About You and Your Family

Select your filing status:

Enter the following information about you and your spouse:
  

You

Your Spouse

Age (on Dec 31, 2004)

Blind

 yes    no

 yes    no

Someone else's dependent

 yes    no

 yes    no

Now tell us how many dependents you have in each category below. For age, use the child's age as of Dec 31, 2004:

  Child under age 14

  Child age 17 - 18

  Disabled child

  Child age 14 - 16

  Student age 19 - 24

  Other dependent

Income and Adjustments to Income

Your wages

Your spouse's wages

Qualified dividends

Capital gain/loss on assets:

  held one year or less

  held more than one year

Your income/loss from self-employment

Your spouse's income/loss from self-employment

Other income/loss

Deductible IRA contribution

Student loan interest (up to $2,500)

Other adjustments to income