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Instructions Form 1040 Bule 1 Uniform Premium for Groun Term Lin in urance Note: This problem is for the 2019 tax year. Alfred E. Old and A Crone, each age 42, married on September , 2017. Atred and Beulah will ea sint return for 2019. ifred's Social Security number 111-11-1109. Bell Social Security number is 123-456700, and she adopted old as her married name They live at 211 Beckstone Drive, Atlanta, GA 30306 Alfred was dvorced from Saran oldin March 2016. Under the divorce agreement, Alfred is to pay Sarah $1,250 per month for the next 10 years or until Saray's death, whichever occurs first. Alfred pays Sarah $15,000 in 2019. In addition, in January 2019. Altre pays Saran 550,000, which is designated as being for her shore of the more property. Ano, Alved is responsible for all prior years income taxe Sarah's Social Security number is 123456788 Aileed's salary for 2019 is $150,000. He is an executive working for Cherry, Inc. (Federal 1.D. No. 98-7654321) As part of a compensation package Cherry provides him with group tem se insurance to win a sainty, employer withheld 124900 for recor Income taxes and $8,000 for state income tax. The roper amounts were withheld for Piata Ben recently graduated from w school and employed by Legal Aid Society, Inc. (Federat No. 111111111), as public defender She receives a salary of $42,000 2019. Herumployer whold $7,500 for Federal income taves and $2.400 for state comtes The proper amounts were withheld for FICA taxes Alfred and telah had nterest income of $500. Alfred and Beah receive a $1,000 refund on their 2018 state income taxes. They claimed the standard deduction on the 2018 Federal income tax retum. Atrod and Beuth pay $4,500 interest and $1.450 property tows on their personal residence in 2019. Their charitable contributions tot $2.400 (to their church). They paid sales taxes of 51,400, for which they maintain the receipts both spouses had health insurance for all of 2019 and they do not want to contribute to the Presidential Election Campaign Required: Instructions Form 1040 Schedule 1 Uniform for Group Term Life in Ech Form 1040 Con D (+ 1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 th 2b 3 2a Tax-exempt interest 2a b Tavale interest. Attach Sch. if required Ordinary dividends. Attach Ja Qualified dividends.. Ja Sch. Bit required 4a TRA distributions 4a b Taxable amount *** c Pensions and annuities 40 d Taxable amount ... Sa Social secfrity benefits Sa b Taxable amount 6 Capital gain or loss). Attach Schedule if required. If not required, check here... 4b Sb 6 Na Standard All Deduction for Single or At Married ning cu separately $12,200 Married ling jointly or Qualifying widower) $24.400 Head of household $18,350 If you checked any box under Standard Deduction, see 7a Other Income from Schedule 1, line 9 7a 7b Add lines 1, 2, 3, 4, 40, 56, 6, and 7a. This is your total income Ba Adjustments to income from Schedule 1, line 22.. b Subtract line Ba from line 76. This is your adjusted gross Income Standard deduction or itemized deductions (from Schedule Al 8b 9 Print item promis for Instructions Form 1040 Schedule 1 Uniform Premiuma for Group Term Life Insurance b Sch Form 1040 Con any box under Standard Deduction, see SI instructions. (F b 9 Subtract line Ba from line 7b. This is your adjusted gross income Standard deduction or itemized deductions (from Schedule A)... Qualified business Income deduction. Attach Form 8995 or Form 8995-A... 10 10 De 11a Add lines 9 and 10 Ini 11a Na AI 11b b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -- BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019) At cu Form 1040 (2019) 111-11-1109 Page 2 Alfred E. and Beulah A. Old 12a Tax (see inst.) Check if any from Form(s): 1 - 8814 2 4972 30 b Add Schedule 2, line 3, and line 12a and enter the total 12a 12b 13a 13a Child tax credit or credit for other dependents. b Add Schedule 3, line 7, and line 13a and enter the total 14 Subtract line 13b from line 12b. If zero or less, enter-O-.. 13b 14 15 15 Other taxes, including self-employment tax, from Schedule 2 line 10 16 16 Add lines 14 and 15. This is your total tax Instructions Form 1040 Schedule 1 Uniform Premiums for Group Term Life Insurance Bch Form 1040 Cor 16 Add lines 14 and 15. This is your total tax 17 SI (F Federal income tax withheld from Forms W-2 and 1099 17 De Ind . If you have a qualifying child, attach Sch. EIC If you have nontaxable combat pay, see instructions NA All 18 Other payments and refundable credits a Earned Income credit (LIC). 180 b Additional child tax credit, Attach Schedule 6812 18b C American opportunity credit from Form 3863, line 8 18 d Schedule 3, line 14.. 150 e Add lines 1Ba through 18d. These are your total other payments and refundable credits At OU 180 19 Add lines 17 and 18e. These are your total payments 19 Refund 20 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 213 Amount of line 20 you want refunded to you. If Form 8888 is attached, check here Routing number c Type: Checking Savings 21 Direct deposit? See instructions d Account number 22 Amount of line 20 you want applied to your 2020 estimated tax 22 5 5 6 6 Rental real estate, royalties, partnerships, Scorporations, trusts, etc. Attach Schedule E... Farm income or (loss). Attach Schedule F Unemployment compensation Other income. List type and amount 7 7 8 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a 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 13 Moving expenses for members of the Armed Forces. Attach Form 3903 14 14 Deductible part of self-employment tax. Attach Schedule SE. 15 15 Self-employed SEP, SIMPLE, and qualified plans Print om Instructions Form 1040 Schedule 1 Uniform Premiums for Group Term Life In Schedule 1 14 15 Self-employed SEP, SIMPLE, and qualified plans 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid .. 18a 123-45-6788 b Recipient's SSN Date of original divorce or separation agreement (see instructions) 03/2016 19 19 IRA deduction .. 20 Student loan interest deduction 20 21 21 Tuition and fees. Attach Form 8917 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a... BAA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040 or 1040-SR) 2019 22 Work uses remaining Instructions Form 1040 Bule 1 Uniform Premium for Groun Term Lin in urance Note: This problem is for the 2019 tax year. Alfred E. Old and A Crone, each age 42, married on September , 2017. Atred and Beulah will ea sint return for 2019. ifred's Social Security number 111-11-1109. Bell Social Security number is 123-456700, and she adopted old as her married name They live at 211 Beckstone Drive, Atlanta, GA 30306 Alfred was dvorced from Saran oldin March 2016. Under the divorce agreement, Alfred is to pay Sarah $1,250 per month for the next 10 years or until Saray's death, whichever occurs first. Alfred pays Sarah $15,000 in 2019. In addition, in January 2019. Altre pays Saran 550,000, which is designated as being for her shore of the more property. Ano, Alved is responsible for all prior years income taxe Sarah's Social Security number is 123456788 Aileed's salary for 2019 is $150,000. He is an executive working for Cherry, Inc. (Federal 1.D. No. 98-7654321) As part of a compensation package Cherry provides him with group tem se insurance to win a sainty, employer withheld 124900 for recor Income taxes and $8,000 for state income tax. The roper amounts were withheld for Piata Ben recently graduated from w school and employed by Legal Aid Society, Inc. (Federat No. 111111111), as public defender She receives a salary of $42,000 2019. Herumployer whold $7,500 for Federal income taves and $2.400 for state comtes The proper amounts were withheld for FICA taxes Alfred and telah had nterest income of $500. Alfred and Beah receive a $1,000 refund on their 2018 state income taxes. They claimed the standard deduction on the 2018 Federal income tax retum. Atrod and Beuth pay $4,500 interest and $1.450 property tows on their personal residence in 2019. Their charitable contributions tot $2.400 (to their church). They paid sales taxes of 51,400, for which they maintain the receipts both spouses had health insurance for all of 2019 and they do not want to contribute to the Presidential Election Campaign Required: Instructions Form 1040 Schedule 1 Uniform for Group Term Life in Ech Form 1040 Con D (+ 1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 th 2b 3 2a Tax-exempt interest 2a b Tavale interest. Attach Sch. if required Ordinary dividends. Attach Ja Qualified dividends.. Ja Sch. Bit required 4a TRA distributions 4a b Taxable amount *** c Pensions and annuities 40 d Taxable amount ... Sa Social secfrity benefits Sa b Taxable amount 6 Capital gain or loss). Attach Schedule if required. If not required, check here... 4b Sb 6 Na Standard All Deduction for Single or At Married ning cu separately $12,200 Married ling jointly or Qualifying widower) $24.400 Head of household $18,350 If you checked any box under Standard Deduction, see 7a Other Income from Schedule 1, line 9 7a 7b Add lines 1, 2, 3, 4, 40, 56, 6, and 7a. This is your total income Ba Adjustments to income from Schedule 1, line 22.. b Subtract line Ba from line 76. This is your adjusted gross Income Standard deduction or itemized deductions (from Schedule Al 8b 9 Print item promis for Instructions Form 1040 Schedule 1 Uniform Premiuma for Group Term Life Insurance b Sch Form 1040 Con any box under Standard Deduction, see SI instructions. (F b 9 Subtract line Ba from line 7b. This is your adjusted gross income Standard deduction or itemized deductions (from Schedule A)... Qualified business Income deduction. Attach Form 8995 or Form 8995-A... 10 10 De 11a Add lines 9 and 10 Ini 11a Na AI 11b b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -- BAA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2019) At cu Form 1040 (2019) 111-11-1109 Page 2 Alfred E. and Beulah A. Old 12a Tax (see inst.) Check if any from Form(s): 1 - 8814 2 4972 30 b Add Schedule 2, line 3, and line 12a and enter the total 12a 12b 13a 13a Child tax credit or credit for other dependents. b Add Schedule 3, line 7, and line 13a and enter the total 14 Subtract line 13b from line 12b. If zero or less, enter-O-.. 13b 14 15 15 Other taxes, including self-employment tax, from Schedule 2 line 10 16 16 Add lines 14 and 15. This is your total tax Instructions Form 1040 Schedule 1 Uniform Premiums for Group Term Life Insurance Bch Form 1040 Cor 16 Add lines 14 and 15. This is your total tax 17 SI (F Federal income tax withheld from Forms W-2 and 1099 17 De Ind . If you have a qualifying child, attach Sch. EIC If you have nontaxable combat pay, see instructions NA All 18 Other payments and refundable credits a Earned Income credit (LIC). 180 b Additional child tax credit, Attach Schedule 6812 18b C American opportunity credit from Form 3863, line 8 18 d Schedule 3, line 14.. 150 e Add lines 1Ba through 18d. These are your total other payments and refundable credits At OU 180 19 Add lines 17 and 18e. These are your total payments 19 Refund 20 20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid 213 Amount of line 20 you want refunded to you. If Form 8888 is attached, check here Routing number c Type: Checking Savings 21 Direct deposit? See instructions d Account number 22 Amount of line 20 you want applied to your 2020 estimated tax 22 5 5 6 6 Rental real estate, royalties, partnerships, Scorporations, trusts, etc. Attach Schedule E... Farm income or (loss). Attach Schedule F Unemployment compensation Other income. List type and amount 7 7 8 8 9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a 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 13 Moving expenses for members of the Armed Forces. Attach Form 3903 14 14 Deductible part of self-employment tax. Attach Schedule SE. 15 15 Self-employed SEP, SIMPLE, and qualified plans Print om Instructions Form 1040 Schedule 1 Uniform Premiums for Group Term Life In Schedule 1 14 15 Self-employed SEP, SIMPLE, and qualified plans 15 16 Self-employed health insurance deduction 16 17 Penalty on early withdrawal of savings 17 18a Alimony paid .. 18a 123-45-6788 b Recipient's SSN Date of original divorce or separation agreement (see instructions) 03/2016 19 19 IRA deduction .. 20 Student loan interest deduction 20 21 21 Tuition and fees. Attach Form 8917 22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 8a... BAA For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040 or 1040-SR) 2019 22 Work uses remaining

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