Melinda Flowers 1040

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1040 U.S.Formats
m Department of the Treasury—Internal Revenue Service

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22
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F Individual Income Tax Return OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

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Filing Status
Check only
Single Married filing jointly Married filing separately (MFS) Qualifying surviving
spouse (QSS)
Head of household (HOH)

one box. If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child’s name if the qualifying
person is a child but not your dependent:

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Your first name and middle initial Last name Your social security number
Melinda
Start your 30 day free trial
I f j oi nt return, spouse’s fi rst name and middle ini tial
Flowers
Last name
9 8 7 x x x x x x
Spouse’s social security number

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Home address (number and street). If you have a P.O. box, see instructions. Apt. no.

OR
Presidential Election Campaign
456 Central Drive Check here if you, or your
spouse if filing jointly, want $3
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r ty, town, or post office. If you have a foreign address, also complete spaces below.
m State ZIP code
o Department of the Treasury—Internal Revenue Service to go to this fund. Checking a
SFan Diego CA 92101 box below will not change
IRS Use Only—Do not write or staple in this space.
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.

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OMB No. 1545-0074

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You Spouse

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W-2 here. Also
attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d 0
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1040

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Form 1040 (2022) Page 2

Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 106
Credits 17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17 0
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 106
19 Child tax credit or credit for other dependents from Schedule 8812 . . . . . . . . . . 19 0
20 Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . 20 0
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 0
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 106
23 Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . . . 23 0
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . . 24 106
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 589
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b 0
c Other forms (see instructions) . . . . . . . . . . . . . 25c 0
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 589
26 2022 estimated tax payments and amount applied from 2021 return . . . . . . . . . . 26 0
If you have a
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . 27 0
attach Sch. EIC.
28 Additional child tax credit from Schedule 8812 . . . . . . . . 28 0
29 American opportunity credit from Form 8863, line 8 . . . . . . . 29 0
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3, line 15 . . . . . . . . . . . . 31 0
32 Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits . . 32 0
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . . 33 589
34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 483
Refund
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a
Direct deposit? b Routing number c Type: Checking Savings
See instructions.
d Account number
36 Amount of line 34 you want applied to your 2023 estimated tax . . . 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions . . . . . . . . 37
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . . Yes. Complete below. No
Designee’s Phone Personal identification
name no. number (PIN)
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
Sign 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 PIN, enter it here
Waiter (see inst.)
Joint return?
See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.)

Phone no. Email address

P reparer’s name Prepar er’ s signature Date PTIN Check if:
Paid Self-employed
Preparer
Firm’s name Phone no.
Use Only
Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2022)

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