8914 Exemption Amount for Taxpayers Housing Midwestern Displa

Form

8914

Exemption Amount for Taxpayers Housing
Midwestern Displaced Individuals

Department of the Treasury
Internal Revenue Service

OMB No. 1545-0074

2008

Attachment
Sequence No.

© Attach to Form 1040, Form 1040A, or Form 1040NR

Name(s) shown on your return

Part I

55

Your social security number

Information on Midwestern Displaced Individuals for Whom You Provided Housing in Your Main
Home for at Least 60 Consecutive Days
Do not enter information for more than four individuals or for anyone included on line 6d of Form 1040 or 1040A
(line 7d of Form 1040NR).

1

(a) First and last name

Part II
2
3
4
5

(c) Former address in disaster area
(number and street, city or town, state, and ZIP code)

(b) Social security number
(see instructions)

(d) Number of
consecutive days housed
in your main home

Exemption Amount

Multiply $500 by the total number of individuals listed in Part I above. Do not enter more than
$2,000 ($1,000 if married filing separately)
Multiply $3,500 by the total number of exemptions claimed on line 6d of Form 1040 or
Form 1040A (line 7d of Form 1040NR)
Add lines 2 and 3
Is the amount on Form 1040, line 38 (Form 1040A, line 22; or
Form 1040NR, line 36), more than the amount shown on line 6 below
for your filing status?
No.

STOP

2
3
4

Enter the amount from line 4 above on Form 1040,

line 42 (Form 1040A, line 26; or Form 1040NR, line 39).

6

7
8

Yes. Enter the amount from Form 1040, line 38 (Form 1040A,
line 22; or Form 1040NR, line 36)
Enter the amount shown below for your filing status.
● Single—$159,950
● Married filing jointly or Qualifying widow(er)—$239,950
● Married filing separately—$119,975
● Head of household—$199,950
Form 1040NR filers, see instructions
Subtract line 6 from line 5
Is line 7 more than $122,500 ($61,250 if married filing separately)?

%

5

6

7

No. Skip line 9; go to line 10.
Yes. Multiply $2,333 by the total number of exemptions claimed
on line 6d of Form 1040 or Form 1040A (line 7d of Form 1040NR)

8

9

Add lines 2 and 8. Enter the result on Form 1040, line 42; Form 1040A,
line 26; or Form 1040NR, line 39. Do not complete the rest of this form

9

10

Divide line 7 by $2,500 ($1,250 if married filing separately). If the result
is not a whole number, increase it to the next higher whole number
(for example, increase .0004 to 1)

10

11
12
13
14

Multiply line 10 by 2% (.02) and enter the result as a decimal rounded
.
11
to at least three places
Multiply line 3 by line 11
Divide line 12 by 3.0
Exemption amount. Subtract line 13 from line 4. Enter the result here and on Form 1040, line
42; Form 1040A, line 26; or Form 1040NR, line 39

For Paperwork Reduction Act Notice, see page 3.

Cat. No. 37724X

12
13
14
Form

8914

(2008)

Form 8914 (2008)

Page

3

General Instructions

Specific Instructions

Purpose of Form

Line 1, Column (a)

Use Form 8914 to claim your personal exemptions,
exemptions for dependents, and the additional exemption
amount for providing housing in your main home to one or
more Midwestern displaced individuals.

Enter the first and last names of up to four displaced
individuals who were provided housing in your main home for
at least 60 consecutive days during 2008. If less than 60
consecutive days, you cannot claim an additional exemption
amount for this individual.

Additional Exemption Amount
You can claim an additional exemption amount of $500 for
each Midwestern displaced individual (defined below). You
can claim an additional exemption amount only one time for
a specific individual. If you claim an additional exemption
amount for an individual in 2008, you cannot claim that
amount again for the same individual in 2009. The maximum
additional exemption amount you can claim for all displaced
individuals is $2,000 ($1,000 if married filing separately). Any
additional exemption amount you claim for displaced
individuals in 2008 will reduce the $2,000 maximum for 2009.
If two or more taxpayers share the same main home, only
one taxpayer in that main home can claim the additional
exemption amount for a specific displaced individual. If
married filing separately, only one spouse can claim the
additional exemption amount for a specific displaced
individual. In order for you to be considered to have provided
housing, you must have a legal interest in the main home
(that is, own or rent the home).

Midwestern Displaced Individual
To qualify as a Midwestern displaced individual, an individual
must meet the following three conditions.
● The individual must have had his or her main home in one
of the counties listed in Table 1 or Table 2 on page 4 on the
applicable disaster date shown in the table for that county,
and he or she must have been displaced from that home. In
addition, if the individual’s main home was in a county listed
in Table 2, the home must have been damaged by the
storms, tornadoes, or flooding that gave rise to the disaster
declaration for that county, or the individual must have been
evacuated from the home because of the storms, tornadoes,
or flooding.
● He or she must have been provided housing in your main
home free of charge for a period of at least 60 consecutive
days ending in the tax year in which the exemption is
claimed. See Compensation for Housing below.
● He or she cannot be your spouse or dependent.

Compensation for Housing
You cannot claim the additional exemption amount if you
received rent (or any other amount) from any source for
providing the housing. You are permitted to receive
payments or reimbursements that do not relate to normal
housing costs, including the following.
● Food, clothing, or personal items consumed or used by the
displaced individual.
● Reimbursement for the cost of any long distance telephone
calls made by the displaced individual.
● Reimbursement for the cost of gasoline for the displaced
individual’s use of your vehicle.
However, you cannot claim the additional exemption
amount if you received any reimbursement for the extra costs
of heat, electricity, or water used by the displaced individual.

Line 1, Column (b)
Enter the displaced individual’s social security number (SSN)
or individual taxpayer identification number (ITIN). You must
provide this information in column (b) to claim an exemption
amount. You can use Form W-9, Request for Taxpayer
Identification Number and Certification, to request an SSN or
ITIN from the displaced individual.

Line 1, Column (c)
Enter the street address where the displaced individual’s
main home was located on the applicable disaster date. That
home must have been located in a Midwestern disaster area
on that date. Include the number and street, city or town,
state, and ZIP code.

Line 1, Column (d)
Enter the number of consecutive days the displaced
individual was provided housing in your main home free of
charge.

Line 6
If you are filing Form 1040NR, enter the amount shown
below for your filing status.
● Filing status box 1 or 2 — $159,950
● Filing status box 3, 4, or 5 — $119,975
● Filing status box 6 — $239,950

Paperwork Reduction Act Notice. We ask for the
information on this form to carry out the Internal Revenue
laws of the United States. You are required to give us the
information. We need it to ensure that you are complying
with these laws and to allow us to figure and collect the right
amount of tax.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in
the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
Internal Revenue Code section 6103.
The average time and expenses required to complete and
file this form will vary depending on individual circumstances.
For the estimated averages, see the instructions for your
income tax return.
If you have suggestions for making this form simpler, we
would be happy to hear from you. See the instructions for
your income tax return.

Form 8914 (2008)

Page

4

Table 1

Table 2

The counties listed in Table 1 below are Midwestern disaster
areas. You may be eligible for the additional $500 exemption
for housing a Midwestern displaced individual if that
individual had his or her main home in one of the counties
listed in this table on the applicable disaster date shown for
that county and was displaced from that home.

The counties listed in Table 2 below are Midwestern disaster
areas. You may be eligible for the additional $500 exemption
for housing a Midwestern displaced individual if that
individual had his or her main home in one of the counties
listed in this table on the applicable disaster date shown for
that county and was displaced from that home and either:
● That home was damaged by the storms, tornadoes, or
flooding that gave rise to the disaster declaration for that
county, or

Applicable
Disaster Date*

State

Affected Counties — Midwestern Disaster Areas

05/02/2008

Arkansas

Arkansas, Benton, Cleburne, Conway, Crittenden,
Grant, Lonoke, Mississippi, Phillips, Pulaski,
Saline, and Van Buren

● The individual was evacuated from that home because of
the storms, tornadoes, or flooding.

06/01/2008

Illinois

Adams, Calhoun, Clark, Coles, Crawford,
Cumberland, Douglas, Edgar, Hancock,
Henderson, Jasper, Jersey, Lake, Lawrence,
Mercer, Rock Island, Whiteside, and Winnebago

Applicable
Disaster Date*

06/06/2008

05/25/2008

Indiana

Iowa

Adams, Bartholomew, Brown, Clay, Daviess,
Dearborn, Decatur, Gibson, Grant, Greene,
Hamilton, Hancock, Hendricks, Henry, Huntington,
Jackson, Jefferson, Jennings, Johnson, Knox,
Lawrence, Madison, Marion, Monroe, Morgan,
Owen, Parke, Pike, Posey, Putnam, Randolph,
Ripley, Rush, Shelby, Sullivan, Tippecanoe,
Vermillion, Vigo, Washington, and Wayne
Adair, Adams, Allamakee, Appanoose, Audubon,
Benton, Black Hawk, Boone, Bremer, Buchanan,
Butler, Cass, Cedar, Cerro Gordo, Chickasaw,
Clarke, Clayton, Clinton, Crawford, Dallas, Davis,
Decatur, Delaware, Des Moines, Dubuque,
Fayette, Floyd, Franklin, Fremont, Greene,
Grundy, Guthrie, Hamilton, Hancock, Hardin,
Harrison, Henry, Howard, Humboldt, Iowa,
Jackson, Jasper, Johnson, Jones, Keokuk,
Kossuth, Lee, Linn, Louisa, Lucas, Madison,
Mahaska, Marion, Marshall, Mills, Mitchell,
Monona, Monroe, Montgomery, Muscatine, Page,
Polk, Pottawattamie, Poweshiek, Ringgold, Scott,
Story, Tama, Union, Van Buren, Wapello, Warren,
Washington, Webster, Winnebago, Winneshiek,
Worth, and Wright

05/10/2008

Missouri

Barry, Jasper, and Newton

06/01/2008

Missouri

Adair, Andrew, Callaway, Cass, Chariton, Clark,
Gentry, Greene, Harrison, Holt, Johnson, Lewis,
Lincoln, Linn, Livingston, Macon, Marion, Monroe,
Nodaway, Pike, Putnam, Ralls, St. Charles, Stone,
Taney, Vernon, and Webster

05/22/2008

Nebraska

Buffalo, Butler, Colfax, Custer, Dawson, Douglas,
Gage, Hamilton, Holt, Jefferson, Kearney,
Lancaster, Platte, Richardson, Sarpy, and
Saunders

06/05/2008

Wisconsin

Adams, Calumet, Columbia, Crawford, Dane,
Dodge, Fond du Lac, Grant, Green, Green Lake,
Iowa, Jefferson, Juneau, Kenosha, La Crosse,
Manitowoc, Marquette, Milwaukee, Monroe,
Ozaukee, Racine, Richland, Rock, Sauk,
Sheboygan, Vernon, Walworth, Washington,
Waukesha, and Winnebago

* In some cases, the date will be later due to the continuation of the severe
storms, tornadoes, or flooding that began on the above date. For more details,
go to www.fema.gov.

State

Affected Counties — Midwestern Disaster Areas

06/01/2008

Illinois

Greene, Madison, Monroe, Pike, Randolph,
St. Clair, and Scott

06/06/2008

Indiana

Benton, Boone, Fountain, Franklin, Jay,
Montgomery, Ohio, Switzerland, Union, and
Wabash

05/25/2008

Iowa

Carroll, Cherokee, Lyon, Palo Alto, Pocahontas,
Taylor, and Wayne

05/22/2008

Kansas

Barber, Barton, Bourbon, Brown, Butler,
Chautauqua, Cherokee, Clark, Clay, Comanche,
Cowley, Crawford, Decatur, Dickinson, Edwards,
Elk, Ellis, Ellsworth, Franklin, Gove, Graham,
Harper, Haskell, Hodgeman, Jackson, Jewell,
Kingman, Kiowa, Lane, Linn, Logan, Mitchell,
Montgomery, Ness, Norton, Osborne, Pawnee,
Phillips, Pratt, Reno, Republic, Riley, Rooks,
Rush, Saline, Seward, Sheridan, Smith, Stafford,
Sumner, Thomas, Trego, Wallace, and Wilson

06/06/2008

Michigan

Allegan, Barry, Eaton, Ingham, Lake, Manistee,
Mason, Missaukee, Osceola, Ottawa, Saginaw,
and Wexford

06/07/2008

Minnesota

Cook, Fillmore, Freeborn, Houston, Mower, and
Nobles

06/01/2008

Missouri

Atchison, Audrain, Bates, Buchanan, Cape
Girardeau, Carroll, Christian, Daviess, Grundy,
Howard, Jefferson, Knox, Mercer, Miller,
Mississippi, Morgan, New Madrid, Pemiscot,
Perry, Pettis, Platte, Polk, Randolph, Ray, Saline,
Schuyler, Scotland, Shelby, St. Genevieve,
St. Louis, the Independent City of St. Louis,
Scott, Sullivan, and Worth

04/23/2008

Nebraska

Gage, Johnson, Morrill, Nemaha, and Pawnee

05/22/2008

Nebraska

Adams, Blaine, Boone, Boyd, Brown, Burt, Cass,
Chase, Cherry, Cuming, Dundy, Fillmore, Frontier,
Furnas, Garfield, Gosper, Greeley, Hall, Hayes,
Howard, Johnson, Keya Paha, Lincoln, Logan,
Loup, Merrick, McPherson, Morrill, Nance,
Nemaha, Otoe, Phelps, Polk, Red Willow, Rock,
Saline, Seward, Sherman, Stanton, Thayer,
Thomas, Thurston, Valley, Webster, Wheeler, and
York

06/27/2008

Nebraska

Dodge, Douglas, Sarpy, and Saunders

06/05/2008

Wisconsin

Lafayette

* In some cases, the date will be later due to the continuation of the severe
storms, tornadoes, or flooding that began on the above date. For more details,
go to www.fema.gov.