(Eic) Alternate Eligibility Record (Due Diligence)

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(EIC) ALTERNATE ELIGIBILITY RECORD (Due Diligence)
 
All questions should be asked and this form shall be filled out by tax preparer.
 
an
In accordance with Internal Revenue Service (IRS) Bulletin 97-65 and Internal Revenue Code (IRC) 1.6695-2, this form serves as
used
Alternate Eligibility Checklist, and as such may be
IN LIEU OF other forms of Due Diligence, including Form 8867. Maintain this
form with your client files.
 
 
HEAD OF HOUSEHOLD (H/H) ELIGIBILTY
You may file Head of Household if you can answer YES to ALL the following questions. (See Publication
Chapter
3)
17,
&
2
 
YES
NO
You are unmarried, or are considered unmarried on the last day of the year.
 
YES
NO
You paid more than half the cost of keeping up a home for the year.
 
YES
NO
qualifying person (see definition below) lived with you in the home for more than half the year
A
(except for temporary absences, such as school), and you can claim an exemption for him/her.
 
Except as noted under Category 3 below.
 
A qualifying person is your (See Table
Publication
2-1,
17)
A qualifying relative such as a parent, grandparent, brother, sister, stepbrother, stepsister, stepmother, stepfather,
1.
mother-in-law, father-in-law, half-brother, half-sister, son-in-law, daughter-in-law, uncle, aunt, nephew, or niece who
is related to you by blood and lived with you for the entire year.
Child, grandchild, stepchild, or adopted child. (Note: Is a qualifying child even if you cannot claim an exemption for
2.
the child)
3.
Eligible foster child. (Note: For eligibility for dependency only a foster child is a child who is in your care, that you care
as your own child, and who lived with you for the entire year. It does not matter how the child became a member of
the household.
EARNED INCOME CREDIT (EIC) EUGIBILITY
You may claim the EIC if you can answer YES to ALL 4 tests below. (See Publication
Chapter 36)
17,
Relationship Test
1.
 
YES
NO
Your child/children is/are one of the following; a son, daughter, adopted child, stepchild,
grandchild, or eligible foster child, or is our brother, sister, stepbrother, stepsister (or the child or
grandchild of your brother, sister, stepbrother, or stepsister, and you care for it/them as you would
your own child.
Age Test
2.
 
YES _'_NO
19
24
Your child/children is/are under
years of age at the end of the year, or is under
years of age at
of
the end
the year and is a full-time student, or was permanently and totally disabled at any time
during the
year, regardless of age.
tax
3. R e s i d e n c y Test
 
YES
NO
Your child/children lived with you for more than half the year (or the whole year if an eligible
foster child)
NO
YES
Your home is in the United States.
 
4. Qualifying Child of Another Test
 
NO
YES
If your child/children is/are the qualifying child/children of another individual, you are the only
person claiming the credit for that/those. child/children during the tax year. (Note: If the answer to
take
this test is NO, refer to the tiebreaker rule. You may still be able to
the credit
 
 
Customer Signature:
(By signing this form I attest that my tax preparer asked me all questions on this form)
X___________________________________
X ____________Date

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