Form 1040A (2011)
Page 2
Tax, credits,
and
payments
22 Enter the amount from line 21 (adjusted gross income). 22
23 a
Check
if:
{
You were born before January 2, 1947,
Blind
Spouse was born before January 2, 1947,
Blind
}
Total boxes
checked
▶
23a
b If you are married filing separately and your spouse itemizes
deductions, check here
▶
23b
Standard
Deduction
for—
• People who
check any
box on line
23a or 23b or
who can be
claimed as a
dependent,
see
instructions.
• All others:
Single or
Married filing
separately,
$5,800
Married filing
jointly or
Qualifying
widow(er),
$11,600
Head of
household,
$8,500
24 Enter your standard deduction. 24
25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 25
26 Exemptions. Multiply $3,700 by the number on line 6d. 26
27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.
This is your taxable income.
▶
27
28 Tax, including any alternative minimum tax (see instructions). 28
29 Credit for child and dependent care expenses. Attach
Form 2441. 29
30 Credit for the elderly or the disabled. Attach
Schedule R. 30
31 Education credits from Form 8863, line 23. 31
32 Retirement savings contributions credit. Attach
Form 8880. 32
33 Child tax credit (see instructions). 33
34 Add lines 29 through 33. These are your total credits. 34
35 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is
your total tax. 35
36 Federal income tax withheld from Forms W-2 and
1099. 36
37 2011 estimated tax payments and amount applied
from 2010 return. 37
If you have
a qualifying
child, attach
Schedule
EIC.
38a Earned income credit (EIC). 38a
b Nontaxable combat pay
election. 38b
39 Additional child tax credit. Attach Form 8812. 39
40 American opportunity credit from Form 8863, line 14. 40
41 Add lines 36, 37, 38a, 39, and 40. These are your total payments.
▶
41
Refund
Direct
deposit?
See
instructions
and fill in
43b, 43c,
and 43d or
Form 8888.
42 If line 41 is more than line 35, subtract line 35 from line 41.
This is the amount you overpaid. 42
43a
Amount of line 42 you want refunded to you. If Form 8888 is attached, check here
▶
43a
▶
b
Routing
number
▶
c Type:
Checking Savings
▶
d
Account
number
44 Amount of line 42 you want applied to your
2012 estimated tax. 44
Amount
you owe
45 Amount you owe. Subtract line 41 from line 35. For details on how to pay,
see instructions.
▶
45
46 Estimated tax penalty (see instructions). 46
Third party
designee
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Yes. Complete the following. No
Designee’s
name
▶
Phone
no.
▶
Personal identification
number (PIN)
▶
Sign
here
Joint return?
See page 13.
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 accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other
than the taxpayer) is based on all information of which the preparer has any knowledge.
▲
Your signature Date
Your occupation Daytime phone number
Spouse’s signature. If a joint return, both must sign. Date
Spouse’s occupation
If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
Paid
preparer
use only
Print/type preparer's name Preparer’s signature Date
Check
▶
if
self-employed
PTIN
Firm's name
▶
Firm's address
▶
Firm's EIN
▶
Phone no.
Form 1040A (2011)
