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Form 1040 U.S. Individual Income Tax Return 2005. Summary: This is an example of Form 1040 (2005) completed as pertains to the example in the text. The completed line items are:

Under “Label Here”:
Your first name and initial” field contains Glenn M.
Last name” field contains Johnson
Your social security number” field contains 765-00-4321
Home address (number and street). If you have a P.O. box, see page 16” field contains 5603 East Main Street
City, town or post office, state, and ZIP code. If you have a foreign address, see page 16.” field contains Anytown, Virginia 20000
Under “Presidential Election Campaign”:
Do you, or your spouse if filing a joint return, want $3 to go to this fund? You--Yes” checkbox checked
Under “Filing Status”:
Single” checkbox checked
Under “Exemptions”:
6a. Yourself. If someone can claim you as a dependent, do not check box 6a” checkbox checked
Number of boxes checked on 6a and 6b” field contains 1
6d. Total number of exemptions claimed” field contains 1
Under “Income”:
7. Wages, salaries, tips, etcetera. Attach Form(s) W-2” field contains 1,225
8a. Taxable interest. Attach Schedule B if required” field contains 425
12. Business income or (loss). Attach Schedule C or C-EZ” field contains negative 5,000
13. Capital gain or (loss). Attach Schedule D if required. If not required, check here” field contains 1,000 Footnote: Net capital gain ($2,000 gain less $1,000 loss)
22. Add the amounts in the far right column for lines 7 through 21. This is your total income” field contains negative 2,350
Under “Adjusted Gross Income”:
37. Subtract line 36 from line 22. This is your adjusted gross income” field contains negative 2,350