gl 040 U.S. Individual Income Tax Return
Department of the Treasury - Internal Revenue Service For the year Jan. 1 - Dec. 31, 2013, or other tax year beginning

(99) 12013 ,2013, ending

_

OMB No. 1545 - 0074
,20

IRS Use Only Do not write or staple in this space.

See separate instructions.
Your social security number

Your first name and initial

Last name

JERAD GADDY
If a joint return, spouse's first name and initial Last name

072-70-1163
Spouse's social security number

Home address (number and street). If you have a P.O. box, see instructions.

Apt. no.

702 CHURCH ST
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).

A Make sure the SSN(s) above and on line 6c are correct.

Presidential Election Campaign
Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax — or refund. —

EATONTON GA 31024
Foreign country name Foreign province/county Foreign postal code

You

Spouse

Filing Status
Check only one box.

1 2 3

Single

4

Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child's name here. ►

ri Married filing separately. Enter spouse's SSN above and full name here.

Married filing jointly (even if only one had income)

Exemptions

6a b

Qualifying widow(er) with dependent child ► 5 Yourself. If someone can claim you as a dependent, do not check box 6a . Boxes checked on Spouse

j

6a and 6b No. of children on 6c who:
. . • did not live with you due to divorce or separation (see instructions)

1

Dependents:
If more than four dependents, see instructions and check here ►
Last name ( 1 ) First name TYQUAVIOUS EVANS

(2) Dependent's social security number