Publication 519: U.S. Tax Guide for Aliens;

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 2003, Pages 1 and 2. Written above title “Dual-Status RETURN”. Summary: This is an example of Form 1040 (2003), pages 1 and 2 with items included as described in the text. Additionally, these line items are completed:

Page 1:

Under “Income”:

“7. Wages, salaries, tips, etc. Attach Form(s) W–2” field contains 28,300

“8a. Taxable interest. Attach Schedule B if required” field contains 395

“9. Ordinary dividends. Attach Schedule B if required” field contains 120

“22. Add the amounts in the far right column for lines 7 through 21. This is your total income” field contains 28,815

Under “Adjusted Gross Income”:

“27. Moving expenses. Attach Form 3903” field contains 8,300

“33. Add lines 23 through 32a” field contains 8,300

“34. Subtract line 33 from line 22. This is your adjusted gross income” field contains 20,515

Page 2:

Under “Tax and Credits”:

“35. Amount from line 34 (adjusted gross income)” field contains 20,515

“37. Itemized deductions (from Schedule A) or your standard deduction (see left margin)” field contains 922

“38. Subtract line 37 from line 35” field contains 19,593

“39. If line 35 is $104,625 or less, multiply $3,050 by the total number of exemptions claimed on line 6d. If line 35 is over $104,625, see the worksheet on page 35” field contains 3,050

“40. Taxable income. Subtract line 39 from line 38. If line 39 is more than line 38, enter 0” field contains 16,543

“41. Tax (see page 36). Check if any tax is from a (checkbox) Form(s) 8814 b (checkbox) Form 4972” field contains 2,129

“43. Add lines 41 and 42” field contains 2,129

“54. Subtract line 53 from line 43. If line 53 is more than line 43, enter 0” field contains 2,129

Under “Other Taxes”:

“60. Add lines 55 through 60. This is your total tax. Add $36 from 1040NR” field contains 2,165

Under “Payments”:

“61. Federal income tax withheld from Forms W–2 and 1099 (Line 61: Includes $36 from Form 1040N.R.)” field contains 2,736

“68. Add lines 61 through 67. These are your total payments” field contains 2,736

Under “Refund”:

“69. If line 68 is more than line 60, subtract line 60 from line 68. This is the amount you overpaid” field contains 571

“70a. Amount of 69 you want refunded to you” field contains 571

Under “Sign Here”:

“Your signature” field contains Sam R. Brown

“Date” field contains 3-16-2004

“Your occupation” field contains R&D Specialist