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Department of the TreasuryInternal Revenue Service

Form Income Tax Return for Single andJoint Filers With No Dependents1040EZ 1995

OMB No. 1545-0675

Spouses social security number

NoYesN o te : Checking Yes will n ot change your tax or reduce your refund.President ia l

Elect ionCampaign(See page 11.)

Do you want $3 to go to this fund?

CentsDollarsTotal wages, salaries, and tips. Thisshould be sh own in box 1 of yourW-2 form(s). Attach your W-2 form(s).

1

1 , .AttachCopy B ofForm(s)W-2 here .Enclose, butdo not at tach,

any paymentwith yourre tu rn .

Taxable int erest income of $400 or less. If th e total isover $400, you cannot use Form 1040EZ.

22

Add lines 1, 2, and 3. This is your a d j u s t e d g r o s si n c o m e . If less than $9,230, see page 15 to find out if youcan claim the earned income credit on line 8.

Can your pa rent s (or someone else) claim you on their r etur n?5Note: Y oumust checkYes or No.

Yes. Do worksheeton back; enteramount fromline G here.

No. If s ingle, enter 6,400.00.If married, enter 11,550.00.For an explanation of theseamounts, see back of form. 5

, .Subtract line 5 from line 4. If line 5 is larger thanline 4, enter 0. This is your taxable income.

66 , .

Paymentsand taxEarned income credi t (see page 15). Enter typeand amount of nontaxable earned income below.

77

, .

Tax. Use the amount on l ine 6 to find your tax in thetax ta ble on pa ges 2933 of the booklet. Then, enter t hetax from the table on this line.

10

10 , .Refundoramount

youowe

If line 9 is larger than line 10, subtract line 10 from line9. This is your refund.

1111 .

If line 10 is larger than line 9, subtract line 9 from line10. This is the a m o u n t y o u o w e . See page 22 for detailson how to pay and what to write on your payment. .

I have read this return. Under penalt ies of perjury, I declare that to the best of my know ledge and belief , thereturn is true, correct , and accurately lists all amounts and sou rces of income I received during the tax ye ar.

Signyourreturn

For IRS Use Only Pleasedo not write in boxes below.Your signature

Keep a copyof this formfor yourrecords.

For Privacy Act and Paperw ork Reduct ion Act Notice, see page 7 . Form 1040EZ (1995)

Income

,,

.

.,

Cat. No. 11329W

Your occupat ion

4

4

12

12

If a joint return, does your spouse want $3 to go to this fund?

Your soc ial secu ri ty number

Date

Spouses signat ure if joint retu rn

Spouses occupationDate

Add lines 7 a nd 8 (dont include nont axable ear nedincome). These a re your total payments .

8

8 .9

9 , .

Enter your Federal income tax withheld from box 2 ofyour W-2 form(s).

Type $

1 2 3 4 5

6 7 8 9 10

Unemployment compensation (see page 14).3 3 , .

See instructions on back and in Form 1040EZ booklet.

UsetheIRSlabel

here

Your first name and initial

Apt. no.Home address (number and street). If you have a P.O. box, see page 11.

City, town or post office, state, and ZIP code. If you have a foreign address, see page 11.

If a joint return, spouses first name and initial

Last name

Last name

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1995 Instructions for Form 1040EZ

You (and your spouse if married) were under 65 onJanuary 1, 1996, and not blind at the end of 1995.

Your filing status is single ormarried filing jointly.

Use thisform if

Your taxable income (line 6) is less than $50,000. You do not claim a ny dependen ts.

You ha d o n l y wages, salaries, t ips, taxable scholarship or fellowship grants, or unemploymentcompen sat ion, and your taxable interes t income was $400 or less . B u t if you earned tips,including allocated tips, that are not included in box 5 and box 7 of your W-2, you may not beable to use F orm 1040EZ. See page 13.

If you a re n ot sure about your filing stat us, see page 10. If you h ave questions aboutdependents, call Tele-Tax (see page 27) and listen to topic 354. If you cant use this form, callTele-Tax (see page 27) and listen to topic 352.

Because this form is read by a machine, please print your n umbers inside the boxes l ike this:Filling inyour return

If you received a scholarship or fellowship grant or tax-exempt interest income, such as onmunicipal bonds, see the booklet before filling in the form. Also, see the booklet if you received aForm 1099-INT showing income tax withheld.

R e m e m b e r , you must report all wages, salaries, and tips even if you dont get a W-2 form from your

employer. You mu st also report al l your taxable inter est income, including inter est from ban ks,savings and loans, credit unions, etc., even if you dont get a Form 1099-INT.

If you paid someone to prepare your r eturn , see page 22.

Use this worksheet to figure the amount to enter on line 5 if someone can claim you (or yourspouse if married) as a dependent, even if that person chooses not to do so. To find out ifsomeone can claim you as a dependent, call Tele-Tax (see page 27) and listen to topic 354.

Worksheetfordependentswhochecked Yes online 5

A.A. Enter the amount from line 1 on the front.

650.00B.B. Minimum standard deduction.

C. Enter the LARGER of line A or line B here. C.

D.D. Maximum standard deduction. If single, enter

3,900.00; if married, enter 6,550.00.

E. En ter the SMALLER of line C or line D h ere. Thisis your standard deduction. E.

Avoidmistakes

Mailingyourreturn

Mail your return by April 15, 1996. Use the envelope that came with your booklet. If you donthave that envelope, see page 36 for the address to use.

You did not r eceive an y advan ce ear ned income credit paymen ts.

Caution:If m arried an d eith er you or your spouse had t otal wages of over $61,200, you m ay notbe able to use this form. See page 9.

See page 5 of the Form 1040EZ booklet for a list of common mistakes to avoid. Errors will delayyour refund.

Do not type your numbers. Do not use dollar signs.

F. Exemption amount.

G. Add lines E and F. Enter the total here and online 5 on t he front.

If you c heck ed No on l ine 5 because no one can claim you (or your spouse if married) as adependent, enter on line 5 the amount shown below that applies to you.

Single, enter 6,400.00. This is the total of your standard deduction (3,900.00) and personalexemption (2,500.00).

Married, enter 11,550.00. This is the total of your standard deduction (6,550.00), exemptionfor your self (2,500.00), a nd exempt ion for your spouse (2,500.00).

F.

G.

If single, enter 0.

If married and both you and your spouse can beclaimed as dependents, enter 0.

If married and only one of you can be claimed as adependent, en ter 2,500.00.