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2014 Form 1040A

Form
1040A
2014
U.S. Individual Income Tax Return
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
(99)
OMB No. 1545-0074
Your first name and initial Last name
Your social security number
If a joint return, spouse’s first name and initial Last name
Spouse’s social security number
Make sure the SSN(s) above
and on line 6c are correct.
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
Filing
status
Check only
one box.
1
Single
2
Married filing jointly (even if only one had income)
3
Married filing separately. Enter spouse’s SSN above and
full name here.
4
Head of household (with qualifying person). (See instructions.)
If the qualifying person is a child but not your dependent,
enter this child’s name here.
5
Qualifying widow(er) with dependent child (see instructions)
Exemptions
If more than six
dependents, see
instructions.
6a
Yourself.If someone can claim you as a dependent, do not check
box 6a.
b
Spouse
}
c
Dependents:
(1) First nameLast name
(2) Dependent’s social
security number
(3) Dependent’s
relationship toyou
(4) if
child under
age 17 qualifying for
child tax credit (see
instructions)
dTotal number of exemptions claimed.
Boxes
checked on
6a and 6b
No. of children
on 6c who:
lived with
you
did not live
with you dueto
divorce or
separation(see
instructions)
Dependents
on 6c not
entered above
Add numbers
on lines
above
Income
Attach
Form(s) W-2
here. Also
attach
Form(s)
1099-R if tax
was
withheld.
If you did not
get a W-2, see
instructions.
7Wages, salaries, tips, etc. Attach Form(s) W-2.7
8aTaxable interest. Attach Schedule B if required.8a
bTax-exempt interest. Do not include on line 8a.8b
9a
Ordinary dividends. Attach Schedule B if required.
9a
bQualified dividends (see instructions).9b
10Capital gain distributions (see instructions).10
11 a IRA
distributions.11a
11b Taxable amount
(see instructions).11b
12 a Pensions and
annuities.12a
12b Taxable amount
(see instructions).12b
13Unemployment compensation and Alaska Permanent Fund dividends.13
14 a Social security
benefits.14a
14b Taxable amount
(see instructions).14b
15
Add lines 7 through 14b (far right column). This is your total income.
15
Adjusted
gross
income
16Educator expenses (see instructions).16
17IRA deduction (see instructions).17
18
Student loan interest deduction (see instructions).
18
19Tuition and fees. Attach Form 8917.19
20Add lines 16 through 19. These are your total adjustments.20
21Subtract line 20 from line 15. This is your adjusted gross income.
21
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 11327A
Form 1040A (2014)
Form 1040A (2014)
Page 2
Tax, credits,
and
payments
22Enter the amount from line 21 (adjusted gross income).22
23 a
Check
if:
{
You were born before January 2, 1950,
Blind
Spouse was born before January 2, 1950,
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,
$6,200
Married filing
jointly or
Qualifying
widow(er),
$12,400
Head of
household,
$9,100
24Enter your standard deduction.24
25Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-.25
26Exemptions. Multiply $3,950 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 Excess advance premium tax credit repayment. Attach
Form 8962.29
30Add lines 28 and 29. 30
31 Credit for child and dependent care expenses. Attach
Form 2441.31
32 Credit for the elderly or the disabled. Attach
Schedule R.32
33Education credits from Form 8863, line 19.33
34
Retirement savings contributions credit. Attach Form 8880.
34
35Child tax credit. Attach Schedule 8812, if required.35
36Add lines 31 through 35. These are your total credits.36
37
Subtract line 36 from line 30. If line 36 is more than line 30, enter -0-.
37
38
Health care: individual responsibility (see instructions).
Full-year coverage
38
39Add line 37 and line 38. This is your total tax.39
40
Federal income tax withheld from Forms W-2 and 1099.
40
41 2014 estimated tax payments and amount applied
from 2013 return.41
If you have
a qualifying
child, attach
Schedule
EIC.
42aEarned income credit (EIC).
42a
b
Nontaxable combat pay election.
42b
43Additional child tax credit. Attach Schedule 8812.43
44American opportunity credit from Form 8863, line 8.44
45Net premium tax credit. Attach Form 8962.45
46Add lines 40, 41, 42a, 43, 44, and 45. These are your total payments.
46
Refund
Direct
deposit?
See
instructions
and fill in
48b, 48c,
and 48d or
Form 8888.
47 If line 46 is more than line 39, subtract line 39 from line 46.
This is the amount you overpaid.
47
48a
Amount of line 47 you want refunded to you. If Form 8888 is attached, check here
48a
b
Routing
number
c Type:
CheckingSavings
d
Account
number
49 Amount of line 47 you want applied to your
2015 estimated tax.49
Amount
you owe
50 Amount you owe. Subtract line 46 from line 39. For details on how to pay,
see instructions.
50
51Estimated tax penalty (see instructions).51
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 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 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 signatureDate
Your occupationDaytime 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 namePreparer’s signatureDate
Check
if
self-employed
PTIN
Firm's name
Firm's address
Firm's EIN
Phone no.
Form 1040A (2014)
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