Form Pit-Cg - New Mexico Caregiver'S Statement - 2010 Page 2
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1
2REV. 12/2010
New Mexico Taxation and Revenue Department
Child Day Care Credit Worksheet
YOUR SOCIAL SECURITY NUMBER
Print your name (first, middle, last)
You must answer both questions.
True
The child day care expenses were not reimbursed or otherwise paid by another party?
You may only claim uncompensated and unreimbursed child day care expenses.
Public assistance was not received under the Temporary Assistance for Needy Families,
True
New Mexico Works Act or a similar program during that part of the tax year for which the
credit was claimed? You may only claim child day care expenses during periods in which
you did not receive assistance from one of these programs.
NOTE: The Department checks with appropriate state agencies to verify whether a claimant is
receiving public assistance.
COLUMN E
COLUMN A
COLUMN B
COLUMN C
COLUMN D
COLUMN F
COLUMN G
Day Care Expenses
Name of Child
Age of Child
Number of days
Amount paid per day
Multiply Col. E by .40
Available day care credit
Multiply Col. C by Col. D
of care
not to exceed $8.00
Enter in Column G
not to exceed $480/child
.40
.40
.40
.40
.40
.40
.40
TOTAL day care credit available. Enter the sum of column G. If supplemental
pages are attached, enter the sum of column G from all pages.
To complete the Child Day Care Credit Worksheet:
Column A:
Enter the name of the qualified dependent child who received day care during 2010. If you
need more space, attach a worksheet in the same format.
Enter the age of the child at the end of the 2010 tax year.
Column B:
Column C:
Enter the total number of days of qualified child day care service provided for the child.
Column D:
Enter the amount paid per day for the child. The maximum is $8 per child per day. Only
include amounts actually paid by you; do not include amounts that were reimbursed or
paid for by another party (such as your employer or the State of New Mexico).
Column E:
Multiply column C by column D and enter the result.
Multiply column E by column F (.40) and enter the result, but no more than $480 per child.
Column G:
Add the amounts in column G and enter the total on line 19, Schedule PIT-RC, but no more than $1,200.
ATTACH TO FORM PIT-1
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