1040 U.S.

Individual Income Tax Return 2019

Department of the Treasury—Internal Revenue Service (99)
Form

OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widow(er) (QW)
Check only 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
one box.
a child but not your dependent.
Your first name and middle initial Last name Your social security number
DAVID ABRAHAM DAVIES 1 2 3 4 0 0 4 1 2
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
4410 SILVERWOOD DR Check here if you, or your spouse if filing
jointly, want $3 to go to this fund.
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Checking a box below will not change your
HOUSTON, TX 77035 tax or refund. You Spouse
Foreign country name Foreign province/state/county Foreign postal code If more than four dependents,
see instructions and here

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

Age/Blindness You: Were born before January 2, 1955 Are blind Spouse: Was born before January 2, 1955 Is blind
Dependents (see instructions): (2) Social security number (3) Relationship to you (4) if qualifies for (see instructions):
(1) First name Last name Child tax credit Credit for other dependents

1 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . . . . . . . 1

2a Tax-exempt interest . . . . 2a b Taxable interest. Attach Sch. B if required 2b
3a Qualified dividends . . . . 3a b Ordinary dividends. Attach Sch. B if required 3b
Standard
Deduction for— 4a IRA distributions . . . . . 4a b Taxable amount . . . . . . 4b
• Single or Married
filing separately,
c Pensions and annuities . . . 4c d Taxable amount . . . . . . 4d
$12,200 5a Social security benefits . . . 5a b Taxable amount . . . . . . 5b
• Married filing
jointly or Qualifying 6 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . . . 6
widow(er), 7a Other income from Schedule 1, line 9 . . . . . . . . . . . . . . . . . . . . 7a
$24,400
• Head of b Add lines 1, 2b, 3b, 4b, 4d, 5b, 6, and 7a. This is your total income . . . . . . . . . . . 7b
household,
$18,350
8a Adjustments to income from Schedule 1, line 22 . . . . . . . . . . . . . . . . . 8a
• If you checked b Subtract line 8a from line 7b. This is your adjusted gross income . . . . . . . . . . . 8b
any box under
Standard 9 Standard deduction or itemized deductions (from Schedule A) . . . . . 9
Deduction, 10 Qualified business income deduction. Attach Form 8995 or Form 8995-A . . . 10
see instructions.
11a Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . . . . . . . 11a
b Taxable income. Subtract line 11a from line 8b. If zero or less, enter -0- . . . . . . . . . . . 11b
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11320B Form 1040 (2019)
 Form 1040 (2019) Page 2
12a Tax (see inst.) Check if any from Form(s): 1 8814 2 4972 3 12a
b Add Schedule 2, line 3, and line 12a and enter the total . . . . . . . . . . . . . . 12b
13a Child tax credit or credit for other dependents . . . . . . . . . . 13a
b Add Schedule 3, line 7, and line 13a and enter the total . . . . . . . . . . . . . . 13b
14 Subtract line 13b from line 12b. If zero or less, enter -0- . . . . . . . . . . . . . . . 14
15 Other taxes, including self-employment tax, from Schedule 2, line 10 . . . . . . . . . . . . 15
16 Add lines 14 and 15. This is your total tax . . . . . . . . . . . . . . . . . . 16
17 Federal income tax withheld from Forms W-2 and 1099 . . . . . . . . . . . . . . . 17

• If you have a
18 Other payments and refundable credits:
qualifying child, a Earned income credit (EIC) . . . . . . . . . . . . . . . 18a
attach Sch. EIC.
• If you have b Additional child tax credit. Attach Schedule 8812 . . . . . . . . . 18b
nontaxable c American opportunity credit from Form 8863, line 8 . . . . . . . . 18c
combat pay, see
instructions. d Schedule 3, line 14 . . . . . . . . . . . . . . . . . 18d
e Add lines 18a through 18d. These are your total other payments and refundable credits . . . . . 18e
19 Add lines 17 and 18e. These are your total payments . . . . . . . . . . . . . . . 19
20 If line 19 is more than line 16, subtract line 16 from line 19. This is the amount you overpaid . . . . . . 20
Refund
21a Amount of line 20 you want refunded to you. If Form 8888 is attached, check here . . . . . . 21a
Direct deposit? b Routing number c Type: Checking Savings
See instructions.
d Account number
22 Amount of line 20 you want applied to your 2020 estimated tax . . . . 22
Amount 23 Amount you owe. Subtract line 19 from line 16. For details on how to pay, see instructions . . . . . 23
You Owe 24 Estimated tax penalty (see instructions) . . . . . . . . . . . 24
Third Party Do you want to allow another person (other than your paid preparer) to discuss this return with the IRS? See instructions. Yes. Complete below.
Designee No
(Other than Designee’s Phone Personal identification
paid preparer) name no. number (PIN)

Sign 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, 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
Joint return? (see inst.)
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

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid 3rd Party Designee
Preparer Firm’s name Phone no. Self-employed
Use Only
Firm’s address Firm’s EIN
Go to www.irs.gov/Form1040 for instructions and the latest information. Form 1040 (2019)
SCHEDULE C Profit or Loss From Business OMB No. 1545-0074
(Form 1040 or 1040-SR)
Department of the Treasury
(Sole Proprietorship)
Go to www.irs.gov/ScheduleC for instructions and the latest information. 2019
Attachment
Internal Revenue Service (99) Attach to Form 1040, 1040-SR, 1040-NR, or 1041; partnerships generally must file Form 1065. Sequence No. 09
Name of proprietor Social security number (SSN)
DAVID ABRAHAM DAVIES 123-40-0412
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
Water purification equipment 2 2 1 3 1 0
C Business name. If no separate business name, leave blank. D Employer ID number (EIN) (see instr.)
HOUSTON BEST WATER
E Business address (including suite or room no.) 4410 SILVERWOOD DR
City, town or post office, state, and ZIP code HOUSTON, TX 77035
F Accounting method: (1) Cash (2) Accrual (3) Other (specify)
G Did you “materially participate” in the operation of this business during 2019? If “No,” see instructions for limit on losses . Yes No
H If you started or acquired this business during 2019, check here . . . . . . . . . . . . . . . . .
I Did you make any payments in 2019 that would require you to file Form(s) 1099? (see instructions) . . . . . . . . Yes No
J If “Yes,” did you or will you file required Forms 1099? . . . . . . . . . . . . . . . . . . . . . Yes No
Part I Income
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on
Form W-2 and the “Statutory employee” box on that form was checked . . . . . . . . . 1
2 Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Cost of goods sold (from line 42) . . . . . . . . . . . . . . . . . . . . . . 4
5 Gross profit. Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . 5
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions) . . . . 6
7 Gross income. Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . 7
Part II Expenses. Enter expenses for business use of your home only on line 30.
8 Advertising . . . . . 8 18 Office expense (see instructions) 18
9 Car and truck expenses (see 19 Pension and profit-sharing plans . 19
instructions) . . . . . 9 20 Rent or lease (see instructions):
10 Commissions and fees . 10 a Vehicles, machinery, and equipment 20a
11 Contract labor (see instructions) 11 b Other business property . . . 20b
12 Depletion . . . . . 12 21 Repairs and maintenance . . . 21
13 Depreciation and section 179 22 Supplies (not included in Part III) . 22
expense deduction (not
included in Part III) (see 23 Taxes and licenses . . . . . 23
instructions) . . . . . 13 24 Travel and meals:
14 Employee benefit programs a Travel . . . . . . . . . 24a
(other than on line 19) . . 14 b Deductible meals (see
15 Insurance (other than health) 15 instructions) . . . . . . . 24b
16 Interest (see instructions): 25 Utilities . . . . . . . . 25
a Mortgage (paid to banks, etc.) 16a 26 Wages (less employment credits) . 26
b Other . . . . . . 16b 27a Other expenses (from line 48) . . 27a
17 Legal and professional services
17 b Reserved for future use . . . 27b
28 Total expenses before expenses for business use of home. Add lines 8 through 27a . . . . . . 28
29 Tentative profit or (loss). Subtract line 28 from line 7 . . . . . . . . . . . . . . . . . 29
30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method (see instructions).
Simplified method filers only: enter the total square footage of: (a) your home:
and (b) the part of your home used for business: . Use the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 . . . . . . . . . 30
31 Net profit or (loss). Subtract line 30 from line 29.

}
• If a profit, enter on both Schedule 1 (Form 1040 or 1040-SR), line 3 (or Form 1040-NR, line
13) and on Schedule SE, line 2. (If you checked the box on line 1, see instructions). Estates and 31
trusts, enter on Form 1041, line 3.
• If a loss, you must go to line 32.

}
32 If you have a loss, check the box that describes your investment in this activity (see instructions).
• If you checked 32a, enter the loss on both Schedule 1 (Form 1040 or 1040-SR), line 3 (or
Form 1040-NR, line 13) and on Schedule SE, line 2. (If you checked the box on line 1, see the line 32a All investment is at risk.
31 instructions). Estates and trusts, enter on Form 1041, line 3. 32b Some investment is not
at risk.
• If you checked 32b, you must attach Form 6198. Your loss may be limited.
For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11334P Schedule C (Form 1040 or 1040-SR) 2019
Schedule C (Form 1040 or 1040-SR) 2019 Page 2
Part III Cost of Goods Sold (see instructions)

33 Method(s) used to
value closing inventory: a Cost b Lower of cost or market c Other (attach explanation)
34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory?
If “Yes,” attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

35 Inventory at beginning of year. If different from last year’s closing inventory, attach explanation . . . 35

36 Purchases less cost of items withdrawn for personal use . . . . . . . . . . . . . . 36

37 Cost of labor. Do not include any amounts paid to yourself . . . . . . . . . . . . . . 37

38 Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . 38

39 Other costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

40 Add lines 35 through 39 . . . . . . . . . . . . . . . . . . . . . . . . 40

41 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . 41

42 Cost of goods sold. Subtract line 41 from line 40. Enter the result here and on line 4 . . . . . . 42
Part IV Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9
and are not required to file Form 4562 for this business. See the instructions for line 13 to find out if you must
file Form 4562.

43 When did you place your vehicle in service for business purposes? (month, day, year) / /

44 Of the total number of miles you drove your vehicle during 2019, enter the number of miles you used your vehicle for:

a Business b Commuting (see instructions) c Other

45 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . . Yes No

46 Do you (or your spouse) have another vehicle available for personal use?. . . . . . . . . . . . . . Yes No

47a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . . . Yes No

b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Part V Other Expenses. List below business expenses not included on lines 8–26 or line 30.

48 Total other expenses. Enter here and on line 27a . . . . . . . . . . . . . . . . 48

Schedule C (Form 1040 or 1040-SR) 2019
SCHEDULE SE OMB No. 1545-0074
(Form 1040 or 1040-SR) Self-Employment Tax
2019
Department of the Treasury Go to www.irs.gov/ScheduleSE for instructions and the latest information. Attachment
Internal Revenue Service (99) Attach to Form 1040, 1040-SR, or 1040-NR. Sequence No. 17

Name of person with self-employment income (as shown on Form 1040, 1040-SR, or 1040-NR) Social security number of person
DAVID ABRAHAM DAVIES with self-employment income 123-40-0412

Before you begin: To determine if you must file Schedule SE, see the instructions.

May I Use Short Schedule SE or Must I Use Long Schedule SE?

Note: Use this flowchart only if you must file Schedule SE. If unsure, see Who Must File Schedule SE in the instructions.

Did you receive wages or tips in 2019?

No Yes

Are you a minister, member of a religious order, or Christian

Yes Was the total of your wages and tips subject to social security Yes
Science practitioner who received IRS approval not to be taxed
or railroad retirement (tier 1) tax plus your net earnings from
on earnings from these sources, but you owe self-employment
self-employment more than $132,900?
tax on other earnings?

No
No

Are you using one of the optional methods to figure your net Did you receive tips subject to social security or Medicare tax Yes
Yes
earnings (see instructions)? that you didn't report to your employer?

No
No
No Did you report any wages on Form 8919, Uncollected Social Yes
Did you receive church employee income (see instructions) Yes Security and Medicare Tax on Wages?
reported on Form W-2 of $108.28 or more?
No

You may use Short Schedule SE below You must use Long Schedule SE on page 2

Section A—Short Schedule SE. Caution: Read above to see if you can use Short Schedule SE.

1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065),
box 14, code A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b If you received social security retirement or disability benefits, enter the amount of Conservation
Reserve Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065),
box 20, code AH . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b ( )
2 Net profit or (loss) from Schedule C, line 31; and Schedule K-1 (Form 1065), box 14, code A (other
than farming). Ministers and members of religious orders, see instructions for types of income to
report on this line. See instructions for other income to report . . . . . . . . . . . . . 2
3 Combine lines 1a, 1b, and 2 . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Multiply line 3 by 92.35% (0.9235). If less than $400, you don't owe self-employment tax; don't file
this schedule unless you have an amount on line 1b . . . . . . . . . . . . . . . . 4
Note: If line 4 is less than $400 due to Conservation Reserve Program payments on line 1b, see
instructions.
5 Self-employment tax. If the amount on line 4 is:
• $132,900 or less, multiply line 4 by 15.3% (0.153). Enter the result here and on Schedule 2 (Form
1040 or 1040-SR), line 4, or Form 1040-NR, line 55.
• More than $132,900, multiply line 4 by 2.9% (0.029). Then, add $16,479.60 to the result.
Enter the total here and on Schedule 2 (Form 1040 or 1040-SR), line 4, or Form 1040-NR, line 55 . 5
6 Deduction for one-half of self-employment tax.
Multiply line 5 by 50% (0.50). Enter the result here and on Schedule 1 (Form
1040 or 1040-SR), line 14, or Form 1040-NR, line 27 . . . . . . . . 6
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 11358Z Schedule SE (Form 1040 or 1040-SR) 2019
Schedule SE (Form 1040 or 1040-SR) 2019 Attachment Sequence No. 17 Page 2
Name of person with self-employment income (as shown on Form 1040, 1040-SR, or 1040-NR) Social security number of person
with self-employment income
Section B—Long Schedule SE
Part I Self-Employment Tax
Note: If your only income subject to self-employment tax is church employee income, see instructions. Also see instructions for the
definition of church employee income.
A If you are a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361, but you had
$400 or more of other net earnings from self-employment, check here and continue with Part I . . . . . . . .
1a Net farm profit or (loss) from Schedule F, line 34, and farm partnerships, Schedule K-1 (Form 1065),
box 14, code A. Note: Skip lines 1a and 1b if you use the farm optional method (see instructions) . 1a
b If you received social security retirement or disability benefits, enter the amount of Conservation Reserve
Program payments included on Schedule F, line 4b, or listed on Schedule K-1 (Form 1065), box 20, code AH 1b ( )
2 Net profit or (loss) from Schedule C, line 31; and Schedule K-1 (Form 1065), box 14, code A (other
than farming). Ministers and members of religious orders, see instructions for types of income to
report on this line. See instructions for other income to report. Note: Skip this line if you use the
nonfarm optional method (see instructions) . . . . . . . . . . . . . . . . . . . . 2
3 Combine lines 1a, 1b, and 2 . . . . . . . . . . . . . . . . . . . . . . . . . 3
4a If line 3 is more than zero, multiply line 3 by 92.35% (0.9235). Otherwise, enter amount from line 3 . 4a
Note: If line 4a is less than $400 due to Conservation Reserve Program payments on line 1b, see instructions.
b If you elect one or both of the optional methods, enter the total of lines 15 and 17 here . . . . . 4b
c Combine lines 4a and 4b. If less than $400, stop; you don't owe self-employment tax. Exception: If
less than $400 and you had church employee income, enter -0- and continue . . . . . . . 4c
5a Enter your church employee income from Form W-2. See instructions for
definition of church employee income . . . . . . . . . . . . . 5a
b Multiply line 5a by 92.35% (0.9235). If less than $100, enter -0- . . . . . . . . . . . . . 5b
6 Add lines 4c and 5b . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Maximum amount of combined wages and self-employment earnings subject to social security tax or
the 6.2% portion of the 7.65% railroad retirement (tier 1) tax for 2019 . . . . . . . . . . . 7 132,900
8a Total social security wages and tips (total of boxes 3 and 7 on Form(s) W-2)
and railroad retirement (tier 1) compensation. If $132,900 or more, skip lines
8b through 10, and go to line 11 . . . . . . . . . . . . . . . 8a
b Unreported tips subject to social security tax (from Form 4137, line 10) . . 8b
c Wages subject to social security tax (from Form 8919, line 10) . . . . . 8c
d Add lines 8a, 8b, and 8c . . . . . . . . . . . . . . . . . . . . . . . . . . 8d
9 Subtract line 8d from line 7. If zero or less, enter -0- here and on line 10 and go to line 11 . . . 9
10 Multiply the smaller of line 6 or line 9 by 12.4% (0.124) . . . . . . . . . . . . . . . . 10
11 Multiply line 6 by 2.9% (0.029) . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Self-employment tax. Add lines 10 and 11. Enter here and on Schedule 2 (Form 1040 or 1040-SR),
line 4, or Form 1040-NR, line 55 . . . . . . . . . . . . . . . . . . . . . . . 12
13 Deduction for one-half of self-employment tax.
Multiply line 12 by 50% (0.50). Enter the result here and on Schedule 1 (Form
1040 or 1040-SR), line 14, or Form 1040-NR, line 27 . . . . . . . . 13
Part II Optional Methods To Figure Net Earnings (see instructions)
Farm Optional Method. You may use this method only if (a) your gross farm income1 wasn't more than
$8,160, or (b) your net farm profits2 were less than $5,891.
14 Maximum income for optional methods . . . . . . . . . . . . . . . . . . . . . 14 5,440
15 Enter the smaller of: two-thirds (2/3) of gross farm income1 (not less than zero) or $5,440. Also include
this amount on line 4b above . . . . . . . . . . . . . . . . . . . . . . . . 15
Nonfarm Optional Method. You may use this method only if (a) your net nonfarm profits3 were less than $5,891
and also less than 72.189% of your gross nonfarm income,4 and (b) you had net earnings from self-employment
of at least $400 in 2 of the prior 3 years. Caution: You may use this method no more than five times.
16 Subtract line 15 from line 14 . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Enter the smaller of: two-thirds (2/3) of gross nonfarm income4 (not less than zero) or the amount on
line 16. Also include this amount on line 4b above . . . . . . . . . . . . . . . . . 17

1 3
From Sch. F, line 9, and Sch. K-1 (Form 1065), box 14, code B. From Sch. C, line 31; and Sch. K-1 (Form 1065), box 14, code A.
2 4
From Sch. F, line 34, and Sch. K-1 (Form 1065), box 14, code A—minus the From Sch. C, line 7; and Sch. K-1 (Form 1065), box 14, code C.
amount you would have entered on line 1b had you not used the optional
method.
Schedule SE (Form 1040 or 1040-SR) 2019
SCHEDULE 1 OMB No. 1545-0074
Additional Income and Adjustments to Income
2019
(Form 1040 or 1040-SR)

Department of the Treasury Attach to Form 1040 or 1040-SR.

Attachment
Internal Revenue Service Go to www.irs.gov/Form1040 for instructions and the latest information. Sequence No. 01
Name(s) shown on Form 1040 or 1040-SR Your social security number
DAVID ABRAHAM DAVIES 123-40-0412
At any time during 2019, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any
virtual currency? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
Part I Additional Income
1 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . . . . . . . 1
2a Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b Date of original divorce or separation agreement (see instructions)
3 Business income or (loss). Attach Schedule C . . . . . . . . . . . . . . . . . . . 3
4 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . . . . . . . . 4
5 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E . . . . . 5
6 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . 6
7 Unemployment compensation . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Other income. List type and amount
8
9 Combine lines 1 through 8. Enter here and on Form 1040 or 1040-SR, line 7a . . . . . . . . 9
Part II Adjustments to Income
10 Educator expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach
Form 2106 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Health savings account deduction. Attach Form 8889 . . . . . . . . . . . . . . . . 12
13 Moving expenses for members of the Armed Forces. Attach Form 3903 . . . . . . . . . . 13
14 Deductible part of self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . 14
15 Self-employed SEP, SIMPLE, and qualified plans . . . . . . . . . . . . . . . . . . 15
16 Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . 16
17 Penalty on early withdrawal of savings . . . . . . . . . . . . . . . . . . . . . 17
18a Alimony paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a
b Recipient’s SSN . . . . . . . . . . . . . . . . . . . . .
c Date of original divorce or separation agreement (see instructions)
19 IRA deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Student loan interest deduction . . . . . . . . . . . . . . . . . . . . . . . 20
21 Tuition and fees. Attach Form 8917 . . . . . . . . . . . . . . . . . . . . . . 21
22 Add lines 10 through 21. These are your adjustments to income. Enter here and on Form 1040 or
1040-SR, line 8a . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71479F Schedule 1 (Form 1040 or 1040-SR) 2019
SCHEDULE 2 OMB No. 1545-0074
Additional Taxes
2019
(Form 1040 or 1040-SR)
▶ Attach to Form 1040 or 1040-SR.
Department of the Treasury Attachment
▶ Go to www.irs.gov/Form1040 for instructions and the latest information.
Internal Revenue Service Sequence No. 02
Name(s) shown on Form 1040 or 1040-SR Your social security number
DAVID ABRAHAM DAVIES 123-40-0412
Part I Tax
1 Alternative minimum tax. Attach Form 6251 . . . . . . . . . . . . . . . . . . . 1
2 Excess advance premium tax credit repayment. Attach Form 8962 . . . . . . . . . . . . 2
3 Add lines 1 and 2. Enter here and include on Form 1040 or 1040-SR, line 12b . . . . . . . . 3
Part II Other Taxes
4 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . . . . . . . . 4
5 Unreported social security and Medicare tax from Form: a 4137 b 8919 . . . . . 5
6 Additional tax on IRAs, other qualified retirement plans, and other tax-favored accounts. Attach Form
5329 if required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7a Household employment taxes. Attach Schedule H . . . . . . . . . . . . . . . . . 7a
b Repayment of first-time homebuyer credit from Form 5405. Attach Form 5405 if required . . . . 7b
8 Taxes from: a Form 8959 b Form 8960
c Instructions; enter code(s) 8
9 Section 965 net tax liability installment from Form 965-A . . . . . . . 9
10 Add lines 4 through 8. These are your total other taxes. Enter here and on Form 1040 or 1040-SR,
line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 71478U Schedule 2 (Form 1040 or 1040-SR) 2019