Question: omplete Form 1 0 4 0 for Beth Jordan for 2 0 2 3 . Form 1 0 4 0 Department of the Treasury Internal
omplete Form for Beth Jordan for Form Department of the TreasuryInternal Revenue Service US Individual Income Tax Return OMB No IRS Use Only For the year Jan. Dec or other tax year beginning ending See separate instructions. Your first name and middle initial Beth R Jordan 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 PO box, see instructions. Skyview Road Apt. no Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $ to go to this fund. Checking a box below will not change your tax or refund. You City, town, or post office. If you have a foreign address, also complete spaces below. Mesa, AZ State ZIP code Foreign country name Foreign provincestatecounty Foreign postal code Filing Status Single Digital Assets At any time during 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 assetSee instructions. No Standard Deduction Someone can claim: None AgeBlindness You: None Spouse: None Dependents If more than four dependents, see instructions and check here see instructions: Social security number Relationship to you Check the box if qualifies for see instructions: First name Last name Child tax credit Credit for other dependents Income
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