Form 8958 - Allocation Of Tax Amounts Between Certain Individuals In Community Property States

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8958
Allocation of Tax Amounts Between
OMB No. 1545-0074
Form
Certain Individuals in Community Property States
(December 2012)
Attachment
Department of the Treasury
72
Sequence No.
Attach to Form 1040.
▶
Internal Revenue Service (99)
Your social security number
Your first name and initial
Your last name
Spouse's or partner's social
Spouse's or partner's first name and initial
Spouse's or partner's last name
security number
1
2
3
Total Income
Allocated to Spouse,
Allocated to Spouse,
(Community/Separate)
RDP, or California
RDP, or California
Same-Sex Spouse
Same-Sex Spouse
SSN
-
-
SSN
-
-
1 Wages (each employer)
2 Interest Income (each payer)
3 Dividends (each payer)
4 State Income Tax Refund
5 Self-Employment Income (See instructions)
6 Capital Gains and Losses
7 Pension Income
8 Rents, Royalties, Partnerships, Estates, Trusts
8958
For Paperwork Reduction Act Notice, see your tax return instructions.
Cat. No. 37779G
Form
(12-2012)

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