�1040 U.S. Individual Income Tax Return �@20
Department of the Treasury-Internal Revenue Service
Filing Status
Check only
one box.
[Z] Single
D
Married filing jointly
D
(99)
0MB No. 1545-0074
Married filing separately (MFS)
D
IRS Use Only-Do not write or staple in this space.
Head of household (HOH)
D
Qualifying widow(er) (QW)
If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child's name if the qualifying
person is a child but not your dependent ►
Your first name and middle initial
Last name
If joint return, spouse's first name and middle initial
Last name
John
Doe
P.O. Box 5555
I
City, town, or post office. If you have a foreign address, also complete spaces below.
I
Foreign country name
123 45 6789
Spouse's social security number
Home address (number and street). If you have a P.O. box, see instructions.
Anytown
Your social security number
#98765-012
I
Apt. no.
Presidential Election Campaign
Check here if you, or your
spouse if filing jointly, want $3
ZIP code
to go to this fund. Checking a
box below will not change
Foreign postal code your tax or refund.
State
State
ZIP
Foreign province/state/county
At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency?
D
D
Age/Blindness You:
D
Were born before January 2, 1956
(see instructions):
(1) First name
If more
than four
dependents,
see instructions
and check
here ►
Dependents
D
Attach
Sch. B if
required.
standard
Deduction for-
Single or
Married filing
separately,
$12,400
Married filing
jointly or
Qualifying
widow(er),
$24,800
Head of
household,
$18,650
If you checked
any box under
Standard
D
Someone can claim:
You as a dependent
Your spouse as a dependent
Spouse itemizes on a separate return or you were a dual-status alien
Standard
Deduction
1
2a
3a
4a
5a
6a
7
8
9
10
a
b
C
11
12
13
Deduction,
see instructions. 14
15
Last name
D Are blind
Spouse:
(2) Social security
number
D
Was born before January 2, 1956
to you
Charitable contributions if you take the standard deduction. See instructions
Add lines 10a and 1Ob. These are your total adjustments to income
Subtract line 10c from line 9. This is your adjusted gross income
Standard deduction or itemized deductions (from Schedule A)
Qualified business income deduction. Attach Form 8995 or Form 8995-A
Add lines 12 and 13
Taxable income. Subtract line 14 from line 11. If zero or less, enter -0- .
I
spouse
D Yes 0 No
D
Is blind
(4) t/ if qualifies for (see instructions):
Credit for other dependents
Child tax credit
(3) Relationship
Wages, salaries, tips, etc. Attach Form(s) W-2
Tax-exempt interest
2a
b Taxable interest
3a
Qualified dividends
b Ordinary dividends
IRA distributions
4a
b Taxable amount .
5a
Pensions and annuities
b Taxable amount .
Social security benefits
6a
b Taxable amount .
Capital gain or (loss). Attach Schedule D if required. If not required, check here
Other income from Schedule 1, line 9 .
Add lines 1, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
Adjustments to income:
1o a
From Schedule 1, line 22
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
□
0You
□
□
□
□
1
2b
□
□
□
□
3b
►
□
4b
5b
6b
7
8
►
9
►
►
10c
11
12
13
I
I 1o b I
Cat. No. 113208
14
15
12,400
12,400
0
Form
1040 (2020)
The Recovery Rebate Credit was eligible to be paid in two rounds of advance payments during 2020 and early 2021.
These advanced payments are referred to as the first and second Economic Impact Payments.
U.S. citizens and U.S. resident aliens may be eligible to claim the Recovery Rebate Credit on Form 1040 if:
1. they did not receive the full amount of each payment,
2. no one else can claim them as a dependent on their 2020 federal income tax return AND
3. they have a social security number (SSN) that is valid for employment in the United States.
If you do not file a joint tax return with your spouse,
and claim no qualifying
children who live with you, claim the Recovery Rebate Credit as follows:
Select 'Single' or 'Married filing separately' as your filing status.
Enter your name, SSN, and address information and answer the question about virtual currency.
Enter your income on lines 1 through 8 followed by the $12,400 standard deduction on lines 12 and 14.
Enter the Recovery Rebate Credit amount on lines 30, 32, 33, 34, and 35a.
If the IRS did not issue you either Economic Impact Payment, enter $1,800.
If the IRS issued a $1,200 payment only, enter $600. If the IRS issued a $600 payment only, enter $1,200.
Sign and date the tax return.
U.S. territory residents should not follow these simplified instructions and should contact their territory tax authorities.
Form 1040 (2020)
0
0
Page2
30
C
4972
Tax (see instructions). Check if any from Form(s): 1
8814 2
Amount from Schedule 2, line 3
Add lines 16 and 17
Child tax credit or credit for other dependents
Amount from Schedule 3, line 7
Add lines 19 and 20
Subtract line 21 from line 18. If zero or less, enter -0Other taxes, including self-employment tax, from Schedule 2, line 10
Add lines 22 and 23. This is your total tax
Federal income tax withheld from:
Form(s) W-2
Form(s) 1099
Other forms (see instructions)
d
Add lines 25a through 25c
25d
2020 estimated tax payments and amount applied from 2019 return .
Earned income credit (EiC)
27
Additional child tax credit. Attach Schedule 8812
28
American opportunity credit from Form 8863, line 8 .
29
Recovery rebate credit. See instructions
30
31
Amount from Schedule 3, line 13
Add lines 27 through 31. These are your total other payments and refundable credits
Add lines 25d, 26, and 32. These are your total payments
26
16
17
18
19
20
21
22
23
24
25
a
b
26
27
If you have a
qualifying child,
attach Sch. EiC. 28
If you have
nontaxable
29
combat pay,
see instructions. 30
31
32
33
16
17
18
19
20
21
22
23
►
24
25a
25b
25c
1,800
►
►
32
33
34
35a
Direct deposit?
►b
See instructions.
►d
36
If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid
►
Amount of line 34 you want refunded to you. If Form 8888 is attached, check here
► cType:
Routing number !
Checking
Savings
Account number I
►
Amount of line 34 you want applied to your 2021 estimated tax
36
□
34
35a
Amount
You Owe
Subtract line 33 from line 24. This is the amount you owe now
►
37
Refund
37
For details on
how to pay, see
instructions.
38
Third Party
Designee
Sign
Here
D
Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for
2020. See Schedule 3, line 12e, and its instructions for details.
►
Estimated tax penalty (see instructions)
38
I
Do you want to allow another person to discuss this return with the IRS? See
instructions
►
Designee's
name ►
Phone
no. ►
I
D Yes. Complete below. D No
I
Personal identification r--""T""---.--r-"""T---.
number (PIN) ►
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
John Doe
Joint return?
See instructions. ,. Spouse's signature. If a joint return, both must sign.
Keep a copy for
your records.
Paid
Preparer
Use Only
D
1,800
1,800
1,800
1,800
Phone no.
Preparer's name
Firm's name ►
I
Your occupation
If the IRS sent you an Identity
Protection PIN, enter it here
(see inSl.) ►
Spouse's occupation
If the IRS sent your spouse an
Identity Protection PIN, enter it here
(see inSl.) ►
I I I I I I I
3/15/21
Date
Email address
Preparer's signature
I
Date
Firm's address ►
I
I I I I I I I
PTIN
Phone no.
I
Check if:
D Self-employed
Firm's EIN ►
Go to www.irs.gov/Form1040 for instructions and the latest information.
Form
1040 (2020)
Mailing addresses are based on the state you live in:
Alabama, Ar ansas, Delaware, eorgia, Illinois, Indiana, Iowa, entuc y, Maine, Massachusetts, Minnesota, Missouri,
New Hampshire, New ersey, New Yor , North Carolina, South Carolina, Tennessee, O lahoma, ermont, irginia, isconsin
ail to Department of the Treasury, Internal Revenue Service, ansas City, MO 4
0002
Alas a, California, Hawaii, Ohio, ashington
Until une 18, 2021
ail to Department of the Treasury, Internal Revenue Service, Fresno, CA 3888 0002
After une 18, 2021
ail to Department of the Treasury, Internal Revenue Service, Ogden, UT 84201 0002
Arizona, Colorado, Connecticut, District of Columbia, Idaho, ansas, Maryland, Michigan, Montana, Nebras a, Nevada,
New Mexico, North Da ota, Oregon, Pennsylvania, Rhode Island, South Da ota, Utah, est irginia, yoming
ail to Department of the Treasury, Internal Revenue Service, Ogden, UT 84201 0002
Florida, ouisiana, Mississippi, Texas
ail to Department of the Treasury, Internal Revenue Service, Austin, T
3301 0002