Form 1040 U.S. Individual Tax Return

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Form

1040 U.S. Individual Income Tax Return 2019

Filing Status
Check only
one box.

(99)

Department of the Treasury—Internal Revenue Service

Single

Married filing jointly

Married filing separately (MFS)

OMB No. 1545-0074

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

Head of household (HOH)

Qualifying widow(er) (QW)

If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is
a child but not your dependent. ▶

Your first name and middle initial

Last name

Your social security number

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

Last name

Spouse’s social security number

DRAFT AS OF
DRAFT AS OF
September 11, 2019
DO NOT FILE
Home address (number and street). If you have a P.O. box, see instructions.

Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund.
Checking a box below will not change your
tax or refund.
You
Spouse

Apt. no.

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

Foreign province/state/county

Standard
Deduction

Someone can claim:

Age/Blindness

You:

You as a dependent

If more than four dependents,
see instructions and ✓ here ▶

Your spouse as a dependent

Spouse itemizes on a separate return or you were a dual-status alien
Were born before January 2, 1955

(1) First name

Spouse:

Are blind

Dependents (see instructions):

Standard
Deduction for—
• Single or Married
filing separately,
$12,200
• Married filing
jointly or Qualifying
widow(er),
$24,400
• Head of
household,
$18,350
• If you checked
any box under
Standard
Deduction,
see instructions.

Foreign postal code

Was born before January 2, 1955

(2) Social security number

(3) Relationship to you

Is blind

(4) ✓ if qualifies for (see instructions):
Child tax credit
Credit for other dependents

Last name

1

Wages, salaries, tips, etc. Attach Form(s) W-2 .

2a

Tax-exempt interest .

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2a

b Taxable interest. Attach Sch. B if required

2b

3a

Qualified dividends .

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3a

b Ordinary dividends. Attach Sch. B if required

3b

4a

IRA distributions .

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4a

b Taxable amount

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4b

c

Pensions and annuities .

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4c

d Taxable amount

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4d

5a

Social security benefits .

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5a

b Taxable amount

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5b

6

Capital gain or (loss). Attach Schedule D if required. If not required, check here

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7a

Other income from Schedule 1, line 9

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7a
7b

b
8a
b
9
10
11a
b

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1

6

Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income

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Adjustments to income from Schedule 1, line 22

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8a

Subtract line 8a from line 7b. This is your adjusted gross income

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8b

Standard deduction or itemized deductions (from Schedule A) .

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9

Qualified business income deduction. Attach Form 8995 or Form 8995-A .

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10

Add lines 9 and 10 .

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11a

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11b

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Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0-

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

Cat. No. 11320B

Form

1040 (2019)

Page 2

Form 1040 (2019)
12a
b
13a
b

Tax (see inst.) Check if any from Form(s): 1

8814 2

4972 3

Add Schedule 2, line 3, and line 12a and enter the total
Child tax credit or credit for other dependents .

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12a

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12b

13a

Add Schedule 3, line 7, and line 13a and enter the total

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13b

14

Subtract line 13b from line 12b. If zero or less, enter -0-

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15

Other taxes, including self-employment tax, from Schedule 2, line 10 .

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15

16

Add lines 14 and 15. This is your total tax .

17

Federal income tax withheld from Forms W-2 and 1099

18

Other payments and refundable credits:

DRAFT AS OF
September 11, 2019
DO NOT FILE
• If you have a
qualifying child,
attach Sch. EIC.
• If you have
nontaxable
combat pay, see
instructions.

Refund

Direct deposit?
See instructions.

Amount
You Owe
Third Party
Designee

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16

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17

a

Earned income credit (EIC) .

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18a

b

Additional child tax credit. Attach Schedule 8812

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18b

c

American opportunity credit from Form 8863, line 8

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18c

d

Schedule 3, line 14 .

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18d

e

Add lines 18a through 18d. These are your total other payments and refundable credits

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18e

19

Add lines 17 and 18e. These are your total payments .

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19

20

If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid .

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21a

Amount of line 20 you want refunded to you. If Form 8888 is attached, check here

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b

Routing number

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d

Account number

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c Type:

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Checking

22

Amount of line 20 you want applied to your 2020 estimated tax .

23

Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions

24

Estimated tax penalty (see instructions) .

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20

21a

Savings

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24

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Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions.

Yes. Complete below.

No

Phone
no. ▶

Personal identification
▶
number (PIN)

(Other than
paid preparer)

Designee’s
name ▶

Sign
Here

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, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Paid
Preparer
Use Only

▲

Joint return?
See instructions.
Keep a copy for
your records.

Your signature

Date

Your occupation

If the IRS sent you an Identity
Protection PIN, enter it here
(see inst.)

Spouse’s signature. If a joint return, both must sign.

Date

Spouse’s occupation

If the IRS sent your spouse an
Identity Protection PIN, enter it here
(see inst.)

Phone no.

Email address

Preparer’s name

Preparer’s signature

Date

PTIN

Check if:
3rd Party Designee

Firm’s name

Firm’s address

Self-employed

Phone no.

▶
▶

Go to www.irs.gov/Form1040 for instructions and the latest information.

Firm’s EIN

▶

Form

1040 (2019)