Name(s) shown on Form 1040, 1040-SR, or 1040-NR David R. and Ella M. Cole 1 Part...

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Name(s) shown on Form 1040, 1040-SR, or 1040-NR David R. and Ella M. Cole 1 Part I Additional Income Taxable refunds, credits, or offsets of state and local income taxes 2a Alimony received. b Date of original divorce or separation agreement (see instructions) Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 3 Business income or (loss). Attach Schedule C.. 4 Other gains or (losses). Attach Form 4797. 5 6 7 8 Other income: Farm income or (loss). Attach Schedule F Unemployment compensation. a Net operating loss 8a ( b Gambling income. c Cancellation of debt. d Foreign earned income exclusion from Form 2555 e Taxable Health Savings Account distribution. f Alaska Permanent Fund dividends. g Jury duty pay h Prizes and awards. i Activity not engaged in for profit income. J Stock options... k Income from the rental of personal property if you engaged in the rental for profit but were not in the business of renting such property 1 Olympic and Paralympic medals and USOC prize money (see instructions)... Bb 8d ( Be 8f 8g 8h Bi 8j 8k 81 Your social security number 123-45-6788 1 2a 3 4 5 6 7 o Section 461(1) excess business loss adjustment.. p Taxable distributions from an ABLE account (see instructions) z Other income. List type and amount I 9 Total other income. Add lines Sa through Sz. 80 8p 8z 10 Combine lines 1 through 7 and 9. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 8. For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040) (2021) Part II David R. and Ella M. Cole Adjustments to Income 11 Educator expenses. 10 Cat. No. 71479F Schedule 1 (Form 1040) 2021 12 13 Health savings account deduction. Attach Form 8889 14 Moving expenses for members of the Armed Forces. Attach Form 3903 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 11 12 13 14 15 Deductible part of self-employment tax. Attach Schedule SE 15 16 Self-employed SEP, SIMPLE, and qualified plans 17 Self-employed health insurance deduction. 18 Penalty on early withdrawal of savings. 19a Alimony paid. b Recipient's SSN. c Date of original divorce or separation agreement (see instructions) 20 IRA deduction 16 17 18 19a 20 123-45-6788 20 IRA deduction. 21 Student loan interest deduction. 22 Reserved for future use 23 Archer MSA deduction. 24 Other adjustments: a Jury duty pay (see instructions). 24a b Deductible expenses related to income reported on line 8k from the rental of personal property engaged in for profit.. 24b c Nontaxable amount of the value of Olympic and Paralympic medals and USOC prize money reported on line 81.. 24c d Reforestation amortization and expenses 24d e Repayment of supplemental unemployment benefits under the Trade Act of 1974. f Contributions to section 501(c)(18)(D) pension plans. 24e 24f g Contributions by certain chaplains to section 403(b) plans. 249 h Attorney fees and court costs for actions involving certain unlawful discrimination claims (see instructions). 24h iAttorney fees and court costs you paid in connection with an award from the IRS for information you provided that helped the IRS detect tax law violations 241 j Housing deduction from Form 2555. 24j k Excess deductions of section 67(e) expenses from Schedule K-1 (Form 1041). 24k z Other adjustments. List type and amount 24z 20 21 22 23 3 25 Total other adjustments. Add lines 24a through 24z.. 25 26 Add lines 11 through 23 and 25. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 10, or Form 1040-NR, line 10a 26 Schedule 1 (Form 1040) 2021 Name(s) shown on Form 1040, 1040-SR, or 1040-NR David R. and Ella M. Cole 1 Part I Additional Income Taxable refunds, credits, or offsets of state and local income taxes 2a Alimony received. b Date of original divorce or separation agreement (see instructions) Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 3 Business income or (loss). Attach Schedule C.. 4 Other gains or (losses). Attach Form 4797. 5 6 7 8 Other income: Farm income or (loss). Attach Schedule F Unemployment compensation. a Net operating loss 8a ( b Gambling income. c Cancellation of debt. d Foreign earned income exclusion from Form 2555 e Taxable Health Savings Account distribution. f Alaska Permanent Fund dividends. g Jury duty pay h Prizes and awards. i Activity not engaged in for profit income. J Stock options... k Income from the rental of personal property if you engaged in the rental for profit but were not in the business of renting such property 1 Olympic and Paralympic medals and USOC prize money (see instructions)... Bb 8d ( Be 8f 8g 8h Bi 8j 8k 81 Your social security number 123-45-6788 1 2a 3 4 5 6 7 o Section 461(1) excess business loss adjustment.. p Taxable distributions from an ABLE account (see instructions) z Other income. List type and amount I 9 Total other income. Add lines Sa through Sz. 80 8p 8z 10 Combine lines 1 through 7 and 9. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 8. For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 1 (Form 1040) (2021) Part II David R. and Ella M. Cole Adjustments to Income 11 Educator expenses. 10 Cat. No. 71479F Schedule 1 (Form 1040) 2021 12 13 Health savings account deduction. Attach Form 8889 14 Moving expenses for members of the Armed Forces. Attach Form 3903 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 11 12 13 14 15 Deductible part of self-employment tax. Attach Schedule SE 15 16 Self-employed SEP, SIMPLE, and qualified plans 17 Self-employed health insurance deduction. 18 Penalty on early withdrawal of savings. 19a Alimony paid. b Recipient's SSN. c Date of original divorce or separation agreement (see instructions) 20 IRA deduction 16 17 18 19a 20 123-45-6788 20 IRA deduction. 21 Student loan interest deduction. 22 Reserved for future use 23 Archer MSA deduction. 24 Other adjustments: a Jury duty pay (see instructions). 24a b Deductible expenses related to income reported on line 8k from the rental of personal property engaged in for profit.. 24b c Nontaxable amount of the value of Olympic and Paralympic medals and USOC prize money reported on line 81.. 24c d Reforestation amortization and expenses 24d e Repayment of supplemental unemployment benefits under the Trade Act of 1974. f Contributions to section 501(c)(18)(D) pension plans. 24e 24f g Contributions by certain chaplains to section 403(b) plans. 249 h Attorney fees and court costs for actions involving certain unlawful discrimination claims (see instructions). 24h iAttorney fees and court costs you paid in connection with an award from the IRS for information you provided that helped the IRS detect tax law violations 241 j Housing deduction from Form 2555. 24j k Excess deductions of section 67(e) expenses from Schedule K-1 (Form 1041). 24k z Other adjustments. List type and amount 24z 20 21 22 23 3 25 Total other adjustments. Add lines 24a through 24z.. 25 26 Add lines 11 through 23 and 25. These are your adjustments to income. Enter here and on Form 1040 or 1040-SR, line 10, or Form 1040-NR, line 10a 26 Schedule 1 (Form 1040) 2021