1040-X

Form Department of the Treasury—Internal Revenue Service

Amended U.S. Individual Income Tax Return OMB No. 1545-0074

(Rev. January 2020) ▶ Go to www.irs.gov/Form1040X for instructions and the latest information.
This return is for calendar year 2019 2018 2017 2016
Other year. Enter one: calendar year or fiscal year (month and year ended):
Your first name and middle initial Last name Your social security number

If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Current 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 Full-year health care coverage (or, for amended
changing your filing status. Caution: In general, you can’t change your filing 2018 returns only, exempt). If amending a 2019
status from a joint return to separate returns after the due date. return, leave blank. See instructions.
Single Married filing jointly Married filing separately (MFS) Qualifying widow(er) (QW) Head of household (HOH)
If you checked the MFS box, enter the name of spouse. If you checked the HOH or QW box, enter the child’s name if the qualifying
person is a child but not your dependent. ▶
A. Original amount B. Net change—
Use Part III on the back to explain any changes reported or as amount of increase C. Correct
previously adjusted or (decrease)— amount
Income and Deductions (see instructions) explain in Part III

1 Adjusted gross income. If a net operating loss (NOL) carryback is

included, check here . . . . . . . . . . . . . . . ▶ 1
2 Itemized deductions or standard deduction . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . 3
4a Exemptions (amended 2017 or earlier returns only). If changing,
complete Part I on page 2 and enter the amount from line 29 . . . . 4a
b Qualified business income deduction (amended 2018 or later returns only) 4b
5 Taxable income. Subtract line 4a or 4b from line 3. If the result is zero
or less, enter -0- . . . . . . . . . . . . . . . . . . 5
Tax Liability
6 Tax. Enter method(s) used to figure tax (see instructions):
6
7 Credits. If a general business credit carryback is included, check here ▶ 7
8 Subtract line 7 from line 6. If the result is zero or less, enter -0- . . . 8
9 Health care: individual responsibility (amended 2018 or earlier returns
only). See instructions . . . . . . . . . . . . . . . . . 9
10 Other taxes . . . . . . . . . . . . . . . . . . . . 10
11 Total tax. Add lines 8, 9, and 10 . . . . . . . . . . . . . 11
Payments
12 Federal income tax withheld and excess social security and tier 1 RRTA
tax withheld. (If changing, see instructions.) . . . . . . . . . 12
13 Estimated tax payments, including amount applied from prior year’s return 13
14 Earned income credit (EIC) . . . . . . . . . . . . . . . 14
15 Refundable credits from: Schedule 8812 Form(s) 2439 4136
8863 8885 8962 or other (specify): 15
16 Total amount paid with request for extension of time to file, tax paid with original return, and additional
tax paid after return was filed . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Total payments. Add lines 12 through 15, column C, and line 16 . . . . . . . . . . . . . 17
Refund or Amount You Owe
18 Overpayment, if any, as shown on original return or as previously adjusted by the IRS . . . . . 18
19 Subtract line 18 from line 17. (If less than zero, see instructions.) . . . . . . . . . . . . 19
20 Amount you owe. If line 11, column C, is more than line 19, enter the difference . . . . . . . 20
21 If line 11, column C, is less than line 19, enter the difference. This is the amount overpaid on this return 21
22 Amount of line 21 you want refunded to you . . . . . . . . . . . . . . . . . . . 22
23 Amount of line 21 you want applied to your (enter year): estimated tax 23
Complete and sign this form on page 2.
For Paperwork Reduction Act Notice, see instructions. Cat. No. 11360L Form 1040-X (Rev. 1-2020)
Form 1040-X (Rev. 1-2020) Page 2
Part I Exemptions and Dependents
Complete this part only if any information relating to exemptions (to dependents if amending your 2018 or later return) has changed
from what you reported on the return you are amending. This would include a change in the number of exemptions (of dependents if
amending your 2018 or later return).

!
▲ For amended 2018 or later returns only, leave lines 24, 28, and 29 blank. A. Original number B. Net change C. Correct
CAUTION Fill in all other applicable lines. of exemptions or number
amount reported or amount
Note: See the Forms 1040 and 1040-SR, or Form 1040A, instructions or as previously
for the tax year being amended. See also the Form 1040-X instructions. adjusted

24 Yourself and spouse. Caution: If someone can claim you as a

dependent, you can’t claim an exemption for yourself. If amending your
2018 or later return, leave line blank . . . . . . . . . . . . 24
25 Your dependent children who lived with you . . . . . . . . . 25
26 Your dependent children who didn’t live with you due to divorce or separation 26
27 Other dependents . . . . . . . . . . . . . . . . . . 27
28 Total number of exemptions. Add lines 24 through 27. If amending your
2018 or later return, leave line blank . . . . . . . . . . . . 28
29 Multiply the number of exemptions claimed on line 28 by the exemption
amount shown in the instructions for line 29 for the year you are
amending. Enter the result here and on line 4a on page 1 of this form. If
amending your 2018 or later return, leave line blank . . . . . . . 29
30 List ALL dependents (children and others) claimed on this amended return. If more than 4 dependents, see inst. and ✓ here ▶
Dependents (see instructions): (d) ✓ if qualifies for (see instructions):
(b) Social security (c) Relationship
Credit for other dependents
(a) First name Last name number to you Child tax credit
(amended 2018 or later returns only)

Part II Presidential Election Campaign Fund

Checking below won’t increase your tax or reduce your refund.
Check here if you didn’t previously want $3 to go to the fund, but now do.
Check here if this is a joint return and your spouse did not previously want $3 to go to the fund, but now does.
Part III Explanation of Changes. In the space provided below, tell us why you are filing Form 1040-X.
▶ Attach any supporting documents and new or changed forms and schedules.

Remember to keep a copy of this form for your records.

Under penalties of perjury, I declare that I have filed an original return and that I have examined this amended return, including accompanying schedules and statements,
and to the best of my knowledge and belief, this amended return is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information
about which the preparer has any knowledge.
Sign Here
▲

Your signature Date Your occupation

▲

Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation
Paid Preparer Use Only
▲

Preparer’s signature Date Firm’s name (or yours if self-employed)

Print/type preparer’s name Firm’s address and ZIP code

Check if self-employed
PTIN Phone number EIN

For forms and publications, visit www.irs.gov. Form 1040-X (Rev. 1-2020)