Form 5695 - Residential Energy Credits - 2012 Page 2
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Form 5695 (2012)
Page
Part II
Nonbusiness Energy Property Credit
19 a Were the qualified energy efficiency improvements or residential energy property costs for your
main home located in the United States? (see instructions)
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19a
Yes
No
Caution: If you checked the “No” box, you cannot claim the nonbusiness energy property credit. Do not complete Part II.
b Print the complete address of the main home where you made the qualifying improvements.
Caution: You can only have one main home at a time.
Number and street
Unit No.
City, State, and ZIP code
c Were any of these improvements related to the construction of this main home?
19c
Yes
No
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Caution: If you checked the “Yes” box, you can only claim the nonbusiness energy property credit for qualifying
improvements that were not related to the construction of the home. Do not include expenses related to the
construction of your main home, even if the improvements were made after you moved into the home.
Lifetime limitation. Amounts claimed in 2006, 2007, 2009, 2010, and
20
2011.
a Amount, if any, from line 12 of your 2006 Form 5695 .
20a
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b Amount, if any, from line 15 of your 2007 Form 5695 .
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20b
c Amount, if any, from line 11 of your 2009 Form 5695 .
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20c
d Amount, if any, from line 11 of your 2010 Form 5695 .
20d
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e Amount, if any, from line 14 of your 2011 Form 5695 .
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20e
f
Add lines 20a through 20e. If $500 or more, stop; you cannot take the nonbusiness energy property credit
20f
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Qualified energy efficiency improvements (original use must begin with you and the component must
reasonably be expected to last for at least 5 years; do not include labor costs) (see instructions).
a Insulation material or system specifically and primarily designed to reduce heat loss or gain of
your home that meets the prescriptive criteria established by the 2009 IECC .
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21a
b Exterior doors that meet or exceed the Energy Star program requirements
21b
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c Metal or asphalt roof that meets or exceeds the Energy Star program requirements and has
appropriate pigmented coatings or cooling granules which are specifically and primarily designed
to reduce the heat gain of your home
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21c
d Exterior windows and skylights that meet or exceed the Energy Star
program requirements .
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21d
e Maximum amount of cost on which the credit can be figured
21e
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$2,000
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If you claimed window expenses on your Form 5695 for 2006, 2007, 2009,
2010, or 2011, enter the amount from the Window Expense Worksheet (see
instructions); otherwise enter -0- .
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21f
g Subtract line 21f from line 21e. If zero or less, enter -0- .
21g
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h Enter the smaller of line 21d or line 21g .
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21h
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Add lines 21a, 21b, 21c, and 21h .
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22
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Multiply line 22 by 10% (.10)
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24
Residential energy property costs (must be placed in service by you; include labor costs for onsite
preparation, assembly, and original installation) (see instructions).
a Energy-efficient building property. Do not enter more than $300 .
24a
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b Qualified natural gas, propane, or oil furnace or hot water boiler. Do not enter more than $150 .
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24b
c Advanced main air circulating fan used in a natural gas, propane, or oil furnace. Do not enter more than $50 .
24c
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Add lines 24a through 24c
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25
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Add lines 23 and 25
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27
Maximum credit amount. (If you jointly occupied the home, see instructions) .
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27
$500
28
Enter the amount, if any, from line 20f
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28
29
Subtract line 28 from line 27. If zero or less, stop; you cannot take the nonbusiness energy property credit .
29
30
Enter the smaller of line 26 or line 29 .
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30
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Limitation based on tax liability. Enter the amount from the Credit Limit Worksheet (see instructions)
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Nonbusiness energy property credit. Enter the smaller of line 30 or line 31. Also include this
amount on Form 1040, line 52, or Form 1040NR, line 49
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32
5695
Form
(2012)
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