Line-By-Line Instructions For Schedule C Page 2

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Line-by-line instructions for Schedule C
16
List the monthly income for each of the items.
18a Mark “yes” if you get Social Security benefits
If none, place a zero in the space.
for a disability. Otherwise, mark “no.”
16a List the monthly amount you get from Social
18b Mark “yes” if you get Social Security benefits
Security (include Medicare deductions).
because you are blind. Otherwise, mark “no.”
16b List the monthly amount you get from Railroad
18c If “yes” for either Line 18a or 18b and you pay
Retirement (include Medicare deductions).
for special transportation, personal attendant
services, or adaptive equipment to work, list
16c List the monthly amount you get from the
how much you pay each month. If this amount
Veterans Administration.
is not the same each month, tell us the average
16d List the monthly amount you get from any other
monthly amount for the past year.
pensions or annuities.
For Lines 16a, 16b, 16c, and 16d, use the
Step 3: Sign below.
amount on your annual cost-of-living
Claimant’s signature
19
adjustment letter. This is the amount before any
deductions.
You, the claimant (the person named
on Line 2a), must sign this schedule.
16e List the monthly amount you get from any other
source, including alimony, net rental income,
Spouse’s signature
20
worker’s compensation, etc. If the amount
Your spouse (the person named on Line 4)
changes from month to month or you do not
must sign this schedule.
receive it every month, tell us the average
monthly income for the past year. Do not
Preparer’s name
21
count: wages, self-employment, interest, public
If someone other than you or your spouse,
assistance, medical reimbursement, or foster
such as a son, daughter, or legal
care payments.
representative, prepares this schedule for you,
17 Mark “yes” if any of the amounts listed on
that person should print or type his or her name
Lines 16a, 16b, 16c, 16d, or 16e have
and telephone number on Line 21.
decreased in the last two years. Mark “no” if
there has been no decrease.
Instructions for Schedule C / IL-1363 (R-12/09)

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