Form 1040 (2011) Page 2

Summary: This is an example of Form 1040 (2011), page 2 as pertains to the text. The completed line items are:

Under Tax and Credits:
- 38. Amount from line 37 (adjusted gross income) field contains negative 2,350
- 40. Itemized deductions (from Schedule A) or your standard deduction (see left margin) field contains 5,800
- 41. Subtract line 40 from line 38 field contains negative 8,150
- 42. Exemptions. Multiply $3,700 by the number on line 6d. field contains 3,700
- 43. Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter 0 field contains 0
Under Sign Here:
- Your signature field contains Glenn M. Johnson
- Date field contains 2-4-2011
- Your occupation field contains Self-employed