Form 9452 - Filing Assistance Program - 2016
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1
2OMB No. 1545-1316
Filing Assistance Program
9452
Form
2016
(Do you have to file a Federal Income Tax Return?)
Department of the Treasury
►
See instructions on back.
Internal Revenue Service
Do not send to IRS.
Keep for your records.
Caution: Do any of the special situations listed in the general instructions on page 2 apply to you?
(
) Yes. Stop here; you must file a Federal income tax return. Do not use this form.
(
) No. Continue.
Part I
Computing Your Total Gross Income (See instructions.)
1
Wages, salaries, tips, etc.
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(Do not include social security income)
2
Interest income .
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(Do not include tax-exempt interest, such as from municipal bonds)
3
Ordinary dividend income
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Refund of state and local income taxes if, in the year the tax was paid, you itemized your
deductions on Schedule A (Form 1040) .
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Retirement income (such as income from a taxable pension, annuity, IRA distributions, etc.) .
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Other income
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(Self-employment, such as income from prizes, awards, gambling winnings, lottery, raffles, jury
duty fees, etc.)
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Gross Income. Add amounts on lines 1 through 6
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7
Determining Your Filing Requirement
Part II
Can someone claim you as a dependent on their 2016 income tax return?
(
) Yes. See instructions on page 2.
(
) No. Use the following chart to make sure you do not have to file a Federal income tax return for 2016.
2016 Filing Requirements for Most People
Then you do not need to file a
If your filing status would be
And at the end of 2016 you were*
return if the amount on line 7 is
less than
under 65
$10,350
Single
65 or older
11,900
under 65 (both spouses)
$20,700
Married filing jointly**
65 or older (one spouse)
21,950
65 or older (both spouses)
23,200
Married filing separately
any age
$4,050
under 65
$13,350
Head of household
65 or older
14,900
under 65
$16,650
Qualifying widow(er)
with dependent child
65 or older
17,900
*If you were born on January 1, 1952, you are considered to be age 65 at the end of 2016.
**If you did not live with your spouse at the end of 2016 (or on the date your spouse died) and your gross income on line 7 above was at least $4,050,
you must file a return regardless of your age.
9452
Cat. No. 14695J
Form
(2016)
For Paperwork Reduction Act Notice, see back of Form.
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