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Form 1040 U.S. Individual Income Tax Return 2005. Summary: This is an example of a Form 1040 (2005) with items included as described in the text. Additionally, these line items are completed:

DECEASED” and “John R. Smith--April 9, 2005” are written across the top of the form.
Under “Label”:
Your first name and initial” field contains John R.
Last name” field contains Smith
Your social security number” field contains 234-00-7890
If a joint return, spouse's first name and initial” field contains Mary L.
Last name” field contains Smith
Spouse's social security number” field contains 567-00-0123
Home address (number and street). If you have a P.O. box, see page 19.” field contains 6406 Mayflower Street
City, town or post office, state, and ZIP code. If you have a foreign address, see page 19.” field contains Juneville, Maine 00000
Under “Presidential Election Campaign”:
Do you, or your spouse if filing a joint return, want $3 to go 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
Number of boxes checked on 6a and 6b” field contains 2
d. Total number of exemptions claimed. Add numbers on lines above” field contains 2
Under “Income”:
22. Add the amounts in the far right column for lines 7 through 21. This is your total income.” field contains 22,323