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1040

Department of the Treasury—Internal Revenue Service

2002

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, 2002, or other tax year beginning

, 2002, ending

, 20

OMB No. 1545-0074

Label

Your first name and initial

Last name

Your social security number

011

2222

John E.

Michaels

(See

instructions

If a joint return, spouse’s first name and initial

Last name

Spouse’s social security number

on page 21.)

011

1111

Susan R.

Michaels

Use the IRS

Home address (number and street). If you have a P.O. box, see page 21.

Apt. no.

label.

Important!

Otherwise,

1040 Main Street

You must enter

please print

City, town or post office, state, and ZIP code. If you have a foreign address, see page 21.

or type.

your SSN(s) above.

Hometown, TX 77099

Presidential

You

Spouse

Election Campaign

Note. Checking “Yes” will not change your tax or reduce your refund.

Do you, or your spouse if filing a joint return, want $3 to go to this fund?

Yes

(See page 21.)

Single

Head of household (with qualifying person). (See page 21.) If

Filing Status

the qualifying person is a child but not your dependent, enter

Married filing jointly (even if only one had income)

this child’s name here.

Married filing separately. Enter spouse’s SSN above

Check only

and full name here.

Qualifying widow(er) with dependent child (year

one box.

spouse died

). (See page 21.)

No. of boxes

Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax

checked on

Exemptions

return, do not check box 6a

6a and 6b

Spouse

No. of children

(3) Dependent’s

(4)

if qualifying

on 6c who:

Dependents:

(2) Dependent’s

● lived with you

relationship to

child for child tax

social security number

(1) First name

Last name

you

credit (see page 22)

● did not live with

Jennifer Michaels

111

1113

daughter

you due to divorce

or separation

If more than five

(see page 22)

dependents,

Dependents on 6c

see page 22.

not entered above

Add numbers

on lines

d Total number of exemptions claimed

above

Excess utility allowance $240

34,640

Wages, salaries, tips, etc. Attach Form(s) W-2

Income

8a Taxable interest. Attach Schedule B if required

b Tax-exempt interest. Do not include on line 8a

Attach

Forms W-2 and

Ordinary dividends. Attach Schedule B if required

W-2G here.

Taxable refunds, credits, or offsets of state and local income taxes (see page 24)

Also attach

Alimony received

Form(s) 1099-R

3,799

if tax was

Business income or (loss). Attach Schedule C or C-EZ

withheld.

Capital gain or (loss). Attach Schedule D if required. If not required, check here

Other gains or (losses). Attach Form 4797

15a

15b

If you did not

15a

IRA distributions

b Taxable amount (see page 25)

get a W-2,

16a

16b

16a

Pensions and annuities

b Taxable amount (see page 25)

see page 23.

Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E

Farm income or (loss). Attach Schedule F

Enclose, but do

not attach, any

Unemployment compensation

payment. Also,

20a

20b

20a Social security benefits

b Taxable amount (see page 27)

please use

Form 1040-V.

Other income. List type and amount (see page 29)

38,439

Add the amounts in the far right column for lines 7 through 21. This is your total income

Educator expenses (see page 29)

Adjusted

IRA deduction (see page 29)

Gross

Student loan interest deduction (see page 31)

Income

Tuition and fees deduction (see page 32)

Archer MSA deduction. Attach Form 8853

Moving expenses. Attach Form 3903

3,132

One-half of self-employment tax. Attach Schedule SE

Self-employed health insurance deduction (see page 33)

Self-employed SEP, SIMPLE, and qualified plans

Penalty on early withdrawal of savings

33a

Alimony paid

b Recipient’s SSN

3,132

Add lines 23 through 33a

35,307

Subtract line 34 from line 22. This is your adjusted gross income

1040

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 76.

Cat. No. 11320B

Form

(2002)

Page 15

Publication 517 - Social Security And Other Information For Members Of The Clergy And Religious Workers - 2002 Page 15

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