Form 1040 - U.s. Individual Income Tax Return - 2010

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1040
2010
Department of the Treasury—Internal Revenue Service
U.S. Individual Income Tax Return
(99)
IRS Use Only—Do not write or staple in this space.
For the year Jan. 1–Dec. 31, 2010, or other tax year beginning
, 2010, ending
, 20
OMB No. 1545-0074
P
Name,
R
Your first name and initial
Last name
Your social security number
I
Address,
N
T
and SSN
If a joint return, spouse’s first name and initial
Last name
Spouse’s social security number
C
L
See separate
Home address (number and street). If you have a P.O. box, see instructions.
Apt. no.
Make sure the SSN(s) above
E
instructions.
and on line 6c are correct.
A
R
City, town or post office, state, and ZIP code. If you have a foreign address, see instructions.
Checking a box below will not
L
change your tax or refund.
Y
Presidential
You
Election Campaign
Check here if you, or your spouse if filing jointly, want $3 to go to this fund
.
.
.
.
.
Spouse
1
4
Single
Head of household (with qualifying person). (See instructions.) If
Filing Status
2
Married filing jointly (even if only one had income)
the qualifying person is a child but not your dependent, enter this
Check only one
child’s name here.
3
Married filing separately. Enter spouse’s SSN above
box.
and full name here.
5
Qualifying widow(er) with dependent child
}
Boxes checked
6a
Yourself. If someone can claim you as a dependent, do not check box 6a .
.
.
.
.
Exemptions
on 6a and 6b
b
Spouse
.
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No. of children
c
Dependents:
(4) ✓ if child under age 17
on 6c who:
(2) Dependent’s
(3) Dependent’s
qualifying for child tax credit
• lived with you
social security number
relationship to you
(1) First name
Last name
(see page 15)
• did not live with
you due to divorce
or separation
If more than four
(see instructions)
dependents, see
Dependents on 6c
instructions and
not entered above
check here
Add numbers on
d
Total number of exemptions claimed
.
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lines above
7
7
Wages, salaries, tips, etc. Attach Form(s) W-2
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Income
8a
Taxable interest. Attach Schedule B if required .
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8a
b
Tax-exempt interest. Do not include on line 8a .
.
.
8b
Attach Form(s)
9 a
9a
Ordinary dividends. Attach Schedule B if required
.
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.
W-2 here. Also
b
Qualified dividends
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9b
attach Forms
W-2G and
10
Taxable refunds, credits, or offsets of state and local income taxes
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.
10
1099-R if tax
11
11
Alimony received .
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was withheld.
12
12
Business income or (loss). Attach Schedule C or C-EZ .
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13
Capital gain or (loss). Attach Schedule D if required. If not required, check here
13
If you did not
14
Other gains or (losses). Attach Form 4797 .
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14
get a W-2,
15 a
15a
b Taxable amount
15b
IRA distributions .
.
.
.
see page 20.
16 a
Pensions and annuities
16a
b Taxable amount
.
.
.
16b
17
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E
17
Enclose, but do
18
18
Farm income or (loss). Attach Schedule F .
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not attach, any
19
Unemployment compensation .
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19
payment. Also,
20 a
Social security benefits
20a
b Taxable amount
.
.
.
20b
please use
Form 1040-V.
21
21
Other income. List type and amount
22
Combine the amounts in the far right column for lines 7 through 21. This is your total income
22
23
Educator expenses
.
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23
Adjusted
24
Certain business expenses of reservists, performing artists, and
Gross
fee-basis government officials. Attach Form 2106 or 2106-EZ
24
Income
25
Health savings account deduction. Attach Form 8889
.
25
26
Moving expenses. Attach Form 3903 .
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26
27
27
One-half of self-employment tax. Attach Schedule SE .
28
Self-employed SEP, SIMPLE, and qualified plans
.
.
28
29
Self-employed health insurance deduction
.
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.
.
29
30
30
Penalty on early withdrawal of savings .
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31 a
Alimony paid
b Recipient’s SSN
31a
32
IRA deduction .
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32
33
Student loan interest deduction .
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33
34
34
Tuition and fees. Attach Form 8917 .
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35
Domestic production activities deduction. Attach Form 8903
35
36
Add lines 23 through 31a and 32 through 35 .
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36
37
Subtract line 36 from line 22. This is your adjusted gross income
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37
1040
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Form
(2010)
Cat. No. 11320B

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