1045 Application for Tentative Refund

Version A, Cycle 3

1045

Form

Type or print

Department of the Treasury
Internal Revenue Service

Application for Tentative Refund

OMB No. 1545-0098

For individuals, estates, or trusts.
Mail in separate envelope. (Don’t attach to tax return.)
Go to www.irs.gov/Form1045 for instructions and the latest information.

2022

Name(s) shown on return

Social security or employer identification number

Number, street, and apt. or suite no. If a P.O. box, see instructions.

Spouse’s social security number (SSN)

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

Daytime phone number

Foreign country name

Foreign postal code

Foreign province/county

a Net operating loss (NOL) (Sch. A, line 24) b Unused general business credit
$
$

1

This application is
filed to carry back:

2a

For the calendar year 2022, or other tax year
beginning
, 2022, and ending

c Net section 1256 contracts loss
$

b Date tax return was filed
, 20

3

If this application is for an unused credit created by another carryback, enter year of first carryback:

4

If you filed a joint return (or separate return) for some, but not all, of the tax years involved in figuring the carryback, list the years
and specify whether joint (J) or separate (S) return for each:

5

If SSN for carryback year is different from above, enter a SSN:

6

If you changed your accounting period, give date permission to change was granted:

7
8
9

INTERNAL USE ONLY
DRAFT AS OF
July 20, 2022
Have you filed a petition in Tax Court for the year(s) to which the carryback is to be applied?

.

Yes

No

Is any part of the decrease in tax due to a loss or credit resulting from a reportable transaction required to be
disclosed on Form 8886, Reportable Transaction Disclosure Statement? . . . . . . . . . . . . .

Yes

No

If you are carrying back an NOL or a net section 1256 contracts loss, did this cause the release of foreign tax
credits or the release of other credits due to the release of the foreign tax credit (see instructions)? . . . .

Yes

No

preceding

Computation of Decrease in Tax
(see instructions)

tax year ended:

Note: If 1a and 1c are blank, skip lines 10 through 15.

10

and b Year(s):

Before
carryback

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preceding

tax year ended:

After
carryback

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Before
carryback

preceding

tax year ended:

After
carryback

Before
carryback

After
carryback

NOL deduction after carryback (see
instructions) . . . . . . . . .

11

Adjusted gross income

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12

Deductions (see instructions)

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13

Subtract line 12 from line 11

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14

Exemptions (see instructions)

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15

Taxable income. Line 13 minus line 14

16

Income tax. See instructions and attach
an explanation . . . . . . . .

17

Excess advance payment(s) for premium
tax credit and/or child tax credit (see
instructions) . . . . . . . . .

18

Alternative minimum tax .

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19

Add lines 16 through 18 .

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

Cat. No. 10670A

Form 1045 (2022)

Version A, Cycle 3
Page 2

Form 1045 (2022)

preceding

Computation of Decrease in Tax
(continued)

tax year ended:
Before
carryback

20

General business credit (see instructions)

21

Net premium tax credit and child tax
credit (see instructions) . . . . .

22

Other credits. Identify .

23

Total credits. Add lines 20 through 22

24

Subtract line 23 from line 19

25

Self-employment tax (see instructions)

26

Additional Medicare Tax (see instructions)

27

Net Investment Income Tax (see
instructions) . . . . . . . . .

28
29
30
31

32
33

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preceding

preceding

tax year ended:
After
carryback

Before
carryback

tax year ended:
After
carryback

Before
carryback

After
carryback

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INTERNAL USE ONLY
DRAFT AS OF
July 20, 2022
Reserved for future use

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Other taxes .

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Total tax. Add lines 24 through 29 .

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Enter the amount from the “After
carryback” column on line 30 for each
year
. . . . . . . . . . .

Decrease in tax. Line 30 minus line 31

Overpayment of tax due to a claim of right adjustment under section 1341(b)(1) (attach computation)

Sign
Here
Keep a copy
of this
application
for your
records.

Your signature

Date

Spouse’s signature. If Form 1045 is filed jointly, both must sign.

Date

Print/Type preparer’s name

Paid
Preparer
Use Only

33

Under penalties of perjury, I declare that I have examined this application and accompanying schedules and statements, and, to the best of my knowledge
and belief, they are true, correct, and complete.

Preparer’s signature

Date

PTIN
Check
if
self-employed

Firm’s name

Firm’s EIN

Firm’s address

Phone no.
Form 1045 (2022)

Version A, Cycle 3
Page 3

Form 1045 (2022)

Schedule A—NOL (see instructions)
1

2

For individuals, subtract your standard deduction or itemized deductions from your adjusted gross
income and enter it here. For estates and trusts, enter taxable income increased by the total of the
charitable deduction, income distribution deduction, and exemption amount (see instructions) . .
Nonbusiness capital losses before limitation. Enter as a positive number
(see instructions) . . . . . . . . . . . . . . . . . . .

2

3

Nonbusiness capital gains (without regard to any section 1202 exclusion) .

3

4

If line 2 is more than line 3, enter the difference. Otherwise, enter -0-

5

If line 3 is more than line 2, enter the difference.
Otherwise, enter -0- . . . . . . . . .

6

Nonbusiness deductions (see instructions) .

7

Nonbusiness income other than capital gains (see
instructions) . . . . . . . . . . . .

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4

5
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6

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8

7

8

Add lines 5 and 7

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9

If line 6 is more than line 8, enter the difference. Otherwise, enter -0-

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10

11
12
13
14
15
16

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1

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9

INTERNAL USE ONLY
DRAFT AS OF
July 20, 2022
If line 8 is more than line 6, enter the difference.
Otherwise, enter -0-. But don’t enter more than
line 5 . . . . . . . . . . . . . .

10

Business capital losses before limitation. Enter as a positive number
Business capital gains (without regard to any
section 1202 exclusion) . . . . . . . .

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11

12

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13

Subtract line 13 from line 11. If zero or less, enter -0-

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14

Add lines 4 and 14 .

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15

Add lines 10 and 12

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Enter the loss, if any, from line 16 of your 2022 Schedule D (Form 1040).
(For estates and trusts, enter the loss, if any, from line 19, column (3), of
Schedule D (Form 1041).) Enter as a positive number. If you don’t have a
loss on that line (and don’t have a section 1202 exclusion), skip lines 16
through 21 and enter on line 22 the amount from line 15 . . . . . .

16

17

Section 1202 exclusion. Enter as a positive number (see instructions) .

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18

Subtract line 17 from line 16. If zero or less, enter -0-

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19

Enter the loss, if any, from line 21 of your 2022 Schedule D (Form 1040).
(For estates and trusts, enter the loss, if any, from line 20 of Schedule D
(Form 1041).) Enter as a positive number . . . . . . . . . . .

19

20

If line 18 is more than line 19, enter the difference. Otherwise, enter -0-

.

20

21

If line 19 is more than line 18, enter the difference. Otherwise, enter -0-

.

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22

Subtract line 20 from line 15. If zero or less, enter -0-

.

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23

NOL deduction for losses from other years. Enter as a positive number

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24

NOL. Combine lines 1, 9, 17, and 21 through 23. If the result is less than zero, enter it here and on
page 1, line 1a. If the result is zero or more, you don’t have an NOL . . . . . . . . . .

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17

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21

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22

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23

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18

24
Form 1045 (2022)

Version A, Cycle 3
Page 4

Form 1045 (2022)

Schedule B—NOL Carryover (see instructions)
Complete one column before going to the next
column. Start with the earliest carryback year.
1

NOL deduction. Enter as a positive
number . . . . . . . . . .

2

Taxable income before 2022 NOL
carryback (see instructions). For estates
and trusts, increase this amount by the
sum of the charitable deduction and
income distribution deduction (see
instructions) . . . . . . . . .

3

Net capital loss deduction (see
instructions) . . . . . . . . .

4

Section 1202 exclusion. Enter as a
positive number (see instructions) . .

5

Qualified business income deduction
(see instructions) . . . . . . .

6
7
8
9

10

preceding
tax year ended:

preceding
tax year ended:

preceding
tax year ended:

INTERNAL USE ONLY
DRAFT AS OF
July 20, 2022
Adjustment to adjusted gross income
(see instructions) . . . . . . .
Adjustment to itemized deductions
(see instructions) . . . . . . .

Estates and trusts, enter exemption
amount . . . . . . . . . .

Modified taxable income. Combine
lines 2 through 8. If zero or less, enter
-0- (see instructions) . . . . . .
NOL carryover (see instructions) .

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Adjustment to Itemized Deductions
(Individuals Only) Complete lines 11
through 38 for the carryback year(s) for
which you itemized deductions only if
line 3, 4, or 5 above is more than zero.

11

Adjusted gross income before 2022
NOL carryback . . . . . . . .

12

Add lines 3 through 6 above

13

Modified adjusted gross income. Add
lines 11 and 12 . . . . . . . .

14

Medical expenses from Sch. A (Form
1040), line 4, or as previously adjusted

15

Medical expenses from Sch. A (Form
1040), line 1, or as previously adjusted

16

Multiply line 13 by percentage from
Sch. A (Form 1040), line 3 . . . .

17

Subtract line 16 from line 15. If zero or
less, enter -0- . . . . . . . .

18

Subtract line 17 from line 14 .

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Form 1045 (2022)

Version A, Cycle 3
Page 5

Form 1045 (2022)

Schedule B—NOL Carryover (continued)
Complete one column before going to the next
column. Start with the earliest carryback year.
19

Mortgage insurance premiums from
Sch. A (Form 1040), line 8d, or as
previously adjusted . . . . . .

20

Refigured mortgage insurance premiums
(see instructions)
. . . . . . .

21

Subtract line 20 from line 19

22

Modified adjusted gross income from
line 13 on page 4 of the form . . .

23

Enter as a positive number any NOL
carryback from a year before 2022 that
was deducted to figure line 11 on page
4 of the form . . . . . . . . .

24

Add lines 22 and 23

25

Charitable contributions from Sch. A
(Form 1040), line 14, or Sch. A (Form
1040-NR), line 5, or as previously
adjusted . . . . . . . . . .

26
27
28
29
30

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preceding
tax year ended:

preceding
tax year ended:

preceding
tax year ended:

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INTERNAL USE ONLY
DRAFT AS OF
July 20, 2022
Refigured charitable contributions (see
instructions) . . . . . . . . .
Subtract line 26 from line 25

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Casualty and theft losses from Form
4684, line 18 . . . . . . . . .
Casualty and theft losses from Form
4684, line 16 . . . . . . . . .
Multiply line 22 by 10% (0.10) .

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31

Subtract line 30 from line 29. If zero or
less, enter -0- . . . . . . . .

32

Subtract line 31 from line 28

33

Reserved for future use

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34

Reserved for future use

35

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Reserved for future use

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36

Reserved for future use

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37

Reserved for future use

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38

Combine lines 18, 21, 27, and 32; enter
the result here and on line 7 (page 4) .
Form 1045 (2022)