2023 IA 1040 Iowa Individual Income Tax Return tax.iowa.gov Current mailing address (number, street, apartment, lot, or suite number) or PO Box City County No. School District No. Yes You are 65 or older Spouse is 65 or older Spouse is blind You are blind No State ZIP       Social Security Number (SSN)  Spouse’s Social Security Number (SSN)  M D M D Y Y Y Y  M D M D Y Y Y Y  For fiscal or short year filers to 41-001a (08/16/2023) Last Name    First Name MI Spouse’s Last Name    Spouse’s First Name MI Check the box if this is an amended return x $40 = x $40 = x $20 = Use Residence as of 12/31/23:             Step 1: You must fill in your Social Security Number (SSN) Step 2: Filing status from federal 1040. Mark one box only Step 3: Exemptions Check if: 1. Single: Were you claimed on another person’s Iowa return? 2. Married filing jointly 3. Married filing separately. Enter your spouse’s information above. Spouse’s net income:........................................................................................... 4. Head of household. Enter qualifying person’s information on Page 2 5. Qualifying surviving spouse with dependent child. Enter dependent’s information on Page 2. 3 a. Personal Credit: Enter 1 (enter 2 if filing status 2 or 4)............................................  c. Dependents: Enter 1 for each dependent. List dependents below.............................................................................................  b. Enter 1 for each taxpayer 65 or older and/or 1 for each taxpayer who is blind...............................................................................................  d. Total. Add lines a, b and c.........................................................................................................................     Enter Dollars and Cents

2023 IA 1040, Page 2 41-001b (08/16/2023) Taxpayer’s SSN Taxpayer’s Name             Dependent’s first name Dependent’s last name Dependent’s SSN Relationship to you 1. Federal total income......................................................................................................................... 1 5. Iowa Tax from tax rate schedule or alternate tax.............................................................................. 5 9. Tuition and textbook credit for dependents K-12.............................................................................. 9 13. Nonresident or part-year resident credit. Include IA 126................................................................... 13 17. Other nonrefundable Iowa credits. Include IA 148............................................................................ 17 2. Federal taxable income..................................................................................................................... 2 6. Iowa lump-sum tax. See instructions................................................................................................ 6 10. Volunteer firefighter/EMS/reserve peace officer credit...................................................................... 10 14. BALANCE. Subtract line 13 from line 12.......................................................................................... 14 18. BALANCE. Subtract line 17 from line 16.......................................................................................... 18 3. Net Iowa modifications from IA 1040 Schedule 1, line 22................................................................. 3 7. Total Tax. Add lines 5 and 6.............................................................................................................. 7 11. Total Credits. Add lines 8, 9, and 10................................................................................................. 11 15. Out-of-State tax credit. Include IA 130.............................................................................................. 15 19. School district surtax or EMS surtax. Multiply line 18 by the percentage from table........................ 19 21. Contributions will reduce your refund or add to the amount you owe. 21 4. Iowa taxable income. Add lines 2 and 3............................................................................................ 4 8. Total exemption credit amount from Step 3...................................................................................... 8 12. BALANCE. Subtract line 11 from line 7. If less than zero, enter zero............................................... 12 16. BALANCE. Subtract line 15 from line 14.......................................................................................... 16 20. Total state tax and local surtax.......................................................................................................... 20 22. TOTAL STATE TAX, LOCAL TAX, AND CONTRIBUTIONS. Add lines 20 and 21............................ 22 Step 4: Iowa Taxable Income Step 5: Tax, Nonrefundable Credits, and Checkoff contributions Fish/Wildlife State Fair Firefighters/ Veterans Child Abuse Prevention Enter total here....................... Enter Dollars and Cents Check if using alternate tax (line 5), tax reduction calculation (line 12), or low-income exemption 

2023 IA 1040, Page 3 41-001c (08/16/2023) Taxpayer’s SSN Taxpayer’s SSN Taxpayer’s Name 23. Iowa Fuel Tax Credit. Include IA 4136 Iowa Fuel Tax Credit ............................................................ 23 26. Other refundable credits. Include IA 148........................................................................................... 26 30. TOTAL. Add lines 23 through 29....................................................................................................... 30 37. TOTAL AMOUNT DUE. ADD lines 34, 35, and 36............................................................................ 37 32. Amount of line 31 to be REFUNDED 32 33. Amount of line 31 to be applied to your 2024 estimated tax............................................................. 33 a. Routing Number 27. Composite and PTET credit. Include IA Schedule CC...................................................................... 27 34. If line 30 is less than line 22, subtract line 30 from line 22................................................................ 34 28. Iowa income tax withheld.................................................................................................................. 28 35. Penalty for underpayment of estimated tax from IA 2210, IA 2210S, or IA 2210F. Check if annualized income (IA 2210AI) or farmer/fisher (IA 2210F) method used 35 25. Iowa Earned Income Tax Credit........................................................................................................ 25 29. Estimated and other payments made for tax year 2023................................................................... 29 36. Penalty and Interest 36a. Penalty 36b. Interest Enter total here....... 36 31. If line 30 is more than line 22, subtract line 22 from line 30; otherwise, go to line 34 31 Step 6: Refundable Credits and Payments Step 7: Refund Step 8: Amount due 24. Check one: Child and Dependent Care Credit OR  Early Childhood Development Credit ........................ 24     c. Account Type Checking Savings   b. Account Number Enter Dollars and Cents

2023 IA 1040, Page 4 41-001d (08/16/2023) Taxpayer’s SSN  Taxpayer’s SSN Taxpayer’s Name   Enter Dollars and Cents A Additions B Subtractions 1. Interest..................................................................................... 1  5. Social Security Benefits........................................................... 5  9. Bonus Depreciation/Section 179 expenses............................. 9  13. Net modifications to federal total income.Subtract line 12 column B from A..................................... 13 21. Net modifications to federal taxable income. Subtract line 20 column B from A............................... 21 22. Net Iowa Modifications. Add lines 13 and 21. Enter here and IA 1040, line 3................................... 22 17. Iowa Net Operating Loss prior to 1/1/23. Include IA 124......... 17  2. Dividends................................................................................. 2  6. Active Duty Military Pay........................................................... 6  10. Federal Net Operating Loss prior to 1/1/23. Include IA 124..... 10  14. Federal income tax refund or overpayment received in 2023.. 14 18. Federal tax paid for prior years................................................ 18  3. RESERVED FOR FUTURE USE............................................. 3  7. IRA/Pension/Railroad Retirement Income............................... 7  11. Other Income........................................................................... 11  15. Health insurance deduction. See instructions.......................... 15  19. Other Adjustments................................................................... 19  4. RESERVED FOR FUTURE USE............................................. 4  8. Railroad Unemployment Income.............................................. 8  12. Total modifications to federal total income. Add lines 1 through 11............................................................. 12  16. Capital Gains Deduction. Include IA 100................................. 16  20. Total modifications to federal taxable income. Add lines 14 through 19........................................................... 20  Iowa Modifications to Federal Total Income Iowa Modifications to Federal Taxable Income Net Modifications IA 1040 Schedule 1

2023 IA 1040, Page 5 41-001e (08/16/2023) Taxpayer’s SSN  Taxpayer’s SSN Taxpayer’s Name   This return is due April 30, 2024. Sign, enclose W-2s, and verify SSNs MAILING ADDRESS: Iowa Income Tax Document Processing PO BOX 9187, Des Moines IA 50306-9187 Make checks payable to Iowa Department of Revenue Date Date Date Date of death Date of death Your Signature  Spouse’s Signature  Preparer’s Signature  Taxpayer’s email address  Your Driver License or State Issued ID number  Spouse’s Driver License or State Issued ID number  Sign Here Sign Here Paid Preparer Use M D M D Y Y Y Y  M D M D Y Y Y Y  M D M D Y Y Y Y  M D M D Y Y Y Y  M D M D Y Y Y Y    Check if deceased: Check if deceased: Taxpayer’s phone number  Preparer’s phone number  Firm’s FEIN  Preparer’s PTIN, STIN, or SSN  Step 9: I, the undersigned, declare under penalties of perjury or false certificate, that I have examined this return, and, to the best of my knowledge and belief, it is true, correct, and complete. Paper-filed returns must be signed by hand or via a digital signature with a digital certificate. Stamped or typed signatures are not accepted. ID Number (optional) City State ZIP Designee’s Name        Mailing address Email Designee’s phone number  Third Party Disclosure Designee. Do you want to allow an individual to discuss this return with the Department? See instructions.