INCOME Wages, salaries, tips, etc Capital gain or loss other incone Total incone 1 , 2 5 0 , 0 0 0 1 , 1 0 0 6 0 , 0 0 0 1 , 3 1 1 , 1 0 0 ADJUSTMENTS TO INCOME Total adjustments Adjusted gross incone ITEMIZED DEDUCTIONS Taxes Contributions other miscellaneous deductions Total itenized deductions TAX COMPUTATION Standard deduction Larger of Itemized or standard deduction Taxable income Tax before credits CREDITS Total credits Tax after credits OTHER TAXES other taxes Total tax PAYMENTS REFUNDABLE CREDITS Federal income tax withheld Estinated tax payments Total payments REFUND OR AMOUNT DUE Amount overpaid Anount refunded to you Anount you owe TAX RATES Marginal tax rate Effective tax rate 1 , 3 1 1 , 1 0 0

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INCOME Wages, salaries, tips, etc Capital gain or loss other incone Total incone 1 , 2 5 0 , 0 0 0 1 , 1 0 0 6 0 , 0 0 0 1 , 3 1 1 , 1 0 0 ADJUSTMENTS TO INCOME Total adjustments Adjusted gross incone  ITEMIZED DEDUCTIONS Taxes Contributions other miscellaneous deductions Total itenized deductions TAX COMPUTATION Standard deduction  Larger of Itemized or standard deduction Taxable income Tax before credits CREDITS Total credits Tax after credits OTHER TAXES other taxes Total tax  PAYMENTS   REFUNDABLE CREDITS Federal income tax withheld  Estinated tax payments Total payments REFUND OR AMOUNT DUE Amount overpaid Anount refunded to you  Anount you owe  TAX RATES Marginal tax rate Effective tax rate 1 , 3 1 1 , 1 0 0

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INCOME Wages, salaries, tips, etc Capital gain or loss other incone Total incone 1 , 2 5 0 , 0 0 0 1 , 1

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