Form 1040 Page 2

Summary: This is an example of Form 1040 (2016), page 2, with items included as described in the text. Additionally, these line items are completed:

Under“Tax and Credits”:
38. Amount from line 37 (adjusted gross income)” field contains 35,280
40. Itemized deductions (from Schedule A) or your standard deduction (see left margin)” field contains 13,722
41. Subtract line 40 from line 38” field contains 21,558
42. Exemptions. If line 38 is $155,650 or less, multiply $4,050, multiply $4,050 by the number on line 6d. Otherwise, see instructions” field contains 12,150
43. Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0-” field contains 9,408
44. Tax (see instructions).” field contains 943
47. Add lines 44, 45 and 46” field contains 943
52. Child tax credit. Attach Schedule 8812, if required” field contains 943
55. Add lines 48 through 54. These are your total credits” field contains 943
56. Subtract line 55 from line 47. If line 55 is more than line 47, enter -0-” field contains -0-
Under“Other Taxes”:
57. Self-employment tax. Attach Schedule SE” field contains 6,177
61. Health care: Individual responsibility (see instructions) Full-year coverage checkbox” Checkbox contains a checkmark indicating full-year coverage
63. Add lines 56 through 62. This is your total tax” field contains 6,177
Under“Payments”:
64. Federal income tax withheld from Forms W-2 and 1099” field contains 272
65. 2016 estimated tax payments and amount applied from 2015 return” field contains 7,000
66a. Earned income credit (EIC)” written on the dotted line “Clergy” field contains 131
67. Additional child tax credit. Attach Schedule 8812” field contains 57
74. Add lines 64, 65, 66a, and 67 through 73. These are your total payments” field contains 7,460
Under“Refund”:
75. If line 74 is more than line 63, subtract line 63 from line 74. This is the amount you overpaid” field contains 1,283
77. Amount of line 75 you want applied to your 2017 estimated tax” field contains 1,283
Under“Third Party Designee”:
Do you want to allow another person to discuss this return with the IRS?” The “No” checkbox is checked.
Under“Sign Here”:
Your signature” field contains John E. White
Date” field contains 3/1/2017
Your occupation” field contains Minister
Spouse's signature. If a joint return, both must sign.” field contains Susan R. White
Date” field contains 3/1/2017
Spouse's occupation” field contains Homemaker