Form 1040 - U.s. Individual Income Tax Return - 2009 Page 3
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Form 1040 (2009)
Page
38
38
Amount from line 37 (adjusted gross income)
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Tax and
{
}
39a
You were born before January 2, 1945,
Blind.
Check
Total boxes
Credits
Spouse was born before January 2, 1945,
checked
39a
if:
Blind.
b
39b
If your spouse itemizes on a separate return or you were a dual-status alien, see page 35 and check here
Standard
Deduction
40 a
Itemized deductions (from Schedule A) or your standard deduction (see left margin)
40a
.
.
for—
b
If you are increasing your standard deduction by certain real estate taxes, new motor
● People who
check any
40b
vehicle taxes, or a net disaster loss, attach Schedule L and check here (see page 35) .
box on line
41
41
Subtract line 40a from line 38 .
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39a, 39b, or
40b or who
42
Exemptions. If line 38 is $125,100 or less and you did not provide housing to a Midwestern
can be
displaced individual, multiply $3,650 by the number on line 6d. Otherwise, see page 37 .
.
42
claimed as a
dependent,
43
Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- .
43
.
see page 35.
44
Tax (see page 37). Check if any tax is from:
a
Form(s) 8814
b
Form 4972 .
44
● All others:
45
Alternative minimum tax (see page 40). Attach Form 6251 .
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45
Single or
Married filing
46
Add lines 44 and 45 .
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46
separately,
$5,700
47
Foreign tax credit. Attach Form 1116 if required .
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47
Married filing
48
48
Credit for child and dependent care expenses. Attach Form 2441
jointly or
49
Education credits from Form 8863, line 29
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49
Qualifying
widow(er),
50
Retirement savings contributions credit. Attach Form 8880
50
$11,400
51
Child tax credit (see page 42) .
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51
Head of
household,
52
Credits from Form:
a
8396
b
8839
c
52
5695
$8,350
3800 b
8801
53
Other credits from Form: a
c
53
54
Add lines 47 through 53. These are your total credits .
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54
55
Subtract line 54 from line 46. If line 54 is more than line 46, enter -0-
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55
Other
56
Self-employment tax. Attach Schedule SE
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56
57
Unreported social security and Medicare tax from Form:
a
4137
b
8919
.
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57
Taxes
58
58
Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required
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59
Additional taxes: a
AEIC payments
b
Household employment taxes. Attach Schedule H
59
60
Add lines 55 through 59. This is your total tax
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60
Payments
61
Federal income tax withheld from Forms W-2 and 1099
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61
62
2009 estimated tax payments and amount applied from 2008 return
62
63
Making work pay and government retiree credits. Attach Schedule M
63
If you have a
64a
Earned income credit (EIC)
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64a
qualifying
b
Nontaxable combat pay election
64b
child, attach
Schedule EIC.
65
Additional child tax credit. Attach Form 8812
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65
66
Refundable education credit from Form 8863, line 16 .
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66
67
First-time homebuyer credit. Attach Form 5405
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67
68
Amount paid with request for extension to file (see page 72) .
68
69
69
Excess social security and tier 1 RRTA tax withheld (see page 72)
70
Credits from Form: a
2439 b
4136 c
8801 d
8885
70
71
Add lines 61, 62, 63, 64a, and 65 through 70. These are your total payments .
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71
Refund
72
If line 71 is more than line 60, subtract line 60 from line 71. This is the amount you overpaid
72
Direct deposit?
73a
Amount of line 72 you want refunded to you. If Form 8888 is attached, check here
.
73a
See page 73
b
Routing number
c Type:
Checking
Savings
and fill in 73b,
d
Account number
73c, and 73d,
or Form 8888.
74
Amount of line 72 you want applied to your 2010 estimated tax
74
Amount
75
Amount you owe. Subtract line 71 from line 60. For details on how to pay, see page 74 .
75
You Owe
76
Estimated tax penalty (see page 74)
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76
Do you want to allow another person to discuss this return with the IRS (see page 75)?
Yes. Complete the following.
No
Third Party
Designee
Designee’s
Phone
Personal identification
name
no.
number (PIN)
Sign
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,
Here
they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature
Date
Your occupation
Daytime phone number
Joint return?
See page 15.
Keep a copy
Spouse’s signature. If a joint return, both must sign.
Date
Spouse’s occupation
for your
records.
Date
Preparer’s SSN or PTIN
Preparer’s
Paid
Check if
signature
self-employed
Preparer’s
Firm’s name (or
EIN
Use Only
yours if self-employed),
Phone no.
address, and ZIP code
1040
Form
(2009)
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