1 040 Department of the Treasury—Internal Rriseue Servne U.S. Individual Income Tax Return OMB No. 1545-0074 IRS Use Only—Do not mite ce staple in the space. For the year Jan. I-Dec.31.2017. or other tax year beginning 2017. ending .20 Vow first name and initial Last rare If a mint return. spouse first name and initial Last name See separate instructions. Your social security number Spouse's social security number Home address (number and street). 1( you have a P.O. box. see instructions. Apt. no. A Make size the SSN(s) above a and on line 6c are correct. City, town or post office. slate. and ZIP code. If you have a foreign address. also complete spaces below (see instructions). Foreign country name Foreign province/state/county Presidential Election Campaign check here if you. or your spouse 4 ding per. yaw $3 to go to ens lund Checkkg Foreign postal code a habelowall net dame yam tax or refund. O You O SPciese Filing Status Check only one box. 1 O Single 2 O Married filing jointly (even if only one had income) 3 rl Married filing separately. Enter spouse's SSN above and full name here. li. Ba O Yourself. If someone can claim you as a dependent do not check box 6a 4 O Head of househdd (wall qualifying person). (See instructions.) If the quabfying person is a child but not your dependent. enter this clam's name here. PO 5 O Qualifying widow(er) (see instructions) Exemptions If more than four dependents. see instructions and check here lil• O b O Spouse c Dependents: (1) First name last (2) Dependent's somal security reinter (3) Dependents relationship to ycu (4) ./ if child under age 17 qualnying for ctdd lax mein (see instructions) O O O O Boxes checked on 6a and 6b No. of children on 6c who: • lived with you • did not live with you due to divorce Of separation (see Instructions) Dependents on 6c not entered above Add numbers on d Total number of exemptions claimed lines above IP El Incom