Schedule Wfc-N/p - Oregon Working Family Child Care Credit For Form 40n And Form 40p Filers - 2005

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Clear Form

Schedule

2005

Oregon Working Family Child Care Credit

WFC-N/P

for Form 40N and Form 40P Filers

Date of birth (mm/dd/yyyy)

Last name

Social Security No. (SSN)

First name and initial

–

Date of birth (mm/dd/yyyy)

Spouse’s last name if joint return

Spouse’s SSN if joint return

Spouse’s ﬁ rst name and initial if joint return

–

Household Size Calculation

Enter the number of exemptions

you claimed on your federal return............................. 1

2. Enter the number of exemptions you did not

claim on your federal return because you released

the exemption to the child’s other parent ................... 2

FOR COMPUTER USE ONLY

3. Add lines 1 and 2........................................................ 3

4. Enter the number of exemptions you claimed on

your federal return for people who did not live in

your household during 2005, including exemptions

released to you by your child’s other parent, or who

are not related by blood, marriage, or adoption ......... 4

5. Household size. Line 3 minus line 4........................... 5

Qualifying Child Care Expenses Paid in 2005.

Enter the following information for each child care provider you paid in 2005.

Provider’s full name and complete address

Provider’s SSN/FEIN/ITIN

Child/Provider Relationship

(enter code)

Name ________________________________________________________________________________

Provider’s Telephone No.

Amount Paid to Provider

Address _______________________________________________________________________________

.............. 6

City, State, ZIP Code

Provider’s full name and complete address

Provider’s SSN/FEIN/ITIN

Child/Provider Relationship

(enter code)

Name ________________________________________________________________________________

Provider’s Telephone No.

Amount Paid to Provider

Address _______________________________________________________________________________

.............. 7

City, State, ZIP Code

Provider’s full name and complete address

Provider’s SSN/FEIN/ITIN

Child/Provider Relationship

(enter code)

Name ________________________________________________________________________________

Provider’s Telephone No.

Amount Paid to Provider

Address _______________________________________________________________________________

.............. 8

City, State, ZIP Code

9. Total qualifying child care expenses paid in 2005. Add amounts on lines 6 through 8 and enter the result here ...................... 9

Qualifying Child Information

Child’s

Expenses

Relationship

First and Last Name of Child

Child’s SSN

Date of Birth

Paid for Child

(enter code)

10.

11.

12.

13.

14. Total qualifying child care expenses. Add amounts on lines 10 through 13 and enter the result here

........................... 14

Computation of Credit

15. Enter your federal adjusted gross income (Form 40N or Form 40P, line 30a) ................................................................... 15

16. Enter your Oregon adjusted gross income (Form 40N or Form 40P, line 30b) ................................................................... 16

17. Enter the larger of line 15 or line 16 .................................................................................................................................... 17

18. Enter the total qualifying child care expenses paid in 2005 from line 9 above................................................................... 18

19. Enter the decimal amount from the working family child care credit table on the back (use the table that

× .

matches your household size on line 5 above). For example, if the amount on line 5 is 4, use Table 4 ......................................... 19

20. Multiply the amount on line 18 by the decimal amount on line 19 and enter here ............................................................. 20

21. Multiply line 20 by the Oregon percentage (Form 40N or Form 40P, line 40). Enter the result

here and on Form 40N or Form 40P, line 63. This is your working family child care credit .............................................. 21

—YOU MUST ATTACH THIS SCHEDULE TO YOUR OREGON INCOME TAX RETURN—

150-101-170 (Rev. 12-05) Web