Form 1969: U.S. Income Tax Return for LIBERALS
NAME
1. Legal name ___________________________
2. Yoga name ___________________________
FILING STATUS
3. Single ____
4. Married ____
5. Gay-Married ____
6. Define yourself on the gender spectrum (with 1 being Boy George and 10 being Lady Gaga) _____
7. Guantanamo Compost-Bin Fund. Please check here if you’d like $3 to go toward installing compost bins in the U.S. detention camp at Guantanamo Bay __
CANADIAN RESIDENCY
8. Please provide the address(es) where you lived in Canada from 1969 to 1973 _____, _____, _____, _____.
INCOME
9. Wages earned from government agencies, non-profits, or from teaching Pilates to homeless folks _______
9a. “Blood money” earned from for-profit exploits ________
10. Check here to donate the total amount in line 9a, above, to Clowns Without Borders __
EXEMPTIONS
11. Number of dependents, including roommates, squatters or people with whom you feel a “deep connection” ______
12. Number of human beings, denied the privilege of U.S. citizenship simply by accident of their birth, whom you allow to clean your toilets ______
ADJUSTED GROSS INCOME
Please deduct the following non-taxable expenses/hardships:
13. Total value of all Toyota Priuses in household ______
14. Amount spent on fair-trade coffee/quinoa/Hacky Sacks ______
15. Credit for water saved by not showering ______
16. Value of total miles biked in 2010, expressed in terms of degrees Fahrenheit reduction in global warming ______
17. Value of the irony inherent in the fact that we kill people who kill people to show people that killing people is wrong ______
PAYMENTS/REFUND
18. Congratulations! You are entitled to a tax refund, and the government will still have enough money to expand. Shhh. It will all work out; just sign here ____________
ADDITIONAL FORMS
To determine if you need to file additional forms, please check any of the following statements that you believe to be true:
19. The white streaks left in the sky by airplanes are “chemtrails” that contain biological/mind-control substances sprayed by the government __
20. The moon landing was faked __
If you checked any of the boxes above, please attach Schedule 420-EZ for “Medical” Marijuana Users (see below).
Schedule 420 EZ: “Medical” Marijuana Tax Form
1. Did you sell/smoke “hella” buds in 2010? __ Sure did.
1a. About how many joints/ounces/pounds? __ (a “guesstimate” will do)
2. What were the primary diagnoses being treated?
2a. Unclassifiable disease or general “vibe” __
2b. Marijuana Deficiency __
3. Is it cool if you pay some taxes?
3a. Dude! LAME to ask me that right now __
3b. Ummmm? __
3c. Right on! __
4. If you answered “right on,” would you prefer to pay your taxes in cash, or barter with Phish tickets and/or bananas? (circle one) ————–
TRUE………………….