//41FormDepartment of the Treasury - Internal Revenue Service    MPSVMPSV    MPSVMPSVU.S. Individual Income Tax ReturnpOMB No. 1545-0085 LStep 1 Z Z Your namedYour social security numberUse IRS Z YNAME*f Z  Jd  Z LABEL. Z Spouse's namedSpouse's social security number Z OtherwiseSNAME*f Z  Jd  Z Home addresspleaseiFor Privacy Act and Z Z print oriPaperwork Reduction Z  J Z type.City, state, and ZIP codeiNotice, see Z Z CITY*iinstructions Z L Presidential Election Campaign Fund Do you want $1 to go to this fund?. . . . . . . . . . . . . .PYesZNobNote:hChecking "Yes" will notKUM ,YW ,N If joint return, does your spouse want $1 to go to this fund?PYesZNobchange tax or reduce refund.KUM ,YW ,N Step 21Single (See page 16 to find out if you can file as head of household.),1Check your2Married filing joint return (even if only one had income).,2filing status3Married filing separate return. Enter spouse's social security number above,3and spouse's full name here.7:9 G(Check only4Head of household (with qualifying person). (See page 16.) If the qualifyng person is your child,4one)but not your dependent, enter the child's name here.NQP 05Qualifying widow(er) with dependent child (year spouse died 19 ). (See page 17.)T,5Z Step 36aYourself!If someone (such as your parent) can claim you as a dependent, doiNo. checkedFigure your!not check box 6a. But be sure to check box on line 18b, page 2.ion 6a and 6b| ~bSpouseexemptions ViNo. of children+ 5 I ] g (See page 17.)cDependents:+(2) Check6(3)If 2 or over,](5)No. ofion 6c who:+ 5 I ] g ,if under9dependent'sJ(4) Relationship^mos.lived+5I]g(1) Name .age 29soc. sec. no.^at homei* lived with you V| ~<+ 5 I ] g +5I]g V09Ka+ 5 I ] g +5I]g V09 K!a"i* didn't live+ 5 I ] g iwith you due+5I]gIf over 7ito divorce or V$0%9&K'a(+ 5 I ] g iseparation+5I]gdependents,i(see page 21) V| *0+9,K-a.~=+ 5 I ] g +5I]gsee page 20. V00192K3a4+ 5 I ] g +5I]giNo. of other V60798K9a:+ 5 I ] g idependents| ~>+5I]g V+ 5 I ] g + 5 I ] g dCheck, if child didn't live with you but is claimed under a pre-1985 agreementbd|f?iAdd numbers|߁~@eTotal number of exemptions claimed.ientered abovex| Step 47Wages, salaries, tips, etc. This should be shown in Box 10 of your W-2Figure yourform(s). (Attach Form(s) W-2.)k7_DcEpF ototal income8a Taxableinterest income. (If over $400, also attach Schedule 1, Part I.)k8apG ob Tax-exemptinterest income. (DO NOT include on line 8a.)U8bZH VAttach Copy Dividends. (If over $400, also attach Schedule 1, Part II.)9k9pI oB of W-2 or Total IRA ink^ -- was 65 or older Blind --(SpouseRboxes checkedd18a!Aai#\C] ZbIf someone (such as your parent) can claim you as a dependent,Figure yourcheck here. . . . . . . . . . . . . . . . . . . . . .d18baik_ ZstandardcIf you are married filing separately and your spouse files Formdeduction, 1040 and itemizes deductions, see page 34 and check here . . . . . .d18caik` Z19 Standard deduction.(Enter your standard deduction. See page 35 for the chart (or worksheet)that applies to you. Be sure to enter your standard deduction here.j19pa oexemption20Subtract line 19 from line 17. Enter the result. (If line 19 is moreamount, andthan line 17, enter -0-.)j20pb o21Multiply $2,050 by the total number of exemptions claimed on line 6e.j21pc otaxable22Subtract line 21 from line 20. Enter the result. (If line 21 is moreincomethan line 20, enter -0-.) This is your;taxable income.j22gpd Step 723Find the tax on the amount on line 22. Check if from:Figure yourj23Tax Table (pages 49-54) or:Form 86155h7ipg otax,24aCredit for child and dependent care expenses.credits,Complete and attach Schedule 2.T24aZj oandbCredit for the elderly or the disabled.payments.Complete and attach Schedule 3.T24bZk ocAdd lines 24a and 24b. These are your:total credits.j24cpl o25Subtract line 24c from line 23 (but not less than -0-).j25pm o26Advance earned income credit payments from Form W-2.j26pn o27Add lines 25 and 26. Enter the total. This is yourHtotal tax.j27po og28aTotal Federal income tax withheld. (If any isfrom Form(s) 1099, check here .)T28a257qZp Vb 1990 estimated tax payments and amount appliedfrom 1989 return.T28bZw VcEarned income credit. See page 38 to find outif you can take this credit. ( )T28c2EIC*5yZz VdAdd lines 28a, 28b, and 28c. These are your@total payments.j28dgp{ Step 829If line 28d is more than line 27, subtract line 27 from line 28d.Figure yourThis is the amount you*overpaid.j29p| orefund30Amount of line 29 that you want3refunded to you.j30p} oor amount31Amount of line 29 that you want3applied to youryou owe1991 estimated tax.T31Z~ o32If line 27 is more than line 28d, subtract line 28d from line 27.This is the Attach check or money order for the full amountamount you owe.payable to "Internal Revenue Service." Write your name, social securitynumber, address, daytime phone number, and "1990 Form 1040A" on it.j32p o33Estimated tax penalty (see page 42).T33