Department of the Treasury
—Internal Revenue Service Form 1040 2025
OMB No. 1545-0074 U.S. Individual Income Tax Return
Filing Status: Married filing Married filing Head of
Single
X
jointly separately household
Your first name and middle initial Last name
John Q. Doe
Spouse's first name and middle initial Last name
Jane M. Doe
Home address (number and street). If you have a P.O. box, see instructions.
123 Maple Avenue, Apt 4B, Springfield, IL 62704
Income
1a Wages, salaries, tips, etc. Attach Form(s) W-2 95,000.00
2a Tax-exempt interest 0.00
2b Taxable interest 450.00
E
3b Ordinary dividends 1,200.00
4b IRA distributions (taxable amount) 0.00
5b Pensions and annuities (taxable amount) PL 0.00
8 Other income from Schedule 1, line 10 0.00
9 Total income. Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8 96,650.00
10 Adjustments to income from Schedule 1, line 26 0.00
11 Adjusted gross income. Subtract line 10 from line 9 96,650.00
AM
Tax and Credits
12 Standard deduction or itemized deductions (from Schedule A) 29,200.00
13 Qualified business income deduction from Form 8995 0.00
15 Taxable income. Subtract lines 12 and 13 from line 11 67,450.00
16 Tax (see instructions). Check if any from Form(s) 8814, 4972, etc. 7,684.00
EX
24 Total tax. Add lines 22 and 23 7,684.00
Payments and Refund
25a Federal income tax withheld from Forms W-2 8,500.00
33 Total payments. Add lines 25d through 32 8,500.00
34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you 816.00
OVERPAID
35a Amount of line 34 you want REFUNDED TO YOU 816.00
This is a simulated example for illustrative purposes. For official tax filing, please use forms provided by the IRS at [Link].