| 0007 |
Return Sequence Number |
|
| 0008 |
Declaration Control Number |
|
| 0010 |
Primary SSN |
|
| 0020 |
Primary Date of Death |
|
| 0030 |
Secondary SSN |
|
| 0040 |
Secondary Date of Death |
|
| 0050 |
Primary Name Control |
|
| 0055 |
Spouse's Name Control |
|
| 0060 |
Name Line 1 |
|
| 0062 |
Foreign Street Address |
|
| 0064 |
Foreign City, State or Province, Postal Code |
|
| 0066 |
Foreign Country |
|
| 0070 |
Name Line 2 |
|
| 0080 |
Street Address |
|
| 0083 |
City |
|
| 0087 |
State Abbreviation |
|
| 0095 |
Zip Code |
|
| 0097 |
Address Ind |
|
| 0098 |
Disaster Designation |
|
| 0100 |
Special Processing Literal |
|
| 0110 |
PECF Primary |
|
| 0120 |
PECF Spouse |
|
| 0130 |
Filing Status |
1-5 |
| 0135 |
Overseas Extension Explanation |
|
| 0140 |
Spouse's Name |
3 |
| 0150 |
Qualifying Name for H of Household |
4 |
| 0153 |
SSN for Qual Name |
4 |
| 0160 |
Exempt Self |
6a |
| 0163 |
Exempt Spouse |
6b |
| 0164 |
Exempt Spouse Name |
6b |
| 0165 |
Exempt Spouse Name Control |
6b |
| 0167 |
Total Box 6a and 6b |
|
| 0170 |
Dependent First Name 1 |
6c(1) |
| 0171 |
Dependent Last Name 1 |
6c(1) |
| 0172 |
Dependent Name Control - 1 |
|
| 0175 |
Dependent's SSN - 1 |
6c(2) |
| 0177 |
Relationship - 1 |
6c(3) |
| 0178 |
Eligibility for Child Tax Credit - 1 |
6c(4) |
| 0180 |
Dependent First Name 2 |
6c(1) |
| 0181 |
Dependent Last Name 2 |
6c(1) |
| 0182 |
Dependent Name control 2 |
|
| 0185 |
Dependent's SSN - 2 |
6c(2) |
| 0187 |
Relationship - 2 |
6c(3) |
| 0188 |
Eligibility for Child Tax Credit - 2 |
6c(4) |
| 0190 |
Dependent First Name 3 |
6c(1) |
| 0191 |
Dependent Last Name 3 |
6c(1) |
| 0192 |
Dependent Name Control - 3 |
|
| 0195 |
Dependent's SSN - 3 |
6c(2) |
| 0197 |
Relationship - 3 |
6c(3) |
| 0198 |
Eligibility for Child Tax Credit - 3 |
6c(4) |
| 0200 |
Dependent First Name 4 |
6c(1) |
| 0201 |
Dependent Last Name 4 |
6c(1) |
| 0202 |
Dependent Name Control 4 |
|
| 0205 |
Dependent's SSN - 4 |
6c(2) |
| 0207 |
Relationship - 4 |
6c(3) |
| 0208 |
Eligibility for Child Tax Credit - 4 |
6c(4) |
| 0240 |
Number of Children Who Lived with You |
6c |
| 0247 |
Number of Children Not living With You |
6c |
| 0350 |
Number of Other Dependents Listed |
6c |
| 0355 |
Total Exemptions |
6d |
| 0357 |
Deferred Compensation Plan Literal |
7 |
| 0358 |
Deferred Compensation Plan Amount |
7 |
| 0362 |
Prisoner Earned Income Literal |
7 |
| 0364 |
Prisoner Earned Income Amount |
7 |
| 0366 |
Household Help Literal |
7 |
| 0367 |
Household Help Amt |
7 |
| 0368 |
Adoption Literal |
7 |
| 0369 |
Adoption Amt |
7 |
| 0370 |
Fringe Benefit Literal |
7 |
| 0371 |
Dependent Care Benefits Literal |
7 |
| 0372 |
Scholarship Literal |
7 |
| 0373 |
Scholarship Amount |
7 |
| 0374 |
Non-W2 Disability Payment Explanation |
7 |
| 0375 |
Wages, Salaries,Tips |
7 |
| 0378 |
Foreign Employer Compensation Literal |
7 |
| 0379 |
Foreign Employer Compensation Total |
7 |
| 0380 |
Taxable Interest |
8a |
| 0385 |
Tax-Exempt Interest |
8b |
| 0390 |
F8814 Dividends Line 9a |
9a |
| 0391 |
F8814 Div Line 9a Amt |
9a |
| 0392 |
F8814 Dividends Line 9b |
9b |
| 0393 |
F8814 Div Line 9b Amt |
9b |
| 0394 |
Total Ordinary Dividends |
9a |
| 0396 |
Qualified Dividends |
9b |
| 0420 |
State/Local Income Tax Refund |
10 |
| 0430 |
Alimony Received |
11 |
| 0440 |
Business Income/Loss |
12 |
| 0447 |
Capital Distribution Box |
13 |
| 0450 |
Capital Gain/Loss |
13 |
| 0460 |
F4684 Literal |
14 |
| 0470 |
Other Gain/Loss |
14 |
| 0475 |
IRA Distributions Received |
15a |
| 0477 |
IRA Distribution Literal |
15a |
| 0479 |
IRA Distribution Explanation |
15b |
| 0480 |
Taxable IRA Amount |
15b |
| 0485 |
Pensions Annuities Received |
16a |
| 0487 |
Pensions and Annuities Literal |
16b |
| 0495 |
Taxable Pensions Amount |
16b |
| 0510 |
Rent/Royalty/Part/ Estates/Trusts Inc |
17 |
| 0520 |
Farm Income |
18 |
| 0545 |
Repayment Literal |
19 |
| 0551 |
Repayment Amount |
19 |
| 0552 |
Unemployment Compensation |
19 |
| 0553 |
Social Security Benefits |
20a |
| 0555 |
SS Benefit Indicator |
20a |
| 0557 |
Taxable Amount of Social Security |
20b |
| 0560 |
Type of Other Income |
21 |
| 0570 |
Amount of Other Income |
21 |
| 0574 |
Housing/Foreign Earned Income Exclusion Literal |
21 |
| 0577 |
Housing/Foreign Earned Income Exclusion Amount |
21 |
| 0590 |
Total Other Income |
21 |
| 0600 |
Total Income |
22 |
| 0622 |
Archer MSA Deduction |
23 |
| 0624 |
Bus Expenses Reservists & Others |
24 |
| 0635 |
Health Savings Account Deduction |
25 |
| 0637 |
Current Year Moving Expenses |
26 |
| 0640 |
Self-Employed Deduction Schedule SE |
27 |
| 0650 |
Keogh/SEP/SIMPLE Deduction |
28 |
| 0670 |
Self-Employed Health Insurance Ded |
29 |
| 0680 |
Early Withdrawal Penalty |
30 |
| 0693 |
Recip Soc Sec No. |
31b |
| 0695 |
Alimony Amount |
31a |
| 0697 |
Total Alimony Paid |
31a |
| 0700 |
IRA Deduction |
32 |
| 0702 |
Student Loan Interest Deduction |
33 |
| 0707 |
Jury Duty Pay |
34 |
| 0710 |
Domestic Production Activities Ded |
35 |
| 0720 |
Other Adjustments Literal |
36 |
| 0730 |
Other Adjustment Amount |
36 |
| 0735 |
Total Other Adjustments |
36 |
| 0740 |
Total Adjustments |
36 |
| 0750 |
Adjusted Gross Income |
37 |
| 0770 |
AGI Repeated |
38 |
| 0772 |
Self 65 or Over Box |
39a |
| 0774 |
Self Blind Box |
39a |
| 0776 |
Spouse 65 or Over Box |
39a |
| 0778 |
Spouse Blind Box |
39a |
| 0783 |
Total Boxes Checked |
39a |
| 0786 |
Must Itemize Indicator |
39b |
| 0787 |
Modified Standard Deduction Ind |
40 |
| 0789 |
Total Itemized or Standard Deduction |
40 |
| 0800 |
AGI Less Deduction |
41 |
| 0810 |
Exemption Amount |
42 |
| 0820 |
Taxable Income |
43 |
| 0853 |
Form 8814 Block |
44a |
| 0857 |
Form 8814 Amount |
44a |
| 0880 |
Form 4972 Block |
44b |
| 0890 |
Education Credit Recapture Literal |
44 |
| 0900 |
Education Credit Recapture Amount |
44 |
| 0915 |
Tax |
44 |
| 0918 |
Alternative Minimum Tax |
45 |
| 0920 |
Total Tax Before Credits & Other Taxes |
46 |
| 0922 |
Foreign Tax Credit |
47 |
| 0925 |
Credit for Child & Dependent Care |
48 |
| 0930 |
Credit for Elderly or Disabled |
49 |
| 0935 |
Education Credits (Form 8863) |
50 |
| 0937 |
Retirement Savings Contribution Credit |
51 |
| 0941 |
Residential Energy Credits |
52 |
| 0955 |
Child Tax Credit |
53 |
| 0985 |
Form 8396, Mortgage Interest Credit Block |
54a |
| 0987 |
Form 8839, Adoption Credit Block |
54b |
| 0990 |
Form 8859, DC First-Time Home Credit Block |
54c |
| 0995 |
Credits from F8396, F8839 & F8859 |
54 |
| 1000 |
Form 3800 Block |
55a |
| 1005 |
Form 8801 Block |
55b |
| 1006 |
Specify Other Credit Block |
55c |
| 1010 |
Specify Other Credit Literal |
55c |
| 1015 |
Other Credits |
55 |
| 1020 |
Total Credits |
56 |
| 1030 |
Tax Less Credits |
57 |
| 1035 |
Exempt SE Tax Indicator |
|
| 1040 |
Self Employment Tax |
58 |
| 1070 |
Railroad Retire Indicator |
59 |
| 1080 |
Social Security & Medicare tax on Tips |
59 |
| 1095 |
Retirement Tax Plan Literal |
60 |
| 1100 |
Tax on Retirement Plans |
60 |
| 1105 |
Advanced EIC Payments |
61 |
| 1107 |
Household Employment Taxes |
62 |
| 1110 |
Other Tax Literal |
63 |
| 1112 |
Other Tax Amount |
63 |
| 1114 |
F8611 Literal |
63 |
| 1116 |
F8611 Amount |
63 |
| 1118 |
Form 8693 Approved Indicator |
63 |
| 1119 |
Form 8693 Approved Date |
63 |
| 1121 |
F4255 Literal |
63 |
| 1122 |
F4255 Amount |
63 |
| 1123 |
F8828 Literal |
63 |
| 1124 |
F8828 Amount |
63 |
| 1126 |
F8834 Literal |
63 |
| 1128 |
F8834 Amount |
63 |
| 1129 |
F8697 Literal or F8866 Literal |
63 |
| 1131 |
F8697 Amount or F8866 Amount |
63 |
| 1132 |
F8845 Literal |
63 |
| 1134 |
F8845 Amount |
63 |
| 1136 |
F8882 Literal |
63 |
| 1137 |
F8882 Amount |
63 |
| 1139 |
F8874 Literal |
63 |
| 1141 |
F8874 Amount |
63 |
| 1145 |
Total Other Tax |
63 |
| 1150 |
Total Tax |
63 |
| 1155 |
Other 1099 Withholding Literal |
64 |
| 1160 |
Withholding |
64 |
| 1161 |
Divorced Spouse SSN |
65 |
| 1162 |
Divorced Literal |
65 |
| 1170 |
ES Payments |
65 |
| 1173 |
Estimated Payment Name Change |
65 |
| 1178 |
EIC Literal |
66a |
| 1180 |
Earned Income Credit |
66a |
| 1183 |
EIC Eligibility |
66a |
| 1185 |
Nontaxable Combat Pay Election |
66b |
| 1188 |
Excess SS & Tier 1 RRTA Tax |
67 |
| 1192 |
Additional Child Tax Credit (Form 8812) |
68 |
| 1197 |
F4868 Amount |
69 |
| 1202 |
Form 2439 Block |
70a |
| 1205 |
Form 4136 Block |
70b |
| 1208 |
Form 8885 Block |
70c |
| 1210 |
Other Payments |
70 |
| 1245 |
Form 8689 Literal |
70 |
| 1246 |
Form 8689 Amount |
70 |
| 1247 |
Federal Telephone Excise Tax Form 8913 |
71 |
| 1248 |
Federal Phone Excise Tax Credit |
71 |
| 1250 |
Total Payments |
72 |
| 1260 |
Overpaid |
73 |
| 1262 |
Direct Deposit-Yes |
|
| 1263 |
Direct Deposit-No |
|
| 1270 |
Refund |
74a |
| 1271 |
Form 8888 Block |
74a |
| 1272 |
Routing Transit Number |
74b |
| 1274 |
Checking Account Indicator |
74c |
| 1276 |
Savings Account Indicator |
74c |
| 1278 |
Depositor Account Number |
74d |
| 1280 |
Applied to ES Tax |
75 |
| 1290 |
Amount Owed |
76 |
| 1295 |
ES Penalty Indicator |
77 |
| 1300 |
ES Penalty Amount |
77 |
| 1303 |
Third Party Designee "Yes" Box |
|
| 1305 |
Third Party Designee "No" Box |
|
| 1307 |
Third Party Designee Name |
|
| 1309 |
Third Party Designee Telephone Number |
|
| 1313 |
Third Party Designee PIN |
|
| 1315 |
Remittance |
|
| 1317 |
Filing A Community Property State Return |
|
| 1321 |
Primary Taxpayer Signature |
|
| 1323 |
Occupation |
|
| 1324 |
Spouse Signature |
|
| 1325 |
Surviving Spouse |
|
| 1326 |
Personal Representative |
|
| 1327 |
Spouse Occupation |
|
| 1328 |
Taxpayer Daytime Telephone Number |
|
| 1329 |
Taxpayer Optional Foreign Telephone Number |
|
| 1338 |
Non-Paid Preparer |
|
| 1340 |
Name of Paid Preparer |
|
| 1350 |
Preparer Self-Employment Indicator |
|
| 1360 |
Preparer SSN/Preparer TIN |
|
| 1370 |
Preparer Firm Name |
|
| 1380 |
Preparer Firm EIN |
|
| 1390 |
Firm City |
|
| 1400 |
Firm State |
|
| 1410 |
Firm Zip |
|
| 1420 |
Firm Telephone Number |
|
| 1465 |
RAL Indicator |
|
| 1470 |
Refund Indicator |
|