| Form 1040 | Department of the TreasuryInternal Revenue Service (99) U.S. Individual Income Tax Return | 2016 | OMB No. 1545-0074 | IRS Use OnlyDo not write or staple in this space. | | For the year Jan. 1Dec. 31, 2016, or other tax year beginning | ,2016, ending ,20 | See separate instructions. | | Your first name and initial LOGAN B | Last name TAYLOR | Your social security number 123-45-6787 | | If a joint return, spouse's first name and initial | Last name | Spouse's social security number | | Home address (number and street). If you have a P.O. box, see instructions. 4680 DOGWOOD LANE | Apt. no. | Make sure the SSN(s) above and on line 6c are correct. | | City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). SPRINGFIELD MO 65801 | Presidential Election Campaign 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 | | Foreign country name | Foreign province/state/country | Foreign postal code | | Filing status | Qualifying widow(er) | | Exemptions | 6a | Yes Yourself. | If someone can claim you as a dependent, do notcheck box 6a . . . . . . . . . . . . . . . . . . . . . | } | | Boxes checked on 6a and 6b | | | No. of children on 6c who: lived with you | | | did not live with you due to divorce or separation (see instructions) | | | Dependents on 6c not entered above | | | Add numbers on lines above | | | | b | No Spouse | . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | If more than four dependents, see instructions and check here. | c | Dependents: | (2) Dependent's social security number | (3) Dependent's relationship to you | (4) If child under age 17 qualifying for child tax credit (see instructions) | | | | | HELEN TAYLOR | 123-45-6780 | Parent | | | ASHER TAYLOR | 123-45-6783 | Son | | | MIA TAYLOR | 123-45-6784 | Daughter | | | | | | | | d | Total number of exemptions claimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | Credit for child and dependent | Income 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. | 7 | Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 7 | | | | 8a | Taxable interest. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 8a | | | | b | Tax-exempt interest. Do not include on line 8a . . . . . . . . | 8b | | | | | | | 9a | Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 9a | | | | b | Qualified dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 9b | | | | | | | 10 | Taxable refunds, credits, or offsets of state and local income taxes. . . . . . . . . . . . . . . . . . . | 10 | | | | 11 | Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 11 | | | | 12 | Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 12 | | | | 13 | Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . | 13 | | | | 14 | Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 14 | | | | 15a | IRA distributions . . . . . . . . . | 15a | | | b | Taxable amount . . . . | 15b | | | | 16a | Pensions and annuities . . . . | 16a | | | b | Taxable amount . . . . | 16b | | | | 17 | Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E | 17 | | | | 18 | Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 18 | | | | 19 | Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 19 | | | | 20a | Social security benefits . . . . | 20a | | | b | Taxable amount . . . . | 20b | | | | 21 | | Other income. List type and amount | | | 21 | | | | 22 | Combine the amounts in the far right column for lines 7 through 21. This is your total income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 22 | | | | Adjusted Gross Income | 23 | Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 23 | | | | | | | 24 | Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 24 | | | | | | 25 | Health savings account deduction. Attach Form 8889 . . . . | 25 | | | | | | 26 | Moving expenses. Attach Form 3903 . . . . . . . . . . . . . . . . . | 26 | | | | | | 27 | Deductible part of self-employment tax. Attach Schedule SE | 27 | | | | | | 28 | Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . | 28 | | | | | | 29 | Self-employed health insurance deduction . . . . . . . . . . . . . | 29 | | | | | | 30 | Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . | 30 | | | | | | 31a | Alimony paid b Recipient's SSN | 31a | | | | | | 32 | IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 32 | | | | | | 33 | Student loan interest deduction . . . . . . . . . . . . . . . . . . . . | 33 | | | | | | 34 | Tuition and fees. Attach Form 8917 . . . . . . . . . . . . . . . . . . | 34 | | | | | | 35 | Domestic production activities deduction. Attach Form 8903 | 35 | | | | | | 36 | Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 36 | | | | 37 | Subtract line 36 from line 22. This is your adjusted gross income . . . . . . . . . . . . . | | 37 | | | | KIA | For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. | | Form 1040 (2016) | | Form 1040 (2016) | LOGAN | B TAYLOR | 123-45-6787 | Page 2 | | Tax and Credits | 38 | Amount from line 37 (adjusted gross income) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 38 | | | | 39a | | Check if: | { | You were born before January 2, 1952, Blind. Spouse was born before January 2, 1952, Blind. | } | Total boxes checked 39a | | | | | | | Standard Deduction for People who check any box on line 39a or 39b or who can be claimed as a dependent, see instructions. All others: Single or Married filing separately, $6,300 Married filing jointly or Qualifying widow(er), $12,600 Head of household, $9,300 | b | If your spouse itemizes on a separate return or you were a dual-status alien, check here 39b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | | | | 40 | Itemized deductions (from Schedule A) or your standard deduction (see left margin) | 40 | | | | 41 | Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 41 | | | | 42 | Exemptions. If line 38 is $155,650 or less, multiply $4,050 by the number on line 6d. Otherwise, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 42 | | | | 43 | Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- | 43 | | | | 44 | Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c ___ | | 44 | | | | 45 | Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . . . . . . . . . . . . | | 45 | | | | 46 | Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . . . . . . . . . | | 46 | | | | 47 | Add lines 44, 45, and 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 47 | | | | 48 | Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . | 48 | | | | | | | 49 | Credit for child and dependent care expenses. Attach Form 2441 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 49 | | | | | | 50 | Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . | 50 | | | | | | 51 | Retirement savings contributions credit. Attach Form 8880 . . | 51 | | | | | | 52 | Child tax credit. Attach Schedule 8812, if required . . . . . . . . . | 52 | | | | | | 53 | Residential energy credit. Attach Form 5695 . . . . . . . . . . . . . | 53 | | | | | | 54 | | Other credits from Form: a 3800 b 8801 c | | | 54 | | | | | | 55 | Add lines 48 through 54. These are your total credits . . . . . . . . . . . . . . . . . . . . . . . . . . | 55 | | | | | 56 | Subtract line 55 from line 47. If line 55 is more than line 47, enter -0- . . . . . . . . . . . . . | | 56 | | | | Other Taxes | 57 | Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 57 | | | | 58 | Unreported social security and Medicare tax from Form: a 4137 b 8919 . . . . . . . . . | | 58 | | | | 59 | Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required | 59 | | | | 60a | Household employment taxes from Schedule H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 60a | | | | b | First-time homebuyer credit repayment. Attach Form 5405 if required . . . . . . . . . . . . . . | | 60b | | | | 61 | Health care: individual responsibility (see instructions) | Full-year coverage | | 61 | | | | 62 | Taxes from: a Form 8959 b Form 8960 c Instructions; enter code(s) _ _ _ _ _ _ | | 62 | | | | 63 | Add lines 56 through 62. This is your total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 63 | | | | Payments | 64 | Federal income tax withheld from Forms W-2 and 1099 . . . . . . | 64 | | | | | | | If you have a qualifying child, attach Schedule EIC. | 65 | 2016 estimated tax payments and amount applied from 2015 return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 65 | | | | 66a | Earned income credit (EIC) . . . . . . . . . . . . . . . . . . . . . . . . | 66a | | | | b | Nontaxable combat pay election | 66b | | | | | | | 67 | Additional child tax credit. Attach Schedule 8812 . . . . . . . . . . . | 67 | | | | | 68 | American opportunity credit from Form 8863, line 8 . . . . . . . . | 68 | | | | | 69 | Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . | 69 | | | | | 70 | Amount paid with request for extension to file . . . . . . . . . . . . . | 70 | | | | | 71 | Excess social security and tier 1 RRTA tax withheld . . . . . . . . | 71 | | | | | 72 | Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . | 72 | | | | | 73 | | Credits from Form: a 2439 b Reserved c 8885 d | | | 73 | | | | | 74 | Add lines 64, 65, 66a, and 67 through 73. These are your total payments . . . . . . . . . | | 74 | | | | Refund | 75 | If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | 75 | | | | | 76a | Amount of line 75 you want refunded to you. If Form 8888 is attached, check here . . | 76a | | | | Direct deposit? See instructions. | b | | Routing number | X | X | X | X | X | X | X | X | X | | c Type: Checking Savings | | | | | | d | | Account number | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | | | | 77 | Amount of line 75 you want applied to your 2017 estimated tax | 77 | | | | | Amount You Owe | 78 | Amount you owe. Subtract line 74 from line 63. For details on how to pay, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | 78 | | | 79 | Estimated tax penalty (see instructions) . . . . . . . . . . . . . . . . . | 79 | | | | | Third Party Designee | | Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No | | Designee's name | | Phone no. | | Personal identification number (PIN) | | | Sign Here Joint return? See instructions. Keep a copy for your records. | | Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. | | Your signature | Date | Your occupation PARALEGAL | Daytime phone number | | Spouse's signature. If a joint return, bothmust sign. | Date | Spouse's occupation | If the IRS sent you an Identity Protection PIN, enter it here (see inst.) | | Paid Preparer Use Only | | Print/Type preparer's name | Preparer's signature | Date | Check if self-employed | PTIN | | Firm's name | Firm's EIN | | Firm's address | Phone no. | | KIA | www.irs.gov/form1040 | Form 1040 (2016) | |
