Fillable Printable Form 8862
Fillable Printable Form 8862
Form 8862
Form 8862
(Rev. December 2012)
Department of the Treasury
Internal Revenue Service
Information To Claim Earned Income Credit
After Disallowance
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Attach to your tax return.
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Information about Form 8862 and its instructions is at www.irs.gov/form8862.
OMB No. 1545-0074
Attachment
Sequence No.
43A
Name(s) shown on returnYour social security number
Before you begin:
✓
See your tax return instructions or Pub. 596, Earned Income Credit (EIC), for the year for which you are filing
this form to make sure you can take the earned income credit (EIC) and to find out who is a qualifying child.
✓
If you have a qualifying child, complete Schedule EIC before you fill in this form.
✓
Do not file this form if you are taking the EIC without a qualifying child and the only reason your EICwas
reduced or disallowed in the earlier year was because it was determined that a child listed on Schedule
EIC was not your qualifying child.
Part I
All Filers
1Enter the year for which you are filing this form (for example, 2012) ............
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2If the only reason your EIC was reduced or disallowed in the earlier year was because you incorrectly
reported your earned income or investment income, check “Yes.” Otherwise, check “No”....
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YesNo
Caution. If you checked “Yes,” stop. Do not fill in the rest of this form. But you must attach it to your tax return to takethe
EIC. If you checked “No,” continue.
3Could you (or your spouse if filing jointly) be claimed as a qualifying child of another taxpayer for the year
shown on line 1? See the instructions before answering ...............
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YesNo
Caution. If you checked “Yes,” stop. You cannot take the EIC. If you checked “No,” continue.
Part II
Filers With a Qualifying Child or Children
Note. Child 1, Child 2, and Child 3 are the same children you listed as Child 1, Child 2, and Child 3 on Schedule EIC for the year
shown on line 1 above.
4Enter the number of days each child lived with you in the United States during the year shown on line 1 above:
a
Child 1
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bChild 2
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cChild 3
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Caution. If you entered less than 183 (184 if the year on line 1 is a leap year) for any child, you cannot take the EIC based on
that child, unless the special rule for a child who was born or died during the year shown on line 1 applies. See theinstructions.
5If your child was born or died during the year shown on line 1, enter the month and day the child was born and/or died.
Otherwise, skip this line.
a
Child 1
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(1) Month and day of birth (MM/DD)
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/
(2)Month and day of death (MM/DD)
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/
b
Child 2
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(1) Month and day of birth (MM/DD)
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/
(2)Month and day of death (MM/DD)
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/
c
Child 3
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(1) Month and day of birth (MM/DD)
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/
(2)Month and day of death (MM/DD)
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/
6Enter the address where you and the child lived together during the year shown on line 1. If you lived with the child at more
than one address during the year, attach a list of the addresses where you lived:
a
Child 1
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Number and street
City or town, state, and ZIP code
b
Child 2
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If same as shown for child 1, check this box.
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Otherwise, enter below:
Number and street
City or town, state, and ZIP code
c
If same as shown for child 1, check this box.
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Or if same as shown for child 2 (and
this is different from address shown for child 1), check this box.
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Otherwise, enter below:
Number and street
City or town, state, and ZIP code
7
Did any other person (except your spouse, if filing jointly, and your dependents under age 19) live with
child 1, child 2, or child 3 for more than half the year shown on line 1? ...........
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YesNo
If “Yes,” enter that person’s name and relationship to the child below. If more than one other person lived
with the child for more than half the year, attach a list of each person’s name and relationship to the child:
a
Other person living with child 1:
Name
Relationship to child 1
b
Other person living with child 2:
If same as shown for child 1, check this box.
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Otherwise, enter below:
Name
Relationship to child 2
c
Other person living with child 3:
If same as shown for child 1, check this box.
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Or if same as shown
for child 2 (and this is different from the person living with child 1), check this box.
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Otherwise, enter below:
Name
Relationship to child 3
Caution. The IRS may ask you to provide additional information to verify your eligibility to claim the EIC.
For Paperwork Reduction Act Notice, see page 3.
Cat. No. 25145E
Form 8862 (Rev. 12-2012)
Child 3
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Form 8862 (Rev. 12-2012)
Page 2
Part III
Filers Without a Qualifying Child
8Enter the number of days during the year shown on line 1 that you lived in the United States...
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Caution. If you entered less than 183 (184 if the year on line 1 is a leap year), stop. You cannot take the EIC. See the
instructions.
9If married filing a joint return, enter the number of daysduring the year shown on line 1 that your spouse
lived in the United States ..........................
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Caution. If you entered less than 183 (184 if the year on line 1 is a leap year),stop. You cannot take the EIC. See the
instructions.
Form 8862 (Rev. 12-2012)
Form 8862 (Rev. 12-2012)
Page 3
General Instructions
Future Developments
For the latest information about developments related to Form
8862 and its instructions, such as legislation enacted after they
were published, go to www.irs.gov/form8862.
Purpose of Form
You must complete Form 8862 and attach it to your tax return if
both of the following apply.
1. Your EIC was reduced or disallowed for any reason other
than a math or clerical error for a year after 1996.
2. You now want to take the EIC and you meet all the
requirements.
Exception 1. Do not file Form 8862 if either of the following
applies.
• After your EIC was reduced or disallowed in an earlier year (a)
you filed Form 8862 (or other documents) and your EIC was
then allowed, and (b) your EIC has not been reduced or
disallowed again for any reason other than a math or clerical
error.
• You are taking the EIC without a qualifying child and the only
reason your EIC was reduced or disallowed in the earlier year
was because it was determined that a child listed on Schedule
EIC was not your qualifying child.
In either of these cases, you can take the EIC without filing
Form 8862 if you meet all the EIC eligibility requirements.
Exception 2. Do not file Form 8862 and do not take the EIC for
the:
• 2 years after the most recent tax year for which there was a
final determination that your EIC claim was due to reckless or
intentional disregard of the EIC rules, or
• 10 years after the most recent tax year for which there was a
final determination that your EIC claim was due to fraud.
You also must attach Schedule EIC to your return if
you have a qualifying child or children. In addition to
filing Form 8862 and, if required, Schedule EIC, you
may be asked to provide other information before any
refund claimed on your return is issued. The process of
establishing your eligibility to take the EIC will delay your refund.
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!
CAUTION
Additional Information
For more details on the EIC, including the definition of a
qualifying child and who is eligible to take the EIC, see your tax
return instructions or Pub. 596, Earned Income Credit (EIC), for
the year for which you are filing Form 8862.
Specific Instructions
Need More Space for an Item?
If you do, attach a statement that is the same size as Form
8862. Number each entry on the statement to correspond with
the line number on Form 8862. Put your name and social
security number on the statement and attach it at the end of
your return.
Line 3
If your filing status is married filing jointly for the year shown on
line 1, check “No” on line 3.
Also check “No” if you could be claimed as a qualifying child
of another person for the year shown on line 1 but the other
person is not required to file, and is not filing, a tax return for
that year or is filing it only as a claim for refund. A claim for
refund is a return filed only to get a refund of withheld income
tax or estimated tax paid. A return is not a claim for refund if the
EIC or any other refundable credit is claimed on it.
Lines 4 and 5
Temporary absences, such as for school, vacation, medical
care, or detention in a juvenile facility, count as time lived at
home.
Child born or died. If your child was born or died during the
year entered on line 1 and your home was the child’s homefor
more than half the time he or she was alive during that year,
replace the number entered on line 4 for that child with
“365” ("366" if the year on line 1 is a leap year) and complete
line 5.
Lines 8 and 9
Enter the number of days you lived in the United States during
the year shown on line 1.
Example.You are single and are filing Form 8862 for2012.
Your home was in the United States for all of 2012.On line 8,
you would enter “366.”
Members of the military. If you were on extended active duty
outside the United States, your home is considered to be inthe
United States during that duty period. Include your activeduty
time on line 8 and your spouse’s, if applicable, on line 9.See
Pub. 596 for the definition of extended active duty.
Paperwork Reduction Act Notice. We ask for the information
on this form to carry out the Internal Revenue laws of theUnited
States. You are required to give us the information. Weneed it
to ensure that you are complying with these laws andto allow
us to figure and collect the right amount of tax.
You are not required to provide the information requested on
a form that is subject to the Paperwork Reduction Act unless
the form displays a valid OMB control number. Books or
records relating to a form or its instructions must be retained as
long as their contents may become material in the
administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
Internal Revenue Code section 6103.
The average time and expenses required to complete and file
this form will vary depending on individual circumstances. For
the estimated averages, see the instructions for your income tax
return.
If you have suggestions for making this form simpler, we
would be happy to hear from you. See the instructions for your
income tax return.
