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mscorlib
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True
[yourString]
g1040Department of the Treasury—Internal Revenue Service (99)
U.S. Individual Income Tax Return
2015
OMB No. 1445-0074
IRS Use Only—Do not write or staple in this space.
Filing Status
Check only
one box.
0 Single g Married filing jointly 0 Married filing separately (MFS) D Head of household (HOH) Qualifying widow(er) (QVV)
If you checked the MFS box, enter the name of spouse. If you checked the HOH or OW box, enter the child’s name if the qualifying person is
a child but not your dependent. 210-
Your first name and middle initial Jaul A Last name Staffer Your social security number 153-10-6799
If joint return, spouse’s first name and middle initial Judeth B Last name Staffer Spouse’s social security number 185-80-9244
Home address (number and street). If you have a P.O. box, see instructions. 167 Cats Back Road Apt. no. Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Iphratta PA 57612
tax or refund. II You 0 Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see instructions and / here 1. II
Standard
Deduction
Age/Blindness