were born before January 2, 1959 Are blind Iwas born before January 2, 1959 Dependents (see instructions): (2) Social security (3) Relationship (4) Check the box if qualifies for (see instructions): (1) First name Last name number to you Child tax credit Credit for other dependents If more than four Mabel White 5 6 6 7 7 8 8 9 9 Cousin dependents, 0OOO see instructions and check here Income 1a Total amount from Form(s) W-2, box 1 (see instructions) 1a 72000 b Household employee wages not reported on Form(s) W-2 . 1b Attach Form(s) W-2 here. Also c Tip income not reported on line 1a (see instructions) 1c attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) 1d W-2G and 1099-R if tax e Taxable dependent care benefits from Form 2441, line 26 le was withheld. f Employer-provided adoption benefits from Form 8839, line 29 if If you did not Wages from Form 8919, line 6 . 1g get a Form Other earned income (see instructions) 1h W-2, see instructions. i Nontaxable combat pay election (see instructions) z Add lines 1a through 1h 1z Attach Sch. B 2a Tax-exempt interest . 2a b Taxable interest 2b 7800 if required. Ba Qualified dividends 3a b Ordinary dividends 3b 72000 4a IRA distributions . 4a b Taxable amount . 4b 4644 Standard 5a Pensions and annuities 5a b Taxable amount . 5b 72000 Deduction for- . Single or 6a Social security benefits . 6a b Taxable amount . 6b Married filing separately, c If you elect to use the lump-sum election method, check here (see instructions) $13,850 7 Capital gain or (loss). Attach Schedule D if required. If not required, check here 7 . Married filing jointly or Additional income from Schedule 1, line 10 8 Qualifying Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income 9 surviving spouse, $27,700 10 Adjustments to income from Schedule 1, line 26 10 * Head of household, 11 Subtract line 10 from line 9. This is your adjusted gross income 11 $20,800 12 Standard deduction or itemized deductions (from Schedule A) 12 . If you checked any box under 13 Qualified business income deduction from Form 8995 or Form 8995-A 13 Standard Deduction, 14 Add lines 12 and 13 14 see instructions. 15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income 15