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Income


1.Wages, Salaries and Tips 
?
$
A. Taxpayer 401(k) or other retirement plan contributions from work
?
$
B. Spouse 401(k) or other retirement plan contributions from work
$

2.Interest & Non-Stock Dividends 
?
$

3.Stock/Qualified Dividends 
?
$

4.Short-Term Capital Gains 
?
$

5.Long-Term Capital Gains 
?
$

6.Business Income/(Loss) - Schedule C or F
?
$

7.IRA/Pension Distributions
?
A. Subject to early distribution penalty:
$
B. Not subject to early distribution penalty:
$

8.Unemployment Compensation 
?
$

9.Social Security Benefits 
?
$

10.Other Income 
?

(Gambling income, baby sitting income, etc.)
$