Form 1040-Ss - U.s. Self-Employment Tax Return (Including The Additional Child Tax Credit For Bona Fide Residents Of Puerto Rico) - 2016 Page 2

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2
Form 1040-SS (2017)
Page
Part II
Bona Fide Residents of Puerto Rico Claiming Additional Child Tax Credit—See instructions.
Caution: You must have three or more qualifying children to claim the additional child tax credit.
1
Income derived from sources within Puerto Rico .
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1
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Withheld social security, Medicare, and Additional Medicare taxes from Puerto Rico Form(s)
499R-2/W-2PR (attach copy of form(s)). If married filing jointly, include your spouse’s amounts
with yours .
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2
3
Additional child tax credit. Use the worksheet in the instructions to figure the amount to enter
here and in Part I, line 9 .
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3
Part III
Profit or Loss From Farming—See the Instructions for Schedule F (Form 1040).
Social security number
Name of proprietor
Note: If you are filing a joint return and both you and your spouse had a profit or loss from a farming business, see Joint returns and
Business Owned and Operated by Spouses in the instructions for more information.
Section A—Farm Income—Cash Method
Complete Sections A and B. (Accrual method taxpayers, complete Sections B and C, and Section A, line 11.)
Don't include sales of livestock held for draft, breeding, sport, or dairy purposes (see instructions).
1
1
Sales of livestock and other items you bought for resale
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2
Cost or other basis of livestock and other items reported on line 1 .
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2
3
Subtract line 2 from line 1.
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3
4
4
Sales of livestock, produce, grains, and other products you raised .
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5 a Total cooperative distributions (Form(s)
1099-PATR) .
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5a
5b Taxable amount
5b
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6
Agricultural program payments received .
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7
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Commodity Credit Corporation (CCC) loans reported under election (or forfeited) .
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8
Crop insurance proceeds .
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8
9
Custom hire (machine work) income .
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9
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10
Other income.
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11
Gross farm income. Add amounts in the right column for lines 3 through 10. If accrual method
taxpayer, enter the amount from Section C, line 50 .
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11
Section B—Farm Expenses—Cash and Accrual Method
Don't include personal or living expenses (such as taxes, insurance, or repairs on your home) that didn't produce farm income.
Reduce the amount of your farm expenses by any reimbursements before entering the expenses below.
12
Car and truck expenses
25
Pension and profit-sharing
(see instructions)
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12
plans
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25
13
Chemicals .
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13
26
Rent or lease:
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Conservation expenses .
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a Vehicles, machinery, and
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26a
Custom hire (machine work)
equipment .
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b Other (land, animals, etc.) .
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26b
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Depreciation and section 179
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Repairs and maintenance .
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expense deduction not
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Seeds and plants purchased
claimed elsewhere (attach
Form 4562 if required).
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16
29
Storage and warehousing
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29
30
Supplies purchased .
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30
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Employee benefit programs
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31
other than on line 25 .
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Taxes
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18
Feed purchased .
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18
32
Utilities .
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32
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Fertilizers and lime .
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19
33
Veterinary, breeding, and
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33
Freight and trucking
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medicine .
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34
Gasoline, fuel, and oil .
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Other expenses (specify):
22
Insurance (other than health)
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a
34a
23
Interest:
b
34b
a Mortgage (paid to banks, etc.)
23a
c
34c
b Other .
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23b
d
34d
24
Labor hired .
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24
e
34e
35
Total expenses. Add lines 12 through 34e .
35
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36
Net farm profit or (loss). Subtract line 35 from line 11. Enter the result here and in Part V, line 1a
36
1040-SS
Form
(2017)

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