This form contains 307 fields organized into 17 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information
topmostSubform[0].Page1[0].f1_20[0 Text
Provide the required information for this field.
topmostSubform[0].Page1[0].f1_21[0 Text
Provide the required information for this field.
If "Yes," enter the expiration date Text
If you answered 'Yes' to the previous question, enter the expiration date here.
d Other (specify) Text
Specify any other relevant information.
Address
U.S. address (number, street, and apt. no. or rural route) Text
Enter your U.S. address, including number, street, and apartment number or rural route.
City, state, and ZIP code Text
Enter the city, state, and ZIP code of your U.S. address.
Checkboxes
topmostSubform[0].Page1[0].c1_1[0]_1 CheckBox
Check this box if applicable.
topmostSubform[0].Page1[0].c1_2[0]_1 CheckBox
Check this box if applicable.
topmostSubform[0].Page1[0].c1_3[0]_1 CheckBox
Check this box if applicable.
topmostSubform[0].Page1[0].c1_4[0]_1 CheckBox
Check this box if applicable.
topmostSubform[0].Page1[0].c1_4[1]_2 CheckBox
Check this box if applicable.
topmostSubform[0].Page1[0].c1_5[0]_1 CheckBox
Check this box if applicable.
topmostSubform[0].Page1[0].c1_5[1]_2 CheckBox
Check this box if applicable.
Dependents Information
topmostSubform[0].Page2[0].Table_Dependents[0].Row1[0].f2_1[0 Text
Enter the first name of your dependent.
topmostSubform[0].Page2[0].Table_Dependents[0].Row1[0].f2_2[0 Text
Enter the Social Security Number (SSN) of your dependent. Maximum length is 9 digits.
Max length: 9 characters
topmostSubform[0].Page2[0].Table_Dependents[0].Row1[0].f2_3[0 Text
Enter the relationship of the dependent to you (e.g., son, daughter).
topmostSubform[0].Page2[0].Table_Dependents[0].Row1[0].c2_1[0]_1 CheckBox
Check this box if the dependent is a U.S. citizen.
topmostSubform[0].Page2[0].Table_Dependents[0].Row1[0].c2_2[0]_1 CheckBox
Check this box if the dependent is a resident alien.
topmostSubform[0].Page2[0].Table_Dependents[0].Row2[0].f2_4[0 Text
Enter the first name of your second dependent.
topmostSubform[0].Page2[0].Table_Dependents[0].Row2[0].f2_5[0 Text
Enter the Social Security Number (SSN) of your second dependent. Maximum length is 9 digits.
Max length: 9 characters
topmostSubform[0].Page2[0].Table_Dependents[0].Row2[0].f2_6[0 Text
Enter the name of the dependent.
topmostSubform[0].Page2[0].Table_Dependents[0].Row2[0].c2_3[0]_1 CheckBox
Check this box if the dependent is a qualifying child for the child tax credit.
topmostSubform[0].Page2[0].Table_Dependents[0].Row2[0].c2_4[0]_1 CheckBox
Check this box if the dependent is a qualifying relative.
topmostSubform[0].Page2[0].Table_Dependents[0].Row3[0].f2_7[0 Text
Enter the dependent's relationship to you (e.g., son, daughter, parent).
topmostSubform[0].Page2[0].Table_Dependents[0].Row3[0].f2_8[0 Text
Enter the dependent's Social Security Number (SSN). Maximum length is 9 digits.
Max length: 9 characters
topmostSubform[0].Page2[0].Table_Dependents[0].Row3[0].f2_9[0 Text
Enter the dependent's date of birth.
topmostSubform[0].Page2[0].Table_Dependents[0].Row3[0].c2_5[0]_1 CheckBox
Check this box if the dependent lived with you for more than half of the year.
topmostSubform[0].Page2[0].Table_Dependents[0].Row3[0].c2_6[0]_1 CheckBox
Check this box if the dependent did not live with you but is claimed under a multiple support agreement.
topmostSubform[0].Page2[0].Table_Dependents[0].Row4[0].f2_10[0 Text
Enter the dependent's name.
topmostSubform[0].Page2[0].Table_Dependents[0].Row4[0].f2_11[0 Text
Enter the dependent's Social Security Number (SSN). Maximum length is 9 digits.
Max length: 9 characters
topmostSubform[0].Page2[0].Table_Dependents[0].Row4[0].f2_12[0 Text
Enter the name of the dependent listed in row 4 of the dependents table.
topmostSubform[0].Page2[0].Table_Dependents[0].Row4[0].c2_7[0]_1 CheckBox
Check this box if the dependent listed in row 4 is a qualifying child for the child tax credit.
topmostSubform[0].Page2[0].Table_Dependents[0].Row4[0].c2_8[0]_1 CheckBox
Check this box if the dependent listed in row 4 is a qualifying relative for the credit for other dependents.
General Information
topmostSubform[0].Page2[0].c2_9[0]_1 CheckBox
Check this box if applicable.
topmostSubform[0].Page2[0].f2_52[0 Text
Enter the required information for the specified field on Page 2 of the form.
General Instructions
See instructions. 25 Text
Refer to the instructions for further details on how to complete this field.
Income Details
topmostSubform[0].Page1[0].f1_38[0 Text
Enter your total income earned in the United States.
16 16 Total income (from page 3, Schedule A, line 4, column (d) or (e)) Text
Enter the total income amount from page 3, Schedule A, line 4, column (d) or (e).
17 17 Adjustments. See the instructions and attach appropriate form or statement Text
Enter any adjustments to income. Refer to the instructions and attach the appropriate form or statement.
topmostSubform[0].Page2[0].f2_15[0 Text
Enter the total amount of adjustments to income.
19 19 Enter the amount from page 4, Schedule D, line 6 or 12, whichever applies Text
Enter the amount from page 4, Schedule D, line 6 or 12, whichever applies.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row1[0].f3_1[0 Text
Enter the income details for the first row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row1[0].f3_2[0 Text
Enter the income details for the first row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row1[0].f3_3[0 Text
Enter the income details for the first row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row1[0].f3_4[0 Text
Enter the income details for the first row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row1[0].f3_5[0 Text
Enter the income details for the first row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row1[0].f3_6[0 Text
Enter the income details for the first row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row2[0].f3_7[0 Text
Enter the income details for the second row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row2[0].f3_8[0 Text
Enter the income details for the second row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row2[0].f3_9[0 Text
Enter the income details for the second row of Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row2[0].f3_10[0 Text
Enter the specific income detail for the first item in Schedule A, Row 2.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row2[0].f3_11[0 Text
Enter the specific income detail for the second item in Schedule A, Row 2.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row2[0].f3_12[0 Text
Enter the specific income detail for the third item in Schedule A, Row 2.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row3[0].f3_13[0 Text
Enter the specific income detail for the first item in Schedule A, Row 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row3[0].f3_14[0 Text
Enter the specific income detail for the second item in Schedule A, Row 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row3[0].f3_15[0 Text
Enter the specific income detail for the third item in Schedule A, Row 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row3[0].f3_16[0 Text
Enter the specific income detail for the fourth item in Schedule A, Row 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row3[0].f3_17[0 Text
Enter the specific income detail for the fifth item in Schedule A, Row 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row3[0].f3_18[0 Text
Enter the specific income detail for the sixth item in Schedule A, Row 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row4[0].f3_19[0 Text
Enter the specific income detail for the first item in Schedule A, Row 4.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row4[0].f3_20[0 Text
Enter the specific income detail for Schedule A, Row 4, Column 1. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row4[0].f3_21[0 Text
Enter the specific income detail for Schedule A, Row 4, Column 2. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row4[0].f3_22[0 Text
Enter the specific income detail for Schedule A, Row 4, Column 3. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row4[0].f3_23[0 Text
Enter the specific income detail for Schedule A, Row 4, Column 4. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row4[0].f3_24[0 Text
Enter the specific income detail for Schedule A, Row 4, Column 5. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row5[0].f3_25[0 Text
Enter the specific income detail for Schedule A, Row 5, Column 1. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row5[0].f3_26[0 Text
Enter the specific income detail for Schedule A, Row 5, Column 2. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row5[0].f3_27[0 Text
Enter the specific income detail for Schedule A, Row 5, Column 3. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row5[0].f3_28[0 Text
Enter the specific income detail for Schedule A, Row 5, Column 4. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row5[0].f3_29[0 Text
Enter the specific income detail for Schedule A, Row 5, Column 5. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row5[0].f3_30[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 5.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row6[0].f3_31[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 6.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row6[0].f3_32[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 6.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row6[0].f3_33[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 6.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row6[0].f3_34[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 6.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row6[0].f3_35[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 6.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row6[0].f3_36[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 6.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row7[0].f3_37[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 7.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row7[0].f3_38[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 7.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row7[0].f3_39[0 Text
Enter the amount for the specific income or deduction item in Schedule A, Row 7.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row7[0].f3_40[0 Text
Enter the specific income detail for Schedule A, Row 7. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row7[0].f3_41[0 Text
Enter the specific income detail for Schedule A, Row 7. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row7[0].f3_42[0 Text
Enter the specific income detail for Schedule A, Row 7. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row8[0].f3_43[0 Text
Enter the specific income detail for Schedule A, Row 8. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row8[0].f3_44[0 Text
Enter the specific income detail for Schedule A, Row 8. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row8[0].f3_45[0 Text
Enter the specific income detail for Schedule A, Row 8. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row8[0].f3_46[0 Text
Enter the specific income detail for Schedule A, Row 8. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row8[0].f3_47[0 Text
Enter the specific income detail for Schedule A, Row 8. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row8[0].f3_48[0 Text
Enter the specific income detail for Schedule A, Row 8. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row9[0].f3_49[0 Text
Enter the specific income detail for Schedule A, Row 9. This could be a type of income or a specific amount related to your stay in the U.S.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row9[0].f3_50[0 Text
Enter the specific income detail for Schedule A, Row 9, Column 1. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row9[0].f3_51[0 Text
Enter the specific income detail for Schedule A, Row 9, Column 2. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row9[0].f3_52[0 Text
Enter the specific income detail for Schedule A, Row 9, Column 3. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row9[0].f3_53[0 Text
Enter the specific income detail for Schedule A, Row 9, Column 4. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row9[0].f3_54[0 Text
Enter the specific income detail for Schedule A, Row 9, Column 5. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row10[0].f3_55[0 Text
Enter the specific income detail for Schedule A, Row 10, Column 1. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row10[0].f3_56[0 Text
Enter the specific income detail for Schedule A, Row 10, Column 2. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row10[0].f3_57[0 Text
Enter the specific income detail for Schedule A, Row 10, Column 3. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row10[0].f3_58[0 Text
Enter the specific income detail for Schedule A, Row 10, Column 4. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row10[0].f3_59[0 Text
Enter the specific income detail for Schedule A, Row 10, Column 5. This is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row10[0].f3_60[0 Text
Enter the specific income detail for Schedule A, Row 10. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row11[0].f3_61[0 Text
Enter the specific income detail for Schedule A, Row 11. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row11[0].f3_62[0 Text
Enter the specific income detail for Schedule A, Row 11. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row11[0].f3_63[0 Text
Enter the specific income detail for Schedule A, Row 11. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row11[0].f3_64[0 Text
Enter the specific income detail for Schedule A, Row 11. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row11[0].f3_65[0 Text
Enter the specific income detail for Schedule A, Row 11. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row11[0].f3_66[0 Text
Enter the specific income detail for Schedule A, Row 11. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row12[0].f3_67[0 Text
Enter the specific income detail for Schedule A, Row 12. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row12[0].f3_68[0 Text
Enter the specific income detail for Schedule A, Row 12. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row12[0].f3_69[0 Text
Enter the specific income detail for Schedule A, Row 12. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row12[0].f3_70[0 Text
Enter the specific income detail for Schedule A, Row 12. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row12[0].f3_71[0 Text
Enter the specific income detail for Schedule A, Row 12. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row12[0].f3_72[0 Text
Enter the specific income detail for Schedule A, Row 12. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row13[0].f3_73[0 Text
Enter the specific income detail for Schedule A, Row 13. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row13[0].f3_74[0 Text
Enter the specific income detail for Schedule A, Row 13. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row13[0].f3_75[0 Text
Enter the specific income detail for Schedule A, Row 13. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row13[0].f3_76[0 Text
Enter the specific income detail for Schedule A, Row 13. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row13[0].f3_77[0 Text
Enter the specific income detail for Schedule A, Row 13. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row13[0].f3_78[0 Text
Enter the specific income detail for Schedule A, Row 13. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row14[0].f3_79[0 Text
Enter the specific income detail for Schedule A, Row 14. This could be a type of income or a specific amount.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row14[0].f3_80[0 Text
Enter the specific income detail for Schedule A, Row 14. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row14[0].f3_81[0 Text
Enter the specific income detail for Schedule A, Row 14. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row14[0].f3_82[0 Text
Enter the specific income detail for Schedule A, Row 14. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row14[0].f3_83[0 Text
Enter the specific income detail for Schedule A, Row 14. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row14[0].f3_84[0 Text
Enter the specific income detail for Schedule A, Row 14. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row15[0].f3_85[0 Text
Enter the specific income detail for Schedule A, Row 15. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row15[0].f3_86[0 Text
Enter the specific income detail for Schedule A, Row 15. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row15[0].f3_87[0 Text
Enter the specific income detail for Schedule A, Row 15. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row15[0].f3_88[0 Text
Enter the specific income detail for Schedule A, Row 15. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row15[0].f3_89[0 Text
Enter the specific income detail for Schedule A, Row 15. This field is part of the income details section.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row15[0].f3_90[0 Text
Enter the specific income detail for Row 15 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row16[0].f3_91[0 Text
Enter the specific income detail for Row 16 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row16[0].f3_92[0 Text
Enter the specific income detail for Row 16 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row16[0].f3_93[0 Text
Enter the specific income detail for Row 16 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row16[0].f3_94[0 Text
Enter the specific income detail for Row 16 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row16[0].f3_95[0 Text
Enter the specific income detail for Row 16 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row16[0].f3_96[0 Text
Enter the specific income detail for Row 16 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row17[0].f3_97[0 Text
Enter the specific income detail for Row 17 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row17[0].f3_98[0 Text
Enter the specific income detail for Row 17 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row17[0].f3_99[0 Text
Enter the specific income detail for Row 17 in Schedule A on Page 3.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row17[0].f3_100[0 Text
Enter the specific income detail for Schedule A, Row 17.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row17[0].f3_101[0 Text
Enter the specific income detail for Schedule A, Row 17.
topmostSubform[0].Page3[0].Table_ScheduleA[0].Row17[0].f3_102[0 Text
Enter the specific income detail for Schedule A, Row 17.
topmostSubform[0].Page3[0].f3_103[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_104[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_105[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_106[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_107[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_108[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_109[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_110[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_111[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_112[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].f3_113[0 Text
Enter the specific income detail required for this field. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].f3_114[0 Text
Enter the specific income detail required for this field. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].f3_116[0 Text
Enter the specific income detail required for this field. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].f3_117[0 Text
Enter the specific income detail required for this field. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].f3_118[0 Text
Enter the specific income detail required for this field. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].f3_119[0 Text
Enter the specific income detail required for this field. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].SchBTable[0].Row2[0].f3_124[0 Text
Enter the specific income detail for the second row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row2[0].f3_125[0 Text
Enter the specific income detail for the second row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row2[0].f3_126[0 Text
Enter the specific income detail for the second row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row2[0].f3_127[0 Text
Enter the specific income detail for the second row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row2[0].f3_128[0 Text
Enter the specific income detail for the second row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row2[0].f3_129[0 Text
Enter the specific income detail for the second row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row3[0].f3_130[0 Text
Enter the specific income detail for the third row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row3[0].f3_131[0 Text
Enter the specific income detail for the third row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row3[0].f3_132[0 Text
Enter the specific income detail for the third row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row3[0].f3_133[0 Text
Enter the specific income detail for the third row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row3[0].f3_134[0 Text
Enter the specific income detail for the third row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row3[0].f3_135[0 Text
Enter the specific income detail for the third row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row4[0].f3_136[0 Text
Enter the specific income detail for the fourth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row4[0].f3_137[0 Text
Enter the specific income detail for the fourth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row4[0].f3_138[0 Text
Enter the specific income detail for the fourth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row4[0].f3_139[0 Text
Enter the specific income detail for the fourth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row4[0].f3_140[0 Text
Enter the specific income detail for the fourth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row4[0].f3_141[0 Text
Enter the specific income detail for the fourth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row5[0].f3_142[0 Text
Enter the specific income detail for the fifth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row5[0].f3_143[0 Text
Enter the specific income detail for the fifth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row5[0].f3_144[0 Text
Enter the specific income detail for the fifth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row5[0].f3_145[0 Text
Enter the specific income detail for the fifth row of Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row5[0].f3_146[0 Text
Enter the specific income detail for Row 5 in Schedule B on Page 3.
topmostSubform[0].Page3[0].SchBTable[0].Row5[0].f3_147[0 Text
Enter the specific income detail for Row 5 in Schedule B on Page 3.
topmostSubform[0].Page3[0].f3_148[0 Text
Enter the specific income detail for Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row3[0].f3_157[0 Text
Enter the specific income detail for the third row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row3[0].f3_158[0 Text
Enter the specific income detail for the third row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row3[0].f3_159[0 Text
Enter the specific income detail for the third row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row3[0].f3_160[0 Text
Enter the specific income detail for the third row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row4[0].f3_161[0 Text
Enter the specific income detail for the fourth row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row4[0].f3_162[0 Text
Enter the specific income detail for the fourth row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row4[0].f3_163[0 Text
Enter the specific income detail for the fourth row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row4[0].f3_164[0 Text
Enter the specific income detail for the fourth row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row5[0].f3_165[0 Text
Enter the specific income detail for the fifth row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row5[0].f3_166\.[0 Text
Enter the specific income detail for the fifth row of Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row5[0].f3_167[0 Text
Enter the amount for the specified line in Schedule C, Row 5.
topmostSubform[0].Page3[0].SchCTable[0].Row5[0].f3_168[0 Text
Enter the amount for the specified line in Schedule C, Row 5.
2 Text
Enter the amount for the specified line on Page 3.
IRS Information
(Field Assistance Area Director) Internal Revenue Service Text
Enter the name of the Field Assistance Area Director of the Internal Revenue Service.
topmostSubform[0].Page2[0].f2_50[0 Text
Enter any additional information required by the IRS.
topmostSubform[0].Page2[0].f2_51[0 Text
Enter the 4-digit code related to the IRS information.
Max length: 4 characters
Miscellaneous
topmostSubform[0].Page2[0].f2_26[0 Text
This field appears to be a placeholder or an incomplete field. Please refer to the form instructions for more details.
topmostSubform[0].Page2[0].f2_27[0 Text
This field appears to be a placeholder or an incomplete field. Please refer to the form instructions for more details.
(see inst.) Text
This field appears to be a placeholder or an incomplete field. Please refer to the form instructions for more details.
Max length: 6 characters
topmostSubform[0].Page2[0].f2_34[0 Text
This field appears to be a placeholder or an incomplete field. Please refer to the form instructions for more details.
Max length: 6 characters
topmostSubform[0].Page2[0].f2_37[0 Text
This field appears to be a placeholder or an incomplete field. Please refer to the form instructions for more details.
Passport Information
Your number Text
Enter your passport number.
Spouse's number Text
Enter your spouse's passport number.
Personal Information
topmostSubform[0].Page1[0].f1_5[0 Text
Enter your first name and middle initial.
Last name Text
Enter your last name.
Your social security number Text
Enter your social security number (SSN).
Max length: 9 characters
topmostSubform[0].Page1[0].f1_8[0 Text
Enter your spouse's last name.
spouse's first name and initial (see instructions) Text
Enter your spouse's first name and initial as instructed.
topmostSubform[0].Page1[0].f1_10[0 Text
Enter your spouse's social security number (SSN).
Max length: 9 characters
Date of departure Text
Enter the date on which you plan to depart from the United States.
Complete foreign address Text
Provide your complete address in the foreign country where you will reside after departing the United States.
Date on which you last arrived in the U.S Text
Enter the date on which you last arrived in the United States.
Of what country are you a citizen or national Text
Specify the country of which you are a citizen or national.
Of what country are you a resident for tax purposes Text
Indicate the country where you are considered a resident for tax purposes.
topmostSubform[0].Page1[0].f1_23[0 Text
Enter your full name as it appears on your tax documents.
topmostSubform[0].Page1[0].c1_6[0]_1 CheckBox
Check this box if you are a nonresident alien.
topmostSubform[0].Page1[0].c1_6[1]_2 CheckBox
Check this box if you are a resident alien.
topmostSubform[0].Page1[0].c1_7[0]_1 CheckBox
Check this box if you are married.
topmostSubform[0].Page1[0].c1_7[1]_2 CheckBox
Check this box if you are single.
topmostSubform[0].Page1[0].c1_8[0]_1 CheckBox
Check this box if you have dependents.
topmostSubform[0].Page1[0].c1_8[1]_2 CheckBox
Check this box if you do not have dependents.
b Your U.S. address, if any, shown on return Text
Enter your U.S. address, if any, as shown on your return.
Text
Enter your foreign address.
Text
Enter your Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN).
Text
Enter your date of birth.
topmostSubform[0].Page1[0].c1_9[0]_1 CheckBox
Check this box if you are filing jointly with your spouse.
topmostSubform[0].Page1[0].c1_9[1]_2 CheckBox
Check this box if you are filing separately from your spouse.
topmostSubform[0].Page1[0].c1_10[0]_1 CheckBox
Check this box if you are a nonresident alien departing the United States.
topmostSubform[0].Page1[0].c1_10[1]_2 CheckBox
Check this box if you are filing a joint return with your spouse.
topmostSubform[0].Page1[0].c1_11[0]_1 CheckBox
Check this box if you are claiming any dependents.
topmostSubform[0].Page1[0].f1_29[0 Text
Enter your first name.
topmostSubform[0].Page1[0].f1_30[0 Text
Enter your last name.
topmostSubform[0].Page1[0].f1_31[0 Text
Enter your Social Security Number (SSN).
topmostSubform[0].Page1[0].f1_32[0 Text
Enter your address in the United States.
Text
Enter your address in your home country.
topmostSubform[0].Page1[0].f1_34[0 Text
Enter your date of birth.
Text
Enter your country of citizenship.
topmostSubform[0].Page1[0].f1_36[0 Text
Enter your passport number.
topmostSubform[0].Page1[0].c1_12[0]_1 CheckBox
Check this box if you are a nonresident alien departing the United States.
topmostSubform[0].Page1[0].c1_12[1]_2 CheckBox
Check this box if you have filed a previous Form 1040-C.
topmostSubform[0].Page1[0].f1_40[0 Text
Enter your first name.
topmostSubform[0].Page1[0].f1_41[0 Text
Enter your last name.
Your occupation Text
Enter your occupation.
Spouse's occupation Text
Enter your spouse's occupation.
Phone no Text
Enter your phone number.
Email address Text
Enter your email address.
(Name) Text
Enter your full name as it appears on your official documents.
Preparer Information
PTIN Text
Enter the Preparer Tax Identification Number (PTIN). This is an 11-character identifier issued by the IRS.
Max length: 11 characters
Firm's name Text
Enter the name of the firm preparing the tax return.
Firm's address Text
Enter the address of the firm preparing the tax return.
Firm's EIN Text
Enter the Employer Identification Number (EIN) of the firm preparing the tax return. This is a 10-character identifier.
Max length: 10 characters
Phone no Text
Enter the phone number of the firm preparing the tax return.
Schedule B - Income Details
topmostSubform[0].Page3[0].SchBTable[0].Row1[0].f3_118[0 Text
Enter the specific income detail for Schedule B, Row 1. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].SchBTable[0].Row1[0].f3_119[0 Text
Enter the specific income detail for Schedule B, Row 1. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].SchBTable[0].Row1[0].f3_120[0 Text
Enter the specific income detail for Schedule B, Row 1. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].SchBTable[0].Row1[0].f3_121[0 Text
Enter the specific income detail for Schedule B, Row 1. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].SchBTable[0].Row1[0].f3_122[0 Text
Enter the specific income detail for Schedule B, Row 1. Refer to the instructions on Page 3 of Form 1040-C for more information.
topmostSubform[0].Page3[0].SchBTable[0].Row1[0].f3_123[0 Text
Enter the specific income detail for Schedule B, Row 1. Refer to the instructions on Page 3 of Form 1040-C for more information.
Tax Computations
topmostSubform[0].Page1[0].c1_11[1]_2 CheckBox
Check this box if you are claiming any tax credits.
topmostSubform[0].Page1[0].f1_39[0 Text
Enter the total tax withheld from your income.
20 20 Credits. See the instructions and attach appropriate form or statement Text
Enter the total amount of credits. Refer to the instructions and attach the appropriate form or statement.
21 Subtract line 20 from line 19. If zero or less, enter -0-. 21 Text
Subtract the amount on line 20 from the amount on line 19. If the result is zero or less, enter -0-.
topmostSubform[0].Page2[0].f2_19[0 Text
Enter the total tax amount after credits and adjustments.
23 Text
Enter the total tax amount due.
topmostSubform[0].Page2[0].f2_21[0 Text
Enter any additional tax amounts.
26 Total tax. Add lines 23 and 25 26 Text
Enter the total tax amount by adding the values from lines 23 and 25.
27 U.S. income tax paid or withheld at source (from page 3, Schedule A, lines 4 and 5, column (c)) 27 Text
Enter the U.S. income tax paid or withheld at the source, as detailed on page 3, Schedule A, lines 4 and 5, column (c).
28 Current year's estimated tax payments and amount applied from preceding year's tax return. 28 Text
Enter the current year's estimated tax payments and any amount applied from the preceding year's tax return.
30 Total payments. Add lines 27 through 29 30 Text
Enter the total payments by adding the values from lines 27 through 29.
31 If line 26 is more than line 29, subtract line 30 from line 26. This is the amount you owe 31 Text
If the amount on line 26 is more than the amount on line 29, subtract the value on line 30 from the value on line 26. This is the amount you owe.
32 If line 30 is more than line 26, subtract line 26 from line 30. This is the amount you overpaid. Any 32 Text
If the amount on line 30 is more than the amount on line 26, subtract the value on line 26 from the value on line 30. This is the amount you overpaid.
topmostSubform[0].Page3[0].SchCTable[0].Row1[0].f3_149[0 Text
Enter the specific tax computation detail for Row 1 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row1[0].f3_150[0 Text
Enter the specific tax computation detail for Row 1 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row1[0].f3_151[0 Text
Enter the specific tax computation detail for Row 1 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row1[0].f3_152[0 Text
Enter the specific tax computation detail for Row 1 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row2[0].f3_153[0 Text
Enter the specific tax computation detail for Row 2 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row2[0].f3_154[0 Text
Enter the specific tax computation detail for Row 2 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row2[0].f3_155[0 Text
Enter the specific tax computation detail for Row 2 in Schedule C on Page 3.
topmostSubform[0].Page3[0].SchCTable[0].Row2[0].f3_156[0 Text
Enter the specific tax computation detail for Row 2 in Schedule C on Page 3.
1 Enter amount from page 2, line 18. 1 Text
Enter the amount from Page 2, Line 18.
2 Text
Enter the amount for the specified line on Page 4.
3 Taxable income. Subtract line 2 from line 1 3 Text
Enter the taxable income by subtracting Line 2 from Line 1.
4 Tax. Figure your tax on the amount on line 3 by using the current year's Tax Rate Schedules in the instructions. Include in the total any tax from Form 4972 and Form 8814. Enter the tax here . 4 S Text
Calculate your tax on the amount on Line 3 using the current year's Tax Rate Schedules. Include any tax from Form 4972 and Form 8814, and enter the total tax here.
topmostSubform[0].Page4[0].f4_5[0 Text
Enter the amount for the specified line on Page 4.
6 Add lines 4 and 5. Enter the result here and on Form 1040-C, line 19 6 Text
Add the amounts from Lines 4 and 5, and enter the result here and on Form 1040-C, Line 19.
7 Text
Enter the amount for the specified line on Page 4.
8 Text
Enter the amount for the specified line on Page 4.
6 Text
Enter the amount for the specified line on Page 4.
10 Tax. Figure your tax on the amount on line 9 by using the current year's Tax Rate Schedules in the instructions. Include in the total any tax from Form 4972 and Form 8814. Enter the tax here . 10 Text
Calculate your tax on the amount on Line 9 using the current year's Tax Rate Schedules. Include any tax from Form 4972 and Form 8814, and enter the total tax here.
11 = Alternative minimum tax (AMT). Enter the amount, if any, of AMT from Form 6251 11 Text
Enter the amount of Alternative Minimum Tax (AMT) from Form 6251, if any.
12 Add lines 10 and 11. Enter the result here and on Form 1040-C, line 19 12 Text
This field requires you to add the amounts from lines 10 and 11 and enter the total here. This total should also be entered on Form 1040-C, line 19.
Tax Information
SR, 1040-NR, etc.) Text
Enter the type of return you are filing (e.g., 1040-NR).
Tax Period
For tax period or year beginning Text
Enter the beginning date of the tax period or year for which you are filing this form.
topmostSubform[0].Page1[0].PgHeader[0].f1_2[0 Text
Enter the month (in two digits) when the tax period or year begins.
Max length: 2 characters
and ending Text
Enter the ending date of the tax period or year for which you are filing this form.
topmostSubform[0].Page1[0].PgHeader[0].f1_4[0 Text
Enter the month (in two digits) when the tax period or year ends.
Max length: 2 characters
beginning Text
Enter the beginning date of the tax period.
topmostSubform[0].Page2[0].f2_44[0 Text
Enter the month of the beginning date of the tax period.
Max length: 2 characters
topmostSubform[0].Page2[0].f2_45[0 Text
Enter the day of the beginning date of the tax period.
topmostSubform[0].Page2[0].f2_46[0 Text
Enter the month of the ending date of the tax period.
Max length: 2 characters
or the tax year ended Text
Enter the ending date of the tax period.
f1fd ,20 Text
Enter the year of the ending date of the tax period.
Max length: 2 characters
Travel Information
Date on which you first arrived in the U.S Text
Enter the date on which you first arrived in the U.S.