The document shows a 1040 form.

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[tex]$1040 E Z$[/tex]
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Income Tax Return for Single and \\
Joint Filers With No Dependents
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Income & & \begin{tabular}{l}
Wages, tips, and other income. \\
Attach Form(s) W-2 here.
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Attach \\
Form(s) W-2 \\
here.
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Other income: \\
Interest, dividends, etc.
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Add lines and enter the total
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& & Spouse & \\
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The 1040 form is used to collect:
A. state tax
B. local tax
C. federal tax
D. sales tax