Form 1npr Draft - Nonresident & Part-Year Resident Wisconsin Income Tax - 2012 Page 14
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18OMB No. 1545- 0074
Schedule 8812
Child Tax Credit
(Form 1040A or 1040)
Information about Schedule 8812 and its separate instructions is at
D epart ment of t h e Treasury
Attachment
47
Attach to Form 1040, Form 1040A, or Form 1040NR.
Int ernal Revenue Service (99)
Sequence No.
Name(s) shown on return
Your social security number
Mary N. Sorrel
400-00-5483
SINGLE PARENT
600-00-1002
Part I
Filers Who Have Certain Child Dependents with an ITIN (Individual Taxpayer Identification Number)
Complete this part only for each dependent who has an ITIN and for whom you are claiming the child tax credit.
If your dependent does not qualify for the credit, you cannot include that dependent in the calculation of this credit.
Answer the following questions for each dependent listed on Form 1040, line 6c; Form 1040A, line 6c; or Form 1040NR, line 7c, who has an ITIN (Individual
Taxpayer Identification Number) and that you indicated qualified for the child tax credit by checking column (4) for that dependent.
A
For the first dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test?
See separate instructions.
Yes
No
B
For the second dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test?
See separate instructions.
Yes
No
C
For the third dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test?
See separate instructions.
Yes
No
D
For the fourth dependent identified with an ITIN and listed as a qualifying child for the child tax credit, did this child meet the substantial presence test?
See separate instructions.
Yes
No
Note. If you have more than four dependents identified with an ITIN and listed as a qualifying child for the child tax credit, see the instructions
and check here
Part II
Additional Child Tax Credit Filers
1
1040 filers:
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040, line 51).
1040A filers:
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
1,000.
Instructions for Form 1040A, line 33).
1
1040NR filers:
Enter the amount from line 6 of your Child Tax Credit Worksheet (see the
Instructions for Form 1040NR, line 48).
If you used Pub. 972, enter the amount from line 8 of the Child Tax Credit Worksheet in the publication.
0.
2
Enter the amount from Form 1040, line 51, Form 1040A, line 33, or Form 1040NR, line 48
2
1,000.
3
Subtract line 2 from line 1. If zero, stop; you cannot take this credit
3
20,000.
4a Earned income (see separate instructions)
4a
b Nontaxable combat pay (see separate
4b
instructions)
Is the amount on line 4a more than $3,000?
5
No.
Leave line 5 blank and enter - 0- on line 6.
X
17,000.
Yes.
Subtract $3,000 from the amount on line 4a. Enter the result
5
2,550.
Multiply the amount on line 5 by 15% (.15) and enter the result
6
6
Next. Do you have three or more qualifying children?
X
No.
If line 6 is zero, stop; you cannot take this credit. Otherwise, skip Part II and enter the
smaller of line 3 or line 6 on line 13.
Yes.
If line 6 is equal to or more than line 3, skip Part II and enter the amount from line 3 on
line 13. Otherwise, go to line 7.
KBA
For Paperwork Reduction Act Notice, see your tax return instructions.
Schedule 8812 (Form 1040A or 1040) 2012
8812 (2012)
FD8812- 1 (DRAFT FORM)
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc. 1.13- 15.2
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