- . 1 0.3. in dividual lnoomv Tax Return 21m? um Only - Do [101 write a utopia in mu 3pm. OMB No. 1505-0074 Your inst name and mum Last name Your Social-lowlily' number 865 instrUClio?ns A NALD page 16.) 2 ll a loinl mum, spouse's first name and mluol [Las name a . . ??mm label. Home address (number and street). If you how a 9.0. box, see page 16. 1 Apt no. You mus. enter Omam?ige' 721 up? 1.1121503 A abM-L_ glegsgepnnt 2 any, town a pool d?u. own. uld ZIP code. "you have moinn oddrm, 3909.90 Checking obox bolow Mil nol . dI Presidential MK NY 10022 chime you! tau! to 0 Election Campaign I- ?9 sm?" 2 Married?llno iolmlyieW""M?Wm?m?mme? Check here lfyou. or your spOuse it ?lin 'o?mtl i [j Sinoln name here. 5 want 53 to .. Head of household (with poison). ll person is a child not your dependent. onler this child's You the qualifying 3 :1 Married tiling separately. Enter spouse?s SSN above Check only I gnobox. an were. Dr 5 9119517] Exemptions 6: Youmlf. ltsomeone can claim youasadepandent,? 00! 6a LED sputum M. .. . u? anecwho. a Depcndonls: masonic-mural L?pj?g?l Wm.ng (?Hm '?umy mm usonaumn (:06 9:9320) 3:323:42? 4 massages? see page 19'. . 1 quw. . .. "b 2 Income 7 7 522. Ba TaxablointeresLAnach Scheduleaifrequirod 3a 9 460 371. AmthorNs) . . v1.2 hue-Mm Tax-exomotlnlerest 00 nouncludoonline 8a . Lib I 35 3 a?aanForms Ga 93 314 320. 5 299 ?withheld. lo .avmpo 11L o_ Alimony/received . "youdid 12 Business incomoor (loss). C-EZ 1; $2 355 804- 99?,wa 13 Capimlqain here L1 32 185 11L. seepagezz 14 other calnsorilnssesl- Attach Form 4797 1* 15: lRAdislributions 15a bTaxable amounlcsee 9119925) 15 Egg'gg?guggi 186 Ponsionsandannuillss ., 16 oTaxable amoumcsce page 25) 16b paymentillso, 17 17 67 393,651.? ?9850088 18 1a 19 Unemplomenlcompensalion 19 20: Social security benefits Izoa bTaxahleamounuseepage 27) 10b 21 Other income. List We and amount (see Dane 29} -WL 21 4103 201 142.4. dd mo nlsinthefr mn 'n hm 21 his (gunman. Mm 22 49.535 51L if Gross 26 6689 zL income 26 Moving exaenses. Attach Form 3903 25 27 Schedules j? 943 79 29 Salt-employod SEP. SIMPLE. and quali?ed plans 23 29 Sell-employed health insuranct deduction (on page so) 29 :0 30 31a Allmonypald Roclplent?sSSN I 2 all 32 IRAdeductinn (see me 31) 3L a: page 33) ii 34 Tuiliunandieosdeducuon(seepage 34) 35 Domestic production activities deducllanAnachForm 5903 141 79.9.. 3mm: 37 or II it linen is income 37 do 592 82L Fen? 104012005) LHA For Dlwiosuro. Privacy Act. and Paperwork Roduction Act Notice. 860 page 78. 51m 940(2005) 90mm I 1mm: Tax and 88 Amountfromline 37(adjusted .. .. 31L 591 525. Credits 39; Check You were born before January 2, 1941, Blind. Total boxes If: soousewas born beforaJanualy2,1941, Danna. checktd I- am who hm 3% a ?fm?gh 40 Itemized deductions (from SchaduleA) DI your ?mum Godwin (seslc? margin?Madam 42 If line 38 is over 5109.475. a: you provided housing to a person displaced by Hurrlcane Kauina, see page 37. Otherwnse. mummy $3.200 by the Iowa! number at exemptions claimud on line Gd ., 42 43 Taxable income. SUWGCI line 42 from line 41. line 4213mm than linad1,enler-0- 345 N'm?m? 44 hm . 44 54310515- ?i??mm 45 Alternative mlnimum'tax.AnachForm6251 _31 2611 UL 3355:? 45 Addlines ?and 45 . AL 511 795+ ?mum, 47 Forelgnlaxcradit. Attach Form 1116 ?required 41 11 54 Emma 48 and dependentcare expenses.Anach Farm 2441 48 49 Creditlorlhe aldertyorthe 49 m?m 50 Educaiionczedits.AHach Form 8863 50 51 Retirement savings contributionscredlL AttachForm 8680 51 ?713? 52 page 41). Attach Farm 8901 "required i2 53 Adoplion creuiLA?ach Form 8839 53 64 oreuixsmm: a :3 Form 8396 C) Form8859 54 55 Other credits. a Form 3800 DFormBam .. 55L 58 Addiines 471hrouan 55.Theseare I 53 33 940, 7 Sui 11' 6h lined .nu SBismomh nline entr- . L. . 57 j; 547 855? Other 58 Sew-employmenuax.Anach SCHOUUIBSE 53 Taxes 59 Social securityandMadicarelaxon up incomenuuepomdt empioyenmacn Form 4137 59 60 . 4532 61 Advance _61 S2 SohedulaH I, . 62 43 Addlines 57throyg?2Jhisisyouuoralm w, A, p- as ausst Payments 64 Fedemlincometaxwilhhaldfrom Forms W?23nd 1099 64 433 365 85 2005 ostimatedtax payments and amount applied 2004 rewm 8,5 251 293. es: Eammcomecreduwc) 55} cans. mm Nontaxable comm: gay election mb mm" 67 Excess social security and tier META tax withheld (see page 67 4,214 as zaxcredimnacn Form . 69 page?) 89 21500 09 70 Payments from: a DForm 2439 [inform 4138 Clam 8885 70 L721 71 71 35 115064 Refund 72 line 71 is more man line 63, subtracl line 63 from line 71.This is the amount you ovcrpaidmumnwm. 7 333'" 73: namgu?ijLi-Li?mhuundedm youand!? savings Fdnu?g 75mm: 736. 74 72 log want ?plied 1o muggy; mummy I 11 Amount 75 Amountyou awn. Sublramlme 71 Immune 531mm: on hawto Day. :06 page 60 . 1?5 2 2:12 93;. 0mg 73 Esumgtedtaxganm (50393;): (L . .k .. 78 hind Party 09 yau wanna allowanothorpersonto wilhtheIRs(sce page 81)? mch.Completethefnllowing. Na Si 9" Be Omsm?: in. Pagen$ ?NanLti?n?M 5'9? a! east 91w Mould?: and ?not. ?my mo. can-m. Here Vow 8' on. Yew amp-m Davum phone numbw .Jolnlrotwn?l . . M. 3:55:33 my?, a pawn return. paid Fm um W0 emu ?we. preparer-a or pm: Preparer?s?" U59 OMY rim-sump: 510002 ?$555 ?029.com: INTEREST NOT INCLUDED new?. now INCLUDED 68,738. TOTAL nus 2.650.557.