Income

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Intake and interview

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Form 1040

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Intake and Interview Line Item Form Certification Form 1040 Line to Report Income

1. Wages and Salary W2 Basic Wages, Salaries, tips Line 7

2. Tip Income W2 Advanced Wages, Salaries, tips Line 7

3. Scholarships (Taxable) 1098-T Basic Wages, Salaries, tips Line 7

4. Interest/Dividends 1099-INT1099-DIVSch K-1

Basic Interest – Line 8Dividends – Line 9

5. State/Local Tax Refund 1099-G Basic Taxable refunds Line 106. Alimony Income   Basic Alimony received Line 11

7. Self Employment income 1099-Misc box 7

Advanced Business Income Line 12

8. Cash/Check payments for work performed not on W2

  Advanced Wages, Salaries, tips Line 7

9. Income/Loss from sale of stock, bonds, real estate

1099-B Advanced Capital Gains Line 13

10. Disability Income W2 Basic Wages, Salaries, tips Line 7

11. Distributions from pensions, IRAs

1099-R 

Advanced, Basic if tax configured

IRA Distributions Line 15Pension income Line 16

12. Unemployment Income 1099-G Basic Unemployment Line 19

13. Social Security/Railroad Retirement

SSA-1099RRB-1099-R

Basic Social Security Line 20Railroad Line 16

14. Income/Loss of rental property

  Military only Rental Real estate Line 17

15. Other Income

GamblingRoyalties

1099-Misc box 3

W-2GSch K-1

Basic  

Advanced

Other income Line 21  Line 17

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W2

5

1099-G

6

1099 INT

7

1099 DIV

8

1099-R

9

Social Security Benefits

10

W-2G

11

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References

• Download: http://www.irs.gov/pub/irs-pdf/p4012.pdf• Email for hard copy: kandrews@enterprisecommunity.org

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