is from: a Form(s) 8814 b Form 472 ~~~~~~~~~~~~~~~~~~ Single or Married filing 45 Alternative minimum tax. Attach Form 6251 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ separately, $5, Add lines 44 and Foreign tax credit. Attach Form 1116 if required ~~~~~~~~~~~~~ 47 Married filing jointly or 48 Credit for child and dependent care expenses. Attach Form 2441 ~~~~~~ 48 Qualifying widow(er), 4 Credit for the elderly or the disabled. Attach Schedule R ~~~~~~~~~~ 4 $10, Education credits. Attach Form 8863 ~~~~~~~~~~~~~~~~~~ 50 Head of household, 51 Retirement savings contributions credit. Attach Form 8880 ~~~~~~~~ 51 $7, Residential energy credits. Attach Form 565 ~~~~~~~~~~~~~~ 52 Other Taxes Payments 64 If you have a qualifying child, attach Schedule EIC. 65 Child tax credit (see page 42). Attach Form 801 if required ~~~~~~~~ Credits from: a Form 836 b Form 883 c Form 885 Other credits: a Form 3800 b Form 8801 c Form Add lines 47 through 55. These are your total credits~~~~~~~~~~~~~~~~~~~~~~~~~~ 56 Subtract line 56 from line 46. If line 56 is more than line 46, enter -0- Self-employment tax. Attach Schedule SE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 58 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 ~~~~~~~~~ Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 532 if required ~~~~~~~~~~ Advance earned income credit payments from Form(s) W-2, box ~~~~~~~~~~~~~~~~~~~~ Household employment taxes. Attach Schedule H ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 57 through 62. This is your total tax 66a Earned income credit (EIC) Federal income tax withheld from Forms W-2 and 10 ~~~~~~~~~~ estimated tax payments and amount applied from 2005 return ~~~~ b Nontaxable combat pay election ~~~ 66b Excess social security and tier 1 RRTA tax withheld (see page 60) ~~~~~ Additional child tax credit. Attach Form 8812~~~~~~~~~~~~~~~ Amount paid with request for extension to file (see page 60) ~~~~~~~~ Payments from: a Form 243 b Form 4136 c Form 8885 Credit for federal telephone excise tax paid. Attach Form 813 if required ~~ 72 Add lines 64, 65, 66a, and 67 through 71. These are your total payments 72 Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid~~~~~~~~~ 73 Direct deposit? 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here 74a See page 61 Routing Account and fill in 74b, b number c Type: Checking Savings d number 74c, and 74d, or Form Amount of line 73 you want applied to your 2007 estimated tax 75 Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see page 62 ~~~~~~~~~ 76 You Owe 77 Estimated tax penalty (see page 62) 77 Third Party Do you want to allow another person to discuss this return with the IRS (see page 63)? Yes. Complete the following. No Designee s Phone Personal identification Designee name no. number (PIN) 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, Sign and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Daytime phone number Here Date Your occupation Joint return? See page 17. Keep a copy = Spouse s signature. If a joint return, bothmust sign. Date Spouse s occupation for your records. Paid Preparer s Use Only Date Preparer s Check if selfsignature employed = EIN Firm s name (or yours if self-employed), address, and ZIP code = a Preparer s SSN or PTIN ADDRESS Phone no , NAME CITY AND STATE