The document shows a 1040 form. The 1040 form is used to collect
O state tax.
Deprem Service
Income Tax Return for Single and
Joint Fillers With No Depondents
1040EZ
Your brotame and
O local tax.
O federal tax.
Osales tax.
Tajor ram, spouse't name and in
Last name
Home resumber and you have a PO box, intructions
End Gourm
Foreign country name
Foreign provincolo
1
Wapes, salaries, and tips. This should be shown in bo
Attach your Forms) W-2.
Income
Attach
Forms) W-2
here.
Enclose, but do
2 Taxable interest. If the total is over $1.500, you canno
payment
3 Unemployment compensation and Alaska Permanent
4 Add lines 1, 2, and 3. This is your adjusted grees in
5 if someone can claim you for your spouse if a jointre
the applicable boxſes) below and enter the amount fro
You
Encime
Spouse
Mark this and return
Save and Exit
Next
Submit