Form 1040 - U.s. Individual Income Tax Return - 2016 Page 3
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38880
OMB No. 1545-0074
Credit for Qualified Retirement Savings Contributions
2016
Form
Attach to Form 1040, Form 1040A, or Form 1040NR.
Attachment
Department of the Treasury
54
Information about Form 8880 and its instructions is at
Sequence No.
Internal Revenue Service
Name(s) shown on return
Your social security number
Donnie
D Sense
123-76-9876
You cannot take this credit if either of the following applies.
!
The amount on Form 1040, line 38; Form 1040A, line 22; or Form 1040NR, line 37 is more than $30,750 ($46,125 if head of
household; $61,500 if married filing jointly).
The person(s) who made the qualified contribution or elective deferral (a) was born after January 1, 1999, (b) is claimed as a
CAUTION
dependent on someone else's 2016 tax return, or (c) was a student (see instructions).
(a) You
(b) Your spouse
1
Traditional and Roth IRA (including myRA) contributions for 2016. Do
5,500
5,500
1
not include rollover contributions
. . . . . . . . . . . . . . . . . . . . . . .
2
Elective deferrals to a 401(k) or other qualified employer plan, voluntary
employee contributions, and 501(c)(18)(D) plan contributions for 2016
18,000
18,000
2
(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23,500
23,500
3
3
Add lines 1 and 2
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Certain distributions received after 2013 and before the due date
(including extensions) of your 2016 tax return (see instructions). If
married filing jointly, include both spouses' amounts in both columns.
See instructions for an exception . . . . . . . . . . . . . . . . . . . . . . . .
4
23,500
23,500
5
Subtract line 4 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . .
5
2,000
2,000
6
6
In each column, enter the smaller of line 5 or $2,000
. . . . . . . . . . . .
4,000
7
7
Add the amounts on line 6. If zero, stop; you cannot take this credit
. . . . . . . . . . . . . . . . . .
8
Enter the amount from Form 1040, line 38*; Form 1040A, line 22; or
37,000
8
Form 1040NR, line 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
Enter the applicable decimal amount shown below:
If line 8 is—
And your filing status is—
Married
Head of
Single, Married filing
But not
Over—
filing jointly
household
separately, or
over—
Qualifying widow(er)
Enter on line 9—
---
$18,500
.5
.5
.5
$18,500
$20,000
.5
.5
.2
$20,000
$27,750
.5
.5
.1
0.5
X
9
$27,750
$30,000
.5
.2
.1
$30,000
$30,750
.5
.1
.1
$30,750
$37,000
.5
.1
.0
$37,000
$40,000
.2
.1
.0
$40,000
$46,125
.1
.1
.0
$46,125
$61,500
.1
.0
.0
$61,500
---
.0
.0
.0
Note: If line 9 is zero, stop; you cannot take this credit.
2,000
10
10
Multiply line 7 by line 9
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
Limitation based on tax liabilty. Enter the amount from the Credit Limit Worksheet in the
1,633
11
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
Credit for qualified retirement savings contributions. Enter the smaller of line 10 or line 11
1,633
12
here and on Form 1040, line 51; Form 1040A, line 34; or Form 1040NR, line 48 . . . . . . . . . . . .
*See Pub. 590-A for the amount to enter if you are filing Form 2555, 2555-EZ, or 4563 or you are excluding income from Puerto Rico.
8880
KIA
For Paperwork Reduction Act Notice, see your tax return instructions.
Form
(2016)
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