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Form Department of the Treasury--Internal Revenue Service 1040A Label (See page 17.) L A B E L H E R E U.S. Individual Income Tax Return Your first name and initial Last name (99) 2008 IRS Use Only--Do not write or staple in this space. OMB No. 1545-0074 Your social security number If a joint return, spouse's first name and initial Last name Spouse's social security number Use the IRS label. Otherwise, please print or type. Home address (number and street). If you have a P.O. box, see page 17. Apt. no. You must enter your SSN(s) above. Checking a box below will not change your tax or refund. You Spouse City, town or post office, state, and ZIP code. If you have a foreign address, see page 17. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund (see page 17) Filing status Check only one box. 1 2 3 Exemptions Single 4 Head of household (with qualifying person). (See page 18.) If the qualifying person is a child but not your dependent, Married filing jointly (even if only one had income) enter this child's name here. Married filing separately. Enter spouse's SSN above and 5 Qualifying widow(er) with dependent child (see page 19) full name here. Boxes 6a Yourself. If someone can claim you as a dependent, do not check checked on box 6a. 6a and 6b b Spouse No. of children on 6c who: (4) if qualifying c Dependents: (3) Dependent's (1) First name Last name (2) Dependent's social security number relationship to you child for child tax credit (see page 20) lived with you did not live with you due to divorce or separation (see page 21) Dependents on 6c not entered above Add numbers on lines above If more than six dependents, see page 20. d Total number of exemptions claimed. Income Attach Form(s) W-2 here. Also attach Form(s) 1099-R if tax was withheld. If you did not get a W-2, see page 23. Enclose, but do not attach, any payment. 7 8a b 9a b 10 11a Wages, salaries, tips, etc. Attach Form(s) W-2. 7 8a 9a 10 11b 12b 13 14b 15 Taxable interest. Attach Schedule 1 if required. Tax-exempt interest. Do not include on line 8a. 8b Ordinary dividends. Attach Schedule 1 if required. Qualified dividends (see page 24). 9b Capital gain distributions (see page 24). IRA 11b Taxable amount distributions. (see page 24). 11a 12a Pensions and 12b Taxable amount annuities. (see page 25). 12a 13 Unemployment compensation and Alaska Permanent Fund dividends. 14a Social security 14b Taxable amount benefits. (see page 27). 14a 15 Add lines 7 through 14b (far right column). This is your total income. Educator expenses (see page 29). IRA deduction (see page 29). Student loan interest deduction (see page 31). 16 17 18 Adjusted gross income 16 17 18 19 20 21 Tuition and fees deduction. Attach Form 8917. 19 Add lines 16 through 19. These are your total adjustments. Subtract line 20 from line 15. This is your adjusted gross income. Cat. No. 11327A 20 21 Form 1040A (2008) For Disclosure, Privacy

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