1-1
Comprehensive Problem 2
1040
Form
Department of the Treasury—Internal Revenue Service
(99)
U.S. Individual Income Tax Return
Last name
2011
, 2011, ending
OMB No. 1545-0074 , 20
IRS Use Only—Do not write or staple in this space.
*
For the year Jan. 1–Dec. 31, 2011, or other tax year beginning Your first name and initial If a joint return, spouse’s first name and initial
See separate instructions.
Your social security number Spouse’s social security number
Ivan I. Incisor Last name Irene I. Incisor Home address (number and street). If you have a P.O. box, see instructions. 468 Mule Deer Lane City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Spokane, WA 99206
Foreign country name Foreign province/county
Filing Status
Check only one box.
1 2 3 6a b c
X
Single Married filing jointly (even if only one had income)
Married filing separately. Enter spouse’s SSN above and full name here. Spouse . Dependents:
Exemptions
x x
Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . . . . . . . . . . . . . . . .
(2) Dependent’s social security number (3) Dependent’s relationship to you
(1) First name
If more than four dependents, see instructions and check here
Ira d Total number of exemptions claimed
of as 11 ft 20 ra 9/ } D /2 8 0
Apt. no.
477 34 4321 637 34 4927
Make sure the SSN(s) above and on line 6c are correct.
Presidential Election Campaign
Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking Foreign postal code a box below will not change your tax or refund. You Spouse
X
X
4
Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child’s name here.
5
Qualifying widow(er) with dependent