E1040 U. For the year Jan 1-Dec 31. 2016, or other tax year begin-Inlay Department of the Treasury- Internal Revenue Service (99) S. Individual Income Tax Return 2?16 ,,2016 ending OMB No. 1545- 0074 IRS Use Only- Do not write or staple In this space. See separate instructions. Your first name and initial Last name PHILIP MURPHY If a joint return, spouse's first name and initial Last name TAMMY SNYDER MURPHY Home addrese (number and street) If you have a 0 box, see instructions. P.O. BOX 73 BOWLING GREEN Fi'i'rl'l' I't'iN Apt no Your social security number Jpousels social securily number Make sure the above and on line 6c are correct. City, town or post office, state, and ZIP code If you have a foreign address, also complete spaces below (see instructions) Presidential Election Campaign Check here if you, or your spouse if filing my If}? 4 jointly, want $3 to go to this fund Foreign country name Foreign province/state/county Foreign postal code a box below will not change row mm 'erund You Spouse Filing Status 1 Single 4 Li Head of household (with qualifying person). (See instructions) If 2 Married filing jointly (even if only one had income) the qualifying person is a child but not your dependent. enter this Check only one 3 Married filing separately. Enter spouse's SSN above child's name here. and full name here. In- 5 Qualifying widowier) with dependent child Exemptions 6a A Yourself. If someone can claim you as a dependent, do not check box Ga Spouse Dependents: (2) Dependent's (3) Dependent's ?if? Child Under 5961.7 . lived with you i . social security number relationship to you quah'ym if" Ch'ldqm ?Ed? did not live with First name Last name (see you due to divorce EUR arse. aratiorl Idr more than four MU HY EQEGHTER (see lFristructIons) ependents, see Dependents on 6c SAMUEL MURPHY SON not entered above here Add numbers on Total number of exemptions claimed lines above 5. [ncome 7 Wages salaries, tips, etc. Attach Form(s) 7 8 a Taxable interest. Attach Schedule if required Attach Form(s) Tax-exempt interest. Do not include on line 8a - STMTW-2 here. Also 9 a Ordinary dividends. Attach Schedule if required i?i?h?ms maimed Mend. STMT1099-R if tax 10 Taxable refunds, credits. or offsets of state and local income taxes STMT- .4 - 10 NONE was withheld. 11 Alimony received 11 . 12 Business income or (loss). Attach Schedule or C-Capital gain or (loss). Attach Schedule if required, If not required, check here isee ?Simmons 14 Other gains or (losses). Attach Form 4797 - - - - - - - 14 64 . 93 15 a IRA distributions 153 Taxable amount 15b ROLLOVER 16 a Pensions and annuities . . . . 163 Taxable amount 15b NONE 17 Rental real estate, royalties, partnerships. corporations. trusts, etc. Attach Schedule 17 5 91.3 8 9. 18 Farm income or (loss). Attach Schedule 18 19 Unemployment compensation . . . 19 20 a Social security benefits . . 20a 1 i Taxable amount 20b 21 Other income. List type and amount SEE STATEMENT Combine the amounts in the far right column for lines 7 through 21. This is your total income 22 4 62 7 69.? Adjusted 23 23 24 Certain busmess expenses of performing artists, and Gross fee-basis government officials. Attach Form 2106 or 2106-EZ . . . 24 Income 25 Health savings account deduction. Attach Form 8889 25 26 Moving expenses. Attach Form 3903 26 27 Deductible part of self-employment tax. Attach Schedule Self-employed SEP, SIMPLE, and qualified plans 28 29 Self-employed health insurance deduction 29 30 Penalty on early withdrawal of savings 30 31a Alimony paid Recipient's SSN 313 32 IRA deduction 32 33 Student loan interest deduction 33 34 Tuition and fees. Attach Form 8917 34 35 Domestic production activities deduction. Attach Form 8903Add lines 23 through Subtract line 36 from line 22. This is your adiusted gross income IIJSA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. 6A1210 2 000 RS H515 Form 1040 (2016) 150 Form Imam: Pitt ttuu. tit-tit It sat jtl'di't aortas? _1493 38 Amountfromline 37 (adjusted gross Incomed?jhj 1-3.53.- Tax and 39a Check . You were born before January 2. 1952. Blind Total boxes Credits if: :ISpous-e was born before January 2, 1952. Blind. checked Ir 39a If your spouse itemizes on a separate return or you were a dual-status alien. check here 39b I Standard Itemized deductions (from Schedule A) or your standard deduction (see left margin) :10_ m4 6'11 Pai?fuwo" 41 Subtractline40fromline38??li?j II People who 42 Exemptions. if line 33 is $155.650 or less, multiply $4.050 by the number on line 6d. Othenrrise. see Instructions 42 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41. enter i. _2 01, 6 . gragibeur 44 Tax (see instructions). Check if any from: an Forms) 3514 bl: Form 4972 c@ it 44 3?1th claimed ass 45 Alternative minimum tax (see instructions). Attach Form 6251 . . . EggendE-"L 46 Excess advance premium tax credit repayment. Attach Form 8962insimc?mS- 47 Add lines 44Foreign tax credit. Attach Form 11 16 if required . ?i 124-33 .24 Married ?ling 49 Credit for child and dependent care expensas. Attach Form 2441 . . . 49 seearatew' 50 Education credits from Form 8863.Iine19 . . . . . . . . . Married ?ling 51 Retirement savings contributions credit. Attach Form 8880 51 6 52 Child tax credit. Attach Schedule 8812. it required . . . . 3; I ?ags?) Residential energy credits Attach Form 5695 53 Head of 54 Other credits from Form: a CI 3800 8801 CI: 54 55 Add lines 48 through 54. These are yourtotal credits i_ . 56 Subtract line 55 from line 47 if line 55 is more than line 47 enter -0- . . . . 56 Lit]- 57 Self-employmenttax. Attach Schedule L51- Other 58 Unreported social security and Medicaretaxfrom Form: a 4137 bI_ I 8919 . . . . 58 Taxes 59 Additional tax on IRAs. other qualified retirement plans. etc Attach Form 5329 irrequired . . . 60a Household employment taxes from ScheduleH . . . . . . . . . . . . 60a irtg?L??I?imJ First- time homebuyer creditrepayment Attach Form 5405 If requued . . . . . . . . 60b 51 Health care: individual responsibiirly tsee Instructions) Full? -year coverage Eta 62 Taxes from: a CI Form 09513 ?also Instructions. enter NJ 62 L13 Irma: . I 63 Addiines?BtirrolghoPayments 64 Federal income tax withheld from Forms W2 and 1099 . 2016 estimated tax payments and amount applied from 2015 return f) 4 . ?5?09 03"? it?; Earned income credit . . . . . 86a Nontaxable combat pay election . LEWJ Schedule EIC. 67 Additional child tax credit. Attach Schedule 8812 . . . . . American Opportunity credit from Form 8863. line Net premium tax credit. Attach Form 8962 70 Amount paid with request for extension to file . 70 2 7 71 Excess social security and tier1 RRTAtexwithheldCredit for federal tax on fuels. Attach Form 4136 it 73 Credits from Form: 2439 bLl?I Reserved GD 8385 cl 73 74 lines_ 631 and 67 73 _T_heIse _are_yo_t_rr__ total payment:- 74 E) r. Q83..- Refund 75 If line 74 is more than line 63. subtract line 63 from line 74 This' Is the amount you overpaid -15_ ?.33 76a Amount of line 75 chu wantrequndad tyoun it From 5888 is attached check here . . . . 76a Dire? ?Spas?? Routing number I _In- I I IbcI Type. Checking LJ Savings - :Zelructions. Account number LII I Ij_ _I?j _Ij 77 Amount of line 75 you want applied to yetrr 21017 estimated tax I- I 14 _1 Amount 78 Amount you owe. Subtract line 74 from line 63 For details on how to pay, see instructions . . . Third Party Do you want to allow another person to discuss this return with the (see instructions)? Complete below. No Designee Dasignee's Phr?" Personal Identi?cation name WILLIAM RABETZ . ??mberlP'Ni Sign Under penaIt?ns or perjury. I declare that I have examined this Ieturn and accompanying schadulasIand statements, and to the tresi at my and better. they are true, wheel. and Here be?? number Jolni return? See instructions - . Iti-lL?A?tTr?tiX?ii. . I Keep a copy far Spouse?s signature. Ila loinl return. both must sign. note Spouse's occupation 9" yourrewds {mm 1I I I I I Paid Print/Type preparers name tors more Date Mini? Preparer L. gird tt_ _?rjy?name plateaus ._twtr .M'd .I: WATER STREET, 9TH FL ?meL_ XQRK 10 5 H515 SA1220 2 COO Ins?mi Form