Name ____________________________ Class ______________________Date __________
PERSONAL FINANCE:
Keeping
Track FORM
Online (continued)
Sample 1040EZ Form
Income Tax Return for Single and
Joint Filers With No Dependents (99)
1040EZ
Label
Use the
IRS label.
L
A
B
E
L
Otherwise,
please print
or type.
H
E
R
E
(See page 9.)
3
2008
Your first name and initial
Last name
Your social security number
If a joint return, spouse’s first name and initial
Last name
Spouse’s social security number
John J.
Elliott
123 45
Home address (number and street). If you have a P.O. box, see page 9.
Apt. no.
6789
You must enter
your SSN(s) above.
123 Maple Street
City, town or post office, state, and ZIP code. If you have a foreign address, see page 9.
Checking a box below will not
change your tax or refund.
Newtown, TN 37502
Income
Attach
Form(s) W-2
here.
Enclose, but
do not
attach, any
payment.
Payments
and tax
Refund
Have it directly
deposited! See
page 18 and fill
in 12b, 12c,
and 12d or
Form 8888.
Amount
you owe
Third party
designee
Sign
here
Joint return?
See page 6.
Keep a copy for
your records.
Do you want to allow another person to discuss this return with the IRS (see page 20)?
Yes. Complete the following.
No
Designee’s
Phone
Personal identification
(
)
name
no.
number (PIN)
Under penalties of perjury, I declare that I have examined this return, and to the best of my knowledge and belief, it is true, correct, and
accurately lists all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxp ayer) is based
on all information of which the preparer has any knowledge.
Your occupation
Daytime phone number
Your signature
Date
(
Spouse’s signature. If a joint return, both must sign.
Date
Date
Preparer’s
signature
Firm’s name (or
yours if self-employed),
address, and ZIP code
)
Spouse’s occupation
Check if
self-employed
Preparer’s SSN or PTIN
EIN
Phone no.
(
)
Form
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113
1040EZ
(2008)