Schedule EIC (Form Earned Income Credit

U.S. Individual Income Tax Return

Form 1040 (Sch EIC)

U.S. Individual Income Tax Return

OMB: 1545-0074

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Earned Income Credit

SCHEDULE EIC
(Form 1040A or 1040)

!
▲
CAUTION

..........

Qualifying Child Information

OMB No. 1545-0074

◀

2011

1040

EIC

Complete and attach to Form 1040A or 1040
only if you have a qualifying child.

Department of the Treasury
Internal Revenue Service (99)
Name(s) shown on return

Before you begin:

1040A

Attachment
Sequence No. 43
Your social security number

• See the instructions for Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b, to make
sure that (a) you can take the EIC, and (b) you have a qualifying child.
• Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card.
Otherwise, at the time we process your return, we may reduce or disallow your EIC. 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.

• If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See page 2 for details.
• It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child.

Qualifying Child Information
1 Child’s name

Child 1
First name

Child 2
Last name

First name

Child 3
Last name

First name

Last name

If you have more than three qualifying
children, you only have to list three to get
the maximum credit.

2 Child’s SSN

The child must have an SSN as defined in
the instructions for Form 1040A, lines 38a
and 38b, or Form 1040, lines 64a and 64b,
unless the child was born and died in
2011. If your child was born and died in
2011 and did not have an SSN, enter
“Died” on this line and attach a copy of
the child’s birth certificate, death
certificate, or hospital medical records.

3 Child’s year of birth

Year
If born after 1992 and the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.

Year

Year

If born after 1992 and the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.

If born after 1992 and the child was
younger than you (or your spouse, if
filing jointly), skip lines 4a and 4b;
go to line 5.

4 a Was the child under age 24 at the end of

2011, a student, and younger than you (or
your spouse, if filing jointly)?

Yes.
Go to line 5.

No.

Yes.

Go to line 4b.

No.

Go to line 5.

Yes.

Go to line 4b.

No.

Go to line 5.

Go to line 4b.

b Was the child permanently and totally
disabled during any part of 2011?

Yes.
Go to
line 5.

No.
The child is not a
qualifying child.

Yes.
Go to
line 5.

No.
The child is not a
qualifying child.

Yes.
Go to
line 5.

No.
The child is not a
qualifying child.

5 Child’s relationship to you
(for example, son, daughter, grandchild,
niece, nephew, foster child, etc.)

6 Number of months child lived
with you in the United States
during 2011
• If the child lived with you for more than
half of 2011 but less than 7 months,
enter “7.”
• If the child was born or died in 2011 and
your home was the child’s home for the
entire time he or she was alive during
2011, enter “12.”

months
Do not enter more than 12
months.

For Paperwork Reduction Act Notice, see your tax
return instructions.

months
Do not enter more than 12
months.
Cat. No. 13339M

months
Do not enter more than 12
months.
Schedule EIC (Form 1040A or 1040) 2011

Page

Schedule EIC (Form 1040A or 1040) 2011

Purpose of Schedule
After you have figured your earned income credit
(EIC), use Schedule EIC to give the IRS information
about your qualifying child(ren).
To figure the amount of your credit or to have the IRS
figure it for you, see the instructions for Form 1040A,
lines 38a and 38b, or Form 1040, lines 64a and 64b.

TIP

Taking the EIC when not eligible. If you take the
EIC even though you are not eligible and it is
determined that your error is due to reckless or
intentional disregard of the EIC rules, you will not be
allowed to take the credit for 2 years even if you are
otherwise eligible to do so. If you fraudulently take the
EIC, you will not be allowed to take the credit for 10
years. You may also have to pay penalties.

You may also be able to take the additional child tax credit if your child was your dependent and under age 17 at the end of 2011.
For more details, see the instructions for line 39 of Form 1040A or line 65 of Form 1040.

Qualifying Child
A qualifying child for the EIC is a child who is your . . .
Son, daughter, stepchild, foster child, brother, sister, stepbrother, stepsister, half brother, half sister, or
a descendant of any of them (for example, your grandchild, niece, or nephew)

AND

▼
was . . .
Under age 19 at the end of 2011 and younger than you (or your spouse, if filing jointly)
or
Under age 24 at the end of 2011, a student, and younger than you (or your spouse, if filing jointly)
or
Any age and permanently and totally disabled

AND

▼
Who is not filing a joint return for 2011
or is filing a joint return for 2011 only as a claim for refund
(as defined in the instructions for Form 1040A, lines 38a and
38b, or Form 1040, lines 64a and 64b)

AND

▼
Who lived with you in the United States for more than half
of 2011. If the child did not live with you for the required time,
see Exception to time lived with you in the instructions for
Form 1040A, lines 38a and 38b, or Form 1040, lines 64a and 64b.

!
▲
CAUTION

If the child was married or meets the conditions to be a
qualifying child of another person (other than your
spouse if filing a joint return), special rules apply. For
details, see Married child or Qualifying child of more
than one person in the instructions for Form 1040A, lines
38a and 38b, or Form 1040, lines 64a and 64b.

2


File Typeapplication/pdf
File Title2011 Form 1040 (Schedule EIC)
SubjectFillable
AuthorSE:W:CAR:MP
File Modified2011-10-19
File Created2008-11-05

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