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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8901, PAGE 1 of 2
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20.
FLAT SIZE: 203 mm (8") 3 279 mm (11")
PERFORATE: NONE
8901
Information on Qualifying Children
Who Are Not Dependents
●
§
OMB No. 1545-0074
2006
8901
Attachment
Sequence No.
59
●
Do not use this form for any child who is claimed as your dependent on Form 1040A or
Form 1040, line 6c, or Form 1040NR, line 7c.
It will take us longer to process your return and issue your refund if you do not complete all
columns for each qualifying child.
Be sure the child’s name and social security number (SSN) agree with the child’s social security
card. Otherwise, at the time we process your return, we may reduce or disallow your child tax
credit. 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.
Qualifying Child Information
(a) First name
Child 1
1040
1040A
..........
1040NR
..........
Your social security number
●
CAUTION
Revised proofs
requested
Complete and attach to Form 1040, Form 1040A, or Form 1040NR.
Name(s) shown on return
Signature
f
o
s
a
6
t
0
f
0
a
2
r
/
D /21
7
0
(For Child Tax Credit)
Department of the Treasury
Internal Revenue Service (99)
Date
O.K. to print
PRINTS: HEAD TO HEAD
INK: BLACK
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Form
Action
Last name
(b) Child’s
social security number
(c) Child’s relationship to you
(son, daughter, etc.)
Child 2
Child 3
Child 4
For Paperwork Reduction Act Notice, see above.
Cat. No. 37710J
Form
8901
(2006)
File Type | application/pdf |
File Title | 2005 Form 1040 |
Subject | U.S. Individual Income Tax Return |
Author | SE:W:CAR:MP |
File Modified | 2006-12-30 |
File Created | 2006-12-30 |