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1040 Department of the Treasury-Intemal Revenue Service (99) U.S. Individual Income Tax Return 2019 OMB No. 1545-0074 IRS Use Only-Do not write or staple in this space, Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (aw) Check only If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child's name it the qualifying person is one box a child but not your dependent. Your first name and middle initial Last name Your social security number Beverly Hair 465743321 If joint return, spouse's first name and middle initial Last name Spouse's social security number Ken Hair 46515719934 Home address (number and street). If you have a P.O.box, see instructions. Apt. no. Presidential Election Campaign Check hered you, or your spouse it Sling jointly, want $3 to go to this fund. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change you 3567 River Street tax or refund. You Spouse Foreign country name Foreign province/state/county Foreign postal code more than four dependents. Springfield, MO 63126 see instructions and / heren Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse itemizes on a separate retum or you were a dual-status alien Age/Blindness You: D Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is bind Dependents (see instructions): (2) Social Security number (3) Relati to you (4) If qualifies instructions: (1) First name Last name Child tax credit Credit for other dependents 1 1 2b 53.700 652 300 3b 4b 4d 5b 6 7a 1 Wages, salaries, tips, etc. Attach Formis) W-2 2a Tax-exempt interest 2a 1,000 b Taxable interest. Attach Sch. B if required 3a Qualified dividends 3a 300 b Ordinary dividends. Attach Sch. Bit required Standard Deduction for 4a IRA distributions. 4a b Taxable amount Single or Married с filing separately. Pensions and annuities 4c d Taxable amount $12.200 5a Social Security benefits. 59 b Taxable amount • Married fling jointly or Qualifying 6 Capital gain or loss). Attach Schedule D if required. If not required, check here widower) 7a Other income from Schedule 1, line 9. $24.400 • Head of • Add lines 1, 2b3b, 4b, 4d. 5b, 6, and 7a. This is your total income household $18.350 Ba Adjustments to income from Schedule 1, line 22 • you checked b Subtract line Ba from line 7b. This is your adjusted gross income any box under 9 9 Standard deduction or itemized deductions (from Schedule A) Standard 24.400 Deduction 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A 10 See Instructions 11a Add lines 9 and 10 b Taxable income. Subtract line 11a from line Bb For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B 1.825 56,477 7b 8a 8b 56,477 11a 11b 24,400 32,077 Form 1040 2019)
Page 2 c Form 1040 (2019) 12a Tax (see inst.) Check if any from Form(s): 1 8814 2 0 4972 3 D 12a 3.425 b Add Schedule 2, line 3, and line 12a and enter the total 12b 3,425 13a Child tax credit or credit for other dependents 13a b Add Schedule 3, line 7, and line 13a and enter the total 13b 14 Subtract line 13b from line 12b. If zero or less, enter-O- 14 3,425 15 Other taxes, including self-employment tax, from Schedule 2, line 10 15 16 Add fines 14 and 15. This is your total tax. 16 3,425 17 Federal income tax withheld from Forms W-2 and 1099 17 4,790 18 • If you have a Other payments and refundable credits: qualifying child, a Eamed income credit (EIC) 18a attach Sch. EIC. b 18b . If you have Additional child tax credit. Attach Schedule 8812 nontaxable American opportunity credit from Form 8863, line 8 18c combat pay, see instructions d Schedule 3, line 14 18d Add fines 18a through 18d. These are your total other payments and refundable credits 18e 19 Add lines 17 and 18e. These are your total payments 19 4.790 Refund 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 20 1.365 21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here 21a 1.365 Direct deposit? b Routing number Type: Checking Savings See instructions. ► d Account number 22 Amount of line 20 you want applied to your 2020 estimated tax 22 Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions 23 You Owe 24 Estimated tax penalty (see instructions) 24 Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below. Designee No (Other than Designee's Phone Personal identification paid preparer no. number PIN) Sign Under penalties of perjury, I declare that I have examined this retum and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Your signature Date Your occupation If the IRS sent you an identity Protection PIN, enter it here Joint return? Accountant (see inst.) See instructions. Spouse's signature. If a joint return, both must sign. Date Spouse's occupation If the IRS sent your spouse an Keep a copy for Identity Protection PIN, enter it here your records. Student (see inst.) Phone no. Email address Preparer's name Preparer's signature Date PTIN Check it Paid 3rd Party Designee Preparer Firm's name Phone no. Self-employed Use Only Firm's address Firm's EIN Go to www.irs.gov/Form1040 for instructions and the latest information Form 1040 (2019) FIE name
11 201 SCHEDULE 1 OMB No. 1545-0074 (Form 1040 or 1040-SR) Additional Income and Adjustments to Income 2019 Department of the Treasury Attach to Form 1040 or 1040-SR. Attachment Internal Revenue Service Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 01 Name(s) shown on Form 1040 or 1040-SR Your social security number Beverly and Ken Hair 465-74-3321 Parti Additional Income 1 Taxable refunds, credits, or offsets of state and local income taxes 1 2a Alimony received 2a b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C 3 4 Other gains or losses). Attach Form 4797 4 5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. 5 6 Farm income or (loss). Attach Schedule F 6 7 Unemployment compensation 7 1,825 8 Other income. List type and amount 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a 9 1.825 Part II Adjustments to Income 10 Educator expenses 10 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 11 12 Health savings account deduction. Attach Form 8889 12 13 Moving expenses for members of the Armed Forces. Attach Form 3903 13 14 Deductible part of self-employment tax. Attach Schedule SE 14 15 Self-employed SEP, SIMPLE, and qualified plans. 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid. b Recipient's SSN C Date of original divorce or separation agreement (see instructions) 19 IRA deduction 19 20 Student loan interest deduction 20 21 Reserved for future use 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a 22 For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019 18a
Before you begin: See the earlier instructions for line 12a to see if you can use this worksheet to figure your tax. Before completing this worksheet, complete Form 1040 or 1040-SR through line 11b. If you don't have to file Schedule D and you received capital gain distributions, be sure you checked the box on Form 1040 or 1040-SR, line 6. 1. Enter the amount from Form 1040 or 1040-SR, line 11b. However, if you are filing Form 2555 (relating to foreign earned income), enter the amount from line 3 of the Foreign Earned Income Tax Worksheet 1. 32,077 2. Enter the amount from Form 1040 or 1040-SR, line 3a® 300 2. 3. Are you filing Schedule D? Yes. Enter the smaller of line 15 or 16 of Schedule D. If either line 15 or 16 is blank or a loss, enter -0. 0 No. Enter the amount from Form 1040 or 1040-SR, line 6. 4. Add lines 2 and 3 4. 300 5. If filing Form 4952 (used to figure investment interest expense deduction), enter any amount from line 4g of that form. Otherwise, enter -- 5. 0 6. Subtract line 5 from line 4. If zero or less, enter-O- 6. 300 7. Subtract line 6 from line 1. If zero or less, enter-O- 7. 31.777 8. Enter: $39,375 if single or married filing separately, $78,750 if married filing jointly or qualifying widow(er), 8. S52.750 if head of household. 78.750 9. Enter the smaller of line 1 or line 8 9. 32.077 10. Enter the smaller of line 7 or line 9 10. 31,777 11. Subtract line 10 from line 9. This amount is taxed at 0% 11. 300 12. Enter the smaller of line 1 or line 6 12. 300 13. Enter the amount from line 11 13. 300 14. Subtract line 13 from line 12 0 15. Enter: S434,550 if single, S244,425 if married filing separately, 15. 488,850 S488.850 if married filing jointly or qualifying widow(er), $461,700 if head of household 16. Enter the smaller of line 1 or line 15 16. 32,077 17. Add lines 7 and 11 17. 32,077 18. Subtract line 17 from line 16. If zero or less, enter-O- 18. 0 19. Enter the smaller of line 14 or line 18 19. 0 20. Multiply line 19 by 15% (0.15) 20. 0 21. Add lines 11 and 19 300 21. 22. Subtract line 21 from line 12 22. 0 23. Multiply line 22 by 20% (0.20) 23. 0 24. Figure the tax on the amount on line 7. If the amount on line 7 is less than $100,000, use the Tax Table to figure the tax. If the amount on line 7 is $100,000 or more, use the Tax Computation Worksheet 24. 3,425 25. Add lines 20, 23, and 24 25. 3,425 26. Figure the tax on the amount on line 1. If the amount on line I is less than $100,000, use the Tax Table to figure the tax. If the amount on line I is $100,000 or more, use the Tax Computation Worksheet ... 26. 3.461 27. Tax on all taxable income. Enter the smaller of line 25 or 26. Also include this amount on the entry space on Form 1040 or 1040-SR, line 12a. If you are filing Form 2555, don't enter this amount on the entry space on Form 1040 or 1040-SR, line 12a. Instead, enter it on line 4 of the Foreign Earned Income Tax Worksheet 27. 3,425 * If you are filing Form 2555, see the footnote in the Foreign Earned Income Tax Worksheet before completing this line.