Form 8815 - Exclusion Of Interest From Series Ee And I U.s. Savings Bonds Issued After 1989 - 2017

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8815
Exclusion of Interest From Series EE and I
OMB No. 1545-0074
U.S. Savings Bonds Issued After 1989
2017
Form
(For Filers With Qualified Higher Education Expenses)
Go to for the latest information.
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Department of the Treasury
Attachment
167
Attach to Form 1040 or Form 1040A.
Internal Revenue Service (99)
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Sequence No.
Name(s) shown on return
Your social security number
1
(a)
(b)
Name of person (you, your spouse, or your dependent) who
Name and address of eligible educational institution
was enrolled at or attended an eligible educational institution
If you need more space, attach a statement.
2
Enter the total qualified higher education expenses you paid in 2017 for the person(s) listed in
column (a) of line 1. See the instructions to find out which expenses qualify .
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2
3
Enter the total of any nontaxable educational benefits (such as nontaxable scholarship or
fellowship grants) received for 2017 for the person(s) listed in column (a) of line 1 (see instructions)
3
4
Subtract line 3 from line 2. If zero or less, stop. You cannot take the exclusion
4
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5
Enter the total proceeds (principal and interest) from all series EE and I U.S. savings bonds issued
after 1989 that you cashed during 2017
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5
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6
Enter the interest included on line 5 (see instructions)
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If line 4 is equal to or more than line 5, enter “1.000.” If line 4 is less than line 5, divide line 4 by line
7
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5. Enter the result as a decimal (rounded to at least three places)
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7
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8
Multiply line 6 by line 7
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8
9
Enter your modified adjusted gross income (see instructions) .
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9
Note: If line 9 is $93,150 or more if single, head of household, or
qualifying widow(er), or $147,250 or more if married filing jointly, stop.
You cannot take the exclusion.
10
Enter: $78,150 if single, head of household, or qualifying widow(er);
$117,250 if married filing jointly
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10
11
Subtract line 10 from line 9. If zero or less, skip line 12, enter -0- on line
13, and go to line 14 .
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11
12
Divide line 11 by: $15,000 if single, head of household, or qualifying widow(er); $30,000 if married
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filing jointly. Enter the result as a decimal (rounded to at least three places) .
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12
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13
Multiply line 8 by line 12 .
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14
Excludable savings bond interest. Subtract line 13 from line 8. Enter the result here and on
Schedule B (Form 1040A or 1040), line 3
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14
8815
For Paperwork Reduction Act Notice, see your tax return instructions.
Form
(2017)
Cat. No. 10822S

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