Form 5217-D - Educational Opportunity Tax Credit Worksheet

2016 Educational Opportunity Tax Credit Worksheet

for Maine Resident & Part-year Resident Individuals

36 M.R.S. § 5217-D

IMPORTANT NOTE: Use this worksheet if you paid all of your education loan payments

directly to the lender. If you are claiming the credit for more than one degree, complete a

separate worksheet for each degree. See instructions.

Note: If this is the ﬁ rst year you are claiming this credit, you must include a complete copy of your college transcript, proof of the

educational loans that qualify for the credit and proof of the educational loan payments you paid directly to the lender during the tax year.

Additionally, Maine Revenue Services may request additional documentation supporting your claim in subsequent tax years.

Your name: ____________________________________________________

Social security number: __________________

Check the type of degree you received: A ____ Bachelor’s

If Box A is checked, also check here if

this is a degree in Science, Technology,

B ____ Associate

Engineering or Mathematics (“STEM”).

____

See instructions.

C ____ Graduate

Date you graduated: ___ / ___ / ______

College or university from which you obtained the degree: ______________________________________________________

State where the college or university is located: ____________________________

Name of degree as it appears on your diploma: _______________________________________________________________

(example, Bachelor of Science Computer Science)

Eligible payments. Enter the amount from the Educational Opportunity Tax Credit - Loan

Payment Schedule, line 3 ..................................................................................................................1. $ _________________

Proration factor. If you earned credit hours toward your degree before January 1, 2008,

complete lines 2, 3 and 4. Otherwise, enter the amount from line 1 on line 5.

Enter the number of credit hours you earned toward your degree after December 31, 2007 ...........2.

_________________

Enter the total number of credit hours earned for your degree ..............................................................3.

_________________

(Do not enter more than the total number of credit hours required to earn the degree)

Divide line 2 by line 3 ....................................................................................................................... 4.

__ . __ __ __ __

If you completed lines 2, 3 and 4, multiply line 1 by 4. Otherwise, enter the amount from line 1 ......5.

_________________

a) Refundable credit. If either line B or line D above is checked, enter the amount from line 5.

Also enter this amount on Form 1040ME, Schedule A, line 4. ..................................................5a.

_________________

b) If neither line B nor line D above is checked, enter the amount from line 5...............................5b.

_________________

Enter the carryforward of unused credit amounts from prior tax years ..............................................6. $ _________________

Nonrefundable credit. Add lines 5b and 6. Enter the total here and on Form 1040ME,

Schedule A, line 13 ............................................................................................................................7. $ _________________

The credit amount on line 7 cannot exceed your tax due; however, unused credit amounts may be

carried forward for up to 10 years - see instructions.

Keep a record of the unused credit amount available for future tax years.

Rev. 12/16