[PDF] 2004 Form 1040 - Internal Revenue Service



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2004 Form W-4 - Internal Revenue Service

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2004 Form 1040 - Internal Revenue Service

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2004 Form 1040 - Internal Revenue Service 4 I.R.S. SPECIFICATIONSTO BE REMOVED BEFORE PRINTING DO NOT PRINT ó DO NOT PRINT ó DO NOT PRINT ó DO NOT PRINTTLS, have you transmitted all R text files for this cycle update? Date

Action

Revised proofs

requested

Date Signature

O.K. to printINSTRUCTIONS TO PRINTERS

FORM 1040, PAGE 1 of 2

MARGINS: TOP 13 mm (

1 ⁄2"), CENTER SIDES. PRINTS: HEAD to HEAD

PAPER: WHITE WRITING, SUB. 20. INK: BLACK

FLAT SIZE: 203 mm (8") ? 279 mm (11")

PERFORATE: (NONE)

Department of the Treasury - Internal Revenue Service

1040U.S. Individual Income Tax Return

OMB No. 1545-0074

For the year Jan. 1-Dec. 31, 2004, or other tax year beginning , 2004, ending , 20 Last nameYour first name and initialYour social security number (See instructions on page 16.) L A B E L H E R E Last nameSpouse's social security numberIf a joint return, spouse's first name and initial

Use the IRS

label.

Otherwise,

please print or type. Home address (number and street). If you have a P.O. box, see page 16.Apt. no. City, town or post office, state, and ZIP code. If you have a foreign address, see page 16.

Presidential

Election Campaign1Single

Filing Status

Married filing jointly (even if only one had income)2

Check only

one box.3 Qualifying widow(er) with dependent child (see page 17)

6a Yourself. If someone can claim you as a dependent, do not check box 6a

ExemptionsSpouseb

(4) if qualifying child for child tax credit (see page 18)

Dependents:c

(2) Dependent's social security number(3) Dependent's relationship to you(1) First name Last name

If more than four

dependents, see page 18. dTotal number of exemptions claimed 7

Wages, salaries, tips, etc. Attach Form(s) W-27

8a8a Taxable interest. Attach Schedule B if required

Income

8b b Tax-exempt interest. Do not include on line 8aAttach Form(s)

W-2 here. Also

attach Forms

W-2G and

1099-R if tax

was withheld.

9a9aOrdinary dividends. Attach Schedule B if required

10

10Taxable refunds, credits, or offsets of state and local income taxes (see page 20)

11

11Alimony received

12

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

Enclose, but do

not attach, any payment. Also, please use

Form 1040-V.13

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

1414Other gains or (losses). Attach Form 4797

15a 15bIRA distributions

bTaxable amount (see page 22)15a

16b16a

Pensions and annuitiesbTaxable amount (see page 22)16a 1717
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E

1818Farm income or (loss). Attach Schedule F

1919Unemployment compensation

20b20ab

Taxable amount (see page 24)20aSocial security benefits 2121

22Add the amounts in the far right column for lines 7 through 21. This is your total income

22

25IRA deduction (see page 26)

23
2726
One-half of self-employment tax. Attach Schedule SE 29
Self-employed health insurance deduction (see page 30)27 3029
Self-employed SEP, SIMPLE, and qualified plans3130

Penalty on early withdrawal of savings

3231

Alimony paid b Recipient's SSN

35Add lines 23 through 34a

32
Subtract line 35 from line 22. This is your adjusted gross income 33

Adjusted

Gross

Income

36If you did not

get a W-2, see page 19. Form Married filing separately. Enter spouse's SSN above and full name here.

Cat. No. 11320B

Label

Form1040(2004)

IRS Use Only - Do not write or staple in this space. Head of household (with qualifying person). (See page 17.) If the qualifying person is a child but not your dependent, enter this child's name here. Other income. List type and amount (see page 24)Moving expenses. Attach Form 3903 25
26
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 75.

Boxes checkedon 6a and 6b

No. of childrenon 6c who:

Dependents on 6c

not entered above

Add numbers on

lines above ●lived with you ●did not live withyou due to divorceor separation(see page 18)

34a34a

Student loan interest deduction (see page 28)

33
35

Separation 1 of 2: Black

Important!

NoYes Note. Checking "Yes" will not change your tax or reduce your refund. Do you, or your spouse if filing a joint return, want $3 to go to this fund??

You must enter

your SSN(s) above.quotesdbs_dbs2.pdfusesText_2