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Filing Status. Check only one box.
Married filling jointly (MFJ)
Married filing separately (MFS)
Head of household (HOH)
Qualifying widow(er) (QW)
Your first name and middle initial
Your social security number
If you select (MFJ) or (MFS) enter your spouse’s first name, middle initial, last name and social security number below.
If you checked the HOH box, enter the name of your dependent, age and social security. Are they a student? if (yes), name of the school and address.
Current Home address (number, street, city, town or post office, state, and ZIP code). If you have a P.O. box, see instructions.
Check the box that apply to you.
Someone can claim me as a dependent
Someone can claim my spouse as a dependent
I am a Student
I have an IP PIN
I have all my W2/1099
My dependent live with me for 6 months or more
I owe IRS
I own a business
I have health insurance through the Market Place
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