Form

1040

Department of the Treasury — Internal Revenue Service

U.S. Individual Income Tax Return

20

23

OMB No. 1545-0074

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

For the year Jan. 1–Dec. 31, 2023, or other tax year beginning , 2023, ending , 20

See separate instructions.

Your first name and middle initial

Last name

Your social security number

If joint return, spouse’s first name and middle initial

Last name

Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions.

Apt. no.

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.

checkbox You checkbox Spouse

City, town, or post office. If you have a foreign address, also complete spaces below.

State

ZIP code

Foreign country name

Foreign province/state/county

Foreign postal code

Filing Status

Check only
one box
checkbox Single
checkbox Head of household (HOH)
checkbox Married filing jointly (even if only one had income)
checkbox Married filing separately (MFS)
checkbox Qualifying surviving spouse (QSS)

If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child’s name if the qualifying person is a child but not your dependent:

Digital Assets

At any time during 2023, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell,

exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) checkbox Yes checkbox No

Standard Deduction

Someone can claim:

checkbox You as a dependent checkbox Your spouse as a dependent

checkbox Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness

You:

checkbox Were born before January 2, 1959 checkbox Is blind

Spouse:

checkbox Were born before January 2, 1959 checkbox Is blind

Dependents

If more than four dependents, see instructions and check here . . checkbox

(see instructions):

(1) First nameLast name

(2) Social security number

(3) Relationship to you

(4) Check the box if qualifies for (see instructions):

Child tax credit

Credit for other dependents

checkbox

checkbox

checkbox

checkbox

checkbox

checkbox

checkbox

checkbox

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 Form W-2, see instructions.

1a

Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . . . . . .

1a

0.00

b

Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . .

1b

0.00

c

Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . .

1c

0.00

d

Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . .

1d

0.00

e

Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . .

1e

0.00

f

Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . .

1f

0.00

g

Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . .

1g

0.00

h

Other earned income (see instructions) . . . . . . . . . . . . . . . . . .

1h

0.00

i

Nontaxable combat pay election (see instructions) . . . . 1i0.00

Attach Sch. B if required.

z

Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . .

1z

0.00

2a

Tax-exempt interest . . . . .

2a0.00b Taxable interest . .

2b

0.00

3a

Qualified dividends . . . . .

3a0.00b Ordinary dividends . .

3b

4a

IRA distributions . . . . . .

4a0.00b Taxable amount . .

4b

Standard Deduction for—
  • Single or Married filing separately, $13,850
  • Married filing jointly or Qualifying surviving spouse, $27,700
  • Head of household, $20,800
  • If you checked any box under Standard Deduction, see instructions.

5a

Pensions and annuities . . . .

5a0.00b Taxable amount . .

5b

0.00

6a

Social security benefits . . . .

6a0.00b Taxable amount . .

6b

c

If you elect to use the lump-sum election method, check here (see instructions) . . . checkbox

7

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

7

0.00

8

Additional income from Schedule 1, line 10 . . . . . . . . . . . . . . . . .

8

0.00

9

Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . .

9

0.00

10

Adjustments to income from Schedule 1, line 26 . . . . . . . . . . . . . . .

10

0.00

11

Subtract line 10 from line 9. This is your adjusted gross income . . . . . . . . .

11

12

Standard deduction or itemized deductions (from Schedule A) . . . . . . . . .

12

13

Qualified business income deduction from Form 8995 or Form 8995-A . . . . . . . .

13

14

Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . .

14

15

Subtract line 14 from line 11. If zero or less, enter -0-. This is your . . . . . . . . .

15

0.00

Tax and Credits

16

Tax x (see instructions). Check if any from Form(s): 1 checkbox 8814 2 checkbox 4972 3 checkbox

16

17

Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . .

17

18

Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . .

18

19

Child tax credit or credit for other dependents from Schedule 8812 . . . . . . . . .

19

20

Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . .

20

21

Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . .

21

22

Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . .

22

23

Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . .

23

24

Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . .

24

Payments

25

Federal income tax withheld from:

a

Form(s) W-2 . . . . . . . . . . . . . . . . . .

25a

b

Form(s) 1099 . . . . . . . . . . . . . . . . . .

25b

c

Other forms (see instructions) . . . . . . . . . . . .

25c

d

Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . .

25d

If you have a qualifying child, attach Sch. EIC.

26

2023 estimated tax payments and amount applied from 2022 return . . . . . . . .

26

27

Earned income credit (EIC) . . . . . . . . . . . . .

27

28

Additional child tax credit from Schedule 8812 . . . . . . .

28

29

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

29

30

Reserved for future use . . . . . . . . . . . . . . .

30

31

Amount from Schedule 3, line 15 . . . . . . . . . . .

31

32

Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits.

32

33

Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . .

33

Refund

Direct deposit? See instructions.

34

If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid

34

35a

Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . checkbox

35a

b

Routing number

c Type: checkbox Checking checkbox Savings

d

Account number

36

Amount of line 34 you want applied to your 2024 estimated tax . .

36

Amount You Owe

37

Subtract line 33 from line 24. This is the amount you owe.

For details on how to pay, go to www.irs.gov/Payments or see instructions . . . . . .

37

38

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

38

Third Party Designee

Do you want to allow another person to discuss this return with the IRS? See

instructions . . . . . . . . . . . . . . . . . . . . . . . checkbox Yes. Complete below. checkbox 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

If the IRS sent you an Identity Protection PIN, enter it here
(see inst.)

Spouse’s signature. If a joint return, both must sign.

Date

Spouse’s occupation

If the IRS sent your spouse an Identity Protection PIN, enter it here (see inst.)

Phone no.

Email address

Paid Preparer Use Only

Preparer’s name

Preparer’s signature

Date

PTIN

Check if:

checkbox Self-employed

Firm’s name

Phone no.

Firm’s address

Firm’s EIN

Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2023)