Form 2441n - Nebraska Child And Dependent Care Expenses Page 2
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2FORM 2441N
Dependent Care Benefits
2007
Name as Shown on Form 1040N
Social Security Number
PART III — Dependent Care Benefits
10 Enter the total amount of dependent care benefits you received in 2007. Amounts you
received as an employee should be shown in box 10 of your Form(s) W-2. Do not include
amounts reported as wages in box 1 of Form(s) W-2. If you were self-employed or a partner,
include amounts you received under a dependent care assistance program from your sole
proprietorship or partnership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Enter the amount forfeited or carried forward to 2008, if any (see the Federal Form 2441 instructions) 11
12 Subtract line 11 from line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
13 Enter the total amount of qualified expenses incurred in 2007 for the care
of the qualifying person(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Enter the smaller of line 12 or 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Enter your earned income. See Federal Form 2441 instructions . . . . . . . . . 15
16 Enter the amount shown below that applies to you.
• If married filing jointly, enter your spouse’s earned income (if your spouse
was a student or was disabled, see the Federal Form 2441 instr. for line 5).
• If married filing separately, see the Federal Form 2441 instructions for the
amount to enter.
• All others, enter the amount from line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Enter the smallest of line 14, 15, or 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Enter the amount from line 10 that you received from your sole proprietorship or partnership.
If you did not receive any such amounts, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Subtract line 18 from line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Enter $5,000 ($2,500 if married filing separately and you were required to enter your spouse’s
earned income on line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
21 Deductible benefits. Enter the smallest of line 17, 18, or 20. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Enter the smaller of line 17 or 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
23 Enter the amount from line 21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24 Excluded benefits. Subtract line 23 from line 22. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . 24
25 Taxable benefits. Subtract line 24 from line 19. If zero or less, enter -0-. . . . . . . . . . . . . . . . . . . . . 25
To claim the child and dependent care credit, complete lines 26-30 below.
26 Enter $3,000 ($6,000 if two or more qualifying persons) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
27 Add lines 21 and 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
28 Subtract line 27 from line 26. If zero or less, stop. You cannot take the credit.
Exception. If you paid 2006 expenses in 2007, see the Federal Form 2441 instructions for line 9
28
29 Complete line 2 on the front of this form. Do not include in Column (C) any benefits shown on
line 27 above. Then, add the amounts in Column (C) and enter the total here. . . . . . . . . . . . . . . . . 29
30 Enter the smaller of line 28 or 29. Also, enter this amount on line 3 on the front of this form and
complete lines 4-9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
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