Form 1040-SS, U.S. Self-Employment Tax Return

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2011

Department of the Treasury
Internal Revenue Service

Instructions for Form
1040-SS
U.S. Self-Employment Tax Return (Including the Additional Child Tax Credit for
Bona Fide Residents of Puerto Rico)
Section references are to the Internal
Revenue Code unless otherwise noted.

receiving social security or Medicare
benefits.

General Instructions

See Who Must File below for
additional uses of this form.

What’s New

You may also be required to file an
income tax return with the government of
Guam, American Samoa, the USVI, the
CNMI, or Puerto Rico. Check with your
local tax office for more details.

Deduction for self-employed health
insurance expired. The self-employed
health insurance deduction expired on
December 31, 2010. Errors discovered on
previously filed Forms 1040-SS are
corrected on Part V, line 1b of Form
1040-SS. At the top of page 1 of the
corrected return, enter “CORRECTED” in
dark bold letters followed by the date.
Maximum income subject to social
security. For 2011, the maximum
amount of self-employment income
subject to social security tax remains at
$106,800.
Optional methods to figure net
earnings. For 2011, the maximum
income for using the optional methods is
$4,480.

Reminders
Electronic filing. You may be able to
e-file Form 1040-SS if you are claiming
only the additional child tax credit. For
general information about electronic filing,
visit www.irs.gov/efile and click on
“Individual Taxpayers.”
Estimated tax payments. If you expect
to owe self-employment (SE) tax of
$1,000 or more for 2012, you may need
to make estimated tax payments. Use
Form 1040-ES, Estimated Tax for
Individuals, to figure your required
payments and for the vouchers to send
with your payments.

Purpose of Form
This form is for residents of the U.S.
Virgin Islands (USVI), Guam, American
Samoa, the Commonwealth of the
Northern Mariana Islands (CNMI), and the
Commonwealth of Puerto Rico (Puerto
Rico) who are not required to file a U.S.
income tax return. One purpose of the
form is to report net earnings from
self-employment to the United States and,
if necessary, pay SE tax on that income.
The Social Security Administration (SSA)
uses this information to figure your
benefits under the social security
program. SE tax applies no matter how
old you are and even if you already are

Who Must File
You must file Form 1040-SS if you meet
all three requirements below.
1. You, or your spouse if filing a joint
return, had net earnings from
self-employment (from other than church
employee income) of $400 or more (or
you had church employee income of
$108.28 or more — see Church
Employees later).
2. You do not have to file Form 1040
with the United States.
3. You are a resident of:
a. Guam,
b. American Samoa,
c. The USVI,
d. The CNMI, or
e. Puerto Rico (you can file either
Form 1040-PR (in Spanish) or Form
1040-SS).
Even if you have a loss or little
TIP income from self-employment, it
may benefit you to file Form
1040-SS and use either ‘‘optional
method’’ in Part VI. See Part VI later.
If (2) and (3) above apply, you also
must file Form 1040-SS (or you can use
Form 1040-PR in Spanish if you are a
resident of Puerto Rico) to:
• Report and pay household employment
taxes;
• Report and pay employee social
security and Medicare tax on (a)
unreported tips, (b) wages from an
employer with no social security or
Medicare tax withheld, or (c) uncollected
social security and Medicare tax on tips or
group-term life insurance (see the
instructions for Part I, line 5, later);
• Claim excess social security tax
withheld;
• Claim the additional child tax credit
(bona fide residents of Puerto Rico only);
and
• Claim the health coverage tax credit
(bona fide residents of Puerto Rico only).
Cat. No. 26341Y

Who Must Pay SE Tax
Self-Employed Persons
You must pay SE tax if you had net
earnings of $400 or more as a
self-employed person. If you are in
business (farm or nonfarm) for yourself,
you are self-employed.
You must also pay SE tax on your
share of certain partnership income and
your guaranteed payments. See
Partnership Income or Loss later.

Church Employees
If you had church employee income of
$108.28 or more, you must pay SE tax on
that income. Church employee income is
wages you received as an employee
(other than as a minister or member of a
religious order) of a church or qualified
church-controlled organization that has a
certificate in effect electing exemption
from employer social security and
Medicare taxes.
If your only income subject to
self-employment tax is church employee
income, skip lines 1a through 4b in Part
V. Enter “-0-” on line 4c and go to line 5a.

Ministers and Members of
Religious Orders
In most cases, you must pay SE tax on
salaries and other income for services
you performed as a minister, a member of
a religious order who has not taken a vow
of poverty, or a Christian Science
practitioner. But if you filed Form 4361,
Application for Exemption From
Self-Employment Tax for Use by
Ministers, Members of Religious Orders
and Christian Science Practitioners, and
received IRS approval, you will be exempt
from paying SE tax on those net earnings.
If you had no other income subject to SE
tax and do not owe any of the taxes listed
earlier under Who Must File, you are not
required to file Form 1040-SS. However,
if you had other earnings of $400 or more
subject to SE tax, see Part V, line A.
If you have ever filed Form 2031,
Revocation of Exemption From
CAUTION
Self-Employment Tax for Use By
Ministers, Members of Religious Orders,
and Christian Science Practitioners, to
elect social security coverage on your
earnings as a minister, you cannot revoke
that election.
If you must pay SE tax, include this
income in Part IV, line 1. But do not report

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it in Part V, line 5a; it is not considered
church employee income.
Also include in Part IV, line 1:
• The rental value of a home or
allowance for a home furnished to you
(including payments for utilities), and
• The value of meals and lodging
provided to you, your spouse, and your
dependents for your employer’s
convenience.
However, do not include in Part IV,
line 1:
• Retirement benefits you received from
a church plan after retirement, or
• The rental value of or allowance for a
home furnished to you (including
payments for utilities) after retirement.
If you were an ordained minister, a
member of a religious order who has not
taken a vow of poverty, or a Christian
Science practitioner, and were employed
by a church (congregation) for a salary,
do not include that income in Form
1040-SS, Part IV. Instead, figure your SE
tax by completing Part V, including on line
2 this income and any rental (parsonage)
allowance or the value of meals and
lodging provided to you. On the same
line, subtract the allowable amount of any
unreimbursed business expenses you
incurred as a church employee. Attach an
explanation.
For details, see Pub. 517, Social
Security and Other Information for
Members of the Clergy and Religious
Workers.

Members of Recognized
Religious Sects
If you have conscientious objections to
social security insurance because of your
membership in and belief in the teachings
of a religious sect recognized as being in
existence at all times since December 31,
1950, and which has provided a
reasonable level of living for its
dependent members, you can request
exemption from SE tax by filing Form
4029, Application for Exemption From
Social Security and Medicare Taxes and
Waiver of Benefits. If you filed Form 4029
and have received IRS approval, do not
file Form 1040-SS. See Pub. 517 for
details.

Employees of Foreign
Governments or International
Organizations
You must pay SE tax on income you
earned as a U.S. citizen or a resident of
Puerto Rico employed by a foreign
government (or, in certain cases, by a
wholly owned instrumentality of a foreign
government or an international
organization under the International
Organizations Immunities Act) for
services performed in the United States,
Puerto Rico, Guam, American Samoa,
the USVI, or the CNMI. Report income
from this employment in Part IV, line 1.
Enter the net amount from Part IV, line
27, in Part V, line 2. If you performed
services elsewhere as an employee of a
foreign government or an international

organization, those earnings are exempt
from SE tax.

Commonwealth or Territory
Residents Living Abroad
Generally, if you are a resident of Guam,
American Samoa, the USVI, the CNMI, or
Puerto Rico living abroad, you must pay
SE tax.
Exception. The United States has social
security agreements with many countries
to eliminate dual taxes under two social
security systems. Under these
agreements, you must generally pay
social security and Medicare taxes only to
the country you live in.
The United States now has social
security agreements with the following
countries: Australia, Austria, Belgium,
Canada, Chile, Czech Republic,
Denmark, Finland, France, Germany,
Greece, Ireland, Italy, Japan,
Luxembourg, the Netherlands, Norway,
Poland, Portugal, South Korea, Spain,
Sweden, Switzerland, and the United
Kingdom. Additional agreements are
expected in the future.
If you have questions about
international social security agreements,
you can:
1. Visit the Social Security
Administration (SSA) website at
www.socialsecurity.gov/international;
2. Call the SSA Office of International
Programs at 410-965-3549 (not toll free)
for questions about the agreements; or
3. Write to Social Security
Administration, Office of International
Programs, P.O. Box 17741, Baltimore,
MD 21235-7741 USA. (Do not send Form
1040-SS to this address. Instead, see
Where To File later.)
Even if you do not have to pay SE tax
because of a social security agreement,
you may still have to file a tax return with
the Internal Revenue Service.

Chapter 11 Bankruptcy Cases
While you are a debtor in a chapter 11
bankruptcy case, your net profit or loss
from self-employment will be included on
the income tax return (Form 1041) of the
bankruptcy estate. However, you — not
the bankruptcy estate — are responsible
for paying self-employment tax on your
net earnings from self-employment.
Enter on the dotted line to the left of
line 3 of Form 1040-SS, Part V, “Chap. 11
bankruptcy income” and the amount of
your net profit or (loss). Combine that
amount with the total of lines 1a, 1b, and
2 (if any) and enter the result on line 3.
For other reporting requirements, see
the instructions for Form 1040.

More Than One Business
If you were a farmer and had at least one
other business or you had two or more
nonfarm businesses, your net earnings
from self-employment are the combined
net earnings from all of your businesses.
If you had a loss in one business, it
reduces the income from another.

SS-2

Complete and file only one Form 1040-SS
for any 1 year. Attach a separate Part III
or Part IV for each trade or business, and
combine the net earnings in a single
Part V.
Joint returns. If both you and your
spouse have self-employment income
from separate farm or nonfarm
businesses, each of you must complete
and file a separate Part III or Part IV. Be
sure to enter at the top of each Part III or
Part IV the name and SSN of the spouse
who owns the business. Each of you must
also complete a separate Part V. Attach
these pages to a single Form 1040-SS.

Husband-Wife Business
If you and your spouse jointly own and
operate an unincorporated farm or
nonfarm business and share in the profits
and losses, you are partners in a
partnership, whether or not you have a
formal partnership agreement. Do not use
Part III or IV. Instead, file the appropriate
partnership return.
Exception — Qualified joint venture.
If you and your spouse materially
participate (see Material participation in
the 2011 Instructions for Schedule C) as
the only members of a jointly owned and
operated business, and you file a joint
Form 1040-SS for the tax year, you can
make a joint election to be taxed as a
qualified joint venture instead of a
partnership. To make this election, you
must divide all items of income, gain,
loss, deduction, and credit attributable to
the business between you and your
spouse in accordance with your
respective interests in the venture. Each
of you must file a separate Part III or Part
IV, as well as a separate Part V. On each
line of your separate Part III or Part IV,
you must enter your share of the
applicable income, deduction, or loss. For
complete information on this election, see
the 2011 Instructions for Schedule C.
For more information on qualified joint
ventures, go to IRS.gov. Enter “QJV
election” in the search box and select
“Benefits of Qualified Joint Ventures for
Family Businesses.”
Rental real estate business. If you
and your spouse make the election for
your rental real estate business, the
income generally is not subject to SE tax
(for an exception, see item 3 under Other
Income and Losses Included in Net
Earnings From Self-Employment later).
If the election is made for a farm rental
business that is not included in
self-employment, file two Forms 4835,
Farm Rental Income and Expenses, with
Form 1040. Do not file Form 1040-SS.
Exception — Community income. If
you and your spouse wholly own an
unincorporated business as community
property under the community property
laws of a state, foreign country, or U.S.
possession, the income and deductions
are reported based on the following.
• If only one spouse participates in the
business, all of the income from that
Instructions for Form 1040-SS (2011)

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business is the self-employment earnings
of the spouse who carried on the
business.
• If both spouses participate, the income
and deductions are allocated to the
spouses based on their distributive
shares.
• If either or both you and your spouse
are partners in a partnership, see
Partnership Income or Loss later.
• If you and your spouse elected to treat
the business as a qualifying joint venture,
see Exception — Qualified joint venture
earlier.

When To File
If you file on a calendar year basis, file by
April 17, 2012. (The due date is April 17,
instead of April 15, because of the
Emancipation Day holiday in the District
of Columbia — even if you do not live in
the District of Columbia).
If you file on a fiscal year basis, file by
the 15th day of the 4th month after the
close of your fiscal year.

Extension of Time To File
If you cannot file Form 1040-SS by the
due date, you can get an extension of
time to file the form. In some cases, you
can get an extension of time to file and
pay any tax due.
Bona fide residents of Puerto Rico.
You can apply for an automatic 6-month
extension of time to file Form 1040-SS
(until October 15, 2012, for calendar year
taxpayers). To get this automatic
extension, you must file Form 4868,
Application for Automatic Extension of
Time To File U.S. Individual Income Tax
Return, by the regular due date of your
return (April 17, 2012, for calendar year
taxpayers). You can file Form 4868 either
by paper or electronically through IRS
e-file. For details, see the instructions on
Form 4868.
This 6-month extension to file
does not extend the time to pay
CAUTION
your tax. Any interest due on
unpaid taxes is calculated from the
original due date of the return.
Bona fide residents of American
Samoa, the CNMI, Guam, or the USVI.
You can apply for the automatic 6-month
extension described above, or you can
receive an automatic 2-month extension
and then apply for an additional 4-month
extension if you still need more time.
Automatic 2-month extension. You
are allowed an automatic 2-month
extension to file your return and pay your
tax if you are outside the United States
and Puerto Rico on the day Form
1040-SS is due (April 17, 2012, for
calendar year taxpayers). Although you
have an extension of time to pay your tax,
interest on any unpaid tax will be charged
from the original due date of the return.
To get this automatic extension, you
must file Form 1040-SS by the extended
due date (June 15, 2012, for calendar
year taxpayers) and attach a statement
explaining that on the regular due date of

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Instructions for Form 1040-SS (2011)

your return you were a bona fide resident
of American Samoa, the CNMI, Guam, or
the USVI.
Additional 4-month extension. If
you cannot file your return within the
automatic 2-month extension period, you
generally can get an additional 4 months
to file your return, for a total of 6 months.
File Form 4868 by the new due date
allowed by the 2-month extension (June
15, 2012, for calendar year taxpayers).
Follow the instructions for completing
Form 4868, and be sure to check the box
on line 8.
Unlike the original 2-month extension,
the additional 4 months of time to file is
not an extension of time to pay. You must
make an accurate estimate of your tax
based on the information available to you.
If you find you cannot pay the full amount
due with Form 4868, you can still get the
extension. You will owe interest on the
unpaid amount from the original due date
of the return.
Where to file extension requests.
If you are making a payment, send Form
4868 with your payment to:
Department of the Treasury
Internal Revenue Service Center
P.O. Box 1302
Charlotte, NC 28201-1302
If you are not making a payment, send
Form 4868 to:
Department of the Treasury
Internal Revenue Service Center
Austin, TX 73301-0045

Where To File
Send your Form 1040-SS to:
Department of the Treasury
Internal Revenue Service Center
Austin, TX 73301-0215

Specific Instructions
Fiscal Year Filers
If your tax year is a fiscal year, use the
tax rate and earnings base that apply at
the time the fiscal year begins. Do not
prorate the tax or earnings base for a
fiscal year that overlaps the date of a rate
or earnings base change.

Name and SSN
To ensure proper credit to your social
security account, enter your name and
social security number (SSN), and your
spouse’s if filing a joint return, exactly as
shown on your social security card. If you
do not have an SSN, get Form SS-5,
Application for a Social Security Card,
from an SSA district office or online at
www.socialsecurity.gov/online/ss-5.html.

SS-3

Part I—Total Tax and
Credits
Line 1
Check the filing status that applies to you.
Single. Your filing status is single if:
1. On the last day of the year, you are
unmarried or legally separated from your
spouse under a divorce or separate
maintenance decree, or
2. You meet all of the following
conditions.
a. You lived apart from your spouse
for the last 6 months of 2011. Temporary
absences for special circumstances, such
as business, medical care, school, or
military service, count as time lived in the
home.
b. You file a separate return from your
spouse.
c. You paid over half the cost of
keeping up your home for 2011.
d. Your home was the main home of
your child, adopted child, stepchild, or
eligible foster child for more than half of
2011 (if half or less, see information on
temporary absences in item 2a above).
e. If you filed Form 1040, you could
claim the child as your dependent or
could claim the child except that the
child’s other parent can claim the child
under the rules for children of divorced or
separated parents (see Pub. 501,
Exemptions, Standard Deduction, and
Filing Information).
Married filing jointly. You can choose
this filing status if you were married at the
end of 2011 and both you and your
spouse agree to file a joint return. You
can also choose this filing status if your
spouse died in 2011 and you did not
remarry in 2011.
If you choose to file a joint return,
check the box for married filing jointly and
be sure to include your spouse’s name
and SSN on the lines provided below your
name and SSN. If your spouse also had
self-employment income, complete and
attach a separate Part V and, if
applicable, Part VI. If necessary, attach a
separate Part III or Part IV for your
spouse’s farm or nonfarm business.
Joint and several tax liability. If you
file a joint return, both you and your
spouse generally are responsible for the
tax and any interest or penalties due on
the return. This means that if one spouse
does not pay the tax due, the other may
have to.
However, you may qualify for relief
from liability for tax on your joint return if
(a) there is an understatement of the
amount of tax because your spouse
omitted income or claimed false
deductions or credits; (b) you are
divorced, separated, or no longer living
with your spouse; or (c) given all the facts
and circumstances, it would not be fair to
hold you liable for the tax. To request
relief, you generally must file Form 8857,
Request for Innocent Spouse Relief, no
later than 2 years after the date on which

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the IRS first attempted to collect the tax
from you. For more information, see Pub.
971, Innocent Spouse Relief, and Form
8857; or you can call the Innocent
Spouse office at 1-866-897-4270 (toll free
except in American Samoa).
Married filing separately. You can
choose this filing status if you were
married at the end of 2011. This method
may benefit you if you want to be
responsible only for your own tax.

Line 4
If either of the following applies, see
Schedule H (Form 1040), Household
Employment Taxes, and its instructions to
find out if you owe these taxes.
• You paid any one household employee
cash wages of $1,700 or more in 2011.
• You paid total cash wages of $1,000 or
more in any calendar quarter of 2010 or
2011 to all household employees.

Line 5
Also include the following taxes in the
line 5 total.
Employee social security and Medicare
tax on tips not reported to employer.
Complete Form 4137, Social Security and
Medicare Tax on Unreported Tip Income,
if you received cash and charge tips of
$20 or more in a calendar month and did
not report all of those tips to your
employer. On the dotted line next to line
5, enter “Tax on Tips,” and the amount of
tax due (from Form 4137, line 13). Be
sure to include this tax in the total for line
5. Attach to Form 1040-SS the completed
Form 4137.
Uncollected employee social security
and Medicare tax on tips. If you did not
have enough wages to cover the social
security and Medicare tax due on tips you
reported to your employer, the amount of
tax due should be identified with codes A
and B in box 12 of your Form W-2AS,
W-2CM, W-2GU, or W-2VI; or entered in
boxes 22 and 23 of your Form 499R-2/
W-2PR. Include this tax in the total for line
5. Enter the amount of this tax and
“Uncollected Tax” on the dotted line next
to line 5.
Uncollected employee social security
and Medicare tax on group-term life
insurance. If you had group-term life
insurance through a former employer, you
may have to pay social security and
Medicare tax on part of the cost of the life
insurance. The amount of tax due should
be identified with codes M and N in box
12 of your Form W-2AS, W-2CM, W-2GU,
or W-2VI. Include this tax in the total for
line 5. Enter the amount of this tax and
“Uncollected Tax” on the dotted line next
to line 5.
Uncollected employee social security
and Medicare tax on wages. If you are
an employee who received wages from
an employer who did not withhold social
security and Medicare tax from your
wages, complete Form 8919, Uncollected
Social Security and Medicare Tax on
Wages, to figure your share of the
unreported tax. Enter the amount of tax

due (from Form 8919, line 13) and
“Uncollected Tax” on the dotted line next
to line 5, and include this tax in the total
for line 5. Attach to Form 1040-SS the
completed Form 8919.
Repayment of excess advance
payments of the health coverage tax
credit. If you received advance
payments of the health coverage tax
credit for months you were not eligible,
the amount on line 5 of Form 8885,
Health Coverage Tax Credit, may be
negative. On the dotted line next to line 5
(Form 1040-SS, Part I), enter “HCTC” and
the additional tax as a positive amount.
Include this tax in the total for line 5.
Attach to Form 1040-SS the completed
Form 8885.

Possessions, for the bona fide residency
rules.

Line 10
Add lines 6 through 9. Enter the total on
line 10.
Amount paid with request for
extension of time to file. If you filed
Form 4868 to get an automatic extension
of time to file, include in the total on line
10 any amount you paid with that form, by
electronic funds withdrawal, or by credit
or debit card. If you paid by credit or debit
card, do not include on line 10 the
convenience fee you were charged. On
the dotted line next to line 10, enter “Form
4868” and show the amount paid.

Line 6

Lines 12a Through 12d

Enter any estimated tax payments you
made for 2011 including any overpayment
from your 2010 return that you applied to
your 2011 estimated tax. If you or your
spouse paid separate estimated tax but
are now filing a joint return, add the
amounts you each paid and enter the
total on line 6. If you and your spouse
paid joint estimated tax but are now filing
separate returns, you can divide the
amount paid in any way you choose as
long as you both agree. If you cannot
agree, you must divide the payments in
proportion to each spouse’s individual tax
as shown on your separate returns for
2011. For an example of how to do this,
see chapter 3 of Pub. 505, Tax
Withholding and Estimated Tax.

If you want us to directly deposit the
amount shown on line 12a to your
checking or savings account at a U.S.
bank or other U.S. financial institution
(such as a mutual fund, brokerage firm, or
credit union):
• Check the box on line 12a and attach
Form 8888, Allocation of Refund
(Including Savings Bond Purchases), if
you want to split the direct deposit of your
refund among two or three accounts; or
• Complete lines 12b through 12d if you
want your refund deposited to only one
account.
Otherwise, we will send you a check.

Line 7
If you, or your spouse if filing a joint
return, had more than one employer for
2011 and total wages of more than
$106,800, too much social security tax
may have been withheld. You can take a
credit on this line for the amount withheld
in excess of $6,621.60. But if any one
employer withheld more than $6,621.60,
you must ask that employer to refund the
excess to you. You cannot claim it on
Form 1040-SS. Figure this amount
separately for you and your spouse. You
must attach Forms W-2AS, W-2CM,
W-2GU, W-2VI, or 499R-2/W-2PR. See
chapter 3 of Pub. 505 for more
information.

Line 9
If, during 2011, you were a bona fide
resident of Puerto Rico and an eligible
trade adjustment assistance (TAA)
recipient, alternative TAA (ATAA)
recipient, reemployment trade adjustment
assistance (RTAA) recipient, or Pension
Benefit Guaranty Corporation (PBGC)
pension recipient, see Form 8885, Health
Coverage Tax Credit, to figure the
amount of your credit, if any.
If you have a negative amount on
Form 8885, line 5, do not make an entry
on line 9, but see Repayment of excess
advance payments of the health coverage
tax credit under Line 5 earlier.
See chapter 1 of Pub. 570, Tax Guide
for Individuals With Income From U.S.

SS-4

Note. If you do not want your refund
directly deposited to your account, do not
check the box on line 12a. Draw a line
through the boxes on lines 12b and 12d.
The IRS is not responsible for a
lost refund if you enter the wrong
CAUTION
account information. Check with
your financial institution to make sure
your direct deposit will be accepted and to
get the correct routing and account
numbers. Do not use the routing number
on a deposit slip if it is different from the
routing number on your checks.

!

You cannot request a deposit of your
refund to an account that is not in your
name (such as your tax preparer’s own
account).
If the direct deposit to your account(s)
is different from the amount you
expected, you will receive an explanation
in the mail about 2 weeks after your
refund is deposited.
TreasuryDirect®. You can request a
deposit of your refund (or part of it) to a
TreasuryDirect® online account to buy
U.S. Treasury marketable securities and
savings bonds. For more information, go
to www.treasurydirect.gov.
Form 8888. You can have your refund
directly deposited into more than one
account or use it to buy up to $5,000 in
paper Series I savings bonds. The
amount you request must be a multiple of
$50. You do not need a TreasuryDirect®
account to do this. See the Form 8888
instructions for details.
Instructions for Form 1040-SS (2011)

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Line 12a
Check the box on line 12a and attach
Form 8888 if you want to split the direct
deposit of your refund among two or three
accounts.
If you file a joint return, check the box
on line 12a and attach Form 8888, or fill
in lines 12b through 12d, your spouse
may get at least part of the refund.

Line 12b
The routing number for your financial
institution must be nine digits. The first
two digits must be 01 through 12 or 21
through 32. Otherwise, the direct deposit
will be rejected and a check sent instead.
Ask your financial institution for the
correct routing number to enter on line
12b if:
• Your deposit is to a savings account
that does not allow you to write checks, or
• Your checks state they are payable
through a financial institution different
from the one at which you have your
checking account.

Line 12c
Check the appropriate box for the type of
account. Do not check more than one
box. You must check the correct box to
ensure your deposit is accepted. For a
TreasuryDirect® online account, check
the “Savings” box.

Line 12d
The account number can be up to 17
characters (both numbers and letters).
Include hyphens but omit spaces and
special symbols. Enter the number from
left to right and leave any unused boxes
blank. Do not include the check number.
Some financial institutions will not
allow a joint refund to be
CAUTION
deposited to an individual account.
If the direct deposit is rejected, a check
will be sent instead. The IRS is not
responsible if a financial institution rejects
a direct deposit.

!

Line 13
Enter on line 13 the amount, if any, of the
overpayment on line 11 you want applied
to your 2012 estimated tax. The election
to apply part or all of the overpaid amount
to your 2012 estimated tax cannot be
changed later.

Line 14—Amount You Owe
There are several ways to pay the
amount of tax you owe.
To pay by check or money order.
Enclose your check or money order for
the full amount due with Form 1040-SS.
Make it payable to the “United States
Treasury.” Do not send cash. Do not
attach the payment to your return. Enter
“2011 Form 1040-SS” and your name,
address, daytime phone number, and
social security number (SSN) on your
payment. If you are filing a joint return,
enter the SSN shown first on your Form
1040-SS.
To help process your payment, enter
the amount on the right side of the check
Instructions for Form 1040-SS (2011)

like this: $ XXX.XX. Do not use dashes or
lines (for example,
do not enter “$ XXX – ”
xx
or “$ XXX100”).
To pay electronically. For information
on paying your taxes by Electronic
Federal Tax Payment System (EFTPS) or
with a credit or debit card, go to
www.irs.gov/e-pay.

Part II—Bona Fide
Residents of Puerto Rico
Claiming Additional Child
Tax Credit
If, during 2011, you were a bona fide
resident of Puerto Rico and you qualify to
claim the additional child tax credit, you
must list your qualifying children in Part I,
line 2. Also complete Part II and the
worksheet later to figure the amount of
your credit.

!

CAUTION

You must have three or more
qualifying children to claim the
additional child tax credit.

Qualifying for the Credit
You may be able to claim the additional
child tax credit for 2011 if all of the
following apply.
• You were a bona fide resident of
Puerto Rico (see Pub. 570, chapter 1).
• Social security and Medicare taxes
were withheld from your wages or you
paid self-employment tax.
• You or your spouse cannot be claimed
as a dependent on someone else’s U.S.
income tax return.
• You had three or more qualifying
children (defined below).
Qualifying child. A qualifying child for
purposes of the additional child tax credit
is a child who:
1. Is your son, daughter, stepchild,
foster child, brother, sister, stepbrother,
stepsister, half brother, half sister, or a
descendant of any of them (for example,
your grandchild, niece, or nephew). A
foster child is any child placed with you by
an authorized placement agency or by a
judgment, decree, or other order of any
court of competent jurisdiction.
2. Was under 19 at the end of 2011.
3. Was younger than you (or your
spouse, if filing jointly) or was
permanently and totally disabled (see
Permanently and totally disabled in the
2011 Instructions for Form 1040, line 6c).
4. Did not provide over half of his or
her own support for 2011.
5. Lived with you for more than half of
2011. If the child did not live with you for
the required time, see Exception to time
lived with you in the 2011 Instructions for
Form 1040, line 6c.
6. Is not filing a joint return for 2011
(or is filing a joint return for 2011 only as a
claim for refund and neither spouse would
have a tax liability if they filed separate
returns).
7. Was a U.S. citizen, U.S. national,
or a U.S. resident alien.

SS-5

Note. An adopted child is always
treated as your own child. An adopted
child includes a child lawfully placed with
you for legal adoption. If you are a U.S.
citizen or U.S. national and your adopted
child lived with you all year as a member
of your household, that child meets the
citizen test.
Information about your qualifying
child. In Part I, line 2, enter each
qualifying child’s name, social security
number, and relationship to you. If you
have more than six qualifying children,
attach a statement to Form 1040-SS with
the required information. If the child
meets the conditions to be a qualifying
child of any other person (other than your
spouse if filing jointly) for 2011, see
Qualifying child of more than one person
in the 2011 Instructions for Form 1040,
line 6c.

Line 1
For purposes of figuring the additional
child tax credit, you must report all of your
income derived from sources within
Puerto Rico that is excluded from U.S. tax
because you were a bona fide resident of
Puerto Rico. This includes items such as
wages, interest, dividends, taxable
pensions and annuities, and taxable
social security benefits. Also include any
profit or (loss) from Part III, line 36, and
Part IV, line 27. For more information on
these and other types of income to
include on line 1, see the Form 1040
instructions. See Pub. 570, chapter 2, for
the rules to use in determining your
Puerto Rican source income.

Part III—Profit or Loss
From Farming
For assistance with Part III (Profit or Loss
From Farming), see the 2011 Instructions
for Schedule F (Form 1040), Profit or
Loss From Farming, and Pub. 225,
Farmer’s Tax Guide.

Accounting Methods
The accounting method you used to
record your farm income determines
whether you complete, in addition to
Section B, Section A or C.
Cash method. Include in income both
the cash actually or constructively
received and the fair market value of
goods or other property you received.
Generally, you deduct your expenses
when you pay them.
Accrual method. Include your income in
the year you earned it. It does not matter
when you get it. Deduct your expenses
when you incur them.

Section A or C—Sales of
Livestock
Form 4797, Sales of Business Property,
is used to report sales of livestock held for
draft, breeding, sport, or dairy purposes,
and is attached to Form 1040. This
income is taxable, but is not subject to
self-employment tax. You should check to
see if this additional amount of gross

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income will require you to file Form 1040
instead of Form 1040-SS.

Line 12
If you claim any car or truck expenses
(actual or the standard mileage rate), you
must provide the information requested in
Part V of Form 4562, Depreciation and
Amortization. Be sure to attach Form
4562 to your return.

Part IV—Profit or Loss
From Business (Sole
Proprietorship)
For assistance with Part IV (Profit or Loss
From Business (Sole Proprietorship)), see
the 2011 Instructions for Schedule C
(Form 1040), Profit or Loss From
Business, and Pub. 334, Tax Guide for
Small Business (For Individuals Who Use
Schedule C or C-EZ).

Line 7
If you claim any car or truck expenses
(actual or the standard mileage rate), you
must provide the information requested in
Part V of Form 4562, Depreciation and
Amortization. Be sure to attach Form
4562 to your return.

Part V—Self-Employment
Tax
Specific line instructions for Part V begin
later.
If you are filing a joint return and
both you and your spouse have
CAUTION
income subject to
self-employment tax, you must each
complete a separate Part V. This includes
those who made a joint election to be
taxed as a qualified joint venture.

!

What Is Included in Net
Earnings From
Self-Employment
Generally, net earnings include your net
profit from a farm or nonfarm business. If
you were a partner in a partnership, see
the following instructions.

Partnership Income or Loss
When figuring your total net earnings from
self-employment, include your share of
partnership income or loss attributable to
a trade or business and any guaranteed
payments for services or the use of
capital. However, if you were a limited
partner, include only guaranteed
payments for services you actually
rendered to or on behalf of the
partnership.
If you were a general partner, reduce
lines 1a and 2 of Part V for any section
179 expense deduction, oil or gas
depletion, and unreimbursed partnership

Additional Child Tax Credit Worksheet—Part II, Line 3

Keep for Your Records

1. Do you have three or more qualifying children?
䡺 No. Stop. You cannot claim the credit.
䡺 Yes. Go to line 2.
2. Number of qualifying children: _______ × $1,000. Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Enter the amount from Part II, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

4. Enter the amount shown below for your filing status . . . . . . . . . . . . . . . . . . . . .

4.

2.

• Married filing jointly — $110,000
• Single — $75,000
• Married filing separately — $55,000

5. Is the amount on line 3 more than the amount on line 4?
䡺 No. Leave line 5 blank. Enter -0- on line 6, and go to line 7.
䡺 Yes. Subtract line 4 from line 3. If the result is not a multiple of
$1,000, increase it to the next multiple of $1,000 (for example,
increase $425 to $1,000, increase $1,025 to $2,000, etc.) . . . . . . . . . . . . . .

5.

6. Multiply the amount on line 5 by 5% (.05). Enter the result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.

7. Is the amount on line 2 more than the amount on line 6?
䡺 No. Stop. You cannot claim the credit.
䡺 Yes. Subtract line 6 from line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8. Enter one-half of the amount from Part V, line 12 . . . . . . . . . . . . . . . . . . . . . . .

8.

9. Enter the total of any:
• Amount from Part II, line 2, plus
• Employee social security and Medicare tax on tips not reported to
employer and shown on the dotted line next to Part I, line 5, plus
• Uncollected employee social security and Medicare tax shown on the dotted
line next to Part I, line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.

7.

10. Add lines 8 and 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.
11. Enter the amount, if any, from Part I, line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Is the amount on line 10 more than the amount on line 11?
䡺 No. Stop. You cannot claim the credit.
䡺 Yes. Subtract line 11 from line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12.

13. Additional child tax credit. Enter the smaller of line 7 or line 12 here and on
Form 1040-SS, Part II, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.

SS-6

Instructions for Form 1040-SS (2011)

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expenses. Attach an explanation of these
deductions.
If your partnership was engaged solely
in the operation of a group investment
program, earnings from the operation are
not self-employment earnings for either
the general or limited partners.
If a partner died and the partnership
continued, include in self-employment
income the deceased partner’s
distributive share of the partnership’s
ordinary income or loss through the end
of the month in which he or she died. See
section 1402(f).
If you were married and both you and
your spouse were partners in a
partnership, each of you must report your
net earnings from self-employment from
the partnership. Each of you must
complete a separate Part V. If only one of
you was a partner in a partnership, the
spouse who was the partner must pay SE
tax on all of his or her share of
partnership income.
Community income. Your own
distributive share of partnership income is
included in figuring your net earnings from
self-employment. Unlike the division of
that income between spouses for figuring
income tax, no part of your share can be
included in figuring your spouse’s net
earnings from self-employment.

Share Farming
You are considered self-employed if you
produced crops or livestock on someone
else’s land for a share of the crops or
livestock produced (or a share of the
proceeds from the sale of them). This
applies even if you paid another person
(an agent) to do the actual work or
management for you. For details, see
Pub. 225.

Other Income and Losses
Included in Net Earnings
From Self-Employment
1. Rental income from a farm if, as
landlord, you materially participated in the
production or management of the
production of farm products on this land.
This income is farm earnings. To
determine if you materially participated in
farm management or production, do not
consider the activities of any agent who
acted for you. The material participation
tests for landlords are explained in
chapter 12 of Pub. 225.
2. Cash or a payment-in-kind from the
Department of Agriculture for participating
in a land diversion program.
3. Payments for the use of rooms or
other space when you also provided
substantial services for the convenience
of your tenants. Examples are hotel
rooms, boarding houses, tourist camps or
homes, parking lots, warehouses, and
storage garages. See chapter 5 of Pub.
334 for more information.
4. Income from the retail sale of
newspapers and magazines if you were
age 18 or older and kept the profits.
5. Income you receive as a direct
seller. Newspaper carriers or distributors
Instructions for Form 1040-SS (2011)

of any age are direct sellers if certain
conditions apply. See chapter 5 of Pub.
334 for details.
6. Amounts received by current or
former self-employed insurance agents
and salespersons that are:
a. Paid after retirement but figured as
a percentage of commissions received
from the paying company before
retirement,
b. Renewal commissions, or
c. Deferred commissions paid after
retirement for sales made before
retirement.
However, certain termination
payments received by former insurance
salespersons are not included in net
earnings from self-employment (as
explained in item 10 under Income and
Losses Not Included in Net Earnings
From Self-Employment).
7. Income of certain crew members of
fishing vessels with crews of normally
fewer than 10 people. See chapter 10 of
Pub. 334 for details.
8. Fees as a state or local
government employee if you were paid
only on a fee basis and the job was not
covered under a federal-state social
security coverage agreement.
9. Interest received in the course of
any trade or business, such as interest on
notes or accounts receivable.
10. Fees and other payments received
by you for services as a director of a
corporation.
11. Recapture amounts under sections
179 and 280F included in gross income
because the business use of the property
dropped to 50% or less. Do not include
amounts you recaptured on the
disposition of property. See Form 4797,
Sales of Business Property.
12. Fees you received as a
professional fiduciary. This may also
apply to fees paid to you as a
nonprofessional fiduciary if the fees relate
to active participation in the operation of
the estate’s business or the management
of an estate that required extensive
management activities over a long period
of time.
13. Gain or loss from section 1256
contracts or related property by an
options or commodities dealer in the
normal course of dealing in or trading
section 1256 contracts.

Income and Losses
Not Included in Net Earnings
From Self-Employment
1. Salaries, fees, etc., subject to
social security or Medicare tax that you
received for performing services as an
employee, including services performed
as a public official (except as a fee basis
government employee as explained in
item 8 under Other Income and Losses
Included in Net Earnings From
Self-Employment earlier).
2. Fees received for services
performed as a notary public. However, if
you have other earnings of $400 or more
subject to SE tax, on the dotted line next

SS-7

to Part V, line 3, enter “Exempt — Notary”
and the amount of your net profit as a
notary public included in line 2. Subtract
that amount from the total of lines 1a, 1b,
and 2 and enter the result on line 3.
3. Income you received as a retired
partner under a written partnership plan
that provides lifelong periodic retirement
payments if you had no other interest in
the partnership and did not perform
services for it during the year.
4. Income from real estate rentals if
you did not receive the income in the
course of a trade or business as a real
estate dealer. Report this income in Part
IV if you and your spouse made an
election to be taxed as a qualified joint
venture.
5. Income from farm rentals (including
rentals paid in crop shares) if, as landlord,
you did not materially participate in the
production or management of the
production of farm products on the land.
See chapter 12 of Pub. 225 for details.
Report this income on Form 4835 and
Form 1040. Use two Forms 4835 if you
and your spouse made an election to be
taxed as a qualified joint venture.
6. Payments you receive from the
Conservation Reserve Program if you are
receiving social security benefits for
retirement or disability. Deduct these
payments on line 1b of Part V.
7. Dividends on shares of stock and
interest on bonds, notes, etc., if you did
not receive the income in the course of
your trade or business as a dealer in
stocks or securities.
8. Gain or loss from:
a. The sale or exchange of a capital
asset;
b. Certain transactions in timber, coal,
or domestic iron ore; or
c. The sale, exchange, involuntary
conversion, or other disposition of
property unless the property is stock in
trade or other property that would be
includible in inventory, or held mainly for
sale to customers in the ordinary course
of the business.
9. Net operating losses from other
years.
10. Termination payments you received
as a former insurance salesperson if all of
the following conditions are met.
a. The payment was received from an
insurance company because of services
you performed as an insurance
salesperson for the company.
b. The payment was received after
termination of your agreement to perform
services for the company.
c. You did not perform any services
for the company after termination and
before the end of the year in which you
received the payment.
d. You entered into a covenant not to
compete against the company for at least
a 1-year period beginning on the date of
termination.
e. The amount of the payment
depended primarily on policies sold by or
credited to your account during the last
year of the agreement, or the extent to

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which those policies remain in force for
some period after termination, or both.
f. The amount of the payment did not
depend to any extent on length of service
or overall earnings from services
performed for the company (regardless of
whether eligibility for the payment
depended on length of service).

Line 1b
Conservation Reserve Program
Payments
If you were receiving social security
retirement or social security disability
benefits at the time you received your
Conservation Reserve Program (CRP)
payment(s), include the amount of your
taxable CRP payment(s) in the total on
line 1b. The amount of these payments is
included in Part III, line 6, and in
information received from farm
partnerships showing your distributive
share.

Lines 4a Through 4c
If both lines 4a and 4c are less than $400
and you have deducted CRP payments
on line 1b, combine lines 1a and 2.
• If the total of lines 1a and 2 is $434 or
more, complete Part V through line 4c.
Enter -0- in Part I, line 3. If you also have
church employee income (see earlier),
also complete lines 5a and 5b. Complete
the rest of Part V, as appropriate.
• If the total of lines 1a and 2 is less than
$434, do not complete Part V unless you
choose to use an optional method to
figure your SE tax.

Line 8b
If you received tips of $20 or more in any
month and did not report the full amount
to your employer, you must file Form
4137 with Form 1040-SS (see instructions
for Part I, line 5, earlier). Disregard the
references to Form 1040 shown on Form
4137. Enter on line 8b the amount from
Form 4137, line 10.

Line 8c
If you are an employee who received
wages from an employer who did not
withhold social security and Medicare tax,
you must file Form 8919 with Form
1040-SS (see instructions for Part I, line
5, earlier). Enter on line 8c the amount
from Form 8919, line 10.

Part VI—Optional Methods
To Figure Net Earnings
The optional methods may give you credit
toward your social security coverage even
though you have a loss or a small amount
of income from self-employment. But the
optional methods may require you to pay
SE tax when you would otherwise not be
required to pay.
If you are filing a joint return and both
you and your spouse choose to use an
optional method to figure net earnings
from self-employment, you must each
complete and attach a separate Part VI.

You can change the method after you
file your return. That is, you can change
from the regular to the optional method or
from the optional to the regular method.
To do this, file a new Form 1040-SS. See
the instructions under Amended returns
earlier.
Using the optional methods may
TIP qualify bona fide residents of
Puerto Rico to claim the additional
child tax credit or give them a larger
credit.

Farm Optional Method
You may use this method to figure your
net earnings from farm self-employment if
your gross farm income was $6,720 or
less or your net farm profits were less
than $4,851. Net farm profits are the total
of the amounts from Part III, line 36, and
your distributive share from farm
partnerships — minus the amount you
would have entered in Part V, line 1b, had
you not used the optional method.
There is no limit on how many years
you can use this method.
Under this method, report in Part VI,
line 2, the smaller of: two-thirds of your
gross farm income (not less than zero), or
$4,480. This method can increase or
decrease your net self-employment farm
earnings. You can use this method even if
your farming business had a loss.
For a farm partnership, figure your
share of gross income based on the
partnership agreement. With guaranteed
payments, your share of the partnership’s
gross income is your guaranteed
payments plus your share of the gross
income after it is reduced by all
guaranteed payments made by the
partnership. If you were a limited partner,
include only guaranteed payments for
services you actually rendered to or on
behalf of the partnership.

Nonfarm Optional Method
You may be able to use this method to
figure your net earnings from nonfarm
self-employment if your net nonfarm
profits were less than $4,851 and also
less than 72.189% of your gross nonfarm
income. Net nonfarm profits are the total
of the amounts from Part IV, line 27, and
your distributive share from other than
farm partnerships.
To use this method, you also must be
regularly self-employed. You meet this
requirement if your actual net earnings
from self-employment were $400 or more
in 2 of the 3 years preceding the year you
use the nonfarm optional method. The net
earnings of $400 or more could be from
either farm or nonfarm earnings or both.
The net earnings include your distributive
share of partnership income or loss
subject to SE tax.
Use of the nonfarm optional method
from nonfarm self-employment is limited
to 5 years. The 5 years do not have to be
consecutive.
Under this method, report in Part VI,
line 4, the smaller of: two-thirds of your

SS-8

gross nonfarm income (not less than
zero), or the amount in Part VI, line 3. But
you cannot report less than your actual
net earnings from nonfarm
self-employment.
Figure your share of gross income
from a nonfarm partnership in the same
manner as a farm partnership. For details,
see Farm Optional Method earlier.

Using Both Optional Methods
If you can use both optional methods, you
can report less than your total actual net
earnings from farm and nonfarm
self-employment, but you cannot report
less than your actual net earnings from
nonfarm self-employment alone.
If you use both methods to figure net
earnings from self-employment, you
cannot report more than $4,480 of net
earnings from self-employment.

Completing Your Return
Third Party Designee
If you want to allow your preparer, a
friend, family member, or any other
person you choose to discuss your 2011
tax return with the IRS, check the “Yes”
box in the “Third Party Designee” area on
page 1 of your return. Also, enter the
designee’s name, phone number, and
any five digits the designee chooses as
his or her personal identification number
(PIN).
If you check the “Yes” box, you (and
your spouse if filing a joint return) are
authorizing the IRS to call the designee to
answer any questions that may arise
during the processing of your return. You
are also authorizing the designee to:
• Give the IRS any information that is
missing from your return,
• Call the IRS for information about the
processing of your return or the status of
your refund or payment(s),
• Receive copies of notices or transcripts
related to your return, upon request, and
• Respond to certain IRS notices about
math errors, offsets, and return
preparation.
You are not authorizing the designee
to receive any refund check, bind you to
anything (including any additional tax
liability), or otherwise represent you
before the IRS. If you want to expand the
designee’s authorization, see Pub. 947,
Practice Before the IRS and Power of
Attorney.
The authorization will automatically
end no later than the due date (without
regard to extensions) for filing your 2012
tax return. This is April 15, 2013, for most
people. If you wish to revoke the
authorization before it ends, see Pub.
947.

Signature and Date
Sign and date your return. It is not valid
unless you sign it. If you are filing a joint
return, your spouse must also sign. If your
spouse cannot sign the return, see Pub.
501.
Instructions for Form 1040-SS (2011)

Page 9 of 10 Instructions for Form 1040-SS (2011)

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Generally, anyone you pay to prepare
your return must sign it and fill in the Paid
Preparer Use Only area in the space
provided. The preparer must give you a
copy of the return for your records.
Someone who prepares your return but
does not charge you should not sign your
return.
If you have someone prepare your
return, you are still responsible for the
correctness of the return.

Daytime Phone Number
Providing your daytime phone number
can help speed the processing of your
return. If we have questions about items
on your return and you can answer our
questions over the phone, we may be
able to continue processing your return
without mailing you a letter. If you are
filing a joint return, you can enter either
your or your spouse’s daytime phone
number.

Additional Information
Amended Returns
File a new Form 1040-SS to change a
Form 1040-SS you already filed. If you
filed Form 1040-SS but should have filed
Form 1040, file a corrected return on
Form 1040. In either case, at the top of
page 1 of the corrected return, enter
“CORRECTED” in dark bold letters
followed by the date. Generally, an
amended Form 1040-SS (or Form 1040, if
applicable) must be filed within 3 years
after the date on which the original return
was filed or within 2 years after the tax
was paid, whichever is later.

Interest and Penalties
Do not figure the amount of any interest
or penalties you may owe. We will send
you a bill for any amount due.

Interest
The IRS will charge you interest on taxes
not paid by their due date, even if an
extension of time to file is granted. Also,
you will be charged interest on penalties
imposed for failure to file, negligence,
fraud, substantial valuation
misstatements, substantial
understatements of tax, and reportable
transaction understatements. Interest is
charged on the penalty from the due date
of the return (including extensions).

Penalties
Late filing. If you do not file your return
by the due date (including extensions),
the penalty is usually 5% of the amount
due for each month or part of a month
your return is late, unless you have a
reasonable explanation. If you do, attach
it to your return. The penalty can be as
much as 25% of the tax due. The penalty
is 15% per month, up to a maximum of
75%, if the failure to file is fraudulent. If
your return is more than 60 days late, the
minimum penalty will be $135 or the
amount of any tax you owe, whichever is
smaller.
Instructions for Form 1040-SS (2011)

Late payment of tax. If you pay your
taxes late, the penalty is usually 1/2 of 1%
of the unpaid amount for each month or
part of a month the tax is not paid. The
penalty can be as much as 25% of the
unpaid amount. It applies to any unpaid
tax on the return. This penalty is in
addition to interest charges on late
payments.
Frivolous return. In addition to any
other penalties, the law imposes a penalty
of $5,000 for filing a frivolous return. A
frivolous return is one that does not
contain information needed to figure the
correct tax or shows a substantially
incorrect tax because you take a frivolous
position or desire to delay or interfere with
the tax laws. This includes altering or
striking out the preprinted language
above the space where you sign. For a
list of positions identified as frivolous, see
Notice 2010-33, 2010-17 I.R.B. 609,
available at
http://www.irs.gov/irb/2010-17_IRB/ar13.
html.
Other. Other penalties can be imposed
for negligence, substantial
understatement of tax, reportable
transaction understatements, filing an
erroneous refund claim, and fraud.
Criminal penalties may be imposed for
willful failure to file, tax evasion, or
making a false statement. See Pub. 17,
Your Federal Income Tax, for details on
some of these penalties.

How To Get Forms and
Publications
By Internet
You can access IRS.gov 24 hours a day,
7 days a week to download forms,
instructions, and publications.

By Phone
You can order forms and publications by
calling 1-800-TAX-FORM
(1-800-829-3676) (not toll free in
American Samoa).

By Mail
You can order forms and publications by
sending your order to:
Internal Revenue Service
1201 N. Mitsubishi Motorway
Bloomington, IL 61705-6613

In Person
You can get forms and publications at the
following walk-in sites.
Note. The following addresses are
subject to change.
American Samoa
American Samoa Government
Tax Office
First Floor
Executive Office Building — Utulei
Pago Pago, AS 96799
CNMI
Division of Revenue and Taxation
DanDan Commercial Center
Saipan, MP 96950

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Guam
Department of Revenue and Taxation
1240 Army Drive
Barrigada, Guam 96913
Puerto Rico
U.S. Internal Revenue Service
7 Tabonuco Street, Suite 120
San Patricio Office Center
Guaynabo, PR 00966
USVI
U.S. Internal Revenue Service
Almeric L. Christian Federal Building
3013 Estate Golden Rock, Room 3013
Christiansted, VI 00820
U.S. Internal Revenue Service
Ron De Lugo Federal Building and
Courthouse
5500 Veterans Drive, Room 216
Charlotte Amalie, VI 00802
USVI Bureau of Internal Revenue
9601 Estate Thomas
Charlotte Amalie, VI 00802
USVI Bureau of Internal Revenue
4008 Estate Diamond
Christiansted, VI 00820
Disclosure, Privacy Act, and
Paperwork Reduction Act Notice. The
IRS Restructuring and Reform Act of
1998, the Privacy Act of 1974, and
Paperwork Reduction Act of 1980 require
that when we ask you for information we
must first tell you our legal right to ask for
the information, why we are asking for it,
and how it will be used. We must also tell
you what could happen if we do not
receive it and whether your response is
voluntary, required to obtain a benefit, or
mandatory under the law.
This notice applies to all papers you
file with us, including this tax return. It
also applies to any questions we need to
ask you so we can complete, correct, or
process your return; figure your tax; and
collect tax, interest, or penalties.
Our legal right to ask for information is
sections 6001, 6011, and 7651 and their
regulations. They say that you must file a
return or statement with the IRS and pay
to the United States Treasury any tax for
which you are liable. Your response is
mandatory under these sections. Section
6109 requires you to provide your
identifying number on the return. This is
so we know who you are, and can
process your return and other papers.
You must fill in all parts of the tax form
that apply to you.
You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records relating
to a form or its instructions must be
retained as long as their contents may
become material in the administration of
any Internal Revenue law.
We ask for tax return information to
carry out the tax laws of the United
States. We need it to figure and collect
the right amount of tax.

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If you do not file a return, do not
provide the information we ask for, or
provide fraudulent information, you may
be charged penalties and be subject to
criminal prosecution. We may also have
to disallow any deductions shown on the
tax return. This could make the tax higher
or delay any refund, and the calculation of
your social security benefits may be
affected. Interest may also be charged.
Generally, tax returns and return
information are confidential, as stated in
section 6103. However, section 6103
allows or requires the IRS to disclose or
give the information shown on your tax
return to others as described in the Code.
For example, we may disclose your tax
information to the SSA for use in
calculating your social security benefits;
to the Department of Justice, to enforce
the tax laws, both civil and criminal; and
to cities, states, the District of Columbia,
and U.S. commonwealths or possessions
to carry out their tax laws.
We may disclose your tax information
to other persons as necessary to obtain

information needed to determine the
amount of or to collect the tax you owe.
We may disclose your tax information to
the Comptroller General of the United
States to permit the Comptroller General
to review the Internal Revenue Service.
We may disclose your tax information to
Committees of Congress; federal, state,
and local child support agencies; and to
other federal agencies for the purposes of
determining entitlement for benefits or the
eligibility for and the repayment of loans.
We may also disclose this information to
other countries under a tax treaty, or to
federal and state agencies to enforce
federal nontax criminal laws, or to federal
law enforcement and intelligence
agencies to combat terrorism.
Keep this notice with your records. It
may help you if we ask you for other
information. If you have questions about
the rules for filing and giving information,
call or visit any IRS office.
The time needed to complete and file
this form will vary depending on individual

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circumstances. The estimated average
time is:
Recordkeeping . . . . . . . .
Learning about the law or
the form . . . . . . . . . . . . .
Preparing the form . . . . . .
Copying, assembling, and
sending the form to the IRS

5 hr., 27 min.
59 min.
3 hr., 46 min.
1 hr., 3 min.

If you have comments concerning the
accuracy of these time estimates or
suggestions for making this form simpler,
we would be happy to hear from you. You
can write to the Internal Revenue Service,
Tax Products Coordinating Committee,
SE:W:CAR:MP:T:T:SP, 1111 Constitution
Ave. NW, IR-6526, Washington, DC
20224. Do not send the form to this
address. Instead, see Where To File
earlier.

Instructions for Form 1040-SS (2011)