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2011 1040a

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2011 1040a

2011 1040a 18. 2011 1040a   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. 2011 1040a Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. 2011 1040a                 Name, address, and employer identification number of seller in subsequent sale             2. 2011 1040a                 Name, address, and employer identification number of the buyer in subsequent sale             3. 2011 1040a         Date and location of subsequent sale             4. 2011 1040a         Volume and type of taxable fuel sold               The undersigned seller (“Seller”) has received the copy of the first taxpayer's report provided with this statement in     connection with Seller's purchase of the taxable fuel described in this statement. 2011 1040a       Under penalties of perjury, Seller declares that Seller has examined this statement, including any accompanying     schedules and statements, and, to the best of Seller's knowledge and belief, they are true, correct and complete. 2011 1040a                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. 2011 1040a                     First Taxpayer's name, address and employer identification number     2. 2011 1040a                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. 2011 1040a           Date and location of removal, entry, or sale       4. 2011 1040a           Volume and type of taxable fuel removed, entered or sold     5. 2011 1040a Check type of taxable event:         Removal from refinery         Entry into United States         Bulk transfer from terminal by unregistered position holder       Bulk transfer not received at an approved terminal       Sale within the bulk transfer/terminal system       Removal at the terminal rack         Removal or sale by the blender                   6. 2011 1040a           Amount of federal excise tax paid on account of the removal, entry, or sale                   The undersigned taxpayer (“Taxpayer”) has not received, and will not claim, a credit with respect to, or a refund of, the tax     on the taxable fuel to which this form relates. 2011 1040a       Under penalties of perjury, Taxpayer declares that Taxpayer has examined this statement, including any accompanying     schedules and statements, and to the best of Taxpayer's knowledge and belief, they are true, correct and complete. 2011 1040a             Signature and date signed               Printed or typed name of person signing this report               Title     Model Certificate C   NOTIFICATION CERTIFICATE OF TAXABLE FUEL REGISTRANT                           Name, address, and employer identification number of person receiving certificate       The undersigned taxable registrant (“Registrant”) hereby certifies under penalties of perjury that Registrant is registered     by the Internal Revenue Service with registration number and that Registrant's registration has not     been revoked or suspended by the Internal Revenue Service. 2011 1040a                 Registrant understands that the fraudulent use of this certificate may subject Registrant and all parties making such     fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a                       Signature and date signed                         Printed or typed name of person signing                         Title of person signing                         Name of Registrant                         Employer identification number                         Address of Registrant     Model Certificate D   CERTIFICATE OF PERSON BUYING GASOLINE BLENDSTOCKS FOR USE OTHER THAN IN THE PRODUCTION OF FINISHED GASOLINE     (To support tax-free sales (other than LUST) under section 4081 of the Internal Revenue Code. 2011 1040a )                 Name, address, and employer identification number of seller       The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:       The gasoline blendstocks to which this certificate relates will not be used to produce finished gasoline. 2011 1040a       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. 2011 1040a Invoice or delivery ticket number       2. 2011 1040a (number of gallons) of(type of gasoline blendstocks)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:     1. 2011 1040a Effective date       2. 2011 1040a Expiration date       (period not to exceed 1 year after the effective date)       3. 2011 1040a Type (or types) of gasoline blendstocks     4. 2011 1040a Buyer's account or order number         Buyer will not claim a credit or refund under section 6427(h) of the Internal Revenue Code for any gasoline blendstocks     covered by this certificate. 2011 1040a         Buyer will provide a new certificate to the seller if any information in this certificate changes. 2011 1040a       If Buyer resells the gasoline blendstocks to which this certificate relates, Buyer will be liable for tax unless Buyer obtains a     certificate from the purchaser stating that the gasoline blendstocks will not be used to produce finished gasoline and otherwise complies with the conditions of §48. 2011 1040a 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. 2011 1040a       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. 2011 1040a       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. 2011 1040a     In addition, the Internal Revenue Service has not notified Buyer that the right to provide a certificate has been withdrawn from a purchaser to which Buyer sells gasoline blendstocks tax free. 2011 1040a       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use     of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a             Signature and date signed               Printed or typed name of person signing               Title of person signing               Name of Buyer               Employer identification number               Address of Buyer     Model Certificate G   CERTIFICATE OF REGISTERED FEEDSTOCK USER     (To support tax-free removals and entries (other than LUST) of kerosene under section 4082 of the Internal Revenue Code. 2011 1040a )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . 2011 1040a Buyer's registration has not been revoked     or suspended. 2011 1040a         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. 2011 1040a                 This certificate applies to percent of Buyer's purchases from (name, address, and employer     identification number of seller) as follows (complete as applicable):       1. 2011 1040a A single purchase on invoice or delivery ticket number . 2011 1040a                 2. 2011 1040a All purchases between (effective date) and (expiration date) (period not to exceed     one year after the effective date) under account or order number(s) . 2011 1040a If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. 2011 1040a                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. 2011 1040a                 Buyer will provide a new certificate to the seller if any information in this certificate changes. 2011 1040a                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. 2011 1040a                 Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use of     this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a             Printed or typed name of person signing               Title of person signing               Employer identification number               Address of Buyer               Signature and date signed     Model Certificate J   CERTIFICATE OF PERSON BUYING COMPRESSED NATURAL GAS (CNG) FOR A NONTAXABLE USE     (To support tax-free sales of CNG under section 4041 of the Internal Revenue Code. 2011 1040a )                                         Name, address, and employer identification number of seller                   (“Buyer”) certifies the following under penalties of perjury:     Name of buyer                     The CNG to which this certificate relates will be used in a nontaxable use. 2011 1040a       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. 2011 1040a Invoice or delivery ticket number       2. 2011 1040a (Gasoline gallon equivalents)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:         1. 2011 1040a Effective date         2. 2011 1040a Expiration date         (period not to exceed 1 year after the effective date)         3. 2011 1040a Buyer's account or order number       Buyer will not claim a credit or refund under section 6427 of the Internal Revenue Code for any CNG to which this certificate relates. 2011 1040a       Buyer will provide a new certificate to the seller if any information in this certificate changes. 2011 1040a       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. 2011 1040a       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. 2011 1040a     In addition, the Internal Revenue Service has not notified Buyer that the right to provide a certificate has been withdrawn     from a purchaser to which Buyer sells CNG tax free. 2011 1040a       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use     of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a             Printed or typed name of person signing               Title of person signing             Employer identification number               Address of Buyer               Signature and date signed     Model Certificate K   CERTIFICATE OF PERSON BUYING KEROSENE FOR USE IN AVIATION FOR     COMMERCIAL AVIATION OR NONTAXABLE USE     (To support operator liability for tax on removals of kerosene for use in aviation directly into the fuel tank of an aircraft in commercial aviation pursuant to § 4081 of the Internal Revenue Code or to support a tax rate of zero under § 4041(c) pursuant to §§4041(c) and 4082. 2011 1040a )           Name, address, and employer identification number of position holder       The undersigned aircraft operator (“Buyer”) hereby certifies the following under the penalties of perjury:       The kerosene for use in aviation to which this certificate relates is purchased (check one): for     use on a farm for farming purposes; for use in foreign trade (reciprocal benefits required for foreign registered airlines); for use in certain helicopter and fixed-wing air ambulance uses; for use other than as a fuel in the propulsion engine of an aircraft; for the exclusive use of a qualified blood collector organization; for the exclusive use of a nonprofit educational organization; for the exclusive use of a state; for use in an aircraft owned by an aircraft museum; for use in military aircraft; or for use in commercial aviation (other than foreign trade). 2011 1040a       With respect to kerosene for use in aviation purchased after June 30, 2005, for use in commercial aviation     (other than foreign trade), Buyer's registration number is. 2011 1040a Buyer's registration has not been suspended or revoked by the Internal Revenue Service. 2011 1040a       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. 2011 1040a Invoice or delivery ticket number       2. 2011 1040a Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. 2011 1040a Effective date       2. 2011 1040a Expiration date (period not to exceed 1 year after the effective date)       3. 2011 1040a Buyer's account number       Buyer agrees to provide the person liable for tax with a new certificate if any information in this certificate changes. 2011 1040a       If the kerosene for use in aviation to which this certificate relates is being bought for use in commercial aviation     (other than foreign trade), Buyer is liable for tax on its use of the fuel and will pay that tax to the government. 2011 1040a       If Buyer sells or uses the kerosene for use in aviation to which this certificate relates for a use other than the use     stated above, Buyer will be liable for tax. 2011 1040a       Buyer understands that it must be prepared to establish by satisfactory evidence the purpose for which the     fuel purchased under this certificate was used. 2011 1040a     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. 2011 1040a     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. 2011 1040a       The fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use of this certificate     to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Waiver L WAIVER FOR USE BY ULTIMATE PURCHASERS OF KEROSENE FOR CERTAIN USES IN AVIATION (To support vendor's claim for a credit or payment under § 6427(l)(4)(C)(i) of the Internal Revenue Code. 2011 1040a )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2011 1040a The kerosene to which this waiver relates is purchased for — (check one):       1. 2011 1040a □ Use on a farm for farming purposes,       2. 2011 1040a □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. 2011 1040a □ Use in certain helicopter and fixed-wing air ambulance uses,       4. 2011 1040a □ The exclusive use of a qualified blood collector organization,       5. 2011 1040a □ The exclusive use of a nonprofit educational organization,       6. 2011 1040a □ Use in an aircraft owned by an aircraft museum,       7. 2011 1040a □ Use in military aircraft, or       8. 2011 1040a □ Use in commercial aviation (other than foreign trade). 2011 1040a     B. 2011 1040a This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. 2011 1040a Invoice or delivery ticket number           2. 2011 1040a Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. 2011 1040a Effective date           2. 2011 1040a Expiration date (period not to exceed 1 year after the effective date)           3. 2011 1040a Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. 2011 1040a       If Buyer uses the kerosene for use in aviation to which this waiver relates for a use other than the use stated above, Buyer will be liable for tax. 2011 1040a       Buyer understands that by signing this waiver, Buyer gives up its right to claim any credit or payment for the kerosene for use in aviation used in a nontaxable use. 2011 1040a       Buyer acknowledges that it has not and will not claim any credit or payment for the kerosene for use in aviation to which this waiver relates. 2011 1040a       Buyer understands that the fraudulent use of this waiver may subject Buyer and all parties making such fraudulent use of this waiver to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate M   CERTIFICATE FOR STATE USE OR NONPROFIT EDUCATIONAL     ORGANIZATION USE     (To support vendor's claim for a credit or payment under § 6416(a)(4) of the Internal Revenue Code. 2011 1040a )                       Name, address, and employer identification number of ultimate vendor       The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under the penalties of perjury:       Buyer will use the gasoline or aviation gasoline to which this certificate relates (check one):     For the exclusive use of a state or local government; or     For the exclusive use of a nonprofit educational organization. 2011 1040a       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. 2011 1040a Invoice or delivery ticket number       2. 2011 1040a Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. 2011 1040a Effective date       2. 2011 1040a Expiration date (period not to exceed 1 year after the effective date)       3. 2011 1040a Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. 2011 1040a       Buyer understands that by signing this certificate, Buyer gives up its right to claim any credit or payment for the gasoline or aviation gasoline to which this certificate relates. 2011 1040a       Buyer acknowledges that it has not and will not claim any credit or payment for the gasoline or aviation gasoline to which this certificate relates. 2011 1040a       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Waiver N   WAIVER FOR USE BY ULTIMATE PURCHASERS OF DIESEL FUEL OR     KEROSENE USED IN INTERCITY BUS TRANSPORTATION     (To support vendor's claim for a credit or payment under § 6427 of the Internal Revenue Code. 2011 1040a )                       Name, address, and employer identification number of ultimate vendor       The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under the penalties of perjury:       The diesel fuel or kerosene to which this waiver relates is purchased for use in intercity bus transportation. 2011 1040a       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. 2011 1040a Invoice or delivery ticket number       2. 2011 1040a Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. 2011 1040a Effective date       2. 2011 1040a Expiration date (period not to exceed 1 year after the effective date)       3. 2011 1040a Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. 2011 1040a       If Buyer uses the diesel fuel or kerosene to which this waiver relates for a use other than in intercity bus transportation, Buyer will be liable for tax. 2011 1040a       Buyer understands that by signing this waiver, Buyer gives up its right to claim any credit or payment for the diesel fuel or kerosene used in intercity bus transportation. 2011 1040a       Buyer acknowledges that it has not and will not claim any credit or payment for the diesel fuel or kerosene to which this waiver relates. 2011 1040a       Buyer understands that the fraudulent use of this waiver may subject Buyer and all parties making such fraudulent use of this waiver to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate O   CERTIFICATE FOR BIODIESEL     Certificate Identification Number:     (To support a claim related to biodiesel or a biodiesel mixture under section 6426 of the Internal Revenue Code. 2011 1040a )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. 2011 1040a             Producer's name, address, and employer identification number (EIN)   2. 2011 1040a             Name, address, and EIN of person buying the biodiesel from Producer   3. 2011 1040a       Date and location of sale to buyer   4. 2011 1040a This certificate applies to gallons of biodiesel. 2011 1040a   5. 2011 1040a Producer certifies that the biodiesel to which this certificate relates is:       % Agri-biodiesel (derived solely from virgin oils)       % Biodiesel other than agri-biodiesel       This certificate applies to the following sale:       Invoice or delivery ticket number       Total number of gallons of biodiesel sold under that invoice or delivery ticket number (including biodiesel not covered by this certificate)       Total number of certificates issued for that invoice or delivery ticket number   6. 2011 1040a             Name, address, and employer identification number of reseller to whom certificate is issued (only in the case of certificates reissued to a reseller after the return of the original certificate)   7. 2011 1040a Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). 2011 1040a       Producer is registered as a biodiesel producer with registration number . 2011 1040a  Producer's registration has not been suspended or revoked by the Internal Revenue Service. 2011 1040a       Producer certifies that the biodiesel to which this certificate relates in monoalkyl esters of long chain fatty acids derived from plant or animal matter that meets the requirements of the American Society of Testing and Materials D6751 and the registration requirements for fuels and fuel additives established by EPA under section 211 of the Clean Air Act (42 U. 2011 1040a S. 2011 1040a C. 2011 1040a 7545). 2011 1040a       Producer understands that the fraudulent use of this certificate may subject Producer and all parties making any fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Model Certificate P CERTIFICATE OF STATE USE (To support vendor's claim for credit or payment under section 6427 of the Internal Revenue Code. 2011 1040a )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2011 1040a Buyer will use the diesel fuel or kerosene to which this certificate relates for the exclusive use of a state or local government, or the District of Columbia. 2011 1040a     B. 2011 1040a This certificate applies to the following (complete as applicable):       1. 2011 1040a   If this is a single purchase certificate, check here □ and enter:           a. 2011 1040a Invoice or delivery ticket number           b. 2011 1040a Number of gallons       2. 2011 1040a   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. 2011 1040a Effective date           b. 2011 1040a Expiration date   (period not to exceed 1 year after effective date)           c. 2011 1040a Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. 2011 1040a     ▪ If Buyer uses the diesel fuel or kerosene to which this certificate relates for a purpose other than stated in the certificate, Buyer will be liable for any tax. 2011 1040a     ▪ Buyer acknowledges that it has not and will not claim any credit or payment for the diesel fuel or kerosene to which this certificate relates. 2011 1040a     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate Q CERTIFICATE OF ULTIMATE PURCHASER OF KEROSENE FOR USE IN NONEXEMPT, NONCOMMERCIAL AVIATION (To support vendor's claim for credit or payment under section 6427(l)(4)(C)(ii) of the Internal Revenue Code. 2011 1040a )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2011 1040a The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. 2011 1040a     B. 2011 1040a This certificate applies to the following (complete as applicable):       1. 2011 1040a   If this is a single purchase certificate, check here □ and enter:           a. 2011 1040a Invoice or delivery ticket number           b. 2011 1040a Number of gallons       2. 2011 1040a   This is a certificate covering all purchases under a specified account or order number:           a. 2011 1040a Effective date           b. 2011 1040a Expiration date   (period not to exceed 1 year after effective date)           c. 2011 1040a Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. 2011 1040a     ▪ If Buyer uses the kerosene to which this certificate relates for a use other than the nontaxable use stated above, Buyer will be liable for tax. 2011 1040a     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate R CERTIFICATE OF BUYER OF TAXABLE FUEL FOR USE BY A STATE OR NONPROFIT EDUCATIONAL ORGANIZATION (To support credit card issuer's claim for credit, refund, or payment under section 6416(a)(4)(B) or section 6427(l)(5)(D) of the Internal Revenue Code. 2011 1040a )               Name, Address, and Employer Identification Number of Credit Card Issuer. 2011 1040a     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. 2011 1040a Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. 2011 1040a Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. 2011 1040a     C. 2011 1040a This certificate applies to all purchases made with the credit card identified below during the period specified:           a. 2011 1040a Effective date of certificate           b. 2011 1040a Expiration date of certificate   (period not to exceed 2 years after effective date)           c. 2011 1040a Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. 2011 1040a     ▪ Buyer understands that by signing this certificate, Buyer gives up its right to claim a credit or payment for the taxable fuel purchased with the credit card to which this certificate relates. 2011 1040a     ▪ Buyer acknowledges that it has not and will not claim any credit or payment for the taxable fuel purchased with the credit card to which this certificate relates. 2011 1040a     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Statement S   STATEMENT OF BIODIESEL RESELLER     (To support a claim related to biodiesel or a biodiesel mixture under section 6426 of the Internal Revenue Code. 2011 1040a )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. 2011 1040a                   Reseller's name, address, and employer identification number (EIN)   2. 2011 1040a                   Name, address, and EIN of Reseller's buyer   3. 2011 1040a       Date and location of sale to buyer   4. 2011 1040a Volume of biodiesel sold   5. 2011 1040a Certificate Identification Number on the Certificate for Biodiesel       Reseller has bought the biodiesel described in the accompanying Certificate for Biodiesel and Reseller has no reason to believe that any information in the certificate is false. 2011 1040a       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. 2011 1040a       Reseller understands that the fraudulent use of this statement may subject Reseller and all parties making any fraudulent use of this statement to a fine or imprisonment, or both, together with the costs of prosecution. 2011 1040a           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Prev  Up  Next   Home   More Online Publications
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Contact My Local Office in Maryland

Face-to-face Tax Help

IRS Taxpayer Assistance Centers (TACs) are your source for personal tax help when you believe your tax issue can only be handled face-to-face. No appointment is necessary.

Keep in mind, many questions can be resolved online without waiting in line. Through IRS.gov you can:
• Set up a payment plan.
• Get a transcript of your tax return.
• Make a payment.
• Check on your refund.
• Find answers to many of your tax questions.

We are now referring all requests for tax return preparation services to other available resources. You can take advantage of free tax preparation through Free File, Free File Fillable Forms or through a volunteer site in your community. To find the nearest volunteer site location or to get more information about Free File, go to the top of the page and enter “Free Tax Help” in the Search box.

If you have a tax account issues and feel that it requires talking with someone face-to-face, visit your local TAC.

Caution:  Many of our offices are located in Federal Office Buildings. These buildings may not allow visitors to bring in cell phones with camera capabilities.

Multilingual assistance is available in every office. Hours of operation are subject to change.

Before visiting your local office click on "Services Provided" in the chart below to see what services are available. Services are limited and not all services are available at every TAC office and may vary from site to site. You can get these services on a walk-in basis.

City Street Address Days/Hours of Service Telephone*
Annapolis 190 Admiral Cochrane Dr.
Annapolis, MD 21401

Monday-Friday - 8:30 a.m.- 4:30 p.m.
(Closed for lunch 12:00 noon - 1:00 p.m.)

 

**This office will be open until 6:00 p.m. on 4/14 & 4/15**

 

Services Provided

(301) 695-7615
Baltimore 31 Hopkins Plaza
Baltimore, MD 21201

Monday-Friday - 8:30 a.m.- 4:30 p.m.


Services Provided

(410) 962-7969 
Frederick  201 Thomas- Johnson Dr.
Frederick, MD 21702 

Monday-Friday - 8:30 a.m.- 4:30 p.m.
(Closed for lunch 1:00 p.m. - 2:00 p.m.) 

 

Services Provided

(301) 695-7615 
Hagerstown  1260 Maryland Ave.
Hagerstown, MD 21740 

Monday-Friday - 8:30 a.m.- 4:30 p.m.
(Closed for lunch 12:30 p.m. - 1:30 p.m.) 

 

Services Provided

(301) 797-6624 
Landover  8401 Corporate Dr.
Landover, MD 20785 

Monday-Friday - 8:30 a.m.- 4:30 p.m. 
(Closed for lunch 12:30 p.m. - 1:30 p.m.)


Services Provided

(240) 613-7952 
LaVale  14701 National Highway 
LaVale, MD 21502 

Monday-Friday - 8:30 a.m.- 2:30 p.m.
(Closed for lunch 11:30 a.m. - 12:30 p.m.)
 

Services Provided

(301) 729-6397 
Salisbury  212 West Main St.
Salisbury, MD 21801 

Monday-Friday - 8:30 a.m.- 4:30 p.m. 


Services Provided

(410) 677-6718
Wheaton  11510 Georgia Ave.
Wheaton, MD 20902 

Monday-Friday - 8:30 a.m.- 4:30 p.m. 

 

Services Provided

(240) 613-8976 

* Note: The phone numbers in the chart above are not toll-free for all locations. When you call, you will reach a recorded business message with information about office hours, locations and services provided in that office. If face-to-face assistance is not a priority for you, you may also get help with IRS letters or resolve tax account issues by phone, toll free at 1-800-829-1040 (individuals) or 1-800-829-4933 (businesses).

For information on where to file your tax return please see Where to File Addresses.

The Taxpayer Advocate Service: Call (443) 853-6000 in Baltimore or 1-877-777-4778 elsewhere, or see  Publication 1546, The Taxpayer Advocate Service of the IRS. For further information, see Tax Topic 104.

Partnerships

IRS and organizations all over the country are partnering to assist taxpayers. Through these partnerships, organizations are also achieving their own goals. These mutually beneficial partnerships are strengthening outreach efforts and bringing education and assistance to millions.

For more information about these programs for individuals and families, contact the Stakeholder Partnerships, Education and Communication Office at:

Internal Revenue Service
Fallon Federal Building
31 Hopkins Plaza, Room 1432
Baltimore, MD 21201

For more information about these programs for businesses, your local Stakeholder Liaison office establishes relationships with organizations representing small business and self-employed taxpayers. They provide information about the policies, practices and procedures the IRS uses to ensure compliance with the tax laws. To establish a relationship with us, use this list to find a contact in your state:

Stakeholder Liaison (SL) Phone Numbers for Organizations Representing Small Businesses and Self-employed Taxpayers.

Page Last Reviewed or Updated: 28-Mar-2014

The 2011 1040a

2011 1040a Part One -   La Declaración de Impuestos sobre los Ingresos Los cuatro capítulos de esta sección presentan información básica sobre el sistema tributario. 2011 1040a Le explican los primeros pasos para llenar una declaración de impuestos; por ejemplo, cómo determinar qué estado civil para efectos de la declaración le corresponde, cuántas exenciones puede reclamar y qué formulario presentar. 2011 1040a Asimismo, explican los requisitos de mantenimiento de documentación, el sistema de presentación electrónica del IRS e-file, determinadas multas y los dos métodos que se utilizan para pagar impuestos durante el año: la retención del impuesto y el impuesto estimado. 2011 1040a Table of Contents 1. 2011 1040a   Información para la Presentación de la Declaración de ImpuestosQué Hay de Nuevo Recordatorios Introduction ¿Debo Presentar una Declaración?Individuos/Personas Físicas—En General Dependientes Determinados Hijos Menores de 19 Años de Edad o Estudiantes a Tiempo Completo Trabajadores por Cuenta Propia Extranjeros Quién Debe Presentar una Declaración ¿Qué Formulario Debo Usar?Formulario 1040EZ Formulario 1040A Formulario 1040 ¿Tengo que Presentar la Declaración en Papel? E-file del IRS ¿Cuándo Tengo que Presentar la Declaración?Servicios de entrega privados. 2011 1040a Prórrogas del Plazo para Presentar la Declaración de Impuestos ¿Cómo Preparo la Declaración de Impuestos?¿Cuándo Declaro los Ingresos y Gastos? Número de Seguro Social Fondo para la Campaña Electoral Presidencial Cálculos Documentos Adjuntos Designación de un Tercero Firmas Preparador Remunerado Reembolsos Cantidad que Adeuda Donaciones Para Reducir la Deuda Pública Nombre y Dirección ¿Dónde Presento la Declaración? ¿Qué Ocurre Después de Presentar la Declaración?¿Qué Documentos Debo Mantener? ¿Por Qué Debe Mantener los Documentos? Tipo de Documentos que Debe Mantener Documentos Básicos Cuánto Tiempo Debe Mantener los Documentos Información sobre Reembolsos Intereses Sobre Reembolsos Cambio de Dirección ¿Qué Sucede Si Cometí un Error?Declaraciones Enmendadas y Reclamaciones de Reembolso Multas Robo de Identidad 2. 2011 1040a   Estado Civil para Efectos de la DeclaraciónQué Hay de Nuevo Introduction Useful Items - You may want to see: Estado CivilPersonas divorciadas. 2011 1040a Divorcio y nuevo matrimonio. 2011 1040a Matrimonios anulados. 2011 1040a Cabeza de familia o viudo que reúne los requisitos con hijo dependiente. 2011 1040a Personas consideradas casadas. 2011 1040a Matrimonio del mismo sexo. 2011 1040a Cónyuge fallecido durante el año. 2011 1040a Personas casadas que viven separadas. 2011 1040a Soltero Casados que Presentan una Declaración ConjuntaPresentación de una Declaración Conjunta Casados que Presentan la Declaración por SeparadoReglas Especiales Cabeza de FamiliaPersonas Consideradas no Casadas Personas que Mantienen una Vivienda Persona Calificada Viudo que Reúne los Requisitos con Hijo Dependiente 3. 2011 1040a   Exenciones Personales y por DependientesQué Hay de Nuevo Introduction Useful Items - You may want to see: ExencionesExenciones Personales Exenciones por Dependientes Hijo Calificado Pariente Calificado Eliminación gradual por fases de la exención Números de Seguro Social para DependientesNacimiento y fallecimiento en el año 2013. 2011 1040a Número de identificación personal del contribuyente del Servicio de Impuestos Internos. 2011 1040a Números de identificación del contribuyente en proceso de adopción. 2011 1040a 4. 2011 1040a   Retención de Impuestos e Impuesto EstimadoQué Hay de Nuevo para el Año 2014 Recordatorios Introduction Useful Items - You may want to see: Retención de Impuesto para el Año 2014Sueldos y Salarios Propinas Beneficios Marginales Tributables Compensación por Enfermedad Pensiones y Anualidades Ganancias Provenientes de Juegos de Azar y Apuestas Compensación por Desempleo Pagos del Gobierno Federal Retención Adicional Impuesto Estimado para el Año 2014Quién no Tiene que Pagar el Impuesto Estimado ¿Quién Tiene que Pagar Impuesto Estimado? Cómo Calcular el Impuesto Estimado Cuándo se Debe Pagar el Impuesto Estimado Cómo Determinar Cada Pago Cómo Pagar el Impuesto Estimado Crédito por Impuestos Retenidos e Impuesto Estimado para el Año 2013Retención Impuesto Estimado Multa por Pago Insuficiente de Impuestos para el Año 2013 Prev  Up  Next   Home   More Online Publications