TotalAdjustments:

ExemptionAmount:

TotalTax:

TotalESPayments:

TotalPayments:

AmountOwed:

HomePhone:

Married Filing Jointly

StandardDeduction:

TotalHouseholdEmploymentTaxes:

TotalIncome:

TotalAdjustments:

TaxableIncome:

Taxpayer

IDNumber

CompleteName

HomePhone:

Exemptions

Spouse

IDNumbe

CompleteName: Occupation: Self Employed

 1------------------ram

Address Street:

City:

State:

ZipCode:

HomePhone:

Authentication abcd2 Identification efgh3

KeyID 998870

Tax Year 1999

Tax Form Form1040 Version

Filing Status

Taxpayer

IDNumber

CompleteName

HomePhone:

Spouse

IDNumbe

CompleteName:

2-Adjusted Gross Income

Tax and Credits

Income

Exemptions

3-------------------TotalAdjustments:

StandardDeduction:

TotalIncome:

TotalHouseholdEmploymentTaxes

4--------------------Total number of exemptions claimed

ExemptionAmount:

Yourself

Spouse

Dependents

Total number of exemptions claimed

5--------------

12 - Business income or loss. Attach Schedule C or C-EZ

13- Capital gain or loss. Attach Schedule D if required. 0

14- Other gains of losses. Attach Form 4797

18- Farm income or loss. Attach Schedule F

22 Add the amounts in the far right column for lines 7 through 21. This is your Total Income

7-Wages, Salaries, tips, etc. Attach Form(s) W-2

19-Unemployment compensation

20a -Social Security Benefits/20bTaxable amount

8a-Taxable interest. Attach Schedule B if required

8b- Tax Exempt Interest. Do Not include on line 8a

9 - Ordinary Dividends. Attach Schedule B if required

10 -Taxable refunds, credits, or offsets of state and local income taxes

11- Alimony Received

15a Total IRA distributions/15b Taxable amount

16a-Total pensions and annuities/16b Taxable amount

17-Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E

21 Other income. List type and amount

6-------------

23-IRA deduction 24-Student loan interest deduction

32 Add lines 23 through 31a

33 Subtract line 32 from line 22. This is your adjusted gross income

Adjusted Gross Income

28-Self-employed health insurance deduction

29- Keogh and self-employed SEP and SIMPLE plans

30- Penalty on early withdrawl of savings

31b-Alimony recipient's SSN

25-Medical savings account deduction. Attach Form 8853. 26-Moving Expenses. Attach Form 3903.

7-------------

38- If line 34 is $94,975 or less, multiply $2,750 by the total number of exemptions claimed on line 6d. If line 34 is over $94,975 see the worksheet on page 31 for the amount to enter

46-Foreign tax credit. Attach Form1116 if required.

47a- Check if other from Form 3800

47b-Check if other from Form 8396

47c Check if other from Form 8801

47 Other

34- Subtract line 32 from line 22. This is your adjusted gross income

37- Subtract line 36 from line 3

Taxable income. Subtract line 38 from line 37. If line 38 is more than line 37, enter 0

48-Add lines 41 through 47. These are your total credits

49-Subtract line 48 from line 40. If line 48 is more than line 40, enter 0

35a-1 Check if You were 65 or older

35a-2 Check if You were Blind

35a-3 Check if Spouse was 65 or older

35a-4 Check if Spouse was Blind

35a Add the number of boxes checked

35b-If you are married filing separately and your spouse itemizes deductions or you were a dual-status alien, check here

36- Enter you itemized deductions from Schedule A, line 28, OR standard deduction.

40a-Any tax from Form(s) 8814? 40b Any tax from Form 4972

40- Tax

41-Credit for child and dependent care expenses. Attach Form 2441

42- Credit for the elderly or the disabled. Attach Schedule R.

43- Child tax credit

44-Education credits. Attach Form 8863.

45- Adoption credit. Attach Form 8839.