Instant Tax Group & Associates Earned Income Tax Credit EligibilityDependent Credit, Schedule C, and American Opportunity Tax Credit Form Taxpayer Name: __________________________________ SSN: ______________________________ Spouse Name: __________________________________ SSN: ______________________________ Healthcare Form __________1095_____ Dependents Name Name
Date of Birth
Social Security Number
School Name
How are you related to your dependent?
□Parents □Mother □Father
□Uncle □Grandparents □Sister □Aunt □Brother □Other _________________ □Adopted Parents
My dependent(s) lived with me? _________Months.
I paid 50% or more for their living expenses?
Someone else can claim my dependents on their taxes?
□Yes □No
□Yes □No
If so who?
_______________________________________________________.
1. Do you have any of the following for Proof of Relationship?
□Yes □No
Birth certificates or other official documents of birth that show your relationship to the child Marriage certificates showing how you are related to the child Letter from the authorized adoption agency:____________________________ Letter from the authorized child placement center or a court document showing the placement
2. Do you have any of the following for Proof of Residency (you may have to send more than one of the following to show your child lived with you for more than half the year)?
□Yes □No
Rental Lease _____________ or Mortgage 1098 ___________________UTILITES Copies of school (no report cards) medical or social services records: _________________________ Letter on official letterhead from school, a healthcare or medical provider, social service agency, placement agency official, employer, Indian tribal official, landlord or property manager or a place of worship that shows: o The name of your child’s parent or guardian o Your child’s address matching your own o Dates the child lived with you
Daycare records or a letter from your day care provider (if the daycare provider is related to you, you must have at least one other record or letter that shows proof) 3. American Opportunity Tax Credit-Do you have any dependents on College?
□Yes □No?
A tax credit that enabled more student and parents to pay for part of their college expenses in the 2015 and 2016 tax years by expanding the existing Hope tax credit. The maximum annual tax credit per student is $2,500 of the cost of qualified tuition and related expenses paid during the tax year. Do you have any of the following for Proof of College and College Expenses?
□Yes □No?
College Name: ____________________________________________ College Address: __________________________________________ College Tuition Form 1098T:_________________________________ College Credits: _______________ Quarter/Semester:______________
4. Schedule C- Are you working for self-employee?
□Yes
□No?
Generally, you are self-employed if any of the following apply to you.
You carry on a trade or business as a sole proprietor or an independent contractor. You are a member of a partnership that carries on a trade or business. You are otherwise in business for yourself (including a part-time business)
1. What is the name of your business: _______________________________? 2. What is the kind of business: ____________________________________? How much income (money)? _____________________ 3. 4. 5. 6.
Had business expenses are $ ___________________________________ How to Use the method of accounting: Cash: __________ Credit Card: _________Other: ____________ Did you have an inventory at any time during the year _____________? Had only one business as either a sole proprietor, qualified joint venture or statutory employee _____________________________________AND you:
Had no employees during the year _________________________ Are not required to file Form 4562, Depreciation and Amortization, for this business_________ Do not deduct expenses for business use of your home ______________
Single-member limited liability company (LLC). Generally, a single-member domestic LLC is not treated as a separate entity for federal income tax purposes. If you are the sole member of a domestic LLC, file Schedule C or C-EZ (or Schedule E or F, if applicable) unless you have elected to treat the domestic LLC as a corporation.
Single-member limited liability companies (LLCs) with employees. A single-member LLC must file employment tax returns using the LLC's name and employer identification number (EIN) rather than the owner's name and EIN, even if the LLC is not treated as a separate entity for federal income tax purposes. Form 8332 - Claiming a dependent who did not live with you
□Yes
□No?
Generally, to claim a child as a dependent, that child had to live with you for over half the year. If the child did not live with you at all during the year, it is typically the case that someone else (usually the custodial parent) is entitled to claim that child as a dependent. However, you (in most cases, the noncustodial parent) may still be able to claim the child as a dependent if the custodial parent signs a Form 8332, Release of Claim to Exemption, or a form containing all of the same information listed on this form. By completing Form 8332, the custodial parent would be indicating that he or she wishes to release his or her claim to a dependency exemption for the child on the form. Without this form, you generally cannot claim a child who did not live with you as a dependent because they are the qualifying child of someone else. Children of divorced or separated parents In most cases, a child of divorced or separated parents is the qualifying child of the custodial parent. However, the child will be treated as the qualifying child of the noncustodial parent if all 4 of the following are true: 1. The parents (only one need apply-Grandparents, Sister, Brother, Uncle, Aunt) This is NOT for a God Parent, Godchild, God sister, God brother, etc. * Are divorced or legally separated under a decree of divorce; * Are separated under a written separation agreement; -OR* Lived apart at all times during the last 6 months of the year 2. The child received over half of his or her support for the year from the parents. 3. The child is in the custody of at least one parent for more than half of the year. 4. The custodial parent signs a written declaration that he or she will not claim the child as a dependent. Generally, this declaration is IRS Form 8332 and is included in the noncustodial parents return
Taxpayer Signature: __________________________________ Spouse Signature: ___________________________________
Date: _____________________ Date: _____________________