f 11 000 4 000 Department of the Treasury - 11 999 999 222 o 111 0 0 44 0 0 Internal Revenue Service 111 9 9 9 9 2 2 r 1 0 0 44444 0 0 U U SSS 1 9999 9999 22 m 1 0 0 4 0 0 U U SSS Individual Income 1 9 9 22 11111 000 4 000 UUU SSS Tax Return 11111 999 999 22222 ------------------------------------------------------------------------------- For the year January 1 - December 31, 1992 or whenever you get around to it. ------------------------------------------------------------------------------- please| FULL NAME | LAST NAME | SECOND TO LAST INITIAL | Starch | []cuffs print,| | | | []yes []no | []nocuffs type |------------------------------------------------------------------------ or use| Present address of addressee (must be filled out by addressor or legal hyro- | guardian of aforementioned (unless greater than line B above)) glyph-| ics |------------------------------------------------------------------------ (no | City, Town, Post Office, Shoe Size| Address greater than line 41? []yes Latin)| | If yes, why? ________________ []no ------------------------------------------------------------------------------- Height | Weight | Sex []yes | Occu- Yours _________ | Social Security Number | | []no | pation Spouse _________ | Yours _|_|_ Spouse _|_| ------------------------------------------------------------------------------- > Do you wish to designate []yes | Isn't | NOTE: if you Presidential >> $1 of your taxes to this []no | this a | checked yes Election >>> worthy cause? []maybe | dumb law?| we will come Campaign >> What about the little lady? []metoo | []yes| and steal all > The kids, dog, cat, fish? []woof | []no | your hubcaps. ------------------------------------------------------------------------------- Requested > A. How many talking chickens do you own? | D yes? []no by >> B. Names _______________________________ | E no? []yes the >>>C. Do any of them play the oboe? []yes []no | F maybe? []perhaps Department >>>>--------------------------------------------------------------- of >>>Do you live within 2 miles | Have you rotated | If no file IRS Agriculture >> of a decent pizza place? | your tires lately? | tire rotation > []yes []no []extra cheese | []yes []no []flat | Schedule L ------------------------------------------------------------------------------- Filing 1 [] Single 2 [] Double 3 [] Triple 4 [] Sacrifice Fly | for IRS use Status 5 [] Married Filing Singly Joint return | O | | X (even if spouse is married separately) | ---|---|--- 6 [] Joint married singly separate spouse | | X | (but filing double jointed) | ---|---|--- 7 [] Head of Household filing separate but joint return | X | O | O (if unmarried but jointly single) |------------ 8 [] Head of joint filing single file spouses separately 9 [] Widow(er) with separate dependent filing out of joint return singly 10 [] Deceased filing posthumous return (attach notarized Death Schedule D, signed by deceased) ------------------------------------------------------------------------------- Exem- 41 a regular? | Enter number of ptions b [] yourself [] 65 or over [] blind [] dead | boxes checked > __ [] spouse [] 65 or over [] blind [] dead | c Names of Dependent children who lived with | Check number of You you __________________ Why? _______________ | boxes entered > __ are d Just first names dummy. | here 4 Do you weigh more than last year's tax form? | Enter number of | e Number of parakeets subtracted from Gross | checkered boxes __ | Rotated Income (plus line 27 - unless greater | \|/ than twelve miles) | Do nothing v f How many inches in a liter? _____ | Here > __ * 11 a Total Confusion (add lines 6e and f,g; fold in eggs, beat until firm) --------> -- ------------------------------------------------------------------------------- Income 12 Wages, Salaries, Tips, Extortion. (attach W2 forms to |##| | | your forehead with heavy duty staplegun) . . . . . . . .|12|_____|_| 13 Remunerations (if less than gross reimbursements then |##| | | Please file schedule Q (see page 14 of "Joy of Cooking")) . . .|13|_____|_| attach 14 Gross influx (see 40% of instructions) . . . . . . . . .|14|_____|_| payment 15 Money you made (if $400 or less, more or less, list |##| | | (small schedule B without not filling in Part II and R2, but |##| | | unmarked more than line 8). . . . . . . . . . . . . . . . . . . .|15|_____|_| bills) 16 What about all that cash you stashed in that jar under |##| | | here. the garage? (see page 7 of instructions) . . . . . . . .|16|_____|_| | -------------------------------------------------------------------- |___ 17 Add lines 12 through 16, multiply by 2, |##| | | this is your total income. . . . . . . . . . . . . . . .|17|_____|_| ------------------------------------------------------------------------------- Taxes 18 Enter Grossly adjusted net average income (line 17). . .|18|_____|_| 19 Enter Total deductions (if greater than 0, enter 0). . .|19|_____|_| 20 Subtract line 19 from line 18. Taxable income. . . . . .|20|_____|_| 21 Figure Total Taxes using line 20 . . . . . . . . . . . .|##| | | [] Tax Table [] Tax Rate Schedule X, Y, or Z [] Guessed.|21|_____|_| ------------------------------------------------------------------------------- Payment 23 Federal income tax withheld . . . . . . . . . . . . . .|23|_____|_| ------------------------------------------------------------------------------- Amount 25 If line 23 is larger that 21, you made a mistake, |##| | | You re-figure your taxes. |##| | | Owe 26 Subtract line 23 from line 21. . . . . . . . . . . . . .|26|_____|_| 27 Add the shirt off your back. . . . . . . . . . . . . . .|27|_____|_| 28 Send it in . . . . . . . . . . . . . . . . . . . . . . .|28|_____|_| 29 Pick a number between 1 and 10 . . . . . . . . . . . . .|29|_____|_| ------------------------------------------------------------------------------- Please > Under penalty of death, I declare that every figure on this return and Sign >> accompanying schedules is correct to within 100% plus or minus some. Here > Signature ___________________________ date ___________ check here [] -------------------------------------------------------------------------------