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1040X Form 2012
1040X Form 2012 -
Where Is My Amended Refund
Form
1040
X
(Rev. December 2012)
Department of the Treasury—Internal Revenue Service
Amended U.S. Individual Income Tax Return
▶
Information about Form 1040X and its separate instructions is at
www.irs.gov/form1040x
.
OMB No. 1545-0074
This return is for calendar year
2012
2011
2010
2009
Other year.
Enter one: calendar year
or
fiscal year (month and year ended):
Your first name and initial
Last name
Your social security number
If a joint return, spouse’s first name and initial
Last name
Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions.
Apt. no.
Your phone number
City, town or post office, state, and ZIP code.
If you have a foreign address, also complete spaces below (see instructions).
Foreign country name
Foreign province/state/county
Foreign postal code
Amended return filing status.
You
must
check one box even if you are not changing your filing status.
Caution.
In general, you cannot change your filing status from joint to separate returns after the due date.
Single
Married filing jointly
Married filing separately
Qualifying widow(er)
Head of household (If the qualifying person is a child but not your dependent, see instructions.)
Use Part III on the back to explain any changes
A. Original amount
or as previously
adjusted
(see instructions)
B. Net change—
amount of increase
or (decrease)—
explain in Part III
C. Correct
amount
Income and Deductions
1
Adjusted
gross
income
.
If
net
operating
loss
(NOL)
carryback
is
included, check here
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▶
1
2
Itemized deductions or standard deduction
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2
3
Subtract line 2 from line 1
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3
4
Exemptions.
If
changing,
complete
Part
I
on
page
2
and
enter
the
amount from line
30
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4
5
Taxable income. Subtract line 4 from line 3
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5
Tax Liability
6
Tax. Enter method used to figure tax:
6
7
Credits.
If
general
business
credit
carryback
is
included,
check
here
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7
8
Subtract line 7 from line 6. If the result is zero or less, enter -0-
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8
9
Other taxes
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9
10
Total tax. Add lines 8 and 9
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10
Payments
11
Federal income tax withheld
and excess social security
and tier 1 RRTA
tax withheld (
if changing
, see instructions)
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11
12
Estimated
tax
payments,
including
amount
applied
from
prior
year’s
return
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12
13
Earned income credit (EIC)
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13
14
Refundable credits from Schedule(s)
8812 or
M or Form(s)
2439
4136
5405
8801
8812 (2009–2011)
8839
8863
8885 or
other (specify):
14
15
Total
amount
paid
with
request
for
extension
of
time
to
file,
tax
paid
with
original
return,
and
additional
tax paid after return was filed
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15
16
Total payments. Add lines 11 through 15
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16
Refund or Amount You Owe
(
Note.
Allow 8–12 weeks to process Form 1040X.)
17
Overpayment, if any, as shown on original return or as previously adjusted by the IRS
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17
18
Subtract line 17 from line 16 (If less than zero, see instructions)
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18
19
Amount you owe.
If line 10, column C, is more than line 18, enter the difference
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19
20
If line 10, column C, is less than line 18, enter the difference. This is the amount
overpaid
on this return
20
21
Amount of line 20 you want
refunded to you
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21
22
Amount of line 20 you want
applied to your
estimated tax .
(enter year):
22
Complete and sign this form on Page 2.
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11360L
Form
1040X
(Rev. 12-2012)
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1040X Form 2012
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