User's Manual
Department of the Treasury - Internal Revenue Service
OMB No. 1545-0074
(Rev. January 2019)
Refundable credits from: Schedule 8812 Form(s) 2439
4136 8863 8885 8962 or
other (specify):
(Rev. 1-2019)
Form
810701 02-06-19
|
Spouse's social security number
Go to www.irs.gov/Form1040X for instructions and the latest information.
This return is for calendar year
Other year.
or
Your social security number
Amended return filing status. must
Caution:
Full-year health care coverage (or, for
2018 amended returns only, exempt).
A. Original amount B. Net change - C. Correct
amount
Income and Deductions
1
2
3
4
5
1
2
3
4a
4b
5
6
7
8
9
10
11
12
13
14
15
a
b
If changing
Tax Liability
6
7
8
9
10
11
Payments
12
13
14
15
16
17
If changing
16
17
18
19
20
21
22
Refund or Amount You Owe
18
19
20
21
22
23
Amount you owe
overpaid
refunded to you
applied to your (enter year): estimated tax 23
Complete and sign this form on page 2.
For Paperwork Reduction Act Notice, see instructions. 1040X
Form
(amended returns for years before 2018 only)
Estimated tax payments, including amount applied from prior year's return
Enter one: calendar year
2018 2017 2016 2015
fiscal year (month and year ended):
Your first name and initial Last name
If a joint return, spouse's first name and initial Last name
Current home address (number and street). If you have a P.O. box, see instructions. Apt. no. Your phone number
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below. See instructions.
Foreign country name Foreign province/state/county Foreign postal code
You check one box even if you are not changing your filing
status. In general, you can't change your filing status from a joint return to separate
returns after the due date.
See inst.
Single Married filing jointly Married filing separately Qualifying widow(er)
Head of household (If the qualifying person is a child but not your dependent, see instructions.)
reported or as
previously adjusted
(see instructions)
amount of increase
or (decrease) -
explain in Part III
Use Part III on page 2 to explain any changes
Adjusted gross income. If a net operating loss (NOL) carryback
is included, check here
Itemized deductions or standard deduction
Subtract line 2 from line 1
~~~~~~~~~~~~~~~~~ |
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
Exemptions . ,
complete Part I on page 2 and enter the amount from line 29 ~~
Qualified business income deduction (2018 amended returns only)
Taxable income. Subtract line 4a or 4b from line 3. If the result is
zero or less, enter -0-
Tax. Enter method(s) used to figure tax:
Credits. If a general business credit carryback is included,
check here ~~~~~~~~~~~~~~~~~~~~~~~ |
Subtract line 7 from line 6. If the result is zero or less, enter -0- ~~
Health care: individual responsibility (see instructions) ~~~~~~
Other taxes
Total tax. Add lines 8, 9, and 10
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Federal income tax withheld and excess social security and tier 1
RRTA tax withheld. ( , see instructions.)~~~~~~~~
Earned income credit (EIC)
Total amount paid with request for extension of time to file, tax paid with original return, and
additional tax paid after return was filed ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total payments. Add lines 12 through 15, column C, and line 16
Overpayment, if any, as shown on original return or as previously adjusted by the IRS
Subtract line 18 from line 17. (If less than zero, see instructions.)
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
. If line 11, column C, is more than line 19, enter the difference
If line 11, column C, is less than line 19, enter the difference. This is the amount on this return
~~~~~~~~~~~~~~~~~
~~~~~
Amount of line 21 you want
Amount of line 21 you want
LHA
1040X
Amended U.S. Individual Income Tax Return
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YISROEL GOLDSTEIN 100 88 1947
GITTY GOLDSTEIN 127 60 9060
1265 51 ST
BROOKLYN, NY 11219
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2,786. 2,786.
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9,800. -894. 8,906.
11,692.
12,374.
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894.