TAX YEAR: 2024 PROCESS DATE: 12/11/2024

CLIENT : 257-00-4321 WHITNEY M REFUND BIRTH DATE : 03/01/1979 Age:45

ADDRESS : 4175 SPRING ST PREPARER : 125

: EVANS GA 30809

Main : (706) 868-0985 PREPARER FEE :

Cell : (706) 868-2985 ELECTRONIC :
Work : TOTAL FEES :
STATUS : HEAD OF HOUSEHOLD
FED TYPE: Regular Tax
ST TYPE : Regular Tax EFFECTIVE RATE: 0.00%
E-MAIL : WHITNEYREFUND@[Link]
_____________________________________________________________________________________
DEPENDENT NAME
__________________________________________________________________________________
BIRTH DATE AGE SSN RELATIONSHIP MONTHS
JEREMY D REFUND 05/03/2013 11 364-00-5654 SON 12
_____________________________________________________________________________________

LISTING OF FORMS FOR THIS RETURN

________________________________
FORM 1040
SCHEDULE 3 (ADDITIONAL CREDITS AND PAYMENTS)
FORM W-2
SCHEDULE EIC (EARNED INCOME CREDIT)
FORM 2441 (CHILD CARE CREDIT)
FORM 8812 (CREDITS FOR QUALIFYING CHILDREN AND OTHER DEPENDENTS)
FORM 8867 (DUE DILIGENCE CHECKLIST)

_____________________________________________________________________________________
* QUICK SUMMARY *
__________________________________________________________________________
SUMMARY FEDERAL
FILING STATUS 4
TOTAL INCOME 26263
TOTAL ADJUSTMENTS 0
ADJUSTED GROSS INCOME 26263
DEDUCTIONS 21900
EXEMPTIONS 0
TAXABLE INCOME 4363
TAX 438
CREDITS 438
PAYMENTS 5609
REFUND 5609
AMOUNT DUE 0

EARNED INCOME CREDIT 3645

 CLIENT : WHITNEY REFUND 257-00-4321

PREPARER : 125 DATE : 12/11/2024

_____________________________________________________________________________________
* W-2 INCOME FORMS SUMMARY *
_____________________________________________________________________________________

FEDERAL FICA MEDICARE STATE

__________________________________________________________________________________________
T/S EIN EMPLOYER WAGES TX/WH TX/WH TX/WH TX/WH ST
1. T 58-6412038 GEORGIA DEPT OF REV 26263 264 1628 381 564 GA

TOTALS...... 26263 264 1628 381 564

 a Employee’s social security number
257-00-4321 OMB No. 1545-0008
b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld
58-6412038 26263 264
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld
GEORGIA DEPT OF REVENUE 26263 1628
610 RONALD REAGAN DR 5 Medicare wages and tips 6 Medicare tax withheld
EVANS GA 30809 26263 381
7 Social security tips 8 Allocated tips

d Control number 9 10 Dependent care benefits

e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a
C
o
WHITNEY M REFUND d
e
Statutory Retirement Third-party
4175 SPRING ST 13 employee plan sick pay
12b
C
o
EVANS GA 30809 d
e

14 Other 12c
C
o
d
e

12d
C
o
d
e

f Employee’s address and ZIP code

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

GA 28594178 26263 564

Form W-2 Wage and Tax Statement

a Employee’s social security number
2024 Department of the Treasury—Internal Revenue Service

OMB No. 1545-0008

b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld

c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld

5 Medicare wages and tips 6 Medicare tax withheld

7 Social security tips 8 Allocated tips

d Control number 9 10 Dependent care benefits

e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a
C
o
d
e

13 Statutory Retirement Third-party 12b

employee plan sick pay C
o
d
e

14 Other 12c
C
o
d
e

12d
C
o
d
e

f Employee’s address and ZIP code

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement

Department of the Treasury—Internal Revenue Service
 1040 U.S. Individual Income Tax Return 2024
Form Department of the Treasury—Internal Revenue Service

OMB No. 1545-0074 IRS Use Only—Do not write or staple in this space.

For the year Jan. 1–Dec. 31, 2024, or other tax year beginning , 2024, ending , 20 See separate instructions.
Your first name and middle initial Last name Your social security number
WHITNEY M REFUND 257-00-4321
If joint return, spouse’s first name and middle initial Last name Spouse’s social security number

Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Presidential Election Campaign
4175 SPRING ST Check here if you, or your
City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3
to go to this fund. Checking a
EVANS GA 30809 box below will not change
Foreign country name Foreign province/state/county Foreign postal code your tax or refund.
You Spouse

Filing Status Single x Head of household (HOH)

Married filing jointly (even if only one had income)
Check only
one box. Married filing separately (MFS) Qualifying surviving spouse (QSS)
If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child’s name if the
qualifying person is a child but not your dependent:
If treating a nonresident alien or dual-status alien spouse as a U.S. resident for the entire tax year, check the box and enter
their name (see instructions and attach statement if required):

Digital At any time during 2024, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell,
Assets exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) Yes X No
Standard Someone can claim: You as a dependent Your spouse as a dependent
Deduction Spouse itemizes on a separate return or you were a dual-status alien

Age/Blindness You: Were born before January 2, 1960 Are blind Spouse: Was born before January 2, 1960 Is blind
Dependents (see instructions): (2) Social security (3) Relationship (4) Check the box if qualifies for (see instructions):
(1) First name Last name number to you Child tax credit Credit for other dependents
If more
than four JEREMY D REFUND 364-00-5654 SON X
dependents,
see instructions
and check
here . .

Income 1a Total amount from Form(s) W-2, box 1 (see instructions) . . . . . . . . . . . . . 1a 26263
b Household employee wages not reported on Form(s) W-2 . . . . . . . . . . . . . 1b
Attach Form(s)
W-2 here. Also c Tip income not reported on line 1a (see instructions) . . . . . . . . . . . . . . 1c
attach Forms d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) . . . . . . . . 1d
W-2G and
1099-R if tax e Taxable dependent care benefits from Form 2441, line 26 . . . . . . . . . . . . 1e
was withheld. f Employer-provided adoption benefits from Form 8839, line 29 . . . . . . . . . . . 1f
If you did not g Wages from Form 8919, line 6 . . . . . . . . . . . . . . . . . . . . . 1g
get a Form
W-2, see
h Other earned income (see instructions) . . . . . . . . . . . . . . . . . . 1h
instructions. i Nontaxable combat pay election (see instructions) . . . . . . . 1i
z Add lines 1a through 1h . . . . . . . . . . . . . . . . . . . . . . 1z 26263
Attach Sch. B 2a Tax-exempt interest . . . 2a b Taxable interest . . . . . 2b
if required. 3a Qualified dividends . . . 3a b Ordinary dividends . . . . . 3b
4a IRA distributions . . . . 4a b Taxable amount . . . . . . 4b
Standard
Deduction for— 5a Pensions and annuities . . 5a b Taxable amount . . . . . . 5b
• Single or 6a Social security benefits . . 6a b Taxable amount . . . . . . 6b
Married filing
separately, c If you elect to use the lump-sum election method, check here (see instructions) . . . . .
$14,600 7 Capital gain or (loss). Attach Schedule D if required. If not required, check here . . . . . 7
• Married filing
jointly or 8 Additional income from Schedule 1, line 10 . . . . . . . . . . . . . . . . . 8
Qualifying
surviving spouse, 9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income . . . . . . . . . . 9 26263
$29,200 10 Adjustments to income from Schedule 1, line 26 . . . . . . . . . . . . . . . 10
• Head of
household, 11 Subtract line 10 from line 9. This is your adjusted gross income . . . . . . . . . . 11 26263
$21,900
• If you checked
12 Standard deduction or itemized deductions (from Schedule A) . . . . . . . . . . 12 21900
any box under 13 Qualified business income deduction from Form 8995 or Form 8995-A . . . . . . . . . 13
Standard
Deduction, 14 Add lines 12 and 13 . . . . . . . . . . . . . . . . . . . . . . . . 14 21900
see instructions.
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income . . . . . 15 4363
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2024)
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 REFUND 257-00-4321
Form 1040 (2024) Page 2

Tax and 16 Tax (see instructions). Check if any from Form(s): 1 8814 2 4972 3 . . 16 438
Credits 17 Amount from Schedule 2, line 3 . . . . . . . . . . . . . . . . . . . . 17
18 Add lines 16 and 17 . . . . . . . . . . . . . . . . . . . . . . . . 18 438
19 Child tax credit or credit for other dependents from Schedule 8812 . . . . . . . . . . 19
20 Amount from Schedule 3, line 8 . . . . . . . . . . . . . . . . . . . . 20 438
21 Add lines 19 and 20 . . . . . . . . . . . . . . . . . . . . . . . . 21 438
22 Subtract line 21 from line 18. If zero or less, enter -0- . . . . . . . . . . . . . . 22 0
23 Other taxes, including self-employment tax, from Schedule 2, line 21 . . . . . . . . . 23 0
24 Add lines 22 and 23. This is your total tax . . . . . . . . . . . . . . . . . 24 0
Payments 25 Federal income tax withheld from:
a Form(s) W-2 . . . . . . . . . . . . . . . . . . 25a 264
b Form(s) 1099 . . . . . . . . . . . . . . . . . . 25b
c Other forms (see instructions) . . . . . . . . . . . . . 25c
d Add lines 25a through 25c . . . . . . . . . . . . . . . . . . . . . . 25d 264
If you have a 26 2024 estimated tax payments and amount applied from 2023 return . . . . . . . . . . 26
qualifying child, 27 Earned income credit (EIC) . . . . . . . . . . . . . . 27 3645
attach Sch. EIC.
28 Additional child tax credit from Schedule 8812 . . . . . . . . 28 1700
29 American opportunity credit from Form 8863, line 8 . . . . . . . 29
30 Reserved for future use . . . . . . . . . . . . . . . 30
31 Amount from Schedule 3, line 15 . . . . . . . . . . . . 31
32 Add lines 27, 28, 29, and 31. These are your total other payments and refundable credits . . 32 5345
33 Add lines 25d, 26, and 32. These are your total payments . . . . . . . . . . . . 33 5609
Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid . . 34 5609
35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here . . . . 35a 5609
Direct deposit? b Routing number X X X X X X X X X c Type: Checking Savings
See instructions.
d Account number X X X X X X X X X X X X X X X X X
36 Amount of line 34 you want applied to your 2025 estimated tax . . . 36
Amount 37 Subtract line 33 from line 24. This is the amount you owe.
You Owe For details on how to pay, go to [Link]/Payments or see instructions . . . . . . . . 37
38 Estimated tax penalty (see instructions) . . . . . . . . . . 38
Third Party Do you want to allow another person to discuss this return with the IRS? See
Designee instructions . . . . . . . . . . . . . . . . . . . . . Yes. Complete below. X No
Designee’s Phone Personal identification
name no. number (PIN)

Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here Your signature Date Your occupation If the IRS sent you an Identity
Protection PIN, enter it here
(see inst.)
Joint return? LIBRARIAN
See instructions. Spouse’s signature. If a joint return, both must sign. Date Spouse’s occupation If the IRS sent your spouse an
Keep a copy for Identity Protection PIN, enter it here
your records. (see inst.)

Phone no. (706) 868-0985 Email address WHITNEYREFUND@[Link]

Preparer’s name Preparer’s signature Date PTIN Check if:
Paid PRACTICE PREPARER 12/11/24 P00000000 Self-employed
Preparer
Firm’s name THE PRACTICE RETURN COMPANY Phone no. 706-868-0985
Use Only
Firm’s address 945 BROAD ST AUGUSTA GA 30901 Firm’s EIN
Go to [Link]/Form1040 for instructions and the latest information. Form 1040 (2024)
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SCHEDULE 3 OMB No. 1545-0074
Additional Credits and Payments
2024
(Form 1040)
Attach to Form 1040, 1040-SR, or 1040-NR.
Department of the Treasury Attachment
Internal Revenue Service Go to [Link]/Form1040 for instructions and the latest information. Sequence No. 03
Name(s) shown on Form 1040, 1040-SR, or 1040-NR Your social security number
WHITNEY REFUND 257-00-4321
Part I Nonrefundable Credits
1 Foreign tax credit. Attach Form 1116 if required . . . . . . . . . . . . . . . . . . 1
2 Credit for child and dependent care expenses from Form 2441, line 11. Attach Form 2441 . . . . 2 438
3 Education credits from Form 8863, line 19 . . . . . . . . . . . . . . . . . . . . 3
4 Retirement savings contributions credit. Attach Form 8880 . . . . . . . . . . . . . . 4
5a Residential clean energy credit from Form 5695, line 15 . . . . . . . . . . . . . . . 5a
b Energy efficient home improvement credit from Form 5695, line 32 . . . . . . . . . . . 5b
6 Other nonrefundable credits:
a General business credit. Attach Form 3800 . . . . . . . . . . . . 6a
b Credit for prior year minimum tax. Attach Form 8801 . . . . . . . . 6b
c Adoption credit. Attach Form 8839 . . . . . . . . . . . . . . 6c
d Credit for the elderly or disabled. Attach Schedule R . . . . . . . . 6d
e Reserved for future use . . . . . . . . . . . . . . . . . . 6e
f Clean vehicle credit. Attach Form 8936 . . . . . . . . . . . . . 6f
g Mortgage interest credit. Attach Form 8396 . . . . . . . . . . . 6g
h District of Columbia first-time homebuyer credit. Attach Form 8859 . . . . 6h
i Qualified electric vehicle credit. Attach Form 8834 . . . . . . . . . 6i
j Alternative fuel vehicle refueling property credit. Attach Form 8911 . . . . 6j
k Credit to holders of tax credit bonds. Attach Form 8912 . . . . . . . 6k
l Amount on Form 8978, line 14. See instructions . . . . . . . . . . 6l
m Credit for previously owned clean vehicles. Attach Form 8936 . . . . . 6m
z Other nonrefundable credits. List type and amount:
6z
7 Total other nonrefundable credits. Add lines 6a through 6z . . . . . . . . . . . . . . 7
8 Add lines 1 through 4, 5a, 5b, and 7. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 20 . 8 438
Part II Other Payments and Refundable Credits
9 Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . . . . . . . . . 9
10 Amount paid with request for extension to file (see instructions) . . . . . . . . . . . . . 10
11 Excess social security and tier 1 RRTA tax withheld . . . . . . . . . . . . . . . . . 11
12 Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . . . . . . . . . 12
13 Other payments or refundable credits:
a Form 2439 . . . . . . . . . . . . . . . . . . . . . . 13a
b Section 1341 credit for repayment of amounts included in income from earlier
years . . . . . . . . . . . . . . . . . . . . . . . . 13b
c Net elective payment election amount from Form 3800, Part III, line 6, column (j) 13c
d Deferred amount of net 965 tax liability (see instructions) . . . . . . . 13d
z Other refundable credits (see instructions):
13z
14 Total other payments or refundable credits. Add lines 13a through 13z . . . . . . . . . . 14
15 Add lines 9 through 12 and 14. Enter here and on Form 1040, 1040-SR, or 1040-NR, line 31 . . . 15
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 3 (Form 1040) 2024

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Form 2441 Child and Dependent Care Expenses
OMB No. 1545-0074

2024
Department of the Treasury
Attach to Form 1040, 1040-SR, or 1040-NR.
Attachment
Internal Revenue Service Go to [Link]/Form2441 for instructions and the latest information. Sequence No. 21
Name(s) shown on return Your social security number

WHITNEY REFUND 257-00-4321

A You can’t claim a credit for child and dependent care expenses if your filing status is married filing separately unless you meet the
requirements listed in the instructions under Married Persons Filing Separately. If you meet these requirements, check this box . .
B If you or your spouse was a student or was disabled during 2024 and you’re entering deemed income of $250 or $500 a month on
Form 2441 based on the income rules listed in the instructions under If You or Your Spouse Was a Student or Disabled, check this box .
Part I Persons or Organizations Who Provided the Care—You must complete this part.
If you have more than three care providers, see the instructions and check this box . . . . . . . .
(d) Was the care provider your
household employee in 2024?
1 (a) Care provider’s (b) Address (c) Identifying number
For example, this generally includes
(e) Amount paid
name (number, street, apt. no., city, state, and ZIP code) (SSN or EIN) (see instructions)
nannies but not daycare centers.
(see instructions)

330 N BELAIR RD
SUNSHINE HOUSE 58-9632100 Yes X No 3800
EVANS GA 30809
Yes No

Yes No

Did you receive No Complete only Part II below.

dependent care benefits?
Yes Complete Part III on page 2 next.

Caution: If the care provider is your household employee, you may owe employment taxes. For details, see the Instructions for
Schedule H (Form 1040). If you incurred care expenses in 2024 but didn’t pay them until 2025, or if you prepaid in 2024 for care to be
provided in 2025, don’t include these expenses in column (d) of line 2 for 2024. See the instructions.
Part II Credit for Child and Dependent Care Expenses
2 Information about your qualifying person(s). If you have more than three qualifying persons, see the instructions and check this box
(c) Check here if the (d) Qualified expenses
(a) Qualifying person’s name (b) Qualifying person’s qualifying person was over you incurred and paid
social security number age 12 and was disabled. in 2024 for the person
First Last (see instructions) listed in column (a)
JEREMY REFUND 364-00-5654 3800

3 Add the amounts in column (d) of line 2. Don’t enter more than $3,000 if you had one qualifying person
or $6,000 if you had two or more persons. If you completed Part III, enter the amount from line 31 . 3 3000
4 Enter your earned income. See instructions . . . . . . . . . . . . . . . . . 4 26263
5 If married filing jointly, enter your spouse’s earned income (if you or your spouse was a student
or was disabled, see the instructions); all others, enter the amount from line 4 . . . . . . 5 26263
6 Enter the smallest of line 3, 4, or 5 . . . . . . . . . . . . . . . . . . . . 6 3000
7 Enter the amount from Form 1040, 1040-SR, or 1040-NR, line 11 . . . 7 26263
8 Enter on line 8 the decimal amount shown below that applies to the amount on line 7.
If line 7 is: If line 7 is: If line 7 is:
But not Decimal But not Decimal But not Decimal
Over over amount is Over over amount is Over over amount is
$0—15,000 .35 $25,000—27,000 .29 $37,000—39,000 .23
15,000—17,000 .34 27,000—29,000 .28 39,000—41,000 .22
8 29
17,000—19,000 .33 29,000—31,000 .27 41,000—43,000 .21
19,000—21,000 .32 31,000—33,000 .26 43,000—No limit .20
21,000—23,000 .31 33,000—35,000 .25
23,000—25,000 .30 35,000—37,000 .24
9a Multiply line 6 by the decimal amount on line 8 . . . . . . . . . . . . . . . . 9a 870
b If you paid 2023 expenses in 2024, complete Worksheet A in the instructions. Enter the amount
from line 13 of the worksheet here. Otherwise, enter -0- on line 9b and go to line 9c . . . . 9b
c Add lines 9a and 9b and enter the result . . . . . . . . . . . . . . . . . . 9c 870
10 Tax liability limit. Enter the amount from the Credit Limit Worksheet in the instructions 10 438
11 Credit for child and dependent care expenses. Enter the smaller of line 9c or line 10 here and
on Schedule 3 (Form 1040), line 2 . . . . . . . . . . . . . . . . . . . . . 11 438
For Paperwork Reduction Act Notice, see your tax return instructions. Form 2441 (2024)
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SCHEDULE EIC Earned Income Credit OMB No. 1545-0074
(Form 1040) Qualifying Child Information
Complete and attach to Form 1040 or 1040-SR only if you have a qualifying child.
2024
Department of the Treasury Attachment
Go to [Link]/ScheduleEIC for the latest information. Sequence No. 43
Internal Revenue Service
Name(s) shown on return Your social security number
WHITNEY REFUND 257-00-4321
If you are separated from your spouse, filing a separate return, and meet the requirements to claim the EIC (see instructions), check here

Before you begin: • See the instructions for Form 1040, line 27, to make sure that (a) you can take the EIC, and (b) you have a
qualifying child. See also Pub. 596.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social
security card. Otherwise, at the time we process your return, we may reduce your EIC. If the name or SSN on
the child’s social security card is not correct, call the Social Security Administration at 800-772-1213.
• If you have a child who meets the conditions to be your qualifying child for purposes of claiming the EIC, but that
child doesn’t have an SSN as defined in the instructions for Form 1040, line 27, see the instructions.
• You can’t claim the EIC for a child who didn’t live with you for more than half of the year.

F
!
CAUTION
• If your child doesn’t have an SSN as defined in the instructions for Form 1040, line 27, see the instructions.
• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details.
• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

Qualifying Child Information Child 1 Child 2 Child 3

1 Child’s name First name Last name First name Last name First name Last name

If you have more than three qualifying

children, you have to list only three to get
the maximum credit. JEREMY REFUND
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040, line 27,
unless the child was born and died in 2024
or you are claiming the self-only EIC (see
instructions). If your child was born and
died in 2024 and did not have an SSN,
enter “Died” on this line and attach a copy
of the child’s birth certificate, death
certificate, or hospital medical records
showing a live birth. 364-00-5654
3 Child’s year of birth Year 2 0 1 3 Year Year
If born after 2005 and the child is If born after 2005 and the child is If born after 2005 and the child is
younger than you (or your spouse, younger than you (or your spouse, younger than you (or your spouse,
if filing jointly), skip lines 4a and if filing jointly), skip lines 4a and if filing jointly), skip lines 4a and
4b; go to line 5. 4b; go to line 5. 4b; go to line 5.

4a Was the child under age 24 at the end of

2024, a student, and younger than you (or Yes. No. Yes. No. Yes. No.
your spouse, if filing jointly)?
Go to Go to line 4b. Go to Go to line 4b. Go to Go to line 4b.
line 5. line 5. line 5.
b Was the child permanently and totally
disabled during any part of 2024? Yes. No. Yes. No. Yes. No.
Go to The child is not a Go to The child is not a Go to The child is not a
line 5. qualifying child. line 5. qualifying child. line 5. qualifying child.
5 Child’s relationship to you
(for example, son, daughter, grandchild,
niece, nephew, eligible foster child, etc.) SON
6 Number of months child lived
with you in the United States
during 2024
• If the child lived with you for more than
half of 2024 but less than 7 months,
enter “7.”
• If the child was born or died in 2024 and 12
your home was the child’s home for more months months months
than half the time they were alive during Do not enter more than 12 Do not enter more than 12 Do not enter more than 12
2024, enter “12.” months. months. months.
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule EIC (Form 1040) 2024

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SCHEDULE 8812 Credits for Qualifying Children OMB No. 1545-0074
(Form 1040) and Other Dependents
Attach to Form 1040, 1040-SR, or 1040-NR.
2024
Department of the Treasury Attachment
Internal Revenue Service Go to [Link]/Schedule8812 for instructions and the latest information. Sequence No. 47
Name(s) shown on return Your social security number
WHITNEY REFUND 257-00-4321
Part I Child Tax Credit and Credit for Other Dependents
1 Enter the amount from line 11 of your Form 1040, 1040-SR, or 1040-NR . . . . . . . . . . . . 1 26263
2a Enter income from Puerto Rico that you excluded . . . . . . . . . . . 2a
b Enter the amounts from lines 45 and 50 of your Form 2555 . . . . . . . . 2b
c Enter the amount from line 15 of your Form 4563 . . . . . . . . . . . 2c
d Add lines 2a through 2c . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d
3 Add lines 1 and 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 26263
4 Number of qualifying children under age 17 with the required social security number 4 1
5 Multiply line 4 by $2,000 . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2000
6 Number of other dependents, including any qualifying children who are not under age
17 or who do not have the required social security number . . . . . . . . 6
Caution: Do not include yourself, your spouse, or anyone who is not a U.S. citizen, U.S. national, or U.S. resident
alien. Also, do not include anyone you included on line 4.
7 Multiply line 6 by $500 . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Add lines 5 and 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2000
9 Enter the amount shown below for your filing status.
• Married filing jointly—$400,000
• All other filing statuses—$200,000 } . . . . . . . . . . . . . . . . . . . . . . 9 200000
10 Subtract line 9 from line 3.

}
• If zero or less, enter -0-.
• If more than zero and not a multiple of $1,000, enter the next multiple of $1,000. For
example, if the result is $425, enter $1,000; if the result is $1,025, enter $2,000, etc. . . . . . . . 10
11 Multiply line 10 by 5% (0.05) . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Is the amount on line 8 more than the amount on line 11? . . . . . . . . . . . . . . . . . 12 2000
No. STOP. You cannot take the child tax credit, credit for other dependents, or additional child tax credit.
Skip Parts II-A and II-B. Enter -0- on lines 14 and 27.
X Yes. Subtract line 11 from line 8. Enter the result.
13 Enter the amount from Credit Limit Worksheet A . . . . . . . . . . . . . . . . . . 13
14 Enter the smaller of line 12 or line 13. This is your child tax credit and credit for other dependents . . . 14
Enter this amount on Form 1040, 1040-SR, or 1040-NR, line 19.
If the amount on line 12 is more than the amount on line 14, you may be able to take the additional child tax credit
on Form 1040, 1040-SR, or 1040-NR, line 28. Complete your Form 1040, 1040-SR, or 1040-NR through line 27
(also complete Schedule 3, line 11) before completing Part II-A.
For Paperwork Reduction Act Notice, see your tax return instructions. Schedule 8812 (Form 1040) 2024
QNA
 WHITNEY REFUND 257-00-4321
Schedule 8812 (Form 1040) 2024 Page 2
Part II-A Additional Child Tax Credit for All Filers
Caution: If you file Form 2555, you cannot claim the additional child tax credit.
15 Check this box if you do not want to claim the additional child tax credit. Skip Parts II-A and II-B. Enter -0- on line 27 . . . . .
16a Subtract line 14 from line 12. If zero, stop here; you cannot take the additional child tax credit. Skip Parts II-A
and II-B. Enter -0- on line 27 . . . . . . . . . . . . . . . . . . . . . . . . . 16a 2000
b Number of qualifying children under age 17 with the required social security number: 1 x $1,700.
Enter the result. If zero, stop here; you cannot claim the additional child tax credit. Skip Parts II-A and II-B.
Enter -0- on line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16b 1700
TIP: The number of children you use for this line is the same as the number of children you used for line 4.
17 Enter the smaller of line 16a or line 16b . . . . . . . . . . . . . . . . . . . . . . 17 1700
18a Earned income (see instructions) . . . . . . . . . . . . . . . . 18a 26263
b Nontaxable combat pay (see instructions) . . . . . . 18b
19 Is the amount on line 18a more than $2,500?
No. Leave line 19 blank and enter -0- on line 20.
X Yes. Subtract $2,500 from the amount on line 18a. Enter the result . . . . 19 23763
20 Multiply the amount on line 19 by 15% (0.15) and enter the result . . . . . . . . . . . . . . 20 3564
Next. On line 16b, is the amount $5,100 or more?
X No. If you are a bona fide resident of Puerto Rico, go to line 21. Otherwise, skip Part II-B and enter the
smaller of line 17 or line 20 on line 27.
Yes. If line 20 is equal to or more than line 17, skip Part II-B and enter the amount from line 17 on line 27.
Otherwise, go to line 21.
Part II-B Certain Filers Who Have Three or More Qualifying Children and Bona Fide Residents of Puerto Rico
21 Withheld social security, Medicare, and Additional Medicare taxes from Form(s) W-2,
boxes 4 and 6. If married filing jointly, include your spouse’s amounts with yours. If
your employer withheld or you paid Additional Medicare Tax or tier 1 RRTA taxes, or
if you are a bona fide resident of Puerto Rico, see instructions. . . . . . . . 21
22 Enter the total of the amounts from Schedule 1 (Form 1040), line 15; Schedule 2 (Form
1040), line 5; Schedule 2 (Form 1040), line 6; and Schedule 2 (Form 1040), line 13 . 22
23 Add lines 21 and 22 . . . . . . . . . . . . . . . . . . . . 23
24 1040 and
1040-SR filers: Enter the total of the amounts from Form 1040 or 1040-SR, line 27,
and Schedule 3 (Form 1040), line 11.
1040-NR filers: Enter the amount from Schedule 3 (Form 1040), line 11.
}
24
25 Subtract line 24 from line 23. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . 25
26 Enter the larger of line 20 or line 25 . . . . . . . . . . . . . . . . . . . . . . . 26
Next, enter the smaller of line 17 or line 26 on line 27.
Part II-C Additional Child Tax Credit
27 This is your additional child tax credit. Enter this amount on Form 1040, 1040-SR, or 1040-NR, line 28 . . 27 1700
QNA Schedule 8812 (Form 1040) 2024
Form 8867 Paid Preparer’s Due Diligence Checklist
Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC),
OMB No. 1545-0074
For tax year
(Rev. November 2024)
Child Tax Credit (CTC) (including the Additional Child Tax Credit (ACTC) and 20 24
Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
Department of the Treasury To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, or 1040-SS. Attachment
Internal Revenue Service Go to [Link]/Form8867 for instructions and the latest information. Sequence No. 70
Taxpayer name(s) shown on return Taxpayer identification number
WHITNEY REFUND 257-00-4321
Preparer’s name Preparer tax identification number
PRACTICE PREPARER P00000000
Part I Due Diligence Requirements
Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I–V
for the benefit(s) claimed (check all that apply). X EIC X CTC/ACTC/ODC AOTC X HOH
1 Did you complete the return based on information for the applicable tax year provided by the taxpayer Yes No N/A
or reasonably obtained by you? . . . . . . . . . . . . . . . . . . . . . . . X
2 If credits are claimed on the return, did you complete the applicable EIC and/or CTC/ACTC/ODC
worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-SS, or Schedule 8812 (Form 1040)
instructions, and/or the AOTC worksheet found in the Form 8863 instructions, or your own worksheet(s)
that provides the same information, and all related forms and schedules for each credit claimed? . . X
3 Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of
the following.
• Interview the taxpayer, ask questions, and contemporaneously document the taxpayer’s responses to
determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.
• Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of any credit(s) . . . . . . . . . . . . . . . . . X
4 Did any information provided by the taxpayer or a third party for use in preparing the return, or
information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If “Yes,”
answer questions 4a and 4b. If “No,” go to question 5.) . . . . . . . . . . . . . . . X
a Did you make reasonable inquiries to determine the correct, complete, and consistent information? .
b Did you contemporaneously document your inquiries? (Documentation should include the questions
you asked, whom you asked, when you asked, the information that was provided, and the impact the
information had on your preparation of the return.) . . . . . . . . . . . . . . . . .
5 Did you satisfy the record retention requirement? To meet the record retention requirement, you must
keep a copy of your documentation referenced in question 4b, a copy of this Form 8867, a copy of any
applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to figure
the amount(s) of the credit(s) . . . . . . . . . . . . . . . . . . . . . . . . X
List those documents provided by the taxpayer, if any, that you relied on:

6 Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
credit(s) and/or HOH filing status and the amount(s) of any credit(s) claimed on the return if his/her
return is selected for audit? . . . . . . . . . . . . . . . . . . . . . . . . . X
7 Did you ask the taxpayer if any of these credits were disallowed or reduced in a previous year? . . X
(If credits were disallowed or reduced, go to question 7a; if not, go to question 8.)
a Did you complete the required recertification Form 8862? . . . . . . . . . . . . . . .
8 If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete and
correct Schedule C (Form 1040)? . . . . . . . . . . . . . . . . . . . . . . . X
For Paperwork Reduction Act Notice, see separate instructions. Form 8867 (Rev. 11-2024)

QNA
 WHITNEY M REFUND 257-00-4321
Form 8867 (Rev. 11-2024) Page 2
Part II Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
9a Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children Yes No N/A
claimed, or is eligible to claim the EIC without a qualifying child? (If the taxpayer is claiming the EIC
and does not have a qualifying child, go to question 10.) . . . . . . . . . . . . . . X
b Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer
has supported the child the entire year? . . . . . . . . . . . . . . . . . . . . . X
c Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of
more than one person (tiebreaker rules)? . . . . . . . . . . . . . . . . . . . . X
Part III Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC,
or ODC, go to Part IV.)
10 Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer’s dependent who is Yes No N/A
a citizen, national, or resident of the United States? . . . . . . . . . . . . . . . . . . X
11 Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the child has not lived with
the taxpayer for over half of the year, even if the taxpayer has supported the child, unless the child’s
custodial parent has released a claim to exemption for the child? . . . . . . . . . . . . X
12 Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or
separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar
statement to the return? . . . . . . . . . . . . . . . . . . . . . . . . . . X
Part IV Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
13 Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified Yes No
tuition and related expenses for the claimed AOTC? . . . . . . . . . . . . . . . . . . . .
Part V Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)
14 Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year Yes No
and provided more than half of the cost of keeping up a home for the year for a qualifying person? . . . . X
Part VI Eligibility Certification
You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing status
on the return of the taxpayer identified above if you:
A. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer’s responses on the return or
in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of the credit(s);
B. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable
credit(s) claimed and HOH filing status, if claimed;
C. Submit Form 8867 in the manner required; and
D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under
Document Retention.
1. A copy of this Form 8867.
2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
3. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer’s eligibility for the
credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was
obtained.
5. A record of any additional information you relied upon, including questions you asked and the taxpayer’s responses, to
determine the taxpayer’s eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).

If you have not complied with all due diligence requirements, you may have to pay a penalty for each failure to comply
related to a claim of an applicable credit or HOH filing status (see instructions for more information).
15 Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and Yes No
complete? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
Form 8867 (Rev. 11-2024)
QNA
WHITNEY REFUND 257-00-4321
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 WHITNEY REFUND 257-00-4321
È»º¿Ê¿Ã¿ÊÅÈÁɾ»»Ê

1. Enter the amount from line 18 of your Form 1040, 1040-SR, or 1040-NR. 1 438

2. Add the following amounts (if applicable) from:

Schedule 3, line 1 . . . . . . . . . . . +
Schedule 3, line 2 . . . . . . . . . . . +
438
Schedule 3, line 3 . . . . . . . . . . . +
Schedule 3, line 4 . . . . . . . . . . . +
Schedule 3, line 6d . . . . . . . . . . +
Schedule 3, line 6e . . . . . . . . . . +
Schedule 3, line 6f . . . . . . . . . . +
Schedule 3, line 6l . . . . . . . . . . +
Form 5695, line 30 . . . . . . . . . . +

438
Enter the total. 2

3. Subtract line 2 from line 1. 3

Complete the Credit Limit Worksheet B only if you meet all of the following.
1. You are claiming one or more of the following credits.
a. Mortgage interest credit, Form 8396.
b. Adoption credit, Form 8839.
c. Residential clean energy credit, Form 5695, Part I.
d. District of Columbia first-time homebuyer credit, Form 8859.
2. You are not filing Form 2555.
3. Line 4 of Schedule 8812 is more than zero.

4. If you are not completing Credit Limit Worksheet B, enter -0-; otherwise, enter
the amount from the Credit Limit Worksheet B. 4

5. Subtract line 4 from line 3. Enter here and on Schedule 8812, line 13. 5
 Form 8867 Due Diligence Notes
Taxpayer: WHITNEY M REFUND 257-00-4321

________________________________________________________________________________

Dependent Information:
_____________________

Name....: JEREMY D REFUND

SSN.....: 364-00-5654 Relationship......: SON
Student.: NO School Attended...:
Disabled: NO Type of Disability:
Notes...:

________________________________________________________________________________

Due Diligence Notes:

_______________________
 Paid Preparer's Earned Income Credit Checklist

%0
/05
."*-
Taxpayer name(s) shown on return Taxpayer's social security number
WHITNEY REFUND 257-00-4321
For the definitions of Qualifying Child and Earned Income, see Pub. 596.

Part I All Taxpayers

1 Enter preparer's name and PTIN a PRACTICE PREPARER P00000000

2 Is the taxpayer’s filing status married filing separately? . . . . . . . . . . . . . . . Yes X No

a If you checked “Yes” on line 2, stop; the taxpayer cannot take the EIC. Otherwise, continue.

3 Does the taxpayer (and the taxpayer’s spouse if filing jointly) have a social security number (SSN)
that allows him or her to work and is valid for EIC purposes? See the instructions before
answering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X Yes No

a If you checked “No” on line 3, stop; the taxpayer cannot take the EIC. Otherwise, continue.

4 Is the taxpayer (or the taxpayer's spouse if filing jointly) filing Form 2555 or 2555-EZ (relating to the
exclusion of foreign earned income)? . . . . . . . . . . . . . . . . . . . . . Yes X No

a If you checked “Yes” on line 4, stop; the taxpayer cannot take the EIC. Otherwise, continue.

5a
Was the taxpayer (or the taxpayer's spouse) a nonresident alien for any part of 2024 ? . . . . Yes X No

a If you checked “Yes” on line 5a, go to line 5b. Otherwise, skip line 5b and go to line 6.

b Is the taxpayer’s filing status married filing jointly? . . . . . . . . . . . . . . . . Yes No

a If
you checked “Yes” on line 5a and “No” on line 5b, stop; the taxpayer cannot take the EIC.
Otherwise, continue.

6 Is the taxpayer’s investment income more than $3,600? See the instructions before answering. Yes X No

a If you checked “Yes” on line 6, stop; the taxpayer cannot take the EIC. Otherwise, continue.

7 Could the taxpayer be a qualifying child of another person for 2024 ? If the taxpayer's filing status is
married filing jointly, check “No.” Otherwise, see instructions before answering . . . . . . . Yes X No

a Ifyou checked “Yes” on line 7, stop; the taxpayer cannot take the EIC. Otherwise, go to Part II
or Part III, whichever applies.
 WHITNEY M REFUND 257-00-4321

Part II Taxpayers With a Child

Caution: If there is more than one child, complete lines 8 through 14 for Child 1 Child 2 Child 3
one child before going to the next column. JEREMY
8 Child’s name . . . . . . . . . . . . . . . . . . . . . REFUND
9 Is the child the taxpayer’s son, daughter, stepchild, foster child, brother, sister,
stepbrother, stepsister, half brother, half sister, or a descendant of any of them? X Yes No Yes No Yes No
10
Was the child unmarried at the end of 2024 ?
If the child was married at the end of 2024 , see the instructions before
answering . . . . . . . . . . . . . . . . . . . . . X Yes No Yes No Yes No
11 Did the child live with the taxpayer in the United States for over half of 2024 ?
See the instructions before answering . . . . . . . . . . . . X Yes No Yes No Yes No
12
Was the child (at the end of 2024 )—
• Under age 19 and younger than the taxpayer (or the taxpayer’s spouse,
if the taxpayer files jointly),
• Under age 24, a student (defined in the instructions), and younger than
the taxpayer (or the taxpayer’s spouse, if the taxpayer files jointly), or
• Any age and permanently and totally disabled? . . . . . . . . X Yes No Yes No Yes No
a If you checked “Yes” on lines 9, 10, 11, and 12, the child is the
taxpayer’s qualifying child; go to line 13a. If you checked “No” on line 9,
10, 11, or 12, the child is not the taxpayer’s qualifying child; see the
instructions for line 12.
13a Do you or the taxpayer know of another person who could check “Yes”
on lines 9, 10, 11, and 12 for the child? (If the only other person is the
taxpayer's spouse, see the instructions before answering.) . . . . . Yes X No Yes No Yes No
a If you checked “No” on line 13a, go to line 14. Otherwise, go to
line 13b.
b Enter the child’s relationship to the other person(s) . . . . . . . .
c Under the tiebreaker rules, is the child treated as the taxpayer’s qualifying Yes No Yes No Yes No
child? See the instructions before answering . . . . . . . . . . Don’t know Don’t know Don’t know
a If you checked “Yes” on line 13c, go to line 14. If you checked “No,” the
taxpayer cannot take the EIC based on this child and cannot take the EIC for
taxpayers who do not have a qualifying child. If there is more than one child,
see the Note at the bottom of this page. If you checked “Don’t know,”
explain to the taxpayer that, under the tiebreaker rules, the taxpayer’s EIC
and other tax benefits may be disallowed. Then, if the taxpayer wants to take
the EIC based on this child, complete lines 14 and 15. If not, and there are no
other qualifying children, the taxpayer cannot take the EIC, including the EIC
for taxpayers without a qualifying child; do not complete Part III. If there is
more than one child, see the Note at the bottom of this page.
14 Does the qualifying child have an SSN that allows him or her to work and is
valid for EIC purposes? See the instructions before answering . . . . X Yes No Yes No Yes No
a If you checked “No” on line 14, the taxpayer cannot take the EIC
based on this child and cannot take the EIC available to taxpayers
without a qualifying child. If there is more than one child, see the Note at
the bottom of this page. If you checked “Yes” on line 14, continue.
15 Are the taxpayer’s earned income and adjusted gross income each less
than the limit that applies to the taxpayer for 2024 ? See instructions .
. X Yes No
a If you checked “No” on line 15, stop; the taxpayer cannot take the
EIC. If you checked “Yes” on line 15, the taxpayer can take the EIC.
Complete Schedule EIC and attach it to the taxpayer’s return. If there
are two or three qualifying children with valid SSNs, list them on
Schedule EIC in the same order as they are listed here. If the taxpayer’s
EIC was reduced or disallowed for a year after 1996, see Pub. 596 to see
if Form 8862 must be filed. Go to line 20.
Note: If there is more than one child, complete lines 8 through 14 for the
other child(ren) (but for no more than three qualifying children).
 EIC Due Diligence Notes
Taxpayer: WHITNEY M REFUND 257-00-4321

Due Diligence Information Obtained on 12/07/2024 from TAXPAYER.

EIC Due Diligence Notes:

_______________________
 WHITNEY REFUND 257-00-4321

Worksheet A—2023 EIC—Line 27 Keep for Your Records

Before you begin: Be sure you are using the correct worksheet. Use this worksheet only if you
answered “No” to Step 5, question 2. Otherwise, use Worksheet B.

Part 1 1. Enter your earned income from Step 5. 1 26263

All Filers Using 2. Look up the amount on line 1 above in the EIC Table (right after
Worksheet A Worksheet B) to find the credit. Be sure you use the correct column
2
for your filing status and the number of qualifying children you have who 3645
have a valid SSN as defined earlier. Enter the credit here.
STOP
If line 2 is zero, You can’t take the credit.
Enter “No” on the dotted line next to Form 1040 or 1040-SR, line 27.

3. Enter the amount from Form 1040 or 1040-SR, line 11. 3 26263

4. Are the amounts on lines 3 and 1 the same?

x Yes. Skip line 5; enter the amount from line 2 on line 6.

No. Go to line 5.

5. If you have:
Part 2 ● No qualifying children who have a valid SSN, is the amount on
line 3 less than $9,800 ($16,370 if married filing jointly)?
Filers Who ● 1 or more qualifying children who have a valid SSN, is the amount

Answered on line 3 less than $21,560 ($28,120 if married filing jointly)?

“No” on Yes. Leave line 5 blank; enter the amount from line 2 on line 6.
Line 4
No. Look up the amount on line 3 in the EIC Table to find the
credit. Be sure you use the correct column for your filing
status and the number of qualifying children you have who 5
have a valid SSN. Enter the credit here.
Look at the amounts on lines 5 and 2.
Then, enter the smaller amount on line 6.

6. This is your earned income credit. 6 3645

Part 3
Enter this amount on
Your Earned Form 1040 or 1040-SR,
line 27.
Income Credit
Reminder— 1040 or
10o4r0
If you have a qualifying child, complete and attach Schedule EIC. 1040-SR
R
EIC 1040-S

If your EIC for a year after 1996 was reduced or disallowed, see
Form 8862, who must file, earlier, to find out if you must file Form 8862 to
CAUTION take the credit for 2023.

1HHGPRUHLQIRUPDWLRQRUIRUPV"9LVLW,56JRY ƖʻʻƖ
WHITNEY REFUND 257-00-4321

Worksheet B—2023 EIC—Line 27 Keep for Your Records

Use this worksheet if you answered “Yes” to Step 5, question 2.
Complete the parts below (Parts 1 through 3) that apply to you. Then, continue to Part 4.
If you are married filing a joint return, include your spouse’s amounts, if any, with yours to figure the amounts to
enter in Parts 1 through 3.

Part 1 1a
1a. Enter the amount from Schedule SE, Part I, line 3.
Self-Employed, + 1b
b. Enter any amount from Schedule SE, Part I, line 4b and line 5a.
Members of the
Clergy, and c. Combine lines 1a and 1b. = 1c
People With
Church Employee d. Enter the amount from Schedule SE, Part I, line 13. – 1d

Income Filing
e. Subtract line 1d from line 1c. = 1e
Schedule SE

2. Don’t include on these lines any statutory employee income, any net profit from services performed as a
Part 2 notary public, any amount exempt from self-employment tax as the result of the filing and approval of Form
4029 or Form 4361, or any other amounts exempt from self-employment tax.
Self-Employed
a. Enter any net farm profit or (loss) from Schedule F, line 34; and
NOT Required 2a
from farm partnerships, Schedule K-1 (Form 1065), box 14, code A*.
To File
b. Enter any net profit or (loss) from Schedule C, line 31; and Schedule
Schedule SE + 2b
K-1 (Form 1065), box 14, code A (other than farming)*.
For example, your
net earnings from c. Combine lines 2a and 2b. = 2c
self-employment
were less than $400. * If you have any Schedule K-1 amounts, complete the appropriate line(s) of Schedule SE, Part I.
Reduce the Schedule K-1 amounts as described in the Partner’s Instructions for Schedule K-1. Enter
your name and social security number on Schedule SE and attach it to your return.

Part 3
Statutory Employees 3. Enter the amount from Schedule C, line 1, that you are filing as a
3
Filing Schedule C statutory employee.

Part 4 4a. Enter your earned income from Step 5. 4a 26263

All Filers Using
4b
Worksheet B b. Combine lines 1e, 2c, 3, and 4a. This is your total earned income.
26263

Note. If line 4b STOP

If line 4b is zero or less, You can’t take the credit. Enter “No” on the dotted line next to Form 1040
includes income on
which you should or 1040-SR, line 27.
have paid self- 5. If you have:
employment tax but ● 3 or more qualifying children who have valid SSNs, is line 4b less than $56,838 ($63,398 if married
didn’t, we may
filing jointly)?
reduce your credit by
● 2 qualifying children who have valid SSNs, is line 4b less than $52,918 ($59,478 if married filing jointly)?
the amount of
self-employment tax ● 1 qualifying child who has a valid SSN, is line 4b less than $46,560 ($53,120 if married filing jointly)?
not paid. ● No qualifying children who have valid SSNs, is line 4b less than $17,640 ($24,210 if married filing jointly)?

x Yes. If you want the IRS to figure your credit, see Credit figured by the IRS, earlier. If you want to
figure the credit yourself, enter the amount from line 4b on line 6 of this worksheet.
STOP
No. You can’t take the credit. Enter “No” on the dotted line next to Form 1040 or
1040-SR, line 27.

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 WHITNEY REFUND 257-00-4321

Worksheet B —2023 EIC—Line 27—Continued Keep for Your Records

Part 5
6. Enter your total earned income from Part 4, line 4b. 6 26263
All Filers Using
Worksheet B 7. Look up the amount on line 6 above in the EIC Table to find
the credit. Be sure you use the correct column for your filing status and
the number of qualifying children you have who have a valid SSN. Enter 7 3645
the credit here.

If line 7 is zero, STOP You can’t take the credit.

Enter “No” on the dotted line next to Form 1040 or 1040-SR, line 27.

8. Enter the amount from Form 1040 or 1040-SR,

8 26263
line 11.

9. Are the amounts on lines 8 and 6 the same?

x Yes. Skip line 10; enter the amount from line 7 on line 11.

No. Go to line 10.

10. If you have:

Part 6
● No qualifying children who have a valid SSN, is the amount on line 8
less than $9,800 ($16,370 if married filing jointly)?
Filers Who
● 1 or more qualifying children who have a valid SSN, is the amount on
Answered line 8 less than $21,560 ($28,120 if married filing jointly)?
“No” on
Yes. Leave line 10 blank; enter the amount from line 7 on line 11.
Line 9
No. Look up the amount on line 8 in the EIC Table to find the
credit. Be sure you use the correct column for your filing status
and the number of qualifying children you have who have a valid 10
SSN. Enter the credit here.
Look at the amounts on lines 10 and 7.
Then, enter the smaller amount on line 11.

Part 7 11. This is your earned income credit. 11 3645

Enter this amount on
Your Earned
Reminder— Form 1040 or 1040-SR,
Income Credit line 27.
If you have a qualifying child, complete and attach Schedule EIC. 1040 or
1040-SR 10o4r0
EIC R
1040-S

If your EIC for a year after 1996 was reduced or disallowed, see
Form 8862, who must file, earlier, to find out if you must file Form
CAUTION 8862 to take the credit for 2023.

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