Form 1040 U.S. Individual Income Tax Return 2012
Summary: This is an example of a Form 1040 (2009) with items included as described in the text. Additionally, these line items are
completed:
DECEASED
andJohn R. Smith--April 9, 2009
are written across the top of the form.
Label
Your first name and initial
field contains John R.Last name
field contains SmithYour social security number
field contains 234-00-7890If a joint return, spouse's first name and initial
field contains Mary L.Last name
field contains SmithSpouse's social security number
field contains 567-00-0123Home address (number and street). If you have a P.O. box, see page
14.
field contains 6406 Mayflower StreetCity, town or post office, state, and ZIP code. If you have a foreign address, see page
14.
field contains Juneville, Maine 00000
Filing Status
2. Married filing jointly (even if only one had income)
checkbox checked
Exemptions
6a. Yourself. If your parent (or someone else) can claim you as a dependent, do not check box
6a
checkbox checked6b. Spouse
checkbox checkedBoxes checked on 6a and 6b
field contains 2d. Total number of exemptions claimed. Add numbers on lines
above
field contains 2
Income
7. Wages, salaries, tips, etc. Attach Form(s) W-2
field contains 11,0008a. Taxable interest. Attach Schedule B if required
field contains 3,14017. Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule
E
field contains 8,18322. Add the amounts in the far right column for lines 7 through 21. This is your total
income.
field contains 22,323
Adjusted Gross Income
37. Subtract line 36 from line 22. This is your adjusted gross
income
field contains 22,323
Close Window