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Form
8867
(Rev. December 2021)
Department of the Treasury
Internal Revenue Service
Paid Preparer’s Due Diligence Checklist
Earned Income Credit (EIC), American Opportunity Tax Credit (AOTC),
Child Tax Credit (CTC) (including the Additional Child Tax Credit (ACTC) and
Credit for Other Dependents (ODC)), and Head of Household (HOH) Filing Status
▶ To be completed by preparer and filed with Form 1040, 1040-SR, 1040-NR, 1040-PR, or 1040-SS.
▶ Go to www.irs.gov/Form8867 for instructions and the latest information.
OMB No. 1545-0074
Attachment
Sequence No. 70
Taxpayer identification number
Taxpayer name(s) shown on return
DRAFT AS OF
September 23, 2021
DO NOT FILE
Enter preparer’s name and PTIN
Part I
Due Diligence Requirements
Please check the appropriate box for the credit(s) and/or HOH filing status claimed on the return and complete the related Parts I–V
for the benefit(s) claimed (check all that apply).
EIC
CTC/ACTC/ODC
AOTC
HOH
1
Did you complete the return based on information for the applicable tax year provided by the taxpayer
or reasonably obtained by you? (See instructions if relying on prior year earned income.)
. . . .
2
If credits are claimed on the return, did you complete the applicable EIC and/or CTC/ACTC/ODC
worksheets found in the Form 1040, 1040-SR, 1040-NR, 1040-PR, 1040-SS, or Schedule 8812 (Form
1040) instructions, and/or the AOTC worksheet found in the Form 8863 instructions, or your own
worksheet(s) that provides the same information, and all related forms and schedules for each credit
claimed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Did you satisfy the knowledge requirement? To meet the knowledge requirement, you must do both of
the following.
• Interview the taxpayer, ask questions, and contemporaneously document the taxpayer’s responses to
determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing status.
3
Yes
No
N/A
• Review information to determine that the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of any credit(s) . . . . . . . . . . . . . . . . .
4
a
Did any information provided by the taxpayer or a third party for use in preparing the return, or
information reasonably known to you, appear to be incorrect, incomplete, or inconsistent? (If “Yes,”
answer questions 4a and 4b. If “No,” go to question 5.) . . . . . . . . . . . . . . .
Did you make reasonable inquiries to determine the correct, complete, and consistent information? .
b Did you contemporaneously document your inquiries? (Documentation should include the questions
you asked, whom you asked, when you asked, the information that was provided, and the impact the
information had on your preparation of the return.) . . . . . . . . . . . . . . . . .
5
Did you satisfy the record retention requirement? To meet the record retention requirement, you must
keep a copy of your documentation referenced in question 4b, a copy of this Form 8867, a copy of any
applicable worksheet(s), a record of how, when, and from whom the information used to prepare Form
8867 and any applicable worksheet(s) was obtained, and a copy of any document(s) provided by the
taxpayer that you relied on to determine eligibility for the credit(s) and/or HOH filing status or to figure
the amount(s) of the credit(s) . . . . . . . . . . . . . . . . . . . . . . . .
List those documents provided by the taxpayer, if any, that you relied on:
6
7
a
8
Did you ask the taxpayer whether he/she could provide documentation to substantiate eligibility for the
credit(s) and/or HOH filing status and the amount(s) of any credit(s) claimed on the return if his/her
return is selected for audit? . . . . . . . . . . . . . . . . . . . . . . . . .
Did you ask the taxpayer if any of these credits were disallowed or reduced in a previous year? . .
(If credits were disallowed or reduced, go to question 7a; if not, go to question 8.)
Did you complete the required recertification Form 8862? . . . . . . . . . . . . . . .
If the taxpayer is reporting self-employment income, did you ask questions to prepare a complete and
correct Schedule C (Form 1040)? . . . . . . . . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 26142H
Form
8867 (Rev. 12-2021)
Page 2
Form 8867 (Rev. 12-2021)
Part II
Due Diligence Questions for Returns Claiming EIC (If the return does not claim EIC, go to Part III.)
9a
Have you determined that the taxpayer is eligible to claim the EIC for the number of qualifying children
claimed, or is eligible to claim the EIC without a qualifying child? (If the taxpayer is claiming the EIC
and does not have a qualifying child, go to question 10.) . . . . . . . . . . . . . .
b Did you ask the taxpayer if the child lived with the taxpayer for over half of the year, even if the taxpayer
has supported the child the entire year? . . . . . . . . . . . . . . . . . . . . .
c Did you explain to the taxpayer the rules about claiming the EIC when a child is the qualifying child of
more than one person (tiebreaker rules)? . . . . . . . . . . . . . . . . . . . .
Yes
No
N/A
DRAFT AS OF
September 23, 2021
DO NOT FILE
Part III
10
11
12
Have you determined that each qualifying person for the CTC/ACTC/ODC is the taxpayer’s dependent who is
a citizen, national, or resident of the United States? . . . . . . . . . . . . . . . . . .
Did you explain to the taxpayer that he/she may not claim the CTC/ACTC if the child has not lived with
the taxpayer for over half of the year, even if the taxpayer has supported the child, unless the child’s
custodial parent has released a claim to exemption for the child? . . . . . . . . . . . .
N/A
Yes
No
Due Diligence Questions for Claiming HOH (If the return does not claim HOH filing status, go to Part VI.)
Have you determined that the taxpayer was unmarried or considered unmarried on the last day of the tax year
and provided more than half of the cost of keeping up a home for the year for a qualifying person? . . . .
Part VI
15
No
Due Diligence Questions for Returns Claiming AOTC (If the return does not claim AOTC, go to Part V.)
Did the taxpayer provide substantiation for the credit, such as a Form 1098-T and/or receipts for the qualified
tuition and related expenses for the claimed AOTC? . . . . . . . . . . . . . . . . . . . .
Part V
14
Yes
Did you explain to the taxpayer the rules about claiming the CTC/ACTC/ODC for a child of divorced or
separated parents (or parents who live apart), including any requirement to attach a Form 8332 or similar
statement to the return? . . . . . . . . . . . . . . . . . . . . . . . . . .
Part IV
13
Due Diligence Questions for Returns Claiming CTC/ACTC/ODC (If the return does not claim CTC, ACTC,
or ODC, go to Part IV.)
Yes
No
Eligibility Certification
▶
You will have complied with all due diligence requirements for claiming the applicable credit(s) and/or HOH filing
status on the return of the taxpayer identified above if you:
A. Interview the taxpayer, ask adequate questions, contemporaneously document the taxpayer’s responses on the return or
in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing
status and to figure the amount(s) of the credit(s);
B. Complete this Form 8867 truthfully and accurately and complete the actions described in this checklist for any applicable
credit(s) claimed and HOH filing status, if claimed;
C. Submit Form 8867 in the manner required; and
D. Keep all five of the following records for 3 years from the latest of the dates specified in the Form 8867 instructions under
Document Retention.
1. A copy of this Form 8867.
2. The applicable worksheet(s) or your own worksheet(s) for any credit(s) claimed.
3. Copies of any documents provided by the taxpayer on which you relied to determine the taxpayer’s eligibility for the
credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
4. A record of how, when, and from whom the information used to prepare this form and the applicable worksheet(s) was
obtained.
5. A record of any additional information you relied upon, including questions you asked and the taxpayer’s responses, to
determine the taxpayer’s eligibility for the credit(s) and/or HOH filing status and to figure the amount(s) of the credit(s).
▶
If you have not complied with all due diligence requirements, you may have to pay a penalty for each failure to
comply related to a claim of an applicable credit or HOH filing status (see instructions for more information).
Do you certify that all of the answers on this Form 8867 are, to the best of your knowledge, true, correct, and
complete? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Form
Yes
No
8867 (Rev. 12-2021)
File Type | application/pdf |
File Title | Form 8867 (Rev. December 2021) |
Subject | Fillable |
Author | SE:W:CAR:MP |
File Modified | 2021-09-23 |
File Created | 2021-09-21 |