Form 8909 - Energy Efficient Appliance Credit - 2012

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8909
OMB No. 1545-2055
Energy Efficient Appliance Credit
2012
Form
Attach to your tax return.
Department of the Treasury
Attachment
159
Internal Revenue Service
Information about Form 8909 and its instructions is at
Sequence No.
Name(s) shown on return
Identifying number
Part I
Dishwashers (see instructions)
(a)
(b)
Type A
Type B
1
Enter the number of eligible dishwashers produced in calendar
1
year 2012 .
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Enter the average number of eligible dishwashers produced in
2
the 2 prior calendar years
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2
3
Subtract line 2 from line 1
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3
4
4
Applicable amount
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$50 00
$75 00
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5
Multiply line 3 by line 4
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6
Add the amounts of line 5 in columns (a) and (b) .
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6
Part II
Clothes Washers (see instructions)
7
Enter the number of eligible clothes washers produced in calendar year 2012
7
8
Enter the average number of eligible clothes washers produced in the 2 prior
8
calendar years .
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9
9
Subtract line 8 from line 7
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10
Applicable amount .
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10
$225 00
11
Multiply line 9 by line 10 .
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11
12
Enter the amount from line 11 .
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12
Part III
Refrigerators (see instructions)
(a)
(b)
Type A
Type B
13
Enter the number of eligible refrigerators produced in calendar
year 2012 .
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13
14
Enter the average number of eligible refrigerators produced in
14
the 2 prior calendar years
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15
15
Subtract line 14 from line 13
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16
Applicable amount .
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16
$150 00
$200 00
17
Multiply line 15 by line 16
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17
18
Add the amounts on line 17 in columns (a) and (b)
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18
Part IV
Current Year Energy Appliance Credit
19
Total. Add lines 6, 12, and 18 .
19
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20
Enter 4% of average annual gross receipts (see instructions) .
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20
21a Maximum credit base amount (see instructions) .
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21a
$25,000,000 00
b Enter the amount from line 19 of your *2011 Form 8909 .
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21b
c Enter the amount from line 21b of your *2011 Form 8909 .
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21c
d Enter the amount from line 21c of your *2011 Form 8909 .
21d
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e Add lines 21c and 21d
21e
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f
Subtract line 21e from line 21b .
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21f
g Enter the amount from line 20 of your *2011 Form 8909
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21g
h Enter the smallest of the amount on line 21a, 21f, or 21g .
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21h
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21i
Subtract line 21h from line 21a
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22a Enter the amount from line 12 .
22a
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b Enter the amount from line 17, column (b) .
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22b
c Add lines 22a and 22b
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22c
23
Maximum credit amount. Add lines 21i through 22c .
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23
24
Enter the smallest of the amount on line 19, 20, or 23 .
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24
25
25
Energy efficient appliance credit from partnerships, S corporations, cooperatives, estates, and trusts (see instructions)
Add lines 24 and 25. Cooperatives, estates, and trusts, go to line 27. Partnerships and S
26
corporations, stop here and report this amount on Schedule K. All others, stop here and report this
amount on Form 3800, line 1q .
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26
27
Amount allocated to beneficiaries of the estate or trust, or to patrons of the cooperative (see instructions)
27
28
Cooperatives, estates, and trusts, subtract line 27 from line 26. Report this amount on Form 3800, line 1q
28
*Include amounts from predecessors.
8909
Form
(2012)
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 37719E

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