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SCHEDULE 1 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Additional Income and Adjustments to Income Names) shown on Form 1040

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SCHEDULE 1 (Form 1040 or 1040-SR) Department of the Treasury Internal Revenue Service Additional Income and Adjustments to Income Names) shown on Form 1040 or 1040-SR Attach to Form 1040 or 1040-SR. Go to www.irs.gov/Form 1040 for instructions and the latest information. OMB No. 1545-0074 2019 Attachment Sequence No. 01 Your social security number At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Part I Additional Income Taxable refunds, credits, or offsets of state and local income taxes 2a Alimony received 1 1 2a Yes No b Date of original divorce or separation agreement (see instructions) 3 Business income or (loss). Attach Schedule C. 3 4 Other gains or (losses). Attach Form 4797. 4 5 6 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F 5 6 7 Unemployment compensation. 7 8 Other income. List type and amount Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a 8 9 Part II Adjustments to Income 10 Educator expenses 10 11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 11 12 Health savings account deduction. Attach Form 8889 12 13 14 Moving expenses for members of the Armed Forces. Attach Form 3903 Deductible part of self-employment tax. Attach Schedule SE 13 14 15 16 Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction. 17 Penalty on early withdrawal of savings 18a Alimony paid. b Recipient's SSN c Date of original divorce or separation agreement (see instructions) IRA deduction.. 15 16 17 18a 19 19 20 Student loan interest deduction 20 21 Tuition and fees. Attach Form 8917 21 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a 22 For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019

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