8862 Information To Claim Earned Income Credit After Disallow

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Form

8862

Action

Department of the Treasury
Internal Revenue Service

©

Signature

O.K. to print
Revised proofs
requested

Information To Claim Earned Income Credit
After Disallowance

(Rev. January 2009)

Date

OMB No. 1545-0074

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Attach to your tax return.

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See instructions on back.

Attachment
Sequence No.

43A

Your social security number

Name(s) shown on return

Before you begin: u See your tax return instructions or Pub. 596, Earned Income Credit (EIC), for the year for which you are
filing this form to make sure you can take the earned income credit (EIC) and to find out who is a
qualifying child.
u If you have a qualifying child, complete Schedule EIC before you fill in this form.
u Do not file this form if you are taking the EIC without a qualifying child and the only reason your EIC
was reduced or disallowed in the earlier year was because it was determined that a child listed on
Schedule EIC was not your qualifying child.

Part I
1
2

3

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Enter the year for which you are filing this form (for example, 2008)
If the only reason your EIC was reduced or disallowed in the earlier year was because you incorrectly
©
reported your earned income or investment income, check “Yes.” Otherwise, check “No”
Yes
No
Caution. If you checked “Yes,” stop. Do not fill in the rest of this form. But you must attach it to your tax return to take
the EIC. If you checked “No,” continue.
Could you (or your spouse if filing jointly) be claimed as a qualifying child of another person for the
©
year shown on line 1?
Yes
No
Caution. If you checked “Yes,” stop. You cannot take the EIC. If you checked “No,” continue.

Part II
4
5

All Filers

Filers Without a Qualifying Child

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Enter the number of days during the year shown on line 1 that you lived in the United States
Caution. If you entered less than 183 (184 if the year on line 1 is 2008), stop. You cannot take the EIC. See the instructions.
If married filing a joint return, enter the number of days during the year shown on line 1 that your spouse
©
lived in the United States
Caution. If you entered less than 183 (184 if the year on line 1 is 2008), stop. You cannot take the EIC. See the instructions.

Part III

Filers With a Qualifying Child or Children

Note. Child 1 and Child 2 are the same children you listed as Child 1 and Child 2 on Schedule EIC for the year shown on line 1 above.
6 Enter the number of days each child lived with you in the United States during the year shown on line 1 above:
©
a Child 1 ©
b Child 2
Caution. If you entered less than 183 for either child (184 if the year on line 1 is 2008), you cannot take the EIC based on
that child, unless the special rule for a child who was born or died during the year shown on line 1 applies. See the
instructions.
7

If your child was born or died during the year shown on line 1, enter the month and day the child was born and/or died.
Otherwise, skip this line.

(2) Month and day of death (MM/DD) ©
a Child 1 © (1) Month and day of birth (MM/DD) ©
/
/
(2) Month and day of death (MM/DD) ©
b Child 2 © (1) Month and day of birth (MM/DD) ©
/
/
8 Enter the address where you and the child lived together during the year shown on line 1. If you lived with the child at more
than one address during the year, attach a list of the addresses where you lived:
a Child 1 © Number and street
City or town, state, and ZIP code
Otherwise, enter below:
b Child 2 © If same as shown for child 1, check this box. ©
Number and street
City or town, state, and ZIP code
9 Did any other person (except your spouse, if filing jointly, and your dependents under age 19) live with
©
child 1 or child 2 for more than half the year shown on line 1?
Yes
No
If “Yes,” enter that person’s name and relationship to the child below. If more than one other person
lived with the child for more than half the year, attach a list of each person’s name and relationship to
the child:
a Other person living with child 1: Name
Relationship to child 1
b Other person living with child 2: If same as shown for child 1, check this box. ©
Otherwise, enter below:
Name
Relationship to child 2
Caution. The IRS may ask you to provide additional information to verify your eligibility to claim the EIC.
For Paperwork Reduction Act Notice, see back of form.

Cat. No. 25145E

Form

8862

(Rev. 1-2009)