owner

Alex Demo

owner@demo.firm.test

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Form

Department of the Treasury — Internal Revenue Service

Additional Income and Adjustments to Income

Attach to Form 1040, 1040-SR, or 1040-NR.

2024

OMB No. 1545-0074
IRS Use Only — Do not write or staple in this space.

Filing StatusSingleMarried filing jointlyMarried filing separatelyHead of householdQualifying surviving spouse

Your first name and middle initial

—

Last name

—

Your social security number

•••-••-••••

If joint return, spouse's first name and middle initial

—

Last name

—

Spouse's social security number

•••-••-••••

Home address (number and street)

—

Apt. no.

—

City / State / ZIP

—

Part I — Additional income (Lines 1–10)2 of 9 populated

AttachForm(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld.

Line 1 — Taxable refunds of state and local income taxes

—

Line 2a — Alimony received

—

Line 3 — Business income (Schedule C)

103,800

99%

Line 4 — Other gains or (losses) (Form 4797)

—

Line 5 — Rental real estate, royalties, partnerships, S corps (Schedule E)

—

Line 7 — Unemployment compensation

—

Line 8 — Other income (gambling, jury duty, prizes, awards, …)

—

Line 8f — Taxable HSA distributions (Form 8889)

—

Line 10 — Total additional income

103,800

99%

Part II — Adjustments to income (Lines 11–26)2 of 11 populated

Line 11 — Educator expenses

—

Line 13 — HSA deduction (Form 8889)

—

13_hsa_contribution

↳ HSA contribution amount (organizer)

—

Line 14 — Moving expenses (Armed Forces only)

—

Line 15 — Deductible part of self-employment tax (½ SE tax)

7,333

99%

Line 16 — Self-employed SEP, SIMPLE, and qualified plans

12,000

97%

Line 17 — Self-employed health insurance deduction

—

Line 20 — IRA deduction

—

20_ira_contribution

↳ Traditional IRA contribution amount (organizer)

—

Line 21 — Student loan interest deduction

—

Line 26 — Total adjustments

—

Sign Here — Your signature

Date: ___ · Your occupation: ___

Spouse's signature (if joint return, BOTH must sign)

Date: ___ · Spouse's occupation: ___

For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.Cat. No. 71479F · Schedule 1 (Form 1040) (2024)

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Citations:IRS Schedule 1 (Form 1040) instructions (TY2025)

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