Professional Documents
Culture Documents
1040
2015
(99)
, 2015, ending
For the year Jan. 1Dec. 31, 2015, or other tax year beginning
Your first name and initial
Last name
, 20
Abigail
Boxer
6 7 6 7 3 3 3 1 1
Last name
Apt. no.
Home address (number and street). If you have a P.O. box, see instructions.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Filing Status
Check only one
box.
Exemptions
Foreign province/state/county
1
2
3
6a
b
c
Attach Form(s)
W-2 here. Also
attach Forms
W-2G and
1099-R if tax
was withheld.
Adjusted
Gross
Income
Spouse
.
Dependents:
(2) Dependents
social security number
Last name
Helen Boxer
(3) Dependents
relationship to you
6 7 6 7 3 3 3 1 2
Boxes checked
on 6a and 6b
No. of children
on 6c who:
lived with you
did not live with
you due to divorce
or separation
(see instructions)
Daughter
1
1
Dependents on 6c
not entered above
Income
the qualifying person is a child but not your dependent, enter this
Single
Married filing jointly (even if only one had income)
42500
.
8b
. .
8a
230
9a
8a
b
9a
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.
125
. . .
10
11
Qualified dividends . . . . . . . . . . .
9b
Taxable refunds, credits, or offsets of state and local income taxes
Alimony received . . . . . . . . . . . . . . .
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10
11
12
13
14
12
13
14
15a
16a
17
IRA distributions .
15a
b Taxable amount
. . .
Pensions and annuities 16a
b Taxable amount
. . .
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E
15b
16b
17
18
19
20a
18
19
20b
21
22
23
Educator expenses
24
25
24
25
26
27
28
26
27
28
29
30
31a
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32
33
34
29
30
31a
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32
33
34
35
36
37
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Add numbers on
lines above
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.
. . . . . .
. . . . . .
b Taxable amount
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21
22
42730
23
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For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
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36
37
42730
Form
1040
(2015)
Page 2
38
Tax and
Credits
39a
Check
if:
Standard
Deduction
for
People who
check any
box on line
39a or 39b or
who can be
claimed as a
dependent,
see
instructions.
All others:
Single or
Married filing
separately,
$6,300
Married filing
jointly or
Qualifying
widow(er),
$12,600
Head of
household,
$9,250
Other
Taxes
Payments
If you have a
qualifying
child, attach
Schedule EIC.
Sign
Here
Paid
Preparer
Use Only
Blind.
Blind.
39b
42
43
Exemptions. If line 38 is $154,950 or less, multiply $4,000 by the number on line 6d. Otherwise, see instructions
Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . .
Form 4972 c
Tax (see instructions). Check if any from: a
Form(s) 8814 b
44
45
46
47
48
49
50
51
52
53
54
55
56
57
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48
52
Residential energy credits. Attach Form 5695 . . . .
53
3800 b
8801 c
Other credits from Form: a
54
Add lines 48 through 54. These are your total credits . . . . .
Subtract line 55 from line 47. If line 55 is more than line 47, enter -0-
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8919
Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required
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58
59
60a
b
61
62
63
Form 8960 c
Taxes from: a
Form 8959 b
Add lines 56 through 62. This is your total tax . .
67
68
69
70
71
72
75
76a
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.
4137
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. . . . .
Instructions; enter code(s)
. . . . . . . . . . .
64
Federal income tax withheld from Forms W-2 and 1099 . .
5160
2015 estimated tax payments and amount applied from 2014 return
65
Earned income credit (EIC) . . . . . . . . . . 66a
67
.
.
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.
68
69
70
71
72
Credits from Form: a
2439 b
Reserved c
8885 d
73
Add lines 64, 65, 66a, and 67 through 73. These are your total payments .
Excess social security and tier 1 RRTA tax withheld
.
.
.
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.
40
41
42
33480
8000
43
25480
44
45
46
47
3164
9250
55
56
57
3164
58
59
60a
60b
Full-year coverage
42730
49
50
51
Credit for child and dependent care expenses. Attach Form 2441
64
65
66a
b
.
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38
Total boxes
checked 39a
.
.
61
62
63
3164
.
.
74
5160
If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid
75
1996
Amount of line 75 you want refunded to you. If Form 8888 is attached, check here
76a
1996
b
d
c Type:
Routing number
Checking
Savings
Account number
Amount of line 75 you want applied to your 2016 estimated tax 77
77
78
Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions 78
79
Estimated tax penalty (see instructions) . . . . . . .
79
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Yes. Complete below.
No
Personal identification
number (PIN)
Phone
no.
Designees
name
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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature
Date
Your occupation
Date
Spouses occupation
Itemized deductions (from Schedule A) or your standard deduction (see left margin)
Subtract line 40 from line 38
. . . . . . . . . . . . . . . . .
Third Party
Designee
40
41
Direct deposit?
See
instructions.
Amount
You Owe
If your spouse itemizes on a separate return or you were a dual-status alien, check here
73
74
Refund
Firms name
Preparers signature
Date
Firm's EIN
Firms address
Phone no.
www.irs.gov/form1040