Department of 11w Tirasury—Iniernal Revenue Service

Department of 11w Tirasury—Iniernal Revenue Service 1040EZ Your fast name and inthal Last name Your social security number If a joint return. spouse's first name and initial Last name Spouse's social security number Home address (number and sheet). 1( you have a P.O. box. see instructions. Apt. no. A Make sure the SSN(s) above are correct. City. town or post office. state. and ZIP code. If you have a foreign ad:Iress. also complete spaces below (see instructions). Presidential Election Campaign Check here ave.,. &your spouse4 fling jot* a box wag t3 toga to ths Iona Cheding Wow ad nlaangsyoir tax or rebind. Ell you osp.... Foreign country name Foreign province/state/county Reign postal code Income Income Tax Return for Single and Joint Filers With No Dependents (99) 2017 OMB No. 1543.007.1 Attach Form(s) W-2 here. Enclose. but do not attach, any payment. 1 Wages. salaries, and tips. This should be shown in box I of your Fonn(s) W-2. Attach your Form(s) W-2. 1 2 Taxable interest. If the total is over $1,500, you cannot use Form 1040EZ. 2 3 Unemployment compensation and Alaska Permanent Fund dividends (see instructions). 3 4 Add lines 1. 2, and 3. This is your adjusted gross Income. S If someone can claim you (or your spouse if a joint return) as a dependent. check the applicable box(es) below and enter the amount from the worksheet on back. O You O Spouse If no one can claim you (or your spouse if a joint return), enter $10.400 if single; $20,800 if married Ming Jointly. See back for explanation. 6 Subtract line 5 from line 4. If line 5 is larger than line 4, enter -0-. This is your taxable Income. 10' 6 7 Federal income tax withheld from Form(s) W-2 and 1099. 7 8a Earned Income credit (EIC) (see instructions) 8a 4 5 Payments, Credits, and Tax b Nontaxable combat pay election. 8b 9 Add lines 7 and 8a. These are your total payments and credits. P. 9 10 Tax. Use the amount on line 6 above to find your tax in the tax table in the instructions. Then, enter the tax from the table on this line. 10 11 Health care: individual responsibility (see instructions) Full-year coverage I I 11 12 Add lines 10 and II. This is your total tax. 12 13a If line 9 is larger than line 12, subtract line 12 from line 9. This is your refund. If Form 8888 is attached, check here P. K 13a Refund Have it directly deposited! See insubctions and fill in 13b. 1k. and I 3d. or Form SSS8. ► b Routing number ► c Type: O Checking K Savings ► d Account number Amount You Owe 14 If line 12 is larger than line 9. subtract line 9 from line 12. This is the amount you owe. For details on how to pay. see instructions. IP 14 Third Party Designee Sign Here Do you want to allow another person to discuss this return with the IRS (see instructions)? O Yes. Complete below. Designee's MOW Personal rdenlilieahon name ► ix. I. number WIN) ► Under penalties of penury. I declare that I have examined this return and. to the best of my knowledge and belief. it is true. correct and accurately lists all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxpayer) is based on all rformation of which the preparer has any knowledge. Your signature Date Your occupation Daytime phone number O No Joint return? See instructions. Keep a copy for your records. Paid Preparer Use Only Spouse's signet's.). If a joint return. both must sign. Date Spouse's occupation If the IRS sent you an Walley Protector, PIN. enter it here(see inst.) Print/Type preparer's name Preparer's signature Date Check K if self-employed PTIN Firm's name e Firm's EIN ► Firm's address a Phone no. For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040EZ (2017) EFTA01222560