Schedule A1 Individual - Dependents And Beneficiaries Of Educational Contribution Accounts - 2006
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1Schedule A1 Individual
DEPENDENTS AND BENEFICIARIES
Rev. 12.06
2006
OF EDUCATIONAL CONTRIBUTION ACCOUNTS
Taxable year beginning on _________________, _____ and ending on ________________, _____
Taxpayer’s name
Social Security Number
Part I
Dependents Information
(See instructions)
55
IMPORTANT INFORMATION PART I
Do not include the spouse on this schedule. A married individual who lives with his spouse is not a head of household for tax purposes, therefore, you should not include
the wife’s name in the box for head of household (line 01).
If you claim the head of household filing status, include the dependent who entitles you to claim such status on the Head of Household line (01), but do not
claim the exemption for this dependent.
In order to consider the exemption for dependents you must include this Schedule with your return.
First Name, Initial
Last Name
Second Last Name
Head of Household
Category
Date of Birth
Social Security Number
R e l a t i o n s h i p
(01)
J
NOT THE
TAXPAYER / NOT THE
SPOUSE
*
Relationship
First Name, Initial
Last
Second Last
Category
Date of Birth
Social Security Number
(N) (U) (I)
Name
Name
Day / Month / Year
(02)
(03)
(04)
(05)
(06)
(07)
(08)
(09)
(10)
Part II
Beneficiaries of Educational Contribution Accounts
(See instructions)
57
IMPORTANT INFORMATION PART II
These beneficiaries must not be considered to determine the exemption for dependents. However, if any of these beneficiaries qualifies as your dependent, you must also
include him/her in Part I of this Schedule.
Relationship
Social Security
Contributed Amount
Name, Initial
Last
Second Last
Date of Birth
Number
Name
Name
Day / Month / Year
(01)
00
(02)
00
(03)
00
(04)
00
(05)
00
Total contributions (Add lines (01) through (05) and transfer to Schedule A Individual, Part II,
(10)
00
line 8 of the Long Form) .................................................................................................................................................
*See instructions.
Retention Period: Ten (10) years
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