2018 Income Tax Return

Federal Return

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Form
1040 U.S. Individual Income Tax Return 2018
Department of the Treasury—Internal Revenue Service (99)
OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

Filing status: Single Married filing jointly Married filing separately X Head of household Qualifying widow(er)
Your first name and initial Last name Your social security number
JAMES W BELTON 367 88 9236
Your standard deduction: Someone can claim you as a dependent You were born before January 2, 1954 You are blind
If joint return, spouse's first name and initial Last name Spouse’s social security number

Spouse standard deduction: Someone can claim your spouse as a dependent Spouse was born before January 2, 1954 X Full-year health care coverage
Spouse is blind Spouse itemizes on a separate return or you were dual-status alien or exempt (see inst.)

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
(see inst.)
207 STEWARD AVE H2 X You Spouse
City, town or post office, state, and ZIP code. If you have a foreign address, attach Schedule 6. If more than four dependents,
JACKSON, MI 49201 see inst. and ✓ here ▶
Dependents (see instructions): (2) Social security number (3) Relationship to you (4) ✓ if qualifies for (see inst.):
(1) First name Last name Child tax credit Credit for other dependents

JADORE J BELTON 788 81 4052 DAUGHTER X

JAMES W BELTON 369 35 0031 SON X

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation If the IRS sent you an Identity Protection
▲

Joint return? PIN, enter it

See instructions. HOME CARE here (see inst.)
Keep a copy for Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent you an Identity Protection
your records. PIN, enter it
here (see inst.)
Preparer’s name Preparer’s signature PTIN Firm’s EIN Check if:
Paid 3rd Party Designee
Preparer SELF-PREPARED
Firm’s name Phone no. Self-employed
Use Only
▶

Firm’s address ▶
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2018)

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Form 1040 (2018) JAMES W BELTON 367-88-9236 Page 2
HSH 18583
1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . 1 18,583.
2a Tax-exempt interest . . . 2a b Taxable interest . . . 2b
Attach Form(s)
W-2. Also attach 3a Qualified dividends . . . 3a b Ordinary dividends . . 3b
Form(s) W-2G and
1099-R if tax was 4a IRAs, pensions, and annuities . 4a b Taxable amount . . . 4b
withheld. 5a Social security benefits . . 5a b Taxable amount . . . 5b
6 Total income. Add lines 1 through 5. Add any amount from Schedule 1, line 22 . . . . . 6 18,583.
7 Adjusted gross income. If you have no adjustments to income, enter the amount from line 6; otherwise,
Standard subtract Schedule 1, line 36, from line 6 . . . . . . . . . . . . . . . . . 7 18,583.
Deduction for— 8 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . . . 8 18,000.
• Single or married
filing separately, 9 Qualified business income deduction (see instructions) . . . . . . . . . . . . . . 9 0.
$12,000
• Married filing
10 Taxable income. Subtract lines 8 and 9 from line 7. If zero or less, enter -0- . . . . . . . . 10 583.
jointly or Qualifying 11 a Tax (see inst.) 59 (check if any from: 1 Form(s) 8814 2 Form 4972 3 )
widow(er),
$24,000 b Add any amount from Schedule 2 and check here . . . . . . . . . . . . ▶ 11 59.
• Head of 12 a Child tax credit/credit for other dependents 59 b Add any amount from Schedule 3 and check here ▶ 12 59.
household,
$18,000 13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . . . . . . . 13 0.
• If you checked 14 Other taxes. Attach Schedule 4 . . . . . . . . . . . . . . . . . . . . 14
any box under
Standard 15 Total tax. Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . 15
deduction,
see instructions. 16 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . 16
17 Refundable credits: a EIC (see inst.) 5,716 b Sch. 8812 2,412 c Form 8863
Add any amount from Schedule 5 . . . . . . . . . . . . . . 17 8,128.
18 Add lines 16 and 17. These are your total payments . . . . . . . . . . . . . . 18 8,128.
Refund 19 If line 18 is more than line 15, subtract line 15 from line 18. This is the amount you overpaid . . . . 19 8,128.
20a Amount of line 19 you want refunded to you. If Form 8888 is attached, check here . . . . ▶ 20a 8,128.
Direct deposit? ▶ b Routing number 0 4 4 1 1 1 1 9 1 ▶ c Type: X Checking Savings
See instructions.
▶ d Account number 9 8 1 0 1 7 9 3 6 7 8 8 9 2 3 6
21 Amount of line 19 you want applied to your 2019 estimated tax . . ▶ 21
Amount You Owe 22 Amount you owe. Subtract line 18 from line 15. For details on how to pay, see instructions . . . ▶ 22 0.
23 Estimated tax penalty (see instructions) . . . . . . . . ▶ 23
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2018)

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SCHEDULE EIC Earned Income Credit OMB No. 1545-0074
(Form 1040) ◀
▶
Qualifying Child Information
Complete and attach to Form 1040 only if you have a qualifying child.
1040
2018
Department of the Treasury
Go to www.irs.gov/ScheduleEIC for the latest information.
EIC Attachment
Internal Revenue Service (99)
▶
Sequence No. 43
Name(s) shown on return Your social security number

JAMES W BELTON 367-88-9236

• See the instructions for Form 1040, line 17a, to make sure that (a) you can take the EIC, and (b) you have a
Before you begin: qualifying child.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card.
Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s
social security card is not correct, call the Social Security Administration at 1-800-772-1213.

▲
!
CAUTION
• You can't claim the EIC for a child who didn't live with you for more than half of the year.
• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details.
• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

Qualifying Child Information Child 1 Child 2 Child 3

1 Child’s name First name Last name First name Last name First name Last name

If you have more than three qualifying

children, you have to list only three to get
the maximum credit. JADORE BELTON JAMES BELTON
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040, line 17a,
unless the child was born and died in
2018. If your child was born and died in
2018 and did not have an SSN, enter
“Died” on this line and attach a copy of
the child’s birth certificate, death
certificate, or hospital medical records
showing a live birth.
788-81-4052 369-35-0031
3 Child’s year of birth
Year 2 0 1 5 Year 2 0 0 7 Year
If born after 1999 and the child is If born after 1999 and the child is If born after 1999 and the child is
younger than you (or your spouse, if younger than you (or your spouse, if younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b; filing jointly), skip lines 4a and 4b;
go to line 5. go to line 5. go to line 5.

4 a Was the child under age 24 at the end of

2018, a student, and younger than you (or Yes. No. Yes. No. Yes. No.
your spouse, if filing jointly)?
Go to Go to line 4b. Go to Go to line 4b. Go to Go to line 4b.
line 5. line 5. line 5.

b Was the child permanently and totally

disabled during any part of 2018? Yes. No. Yes. No. Yes. No.
Go to The child is not a Go to The child is not a Go to The child is not a
line 5. qualifying child. line 5. qualifying child. line 5. qualifying child.

5 Child’s relationship to you

(for example, son, daughter, grandchild,
niece, nephew, eligible foster child, etc.)
DAUGHTER SON
6 Number of months child lived
with you in the United States
during 2018

• If the child lived with you for more than

half of 2018 but less than 7 months,
enter “7.”
• If the child was born or died in 2018 and 12 months 12 months months
your home was the child’s home for more
than half the time he or she was alive Do not enter more than 12 Do not enter more than 12 Do not enter more than 12
during 2018, enter “12.” months. months. months.
For Paperwork Reduction Act Notice, see your tax Cat. No. 13339M Schedule EIC (Form 1040) 2018
return instructions.

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SCHEDULE 8812
(Form 1040) Additional Child Tax Credit 1040 ◀
OMB No. 1545-0074

▶ Attach to Form 1040 or Form 1040NR. 1040NR

2018
Department of the Treasury
▶ Go to www.irs.gov/Schedule8812 for instructions and the latest 8812 Attachment
Internal Revenue Service (99) information. Sequence No. 47

Name(s) shown on return Your social security number

JAMES W BELTON 367-88-9236
Part I All Filers
Caution: If you file Form 2555 or 2555-EZ, stop here; you cannot claim the additional child tax credit.
1 If you are required to use the worksheet in Pub. 972, enter the amount from line 10 of the Child Tax Credit

}
and Credit for Other Dependents Worksheet in the publication. Otherwise:
1040 filers: Enter the amount from line 8 of your Child Tax Credit and Credit for Other
Dependents Worksheet (see the instructions for Form 1040, line 12a). 1 4,000.
1040NR filers: Enter the amount from line 8 of your Child Tax Credit and Credit for Other
Dependents Worksheet (see the instructions for Form 1040NR, line 49).
2 Enter the amount from Form 1040, line 12a, or Form 1040NR, line 49 . . . . . . . . . . . . 2 59.
3 Subtract line 2 from line 1. If zero, stop here; you cannot claim this credit . . . . . . . . . . . 3 3,941.
4 Number of qualifying children under 17 with the required social security number: 2 X $1,400.
Enter the result. If zero, stop here; you cannot claim this credit . . . . . . . . . . . . . . 4 2,800.
TIP: The number of children you use for this line is the same as the number of children you used for line 1 of
the Child Tax Credit and Credit for Other Dependents Worksheet.
5 Enter the smaller of line 3 or line 4 . . . . . . . . . . . . . . . . . . . . . . 5 2,800.
6a Earned income (see separate instructions) . . . . . . . . . . . 6a 18,583.
b Nontaxable combat pay (see separate
instructions) . . . . . . . . . . . 6b
7 Is the amount on line 6a more than $2,500?
No. Leave line 7 blank and enter -0- on line 8.
X Yes. Subtract $2,500 from the amount on line 6a. Enter the result . . . 7 16,083.
8 Multiply the amount on line 7 by 15% (0.15) and enter the result . . . . . . . . . . . . . . 8 2,412.
Next. On line 4, is the amount $4,200 or more?
X No. If line 8 is zero, stop here; you cannot claim this credit. Otherwise, skip Part II and enter the
smaller of line 5 or line 8 on line 15.
Yes. If line 8 is equal to or more than line 5, skip Part II and enter the amount from line 5 on line 15.
Otherwise, go to line 9.
Part II Certain Filers Who Have Three or More Qualifying Children
9 Withheld social security, Medicare, and Additional Medicare taxes from
Form(s) W-2, boxes 4 and 6. If married filing jointly, include your spouse’s
amounts with yours. If your employer withheld or you paid Additional

}
Medicare Tax or tier 1 RRTA taxes, see separate instructions . . . . . . 9
10 1040 filers: Enter the total of the amounts from Schedule 1 (Form
1040), line 27, and Schedule 4 (Form 1040), line 58,
plus any taxes that you identified using code “UT” and
entered on Schedule 4 (Form 1040), line 62. 10
1040NR filers: Enter the total of the amounts from Form 1040NR,
lines 27 and 56, plus any taxes that you identified using
code “UT” and entered on line 60.
11 Add lines 9 and 10 . . . . . . . . . . . . . . . . . . 11

}
12 1040 filers: Enter the total of the amounts from Form 1040, line
17a, and Schedule 5 (Form 1040), line 72.
1040NR filers: Enter the amount from Form 1040NR, line 67. 12
13 Subtract line 12 from line 11. If zero or less, enter -0- . . . . . . . . . . . . . . . . . 13
14 Enter the larger of line 8 or line 13 . . . . . . . . . . . . . . . . . . . . . . 14
Next, enter the smaller of line 5 or line 14 on line 15.
Part III Additional Child Tax Credit
15 This is your additional child tax credit . . . . . . . . . . . . . . . . . . . . . 15 2,412.
Enter this amount on
1040 Form 1040, line 17b, or
Form 1040NR, line 64.
1040NR ◀

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 59761M Schedule 8812 (Form 1040) 2018

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