Schedule Eic (Form 1040a Or 1040) - Earned Income Credit - 2012
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1
2SCHEDULE EIC
Earned Income Credit
OMB No. 1545-0074
◀
1040A
(Form 1040A or 1040)
2012
Qualifying Child Information
. . . . . . . . . .
1040
Complete and attach to Form 1040A or 1040 only if you have a qualifying child.
▶
EIC
Department of the Treasury
Attachment
Information about Schedule EIC (Form 1040A or 1040) and its instructions is at
▶
43
Internal Revenue Service (99)
Sequence No.
Name(s) shown on return
Your social security number
• See the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, to make
Before you begin:
sure that (a) you can take the EIC, and (b) you have a qualifying child.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card.
Otherwise, at the time we process your return, we may reduce or disallow your EIC. If the name or SSN on the child’s
social security card is not correct, call the Social Security Administration at 1-800-772-1213.
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• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See page 2 for details.
!
• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.
CAUTION
Qualifying Child Information
Child 1
Child 2
Child 3
1 Child’s name
First name
Last name
First name
Last name
First name
Last name
If you have more than three qualifying
children, you only have to list three to get
the maximum credit.
2 Child’s SSN
The child must have an SSN as defined in
the instructions for Form 1040A, lines 38a
and 38b, or Form 1040, lines 64a and 64b,
unless the child was born and died in
2012. If your child was born and died in
2012 and did not have an SSN, enter
“Died” on this line and attach a copy of
the child’s birth certificate, death
certificate, or hospital medical records.
3 Child’s year of birth
Year
Year
Year
If born after 1993 and the child was
If born after 1993 and the child was
If born after 1993 and the child was
younger than you (or your spouse, if
younger than you (or your spouse, if
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
filing jointly), skip lines 4a and 4b;
filing jointly), skip lines 4a and 4b;
go to line 5.
go to line 5.
go to line 5.
4 a
Was the child under age 24 at the end of
Yes.
No.
Yes.
No.
Yes.
No.
2012, a student, and younger than you (or
your spouse, if filing jointly)?
Go to
Go to line 4b.
Go to
Go to line 4b.
Go to
Go to line 4b.
line 5.
line 5.
line 5.
b
Was the child permanently and totally
disabled during any part of 2012?
Yes.
No.
Yes.
No.
Yes.
No.
Go to
Go to
Go to
The child is not a
The child is not a
The child is not a
line 5.
qualifying child.
line 5.
qualifying child.
line 5.
qualifying child.
5 Child’s relationship to you
(for example, son, daughter, grandchild,
niece, nephew, foster child, etc.)
6 Number of months child lived
with you in the United States
during 2012
• If the child lived with you for more than
half of 2012 but less than 7 months,
enter “7.”
• If the child was born or died in 2012 and
months
months
months
your home was the child’s home for more
Do not enter more than 12
Do not enter more than 12
Do not enter more than 12
than half the time he or she was alive
months.
months.
months.
during 2012, enter “12.”
For Paperwork Reduction Act Notice, see your tax
Cat. No. 13339M
Schedule EIC (Form 1040A or 1040) 2012
return instructions.
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