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Ken is 63 years old and unmarried. He retired at age 55 when he sold his business, Understock.com. Though Ken is retired, he is still very active. Ken reported the following financial information

Ken is 63 years old and unmarried. He retired at age 55 when he sold his business, Understock.com. Though Ken is retired, he is still very active. Ken reported the following financial information this year. Assume Ken files as a single taxpayer.

Ken won $1,200 in an illegal game of poker (the game was played in Utah, where gambling is illegal).

Ken sold 1,000 shares of stock for $32 a share. He inherited the stock two years ago. His tax basis (or investment) in the stock was $31 per share.

Ken received $25,000 from an annuity he purchased eight years ago. He purchased the annuity, to be paid annually for 20 years, for $210,000.

Ken received $13,000 in disability benefits for the year. He purchased the disability insurance policy last year.

Ken decided to go back to school to learn about European history. He received a $500 cash scholarship to attend. He used $300 to pay for his books and tuition, and he applied the rest toward his new car payment.

Ken’s son, Mike, instructed his employer to make half of his final paycheck of the year payable to Ken as a gift from Mike to Ken. Ken received the check on December 30 in the amount of $1,100.

Ken received a $610 refund of the $3,600 in state income taxes his employer withheld from his pay last year. Ken claimed $6,350 in itemized deductions last year (the standard deduction for a single filer was $6,300).

Ken received $30,000 of interest from corporate bonds and money market accounts.

Complete page 1 of Form 1040 for Ken.


Ken's address is 1001 N.W. 93 Street, Miami, FL 33168.


Ken's Social security number: 412-34-5670

1040 PG1

   
 
 
Form 1040 Department of the Treasury—Internal Revenue Service (99) 2016 OMB No. 1545-0074 IRS Use Only - Do not write in this space.
U.S. Individual Income Tax Return
For the year Jan. 1–Dec. 31, 2016, or other tax year beginning , 2016, ending   , 20   See separate instructions.
Your first name and initial Last name   Your social security number
Ken     412-34-5670
If a joint return, spouse's first name and initial Last name   Spouse's social security number
       
Home address (number and street). If you have a P.O. box, see instructions.   Apt. no. ▲ Make sure the SSN(s) above and on line 6c are correct.
1001 N.W. 93 Street, Miami, FL 33168.    
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below.   Presidential Election Campaign
    Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund.
Foreign country name Foreign province   Foreign postal code
     
You Spouse
Filing Status 1  
Single 4  
Head of household (with qualifying person). If the qualifying person is a child
Check only one box. 2  
Married filing jointly (even if only one had income)   but not your dependent, enter this child's name here. ▶  
  3  
Married filing separately. Enter spouse’s 5  
Qualifying widow(er) with dependent child  
  SSN above and full name here. ▶          
Exemptions 6a  
Yourself. If someone can claim you as a dependent, do not check box 6a Boxes checked on 6a and 6b 1
  b  
Spouse No. of children on 6c who:  
  c Dependents:   (2) Dependent's (3) Dependent's (4) X if child under ● Lived with you  
  (1) First name Last name SSN Relationship age 17 qualifying ● Did not live with you due to divorce  
        (xxx-xx-xxxx) to you for child tax credit. or separation (see instruction)  
If more than four dependents, see instructions and check here            
Dependents on 6c not entered above  
           
           
     
 
           
Add numbers on lines above ▶ 1
  d Total number of exemptions claimed ……………………………………………
Income 7 7 Wages, salaries, tips, etc. Attach Form(s) W-2 7  
  8a 8a Taxable interest. Attach Schedule B if required 8a  
Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld. b Tax-exempt interest. Do not include on line 8a 8b      
9a Ordinary dividends. Attach Schedule B if required 9a  
b Qualified Dividends 9b      
10 Taxable refunds, credits, or offsets of state and local income taxes 10  
11 Alimony received 11  
12 Business income or (loss). Attach Schedule C or C-EZ 12  
13 Capital gain or (loss). Attach Schedule D if required.   13  
  14 Other gains or (losses). Attach Form 4797 14  
  15a IRA distributions   15a   b Taxable amount 15b  
If you did not get a W-2, see instructions. 16a Pensions and annuities   16a   b Taxable amount 16b  
17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. 17  
18 Farm income or (loss). Attach Schedule F 18  
19 Unemployment compensation 19  
20a Social security benefits   20a   b Taxable amount 20b  
  21 Other income. List type and amount   21  
  22 Combine the amounts in the far right column for lines 7 through 21. This is your total income ▶ 22  
Adjusted 23 Educator expenses 23      
Gross 24 Certain business expenses of reservists, performing artists, and 24    
Income   fee-basis government officials. Attach Form 2106 or 2106-EZ  
  25 Health savings account deduction. Attach Form 8889 25    
  26 Moving expenses. Attach Form 3903 26    
  27 Deductible part of self-employment tax. Attach Schedule SE 27    
  28 Self-employed SEP, SIMPLE, and qualified plans 28    
  29 Self-employed health insurance deduction 29    
  30 Penalty on early withdrawal of savings 30    
  31a Alimony paid b Recipient’s SSN (xxx-xx-xxxx)   31a    
  32 IRA deduction 32    
  33 Student loan interest deduction 33    
  34 Tuition and fees. Attach Form 8917 34    
  35 Domestic production activities deduction. Attach Form 8903 35    
  36 Add lines 23 through 35 36  
  37 Subtract line 36 from line 22. This is your adjusted gross income . . . . . ▶ 37  
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2016)
UYA

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