Publication 517: Social Security and Other Information for Members of the Clergy and Religious Workers;

This is archived information that pertains only to the 2004 Tax Year. If you
are looking for information for the current tax year, go to the Tax Prep Help Area.

Form 1040 U.S. Individual Income Tax Return 2004. Summary: This is an example of Form 1040 (2004) with items included as described in the text. Additionally, these line items are completed:

Under “Label”:

“Your first name and initial” field contains John E.

“Last name” field contains Michaels

“Your social security number” field contains 011-00-2222

“If a joint return, spouse's first name and initial” field contains Susan R.

“Last name” field contains Michaels

“Spouse's social security number” field contains 011-00-1111

“Home address (number and street). If you have a P.O. box, see page 19.” field contains 1040 Main Street

“City, town or post office, state, and ZIP code. If you have a foreign address, see page 19.” field contains Hometown, Texas 77099

“Presidential Election Campaign (See page 19.): Do you, or your spouse if filing a joint return, want $3 to go to this fund?”

“You: Yes” checkbox checked

“Spouse: Yes” checkbox checked

Under “Filing Status”:

“2. Married filing jointly (even if only one had income)” checkbox checked

Under “Exemptions”:

“6a. Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax return, do not check box 6a)” checkbox checked

“6b. Spouse” checkbox checked

“6c. Dependents:”

“(1) First name Last name” field contains Jennifer Michaels

“(2) Dependent's social security number” field contains 111-00-1113

“(3) Dependent's relationship to you” field contains daughter

“(4) Check if qualifying child for child tax credit (see page 22)” checkbox checked

“Number of boxes checked on 6a and 6b” field contains 2

“Number of children on 6c who lived with you” field contains 1

“6d. Total number of exemptions claimed” field contains 3

Under “Income”:

“7. Wages, salaries, tips, etc. Attache Form(s) W-2” field contains 34,640

“12. Business income or (loss). Attach Schedule C or C-EZ” field contains 3,801

“22. Add the amounts in the far right column for lines 7 through 21. This is your total income” field contains 38,441

Under “Adjusted Gross Income”:

“30. One-half of self-employment tax. Attach Schedule SE” field contains 3,133

“35. Add lines 23 through 34a” field contains 3,133

“36. Subtract line 35 from line 22. This is your adjusted gross income” field contains 35,308