tax return

Form1040ADepartment of the Treasury—Internal Revenue ServiceU.S. Individual Income Tax Return (99)2014IRS Use Only—Do not write or staple in this space.Your first name and initialLast nameOMB No. 1545-0074
Your social security numberIf a joint return, spouse’s first name and initialLast nameSpouse’s social security numberHome 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 nameFiling
status
Check only
one box.Exemptions^Make sure the SSN(s) above
and on line 6c are correct.Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign postal code a box below will not change your tax or
refund.
You
SpouseForeign province/state/county1
2
34
Single
Head of household (with qualifying person). (See instructions.)
Married filing jointly (even if only one had income)
If the qualifying person is a child but not your dependent,
enter this child’s name here. Married filing separately. Enter spouse’s SSN above and
full name here.
5
Qualifying widow(er) with dependent child (see instructions)
Boxes
6a
Yourself. If someone can claim you as a dependent, do not check
checked on
box 6a.
6a and 6b
No. of children
b
Spouse
on 6c who:
(4) ? if child under
c Dependents:
• lived with
(3) Dependent’s}If more than six
dependents, see
instructions.(1) First nameLast name(2) Dependent’s social
security numberrelationship to youage 17 qualifying for
child tax credit (see
instructions)you• did not live
with you due to
divorce or
separation (see
instructions)
Dependents
on 6c not
entered above
Add numbers
on lines
above
d Total number of exemptions claimed.Income
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