Department of the Treasury—Internal Revenue Service Form
(See page 9.)
Income Tax Return for Single and Joint Filers With No Dependents (99) Your first name and initial
L A B E L H E R E
OMB No. 1545-0074 Your social security number Spouse’s social security number Apt. no.
Last name Last name
Use the IRS label.
Otherwise, please print or type.
Presidential Election Campaign (see page 9)
If a joint return, spouse’s first name and initial
Home address (number and street). If you have a P.O. box, see page 9. City, town or post office, state, and ZIP code. If you have a foreign address, see page 9.
You must enter your SSN(s) above. Checking a box below will not change your tax or refund.
Check here if you, or your spouse if a joint return, want $3 to go to this fund . 1 Wages, salaries, and tips. This should be shown in box 1 of your Form(s) W-2. Attach your Form(s) W-2.
You 1 2 3 4
Attach Form(s) W-2 here.
Enclose, but do not attach, any payment.
You may benefit from filing Form 1040A or 1040. See Before You Begin on page 4.
Taxable interest. If the total is over $1,500, you cannot use Form 1040EZ. Unemployment compensation in excess of $2,400 per recipient and Alaska Permanent Fund dividends (see page 11). Add lines 1, 2, and 3. This is your adjusted gross income. If someone can claim you (or your spouse if a joint return) as a dependent, check the applicable box(es) below and enter the amount from the worksheet on back. You Spouse If no one can claim you (or your spouse if a joint return), enter $9,350 if single; $18,700 if married filing jointly. See back for explanation. Subtract line 5 from line 4. If line 5 is larger than line 4, enter -0-. This is your taxable income. Federal income tax withheld from Form(s) W-2 and 1099. Making work pay credit (see worksheet on back). Earned income credit (EIC) (see page 13). Nontaxable combat pay election. 9b Add lines 7, 8, and 9a. These are your total payments and credits. Tax. Use the amount on line 6 above to find your tax in the tax table on pages 27 through 35 of the instructions. Then, enter the tax from the table on this line. If line 10 is larger than line 11, subtract line 11 from line 10. This is your refund. If Form 8888 is attached, check here Routing number Account number If line 11 is larger than line 10, subtract line 10 from line 11. This is the amount you owe. For details on how to pay, see page 19.
5 6 7 8 9a 10 11 12a
Payments, Credits, and Tax
7 8 9a b 10 11 12a b d 13
Have it directly deposited! See page 18 and fill in 12b, 12c, and 12d or Form 8888.
Amount you owe Third party designee
Yes. Complete the following. No
Do you want to allow another person to discuss this return with the IRS (see page 20)?
Joint return? See page 6.
Keep a copy for your records.
Designee’s Phone Personal identification name no. number (PIN) Under penalties of perjury, I declare that I have examined this return, and to the best of my knowledge and belief, it is true, correct, and accurately lists 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 occupation Daytime phone number Your signature Date Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation Date Preparer’s SSN or PTIN
Paid preparer’s use only
Preparer’s signature Firm’s name (or yours if self-employed), address, and ZIP code
Check if self-employed EIN Phone no.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 36.
Cat. No. 11329W
Form 1040EZ (2009)
Form 1040EZ (2009)
Worksheet for Use this worksheet to figure the amount to enter on line 5 if someone can claim you (or your spouse if married filing jointly) as a dependent,...
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