User's Manual

Credit for other
dependents (2018
amended returns only)
810702
02-06-19
Note:
See the Form 1040 or, for amended returns for years before 2018,
the Form 1040A instructions. See also the Form 1040X instructions.
Multiply the number of exemptions claimed on line 28 by the exemption
amount shown in the instructions for line 29 for the year you are
amending. Enter the result here and on line 4a on page 1 of this form. If
amending your 2018 return, leave line blank
if qualifies for (see instr.):
Child tax
credit
Under penalties of perjury, I declare that I have filed an original return and that I have examined this amended return, including accompanying schedules and statements,
and to the best of my knowledge and belief, this amended return is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information
about which the preparer has any knowledge.
2
Exemptions and Dependents
only
A. Original number
of exemptions or
amount
B. Net change C. Correct number
or amount
24 Caution:
24
25
26
27
28
29
25
26
27
28
29
30 ALL
(d)
Dependents
(b)
(c)
(a)
Presidential Election Campaign Fund
Explanation of Changes.
Remember to keep a copy of this form for your records.
both
Paid Preparer Use Only
1040X
For 2018 amended returns only, leave lines 24, 28, and 29 blank. Fill
in all other applicable lines.
www.irs.gov.
Page
Form 1040X (Rev. 1-2019)
Complete this part if any information relating to exemptions (to dependents if amending your 2018 return) has changed from what you reported
on the return you are amending. This would include a change in the number of exemptions (of dependents if amending your 2018 return).
reported or
as previously adjusted
Yourself and spouse. If someone can claim you as a
dependent, you can't claim an exemption for yourself. If amending
your 2018 return, leave line blank
~~~~~~~~~~~~~~~~
Your dependent children who lived with you ~~~~~~~~~~
Your dependent children who didn't live with you due to divorce
or separation ~~~~~~~~~~~~~~~~~~~~~~~~~~
Other dependents ~~~~~~~~~~~~~~~~~~~~~~~
Total number of exemptions. Add lines 24 through 27. If amending
your 2018 return, leave line blank ~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
List dependents (children and others) claimed on this amended return. If more than 4 dependents, see inst. and here |
(see instructions):
Social
security number
Relationship
to you
First name Last name
Checking below won't increase your tax or reduce your refund.
Check here if you didn't previously want $3 to go to the fund, but now do.
Check here if this is a joint return and your spouse did not previously want $3 to go to the fund, but now does.
In the space provided below, tell us why you are filing Form 1040X.
| Attach any supporting documents and new or changed forms and schedules.
Your signature Date Your occupation
Spouse's signature. If a joint return, must sign. Date Spouse's occupation
Preparer's signature Date Firm's name (or yours if self-employed)
Print/type preparer's name Firm's address and ZIP code
Check if self-employed
PTIN Phone number EIN
For forms and publications, visit Form (Rev. 1-2019)
Sign Here
Part I
Part II
Part III
u 
u







=
=
=
YISROEL & GITTY GOLDSTEIN 100-88-1947
X
SEE STATEMENT 1
CHILDREN CLAIMED AS DEPENDENTS ON ORIGINAL RETURN WERE NOT ELIGIBLE TO BE
CLAIMED AS DEPENDENTS AND WERE REMOVED
PHOTOGRAPHY
HOMEMAKER
ZACHARIA WAXLER 06/24/19 ROTH & COMPANY, LLP
200 CENTRAL AVENUE
ZACHARIA WAXLER LAKEWOOD, NJ 07727
P00502633 732.276.1220 11-3360065