Form W-5 - Earned Income Credit Advance Payment Certificate - 2009 Page 2
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42009
Form W-5
Department of the Treasury
Internal Revenue Service
(Rev. January 2009)
Instructions
1. You (and your spouse, if filing a joint return) have a valid
social security number (SSN) issued by the Social Security
What’s New
Administration. For more information on valid SSNs, see Pub.
596, Earned Income Credit (EIC).
Definition of qualifying child revised
2. You expect to have at least one qualifying child and to be
The following changes have been made to the definition of a
able to claim the credit using that child. If you do not expect to
qualifying child.
have a qualifying child, you may still be eligible for the EIC, but
you cannot receive advance EIC payments. See Who Is a
Your qualifying child must be younger than you.
Qualifying Child? on page 3.
A child cannot be your qualifying child if he or she files a joint
3. You expect that your 2009 earned income and adjusted
return, unless the return was filed only as a claim for refund.
gross income (AGI) will each be less than $35,463 ($38,583 if you
If the parents of a child can claim the child as a qualifying child
expect to file a joint return for 2009). Include your spouse’s
but no parent so claims the child, no one else can claim the child
income if you plan to file a joint return. As used on this form,
as a qualifying child unless that person’s AGI is higher than the
earned income does not include amounts inmates in penal
highest AGI of any parent of the child.
institutions are paid for their work, amounts received as a pension
Purpose of Form
or annuity from a nonqualified deferred compensation plan or a
nongovernmental section 457 plan, or nontaxable earned income.
Use Form W-5 if you are eligible to get part of the earned income
4. You expect to be able to claim the EIC for 2009. To find out if
credit (EIC) in advance with your pay and choose to do so. See
you may be able to claim the EIC, answer the questions on page
Who Is Eligible To Get Advance EIC Payments? below. The
2.
amount you can get in advance generally depends on your
wages. If you are married, the amount of your advance EIC
How To Get Advance EIC Payments
payments also depends on whether your spouse has filed a Form
W-5 with his or her employer. However, your employer cannot
If you are eligible to get advance EIC payments, fill in the 2009
give you more than $1,826 throughout 2009 with your pay. You
Form W-5 at the bottom of this page. Then, detach it and give it
will get the rest of any EIC you are entitled to when you file your
to your employer. If you get advance payments, you must file a
tax return and claim the EIC.
2009 Form 1040 or 1040A income tax return.
If you do not choose to get advance payments, you can still
You may have only one Form W-5 in effect at one time. If you
claim the EIC on your 2009 tax return.
and your spouse are both employed, you should file separate
Forms W-5.
What Is the EIC?
This Form W-5 expires on December 31, 2009. If you are
The EIC is a credit for certain workers. It reduces the tax you
eligible to get advance EIC payments for 2010, you must file a
owe. It may give you a refund even if you do not owe any tax.
new Form W-5 next year.
You may be able to get a larger credit when you file
Who Is Eligible To Get Advance EIC
TIP
your 2009 return. For details, see Additional Credit on
Payments?
page 3.
You are eligible to get advance EIC payments if all four of the
following apply.
(continued on page 3)
Give the bottom part to your employer; keep the top part for your records.
Detach here
W-5
Earned Income Credit Advance Payment Certificate
OMB No. 1545-0074
Form
Use the current year’s certificate only.
(Rev. January 2009)
2009
Give this certificate to your employer.
Department of the Treasury
This certificate expires on December 31, 2009.
Internal Revenue Service
Your social security number
Print or type your full name
Note. If you get advance payments of the earned income credit for 2009, you must file a 2009 federal income tax return. To get advance
payments, you must have a qualifying child and your filing status must be any status except married filing a separate return.
1
I expect to have a qualifying child and be able to claim the earned income credit for 2009 using that child. I do not have
another Form W-5 in effect with any other current employer, and I choose to get advance EIC payments
Yes
No
2
Check the box that shows your expected filing status for 2009:
Single, head of household, or qualifying widow(er)
Married filing jointly
3
If you are married, does your spouse have a Form W-5 in effect for 2009 with any employer?
Yes
No
Under penalties of perjury, I declare that the information I have furnished above is, to the best of my knowledge, true, correct, and complete.
Signature
Date
Cat. No. 10227P
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