1040 U.S. Individual Income Tax Return 2013
Department of the Treasury—Internal Revenue Service
For the year Jan. 1–Dec. 31, 2013, or other tax year beginning
Your first name and initial
OMB No. 1545-0074
, 2013, ending
IRS Use Only—Do not write or staple in this space.
See separate instructions.
Your social security number
,20
Last name
Russell
Long
If a joint return, spouse's first name and initial
Linda
664-98-5678
Last name
Spouse's social security number
Long
554-98-3946
Apt. no.
Home address (number and street). If you have a P.O. box, see instructions.
Make sure the SSN(s) above and on line 6c are correct.
1234 Katy Rd.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Katy
TX
Foreign country name
Filing Status
Foreign province/state/county
Single
1
X
2
3
Exemptions
6a b c
X
X
Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund
You
Spouse
4
Head of household (with qualifying person). (See instr.) If the qualifying person is a child but not your dependent, enter this child's name here.
5
Qualifying widow(er) with dependent child
Yourself. If someone can claim you as a dependent, do not check box 6a
Boxes checked on 6a and 6b
. . . . . . .
Bill
Martha
Last name
Long
Long
social security number
relationship to you
•
•
lived with you did not live with you due to divorce or separation
(see instructions)
(see instructions)
123-23-7654 Son
345-67-8654 Daughter
Attach Form(s)
W-2 here. Also attach Forms
W-2G and
1099-R if tax was withheld.
If you did not get a W-2, see instructions.
Adjusted
Gross
Income
KIA
2
Dependents on 6c not entered above
Add numbers on lines above
d Total number of exemptions claimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income
2
No. of children on 6c who:
Spouse . . . . . . . . . . . . .