Form 1040x - Amended U.s. Individual Income Tax Return Page 2
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Form 1040X (Rev. 1-2018)
Page
Part I
Exemptions
Complete this part only if any information relating to exemptions has changed from what you reported on the return you are
amending. This would include a change in the number of exemptions, either personal exemptions or dependents.
A. Original number
of exemptions or
C. Correct
See Form 1040 or Form 1040A instructions and Form 1040X instructions.
amount reported or
B. Net change
number
as previously
or amount
adjusted
24
Yourself and spouse. Caution: If someone can claim you as a
24
dependent, you can’t claim an exemption for yourself .
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25
25
Your dependent children who lived with you
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26
Your dependent children who didn’t live with you due to divorce or separation
26
27
Other dependents .
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27
28
Total number of exemptions. Add lines 24 through 27 .
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28
29
Multiply the number of exemptions claimed on line 28 by the exemption
amount shown in the instructions for line 29 for the year you are
amending. Enter the result here and on line 4 on page 1 of this form .
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29
30
List ALL dependents (children and others) claimed on this amended return. If more than 4 dependents, see instructions.
(d) Check box if qualifying
(b) Dependent’s social
c) Dependent’s
(
(a) First name
Last name
child for child tax credit
security number
relationship to you
(see instructions)
Part II
Presidential Election Campaign Fund
Checking below won’t increase your tax or reduce your refund.
Check here if you didn’t previously want $3 to go to the fund, but now do.
Check here if this is a joint return and your spouse did not previously want $3 to go to the fund, but now does.
Part III
Explanation of changes. In the space provided below, tell us why you are filing Form 1040X.
Attach any supporting documents and new or changed forms and schedules.
▶
Remember to keep a copy of this form for your records.
Under penalties of perjury, I declare that I have filed an original return and that I have examined this amended return, including accompanying schedules and
statements, and to the best of my knowledge and belief, this amended return is true, correct, and complete. Declaration of preparer (other than taxpayer) is
based on all information about which the preparer has any knowledge.
Sign Here
Your signature
Date
Your occupation
Spouse’s signature. If a joint return, both must sign.
Date
Spouse’s occupation
Paid Preparer Use Only
Preparer’s signature
Date
Firm’s name (or yours if self-employed)
Print/type preparer’s name
Firm’s address and ZIP code
Check if self-employed
PTIN
Phone number
EIN
1040X
For forms and publications, visit IRS.gov.
Form
(Rev. 1-2018)
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