Form
1040
Department of the Treasury—Internal Revenue Service
(99)
U.S. Individual Income Tax Return
2019
OMB No. 1545-0074
IRS Use Only—Do not write or staple in this space.
Filing Status
Check only
one box.
Single Married filing jointly
Married filing separately (MFS)
Head of household (HOH)
Qualifying widow(er) (QW)
If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying person is
a child but not your dependent.
Your first name and middle initial Last name Your social security number
If joint return, spouse’s first name and middle initial Last name
Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions. Apt. no.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Foreign country name Foreign province/state/county
Foreign postal code
Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund.
Checking a box below will not change your
tax or refund.
You
Spouse
Standard
Deduction
Someone can claim: You as a dependent Your spouse as a dependent
Spouse itemizes on a separate return or you were a dual-status alien
Age/Blindness
You:
Were born before January 2, 1955
Are blind
Spouse: Was born before January 2, 1955 Is blind
If more than four dependents,
see instructions and here
Dependents (see instructions):
(2) Social security number (3) Relationship to you (4) if qualifies for (see instructions):
(1) First name Last name
Child tax credit Credit for other dependents
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1
2a Tax-exempt interest . . . . 2a b
Taxable interest. Attach Sch. B if required
2b
3a Qualified dividends . . . . 3a b
Ordinary dividends. Attach Sch. B if required
3b
4a IRA distributions . . . . . 4a b Taxable amount . . . . . . 4b
c Pensions and annuities . . . 4c d Taxable amount . . . . . . 4d
5a Social security benefits . . . 5a b Taxable amount . . . . . . 5b
6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . .
6
7a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . 7a
b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . . . . . . . .
7b
8 a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . . . . . . 8a
b Subtract line 8a from line 7b. This is your adjusted gross income . . . . . . . . . . .
8b
9 Standard deduction or itemized deductions (from Schedule A) . . . . .
Standard
Deduction for—
• Single or Married
filing separately,
$12,200
• Married filing
jointly or Qualifying
widow(er),
$24,400
• Head of
household,
$18,350
• If you checked
any box under
Standard
Deduction,
see instructions.
9
10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10
11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . 11a
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . . . . . . . . .
11b
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 11320B
Form 1040 (2019)
Form 1040 (2019)
Page 2
12a
Tax (see inst.)
Check if any from Form(s):
1 8814 2 4972 3 12a
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . . . . . . .
12b
13
a Child tax credit or credit for other dependents . . . . . . . . . .
13a
b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . . . . . . .
13b
14 Subtract line 13b from line 12b. If zero or less, enter -0- . . . . . . . . . . . . . . . 14
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . 15
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . . . . . .
16
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . . . 17
18 Other payments and refundable credits:
a Earned income credit (EIC) . . . . . . . . . . . . . . .
• If you have a
qualifying child,
attach Sch. EIC.
• If you have
nontaxable
combat pay, see
instructions.
18a
b Additional child tax credit. Attach Schedule 8812 . . . . . . . . . 18b
c American opportunity credit from Form 8863, line 8 . . . . . . . . 18c
d Schedule 3, line 14 . . . . . . . . . . . . . . . . . 18d
e
Add lines 18a through 18d. These are your total other payments and refundable credits . . . . .
18e
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . . . . . . .
19
Refund
20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid . . . . . . 20
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here . . . . . .
21a
Direct deposit?
See instructions.
b Routing number
c Type: Checking Savings
d Account number
22 Amount of line 20 you want applied to your 2020 estimated tax . . . .
22
Amount
You Owe
23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions . . . . .
23
24 Estimated tax penalty (see instructions) . . . . . . . . . . .
24
Third Party
Designee
(Other than
paid preparer)
Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions.
Yes. Complete below.
No
Designee’s
name
Phone
no.
Personal identification
number (PIN)
Sign
Here
Joint return?
See instructions.
Keep a copy for
your records.
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature Date Your occupation
If the IRS sent you an Identity
Protection PIN, enter it here
(see inst.)
Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation
If the IRS sent your spouse an
Identity Protection PIN, enter it here
(see inst.)
Phone no.
Email address
Paid
Preparer
Use Only
Preparer’s name
Preparer’s signature Date
PTIN
Check if:
3rd Party Designee
Self-employed
Firm’s name
Phone no.
Firm’s address
Firm’s EIN
Go to www.irs.gov/Form1040 for instructions and the latest information.
Form 1040 (2019)
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