Clear Form
Schedule
Oregon Working Family Child Care Credit
2006
WFC-N/P
for Form 40N and Form 40P Filers
Last name
First name and initial
Social Security No. (SSN)
Date of birth (mm/dd/yyyy)
–
–
Spouse’s last name if joint return
Spouse’s first name and initial if joint return
Spouse’s SSN if joint return
Date of birth (mm/dd/yyyy)
–
–
YOU MAY BE REQUIRED TO PROVIDE PROOF OF YOUR
PAYMENT OF YOUR CHILD CARE EXPENSES
Household Size Calculation
Enter the number of exemptions
1.
you claimed on your federal return ............................ 1
2. Enter the number of exemptions you did not
claim on your federal return because you released
FOR COMPUTER USE ONLY
the exemption to the child’s other parent .................. 2
3. Add lines 1 and 2 ....................................................... 3
4. Enter the number of exemptions you claimed on
your federal return for people who did not live in
your household during 2006, including exemptions
released to you by your child’s other parent, or who
are not related by blood, marriage, or adoption ........ 4
5. Household size. Line 3 minus line 4 ........................... 5
Qualifying Child Care Expenses Paid in 2006. Complete all information for each child care provider you paid in 2006.
Child to Provider
Provider’s full name and complete address
Relationship
Provider’s SSN or FEIN
(enter code)
6.
Name __________________________________________________________________________________________
Provider’s Telephone No.
Amount You Paid to Provider
Address _______________________________________________________________________________________
$
.............. 6
City, State, ZIP Code
Child to Provider
Provider’s full name and complete address
Relationship
Provider’s SSN or FEIN
(enter code)
7.
Name __________________________________________________________________________________________
Provider’s Telephone No.
Amount You Paid to Provider
Address _______________________________________________________________________________________
$
.............. 7
City, State, ZIP Code
Child to Provider
Provider’s full name and complete address
Relationship
Provider’s SSN or FEIN
(enter code)
8.
Name __________________________________________________________________________________________
Provider’s Telephone No.
Amount You Paid to Provider
Address _______________________________________________________________________________________
$
...............8
City, State, ZIP Code
$
9. Total qualifying child care expenses you paid in 2006. Add amounts on lines 6 through 8 and enter the result here ...............9
Child to
Qualifying Child Information—Complete all information for each child
Taxpayer
Child’s
Qualifying Expenses
Relationship
(enter code)
First and Last Name of Child
Child’s SSN
Date of Birth
You Paid for Child
10.
$
11.
$
12.
$
13.
$
14. Total qualifying child care expenses you paid. Add amounts on lines 10 through 13 and enter the result here
$
...........14
Computation of Credit
15. Enter your federal adjusted gross income (Form 40N or Form 40P, line 30F) ..................................................................... 15
16. Enter your Oregon adjusted gross income (Form 40N or Form 40P, line 30S) ................................................................... 16
17. Enter the larger of line 15 or line 16 .................................................................................................................................... 17
18. Enter the total qualifying child care expenses you paid in 2006 from line 9 above ............................................................ 18
19. Enter the decimal amount from the working family child care credit table on the back (use the table that
.
x
matches your household size on line 5 above). For example, if the amount on line 5 is 4, use Table 4 ......................................... 19
20. Multiply the amount on line 18 by the decimal amount on line 19 and enter here ............................................................. 20
21. Multiply line 20 by the Oregon percentage (Form 40N or Form 40P, line 39). Enter the result
here and on Form 40N, line 63, or Form 40P, line 62. This is your working family child care credit ................................... 21
150-101-170 (Rev. 12-06) Web
—YOU MUST ATTACH THIS SCHEDULE TO YOUR OREGON INCOME TAX RETURN—