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1/5 Personal Information

Year of filing

MARITAL STATUS

Are you treating a nonresident alien or dual-status alien spouse as a U.S. resident for the entire tax year?

First Name and Middle Initial

Last Name

Spouse First Name

Spouse Last Name

Personal Social Security Number

Spouse Social Security Number

Country

Address i

Apt/Ste No

City

State

Zip Code

Check here if you, or your spouse if filing jointly, want $3 to go to Presidential Election Campaign fund You Spouse

During this year, did you at any point: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, gift, or otherwise dispose of a digital asset (or a financial interest in a digital asset)?

3/5 Tax and Payments

Tax

16. Tax i

Check if any from Form(s) 8814 i

Check if any from Form 4972 i

Others i

17. Amount from Schedule 2, line 3 i

19. Child tax credit or credit for other dependents from Schedule 8812 i

20. Amount from Schedule 3, line 8 i

23. Other taxes, including self-employment tax, from Schedule 2, line 21 i

Payments

25a. Federal income tax withheld from Form W-2 i

25b. Federal income tax withheld from Form 1099 i

25c. Federal income tax withheld from other forms i

26. 2024 estimated tax payments and amount applied from 2023 return i

27. Earned income credit (EIC) i

28. Refundable child tax credit or additional child tax credit from Schedule 8812 i

29. American opportunity credit from Form 8863, line 8 i

31. Amount from Schedule 3, line 15 i

Refund

7. Refund - Amount you will be refunded to you (Line 35a) i

If Form 8888 is attached i

35b. Routing Number i

Account Type (Line 35c) i

Checking Savings

Account Number (Line 35d) i

8. Amount You Owe - Estimated Tax Penalty (line 38) i

9. Third Party Designee - Do you want to allow another person to discuss this return with the IRS? i

Yes No

4/5 Other

10. Signature

Date Signed

Your Occupation

If the IRS sent you an Identity Protection PIN, enter it here

Phone Number

Email Address

Paid Preparer

10. Paid Preparer Use Only - Are you a paid preparer?

Yes No

5/5 Submit

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1040 Form

1/5 Personal Information

2/5 Deduction & Income

Deductions

Dependent 1

Dependent 2

Dependent 3

Dependent 4

Dependent 5

Income

3/5 Tax and Payments

Tax

Payments

Refund

4/5 Other

Spouse Detail

Paid Preparer

5/5 Submit

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