Form 8914 - Exemption Amount For Taxpayers Housing Midwestern Displaced Individuals - 2009 Page 3
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Form 8914 (2009)
Page
General Instructions
However, you cannot claim the additional exemption amount
if you received any reimbursement for the extra costs of heat,
Purpose of Form
electricity, or water used by the displaced individual.
Use Form 8914 to claim your personal exemptions, exemptions
Specific Instructions
for dependents, and the additional exemption amount for
providing housing in your main home to one or more
Line 1, Column (a)
Midwestern displaced individuals.
Enter the first and last names of up to four displaced individuals
Additional Exemption Amount
who were provided housing in your main home for a period of at
least 60 consecutive days ending in 2009. If less than 60
You can claim an additional exemption amount of $500 for each
consecutive days, you cannot claim an additional exemption
Midwestern displaced individual (defined below). You can claim
amount for this individual.
an additional exemption amount only one time for a specific
individual. If you claimed an additional exemption amount for an
Do not enter the name of any individual you included on a
individual in 2008, you cannot claim that amount again for the
Form 8914 you filed for 2008.
same individual in 2009.
Line 1, Column (b)
The maximum additional exemption amount you can claim for
Enter the displaced individual’s social security number (SSN) or
all displaced individuals is $2,000. Any additional exemption
individual taxpayer identification number (ITIN). You must
amount you claimed for displaced individuals in 2008 will
provide this information in column (b) to claim an exemption
reduce the $2,000 maximum for 2009. The $2,000 limit applies
amount. You can use Form W-9, Request for Taxpayer
to a husband and wife, whether the husband and wife file joint
Identification Number and Certification, to request an SSN or
returns or separate returns. If married filing separately, the
ITIN from the displaced individual.
$2,000 can be divided in $500 increments between the
spouses. For example, if one spouse claims an additional
Line 1, Column (c)
exemption amount for one displaced individual, the other
Enter the street address where the displaced individual’s main
spouse, if otherwise eligible, can claim additional exemption
home was located on the applicable disaster date. That home
amounts for three different displaced individuals.
must have been located in a Midwestern disaster area on that
If two or more taxpayers share the same main home, only
date. Include the number and street, city or town, state, and ZIP
one taxpayer in that main home can claim the additional
code.
exemption amount for a specific displaced individual. In order
Line 1, Column (d)
for you to be considered to have provided housing, you must
have a legal interest in the main home (that is, own or rent the
Enter the number of consecutive days the displaced individual was
home).
provided housing in your main home free of charge.
Midwestern Displaced Individual
Line 10
To qualify as a Midwestern displaced individual, an individual
If you are filing Form 1040NR, enter the amount shown below
must meet the following three conditions.
for your filing status.
• The individual must have had his or her main home in one of
• Filing status box 1 or 2 — $166,800
the counties listed in Table 1 or Table 2 on page 4 on an
• Filing status box 3, 4, or 5 — $125,100
applicable disaster date shown in the table for that county, and
• Filing status box 6 — $250,200
he or she must have been displaced from that home. In
addition, if the individual’s main home was in a county listed in
Paperwork Reduction Act Notice. We ask for the information
Table 2, the home must have been damaged by the storms,
on this form to carry out the Internal Revenue laws of the United
tornadoes, or flooding that gave rise to the disaster declaration
States. You are required to give us the information. We need it
for that county, or the individual must have been evacuated
to ensure that you are complying with these laws and to allow
from the home because of the storms, tornadoes, or flooding.
us to figure and collect the right amount of tax.
• He or she must have been provided housing in your main
You are not required to provide the information requested on
home free of charge for a period of at least 60 consecutive days
a form that is subject to the Paperwork Reduction Act unless
ending in 2009. See Compensation for Housing below.
the form displays a valid OMB control number. Books or
• He or she cannot be your spouse or dependent.
records relating to a form or its instructions must be retained as
Compensation for Housing
long as their contents may become material in the
administration of any Internal Revenue law. Generally, tax
You cannot claim the additional exemption amount if you
returns and return information are confidential, as required by
received rent (or any other amount) from any source for
Internal Revenue Code section 6103.
providing the housing. You are permitted to receive payments or
The average time and expenses required to complete and file
reimbursements that do not relate to normal housing costs,
this form will vary depending on individual circumstances. For
including the following.
the estimated averages, see the instructions for your income tax
• Food, clothing, or personal items consumed or used by the
return.
displaced individual.
If you have suggestions for making this form simpler, we
• Reimbursement for the cost of any long distance telephone
would be happy to hear from you. See the instructions for your
calls made by the displaced individual.
income tax return.
• Reimbursement for the cost of gasoline for the displaced
individual’s use of your vehicle.
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