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Form 1040A 2013 U.S. Individual Income Tax Return Department of the Treasury—Internal Revenue Service IRS Use Only—Do not write or staple in this space. (99) OMB No. 1545-0074 Your first name and initial Last name Your social security number If a joint return, spouse’s first name and initial Last name Spouse's social security number c Make sure the SSN(s) above and on line 6c are correct. Home address (number and street). If you have a P.O. box, see instructions. Apt. no. City, town or post office. If you have a foreign address, also complete spaces below (see instructions). Foreign country name Foreign province/state/county Foreign postal code Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse Filing status Check only one box. 1 Single 2 Married filing jointly (even if only one had income) 3 Married filing separately. Enter spouse’s SSN above and full name here. a 4 Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child’s name here. a 5 Qualifying widow(er) with dependent child (see instructions) Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box 6a. b Spouse } c Dependents: (1) First name Last name (2) Dependent’s social security number (3) Dependent’s relationship to you (4) if child under age 17 qualifying for child tax credit (see instructions) If more than six dependents, see instructions. d Total number of exemptions claimed. Boxes checked on 6a and 6b No. of children on 6c who: • lived with you • did not live with you due to divorce or separation (see instructions) Dependents on 6c not entered above Add numbers on lines above a Income Attach Form(s) W-2 here. Also attach Form(s) 1099-R if tax was withheld. If you did not get a W-2, see instructions. 7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7 8a Taxable interest. Attach Schedule B if required. 8a b Tax-exempt interest. Do not 9a Ordinary dividends. Attach Schedule B if required. 9a b Qualified dividends (see instructions). 9b 10 Capital gain distributions (see instructions). 10 11 a IRA distributions. 11a 11b Taxable amount (see instructions). 11b 12 a Pensions and annuities. 12a 12b Taxable amount (see instructions). 12b 13 Unemployment compensation and Alaska Permanent Fund dividends. 13 14 a Social security benefits. 14a 14b Taxable amount (see instructions). 14b 15 Add lines 7 through 14b (far right column). This is your total income. a 15 Adjusted gross income 16 Educator expenses (see instructions). 16 17 IRA deduction (see instructions). 17 18 Student loan interest deduction (see instructions). 18 19 Tuition and fees. Attach Form 8917. 19 20 Add lines 16 through 19. These are your total adjustments. 20 21 Subtract line 20 from line 15. This is your adjusted gross income. a 21 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11327A Form 1040A (2013) include on line 8a. 8b State ZIP code ----------------Page (0) Break---------------- Form 1040A (2013) Page 2 Tax, credits, and payments 22 Enter the amount from line 21 (adjusted gross income). 22 23 a Check if: { You were born before January 2, 1949, Blind Spouse was born before January 2, 1949, Blind } Total boxes checked a 23a b If you are married filing separately and your spouse itemizes deductions, check here a 23b Standard Deduction for- • People who check any box on line 23a or 23b or who can be claimed as a dependent, see instructions. • All others: Single or Married filing separately, $6,100 Married filing jointly or Qualifying widow(er), $12,200 Head of household, $8,950 24 Enter your standard deduction. 25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 25 26 Exemptions. Multiply $3,900 by the number on line 6d. 26 27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-. This is your taxable income. a 27 28 Tax, including any alternative minimum tax (see instructions). 28 29 Credit for child and dependent care expenses. Attach Form 2441. 29 30 Credit for the elderly or the disabled. Attach Schedule R. 30 31 Education credits from Form 8863, line 19. 31 32 Retirement savings contributions credit. Attach Form 8880. 32 33 Child tax credit. Attach Schedule 8812, if required. 33 34 Add lines 29 through 33. These are your total credits. 34 35 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is your total tax. 35 36 Federal income tax withheld from Forms W-2 and 1099. 36 37 2013 estimated tax payments and amount applied from 2012 return. 37 If you have a qualifying child, attach Schedule EIC. 38a Earned income credit (EIC). 38a b Nontaxable combat pay election. 38b 39 Additional child tax credit. Attach Schedule 8812. 39 40 American opportunity credit from Form 8863, line 8. 40 41 Add lines 36, 37, 38a, 39, and 40. These are your total payments. a 41 Refund Direct deposit? See instructions and fill in 43b, 43c, and 43d or Form 8888. 42 If line 41 is more than line 35, subtract line 35 from line 41. This is the amount you overpaid. 42 43a Amount of line 42 you want refunded to you. If Form 8888 is attached, check here a 43a a b Routing number a c Type: Checking Savings a d Account number 44 Amount of line 42 you want applied to your 2014 estimated tax. 44 Amount you owe 45 Amount you owe. Subtract line 41 from line 35. For details on how to pay, see instructions. a 45 46 Estimated tax penalty (see instructions). 46 Third party designee Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete the following. No Designee’s name a Phone no. a Personal identification number (PIN) a Sign here Joint return? See instructions. Keep a copy for your records. Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the be st of my knowledge and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Decla ration of preparer (other than the taxpayer) is based on all information of which the preparer has any knowledge. F Your signature Date Your occupation Daytime phone number Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protection PIN, enter it here (see inst.) Paid preparer use only Print/type preparer's name Preparer’s signature Date Check a if self-employed PTIN Firm's name a Firm's address a Firm's EIN a Phone no. Form 1040A (2013) 24 ----------------Page (1) Break----------------