Statistics of Income Program DocumentationStatistics of Income Program Documentation Data Items by...

Statistics of Income Program Documentation

Data Items by Forms and Schedules2012

iii

Form 1040, U.S. Individual Income Tax Return ....................................................................................................................................6Form 1040A, U.S. Individual Income Tax Return .................................................................................................................................8Form 1040EZ, Income Tax Return for Single and Joint Filers With No Dependents .........................................................................10 Schedule A (Form 1040), Itemized Deductions ..............................................................................................................................11 Schedule B (Form 1040A or 1040), Interest and Ordinary Dividends ...........................................................................................12 Schedule C (Form 1040), Profit or Loss From Business (Sole Proprietorship) ..............................................................................13 Schedule C-EZ (Form 1040), Net Profit From Business (Sole Proprietorship) .............................................................................15 Schedule D (Form 1040), Capital Gains and Losses .......................................................................................................................16 Schedule E (Form 1040), Supplemental Income and Loss (From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) ...........................................................................................................18 Schedule EIC (Form 1040A or 1040), Earned Income Credit Qualified Child Information .........................................................20 Schedule F (Form 1040), Profit or Loss From Farming ..................................................................................................................21 Schedule H (Form 1040), Household Employment Taxes (For Social Security, Medicare, Withheld Income, and Federal Unemployment (FUTA) Taxes ......................................................................................................23 Schedule J (Form 1040), Income Averaging for Farmers and Fishermen ......................................................................................25 Schedule R (Form 1040A or 1040), Credit for the Elderly or the Disabled ...................................................................................27 Schedule SE (Form 1040), Self-Employment Tax ..........................................................................................................................29Form 982, Reduction of Tax Attributes Due to Discharge of Indebtedness ........................................................................................31Form 1116, Foreign Tax Credit (Individual, Estate, or Trust) ..............................................................................................................32Form 2106, Employee Business Expenses ..........................................................................................................................................34Form 2106-EZ, Unreimbursed Employee Business Expenses ............................................................................................................36Form 2439, Notice to Shareholder of Undistributed Long-Term Capital Gains..................................................................................37Form 2441, Child and Dependent Care Expenses ...............................................................................................................................38Form 2555, Foreign Earned Income ....................................................................................................................................................40Form 2555-EZ, Foreign Earned Income Exclusion .............................................................................................................................43Form 3468, Investment Credit .............................................................................................................................................................45Form 3800, General Business Credit ...................................................................................................................................................48Form 3903, Moving Expenses .............................................................................................................................................................51Form 4136, Credit for Federal Tax Paid on Fuels ................................................................................................................................52Form 4137, Social Security and Medicare Tax on Unreported Tip Income ........................................................................................56Form 4562, Depreciation and Amortization (Including Information on Listed Property) ...................................................................57Form 4684, Casualties and Thefts ........................................................................................................................................................59Form 4797, Sales of Business Property (Also Involuntary Conversions and Recapture Amounts Under Sections 179 and 280F(b)(2)) ..................................................................................................................................................61

Statistics of Income Program DocumentationData Items by Forms and Schedules

2012

Table of ContentsPage

Preface ....................................................................................................................................................................................................xi

Individual Statistics Branch

Changes to Individual Statistics Branch Programs .................................................................................................................................1

Basic Individual Study

iv

Form 4835, Farm Rental Income and Expenses (Crop and Livestock Shares (Not Cash) Received by Landowner (or Sub-Lessor)) (Income not subject to self-employment tax) ..................................................................63Form 4952, Investment Interest Expense Deduction ...........................................................................................................................64Form 4972, Tax on Lump-Sum Distributions (From Qualified Plans of Participants Born Before January 2, 1936) .............................................................................................................................................................65Form 5329, Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts ..............................................66Form 5405, Repayment of the First-Time Homebuyer Credit .............................................................................................................68Form 5695, Residential Energy Credits ...............................................................................................................................................69Form 5884, Work Opportunity Credit ..................................................................................................................................................71Form 5884-B, New Hire Retention Credit ...........................................................................................................................................72Form 6198, At-Risk Limitations ..........................................................................................................................................................73Form 6251, Alternative Minimum Tax—Individuals ..........................................................................................................................74Form 6252, Installment Sale Income ...................................................................................................................................................76Form 6781, Gains And Losses From Section 1256 Contracts and Straddles ......................................................................................77Form 8283, Noncash Charitable Contributions ...................................................................................................................................78Form 8396, Mortgage Interest Credit (For Holders of Qualified Mortgage Credit Certificates Issued by State or Local Governmental Units or Agencies) ...............................................................................................................80Form 8582, Passive Activity Loss Limitations ....................................................................................................................................81Form 8586, Low-Income Housing Credit ............................................................................................................................................82Form 8606, Nondeductible IRAs .........................................................................................................................................................83Form 8609-A, Annual Statement for Low-Income Housing Credit ....................................................................................................85Form 8615, Tax for Certain Children Who Have Investment Income of More Than $1,900 ..............................................................86Form 8801, Credit for Prior Year Minimum Tax—Individuals, Estates, and Trusts ...........................................................................87 Schedule 8812 (Form 1040A or 1040), Child Tax Credit ...............................................................................................................91Form 8814, Parents’ Election To Report Child’s Interest and Dividends ............................................................................................93Form 8824, Like-Kind Exchanges (and section 1043 conflict-of-interest sales) .................................................................................94Form 8829, Expenses for Business Use of Your Home .......................................................................................................................96Form 8834, Qualified Plug-in Electric and Electric Vehicle Credit .....................................................................................................97Form 8835, Renewable Electricity, Refined Coal, and Indian Coal Production Credit .......................................................................99Form 8839, Qualified Adoption Expenses .........................................................................................................................................101Form 8844, Empowerment Zone Employment Credit .......................................................................................................................103Form 8846, Credit for Employer Social Security and Medicare Taxes Paid on Certain Employee Tips ..........................................104Form 8853, Archer MSAs and Long-Term Care Insurance Contracts...............................................................................................105Form 8863, Education credits (American Opportunity and Lifetime Learning Credits) ...................................................................107Form 8864, Biodiesel and Renewable Diesel Fuels Credit ...............................................................................................................109Form 8867, Paid Preparer’s Earned Income Credit Checklist ...........................................................................................................110Form 8874, New Markets Credit .......................................................................................................................................................114Form 8880, Credit for Qualified Retirement Savings Contributions .................................................................................................115Form 8885, Health Coverage Tax Credit ...........................................................................................................................................116Form 8888, Allocation of Refund (Including Savings Bond Purchases) ...........................................................................................117Form 8889, Health Savings Accounts (HSAs) ...................................................................................................................................118Form 8903, Domestic Production Activities Deduction ....................................................................................................................120Form 8910, Alternative Motor Vehicle Credit ...................................................................................................................................121Form 8911, Alternative Fuel Vehicle Refueling Property Credit .......................................................................................................122Form 8917, Tuition and Fees Deduction ............................................................................................................................................123Form 8919, Uncollected Social Security and Medicare Tax on Wages .............................................................................................124Form 8936, Qualified Plug-in Electric Drive Motor Vehicle Credit (Including Qualified Two- or Three-Wheeled Plug-In Electric Vehicles) ...................................................................................................................................125Form 8941, Credit for Small Employer Health Insurance Premiums ................................................................................................127Form 8949, Sales and Other Dispositions of Capital Assets ..............................................................................................................128Form W-2, Wage and Tax Statement .................................................................................................................................................130

Basic Individual Study—continued

v

Schedule D (Form 1040), Capital Gains and Losses .....................................................................................................................131Form 2439, Notice to Shareholder of Undistributed Long-Term Capital Gains................................................................................133Form 4684, Casualties and Thefts ......................................................................................................................................................134Form 4797, Sales of Business Property (Also Involuntary Conversions and Recapture Amounts Under Sctions 179 and 280F(b)2)) ...................................................................................................................................................136Form 6252, Installment Sale Income .................................................................................................................................................138Form 6781, Gains and Losses From Section 1256 Contracts and Straddles .....................................................................................139Form 8824, Like-Kind Exchanges (and section 1043 conflict-of-interest sales) ...............................................................................140Form 8949, Sales and Other Dispositions of Capital Assets ..............................................................................................................142

Sales of Capital Assets Study

Information Returns Match Study

Form W-2, Wage and Tax Statement .................................................................................................................................................144Form W-2G, Certain Gambling Winnings .........................................................................................................................................145Form 1098, Mortgage Interest Statement ..........................................................................................................................................146Form 1098-C, Contributions of Motor Vehicles, Boats, and Airplanes .............................................................................................147Form 1098-E, Student Loan Interest Statement .................................................................................................................................148Form 1098-T, Tuition Statement ........................................................................................................................................................149Form 1099-B, Proceeds From Broker and Barter Exchange Transactions ........................................................................................150Form 1099-C, Cancellation of Debt ..................................................................................................................................................151Form 1099-CAP, Changes in Corporate Control and Capital Structure ............................................................................................152Form 1099-DIV, Dividends and Distributions ...................................................................................................................................153Form 1099-G, Certain Government Payments ..................................................................................................................................154Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments .........................................................................................155Form 1099-INT, Interest Income .......................................................................................................................................................156Form 1099-K, Payment Card and Third Party Network Transactions...............................................................................................157Form 1099-LTC, Long-Term Care and Accelerated Death Benefits .................................................................................................158Form 1099-MISC, Miscellaneous Income ........................................................................................................................................159Form 1099-OID, Original Issue Discount .........................................................................................................................................160Form 1099-PATR, Taxable Distributions Received From Cooperatives ..........................................................................................161Form 1099-Q, Payments From Qualified Education Programs (Under Sections 529 and 530) ........................................................162Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc. .........................................................................................................................................................163Form 1099-S, Proceeds From Real Estate Transactions ....................................................................................................................164Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA ..............................................................165Form SSA-1099, Social Security Benefit Statement .........................................................................................................................166Form 5498, IRA Contribution Information ........................................................................................................................................167Form 5498-ESA, Coverdell ESA Contribution Information .............................................................................................................168Form 5498-SA, HSA, Archer MSA, or Medicare Advantage MSA Information ..............................................................................169 Schedule K-1 (Form 1041), Beneficiary’s Share of Income, Deductions, Credits, etc .................................................................170 Schedule K-1 (Form 1065), Partner’s Share of Income, Deductions, Credits, etc. ......................................................................171 Schedule K-1 (Form 1120S), Shareholder’s Share of Income, Deductions, Credits, etc..............................................................172

vi

Form 706, United States Estate (and Generation-Skipping Transfer) Tax Return .............................................................................176Form 706-NA, United States Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States ....................................................................................................................195Form 709, United States Gift (and Generation-Skipping Transfer) Tax Return ................................................................................197

Special Studies Branch

Changes to Special Studies Branch Programs ....................................................................................................................................173

Estate and Gift Programs

Tax-Exempt Organizations Programs

Form 990, Return of Organization Exempt From Income Tax Under Section 501(c), 527, or 4979(a)(1) (except black lung benefit trust or private foundation) ..............................................................................................202 Schedule A (Form 990 or 990-EZ), Public Charity Status and Public Support............................................................................214 Schedule C (Form 990 or 990-EZ), Political Campaign and Lobbying Activities ......................................................................218 Schedule D (Form 990), Supplemental Financial Statements .......................................................................................................221 Schedule G (Form 990 or 990-EZ), Supplemental Information Regarding Fundraising or Gaming Activities ..........................225 Schedule H (Form 990), Hospitals ................................................................................................................................................227 Schedule J (Form 990), Compensation Information .....................................................................................................................234 Schedule K (Form 990), Supplemental Information on Tax-Exempt Bonds ................................................................................236 Schedule M (Form 990), Noncash Contributions .........................................................................................................................240 Schedule N (Form 990 or 990-EZ), Liquidation, Termination, Dissolution, or Significant Disposition of Assets ..............................................................................................................................................241 Schedule R (Form 990), Related Organizations and Unrelated Partnerships ...............................................................................243Form 990-EZ, Short Form Return of Organization Exempt From Income Tax Under Section 501(c), 527, or 4947(a)(1) (except black lung benefit trust or private foundation) ......................................................................................247Form 990-PF, Return of Private Foundation or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation ........................................................................................................................................................251 Schedule B (Form 990, 990-EZ, or 990-PF), Schedule of Contributors......................................................................................264Form 990-T, Exempt Organization Business Income Tax Return .....................................................................................................266Form 4720, Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code ...........................................270

vii

Form 8038, Information Return for Tax-Exempt Private Activity Bond Issues (Under Internal Revenue Code section 149(e)) ................................................................................................................................280Form 8038-CP, Return for Credit Payments to Issuers of Qualified Bonds ......................................................................................283Form 8038-G, Information Return for Tax-Exempt Governmental Obligations ...............................................................................284Form 8038-TC, Information Return for Tax Credit Bonds and Specified Tax Credit Bonds ............................................................286

Tax-Exempt Bonds Programs

International Special Studies

Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding ..................................................................................291Form 1118, Foreign Tax Credit—Corporations .................................................................................................................................294 Schedule I (Form 1118), Reduction of Foreign Oil and Gas Taxes ..............................................................................................299 Schedule J (Form 1118), Adjustments to Separate Limitation Income (Loss) Categories for Determining Numerators of Limitation Fractions, Year-End Recharacterization Balances, and Overall Foreign and Domestic Loss Account Balances .........................................................................................................301 Schedule K (Form 1118), Foreign Tax Carryover Reconciliation Schedule .................................................................................302Form 1120-IC-DISC, Interest Charge Domestic International Sales Corporation Return ................................................................304Form 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations ....................................................310Form 5472, Information Return of a 25% Foreign-Owned U.S. Corporation or a Foreign Corporation Engaged in a U.S. Trade or Business (Under Sections 6038A and 6038C of the Internal Revenue Code) ..........................................................................................................................................................316Form 5713, International Boycott Report ..........................................................................................................................................318 Schedule A (Form 5713), International Boycott Factor (Section 999 (c) (1)) ................................................................................322 Schedule B (Form 5713), Specifically Attributable Taxes and Income (Section 999 (c) (2)) ........................................................323 Schedule C (Form 5713), Tax Effect of the International Boycott Provisions .............................................................................324Form 8288-A, Statement of Withholding by Foreign Persons of U.S. Real Property Interests ........................................................326Form 8404, Interest Charge on DISC-Related Deferred Tax Liability ..............................................................................................327Form 8805, Foreign Partner’s Information Statement of Section 1446 Withholding Tax .................................................................328Form 8832, Entity Classification Election .........................................................................................................................................329Form 8858, Information Return of U.S. Persons With Respect To Foreign Disregarded Entities ....................................................332Form 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships ..........................................................................336

viii

Form 1120, U.S. Corporation Income Tax Return .............................................................................................................................346 Schedule D (Form 1120), Capital Gains and Losses .....................................................................................................................351 Schedule G (Form 1120), Information on Certain Persons Owning the Corporation’s Voting Stock ..........................................352 Schedule M-3 (Form 1120), Net Income (Loss) Reconciliation for Corporations With Total Assets of $10 Million or More ....................................................................................................................................353 Schedule N (Form 1120), Foreign Operations of U.S. Corporations ............................................................................................356 Schedule O (Form 1120), Consent Plan and Apportionment Schedule for a Controlled Group ..................................................357 Schedule UTP (Form 1120), Uncertain Tax Position Statement ...................................................................................................361Form 1120-F, U.S. Income Tax Return of a Foreign Corporation .....................................................................................................364 Schedules M-1 and M-2 (Form 1120-F), Reconciliation of Income (Loss) and Analysis of Unappropriated Retained Earnings per Books .........................................................................................................................371 Schedule M-3 (Form 1120-F), Net Income (Loss) Reconciliation for Foreign Corporations With Reportable Assets of $10 Million or More ...........................................................................................................................372Form 1120-L, U.S. Life Insurance Company Income Tax Return .....................................................................................................376 Schedule M-3 (Form 1120-L), Net Income (Loss) Reconciliation for U.S. Life Insurance Companies With Total Assets of $10 Million or More ....................................................................................................................................384Form 1120-PC, U.S. Property and Casualty Insurance Company Income Tax Return .....................................................................387 Schedule M-3 (Form 1120-PC), Net Income (Loss) Reconciliation for U.S. Property and Casualty Insurance Companies With Total Assets of $10 Million or More ...........................................................................395Form 1120-REIT, U.S. Income Tax Return for Real Estate Investment Trusts ................................................................................398Form 1120-RIC, U.S. Income Tax Return for Regulated Investment Companies ............................................................................402Form 1120S, U.S. Income Tax Return for an S Corporation .............................................................................................................406 Schedule D (Form 1120S), Capital Gains and Losses and Built-In Gains ....................................................................................411 Schedule K-1 (Form 1120S), Shareholder’s Share of Income, Deductions, Credits, etc..............................................................412 Schedule M-3 (Form 1120S), Net Income (Loss) Reconciliation for S Corporations With Total Assets of $10 Million or More ....................................................................................................................................414Form 1118, Foreign Tax Credit—Corporations .................................................................................................................................417Form 1125-A, Cost of Goods Sold.....................................................................................................................................................420Form 1125-E, Compensation of Officers ...........................................................................................................................................421Form 3468, Investment Credit ...........................................................................................................................................................422Form 3800, General Business Credit .................................................................................................................................................425Form 4562, Depreciation and Amortization (Including Information on Listed Property) .................................................................428Form 4626, Alternative Minimum Tax—Corporations .....................................................................................................................430Form 4797, Sales of Business Property (Also Involuntary Conversions and Recapture Amounts Under Sections 179 and 280F(b)(2)) ................................................................................................................................................431Form 5884, Work Opportunity Credit ................................................................................................................................................433Form 6478, Alcohol and Cellulosic Biofuel Fuels Credit (Including Second Generation Biofuel) ..................................................434Form 6765, Credit for Increasing Research Activities .......................................................................................................................435

Corporation Statistics Branch

Changes to Corporation Statistics Branch Programs ..........................................................................................................................343

Corporation Programs

ix

Form 8586, Low-Income Housing Credit ..........................................................................................................................................437Form 8594, Asset Acquisition Statement Under Section 1060 ..........................................................................................................438Form 8609-A, Annual Statement for Low-Income Housing Credit ..................................................................................................439Form 8611, Recapture of Low-Income Housing Credit ....................................................................................................................440Form 8816, Special Loss Discount Account and Special Estimated Tax Payments for Insurance Companies ..................................................................................................................................................................441Form 8820, Orphan Drug Credit ........................................................................................................................................................442Form 8824, Like-Kind Exchanges (and section 1043 conflict-of-interest sales) ...............................................................................443Form 8825, Rental Real Estate Income and Expenses of a Partnership or an S Corporation ............................................................445Form 8826, Disabled Access Credit ...................................................................................................................................................447Form 8827, Credit for Prior Year Minimum Tax—Corporations ......................................................................................................448Form 8834, Qualified Plug-in Electric Vehicle and Electric Vehicle Credit ......................................................................................449Form 8835, Renewable Electricity, Refined Coal, and Indian Coal Production Credit .....................................................................451Form 8844, Empowerment Zone Employment Credit .......................................................................................................................453Form 8845, Indian Employment Credit .............................................................................................................................................454Form 8846, Credit for Employer Social Security and Medicare Taxes Paid on Certain Employee Tips .................................................................................................................................................................455Form 8864, Biodiesel and Renewable Diesel Fuels Credit ...............................................................................................................456Form 8869, Qualified Subchapter S Subsidiary Election (Under section 1361 (b) (3) of the Internal Revenue Code) ..........................................................................................................................................................457Form 8874, New Markets Credit .......................................................................................................................................................458Form 8881, Credit for Small Employer Pension Plan Startup Costs .................................................................................................459Form 8882, Credit for Employer-Provided Childcare Facilities and Services ..................................................................................460Form 8896, Low Sulfur Diesel Fuel Production Credit .....................................................................................................................461Form 8903, Domestic Production Activities Deduction ....................................................................................................................462Form 8910, Alternative Motor Vehicle Credit ...................................................................................................................................463Form 8911, Alternative Fuel Vehicle Refueling Property Credit .......................................................................................................464Form 8916, Reconciliation of Schedule M-3 Taxable Income with Tax Return Taxable Income for Mixed Groups ..............................................................................................................................................................................465Form 8916-A, Supplemental Attachment to Schedule M-3 ...............................................................................................................466Form 8925, Report of Employer-Owned Life Insurance Contracts ...................................................................................................468Form 8926, Disqualified Corporate Interest Expense Disallowed Under Section 163 (j) and Related Information ...................................................................................................................................................................469Form 8936, Qualified Plug-in Electric Drive Motor Vehicle Credit (Including Qualified Two- or Three-Wheeled Plug-In Electric Vehicles) ...................................................................................................................................471Form 8941, Credit for Small Employer Health Insurance Premiums ................................................................................................473

Corporation Programs—continued

x

Form 1065, U.S. Return of Partnership Income ................................................................................................................................476 Schedule B-1 (Form 1065), Information on Partners Owning 50% or More of the Partnership ..................................................481 Schedule D (Form 1065), Capital Gains and Losses .....................................................................................................................482Form 1065-B, U.S. Return of Partnership Income for Electing Large Partnerships .........................................................................483Form 1125-A, Cost of Goods Sold.....................................................................................................................................................488 Schedule M-3 (Form 1065), Net Income (Loss) Reconciliation for Certain Partnerships ...........................................................489 Schedule C (Form 1065), Additional Information for Schedule M-3 Filers .................................................................................492 Schedule F (Form 1040), Profit or Loss from Farming .................................................................................................................493Form 3468, Investment Credit ...........................................................................................................................................................494Form 4562, Depreciation and Amortization (Including Information on Listed Property) .................................................................497Form 4797, Sales of Business Property (Also Involuntary Conversions and Recapture Amounts Under Sections 179 and 280F(b)(2)) ................................................................................................................................................499Form 5884, Work Opportunity Credit ................................................................................................................................................500Form 5884-B, New Hire Retention Credit .........................................................................................................................................501Form 6765, Credit for Increasing Research Activities .......................................................................................................................502Form 8820, Orphan Drug Credit ........................................................................................................................................................504Form 8824, Like-Kind Exchanges (and section 1043 conflict-of-interest sales) ...............................................................................505Form 8825, Rental Real Estate Income and Expenses of a Partnership or S Corporation ................................................................507Form 8834, Qualified Plug-in Electric and Electric Vehicle Credit ...................................................................................................508Form 8844, Empowerment Zone Employment Credit .......................................................................................................................509Form 8845, Indian Employment Credit .............................................................................................................................................510Form 8846, Credit for Employer Social Security and Medicare Taxes Paid on Certain Employee Tips ..........................................511Form 8864, Biodiesel and Renewable Diesel Fuels Credit ...............................................................................................................512Form 8874, New Markets Credit .......................................................................................................................................................513Form 8881, Credit for Small Employer Pension Plan Startup Costs .................................................................................................514Form 8882, Credit for Employer-Provided Child Care Facilities and Services ................................................................................515Form 8896, Low Sulfur Diesel Fuel Production Credit .....................................................................................................................516Form 8903, Domestic Production Activities Deduction ....................................................................................................................517Form 8910, Alternative Motor Vehicle Credit ...................................................................................................................................518Form 8911, Alternative Fuel Vehicle Refueling Property Credit .......................................................................................................519Form 8925, Report of Employer Owned Life Insurance Contracts ...................................................................................................520Form 8936, Qualified Plug–in Electric Drive Motor Vehicle Credit (Including Qualified Two- or Three-Wheeled Plug-in Electric Vehicles) ...................................................................................................................................521Form 8941, Credit for Small Employer Health Insurance Premiums ................................................................................................522Form 8752, Required Payment or Refund Under Section 7519 ........................................................................................................523

Partnership Programs

Changes to Corporation Statistics Branch Partnership Programs .......................................................................................................474

xi

Statistics of Income Program DocumentationData Items by Forms and Schedules

2012

Preface

This document contains the federal tax forms, schedules, and information documents that the Statistics of In-come (SOI) Division of the IRS has selected for its Tax Year (TY) 2012 program. It is organized in 3 parts:

• Individual Statistics Branch studies include data related to the Form 1040 Individual income tax return series, as well as data on sales of capital assets and an extensive program that connects income tax returns with information documents filed by third parties.

• The Corporation Statistics Branch studies focus on data collected from the Form 1120 series and SOI’s Partnership program.

• Special Studies Branch programs include data collected for Estate and Gift Taxes, Tax-exempt Organiza-tions, and Tax-Exempt Bonds, as well as information collected for international filers.

Each tax form included in the SOI program is represented in this volume. Due to resource constraints, data from certain forms and schedules are collected periodically, rather than annually. For this reason, the contents of this document will vary somewhat from year to year. The information collected for each SOI project is developed in close collaboration with data users both inside and outside of the government. Most SOI programs are based on stratified samples of returns for which data are collected prior to IRS audits; therefore the data represent infor-mation as originally reported by taxpayers.

Returns for TY 2012 are filed primarily during calendar year 2013, although returns for fiscal-year filers or filers for whom filing extensions have been granted may not be received by the IRS until calendar year 2014. Conse-quently, data collected by SOI for TY 2012 will generally be made available to the public, in the form of tables and summary analyses, during calendar years 2014 and 2015.

The specific data items captured for each SOI project are indicated with a red block ( █ ) on facsimiles of the forms and schedules. Forms and schedules that can be filed by different types of taxpayers are repeated in sev- eral sections of this document. Specific changes to the data collected for each form and schedule since the TY 2011 studies are summarized at the beginning of each section. Draft copies of tax forms, or copies of tax forms from earlier tax years, were inserted in this document if TY 2012 revisions of forms and schedules were not available at the time this document was produced.

1

STATISTICS OF INCOME PROGRAM DOCUMENTATIONData Items by Forms and Schedules

2012

Changes to Individual Statistics Branch Programs

Basic Individual Study

Forms 1040, 1040A, 1040EZ, U.S. Individual Income Tax Return seriesThe first time homebuyer credit and refundable credit for qualified adoption expenses have been re-moved from the form, but will continue to be picked up for prior year returns.

Schedule C/CEZ, Profit or Loss from BusinessLine 1a for gross merchant card and third party payments, line 1b for gross receipts or sales not en-tered on line 1a, and line 1c for income reported on Form W-2 if the “Statutory Employee” box was checked, have been removed from the form and will not be picked up for prior year returns.

Schedule E, Supplemental Income and LossLines 3a and 3b for merchant card and third party payments have been removed from the form and will not be picked up for prior year returns. As a result, lines 23a and 23b were also removed from the form and will not be picked up for prior year returns.

Schedule F, Profit or Loss from FarmingThe amounts for sales of livestock and other resale items not reported on lines 1a/37a have been re-moved from the form and will not be picked up for prior year returns.

The amount computing the sum of sales of livestock and other resale items and sales of livestock and other resale items not reported on line 1a has been removed from the form and will not be picked up for prior year returns.

The amount for sales of products you raised not reported on line 2a has been removed and will not be picked up for prior year returns.

The amounts for custom hire income not reported on lines 7a/42a have been removed from the form and will not be picked up for prior year returns.

The amounts for other income not reported on lines 8a/43a have been removed from the form and will not be picked up for prior year returns.

Schedule L, Standard Deduction for Certain FilersSchedule L, Standard Deduction for Certain Filers, is now obsolete but will continue to be picked up for prior year returns.

Schedule M, Making Work Pay and Government Retiree CreditsThe Schedule M, Making Work Pay Credit, is now obsolete, but will continue to be picked up for prior year returns.

Form 3468, Investment CreditThe qualifying therapeutic discovery project credit has expired; therefore, line 8 has been reserved for future use. We will continue to pick this up for prior year returns.

2


2012


Form 4136, Credit For Federal Tax Paid On FuelsLines 9a and 9b (alcohol fuel mixtures credits) have been removed from the form but will continue to be picked up for prior year returns.

Form 4684, Casualties and TheftsLine 35b(ii), losses from casualties or thefts from income producing and employee property, will now be picked up.

Form 5405, First-Time Homebuyer Credit and Repayment of the CreditDue to the expiration of the first-time homebuyer credit the title has been changed to Repayment of the First-Time Homebuyer Credit, and the first page of the form that dealt with figuring the credit has been eliminated. Since page 1 was removed, the remainder of the form was renumbered.

Also, the checkbox on line 2, which pertains to whether or not the house has ceased to be your main home, will be picked up.

Form 5695, Residential Energy CreditsThe two parts of the credit have been reversed on the form, with the Residential Energy Efficient Property credit now computed in Part I, and the Nonbusiness Energy Property credit computed in Part II. The form was renumbered accordingly, and all items picked up in previous years will continue to be picked up for the current year form.

Line 20e, amount of nonbusiness energy property credit from 2011, is new and will be picked up.

Form 8283, Noncash Charitable ContributionsIn Part 1 of Section A, the new check box in column 1b for identifying vehicle donations will be picked up and in Part I of Section B, the new check box on line 4 for vehicle donations will also be picked up.

Form 8606, Nondeductible IRAsLines 26–38 and Part 4 that dealt with certain distributions for Roth accounts do not need to be re-ported on this year’s Form 8606 so they have been deleted from the form. However they will continue to be picked up for prior year returns.

Form 8812, Additional Child Tax CreditForm 8812 has been rendered obsolete for TY2012 and is being replaced with Schedule 8812. The same lines will be picked up on Schedule 8812, lines 1 through 13, as were picked up on the Form 8812. In addition, lines A through D, as well as the additional dependent checkbox, will be picked up from Part I of the schedule. We will still pick up the Form 8812 for prior year returns.

Form 8835, Renewable Electricity, Refined Coal, and Indian Coal Production CreditThe credit for steel industry fuel has expired; therefore line 21 has been marked reserved.

Form 8863, Education CreditsForm 8863 has been changed into Worksheet form with Part I and Part II being the American Oppor-tunity Credit and Lifetime Learning Credit and Part III being the student credit worksheet.

3


2012


American Opportunity Credit will now be lines 1 through 8, Lifetime Learning Credit will now be lines 9 through 19.

Lines 22 through 26 are new Worksheet checkboxes used to determine eligibility for either credit while lines 27 through 31 are used to compute the tentative maximum credit amount.

Form 8867, Paid Preparer’s Earned Income Credit ChecklistForm 8867, Paid Preparer’s Earned Income Credit Checklist has been modified. We will pick up lines 7, 9, 11, 13a, 13b, 13c, 20, and 22 through 27.

Form 8885, Health Coverage Tax CreditThe form is reverting back to a 1-column format. As a result, columns A and B of lines 2 through 7 have been combined into one column and lines 5 and 6 have been removed from the form.

Form 8889, Health Savings AccountsLine 18 has been deleted, but prior year will continue to be picked up.

Form 8910, Alternative Motor Vehicle CreditLines 4 through 10 have been deleted from the form, but prior year will continue to be picked up.

Form 8941, Credit for Small Employer Health Insurance PremiumsLine 1b, pertaining to the Employer Identification Number (EIN), is new and being picked up this year.

Sales of Capital Assets Study

Form 4684, Casualties and TheftsLine 35b(ii), losses from casualties or thefts from income producing and employee property, will now be picked up.

Form 8949, Sales and Other Dispositions of Capital AssetsFor both short-term and long-term transactions, the adjustment code field has been moved to column 1 and 8 (f) next to the adjustment amount. A gain or (loss) column has been added as column (h) and will be picked up.

4


2012


Information Returns Match Study

Form 1099-K, Merchant Card and Third Party Network PaymentsA new field, “Number of Purchased Transactions” (box 3), was added.

Form 1065, Schedule K-1, Partner’s Share of Income, Deductions, Credits, etc. A new field, “IRA-SEP-KEOUGH-IND” (Part II, box I1), was added.

Form 1099-B, Proceeds From Broker and Barter Exchange TransactionsTwo new fields have been added: “Stock or other Symbol” (box 1d) and “Quantity sold” (box 1e). Box 6, Indicator for Noncovered Security, has been split into 6a, “Noncovered security,” and 6b, “Ba-sis reported to IRS.”

Form 1098-C, Cancellation of DebtBox 2, has been split into boxes 2a, 2b, and 2c for year, make, and model.

Form 1098, Mortgage Interest Statement“Mortgage insurance premium” (previously box 4) is no longer on the form and will not be picked up.

Form 1099-C, Cancellation of DebtBox 1 has been renamed to “Date of identifiable event.” Box 2 has also been renamed to “Amount of debt discharged.” Box 6 has been renamed to “Identifiable event code.”

Form 1099-DIV, Dividends and DistributionsTwo new payment amounts will be picked up: “Exempt interest dividends” (box 10) and “Specified private activity bond interest dividend” (box 11).

6 Basic Individual Study

Form 1040 Department of the Treasury—Internal Revenue Service OMB No. 1545-0074(99) IRS Use Only—Do not write or staple in this space. U.S. Individual Income Tax Return 2012

For the year Jan. 1–Dec. 31, 2012, or other tax year beginning , 2012, ending , 20 See separate instructions.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 instructions. Apt. no.

City, town or post office, state, and ZIP code. 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. ▶

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

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 four dependents, see instructions and check here ▶

d Total number of exemptions claimed . . . . . . . . . . . . . . . . .

Boxes checked on 6a and 6bNo. 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 Forms W-2G and 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

8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a

b Tax-exempt interest. Do not include on line 8a . . . 8b

9 a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a

b Qualified dividends . . . . . . . . . . . 9b

10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10

11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11

12 Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . 12

13 Capital gain or (loss). Attach Schedule D if required. If not required, check here ▶ 13

14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . 14

15 a IRA distributions . 15a b Taxable amount . . . 15b

16 a Pensions and annuities 16a b Taxable amount . . . 16b

17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17

18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . 18

19 Unemployment compensation . . . . . . . . . . . . . . . . . 19

20 a Social security benefits 20a b Taxable amount . . . 20b

21 Other income. List type and amount 21 22 Combine the amounts in the far right column for lines 7 through 21. This is your total income ▶ 22

Adjusted Gross Income

23 Educator expenses . . . . . . . . . . 23

24 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ 24

25 Health savings account deduction. Attach Form 8889 . 25

26 Moving expenses. Attach Form 3903 . . . . . . 26

27 Deductible part of self-employment tax. Attach Schedule SE . 27

28 Self-employed SEP, SIMPLE, and qualified plans . . 28

29 Self-employed health insurance deduction . . . . 29

30 Penalty on early withdrawal of savings . . . . . . 30

31 a Alimony paid b Recipient’s SSN ▶ 31a

32 IRA deduction . . . . . . . . . . . . . 32

33 Student loan interest deduction . . . . . . . . 33

34 Tuition and fees. Attach Form 8917 . . . . . . . 34

35 Domestic production activities deduction. Attach Form 8903 35

36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36 37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . ▶ 37

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2012)

TAX FILING PERIOD DLN

(zip code)

1st thru 4th parents 1st thru 4th1st thru 10th

5th thru 10th other dep 5th thru 10th

dependent other earned inc

(13) cap gain distrib

Official Use Only

qual char/HSA dist

frgn ernd inc excl NOL

(21) stock options(21) gambling income(21) cancellation of debt(21) Frm 8889 HSA inc

Archer MSAfrgn housing dedother deductions

7Basic Individual Study

Form 1040 (2012) Page 2

Tax and Credits

38 Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . 38

39a Check if:

{ You were born before January 2, 1948, Blind.Spouse was born before January 2, 1948, Blind.

} Total boxes checked ▶ 39a

b If your spouse itemizes on a separate return or you were a dual-status alien, check here ▶ 39b Standard Deduction for— • People who check any box on line 39a or 39b 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

40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) . . 40

41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41

42 Exemptions. Multiply $3,800 by the number on line 6d . . . . . . . . . . . . 42

43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . . 43

44 Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 962 election 44

45 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . 45

46 Add lines 44 and 45 . . . . . . . . . . . . . . . . . . . . . ▶ 46

47 Foreign tax credit. Attach Form 1116 if required . . . . 47

48 Credit for child and dependent care expenses. Attach Form 2441 48

49 Education credits from Form 8863, line 19 . . . . . 49

50 Retirement savings contributions credit. Attach Form 8880 50

51 Child tax credit. Attach Schedule 8812, if required . . . 51

52 Residential energy credits. Attach Form 5695 . . . . 52

53 Other credits from Form: a 3800 b 8801 c 53

54 Add lines 47 through 53. These are your total credits . . . . . . . . . . . . 5455 Subtract line 54 from line 46. If line 54 is more than line 46, enter -0- . . . . . . ▶ 55

Other Taxes

56 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . 56

57 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . 57

58 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required . . 58

59a 59a

b 59bHousehold employment taxes from Schedule H . . . . . . . . . . . . . .

First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . .

60 Other taxes. Enter code(s) from instructions 60

61 Add lines 55 through 60. This is your total tax . . . . . . . . . . . . . ▶ 61

Payments 62 Federal income tax withheld from Forms W-2 and 1099 . . 6263 2012 estimated tax payments and amount applied from 2011 return 63

If you have a qualifying child, attach Schedule EIC.

64a Earned income credit (EIC) . . . . . . . . . . 64a

b Nontaxable combat pay election 64b

65 Additional child tax credit. Attach Schedule 8812 . . . . . 65

66 American opportunity credit from Form 8863, line 8 . . . . 66

67 Reserved . . . . . . . . . . . . . . . . 67

68 Amount paid with request for extension to file . . . . . 68

69 Excess social security and tier 1 RRTA tax withheld . . . . 69

70 Credit for federal tax on fuels. Attach Form 4136 . . . . 70

71 Credits from Form: a 2439 b Reserved c 8801 d 8885 7172 Add lines 62, 63, 64a, and 65 through 71. These are your total payments . . . . . ▶ 72

Refund

Direct deposit? See instructions.

73 If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid 73

74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here . ▶ 74a ▶

▶

b Routing number ▶ c Type: Checking Savings

d Account number

75 Amount of line 73 you want applied to your 2013 estimated tax ▶ 75Amount You Owe

76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions ▶ 76

77 Estimated tax penalty (see instructions) . . . . . . . 77

Third Party Designee

Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. 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 complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has 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 1040 (2012)

additional deditemized ded

Sch L ind

dependent status

Cr for elderlyElec veh crAlt ful vh crPlugin vh cr

Official Use Only

Alt mot vh cr

rl est tx/dis loss ded

ccf reduction amt

MIC cr

(54c)

other credits

recapture:Form 4255Form 4970COBRA

Advnc EIC

First tm hmbyr crRefndbl adopt cr

Making work pay crOther payments

direct deposit refund anticipation loan


Form

1040A 2012U.S. Individual Income Tax ReturnDepartment of the Treasury—Internal Revenue Service

IRS Use Only—Do not write or staple in this space. (99)

OMB No. 1545-0074Your first name and initial Last name

Your social security number


▲ Make sure the SSN(s) above and on line 6c are correct.




Presidential Election CampaignCheck 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 Single2 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.

d Total number of exemptions claimed.

Boxes checked on 6a and 6bNo. 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

8a Taxable interest. Attach Schedule B if required. 8ab Tax-exempt interest. Do not include on line 8a. 8b

9a Ordinary dividends. Attach Schedule B if required. 9ab Qualified dividends (see instructions). 9b

10 Capital gain distributions (see instructions). 1011 a IRA

distributions. 11a11b Taxable amount

(see instructions). 11b12 a Pensions and

annuities. 12a12b Taxable amount

(see instructions). 12b

13 Unemployment compensation and Alaska Permanent Fund dividends. 1314 a Social security

benefits. 14a14b Taxable amount

(see instructions). 14b

15 Add lines 7 through 14b (far right column). This is your total income. ▶ 15Adjusted gross income

16 Educator expenses (see instructions). 1617 IRA deduction (see instructions). 1718 Student loan interest deduction (see instructions). 18

19 Tuition and fees. Attach Form 8917. 1920 Add lines 16 through 19. These are your total adjustments. 20

21 Subtract line 20 from line 15. This is your adjusted gross income. ▶ 21For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11327A Form 1040A (2012)

Tax Filing Period DLN

(zip code)

up to ten dependents 1st thru 4th parents 1st thru 4th

5th thru 10th other dependents 5th thru 10th

Official Use Only

qual char dist

other income

Penalty on early withdrawal


Form 1040A (2012) Page 2Tax, credits, and payments

22 Enter the amount from line 21 (adjusted gross income). 2223 a Check

if: { You were born before January 2, 1948, BlindSpouse 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 ▶ 23bStandard

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. 2425 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-. 2526 Exemptions. Multiply $3,800 by the number on line 6d. 2627 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.

This is your taxable income. ▶ 2728 Tax, including any alternative minimum tax (see instructions). 2829 Credit for child and dependent care expenses. Attach

Form 2441. 2930 Credit for the elderly or the disabled. Attach

Schedule R. 3031 Education credits from Form 8863, line 19. 3132 Retirement savings contributions credit. Attach

Form 8880. 3233 Child tax credit. Attach Schedule 8812, if required. 3334 Add lines 29 through 33. These are your total credits. 3435 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is

your total tax. 3536 Federal income tax withheld from Forms W-2 and

1099. 3637 2012 estimated tax payments and amount applied

from 2011 return. 37If you have a qualifying child, attach Schedule EIC.

38a Earned income credit (EIC). 38ab Nontaxable combat pay

election. 38b39 Additional child tax credit. Attach Schedule 8812. 3940 American opportunity credit from Form 8863, line 8. 4041 Add 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

▶ b Routing number

▶ c Type: Checking Savings

▶ d Account 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

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


Phone no. ▶


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 has 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 DateCheck ▶ if self-employed

PTIN

Firm's name ▶

Firm's address ▶

Firm's EIN ▶

Phone no.

Form 1040A (2012)

Sch L indadditional deductions

dependent status

ALT MIN TAX

Official Use Only

real est tx deduction

Adoption cr (PY)

Advanced EIC

excess FICA w/held

Form 4868 payment

Other payments

direct deposit

Making work pay cr

refund anticipation loan


Form

1040EZ

Department of the Treasury—Internal Revenue Service

Income Tax Return for Single and Joint Filers With No Dependents (99) 2012 OMB No. 1545-0074

Your first name and initial Last name Your social security number


▲ Make sure the SSN(s) above are correct.




Presidential Election CampaignCheck 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

IncomeAttach Form(s) W-2 here.

Enclose, but do not attach, any payment.

1 Wages, salaries, and tips. This should be shown in box 1 of your Form(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. 4 5 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.

You SpouseIf no one can claim you (or your spouse if a joint return), enter $9,750 if single; $19,500 if married filing jointly. See back for explanation. 5

6 Subtract line 5 from line 4. If line 5 is larger than line 4, enter -0-. This is your taxable income. ▶ 6

Payments, Credits, and Tax

7 Federal income tax withheld from Form(s) W-2 and 1099. 7 8a Earned income credit (EIC) (see instructions). 8a

b Nontaxable combat pay election. 8b 9 Add lines 7 and 8a. These are your total payments and credits. ▶ 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

11a If line 9 is larger than line 10, subtract line 10 from line 9. This is your refund. If Form 8888 is attached, check here ▶ 11a

RefundHave it directly deposited! See instructions and fill in 11b, 11c, and 11d or Form 8888.

▶ b Routing number ▶ c Type: Checking Savings

▶ d Account number

Amount You Owe

12 If line 10 is larger than line 9, subtract line 9 from line 10. This is the amount you owe. For details on how to pay, see instructions. ▶ 12

Third Party Designee

Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No


Phone no. ▶


Sign HereJoint return? See instructions.

Keep a copy for your records.

Under penalties of perjury, 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 information of which the preparer has 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.

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. Cat. No. 11329W Form 1040EZ (2012)

Tax Filing Period DLN

(zip code)

tax exempt interest

dependent status Total exemptions

excess soc sec w/held

Mk wrk py cr

Official Use Only

F4868 payment

direct depositrefund anticipation loan

other income


SCHEDULE A (Form 1040)

Department of the Treasury Internal Revenue Service (99)

Itemized Deductions▶ Information about Schedule A and its separate instructions is at www.irs.gov/form1040.

▶ Attach to Form 1040.

OMB No. 1545-0074

2012Attachment Sequence No. 07

Name(s) shown on Form 1040 Your social security number

Medical and Dental Expenses

Caution. Do not include expenses reimbursed or paid by others. 1 Medical and dental expenses (see instructions) . . . . . 1 2 Enter amount from Form 1040, line 38 2 3 Multiply line 2 by 7.5% (.075) . . . . . . . . . . . 3 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter -0- . . . . . . . . 4

Taxes You Paid

5 State and local (check only one box):a Income taxes, orb General sales taxes } . . . . . . . . . . . 5

6 Real estate taxes (see instructions) . . . . . . . . . 6 7 Personal property taxes . . . . . . . . . . . . . 7 8 Other taxes. List type and amount ▶

8 9 Add lines 5 through 8 . . . . . . . . . . . . . . . . . . . . . . 9

Interest You Paid

Note. Your mortgage interest deduction may be limited (see instructions).

10 Home mortgage interest and points reported to you on Form 1098 10 11

Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see instructions and show that person’s name, identifying no., and address ▶

11 12

Points not reported to you on Form 1098. See instructions for special rules . . . . . . . . . . . . . . . . . 12

13 Mortgage insurance premiums (see instructions) . . . . . 13 14 Investment interest. Attach Form 4952 if required. (See instructions.) 14 15 Add lines 10 through 14 . . . . . . . . . . . . . . . . . . . . . 15

Gifts to CharityIf you made a gift and got a benefit for it, see instructions.

16

Gifts by cash or check. If you made any gift of $250 or more, see instructions . . . . . . . . . . . . . . . . 16

17

Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $500 . . . 17

18 Carryover from prior year . . . . . . . . . . . . 1819 Add lines 16 through 18 . . . . . . . . . . . . . . . . . . . . . 19

Casualty and Theft Losses 20 Casualty or theft loss(es). Attach Form 4684. (See instructions.) . . . . . . . . 20 Job Expenses and Certain Miscellaneous Deductions

21

Unreimbursed employee expenses—job travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) ▶ 21

22 Tax preparation fees . . . . . . . . . . . . . 22 23

Other expenses—investment, safe deposit box, etc. List type and amount ▶

23 24 Add lines 21 through 23 . . . . . . . . . . . . 24 25 Enter amount from Form 1040, line 38 25 26 Multiply line 25 by 2% (.02) . . . . . . . . . . . 26 27 Subtract line 26 from line 24. If line 26 is more than line 24, enter -0- . . . . . . 27

Other Miscellaneous Deductions

28 Other—from list in instructions. List type and amount ▶

28 Total Itemized Deductions

29

Add the amounts in the far right column for lines 4 through 28. Also, enter this amount on Form 1040, line 40 . . . . . . . . . . . . . . . . . . . . . 29

30

If you elect to itemize deductions even though they are less than your standard deduction, check here . . . . . . . . . . . . . . . . . . . ▶

For Paperwork Reduction Act Notice, see Form 1040 instructions. Cat. No. 17145C Schedule A (Form 1040) 2012

other investment interest

capital gains limitedContributions not limited

other than gamblingcasualty or theft of income producing property

deduction limited


SCHEDULE B (Form 1040A or 1040)

Department of the Treasury Internal Revenue Service (99)

Interest and Ordinary Dividends▶ Attach to Form 1040A or 1040.

▶ Information about Schedule B (Form 1040A or 1040) and its instructions is at www.irs.gov/form1040.

OMB No. 1545-0074

2012Attachment Sequence No. 08

Name(s) shown on return Your social security number

Part I

Interest

(See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note. If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the total interest shown on that form.

1

List name of payer. If any interest is from a seller-financed mortgage and the buyer used the property as a personal residence, see instructions on back and list this interest first. Also, show that buyer’s social security number and address ▶

1

Amount

2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . 2 3

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . 3

4

Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a . . . . . . . . . . . . . . . . . . . . . . ▶ 4

Note. If line 4 is over $1,500, you must complete Part III. Amount

Part II

Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 9a.)

Note. If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm’s name as the payer and enter the ordinary dividends shown on that form.

5 List name of payer ▶

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