IRS 1040-A U.S. Individual Income Tax Return Form

In the case of wanting to know the value of individual itemized deductions, the following form has to be completed and submitted.

Extracted Text for Proper Search

Form 
1040A2012	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 
▲	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 instruct\
ions. 	Apt. no. 	
City, town or post office, state, and ZIP code. If you have a foreign ad\
dress, 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. 	▶	
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.  	▶	
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.	
dTotal 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 	
▶	
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.  
  
Enclose, but do 
not attach, any 
payment. Also, 
please use Form 
1040-V.	
7 Wages, salaries, tips, etc. Attach Form(s) W-2. 7
8aTaxable interest. Attach Schedule B if required. 8a
bTax-exempt interest. Do not include on line 8a. 8b
9a	Ordinary dividends. Attach Schedule B if required.	9a	
bQualified dividends (see instructions). 9b	
10Capital 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	
13Unemployment compensation and Alaska Permanent Fund dividends. 13
14 a  Social security 
benefits. 14a	14b Taxable amount 
(see instructions).	
14b	
15Add lines 7 through 14b (far right column). This is your total income.   	▶	15	
Adjusted 
gross  
income	16
Educator expenses (see instructions). 16
17IRA deduction (see instructions). 17
18	Student loan interest deduction (see instructions).	18	
19Tuition and fees. Attach Form 8917.	19	
20Add lines 16 through 19. These are your total adjustments.	20	
21Subtract line 20 from line 15. This is your adjusted gross income.       	▶	21	
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see sep\
arate instructions.	Cat. No. 11327A	Form 1040A (2012)

Form 1040A (2012)	Page 	2	
Tax, credits, 
and 
payments	22Enter the amount from line 21 (adjusted gross income). 22
23 a 	Check 
if:	{	You were born before January 2, 1948,	Blind	
Spouse was born before January 2, 1948,	Blind	}Total boxes 
checked  	
▶	23a	
b  If you are married filing separately and your spouse itemizes 
deductions, check here	
                                                                       	▶	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,  
$5,950 
Married filing  
jointly or  
Qualifying  
widow(er),  
$11,900  
Head of  
household,  
$8,700 	
24 Enter your standard deduction. 24
25Subtract line 24 from line 22. If line 24 is more than line 22, enter -0\
-. 25
26Exemptions. Multiply $3,800 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.                                                                        \
   	
▶	27	
28Tax, 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	
31Education credits from Form 8863, line 19. 31
32 Retirement savings contributions credit. Attach  
Form 8880. 32
33Child tax credit. Attach Schedule 8812, if required. 33
34Add 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 2012 estimated tax payments and amount applied 
from 2011 return. 37	If you have  
a qualifying 
child, attach 
Schedule  
EIC.	
38aEarned income credit (EIC). 38a	
b Nontaxable combat pay 
election. 38b	
39Additional child tax credit. Attach Schedule 8812.	39	
40American opportunity credit from Form 8863, line 8. 40
41Add lines 36, 37, 38a, 39, and 40. These are your total payments.               	▶	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 	▶	43a	
▶	bRouting 
number	▶ c  Type:	Checking	Savings	
▶	dAccount 
number	
44 
Amount of line 42 you want applied to your  
2013 estimated tax. 44	
Amount 
you owe	45 Amount you owe. Subtract line 41 from line 35. For details on how to pay, 
see instructions.       	
▶	45	
46Estimated 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          	▶	Phone  
no.       	▶	Personal identification 
number (PIN)               	▶	
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  best  of my  knowledge 
and  belief,  they are true,  correct,  and accurately  list all amounts  and sources  of income  I received  during the tax year.  Declaration  of preparer  (other 
than the taxpayer) is based on all information of which the preparer ha\
s any knowledge.	
▲	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 	▶          	if 
self-employed	PTIN	
Firm's name 	▶	
Firm's address 	▶	
Firm's EIN 	▶	
Phone no.	
Form 	1040A 	 (2012)