Application for Tentative Refund                                                                     OMB No. 1545-0098
Form  1045                                                                 For individuals, estates, or trusts.  
Department of the Treasury                                      Mail in separate envelope. (Don’t attach to tax return.)                                               2022
Internal Revenue Service                                Go to www.irs.gov/Form1045 for instructions and the latest information.
                           Name(s) shown on return                                                                                              Social security or employer identification number

                           Number, street, and apt. or suite no. If a P.O. box, see instructions.                                               Spouse’s social security number (SSN)

                           City, town or post office, state, and ZIP code. If a foreign address, also complete spaces below (see instructions). Daytime phone number
             Type or print
                           Foreign country name                            Foreign province/county                                              Foreign postal code

1                          This application is     a  Net operating loss (NOL) (Sch. A, line 24)   b  Unused general business credit                  c  Net section 1256 contracts loss
                           filed to carry back:       $                                               $                                                   $ 
2 a                        For the calendar year 2022, or other tax year                                                                        b  Date tax return was filed
                           beginning                            , 2022, and ending                               , 20
3                          If this application is for an unused credit created by another carryback, enter year of first carryback:
4                          If you filed a joint return (or separate return) for some, but not all, of the tax years involved in figuring the carryback, list the years
                           and specify whether joint (J) or separate (S) return for each:
5                          If SSN for carryback year is different from above, enter               a  SSN:                and   bYear(s):
6                          If you changed your accounting period, give date permission to change was granted:
7                          Have you filed a petition in Tax Court for the year(s) to which the carryback is to be applied?  .                             . .   .  .   .    Yes      No
8                          Is any part of the decrease in tax due to a loss or credit resulting from a reportable transaction required to be 
                           disclosed on Form 8886, Reportable Transaction Disclosure Statement?  .             . .     . .                      .  .  .   . .   .  .   .    Yes      No
9                          If you are carrying back an NOL or a net section 1256 contracts loss, did this cause the release of foreign tax 
                           credits or the release of other credits due to the release of the foreign tax credit (see instructions)?  .                          .  .   .    Yes      No

                           Computation of Decrease in Tax                                         preceding            preceding                                         preceding
                                     (see instructions)                    tax year ended:                   tax year ended:                                tax year ended:
                                                                           Before                  After     Before                             After           Before        After 
Note:  If1a                   and 1c are blank, skip lines 10 through 15.  carryback               carryback carryback                          carryback     carryback     carryback

10                         NOL  deduction  after  carryback  (see 
                           instructions)  .     .  . .  .  .  . . .

11                         Adjusted gross income  .        .  . . .

12                         Deductions (see instructions)  .     . .

13                         Subtract line 12 from line 11      . . .

14                         Exemptions (see instructions)  .     . .

15                         Taxable income. Line 13 minus line 14
16                         Income tax. See instructions and attach 
                           an explanation  .       . .  .  .  . . .

17                         Excess advance payment(s) for premium 
                           tax  credit  and/or  child  tax  credit  (see 
                           instructions)  .     .  . .  .  .  . . .

18                         Alternative minimum tax  .      .  . . .

19                         Add lines 16 through 18  .      .  . . .
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.                                                     Cat. No. 10670A          Form 1045 (2022)

Form 1045 (2022)                                                                                                                           Page 2 
   Computation of Decrease in Tax                                          preceding                  preceding                   preceding
                   (continued)                       tax year ended:                        tax year ended:           tax year ended:
                                                                 Before               After Before          After     Before           After 
                                                                 carryback       carryback  carryback       carryback carryback       carryback

20       General business credit (see instructions) 
21       Net  premium  tax  credit  and  child  tax 
         credit (see instructions)  .    . . . .

22       Other credits. Identify  . .    . . . .

23       Total credits. Add lines 20 through 22 

24       Subtract line 23 from line 19     . . .

25       Self-employment tax (see instructions)

26       Additional Medicare Tax (see instructions)  
27       Net  Investment  Income  Tax  (see 
         instructions)  . .  . .    .    . . . .

28       Reserved for future use  .      . . . .

29       Other taxes  .   .  . .    .    . . . .

30       Total tax. Add lines 24 through 29 .  .

31       Enter the amount from the “After 
         carryback” column on line 30 for each 
         year    . . .    .  . .    .    . . . .

32       Decrease in tax. Line 30 minus line 31

33       Overpayment of tax due to a claim of right adjustment under section 1341(b)(1) (attach computation)          33
              Under penalties of perjury, I declare that I have examined this application and accompanying schedules and statements, and, to the best of my knowledge 
Sign          and belief, they are true, correct, and complete.
Here          Your signature                                                                                          Date
Keep a copy 
of this 
application   Spouse’s signature. If Form 1045 is filed jointly, both must sign.                                      Date
for your 
records.

              Print/Type preparer’s name                         Preparer’s signature       Date                                  PTIN
                                                                                                                  Check        if 
Paid                                                                                                              self-employed
Preparer 
Use Only      Firm’s name                                                                                   Firm’s EIN
              Firm’s address                                                                                Phone no.
                                                                                                                                  Form 1045 (2022)

Form 1045 (2022)                                                                                                 Page 3 
Schedule A—NOL (see instructions)

1  For individuals, subtract your standard deduction or itemized deductions from your adjusted gross 
   income and enter it here. For estates and trusts, enter taxable income increased by the total of the
   charitable deduction, income distribution deduction, and exemption amount (see instructions) .   .    1 
2  Nonbusiness  capital  losses  before  limitation.  Enter  as  a  positive  number 
   (see instructions)  .   . . . . . . .    .   .      . .   .  . . . .  .       .     2 
3  Nonbusiness capital gains (without regard to any section 1202 exclusion) .          3 
4  If line 2 is more than line 3, enter the difference. Otherwise, enter -0-  .  .     4 
5  If line 3 is more than line 2, enter the difference. 
   Otherwise, enter -0-  .   . . . . . .    .   .          5 
6  Nonbusiness deductions (see instructions)  . .      . .   .  . . . .  .       .     6 
7  Nonbusiness income other than capital gains (see 
   instructions)  .    . . . . . . . . .    .   .          7 
8  Add lines 5 and 7  .    . . . . . . .    .   .      . .   .  . . . .  .       .     8 
9  If line 6 is more than line 8, enter the difference. Otherwise, enter -0-   . .   . .  . . . . . .    9 

10 If line 8 is more than line 6, enter the difference. 
   Otherwise, enter -0-. But don’t enter more than 
   line 5        . . . . . . . . . . . .    .   .        10 
11 Business capital losses before limitation. Enter as a positive number  .      .     11 
12 Business  capital  gains  (without  regard  to  any 
   section 1202 exclusion)  .  . . . . .    .   .        12 
13 Add lines 10 and 12  .    . . . . . .    .   .      . .   .  . . . .  .       .     13 
14 Subtract line 13 from line 11. If zero or less, enter -0-  . . . . .  .       .     14 
15 Add lines 4 and 14  .   . . . . . . .    .   .      . .   .  . . . .  .       .     15 
16 Enter the loss, if any, from line 16 of your 2022 Schedule D (Form 1040). 
   (For estates and trusts, enter the loss, if any, from line 19, column (3), of
   Schedule D (Form 1041).) Enter as a positive number. If you don’t have a 
   loss on that line (and don’t have a section 1202 exclusion), skip lines 16 
   through 21 and enter on line 22 the amount from line 15  .     . . .  .       .     16 
17 Section 1202 exclusion. Enter as a positive number (see instructions)  .      .   . .  . . . . . .    17 
18 Subtract line 17 from line 16. If zero or less, enter -0-  . . . . .  .       .     18 
19 Enter the loss, if any, from line 21 of your 2022 Schedule D (Form 1040). 
   (For estates and trusts, enter the loss, if any, from line 20 of Schedule D 
   (Form 1041).) Enter as a positive number .   .      . .   .  . . . .  .       .     19 
20 If line 18 is more than line 19, enter the difference. Otherwise, enter -0-  .      20 
21 If line 19 is more than line 18, enter the difference. Otherwise, enter -0-  .    . .  . . . . . .    21 
22 Subtract line 20 from line 15. If zero or less, enter -0-  . . . . .  .       .   . .  . . . . . .    22 
23 NOL deduction for losses from other years. Enter as a positive number         .   . .  . . . . . .    23
24 NOL. Combine lines 1, 9, 17, and 21 through 23. If the result is less than zero, enter it here and on 
   page 1, line 1a. If the result is zero or more, you don’t have an NOL .       .   . .  . . . . . .    24
                                                                                                            Form 1045 (2022)

Form 1045 (2022)                                                                                  Page 4 
Schedule B—NOL Carryover (see instructions)

Complete one column before going to the next       preceding       preceding       preceding
column. Start with the earliest carryback year.    tax year ended: tax year ended: tax year ended:

1   NOL  deduction.  Enter as  a  positive 
    number       .  . . .    . .  . .  .  .
2   Taxable  income  before  2022  NOL 
    carryback (see instructions). For estates 
    and trusts, increase this amount by the 
    sum  of  the  charitable  deduction  and 
    income  distribution  deduction  (see 
    instructions) .   . .    . .  . .  .  .
3   Net  capital  loss  deduction  (see 
    instructions)  .  . .    . .  . .  .  .
4   Section  1202  exclusion.  Enter  as  a 
    positive number (see instructions)  . .
5   Qualified  business  income  deduction 
    (see instructions)  .    . .  . .  .  .
6   Adjustment  to  adjusted  gross  income  
    (see instructions)  .    . .  . .  .  .
7   Adjustment  to  itemized  deductions 
    (see instructions)  .    . .  . .  .  .
8   Estates  and  trusts,  enter  exemption 
    amount       .  . . .    . .  . .  .  .
9   Modified  taxable  income.  Combine 
    lines 2 through 8. If zero or less, enter 
    -0- (see instructions)  .  .  . .  .  .
10  NOL carryover (see instructions)  .   .
    Adjustment  to  Itemized  Deductions 
    (Individuals  Only) Complete  lines  11 
    through 38 for the carryback year(s) for 
    which you itemized deductions   only        if 
    line 3, 4, or 5 above is more than zero.
11  Adjusted  gross  income  before  2022 
    NOL carryback  .    .    . .  . .  .  .
12  Add lines 3 through 6 above     .  .  .
 13 Modified  adjusted  gross  income.  Add  
    lines 11 and 12  .  .    . .  . .  .  .
14  Medical  expenses  from  Sch.  A  (Form 
    1040), line 4, or as previously adjusted
15  Medical  expenses  from  Sch.  A  (Form 
    1040), line 1, or as previously adjusted
16  Multiply  line  13  by  percentage  from 
    Sch. A (Form 1040), line 3    . .  .  .
 17 Subtract line 16 from line 15. If zero or 
    less, enter -0-  .  .    . .  . .  .  .
18  Subtract line 17 from line 14 . .  .  .
                                                                                   Form 1045 (2022)

Form 1045 (2022)                                                                                Page 5 
Schedule B—NOL Carryover (continued)

Complete one column before going to the next     preceding       preceding       preceding
column. Start with the earliest carryback year.  tax year ended: tax year ended: tax year ended:

19  Mortgage  insurance  premiums  from 
    Sch.  A  (Form  1040),  line  8d,  or  as 
    previously adjusted  . .   .  .   . .

20  Refigured mortgage insurance premiums 
    (see instructions) . . .   .  .   . .
21  Subtract line 20 from line 19 .   . .
22  Modified  adjusted  gross  income  from 
    line 13 on page 4 of the form  .  . .
23  Enter  as  a  positive  number  any  NOL  
    carryback from a year before 2022 that 
    was deducted to figure line 11 on page 
    4 of the form .  . . . .   .  .   . .
24  Add lines 22 and 23  . .   .  .   . .
25  Charitable  contributions  from  Sch.  A 
    (Form  1040),  line  14,  or  Sch.  A  (Form 
    1040-NR),  line  5,  or  as  previously 
    adjusted  .  .   . . . .   .  .   . .  
26  Refigured charitable contributions (see 
    instructions)  . . . . .   .  .   . .
27  Subtract line 26 from line 25 .   . .
28  Casualty  and  theft  losses  from  Form 
    4684, line 18 .  . . . .   .  .   . .
29  Casualty  and  theft  losses  from  Form 
    4684, line 16 .  . . . .   .  .   . .
30  Multiply line 22 by 10% (0.10)  . . .
 31 Subtract line 30 from line 29. If zero or 
    less, enter -0-  . . . .   .  .   . .
32  Subtract line 31 from line 28 .   . .
33  Reserved for future use  . .  .   . .
34  Reserved for future use  . .  .   . .
35  Reserved for future use  . .  .   . .
36  Reserved for future use  . .  .   . .
37  Reserved for future use  . .  .   . .
38  Combine lines 18, 21, 27, and 32; enter 
    the result here and on line 7 (page 4)  .
                                                                                 Form 1045 (2022)