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Taxpayer Information (as of December 31)

Tax year:
Name:		Blind
Birthdate:		Age:
Marital Status:		Taxpayer is claimed as dependent for another person
		Taxpayer pays over 50% of household expenses

Dependents

Name	Birthdate	Other information	Childcare Expenses	Age	QD	QC
		Full-time student Pays over 50% of their own living expenses

W2 Income

Company	Salary	401(k)	FICA	Fed WH	State WH

Adjustments to Income

IRA Contribution:		Educator Expenses:
Student Loan Interest:		Tuition and Fees:

Payments

Estimated tax payments:

Credits

Childcare credit:		Making Work Pay
Child tax credit:		Additional child tax credit:

Results

Refund:

Filing Status:

Total Income:

Adjustments:

AGI:

Deductions:

Taxable Income:

Income Tax Owed:

Tax Credits:

Income Tax Paid:

Variables

Test =