Form 1040 Schedule Form 1040 Schedule 1 Additional Income and Adjustments t

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SCHEDULE 1
(Form 1040 or 1040-SR)
Department of the Treasury
Internal Revenue Service

OMB No. 1545-0074

Additional Income and Adjustments to Income
▶ Go

2019

▶ Attach to Form 1040 or 1040-SR.
to www.irs.gov/Form1040 for instructions and the latest information.

Attachment
Sequence No. 01
Your social security number

Name(s) shown on Form 1040 or 1040-SR

DRAFT AS OF
October 10, 2019
DO NOT FILE
At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any
virtual currency? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part I
1
2a
b
3
4
5
6
7
8

Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . .
Alimony received . . . . . . . . . . . . . . . . . . . . . . . .
Date of original divorce or separation agreement (see instructions) ▶
Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . .
Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . .
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E .
Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . .
Unemployment compensation . . . . . . . . . . . . . . . . . . . .
Other income. List type and amount ▶

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1
2a

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3
4
5
6
7

9

Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a

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8
9

Part II

Yes

No

Additional Income

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Adjustments to Income

10
11

Educator expenses
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach
Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . .
13
Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . . .
14
Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . . . .
15
Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . .
16
Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . .
17
Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . .
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Recipient’s SSN
. . . . . . . . . . . . . . . . . . . . . ▶
c Date of original divorce or separation agreement (see instructions) ▶
19
IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . .
21
Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . .
22
Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or
1040-SR, line 8a . . . . . . . . . . . . . . . . . . . . . . . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 71479F

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18a

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21
22

Schedule 1 (Form 1040 or 1040-SR) 2019