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Department of the Treasury—Internal Revenue Service
Form 1040-SR U.S. Tax Return for Seniors 2023 OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.
For the year Jan. 1–Dec. 31, 2023, or other tax year beginning , 2023, ending , 20 See separate instructions.
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
Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
Check here if you, or your
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3
to go to this fund. Checking a
box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse
Filing Single Married filing jointly (even if only one had income) Married filing separately (MFS)
Status Head of household (HOH) Qualifying surviving spouse (QSS)
Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child’s
one box. name if the qualifying person is a child but not your dependent:
Digital At any time during 2023, did you: (a) receive (as a reward, award, or payment for
Assets 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
Standard Someone can claim: You as a dependent Your spouse as a dependent
Deduction Spouse itemizes on a separate return or you were a dual-status alien
You: Were born before January 2, 1959 Are blind
Age/Blindness
{ Spouse: Was born before January 2, 1959 Is blind
Dependents (2) Social security number (3) Relationship to (4) Check the box if qualifies for (see instructions):
(see instructions): (1) First name Last name you Child tax credit Credit for other dependents
If more than four
dependents, see
instructions and
check here
Income 1 a Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . 1a
Attach
Form(s) W-2 b Household employee wages not reported on Form(s) W-2 . . . . . . 1b
here. Also
attach Forms c Tip income not reported on line 1a (see instructions) . . . . . . . . 1c
W-2G and
1099-R if tax d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) 1d
was
withheld. e Taxable dependent care benefits from Form 2441, line 26 . . . . . . 1e
If you did not f Employer-provided adoption benefits from Form 8839, line 29 . . . . 1f
get a Form
W-2, see
instructions. g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . 1g
h Other earned income (see instructions) . . . . . . . . . . . . . . 1h
i Nontaxable combat pay election (see instructions) . 1i
z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . 1z
Attach 2a Tax-exempt interest . 2a b Taxable interest . . 2b
Schedule B
if required. 3a Qualified dividends . . 3a b Ordinary dividends . 3b
4a IRA distributions . . . 4a b Taxable amount . . 4b
5a Pensions and annuities 5a b Taxable amount . . 5b
6a Social security benefits . 6a b Taxable amount . . 6b
c If you elect to use the lump-sum election method, check here (see
instructions) . . . . . . . . . . . . . . . . . . . . . . . .
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 71930F Form 1040-SR (2023)
