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US1040A.P89
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1990-01-24
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179 lines
177
000,00,001, ,00,0, , , ,C,
000,00,002, ,00,0, , , ,C,
000,00,003, ,00,0, , , ,C,
000,00,004, ,00,0, , , ,C, Form *NOT SUITABLE FOR FILING - FOR INFORMATION USE ONLY!
000,00,005, ,00,0, , , ,C, 1040A U.S. Individual Income Tax Return 1989 OMB # 1545-0085
000,00,006, ,00,0, , , ,C, ==========================================================================
000,00,007, ,00,0, , , ,C, STEP 1 Your name and address
000,00,008, ,00,0, , , ,C, LABEL Your first name Last name Your SSN
000,14,009,S,22,0,E, , , ,
001,38,009,S,21,0,E, , , ,
002,62,009,S,14,0,E, , , ,
000,00,010, ,00,0, , , ,C, L Spouse's first name Last name Spouse's SSN
003,14,011,S,22,0,E, , , , A H
004,38,011,S,21,0,E, , , ,
005,62,011,S,14,0,E, , , ,
000,00,012, ,00,0, , , ,C, B E Home address Apt. For Paperwork
006,14,013,S,38,0,E, , , , E R Reduction Act
007,54,013,S,06,0,E, , , ,
000,00,014, ,00,0, , , ,C, L E City or town, State, ZIP Notice, see
008,14,015,S,40,0,E, , , , Separate
000,00,016, ,00,0, , , ,C, Instructions.
000,00,017, ,00,0, , , ,C, PRESIDENTIAL ELECTION CAMPAIGN FUND
000,51,018,B,01,0,E, , , , Do you want $1 to go to this fund?...[ ]Yes [ ]No
001,58,018,B,01,0,E, , , ,
002,51,019,B,01,0,E, , , , __________Does spouse want $1 to go to fund?...[ ]Yes [ ]No
003,58,019,B,01,0,E, , , ,
004,17,020,B,01,0,E, , , , STEP 2 1[ ] Single
005,17,021,B,01,0,E, , , , 2[ ] Married filing joint return (even if only one had income)
006,17,022,B,01,0,E, , , , CHECK 3[ ] Married filing separate return. Enter spouse's SSN above
009,39,023,S,37,0,E, , , , YOUR & full name here.
007,17,024,B,01,0,E, , , , FILING 4[ ] Head of household. If qualifying person is your child but
010,52,025,S,24,0,E, , , , STATUS not your dependent, enter name.
008,17,026,B,01,0,E, , , , 5[ ] Qualifying widow(er)(yr. spouse died>19 )
011,59,026,S,03,0,E, , , ,
000,00,027, ,00,0, , , ,C, __________ with dependent child. No. of boxes
009,17,028,B,01,0,E, , , , STEP 3 6a[ ] YOURSELF - Do not check box 6a if someone checked on
000,74,029,V,03,0,E, , , , can claim you as a dependent on 6a and 6b
010,17,030,B,01,0,E, , , , FIGURE 6b[ ] SPOUSE his or her tax return. Number on
000,00,031, ,00,0, , , ,C, YOUR c Dependents: 2.Under |4.Rela- |5.No. 6c who:
000,00,032, ,00,0, , , ,C, EXEMPTIONS 1.Name | 2 | 3.SSN |tionship |months*lived w/
012,14,033,S,20,0,E, , , , |[ ]| | | you
011,36,033,B,01,0,E, , , ,
013,39,033,S,11,0,E, , , ,
014,51,033,S,09,0,E, , , ,
015,61,033,S,05,0,E, , , ,
001,74,033,V,03,0,E, , , ,
016,14,034,S,20,0,E, , , , |[ ]| | |
012,36,034,B,01,0,E, , , ,
017,39,034,S,11,0,E, , , ,
018,51,034,S,09,0,E, , , ,
019,61,034,S,05,0,E, , , ,
020,14,035,S,20,0,E, , , , |[ ]| | | *didn't
013,36,035,B,01,0,E, , , ,
021,39,035,S,11,0,E, , , ,
022,51,035,S,09,0,E, , , ,
023,61,035,S,05,0,E, , , ,
024,14,036,S,20,0,E, , , , |[ ]| | | live with
014,36,036,B,01,0,E, , , ,
025,39,036,S,11,0,E, , , ,
026,51,036,S,09,0,E, , , ,
027,61,036,S,05,0,E, , , ,
028,14,037,S,20,0,E, , , , |[ ]| | | you
015,36,037,B,01,0,E, , , ,
029,39,037,S,11,0,E, , , ,
030,51,037,S,09,0,E, , , ,
031,61,037,S,05,0,E, , , ,
002,74,037,V,03,0,E, , , ,
032,14,038,S,20,0,E, , , , |[ ]| | | No. of
016,36,038,B,01,0,E, , , ,
033,39,038,S,11,0,E, , , ,
034,51,038,S,09,0,E, , , ,
035,61,038,S,05,0,E, , , ,
036,14,039,S,20,0,E, , , , |[ ]| | | OTHER
017,36,039,B,01,0,E, , , ,
037,39,039,S,11,0,E, , , ,
038,51,039,S,09,0,E, , , ,
039,61,039,S,05,0,E, , , ,
003,74,039,V,03,0,E, , , ,
000,00,040, ,00,0, , , ,C, d Check if your child didn't live with you,_but Add
018,58,041,B,01,0,E, , , , you claim under a pre-1985 agreement...>[ ] above
004,73,042,V,04,0,C, , , , __________ e Total number of exemptions claimed. no.'s
000,00,043, ,00,0, , , ,C, STEP 4 7 Wages, salaries, tips, etc. This should be
005,65,044,V,12,2,E, , , , shown in Box 10 of your W-2 form(s)...........7
000,00,045, ,00,0, , , ,C, FIGURE 8a TAXABLE interest income. (If over $400, also
006,65,046,V,12,2,E, , , , YOUR complete & attach Schedule 1, Part II.)......8a
000,00,047, ,00,0, , , ,C, TOTAL b TAX-EXEMPT interest income. (DO
007,53,048,V,12,2,E, , , , INCOME NOT include on line 8a.).........8b
000,00,049, ,00,0, , , ,C, 9 Dividends. (If over $400, also
008,66,050,V,11,2,E, , , , complete and attach Schedule 1, Part III.)....9
000,00,051, ,00,0, , , ,C, 10 Unemployment compensation (insurance)
009,66,052,V,11,2,E, , , , from Form(s) 1099-G..........................10
000,00,053, ,00,0, , , ,C, 11 Add lines 7, 8a, 9, and 10. This is
010,66,054,V,11,2,C, , , , __________ your TOTAL INCOME...........................>11
000,00,055, ,00,0, , , ,C, STEP 5 12a Your IRA deduction from
011,53,056,V,12,2,E, , , , applicable worksheet............12a
000,00,057, ,00,0, , , ,C, FIGURE b Spouse's IRA deduction from
012,53,058,V,12,2,E, , , , YOUR applicable worksheet............12b
000,00,059, ,00,0, , , ,C, ADJUSTED c Add lines 12a and 12b. These are your
013,66,060,V,11,2,C, , , , GROSS TOTAL ADJUSTMENTS...........................12c
000,00,061, ,00,0, , , ,C, INCOME
000,00,062, ,00,0, , , ,C, 13 Subtract line 12c from line 11. This is
014,66,063,V,11,2,C, , , , your ADJUSTED GROSS INCOME..................>13
000,00,064, ,00,0, ,F, ,C, For Paperwork Reduction Act Notice, see Form 1040 Instructions
000,00,065, ,00,0, , , ,C,
000,00,066, ,00,0, , , ,C,
000,00,067, ,00,0, , , ,C,
000,00,068, ,00,0, , , ,C, 1989 Form 1040A Pg. 2
000,00,069, ,00,0, , , ,C, ==========================================================================
015,66,070,V,11,2,E, , , , STEP 6 14 Enter the amount from line 13................14
000,00,071, ,00,0, , , ,C, YOU were
019,23,072,B,01,0,E, , , , 15a Check[ ]65 or older [ ]Blind NO. OF BOXES
020,39,072,B,01,0,E, , , ,
021,23,073,B,01,0,E, , , , if: [ ]SPOUSE was [ ]Blind CHECKED.>
022,39,073,B,01,0,E, , , ,
016,59,073,V,04,0,C, , , ,
000,00,074, ,00,0, , , ,C, 65 or older
023,60,075,B,01,0,E, , , , FIGURE b Ck. if someone can claim you as a dep.>15b[ ]
000,00,076, ,00,0, , , ,C, YOUR c Check if you are married filing separately and your spouse
024,60,077,B,01,0,E, , , , STANDARD files Form 1040 and itemizes deductions..>[ ]
000,00,078, ,00,0, , , ,C, DEDUC-
017,66,079,V,11,2,C, , , , TION, 16 ENTER YOUR STANDARD DEDUCTION................16
000,00,080, ,00,0, , , ,C,
018,66,081,V,11,2,C, , , , 17 Subtract line 16 from line 14................17
000,00,082, ,00,0, , , ,C, EXEMPTION 18 Multiply $2,000 by the total number of
019,66,083,V,11,2,C, , , , AMOUNT, & exemptions claimed on line 6e................18
000,00,084, ,00,0, , , ,C, TAXABLE 19 Subtract line 18 from line 17. This is
020,66,085,V,11,2,C, , , , INCOME your TAXABLE INCOME.........................>19
000,00,086, ,00,0, , , ,C, __________________________________________________________________________
000,00,087, ,00,0, , , ,C, STEP 7 CAUTION: Check if you are under age 14 and have
025,60,088,B,01,0,E, , , , more than $1,000 of investment income....>[ ]
000,00,089, ,00,0, , , ,C,
000,00,090, ,00,0, , , ,C, 20 Check if tax on the line 19 amount is from:
026,17,091,B,01,0,E, , , , [ ]Tax Table or [ ]Form 8615 20
027,37,091,B,01,0,E, , , ,
021,66,091,V,11,2,C, , , ,
000,00,092, ,00,0, , , ,C, 21 Credit for child and dependent care expenses.
022,66,093,V,11,2,E, , , , Complete and attach Schedule 1, Part I.......21
000,00,094, ,00,0, , , ,C,
023,66,095,V,11,2,C, , , , FIGURE 22 Subtract line 21 from line 20................22
000,00,096, ,00,0, , , ,C, YOUR TAX, 23 SUPPLEMENTAL MEDICARE PREMIUM. Complete
024,66,097,V,11,2,E, , , , CREDITS, and attach Schedule 2 (Form 1040A)...........23
000,00,098, ,00,0, , , ,C, AND 24 Add lines 22 and 23. This is your TOTAL
025,66,099,V,11,2,C, , , , PAYMENTS TAX and any supplemental Medicare premium...>24
000,00,100, ,00,0, , , ,C, 25a Total Federal income tax withheld - from Box 9 of
000,00,101, ,00,0, , , ,C, your W-2 form(s). (If any is from Form(s) 1099,
028,30,102,B,01,0,E, , , , check here.>[ ])..............25a
026,51,102,V,12,2,E, , , ,
000,00,103, ,00,0, , , ,C,
027,51,104,V,12,2,E, , , , b EARNED INCOME CREDIT..........25b
000,00,105, ,00,0, , , ,C, 26 Add lines 25a and 25b. These are
028,66,106,V,11,2,C, , , , ______________your TOTAL PAYMENTS.........................>26
000,00,107, ,00,0, , , ,C, STEP 8 27 If line 26 is more than line 24, subtract
029,66,108,V,11,2,C, , , , FIGURE line 24 from line 26. This is your REFUND...27
000,00,109, ,00,0, , , ,C, YOUR REFUND
000,00,110, ,00,0, , , ,C, OR AMOUNT 28 If line 24 is more than line 26, subtract line
000,00,111, ,00,0, , , ,C, YOU OWE 26 from line 24. This is the AMOUNT YOU OWE.
030,66,112,V,11,2,C, , , , ______________Attach check or money order for full amount..28
000,00,113, ,00,0, , , ,C, STEP 9 I declare that I have examined this return and to the best of
000,00,114, ,00,0, , , ,C, my knowledge and belief, it is true, correct, and complete.
000,00,115, ,00,0, , , ,C, Your signature Date Your occupation
000,00,116, ,00,0, , , ,C, SIGN
040,49,117,S,10,0,E, , , , YOUR X_______________________________
041,61,117,S,15,0,E, , , ,
000,00,118, ,00,0, , , ,C, RETURN Spouse's signature Date Spouse's occp
000,00,119, ,00,0, , , ,C,
040,49,120,S,10,0,E, , , , ___________X_______________________________
042,61,120,S,15,0,E, , , ,
000,00,121, ,00,0, , , ,C, PAID Preparer's signature Date Preparer's SSN
000,00,122, ,00,0, , , ,C, PREPARER'S
040,49,123,S,10,0,E, , , , USE ONLY X_______________________________
043,61,123,S,15,0,E, , , ,
000,00,124, ,00,0, , , ,C, Firm name Employer I.D.#
044,25,125,S,35,0,E, , , ,
045,61,125,S,15,0,E, , , ,
046,25,126,S,35,0,E, , , , Address Check if
047,25,127,S,10,0,E, , , , [ ] self-emp.
029,64,127,B,01,0,E, , , ,