LF.lroracllH.Ob8m8
:Ir
a
jOll1t
mlum.
spouse's
first
nameend
initlaJ
last
nama
EMichelle
L.
Obama
!.
UeB~mIRSL
---:----'-=--::-~-----:c:-----...
~----t-~-~.-=""""-
abel.
I
II
II~.
ildo,""
(nllmber
a"~
5.",.11.
IF
l~U
lJ,1'JaP.O.
be.
see
P"~"
19Aptno.
A
Important!
A
vih;;.r,vi::e.
£.~....•,.
~:",~~a~p:'ir.(
I~
CCll~..~....~-.
,;;0:"
;,~tg.
"no
liPc"d:.li:;;'-y
hm·ea
fure'9nr.ddrO!S,;.
:;oJ"
psge1g.
;~~r
~~~(5)nal;~ve.
?wsldenlifli\_Chicago,IL60615__
~YouSpouseElucllonCampaign,
NOlI'.
Checl;ing
"Yes"will
nOI
changeyourtaxorreduceyourrefund,
(~;E<J
',=11119.\'
Doyou.
Of
i'ollr
spouseIfnlingaJol111eturn,want$3to
']0
to
thisfund?
/.>
0ves
DNa
!i2lves
Dr~o
{S~
instnJctlon!:
Oil
peqe
19.1
YOU:
first
namaand
InItial
LastnameYour
social
security
number
Spousa'ssocial
sacurity
number
FilingStatus
Single
Marrl~dfilinujolnr.return(evenIf
only
onehadincome)Cileckonl~one
bOJ:,
3
4
MarrJed
liling
separate
return.
Enterspouse's
social
secu;~.yno,aboveand
full
n.me
here.
I>-
Heedofhousehold(withquaITiymgperson).(Seepage19.)Ifthaqualifyingpersonlsachildbutnotyourdependent,enterthischild'snamehere,
i>-.,-_
QU"lifyil1gwidow!"r)witll
de
endantchild
(year
spousedied
I>
1.(See
pae
19.)
Exemptions
2
If
mora
lJ"mn
5i:!
d[,pl!Fldenls.
5l:!S
page
20.
d
"I
income
Sa
Allach
b
r'Jrms
W-2
and
9W-ZGhero,
10
Alsoattacn
FOlTI1ls)1Q99-F!
11
if
taxwas
12
wit:hh~ld.
13
14
Iflnudidnot
150
g~r
1I
W-2.
16a
~lH~
~t5ge
21,
17
f
r.clr'"..t'!;!~,
butJo
16
11't,,;
:-,riC:h~~l
'11'1'
19
pl~ytr.t!llt
iiof;IW
20a
pl;~?1~~
use
form
10~0-V.
21
23
Acijusted
211
Gross
25
Income
25
27
20
29
3031a
32
33
sa
0
Your,;alr.Ifyourparent(Drsomeone
elsel
canclaimyouasadependentonhiSorber
ta~}
return.do
nol
cneckbox
6a_..~..
b
0
Spouse,...........
.-r'
'n:-:~-:=:-:.::-=-.....,r.,c-h=i=:-
c
Dependents:
(2lO"jl~III
[)'p"ndMt's('I)l/il!\llililylrog~oo'l
.I!!<:un",
nu'nbor
r"l!licnslllp
10
tllW
FEf
<i,lld
M
Lastnnrne
'J
.:tu"",111
>'l••"~
WI
IIn,afboles
olli!<l!erlon
6aandGb
No.
UiyOIlT
ellil","non5c
\\110'
(1)
fir"n,m'
2
o
Ilv"dwiU'you
odid
n.t
live
,.,;tl,
youduetodi••"",
or'''ParoIiDn
i<copage
20j
o
MaliE!A.obama
[dauqhtar
0
NatashaM.Ohamadaughter
0
~~~~~~~~-------r--
----~----+-~-----+--~~--
I
0
o
0"l'~ndrun"
on
60
nol
.,,!ernd
.boye_
Addnuml",,.,;
0
entl!<edon
4
Ii",,"-
o
TotalrnrrnberofWages.
salaries.
tips,ere.Attach
FormlsjW-2
Taxableinll!J"est.AttachScheduleB
if
req'Jin~dTag·"~emptinlar~st.Donotinclude.unlinedaOrdinary(livid"nds.
AtllH;11
ScheduleBIFmqul",dTax.ble
rsfunds.
credits.
or
ofrsm~of~!olr.
and
locallnccrnarases(seepage22)Alimony
receweo
Buslne
5.5
incorneor
111)55).
AltachScl"tedulaCorC-E.l.Capitalgain
Of
(1055).
Attach
Schedule
Difreqused.
II
not
required.
cheel,
herr;
l>-
Other
98Insor(lasses],A
ua
chForm4797.Total
IRA
dlslributions.
1
162
j
I'
b~,,~;ble
~1\~Urol'.,
pa'ge
;3)
'01.1
p.ll!lons
and
anroJilie,
1fia.b
T~KDbIB
mO\Jr~(seepage23)
RenWIrawlestate.
royallies.
parln8rship~.
Scoroorauons.
trusts,
etc.AUach
Schedule
E
Farrn
Inwrne
or
(lOSS).
Attach
ScheduleF
UnemplDymenLcompensation.'
SoclDI.ecuritjbenelils,
LI~:::'D::':~'-LI
---,,--_,I
'b;a.~a~1e
~m~unl',:,~
pa~e
~5)
Dtlle,
incomeList
Iypeand
amount{se..
r"'9~
27)AddtheI'conranlor
I,nlo:;
?
IRAdaoucuon
(see
page27)•Studentloanlntarestdeduction
(see
page
(8).
ArcherMSA
deduction.AttachFormS9S3.ivlovtng
e:;penses.
AlleellForm3903One·halfofself-employmenttall.Attach
Schedule
SE
Selr
-ernpIDyedhealthInsurancededuetion
(S9
epa9e30)Self-employed
SEP,SIMPLE,
andqualifiedplansPenallyonesrlywltlldrllwalorsavings
Alimony
paidbR~dpienl'5
SSN
r>--'-_.....:.._
AdrJline;23throuqh31a.Subtractlins32rromUne22.Till';is
55
Income
Form
1040
{20m)
or
DI~cID.ure,
Prlvacy
Act.and
PapefWorl<
Redu~tinfl
1\,,\
NOlice.
seepag~72.
 
F01iTI
10t,O
Taxand
Credits
Standard
Dedu~tion
for-
oPeoplewho
checked
HOY
box
on
line
.350
or
.35b
Dr
whocanbe
daimed
asa
dopsndel1l,seepage31,
o
Allothers:Single,
$4,550
Headofhousehold,
$6.650
Marriednlirog
jolll1JX
or
Quallfyin9)
wl<low(er,
$7,600
Married
min!'!
sep"arately.
53,60051
62
Other
53
Tam:~s
54
55
5657
5B
Payments
59
GO
IfyouhavenS-Ia
quail
lying
b
cl111d,U11ach
ScheduleEIC.
62
63
S4
65
66
Refund
67
GSa
J>
b
ThirdParty
Designee
SignHere
jointr"tum?Seepage19,
I(eepaCOP1
For
your
records.
PaidPreparer's
IJs.e.
OI4!y
34Arnnuntfromline33(adjustedgrossincome).
35a
Cheel:
if:
0
You
were65
Dr
older.
0
Blind;
0
SpouseVias65
Of
older,
Addthenumberofboxescheckedaboveandenterthetotalhare.
b
363738
39
40
41
42
43
'14
45
46
47
48
All
50
IfyouarsmarriedmingseporalelyandyourSPOUS9
Itemizes
deductions,or
youwemadual-statusarlen,seepage31
and
check
here.Itemizeddeductions(fromSchedule
Al
oryourstandarddeduction(seeleftmargin).Subtract
lina
36
fromline
34.
Ifline34Is~98,725or
less.
multiply$2,900
by
thE
torat
numberofexemptionsdaimedonline6[1.Ifline3~
15
over$99,725,seatheworkshestonpegs32TaKable
Income.
Subnactlina
38irom
lina37,If
line
38Is
more
uien
lenL'!
37,
enter
·0·
Tax
(see
page33).CheckIfanyIIll<isfroma
0
Formls)B814b
0
Form4972Altomatilleminimum
tall
(seep~gG34).AttachForm6251Addlines
40
and
41Foreignlaxcredit.AttacllForm1116ifrequired
Creditfor
child
BI10
dependent
emsexpanses.Attach
Form
2441
Creditfortheelderly
Dr
thadisabled.AttachScheduleR.
EdwcaUon'
credits,
Attach
Form
BBG3
Rate
reduction
credit.
SEa
theworksheJll
011
page36.
Child
taX
credit
I,ec
page37)."..doptlon
Cia@.,,'''tlsch
Form
983\1.
Other
creditsfrom:a
0
orm
:lBOO
b
0
orm83\lfic
0
Form
B80l
d
0
FNrn(5pedfyl__~__Addtines43through50,Theseare)'ourtotalcredits
2,If
thanSelf·employment
tax.
AtlBchScheduleSE.SocialsecurityandMedicarelaxonlipIncomenotreponed
10
employer.AttachForm4137Ta~onqualilledplaru,IndudingIRAs,~ndOth.".
tsy.,favored
uccourasAtlac~form5329IfrequlredAdvanceearnedIncomecreditpaymentsfromFarm(s)W-2•Householdemploymenttaxes.AttachScheduteHAddlines5257,ThisistotallaxFederalincome
tax
withheld
fromFormsW·2and1099
20019sUmaiedlaxpajrnemssodBlpOunt'<JppllEdfrom<000
rewm
10arned
incomecredit(ElC)•NomaxablsearnedIncome
I
E1L(
ExcesssoctotsgcurilyandRRTA16:<wilhllc!c;
(!"''''
pag"51)Additionalchild
lax
credit.AllDch
Form
B812.Amountpaid'l\'ill1requestforextenslun
'.0
fileJ5eepage
5~
I
Olherpayments,Chock
Ir
from
aD
Fmm1419
t.
0
FOlm
'1'136
Addllnes59.
eo,
61a,am:!6265.Tlles«
ora
F'flun;.
IlL'
I,:r[
Ps.;,r:...;nn~1klBl'ltJfL'Ciiti(.ln
nUI11ber
I'Ji.I)""
i
..L.J
or
pEljurJ.I
clf£Iar~
lh~t
r
hu\.C'5~.arni!l:::dthl~relurnWn~D.:cornpal"Y~;'~J5.:tte:ll1Itt5
Ijncj
~alem..~"t~.andtotheb~
ormy
r:-Q\·JiF.{1g~;od
lrue,COJ<ect.andccrnpJe1,:;;.i::clf1rt;UOOorpp~per';i
(OIr'~'
Ihan
ta:Mpayr-,r;
ts
bssr:Oonrlll
ir.frnngtion
oiwi'iich
prfitJal~i
has
iJl'\','
~!fjcwln.!yc
D~~
rJnnn~
hl,unbil
!I>~s~p~~2:.se~~~~I~g~~n";t~urr.e~'fflf"'~jO~i~n~~'~"~~~m~,~b~o~tho;m~U~"t~'~r~;I1~,=rlf.~-~~=t-i~~~~~;';~~~~~----~
 
OMS
(liD.
1545·0.0.74
SCHEDULES1-\8,8
iF"
rr11
1W-lO)
(ScheduleBis
on
bac!q
Medical
find.
Dent.al
Expenses
~,AttachtoFonn
10110.
I>
InstructionsforSchedules
A
andB
Caution.Do
notincludeexpenses
reimbursedorpaid
by
others.
1.MedlcaLan~.d.ental.e)(penses(see.
Ac2).
:2
Eoter
amllunt
fmmFnrm1040,line34.
L....!!........!
'---!·whw1
2Multiplyline2above
by
7,5
%
Ii
Subtract
sallesvou
Paid
~5foh'l'
p~go
A.2.!
!n~erest
YouPaid
(See
p~ge
1\·.1.]
Note.
Parsonat
12
Inli.ref.rIs
nor
doductlble.
13
14
Gifts
to
15
Cl1ar'lty
H
you
m~t1~a
16
nJLo"~r.·1
Q'Y'~
i=".....
r1i:lit
f.~r':,
i]
:,~!1i=.1~6,,-~.
1B
5Stateandlocal
Income
taxes6Realestatetaxes(seepageA-2)
7
Personalpropertytaxes.
BOther
taxes.Listtype
Bndamount
1>.._._._._•..
1[]HomemortgageImereSland
points
reported
to.
youor.Form1098
11HomemQ[1.gageinteresrnor
reported
to
you
on
Form
1098.
Ifpaid
l'l
tilepersonimm
wl10m
)'ou
boughtlhehorne,
;;1'"page
A·3
andshew,
thnt
perssn's-narne-Identifyingno.,nndaddress
I>
Points
notreportedtoyouonForm109S,SeepageA-3
for
speclalrules.Investment
Interest
AttachForm4952Ifraqulrsd.(Seepage
A-3.)
Add
llnas1013.
Giftsbycashorcheck,Ifyoumadeanygiftof$250or
mere.seepaqe
A·4
Otherthan
by
cashorcheck,
if
any
gift
of$250
Of
more,
.,r,,,,pag~
A·'1.
Ycu
must
atwr.hForm82,0,3
f
over$.500
C
iliT'Joverfrom
J}ncr
yeai'
.~,dd
lines
'15
'11
Casualty
and
Theft
Losses
19
Attach
Form
4584,
Job
E;rpenses20
andMost
Other
!\Hiscellaneous
Dmillctions
21
I~.·!u22
I:,"geA·&lor
e"f'en5e~"-'
dl':}r.1lll;.~J
her~"lI
Othar27
IVliscelianeot!s
lJedur.(ion,
Unreirnbursed
employeeexpenses-jobtravel.
union
dues.jobeducatton,etc.
You
mustattachForm2105
or210B-EZ
if
required.{SeapageA-5.1
!>...._...__....
Tax
preparation
files.
Other
expensr~s-invesrment.
safedepoo;ilor.x.
RlC.LiH
type
and
amoum
j;:o._........._.__...._...._••••_..._
23
2/1
25
26
Addlines20through22.
Enter"mournfrumFormi040,
Ii[]e
:l4.
'-"'-'-!.-.-----'---f"'.,..F;."'j
IVlultiply
line2~
above
by
2%SubtractI
Olher-from
listonpageA-5.Listtypeandamount
i>______
To~al28
itemized
Deductions
Is
Form
1
D'W.
line34.
OVl3f
$-:
32.950toverS55,475
ifmarried
filing
separately)?
o
No.Yourdeduct:on
i~
notllrnlted.Addthearnountsinthefarrightcolumn
'j
for
lines4
:hrough
~7Also,
IOn!w
lhis
arnoum
1)1,
Form
'1040,llne36..
t,>
o
Yes.Yourdsducnon
m~y
be!illlit~d.SeeoagaA·6for
\11:
amount
toeruer.
FarPaparworl(1?9ductionActNotice,seeForm
1040
Instructions.
o
8,i'28
'11,439
1,4-70
o
G~t.No.11330li
SchoduleA(Form1tl40)2001
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