Form 1040 Schedule Form 1040 Schedule 5 Other payments and Refundable Credi

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SCHEDULE 5
Department of the Treasury
Internal Revenue Service

a

2018

a Attach to Form 1040.
Go to www.irs.gov/Form1040 for instructions and the latest information.

Name(s) shown on Form 1040

Other
Payments
and
Refundable
Credits

OMB No. 1545-0074

Other Payments and Refundable Credits

(Form 1040)

Attachment
Sequence No. 05
Your social security number

DRAFT AS OF
July 31, 2018
DO NOT FILE
65
66
67a
b
68–69
70
71
72
73
74
75

Reserved . . . . . . . . . . . . . . . . . . . . . . . .
2018 estimated tax payments and amount applied from 2017 return . . . .
Reserved . . . . . . . . . . . . . . . . . . . . . . . .
Reserved . . . . . . . . . . . . . . . . . . . . . . . .
Reserved . . . . . . . . . . . . . . . . . . . . . . . .
Net premium tax credit. Attach Form 8962 . . . . . . . . . . . . .
Amount paid with request for extension to file (see instructions) . . . . . .
Excess social security and tier 1 RRTA tax withheld . . . . . . . . . .
Credit for federal tax on fuels. Attach Form 4136 . . . . . . . . . . .
Credits from Form: a
2439 b
Reserved c
8885
d
Add the amounts in the far right column. These are your total other payments
and refundable credits. Enter here and include on Form 1040, line 17 . . . .

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

Cat. No. 71482C

65
66
67a
67b
68–69
70
71
72
73
74
75

Schedule 5 (Form 1040) 2018