Form 1040-SS                                                  U.S. Self-Employment Tax Return                                                                      OMB No. 1545-0074 
                            (Including the Additional Child Tax Credit for Bona Fide Residents of Puerto Rico)
Department of the Treasury  U.S. Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, or Puerto Rico
Internal Revenue Service    For the year Jan. 1–Dec. 31, 2024, or other tax year beginning               , 2024, and ending       , 20                               2024
Your first name and initial                                                 Last name                                                     Your social security number 

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

Home address (number, street, and apt. no., or rural route) 

City, town or post office, commonwealth or territory, and ZIP code 

Foreign country name                                                                         Foreign province/state/county                                          Foreign postal code       

At any time during 2024, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, or otherwise 
dispose of a digital asset (or a financial interest in a digital asset)? (See instructions)  .               . .    .       . . . .       .     .                .   .   Yes   No
Part I        Total Tax and Credits (see instructions) 
1    Filing status. Check the box for your filing status.  
       Single               Married filing jointly                Married filing separately (MFS)          Head of household              Qualifying surviving spouse
     If you checked the MFS box, enter spouse’s social security no. above and full name here:
2    Qualifying children.        Complete only if you are a bona fide resident of Puerto Rico and you are claiming the additional child tax 
     credit. If more than four qualifying children, see instructions and check here  .                       . .    .       . . . .       .     .                .   . . . . .
              (a) First name                                Last name            (b) Child’s social security number             (c) Child’s relationship to you 

3    Self-employment tax from Schedule SE (Form 1040), line 12. Attach Schedule
     SE (Form 1040) and applicable schedules  .                         . . .    .         . .    . . .  . .   3 
4    Household employment taxes. Attach Schedule H (Form 1040)  .                                   . .  . .   4 
5    Additional Medicare Tax. Attach Form 8959                          . . .    .         . .    . . .  . .   5
6    Other taxes  .         . .   . . .                     . . . .   . . . .    .         . .    . . .  . .   6
7    Total tax. Add lines 3 through 6  .                        . .   . . . .    .         . .    . . .  . . . .    .       . . . .       .                      7
8    2024 estimated tax payments   .                          . . .   . . . .    .         . .    . . .  . .   8
9    Excess social security tax withheld  .                       .   . . . .    .         . .    . . .  . .   9
10   Additional child tax credit from Part II, line 19  .                 . .    .         . .    . . .  . .   10
11a  Additional Medicare Tax withheld. Attach Form 8959                          .         . .    . . .  . .   11a
b    Amount paid with request for extension of time to file  .                             . .    . . .  . .   11b
12   Total payments and credits. Add lines 8 through 11b .                                 . .    . . .  . . . .    .       . . . .       .                      12 
13   If line 12 is more than line 7, subtract line 7 from line 12. This is the amount you overpaid                            . . .       .                      13
14a  Amount of line 13 you want refunded to you. If Form 8888 is attached, check here  .                                    . . . .                              14a 
b    Routing number                                                                               c Type:     Checking          Savings
d    Account number
15   Amount of line 13 you want applied to 2025 estimated tax                                .    . . .  . .   15
16   Amount you owe. If line 7 is more than line 12, subtract line 12 from line 7 .                          . .    .       . . . .       .                      16
                  Do you want to allow another person to discuss this return with the IRS? See instructions.                    Yes. Complete the following.                   No
Third Party 
Designee          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 belief, 
Sign              they are true, correct, and complete. Declaration of preparer (other than the taxpayer) is based on all information of which the preparer has any knowledge.
Here              Your signature                                            Date                    Daytime phone number    If the IRS sent you an Identity Protection PIN, 
                                                                                                                            enter it here 
Joint return?                                                                                                               (see instructions) 
See instructions. Spouse’s signature. If a joint return, both must sign.                            Date                    If the IRS sent your spouse an Identity Protection 
Keep a copy                                                                                                                 PIN, enter it here 
for your records.                                                                                                           (see instructions) 
                  Preparer’s name                                       Preparer’s signature                        Date                  Check          if            PTIN
Paid                                                                                                                                      self-employed
Preparer          Firm’s name                                                                                                     Firm’s EIN
Use Only          Firm’s address                                                                                                  Phone no.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice,                             www.irs.gov/Form1040SS         Cat. No. 17184B                       Form 1040-SS (2024)
see instructions. 

Form 1040-SS (2024)                                                                                                    Page 2 
Part II Bona Fide Residents of Puerto Rico Claiming Additional Child Tax Credit (see instructions)
1    Do you have one or more qualifying children under age 17 with the required social security number?
        No. Stop. You can’t claim the credit.
        Yes. Go to line 2.
2    Number of qualifying children under age 17 with the required social security number:
                          x  $1,700   . .  .   . .    . . . .  . . . .  . .        . .            .  . . . . . . 2
3    Enter your modified adjusted gross income  .     . . . .  . . . .  . .        .              3
4    Enter the amount shown below for your filing status  . .  . . . .  . .        .              4
     • Married filing jointly – $400,000
     • All other filing statuses – $200,000
5    Is the amount on line 3 more than the amount on line 4?
        No. Leave line 5 blank. Enter the amount from line 2 on line 11, and go to 
        line 12.
        Yes.  Subtract  line  4  from  line  3.  If  the  result  isn’t  a  multiple  of  $1,000, 
        increase  it  to  the  next  multiple  of  $1,000  (for  example,  increase  $425  to 
        $1,000, increase $1,025 to $2,000, etc.)      . . . .  . . . .  . .        .              5
6    Multiply the amount on line 5 by 5% (0.05)  .    . . . .  . . . .  . .        . .            .  . . . . . . 6
7    Number of qualifying children from line 2 x $2,000   . .  . . . .  . .        .              7
8    Number of other dependents, including children who are not under age 17:
                          x  $500. See instructions   . . . .  . . . .  . .        .              8
9    Add lines 7 and 8  .   . .  . .    .  .   . .    . . . .  . . . .  . .        .              9
10   Is the amount on line 9 more than the amount on line 6?
        No. Stop. You can’t claim the credit.
        Yes. Subtract line 6 from line 9   .   . .    . . . .  . . . .  . .        . .            .  . . . . . . 10 
11   Enter the smaller of line 2 or line 10  . . .    . . . .  . . . .  . .        . .            .  . . . . . . 11 
12a  Enter one-half of self-employment tax from Part I, line 3 . . . .  . .        .              12a 
b    Enter  one-half  of  the  Additional  Medicare  Tax  on  self-employment  income
     from Form 8959, line 13  .  . .    .  .   . .    . . . .  . . . .  . .        .              12b 
c    Add lines 12a and 12b.   .  . .    .  .   . .    . . . .  . . . .  . .        .              12c 
13 a Enter the amount, if any, of withheld social security, Medicare, and Additional
     Medicare  taxes  from  Puerto  Rico  Form(s)  499R-2/W-2PR  (attach  copy  of 
     form(s)). If married filing jointly, include your spouse’s amounts with yours .              13a
b    Enter the amount reported on Part I, line 6, if any, of employee social security 
     and Medicare tax on tips not reported to employer from Form 4137 . . .        .              13b
c    Enter the amount reported on Part I, line 6, if any, of  uncollected  employee 
     social security and Medicare tax on wages from Form 8919   .  . .  . .        .              13c
d    Enter the amount reported on Part I, line 6, if any, of  uncollected  employee 
     social security tax and Medicare tax on tips and group-term life insurance    .              13d
e    Enter the amount, if any, of Additional Medicare Tax on Medicare wages from
     Form 8959, line 7  .   . .  . .    .  .   . .    . . . .  . . . .  . .        .              13e
f    Add lines 13a through 13e   . .    .  .   . .    . . . .  . . . .  . .        .              13f
14   Add lines 12c and 13f .  .  . .    .  .   . .    . . . .  . . . .  . .        .              14 
15   Enter the amount, if any, of Additional Medicare Tax withheld from Form 8959, 
     line 22  .     . . . . . .  . .    .  .   . .    . . . .  . . . .  . .        .              15 
16   Subtract line 15 from line 14 .    .  .   . .    . . . .  . . . .  . .        .              16 
17   Enter the amount, if any, from Part I, line 9  . . . . .  . . . .  . .        .              17 
18   Is the amount on line 16 more than the amount on line 17?
        No. Stop. You can’t claim the credit.
        Yes. Subtract line 17 from line 16     . .    . . . .  . . . .  . .        . .            .  . . . . . . 18 
19   Additional child tax credit. Enter the smaller of line 11 or line 18 here and on Part I, line 10      . . . 19 
                                                                                                                  Form 1040-SS (2024)