Form 1040A (2011), Page 2

• Under Tax, credits, and payments:
• • 24. Enter your standard deduction. field contains 1,850
  • 25. Subtract line 24 from line 22. If line 24 is more than line 22, enter 0. field contains 2,500
  • 27. Subtract line 26 from line 25. If line 26 is more than line 25, enter 0. This is your taxable income. field contains 2,500
  • 28. Tax, including any alternative minimum tax (see instructions). field contains 86
  • 35. Subtract line 34 from line 28. If line 34 is more than line 28, enter 0. This is your total tax. field contains 86
  • 36. Federal income tax withheld from Forms W-2 and 1099.. field contains 155
  • 37. 2011 estimated tax payments and amount applied from 2010 return. field contains 100
  • 41. Add lines 36, 37, 38a, 39, and 40. These are your total payments. field contains 255
• Under Refund:
• • 42. If line 41 is more than line 35, subtract line 35 from line 41. This is the amount you overpaid. field contains 169
  • 43a. Amount of line 42 you want refunded to you. If Form 8888 is attached, check here field contains 169
• b. Routing number field contains 090000000
• c Type: Checking checkbox, Savings checkbox
• d Account number field contains 123456789
• Third party designee field contains Bob Blake
• Phone no. field contains 800–829–1040
• Personal identification number (PIN) field contains 56789
• Under Sign here:
• • Your signature field contains Joshua A. Blake
  • Date field contains 2-15-12
  • Your occupation field contains Student
  • Daytime phone number field contains (800) 829-1040

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