Form Educational Opportunity Tax Credit Worksheet

2014 Educational Opportunity Tax Credit Worksheet

for Maine Resident & Part-year Resident Individuals Only - 36 M.R.S. § 5217-D

NOTE: Use this worksheet only if your employer paid part of your education loan payments directly to the lender.

If your employer paid all of your education loan payments directly to the lender, you do not qualify for this credit.

Your name: ____________________________________________________

Social security number: __________________

Check the type of degree you received: ___ Bachelor’s ___ Associate's

Date you graduated: ___/___/_____

College or university from which you obtained the degree: ________________________________________________________

Name of degree as it appears on your diploma: ________________________________________________________________

C. Check here if this is a degree in Science, Technology, Engineering or Mathematics (“STEM”) (see instructions):

_______

D. If your employer made eligible education loan payments for you during your 2014 tax year, complete the following:

Employer Name: ___________________________________________

EIN: ____________________________

Enter the monthly benchmark loan payment (see instructions) ........................................................1.

$ _________________

Enter the monthly eligible education loan payment due during your 2014 tax year ........................2.

$ _________________

Enter the monthly eligible education loan payment amount paid by you and your employer

during your 2014 tax year ............................................................................................................................... 3.

$ ___________________

Enter the smallest of lines 1, 2 and 3 ....................................................................................................4.

$ _________________

a. Enter the number of months* during your tax year you were a Maine resident ..............................5a.

_________________

b. With respect to the months on line 5a, enter the number of months* you worked for an

employer located in Maine or were deployed for military service in the U.S. Armed Forces ..........5b.

_________________

c. With respect to the months on line 5b, enter the number of months* you and your employer

made eligible education loan payments .......................................................................................... 5c.

_________________

* Count any part of a month as a whole month.

Gross Credit. Multiply line 4 by line 5c .................................................................................................6.

$ _________________

a. Enter the eligible education loan amount you paid directly to the lender during your tax year,

excluding any amount exceeding the amount due ..........................................................................7a.

$ _________________

b. Enter the total eligible education loan amount paid during your tax year paid by you and your

employer, excluding any amount exceeding the amount due .........................................................7b.

$ _________________

Divide line 7a by line 7b and enter the result here .............................................................................. 7c.

__ . __ __ __ __

Modiﬁ ed gross credit. Multiply line 6 by line 7c .....................................................................................8.

$ _________________

Note: If all credit hours for your degree were earned after 2007, skip lines 9, 10 and 11 and enter the amount from line 8 on line 12.

Enter the number of credit hours you earned toward your degree after December 31, 2007 ...............9.

_________________

10. Enter the total number of credit hours you earned toward your degree ..............................................10.

_________________

11. Divide line 9 by line 10 ........................................................................................................................ 11.

__ . __ __ __ __

12. If you completed lines 9, 10 and 11, multiply line 8 by line 11. Otherwise, enter the amount from line 8. ...12.

$ _________________

13. Adjustment for transferring students (see instructions) .......................................................................13.

__ . __ __

Note: If all credit hours were earned at a Maine college or university, enter 1.00.

continue on next page

Revised 12/14