Form D-2441 - Child And Dependent Care Credit For Part-Year Residents - Government Of The District Of Columbia - 2002 Page 2

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*022410120000*
D-2441 PAGE 2
Enter your last name.
Your social security number
Dependent care expenses
Complete for all people or organizations who provided care during 2002 so that you could work or look for work.
Round all amounts
to the nearest dollar.
Name
From (MMDD)
To
(MMDD)
Amount paid
.00
$
Address
Social security or Fed. employer ID
If an individual, identify their relationship to you
Name
From (MMDD)
To
(MMDD)
Amount paid
.00
$
Address
Social security or Fed. employer ID
If an individual, identify their relationship to you
Name
From (MMDD)
To
(MMDD)
Amount paid
.00
$
Address
Social security or Fed. employer ID
If an individual, identify their relationship to you
Name
From (MMDD)
To
(MMDD)
Amount paid
.00
$
Address
Social security or Fed. employer ID
If an individual, identify their relationship to you
Name
From (MMDD)
To
(MMDD)
Amount paid
.00
$
Address
Social security or Fed. employer ID
If an individual, identify their relationship to you
6
Total expenses paid
.00
Add whole dollar amounts.
$
Who can use the Form D-2441?
You must meet all of the following requirements to use this form:
• You are a part-year resident of D.C.
• You are filing a part-year D-40 return
• You were eligible to claim the child and dependent care credit on
your federal return
If you are a full-year resident of D.C., you only need to file the
Form D-40 to claim this credit.
D-2441 P2
Child and Dependent Care Credit for Part-Year Residents

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