Form 1040 United States Individual Income Tax Return 2004. Summary: This is an example of Form 1040 (2004) with items included as described in the text. Additionally, these line items
are
completed:
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Under
“Label here”:
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“Your first name and initial” field contains James M.
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“Last name” field contains Adams
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“Your social security number” field contains 111-00-1111
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“If a joint return, spouse's first name and initial” field contains Judith E.
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“Last name” field contains Adams
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“Spouse's social security number” field contains 222-00-2222
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“Home address (number and street). If you have a post office box, see page 21.” field contains 21 Rue Reynaud
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“City, town or post office, state, and ZIP code. If you have a foreign address, see page 21.” field contains Paris,
France
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Under
“Presidential Election Campaign”:
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“Do you, or your spouse if filing a joint return, want $3 to go to this fund?”
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“You Yes” checkbox checked
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“Spouse Yes” checkbox checked
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Under
“Filing Status”:
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“2. Married filing jointly (even if only one had income)” checkbox checked
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Under
“Exemptions”:
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“6a. Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax return, do not check box 6a” checkbox
checked
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“6b. Spouse” checkbox checked
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“6c. Dependents:”
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“(1) First name Last name” field contains Chris T. Adams
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“(2) Dependent's social security number” field contains 333-00-3333
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“(3) Dependent's relationship to you” field contains Daughter
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“(4) If qualifying child for child tax credit (see page 22)” checkbox checked
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“6c. Dependents:”
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“(1) First name Last name” field contains Stephen F. Adams
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“(2) Dependent's social security number” field contains 444-00-4444
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“(3) Dependent's relationship to you” field contains Son
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“(4) If qualifying child for child tax credit (see page 22)” checkbox checked
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“No. of boxes checked on 6a and 6b” field contains 2
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“No. of children on 6c who: lived with you” field contains 2
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“6d. Total number of exemptions claimed. Add numbers on lines above” field contains 4
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Under
“Income”:
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“22. Add the amounts in the far right column for lines 7 through 21. This is your total income” field contains
7,500
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Under
“Adjusted Gross Income”:
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“34. Add lines 23 through 33a” field contains 0
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