Publication 503 - Child And Dependent Care Expenses - 2002 Page 16
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22Schedule 2
Department of the Treasury—Internal Revenue Service
Child and Dependent Care
(Form 1040A)
2002
Expenses for Form 1040A Filers
(99)
OMB No. 1545-0085
Your social security number
Name(s) shown on Form 1040A
JERRY & ANN
JONES
246
00
2468
Before you begin: You need to understand the following terms. See Definitions on page 1 of the separate instructions.
● Dependent Care Benefits
● Qualifying Person(s)
● Qualified Expenses
● Earned Income
(a) Care provider’s
(b) Address (number, street, apt. no.,
(c) Identifying
(d) Amount paid
Part I
name
city, state, and ZIP code)
number (SSN or EIN)
(see instructions)
1
413 MAPLE STREET
Persons or
SUE SMITH
132 - 00 - 5467
3,000
ANYTOWN, PA 18605
organizations
who provided
PINE STREET
706 PINE STREET
10 - 6754321
2,200
the care
NURSERY SCHOOL
ANYTOWN, PA 18605
(If you need more space, use the bottom of page 2.)
You must
complete this
No
Complete only Part II below.
Did you receive
part.
dependent care benefits?
Yes
Complete Part III on the back next.
Caution. If the care was provided in your home, you may owe employment taxes. If you do, you
must use Form 1040. See Schedule H and its instructions for details.
2
Information about your qualifying person(s). If you have more than two qualifying persons, see
Part II
the instructions.
(c) Qualified expenses
Credit for child
(a) Qualifying person’s name
(b) Qualifying person’s social
you incurred and paid
and dependent
security number
in 2002 for the person
First
Last
care expenses
listed in column (a)
123
00
9876
3,000
DANIEL
JONES
123
00
6789
2,200
AMY
JONES
3
Add the amounts in column (c) of line 2. Do not enter more than
$2,400 for one qualifying person or $4,800 for two or more persons.
If you completed Part III, enter the amount from line 26.
4,800
3
4
Enter your earned income.
4
12,500
5
If married filing jointly, enter your spouse’s earned income (if your
spouse was a student or was disabled, see the instructions); all
others, enter the amount from line 4.
5
15,000
6
Enter the smallest of line 3, 4, or 5.
6
4,800
7
Enter the amount from Form 1040A, line 22.
7
27,500
8
Enter on line 8 the decimal amount shown below that applies to the
amount on line 7.
If line 7 is:
If line 7 is:
But not
Decimal
But not
Decimal
Over
over
amount is
Over
over
amount is
$0—10,000
$20,000—22,000
.30
.24
10,000—12,000
22,000—24,000
.29
.23
12,000—14,000
24,000—26,000
.28
.22
14,000—16,000
26,000—28,000
.27
.21
16,000—18,000
28,000—No limit
.26
.20
18,000—20,000
.25
.
8
21
9
Multiply line 6 by the decimal amount on line 8. If you paid 2001
expenses in 2002, see the instructions.
1,008
9
10
Enter the amount from Form 1040A, line 28.
10
768
11
Credit for child and dependent care expenses. Enter the smaller
of line 9 or line 10 here and on Form 1040A, line 29.
768
11
For Paperwork Reduction Act Notice, see Form 1040A instructions.
Schedule 2 (Form 1040A) 2002
Cat. No. 10749I
Page 16
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