Form 3596 - Paid Preparer'S California Earned Income Tax Credit Checklist

25 Did you document (a) the taxpayer's answer to question 22 (if applicable), (b) whether you explained the

tiebreaker rules to the taxpayer and any additional information you got from the taxpayer as a result, and

(c) any additional questions you asked and the taxpayer's answers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Yes

Does not apply

Due Diligence Checklist

You have complied with all the due diligence requirements if you:

1. Completed the actions described on lines 20 and 21 and checked "Yes" on those lines,

2. Completed the actions described on lines 22, 23, 24, and 25 (if they apply) and checked "Yes" (or "Does not apply") on those lines,

3. Submit form FTB 3596 in the manner required, and

4. Keep all five of the following records for 4 years from the latest of the dates specified in the instructions under Document Retention:

a. Form FTB 3596,

b. The EITC worksheet(s) or your own worksheet(s),

c. Copies of any taxpayer documents you relied on to determine eligibility for or amount of EITC,

d. A record of how, when, and from whom the information used to prepare the form and worksheet(s) was obtained, and

e. A record of any additional questions you asked and your client's answers.

You have not complied with all the due diligence requirements if you checked “No” on line 20, 21, 22, 23, 24, or 25. You may have to pay a $500

penalty for each failure to comply.

Part V – Documents Provided to You

26 Identify below any document that the taxpayer provided to you and that you relied on to determine the taxpayer's EITC eligibility. Check all that

apply. Keep a copy of any documents you relied on. See the instructions before answering. If there is no qualifying child, check box a. If there is no

disabled child, check box o.

Residency of Qualifying Child(ren)

a No qualifying child

Indian tribal official statement

b School records or statement

k Employer statement

c Landlord or property management statement

Other (specify)

d Health care provider statement

____________________________________________________

e Medical records

____________________________________________________