//4ä1íåÞßÞßÞß ÞßJÞßMÞßPÞßSÞßZÞ ÜÞßÞßÞß ÞßJÞßMÞßPÞßSÞßëDepartment of the Treasury - Internal Revenue ServiceêÝÞßÞßÞß ÞßJÞßMÞßPÞßSÞßZÞ ÜÞßÞßÞß ÞßJÞßMÞßPÞßSÞßçò U.S. Individual Income Tax ReturnèÝßZÞ ÝÞßnÞ ÝëFor the year Jan 1-Dec 31, 1990 or other tax yearò ,1990 toò ,19ò .êßnÞ OMB No. 1545-0074Üîò ïÝÝUse IRSß Þ ßZÞ ßëYour nameêß\ëYour social security numberêÝß Þ ßZÞ ÝçLABEL.èßãYNAME*ß^áß Þ ßZÞ ßîò JïßZîò (ïÝß Þ ßZÞ ÝOtherwiseß Þ ßZÞ ßëSpouse's nameêß\ëSpouse's social security numberêÝß Þ ßZÞ ÝpleaseßãSNAME*ß^áß Þ ßZÞ ßîò JïßZîò (ïÝß Þ ßZÞ ÝßëHome addressêÜprint orß_For Privacy Act andß Þ ßZÞ Ýß Þ ßZÞ Ýtypeßáß_Paperwork Reductionß Þ ßZÞ ßîò JïÝß Þ ßZÞ ÝßëCity, state, and ZIP codeêß_Notice, seeß Þ ßZÞ Ýß Þ ßZÞ ÝßãCITY*ß_instructionsß Þ ßZÞ Üîò ïÝßPÞßUÞßZÞßZÞß_ÞßdÞßiÞÝçPresidentialèßDo you want $1 to go to this fund? ò.ßVYesßfNo çNote:èßpéChecking 'Yes' willêßRâ,Yßaâ,NßÞßÞßPÞ ßUÞ ßZÞ ßZÞß_Þ ßdÞ ßiÞ ßPîò ïÝßÞßÞßPÞßUÞßZÞ ßZÞß_ÞßdÞßiÞßpénot change tax orêÝçElection CampaignèßIf joint return, does spouse want $1 to go to fund?....ßVYesßfNoßRâ ,Yßaâ ,NßÞßÞßPÞ ßUÞ ßZÞ ßZÞß_Þ ßdÞ ßiÞ ßpéreduce refund.êÜîò ïÝßPÞßUÞßZÞß_ÞßdÞßiÞßÞßÞÝß 1ßâ,1ßSingle (See page 10 to find out if you can file as head of household.)ßÞ ßÞ ßî ïÝßÞßÞÝçFILING STATUSèß 2ßâ,2ßMarried filing joint return (even if only one had income)ßÞ ßÞ ßî ïÝßÞßÞÝß 3ßâ,3ßMarried filing separate return. Enter spouse's SSN above and full name here. áßÞ ßÞ ßgÞßî ïßiîò ïÝßÞßÞÝCheck onlyß 4ßâ,4ßHead of Household. If person is your child but not your dependent, enter name. áßÞ ßÞ ßiÞßî ïßkîò ïÝßÞßÞÝone box.ß 5ßâ,5ßQualifying widow(er) with dependent child (year spouse diedò .)(See page 10 of Instructions.)ßUÞßXç19è áßÞ ßÞ Üîò ïÝßÞßÞÝß 6aßáßçYourselfèß!If someone (such as your parent) can claim you as a dependent, doßÞÝßiéNo. checkedêÝß!not check box 6a. But be sure to check box on line 33b, page 2.ßiéon 6a and 6bêß|î ïß~áÝçEXEMPTIONSßçSpouseèß bßáßÞÝßiéNo. of childrenêÝßîò Vïßiéon 6c who:êÝß+Þß5ÞßIÞß]ÞßgÞÝ(Seeò c Dependents:ß+é(2) Checkêß6é(3)If 2 or older,êß]é(5)No. ofêß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýß,éif underêß9édependent'sêßJé(4) Relationshipêß^émos.livedêß+Þß5ÞßIÞß]ÞßgÞÝInstructionsßé(1) Name êß.éage 2êß9ésoc. sec. no.êß^éat homeêßié* lived with youêßîò Vïß|î ïß~á>ß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýß+Þß5ÞßIÞß]ÞßgÞÝon page 10.)ßîò Vïßáß0áß9áßKáß_áß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýß+Þß5ÞßIÞß]ÞßgÞÝßîò Vïßá ß0á!ß9á"ßKá#ß_á$ßié* didn't live withêß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýßiéyou due to divorceêß+Þß5ÞßIÞß]ÞßgÞÝIf more than 6ßiéor separationêßîò Vïß|î ïßá&ß0á'ß9á(ßKá)ß_á*ß~á?ß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýß+Þß5ÞßIÞß]ÞßgÞÝdependents,seeßîò Vïßá,ß0á-ß9á.ßKá/ß_á0ß+Þ ß5Þ ßIÞ ß]Þ ßgÞ ÝßiéNo. of otherêß+Þß5ÞßIÞß]ÞßgÞÝinstructionsßiédependentsêßîò Vïß|î ïßá2ß0á3ß9á4ßKá5ß_á6ß~á@ß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýß+Þß5ÞßIÞß]ÞßgÞÝon page 11.ßîò Vïßá8ß0á9ß9á:ßKá;ß_á<ß+Þ ß5Þ ßIÞ ß]Þ ßgÞ Ýß+Þß5ÞßIÞß]ÞßgÞÝÝßd Check, if child didn't live with you but is claimed under a pre-1985 agreementßbÞßdÞß|ÞßfáAÝßiéAdd numbersêß|ÞßÞß~áBÝße Total number of exemptions claimed ò.2ßiéentered aboveêßxÞß|ÞÝÜîò ïÝßnÞßsÞÝò 7. Wages, salaries, tips, etc. (attach Form(s) W-2)ò.) 7ßnÞ ßsÞ ßnîò ïß<áPß?áQßuáRÝßnÞßsÞÝçINCOMEßTaxableèÜò 8a.ò interest income (also attach Schedule B if over $400)ò. 8aßnÞ ßsÞ ßnîò ïßuáSÝßXÞß]ÞßnÞÝAttachò b.ò interest income (see pg 13). DON'T include on line 8a ... 8bßçTax-exemptèßXÞß]ÞßnÞßXîò ïß_áTÝßXÞß]ÞßnÞßsÞÝCopy B ofò 9. Dividend income (also attach Schedule B if over $400)ò.$ 9ßnÞ ßsÞ ßnîò ïßuáUÝßnÞßsÞÝyour Forms 10. Taxable refunds of state and local income taxes, if anyò." 10ßnÞ ßsÞ ßnîò ïßuáVÝßnÞßsÞÝW-2,W-2Gò 11. Alimony received ò.H 11ßnÞ ßsÞ ßnîò ïßuáWÝßnÞßsÞÝ& W-2P.ò 12. Business income or (loss) (attach Schedule C)ò., 12ßnÞ ßsÞ ßnîò ïßuáXÝßnÞßsÞÝò 13. Capital gain or (loss) (attach Schedule D) ò.. 13ßnÞ ßsÞ ßnîò ïßuáYÝßnÞßsÞÝIf you do not 14. Capital gain distributions not reported on line 13 ò.& 14ßnÞ ßsÞ ßnîò ïßuáZÝßnÞßsÞÝhave a W-2 15. Other gains or (losses) (attach Form 4797) ò.. 15ßnÞ ßsÞ ßnîò ïßgá[ßuá\Ýß7Þß<ÞßnÞßsÞÝsee pg 8. 16a.Total IRA distributionsò. 16aò , ò. 16b. Taxable amount 16bß7Þ ß<Þ ßnÞ ßsÞ ß7îò ïßnîò ïß>á]ßuá^Ýß7Þß<ÞßnÞßsÞÝò 17a.Total pensions and annuitiesò. 17aò , ò. 17b. Taxable amount 17bß7Þ ß<Þ ßnÞ ßsÞ ß7îò ïßnîò ïß>á_ßuá`Ýß7Þß<ÞßnÞßsÞÝò 18. Rents, royalties, partnerships, estates, trusts, etc (attach Schedule E)ò. 18ßnÞ ßsÞ ßnîò ïßuácÝßnÞßsÞÝAttach check 19. Farm income or (loss) (attach Schedule F)ò.0 19ßnÞ ßsÞ ßnîò ïßuádÝßnÞßsÞÝor moneyò 20. Unemployment compensation (insurance) (see page 16)ò.& 20ßnÞ ßsÞ ßnîò ïßuáeÝß7Þß<ÞßnÞßsÞÝorder on top 21a.Social security benefitsò. 21aò , ò. 21b. Taxable amount 21bß7Þ ß<Þ ßnÞ ßsÞ ß7îò ïßnîò ïß>áfßVágßuáhÝßnÞßsÞÝof W-2,W-2G 22. Other income:ò.)(ò )..... 22ßnÞ ßsÞ ßnîò ïßKîãZ1*ïß\îámïßuámÝßnÞßsÞÝand W-2P. 23. Add amounts in far right column for lines 7-22. This is yourò ò. 23ßQçtotal incomeèßkÞßnÞ ßsÞ Üîò ïßuánÝßXÞß]ÞßnÞÝò 24a. Your IRA deduction, from worksheet on page 17 or 18ò. 24aßXÞß]ÞßnÞßXîò ïß_árÝßXÞß]ÞßnÞÝçADJUSTMENTSèÜò 24b. Spouse's IRA deduction, from worksheet on page 17 or 18ò. 24bßXÞß]ÞßnÞßXîò ïß_ásÝßXÞß]ÞßnÞÝçTO INCOMEèÜò 25. One-half of self-employment tax (see page 18)ò. 25ßXÞß]ÞßnÞßXîò ïß_átÝßXÞß]ÞßnÞÝò 26. Self-employed health insurance deduction from worksheet on page 18.. 26ßXÞß]ÞßnÞßXîò ïß_ávÝßXÞß]ÞßnÞÝ(Seeò 27. Keogh retirement plan and self-employed SEP deductionò. 27ßXÞß]ÞßnÞßXîò ïß_áyÝßXÞß]ÞßnÞÝinstructions 28. Penalty on early withdrawal of savingsò. 28ßXÞß]ÞßnÞßXîò ïß_ázÝßXÞß]ÞßnÞÝon page 17.) 29. Alimony paid. Recipient's SSNò '29ß3ÞßXÞß]ÞßnÞß8îò ïßXîò ïß:á|ß_á{ÝßXÞß]ÞßnÞßsÞÝßnÞ ßsÞ ßKá}ß_á~ÝßnÞßsÞÝò 30. Add lines 24a through 29. These are yourò ò. 30ß<çtotal adjustmentsèßkÞßnÞßsÞÜîò ïßuáÝßnÞßsÞÝçADJ.GR.INC.èÜò 31. Subtract line 30 from line 23. This is yourò ò. 31ß?çtotal adjusted gross incomeèßkÞßnÞ ßsÞ Üîò ïßuá€ÝÝéAM Software H838êðä2çForm 1040 (1990)ß|Page 2èß!ãNAME*ßdáÜîò ïÝßnÞßsÞÝò 32. Amount from line 31 (adjusted gross income)ò.. 32ßnÞ ßsÞ ßnîò ïßuá€ÝßnÞÝò 33a Check if:ò were 65 or overò Blindò was 65 or overò BlindÜçTAXò Youò #SpouseèßÞß7ÞßDÞßaÞßnÞßáß9á‚ßFáƒßcá„ÝßbÞßgÞßnÞßnÞßsÞÝò Add the number of boxes checked and enter the total here ò.ò 33aÜçCOMPU-èß^ÞßbÞ ßgÞ ßnÞßbîò ïßiá…ÝßbÞßgÞßnÞßnÞßsÞÝò b If you can be claimed as a dependent on another person's return, check.....ò 33bÜçTATIONèß^ÞßgÞßnÞßiá†ÝßnÞßnÞßsÞÝò c If you are married filing a separate return and your spouse itemizesßnÞÝßnÞßnÞßsÞÝò or you are a dual-status alien, see page 19 and check hereò.ò 33cß^ÞßgÞßnÞßiá‡ÝßnÞßnÞßsÞÝò 34. Enter the | * Yourò (from page 20 of the instructions),ß'çstandard deductionò $ORèßnÞÝßnÞßsÞÝò --| * Yourò (from Schedule A, line 27)ò. 34ßçlargerò itemized deductionsèßnÞ ßsÞ ßnîò ïßuá‹ÝßnÞßsÞÝò of:ò | If you itemize, attach Schedule A and check hereò. ß^ÞßbÞßnÞßsÞßdáŠÝßnÞßsÞÝò 35. Subtract line 34 from line 32ò.= 35ßnÞ ßsÞ ßnîò ïßuáŒÝßnÞßsÞÝò 36. Multiply $2,050 by the total number of exemptions claimed on line 6eò. 36ßnÞ ßsÞ ßnîò ïßuáÝßnÞßsÞÝò 37.ò Subtract line 36 from line 35. (If line 36 is more than line 35, enter 0.). 37ßçTaxable income.èßnÞ ßsÞ ßnîò ïßuáŽÝßnÞßsÞÝò 38. Enter tax. Check if from a.ò Tax Table, b.ò Tax Schedules, or c.ò Form 8615ß.ÞßAÞß[ÞßnÞ ßsÞ ß0á“ßCá”ß]á•ÝßnÞßsÞÝò (If any is from Form(s) 8814, enter that amount hereò. d.ò )ò. 38ßQÞßnÞßsÞßXîò ïßnîò ïßYá‘ßuá’ÝßnÞßsÞÝò 39. Additional taxes. Check if from a.ò Form 4970 b.ò Form 4972 ò. 39ß6ÞßLÞßnÞ ßsÞ ßnîò ïß8á˜ßNá™ßuá—ÝßnÞßsÞÝò 40. Add lines 38 and 39. Enter the totalò.2 40ßjÞßnÞ ßsÞ Üîò ïßuášÝßXÞß]ÞßnÞßnÞßsÞÝò 41. Credit for child and dependent care expenses (att. Form 2441)ò. 41ßXÞß]ÞßnÞßXîò ïßRá›ß_áœÝßXÞß]ÞßnÞÝò 42. Credit for the elderly or the disabled (attach Schedule R)ò. 42ÜçCREDITSèßXÞß]ÞßnÞßXîò ïßRáß_ážÝßXÞß]ÞßnÞÝò 43. Foreign tax credit (attach Form 1116)ò. 43ßXÞß]ÞßnÞßXîò ïß_áŸÝßXÞß]ÞßnÞÝSeeò 44. General business credit. Check if from:ßXÞß]ÞßnÞÝßXÞß]ÞßnÞÝinstructions a.ò Form 3800, or b.ò Formò ò. 44ßÞß-ÞßXÞß]ÞßnÞßXîò ïßá¡ß/á£ß7á¢ß_á ÝßXÞß]ÞßnÞÝon page 21. 45. Credit for prior year minimum tax (attach Form 8801) ò. 45ßXÞß]ÞßnÞßXîò ïß_á¤ÝßXÞß]ÞßnÞßsÞÝò 46. Add lines 41 through 45. Enter the totalò.1 46ßnÞ ßsÞ ßnîò ïßuá¥ÝßnÞßsÞÝò 47. Subtract line 46 from line 40. Enter the result (but not less than zero)ò. 47ßjÞßnÞ ßsÞ Üîò ïßuá¦ÝßnÞßsÞÝò 48. Self-employment tax (attach Schedule SE) ò.1 48ßnÞ ßsÞ ßnîò ïßZá§ßuá¨ÝßnÞßsÞÝò 49. Alternative minimum tax (attach Form 6251) ò./ 49ÜçOTHERèßnÞ ßsÞ ßnîò ïßuá©ÝßnÞßsÞÝò 50. Recapture taxes (see page 22). Check if from a.ò Form 4255 or b.ò Form 8611ò. 50ÜçTAXESèßCÞßYÞßnÞ ßsÞ ßnîò ïßEá«ß[á¬ßuáªÝßnÞßsÞÝò 51. Social security tax on tip income not reported to employer (attach Form 4137)ò. 51ßnÞ ßsÞ ßnîò ïßuáÝßnÞßsÞÝò 52. Tax on an IRA or a qualified retirement plan (attach Form 5329)ò. 52ßnÞ ßsÞ ßnîò ïßuá®ÝßnÞßsÞÝò 53. Advance earned income credit payments, from Form W-2ò.& 53ßnÞ ßsÞ ßnîò ïßuá¯ÝßnÞßsÞÝò 54. Add lines 47 through 53. This is yourò ò.' 54ß9çtotal taxèßjÞßnÞ ßsÞ Üîò ïßuá°ÝßXÞß]ÞßnÞßnÞßsÞÝò 55. Federal income tax withheld (if any Form(s) 1099, checkò ) ò. 55ßIÞßXÞß]ÞßnÞßXîò ïßKá²ß_á±ÝßXÞß]ÞßnÞÝò 56. 1990 estimated tax payments and amount applied from 1989 returnò. 56ÜçPAYMENTSèßXÞß]ÞßnÞßXîò ïß_á¸ÝßXÞß]ÞßnÞÝò 57. Earned income credit (see page 23) ò.! 57ßXÞß]ÞßnÞßXîò ïß<ãEIC*ßAáºß_á»ÝßXÞß]ÞßnÞÝAttach W-2, 58. Amount paid with Form 4868 (extension request) ò. 58ßXÞß]ÞßnÞßXîò ïß_á¼ÝßXÞß]ÞßnÞÝW-2G, W-2P 59. Excess social security tax and RRTA tax withheld ò. 59ßXÞß]ÞßnÞßXîò ïß_á½ÝßXÞß]ÞßnÞÝto front. 60. Credit for federal tax on fuels (attach Form 4136) ò. 60ßXÞß]ÞßnÞßXîò ïß_á¾ÝßXÞß]ÞßnÞÝò 61. Regulated investment company credit (attach Form 2439) ò. 61ßXÞß]ÞßnÞßXîò ïß_á¿ÝßXÞß]ÞßnÞßsÞÝò 62. Add lines 55 through 61. These are yourò ò.! 62ß;çtotal paymentsèßjÞßnÞ ßsÞ Üîò ïßuáÀÝßnÞßsÞÝò 63. If line 62 is larger than line 54, enter amountò ò. 63ßBçOVERPAIDèßjÞßnÞ ßsÞ ßnîò ïßuáÁÝßnÞßsÞÝò 64. Amount of line 63 to beò ò.1 64ÜçREFUND orß*çREFUNDED TO YOUèßjÞßnÞ ßsÞ ßnîò ïßuáÂÝßnÞßnÞßsÞÝò 65. Amount of line 63 to beò #ò. 65ÜçAMOUNTß*APPLIED TO YOUR 1991 ESTIMATED TAXèßTÞßXÞ ß]Þ ßnÞßXîò ïß_áÃÝßXÞß]ÞßnÞÝò 66. If line 54 is larger than line 62, enterò . Attach check or money order forÜçYOU OWEò 2AMOUNT YOU OWEèßnÞÝßnÞßnÞßsÞÝò full amount payable to "Internal Revenue Service." Write your name, social securityßnÞÝßnÞßsÞÝò number, address, daytime phone number, and "1990 Form 1040" on itò. 66ßnÞ ßsÞ ßnîò ïßuáÄÝßnÞßnÞßsÞÝò 67. Estimated tax penalty (see page 25)ò. 67ßTÞßXÞ ß]Þ ßnÞßsÞ Üîò ïß<áÆß_áÅÝßnÞßsÞÝéò Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements,êÝçSignèÜéò and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (otherêÝéò than taxpayer) is based on all information of which preparer has any knowledge.êÝçHereèÝÝÜëò Your signatureò $Dateò Your OccupationêßÞßÞßCÞ ßPÞ ÝßÞßÞßCÞßPÞÝ(Keep copyßÞßÞßCÞ ßPÞ ßîò oïßUáÝßCÞßPÞÝÜfor yourÜëò Spouse's signature (if joint, both must sign)ò Dateò Spouse's OccupationêßÞßÞßCÞ ßPÞ ÝßÞßÞßCÞßPÞÝÜîò ïÜrecords)ßÞßÞßCÞ ßPÞ ßUáÝßCÞßPÞßfÞÝÜëò Preparer's signatureò Dateò Check ifò Preparer's SSNêßÞßÞßCÞ ßPÞ ßfÞ ÝëßQself-employedêßÞßÞßCÞßPÞßfÞÝçPaidèßîò oïßÞßÞßCÞ ßPÞ ßaÞßfÞ ßcâÈ,YßiáÐÝßWÞÝçPreparer'sèÜëò Firm's name and address (or yours if self-employed)êßWÞ ÝßWÞÝßXëE.I. No.êÜçUse Onlyèßîò oïßÞßÞßWÞ ßáÉßcáÊÝßÞßÞßWÞÝßXëZip CodeêÜîò ïßÞßÞßWÞ ßáÌß7áÍßLáÎßcáÏÝÝéAM Software H838ðñæÿÿÿ