District of Columbia (DC) Individual Income Tax Forms and Instructions ' All Individual Income Tax Filers 2025 Revised 05/2025 • Payments can be made by ACH debit, credit/debit card, check or money order (US dollars). • Direct deposit, U.S. Bank ReliaCard® or paper check refund options are available. Who must file a DC income tax return? Other forms you may have to file When are your taxes due? Extension of time to file Filing your return Payment options Penalties and interest Direct deposit of refund Refund status inquiry Forms D-40 form and schedules Tax tables and ads Tax tables for taxable income of $100,000 or less DC College Savings Plan Need assistance? Back Cover Simpler. Faster. Safer. At the time of printing, all forms and line references were correct. Any language changes will be announced on the DC website, MyTax.DC.gov. 93-102 You may use MyTax.DC.gov to file and pay online for Forms D-40 (individual income tax return), D-40ES (estimated tax) and FR-127 (extension of time to file). INSIDE Contents Chief Financial Officer's Letter 2 New for 2025 Income Tax Returns Reminders Instructions • 41-92 103 Schedule S, Supplemental Information and Dependents Schedule H, Homeowner and Renter Property Tax Credit Schedule U, Additional Miscellaneous Credits and Contributions D-8609, District of Columbia Low-Income Housing Tax Credit Allocation and Certification Schedule I, Additions to and Subtractions from Federal Adjusted Gross Income Schedule N, DC Non-Custodial Parent EITC Claim Schedule ELC, Keep Child Care Affordable Tax Credit Schedule HSR, DC Health Care Shared Responsibility DC-8379, Injured Spouse Allocation D-2210, Underpayment of Estimated Income Tax by Individuals D-40P, Payment Voucher FR-127, Extension of Time to File a DC Income Tax Return 7 8 8 8 8 9 9 15 14 4 5 7

GOVERNMENT OF THE DISTRICT OF COLUMBIA OFFICE OF THE CHIEF FINANCIAL OFFICER

John A. Wilson Building * 1350 Pennsylvania Avenue, NW * Suite 203 * Washington, DC 20004 Phone: (202) 727-2476 * Fax: (202) 727-1643 * www.cfo.dc.gov

Glen M. Lee Chief Financial Officer

Dear District of Columbia Taxpayer:

Welcome to the 2026 tax season! The Office of Tax and Revenue (OTR) is here to assist you. OTR works hard each year to make filing your taxes as easy as possible and to keep you informed of changes in filing requirements. This year, there are several important changes that you should know about.

Federal Tax Changes and the District

In July 2025, the U.S. Congress passed the One Big Beautiful Bill Act (OBBBA) which made significant changes to federal tax laws. In November 2025, the D.C. Council passed a new law limiting the number of OBBBA tax changes that will affect District taxpayers. As a result, several federal tax changes will not apply when filing District taxes, and some taxpayers may need to file a District return even if they don’t need to file a federal return.

The District will not recognize the following federal tax changes from the OBBBA legislation: • Higher federal basic standard deduction • Deductions for tips, overtime pay, or car loan interest • A larger tax deduction for seniors • Full expensing of research and experimental costs • Changes to the calculation of the business interest limitation deduction • Special depreciation for certain business production property • A small charitable deduction for people who don’t itemize (starts federally in 2026) • Excluding capital gains from the sale of small business stock

Tax Year 2025 Changes

In addition to OBBBA-related adjustments, several other changes to the District’s tax law are effective for tax year 2025. • DC Earned Income Tax Credit (EITC): The District EITC is now 100% of the federal EITC amount, giving more support to eligible workers. • Child Tax Credit: This credit is repealed for 2025. • Out-of-State Municipal Bonds: Interest earned from bonds issued by other states is now taxable in the District. • FAS 109 Deduction: This deduction is delayed until tax years beginning after Dec. 31, 2029. • D-40 Filing Requirement: You must file a D-40 return if your gross income is equal to or exceeds the District’s basic standard deduction, even if you do not have to file a federal individual income tax return. • Schedule H Property Tax Credit: The maximum credit increases to $1,425. The income limits increase to $66,000 for people under 70 and $90,000 for people 70 or older.

Updates to MyTax.DC.gov This year, the D-40B Nonresident Request for Refund form is now available on MyTax.DC.gov. This makes it easier for nonresidents to request a refund online. We encourage all taxpayers to create a MyTax account and choose digital letters and notices. This helps you get information faster and keeps your tax records in one secure place. OTR’s New Website In October 2025, OTR launched a redesigned website to make it easier for everyone to find what they need. This new platform makes the site user friendly and easier to navigate. You will now find forms, deadlines, and important information more quickly and with fewer clicks on MyTax.DC.gov. If you have questions or need help, please call OTR at (202) 727-4TAX (4829) or visit us at 1101 4th Street SW, Suite W270, Washington, DC 20024. We look forward to serving you this tax season! Sincerely, Glen M. Lee Chief Financial Officer

4 New for 2025 Income Tax Returns • Filing Deadline. For Tax Year 2025 the filing deadline is April 15, 2026. • Filing Threshold. The District has established its own filing threshold requirements for the D-40 Individual Income Tax Return beginning with tax year 2025. This means DC taxpayers may be required to file a D-40 return even if they are not required to file a Form 1040 federal income tax return. Please refer to the "2025 Filing Requirements Chart for Most Taxpayers" on page 7 of this booklet. • New Filing Requirement - OTR Tax Notice 2025-01. Beginning with tax year 2025, the following persons must submit an electronic copy of their federal income tax return (including any schedules or other information provided to the IRS) for the o Individuals with gross income exceeding $1,000,000 with the filing status of married/registered domestic partner filing jointly or married/registered domestic partner filing separately on a combined return. • DC Basic Standard Deduction - The District has established its own basic standard deduction amounts. For tax year 2025, those amounts are: o $15,000 for single filers, dependent filers and married/registered domestic partner filers filing separately; o $22,500 for head of household filers; and • Additional Standard Deduction. If you or your spouse/registered domestic partner were born before January 2, 1961, or blind, an additional standard deduction of $1,600 ($2000 if single, head of household, or dependent claimed by someone else and are not married) is allowed. The Schedule S, Calculation G-1 computing any additional standard deductions must be submitted with your return. (When married filing separately, you may take an additional standard deduction for your spouse/registered domestic partner only if your spouse/registered domestic partner had no gross income, is not filing a return, and cannot be claimed as a dependent by another taxpayer.) • Schedule I - Additions to and Subtractions from Federal Adjusted Gross Income. The District does not allow certain exclusions and/or deductions allowed under federal law on your federal return. If you claimed those items on your federal return (or you have income from a pass-through entity that claimed these items) you must add them to your federal adjusted gross income. For tax year 2025, those items should be reported on Schedule I, Calculation A, Line 7 "Other" and include: o Municipal bonds - Interest on the obligations of other states and their political subdivisions will be included in District gross income. Interest earned on obligations of the District or a territory of the United States as well as obligations issued by DC Water, the Washington Metropolitan Area Transit Authority (WMATA), and the District of Columbia Housing Finance Agency (DCHFA) remain exempt. o Capital gains on qualified small business stocks. The capital gains from the sale or exchange of "qualified small business stock", as defined under Internal Revenue Code (IRC) § 1202, will be included in District gross income. The gross income exclusion under IRC § 1202 does not apply. o Calculation of limitation of business interest expenses. When computing the limitation of business interest expenses under IRC § 163, the "adjusted taxable income" shall not include any subtractions for depreciation, amortization, or depletions of property. Additionally, the "floor plan financing interest expense as defined under IRC § 163(j) shall not apply. • State and Local Taxes (SALT). DC does not allow a deduction for state and local income taxes. However, you can deduct your entire state and local real estate taxes on your DC Individual D-40 Income Tax return, and the federal limitation (increased to $40,000) does not apply. Refer to Calculation D if a part-year resident, or Calculation F if a full-year resident. • Federal Schedule 1-A Additional Deductions. The District does not allow the following federal schedule 1-A Additional Deductions: No Tax on Tips; No Tax on Overtime; No Tax on Car Loan Interest; and the Enhanced Deduction for Seniors. This means you cannot claim these deductions on your DC Individual D-40 Income Tax return even if you claimed them on your federal return. • DC Earned Income Tax Credit (EITC). o For tax year 2025 DC EITC is increased to 100% of the federal credit. o The limit on investment income is increased from $11,600 to $11,950. o For EITC Without Qualifying Children the maximum credit amount has increased from $632 to $649. corres«ondin} tax year or «eriod: o
ny indiÛidual Üit }ross inco“e exceedin} fxää]äää Üit t e vilin} status ov sin}le] head of household, µualivyin} ÜidoÜ­er® Üit de«endent c ild] or “arried vilin} se«arately; or o fÎä]äää vor “arriedÉre}istered do“estic «artners vilin} ointly and µualivyin} widow(er) with dependent child vilers°

5 U Schedule SR -

ealth are Shared ResponsiLility. o The Percentage Income Calculation (Worksheet B-1) has changes based on the new filing thresholds for D-40 returns. o The District Average Bronze Plan Premium Calculation (Worksheet C-1) amounts have been updated. U Schedule  - omeowner and Renter *roperty Tax redit. o o The maximum property tax credit limit is increased from $1,375 to $1,425. Schedule H federal Adjusted Gross Income (AGI) eligibility threshold has increased to $66,000 for claimants under age 70, and $90,000 for claimants age 70 and older. U Schedule

q eep hild are
ffordaLle Tax redit. The District taxable income thresholds have changed and the maximum credit amount has been increased to $1,200 per eligible child. U

-{0 onresident Reµuest for Refund - Starting with tax year 2025, the D-40B Nonresident Request for Refund form can be filed electronically through MyTax.DC.gov. U Other iscellaneous xclusions. Unless otherwise prohibited by federal law, lump-sum payments an individual receives from the Early Childhood Educator Equity Fund is excluded from DC income or assets. Also, for tax year 2025, forgiveness of River East at Grandview Condominium Loans are excluded from DC income. If these items are included in your federal adjusted gross income, use Schedule I, Calculation B, Line 13, "Other" to subtract them from District gross income. ew for Ó0Óx ncome Tax Returns] ontinued Reminders U ncome Tax Rate TaLle - For taxable years beginning January 1, 2022, the DC income tax rate table is: Not over $10,000 Over $10,000 but not over $40,000 Over $40,000 but not over $60,000 Over $60,000 but not over $250,000 Over $250,000 but not over $500,000 Over $500,000 but not over $1,000,000 Ov Over $1,000,000 4% of the taxable income $400, plus 6% of the excess over $10,000 $2,200, plus 6.5% of the excess over $40,000 . $3,500, plus 8.5% of the excess over $60,000 $19,650, plus 9.25% of the excess over $250,000 $42,775, plus 9.75% of the excess over $500,000 $91,525, plus 10.75% of the excess over $1,000,000 U ndividual Taxpayer dentification umLer (T ) - As of January 1, 2023, an individual who is a resident of the District but is not a citizen or resident alien of the United States, who would otherwise be allowed a federal earned income credit but for possessing a social security number, may claim the DC EITC by filing a DC return with an ITIN issued by the IRS to the individual, individual's spouse, and any qualified child claimed on the return. U

ow-ncome ousing Tax redit ( T ) - Taxpayers transferring or receiving DC LIHTC must be registered online at MyTax.DC.gov. See Instructions for Low-Income Housing Tax Credit Allocation and Certification on MyTax.DC.gov. U 6erify your Tax *reparer. 6isit https\ÉÉirs.treasury.govÉrpoÉrpo.sf. You are responsiLle for the suLmission of your

Tax Return.
lso] if you file electronically] you must receive a copy of your -{0 form for your records in addition to a copy of your

return. U 1nemployment nsurance - For taxable years beginning January 1, 2021, unemployment insurance benefits provided by the federal government, District of Columbia, and any other state, are excluded from the computation of District gross income. U

is collecting sales tax for online purchases. Use the online FR-329, Consumer Use Tax Return to report the sales tax for online purchases on which sales tax was not paid. U 1099-G - The Office of Tax and Revenue (OTR) offers a paperless option for receiving the 1099-G income tax refund statement. You will continue to receive your paper statement unless you choose the paperless option. See instructions. U Schedule SR - DC Health Care Shared Responsibility. If you and your health care shared responsibility family had full coverage the entire year] do not complete this schedule. Complete the oval on Line 3 of the D40 and enter zero ($0) on Line 25. U Receiving your refund via the 1S anŽ Relia ard\ *re-
cµuisition isclosures The Consumer Financial Protection Board (CFPB) has published its final Prepaid Account Rule, creating detailed consumer protections for prepaid accounts. For tax year 2025, if you elect to receive a refund using the ReliaCard, you are required to review and acknow- ledge the Pre-Acquisition Disclosures (Short and Long Forms) prior to selecting the ReliaCard option as a method for receiving a refund. Copies of the ReliaCard Pre-Acquisition Disclosure and the ReliaCard Fee Schedule can be found on pages 28-39.

6 The Office of Tax and Revenue Will No Longer Prepare Individual Income Tax Returns The Office of Tax and Revenue (OTR) no longer prepares District of Columbia individual income tax returns at its Walk-In Center located at 1101 4th Street, SW, Washington, DC 20024. OTR recommends the following free tax preparation services available throughout the District of Columbia and online: • VITA – By appointment only. The Internal Revenue Service (IRS) Volunteer Income Tax Assistance (VITA) program offers free tax preparation to low-moderate income taxpayers. IRS-certified volunteers help eligible taxpayers e-file their federal and District tax returns. During the filing season, taxpayers can locate the VITA site nearest them by visiting http://irs.treasury.gov/freetaxprep/ or by calling 1-800-906-9887. • AARP (Tax-Aide Locator) – By appointment only. The Tax-Aide Program offers free tax help for everyone, with priority assistance to taxpayers who are 60 years of age and older, specializing in questions about pensions, and retirement issues unique to seniors. During the filing season, taxpayers can locate a site nearest them at https://secure.aarp.org/applications/VMISLocator/searchTaxAideLocations.action or by calling 1-888-227-7669. • MyTax.DC.gov – The OTR web portal offers the ability to file online the D-40/Schedules with certain limitations. Should you have additional questions, please call OTR’s Customer Service Center at (202) 727-4TAX (4829). • DO NOT STAPLE OR DESTROY THE BARCODE PRINTED AT THE TOP OF THE RETURN. • DO NOT USE THE 2025 RETURN IF YOU ARE FILING FOR A PREVIOUS YEAR. REFER TO THE BOOKLET AND INSTRUCTIONS ON THE DC TAX FORMS/INSTRUCTIONS PAGE. Reminders, Continued

• You were a District of Columbia (DC) resident in 2025 and you meet the filing requirements in the chart below according to your filing status and age; • You maintained a place of abode in DC for a total of 183 days or more during 2025 even if your permanent home was outside DC; • You were a part-year resident of DC during 2025 (see instructions for part-year residents, page 18); • You were a member of the United States (US) armed forces and DC was your legal residence for tax purposes for all or part of 2025. • If you want to receive a refund of DC taxes withheld or estimated payments made during the year, or if you qualify for and want to receive the following refundable credits: o DC Earned Income Credit; o Schedule N, Non-Custodial Parent Earned Income Credit; o Schedule H, Homeowner and Renter Property Tax Credit; or o Schedule ELC, Keep Child Care Affordable Tax Credit. You must file a 2025 DC Individual Income Tax Return if: You do not need to file a 2025 DC Individual Income tax return if: • You do not meet the filing requirements in the chart below according to your filing status and age; • You were not considered a resident of DC during 2025; • You were an elected member of the US government who was not domiciled in DC; • You were an employee on the personal staff of an elected member of the US Congress and you and the elected member were bona fide residents of the same state; • You were a member of the US Executive Branch appointed by the President, subject to US Senate confirmation, whose tenure of office is at the pleasure of the President and you were not domiciled in DC during any part of 2025; or • You were a justice of the US Supreme Court and were not domi- ciled in DC during any part of 2025. Who must file a DC Income tax return? Instructions

7 2025 DC Individual Income Tax Filing Requirements Chart IF your filing status is… THEN file a D-40 return if your gross income was at least… Single $ 15,000 Married/registered domestic partner filing jointly or filing separately on the same return $ 30,000 $ 30,000 Head of household $ 22,500 Married filing separately $ 15,000 Dependent filer $ 15,000 Note: You must file a D-40 Individual Income Tax return if your gross income for the year was at least the amount shown on the appropriate line in the above chart. If you are not required to file a federal individual income tax return, you should prepare a mock-up of the applicable federal return (Form 1040, 1040-SR, 1040-NR or 1040-NR-EZ), including any additional forms or worksheets related to the return, as if you are filing the return with the IRS. This will help you determine the federal adjusted gross income amount, and other applicable amounts to include in your D-40 Individual Income Tax return. Note: If you are the spouse/registered domestic partner of someone not required to file, such as a nonresident Congressional appointee, and you meet any of the requirements, you yourself must file. Effective for tax years beginning January 1, 2025, the District of Columbia has decoupled from the federal standard deduction amounts and has established its own filing requirements for the D-40 Individual Income Tax return. This means some taxpayers will have to file a DC D-40 Individual Income Tax return even when they are not required to file the federal 1040 Individual Income tax return. You must refer to the "2025 DC Individual Income Tax Filing Requirements Chart" below to determine if you need to file a D-40 return. If your gross income for the year was at least the amount shown on the appropriate line in the chart below, you must file a D-40 Individual Income Tax return. The filing requirements apply even if you owe no tax. You may have to pay a penalty if you are required to file a return but fail to do so. +Õ>ˆvވ˜} widow(er) with dependent child

8 ________________________________________ 2WKHUIRUPV\RXPD\KDYHWRILOH '%1RQUHVLGHQW5HTXHVWIRU5HIXQG If you were not a DC resident and you had DC taxes withheld or you are requesting a refund for erroneous estimated taxes paid, file Form D-40B, Nonresident Request for Refund, along with your W2's or 1099s attached. Military Spouses must include DD FORM 2058, JAN 2018 to honor your request for refund, including your W-2s and/or 1099s. Schedule K-1's are not a substitute for W2/1099's. Failure to provide this information will delay processing your request. Starting with tax year 2025, the D-40B can be filed electronically through MyTax.DC.gov. '(6(VWLPDWHG3D\PHQWIRU,QGLYLGXDO,QFRPH7D[ You must file these vouchers if you are required to file a District of Columbia (DC) income tax return and you expect to owe $100 or more in taxes. See Worksheet to Estimate DC Tax Payments. You will automatically be assessed interest for any underpayment of DC estimated tax. œÌi\ Electronic payment required. If the amount of the payment due for a period exceeds $5,000, you must pay electronically via MyTax.DC.gov or through Modernized e-File (MeF). ')LGXFLDU\,QFRPH7D[5HWXUQ Use the D-41 if you are the fiduciary of a DC estate or trust and the gross income for the trust is $100 or more for the year. )5 &RQVXPHU8VH7D[RQ3XUFKDVHVDQG5HQWDOV You should file this form electronically via MyTax.DC.gov and pay if during the tax year you paid a total of more than $400 for merchandise, services, or rentals subject to DC use tax on which you did not pay sales tax. _____________________________________________ :KHQDUH\RXUWD[HVGXH" April 15, 2026 is the deadline for filing your return and paying any taxes due. If the due date falls on a Saturday, Sunday, or legal holiday, the return should be filed no later than the next business day. _____________________________________________ ([WHQVLRQRI7LPHWR)LOH )5([WHQVLRQRI7LPHWR)LOHD'&,QFRPH7D[5HWXUQ An extension of time to file of six months may be granted if a valid ex- tension of time to file is requested. In order to be valid, an FR-127 Extension of Time to File form is due by April 15, 2026. If the due date falls on a Saturday, Sunday, or legal holiday, the request for extension of time should be filed no later than the next business day. The submission of the extension of time to file is subject to the following considerations: 1. If you expect to have a balance due when you file your D-40, you must pay your taxes owed when submitting your timely filed extension. Penalty and interest charges are imposed on any tax owed that is not paid on time with the extension request. 2. If you do not expect to have a balance due when you file your D-40, you would not be required to file a Form FR-127 provided you have reasonably estimated your D-40 tax liability and paid the estimated amount of DC income taxes through withholding or estimated tax payments. 3. If you do not expect to have a balance due but wish to request an extension for your DC income tax return anyway, you should submit a Form FR-127.
``ˆÌˆœ˜> iÝÌi˜Ãˆœ˜Ã In addition to the 6-month extension, you may receive an additional 6- month extension if you are living or traveling outside the U.S. You must file Form FR-127 for the first 6-month extension by the April 15, 2026 deadline before applying for the additional extension of time to file.

ÝÌi˜Ãˆœ˜Ã vœÀ i“LiÀà œv Ì i 1-
À“i` œÀVià i«œÞi` ˆ˜ > œ“L>Ì <œ˜i œÀ œ˜Ìˆ˜}i˜VÞ "«iÀ>̈œ˜° Deadlines for filing your return, paying your tax, claiming a refund, and taking other actions with OTR are extended for persons in the Armed Forces serving in a Combat Zone or a Contingency Operation. The extension also applies to spouses/registered domestic partners, whether they file jointly or separately on the same return. See IRS Pub. 3, Armed Forces Tax Guide for further information. )LOLQJ\RXUUHWXUQ This booklet has all the forms and instructions you will need. You are responsible for filing and paying taxes on time whether or not you receive the printed forms. ‡ 0RGHUQL]HGH)LOH 0H)

MeF offers most DC individual income taxpayers a full federal/ state electronic filing program. There are three ways for taxpayers to file their federal and District returns together electronically: 1. Through an authorized software provider listed on the IRS website or the OTR website; 2. Through a tax practitioner who is an authorized e-File provider; or 3. Through a commercial online filing service. This allows taxpayers to transmit their DC and federal returns from their computer for a fee. If you use the e-File options to file your DC return, you also have three options to receive your refund: 1. Direct Deposit; 2. U.S. Bank ReliaCard; or 3. Paper Check. Be sure to make a selection on the return for the refund option that you want. If you do not select an option, you will receive a paper check. Please review the information about the refund card at the front of this book. Instructions for direct deposit can be found on page 15. (OHFWURQLF)LOLQJ,QVWUXFWLRQV The instructions in this booklet are specifically for filers of paper returns. When you file electronically, note that the instructions may differ. Follow the ¸on screen¸ instructions. If you need further explanations, review the instructions in this booklet. ‡ 6XEVWLWXWHIRUPV You may file your DC tax return using a computer-prepared or computer-generated substitute form, provided the form is approved in advance by the Office of Tax and Revenue (OTR). The fact that a software package is available for retail purchase does not mean that the substitute form has been approved for use. Call or check with the software developer to determine if their form is an OTR- approved form.

___________________________________________ __________________________________________

• individuals who are single, head of household, µualifying widow­er® with dependent child, or married filing separately, with gross income exceeding fx00,000 for the taxable yearÆ • individuals who are married filing ointly, registered domestic partners filing ointly, married filing separately on a combined return or registered domestic partners filing separately on a combined return with gross income exceeding f1,000,000. U
penalty of x¯ per month if you fail to file a return or pay any tax due on time. t is computed on the unpaid tax for each month, or fraction of a month, that the return is not filed or the tax is not paid. t may not exceed an additional amount eµual to Óx¯ of the tax dueÆ U
Ó0¯ penalty on the portion of an underpayment of taxes if attributable to negligence. Negligence is a failure to maŽe a reasonable attempt to comply with the law or to exercise ordinary and reasonable care in preparing tax returns without the intent to defraud. One indication of negligence is failure to Žeep adeµuate booŽs and recordsÆ U nterest of 10¯ per year, compounded daily, on a late paymentÆ U
one‡time fee to cover internal collection efforts on any unpaid balance. The collection fee assessed is 10¯ of the tax balance due after ™0 days. *ayments received by OTR on accounts subect to the collection fee are first applied to the collection fee, then to the penalty, interest and tax owedÆ U
civil fraud penalty of Çx¯ of the underpayment which is at‡ tributable to fraud ­see D

ode Å{LJ{Ó1Ó®. Form D-40P, Payment Voucher - by mail 1se this form when sending a checŽ or money order. Do not staple the voucher to the D‡{0. f you pay at the same time that you file your return, include the D‡{0* with your D‡{0 in the return envelope provided. 1se the *O ox ™È1ș mailing label from the bacŽ flap of the return envelope. Dishonored Payments aŽe sure your checŽ or electronic payment will clear. 9ou will be charged a fÈx fee if your checŽ or electronic payment is not honored by your financial institution and returned to OTR. Penalties and Interest OTR will charge q • By mail • f mailing a return with a payment, send it to\ Office of Tax and Revenue *O ox ™È1ș 7ashington, D Ó00™0‡È1ș f mailing a refund reµuest return or a no money due return, send it to\ Office of Tax and Revenue *O ox ™È1{x 7ashington, D Ó00™0‡È1{x U ail to file the return or report timely. f convicted, you will be fined not more than f1,000 or imprisoned for not more than 1n0 days, or both, for each failure or neglectÆ U 7illfully fail to file the return or report timely. f convicted, you will be fined not more than f1,000 or imprisoned for not more than 1n0 days, or bothÆ U 7illfully attempt to evade or defeat a taxÆ willfully fail to collect, account for, or pay a taxÆ or willfully maŽe fraudulent and false statements or fail to provide information. -ee D Official ode Å{LJ{101 through {10Ç. These penalties are in addition to penalties under D

ode ÅÓӇÓ{0x for false statements ­and any other applicable penalties®. Enforcement Actions OTR may use lien, levy, seizure, collection agencies, and liability offset if the taxpayer fails to pay the District within 10 days after receiving a Notice of Enforcement and a demand for payment. or stimated Tax 1nderpayment nterest, orm D‡ÓÓ10, use D‡{0

ine {0. The form can also be located at D Tax ormsÉInstructions. ile the orm D‡ÓÓ10 with your return. Criminal Penalties 9ou will be penalized under the criminal provisions of D

ode, Title {Ç, if you are reµuired to file a return or report, or to perform any act, and you\ There are two adhesive mailing labels on the bacŽ flap of your return envelope. f you are sending a payment with your return, use the *O ox ™È1ș mailing label on your return envelope. f you are filing a no money due or a refund reµuest return, use the *O ox ™È1{x mailing label on your return envelope. Do not include more than one return per envelope. Requirement to Submit an Electronic Copy of Federal Tax Return -tarting anuary 1, Ó0Óx, the following persons are reµuired to submit an electronic copy of their federal income tax return, including any schedules or other information provided to the R- for the corresponding tax year or period\ Note: If filing your DC return by paper, do not submit paper copies of your federal return. You will receive a letter with instructions on how to upload your federal return information electronically on MyTax.DC.gov. ___________________________________________ Payment Options ACH Debit
 debit is available for taxpayers who have signed up for a yTax.D .gov account. There is no fee. anŽ account information is stored within the online account. yTax.D .gov can store multiple banŽ accounts across multiple tax types. Taxpayers give OTR the right to debit the money from their banŽ account. nsure you allow 1‡Î business days for processing if entering change of banŽing information. Direct Debit

eVtro˜ˆV fˆerà have the ability to pay their tax due or estimated payment by direct debit. nter your banŽing information, including the routing and account numbers of the checŽing or savings account and the date of withdrawal. The date of withdrawal cannot be greater than Î0 days after the due date of the return. Credit/Debit Card The taxpayer may pay the amount owed using 6isaÁ, aster ardÁ, DiscoverÁ or
merican xpressÁ. They will be charged a fee that is paid directly to the District¿s credit card service provider. *ayment is effective on the day it is charged. 6isit yTax.D .gov for more information. Note: nternational
 Transaction ­
T®. 9our payment cannot be drawn on a foreign account. 9ou must pay by money order ­1- dollars® or credit card instead. Check or money order (US dollars) Include a check or money order (US dollars), payable to the DC Treasurer, with your completed return. Write your Taxpayer Identification Number (TIN), daytime telephone number, tax year 2025 and "Form D-40" on your payment. Attach your payment to the Form D-40P voucher provided in this booklet. Do not attach either your payment or the Form D-40P to your return. 9

10 10 U *ublic health emergency grants authoriâed pursuant to section £È­m®­£® of the AdÛisory eighborhood ommissions Act of £™Çx, effectiÛe arch ÓÈ, £™ÇÈ ­ . . aw £‡xnÆ

"fficial

ode Å £‡3ä™.£3­m®­£®Æ U ump‡sum payments receiÛed by indiÛiduals from the arly

ducator *ay *arity *rogram pursuant to

ode Å £‡3Óx.{3£Æ U ,ebates issued by the ayor pursuant to the Automated

xternal efibrillator ncentiÛe *rogramÆ U rants awarded by the ayor under the "6 ‡£™ otel ,ecoÛery rant *rogram of Óä U The following grants awarded by the "ffice of the eputy ayor for *lanning and conomic eÛelopment ­ *

®Æ ‡ rants awarded to hecŽ t nterprises under Å£‡3Ón.{­h®­£®­A®Æ ‡ -mall business grants awarded under Å £‡3Ón.ä{­l®Æ ‡ rants to

enter for  T ommunity awarded under Å £‡3Ón.ä{­m®Æ 6‡

arge company grants awarded under Å £‡3Ón.ä{­n®Æ 6‡

ocal food access grants awarded under Å £‡3Ón.ä{­o®Æ 6‡ uaranteed income pilot program grants awarded under Å £‡3Ón.ä{­p®Æ 6‡ rants awarded to ommunity eÛelopment inancial nstitutions or inority epository nstitutions awarded under Å £‡3Ón.ä{­µ®Æ 6‡ µuity growth impact grants awarded under Å £‡3Ón.ä{­r®Æ 8‡ reat -treets program grants awarded under Å £‡3Ón.ä{­s®Æ 8‡ ridge fund recoÛery and special eÛent support grants awarded under Å £‡3Ón.ä{­t®Æ 8‡ -mall and medium business recoÛery and growth program grants awarded under Å £‡3Ón.ä{­u®Æ 8‡

µuity impact enterprise commercial property acµuisition grants awarded under Å £‡3Ón.ä{­Û®Æ 8‡ rants awarded to housing proÛiders under

ode Å £‡3Ón.ä{­w®Æ and 86‡ entral usiness istrict grants awarded under

ode Å £‡3Ón.ä{­x®Æ U The following grants awarded by the epartment of nergy

nÛironmentÆ ‡ unding receiÛed pursuant to the -olar for All *rogram established by

ode Å n‡£ÇÇ{.£ÈÆ and ‡ -ustainable nergy Trust und grants awarded pursuant to

ode Å n‡£ÇÇ{.£ä­c®­ÓÓ®. ___________________________________________ Special filing circumstances Amended return File an amended DC return if your DC tax liability for a prior open tax year (usually 3 years from date of filing) has changed on the D-40 return for the tax year you are amending. To file an amended return for the current year, complete another 2025 DC Individual Income Tax Return and fill in the "amended return" oval on the form. Attach a list with explanations of the changes covered by your amended return. f you are filing an amended return for a prior year, attach a copy of the original and any amended returns filed for that tax year. You can download forms from

Tax orms/nstructions or call ÓäӇÇÓLJ{nә to reµuest forms by mail. f the ,- adjusts your indiÛidual federal income tax return, you must file an amended

return within ™ä days of receiÛing a final determination of the federal adjustment. Attach a copy of the adjusted federal return and/or determination letter. Filing for a deceased taxpayer. ill in the oÛal for a deceased taxpayer at the top of the page of the ‡{ä. f a taxpayer died in ÓäÓ{ or ÓäÓx before filing a return, a return must be filed for that person. omplete a ‡{ä on the correct year¿s tax return and proÛide the deceased person¿s information, not your own. o not adjust the deceased¿s income, exemptions or deductions to reflect the date of death, unless a ‡{£ is being filed for the remainder of the year after the date of death. Tax preparers, other than the surÛiÛing spouse/ registered domestic partner, such as executors, attorneys, or other personal representatiÛes, must attach letters of administration. f a refund is due, all tax preparers must attach a completed orm ,‡£{Ç, -tatement of *ersons laiming ,efund ue a eceased Taxpayer, found on the

Tax orms/nstructions page and a copy of the death certificate. o not use the federal form to reµuest a

refund. ,efunds will be issued by paper checŽ only. Joint Returns After Separate Returns You can change your filing status from a separate return to a joint return by filing an amended return. You generally can change a joint return anytime within 3 years from the due date of the separate return or returns. This does not include any extensions. A separate return includes a return filed by you or your spouse/registered domestic partner claiming married filing separately, registered domestic partners filing separately, single, or head of household filing status. Separate Returns After Joint Return "nce you file a joint return, you cannot choose to file separate returns for that year after the due date of the return. Exception: A personal representatiÛe for a deceased person can change from a joint return elected by the surÛiÛing spouse to a separate return for the deceased. The personal representatiÛe has £ year from the due date of the return ­including extensions® to maŽe this change. Exclusion of Certain Grants From District Gross Income *ursuant to

ode Å {LJ£nä3.äÓ, the following grants are excluded from istrict gross income\ • Small business loans awarded and subsequently forgiven under Å 7A of the Small Business Act (15 U.S.C. § 636m); The amount received by businesses and individuals pursuant to these grants may be subject to federal income tax and included in federal gross income. For Form D-40 Individual Income Tax Return: the amount of the grant should be included in the federal Adjusted Gross Income that is reported on the federal Form 1040 to Line 4 of Form D-40. Therefore, complete and submit Schedule I which is a Schedule for Additions to and Subtractions from federal Adjusted Gross Income. Use Line 13 of Schedule I to report the amount of the grant. The total additions to and subtractions from federal Adjusted Gross Income captured by Schedule I are carried over to Form D-40. Submit the 1099-G showing the amount of the grant.

11 $ .00 • Fill in ovals completely. Do not .✓º or ºx» ovals. ✓ x 3 7 Write 3s with a rounded top, not a flat top. Write 7s without a middle bar. 3 • 7 Leave a space between words and between words and numbers. 8 • E L • R O B E R T S Use black ink. Print in CAPITAL letters. • Do not enter cents. Round cents to the nearest dollar. Note: Your taxpayer identification number is used for tax purposes only. • 5 7 2 0 4 Do not print outside the boxes. .00 Personal information Complete the personal information as instructed using CAPITAL letters and black ink. Use one block per letter, including using a space between address fields. Please write clearly, as writing that is hard to read can delay processing your return. Wages, tips and salaries Enter the amount from your federal 1040, 1040-SR, 1040-NR, or 1040- NR-EZ, plus any unemployment compensation received on Line a. DC income tax withheld (paper filers) Add the DC income tax withheld as shown on your 2025 federal Forms W-2 and applicable Forms 1099. Attach all copies of your Forms W-2 and 1099 that show DC tax withheld to Form D-40 and submit with Form D-40. Filing Status More than one filing status may apply to you. Use the one that will give you the lowest tax. Please ensure the oval to the left of the filing status is filled in. Generally, you will use the same filing status on your DC return as the one you used on your federal return. However, if you used married filing jointly on your federal return, it may be better for you to file your DC return using either married/registered domestic partners filing separately or married/ registered domestic partners filing separately on the same return. If both have income, figure the tax both ways to determine which status will give you the lowest tax. Single You were unmarried, divorced or legally separated as of December 31, 2025, or were widowed prior to January 1, 2026, and did not remarry before January 1, 2026. You must wait until you receive either one of these numbers before you file a DC return. Your return may be rejected if your TIN is missing, incorrect or invalid. You could be subject to a balance due or disallowance of credits if your dependent's or other qualifying person's TINs are missing, incorrect or invalid. __________________________________________ Filling out the form To aid us in processing your return please follow these rules. v • Your 2025 W-2 and applicable 1099 forms with DC withholding tax or taxable income; • A pen with black ink; • A calculator. Not all items will apply. Fill in only those that do. If an amount is zero, make no entry, leave the line blank. Do not enter cents. Round to the nearest dollar. Examples: $10,500.50 rounds to $10,501 $10,500.49 rounds to $10,500 Taxpayer Identification Number(s) (TIN) You must have a TIN, whether it is a Federal Employer Identification Number (FEIN), Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN). v An FEIN is a valid number issued by the Interna l Revenue Service . To apply for an FEIN, get Form SS-4, Application for Employer Identification Number, or get this form online at www.irs.gov/businesses. You may also get this form by calling 1-800-TAX-FORM (1-800-829-3676). An SSN is a valid number issued by the Social Security Administration (SSA) of the United States Government.

To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. • An ITIN is a valid number issued by the IRS. The IRS issues ITINs to individuals who are required to have a U.S. taxpayer identification number but who do not have, and are not eligible to obtain an SSN from the SSA. ITINs do not serve any purpose other than federal and state tax reporting. • • A copy of your completed 2025 federal return, as applicable (Form 1040, 1040-SR, 1040-NR, or 1040-NR-EZ) and any additional forms or worksheets related to the return. If you are not required to file the 2025 federal return, you should prepare a mock-up of the applicable form as if you are required to file it with the IRS. You can copy many entries directly from federal forms 1040, 1040-SR, 1040-NR or 1040-NR-EZ. Please be careful since the line numbers may differ from the District Form D-40 line numbers; A copy of your completed state return if you filed an income tax return with another state; Other Exclusion In addition to the grants listed above, and the exclusions enumerated in D.C. Code § 47-1803.02, for tax year 2025, forgiveness of River East at Grandview Condominium Loans are also excluded from DC income. If this item is included in your federal adjusted gross income, use Schedule I, Calculation B, Line 13, "Other" to subtract it from District gross income. Attach a statement identifying the item, including an explanation and/or computation for the amount. __________________________________________ Getting Started To complete the paper Form D-40, in general you will need: Preparer Tax Identification Number (PTIN) A PTIN is an identification number issued by the IRS. • All paid tax preparers must use their PTIN on tax returns or claims for refund.

12 Filing Jointly You were married or have a registered domestic partner and both spouses/registered domestic partners were DC residents as of December 31, 2025, or your spouse/registered domestic partner died in 2025 and you did not remarry/register in 2025. If legally separated, do not file jointly. If your spouse died during the year, you are considered married for the whole year for filing status purposes. If you did not remarry before the end of the tax year, you can file a joint return for yourself and your deceased spouse. If claiming injured spouse allocation, complete Form DC-8379 and attach it to your D-40 return. If you are filing a joint return or filing separately on the same return, enter the name and TIN shown first on your previous year return, then enter the name and TIN shown second on your previous year return. Registered domestic partners To be considered as a registered domestic partner for DC tax purposes, the parties must be registered with the Vital Records Division of the DC Department of Health. If you have registered your relationship you may either file a joint return or file separately on the same return. You may also file separately using the married filing separately status. Domestic partners or other similar relationship registered in other jurisdictions. If you have registered your relationship in another jurisdiction, you may file a joint return, or file separately on the same return, or file a separate return using the single status. • If filing jointly is chosen, enter the total federal adjusted gross income of both registered domestic partners on Line 4 of the Form D-40. • If you are married or registered domestic partners, you may file either a joint return or file separately on the same return. If filing jointly is chosen, enter the total federal adjusted gross income of both spouses/partners on Line 4, Form D-40. • If filing separately on the same return is chosen, follow the in- structions under Married or Registered Domestic Partners filing separately on the same return. Married or registered domestic partner filing separately If you are married or have a registered domestic partner and both spouses/partners had income, you can use this filing status. Include your spouse/registered domestic partner's name and Taxpayer Identi- fication Number (TIN) in the Personal Information section. You will each report only your own income, deductions, and credits. You will each report one-half of the income from any securities, bank accounts, real estate, etc., that are registered or titled in both names. Registered domestic partners who choose to file as married and married individuals must use this filing status if: • You and/or your spouse/registered domestic partner were part- year residents of DC during different periods of 2025; • You were a DC resident and your spouse/registered domestic partner was one of the following: – A member of the US armed forces and not considered a DC resident, but you are required to report income in DC; – A member of the US Congress or an employee on the personal staff of a member of Congress who is considered a resident of the member's state of residency; – An officer of the US Executive Branch whose primary residence was not in DC, who is appointed by the President, confirmed by the US Senate and serves at the pleasure of the President; or – A justice of the US Supreme Court whose primary residence was not in DC. Dependent claimed by someone else Married or registered domestic partner filing separately on the same return You and your spouse/registered domestic partner must combine your separate amounts using Calculation J on Schedule S so that you will either receive one refund or make one tax payment. You may also claim a credit for child and dependent care expenses. Using this filing status may reduce the amount of tax you owe by allowing each spouse/ registered domestic partner to take advantage of lower tax brackets. Before completing Calculation J, and the Form D-40, you will need to figure the following for you and your spouse/registered domestic partner: • Each person's federal adjusted gross income; • Each person's additions to federal income; • Each person's subtractions from federal income; and • Each person's deductions. NOTE: If you and your spouse/registered domestic partner were part- year residents of DC during different periods of 2025, you cannot file separately on the same return. You must file separate returns. Injured Spouse Allocation If either spouse/registered domestic partner has an outstanding liability for prior federal tax, DC income tax, DC unemployment compensation debt, child support, a federal non-tax debt, such as a student loan or DC ticket and traffic penalties, the non-liable party may request that their portion of the refund, if any, not be offset to satisfy the other spouse’s/registered domestic partner’s debt by requesting “injured spouse” allocation. You must file Form DC-8379 before an offset occurs. Once the offset has been applied to a debt, you must contact the agency to which the offset was directed. After an offset has occurred, OTR cannot refund offset amounts. If not filing electronically, fill in the oval on the D-40 form, attach Form DC-8379 (Injured Spouse Allocation) to your return and mail to: Office of Tax and Revenue PO Box 96145 Washington, DC 20090-6145 Head of Household You may claim this status if you were unmarried or legally separated as of December 31, 2025, and paid over half of the costs of maintaining a home for a qualifying person, such as a child or parent. Certain individuals who lived apart from the spouse/domestic partner for the last six (6) months of 2025 may also be able to use this filing status. Use the appropriate section of Schedule S to enter the full name, TIN, relationship and Date of Birth (DOB) of the qualifying person whether that person is a dependent or the qualifying non-dependent. Failure to provide a Schedule S can delay processing. All the information must be complete, i.e., name, TIN, relationship and DOB. Qualifying Widow(er) with Dependent Child If your spouse/registered domestic partner died in 2025, you can use married filing jointly as your filing status for 2025 if you otherwise qualify to use this status. The year of death is the last year for which you can file jointly with your deceased spouse. You may be eligible to use qualifying widow(er) with dependent child as your filing status for 2 years following the year your spouse/registered domestic partner died. For example, if your spouse/registered domestic partner died in 2023, and you have not remarried, you may be able to use this filing status for 2025. f you are claimed as a de«endent on someone else¿s return] fill in the de- «endent claimed Ly someone else¿ oÛal on the ‡{ä return° f you are a married dependent, and you are claiming the standard deduction, fill in the oÛal on -chedule -] alculation ‡£.

13 This filing status entitles you to use oint return taÝ rates and the highest standard deduction amount ­if you do not itemiâe deductions® but it does not entitle you to file a oint return° Eligibility rules° 9ou are eligible to file your 202x return as a µualifying ÜidoÜ­er® Üith dependent child if you meet all of the folloÜing tests\ • 9ou Üere entitled to file a oint return Üith your spouseÉreg- istered domestic partner for the year your spouseÉregistered domestic partner died° t does not matter Ühether you actually filed a oint return° • Your spouse/registered domestic partner died in 2023 or 2024 and you did not remarry by the end of 2025. • You have a child or stepchild whom you can claim as a dependent. This does not include a foster child. • Your child lived in your home all year, except for temporary absences. There are exceptions for a child who was born or died during the year and for a kidnapped child. • You paid more than half the cost of keeping up your home for the year. /he

/ has noÜ been eÝpanded to include

residents Üho are not citiâens or resident aliens of the 1nited -tates° -tarting anuary £, 202Î, an indiÛidual taÝpayer identification number ­/ ® issued by the ,- shall be permitted for the indiÛidual, the indiÛidual¿s spouse, or any µualifying child claimed on a ‡{0 indiÛidual income taÝ return that claims the

/ ° /his means taÝpayers not eligible for the federal earned income credit ­  ® because they do not haÛe social security numbers may claim the

/ by calculating the federal earned income credit amount, ignoring the -- reµuirement° 9ou must meet all other reµuirements and haÛe a Ûalid / ­s® issued by the ,-° Payment of the credit amount allowed will be made differently than in previous years. For taxable years starting January 1, 2024, the DC EITC will be distributed as follows: if the amount of the DC EITC allowed is at least $1,200, you may choose to receive the DC EITC portion of your refund in 12 equal monthly payments instead of one total payment. To choose 12 equal monthly payments, fill in the oval on Line 27 of your D-40 return. If you do not fill in the oval, you will receive your refund, including the DC EITC portion of your refund, in one total payment. Please note: Choosing to receive this credit in monthly payments may cause you to lose your Supplemental Nutrition Assistance Program (SNAP) or other federal benefits. For more information about SNAP, contact the the Department of Human Services at (202) 807-0405 or dhs°dc.gov. f you choose to receiÛe monthly

/ payments, "/, Üill calculate the distribution of your net refund amount for you° 9our initial payment Üill be different from the ‡{0, ine {Î et ,efund amount° "/, Üill send a notice to eÛery indiÛidual Üho chooses to receiÛe their

/ in £2 eµual monthly payments° /he notice Üill tell you the amount of your monthly

/ pay- ment° Taxpayers with a Qualifying Child The DC EITC is equal to 100% of federal EIC, or 100% of the federal EIC amount you would be eligible for if you met all other requirements for federal EIC but do not have an SSN. If married filing jointly, you, your spouse and your qualifying child(ren) must have an SSN or an ITIN issued by the IRS. If you and your spouse have SSNs or ITINs but your child(ren) do not, you need to claim the DC EITC for filers without a qualifying child.

nter the number of µualifying children on ine 2Ça of the ‡{0° nter your calculated federal  amount on ine 2Çc° nter the same amount on ine 2Çd° +ualivying

il` vor / *ur«oses A qualifying child as defined by the IRS for the EIC is a child who is your son, daughter, stepchild, foster child, brother, sister, stepbrother, stepsister, or a descendant of any of them (for example, your grandchild, niece or nephew) and was: n addition, the µualifying child must haÛe liÛed Üith you in the 1- for more than half of 202x, unless you are claiming the

/ as a non‡custodial parent ­see instructions for -chedule ®° f your child Üas married at the end of the year, the child is not a µualifying child, unless you can claim the child as a dependent or you haÛe been giÛen the right to claim the child as a dependent in an agreement signed by the child¿s custodial parent releasing the dependency eÝemption° Standard Deduction Starting Üith taÝ year 202x, the istrict has established its oÜn standard deduction amounts Ühich are different from the federal standard deduction amounts° ,efer to the ¸202x

ndiÛidual ncome /aÝ iling ,eµuirements

hart¸ on page Ç of this booŽlet° -ingle indiÛiduals, dependents and marriedÉregistered domestic partners filing separately are alloÜed a standard deduction amount of $£x,000° ead of household filers are alloÜed a standard deduction of $22,x00° Married/registered domestic partners filing jointly, qualifying widow(ers) with dependent children, and married/registered domestic partners filing separately on the same return are allowed a standard deduction of $30,000. An additional standard deduction amount of $1,600 ($2,000 if single, head of household, or dependent claimed by someone else and are not married) is allowed if you were born before January 2, 1961, or are blind. You must attach the Schedule S with a completed Calculation G-1 to claim the additional standard deduction. You are not entitled to the standard deduction if you itemize on your federal return. You are entitled to the itemized deductions excluding the state and local taxes and subject to the DC 5% limitation. District Code § 47-1803.04(b) states "If an individual elects to claim the standard deduction on the individual's federal income tax return, the individual must claim the standard deduction as defined in § 47-1801.04(44) and no itemized deductions and other additions to the standard deduction are allowed, except as otherwise provided in this chapter. If an individual elects to claim any itemized deductions on the individual's federal return, the individual must claim the itemized deduction as allowed under this section and the standard deduction is not allowed. For married individuals or domestic partners, if the net income of one of the spouses or registered domestic partners is determined by itemizing deductions on a separate return, neither of the spouses or registered domestic partners is allowed the standard deduction." DC Earned Income Tax Credit (EITC) The DC EITC is a credit for certain District residents who work. The credit may give you a refund even if you don't owe any tax or didn't have any tax withheld. You cannot claim the DC EITC, however, if your filing status is Dependent claimed by someone else. • At the end of the filing year, younger than you (or your spouse, if you file a joint return), and younger than 19; • At the end of the filing year, younger than you (or your spouse, if you file a joint return), younger than 24 and a full-time student; and, • At the end of the filing year, any age and permanently and totally disabled.

• Nine (9) digits in length, including zeros; • A current valid bank routing number. Your account number: • Is usually just to the right of your ABA routing number includ- ing zeros; • Can be up to 17 digits long; and • Can be both letters and numbers. You may want to verify your account and routing numbers with your financial institution before filling in the information. Fill in the oval to show the type of bank account. If you want the refund to go to a savings account instead of your checking account, you may need to contact your financial institution for the account and routing number information. Check the ABA routing number and account number carefully. If your bank account information is incorrect or missing digits, the money can be deposited in someone else's account. Please double check your routing and account number. OTR is not liable for any ABA routing and account numbers reported on the return in error. If you do not select the checking or savings oval, we will assume the refund will be deposited in your checking account. If the funds are returned to OTR, a paper check will be issued. In the event of a rejection of direct deposit, refunds will be reissued on a paper check. Note: Identity theft and fraud using direct deposit has grown signifi- cantly nationally and locally in recent years. To minimize direct deposit/identity theft refund fraud, OTR is converting new direct deposit refund requests to paper checks mailed to the taxpayer's address of record. Also see number 3, Paper Check section below for when paper checks will be issued. Refund direct deposit to a foreign account – International ACH Transaction (IAT) If you request your refund to be direct deposited to an account outside of the United States, you will receive a paper check. NOTE: Refer to your own check or financial institution for your numbers. The routing and account numbers may be in different places on your check. Your routing number is the left-most number located on your check, identified as the American Banking Association (ABA) routing number. The ABA number identifies your bank uniquely within the direct deposit system. It must be: Fill in the bank routing and account number information. You can obtain this information from the lower left portion of your check (see example below). 14 Schedule N, DC Non-Custodial Parent EITC Claim DC Law also allows the same 100% of federal EIC to those who are not allowed to claim the EIC at the federal level but who meet other DC requirements, such as a non-custodial parent who is a District resident between the ages of 18 and 30, and is paying child support under a court order for a minor child. The taxpayer must have paid the child support of at least the amount due for the year through a government sponsored support collection unit and the order must have been in effect for at least one-half of the year. You must file a D-40 form to use this exception. Complete Schedule N, DC Non-Custodial Parent EITC Claim and attach to the D-40. Also enter the amount to be claimed on Schedule U, Part 1B, Line 1. Taxpayers without a Qualifying Child Taxpayers without a qualifying child must use the DC Earned Income Tax Credit (DC EITC) Worksheet For Filers Without a Qualifying Child on page 24 to determine the DC EITC. You may need information from the federal instruction booklet concerning the Earned Income Credit to determine your eligibility for the DC Earned Income Tax Credit. If you do not have a qualifying child for the EITC and did not qualify for the federal credit due to your income, or your lack of an SSN, you may still qualify for the DC EITC. Contributions There are 3 optional DC contributions. Contributions will be deducted from the refund due or added to the tax due. You can contribute as much as you would like. However your contribution cannot exceed your amount to be overpaid and the smallest contribution you can make to any one fund is $1.00. DC Statehood Delegation Fund Enter on Part II Contributions, Line 1 of the Schedule U, and attach to the D-40. Taxpayer Support for Afterschool Programs for At-Risk Students Enter on Part II Contributions, Line 2 of the Schedule U, and attach to the D-40. Anacostia River Cleanup and Protection Fund Enter on Part II Contributions, Line 3 of the Schedule U, and attach to the D-40. Tax tables If your taxable income is $100,000 or less, use the tax tables on pages
93-102 to find the tax for Line 20 of the D-40. If your taxable income is greater than $100,000, use Calculation I on page 20 to determine your tax. Tax paid with extensions Report tax paid with extension of time to file on Line 33 of the D-40. Tax paid with original return If this is an amended return, report tax paid with original return on Line 34 of the D-40. Refund Options There are 3 refund options offered for individual income tax returns. All individual income tax returns require that one of these refund options be selected. 1. Direct deposit of refund Direct Deposit Facts: 1. It’s simple. You don’t have to cash a check. 2. It’s safe. No more lost, stolen or misplaced checks. 3. It’s fast. Your money will be available the morning of the payment. All new direct deposit requests (taxpayers requesting a direct deposit for the first time) will receive a paper check. If you want your refund deposited directly in your bank account, complete the Direct Deposit Information on the D-40. If the routing or account number begins with zeros, include the zeros.

2. U.S. Bank ReliaCard If you want your refund on a ReliaCard, select "ReliaCard" under the Refund Options on the D-40 form. Refunds under $2 or greater than $4,000 do not qualify for the ReliaCard. Non-qualified refunds will receive a paper check if direct deposit is not selected. To obtain more information, visit https://www.usbankreliacard.com. Note: If you selected the ReliaCard as your refund choice and are eligible to receive monthly EITC refund payments, please retain your ReliaCard. Monthly payments will be reloaded onto the initial card that you received containing your initial lump sum refund payment. 3. Paper Check A paper check will be issued if: • no refund option is selected; • the taxpayer selects this option, or direct deposit is not selected or if the taxpayer selects ReliaCard and it is beyond the threshold for a ReliaCard; • the taxpayer is a first time filer, even if they select direct deposit; • there is a gap between filing i.e., filed in 2022 and 2023, but did not file in 2024; or • the bank account changes from one year to the next; or • the taxpayer requests a refund on behalf of a deceased taxpayer. Refund status inquiry To check the status of your refund visit MyTax.DC.gov. You will need to enter your taxpayer identification number (TIN) and the refund amount you requested on your return. Third Party Designee If you want to authorize another person to discuss your 2025 tax return with OTR, fill-in the oval in the Third Party Designee block on page 3 of the D-40, and enter the designee's name and phone number. If you want to authorize your paid preparer, enter 'preparer' in the 'third party designee' block. If you are filing a joint return, filling in the third party designee block oval constitutes authorization by both filers. Filling in the oval also gives the designee authorization to: • Give OTR any information missing from your return; • Contact OTR for information about processing your return and the status of any refund or payment; and • Request, receive and/or respond to OTR notices related to your return. The authorization does not: • Give the designee the right to receive your refund; • Bind you to any additional tax liability related to your return; or • Otherwise give them the right to represent you before OTR. This authorization automatically ends on April 15, 2027 (without regard to extensions). Signature Sign and date your return. If your filing status is married filing jointly or married filing separately on the same return, both spouses/ registered domestic partners must sign. If the return is not signed, it will be sent back to you. If the return was prepared by a paid tax preparer, the tax preparer must also sign the return and provide their identification (PTIN) and telephone number. You, the taxpayer(s) are responsible for the information prepared and submitted by a paid preparer. Email address Enter the email address of the person authorized to discuss your 2025 tax return with OTR. This can be the taxpayer, the third party designee, or the paid preparer if you have filled in the oval authorizing the paid preparer to discuss this return with OTR. Send in your original return and attachments, if applicable; please keep a copy for your records. Do not understate your taxes There may be a penalty if an understatement of the tax required to be shown on your return exceeds the greater of: • 10% of the tax required to be shown on the return; or • $2,000 The penalty is 20% of the excess of the amount required to be shown on the return over the tax shown on the return. Using a Paid Preparer Although you may use a paid preparer, you the taxpayer(s) are responsible for the filing and payment of your tax return. Please review the tax return before you allow a paid preparer to issue a return on your behalf. Preparers must pay a penalty for understating taxes where: • The refund or amount due is based on unrealistic information; or • The preparer should have been aware of a relevant law or regulation; or • Relevant facts about the return are not adequately disclosed. Penalties range from $250 to $10,000. __________________________________________ Assembling your D-40 return • Staple Forms W-2 and applicable 1099 to the front of your return; • Staple any of the other required documents listed on this page in the upper left corner behind the return; • Send in an original, signed DC return with attachments, if ap- plicable, not a copy. Please fold your return once and use the return envelope provided; Staple all supporting forms and schedules behind the D-40. Staple Forms W-2 and 1099 to the front of Form D-40. D-40 W2, 1099 • • • • • There are two adhesive mail labels on the back flap of the return envelope. If you are sending a payment by mail with your return, use the PO Box 96169 label on the return envelope. If you are filing a return with no payment due or refund return, use the PO Box 96145 label. • Copies of the federal return and schedules are not required to be filed with DC and should not be attached unless: - your filing status is single, qualifying widow(er) with dependent with gross income exceeding $500,000; or - your filing status is individuals who are married/registered domestic partners filing jointly or separately on a combined return with gross income exceeding $1,000,000. (See Requirement to Submit an Electronic Copy of Federal Tax 15 Do not staple or otherwise damage the Bar Code located in the upper right hand corner of the form or schedule being attached; Do not cross out the tax year on the 2025 return. If you are not filing an Individual Income Tax Return, do not use this booklet. Request a booklet for the specific year you are filing by calling our Customer Service Center at (202) 727-4829, or visit our Customer Service Administration (CSA) at 1101 4th Street, SW, Washington, DC 20024. Visit DC Tax Forms/Instructions for prior year(s) individual income tax booklets/returns; Staple check or money order to the D-40P, Payment Voucher; • child, or married/registered domestic partners filing separately ,iÌÕÀ˜] «>}i ™. Do not submit paper copies of your federal return.)

16 /ist of otKer documents for ' filers -Ì>«iÊÌ iÃiÊLi ˆ˜`ÊÌ iÊ ‡{äÊÀiÌÕÀ˜Êˆ˜ÊvˆiʜÀ`iÀ.Ê ‡ -V i`ՏiÊ-Ê-Õ««i“i˜Ì>Ê˜vœÀ“>̈œ˜Ê>˜`Ê i«i˜`i˜ÌÃÆ ‡ -V i`ՏiÊ]Êœ“iœÜ˜iÀÊ>˜`Ê,i˜ÌiÀÊ*Àœ«iÀÌÞÊ/>ÝÊ Ài`ˆÌÆ ‡ -V i`ՏiÊ1]Ê
``ˆÌˆœ˜>Ê ˆÃVi>˜iœÕÃÊ Ài`ˆÌÃÊ>˜`Ê œ˜ÌÀˆLṎœ˜ÃÆ ‡ ‡nÈä™]Ê ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ>Ê œÜ‡˜Vœ“iÊœÕȘ}Ê/>ÝÊ Ài`ˆÌ
œV>̈œ˜Ê>˜`Ê iÀ̈vˆV>̈œ˜Æ ‡ -V i`ՏiÊ]Ê
``ˆÌˆœ˜ÃÊ̜Ê>˜`Ê-ÕLÌÀ>V̈œ˜ÃÊvÀœ“Êi`iÀ>Ê
`ÕÃÌi` ÀœÃÃʘVœ“iÆ ‡ -V i`ՏiÊ ]Ê

Ê œ˜‡ ÕÃ̜`ˆ>Ê*>Ài˜ÌÊ / Ê >ˆ“Æ ‡ -V i`ՏiÊ

]Ê ii«Ê

ˆ`Ê >ÀiÊ
vvœÀ`>LiÊ/>ÝÊ Ài`ˆÌÆ ‡ -V i`ՏiÊ-,]Ê

Êi>Ì Ê >ÀiÊ- >Ài`Ê,i뜘ÈLˆˆÌÞÆ ‡

‡nÎǙ]ʘÕÀi`Ê-«œÕÃiÊ
œV>̈œ˜Æ ‡ ‡ÓÓ£ä]Ê1˜`iÀ«>ޓi˜ÌʜvÊ Ã̈“>Ìi`ʘVœ“iÊ/>ÝÊLÞʘ`ˆÛˆ`Õ>ÃÆ ‡ ‡{ä*]Ê*>ޓi˜ÌÊ6œÕV iÀÆ ‡ ,‡£ÓÇ]Ê ÝÌi˜Ãˆœ˜ÊœvÊ/ˆ“iÊ̜ʈiÊ>Ê

ʘVœ“iÊ/>ÝÊ,iÌÕÀ˜Æ ‡

ÊœÀ“Ê,‡£{Ç]Ê,iv՘`Ê >ˆ“ÊvœÀÊ iVi>Ãi`Ê/>Ý«>ÞiÀ]ÊÜˆÌ ÊiÌÌiÀà œvÊ>`“ˆ˜ˆÃÌÀ>̈œ˜Ê>˜`Ê>ÊVœ«ÞʜvÊÌ i `i>Ì ÊViÀ̈vˆV>ÌiÆ ‡

ÊœÀ“Ê ‡Ó{{ä]Ê ˆÃ>LˆˆÌÞʘVœ“iÊ ÝVÕȜ˜Ê­>˜`Ê>˜Þ ViÀ̈vˆV>̈œ˜®Æ ‡

ÊœÀ“Ê ‡Ó{{£]Ê

ˆ`Ê>˜`Ê i«i˜`i˜ÌÊ >ÀiÊ Ài`ˆÌÊvœÀÊ*>À̇9i>À ,iÈ`i˜ÌÃÆ ‡

Ê,iÈ`i˜Ìˆ>ÊœÀ“]Ê
ÌiÀ˜>̈ÛiÊÕiÊ6i ˆViÊ œ˜ÛiÀȜ˜Ê>˜` ˜vÀ>ÃÌÀÕVÌÕÀiÊ Ài`ˆÌÃ. vÊ>˜ÞʜvÊÌ iÊ>LœÛi‡ÀiviÀi˜Vi`ÊvœÀ“ÃÊ>Àiʘii`i`]ÊۈÈÌÊ

Ê/>ÝÊœÀ“ÃÉInstruc̈œ˜Ã >˜`ÊÃiiVÌÊvœÀ“Ãʘii`i`.Ê 9œÕʓ>ÞÊ>ÃœÊVœ˜Ì>VÌʜÕÀÊ ÕÃ̜“iÀÊ-iÀۈViÊ i˜ÌiÀÊ>ÌÊ­ÓäÓ®ÊÇÓLJÊ{nә. /œÊVœ“«iÌiÊޜÕÀÊ ‡{äÊÀiÌÕÀ˜]ÊޜÕÊ܈Ê˜ii`Ê̜Ê`œÊ>ÊÃiÀˆiÃʜvÊV>VՏ>̈œ˜ÃÊ Vœ˜Ì>ˆ˜i`ʈ˜ÊÌ iÃiʈ˜ÃÌÀÕV̈œ˜ÃÊ>˜`ÊVœ«Þʓ>˜ÞʜvÊÌ iʏˆ˜iʈÌi“ÃÊ>˜`Ê ÌœÌ>Ãʜ˜ÌœÊޜÕÀÊ ‡{ä.Ê9œÕʓ>ÞÊ>ÃœÊ˜ii`Ê̜Ê>ÌÌ>V Ê

ÊÃV i`ՏiÃʜÀÊ vœÀ“ÃÊ̜ÊޜÕÀÊ ‡{ä.Ê1˜iÃÃʈ˜ÃÌÀÕVÌi`ÊœÌ iÀ܈Ãi]ʈvÊޜÕÊVœ“«iÌiÊ>˜ÞÊ «>ÀÌʜvÊ>˜ÞÊ-V i`ՏiÃÊ-]Ê]Ê1]Ê]Ê ]Ê

]Ê-,]Ê

‡nÎǙ]ÊD-8609,

‡ÓÓ£ä]Ê ‡{ä*]Ê,‡£ÓÇ]Ê>ÌÌ>V ʈÌÊ̜ÊޜÕÀÊÀiÌÕÀ˜. '&  ,njured SSouse $llocation 9œÕʓ>ÞÊLiÊ>˜Êˆ˜ÕÀi`ÊëœÕÃiʈvÊޜÕÊvˆiÊ>ʍœˆ˜ÌÊÀiÌÕÀ˜Ê>˜`Ê>ÊœÀÊ«>ÀÌʜvÊ ÞœÕÀÊ«œÀ̈œ˜ÊœvÊÌ iʜÛiÀ«>ޓi˜ÌʈÃÊiÝ«iVÌi`Ê̜ÊLiʜvvÃiÌÊ̜ÊޜÕÀÊëœÕÃiÉ Ài}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½Ãʏi}>ÞÊi˜vœÀVi>LiÊ«>Ã̇`ÕiÊvi`iÀ>ÊÌ>Ý]Ê ÃÌ>Ìiʈ˜Vœ“iÊÌ>Ý]ÊÃÌ>ÌiÊ՘i“«œÞ“i˜ÌÊVœ“«i˜Ã>̈œ˜Ê`iLÌÃ]ÊV ˆ`ÊÃÕ«‡Ê «œÀÌ]ʜÀÊ>Êvi`iÀ>Ê˜œ˜Ì>ÝÊ`iLÌ]ÊÃÕV Ê>ÃÊ>ÊÃÌÕ`i˜Ìʏœ>˜.Ê9œÕʓÕÃÌÊvˆiÊ Ì iÊ

‡nÎǙÊÜˆÌ ÊޜÕÀÊÀiÌÕÀ˜.ʘÊoÀ`eÀÊtoÊLeÊeˆ}ˆLeÊvoÀÊt ˆÃÊÀeˆev] ÞoÕÊʓÕÃtÊÊÃÕL“ˆtÊÊÞoÕÀÊÊVo“«ete`ÊÊ

‡nÎǙÊÊ«ÀˆoÀÊÊtoÊÊt eÊÊovvÃet oVVÕÀÀˆ˜}Ê>˜`Êvˆe`Ê܈t Êt eÊÀetÕÀ˜°Ê"˜VeÊv՘`ÃÊ >ÛeÊLee˜ÊovvÃet]Êt ˆÃ Àeˆevʓ>ÞÊLeÊ՘>Û>ˆ>Le° ScKedule (/& .eeS &Kild &are $ffordable 7a[ &redit / ˆÃÊÊÃV i`ՏiÊÊ>œÜÃÊÊiˆ}ˆLiÊÊÌ>Ý«>ÞiÀÃÊÊ̜ÊÊV>ˆ“ÊÊ>˜ÊÊi>ÀÞÊʏi>À˜ˆ˜}ÊÊ Ì>ÝÊVÀi`ˆÌÊvœÀÊ>˜Êiˆ}ˆLiÊV ˆ`Ê՘`iÀÊÌ iÊ>}iʜvÊ{Ê>ÃʜvʙÉÎäÉÓxÊ>˜`ÊÊ «>ޓi˜ÌÃʓ>`iÊ`ÕÀˆ˜}ÊÌ iÊÌ>Ý>LiÊÞi>ÀÊ>vÌiÀÊ
Õ}ÕÃÌÊΣÃÌʈvÊÌ iÊiˆ}ˆLiÊÊÊ V ˆ`ʓiiÌÃÊ>}iÊÀiµÕˆÀi“i˜ÌÃÊvœÀÊi˜Àœ“i˜Ìʈ˜Ê*Ài‡ Ê>VVœÀ`ˆ˜}Ê̜Ê

ÊÊÊ

œ`iÊÅÊÎn‡ÓÇÎ.äÓ­>®. ScKedule + +omeoZners and 5enter 3roSert\ 7a[ &redit / ˆÃÊÃV i`ՏiÊ >œÜÃÊ iˆ}ˆLiÊ ÀiÈ`i˜ÌÃÊ ÌœÊ V>ˆ“Ê >Ê «Àœ«iÀÌÞÊ Ì>ÝÊ VÀi`ˆÌÊÊ >}>ˆ˜ÃÌÊÌ iˆÀÊ

ʈ˜Vœ“iÊÌ>Ýʏˆ>LˆˆÌÞ.ÊÊ/ iÊ̜Ì>ÊÓäÓxÊvi`iÀ>Ê
`ÕÃÌi`ÊÊ ÀœÃÃÊ ˜Vœ“iÊ ­
®Ê œvÊ ÞœÕÀÊ ¸Ì>ÝÊ vˆˆ˜}Ê Õ˜ˆÌ¸Ê V>˜˜œÌÊ iÝVii`Ê fÈÈ]äää ­Õ˜`iÀÊ>}iÊÇä®ÊœÀÊf™ä]äää ­>}iÊÇäʜÀʜ`iÀ®.ÊÊ oʘotÊV>ˆ“Êt ˆÃÊVÀe`ˆtÊ voÀÊ>˜ÊeÝe“«tÊ«Ào«eÀtÞÊoܘe`ÊLÞÊ>Ê}oÛeÀ˜“e˜t]Ê>Ê oÕÃeÊovÊÜoÀà ˆ«ÊÊ oÀÊ>ʘo˜‡«ÀovˆtÊoÀ}>˜ˆâ>tˆo˜°ÊÊ-eeÊ-V e`ՏeÊʈ˜Êt ˆÃÊLooŽet° >ÊÊ
“œÕ˜Ìʜvʈ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>ÝÊ«>ˆ`ÊÌœÊœÌ iÀÊÃÌ>Ìi.Ê ˜ÌiÀÊvÀœ“ÊÌ iÊœÌ iÀÊÃÌ>Ìi¿ÃÊÀiÌÕÀ˜. > LÊ ˜Vœ“iÊÃÕLiVÌÊ̜ʈ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>Ýʈ˜ÊÌ iÊœÌ iÀÊÃÌ>ÌiÊ­ÜˆÌ œÕÌÊ`i`ÕV̈œ˜ÃÉiÝi“«Ìˆœ˜ÃÉ ÊÊÊÊVÀi`ˆÌÃÊÌ >ÌʈÃʈ˜VÕ`i`ʈ˜Ê

Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊ>˜`ÊÀiViˆÛi`ÊÜ ˆiÊ>ÊÀiÈ`i˜ÌʜvÊ

.Ê L VÊ

Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊvÀœ“Ê ‡{ä]Ê ˆ˜iÊ£È.Ê V `ÊÊ ˆÛˆ`iÊ ˆ˜iÊLÊLÞÊ ˆ˜iÊV°Ê­ ˜ÌiÀÊÌ iÊresult°®Ê ` iÊ

Ê/>ÝÊvÀœ“Ê ‡{ä]Ê ˆ˜iÊÓä.Ê i vÊ >݈“Õ“ÊœÕ̇œv‡ÃÌ>ÌiÊVÀi`ˆÌ.ÊÊ ÕÌˆ«ÞÊ ˆ˜iÊiÊLÞÊ ˆ˜iÊ`°Ê v }Ê ˜ÌiÀÊÌ iʏiÃÃiÀʜvÊ ˆ˜iÊ>ʜÀÊ ˆ˜iÊv°Ê
ÃœÊi˜ÌiÀʜ˜Ê-V i`ՏiÊ1]Ê*>ÀÌÊ£>°Ê } &alculation . "Õ̇œv‡ÃÌ>Ìiʈ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>ÝÊVÀi`ˆÌʇÊ>ÊÃi«>À>ÌiÊ >VՏ>̈œ˜Ê ʓÕÃÌÊLiÊVœ“«iÌi`ÊvœÀÊi>V ÊÃÌ>ÌiÊV>ˆ“i`. Note:ʈiÊÌ iÊ-V i`ՏiÊÊÜˆÌ ÊޜÕÀÊ ‡{äÊÀiÌÕÀ˜.ÊvÊޜÕÊ>ÀiʘœÌÊÀiµÕˆÀi`Ê ÌœÊvˆiÊ>Ê ‡{äÊLiV>ÕÃiÊޜÕÊ>ÀiÊLiœÜÊÌ iÊvˆˆ˜}ÊÌ Àià œ`]ÊޜÕʓ>ÞÊvˆiÊ Ì iÊ -V i`ՏiÊ Ê LÞÊ ˆÌÃiv.Ê ÌÊ V>˜Ê LiÊ vˆi`Ê œ˜ˆ˜iÊ Ûˆ>Ê Þ/>Ý.

.}œÛÊ ­ˆvÊ ÞœÕÊ>ÀiʘœÌÊ>ÊvˆÀÃÌÊ̈“iÊ-V i`ՏiÊÊvˆiÀÊ>˜`ÊÀi}ˆÃÌiÀi`Ê̜ÊÕÃiÊÌ iÊÜiLÊ «œÀÌ>®]ʜÀʓ>ˆi`Ê̜\Ê "vvˆViʜvÊ/>ÝÊ>˜`Ê,iÛi˜Õi ££ä£Ê{Ì Ê-ÌÊ-7]Ê { 7>à ˆ˜}̜˜Ê

ÊÓääÓ{ ScKedule +S5 '& +ealtK &are SKared 5esSonsibilit\

ʏ>ÜÊÀiµÕˆÀiÃÊ>ÊÀiÈ`i˜ÌÃÊÌœÊ >ÛiÊ i>Ì ÊV>ÀiÊVœÛiÀ>}i]Ê >ÛiÊ>˜Ê iÝi“«Ìˆœ˜ÊœÀÊ«>ÞÊ>ÊÌ>ÝÊ«i˜>ÌÞʜ˜ÊÌ iˆÀÊ

ÊÌ>ÝÊÀiÌÕÀ˜.Ê-iiʈ˜ÃÌÀÕV̈œ˜ÃÊ vœÀÊ-V i`ՏiÊ-,]Ê

Êi>Ì Ê >ÀiÊ- >Ài`Ê,i뜘ÈLˆˆÌÞ. ScKedule , $dditions to and Subtractions from )ederal $*, 1ÃiÊ-V i`ՏiÊÊ̜ÊÀi«œÀÌʈ˜Vœ“iʜÀÊ>`ÕÃ̓i˜ÌÃÊ̜Êvi`iÀ>Ê>`ÕÃÌi`Ê }ÀœÃÃʈ˜Vœ“i.Ê
``ˆÌˆœ˜s to ˆ˜Vœ“iÊareÊi˜ÌiÀi`ʜ˜Ê-V i`ՏiÊ]Ê >VՏ>̈œ˜Ê
.ÊÊ/ iÊ >“œÕ˜Ìʜ˜Ê >VՏ>̈œ˜Ê
]Ê ˆ˜iʙʈÃÊi˜ÌiÀi`ʜ˜ÊœÀ“Ê ‡{ä]Ê ˆ˜iÊÈ. -ÕLÌÀ>V̈œ˜ÃÊvÀœ“Êvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊ>ÀiÊi˜ÌiÀi`ʜ˜Ê -V i`ՏiÊ]Ê >VՏ>̈œ˜Ê .Ê/ iÊ>“œÕ˜Ìʜ˜Ê >VՏ>̈œ˜Ê ]Ê ˆ˜iÊ£ÈʈÃÊ i˜ÌiÀi`ʜ˜ÊœÀ“Ê ‡{ä]Ê ˆ˜iÊ£{.Ê-iiʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊ-V i`ՏiÊʈ˜ÊÌ ˆÃÊ LœœŽiÌ. ScKedule 1 '& 1on&ustodial 3arent (,7& &laim 1ÃiÊÌ ˆÃÊÃV i`ՏiÊ̜Ê`iÌiÀ“ˆ˜iÊÜ iÌ iÀÊ>ʘœ˜‡VÕÃ̜`ˆ>Ê«>Ài˜Ìʓ>Žˆ˜}Ê VœÕÀ̇œÀ`iÀi`Ê V ˆ`Ê ÃÕ««œÀÌÊ «>ޓi˜ÌÃÊ “>ÞÊ V>ˆ“Ê Ì iÊ

Ê / .Ê -iiÊ -V i`ՏiÊ Êˆ˜ÊÌ ˆÃÊLœœŽiÌ. ScKedule S SuSSlemental ,nformation and 'eSendents vÊV>ˆ“ˆ˜}Ê`i«i˜`i˜ÌÃ]ÊÕÃiÊ-V i`ՏiÊ-Ê̜ʏˆÃÌÊi>V Ê`i«i˜`i˜Ì¿Ãʘ>“i]Ê Ì>Ý«>ÞiÀÊ ˆ`i˜ÌˆvˆV>̈œ˜Ê ˜Õ“LiÀÊ ­/ ®]Ê Ài>̈œ˜Ã ˆ«Ê >˜`Ê `>ÌiÊ œvÊ LˆÀÌ Ê ­ " ®.ÊvÊvˆˆ˜}Ê i>`ʜvÊ œÕÃi œ`ɵÕ>ˆvވ˜}Ê܈`œÜ­iÀ®ÊÕÃiÊ-V i`ՏiÊ-ÊÌœÊ Ài«œÀÌÊ`i«i˜`i˜ÌÃʜÀÊœÌ iÀʵÕ>ˆvވ˜}ʘœ˜‡`i«i˜`i˜ÌÊ«iÀܘ.

>VՏ>̈œ˜Ê‡£ÊˆÃÊÕÃi`Ê̜Ê`iÌiÀ“ˆ˜iÊÌ iÊVœ“«ÕÌ>̈œ˜ÊœvÊÌ iÊÃÌ>˜`>À`Ê `i`ÕV̈œ˜.Ê9œÕʓÕÃÌÊ>ÃœÊÕÃiÊ >VՏ>̈œ˜Ê‡£Ê̜ÊV>ˆ“ÊÌ iÊ>``ˆÌˆœ˜>Ê ÃÌ>˜`>À`Ê`i`ÕV̈œ˜ÊvœÀÊޜÕÀÃivʜÀÊޜÕÀÊëœÕÃiÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ «>À̘iÀÊ vœÀÊ Liˆ˜}Ê Lˆ˜`Ê >˜`ɜÀÊ >}iÊ ÈxÊ œÀÊ œ`iÀ.

>VՏ>̈œ˜ÊʈÃÊÕÃi`Ê̜Ê`iÌiÀ“ˆ˜iÊÌ iÊ

ÊÌ>ÝÊ>“œÕ˜ÌÊvœÀʓ>ÀÀˆi`ʜÀÊ Ài}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀÃÊvˆˆ˜}ÊÃi«>À>ÌiÞʜ˜ÊÌ iÊÃ>“iÊÀiÌÕÀ˜.ÊÊ

ˆÃÌÊ>˜ÞÊ/ ÃÊ­  ®Êˆ˜ÊÌ iÊ>««ˆV>LiÊë>Vi­Ã®ÊˆvÊÌ iÀiʈÃÊ>˜Ê>“œÕ˜Ìʜ˜Ê

‡{ä]Ê ˆ˜iÊ££.

17 Calculation C Standard deduction for part-year DC residents a a Your standard deduction. See instructions, page 13. b Number of days you lived in DC from D-40, Line 2. b c Divide Line b by the number 365 (366 if leap year). c d Part-year DC standard deduction. Multiply Line a by Line c, enter result here and on D-40, Line 18. d (Note: Calculations A and B are on Schedule I) Calculation D DC Itemized deductions for part-year DC residents. a Total Itemized Deductions from Form 1040 or 1040-SR, Schedule A, Line 17, or a Form 1040-NR, Schedule A, Line 8. b Portion of Line a that applies to the time you were a DC resident. b c c Portion of your state and local tax deduction reported on Form 1040 or 1040-SR,

Schedule A, Line 7, or Form 1040-NR, Schedule A, Line 1b that was paid to DC. d Subtract Line c from Line b. d e Portion of your state and local real estate tax deduction from Form 1040 or 1040-SR, e Schedule A, Line 5b that was paid to DC. f Portion of your other taxes deduction from Form 1040 or 1040-SR, Schedule A, Line 6 f that was paid to DC. g DC itemized deductions. Add Lines d, e, and f. If your District Adjusted Gross Income (AGI) g is equal to or less than $200,000 ($100,000 if married filing separately) stop here and enter this amount on Line 18 of the D-40. Note: If your District AGI is greater than $200,000 ($100,000 if married filing separately) continue below to determine the allowable itemized deductions. h Enter the sum of Form 1040 or 1040-SR, Schedule A, Lines 4, 9, and 15 allocable to the time you were a DC resident. h i Subtract amount on Line h from Line g. i j Enter the amount of DC adjusted gross income. j k Enter $200,000 (or $100,000 if married filing separately). k l Subtract amount on Line k from Line j. l m Multiply amount on Line l by 5%. m n Subtract amount on Line m from amount on Line i (if<0, enter 0). n o Add the amounts on Line h and Line n (enter the result on Line 18 of the D-40). o • Corporate franchise tax; • License tax; • Excise tax; • Unincorporated business franchise tax; and • Occupation tax. Schedule U, Additional Miscellaneous Credits and Contributions. This schedule lists certain additional non-refundable and refundable credits you may be able to claim. It also lists several contributions funds to which you may wish to contribute. See Schedule U in this booklet. Non-refundable credits include: 1. Out of State tax credit. The amount taxpayers domiciled in DC may claim as a credit for individual income tax paid to other state(s) if the income taxed by that state is derived from that state. The tax paid to a State is the total state tax liability shown on the state tax return. (It is not the state withholding shown on your Form W-2.) The credit is limited to the rate of tax charged in the District. If you are a statutory resident, the state in which you are domiciled gives you a credit for the taxes paid to DC. Complete Calculation K on the previous page to determine your out of state credit. If you paid tax to more than one state, the credit for each state must be calculated separately on the Calculation K worksheet. Enter the respective amounts and other state codes in the spaces provided. Enter the total credit amount on Schedule U, Part 1a, Line 2. For information regarding credits for income taxes paid by pass-through entities (PTE taxes) to other states, see OTR Notice 2022-03, District Treatment of Pass-through Entities Taxes Paid to Other Jurisdictions. No DC credit is allowed for any other tax imposed by a state, including the following:

_________________________________________ Who is a Resident? You are a resident of DC if: 1. You are an individual domiciled in DC at any time during the taxable year, or 2. You are an individual who maintains a place of abode within DC for an aggregate of 183 days or more during the taxable year, this is also known as a statutory resident. Domiciliary An individual is domiciled in DC if their permanent home is in DC. Domicile, once established, is presumed to continue until it is shown to have been changed. To establish a change of domicile from DC to a new jurisdiction, a person must demonstrate (1) physical presence in the new jurisdiction, (2) an intent to abandon their domicile in DC, and (3) an intent to remain in the new jurisdiction for an indefinite period of time. An individual can only have one domicile at a time. An individual domiciled in DC is a full-year resident under DC law and must file a full-year individual income tax return, except, if you establish or abandon your DC domicile during the year, then you are a part-year resident and will file a part-year return. Statutory Resident An individual is a DC statutory resident, even though not domiciled in DC, if they maintained a place of abode in DC for an aggregate of 183 or more days during the taxable year. The period of residency does not have to be consecutive days. In determining whether an individual has maintained a place of abode in DC for 183 or more days, temporary absences from the DC residence i.e. vacations, hospitalization, business trips, and the like, shall be considered as periods of District residency. A statutory resident is a full-year resident under DC law and therefore must file a tax return reporting their entire income for the taxable year even if they maintained a place of abode for less than the full year. A statutory resident may seek credits for individual income taxes paid to other state(s), while concurrently a resident of DC. However, they must provide satisfactory proof of payment, including an individual income tax return filed with the other state(s), in order to be eligible for a credit. Part-Year Resident An individual is a part-year resident if they move into or out of DC during the year with the intent to establish or abandon their domicile in DC. The calculation of tax liability for a part-year resident is prorated based on the income earned in DC during the period of residency. An individual filing a part-year return must indicate the period of domicile on Line 2 of Form D-40. All credits, exemptions and deductions must be prorated according to the time domiciled in DC. Part-Year Instructions If you are a part-year resident for the 2025 tax year, fill in the oval on Line 2 of the D-40, complete the applicable month, day and year in the "from" and "to" boxes. Divide the number of days lived in DC by 365 (366 if leap year). Use that number (standard rounding to four decimal places) and multiply by your credit, additions or subtractions amounts not previously prorated. Complete Calculation C for standard deduction and Calculation D for DC itemized deductions showing the type and amount of income received: • During the time you were domiciled in DC; • During the time you were not domiciled in DC; and • The total income reported on your federal return as adjusted for DC purposes. Before completing the D-40, calculate the following: • Income received when you were domiciled in DC; • Allowable expenses paid or incurred when you were domiciled in DC; Allowable expenses paid or incurred when you were domiciled outside of DC. 2. Alternative Fuel Vehicle Conversion and Infrastructure Credits. There are 2 credits related to Alternative Fuel Vehicle Conversion and Infrastructure: (1) A credit up to 50% of the costs for purchase and installation of qualified alternative fuel storage and dispensing or charging equipment per qualified alternative fuel vehicle refueling property or private residence. The credit shall not exceed $1,000 per vehicle charging station for a private residence and $10,000 per qualified alternative fuel vehicle refueling property or vehicle charging station. The cost of the purchase of the land on which the refueling or charging station will be located or the construction or purchase of any structure is not included in the equipment or labor costs. The unused credit can be carried over for two years. (2) A credit not to exceed $19,000 per vehicle, up to the tax liability, for 50% of the cost of equipment and labor per vehicle for vehicle owners who modify their existing petroleum-derived gasoline or diesel fuel vehicle into a vehicle capable of operating on one of a list of acceptable operating fuels: 85% ethanol; natural gas; compressed natural gas; liquefied natural gas; liquefied petroleum gas; biodiesel (excluding kerosene); electricity from a vehicle charging station; or hydrogen. Any unused credit for vehicle conversion cannot be carried forward. See D.C. Code Sections 47-1806.12 and • Income received when you were domiciled outside of DC; and • The same allocation is required for credits and other deductions. Refundable credits include: 1. DC Non-custodial parent EITC. See Schedule N. 2. Keep Child Care Affordable Tax Credit. See Schedule ELC. Contributions include: 1. DC Statehood Delegation Fund; 2. Taxpayer Support for Afterschool Programs For At-Risk Stu- dents; and 3. Anacostia River Cleanup and Protection Fund. 18 3. DC Low-Income Housing Tax Credit (DC LIHTC) The DC LIHTC is a non-refundable credit for taxpayers who invest in the construction and rehabilitation of housing for low and moderate- income individuals and families in the District of Columbia. The credit can be taken against income tax, franchise tax and insurance premium tax. For more information, see the "Instructions for Low-Income Housing Tax Credit Allocation and Certification" on DC Tax Forms/Instructions. 4. Department of Housing and Community Development (DHCD) Rental Accommodations Division (RAD) Housing Provider Credit The DHCD RAD Housing Provider Credit is a non-refundable tax credit against income or franchise taxes that is available to certain housing providers as a result of a hardship petition filed with RAD. See DC Code § 42-3502.24 (g). To claim this credit on the D-40 return you must have a certification of income tax credit from RAD. Enter the amount of the certified income tax credit on Schedule U, Line 6. Attach a copy of the certification. 47-1806.13. If you are claiming one of these credits, complete the residential form, Alternative Fuel Vehicle Conversion and Infrastructure Credits available online only at DC Tax Forms/Instructions under Individual Income Tax Forms: attach it to the D-40, Schedule U. If gross income derived from the operation of an alternative fuel dispensing or charging station exceeds $12,000, you must file a DC Form D-30 Unincorporated Business Franchise Tax Return.

Line b Business income or loss If you had gross business/self-employment income from DC sources of more than $12,000 from an unincorporated business or business activity, see the instructions for D-30, Unincorporated Franchise Tax Return, to see if you are required to file that return. If you are, do not include the income here, but report it on your D-30 return instead. Line c Capital gain or loss Enter the amount from your 1040, 1040-SR or 1040-NR. The maximum allowable annual capital loss claim is $3000 ($1500 if married or registered domestic partner filing separately). If you have farm income or loss listed on federal form 1040 or 1040SR or 1040 NR, Schedule 1, Part 1, Line 6, include the amount in the amount entered on Line c and attach a copy of Schedule 1. If a loss, fill in the oval. For DC tax purposes, upon disposing of an asset not fully depreciated, compute the capital gain/loss reported on your federal return for the year of disposition excluding any bonus depreciation. Line d Rental real estate, royalties, S corporations, trusts, etc Enter the amount from your 1040, 1040-SR or 1040-NR. If you had gross income, from DC sources, of more than $12,000 from a unincor- porated business or business activity, including rents and royalties, do not include on D-40. You are required to file a D-30 return. File a DC Form D-30, Unincorporated Franchise Tax Return if capital is a material income producing factor. An S Corporation must file a D-20, Corporation Franchise Tax Return. ___________________________________________ Computation of DC Gross and Adjusted Gross Income Line 4 Federal adjusted gross income Enter the amount from 1040, 1040-SR, 1040-NR, or 1040-NR-EZ. Include your taxable portion of pension/annuity in your federal adjusted gross income. NOTE: Any grants and stipends received by certain DC public or charter school teachers under the Housing Support for Teachers Act of 2007 are subject to both federal and DC income tax. ___________________________________________ Additions to DC Income Line 5 Franchise Tax Enter any franchise tax deducted on a federal business tax return, from federal Forms 1065 or 1120S. Line 6 Other additions from DC Schedule I Enter the amount from Line 9 of Calculation A, Schedule I. Line 7 Add Lines 4, 5 and 6 Add federal adjusted gross income, franchise tax deducted and addi- tions to DC income. Fill in oval if loss. ___________________________________________ Subtractions from DC Income Line 8 Income received by a part-year resident during period domiciled outside DC For each type of income reported on your federal 1040 or 1040-SR, determine the amount you received when you were domiciled in DC. Subtract that amount from your total income and enter the results on Line 8. NOTE: Do not include any unemployment insurance benefits as a part of income received during the period domiciled outside DC on Line 8. Enter the total amount of all unemployment insurance benefits on Line 13, provided this amount is also included on Line 4 of the D-40 return. 19 If you claimed itemized deductions on your federal income tax return, include for DC purposes only those relating to the time you were domiciled in DC. Your federal worksheet will assist you in completing Schedule I (Calculations A and B) and Calculation D (if applicable). Keep a copy of your worksheet, a copy of your tax return and all calculations. If you were domiciled in DC for only part of the 2025 tax year, allocate your DC income and deductions attributable to the time you were domiciled in DC. Also prorate your standard deduction and credits by dividing the number of days you were domiciled in DC by 365 (366 if leap year) and multiplying the result by the standard deduction/credit amount. Example: *71 days of residency domiciled in DC divided by 365 (366 for leap year) equals 0.1945. For a t axpayer who is eligible to claim the maximum EITC For Filers Without a Qualifying Child, the credit amount is $649. Multiply $649 by 0.1945. The result $126 is the prorated amount of the credit. January February March 31 + 28 + 12 = 71 Days* Line a Wages, salaries, unemployment compensation, and/or tips Enter the amount from your federal 1040, 1040-SR, 1040-NR or 1040-NR-EZ plus any unemployment compensation received. All unemployment compensation received in 2025 is

taxable by the federal government. However, DC has enacted legislation that excludes all unemployment insurance benefits provided by the District, any other state, or the federal government, from District gross income. If any such unemployment insurance benefits are included in your D-40, Line 4 federal adjusted gross income, use Line 13 of the D-40 return to subtract all unemployment insurance benefits from District gross income. • Copy Line a through d from the appropriate lines on the federal return. Do not recalculate any amounts or totals. • Not all items will apply to you. Fill in only those that do. If the amount is zero, leave the line blank. • If you had a loss for Lines b, c, d, 4, 7, 16, or 19, fill in the "Fill in if loss" oval to indicate that the figure entered is a negative one. Do not enter a minus sign or brackets within the boxes. Standard deduction for part-year DC residents. Adjust your standard deduction to reflect the number of days you were domiciled in DC. Complete Calculation C on page 17. Itemized deductions for part-year DC residents. Effective January 1, 2011, DC Official Code §47-1803.03 (b-4) provides that certain DC itemized deductions of DC taxpayers with over $200,000 of DC AGI ($100,000 for a separate return filed by a married individual) will be limited. Reduce the DC itemized deduction amount by 5% of the DC AGI in excess of $200,000 ($100,000 for a separate return filed by a married individual). The itemized deductions that are not subject to the 5% limitation are medical and dental expenses, expenses incurred in the production of investment interest, and casualty or theft loss deduction. If your DC deductions are limited and you were a part-year DC resident, complete Calculation D on page 17. Credit for child and dependent care expenses for part-year DC residents. Complete the DC Form D-2441 and enter the amount from Line 5 on Line 21 of the D-40. Attach a copy of your DC Form D-2441. Do not include income tax withheld for other states in the DC tax with- held, Line 31, D-40. Income Information Section

Calculation F DC Itemized deductions for full-year DC residents a Total itemized deductions from Form 1040 or 1040-SR, Schedule A, Line 17, or Form 1040-NR, a b Total state and local tax deductions. Enter the amount from your Form 1040 or 1040-SR, Schedule A, Line 7, or Form 1040-NR, Schedule A, Line 1b. b c Subtract Line b from Line a. c d State and local real estate tax from Form 1040 or 1040-SR, Schedule A, Line 5b. d e Other taxes from Form 1040 or 1040-SR, Schedule A, Line 6. e f DC itemized deductions. Add Lines c, d, and e. If your District Adjusted Gross Income (AGI) f is equal to or less than $200,000 ($100,000 if married filing separately) stop here and enter this amount on Line 18 of the D-40 form. Note: If your District AGI is greater than $200,000 ($100,000 if Married filing separately) continue below to determine the allowable itemized deductions g Enter the sum of Form 1040 or 1040-SR, Schedule A, Lines 4, 9 and 15 g h Subtract amount on Line g from Line f. h i Enter the amount of DC adjusted gross income. i j Enter $200,000 ($100,000 if married filing separately). j k Subtract amount on Line j from Line i. k l Multiply amount on Line k by 5%. l m Subtract amount on Line l from amount on Line h (if less than 0, enter 0). m n Add the amounts on Lines g and m (enter the result on Line 18 of the D-40). n Schedule A, Line 8. Line 12 DC and federal government survivor benefits If you are an annuitant's survivor and 62 years of age or older as of December 31, 2025, enter the total survivor benefits (do not include Social Security survivor benefits). Line 13 Unemployment Insurance Benefits Unemployment insurance benefits provided by the District or any other state are excluded in the computation of District gross income. Line 14 Other subtractions from DC Schedule I Line 15 Total subtractions from DC Income Add Lines 8-14. ___________________________________________ DC Adjusted Gross Income Line 16 DC adjusted gross income Subtract Line 15 from Line 7 and enter the result on Line 16. ___________________________________________ DC Taxable Income Line 17 Deduction type Indicate which type of deduction (itemized or standard) you are taking by filling in the appropriate oval. You must take the same type of deduction on your DC return as you took on your federal return. Calculation I/Tax Rate Schedule If your taxable income from D-40, Line 19 is: Not over $10,000 Over $10,000 but not over $40,000 Over $40,000 but not over $60,000 Over $60,000 but not over $250,000 Over $250,000 but not over $500,000 $19,650, plus 9.25% of the excess over $250,000 Over $500,000 but not over $1,000,000 $42,775, plus 9.75% of the excess over Over $1,000,000 $500,000 $91,525, plus 10.75% of the excess over $1,000,000 Then your tax rate is: 4% of the taxable income $400, plus 6% of the excess over $10,000 $2,200, plus 6.5% of the excess over $40,000 $3,500, plus 8.5% of the excess over $60,000 20 Line 9 Taxable refunds, credits or offset of state and local income tax Enter the amount from your 1040, 1040-SR or 1040-NR. Line 10 Taxable amount of social security and tier 1 railroad retirement Enter the amount from 1040 or 1040-SR. Line 11 Income reported and taxed this year on a DC franchise or fiduciary return (D-20, D-30 or D-41) If the income reported on your 1040 or 1040-SR included income reported and taxed on a DC franchise or DC fiduciary return, enter that amount here. Provide the taxpayer identification number (TIN) and your share of the income reported. Refer to Instructions, page 11 regarding TINs. Include the TIN on page 2 of the Schedule S.

21 If you were eligible for the Child and Dependent Care Credit but did not claim it for federal purposes, complete the federal Form 2441, multiply the result by .32 and claim the DC credit for child and dependent care expenses. Generally, married persons must file a joint return to claim the credit. If you claim the credit and your filing status is married filing separately, you are required to show you meet the special requirements listed in the IRS Form 2441 instructions. Line 22 Non-refundable credits from DC Schedule U This entry is the total of non-refundable amounts from DC Schedule U, Part 1a, Line 7. Line 23 Total non-refundable credits Add Lines 21 and 22. Line 24 Subtract Line 23 from Line 20 Subtract Line 23 from Line 20 and enter the result on Line 24. If Line 20 is less than Line 23, enter zero. Line 25 DC Health Care Shared Responsibility If you, your spouse/registered domestic partner (If filing jointly or separately on the same return), and anyone you or your spouse/ registered domestic partner can claim as a dependent, had qualifying health coverage or an exemption for every month of 2025, enter zero. Otherwise complete Schedule HSR and accompanying worksheets to determine the amount of your Health Care Shared Responsibility Payment. From Schedule HSR, Part IV, Line 17. Line 26 Total tax and DC Health Care Shared Responsibility Add Lines 24 and 25. DC EITC Refer to Instructions, page 13. Filers with qualifying children must complete Lines 27a, 27b, 27c and 27d or the credit will be denied. Filers without qualifying children must complete Line 27e or the credit will be denied. Schedule N Non-Custodian Parent EITC filers must complete Schedule N and Schedule U and attach them to the D-40. Line 27a Qualified EITC children Refer to Instructions, page 13 If you have a qualifying child or children, enter the number of EITC children on Line 27a. Each qualifying child must have a valid social security number (SSN) or individual tax identification number (ITIN) issued by the IRS. If you have no children who qualify, you must claim the DC EITC without qualifying children. Line 27b Enter your earned income amount. If you filed a 2025 federal return, enter the earned income amount reported on your federal return. If you did not file a federal return because you are below the federal filing threshold and/or lack a social security number, you may still claim the DC EITC by filing a D-40 return with an ITIN. To calculate the amount of your earned income refer to IRS Publication 596, Earned Income Credit (EIC) and the EIC Worksheet in the instructions for IRS Form 1040 and 1040-SR. Line 27c (For taxpayers with qualifying children only). Enter the amount of federal earned income credit reported on your 2025 federal return. If you did not file a federal return because you are below the federal filing threshold and/or lacked a social security number, you may still claim the DC EITC by filing a D-40 return with an ITIN. To calculate the amount of your earned income refer to IRS Publication 596, Earned Income Credit (EIC) and the EIC Worksheet in the instructions for IRS Form 1040 and 1040-SR. Line 18 DC deduction amount Standard deduction. Reference page 13 of the Instructions. Part-year DC residents, reference page 18. Itemized deductions. Do not copy the amount from your federal return. Use Calculation D if you are a part-year DC resident, or Calculation F if you are a full-year or statutory DC resident. DC does not allow a deduction for state and local income taxes. You can deduct your entire state and local real estate taxes. If your DC Adjusted Gross Income (AGI) is $200,000 or less, complete Calculation F on page 20. DC income taxes paid are not deductible on your DC return. Therefore, reduce your federal itemized deductions amount by those taxes before entering the total on your DC return. Certain DC itemized deductions of DC taxpayers with over $200,000 of DC adjusted gross income ($100,000 for a separate return filed by a married individual) will be limited. Reduce the DC itemized deduction amount by 5% of the DC AGI in excess of $200,000 ($100,000 for a separate return filed by a married individual). The itemized deductions that are not subject to the 5% limitation are medical and dental expenses, expenses incurred in the production of investment interest, and casualty or theft loss deduction. If your DC deductions are limited, complete Calculation F on page 20. _________________________________________ Line 19 DC taxable income Subtract Line 18 from Line 16. Enter the result; if a loss, fill in the oval. Line 20 Tax If Line 19 is $100,000 or less, use the tax tables on pages 93-102 to determine your tax. If Line 19 is more than $100,000, use Calculation I on page 20. Married or registered domestic partners filing separately on the same return - Before completing Calculation J, the tax computation, on Schedule S, you must determine each person's separate federal AGI, additions to income, subtractions from income, and deductions. You must combine the separate amounts for each person before making entries on Lines 21-35 of the D-40. ____________________________________________ DC tax, credits, and payments The credits claimed on Lines 21 and 22 are non-refundable, which means they can reduce the taxes you owe, but they will not result in a tax refund. The credits you claim on Lines 27d or 27e, 28 and 29 are refundable credits, which means if these credits plus any tax payments are greater than your total tax due, you may receive a refund. Line 21 Credit for child and dependent care expenses If your status is married or registered domestic partner filing separately on the same return, you may claim the credit and divide it between spouses/ registered domestic partners any way you wish. If you were a full-year or statutory DC resident, to figure your DC credit, multiply the amount from federal Form 2441, Line 9c by .32. Enter the result on Line 21 of the D-40. (Do not use the DC Form D-2441.) If you were a part-year resident, see the instructions on page 18.

22 Line 40 Underpayment interest Fill in the oval if Form D-2210 is attached. D-2210 Underpayment of Estimated Income Tax By Individuals You may use this form to calculate your underpayment interest when submitting your D-40 form. If you do, fill in the oval, attach the form to your tax return and enter the interest amount on Line 40 of the D-40. If you do not wish to calculate the interest, the Office of Tax and Revenue (OTR) will do it when your return is processed and will notify you of the amount due. You may also complete this form if you believe the interest assessed by OTR for underpayment of estimated income tax is incorrect. Line 41 Contribution amount from Schedule U, Part II, Line 5 (Cannot exceed refund amount on Line 38) Reference Instructions, page 14. If you wish to contribute and you are not due a refund or do not owe additional tax, please enter the total contribution amount on Line 41. Make your payment payable to the DC Treasurer and include it with your return. Line 42 Total amount due Add Lines 37, 40 and 41. You must pay this amount in full with your return. See page 9 for payment options under Instructions. Line 43 Net Refund Subtract the total of Lines 39, 40 and 41 from Line 38. Be sure to use the PO Box 96145 mail label from the back flap of the return envelope when mailing your return if requesting a refund. If you answer yes to the question, "Will this refund go to an account outside the U.S?," you will be issued a paper check in lieu of direct deposit. See page 14 of the Instructions. Line 44 Injured spouse allocation Fill in the oval if either spouse is claiming injured spouse allocation, and attach Form DC-8379 (Injured Spouse Allocation). Your DC-8379 must be attached to your return at the time of filing or the offsets cannot be recoverable by OTR. Electronic 1099-G The Office of Tax and Revenue (OTR) offers a paperless option for receiving the Form 1099-G income tax refund statement. If you agree to receive your statement electronically, fill in the oval. We will notify you in January 2026 that your statement is available to be viewed and printed from our web portal if you are a registered user. Otherwise, you will continue to receive your paper statement unless you choose the paperless option. Line 27d Multiply the calculated federal EIC amount x 1.00 and enter result (for taxpayers with qualifying children only). This will be the same amount as your calculated federal EIC amount on Line 27c. Line 27e For filers without qualifying children, use the DC Earned Income Tax Credit Worksheet For Filers Without a Qualifying Child to determine your DC EITC and enter the result. Line 28 Property tax credit If you filed a DC Schedule H, Homeowner and Renter Property Tax Credit, enter the amount from the appropriate Line (3 or 7). See the instructions in this booklet for assistance in completing Schedule H. If you are filing a D-40 and Schedule H by paper, attach Schedule H to your D-40. Line 29 Refundable credits from DC Schedule U Complete Schedule U, Part 1b. Attach Schedule U to your D-40. See Schedule N, DC Non-Custodial Parent EITC Claim, to determine if you are eligible to claim this credit. If you complete a Schedule N, attach it to your D-40. Line 30 Total Refundable Credits Add line 27d or 27e through Line 29. Line 31 DC income tax withheld Add the amount of DC income tax withheld as shown on your applicable 2025 federal Forms W-2 and 1099 that show DC tax withheld. Line 32 2025 Estimated income tax payments and amount applied from 2024 return Enter the total of your 2025 DC estimated income tax payments and any amount applied from your 2024 return as a carryforward. If you are filing separate returns and paid estimated income tax payments, you and your spouse/registered domestic partner must divide the payments according to which spouse/registered domestic partner paid them. You cannot arbitrarily allocate the estimated payments between yourselves. Line 33 Tax paid with extension of time to file If you filed Form FR-127, Extension of Time to file a DC Income Tax Return, enter the amount you paid with the FR-127. Line 34 If this is an amended 2025 return, enter payments made with original 2025 D-40 return. Line 35 If this is an amended 2025 return, enter refunds requested with original 2025 D-40 return. Line 36 Total payments and refundable credits Add Lines 30 through Line 34. Do not include Line 35. Line 37 Tax due Subtract Line 36 from Line 26 and enter the result on Line 37. Line 38 Amount overpaid Subtract Line 26 from Line 36 and enter the result on Line 38. Line 39 Amount to be applied to your 2026 estimated tax

23

District of Columbia Earned Income Tax Credit (EITC) Worksheet For Filers Without A Qualifying Child This worksheet is for taxpayers who do not have a qualifying child for the Earned Income Credit. If you have a qualifying child DO NOT USE THIS WORKSHEET. If your earned income or federal adjusted gross income (fed AGI) is greater than $30,941 Section A: General Eligibility for the DC Childless Worker EITC. If you qualified for the federal Earned Income Credit, go directly to Section B, below. If you did not qualify for the federal Earned Income Credit, answer these questions: YOU CANNOT CLAIM THIS CREDIT STOP 1. Were you, or your spouse/registered domestic partner if married filing jointly, or married filing separately on the same return, at least age 25, but not age 65 at the end of 2025? (born after December 31, 1960, and before January 2, 2001). If your spouse died in 2025 or if you are preparing a return for someone who died in 2025, see IRS Pub. 596 before you answer. If YES continue. If NO, STOP, you cannot claim the EITC. 2. Do you, and your spouse/registered domestic partner (if filing on the same tax return) have a social security number or individual taxpayer identification number that allows you to work, or is valid for DC EITC purposes? (See p. 13 herein and the federal tax return instruction booklet for more information). If YES, continue. 3. If you answer YES to any of the following questions, STOP, you are not eligible for the EITC. If you can answer NO to all the questions, go to step 4. a. If you are unmarried, can you be claimed as a dependent on someone else’s 2025 tax return, or are you someone else’s qualifying child? b. If you are married, and you are not filing with your spouse, can you be claimed as a dependent on someone else’s 2025 tax return, or are you someone else’s qualifying child? c. On your federal return are you filing form 2555? d. Is your investment income more than $11,950? (Investment income includes: taxable interest, tax-exempt interest, ordinary dividends and capital gains more than $0) e. Did you file form 4797 with your federal return? f. Did you file Schedule E with your federal return? g. Did you have income from the rental of personal property not used in trade or business on your federal return? h. Did you elect to report child's interest and dividends on your federal return? i. Are you a qualifying child of another person for the Earned Income Credit? 4. If you had income or loss from a passive activity, see IRS Pub. 596 to see if you can claim the EITC. 24

SECTION B: Calculating Your Earned Income (For Individuals without federal Schedule SE, Schedule C, and who were not members of the clergy or statutory employees) If you were self-employed at any time in 2025, or are filing federal Schedule SE because you were a member of the clergy or had church employee income, or are filing federal Schedule C as a statutory employee, DO NOT USE THIS WORKSHEET to figure out your earned income. See special instructions below. This worksheet is for taxpayers without a qualifying child only. If you claimed the federal EITC on a 1040 or a 1040-SR, DO NOT USE THIS WORKSHEET to figure out your earned income. Report the earned income amount derived from the federal worksheet used to make your federal EITC claim on your 1040 or 1040-SR. 1. Enter the amount of your wages, salaries, tips, etc., (from federal Form 1040 or 1040-SR)..............................................................1. 2. (QWHUDQ\DPRXQWLQFOXGHGRQ/LQHWKDWLVD0HGLFDLGZDLYHU SD\PHQW\RXH[FOXGHIURPLQFRPH 2.  6XEWUDFW/LQHIURP/LQH and enter the result here . Enter all of your nontaxable combat pay if you elect to include it in earned income............................................................................................... . Add Lines  and . This is your earned income................................................... Special instructions for Members of the Clergy, Statutory employees and those filing Schedule SE, Schedule C. See IRS 1040 instruction, Worksheet B. Use the amount on line 4b as your earned income. (Ignore line 5). Clergy and Church employees take note of special instructions. 25

SECTION C: Figuring your DC Earned Income Credit Note: This Earned Income Credit Worksheet is for filers without a qualifying child only. If you are a filer with a qualifying child, DO NOT USE THIS WORKSHEET. If your earned income or federal adjusted gross income (fed AGI) is greater than $30,941, STOP, you cannot claim this credit. 1. Enter your earned income from Line 5 of the Earned Income worksheet on the previous page, or from Line 4b of Worksheet B from the IRS instructions.........1. 2. If earned income is less than $8,484, multiply the amount by 0.0765. Otherwise enter $649. $649 is the maximum amount that can be claimed. This is your tentative EITC amount based on your earned income. Complete the Lines below to determine the actual EITC amount.......................... 2. 3. Enter your federal adjusted gross income (from Form 1040 or 1040-SR).............. 3. 4. Enter the higher of Line 1 or Line 3................................................................. 4. If Line 4 is less than $23,288, enter the amount from Line 2. This is your actual EITC. If you are a part-year resident, you must prorate the credit attributable to the time of your DC residency. Enter this amount on Form D-40, Line 27e................................................................................ 5. 6. If Line 4 is between $23,288 and $30,941 subtract $23,288 from the amount on Line 4 and enter the result here...................................................... 6. 7. Multiply the amount on Line 6 by 0.0848 and enter the result here.................... 7. 8. Subtract Line 7 from Line 2 and enter the result here. If less than zero, enter zero. If you are a part-year resident, you must prorate the credit attributable to the time of your DC residency. This is your actual EITC. Enter this amount on Form D-40, Line 27e......................................................8. 5. 26

27

U.S. Bank ReliaCard® Pre-Acquisition Disclosure Program Name: District of Columbia Personal Income Tax

Monthly fee $0 Per purchase $0 ATM withdrawal $0 in-network $2.00 out-of-network Cash reload N/A

ATM Balance Inquiry (in-network or out-of-network) $0

Customer Service (automated or live agent) $0 per call

Inactivity (after 365 days with no transactions) $2.00 per month

We charge 3 other types of fees.

No overdraft/credit feature. Your funds are eligible for FDIC insurance.

For general information about prepaid accounts, visit cfpb.gov/prepaid. Find details and conditions for all fees and services inside the card package or call 1-877-528-6408 or visit usbankreliacard.com.

CR-57056126

The ReliaCard is issued by U.S. Bank National Association pursuant to a license from Visa U.S.A. Inc. © 2026 U.S. Bank. Member FDIC. U.S. Bank ReliaCard® Fee Schedule Program Name: District of Columbia Personal Income Tax

All fees Amount Details Get cash ATM Withdrawal (in- network) $0 This is our fee per withdrawal. “In-network” refers to the U.S. Bank or MoneyPass® or Allpoint® ATM networks. Locations can be found at usbank.com/locations or moneypass.com/atm- locator.html or allpointnetwork.com. ATM Withdrawal (out-of- network) $2.00 This is our fee per withdrawal. “Out-of-network” refers to all the ATMs outside of the U.S. Bank or MoneyPass or Allpoint ATM networks. You may also be charged a fee by the ATM operator even if you do not complete a transaction. Teller Cash Withdrawal $0 This is our fee for when you withdraw cash off your card from a teller at a bank or credit union that accepts Visa®. Using your card outside the U.S. International Transaction 3% This is our fee which applies when you use your card for purchases at foreign merchants and for cash withdrawals from foreign ATMs and is a percentage of the transaction dollar amount, after any currency conversion. Some transactions, even if you and/or the merchant or ATM are located in the United States, are considered foreign transactions under the applicable network rules, and we do not control how these merchants, ATMs and transactions are classified for this purpose. International ATM Withdrawal $2.00 This is our fee per withdrawal. You may also be charged a fee by the ATM operator even if you do not complete a transaction. Other Card Replacement $5.00 This is our fee per replacement of a lost card mailed to you with standard delivery (up to 10 business days). Card Replacement Expedited Delivery $15.00 This is our fee for expedited delivery (up to 3 business days) charged in addition to any Card Replacement fee. Inactivity $2.00 This is our fee charged each month after you have not completed a transaction using your card or received a load for 365 consecutive days. This fee is not charged where prohibited by law. Your funds are eligible for FDIC insurance. Your funds will be held at U.S. Bank National Association, an FDIC-insured institution, and are insured up to $250,000 by the FDIC in the event U.S. Bank fails. See fdic.gov/deposit/deposits/prepaid.html for details. No overdraft/credit feature. Contact Cardholder Services by calling 1-877-528-6408, by mail at P.O. Box 551617, Jacksonville, FL 32255 or visit usbankreliacard.com. For general information about prepaid accounts, visit cfpb.gov/prepaid. If you have a complaint

about a prepaid account, call the Consumer Financial Protection Bureau at 1-855-411-2372 or visit cfpb.gov/complaint.

CR-68221148 The ReliaCard is issued by U.S. Bank National Association pursuant to a license from Visa U.S.A. Inc. © 2026 U.S. Bank. Member FDIC.

Divulgación Previa a la Adquisición de la Tarjeta U.S. Bank ReliaCard® Nombre del Programa: District of Columbia Personal Income Tax Algunos materiales y servicios podrían estar disponibles solamente en inglés. Los enlaces incluidos en esta comunicación podrían dirigirlo a sitios web en inglés. Cargo mensual $0 Por compra $0 Retiro de fondos en ATM $0 dentro de la red $2.00 fuera de la red Recarga de efectivo N/A Consulta de Saldo en ATM (dentro o fuera de la red) $0 Servicio de Atención al Cliente (automatizado o representante en vivo) $0 por llamada Inactividad (después de 365 días sin transacciones) $2.00 por mes Cobramos otros 3 tipos de cargos. Sin prestación de sobregiro/crédito. Sus fondos son elegibles para el seguro FDIC. Para obtener información general sobre cuentas prepagadas, visite cfpb.gov/prepaid. Encuentre detalles y condiciones de todos los cargos y servicios consultando el paquete de la tarjeta, llamando al 1-877-528-6408 o visitando usbankreliacard.com. CR-57056126 - Spanish

La Tarjeta ReliaCard es emitida por U.S. Bank National Association de conformidad con una licencia de Visa U.S.A. Inc. ©2026 U.S. Bank. Miembro FDIC. Lista de Cargos de la Tarjeta U.S. Bank ReliaCard® Nombre del Programa: District of Columbia Personal Income Tax

Todos los cargos Monto Detalles Retiros de efectivo Retiro de Fondos en ATM (dentro de la red) $0 Este es nuestro cargo por cada retiro de fondos. “Dentro de la red” se refiere a las redes de ATM de U.S. Bank, MoneyPass® y Allpoint®. Puede encontrar ubicaciones en usbank.com/locations, moneypass.com/atm-locator.html y allpointnetwork.com. Retiro de Fondos en ATM (fuera de la red) $2.00 Este es nuestro cargo por cada retiro de fondos. “Fuera de la red” se refiere a todos los ATM que se encuentran fuera de las redes de ATM de U.S. Bank, MoneyPass y Allpoint. El operador del ATM también puede cobrarle un cargo, incluso si no termina de realizar la transacción. Retiro de Efectivo con Personal de Ventanilla $0 Este es nuestro cargo por realizar un retiro de efectivo desde su tarjeta con la ayuda del personal de ventanilla en un banco o cooperativa de crédito que acepte Visa®. Uso de su tarjeta fuera de los EE. UU. Transacción Internacional 3% Este es el cargo que cobramos y que se aplica al uso de su tarjeta para compras en comercios extranjeros y por retiros de efectivo en ATM extranjeros y es un porcentaje del monto en dólares de la transacción después de cualquier conversión de moneda. Algunas transacciones, aunque usted y/o el comercio o ATM estén ubicados en los Estados Unidos, se consideran transacciones en el extranjero conforme a las reglas correspondientes de la red, y nosotros no tenemos control sobre cómo se clasifican estos comercios, ATM y transacciones para este fin. Retiro de Fondos en ATM Internacional $2.00 Este es nuestro cargo por cada retiro de fondos. El operador del ATM también puede cobrarle un cargo, incluso si no termina de realizar la transacción. Otros Reemplazo de Tarjeta $5.00 Este es nuestro cargo por reemplazo de una tarjeta extraviada con servicio de entrega estándar (hasta 10 días hábiles). Reemplazo de Tarjeta con Entrega Urgente $15.00 Este es nuestro cargo por entrega urgente (hasta 3 días hábiles), adicional a cualquier cargo por Reemplazo de Tarjeta. Inactividad $2.00 Este es nuestro cargo por mes después de que no haya realizado una transacción utilizando su tarjeta o recibido un depósito durante 365 días consecutivos. Este cargo no se cobra donde lo prohíba la ley. Si bien esta comunicación de U.S. Bank se ofrece en español, las futuras comunicaciones de U.S. Bank y los documentos relacionados con sus acuerdos contractuales, divulgaciones, notificaciones y estados de cuenta, así como los servicios en Internet y de la banca móvil, y contenido vinculado, podrían estar disponibles solamente en inglés. Usted debe poder leer y

comprender estos documentos o tener asistencia en su traducción para poder entender y utilizar este producto o servicio. Los documentos en inglés están disponibles a petición suya. Sus fondos son elegibles para el seguro FDIC. Sus fondos se conservarán en U.S. Bank National Association, una institución asegurada por la FDIC, y están asegurados por la FDIC hasta $250,000 en caso de que U.S. Bank quiebre. Consulte fdic.gov/deposit/deposits/prepaid.html para obtener detalles. Sin prestación de sobregiro/crédito. Comuníquese con Servicios para Titulares de Tarjetas, llamando al 1-877-528-6408, por correo a: Cardholder Services P.O. Box 551617, Jacksonville, FL 32255 o visite usbankreliacard.com. Para obtener información general sobre cuentas prepagadas, visite cfpb.gov/prepaid. Si tiene alguna queja sobre una cuenta prepagada, llame a la Oficina para la Protección Financiera del Consumidor (Consumer Financial Protection Bureau) al 1-855-411-2372, o visite cfpb.gov/complaint. CR-68221148 - Spanish La Tarjeta ReliaCard es emitida por U.S. Bank National Association de conformidad con una licencia de Visa U.S.A. Inc. ©2026 U.S. Bank. Miembro FDIC.

If you require this document to be read digitally for accessibility in additional languages, please contact Cardholder Services to utilize the language line at the number on the back of your card. Chinese Traditional - 如果您因無障礙訪問需求而需要本文檔用其他語種以數位方式朗讀，請撥打 卡片背面號碼聯絡持卡人服務部，以便使用語言專綫。 Korean - 다른 언어로 접근성을 높이기 위해 이 문서를 디지털 방식으로 읽어야 하는 경우, 뒷면에 있는 번호로 카드소지자 서비스에 문의하여 번역 서비스를 이용하시기 바랍니다.

CR-57056126 - Traditional Chinese U.S. Bank 全美銀行 ReliaCard® 領卡前披露事項 計劃名稱：District of Columbia Personal Income Tax（哥倫比亞特區個人所得稅） 某些資料與服務可能僅提供英文版本。本通訊中包含的連結可能會將您引導至英 語網站。 月費 $0 每次購物 $0 ATM 提款 $0 網絡內 $2.00 網絡外 現金儲值 不適用 ATM 餘額查詢（網絡內或網絡外） $0 客戶服務（自動語音或線上客服人員） 每通電話 $0 閒置 （未進行交易逾 365 天後） 每月 $2.00 我們還收取另外 3 種費用。 無透支/信貸功能。 您的資金符合 FDIC 保險資格。 如需瞭解預付帳戶的一般資訊，請造訪 cfpb.gov/prepaid。 如需瞭解所有費用和服務的詳細資訊與條件，請參閱卡片文件包內資訊， 也可致電 1-877-528-6408 或造訪 usbankreliacard.com。

ReliaCard 由 U.S. Bank National Association 依據 Visa U.S.A. Inc. 的許可發行。©2026 U.S. Bank 全美銀行。Member FDIC。 U.S. Bank ReliaCard® 收費表 計畫名稱：District of Columbia Personal Income Tax（哥倫比亞特區個人所得稅）

所有費用 金額 詳情 提領現金 ATM 提款（網絡內） 0 美元 這是我們按次收取的提款費用。「網絡內」是指 U.S. Bank 全美銀行、MoneyPass® 或 Allpoint® ATM 網絡。如需查詢 ATM 地點，請瀏覽 usbank.com/locations 或 moneypass.com/atm- locator.html，或 allpointnetwork.com。 ATM 提款（網絡外） 2 美元 這是我們按次收取的提款費用。「網絡外」是指 U.S. Bank 全美銀行、MoneyPass 或 Allpoint ATM 網 絡外的所有 ATM。即使未完成交易，ATM 營運商仍 可能向您收取費用。 臨櫃提款 0 美元 這是當您在受理 Visa® 的銀行或信用合作社，透過臨 櫃方式以卡片提取現金時，我們所收取的費用。 在美國境外使用您的卡 國際交易 3% 這是您在境外向商家購物，以及從境外 ATM 提領現金 時我們向您收取的費用，且是經匯率換算後依照美元交 易金額所計算的百分比。即使您及／或商家或 ATM 位 於美國境內，部分交易仍會根據適用的網絡規則視為國 際交易；而且我們無法控制這些商家、ATM 和交易如 何為此目的進行分類。 國際 ATM 提款 2 美元 這是我們按次收取的提款費用。即使未完成交易， ATM 營運商仍可能向您收取費用。 其他 補發新卡 5 美元 這是在您遺失卡片後，我們以郵寄方式在 10 個工作日 內寄送新卡給您的補發新卡費用。 補發新卡急件寄送費用 15 美元 這是我們在任何補發新卡費用以外加收的急件寄送費用 （最多 3 個工作日）。 帳戶閒置狀態 2 美元 這是您連續 365 天未使用卡片完成任何交易或未收到 儲值時，我們每月所收取的費用。若法律禁止收取，則 不收取此費用。 雖然這份通訊文件是以中文提供，但 U.S. Bank 全美銀行的後續通訊，與您的契約、披露、通 知與對帳單、網路與行動銀行服務，以及相關連結內容有關的文件，可能只以英文提供。您必

ReliaCard 由 U.S. Bank National Association 依據 Visa U.S.A. Inc. 的許可發行。©2026 U.S. Bank 全美銀行。Member FDIC。 須能夠閱讀和理解這些文件，或取得協助以翻譯這些文件，才能了解和使用此產品或服務。可 透過要求索取英文文件。 您的資金符合 FDIC 保險資格。您的資金將存放在經 FDIC 承保的 U.S. Bank National Association。如果 U.S. Bank 全美銀行倒閉，FDIC 會為您承保高達 25 萬美元的資金。如欲查 詢詳情，請造訪 fdic.gov/deposit/deposits/prepaid.html。 本卡無透支或信貸功能。 要聯絡持卡人服務部，請致電 1-877-528-6408，或郵寄函件至 PO Box 551617, Jacksonville, FL 32255，也可造訪 usbankreliacard.com。 如欲瞭解預付帳戶的一般資訊，請造訪 cfpb.gov/prepaid。如您欲就預付帳戶提出申訴，請致 電 Consumer Financial Protection Bureau（消費者金融保護局），電話 1-855-411-2372，或造 訪 cfpb.gov/complaint。

CR-68221148 - Chinese

CR-57056126 - Korean

U.S. Bank ReliaCard® 수령 전 공시 프로그램명: District of Columbia Personal Income Tax

일부 자료와 서비스는 영어로만 제공될 수 있습니다. 본 커뮤니케이션에 포함된 링크는 영어 웹사이트로 연결될 수 있습니다.

월 수수료 $0 구매 건당 $0 ATM 인출 $0 네트워크 내 $2.00 네트워크 외 현금 충전 해당 없음

ATM 잔액 조회(네트워크 내 또는 네트워크 외) $0

고객 서비스(자동 음성 서비스 또는 상담원) $0 통화당

휴면 상태(거래 없이 365일 경과 후) $2.00 매월

3가지 유형의 기타 수수료가 부과됩니다.

당좌차월/신용 기능은 없습니다. 고객의 자금은 FDIC 보험으로 보호받습니다.

선불 계좌에 대한 일반 정보를 원하시면 cfpb.gov/prepaid에서 확인하십시오. 모든 수수료와 서비스에 대한 상세내역과 조건은 본 카드 패키지에서 찾아보거나, 1-877-528-6408번으로 전화하거나 usbankreliacard.com에서 확인하십시오.

ReliaCard는 Visa U.S.A. Inc.의 라이선스에 따라 U.S. Bank National Association에서 발급합니다. © 2026 U.S. Bank. Member FDIC. U.S. Bank ReliaCard® 요율표 프로그램명: District of Columbia Personal Income Tax

모든 수수료 금액 세부 내용 출금 ATM 인출 (네트워크 내) $0 이는 인출 건당 수수료입니다. '네트워크 내'는 U.S. Bank, MoneyPass® 또는 Allpoint® ATM 네트워크를 의미합니다. 위치 정보는 usbank.com/locations 또는 moneypass.com/atm-locator.html 또는 allpointnetwork.com에서 확인할 수 있습니다. ATM 인출(네트워크 외) $2.00 이는 인출 건당 수수료입니다. '네트워크 외'는 U.S. Bank, MoneyPass 또는 Allpoint ATM 네트워크 외의 기타 모든 ATM을 의미합니다. 거래를 완료하지 않은 경우에도 ATM 운영자가 수수료를 부과할 수 있습니다. 창구 현금 인출 $0 이 수수료는 은행이나 신용협동조합의 창구 직원으로부터 Visa® 카드로 현금을 인출할 때 적용됩니다. 미국 외에서의 카드 사용 해외 거래 3% 고객이 해외 상점에서 카드로 구매하거나 해외 ATM에서 현금을 인출한 경우에 적용되는 수수료이며, 환전 후 달러 기준 거래 금액에 대한 백분율입니다. 일부 거래는 고객 및/또는 상점 또는 ATM이 미국에 있어도 해당 네트워크 규칙에 따라 해외 거래로 간주되며, 당사는 해당 상점, ATM 및 거래가 해당 목적으로 분류되는 방식을 통제하지 않습니다. 해외 ATM 인출 $2.00 이는 인출 건당 수수료입니다. 거래를 완료하지 않은 경우에도 ATM 운영자가 수수료를 부과할 수 있습니다. 기타 카드 재발급 $5.00 이 수수료는 카드 분실 시 재발급 카드를 표준 배송(최대 10영업일 소요)으로 우송할 때 부과되는 카드 교체 건당 수수료입니다. 카드 교체 빠른 배송 $15.00 이 수수료는 카드 교체 수수료 외에 별도로 부과되는 빠른 배송(최대 3영업일 소요) 수수료입니다. 장기 미거래 $2.00 이 수수료는 365일 연속으로 카드를 한 번도 사용하지 않거나 카드에 금액을 충전하지 않을 경우 매월 부과되는 수수료입니다. 법으로 금지된 곳에서는 이 수수료가 부과되지 않습니다. 본 커뮤니케이션은 한국어로 제공되지만, 이후의 U.S. Bank 커뮤니케이션과 계약 동의서, 공시, 알림 및 입출금 내역서와 관련된 문서와 인터넷, 모바일 뱅킹 서비스 및 연결된 콘텐츠의 경우 영어로만 이용 가능할 수 있습니다. 본인이 이런 문서를 읽고 이해할 수 있거나 다른 사람의 도움을 받아 이들 문서를 번역할 수 있어야만 본 상품이나 서비스를 이해하고 이용하실 수 있습니다. 영어 문서는 요청하시면 언제든지 이용 가능합니다.

ReliaCard는 Visa U.S.A. Inc.의 라이선스에 따라 U.S. Bank National Association에서 발급합니다. © 2026 U.S. Bank. Member FDIC. 고객의 자금은 FDIC 보험 적용 대상입니다. 고객의 자금은 FDIC 보험 기관인 U.S. Bank National Association에 보관되며 U.S. Bank가 파산할 경우 FDIC가 최대 $250,000까지 보장합니다. 자세한 내용은 fdic.gov/deposit/deposits/prepaid.html에서 볼 수 있습니다. 당좌차월/신용 기능은 없습니다. 카드 소지자 서비스에 문의하려면 1-877-528-6408번으로 전화하거나, P.O. Box 551617, Jacksonville, FL 32255로 우편물을 보내거나, usbankreliacard.com에서 문의해 주시기 바랍니다. 선불 계좌에 대한 일반적인 정보는 cfpb.gov/prepaid에서 확인할 수 있습니다. 선불 계좌에 대해 불만 사항이 있는 경우, 1-855-411-2372번으로 Consumer Financial Protection Bureau에 전화하거나 cfpb.gov/complaint를 방문하십시오.

CR-68221148 - Korean

40

*250400110000* Government of the District of Columbia

Important: Print in CAPITAL letters using black ink. Revised 11/2025 OFFICIAL USE ONLY Vendor Vendor ID#0000 ID#0000 z z z STAPLE W-2s AND ANY OTHER WITHHOLDING STATEMENTS HERE ˆÊˆ˜Ê ˆv\ÊFiling an >“i˜`i`ÊÀiÌÕÀ˜.Ê-iiʈ˜ÃÌÀÕV̈œ˜Ã°Ê Personal information 9œÕÀÊÌii« œ˜iʘՓLiÀ Your taxpayer identification number (TIN) >˜` Date of Birth (MMDDYYYY) Spouse’s/registered domestic partner’s TIN >˜` Date of Birth (MMDDYYYY) Home address (number, street and suite/apartment number if applicable) City State Zip Code +4 Your first name M.I. Last name Spouse’s/registered domestic partner’s first name M.I. Last name STAPLE OTHER DOCUMENTS IN UPPER LEFT IN BACK 4 $ .00 Filing status Single, Married filing jointly, Married filing separately, Dependent claimed by someone else 1 ˆÊˆ˜Êœ˜Þʜ˜i\ 2 ˆÊˆ˜ÊˆvÊޜÕÊ>Ài\ Married filing separately on same return ˜ÌiÀÊVœ“Lˆ˜i`Ê>“œÕ˜ÌÃÊvœÀÊ ˆ˜iÃÊxq{ΰÊ-iiʈ˜ÃÌÀÕV̈œ˜Ã°Ê filing separately on same return Enter combined amounts Registered domestic partners filing jointly for Lines 5-43. See instructions. Qualifying widow(er) with dependent child ˜ÌiÀʵÕ>ˆvވ˜}Ê`i«i˜`i˜ÌÊ>˜`ɜÀʘœ˜‡`i«i˜`i˜Ìʈ˜vœÀ“>̈œ˜Êœ˜Ê-V i`ՏiÊ-° Part-year resident in DC vÀœ“

to -iiʈ˜ÃÌÀÕV̈œ˜Ã° Income Information a Wages, salaries, unemployment compensation and/or tips, b Business income or loss, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° c Capital gain or loss. d Rental real estate, royalties, partnerships, etc. Computation of DC Gross and Adjusted Gross Income 4 Federal adjusted gross income. From adjusted gross income lines on federal Forms 1040, 1040-SR, 1040-NR or 1040-NR-EZ. a $ .00 b $ .00 c $ .00 d $ .00 ,œÕ˜`ÊVi˜ÌÃÊ̜ʘi>ÀiÃÌÊ`œ>À°ÊÊvÊ>“œÕ˜ÌʈÃÊâiÀœ]ʏi>Ûiʏˆ˜iÊL>˜ŽÆ ˆvʓˆ˜ÕÃ]Êi˜ÌiÀÊ>“œÕ˜ÌÊ>˜`ÊwÊˆ˜ÊœÛ>° )LOOLQLIORVV )LOOLQLIORVV )LOOLQLIORVV Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° )LOOLQLIORVV Complete your federal return first – Enter your dependents’ information on DC Schedule S ˆÊˆ˜ÊˆvÊ iVi>Ãi` ˆÊˆ˜ÊˆvÊ iVi>Ãi` (MMDDYYYY) (MMDDYYYY) 3 ÊÊÊ ˆ`ÊޜÕÊ >ÛiʵÕ>ˆvވ˜}Ê i>Ì ÊV>ÀiÊVœÛiÀ>}iÊvœÀÊ>Ê“i“LiÀÃʜvÊޜÕÀÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞÊvœÀÊÌ iÊi˜ÌˆÀiÊÞi>À¶ 9ià œ Êvʘœ]ʜÀʈvÊV>ˆ“ˆ˜}Ê>˜ÊiÝi“«Ìˆœ˜]ÊVœ“«iÌiÊ-V i`ՏiÊ-,Ê­Ãiiʈ˜ÃÌÀÕV̈œ˜Ã®° ÊÊÊ Email Address Head of household ˜ÌiÀʵÕ>ˆvވ˜}Ê`i«i˜`i˜ÌÊ>˜`ɜÀʘœ˜‡`i«i˜`i˜Ìʈ˜vœÀ“>̈œ˜Êœ˜Ê-V i`ՏiÊ-° Income Tax Return ÓäÓ5ÊÊ D-40 Individual

* 50400120000*

˜ÌiÀÊޜÕÀʏ>ÃÌʘ>“i° D-40 PAGE 2

˜ÌiÀÊޜÕÀÊ/ z z 18$ 19 $ .00 20 $ .00 21 $ .00 22$ .00 or Itemized -iiʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊ>“œÕ˜ÌÊ̜Êi˜ÌiÀʜ˜Ê ˆ˜iÊ£8° 27b Enter earned income amount Enter result > z 27e $ .00 27d $ .00 23$ .00 26$ .00 27b $ .00 28 $ .00 .00 X 1.00 Enter result > 24 $ .00 25 $ .00 .00 17 Deduction type. />ŽiÊÌ iÊÃ>“iÊÌÞ«iÊ>ÃÊޜÕÊ̜œŽÊœ˜ÊޜÕÀÊvi`iÀ>ÊÀiÌÕÀ˜°ÊʈÊˆ˜ÊÜ ˆV ÊÌÞ«i\Ê Standard 18 DC deduction amount. Fill in if loss Additions to DC Income 5 Franchise tax deducted on federal forms, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 6 Other additions from DC Schedule I, Calculation A, Line 9. 7 Add Lines 4, 5 and 6. Subtractions from DC Income 8 Part year residents, enter income received during period of nonresidence, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 9 Taxable refunds, credits or offsets of state and local income tax. 10 Taxable amount of social security and tier 1 railroad retirement 11 Income reported and taxed this year on a DC franchise or fiduciary return. 12 DC and federal government survivor benefits, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 13 Unemployment Insurance Benefits, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 14 Other subtractions from DC Schedule I, Calculation B, Line 16. 15 Total subtractions from DC income, Lines 8-14. 16 DC adjusted gross income, Line 7 minus Line 15. 5 $ .00 6 $ .00 7 $ .00 Fill in if loss 8 $ .00 9 $ .00 10 $ .00 11 $ .00 12 $ .00 13 $ .00 14 $ 15 $ .00 .00 27e For filers without qualifying children. -iiʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊëiVˆ>ÊV>VՏ>̈œ˜Ã° 28 Property Tax Credit. Àœ“ÊޜÕÀÊ

Ê-V i`ՏiÊÆÊ>ÌÌ>V Ê>ÊVœ«Þ° 19 DC taxable income. -ÕLÌÀ>VÌÊ ˆ˜iÊ£nÊvÀœ“Ê ˆ˜iʣȰ Fill in if loss 16 $ .00 20 Tax.  vÊ ˆ˜iÊ£™ÊˆÃÊf£ää]äääʜÀʏiÃÃ]ÊÕÃiÊÌ>ÝÊÌ>LiÃÊ̜Êvˆ˜`ÊÌ iÊÌ>Ý]ʈvʓœÀi]ÊÕÃiÊ >VՏ>̈œ˜Êʈ˜ÃÌÀÕV̈œ˜Ã° Fill inÊÊÊÊÊÊÊÊif filing separately on same return. œ“«iÌiÊ >VՏ>̈œ˜Êʜ˜Ê-V i`ՏiÊ-° 21 Credit for child and dependent care expenses $ .00 X .32 Àœ“Êvi`iÀ>ÊœÀ“ÊÓ{{£ÆʈvÊ«>À̇Þi>ÀÊ

ÊÀiÈ`i˜Ì]ÊvÀœ“Ê ˆ˜iÊx]Ê

ÊœÀ“ÊÓ{{£ 22 Non-refundable credits from DC Schedule U, Part 1a, Line 7.
ÌÌ>V Ê-V i`ՏiÊ1° 23Ê Total non-refundable credits.
``Ê ˆ˜iÊÓ£Ê>˜`Ê ˆ˜iÊÓÓ° 24 Subtract Line 23 from Line 20. vʏiÃÃÊÌ >˜ÊâiÀœ]Êi˜ÌiÀÊâiÀœ° 25 DC Health Care Shared Responsibility -iiʈ˜ÃÌÀÕV̈œ˜Ã°ÊvÊvՏÞÊVœÛiÀi`ʜÀÊvՏÞÊiÝi“«Ì]Êi˜ÌiÀÊâiÀœ°
26 Total taxÊand DC Health Care Shared Responsibility.
``Ê ˆ˜iÊÓ{Ê>˜`Ê ˆ˜iÊÓx° 27 DC Earned Income Tax Credit * Do you choose to receive your DC EITC refund in 12 monthly payments instead of one total payment? * Caution: Choosing to receive this credit in monthly payments may cause you to lose your Supplemental Nutrition Assistance Program (SNAP) or other federal benefits (For more information about SNAP, contact the Department of Human Services at (202) 807-0405 or dhs@dc.gov.) Taxpayers receiving DC EITC amounts of $1,200 or more may choose to receive the DC EITC portion of their refund in 12 equal monthly payments instead of one total payment. If you choose to receive monthly DC EITC payments, OTR will calculate the distribution of your net refund amount for you. Your initial payment will be different from the Line 43 Net Refund amount. federal EIC amount 27a Enter the number of qualified EITC children. 27c For filers with qualifying children. Enter calculated > $ If so, see instructions for eligibility.

*250400130000* D-40 PAGE 3

˜ÌiÀÊޜÕÀʏ>ÃÌʘ>“i°

˜ÌiÀÊޜÕÀÊ/ Preparer’s signature Date Your signature Date Spouse’s/registered domestic partner’s signature if filing jointly or separately on same return Date Preparer's Tax Identification Number (PTIN) PTIN telephone number ° Will this refund go to an account outside the U.S.? 9ià œ -iiʈ˜ÃÌÀÕV̈œ˜Ã° ,iv՘`Ê"«Ìˆœ˜Ã\ÊœÀʈ˜vœÀ“>̈œ˜Êœ˜ÊÌ iÊÌ>ÝÊÀiv՘`ÊV>À`Ê>˜`Ê«Àœ}À>“ʏˆ“ˆÌ>̈œ˜Ã]ÊÃiiʈ˜ÃÌÀÕV̈œ˜ÃʜÀÊۈÈÌʜÕÀÊÜiLÈÌiÊ Þ/>Ý°

°}œÛ° Reliacard (See instructions) œÀ Paper check Mark œ˜i refund choice: Direct Deposit. /œÊ >ÛiÊޜÕÀÊÀiv՘`Ê`i«œÃˆÌi`Ê̜ÊޜÕÀÊ ÊV iVŽˆ˜}ʜÀÊ ÊÃ>ۈ˜}ÃÊ>VVœÕ˜Ì]ÊwÊˆ˜ÊœÛ>Ê>˜`Êi˜ÌiÀÊL>˜ŽÊÀœṎ˜}Ê>˜`Ê>VVœÕ˜ÌʘՓLiÀðÊ-iiʈ˜ÃÌÀÕV̈œ˜Ã. Routing Number Account Number Third party designee /œÊ>ÕÌ œÀˆâiÊ>˜œÌ iÀÊ«iÀܘÊ̜Ê`ˆÃVÕÃÃÊÌ ˆÃÊÀiÌÕÀ˜ÊÜˆÌ Ê"/,]ÊwÊˆ˜Ê iÀiÊ Ê>˜`Êi˜ÌiÀÊÌ iʘ>“iÊ>˜`Ê« œ˜iʘՓLiÀʜvÊÌ >ÌÊ«iÀܘ°Ê-iiʈ˜ÃÌÀÕV̈œ˜Ã° Designee’s name Phone number Signature Under penalties of law, I declare that I have examined this return and, to the best of my knowledge, it is correct. Declaration of paid preparer is based on information available to the preparer. 29 $ °00 31 $ °00 32 $ °00 33 $ °00 34 $ °00 35 $ °00 36 $ °00 37 $ °00 38 $ °00 39 $ °00 40 $ °00 41 $ °00 42 $ °00 43 $ °00 DC tax, credit and payments Fill in if you agree to receive your 1099-G Income Tax refund statement electronically (see instructions). z z z °00 ° 30 $ 44 Fill in if either spouse is claiming injured spouse protection. You “ÕÃÌÊattach Form DC-8379. 29 Refundable credits from DC Schedule U, Part 1b, Line 3.
ÌÌ>V Ê-V i`ՏiÊ1° 30 Total refundable credits.
``Ê ˆ˜iÊÓÇ`ʜÀÊÓÇiÊÌ ÀœÕ} Ê ˆ˜iÊә° 31 DC income tax withheld à œÜ˜Êœ˜ÊœÀ“ÃÊ7‡ÓÊ>˜`ʣ䙙°Ê
ÌÌ>V ÊÌ iÃiÊvœÀ“ð 32 2025 estimated income tax payments and amount applied from 2024 return. 33 Tax paid with Form FR-127 Extension of Time to File. 34 If this is an amended 2025 return, enter payments made with original 2025 D-40 return. 35 If this is an amended 2025 return, enter refunds requested with original 2025 D-40 return. 36 Total payments and refundable credits.
``Ê ˆ˜iÊÎäÊÌ ÀœÕ} Ê ˆ˜iÊÎ{°Ê­ œÊ˜œÌʈ˜VÕ`iÊ ˆ˜iÊÎx®° 37 Tax Due.ÊÊ-ÕLÌÀ>VÌÊ ˆ˜iÊÎÈÊvÀœ“Ê ˆ˜iÊÓÈ° 38 Amount overpaid. -ÕLÌÀ>VÌÊ ˆ˜iÊÓÈÊvÀœ“Ê ˆ˜iÊÎÈ° 39Ê Amount to be applied to your 2026 estimated tax. 40 Underpayment Interest.ÊʈÊˆ˜ÊÌ iʜÛ>Ê>˜`Ê>ÌÌ>V ÊœÀ“Ê ‡ÓÓ£ä°Ê 41 Contribution amount from Schedule U, Part ll, Line 5. (Cannot exceed amount on Line 38) 42 Total Amount Due.
``Ê ˆ˜iÃÊÎÇ]Ê{äÊ>˜`Ê{£° 43 Net Refund.*Ê-ÕLÌÀ>VÌÊ̜Ì>ÊœvÊ ˆ˜iÃÊΙ]Ê{äÊ>˜`Ê{£ÊvÀœ“Ê ˆ˜iÊÎn° Direct deposit œÀ Ê

*250400110000* Government of the District of Columbia

Important: Print in CAPITAL letters using black ink. Revised 11/2025 OFFICIAL USE ONLY Vendor Vendor ID#0000 ID#0000 z z z STAPLE W-2s AND ANY OTHER WITHHOLDING STATEMENTS HERE ˆÊˆ˜Ê ˆv\ÊFiling an >“i˜`i`ÊÀiÌÕÀ˜.Ê-iiʈ˜ÃÌÀÕV̈œ˜Ã°Ê Personal information 9œÕÀÊÌii« œ˜iʘՓLiÀ Your taxpayer identification number (TIN) >˜` Date of Birth (MMDDYYYY) Spouse’s/registered domestic partner’s TIN >˜` Date of Birth (MMDDYYYY) Home address (number, street and suite/apartment number if applicable) City State Zip Code +4 Your first name M.I. Last name Spouse’s/registered domestic partner’s first name M.I. Last name STAPLE OTHER DOCUMENTS IN UPPER LEFT IN BACK 4 $ .00 Filing status Single, Married filing jointly, Married filing separately, Dependent claimed by someone else 1 ˆÊˆ˜Êœ˜Þʜ˜i\ 2 ˆÊˆ˜ÊˆvÊޜÕÊ>Ài\ Married filing separately on same return ˜ÌiÀÊVœ“Lˆ˜i`Ê>“œÕ˜ÌÃÊvœÀÊ ˆ˜iÃÊxq{ΰÊ-iiʈ˜ÃÌÀÕV̈œ˜Ã°Ê filing separately on same return Enter combined amounts Registered domestic partners filing jointly for Lines 5-43. See instructions. Qualifying widow(er) with dependent child ˜ÌiÀʵÕ>ˆvވ˜}Ê`i«i˜`i˜ÌÊ>˜`ɜÀʘœ˜‡`i«i˜`i˜Ìʈ˜vœÀ“>̈œ˜Êœ˜Ê-V i`ՏiÊ-° Part-year resident in DC vÀœ“

to -iiʈ˜ÃÌÀÕV̈œ˜Ã° Income Information a Wages, salaries, unemployment compensation and/or tips, b Business income or loss, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° c Capital gain or loss. d Rental real estate, royalties, partnerships, etc. Computation of DC Gross and Adjusted Gross Income 4 Federal adjusted gross income. From adjusted gross income lines on federal Forms 1040, 1040-SR, 1040-NR or 1040-NR-EZ. a $ .00 b $ .00 c $ .00 d $ .00 ,œÕ˜`ÊVi˜ÌÃÊ̜ʘi>ÀiÃÌÊ`œ>À°ÊÊvÊ>“œÕ˜ÌʈÃÊâiÀœ]ʏi>Ûiʏˆ˜iÊL>˜ŽÆ ˆvʓˆ˜ÕÃ]Êi˜ÌiÀÊ>“œÕ˜ÌÊ>˜`ÊwÊˆ˜ÊœÛ>° )LOOLQLIORVV )LOOLQLIORVV )LOOLQLIORVV Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° )LOOLQLIORVV Complete your federal return first – Enter your dependents’ information on DC Schedule S ˆÊˆ˜ÊˆvÊ iVi>Ãi` ˆÊˆ˜ÊˆvÊ iVi>Ãi` (MMDDYYYY) (MMDDYYYY) 3 ÊÊÊ ˆ`ÊޜÕÊ >ÛiʵÕ>ˆvވ˜}Ê i>Ì ÊV>ÀiÊVœÛiÀ>}iÊvœÀÊ>Ê“i“LiÀÃʜvÊޜÕÀÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞÊvœÀÊÌ iÊi˜ÌˆÀiÊÞi>À¶ 9ià œ Êvʘœ]ʜÀʈvÊV>ˆ“ˆ˜}Ê>˜ÊiÝi“«Ìˆœ˜]ÊVœ“«iÌiÊ-V i`ՏiÊ-,Ê­Ãiiʈ˜ÃÌÀÕV̈œ˜Ã®° ÊÊÊ Email Address Head of household ˜ÌiÀʵÕ>ˆvވ˜}Ê`i«i˜`i˜ÌÊ>˜`ɜÀʘœ˜‡`i«i˜`i˜Ìʈ˜vœÀ“>̈œ˜Êœ˜Ê-V i`ՏiÊ-° Income Tax Return ÓäÓ5ÊÊ D-40 Individual

* 50400120000*

˜ÌiÀÊޜÕÀʏ>ÃÌʘ>“i° D-40 PAGE 2

˜ÌiÀÊޜÕÀÊ/ z z 18$ 19 $ .00 20 $ .00 21 $ .00 22$ .00 or Itemized -iiʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊ>“œÕ˜ÌÊ̜Êi˜ÌiÀʜ˜Ê ˆ˜iÊ£8° 27b Enter earned income amount Enter result > z 27e $ .00 27d $ .00 23$ .00 26$ .00 27b $ .00 28 $ .00 .00 X 1.00 Enter result > 24 $ .00 25 $ .00 .00 17 Deduction type. />ŽiÊÌ iÊÃ>“iÊÌÞ«iÊ>ÃÊޜÕÊ̜œŽÊœ˜ÊޜÕÀÊvi`iÀ>ÊÀiÌÕÀ˜°ÊʈÊˆ˜ÊÜ ˆV ÊÌÞ«i\Ê Standard 18 DC deduction amount. Fill in if loss Additions to DC Income 5 Franchise tax deducted on federal forms, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 6 Other additions from DC Schedule I, Calculation A, Line 9. 7 Add Lines 4, 5 and 6. Subtractions from DC Income 8 Part year residents, enter income received during period of nonresidence, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 9 Taxable refunds, credits or offsets of state and local income tax. 10 Taxable amount of social security and tier 1 railroad retirement 11 Income reported and taxed this year on a DC franchise or fiduciary return. 12 DC and federal government survivor benefits, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 13 Unemployment Insurance Benefits, Ãiiʈ˜ÃÌÀÕV̈œ˜Ã° 14 Other subtractions from DC Schedule I, Calculation B, Line 16. 15 Total subtractions from DC income, Lines 8-14. 16 DC adjusted gross income, Line 7 minus Line 15. 5 $ .00 6 $ .00 7 $ .00 Fill in if loss 8 $ .00 9 $ .00 10 $ .00 11 $ .00 12 $ .00 13 $ .00 14 $ 15 $ .00 .00 27e For filers without qualifying children. -iiʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊëiVˆ>ÊV>VՏ>̈œ˜Ã° 28 Property Tax Credit. Àœ“ÊޜÕÀÊ

Ê-V i`ՏiÊÆÊ>ÌÌ>V Ê>ÊVœ«Þ° 19 DC taxable income. -ÕLÌÀ>VÌÊ ˆ˜iÊ£nÊvÀœ“Ê ˆ˜iʣȰ Fill in if loss 16 $ .00 20 Tax.  vÊ ˆ˜iÊ£™ÊˆÃÊf£ää]äääʜÀʏiÃÃ]ÊÕÃiÊÌ>ÝÊÌ>LiÃÊ̜Êvˆ˜`ÊÌ iÊÌ>Ý]ʈvʓœÀi]ÊÕÃiÊ >VՏ>̈œ˜Êʈ˜ÃÌÀÕV̈œ˜Ã° Fill inÊÊÊÊÊÊÊÊif filing separately on same return. œ“«iÌiÊ >VՏ>̈œ˜Êʜ˜Ê-V i`ՏiÊ-° 21 Credit for child and dependent care expenses $ .00 X .32 Àœ“Êvi`iÀ>ÊœÀ“ÊÓ{{£ÆʈvÊ«>À̇Þi>ÀÊ

ÊÀiÈ`i˜Ì]ÊvÀœ“Ê ˆ˜iÊx]Ê

ÊœÀ“ÊÓ{{£ 22 Non-refundable credits from DC Schedule U, Part 1a, Line 7.
ÌÌ>V Ê-V i`ՏiÊ1° 23Ê Total non-refundable credits.
``Ê ˆ˜iÊÓ£Ê>˜`Ê ˆ˜iÊÓÓ° 24 Subtract Line 23 from Line 20. vʏiÃÃÊÌ >˜ÊâiÀœ]Êi˜ÌiÀÊâiÀœ° 25 DC Health Care Shared Responsibility -iiʈ˜ÃÌÀÕV̈œ˜Ã°ÊvÊvՏÞÊVœÛiÀi`ʜÀÊvՏÞÊiÝi“«Ì]Êi˜ÌiÀÊâiÀœ°
26 Total taxÊand DC Health Care Shared Responsibility.
``Ê ˆ˜iÊÓ{Ê>˜`Ê ˆ˜iÊÓx° 27 DC Earned Income Tax Credit * Do you choose to receive your DC EITC refund in 12 monthly payments instead of one total payment? * Caution: Choosing to receive this credit in monthly payments may cause you to lose your Supplemental Nutrition Assistance Program (SNAP) or other federal benefits (For more information about SNAP, contact the Department of Human Services at (202) 807-0405 or dhs@dc.gov.) Taxpayers receiving DC EITC amounts of $1,200 or more may choose to receive the DC EITC portion of their refund in 12 equal monthly payments instead of one total payment. If you choose to receive monthly DC EITC payments, OTR will calculate the distribution of your net refund amount for you. Your initial payment will be different from the Line 43 Net Refund amount. federal EIC amount 27a Enter the number of qualified EITC children. 27c For filers with qualifying children. Enter calculated > $ If so, see instructions for eligibility.

*250400130000* D-40 PAGE 3

˜ÌiÀÊޜÕÀʏ>ÃÌʘ>“i°

˜ÌiÀÊޜÕÀÊ/ Preparer’s signature Date Your signature Date Spouse’s/registered domestic partner’s signature if filing jointly or separately on same return Date Preparer's Tax Identification Number (PTIN) PTIN telephone number ° Will this refund go to an account outside the U.S.? 9ià œ -iiʈ˜ÃÌÀÕV̈œ˜Ã° ,iv՘`Ê"«Ìˆœ˜Ã\ÊœÀʈ˜vœÀ“>̈œ˜Êœ˜ÊÌ iÊÌ>ÝÊÀiv՘`ÊV>À`Ê>˜`Ê«Àœ}À>“ʏˆ“ˆÌ>̈œ˜Ã]ÊÃiiʈ˜ÃÌÀÕV̈œ˜ÃʜÀÊۈÈÌʜÕÀÊÜiLÈÌiÊ Þ/>Ý°

°}œÛ° Reliacard (See instructions) œÀ Paper check Mark œ˜i refund choice: Direct Deposit. /œÊ >ÛiÊޜÕÀÊÀiv՘`Ê`i«œÃˆÌi`Ê̜ÊޜÕÀÊ ÊV iVŽˆ˜}ʜÀÊ ÊÃ>ۈ˜}ÃÊ>VVœÕ˜Ì]ÊwÊˆ˜ÊœÛ>Ê>˜`Êi˜ÌiÀÊL>˜ŽÊÀœṎ˜}Ê>˜`Ê>VVœÕ˜ÌʘՓLiÀðÊ-iiʈ˜ÃÌÀÕV̈œ˜Ã. Routing Number Account Number Third party designee /œÊ>ÕÌ œÀˆâiÊ>˜œÌ iÀÊ«iÀܘÊ̜Ê`ˆÃVÕÃÃÊÌ ˆÃÊÀiÌÕÀ˜ÊÜˆÌ Ê"/,]ÊwÊˆ˜Ê iÀiÊ Ê>˜`Êi˜ÌiÀÊÌ iʘ>“iÊ>˜`Ê« œ˜iʘՓLiÀʜvÊÌ >ÌÊ«iÀܘ°Ê-iiʈ˜ÃÌÀÕV̈œ˜Ã° Designee’s name Phone number Signature Under penalties of law, I declare that I have examined this return and, to the best of my knowledge, it is correct. Declaration of paid preparer is based on information available to the preparer. 29 $ °00 31 $ °00 32 $ °00 33 $ °00 34 $ °00 35 $ °00 36 $ °00 37 $ °00 38 $ °00 39 $ °00 40 $ °00 41 $ °00 42 $ °00 43 $ °00 DC tax, credit and payments Fill in if you agree to receive your 1099-G Income Tax refund statement electronically (see instructions). z z z °00 ° 30 $ 44 Fill in if either spouse is claiming injured spouse protection. You “ÕÃÌÊattach Form DC-8379. 29 Refundable credits from DC Schedule U, Part 1b, Line 3.
ÌÌ>V Ê-V i`ՏiÊ1° 30 Total refundable credits.
``Ê ˆ˜iÊÓÇ`ʜÀÊÓÇiÊÌ ÀœÕ} Ê ˆ˜iÊә° 31 DC income tax withheld à œÜ˜Êœ˜ÊœÀ“ÃÊ7‡ÓÊ>˜`ʣ䙙°Ê
ÌÌ>V ÊÌ iÃiÊvœÀ“ð 32 2025 estimated income tax payments and amount applied from 2024 return. 33 Tax paid with Form FR-127 Extension of Time to File. 34 If this is an amended 2025 return, enter payments made with original 2025 D-40 return. 35 If this is an amended 2025 return, enter refunds requested with original 2025 D-40 return. 36 Total payments and refundable credits.
``Ê ˆ˜iÊÎäÊÌ ÀœÕ} Ê ˆ˜iÊÎ{°Ê­ œÊ˜œÌʈ˜VÕ`iÊ ˆ˜iÊÎx®° 37 Tax Due.ÊÊ-ÕLÌÀ>VÌÊ ˆ˜iÊÎÈÊvÀœ“Ê ˆ˜iÊÓÈ° 38 Amount overpaid. -ÕLÌÀ>VÌÊ ˆ˜iÊÓÈÊvÀœ“Ê ˆ˜iÊÎÈ° 39Ê Amount to be applied to your 2026 estimated tax. 40 Underpayment Interest.ÊʈÊˆ˜ÊÌ iʜÛ>Ê>˜`Ê>ÌÌ>V ÊœÀ“Ê ‡ÓÓ£ä°Ê 41 Contribution amount from Schedule U, Part ll, Line 5. (Cannot exceed amount on Line 38) 42 Total Amount Due.
``Ê ˆ˜iÃÊÎÇ]Ê{äÊ>˜`Ê{£° 43 Net Refund.*Ê-ÕLÌÀ>VÌÊ̜Ì>ÊœvÊ ˆ˜iÃÊΙ]Ê{äÊ>˜`Ê{£ÊvÀœ“Ê ˆ˜iÊÎn° Direct deposit œÀ Ê

Government of the District of Columbia ÓäÓ5 Revised 11/2025 Unless instructed otherwise – If you fill in any part of this schedule, attach it to your D-40. Print in CAPITAL letters using black ink. Enter your last name Enter your TIN First name of qualifying non-dependent person M.I. Last Name TIN of qualifying non-dependent person Date of Birth of qualifying non-dependent person (MMDDYYYY) z z z Dependents If you have more than 8 dependents, list them on an attachment. First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) OFFICIAL USE ONLY Vendor ID#0000 * 50400 30000* SCHEDULE S Supplemental Information and Dependents Head of household filers or qualifying widow(er) Do not enter information

* 50400 40000* Revised 11/2025 Last name and TIN SCHEDULE S PAGE 2 Calculation G-1 Computation of Standard Deduction g h Total standard deduction. Add Lines a and g, enter here and on D-40, Line 1n. i Total number of dependents z z z You Your spouse/registered domestic partner $ Total tax List TINs associated with Income

Ài«œÀÌi`Ê>˜`ÊÌ>Ýi`Êon Franchise and Fiduciary Returns for the amount listed

œ˜Ê ‡{ä]Ê ˆ˜iÊ££° a d g b e h c f i Fill in if loss Fill in if loss Fill in if loss Fill in if loss $ .00 .00 $ $ $ $ $ .00 $ $ $ $ $ a b c d e f g h i .00 .00 .00 .00 .00 .00 .00 .00 $ .00 $ .00 $ .00 Calculation J Tax computation for married or registered domestic partners filing separately on the same DC return. Enter separate amounts in each column. Combine amounts on Line ˆ. a Federal adjusted gross income (AGI). a If you and your spouse filed a joint federal return, enter each person’s portion of federal adjusted gross income. Registered domestic partners should enter the federal AGI reported on their separate federal returns. b Total additions to federal adjusted gross income. b Enter each person’s portion of additions entered on D-40, Lines x and È. c Add Lines a and b. c d Total subtractions from federal adjusted gross income. d Enter each person’s portion of subtractions entered on D-40, Line 1x. e DC adjusted gross income. Subtract Line d from Line c. f Deduction amount. h Enter each person’s portion of the amount entered on D-40, Line 1n. (You may allocate this amount as you wish.) g Taxable income. Subtract Line f fro“Ê ˆ˜iÊi° i Add the amounts on Line , enter here and on D-40, Line Óä° i $ $ $ $ $ $ .00 .00 .00 .00 .00 .00 e f g h Tax. If Line } is $100,000 or less, use tax tables. If more than $100,000, use Calculation ˆ in instructions. * If you were born before January 2, 1961, you are considered to be age 65 at the end of 2025 b Enter 1 if you are age 65 or over * c Enter 1 if you are blind d Enter 1 if you are married or are a registered domestic partner filing jointly or filing separately on same return and your spouse or registered domestic partner is 65 or over * e Enter 1 if you are married or are a registered domestic partner filing jointly or filing separately on same return and your spouse or registered domestic partner is blind f Total number of additions to standard deductions. Add Lines b through e. Additional standard deduction amount. Multiply $1,600 ($2,000 if your filing status is single, head of household, or dependent claimed by someone else and are not married) LÞÊthe number on Line f. -iiʈ˜ÃÌÀÕV̈œ˜Ã° Calculation G-1 must be completed and submitted with the return. a Basic standard deduction amount. See instructions. if you are married and your filing status is dependent claimed by someone else Fill in

Government of the District of Columbia ÓäÓ5 Revised 11/2025 Unless instructed otherwise – If you fill in any part of this schedule, attach it to your D-40. Print in CAPITAL letters using black ink. Enter your last name Enter your TIN First name of qualifying non-dependent person M.I. Last Name TIN of qualifying non-dependent person Date of Birth of qualifying non-dependent person (MMDDYYYY) z z z Dependents If you have more than 8 dependents, list them on an attachment. First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) First name M.I. Last Name Taxpayer identification number Relationship Date of Birth (MMDDYYYY) OFFICIAL USE ONLY Vendor ID#0000 * 50400 30000* SCHEDULE S Supplemental Information and Dependents Head of household filers or qualifying widow(er) Do not enter information

* 50400 40000* Revised 11/2025 Last name and TIN SCHEDULE S PAGE 2 Calculation G-1 Computation of Standard Deduction g h Total standard deduction. Add Lines a and g, enter here and on D-40, Line 1n. i Total number of dependents z z z You Your spouse/registered domestic partner $ Total tax List TINs associated with Income

Ài«œÀÌi`Ê>˜`ÊÌ>Ýi`Êon Franchise and Fiduciary Returns for the amount listed

œ˜Ê ‡{ä]Ê ˆ˜iÊ££° a d g b e h c f i Fill in if loss Fill in if loss Fill in if loss Fill in if loss $ .00 .00 $ $ $ $ $ .00 $ $ $ $ $ a b c d e f g h i .00 .00 .00 .00 .00 .00 .00 .00 $ .00 $ .00 $ .00 Calculation J Tax computation for married or registered domestic partners filing separately on the same DC return. Enter separate amounts in each column. Combine amounts on Line ˆ. a Federal adjusted gross income (AGI). a If you and your spouse filed a joint federal return, enter each person’s portion of federal adjusted gross income. Registered domestic partners should enter the federal AGI reported on their separate federal returns. b Total additions to federal adjusted gross income. b Enter each person’s portion of additions entered on D-40, Lines x and È. c Add Lines a and b. c d Total subtractions from federal adjusted gross income. d Enter each person’s portion of subtractions entered on D-40, Line 1x. e DC adjusted gross income. Subtract Line d from Line c. f Deduction amount. h Enter each person’s portion of the amount entered on D-40, Line 1n. (You may allocate this amount as you wish.) g Taxable income. Subtract Line f fro“Ê ˆ˜iÊi° i Add the amounts on Line , enter here and on D-40, Line Óä° i $ $ $ $ $ $ .00 .00 .00 .00 .00 .00 e f g h Tax. If Line } is $100,000 or less, use tax tables. If more than $100,000, use Calculation ˆ in instructions. * If you were born before January 2, 1961, you are considered to be age 65 at the end of 2025 b Enter 1 if you are age 65 or over * c Enter 1 if you are blind d Enter 1 if you are married or are a registered domestic partner filing jointly or filing separately on same return and your spouse or registered domestic partner is 65 or over * e Enter 1 if you are married or are a registered domestic partner filing jointly or filing separately on same return and your spouse or registered domestic partner is blind f Total number of additions to standard deductions. Add Lines b through e. Additional standard deduction amount. Multiply $1,600 ($2,000 if your filing status is single, head of household, or dependent claimed by someone else and are not married) LÞÊthe number on Line f. -iiʈ˜ÃÌÀÕV̈œ˜Ã° Calculation G-1 must be completed and submitted with the return. a Basic standard deduction amount. See instructions. if you are married and your filing status is dependent claimed by someone else Fill in

œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ>

“«œÀÌ>˜Ì\Ê,i>`Êiˆ}ˆLˆˆÌÞÊÀiµÕˆÀi“i˜ÌÃÊLivœÀiÊVœ“«ï˜}° *Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž° xÊfÊ .ää .ää Ê.ää Round cents to nearest dollar. ,iۈÃi`Ê11/2025 z z

>˜`œÀ`½ÃÊÌii« œ˜iʘՓLiÀ

>˜`œÀ`½ÃÊ>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃuˆÌi/>«>À̓i˜Ìʘu“LiÀʈvÊ>««ˆV>Li®Ê
«>À̓i˜ÌʘՓLiÀ

ˆÌÞÊ -Ì>ÌiÊ <ˆ«Ê œ`iʳ{ -iV̈œ˜Ê ÊÊ Ài`ˆÌÊV>ˆ“ÊL>Ãi`ʜ˜ÊÀi>Ê«Àœ«iÀÌÞÊÌ>ÝʜÜi` ÈÊfÊ Çf >ˆˆ˜}Ê>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li®
``ÀiÃÃʜvÊDC «Àœ«iÀÌÞÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li®ÊvœÀÊÜ ˆV ÊޜÕÊ>ÀiÊV>ˆ“ˆ˜}ÊÌ iÊVÀi`ˆÌÊ(ˆvÊ`ˆvviÀi˜ÌÊvÀœ“Ê>LœÛi)

ˆÌÞÊ -Ì>ÌiÊ <ˆ«Ê œ`iʳ{ Type of property for which you are claiming the credit. Fill in only one:

“ Ո˜ˆ “ œ ` ˜ œ

Êi Ã Õ œ

Ê} ˜ˆ “ œ œ ,ÊÊ ÊÌ ˜ i “ ÌÀ > «
ÊÊ Êi Ã Õ œ  *iÀܘ>Êˆ˜vœÀ“>̈œ˜Ê 9œÕÀÊvˆÀÃÌʘ>“iÊ °°Ê

>ÃÌʘ>“i -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊvˆÀÃÌʘ>“iÊ °°Ê

>ÃÌʘ>“i Complete Section A or Section B, whichever applies. Do not claim this credit for an exempt property owned by a government,Ê a house of worship or a non-profit organization. " 
Ê1- Ê" 9ÊÊÊ6i˜`œÀ 6i˜`œÀ 6i˜`œÀÊ ›ääää Ê ›ääää Ê ›ääää -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊ/ andÊ >ÌiʜvÊ ˆÀÌ Ê­

9999® andÊ >ÌiʜvÊ ˆÀÌ Ê­

9999® 9œÕÀÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ® 9œÕÀÊ`>Þ̈“iÊÌii« œ˜iʘՓLiÀ ÓÊ,i˜ÌÊ«>ˆ`ÊLÞÊޜÕʜ˜ÊÌ iÊ«Àœ«iÀÌÞʈ˜ÊÓäÓ5Ê ÎÊ*Àœ«iÀÌÞÊÌ>ÝÊVÀi`ˆÌ°ÊÊUse the "Worksheet to Compute Your Property Tax Credit." {Ê >˜`œÀ`½Ãʘ>“i Round cents to nearest dollar. £ÊfÊ .ää x.20Êr ÊfÊ °ää -iV̈œ˜Ê
ÊÊ Ài`ˆÌÊV>ˆ“ÊL>Ãi`ʜ˜ÊÀi˜ÌÊ«>ˆ` £Êi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iʜvÊÌ iÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌÊ­Ãiiʈ˜ÃÌÀÕV̈œ˜Ã®°ÊvʏiÃÃÊÌ >˜ÊâiÀœ]Êi˜ÌiÀÊâiÀœ° ÓÊfÊ .ää ÎÊfÊ .ää

œœ«iÀ>̈Ûi nÊ Enter information from your real property tax bill or assessment. If a section is blank on your property tax bill, leave it blank here. Ê-µÕ>ÀiʘՓLiÀÊ Ê-ÕvvˆÝʘՓLiÀÊ Ê œÌʘՓLiÀÊ

“>ˆÊ
``ÀiÃÃÊ xÊi`iÀ> >`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iʜvÊÌ iÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌÊ­Ãiiʈ˜ÃÌÀÕV̈œ˜Ã®°ÊvʏiÃÃÊÌ >˜ÊâiÀœ]Êi˜ÌiÀÊâiÀœ° ÈÊ

ÊÀi>Ê«Àœ«iÀÌÞÊÌ>ÝÊLˆÊvœÀÊÌ>ÝÊÞi>ÀÊÓäÓ5°Ê œÊ˜œÌʈ˜VÕ`iÊëiVˆ>Ê>ÃÃiÃÓi˜ÌÃ]ʈ˜ÌiÀiÃÌ] «i˜>ÌˆiÃÊ>˜`ÊÃiÀۈViÊV >À}ið ÇÊ*Àœ«iÀÌÞÊÌ>ÝÊVÀi`ˆÌÊÊÊ1ÃiÊÌ iʸWorksheet to œ“«ÕÌeÊ9œÕÀÊ*Àœ«iÀÌÞÊ/>ÝÊ Ài`ˆÌ.¸ - 

1

ÊÊ œ“iœÜ˜iÀÊÊÊÊÊ >˜`Ê,i˜ÌiÀÊ*Àœ«iÀÌÞÊ/>ÝÊ Ài`ˆÌÊ 20Ó5 *259980110000*

z z ÓäÓ5Ê- 

1

ÊÊÊ*
 ÊÓÊLast name and TIN Refund Options: For information on the tax refund card and program limitations, see instructions or visit our website MyTax.DC.gov. >ÀŽÊoneÊÀiv՘`ÊV œˆVi\ÊÊ ÊÊÊ ˆÀiVÌÊ`i«œÃˆÌÊorÊÊ ÊÊÊÊÊÊÊ,iˆ> >À`Ê­-iiʈ˜ÃÌÀÕV̈œ˜Ã®ÊorÊ ÊÊÊÊÊÊ*>«iÀÊV iVŽ

ˆÀiVÌÊ i«œÃˆÌ°ÊTo have your refund deposited to your checking or *Ài«>ÀiÀ½ÃÊÈ}˜>ÌÕÀi

>Ìi 9œÕÀÊÈ}˜>ÌÕÀiÊ

>Ìi ÊÊ ÊÊ >ÌiÊÊ *Ài«>ÀiÀ¿ÃÊ/>ÝÊ`i˜ÌˆvˆV>̈œ˜Ê ՓLiÀÊ­*/ ®ÊÊ *reparer'sÊÌii« œ˜iʘՓLiÀÊ -«œÕÃi½ÃÉ`œ“iÃ̈VÊ«>À̘iÀ½ÃÊÈ}˜>ÌÕÀiʈvÊvˆˆ˜}ʍœˆ˜ÌÞʜÀÊÃi«>À>ÌiÞ œ˜ÊÃ>“iÊÀiÌÕÀ˜° For STANDALONE FILERS only, please complete the following "Refund Options" information Will this refund go to an account outside of the U.S.? efund go 9ià ,œṎ˜}Ê Õ“LiÀ savings account, fill in oval and enter bank routing and account numbers. See instructions°Ê ,iۈÃi`Ê11/2025 £ fÊ fÊ £Ê Ê7>}iÃ]ÊÃ>>ÀˆiÃ]Ê̈«Ã]ÊiÌV°Ê ÓÊ />Ý>Liʈ˜ÌiÀiÃÌÊ Ó ÎÊ "À`ˆ˜>ÀÞÊ ˆÛˆ`i˜`ÃÊ Î {Ê />Ý>LiÊÀiv՘`Ã]ÊVÀi`ˆÌÃ]ʜÀʜvvÃiÌÃʜvÊÃÌ>ÌiÊ>˜`ʏœV>Êˆ˜Vœ“iÊÌ>ÝiÃÊ { xÊ
ˆ“œ˜ÞÊÀiViˆÛi`Ê x ÈÊ ÕȘiÃÃʘVœ“iÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ÊÊÈ ÇÊ >«ˆÌ>Ê}>ˆ˜sÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ Ç nÊ "Ì iÀÊ}>ˆ˜ÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ n ™Ê ,
Ê`ˆÃÌÀˆLṎœ˜Ã\Ê/>Ý>LiÊ>“œÕ˜Ì ™ £äÊÊ*i˜Ãˆœ˜ÃÊ>˜`Ê>˜˜ÕˆÌˆiÃ\Ê/>Ý>LiÊ>“œÕ˜ÌÊ £ä ££ÊÊ,i˜Ì>ÊÀi>ÊiÃÌ>Ìi]ÊÀœÞ>ÌˆiÃ]Ê«>À̘iÀà ˆ«Ã]Ê-‡ œÀ«°]ÊÌÀÕÃÌÃ]ÊiÌV°ÊʈÊˆ˜Êˆvʓˆ˜ÕÃÊ ££ £ÓÊ >À“ʈ˜Vœ“iÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ £Ó £ÎÊÊ1˜i“«œÞ“i˜ÌÊVœ“«i˜Ã>̈œ˜Ê £ÎÊ £{ £{ÊÊ-œVˆ>ÊÃiVÕÀˆÌÞÊLi˜ivˆÌÃ\Ê/>Ý>LiÊ>“œÕ˜ÌÊ £xÊÊ"Ì iÀÊÌ>Ý>Liʈ˜Vœ“i°Ê
ÌÌ>V ÊÃi«>À>ÌiÊà iiÌ­Ã®Ê ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ £xÊ 16 Add Lines 1 through 15 in each column. ˆÊˆ˜Êˆvʓˆ˜Õà 16 £ÇÊÊ `ÕV>̜ÀÊiÝ«i˜ÃiÃÊ £Ç £nÊÊ iÀÌ>ˆ˜ÊLÕȘiÃÃÊiÝ«i˜ÃiÃʜvÊÀiÃiÀۈÃÌÃ]Ê«iÀvœÀ“ˆ˜}Ê>À̈ÃÌÃ]Ê>˜`Ê vii‡L>ÈÃÊ}œÛiÀ˜“i˜ÌʜvvˆVˆ>ÃÊ £n £™ÊÊi>Ì ÊÃ>ۈ˜}ÃÊ>VVœÕ˜ÌÊ`i`ÕV̈œ˜Ê £™Ê ÓäÊÊ œÛˆ˜}ÊiÝ«i˜ÃiÃÊvœÀʓi“LiÀÃʜvÊÌ iÊ>À“i`ÊvœÀViðÊ
ÌÌ>V Êvi`°ÊœÀ“ÊΙäÎÊÓäÊ Ó£ÊÊ i`ÕV̈LiÊ«>ÀÌʜvÊÃiv‡i“«œÞ“i˜ÌÊÌ>ÝÊ Ó£ ÓÓÊÊ-iv‡i“«œÞi`Ê- *]Ê- *

]Ê>˜`ʵÕ>ˆvˆi`Ê«>˜ÃÊ ÓÓ ÓÎÊÊ-iv‡i“«œÞi`Ê i>Ì ʈ˜ÃÕÀ>˜ViÊ`i`ÕV̈œ˜Ê ÓÎ Ó{ÊÊ*i˜>ÌÞʜ˜Êi>ÀÞÊÜˆÌ `À>Ü>ÊœvÊÃ>ۈ˜}ÃÊ Ó{ ÓxÊÊ
ˆ“œ˜ÞÊ«>ˆ` Óx ÓÈÊÊ,
Ê`i`ÕV̈œ˜Ê ÓÈ ÓÇÊÊ-ÌÕ`i˜Ìʏœ>˜Êˆ˜ÌiÀiÃÌÊ`i`ÕV̈œ˜Ê ÓÇ ÓnÊÊ/Ո̈œ˜Ê>˜`ÊviiÃÊ«iÀÊvi`iÀ>ÊœÀ“Ên™£ÇÊ Ón Ó™Ê Add Lines 17 through 28 in each column ә ÎäÊÊ-ÕLÌÀ>VÌÊ ˆ˜iÊәÊvÀœ“Ê ˆ˜iÊ£ÈÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ Î£ ΣÊÊ/œÌ>Êvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“i°ÊAdd amounts entered on Line 30,] Columns A -Ê >˜`Êi˜ÌiÀÊ̜Ì>Ê iÀiʜ˜Ê ˆ˜iÊΣÊandʜ˜Ê-iV̈œ˜Ê
]Ê ˆ˜iʣʜÀÊ-iV̈œ˜Ê ]Ê ˆ˜iÊx°

" 1 Ê
Ê­9"1®Ê

" 1 Ê Ê­-*"1- É " -/ Ê*
,/ ,®Ê  "
1-/ /- fÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ˆÊˆ˜Êˆvʓˆ˜ÕÃÊ ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ ",Ê-/

" Ê

,-Ê" 9ʇÊ7", -

/Ê/"Ê

/ ,  Ê

,
Ê
1-/

Ê,"--Ê " Ê / ˆÃÊ7œÀŽÃ iiÌʈÃÊvœÀÊÕÃiÊLÞÊÃÌ>˜`>œ˜iÊvˆiÀÃʜ˜Þ°ÊvÊޜÕÊ>ÀiÊvˆˆ˜}Ê>Ê ‡{äÊ,iÌÕÀ˜]Ê`œÊ˜œÌÊVœ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌ° œ
VVœÕ˜ÌÊ Õ“LiÀ UOEFS
QFOBMUZ
PG
MBX
*
EFDMBSF
UIBU
*
IBWF
FYBNJOFE
UIJT
SFUVSO
BOE
UP
UIF
CFTU
PG
NZ
LOPXMFEHF
JU
JT
DPSSFDU
%FDMBSBUJPO
PG
QBJE
QSFQBSFS
JT
CBTFE
PO
JOGPSNBUJPO
BWBJMBCMF
UP
UIF
QSFQBSFS ­œ˜ÞʈvÊ`ˆÛœÀViʜÀÊÃi«>À>̈œ˜Ê>}Àii“i˜Ìʜ˜ÊœÀÊLivœÀiÊ£ÓÉΣɣn® ­œ˜ÞʈvÊ`ˆÛœÀViʜÀÊÃi«>À>̈œ˜Ê>}Àii“i˜Ìʜ˜ÊœÀÊLivœÀiÊ£ÓÉΣɣn® vʏiÃÃÊÌ >˜ÊâiÀœ]Êi˜ÌiÀÊâiÀœ° Îä *259980120000*

WORKSHEET72&20387(<2853523(57<7$;&5(',7 / ˆÃÊVÀi`ˆÌʓ>ÞʘœÌÊLiÊV>ˆ“i`ʈvÊޜÕʏˆÛiʈ˜Ê>Ê«Àœ«iÀÌÞʜܘi`ÊLÞÊ>Ê}œÛiÀ˜“i˜Ì]Ê>Ê œÕÃiʜvÊܜÀà ˆ«ÊœÀÊ>ʘœ˜«ÀœvˆÌʜÀ}>˜ˆâ>̈œ˜° / iÊVÀi`ˆÌÊiµÕ>ÃÊ>Ê«iÀVi˜Ì>}iʜvÊÌ iÊ«Àœ«iÀÌÞÊÌ>ÝiÃÊ«>ˆ`ʜÀÊ>VVÀÕi`,ÊorÊÌ iÊ«œÀ̈œ˜ÊœvÊÌ iÊÀi˜ÌÊ«>ˆ`ÊÌ >ÌʈÃÊiµÕˆÛ>i˜ÌÊÌœÊ «Àœ«iÀÌÞÊÌ>ÝiÃÊÊ­Óä¯ÊœvÊÀi˜ÌÊ«>ˆ`®Êin excessʜvÊÌ iÊ>««ˆV>LiÊ«iÀVi˜Ì>}iʜvÊÌ iÊ̜Ì>Êvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“i°Ê/ iÊ “>݈“Õ“ÊVÀi`ˆÌÊ>“œÕ˜ÌʈÃÊf£425° *iÀVi˜Ì>}iʇ / iÊ>“œÕ˜ÌʜvÊ«Àœ«iÀÌÞÊÌ>ÝÊÌ >ÌÊiÝVii`ÃÊΰä¯ÊœvÊÌ iÊ>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“i
/ iÊ>“œÕ˜ÌʜvÊ«Àœ«iÀÌÞÊÌ>ÝÊÌ >ÌÊiÝVii`ÃÊ°ä¯ÊœvÊÌ iÊ>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“i 5IF
BNPVOU
PG
QSPQFSUZ
UBY
UIBU
FYDFFET

PG
UIF
BEKVTUFE
HSPTT
JODPNF *iÀVi˜Ì>}iʇ / iÊ>“œÕ˜ÌʜvÊ«Àœ«iÀÌÞÊÌ>ÝÊÌ >ÌÊiÝVii`ÃÊΰä¯ÊœvÊÌ iÊ>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iʜvÊÌ iÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌ £° ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ Ó° ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ Î° ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ {° ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ x° ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ È° ÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ -V i`ՏiÊ]Ê-iV̈œ˜Ê
ÊvœÀÊVÀi`ˆÌÊL>Ãi`ʜ˜ÊÀi˜ÌÊ«>ˆ`]ʜÀÊ ˆ˜iÊÇʜvÊ-V i`Տi ]Ê-iV̈œ˜Ê ÊvœÀÊVÀi`ˆÌÊL>Ãi`ʜ˜ Ài>Ê«Àœ«iÀÌÞÊÌ>ÝʜÜi`° Ê,œÕ˜`Ê̜ÊÌ iÊ ˜i>ÀiÃÌ Ü œiÊ`œ>À° f£ 42x°ää vÊޜÕÊ>ÀiÊ՘`iÀÊ>}iÊÇäÊ>˜`ÊÌ iÊ i`iÀ>Ê
ʜvÊޜÕÀÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌÊis: ÊfäʇÊfÓ{]™™™Ê f]äääʇÊfx  f ʇÊfÈ6]0ääÊ vÊޜÕÊ>ÀiÊ>}iÊÇäʜÀʜ`iÀÊ>˜`ÊÌ iÊ i`iÀ>Ê
ʜvÊޜÕÀÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌ is: fäʇÊf90]0ääÊ ,iۈÃi`Ê11/2025 £°Ê ˜ÌiÀÊvi`iÀ>Ê
Ê­ ˆ˜iÊ£]Ê-iV̈œ˜Ê
]Ê-V i`ՏiÊʜÀÊ ˆ˜iÊx]Ê-iV̈œ˜Ê ] -V i`ՏiÊ®° Ó°Ê ˜ÌiÀÊÀi>Ê«Àœ«iÀÌÞÊÌ>ÝÊLˆÊvœÀÊÓäÓ5ʜÀÊÓä¯ÊœvÊÀi˜ÌÊ«>ˆ`ʈ˜ÊÓäÓ5° ­ œÊ˜œÌʈ˜VÕ`iÊëiVˆ>Ê>ÃÃiÃÓi˜ÌÃ]ʈ˜ÌiÀiÃÌ]Ê«i˜>ÌˆiÃÊ>˜`ÊÃiÀۈViÊV >À}iî° Î°Ê ÕÌˆ«ÞÊ ˆ˜iÊ£ÊLÞÊÌ iÊ>««ˆV>LiÊ«iÀVi˜Ì>}iÊ­°äÎ

ä{®
PS
 ° {°Ê >>˜ViÊ­-ÕLÌÀ>VÌÊ ˆ˜iÊÎÊvÀœ“Ê ˆ˜iÊÓ®° x°Ê*Àœ«iÀÌÞÊ/>ÝÊ Ài`ˆÌÊ ˆ“ˆÌ° È°ÊEnterÊÌ iÊÓ>iÀʜvÊ ˆ˜iÊ{ʜÀÊ ˆ˜iÊxÊ iÀiʜ˜Ê ˆ˜iÊÈÊandʜ˜Ê ˆ˜iÊÎʜv

Instructions for Schedule H Homeowner and Renter Property Tax Credit Home Defined / iÊÌiÀ“ʺ œ“i»ÊÀiviÀÃÊÌœÊ œÕÃiÃ]Ê>«>À̓i˜ÌÃ]ÊÀœœ“ˆ˜}Ê œÕÃiÃ]ÊÊ Vœ˜`œ“ˆ˜ˆÕ“Ã]Ê>˜`ÊVœœ«iÀ>̈Ûið Eligibility 9œÕʓÕÃÌʓiiÌÊÌ iÊvœœÜˆ˜}ÊÀiµÕˆÀi“i˜ÌÃÊ̜ÊV>ˆ“ÊÌ ˆÃÊVÀi`ˆÌ\ X 9œÕÊÜiÀiÊ>Ê ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ>Ê­

®ÊÀiÈ`i˜ÌÊ vÀœ“Ê>˜Ê£°ÊÌ ÀœÕ} Ê iV°ÊΣ]ÊÓäÓ5Æ X 9œÕÀÊÀiÈ`i˜ViʈÃʘœÌÊ«>ÀÌʜvÊ>Ê«ÕLˆV X

œÕȘ}Ê`Üiˆ˜}Æ 9œÕÊÀi˜Ìi`ʜÀʜܘi`Ê>˜`ʏˆÛi`ʈ˜Ê>Ê

œ“i]Ê>«>À̓i˜Ì]ÊÀœœ“ˆ˜}Ê œÕÃi]ʜÀÊ Vœ˜`œ“ˆ˜ˆÕ“ʈ˜Ê

Ê`ÕÀˆ˜}Ê>ÊœvÊÓäÓ5Æ X 9œÕÀÊÓäÓ5Êvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊ­
®]Ê Ü>ÃÊ fÊÈ6]0ääÊ œÀÊ iÃÃÊ ­f90]0ääÊ œÀÊ iÃÃÊ ˆv
ÊޜÕÊ >ÀiÊ>}iÊÇäʜÀʜ`iÀ®Æ X 9œÕÊ`ˆ`ʘœÌÊÀi˜ÌÊvÀœ“Ê>ʏ>˜`œÀ`ÊÜ œÃiÊ«Àœ«iÀÌÞ X Ü>ÃÊiˆÌ iÀÊiÝi“«ÌÊvÀœ“ÊÀi>Ê«Àœ«iÀÌÞÊÌ>ÝiÃʜÀ Ü œÊ«>ˆ`Ê>Ê«iÀVi˜Ì>}iʜvÊÀi˜Ì>Êˆ˜Vœ“iÊ̜Ê

Ê ˆ˜ÃÌi>`ʜvÊ«>ވ˜}Ê>ÊÀi>ÊiÃÌ>ÌiÊÌ>ÝÆ 9œÕʓÕÃÌʘœÌÊLiÊV>ˆ“i`Ê>ÃÊ>Ê`i«i˜`i˜Ìʜ˜Ê ܓiœ˜iÊiÃi½ÃÊvi`iÀ>]ÊÃÌ>Ìi]ʜÀÊ

ʈ˜Vœ“iÊÌ>ÝÊ ÀiÌÕÀ˜Ê՘iÃÃÊޜÕÊÀi>V i`Ê>}iÊÈxʜ˜ÊœÀÊLivœÀiÊ

iVi“LiÀÊΣ]ÊÓäÓ5°
``ˆÌˆœ˜>Ê˜vœÀ“>̈œ˜\ X X
Êœ“iœÜ˜iÀÊ>˜`Ê,i˜ÌiÀÊ*Àœ«iÀÌÞÊ/>ÝÊ

Ài`ˆÌÊV>˜˜œÌÊLiÊV>ˆ“i`ʜ˜ÊLi >vʜvÊ>Ê Ì>Ý«>ÞiÀÊÜ œÊ`ˆi`ʜ˜ÊœÀÊLivœÀiÊ

iVi“LiÀÊΣ]ÊÓäÓ5° "˜Þʜ˜iÊV>ˆ“>˜ÌÊ«iÀʸÌ>ÝÊvˆˆ˜}Ê՘ˆÌ¸Ê V>˜ÊV>ˆ“ÊÌ iÊ«Àœ«iÀÌÞÊÌ>ÝÊVÀi`ˆÌ° X
˜Êˆ˜`ˆÛˆ`Õ>ÊÜ œÊˆÃÊV>ˆ“i`Ê>ÃÊ> `i«i˜`i˜Ìʜ˜Êܓiœ˜iÊiÃi¿Ãʈ˜`ˆÛˆ`Õ> ˆ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜ÊˆÃÊonly eligible to file Ì i claim for their tax filing unit if they are ÈxÊÞi>ÀÃʜvÊ>}iʜÀʜ`iÀ° Tax Filing Unit Defined -1-
ÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌʈÃÊ`ivˆ˜i`Ê>ÃÊ>˜Êˆ˜`ˆÛˆ`Õ>ÊœÀʓ>ÀÀˆi`ÊVœÕ«iÊ

—ÊvˆiÊ>˜Êˆ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜°Ê
ʓ>ÀÀˆi`ÊVœÕ«iÉ Ài}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀÃÊÀiÈ`ˆ˜}ʈ˜ÊÌ iÊÃ>“iÊ œÕÃi œ`Ê>ÀiÊ «>ÀÌʜvÊÌ iÊÃ>“iÊÌ>ÝÊvˆˆ˜}Ê՘ˆÌÊÜ iÌ iÀÊvˆˆ˜}ʍœˆ˜ÌÞ]ÊÃi«>À>ÌiÞÊ œ˜ÊÌ iÊÃ>“iÊÀiÌÕÀ˜]ʜÀÊÃi«>À>ÌiÞʜ˜ÊÃi«>À>ÌiÊÀiÌÕÀ˜Ã° D-40 Filers vÊޜÕÊ>ÀiÊÀiµÕˆÀi`Ê̜ÊvˆiÊ>Ê

ʈ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜ÊÊ ­ ‡{ä®]Ê>ÌÌ>V Ê-V i`ՏiÊÊ̜ÊޜÕÀÊ ‡{äÊÀiÌÕÀ˜°Ê1ÃiÊÌ iÊvi`iÀ>Ê >`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊ>“œÕ˜ÌÊvÀœ“Ê ˆ˜iÊʜvÊޜÕÀÊ ‡{äÊ­>˜`Ê Ì iÊ
ʜvÊޜÕÀÊëœÕÃiÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀʈvÊvˆˆ˜}Ê Ãi«>À>ÌiÞʜ˜ÊÃi«>À>ÌiÊÀiÌÕÀ˜Ã®°ÊÊ9œÕÊ >ÛiÊÌ ÀiiÊÞi>ÀÃÊvÀœ“ÊÌ iÊ `ÕiÊ`>ÌiÊ̜ÊV>ˆ“ÊÌ iÊVÀi`ˆÌ°ÊvÊޜÕÊ >ÛiÊ>Ài>`ÞÊÃÕL“ˆÌÌi`ÊޜÕÀÊ Ì>ÝÊÀiÌÕÀ˜ÊvœÀÊ>Ê«ÀiۈœÕÃÊÞi>ÀÊÜˆÌ œÕÌÊÌ iÊ-V i`ՏiÊÊvœÀ“]ÊޜÕÊ “>ÞÊvˆiÊ>˜Ê>“i˜`i`ÊÀiÌÕÀ˜Ê̜ʈ˜VÕ`iÊ-V i`ՏiÊ° Standalone Filers vÊޜÕÊ>ÀiʘœÌÊÀiµÕˆÀi`Ê̜ÊvˆiÊ>Ê

ʈ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>ÝÊÀiÌÕÊÀ˜Ê LiV>ÕÃiÊޜÕÊ>ÀiÊLiœÜÊÌ iʈ˜Vœ“iÊÌ>ÝÊvˆˆ˜}ÊÌ Àià œ`]ÊޜÕÊV>˜Ê vˆiÊ -V i`Տi ÊÊ>à >ÊÃÌ>˜`>œ˜iÊÀiÌÕÀ˜°Ê :PV
NBZ
VTF
UIÊF
8PSLTIFFU
Ê5P
Ê%FUFSNJOF
Ê'FEFSBM
Ê"EKVTUFE
GrossÊ*ODPNF
ÊPO
ÊQBHF 
PG
4DIFEVMF
)
UP
DBMDVMBUF
UIF
UPUBM
GFEFSBM
BEKVTUFE
HSPTT
JODPNF
GPS
ZPVSTFMG
BOE
JG
BQQMJDBCMF
ZPVS
TQPVTF
PS
SFHJTUFSFE
EPNFTUJD
QBSUOFS 9œÕÊ V>˜Ê ˜œÜÊ iiVÌÀœ˜ˆV>ÞÊ vˆiÊ Ì iÊ ÃÌ>˜`>œ˜iÊ -V i`ՏiÊ Ê LÞÊ >VViÃȘ}ÊÊÌ iÊÊ Þ/>Ý°

°}œÛÊÊÜiLÊÊ«œÀÌ>°ÊÊœÀÊʓœÀiÊʈ˜vœÀ“>̈œ˜]ÊÊ ÛˆÃˆÌÊ Þ/>Ý°

°}œÛʜÀÊV>Êi‡-iÀۈViÃÊ>ÌÊ­ÓäÓ®ÊÇx™‡£™{È° When is Schedule H due? / iÊ-V i`ՏiÊʈÃÊ`ÕiÊLÞÊ
«ÀˆÊ£x]ÊÓä6°Ê9œÕÊ >ÛiÊÌ ÀiiÊÞi>ÀÃÊ vÀœ“ÊÌ iÊ`ÕiÊ`>ÌiÊ̜ÊV>ˆ“ÊÌ iÊVÀi`ˆÌ°Ê Where to Mail Schedule H vÊޜÕÊ>ÀiÊÀiµÕˆÀi`Ê̜ÊvˆiÊ>Ê

ʈ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜]ÊÊ>ÌÌ>V Ê -V i`ՏiÊÊ̜ÊޜÕÀÊ

ʈ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜°Ê4i˜`ʈÌÊ̜\ "vvˆViʜvÊ/>ÝÊ>˜`Ê,iÛi˜Õi *"Ê œÝʙȣ{x 7>à ˆ˜}̜˜]Ê

ÊÓää™ä‡È£{x *G
ZPV
GJMF
-V i`ՏiÊÊLÞʓ>ˆÊBT
B
TUBOEBMPOFÊÀiÌÕÀ˜ ÊTi˜`ʈÌÊ̜\ "vvˆViʜvÊ/>ÝÊ>˜`Ê,iÛi˜Õi

UI
4USFFU
48
'-
 7>à ˆ˜}̜˜]Ê

ÊÓää Do I Use Section A or Section B? vÊޜÕÊrentÊޜÕÀÊ œ“i]Ê>«>À̓i˜Ì]ÊÀœœ“ˆ˜}Ê œÕÃi]ÊVœ˜`œ“ˆ˜ˆÕ“]Ê œÀÊVœœ«iÀ>̈Ûi]ÊÕÃiÊ-iV̈œ˜Ê
° vÊޜÕÊownÊޜÕÀÊ œ“i]Ê>«>À̓i˜Ì]ÊÀœœ“ˆ˜}Ê œÕÃi]ÊVœ˜`œ“ˆ˜ˆÕ“Ê œÀÊVœœ«iÀ>̈Ûi]ÊÕÃiÊ-iV̈œ˜Ê ° ,iۈÃi`Ê11/2025 Ì >Ì ÜœÕ`Êp ˆvÊÌ iˆÀʈ˜Vœ“iʈÃÊ>LœÛiÊÌ iÊDC vˆˆ˜}ÊÌ Àià œ`Ê

-2- RevisedÊ11/2025 Section B—Credit claim based on real Section A—Credit claim based on rent paid Line 1 Total federal AGI of the tax filing unit If you filed a D-40, enter the amount that you and, if applicable, your spouse or registered domestic partner reported on Line 4 of your D-40. If you are a standalone filer, you must compute your federal adjusted gross income (AGI) and enter that amount on Line 1 of Schedule H. For assistance in computing your federal adjusted gross income you can complete the “Worksheet To Determine Federal Adjusted Gross Income.” If the sum of your federal AGI is more than $6È,ä00, ($™ä,ä00 if you are age 70 or older) you are not eligible to claim the property tax credit. If you are a standalone filer it is important that you list the name, taxpayer identification number, and date of birth on page 1 of Schedule H of the person whose income is included in the total federal AGI of your tax filing unit. Line Ó Rent paid on the property in 2025 Enter the total rent you paid for the property during the year and multiply it by .20. If you sublet part of your home to another person, the rent that you received is gross income and must be reported on your D-40, or D-30 if gross rental income is greater than $12,000. Note: If you rent more than one home in the District in the same calendar year, renÌ you paid during the year is determined by dividing the rent paid pursuant to the last rental agreement in force during the year by the number of months during the year for which this rent was paid and then multiplying the result by 12. Enter this number for “Rent paid by you on the property in 2025.” Multiply the rent entered by .20. LineÊÎ Property tax credit Using the amounts entered in Lines 1 and 3, calculate your property tax credit amount using the “Worksheet to Compute Your Property Tax Credit.” property tax paidʜÀÊ>VVÀÕi` Line xÊ/œtal federal AGI of the tax filing unit If you filed a D-40, enter the amount that you and, if applicable, your spouse or registered domestic partner reported on Line 4 of your D-40. If you are a standalone filer, you must compute your federal adjusted gross income (AGI) and enter that amount on Line 5 of Schedule H. For assistance in computing your federal adjusted gross income you may complete the “Worksheet To Determine Federal Adjusted Gross Income.” If the sum of your federal AGI is more than $6È,ä00, ($™ä,ä00 if you are age 70 or older) you are not eligible to claim the property tax credit. If you are a standalone filer, it is important that you list the name, taxpayer identification number, and date of birth on Page 1 of the person whose income is included in the total federal AGI of your tax filing unit. Line È DC real property tax bill for tax year 2025 Refer to your real property tax bill. Enter the amount of DC real property tax for tax year 2025 as reflected on the District real estate tax bill ordinarily sent out in September each year. The credit is based upon the amount of real property taxes owed, whether paid or unpaid. Do not include interest, penalties, special assessments or service charges, and do not include taxes paid for earlier tax periods. If a home is an integral part of a larger unit such as a multi-purpose building or a multi-dwelling building, property taxes accrued shall be that percentage of the total property taxes accrued as the value of the home bears to the total value of the property. REMINDER: If you rent out part of your residence to another person, the rent you receive is gross income and needs to be reported on your federal and DC tax returns. If gross rental income is greater than $12,000, you will need to file a DC Form D-30. Line Ç Property tax credit Using the amounts entered on Lines 8 and 9, calculate your property tax credit amount using the “Worksheet to Compute Your Property Tax Credit.”

* 50400170000* Government of the District of Columbia
20Ó5 Contributions Revised 11/2025 Important: Print in CAPITAL letters using black ink. Attach to D-40. NOTE: Contribution(s) will either decrease a refund or increase the tax owed by the amount of the contribution(s). z z z Enter your last name Taxpayer Identification Number (TIN) Part I Credits a. Non-refundable Credits 1 Enter state individual income tax credit.

2 Total of Line 1 state tax credits and any additional tax credits from the attachments. 2 3 Enter alternative fuel credits, see instructions. 3(a) Alternative fuel infrastructure - private residence. 3(b) Alternative fuel infrastructure - public use. 3(c) Alternative fuel vehicle conversion. 4 4 Total of Line 3 alternative fuel credits. Add Lines 3(a) through 3(c) only and enter here. 5 DC œÜ‡˜Vœ“iÊœÕȘ}Ê/>Ý redit. Ê-iiÊ

Ê / ʈ˜ÃÌÀÕV̈œ˜Ã on MyTax.DC.gov° 5 6 6 7 Total your non-refundable credits, enter here and on Form D-40, Line 2Ó. 7 b. Refundable Credits 1 DC Non-custodial parent EITC. See Schedule N. 1 2 ,FFQ
$IJME
$BSF
"GGPSEBCMF Tax Credit. See Schedule ELC. 2 3 3 Total your refundable credits, enter here and on Form D-40, Line ә. Part II Contributions (The minimum contribution is $1.00.) 1 2 3 4 5

OFFICIAL USE ONLY Vendor Vendor Vendor ID#0000 ID#0000 ID#0000 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 State (a) $ .00 (b) $ .00 State (c) $ .00 (d) $ .00 $ .00 # of stations $ .00 # of stations $ .00 # of vehicles Attach this schedule to your D-40 Return. DHCD Rental Accommodations Division Housing Provider Credit. See instructions. List additional states on a separate sheet, attach it to this Schedule. (Enter total of all state individual income tax credits, each computed separately on Calculation K, on Line 2 below.)  %$
4UBUFIPPE
%FMFHBUJPO
'VOE. 2 Taxpayer Support for Afterschool Programs for At-Risk Students. 3 Anacostia River Cleanup and Protection Fund. 4Ê RESERVED /œÌ>ÊޜÕÀÊVœ˜ÌÀˆLṎœ˜Ã]Êi˜ÌiÀÊ iÀiÊ>˜`ʜ˜ÊœÀ“Ê ‡{ä]Ê ˆ˜iÊ{£° 5 If you are not due a refund and do not owe tax, you may still make contributions. Total your Vœ˜ÌÀˆLṎœ˜ÃÊand enter on Form D-40, Line {£Ê If you owe tax, make the payment plus any contributions, payable to the DC Treasurer and mail it with your return. SCHEDULE U Additional Miscellaneous Credits and

54 54 54

œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> 2025 “«œÀÌ>˜Ì\Ê*Àˆ˜Ìʈ˜Ê
*/ Ê
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž° z This Section to be completed by DHCD Part IA. Credit £°Ê Ո`ˆ˜}Ê
``ÀiÃà Ó>°Ê Ո`ˆ˜}Ê"ܘiÀÊ >“i L° Ո`ˆ˜}Ê"ܘiÀÊ
``ÀiÃÃ Î°Ê Õˆ`ˆ˜}Ê"ܘiÀÊ/ {°Êi`iÀ>Ê Ո`ˆ˜}Ê`i˜ÌˆvˆV>̈œ˜Ê ՓLiÀÊ x°Ê >݈“Õ“Ê
œÜ>LiÊ

Ê / Ê
“œÕ˜ÌIÊ È°Ê >ÌiʜvÊ
œV>̈œ˜ Ç° >ÌiÊ Õˆ`ˆ˜}Ê*>Vi`ʈ˜Ê-iÀۈVi

>Ìi -ˆ}˜>ÌÕÀiʜvÊ
ÕÌ œÀˆâi`Ê 

Ê"vvˆVˆ> Part IB. Owner Certification Ownership Entity 1˜`iÀÊ«i˜>ÌˆiÃʜvÊ«iÀÕÀÞ]ÊÊ`iV>ÀiÊÌ >Ì\Ê­£®ÊÌ iÊ>LœÛiÊLՈ`ˆ˜}ÊVœ˜Ìˆ˜ÕiÃÊ̜ʵÕ>ˆvÞÊ>ÃÊ>Ê«>ÀÌʜvÊ>ʵÕ>ˆvˆi`ʏœÜ‡ˆ˜Vœ“iÊ

œÕȘ}Ê`iÛiœ«“i˜ÌÊ>˜`ʓiiÌÃÊÌ iÊÀiµÕˆÀi“i˜ÌÃʜvʘÌiÀ˜>Ê,iÛi˜ÕiÊ œ`iÊ-iV̈œ˜Ê{Ó­}®Ê>˜`Ê

Ê œ`iÊÅ{LJ{nä£Ê>˜`Ê ­Ó® Ì iʵÕ>ˆvˆi`ÊL>ÈÃʜvÊÌ iÊLՈ`ˆ˜}Ê­V iVŽÊœ˜i®ÊÊÚÚÚ >ÃÊÚÚÚ >ÃʘœÌÊ`iVÀi>Ãi`ÊvœÀÊÌ ˆÃÊÌ>ÝÊÞi>À°ÊÊ >ÛiÊiÝ>“ˆ˜i`ÊÌ ˆÃÊvœÀ“] >˜`Ê̜ÊÌ iÊLiÃÌʜvʓÞʎ˜œÜi`}iÊ>˜`ÊLiˆiv]ʈÌʈÃÊÌÀÕi]ÊVœÀÀiVÌÊ>˜`ÊVœ“«iÌi° -ˆ}˜>ÌÕÀi />Ý«>ÞiÀÊ Ê Õ“LiÀ

>Ìi >“iÊ­«i>ÃiÊÌÞ«iʜÀÊ«Àˆ˜Ì® I/ iÊ>“œÕ˜ÌÊvœÀÊi>V ÊÞi>ÀʜvÊÌ iÊ£ä‡Þi>ÀÊVÀi`ˆÌÊ«iÀˆœ` " 
Ê1- Ê" 9 6HQGRU,' z z ,iÛisedÊ05/2025

‡

D-8609 District of Columbia Low-Income Housing Tax Credit Allocation and Certification n°ÊˆÊˆ˜ ˆvÊiiV̈œ˜Ê̜ÊLi}ˆ˜ÊVÀi`ˆÌÊ«iÀˆœ`ÊÌ iÊvˆÀÃÌÊÞi>ÀÊ>vÌiÀÊÌ iÊLՈ`ˆ˜}ʈÃÊ«>Vi`ʈ˜ÊÃiÀۈViÊÜ>ÃÊ “>`iʜ˜Êi`iÀ>ÊœÀ“ÊnÈä™]Ê ˆ˜iÊ£ä>°Ê *25LIH0110000*

DISTRICT OF COLUMBIA LOW-INCOME HOUSING TAX CREDIT / iÊvi`iÀ>Ê œÜ‡˜Vœ“iÊœÕȘ}Ê/>ÝÊ Ài`ˆÌÊ­ / ®ÊÜ>ÃÊ iÃÌ>LˆÃ i`ÊLÞÊÌ iÊ/>ÝÊ,ivœÀ“Ê
VÌʜvÊ£™nÈÊ>˜`ʈÃÊ>Ê`œ>À‡vœÀ‡ `œ>ÀÊÌ>ÝÊVÀi`ˆÌÊvœÀÊvi`iÀ>ÊÌ>Ý«>ÞiÀÃÊÜ œÊˆ˜ÛiÃÌʈ˜ÊÌ iÊ Vœ˜ÃÌÀÕV̈œ˜Ê>˜`ÊÀi >LˆˆÌ>̈œ˜ÊœvÊ œÕȘ}ÊvœÀʏœÜÊ>˜`ʓœ`iÀ>Ìi‡ ˆ˜Vœ“iʈ˜`ˆÛˆ`Õ>ÃÊ>˜`Êv>“ˆˆiÃʈ˜ÊÌ iÊ1˜ˆÌi`Ê-Ì>ÌiÃ°Ê *ÕÀÃÕ>˜ÌÊ̜ÊÌ iÊ ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ>Ê œÜ‡˜Vœ“iÊœÕȘ}Ê/>ÝÊ

Ài`ˆÌÊ >ÀˆvˆV>̈œ˜Ê
“i˜`“i˜ÌÊ
VÌʜvÊÓäÓä]Ê­ ° °Ê >ÜÊ Ó·£{™]ÊÅÊÇÓ䣮]Êand the istrict of olumLia o܇ncome ousin} TaÝ redit
mendment
ct of ÓäÓ{ ­ . . aÜ Óx‡xxä §Ó£È£® the istrict of olumLia has estaLlished a lo܇income

œÕȘ}ÊÌ>ÝÊVÀi`ˆÌÊvœÀÊeli}iLleÊ«ÀœiVÌà located in the istrict of

olumLia°Ê
n "eli}iLle proect" means a rental housin} develop‡ ment in the istrict that includes more than x housin} unitsÆ and units that Üill Le affordaLle to tenants at an income level no }reater than nä¯ of the median famiÞ income in the 7ashin}ton etropolitan -tatistical
rea. / iÊ ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ>ʏœÜ‡ˆ˜Vœ“iÊ œÕȘ}ÊÌ>ÝÊVÀi`ˆÌÊ­

Ê

/ ®ÊV>˜ÊLiÊÌ>Ži˜Ê>}>ˆ˜ÃÌʈ˜Vœ“iÊÌ>Ý]ÊvÀ>˜V ˆÃiÊÌ>Ý]Ê>˜`Ê ˆ˜ÃÕÀ>˜ViÊ«Ài“ˆÕ“ÊÌ>Ý°ÊÊ/ iÊVÀi`ˆÌÊV>˜ÊLiÊV>ˆ“i`ÊiµÕ>ÞÊvœÀÊ £äÊÞi>ÀÃÊor £Óä months and suLtracted from the amount of

strictÊÌ>ÝÊotherÜise due for each taÝaLle period. The taÝ cannot Le Ì>Ži˜Ê>}>ˆ˜ÃÌÊ>˜ÞÊÌ>ÝÊÌ >ÌʈÃÊ`i`ˆV>Ìi`ʈ˜ÊÜ œiʜÀʈ˜Ê«>ÀÌÊ̜ÊÊ the ealthÞ

and ealth are Ýpansion und estaLlished LÞ LÞÊ

Ê œ`iÊÅΣ‡Îx£{°äÓ° / iÊVÀi`ˆÌʈÃʘœÌÊÀiv՘`>Li]ÊLÕÌÊ>˜ÞÊ>“œÕ˜ÌʜvÊÌ iÊVÀi`ˆÌÊÌ >ÌÊ iÝVii`ÃÊÌ iÊÌ>ÝÊ`ÕiÊvœÀÊ>ÊÌ>Ý>LiÊÞi>ÀÊV>˜ÊLiÊV>ÀÀˆi`ÊvœÀÜ>À`ÊÌœÊ >˜ÞʜvÊÌ iÊ£äÊÀi“>ˆ˜ˆ˜}ÊÃÕLÃiµÕi˜ÌÊÌ>Ý>LiÊÞi>ÀðÊ/ iʜܘiÀʜvÊ >n eli}iLle «ÀœiVÌÊthat µualifiesÊvœÀÊÌ iÊ

T ʓÕÃÌÊoLtain an eli}iLilitÞÊÃÌ>Ìi“i˜ÌʈÃÃÕi`ÊLÞÊÌ iÊ i«>À̓i˜ÌʜvÊœÕȘ}Ê>˜`Ê

œ““Õ˜ˆÌÞÊ iÛiœ«“i˜ÌÊ­ 

® ÜˆÌ Êrespect to the proect and suLmit an eÝecuted orm ‡nÈä™] istrict of olumLia o܇ ncome ousin} TaÝ redit
llocation and ertification.
ÊœÀÊ>˜ÞÊ«œÀ̈œ˜ÊœvÊ ˆÃÌÀˆVÌʏœÜ‡ˆ˜Vœ“iÊhousing tax credits may beÊ ÌÀ>˜ÃviÀÀi`]Ê܏`]Ê>ÃÈ}˜i`]ʜÀÊ>œV>Ìi`Ê̜ʫ>À̈iÃÊÜ œÊ>ÀiÊ iˆ}ˆLiÊ«ÕÀÃÕ>˜ÌÊ̜Ê

>«ÌiÀÊ{nʜvÊ/ˆÌiÊ{ÇʜvÊÌ iÊ ˆÃÌÀˆVÌʜvÊ

œÕ“Lˆ>Ê"vvˆVˆ>Ê œ`i°Ê/ iÀiʈÃʘœÊˆ“ˆÌʜ˜ÊÌ iÊ̜Ì>Ê˜Õ“LiÀʜvÊ >œV>̈œ˜ÃʜvÊ>ÊœÀÊ«>ÀÌʜvÊÌ iÊ̜Ì>ÊVÀi`ˆÌÊ>ÕÌ œÀˆâi`°Ê

œiV̈ÛiÞ]Ê>ÊÌÀ>˜ÃviÀÃ]ÊÃ>iÃ]Ê>ÃÈ}˜“i˜ÌÃ]Ê>˜`Ê>œV>̈œ˜ÃÊ>ÀiÊ ÃÕLiVÌÊ̜ÊÌ iʓ>݈“Õ“ÊVÀi`ˆÌÊ>œÜ>LiÊ̜Ê>Ê«>À̈VՏ>ÀʵÕ>ˆvˆi`Ê «ÀœiVÌ°Ê
ÊÌ>ÝÊVÀi`ˆÌÊi>À˜i`ʜÀÊ«ÕÀV >Ãi`ÊLÞ]ʜÀÊÌÀ>˜ÃviÀÀi`ʜÀÊ >ÃÈ}˜i`Ê̜]Ê>Ê«>À̘iÀà ˆ«]ʏˆ“ˆÌi`ʏˆ>LˆˆÌÞÊVœ“«>˜Þ]Ê-Ê VœÀ«œÀ>̈œ˜]ʜÀÊœÌ iÀÊ«>ÃÃ‡Ì ÀœÕ} Êi˜ÌˆÌÞʓ>ÞÊLiÊ>œV>Ìi`Ê̜ÊÌ iÊ «>À̘iÀÃ]ʓi“LiÀÃ]ʜÀÊà >Ài œ`iÀÃʈ˜Ê>VVœÀ`>˜ViÊÜˆÌ ÊÌ iÊ «ÀœÛˆÃˆœ˜ÃʜvÊ>˜ÞÊ>}Àii“i˜ÌÊ>“œ˜}ÊÌ iÊ«>À̘iÀÃ]ʓi“LiÀÃ]ʜÀÊ Ã >Ài œ`iÀÃÊ>˜`ÊÜˆÌ œÕÌÊÀi}>À`Ê̜ÊÌ iʜܘiÀà ˆ«Êˆ˜ÌiÀiÃÌʜvÊÌ iÊ «>À̘iÀÃ]ʓi“LiÀÃ]ʜÀÊà >Ài œ`iÀÃʈ˜ÊÌ iÊ«ÀœiVÌ°ÊÊ
Ê «>À̘iÀ]ʓi“LiÀ]ʜÀÊà >Ài œ`iÀÊ̜ÊÜ œ“Ê>ÊÌ>ÝÊVÀi`ˆÌʈÃÊ >œV>Ìi`ʓ>ÞÊvÕÀÌ iÀÊ>œV>ÌiÊ>ÊœÀÊ«>ÀÌʜvÊÌ iÊ>œV>Ìi`ÊVÀi`ˆÌÊ œÀʓ>ÞÊÌÀ>˜ÃviÀ]ÊÃi]ʜÀÊ>ÃÈ}˜ÊÌ iÊ>œV>Ìi`ÊVÀi`ˆÌ°Ê œiV̈ÛiÞÊ >ÊÌÀ>˜ÃviÀÃ]ÊÃ>iÃ]Ê>ÃÈ}˜“i˜ÌÃ]Ê>˜`Ê>œV>̈œ˜ÃÊ>ÀiÊÃÕLiVÌÊÌœÊ Ì iʓ>݈“Õ“ÊVÀi`ˆÌÊ>œÜ>LiÊ̜Ê>Ê«>À̈VՏ>ÀʵÕ>ˆvˆi`Ê«ÀœiVÌ°ÊÊ
˜ÊœÜ˜iÀ]ÊÌÀ>˜ÃviÀii]Ê«ÕÀV >ÃiÀ]Ê>ÃÈ}˜ii]ʜÀÊÌ>Ý«>ÞiÀÊ̜ÊÜ œ“Ê >ÊVÀi`ˆÌʈÃÊ>œV>Ìi`Ê`iÈÀˆ˜}Ê̜ʓ>ŽiÊ>ÊÌÀ>˜ÃviÀ]ÊÃ>iÊ>ÃÈ}˜“i˜Ì œÀÊ>œV>̈œ˜Êto another transferee] purchaser] assi}nee or taÝpaÞer] “ÕÃÌÊÃÕL“ˆÌÊappropriate information ̜ÊÌ iÊ"ffice of TaÝ and ,evenue ­"T,® and report the amount of

T

transferred] sold] assi}ned] or allocated] and the recipient of the credit. olloÜ the steps descriLed in the nstructions for o܇ ncome ousin} TaÝ redit ­ T ®
llocation and ertification LooŽlet on ÞTaÝ.

.}ov. ÊÊ / iÊ ˆÃÌÀˆVÌʏœÜ‡ˆ˜Vœ“iÊ œÕȘ}ÊÌ>ÝÊVÀi`ˆÌÊV>˜ÊLiÊÀiV>«ÌÕÀi`ʈvÊ Ì iʜܘiÀÊv>ˆÃÊ̜ÊÃÕL“ˆÌÊ>ÊVœ«ÞʜvÊÌ iÊiˆ}ˆLˆˆÌÞÊÃÌ>Ìi“i˜ÌÊ ˆÃÃÕi`ÊLÞÊÌ iÊ i«>À̓i˜ÌÊÜˆÌ ÊÀiëiVÌÊ̜ÊÌ iÊeli}iLleÊ«ÀœiVÌÊ>ÌÊ Ì iÊ̈“iʜvÊvˆˆ˜}ÊÌ iÊÀiÌÕÀ˜]ʜÀ]ʈvÊ՘`iÀÊ, ÊÅ{Ó]Ê>Ê«œÀ̈œ˜ÊœvÊany vi`iÀ>ÊœÜ‡ˆ˜Vœ“iÊhousing Ì>ÝÊVÀi`ˆÌÃÊÌ>Ži˜Êœ˜Ê>ʏœÜ‡ˆ˜Vœ“iÊ µÕ>ˆvˆi`Ê«ÀœiVÌʈÃÊÀiµÕˆÀi`Ê̜ÊLiÊÀiV>«ÌÕÀi`°ÊÊvÊ>ÊÀiV>«ÌÕÀiʈÃÊ ÀiµÕˆÀi`]Ê>˜ÞÊÃÌ>Ìi“i˜ÌÊÃÕL“ˆÌÌi`Ê̜Ê"T,Ê>ÃÊÀiµÕˆÀi`ÊLÞÊ

Ê

œ`iÊÅ{LJ{näÈ­L®Ê“ÕÃÌʈ˜VÕ`iÊÌ iÊ«Àœ«œÀ̈œ˜ÊœvÊÌ iÊVÀi`ˆÌÊ ÀiµÕˆÀi`Ê̜ÊLiÊV>«ÌÕÀi`]ÊÌ iʈ`i˜ÌˆÌÞʜvÊi>V ÊÌÀ>˜ÃviÀiiÊÃÕLiVÌÊ ÌœÊÀiV>«ÌÕÀi]Ê>˜`ÊÌ iÊ>“œÕ˜ÌʜvÊVÀi`ˆÌÊ«ÀiۈœÕÏÞÊÌÀ>˜ÃviÀÀi`]Ê Ãœ`]Ê>ÃÈ}˜i`]ʜÀÊ>œV>Ìi`Ê̜ÊÃÕV ÊÌÀ>˜ÃviÀii]Ê«ÕÀV >ÃiÀ]Ê >ÃÈ}˜ii]ʜÀÊÌ>Ý«>ÞiÀÊ̜ÊÜ œ“Ê>ÊVÀi`ˆÌʈÃÊ>œV>Ìi`°

ÝVi«ÌÊvœÀÊ՘ÕÃi`ÊVÀi`ˆÌÃÊV>ÀÀˆi`ÊvœÀÜ>À`Ê>˜`ÊvœÀÊVÀi`ˆÌÃÊV>ˆ“i`Ê Õ˜`iÀÊÀi}Տ>̈œ˜ÃÊ«Àœ“Տ}>Ìi`ÊLÞÊÌ iÊ i«>À̓i˜ÌÊVœ˜ÃˆÃÌi˜ÌÊ ÜˆÌ ÊÌ iÊëiVˆ>ÊÀՏiÊÃiÌÊvœÀÌ Êˆ˜Ê, ÊÅ{Ó]Ê>n eli}iLleÊ ˆÃÌÀˆVÌʜvÊ

œÕ“Lˆ>Ê«ÀœiVÌʈÃʘœÌÊiˆ}ˆLiÊvœÀÊ>˜ÞÊ ˆÃÌÀˆVÌÊÌ>ÝÊVÀi`ˆÌÃÊvœÀÊ “œÀiÊÌ >˜Ê££ÊÌ>Ý>LiÊÞi>ÀðÊÊ Sign-Up for MyTax.DC.gov Þ/>Ý°

°}œÛʈÃÊÌ iÊÜiLÊ«œÀÌ>ÊÜ iÀiÊޜÕÊV>˜ÊۈiÜÊޜÕÀÊ >Û>ˆ>LiÊ

Ê / Ê>“œÕ˜ÌÊ>˜`ÊÀi«œÀÌÊVÀi`ˆÌÊÌÀ>˜ÃviÀÃ]ÊÃ>iÃ]Ê >ÃÈ}˜“i˜ÌÃÊ>˜`Ê>œV>̈œ˜ÃÊÌœÊœÌ iÀÊVÀi`ˆÌÊÀiVˆ«ˆi˜ÌðÊÊ
Ê VÀi`ˆÌʜܘiÀÃ]ÊÌÀ>˜ÃviÀœÀÃÊ>˜`ÊÀiVˆ«ˆi˜ÌÃʓÕÃÌÊVœ“«iÌiÊ>ʜ˜i‡ ̈“iÊÀi}ˆÃÌÀ>̈œ˜Ê̜ÊÈ}˜ÊÕ«ÊvœÀÊ>˜Êœ˜ˆ˜iÊ>VVœÕ˜Ì°ÊÊ Ài`ˆÌÊ ÌÀ>˜ÃviÀœÀÃʓÕÃÌÊÀi«œÀÌÊ>˜ÞÊVÀi`ˆÌÊÌÀ>˜ÃviÀÃ]ÊÃ>iÃ]Ê>ÃÈ}˜“i˜ÌÃÊ >˜`Ê>œV>̈œ˜Ãʜ˜ÊÌ iˆÀÊ Þ/>Ý°

Ê>VVœÕ˜ÌÊLivœÀiÊÌ iÊVÀi`ˆÌÊ ÀiVˆ«ˆi˜ÌÃÊV>˜ÊۈiÜÊÌ iˆÀÊ«œÀ̈œ˜ÊœvÊ>Û>ˆ>LiÊ

Ê / ÊVÀi`ˆÌ°ÊÊ œÀÊvÕÀÌ iÀʈ˜vœÀ“>̈œ˜Êœ˜Ê œÜÊ̜ÊۈiÜÊޜÕÀÊ

Ê / Ê ˆ˜vœÀ“>̈œ˜Ê>˜`ÊÀi«œÀÌÊÌÀ>˜Ã>V̈œ˜Ã]Ê«i>ÃiÊÃiiʘÃÌÀÕV̈œ˜ÃÊvœÀÊ

Ê œÜ‡˜Vœ“iÊœÕȘ}Ê/>ÝÊ Ài`ˆÌÊ
œV>̈œ˜Ê>˜`Ê iÀ̈vˆV>̈œ˜° Claiming the Credit The Luildin} oÜners of an eli}iLle proect must complete orm

‡nÈä™] istrict of olumLia o܇ncome ousin} TaÝ redit
llocation and ertification] and have it si}ned LÞ an authoriâed official from the istrict of olumLia epartment of ousin} and

ommunitÞ evelopment ­ 

®. *rovide the folloÜin} documents to "T, LÞ email "T, T TeamJdc.}ov: 
copÞ of the eÝecuted ‡nÈä™] 
copÞ of Þour eli}iLilitÞ letter issued LÞ 

] 
copÞ of Þour federal orm nÈä™
]
nnual -tatement for

o܇ncome ousin} redit] a˜d 
cœ«Þ œf ޜÕÀ

cÀediÌ ÃchedՏe fœÀ Ìhe bÕidi˜g «ÀœecÌ.

‡{äÊ-V i`ՏiÊ1Ê ˆ˜iÊx

‡{£Ê ˆ˜iÊ£Èa

‡ÓäÊ-V i`ՏiÊ1 Ê ˆ˜iÊn

‡ÎäÊ-V i`ՏiÊ1 Ê ˆ˜iÊ£™ / ˆÃʈÃÊ>ʘœ˜‡Àiv՘`>LiÊVÀi`ˆÌ°ÊÊ/ iÊ̜Ì>Ê>“œÕ˜ÌʜvÊÌ iÊVÀi`ˆÌÊ Liˆ˜}ÊV>ˆ“i`Êà œÕ`ʘœÌÊiÝVii`ÊÌ iÊ>“œÕ˜ÌʜvÊÌ>ÝÊ`Õi°Ê
istrict taÝ return must Le filed Üith the credit amount on the appropriate line of the return or schedule to receive the credit. The lines to claim this credit are:

* Note: Since income reported on Federal Form 8814, Parents’ Election to Report Child’s Interest and Dividends, and included in the parents’ federal return income is subtracted above on Line 3 of Calculation B, the child must file a separate DC return reporting this income. Important: Print in CAPITAL letters using black ink. Attach to your D-40. Government of the District of Columbia 2025 SCHEDULE I Additions to and Subtractions from Federal Adjusted Gross Income

Last name Taxpayer Identification Number (TIN) * 50400180000* z z z Calculation A Additions to federal adjusted gross income. Fill in only those that apply. Dollars only, do not enter cents 1 Part-year DC resident – enter the portion of adjustments (from Federal Form  1 $ .00 104043 or 1040NR) that relate to the time you resided outside DC. For Lines 2 – 7 below include only the amounts related to the time you resided in DC. 2 Income distributions eligible for income averaging on your federal tax return 2 $ .00 (from federal Form 4972). 3 3 $ .00

4 Any part of a discrimination award subject to income averaging. 4 $ .00 5 Deductions for S Corporations from Schedule K-I, Form 1120-S. 5 $ .00 6 *ass-through losses from DC unincorporated businesses that exceed the $12,000Ê threshold (reported as a loss on federal 1040 PS
43
return). 6 $ .00 7 Other. Attach a "Calculation A, Line 7 Statement". See instructions. 7 $ .00 ™ Total additions. Add entries on Lines 1‡n. Enter the total here and on D-40, Line È. ™ $ .00 Calculation B Subtractions from federal adjusted gross income. Fill in only those that apply. 1 Taxable interest and dividends from US Treasury bonds and other obligations. See instructions 1 $ .00 2 Disability income exclusion from DC Form D-2440, Line 10. See instructions on other side. 2 $ .00 3 Interest and dividend income of a child from Federal Form 8814.* 3 $ .00 4 Awards, other than front and back pay, received due to unlawful 4 $ .00 employment discrimination. 5 Excess of DC allowable depreciation over federal allowable depreciation. See instructions. 5 $ .00 6ÊÊ Amount paid (or carried over) to DC College Savings plan in 20Ó5Ê(maximum $4,000 per 6 $ .00 person, $8,000 for joint filers if each is an account owner). Part-year residents see instructions. 7a Exclusion of up to $10,000 for DC residents (certified by the Social Security Adm. 7a $ .00 as disabled) with adjusted annual household income of less than $100,000. See instructions. 7b Annual household adjusted gross income.

C 8 Expenditures by DC teachers for necessary classroom teaching materials, $500 annual limit 8 $ .00 per person. See instructions on other side. 9 Expenditures by DC teachers for certain tuition and fees, $1500 annual limit per person. 9 $ .00 See instructions on other side. 10 Loan repayment awards received by health-care professionals from DC government. 10 $ .00 See instructions on other side. 11 Health-care insurance premiums paid by an employer for an employee’s registered 11 $ .00 domestic partner or same sex spouse. Make no entry if the premium was deducted on your federal return. See instructions on other side. 12 DC Poverty Lawyer Loan Assistance. See instructions on other side. 12 $ .00 13 Other. Attach a "Calculation B, Line 13 Statement". See instructions. 13 $ .00 14 Military Spouse Residency Relief Act. See instructions on other side. 14 $ .00 15 $ .00 15Ê

>«ˆÌ>Ê}>ˆ˜ÃÊ`iviÀÀi`Ê`ÕiÊ̜Ê

Ê>««ÀœÛi`ʈ˜ÛiÃ̓i˜Ìʈ˜Ê

Ê+Õ>ˆvˆi`Ê"««œÀÌ՘ˆÌÞÊ՘`Ê 16Ê Total subtractions.ÊAdd entries on Lines 1–7a and 8-15. Enter the total here and on D-40, Line 1{. 16 $ .00

OFFICIAL USE ONLY Vendor ID#0000 $ .00 8 8 $ .00

>«ˆÌ>Ê}>ˆ˜ÃÊ`iviÀÀi`ʜ˜Êvi`iÀ>ÊÀiÌÕÀ˜Ê`ÕiÊ̜ʈ˜ÛiÃ̓i˜Ìʈ˜Ê+Õ>ˆvˆi`Ê"««œÀÌ՘ˆÌÞÊ՘` ,iۈÃi` £ÉÓäÓ6 , Å£68 additional depreciation and/or extra IRC ţǙ iÝ«i˜Ãià V>ˆ“i` œ˜Êvi`iÀ>ÊÀiÌÕÀ˜°

6&+('8/( I $GGitions to anG 6uEtractions IroP )eGeral $GMusteG Gross IncoPe BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB General Instructions 1se -chedule I to report income or adustments to federal adusted gross income.
dditions to federal adjusted gross income are entered on -chedule I,

alculation
. /he amount on alculation
, ine ™ is entered on Form

‡{ä, ine È. -ubtractions from federal adusted gross income are entered on -chedule I,

alculation . /he amount on alculation , ine £È is entered on Form

‡{ä, ine £{. œÌi\Ê˜Ê iVi“LiÀÊÓäÓx]ÊÌ iÊ ˆÃÌÀˆVÌÊi˜>VÌi`ÊÌ iÊ

ʘVœ“iÊ>˜`ÊÀ>˜V ˆÃiÊ />ÝÊ œ˜vœÀ“ˆÌÞÊ “iÀ}i˜VÞÊ
VÌʜvÊÓäÓxʈ`i˜Ìˆvވ˜}ÊÜ ˆV Ê«ÀœÛˆÃˆœ˜ÃʜvÊÌ i vi`iÀ>Ê"˜iÊ ˆ}Ê i>ṎvÕÊ ˆÊ
VÌÊ­"
®ÊÌ iÊ ˆÃÌÀˆVÌÊ܈Ê˜œÌÊ>`œ«ÌÊ>˜` ˆ˜VœÀ«œÀ>̈˜}Ê>``ˆÌˆœ˜>ÊÌ>ÝÊV >˜}iðÊ-œ“iÊvi`iÀ>ÊV >˜}iÃÊ܈Ê˜œÌÊ>««Þʈ˜Ê Ì iÊ ˆÃÌÀˆVÌ°Ê/ iÊ ˆÃÌÀˆVÌÊ`œiÃʘœÌÊ>œÜÊViÀÌ>ˆ˜ÊiÝVÕȜ˜ÃÊ>˜`ɜÀÊ`i`ÕV̈œ˜ÃÊ >œÜi`Ê՘`iÀÊvi`iÀ>Ê>Üʜ˜ÊޜÕÀÊvi`iÀ>ÊÀiÌÕÀ˜°ÊvÊޜÕÊiÝVÕ`i`ʜÀÊ`i‡ `ÕVÌi`ÊÌ œÃiʈÌi“Ãʈ˜ÊVœ“«Ṏ˜}ÊޜÕÀÊvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊ­œÀÊ ÞœÕÊ >Ûiʈ˜Vœ“iÊvÀœ“Ê>Ê«>ÃÃ‡Ì ÀœÕ} Êi˜ÌˆÌÞÊÌ >ÌÊV>ˆ“i`ÊÌ œÃiʈÌi“îÊޜÕÊ “ÕÃÌÊ>``ÊÌ i“ÊL>VŽÊ̜ÊޜÕÀÊvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“i°Ê

>VՏ>̈œ˜Ê
]Ê ˆ˜iÊÇʇʸ"Ì iÀ¸°Ê1ÃiÊ >VՏ>̈œ˜Ê
]Ê ˆ˜iÊÇÊ̜ÊÀi«œÀÌʈ˜Vœ“i vœÀʈÌi“ÃÊÌ >ÌÊ>ÀiʘœÊœ˜}iÀÊÃÕLiVÌÊ̜Êvi`iÀ>ÊÌ>ÝÊLÕÌÊÀi“>ˆ˜ÊÌ>Ý>Liʈ˜Ê Ì iÊÊ ˆÃÌÀˆVÌ°Ê,iviÀÊ̜ÊÌ iʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊ >VՏ>̈œ˜Ê
]Ê ˆ˜iÊÇÊLiœÜ]ÊvœÀÊ Ü ˆV ʈÌi“Ãʜvʈ˜Vœ“iʘii`Ê̜ÊLiÊ>``i`ʜ˜Ê ˆ˜iÊÇ]Ê>˜`Ê œÜÊ̜ÊÀi«œÀÌÊ Ì i“°Ê
ÃœÊˆ˜VÕ`iÊœÌ iÀʓˆÃVi>˜iœÕÃʈÌi“Ãʜvʈ˜Vœ“iÊÌ >ÌÊ >ÛiʘœÊ `i`ˆV>Ìi`ʏˆ˜iÊvœÀÊÌ i“Êœ˜Ê-V i`ՏiÊ°Ê
ÌÌ>V Ê>ʸ >VՏ>̈œ˜Ê
]Ê ˆ˜iÊÇÊ -Ì>Ìi“i˜Ì¸Ê̜Ê-V i`ՏiÊʈ˜ÊÜ ˆV ÊޜÕʈ`i˜ÌˆvÞÊi>V ʈÌi“ʈ˜VÕ`i`ʈ˜Ê Ì iÊ ˆ˜iÊÇÊ̜Ì>Ê>“œÕ˜Ì]ʈ˜VÕ`ˆ˜}Ê>˜ÊiÝ«>˜>̈œ˜Ê>˜`ɜÀÊVœ“«ÕÌ>̈œ˜Ê vœÀÊi>V Ê>“œÕ˜Ì°ÊÊ &alculation $ Instructions
``ˆÌˆœ˜ÃÊ̜Êvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“i ­
® Ê

ˆ˜iÊ£Ê*art‡year

residents ‡ If you Üere not a resident of

for the full year, enter all eÝclusions or deductions from your federal adusted gross income that relate to the time period during the year Ühen you Üere not a resident of

.

ˆ˜iÊÓ Income distributions eligible for income averaging on your federal taÝ return ­from federal Form {™ÇÓ®.

ˆ˜iÊÎÊIf you claimed, or Üere allocated portions of, the £ää¯ I, £Èn­k® bonus depreciation, the £ää¯ I, £Èn­n® depreciation deduction for µualified production property, andÉor the additional I, £Ç™ eÝpense de‡ duction, those deductions are disalloÜed. 9ou must add‡back the eÝcess of the £ää¯ I, £Èn­k® bonus depreciation and the £ää¯ I, £Èn­n® additional deduction over the depreciation amount calculated using regular depreciation methods for the µualifying property. 9ou must also add‡back the eÝcess of the I, £Ç™ additional eÝpense over the lesser of fÓx,äää or the actual cost of the property in the year the property Üas placed in service.

ˆ˜iÊ{Ê
˜ÞÊ«>ÀÌʜvÊ>Ê`ˆÃVÀˆ“ˆ˜>̈œ˜Ê>Ü>À`ÊÃÕLiVÌÊ̜ʈ˜Vœ“iÊ>ÛiÀ>}ˆ˜}°Ê

ˆ˜iÊx
ny deductions distributed from -‡ orporations and included in the -chedule ‡£, Form ££Óä‡- that are disalloÜed in the istrict must be added‡back. -ee

ode Å {LJ£näÎ.äÎ for disalloÜed deductions.

ˆ˜iÊÈÊ*ass‡through losses from

unincorporated businesses that eÝceed the f£Ó,äää threshold ­reported as a loss on federal £ä{ä or £ä{ä‡-, return®. >° "Õ̇œv‡-Ì>ÌiÊ Õ˜ˆVˆ«>ÊLœ˜`Ãʇ Interest on the obligations of other states, and their political subdivisions must be included in istrict gross income. If you eÝcluded such income on your federal return, you must add‡back that income on alculation
, ine Ç. Interest earned on obligations of the istrict or a territory of the 1nited -tates, as Üell as obligations issued by

7ater, the 7ashington etropolitan
rea /ransit
uthority ­7
/
®, and the istrict of olumbia ousing Finance
gency ­

F
® remain eÝempt. L° >«ˆÌ>Ê}>ˆ˜Ãʜ˜ÊµÕ>ˆvˆi`ÊÓ>ÊLÕȘiÃÃÊÃ̜VŽÃʇÊIf you claimed the eÝclusion of capital gains from the sale or eÝchange of ¸µualified small business stock¸ as provided under I, Å £ÓäÓ you must add‡back the gain on alculation
, ine Ç./he gross income eÝclusion under I, Å £ÓäÓ does not apply. V° >«ˆÌ>ˆâ>̈œ˜Ê>“œÀ̈â>̈œ˜ÊœvÊ`œ“iÃ̈VÊÀiÃi>ÀV Ê>˜` iÝ«iÀˆ“i˜Ì>ÊiÝ«i˜`ˆÌÕÀiÃʇÊIf your federal adusted gross income includes claimed andÉor passed‡through deduction of the immediate eÝpensing of research and eÝperimental ­,E ® eÝpenditures under I, Å £Ç{
, the immediate eÝpensing is disalloÜed. ,E eÝpenditures must be amortiâed and capitaliâed over a period of x years. 9ou must add‡back that amount on

alculation
, ine Ç. `° >VՏ>̈œ˜Êœvʏˆ“ˆÌ>̈œ˜ÊœvÊLÕȘiÃÃʈ˜ÌiÀiÃÌÊiÝ«i˜ÃiÃʇÊIf your federal adusted gross income includes claimed andÉor passed‡through business interest deductions as provided under I, Å £Èݍ®, the business interest deduction must be computed by adding back depreciation, amortiâation,and depletion to adusted taÝable income. In addition, the ¸floor‡plan¸ financing interest as defined under I, Å £Èݍ®­™® does not apply. i° ˆÃVi>˜iœÕÃʈÌi“Ãʜvʈ˜Vœ“iÊÌ >ÌʓÕÃÌÊLiÊ>``i`ÊL>VŽÊ̜

ˆÃÌÀˆVÌÊ}ÀœÃÃʈ˜Vœ“iʇ If you have other items of income that you deducted on your federal return, but are taxable in the District, you must be add back those items of income to

istrict gross income.

ˆ˜iÊÇ "Ì iÀ ‡ nter items of income eÝcluded from federal adusted gross income but subect to

taÝ, including, but not limited to\
ÌÌ>V Ê>ʸ >VՏ>̈œ˜Ê
]Ê ˆ˜iÊÇÊ-Ì>Ìi“i˜Ì¸Ê̜Ê-V i`ՏiÊʈ˜ÊÜ ˆV ÊޜÕÊ ˆ`i˜ÌˆvÞÊi>V ʈÌi“ʈ˜ÊÌ iÊ ˆ˜iÊÇÊ̜Ì>Ê>“œÕ˜Ì]ʈ˜VÕ`ˆ˜}Ê>˜ÊiÝ«>˜>̈œ˜Ê >˜`ɜÀÊVœ“«ÕÌ>̈œ˜ÊvœÀÊi>V Ê>“œÕ˜Ì°

ˆ˜i 8 If you reported deferred capital gains on your federal return due to an investment in a Qualified Opportunity Fund, you must add‡back the amount of the deferment here.

ˆ˜iʙ
dd the entries on ines £ through n. nter the total on ine ™ and on Form ‡{ä, ine È.

Calculation B Instructions Subtractions from federal adjusted gross income Line 1 Interest and dividend income on obligations or securities of the United States, or its agencies or instrumentalities, to the extent that this income is included in federal gross income. Attach a detailed statement including an explanation of the amount of exempt interest and/or dividends and the name of the payor(s). Line 2 Disability income exclusion from DC Form D-2440. Enter the amount from Form D-2440, Line 10. Attach a completed D-2440. If disability payments were included in your federal gross income, you may be able to claim an exclusion for them on your DC return. Line 3 Interest and dividend income of a child from Federal Form 8814. You may subtract this income from your adjusted gross income ony if the child filed a separate Form D-40 reporting this income. Line 4 Awards, other than front and back pay, received due to unlawful employment discrimination. Line 5 Excess of DC allowable depreciation over federal allowable depreciation. If you claimed the federal bonus depreciation (100%) on your federal return, the DC basis for the depreciated property will be more than the federal basis. Use this line to subtract the excess depreciation from the federal AGI to show the proper DC depreciation allowable. Line 6 DC College Savings Plan payments. Enter the amount contributed to a qualified DC “529” College Savings Plan. You may deduct up to $4,000 annually for contributions you made to all qualified college savings accounts of which you are the owner. If you are married and file a joint or combined separate return, each spouse/registered domestic partner may deduct up to $4,000 for contributions made to all accounts for which that spouse/registered domestic partner is the sole owner. A rollover distribution is not a contribution for purposes of this deduction. Contributions made to one or more accounts in excess of the allowable $4,000 ($8,000 for eligible joint filers) annual deduction may be carried forward as a deduction (subject to the annual limitation) for up to five years. If you were a part-year DC resident during the tax year, you may deduct only the amount contributed when you resided in DC. Line 7a and 7b Exclusions for DC residents. Income not to exceed $10,000 is excludable in computing DC gross income for persons determined by the Social Security Administration to be totally and permanently disabled and who are receiving: Supplemental Security Income or Social Security Disability; or railroad retirement disability benefits; or federal or DC govern- ment disability benefits; and whose annual household adjusted gross income is less than $100,000. Household income includes income received by all household members in the year, even income excluded from federal adjusted gross income. Adjusted gross income is that of all persons residing in a household, ex- cluding the adjusted gross income of any person who is a tenant under a written lease for fair market value. Lines 8 and 9 Expenditures by DC teachers. An individual who: 1) has been approved by the DC public schools; and 2) has been a classroom teacher in a DC public school or public charter school for this entire tax year or the entire prior tax year may deduct: • the amount the teacher paid during the year for basic and necessary classroom teaching materials and supplies – up to $500 per person whether filing individually or jointly. • the tuition and fees paid during the year for postgraduate education, professional development, or state licensing examination and testing for improving teaching credentials or maintaining professional certification – up to $1,500 per person whether filing individually or jointly. Interaction between DC deductions and similar federal deductions. /œ «ÀiÛi˜Ì > º`œÕLi `i`ÕV̈œ˜» ÈÌÕ>̈œ˜ q ˆv >

V>ÃÃÀœœ“ Ìi>V iÀ V>ˆ“à > `i`ÕV̈œ˜ œ˜ Ì iˆÀ vi`iÀ> ÀiÌÕÀ˜ vœÀ «iÀܘ> iÝ«i˜ÃiÃ] Ì i vi`iÀ> Ì>Ý `i`ÕV̈œ˜ V>ˆ“i` reduces Ì i >“œÕ˜Ì Ì >Ì “>Þ Li V>ˆ“i` vœÀ Ì œÃi Ã>“i iÝ«i˜Ãià œ˜ Ì i

ÀiÌÕÀ˜° For eÝam«le\ >

V>ÃÃÀœœ“ Ìi>V iÀ Ü œ V>ˆ“à f£]xää œÀ “œÀi vœÀ ÌՈ̈œ˜ >˜` viià œ˜ Ì i vi`iÀ> ÀiÌÕÀ˜ ­œÀ“ £ä{ä œÀ £ä{ä‡-,® may not Ì>Ži >˜Þ `i`ÕV̈œ˜ vœÀ Ì iÃi Ã>“i iÝ«i˜Ãià œ˜ Ì i

ÀiÌÕÀ˜° Line 10 Loan re«ayment aÜards. º œ>˜ Ài«>ޓi˜Ì >Ü>À`û œv Õ« ̜ f£Óä]äää «>ˆ` œÛiÀ vœÕÀ Þi>Àà LÞ

̜ i>Ì V>Ài «ÀœviÃȜ˜>Ã ̜ Ài‡ `ÕVi Ì iˆÀ “i`ˆV> i`ÕV>̈œ˜ `iLÌ >Ài ˜œÌ Ì>Ýi` LÞ

° ­/ ˆÃ «Àœ}À>“ ˆÃ >`“ˆ˜ˆÃÌiÀi` LÞ Ì i

i«>À̓i˜Ì œv i>Ì °® Line 11 ealthcare insurance «remiums.
˜Þ i>Ì V>Ài ˆ˜ÃÕÀ>˜Vi «Ài“ˆÕ“ «>ˆ` LÞ >˜ i“«œÞiÀ vœÀ >˜ i“«œÞii½Ã `œ“iÃ̈V «>À̘iÀ Ài‡ }ˆÃÌiÀi` ÜˆÌ Ì i 6ˆÌ> ,iVœÀ`à ˆÛˆÃˆœ˜ œv Ì i

i«>À̓i˜Ì œv i>Ì

­Ãii

œ`i ÅÎӇÇä£ ­Î® >˜` ÇäÓ® œÀ >˜ i“«œÞii¿Ã ëœÕÃi ˆÃ `i`ÕV̈Li] ՘iÃà œ˜ ޜÕÀ vi`iÀ> ÀiÌÕÀ˜ Ì i i“«œÞii½Ã Ài}ˆÃÌiÀi` `œ“iÃ̈V «>À̘iÀ œÀ ëœÕÃi ˆÃ Vœ˜Ãˆ`iÀi` > `i«i˜`i˜Ì «ÕÀÃÕ>˜Ì ̜ , Å£xÓ >˜` > `i‡ `ÕV̈œ˜ vÀœ“ ˆ˜Vœ“i Ü>à Ì>Ži˜ vœÀ Ì i «Ài“ˆÕ“ œ˜ Ì i i“«œÞii½Ã vi`iÀ> Ì>Ý ÀiÌÕÀ˜° Line 1Ó D *overty LaÜyer Loan Assistance.
ÌÌ>V > Vœ«Þ œv ޜÕÀ œÀ“ £ä™™ ­ >˜Vi>̈œ˜ œv iLÌ® ˆÃÃÕi` LÞ Ì i

"vwVi œv Ì i
Ì̜À˜iÞ i˜iÀ> ­"
®° >ÜÞiÀà iˆ}ˆLi vœÀ Ì ˆÃ >Ü>À` >Ài Ì œÃi Ü œÃi i}> «À>V̈Vi >à Lii˜ ViÀ̈wi` LÞ Ì i

"
 >à ÃiÀۈ˜} Ì i «ÕLˆV ˆ˜ÌiÀiÃÌ° Line 1Î "ther. "Ì iÀ ˆÌi“à ˜œÌ ÃÕLiVÌ Ìœ

Ì>Ý ÃÕLÌÀ>VÌi` vÀœ“ vi`iÀ> >`ÕÃÌi` }ÀœÃà ˆ˜Vœ“i° -ii ‡{ä ˆ˜ÃÌÀÕV̈œ˜ LœœŽiÌ «>}i 10 >˜`

œ`i Å {LJ£näΰäÓ­>®­Ó®° Attach a ¸ alculation , Line 1Î Statement¸ in Ühich you identify each item in the Line 1Î total amount, including an eÝ«lanation andÉor com«utation for each amount. Line 14 ilitary S«ouse ,esidency ,elief Act. v ÞœÕ >Ûi `iÌiÀ“ˆ˜i` Ì >Ì ÞœÕ >Ài ÀiµÕˆÀi` ̜ wi > ˆÃÌÀˆVÌ œv œÕ“Lˆ> Ì>Ý ÀiÌÕÀ˜ >˜` ÞœÕ >Ài ˆ˜ œ˜i œv Ì i 1°-° “ˆˆÌ>ÀÞ ÃiÀۈViÃ] œ˜i œv Ì i vœœÜˆ˜} “>Þ >««Þ\ £® v > ÃiÀۈVi“i“LiÀ½Ã i}> ÀiÈ`i˜Vi vœÀ Ì>Ýià ˆÃ ˜œÌ ˆ˜

LÕÌ Ì i ÃiÀۈVi “i“LiÀ >˜` ëœÕÃi ÀiÈ`i ˆ˜

`Õi ̜ “ˆˆÌ>ÀÞ œÀ`iÀÃ] Ì i “ˆˆÌ>ÀÞ Vœ“«i˜Ã>̈œ˜ >˜` Ì i ˜œ˜‡“ˆˆÌ>ÀÞ Ã«œÕÃi½Ã Vœ“«i˜Ã>̈œ˜ à œÕ` Li `i`ÕVÌi` œ˜ -V i`Տi ] ˆ˜i £{° v Ì ˆÃ >««ˆià ̜ ޜÕ] > Vœ«Þ œv Ì i i«>À̓i˜Ì œv ivi˜Ãi vœÀ“ «ÀœÛˆ`ˆ˜} Ì i ÃiÀۈVi “i“LiÀ½Ã i}> ÀiÈ`i˜Vi vœÀ Ì>Ýià >˜` > Vœ«Þ œv Ì i ˜œ˜‡“ˆˆÌ>ÀÞ Ã«œÕÃi½Ã i}> ÀiÈ`i˜Vi vœÀ Ì>Ýià à œÕ` Li Ži«Ì ÜˆÌ ÞœÕÀ Ì>Ý ÀiVœÀ`à ˆ˜ V>Ãi ˆÌ ˆÃ ÃÕLÃiµÕi˜ÌÞ ˜ii`i`° Ó® v > ÃiÀۈVi“i“LiÀ½Ã i}> ÀiÈ`i˜Vi vœÀ Ì>Ýià ˆÃ ˆ˜

>˜` Ì i ÃiÀۈVi “i“LiÀ >˜` ëœÕÃi ÀiÈ`i ˆ˜

ˆ˜ Vœ“«ˆ>˜Vi ÜˆÌ Ì i ÃiÀۈVi“i“LiÀ½Ã “ˆˆÌ>ÀÞ œÀ`iÀÃ] Ì iÞ Üˆ wi œÀ“ ‡{ä >˜` ܈ Ài«œÀÌ > Ì iˆÀ ˆ˜Vœ“i ˆ˜

] >à iˆÌ iÀ “>ÀÀˆi` wˆ˜} œˆ˜ÌÞ œÀ “>ÀÀˆi` wˆ˜} Ãi«>À>ÌiÞ° Line 15 D "««ortunity Fund Investment. v ÞœÕ >Ûi `iviÀÀi` V>«ˆÌ> }>ˆ˜Ã `Õi ̜ >˜ ˆ˜ÛiÃ̓i˜Ì ˆ˜ >

>««ÀœÛi` +Õ>ˆvˆi` "««œÀÌ՘ˆÌÞ ՘`] ÃÕLÌÀ>VÌ Ì i >“œÕ˜Ì œv Ì i `iviÀ“i˜Ì iÀi] «ÀœÛˆ`i` Ì ˆÃ >“œÕ˜Ì ˆÃ >Ãœ ˆ˜VÕ`i` ˆ˜ >VՏ>̈œ˜
] ˆ˜i n œv -V i`Տi ° Line 16 Total Subtractions.
`` i˜ÌÀˆià œ˜ ˆ˜ià £ Ì œÕ} Ç> >˜` n Ì ÀœÕ} £x° ˜ÌiÀ Ì i ̜Ì> iÀi >˜` œ˜ œÀ“ ‡{ä] ˆ˜i £{°

* 50400150000* œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> ÓäÓ5ÊÊÊ ,iۈÃi`Ê05/2025 " 
Ê1- Ê" 9 6i˜`œÀÊ ›ääää Important: *Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž°
ÌÌ>V Ê̜Ê-V i`ՏiÊ1°ÊˆiÊ-V i`ՏiÃÊ Ê>˜`Ê1ÊÜˆÌ ÊޜÕÀÊ ‡{ä° z z z ˆÀÃÌʘ>“iʜvʘœ˜‡VÕÃ̜`ˆ>Ê«>Ài˜ÌÊ °°Ê

>ÃÌʘ>“i
``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li®

ˆÌÞÊ -Ì>ÌiÊ <ˆ«Ê œ`iʳÊ{Ê />Ý«>ÞiÀÊ`i˜ÌˆvˆV>̈œ˜Ê ՓLiÀÊ­/ ®Ê

>ÌiʜvÊLˆÀÌ Ê­

9999®

Ûi˜ÊˆvÊޜÕÊ>ÀiʘœÌÊiˆ}ˆLiÊ̜ÊV>ˆ“ÊÌ iÊi`iÀ>Ê >À˜i`ʘVœ“iÊ Ài`ˆÌÊޜÕʓ>ÞÊLiÊ>LiÊ̜ÊV>ˆ“ÊÌ iÊ

Ê >À˜i`ʘVœ“iÊ/>ÝÊ Ài`ˆÌ°

Ê œ˜‡ ÕÃ̜`ˆ>Ê*>Ài˜ÌÊ / Ê ˆ}ˆLˆˆÌÞÊqÊ*i>ÃiÊVœ“«iÌiÊÌ ˆÃÊV iVŽˆÃÌÊ̜Ê`iÌiÀ“ˆ˜iÊޜÕÀÊiˆ}ˆLˆˆÌÞÊ̜ÊvˆiÊ-V i`ՏiÊ ° 9œÕʓ>ÞÊV>ˆ“ÊÌ iÊ

Ê œ˜‡ ÕÃ̜`ˆ>Ê*>Ài˜ÌÊ / ʜ˜ÞʈvÊޜÕÊV>˜Ê>˜ÃÜiÀʺ9iûÊ̜ÊÌ iÊvœœÜˆ˜}ʵÕiÃ̈œ˜Ã° 9 -Ê " £ÊÊÃÊޜÕÀÊi`iÀ>Ê
`ÕÃÌi`ÊÀœÃÃʘVœ“iÊvœÀÊÓäÓ5ʏiÃÃÊÌ >˜\ f50]434Ê­fx7]554ʓ>ÀÀˆi`Êvˆˆ˜}ʍœˆ˜ÌÞ®ÊÜˆÌ Êœ˜iʵÕ>ˆvވ˜}ÊV ˆ`Ê fx7,310Ê­f64]430Êʓ>ÀÀˆi`Êvˆˆ˜}ʍœˆ˜ÌÞ®ÊÜˆÌ ÊÌܜʵÕ>ˆvވ˜}ÊV ˆ`Ài˜Ê f61]555Ê­fÈ8]675ʓ>ÀÀˆi`Êvˆˆ˜}ʍœˆ˜ÌÞ®ÊÜˆÌ ÊÌ ÀiiʜÀʓœÀiʵÕ>ˆvވ˜}ÊV ˆ`Ài˜ ÓÊÊ7iÀiÊޜÕÊ>Ê

ÊÀiÈ`i˜ÌÊÌ>Ý«>ÞiÀÊ`ÕÀˆ˜}ÊÌ iÊÞi>À¶Ê ÎÊÊ7iÀiÊޜÕÊLiÌÜii˜ÊÌ iÊ>}iÃʜvÊ£nÊ>˜`ÊÎäÊ>ÃʜvÊ iVi“LiÀÊΣ]ÊÓäÓ5¶Ê {ÊÊ
ÀiÊޜÕÊ>Ê«>Ài˜ÌʜvÊ>ʓˆ˜œÀÊV ˆ`­Ài˜®ÊÜˆÌ ÊÜ œ“ÊޜÕÊ`œÊ˜œÌÊÀiÈ`i¶Ê xÊÊ
ÀiÊޜÕÊ՘`iÀÊ>ÊVœÕÀÌʜÀ`iÀÊÀiµÕˆÀˆ˜}ÊޜÕÊ̜ʓ>ŽiÊV ˆ`ÊÃÕ««œÀÌÊ«>ޓi˜ÌÃ¶Ê ÈÊÊ7>ÃÊÌ iÊV ˆ`ÊÃÕ««œÀÌÊ«>ޓi˜ÌʜÀ`iÀÊJO
FGGFDU
GPS
BU
MFBTU

EBZT
JOÊÓäÓ5 ÇÊÊ ˆ`ÊޜÕʓ>ŽiÊV ˆ`ÊÃÕ««œÀÌÊ«>ޓi˜Ì­Ã®ÊÌ ÀœÕ} Ê>Ê}œÛiÀ˜“i˜ÌÊ뜘ÜÀi`ÊÃÕ««œÀÌÊVœiV̈œ˜Ê՘ˆÌ¶Ê nÊÊ ˆ`ÊޜÕÊ«>ÞÊ>ÊœvÊÌ iÊVœÕÀÌʜÀ`iÀi`ÊV ˆ`ÊÃÕ««œÀÌÊ`ÕiÊvœÀÊÓäÓ5ÊLÞÊ iVi“LiÀÊΣ]ÊÓäÓ5¶Ê vÊޜÕÊ>˜ÃÜiÀi`ʺ9iûÊ̜ÊÌ iÊ>LœÛiʵÕiÃ̈œ˜Ã]ÊޜÕʓ>ÞÊV>ˆ“ÊÌ iÊ

Ê œ˜‡ ÕÃ̜`ˆ>Ê*>Ài˜ÌÊ / °

œ“«iÌiÊ-V i`ՏiÊ Ê>˜`Ê>ÌÌ>V ʈÌ]Ê>˜`Ê-V i`ՏiÊ1]Ê̜ÊޜÕÀÊ ‡{ä° - 

1

Ê Ê

Ê œ˜‡

ÕÃ̜`ˆ>Ê*>Ài˜ÌÊ / Ê >ˆ“

,iۈÃi`Ê05/2025 z z z ՓLiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀ

ˆÌÞÊ -Ì>ÌiÊ <ˆ«Ê œ`iʳÊ{ ›£ ›Î ›£ ›Ó ›£ ›Ó ›Î ›£ ›Ó ›ÎÊÊ +Õ>ˆvވ˜}Ê

ˆ`ʘvœÀ“>̈œ˜Ê ˆÀÃÌÊ >“iÊ °°Ê

>ÃÌÊ >“i £°

ˆ`½Ãʘ>“i]ʛ£

ˆ`½Ãʘ>“i]ʛÓ

ˆ`½Ãʘ>“i]ʛΠvÊޜÕÊ >ÛiʓœÀiÊÌ >˜ÊÌ ÀiiʵÕ>ˆvވ˜}ÊV ˆ`Ài˜]ÊޜÕʜ˜Þʘii`Ê̜ʏˆÃÌÊÌ ÀiiÊ̜Ê}iÌÊÌ iʓ>݈“Õ“ÊVÀi`ˆÌ° Ó° Ê

ˆ`½Ã / ›£ ›Ó ›Î ΰ

ˆ`½ÃÊ`>ÌiʜvÊLˆÀÌ

{° ÕÃ̜`ˆ>˜½Ãʘ>“i x° ÕÃ̜`ˆ>˜½ÃÊ>``ÀiÃà Ȱ ÕÃ̜`ˆ>˜½ÃÊ/ Ç° œV>̈œ˜ÊœvÊÌ i VœÕÀÌÊÌ >ÌʜÀ`iÀi` ÃÕ««œÀÌÊ«>ޓi˜ÌÃÊvœÀ\ n° >ÃiʜÀÊ œVŽiÌʘՓLiÀÊvœÀ\ ˆÀÃÌÊ >“iÊ °°Ê

>ÃÌÊ >“i ›£ ›Ó ›Î ›Ó ™° Ê >“iʜvÊ}œÛiÀ˜“i˜ÌÊ>}i˜VÞÊ̜ÊÜ ˆV ÊޜÕʓ>ŽiÊ«>ޓi˜ÌÃÊvœÀ\ £ä° Ê
``ÀiÃÃʜv Ì iÊ}œÛiÀ˜“i˜Ì >}i˜VÞÊvœÀ\ ›Î ££° Ê
“œÕ˜Ìʜv VœÕÀÌʜÀ`iÀi` «>ޓi˜Ì fÊ °ääÊ«iÀʓœ˜Ì

fÊ °ääÊ«iÀʓœ˜Ì

fÊ °ääÊ«iÀʓœ˜Ì

›£Ê ›ÎÊ ›ÓÊ £Ó° >ÌiÊ«>ޓi˜ÌÃÊÜiÀi ›£Ê­

9999®Ê ›ÓÊ­

9999®Ê ›ÎÊ­

9999®Ê œÀ`iÀi`Ê̜ÊÃÌ>ÀÌ ›£ ›Ó ›Î £Î°Ê /œÌ>Ê«>ޓi˜ÌÃʓ>`iÊ`ÕÀˆ˜}ÊÓäÓ5 fÊ °ääÊ ÊfÊ °ääÊ fÊ °ää ÓäÓ5Ê- 

1

Ê ÊÊ*
 ÊÓÊÊ Last name and TIN * 5040010000* £{° Ê œ“«ÕÌ>̈œ˜\ÊÊ1Ș}ÊÌ iÊ>“œÕ˜Ìʜ˜Ê ˆ˜iÊ{ʜvÊœÀ“Ê ‡{ä]Êvˆ˜`ÊÌ iÊVœÀÀiVÌÊ >À˜i`ʘVœ“iÊ Ài`ˆÌÊ­  ®Ê>“œÕ˜ÌÊvÀœ“ÊÌ iÊ  ÊÌ>Liʈ˜ÊÌ i i`iÀ>Ê£ä{äÊÌ>ÝÊÀiÌÕÀ˜ÊLœœŽiÌ°Ê ÕÌˆ«ÞÊÌ >ÌÊ>“œÕ˜ÌÊLÞÊ1.00Ê̜Ê`iÌiÀ“ˆ˜iÊÌ iÊ

Ê œ˜‡ ÕÃ̜`ˆ>Ê*>Ài˜ÌÊ / Ê>“œÕ˜ÌÊ̜ÊV>ˆ“Êœ˜Ê-V i`ՏiÊ 1] *>ÀÌÊ£L]Ê ˆ˜iÊ£°ÊvÊޜÕÊ>ÀiÊ>Ê«>À̇Þi>ÀÊvˆiÀ]ÊÃiiÊ«>À̇Þi>ÀÊÀiÈ`i˜Ìʈ˜ÃÌÀÕV̈œ˜Ãʈ˜ÊÌ iÊ ‡{äÊLœœŽiÌʜ˜Ê«ÀœÀ>̈˜}ÊÌ iÊVÀi`ˆÌÊ̜ÊLiÊV>ˆ“i`°

 53  z z z Child 1 Child 2 Child 3 Eligible Child Information 1a Is this child a recipient of the District's subsidized child care program? 5 Child's relationship to you 6 Name of Child Development Facility 7a Child Development Facility 8 Child Development Facility taxpayer identification number 10 Amount paid. See instructions The maximum credit you can receive for each eligible child is $1,200 12 Enter the lesser of Line 10 or Line 11 for each eligible child here and on Schedule U, Part 1b, Line 2. OFFICIAL USE ONLY Vendor ID# 000ä ▶ œ“«iÌiÊ>˜`Ê>ÌÌ>V Ê̜ÊœÀ“Ê ‡{äʜ˜ÞʈvÊޜÕÊ >ÛiÊ>˜Êiˆ}ˆLiÊV ˆ`° >“i Ê Ã œÜ˜Êœ˜ÊÀiÌÕÀ˜Ê 9œÕÀÊvˆÀÃÌʘ>“iÊ °ÊÊÊÊ >ÃÌʘ>“i ivœÀiÊޜÕÊLi}ˆ˜\ v-iiʈ˜ÃÌÀÕV̈œ˜Ãʜ˜Êthe L>VŽÊœvÊÌ ˆÃÊvœÀ“Ê̜ʓ>ŽiÊÃÕÀiÊÌ >ÌÊ1) ޜÕÊV>˜ÊÌ>ŽiÊÌ iÊ ii«Ê

ˆ`Ê >ÀiÊ
vvœÀ`>LiÊ/>ÝÊ Ài`ˆÌÊ>˜`Ê2) ޜÕÊ >ÛiÊ>˜Êiˆ}ˆLi V ˆ`° v iÊÃÕÀiÊÌ iÊV ˆ`½Ãʘ>“iʜ˜Ê ˆ˜iÊÓÊ>˜`Êthe Ì>Ýʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ®Êœ˜Ê ˆ˜iÊÎʓ>ÌV ÊÜˆÌ ÊÌ iÊiˆ}ˆLiÊV ˆ`½ÃÊÜVˆ>ÊÃiVÕÀˆÌÞÊV>À`°Ê"Ì iÀ܈Ãi]Ê>Ì Ì iÊ̈“iÊÜiÊ«ÀœViÃÃÊޜÕÀÊÀiÌÕÀ˜]ÊÜiʓ>ÞÊÀi`ÕViʜÀÊ`ˆÃ>œÜÊޜÕÀÊ

ʈvÊÌ iʘ>“iʜÀÊ/ Ê`œÊ˜œÌʓ>ÌV ÊÌ iÊÜVˆ>ÊÃiVÕÀˆÌÞÊV>À`°Ê >ÊÌ iÊ-œVˆ> -iVÕÀˆÌÞÊ
`“ˆ˜ˆÃÌÀ>̈œ˜Ê>ÌÊ£‡nää‡ÇÇӇ£Ó£Î Yes. œÊÌœÊ ˆ˜iÊÓ° No. STOP, your child is not eligible for this credit. Yes. STOP, ޜÕÀÊV ˆ`ʈÃÊÊÊÊ ˜œÌÊiˆ}ˆLiÊvœÀÊÌ ˆÃÊVÀi`ˆÌ°Ê No. œÊÌœÊ ˆ˜iÊ£L° $ .00 ÊfÊ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 $ .00 9 For payment purposes, was the />Ý«>ÞiÀÊ`i˜ÌˆvˆV>̈œ˜Ê ՓLiÀÊ­/ ® 1b Was the child under age 4 as of 09/30/2025? Yes. œÊÌœÊ ˆ˜iÊÓ° No. STOP, your child is not eligible for this credit. Yes. STOP, ޜÕÀÊV ˆ`ʈÃÊÊÊÊ ˜œÌÊiˆ}ˆLiÊvœÀÊÌ ˆÃÊVÀi`ˆÌ°Ê No. œÊÌœÊ ˆ˜iÊ£L° Yes. œÊÌœÊ ˆ˜iÊÓ° No. STOP, your child is not eligible for this credit. Yes. STOP, ޜÕÀÊV ˆ`ʈÃÊÊÊÊ ˜œÌÊiˆ}ˆLiÊvœÀÊÌ ˆÃÊVÀi`ˆÌ°Ê No. œÊÌœÊ ˆ˜iÊ£L° (MMDDYYYY) 2 Child's name 3 Child's taxpayer identification number 4 Child's Date of Birth ˆÀÃÌʘ>“i /DVWQDPH ˆÀÃÌʘ>“i /DVWQDPH ˆÀÃÌʘ>“i /DVWQDPH (MMDDYYYY) (MMDDYYYY) Yes°Ê˜VÕ`iÊ«>ޓi˜ÌÃʓ>`iÊÊ vœÀÊV>ÀiÊvÀœ“ÊÊä£Éä£ÉÓäÓ5Ê Ì ÀœÕ} Ê£ÓÉΣÉÓäÓ5 No. ˜VÕ`iÊ«>ޓi˜ÌÃʓ>`iÊÊ vœÀÊV>ÀiÊvÀœ“Êä£Éä£ÉÓäÓ5Ê Ì ÀœÕ} ÊnÉΣÉÓäÓ5 ÊÊYes.ʘVÕ`iÊ«>ޓi˜ÌÃʓ>`iÊ vœÀÊV>ÀiÊvÀœ“ÊÊä£Éä£ÉÓäÓ5Ê Ì ÀœÕ} Ê£ÓÉΣÉÓäÓ5 No°Ê˜VÕ`iÊ«>ޓi˜ÌÃʓ>`iÊÊ vœÀÊV>ÀiÊvÀœ“Êä£Éä£ÉÓäÓ5Ê Ì ÀœÕ} ÊÊnÉΣÉÓäÓ5 Yes.ʘVÕ`iÊ«>ޓi˜ÌÃʓ>`iÊÊ vœÀÊV>ÀiÊvÀœ“ÊÊä£Éä£ÉÓäÓ5Ê Ì ÀœÕ} Ê£ÓÉΣÉÓäÓ5 No.ʘVÕ`iÊ«>ޓi˜ÌÃʓ>`iÊ ÊÊvœÀÊV>ÀiÊvÀœ“Êä£Éä£ÉÓäÓ5 Ì ÀœÕ} ÊnÉΣÉÓäÓ5 Is the child development facility operated by the federal government or by a private provider on federal property? -V i`ՏiÊ

Ê

ii«Ê

ˆ`Ê >ÀiÊ
vvœÀ`>LiÊ />ÝÊ Ài`ˆÌ Yes. No. Yes. No. Yes. No. License Number 11 7b $ $ 1 2 0 0 .00 $ 0 1 2 0 .00 2 0 0 .00 Revised 05/2025 œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> *25ELC0010000* child under age 3 as of 09/30/2025? $ 1 ÓäÓ5

,QVWUXFWLRQVIRU.HHS&KLOG&DUH$IIRUGDEOH7D[&UHGLW 6FKHGXOH(/&

You are not eligible to receive this credit if: £°Ê9œÕÊ`œÊ˜œÌÊV>ˆ“ÊÌ iÊiˆ}ˆLiÊV ˆ`Ê>ÃÊ>Ê`i«i˜`i˜Ìʜ˜ÊޜÕÀ vi`iÀ>ÊœÀÊ ˆÃÌÀˆVÌʈ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜ÊvœÀÊÌ e relevantÊÌ>Ý>LiÊÞi>ÀÆ Ó°Ê
Ê«iÀÜ˜ÊœÌ iÀÊÌ >˜ÊyouÊV>ˆ“i`ÊÌ iÊiˆ}ˆLiÊV ˆ`Ê>ÃÊ >Ê`i«i˜`i˜Ìʜ˜ÊtheirÊvi`iÀ>Ê>˜`Ê ˆÃÌÀˆVÌʈ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜ÃÊÊ vœÀÊÌ eÊÌ>Ý>LiÊÞi>ÀÆ Î°Ê/ iÊV ˆ`ÊÜ>ÃÊiˆ}ˆLiÊvœÀÊ>˜`ÊÀiViˆÛi`Ê ÃiÀۈViÃÊ«ÕÀÃÕ>˜ÌÊ̜Ê

>«ÌiÀÊ{]Ê/ˆÌiÊ{ʜvÊÊ `ÕÀˆ˜}ÊÌ iÊÌ>Ý>LiÊÞi>ÀÆ {°Ê
Ê«iÀÜ˜ÊœÌ iÀÊÌ >˜ÊÌ iÊÌ>Ý«>ÞiÀÊÀiViˆÛi`Ê>ÊVÀi`ˆÌÊ՘`iÀÊ

Ê

œ`iÊ{LJ£näÈ°£xÊvœÀÊÌ iÊÃ>“iÊÌ>Ý>LiÊÞi>ÀÊvœÀÊÌ iÊÃ>“iÊ iˆ}ˆLiÊV ˆ`Æ x°Ê/ iÊ«>ޓi˜ÌÃÊvœÀÊV ˆ`ÊV>ÀiÊÃiÀۈViÃÊvœÀÊÜ ˆV ÊޜÕÊÃiiŽÊ>ÊÌ>ÝÊ VÀi`ˆÌÊÜiÀiÊ«>ˆ`Ê̜Ê>˜Êi˜ÌˆÌÞʘœÌʏˆVi˜Ãi`ÊLÞÊÌ iÊ ˆÃÌÀˆVÌÊ̜ÊÊ œ«iÀ>ÌiÊ>ÊV ˆ`Ê`iÛiœ«“i˜ÌÊv>VˆˆÌÞ
(VOMFTT
PQFSBUFE
CZ
UIF
GFEFSBM
HPWFSONFOU
PS
CZ
B
QSJWBUF
QSPWJEFS
PO
GFEFSBM
QSPQFSUZ) Ê PS È°ÊYourÊ ˆÃÌÀˆVÌÊÌ>Ý>Liʈ˜Vœ“iÊvœÀÊÌ iÊÌ>Ý>LiÊÞi>À iÝVii`ÃÊÌ iÊ>“œÕ˜ÌÃÊvœÀÊÌ>Ý>LiÊÞi>ÀÊÓäÓ5\ >°ÊÊ-ˆ˜}iÊ>˜`Ê i>`ʜvÊ œÕÃi œ`\ÊÊf80]1ääÆ L° V° `° Eligible Expenses Married/Registered Domestic Partners Filing Jointly: $180,100; Married/Registered Domestic Partners Filing Separately on the same return: $180,100; Married/Registered Domestic Partners Filing Separately: $90,000 ÊDefinitions £° º ˆ}ˆLiÊV ˆ`»Ê“i>˜ÃÊ>Ê`i«i˜`i˜Ì who is V>ˆ“i`ÊLÞÊ> Ì>Ý«>ÞiÀÊand who has not reached the age of 4 years by September ÎäÌ ÊœvÊÌ iÊÌ>Ý>LiÊÞi>À° Ó° º ˆ}ˆLiÊV ˆ`ÊV>ÀiÊiÝ«i˜Ãiûʓi>˜ÃÊ«>ޓi˜ÌÃʓ>`i LÞÊ>ÊÌ>Ý«>ÞiÀÊ̜Ê>ʏˆVi˜Ãi`ÊV ˆ`Ê`iÛiœ«“i˜ÌÊv>VˆˆÌÞÊvœÀÊV ˆ`Ê V>ÀiÊÃiÀۈViÃʜvÊ>˜Êiˆ}ˆLiÊV ˆ`Ê`ÕÀˆ˜}ÊÌ iÊÌ>Ý>LiÊÞi>À.ÊItÊ`œiÃÊ ˜œÌʈ˜VÕ`iÊ>˜ÞÊ«>ޓi˜ÌÃÊvœÀÊV ˆ`ÊV>ÀiÊÃiÀۈViÃÊ«ÀœÛˆ`i`Ê>vÌiÀÊÊ
Õ}ÕÃÌÊΣÃÌʜvÊÌ iÊÌ>Ý>LiÊÞi>ÀʜvÊ>˜Êiˆ}ˆLiÊV ˆ`ÊÜ œÊ“iiÌÃÊÊ Ì iÊ>}iÊÀiµÕˆÀi“i˜ÌÃÊvœÀÊi˜Àœ“i˜ÌÊvœÀÊ*Ài‡ ° ΰ º

ˆ`Ê`iÛiœ«“i˜ÌÊv>VˆˆÌ޻ʓi>˜ÃÊ>ÊVi˜ÌiÀ]Ê œ“i]ʜÀ œÌ iÀÊÃÌÀÕVÌÕÀiÊÌ >ÌÊ«ÀœÛˆ`iÃÊV>ÀiÊ>˜`ÊœÌ iÀÊÃiÀۈViÃ]Ê ÃÕ«iÀۈȜ˜]Ê>˜`Ê}Ո`>˜ViÊvœÀÊV ˆ`Ài˜]ʈ˜v>˜ÌÃ]Ê>˜`Ê̜``iÀÃʜ˜ >ÊÀi}Տ>ÀÊL>ÈÃ. It must be MJDFOTFE tP operate as a childcare development GBDJMJUZ JO UIF %JTUSiDU VOMFTT PQFSBUFE CZ UIF GFEFSBM government PS CZ B QSJWBUF QSPWJEFS PO GFEFSBM QSPQFSUZÊÊ"

ˆ`Ê development v>VˆˆÌÞ"Ê`œiÃʘœÌʈ˜VÕ`iÊ>Ê«ÕLˆVʜÀÊ«ÀˆÛ>ÌiÊii“i˜Ì>ÀÞÊ «ÕÀÃÕ>˜ÌÊ̜ÊÌ iÊ*Ài‡ Ê
VÌʜvÊÓään° {° />Ý«>ÞiÀÊ`i˜ÌˆvˆV>̈œ˜Ê ՓLiÀÊ­/ ®Ê“i>˜ÃÊ>ÊÛ>ˆ` vi`iÀ>Êi“«œÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­  ®, an individual taxpayer identification number (ITIN) ˆÃÃÕi`ÊLÞÊÌ iÊ,-ÆÊor a valid social siVÕÀˆÌÞʘՓLiÀʈÃÃÕi`ÊLÞÊÌ iÊ-œVˆ>Ê-iVÕÀˆÌÞÊ
`“ˆ˜ˆÃÌÀ>̈œ˜° ÃÕLÈ`ˆâi`ÊV ˆ`ÊV>ÀiÊ Ì iÊ ° °Ê œ`i]Ê 1. Eligible expenses are limited to the amounts paid to a licensed child development facility for child care services of the eligible child. 2. Child support payments are not qualified expenses, even if intended to be used to pay for child care services. 3. Child care expenses that are paid for upfront by a taxpayer but then reimbursed by a state social service agency are not eligible expenses. 4. Expenses do not include food, lodging, clothing or entertainment, even if provided for eligible child. Line by Line Instructions for Child 1, 2 and 3: Line 1a: Is the eligible child a recipient of the District’s subsidized child care program? If yes, your child does not qualify for the credit. If no, continue to Line 1b. Line 1b: The child must be under the age of 4 as of 9/30/25. If under age 4, continue to Line 2. If age 4 or over, your child does not qualify for this credit. Line 2: Enter your eligible child’s first and last name. Line 3: Enter your eligible child’s tax identification number. Ensure the name and tax identification number entered match the eligible child’s social security card. Line 4: Enter your eligible child’s date of birth in MMDDYYYY format. Line 5: Enter the eligible child’s relationship to you. For example: son, daughter, grandchild, niece, nephew, eligible foster child. Line 6: Enter the name of the Child Development Facility. Line 7a: Enter the Child Development Facility License Number. Line 7b: Check the applicable box. Line 8: Enter the TIN of the Child Development Facility. Line 9: Enter the date range of the payments made during the taxable year. This date cannot be a date after August 31st of the taxable year if eligible child meets age requirements for enrollment in Pre-K according to DC Code § 38-273.02(a). For more information visit dcps.dc.gov/ece. Line 10: Enter the total amount actually paid in 2025 but do not include any payments for child care services provided after August 31, 2025 of the taxable year if your eligible child meets the age requirements for enrollment in Pre-K according to DC Code § 38-273.02(a). Line 11: The maximum credit amount that can be claimed per child is $1,200. Line 12: Enter the lesser of Line 10 or Line 11 and enter here and on Schedule U, Part 1B, Line 2. or ÃiVœ˜`>ÀÞÊÃV œœÊi˜}>}i`ʈ˜Êi}>ÞÊÀiµÕˆÀi`Êi`ÕV>̈œ˜>Ê>˜`ÊÀi- l>Ìi`Êv՘V̈œ˜ÃʜÀÊ>Ê«Ài‡Žˆ˜`iÀ}>ÀÌi˜Êi`ÕV>̈œ˜Ê«Àœ}À>“ʏˆVi˜Ãi`



 55 55 55 53 55 * 5040

* œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> ,iۈÃi`Ê12ÉÓäÓx " 
Ê1- Ê" 9ÊÊ6i˜`œÀ i˜`œÀÊ

 ›ääää ›ääää 6i˜`œÀÊ ›ääää 6i˜`œÀ  ›ääää ,PSRUWDQW  *Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž°ÊʈiÊÜˆÌ ÊޜÕÀÊ ‡{ä° z z z >ˆˆ˜}Ê>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li®

ˆÌÞÊ -Ì>ÌiÊ <ˆ«Ê œ`iʳ{ 9œÕÀÊwÀÃÌʘ>“iÊ °°Ê

>ÃÌʘ>“i -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊwÀÃÌʘ>“iÊ °°Ê

>ÃÌʘ>“i andÊ >ÌiʜvÊ ˆÀÌ Ê­

9999® -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊ/ andÊ >ÌiʜvÊ ˆÀÌ Ê­

9999® 9œÕÀÊÌ>Ý«>ÞiÀʈ`i˜ÌˆwV>̈œ˜Ê˜Õ“LiÀÊ­/ ® *iÀܘ>Êˆ˜vœÀ“>̈œ˜Ê 9œÕÀÊ`>Þ̈“iÊÌii« œ˜iʘՓLiÀ *
,/ÊÊÊ œÊޜÕÊ >ÛiʵÕ>ˆvވ˜}Ê i>Ì ÊVœÛiÀ>}i¶

ˆ`ÊޜÕÊ>˜`]ʈvÊ>««ˆV>Li]Ê>Ê“i“LiÀÃʜvÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞÊ >ÛiʵÕ>ˆvވ˜}Ê i>Ì ÊVœÛiÀ>}iÊvœÀÊiÛiÀÞÊ “œ˜Ì ʈ˜ÊÓäÓ5¶ £ Î *
,/ÊÊÊ œÊޜÕÊ >ÛiÊ>˜ÊiÝi“«Ìˆœ˜¶ Ó

œÊޜÕÊ>vvˆÀ“Ê՘`iÀÊÌ iÊ«i˜>ÌˆiÃʜvÊ«iÀÕÀÞÊÌ >ÌÊޜÕʜÀÊ>˜Þʓi“LiÀʜvÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞÊ >VŽi`ʵÕ>ˆvވ˜}Ê i>Ì ÊVœÛiÀ>}iʈ˜ÊÓäÓxʜ˜ÊÌ iÊL>ÈÃʜvÊ>ÊȘViÀiÞÊ i`ÊÀiˆ}ˆœÕÃÊLiˆivÊ`ÕÀˆ˜}ÊÌ iÊi˜ÌˆÀiÊÌ>Ý>LiÊÞi>À¶ ÊÊÊÊÊ9iðÊÊ9œÕʓÕÃÌÊVœ“«iÌiÊ*>ÀÌÊÊLivœÀiÊVœ“«ï˜}Ê*>ÀÌÊ6° ÊÊÊÊÊ œ°Ê
ÀiÊޜÕÊV>ˆ“ˆ˜}Ê>˜ÊiÝi“«Ìˆœ˜Ê­œÌ iÀÊÌ >˜Ê>ÊȘViÀiÞÊ i`ÊÀiˆ}ˆœÕÃÊLiˆiv®ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓœ˜Ì ÊvœÀÊÓäÓx vœÀÊޜÕÀÃivʜÀÊ>˜Þʓi“LiÀÊ œvÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ¶ ÊÊÊÊÊ9iðÊÊ9œÕʓÕÃÌÊVœ“«iÌiÊ*>ÀÌÊÊLivœÀiÊVœ“«ï˜}Ê*>ÀÌÊ6° ÊÊÊÊÊ œ°Ê { x
vÌiÀÊ>˜ÃÜiÀˆ˜}ʵÕiÃ̈œ˜ÃÊxʇÊÈ]ÊVœ“«iÌiÊ*>ÀÌÊ6Ê̜Ê`iÌiÀ“ˆ˜iÊÌ iÊ>“œÕ˜ÌÊ̜Êi˜ÌiÀʜ˜Ê ˆ˜iÊÓxʜvÊޜÕÀÊ ‡{ä°ÊÊvÊޜÕÊ>˜ÃÜiÀi`ÊÞiÃÊÌœÊ µÕiÃ̈œ˜ÊxʜÀÊÈ]ÊޜÕʓÕÃÌÊ>ÃœÊVœ“«iÌiÊ*>ÀÌÊ°ÊÊÊ È vÊޜÕÊ>˜ÃÜiÀi`Ê9iÃÊ̜Ê>˜ÞʜvʵÕiÃ̈œ˜ÃÊÓʇÊ{]Êi˜ÌiÀÊâiÀœÊœ˜Ê ˆ˜iÊÓx œvÊޜÕÀÊ ‡{ä°ÊÊÊvʘœÌ]ÊVœ˜Ìˆ˜ÕiÊLÞÊ>˜ÃÜiÀˆ˜}ʵÕiÃ̈œ˜ÃÊxʇÊÈ°Ê

>˜Êܓiœ˜iÊiÃiÊV>ˆ“ÊޜÕÊ>ÃÊ>Ê`i«i˜`i˜Ìʜ˜ÊÌ iˆÀÊvi`iÀ>Êˆ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜ÊvœÀÊÓäÓx¶ ÊÊÊÊÊ9iðÊÊ*ÀœVii`Ê̜Ê*>ÀÌÊ6° -iiʈ˜ÃÌÀÕV̈œ˜Ã° ÊÊÊ œ° 7>ÃÊޜÕÀÊvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊLiœÜÊÌ iÊ>««ˆV>LiÊvˆˆ˜}ÊÌ Àià œ`ÊvœÀÊޜÕÀÊ ‡{äÊvˆˆ˜}ÊÃÌ>ÌÕÃÊvœÀÊÓäÓx¶Ê-iiʈ˜ÃÌÀÕV̈œ˜Ã° ÊÊÊÊÊ9iðÊÊ*ÀœVii`Ê̜Ê*>ÀÌÊ6° -iiʈ˜ÃÌÀÕV̈œ˜Ã° ÊÊÊÊÊ œ° 7>ÃÊޜÕÀÊvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊÀi«œÀÌi`ʜ˜ÊޜÕÀÊ ‡{ä]Ê ˆ˜iÊ{ vœÀÊÓäÓxÊiµÕ>Ê̜ʜÀʏiÃÃÊÌ >˜ÊfÎ{]Ç{Î? ÊÊÊÊÊ9iðÊÊ*ÀœVii`Ê̜Ê*>ÀÌÊ6° -iiʈ˜ÃÌÀÕV̈œ˜Ã° ÊÊÊÊÊ œ° 9iðÊÊ-/"*°ÊÊ9œÕÊ`œÊ˜œÌʜÜiÊ>Ê i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊ«>ޓi˜ÌÊ>˜`Ê`œÊ˜œÌʘii`Ê̜ÊVœ“«iÌiÊ>Ê-V i`ՏiÊ-,°Ê­ ˜ÌiÀÊâiÀœÊ œ˜Ê ˆ˜iÊÓxʜvÊޜÕÀÊ ‡{ä® œ°ÊÊÊvÊޜÕÊ>˜ÃÜiÀi`Ê œ]ÊVœ“«iÌiÊ*>ÀÌÊ°Ê ÓäÓ5ÊÊÊ- 

1

Ê-,ÊÊ

Êi>Ì Ê >ÀiÊ - >Ài`Ê,i뜘ÈLˆˆÌÞÊ

z z z Enter your last name Enter your taxpayer identification number (TIN) - 

1

Ê-,ÊÊÊ*
 ÊÓ * 5 

* *
,/ÊÊÊ7 >ÌÊVœÛiÀ>}iÊiÝi“«Ìˆœ˜ÃÊ>ÀiÊޜÕÊV>ˆ“ˆ˜}ÊvœÀʓi“LiÀÃʜvÊޜÕÀÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊ v>“ˆÞÊ>˜`ÊvœÀÊ œÜʓ>˜Þʓœ˜Ì öÊ6HHLQVWUXFWLRQVIRUH[HPSWLRQW\SH V  >“iʜvʘ`ˆÛˆ`Õ> />Ý«>ÞiÀÊ`i˜ÌˆvˆV>̈œ˜Ê ՓLiÀÊ­/ ®

Ýi“«Ìˆœ˜ /Þ«i ՓLiÀ œvÊ Ýi“«ÌÊ œ˜Ì ÃÊ

>ˆ“i` ÊÇ ˆÀÃÌʘ>“iÊ>˜`Ê °°Ê

>ÃÌʘ>“i Ên ˆÀÃÌʘ>“iÊ>˜`Ê °°Ê

>ÃÌʘ>“i ™ ˆÀÃÌʘ>“iÊ>˜`Ê °°Ê

>ÃÌʘ>“i £ä ˆÀÃÌʘ>“iÊ>˜`Ê °°Ê

>ÃÌʘ>“i ££ ˆÀÃÌʘ>“iÊ>˜`Ê °°Ê

>ÃÌʘ>“i £Ó ˆÀÃÌʘ>“iÊ>˜`Ê °°Ê

>ÃÌʘ>“i *
,/Ê6ÊÊ œ“«iÌiÊÌ iÊ>««ˆV>LiÊܜÀŽÃ iiÌÃÊLivœÀiÊVœ“«ï˜}Ê*>ÀÌÊ6° £{ÊÊÊ ˜ÌiÀÊÌ iÊ«iÀVi˜Ì>}iʈ˜Vœ“iÊ>“œÕ˜ÌÊ­ÃiiÊ7œÀŽÃ iiÌÊ ‡£]Ê ˆ˜iÊ{ʜÀÊ7œÀŽÃ iiÌÊ ‡Ó]Ê ˆ˜iÊ£{®°°°°°°° £xÊ ˜ÌiÀÊÌ iʏ>À}iÀʜvÊ ˆ˜iÊ£ÎʜÀÊ ˆ˜iÊ£{Ê­vÊ ˆ˜iÃÊ£ÎÊ>˜`Ê£{Ê>ÀiÊÌ iÊÃ>“i]Êi˜ÌiÀÊÌ >ÌʘՓLiÀ°®°°°°°°°°° £ÈÊ ˜ÌiÀÊÌ iÊ ˆÃÌÀˆVÌÊ
ÛiÀ>}iÊ Àœ˜âiÊ*>˜Ê*Ài“ˆÕ“Ê­ÃiiÊ7œÀŽÃ iiÌÊ ‡£]Ê ˆ˜iÊÓʜÀÊ7œÀŽÃ iiÌÊ ‡Ó]Ê

ˆ˜iÊÓ®°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°° £ÇÊÊÊ ˜ÌiÀÊÌ iÊÓ>iÀʜvÊ ˆ˜iÊ£xʜÀÊ ˆ˜iÊ£ÈÊ iÀiÊ>˜`ʜ˜Ê ‡{ä]Ê ˆ˜iÊÓxÊ°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°Ê £Î fÊ °ää £xÊÊfÊ °ää °ää °ää £ÎÊÊÊ ˜ÌiÀÊv>ÌÊ`œ>ÀÊ>“œÕ˜ÌÊ­ÃiiÊ7œÀŽÃ iiÌÊ
‡£]Ê ˆ˜iÊxʜÀÊ7œÀŽÃ iiÌÊ
‡Ó]Ê ˆ˜iÊÇ®°°°°°°°°°°°°°°°°°°°°°°°°°°°°° £ÈÊÊfÊ £ÇÊÊfÊ °ää £{ÊÊfÊ Round cents to nearest dollar.

 

   55  £° £° Տ̈«ÞÊfÇ9xÊvœÀÊi>V ʓi“LiÀʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞÊÜ œÊÜ>ÃÊ>Ìʏi>ÃÌÊ£nÊÞi>ÀÃʜ` >ÃʜvÊ iVi“LiÀÊΣ]ÊÓäÓx° Ó° Տ̈«Þ fÎ9Ç°xä vœÀÊi>V ʓi“LiÀʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞÊÜ œÊÜ>ÃÊ՘`iÀÊÌ iÊ>}iʜv £nÊÞi>ÀÃʜ`Ê>ÃʜvÊ iVi“LiÀÊΣ]ÊÓäÓx° ΰ
``Ê ˆ˜iÃÊ£Ê>˜`ÊÓ° {° >݈“Õ“Êv>ÌÊ`œ>ÀÊ>“œÕ˜ÌÊvœÀÊÓäÓx° x° ˜ÌiÀÊÌ iÊÓ>iÀʜvÊ ˆ˜iÃÊÊÎʜÀÊ{ÊÊ iÀiÊ>˜`ʜ˜Ê-V i`ՏiÊ-,]Ê*>ÀÌÊ6]Ê ˆ˜iʣΰÊÊ­*ÀœVii`Ê̜Ê7œÀŽÃ iiÌÊ ‡£® Ó° ΰ œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> ÊÊÊ

Êi>Ì Ê >ÀiÊ- >Ài`Ê,i뜘ÈLˆˆÌÞÊ7œÀŽÃ iiÌà ,PSRUWDQW 

*Ê",Ê9"1,Ê, ", -°ÊÊ

"Ê "/Ê

°
° >ÌÊ œ>ÀÊ
“œÕ˜ÌÊ >VՏ>̈œ˜ 7œÀŽÃ iiÌÊ
‡£Ê­ œÊiÝi“«Ìˆœ˜ÃÊV>ˆ“i`® 7œÀŽÃ iiÌÊ
‡£Ê‡Ê œ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʈvÊޜÕÊ>ÀiʘœÌÊV>ˆ“ˆ˜}Ê>˜ÞÊiÝi“«Ìˆœ˜ÃÊvœÀÊ>˜Þʓœ˜Ì ÊvœÀÊ>˜Þʓi“LiÀʜvÊޜÕÀÊ i>Ì ÊV>ÀiÊ Ã >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ°ÊÊ­-iiʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊ>Û>ˆ>LiÊiÝi“«Ìˆœ˜ÃÊ>˜`ÊÜ œÊˆÃʈ˜VÕ`i`ʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ°® {° x° fÓ]Înx°ää 7œÀŽÃ iiÌÊ
‡ÓÊ­ Ýi“«Ìˆœ˜ÃÊV>ˆ“i`ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓœ˜Ì ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓi“LiÀʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ® 7œÀŽÃ iiÌÊ
‡ÓÊ‡Ê œ“«iÌiÊÌ iʓœ˜Ì ÞÊVœÕ“˜ÃÊLÞÊ«>Vˆ˜}Ê>˜Ê¸8¸Êˆ˜Êi>V ʓœ˜Ì Ê̜ÊÀi«ÀiÃi˜ÌÊ>˜Þʓi“LiÀʜvÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`Ê Ài뜘ÈLˆˆÌÞÊv>“ˆÞÊÌ >ÌÊ`ˆ`ʘœÌÊ >Ûiʓˆ˜ˆ“Õ“ÊiÃÃi˜Ìˆ>ÊVœÛiÀ>}iʜÀÊ>ÊVœÛiÀ>}iÊiÝi“«Ìˆœ˜°ÊvÊޜÕÊ>ÀiÊV>ˆ“ˆ˜}Ê>˜ÊiÝi“«Ìˆœ˜ÊvœÀÊÌ iÊ i˜ÌˆÀiÊÞi>ÀÊvœÀÊޜÕÀÃivÊ>˜`ÊiÛiÀÞʓi“LiÀʜvÊޜÕÀÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ]ÊޜÕÊ`œÊ˜œÌÊVœ“«iÌiÊÌ ˆÃÊÃiV̈œ˜°Ê"˜ÞÊVœ“«iÌiÊÌ ˆÃÊ ÜœÀŽÃ iiÌʈvÊޜÕÊ>ÀiÊV>ˆ“ˆ˜}Ê>˜ÊiÝi“«Ìˆœ˜ÊvœÀÊ>˜Þʓœ˜Ì ÊvœÀÊ>˜Þʓi“LiÀʈ˜ÊޜÕÀÊ i>Ì V>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞʜÀʈvÊޜÕʜÀÊ>Ê “i“LiÀʜvÊޜÕÀÊv>“ˆÞÊ >`ʜ˜ÞÊ«>À̈>ÊÞi>Àʓˆ˜ˆ“Õ“ÊiÃÃi˜Ìˆ>ÊVœÛiÀ>}i]ÊiÛi˜ÊˆvʘœÊœÌ iÀÊiÝi“«Ìˆœ˜ÊˆÃÊV>ˆ“i`°Ê >“i >˜ÊÊÊiLÊÊÊÊ >ÀÊÊÊ
«ÀÊÊÊÊ >ÞÊÊÊ՘ÊÊÊÊՏÊÊÊÊÊ
Õ}ÊÊÊ-i«ÊÊÊ"VÌÊÊÊÊ œÛÊÊÊ iV Ó° /œÌ>Ê˜Õ“LiÀʜvÊ8¿Ãʈ˜Ê>ʓœ˜Ì ÊvœÀʓi“LiÀÃÊ>}iÊ£n œÀʜ`iÀÊ>ÃʜvÊ iVi“LiÀÊΣ]ÊÓäÓx° ΰ "˜i‡ >vÊÌ iʘՓLiÀʜvÊ8¿Ãʈ˜Ê>ʓœ˜Ì ÊvœÀʓi“LiÀà ՘`iÀÊÌ iÊ>}iʜvÊ£nÊÞi>ÀÃʜ`Ê>ÃʜvÊ iVi“LiÀÊΣ]ÊÓäÓx° {°
``Ê ˆ˜iÃÊÓÊ>˜`ÊÎÊvœÀÊi>V ʓœ˜Ì ° x° Տ̈«ÞÊ ˆ˜iÊ{ÊLÞÊfÇ9xÊvœÀÊi>V ʓœ˜Ì °ÊÊvÊfÓÎn5ʜÀ “œÀi]Êi˜ÌiÀÊfÓÎn5° È° /œÌ>ÊÌ iÊ>“œÕ˜ÌÃÊvœÀÊi>V ʓœ˜Ì ʜ˜Ê ˆ˜iÊx° Ç°

ˆÛˆ`iÊ ˆ˜iÊÈÊLÞÊ£Ó°ä°ÊÊ/ ˆÃʈÃÊޜÕÀÊv>ÌÊ`œ>ÀÊ>“œÕ˜Ì°

˜ÌiÀÊÌ ˆÃÊ>“œÕ˜Ìʜ˜Ê-V i`ՏiÊ-,]Ê*>ÀÌÊ6]Ê ˆ˜iʣΰ ­*ÀœVii`Ê̜Ê7œÀŽÃ iiÌÊ ‡£® f f ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää Round cents to nearest dollar. If amount is zero, leave line blank° £>°Ê/œÌ>Ê˜Õ“LiÀʜvÊ8¿Ãʈ˜Ê>ʓœ˜Ì °ÊÊvÊxʜÀʓœÀi]Êi˜ÌiÀÊx°Ê £L°Ê
``ÊÌ iÊ̜Ì>Ê˜Õ“LiÀÊÀi«œÀÌi`ʈ˜Ê ˆ˜iÊ£>Ê iÀi ÊÊÊÊÊÊ >˜`ʜ˜Ê7œÀŽÃ iiÌÊ ‡Ó]Ê ˆ˜iÊ£° z z z ÓäÓ5

  58   56  £° £°Ê ˜ÌiÀÊޜÕÀÊvi`iÀ>Ê>`ÕÃÌi`Ê}ÀœÃÃʈ˜Vœ“iÊÀi«œÀÌi`ʜ˜ÊޜÕÀÊ ‡{ä]Ê ˆ˜iÊ{ÊvœÀÊÓäÓx° Ó° ˜ÌiÀÊÌ iÊDC filing thresholdÊ>“œÕ˜ÌÊÌ >ÌÊVœÀÀi뜘`ÃÊ̜ÊÌ iÊvˆˆ˜}ÊÃÌ>ÌÕÃÊÌ >ÌÊޜÕÊV>ˆ“i`ʜ˜ÊޜÕÀÊ ‡{ä°Ê­-ii -,ʈ˜ÃÌÀÕV̈œ˜ÃÊvœÀÊ>“œÕ˜Ìî° ΰ -ÕLÌÀ>VÌÊ ˆ˜iÊÓÊvÀœ“Ê ˆ˜iÊ1° {° Տ̈«ÞÊ ˆ˜iÊÎÊLÞÊÓ°x¯Ê­ä°äÓx®°ÊÊ/ ˆÃʈÃÊޜÕÀÊ«iÀVi˜Ì>}iʜvʈ˜Vœ“iÊ>“œÕ˜Ì°ÊÊ ˜ÌiÀÊÌ ˆÃÊ>“œÕ˜Ìʜ˜Ê-V i`Տi -,]Ê*>ÀÌÊ6]Ê ˆ˜iÊ£{ÊvÊޜÕÊVœ“«iÌi`Ê7œÀŽÃ iiÌÊ
‡£]Ê>˜`Ê«ÀœVii`Ê̜Ê7œÀŽÃ iiÌÊ ‡£°ÊÊÊÊ­vÊޜÕÊÜiÀiÊÀiµÕˆÀi` ̜ÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ
‡Ó]ÊޜÕʓÕÃÌÊ«ÀœVii`Ê̜Ê7œÀŽÃ iiÌÊ ‡ÓÊ̜ÊV>VՏ>ÌiÊޜÕÀÊ«iÀVi˜Ì>}iʜvʈ˜Vœ“iÊ>“œÕ˜Ì°

œÊ˜œÌÊi˜ÌiÀÊÌ ˆÃÊ>“œÕ˜Ìʜ˜Ê-V i`ՏiÊ-,]Ê*>ÀÌÊ6]Ê ˆ˜iÊ£{° Ó° ΰ œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> ÓäÓ5 ÊÊ

Êi>Ì Ê >ÀiÊ- >Ài`Ê,i뜘ÈLˆˆÌÞÊ7œÀŽÃ iiÌà ,PSRUWDQW 

*Ê",Ê9"1,Ê, ", -°ÊÊ

"Ê "/Ê

° ° *iÀVi˜Ì>}iʘVœ“iÊ >VՏ>̈œ˜ 7œÀŽÃ iiÌÊ ‡£ 7œÀŽÃ iiÌÊ ‡£Ê‡Ê œ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʈvÊޜÕÊVœ“«iÌi`ÊiˆÌ iÀÊ7œÀŽÃ iiÌÊ
‡£ÊœÀÊ7œÀŽÃ iiÌÊ
‡Ó°ÊÊÊÊvÊޜÕÊVœ“«iÌi`Ê7œÀŽÃ iiÌÊ
‡Ó]ÊޜÕʓÕÃÌÊ>ÃœÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ ‡Ó° 7œÀŽÃ iiÌÊ ‡ÓÊ­ Ýi“«Ìˆœ˜ÃÊV>ˆ“i`ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓœ˜Ì ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓi“LiÀʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ® 7œÀŽÃ iiÌÊ ‡ÓÊ‡Ê œ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʜ˜ÞʈvÊޜÕÊÜiÀiÊÀiµÕˆÀi`Ê̜ÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ
‡Ó°ÊÊ œÊ˜œÌÊVœ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʈvÊޜÕÊÊ Vœ“«iÌi`Ê7œÀŽÃ iiÌÊ
‡£°ÊÊIÊvÊÌ iÊ>“œÕ˜Ìʜ˜Ê ˆ˜iÊ£>ʜvÊ7œÀŽÃ iiÌÊ
‡ÓʈÃÊâiÀœÊvœÀÊ>˜Þʓœ˜Ì ]ʏi>ÛiÊ>ÊVœÕ“˜ÃʜvÊÌ ˆÃÊܜÀŽÃ iiÌÊ L>˜ŽÊvœÀÊÌ >Ìʓœ˜Ì °ÊÊ œÀÊi>V ʓœ˜Ì ]ÊޜÕʓÕÃÌÊ`iÌiÀ“ˆ˜iʈvÊÌ iÊ >“œÕ˜Ìʜ˜Ê ˆ˜iÊxʜvÊ7œÀŽÃ iiÌÊ
‡ÓʈÃʏiÃÃÊ Ì >˜ÊÌ iÊ>“œÕ˜Ìʜ˜Ê ˆ˜iÊ{ʜvÊ7œÀŽÃ iiÌÊ ‡£° ­>® ­L® ­V®

˜ÌiÀÊÌ iÊ>“œÕ˜ÌÊvÀœ“Ê 7œÀŽÃ iiÌÊ
‡Ó]Ê ˆ˜iÊx

˜ÌiÀÊÌ iʏ>À}iÀʜvÊ VœÕ“˜Ê­>®ÊœÀÊVœÕ“˜Ê­L®

˜ÌiÀÊÌ iÊ>“œÕ˜ÌÊvÀœ“Ê 7œÀŽÃ iiÌÊ ‡£]Ê ˆ˜iÊ{ £° >˜Õ>ÀÞ Ó° iLÀÕ>ÀÞ Î° >ÀV

{°
«Àˆ x° >Þ È° ՘i Ç° ÕÞ n°
Õ}ÕÃÌ ™° -i«Ìi“LiÀ £ä° "V̜LiÀ ££° œÛi“LiÀ £Ó°

iVi“LiÀ £Î°
``ÊÌ iÊ>“œÕ˜ÌÃʈ˜ÊVœÕ“˜Ê­V® £{°

ˆÛˆ`iÊ ˆ˜iÊ£ÎÊLÞÊ£Ó°äÊÊ ˜ÌiÀÊÌ ˆÃÊ>“œÕ˜Ìʜ˜Ê-V i`ՏiÊ-,]Ê*>ÀÌÊ6]Ê ˆ˜iÊ£{°ÊÊ­*ÀœVii`Ê̜Ê7œÀŽÃ iiÌÊ ‡Ó°® ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää Ê°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää Ê°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää Round cents to nearest dollar. If amount is zero, leave line blank° {° z z z

£° £° ˜ÌiÀÊÌ iʘՓLiÀʜvʓi“LiÀÃʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ° œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> ÓäÓ5ÊÊÊ

Êi>Ì Ê >ÀiÊ- >Ài`Ê,i뜘ÈLˆˆÌÞÊ7œÀŽÃ iiÌà ,PSRUWDQW 

*Ê",Ê9"1,Ê, ", -°ÊÊ

"Ê "/Ê

°

° ˆÃÌÀˆVÌÊ
ÛiÀ>}iÊ Àœ˜âiÊ*>˜Ê*Ài“ˆÕ“Ê >VՏ>̈œ˜ 7œÀŽÃ iiÌÊ ‡£Ê­ œÊiÝi“«Ìˆœ˜ÃÊV>ˆ“i`® 7œÀŽÃ iiÌÊ ‡£Ê‡Ê œ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʈvÊޜÕÊVœ“«iÌi`Ê7œÀŽÃ iiÌÊ
‡£°ÊÊvÊޜÕÊÜiÀiÊÀiµÕˆÀi`Ê̜ÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ
‡Ó]ÊޜÕÊ “ÕÃÌÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ ‡Ó°Ê­-iiʈ˜ÃÌÀÕV̈œ˜Ãʜ˜ÊÜ œÊˆÃʈ˜VÕ`i`ʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ°® Ó° 7œÀŽÃ iiÌÊ ‡ÓÊ­ Ýi“«Ìˆœ˜ÃÊV>ˆ“i`ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓœ˜Ì ÊvœÀÊ>Ìʏi>ÃÌʜ˜iʓi“LiÀʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ® 7œÀŽÃ iiÌÊ ‡ÓÊ‡Ê œ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʜ˜ÞʈvÊޜÕÊÜiÀiÊÀiµÕˆÀi`Ê̜ÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ
‡Ó°ÊvÊޜÕÊÜiÀiʘœÌÊÀiµÕˆÀi`ÊÌœÊ Vœ“«iÌiÊ7œÀŽÃ iiÌÊ
‡Ó]ÊVœ“«iÌiÊ7œÀŽÃ iiÌÊ ‡£°ÊÊ œÊ˜œÌÊVœ“«iÌiÊÌ ˆÃÊܜÀŽÃ iiÌʈvÊޜÕÊVœ“«iÌi`Ê7œÀŽÃ iiÌÊ
‡£°ÊÊ Ê­-iiʈ˜ÃÌÀÕV̈œ˜Ãʜ˜ÊÜ œÊˆÃʈ˜VÕ`i`ʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞÊv>“ˆÞ°® £° £° ˜ÌiÀÊÌ iÊ̜Ì>Ê˜Õ“LiÀÊÀi«œÀÌi`ʜ˜Ê7œÀŽÃ iiÌÊ
‡Ó]Ê ˆ˜iÊ£L° Ó°Ê ÕÌˆ«ÞÊ ˆ˜iÊ£ÊLÞÊÎ75. ˜ÌiÀÊÌ ˆÃÊ>“œÕ˜Ìʜ˜Ê-V i`ՏiÊ-,]Ê*>ÀÌÊ6]Ê ˆ˜iʣȰ Ó° ÊÊÊÊÊÊÊÊÊÊÊ°ää ÊÊÊÊÊÊÊÊÊÊÊ°ää Round cents to nearest dollar. If amount is zero, leave line blank° z z z Ó° ˜ÌiÀÊÌ iÊ>“œÕ˜ÌÊÌ >ÌÊVœÀÀi뜘`ÃÊ̜ÊÌ iʘՓLiÀʜvʓi“LiÀÃʈ˜ÊޜÕÀÊ i>Ì ÊV>ÀiÊà >Ài`ÊÀi뜘ÈLˆˆÌÞ v>“ˆÞ°

˜ÌiÀÊÌ ˆÃÊ>“œÕ˜Ìʜ˜Ê-V i`ՏiÊ-,]Ê*>ÀÌÊ6]Ê ˆ˜iʣȰ x £Ê«iÀܘʇ f4,494 x ÓÊ«iÀܘÃʇf8,987 x ÎÊ«iÀܘÃʇf13,481 x {Ê«iÀܘÃʇÊf17,975 x xʜÀʓœÀiÊ«iÀܘÃʇÊf22,468

INSTRUCTIONS FOR SCHEDULE HSR DC HEALTH CARE SHARED RESPONSIBILITY PAYMENT 6723 ,I\RXDQVZHUHG \HV WR3DUW,/LQH. '2127FRPSOHWHWKLV VFKHGXOH0DUNWKHRYDORQ/LQHRIWKH'DQGHQWHU]HUR  RQ /LQHRIWKH' DC law requires all residents to have health coverage, have an exemption, or pay a tax penalty on their D-40. DC enacted the law in response to the reduction of the federal individual responsibility payment and modeled it after the federal requirement. Beginning in 2020, all District residents must either: 1) Have qualifying health care coverage (see definition below) for yourself, your spouse/registered domestic partner ( if filing jointly or separate on the same return), and anyone you or your married/ registered domestic partner claim (or can claim) as a dependent; 2) Have a coverage exemption for yourself, your spouse/registered domestic partner ( if filing jointly or separate on the same return), and anyone you or your married/ registered domestic partner claim (or can claim) as a dependent; or 3) Make a health care shared responsibility payment. D-40 If you and, if applicable, all members of your shared re- sponsibility family (see definition below) had qualifying health care coverage for every month in 2025, fill in the oval on Page 1 of your D-40 and enter zero on Line 25 of your D-40. You do not need to complete Schedule HSR or make a shared responsibility payment. If you (and, if applicable, all members of your shared responsibility family) did not have qualifying health care coverage for every month in 2025, you must complete Schedule HSR to calculate your shared responsibility payment and/or to claim an exemption. Schedule HSR Part I - Complete Part I of the Schedule HSR. If you answer "yes" to question 1, mark the oval on Line 3 of your D-40 and enter zero on Line 25. If you answer "no" to question 1, you must complete Part II. Part II - If you answer " yes" to question 2, 3 or 4, skip Part III and continue to complete Part IV. Enter zero on Lines 13-17 of Part IV and on Line 25 of the D-40. If you answer "no" to questions 2-4, you must answer question 5-6 and complete Part III. Part III - Enter the name and taxpayer identification number (TIN) for each member of your shared responsibility family, the code for the exemption claimed and the number of exempt months claimed for each exemption type claimed. For a list of exemption codes, see the Exemption Chart. • If you are claiming one exemption type for the entire year, enter the applicable exemption code and "12" for the number of exempt months claimed for that member. • If you are claiming an exemption for less than 12 months, enter the applicable exemption code and the total number of months claimed for that exemption type for that member. • If you are claiming multiple exemption types for one member, list that member more than once and enter the exemption code and number of months claimed for each exemption type for that member.

A. Flat Dollar Amount Calculation Worksheets Worksheet A-1 Complete this worksheet if you are not claiming any ex- emptions for any month for any member of your shared responsibility family. Follow the line-by-line directions provided on the form. Enter the amount from Line 5 on Schedule HSR, Part IV, Line 13. Proceed to Worksheet B-1. Worksheet A-2 Complete this worksheet only if you are claiming an ex- emption, including maintaining partial-year minimum essential coverage, for any month for any member of your shared responsibility family. List the name of each member of your shared responsibility family in the provided row. Then, for each month, mark an "X" in the appropriate column listed for the member(s) of your shared responsibility family who did not have minimum essential coverage or a coverage exemption. For example, if your dependent "John" had a health care coverage only for the month of January and had no coverage exemptions for the remainder of the year, mark an "X" in each of the month columns February through December on the row associated with John's name. Line 1a: For each month, add the total number of "X's" in the column. The maximum number entered in any month's column is 5, even if that column includes more than 5 "X's". For example, if each of the 6 members of your shared responsibility family did not have health care coverage or a coverage exemption for January, you should enter "5" on Line 1 in the January column. 3DUW,9&RPSOHWH3DUW,9RIWKH6FKHGXOH+65WRFRPSXWH \RXUVKDUHGUHVSRQVLELOLW\SD\PHQW.<RXPXVWFRPSOHWH WKH ZRUNVKHHWV WR FRPSXWH \RXU VKDUHG UHVSRQVLELOLW\ SD\PHQW. ,I\RXFODLPHGDQH[HPSWLRQIRUDOOPHPEHUVRI \RXUVKDUHGUHVSRQVLELOLW\IDPLO\IRUHYHU\PRQWKRI22 HQWHU ]HUR RQ /LQHV 11 RI \RXU 6FKHGXOH +65. 7KH ZRUNVKHHWVFRQWDLQWKHIROORZLQJ

A )ODW'ROODU$PRXQWCDOFXODWLRQ /LQH

1. 2. &RPSOHWH:RUNVKHHW$1LIQRH[HPSWLRQV DUHFODLPHGE\DQ\RQHLQ\RXUVKDUHG UHVSRQVLELOLW\IDPLO\. &RPSOHWH:RUNVKHHW$2LIH[HPSWLRQV DUH claimed for at least one month for at least one member of your shared responsibility family. B. Percentage Income Amount Calculation (Line 14) 1. Complete Worksheet B-1. (If you completed worksheet A-2, you must also complete Worksheet B-2.) 2. Complete Worksheet B-2 if you claimed exemptions for at least one month for at least one member of your shared responsibility family. C. 'iVtrict AYerage %ron]e Plan Premium Calculation (Line 1) 1. 2. Complete Worksheet C-1 if no exemptions were claimed. Complete Worksheet C-2 if you claimed exemptions for at least one month for at least one member in your shared responsibility family.

$15,000 $30,000 $30,000 $22,500 $15,000 The applicable D-40 filing threshold amounts for 2025 are: Single Married/ Registered Domestic Partner filing jointly or separately on the same return Qualifying Widow(er) Head of Household Married filing separately NOTE: The IRS does not consider "blind" as an additional standard deduction. If you completed Worksheet A-1, enter the amount from Line 4 on Schedule HSR, Part IV, Line 14 and proceed to Worksheet C-1. If you completed Worksheet A-2, proceed to Worksheet B-2 to calculate your percentage of income amount. Worksheet B-2 Complete this worksheet only if you completed Worksheet A-2 (if you claimed exemptions for at least one month for at least one member of your shared responsibility family). Lines 1-12: For each month enter the amount from Worksheet A-2, Line 5 in column (a) and the amount from Worksheet B-1, Line 4 in column (b). In column (c), enter the larger of column (a) or (b). Line 13: Add together the amounts in column (c) and enter the result here. Line 14: Divide the total on Line 13 by 12. Enter this amount on Schedule HSR, Part IV, Line 14. Proceed to Worksheet C-2. Line 1b: After you have completed the step above for each month, add together the totals calculated for each month. Enter this sum on the provided space in the "Line 1b" box. For example, if you entered "5" in the -anuary column for Line 1a, "4" in the April column, and "0" in all other columns, enter "9" in the space provided in the "Line 1b" box. Line 2: Enter the total number of "X's" ̀ in each month that correspond to members age 18 or older as of December 31, 225. Line 3: Enter one-half the total number of "X's" ̀ in each month that correspond to members under the age of 18 as of December 31, 225. Line 4: Add Lines 2 and 3 for each month. Line 5: Multiply Line 4 by $795 for each month. If $2,385 or more, enter $2,385. Line 6: Total the amounts reported in each month's column on Line 5 and enter the result here. Line 7: Divide the amount reported on Line 6 by 12. This is your flat dollar amount. Enter this amount on Schedule HSR, Part IV, Line 13 and proceed to Worksheet B-1. B 3erFeQtDJe ,Qterest &DOFXODtLoQ Worksheets Worksheet B-1 Complete this worksheet if you completed either Worksheet A-1 or Worksheet A-2. If you completed Worksheet A-2, you must also complete Worksheet B-2. Follow the line-by-line directions provided on the form.

C. District $verage %ron]e 3lan 3rePiuP :orNsheet & &alculation :orNsheets • D& resiGent. For purposes of Schedule HSR, D& resident has the same meaning as resident defined on page 8 of the D-40 instruction booNlet. See D& 2fficial &ode † 4-0.04(4). (3art-year residents should claim an e[emption as a nonresident of the District for the month(s) during the ta[ year that they were not a D& resident.) • 6hareG resSonsiEility faPily. For purposes of Schedule HSR, shared responsibility family includes the following indiYiduals

o 7he ta[payer

o 7he ta[payer s spouse or registered domestic partner if they file a D-40 jointly or separately on the same return and o Any dependents that the ta[payer (or the ta[payer s spouseregistered domestic partner) claimed or could haYe claimed on their D-40. &omplete this worNsheet if you completed :orNsheet A-. Do not complete this worNsheet if you completed :orNsheet A- (if you claimed no e[emptions for any member of your shared responsibility family). Follow the line-by-line directions provided on the form. Enter the amount from Line 2 on Schedule HSR, Part IV, Line 16. :orNsheet C-2 &omplete this worNsheet if you completed Worksheet A-2. Do not complete this worksheet if you completed Worksheet A-1 (if you claimed exemptions for at least one month for at least one member of your shared responsibility family). Follow the line-by-line directions provided on the form. Enter the amount from Line 2 on Schedule HSR, Part IV, Line 16. Definitions • Qualifying health coverage. For purposes of Schedule HSR, qualifying health coverage means: o Minimum essential coverage as defined by section 5000A of the Internal Revenue Code of 1986 (26 U.S.C. § 5000A) and its implementing regulations, as that section and its implementing regulations were in effect on December 15, 2017; o The immigrant Children's Program; and o Health coverage provided under a multiple employer welfare arrangement; provided that the multiple employer welfare arrangement provided coverage in the District on December 15, 2017, or complies with federal law and regulations applicable to multiple employer welfare arrangements that were in place as of December 15, 2017. • Adjusted Gross Income (AGI). For purposes of Schedule HSR AGI is the federal AGI reported on Line 4 of your D-40 return. If you are filing a joint return or filing separately on the same return with your spouse or registered domestic partner, use the combined federal AGI reported on Line 4 of your D-40 return. If a member of your shared responsibility family (spouse or dependent) filed a separate return, the federal AGI reported by that member on their separate return does not need to be added to the federal AGI reported on your D-40 for the purposes of calculating the shared responsibility payment on your return. For additional information regarding qualifying coverage, contact DC Health Link at www.dchealthlink.com or at (855) 532-5465.

Exemptions Chart Exemption Type Exemption Code Affordability²<RXUHFHLYHGDQDIIRUGDELOLW\H[HPSWLRQFHUWLILFDWHIURPWKH+HDOWK %HQHILWV([FKDQJH$XWKRULW\)RULQIRUPDWLRQUHJDUGLQJWKHDIIRUGDELOLW\H[HPSWLRQ FRQWDFW'&+HDOWK/LQNDWZZZGFKHDOWKOLQNFRPRU   $ Short coverage gap²<RXZHQWZLWKRXWFRYHUDJHIRUOHVVWKDQFRQVHFXWLYHPRQWKV GXULQJWKH\HDU % Citizens living abroad and certain noncitizens²<RXZHUH

‡ $86FLWL]HQRUDUHVLGHQWDOLHQZKRZDVSK\VLFDOO\SUHVHQWLQDIRUHLJQ FRXQWU\ RUFRXQWULHVIRUDWOHDVWIXOOGD\VGXULQJDQ\SHULRGRIFRQVHFXWLYH PRQWKV

‡ $86FLWL]HQZKRZDVDERQDILGHUHVLGHQWRIDIRUHLJQFRXQWU\RUFRXQWULHVIRU DQXQLQWHUUXSWHGSHULRGWKDWLQFOXGHVWKHHQWLUHWD[\HDU

‡ $ERQDILGHUHVLGHQWRID86WHUULWRU\

‡ $UHVLGHQWDOLHQZKRZDVDFLWL]HQRUQDWLRQDORIDIRUHLJQFRXQWU\ZLWKZKLFKWKH 86KDVDQLQFRPHWD[WUHDW\ZLWKDQRQGLVFULPLQDWLRQFODXVHDQG\RXZHUHDERQD ILGHUHVLGHQWRIDIRUHLJQFRXQWU\IRUDQXQLQWHUUXSWHGSHULRGWKDWLQFOXGHVWKHHQWLUHWD[ \HDU

‡ 1RWODZIXOO\SUHVHQWLQWKH86DQGQRWD86FLWL]HQRU86QDWLRQDO)RUPRUH LQIRUPDWLRQDERXWZKRLVWUHDWHGDVODZIXOO\SUHVHQWLQWKH86IRUSXUSRVHVRIWKLV FRYHUDJHH[HPSWLRQYLVLWZZZ+HDOWK&DUHJRY RU ‡ $QRQUHVLGHQWDOLHQLQFOXGLQJ  DGXDOVWDWXVDOLHQLQWKHILUVW\HDURI86 UHVLGHQF\DQG  DQRQUHVLGHQWDOLHQRUGXDOVWDWXVDOLHQZKRHOHFWVWRILOHDMRLQWUHWXUQ ZLWKD86VSRXVH7KLVH[HPSWLRQGRHVQ WDSSO\LI\RXDUHDQRQUHVLGHQWDOLHQIRU EXWPHWFHUWDLQSUHVHQFHUHTXLUHPHQWVDQGHOHFWHGWREHWUHDWHGDVDUHVLGHQW DOLHQ)RUPRUHLQIRUPDWLRQVHH,563XE  & Members of a health care sharing ministry²<RXZHUHDPHPEHURIDKHDOWKFDUH VKDULQJPLQLVWU\ ' Members of Indian tribes²<RXZHUHHLWKHUDPHPEHURIDIHGHUDOO\UHFRJQL]HG,QGLDQ WULEHLQFOXGLQJDQ$ODVND1DWLYH&ODLPV6HWWOHPHQW$FW $1&6$ &RUSRUDWLRQ 6KDUHKROGHU UHJLRQDORUYLOODJH RU\RXZHUHRWKHUZLVHHOLJLEOHIRUVHUYLFHVWKURXJKDQ ,QGLDQKHDOWKFDUHSURYLGHURUWKH,QGLDQ+HDOWK6HUYLFH ( Incarceration²<RXZHUHLQDMDLOSULVRQRUVLPLODUSHQDOLQVWLWXWLRQRUFRUUHFWLRQDO IDFLOLW\DIWHUWKHGLVSRVLWLRQRIFKDUJHV ) General hardship²<RXUHFHLYHGDKDUGVKLSH[HPSWLRQFHUWLILFDWHIURPWKH+HDOWK %HQHILWV([FKDQJH$XWKRULW\ )RULQIRUPDWLRQUHJDUGLQJWKHKDUGVKLSH[HPSWLRQFRQWDFW '&+HDOWK/LQNDWZZZGFKHDOWKOLQNFRPRU   * Member of shared responsibility family born or adopted during the year²7KH PRQWKVEHIRUHDQGLQFOXGLQJWKHPRQWKWKDWDQLQGLYLGXDOZDVDGGHGWR\RXUVKDUHG UHVSRQVLELOLW\IDPLO\E\ELUWKRUDGRSWLRQ You should claim this exemption only if you also are claiming another exemption in Part III. + Member of shared responsibility family died during the year²7KHPRQWKVDIWHUWKH PRQWKWKDWDPHPEHURI\RXUVKDUHGUHVSRQVLELOLW\IDPLO\GLHGGXULQJWKH\HDU You should claim this exemption only if you also are claiming another exemption in Part III. + NonUesident of the District±<RXZHUHQRWDUHVLGHQWRIWKH'LVWULFWRI&ROXPELD , Sincerely Held Religious Belief²<RXODFNHGTXDOLI\LQJKHDOWKFRYHUDJHRQWKHEDVLV RIDVLQFHUHO\KHOGUHOLJLRXVEHOLHIGXULQJWKHHQWLUHWD[DEOH\HDU - DC Health Alliance±<RXZHUHHQUROOHGLQWKH'&+HDOWK$OOLDQFH3URJUDP .

Low income ±<RXUIHGHUDODGMXVWHGJURVVLQFRPHUHSRUWHGRQ\RXU'/LQH LVHTXDOWRRUEHORZWKHDPRXQWVWKDWFRUUHVSRQGWRWKHQXPEHURIPHPEHUVLQ \RXUVKDUHGUHVSRQVLELOLW\IDPLO\DQGWKHDJHRIWKHLQGLYLGXDOIRUZKLFKWKH H[HPSWLRQLVFODLPHG(If you qualify for this exemption, you may be eligible for Medicaid. Contact DC Health Link at (855) 532-5465 or www.dchealthlink.com or the Department of Health Care Finance at (202) 442- 5 or https://dhcf.dc.gov/service/medicaid or for more information.) If your AGI is equal to or below the following amounts, members age 21 or older as of 12/31/2025 are exempt: If your AGI is equal to or below the following amounts, members under age 21 as of 12/31/2025 are exempt: 3400 0000 $ 00 8200 Number of Shared Responsibility Family Members:    $ 100 $800  100 10100  8800 121 800    00 1 8000  1080000 1200  1202100 100 )RU(DFK $GGLWLRQDO 0HPEHUDGG  $1221000 182000 / A Religious Sect that is Conscientiously Opposed - If you are a member of a religious sect that is conscientiously opposed to accepting health benefits, including Social Security and Medicare, and need to claim an exemption from the Shared Responsibility Payment 0 0DLQWDLQHG0LQLPXP(VVHQWLDO&RYHUDJH Z

81 

 65 

‡nÎǙʘÕÀi`Ê-«œÕÃiÊ
œV>̈œ˜ Part I Should You File This Form? You must complete this part. 1 Enter the tax\HDUIor which \RX are filing this form. $QVZHUWKHIROORZLQJTXHVWLRQVIRUWKDW\HDU 3 Did (or will) DC use the joint overpayment to pay any of the following legally enforceable past-due debt(s) owed only by your spouse? * DC income tax * '& unemployment compensation * Child support '&WLFNHWVDQGWUDIILFSHQDOWLHV IHGHUDOLQFRPHWD[ * IHGHUDOVWXGHQWORDQV <HV*RWR/LQH No. Stop here. Do not file this form. You are not an injured spouse. 4 Are you legally obligated to pay this past-due amount? Yes. Stop here. Do not file this form. You are not an injured spouse.  Did you make and report payments, such as DC income tax withholding or estimated tax payments? Yes. Skip /ine  and go to Part II and complete the rest of this form. No. Go to /ine .  Did you have earned income, such as wages, salaries, or self-employment income? 



 *RYHUQPHQWRIWKH 'LVWULFWRI&ROXPELD z z z OFFICIAL USE ONLY Vendor ID# 000ä Information About the Tax Return for Which This Form Is Filed Enter the following information exactly as it is shown on the tax return for which you are filing this form. The spouse’s name and WD[SD\HULGHQWLILFDWLRQnumber shown first on that tax return must also be shown first below. )LUVWQDPHLQLWLDODQGODVWQDPHVKRZQILUVWRQWKHUHWXUQ 7D[SD\HULGHQWLILFDWLRQ number shown first If Injured Spouse, check here ڼ First name, initial, and last name shown second on the return 7D[SD\HULGHQWLILFDWLRQ number shown second If Injured Spouse, check here ڼ 0DLOLQJDGGUHVV QXPEHUVWUHHWDQGVXLWHDSDUWPHQWQXPEHULIDSSOLFDEOH

&LW\ 6WDWH =LS&RGH Yes. Go to 3DUW,,DQGFRPSOHWHWKHUHVWRIWKHIRUP 1R6WRSKHUH'RQRWILOHWKLVIRUP<RXDUHQRWDQLQMXUHGVSRXVH 1R Yes. Go to /ine 3. 1R6WRSKHUH'RQRWILOHWKLVIRUP<RXDUHQRWDQLQMXUHGVSRXVH 'LG\RX RUZLOO\RX ILOHDMRLQWUHWXUQRUare you PDUULHGUHJLVWHUHGGRPHVWLFSDUWQHUVILOLQJVHSDUDWHO\RQthe VDPHUHWXUQ" '& (Rev. 55)

Part II Allocation Between Spouses of Items on the Tax Return (See the separate DC Form 8379 instructions for Part II). Allocated Items (Column (a) must equal columns (b) + (c)) (a) Amount shown on joint return (b) Allocated to injured spouse (c) Allocated to other spouse  DC withholding tax paid Part I,,Signature. Under penalties of perjury, I declare that I have examined this form and any accompanying schedules or statements and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Keep a copy of this form for your records. Injured spouse’s signature Date Phone number Paid Preparer Use Only Print/Type preparer’s name Preparer’s signature Date Check if self-employed PTIN Firm’s name ڼ Firm’s EIN ڼ Firm’s address ڼ Phone no.  Federal adjusted gross income  Total additions to federal adjusted gross income

     Total subtractions from federal adjusted gross income   Deduction amount Fill in if loss 7RWDOUHIXQGDEOHDQGRUQRQUHIXQGDEOH FUHGLWV,H[FOXGLQJHDUQHGLQFRPH                          Fill in if loss Fill in if loss  7ax        '&WD[DEOHLQFRPH6XEWUDFW/LQHIURP/LQH     Add Line 7 and Line 8 DC adjusted gross income (subtract Line 10 from Line 9) DC estimated tax payments '& (Rev. 5-205) 



 '& 3age  Enter your TIN Enter your >ÃÌʘ>“i z z z

Instructions for DC-8379 Injured Spouse Allocation Purpose of form DC-8379 is filed by one spouse/registered domestic partner (the injured spouse/registered domestic partner) on a jointly filed tax return when the joint overpayment was (or is expected to be) applied (offset) to a past-due obligation of the other spouse/registered domestic partner. By filing DC-8379, the injured spouse/registered domestic partner may be able to get back their share of the joint refund. Are you an injured spouse? <RXPD\EHDQLQMXUHGVSRXVHLI\RX¿OHD MRLQWUHWXUQDQGDOORUSDUWRI\RXUSRUWLRQRI the overpayment is expected to be offset WR\RXUVSRXVH¶VOHJDOO\HQIRUFHDEOHSDVW GXH IHGHUDOincome WD[ VWDWH LQFRPH WD[ VWDWH XQHPSOR\PHQW FRPSHQVDWLRQ GHEWV FKLOGVXSSRUWRUDIHGHUDOQRQWD[GHEWVXFK DVD VWXGHQWORDQ A Notice of Offset for federal tax debts is issued by the Internal Revenue Service (IRS). All other Notice of Offsets are issued by the DC Office of Tax and Revenue (OTR) on behalf of the affected agency. Complete Part I to determine if you are an injured spouse/registered domestic partner. When to file You PXVW file the DC-8379 with your return in order to be eligible for this relief. You must submit your completed D-8379 prior to the offset occurring. Once funds have been offset, this relief may be unavailable. How to file You can file DC-8379 with your joint tax return. If you file DC-8379 with your joint return, attach it to your return. The processing of DC-8379 may be delayed if the form is incomplete when filed Specific Instructions Part I Complete Lines 1-6 to determine if you are an injured spouse. Part II Line 7. Enter your federal adjusted gross income. (From your D-40, Line 4) Line 8 . Enter total additions to federal adjusted gross income. (From your D-40, Line 7) Line 10. Enter total subtractions from federal adjusted gross income. (From your D-40, Line 15) Lines 11 – 17 $mounts come from your DC D-40 return. Part III Signature Make sure to sign and date your DC-8379 Form

ÓäÓ5 7 Enter Line 6 amount or the annualized income amount in each period (The 2nd period includes the 1st period amount, 3rd period includes the 1st and 2nd period amounts, the 4th period includes all period amounts). 8 DC withholding and estimated tax paid each period (The 2nd period includes the 1st period amount, 3rd period includes the 1st and 2nd period amounts, the 4th period includes all period amounts). 9 Underpayment each period (Line Ç minus Line n) 10 Underpayment interest factors 11 Line 9 multiplied by Line 10 12 Underpayment interest – Total of amounts from Line 11. (See instructions on reverse) Your First name, M.I., Last name Spouse’s/registered domestic partner’s First name, M.I., Last name Taxpayer Identification Number (TIN)

Spouse’s/registered domestic partner’s TIN Daytime telephone number A. Your tax liability on taxable income after deducting your District of Columbia (DC) withholding tax and applicable credits is less than $100, or B. You made periodic estimated tax payments and had amounts withheld as required and the total is equal to or more than 110% of your last year’s taxes or is at least 90% of your current year’s taxes. Note: You must have been a 12-month DC resident last year in order to use the prior year 110% exception. $ Government of the District of Columbia Check here if you are using the “Annualized Income” method. Revised 05/2025 Due date of Payments 1st Period 2nd Period 3rd Period 4th Period 04/15/25 06/15/25 09/15/25 01/15/26 .0175 .0265 .0351 .0259 Make check or money order payable to: DC Treasurer Computation of Underpayment Interest 1 $ 2 3 $ $ Note: If your income was not evenly divided over 4 periods, see instructions on the reverse of this form on the “Annualized Income” method. Pay this amount $ $ $ 4 Multiply Line 3 amount by 110% (1.10). 5 Minimum withholding and estimated tax payment required for tax year 2025. (lesser of Line 2 and {). 6 Multiply Line 5 amount by 25% (.25) for the amount required for each periodic payment. 2025 DC Tax Liability - Line 24 from your 2025 DC Individual Income Tax Return minus Line 30. Multiply the amount on Line 1 by 90% (.90). 2024 DC Tax Liability - Line 24 from your 2024 DC Individual Income Tax Return Minus Line 30. z z D-2210 Underpayment of IMPORTANT: Please read the instructions on the reverse before completing this form. Estimated Income Tax By Individuals *252210110000* z No underpayment Interest Is due and this form should not be filed If:

Estimated Tax Interest DC law requires every individual or couple filing jointly to pay estimated tax if they: x receive taxable income which is not subject to DC withholding; or x receive wages with insufficient withholding; or x the tax on this taxable income is expected to be more than $100. The law states that anyone required to file and pay estimated tax who fails to pay the amount required by the periodic payment due date is subject to interest on the underpayment of estimated income tax. When is interest assessed for underpayment of estimated income tax? Underpayment interest is assessed if your total DC estimated income tax payments (and withheld amounts) compared to your DC tax liability do not equal at least the smaller of: x 90% of the tax due shown on your 2025 DC return; or x 110% of the tax due shown on your 2024 DC tax return. You must have been a DC resident during all of 2024 to use the 110% exception. payments and withholding, is less than 10% of your total DC tax liability for the year. When may you use this form? x You may use this form to calculate your underpayment interest when submitting your D-40 form. If you do, fill in the oval, attach it to your tax return and enter the underpayment interest amount on Line 40 of the D-40. If you do not wish to calculate the interest, the Office of Tax and Revenue (OTR) will calculate it when your return is processed and will notify you of the amount due. x You may also complete this form if you believe the underpayment interest assessed by OTR for an underpayment of estimated income tax is incorrect. Office of Tax and Revenue Attn: Customer Service Administration 1101 4th St SW, 2nd Floor Washington DC 20024 Revised 05/2025 Instructions for Underpayment of Estimated Income Tax by Individuals Office of Tax and Revenue PO Box 96169 Washington DC 20090-6169 Completing this form Line 1 Enter the amount from your 2025 D-40, Line 24 minus Line 30. Line 2 Multiply the amount on Line 1 by 90% (.90). Your withheld taxes and/or estimated tax payments must be equal to or greater than this amount. Attach this form D-2210 to your D-40 return, if you complete it before filing your D-40 return. If you complete this form after filing and/or receiving a notice of an underpayment interest assessment, send it to: Line
3 Enter the amount from your 2024 D-40, Line 24 minus Line 30. Line 4 Enter 110% of the amount from Line 3. If your 2024 return was amended or corrected, multiply 110% (1.10) times the corrected amount. You must have been a DC resident during all of 2024 to use this exception. Line 5 Enter the lesser of the amounts on Line 2 and Line 4. If you did not file a DC return for 2024, use only the Line 2 amount. Line 6 Multiply the amount on Line 5 by 25% (.25). This gives you an even distribution of your liability, payable over four periods. Line 7 Enter the amount required from Line 6 under each of the payment columns. Include the amounts from the previous period in with the 2nd, 3rd and 4th periods. For example, if Line 6 is $2000, you would enter $2000 for the 1st period, $4000 for the 2nd period, $6000 for the 3rd period and $8000 for the 4th period. Annualized Income method: If your income was different for each period, you may want to determine the percentage for each period (divide the period income by the full year’s income). Multiply Line 5 by each period’s percentage and enter the amounts as shown above. Check the “Annualized Income” method box. Line 8 Enter the amounts withheld and estimated tax payments made for each period. Include the amounts from the previous period in with the 2nd, 3rd and 4th periods. For example, if your withheld and estimated tax payment amount is $1000 in each period, you would enter $1000 in the 1st period, $2000 in the 2nd period, $3000 in the 3rd period and $4000 in the 4th period. Line 9 Underpayment each period For each column, subtract Line 8 from Line 7. If Line 8 exceeds Line 7, you have no underpayment interest. If there is an amount remaining, this is your periodic underpayment amount. Line 10 Underpayment interest factors These are the underpayment interest factors by period. Line 11 For each column, multiply the amount on Line 9 by the penalty factor on Line 10. This is your underpayment interest amount by period. Line 12 Underpayment interest Add the amounts from each period on Line 11. This is your total underpayment interest for your estimated income tax underpayment. x If you are filing the D-2210 with your D-40 return, enter the amount of underpayment interest on Line 40, page 3 of the D-40. x If you are filing the D-2210 separately, pay the amount you owe. Attach payment to Form D-40P, Payment Voucher. Make the check or money order (in U.S. dollars) payable to the DC Treasurer and mail the D-2210 and D-40P with payment to: How do you file this form? Are there any exceptions to imposition of interest? You are not subject to interest for underpayment of estimated tax if: x You had no DC income tax liability for the tax year 2024 and in that year, you lived in DC the entire 12 months; x The tax due for 2025 minus income tax withheld and/or estimated tax payments is less than $100; x Your DC estimated tax payments plus any DC income tax withheld equals at least 110% of your 2024 DC income tax liability; or x Your remaining tax due after totaling all credits, estimated tax

‡ ,iۈÃi`Ê05/2025

‡{ä*Ê*>ޓi˜ÌÊ ˜`ˆÛˆ`Õ>Ê˜Vœ“iÊ/>ÝÊ 6œÕV iÀÊvœÀÊ œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> -/
*

Ê 

Ê",Ê " 9Ê",

,Ê , Ê * 5040P110000* 9œÕÀÊfiÀÃÌʘ>“iÊÊ °°Ê Ê >ÃÌʘ>“i -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊfiÀÃÌʘ>“iÊ °°Ê Ê >ÃÌʘ>“iÊ Ê 9œÕÀÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ® -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊ/ Ê ÊÊ/>Ý«>ÞiÀÊ`>Þ̈“iÊÌii« œ˜iʘՓLiÀ Ê Ê œ“iÊ>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li® Ê

ˆÌÞ Ê ÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊ ÊÊÊÊÊ -Ì>Ìi ÊÊÊÊÊÊÊÊÊÊÊÊ Ê Ê Ê <ˆ« œ`i ³ { Amount of payment fÊ .00 To avoid penalties and interest, your payment must be postmarked no later

than April 1x, 20Ó6. "vfiVˆ>Ê1ÃiÊ"˜Þ Ê6i˜`œÀÊ ›Êääää Ê “«œÀÌ>˜Ì\Ê*Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž° ‡ ,iۈÃi`Ê05/2025 ˜`ˆÛˆ`Õ>Ê˜Vœ“iÊ/>ÝÊ ÓäÓ5Ê ‡{ä*Ê*>ޓi˜ÌÊ6œÕV iÀÊvœÀÊ œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> -/
*

Ê 

Ê",Ê " 9Ê",

,Ê , Ê * 5040P110000* 9œÕÀÊfiÀÃÌʘ>“iÊÊ °°Ê Ê >ÃÌʘ>“iÊ -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊfiÀÃÌʘ>“i °°Ê Ê >ÃÌʘ>“iÊ Ê 9œÕÀÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ® -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊ/ Ê ÊÊ/>Ý«>ÞiÀÊ`>Þ̈“iÊÌii« œ˜iʘՓLiÀ Ê Ê œ“iÊ>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li® Ê

ˆÌÞ Ê ÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊÊ ÊÊÊÊÊ -Ì>Ìi ÊÊÊÊÊÊÊÊÊÊÊÊ Ê Ê Ê <ˆ« œ`i ³ { Amount of payment fÊ To avoid penalties and interest, your payment must be postÊmarked noʏ>ÌiÀÊÊ Ì >˜ÊApril 1x, 20Ó6.Ê "vfiVˆ>Ê1ÃiÊ"˜Þ Ê6i˜`œÀÊ ›Êääää Ê “«œÀÌ>˜Ì\Ê*Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž° Detach at perforation and mail the voucher, with payment attached, to the Office of Tax and Revenue, PO Box 96169, Washington DC 20090-6169. '33$<0(17928&+(5 6HHLQVWUXFWLRQVRQEDFN ÓäÓ5Ê .00 ‡

,QVWUXFWLRQVIRU'33$<0(17928&+(5‡Ê*i>ÃiÊ«Àˆ˜ÌÊVi>ÀÞ° 1ÃiÊÌ iÊ ‡{ä*Ê*>ޓi˜ÌÊ6œÕV iÀÊ̜ʓ>ŽiÊ>˜ÞÊ«>ޓi˜ÌÊ`Õiʜ˜ÊޜÕÀÊ ‡{äÊÀiÌÕÀ˜°

ˆÃ œ˜œÀi`Ê*>ޓi˜Ìà >ŽiÊÃÕÀiÊޜÕÀÊV iVŽÊœÀÊiiVÌÀœ˜ˆVÊ«>ޓi˜ÌÊ܈ÊVi>À°Ê9œÕÊ܈ÊLiÊV >À}i`Ê>ÊfÈxÊviiʈvÊޜÕÀÊV iVŽÊœÀÊiiVÌÀœ˜ˆVÊ«>ޓi˜ÌÊ ˆÃʘœÌÊ œ˜œÀi`ÊLÞÊޜÕÀÊvˆ˜>˜Vˆ>Êˆ˜Ã̈ÌṎœ˜Ê>˜`ÊÀiÌÕÀ˜i`Ê̜Ê"/,° U œÊ˜œÌÊÕÃiÊÌ ˆÃÊۜÕV iÀÊ̜ʓ>ŽiÊiÃ̈“>Ìi`ÊÌ>ÝÊ«>ޓi˜Ìð U ˜ÌiÀÊޜÕÀʘ>“i]ÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ®Ê>˜`Ê>``ÀiÃðÊvÊޜÕÊ>ÀiÊvˆˆ˜}Ê>ʍœˆ˜ÌÊÀiÌÕÀ˜ÊœÀÊvˆˆ˜}ÊÃi«>À>ÌiÞʜ˜Ê Ì iÊÃ>“iÊÀiÌÕÀ˜]Êi˜ÌiÀÊÌ iʘ>“iÊ>˜`Ê/ Êà œÜ˜ÊvˆÀÃÌʜ˜ÊޜÕÀÊÀiÌÕÀ˜]ÊÌ i˜Êi˜ÌiÀÊÌ iʘ>“iÊ>˜`Ê/ Êà œÜ˜ÊÃiVœ˜`ʜ˜Ê ޜÕÀÊÀiÌÕÀ˜° U Ê

Enter Ì iÊ>“œÕ˜ÌʜvÊޜÕÀÊ«>ޓi˜Ì° U >ŽiÊV iVŽÊœÀʓœ˜iÞʜÀ`iÀÊ­1-Ê`œ>Àîʫ>Þ>LiÊ̜ÊÌ iÊ

Ê/Ài>ÃÕÀiÀ° U >ŽiÊÃÕÀiÊޜÕÀʘ>“iÊ>˜`Ê>``ÀiÃÃÊ>««i>Àʜ˜ÊޜÕÀÊ«>ޓi˜ÌÊ­V iVŽÊœÀʓœ˜iÞʜÀ`iÀ®° U WriteÊޜÕÀÊ/ Ê>˜` "2025Ê ‡{ä"ʜ˜ÊޜÕÀÊ«>ޓi˜Ì° U /œÊ>ۜˆ`Ê«i˜>ÌˆiÃÊ>˜`ʈ˜ÌiÀiÃÌ]Ê«>Þʈ˜ÊvՏÊLÞÊApril 15, 2026. U -Ì>«iÊޜÕÀÊ«>ޓi˜ÌÊ̜ÊÌ iÊ ‡{ä*ÊۜÕV iÀ°Ê œÊ˜œÌÊ>ÌÌ>V ÊޜÕÀÊ«>ޓi˜ÌÊ̜ÊޜÕÀÊ ‡{äÊÀiÌÕÀ˜° U Ê

Mail Ì iÊ ‡{ä* ÊÜˆÌ ]ÊLÕÌʘœÌÊ>ÌÌ>V i`Ê̜]ÊޜÕÀÊ ‡{äÊÌ>ÝÊÀiÌÕÀ˜Êˆ˜ÊÌ iÊi˜Ûiœ«iÊ«ÀœÛˆ`i`ʈ˜ÊÌ ˆÃÊÌ>ÝÊLœœLMFU. vÊޜÕÊ`œÊ˜œÌÊ >ÛiÊÌ iÊÀiÌÕÀ˜Êi˜Ûiœ«i]ʓ>ŽiÊÃÕÀiÊ̜Ê>``ÀiÃÃÊޜÕÀÊi˜Ûiœ«iÊ̜\ "vvˆViʜvÊ/>ÝÊ>˜`Ê,iÛi˜ÕiÊ *"Ê œÝʙȣș 7>à ˆ˜}̜˜]Ê

ÊÊÓää™ä‡È£È™

i>Ûiʏˆ˜iÃÊL>˜ŽÊÌ >ÌÊ`œÊ˜œÌÊ>««Þ° ÓÊ

ʘVœ“iÊÌ>ÝÊ܈Ì

i`° ÎÊÊ ÓäÓ5ÊiÃ̈“>Ìi`ÊÌ>ÝÊ«>ޓi˜Ìð {Ê /œÌ>Ê«>ޓi˜ÌÃÊ
``Ê ˆ˜iÃÊÓÊ>˜`Êΰ xÊ Ì ˜ Õ œ “
Ê Ê`ÕiÊÜˆÌ ÊÌ ˆÃÊÀiµÕiÃÌ°Ê vÊ ˆ˜iʣʈÃʓœÀiÊÌ >˜Ê ˆ˜iÊ{]ÊÃÕLÌÀ>VÌÊ ˆ˜iÊ{ÊvÀœ“Ê ˆ˜iÊ£°Ê *>ÞÊÌ ˆÃÊ>“œÕ˜ÌÊ>˜`ÊÃi˜`ʈÌÊÜˆÌ ÊÌ iÊۜÕV iÀÊLiœÜ°Ê-iiʈ˜ÃÌÀÕV̈œ˜Ãʜ˜ÊL>VŽ°Ê ,œÕ˜`ÊVi˜ÌÃÊ̜ÊÌ iʘi>ÀiÃÌÊ`œ>À°ÊÊvÊÌ iÊ>“œÕ˜ÌʈÃÊâiÀœ]ʏi>ÛiÊ Ì iʏˆ˜iÊL>˜Ž° £Ê fÊ °ää ÓÊ fÊ °ää ÎÊÊÊfÊ °ääÊ {Ê fÊ °ää xÊ fÊ °ää Payment and mailing Instructions. Ê Ê FR-127 Extension of Time to File a DC Income Tax Return Worksheet Detach at perforation and mail the voucher, with payment attached, to the Office of Tax and Revenue, PO Box 96018, Washington, DC 20090-6018. ,iۈÃi`Êä5ÉÓäÓ5 9œÕÀÊvˆÀÃÌʘ>“iÊ °°



>ÃÌʘ>“i 9œÕÀÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ®Ê -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊ/ Ê -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊvˆÀÃÌʘ>“iÊ °°



>ÃÌʘ>“i œ“iÊ>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li®Ê

ˆÌÞÊ -Ì>Ìi <ˆ«Ê œ`iʳ{ * 51270110000* œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> “«œÀÌ>˜Ì\ Ê*Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž° "vvˆVˆ>Ê1ÃiÊ"˜Þ Ê6i˜`œÀÊ ›Êääää Ê,‡£ÓÇÊÊÊ ÝÌi˜Ãˆœ˜ÊœvÊ/ˆ“iÊ̜ʈiÊ >Ê

ʘVœ“iÊ/>ÝÊ,iÌÕÀ˜
“œÕ˜ÌʜvÊ«>ޓi˜Ì ­`œ>ÀÃʜ˜Þ®ÊÊÊ fÊ °ää ÓäÓ5 ‡ ˆÊˆ˜Ê ʈvÊ-JWJOH
PS
5SBWFMJOH
0VUTJEF
UIF
64 ˆÊˆ˜Ê ʈvÊin ˆˆÌ>ÀÞÊ œ“L>ÌÊ<œ˜i 9œÕÀÊ`>Þ̈“iÊÌii« œ˜iʘՓLiÀ ,iۈÃi`Êä5ÉÓäÓ5 9œÕÀÊvˆÀÃÌʘ>“iÊ °°



>ÃÌʘ>“i 9œÕÀÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ®Ê -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊ/ Ê -«œÕÃi½ÃÉÀi}ˆÃÌiÀi`Ê`œ“iÃ̈VÊ«>À̘iÀ½ÃÊvˆÀÃÌʘ>“iÊ °°



>ÃÌʘ>“i œ“iÊ>``ÀiÃÃÊ­˜Õ“LiÀ]ÊÃÌÀiiÌÊ>˜`ÊÃՈÌiÉ>«>À̓i˜ÌʘՓLiÀʈvÊ>««ˆV>Li®Ê

ˆÌÞÊ -Ì>Ìi <ˆ«Ê œ`iʳ{ * 51270110000* œÛiÀ˜“i˜ÌʜvÊÌ i

ˆÃÌÀˆVÌʜvÊ œÕ“Lˆ> “«œÀÌ>˜Ì\ Ê*Àˆ˜Ìʈ˜Ê
*/
ʏiÌÌiÀÃÊÕȘ}ÊL>VŽÊˆ˜Ž° "vvˆVˆ>Ê1ÃiÊ"˜Þ Ê6i˜`œÀÊ ›Êääää Ê,‡£ÓÇÊÊÊ ÝÌi˜Ãˆœ˜ÊœvÊ/ˆ“iÊ̜ʈiÊ >Ê

ʘVœ“iÊ/>ÝÊ,iÌÕÀ˜
“œÕ˜ÌʜvÊ«>ޓi˜Ì ­`œ>ÀÃʜ˜Þ®ÊÊÊ fÊ °ää ÓÊäÓ5 ‡ ˆÊˆ˜Ê ʈvÊ-JWJOH
PS
5SBWFMJOH
0VUTJEF
UIF
64 ˆÊˆ˜Ê ʈvÊin ˆˆÌ>ÀÞÊ œ“L>ÌÊ<œ˜i 9œÕÀÊ`>Þ̈“iÊÌii« œ˜iʘՓLiÀ Extension of time to file until October 15, 2026

 £ÊÊÊ/œÌ>ÊiÃ̈“>Ìi`ʈ˜Vœ“iÊÌ>Ýʏˆ>LˆˆÌÞÊvœÀÊÓäÓ5° Ê >ŽiÊÊV iVŽÊʜÀÊʓœ˜iÞÊʜÀ`iÀÊÊ­`œÊʘœÌÊ Ãi˜`ÊÊV>à ®ÊÊ«>Þ>LiÊÊ̜\ÊÊ

ÊÊ/Ài>ÃÕÀiÀ°Ê7ÀˆÌiÊÊޜÕÀÊÊÌ>Ý«>ÞiÀʈ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀÊ­/ ®Ê>˜`ʺÓäÓ5Ê,‡£ÓÇ»Ê œ˜ÊޜÕÀÊ«>ޓi˜Ì°Ê iÌ>V Ê>˜`ʓ>ˆÊÌ iÊۜÕV iÀÊ«œÀ̈œ˜ÊœvÊÌ ˆÃÊvœÀ“ÊÜˆÌ ÊvՏÊ«>ޓi˜ÌʜvÊ>˜ÞÊÌ>ÝÊ`ÕiÊLÞÊ
«ÀˆÊ£x]ÊÓäÊ6Ê̜ÊÌ iÊ"vvˆViʜvÊ/>ÝÊ>˜`Ê ,ivi˜Õi]Ê*"Ê œÝʙÈä£n]Ê7>à ˆ˜}̜˜]Ê

ÊÓää™ä‡Èä£n° NOTE: You may also ile and pay electronically. Visit MyTax.DC.gov.

“>݈“Õ“Ê«i˜>ÌÞʈÃÊ>˜Ê>``ˆÌˆœ˜>Ê>“œÕ˜ÌÊ`Õi]ÊiµÕ>Ê̜ÊÓx¯ÊœvÊÌ iÊÌ>ÝÊ`Õi° /œÊ>ۜˆ`Ê«i˜>ÌˆiÃÊ>˜`ʈ˜ÌiÀiÃÌ]Ê`œÊ˜œÌÊ՘`iÀiÃ̈“>ÌiÊޜÕÀÊiÃ̈“>Ìi`ʈ˜Vœ“iÊ Ì>Ýʏˆ>LˆˆÌÞ°Ê œ“«iÌiÊÌ iÊܜÀŽÃ iiÌÊ>LœÛiÊ>˜`Ê«>ÞÊÌ iÊ>“œÕ˜ÌÊ`ÕiÊÜˆÌ ÊÌ ˆÃÊ ÀiµÕiÃÌ

ˆÃ œ˜œÀi`Ê*>ޓi˜Ìà >ŽiÊÃÕÀiÊޜÕÀÊV iVŽÊœÀÊiiVÌÀœ˜ˆVÊ«>ޓi˜ÌÊ܈ÊVi>À°Ê9œÕÊ܈ÊLiÊV >À}i`Ê>Ê fÈxÊviiʈvÊޜÕÀÊV iVŽÊœÀÊiiVÌÀœ˜ˆVÊ«>ޓi˜ÌʈÃʘœÌÊ œ˜œÀi`ÊLÞÊޜÕÀÊvˆ˜>˜Vˆ>Ê ˆ˜Ã̈ÌṎœ˜Ê>˜`ÊÀiÌÕÀ˜i`Ê̜Ê"/,° / iÊ Instructions for Form FR-127 Why file Form FR-127? 1ÃiÊ Ì ˆÃÊ vœÀ“Ê ˆvÊޜÕÊV>˜˜œÌ ÊwiÊޜÕÀÊ

ʈ˜`ˆÛˆ`Õ>Ê ˆ˜Vœ“iÊ Ì>ÝÊÀiÌÕÀ˜ÊLÞÊÌ iÊ
«ÀˆÊ£x]ÊÓäÓ6Ê`i>`ˆ˜i°Ê ÞÊwˆ˜}ÊÌ ˆÃÊvœÀ“]ÊޜÕÊ V>˜ÊÀiViˆÛiÊ>˜ÊiÝÌi˜Ãˆœ˜ œvÊ Ìˆ“i ̜ÊvˆiÊ՘̈Ê"V̜LiÀÊ£x]ÊÓäÓ6° 9œÕʓÕÃÌÊÕÃiÊœÀ“Ê,‡£ÓÇÊ̜ÊÀiµÕiÃÌÊ>˜ÊiÝÌi˜Ãˆœ˜ÊœvÊ̈“iÊÌœÊ vˆiÊ>Ê

Ê ˆ˜`ˆÛˆ`Õ>Êˆ˜Vœ“iÊÌ>ÝÊÀiÌÕÀ˜°Ê
wˆ˜}ÊiÝÌi˜Ãˆœ˜ÊˆÃʘœÌÊ>˜ÊiÝÌi˜Ãˆœ˜ÊœvÊÌ iÊ`ÕiÊ`>ÌiÊvœÀÊ«>ވ˜}Ê>˜ÞÊ Ì>ÝÊޜÕʓ>ÞʜÜi°Ê ivœÀiÊÊwˆ˜}ÊvœÀÊ>˜ÊiÝÌi˜Ãˆœ˜]ÊiÃ̈“>ÌiÊÌ iÊÌ>ÝiÃÊ ÞœÕÊ܈ÊœÜiÊ>˜`Ê«>ÞÊ>˜ÞÊ«>ÀÌʜvÊÌ >ÌÊ>“œÕ˜ÌÊÌ >ÌʈÃʘœÌÊVœÛiÀi`ÊLÞÊ

Ê܈Ì

i`ÊÌ>ÝÊ>“œÕ˜ÌÃÊ>˜`ɜÀÊiÃ̈“>Ìi`ÊÌ>ÝÊ«>ޓi˜ÌðÊʘVÕ`iÊ ÞœÕÀÊ«>ޓi˜ÌÊÜˆÌ ÊÌ iÊ,‡£ÓÇÊۜÕV iÀÊ>˜`ÊvˆiʈÌÊLÞÊ
«ÀˆÊ£x]ÊÓäÓ6° vÊÊwˆ˜}Ê œˆ˜ÌÞ]Ê œÀÊÊwˆ˜}ÊÃi«>À>ÌiÞ œ˜Ê UIFÊÃ>“i ÀiÌÕÀ˜]Êi˜ÌiÀÊ Ì iÊ Ì>Ý«>ÞiÀÊ ˆ`i˜ÌˆvˆV>̈œ˜Ê˜Õ“LiÀ ­/ ®Ê >˜`ʘ>“iÊà œÜ˜ ÊwÀÃÌÊ œ˜ÊޜÕÀÊ ‡{äÊÀiÌÕÀ˜]ÊÌ i˜Êi˜ÌiÀÊÌ iÊ/ Ê>˜`ʘ>“iÊà œÜ˜ÊÃiVœ˜`ʜ˜ ޜÕÀÊÀiÌÕÀ˜°
``ˆÌˆœ˜>ÊiÝÌi˜Ãˆœ˜° ˜Ê>``ˆÌˆœ˜Ê̜ÊÌ iÊȇ“œ˜Ì ÊiÝÌi˜Ãˆœ˜]ÊޜÕʓ>ÞÊÀiViˆÛiÊ>˜œÌ iÀ
ȇ“œ˜Ì ÊiÝÌi˜Ãˆœ˜ÊˆvÊޜÕÊ>ÀiʏˆÛˆ˜}ʜÀÊÌÀ>Ûiˆ˜}ʜÕÌÈ`iÊÌ i 1°-°Ê9œÕʓÕÃÌÊvJMFÊÌ iÊvˆÀÃÌÊȇ“œ˜Ì ÊiÝÌi˜Ãˆœ˜ÊLÞÊÌ i
«Àˆ £x]ÊÓäÓ6Ê`i>`ˆ˜iÊLivœÀiÊ>««Þˆ˜}ÊvœÀÊÌ iÊ>``ˆÌˆœ˜> iÝÌi˜Ãˆœ˜ÊœvÊ̈“iÊ̜Êvˆi
CZ
0DUPCFS
x
6. Extensions for Members of US Armed Forces Deployed in a Combat Zone or Contingency Operation. %FBEMJOFT
GPS
GJMJOH
ZPVS
SFUVSO
QBZJOH
ZPVS
UBY
DMBJNJOH
B
SFGVOE
BOE
UBLJOH
PUIFS
BDUJPOT
XJUI Ì iÊ

Ê"vvˆViʜvÊ/>ÝÊ>˜`Ê,iÛi˜ÕiÊ­"/,®ÊˆÃ FYUFOEFE
GPS
QFSTPOT
JO
UIF
"SNFE
'PSDFT
TFSWJOH
JO
B
$PNCBU
;POF
PS

œ˜Ìˆ˜}i˜VÞÊ0QFSBUJPO
5IF
FYUFOTJPO
BMTP
>««ˆiÃÊ̜ÊëœÕÃiÃÉÀi}ˆÃÌiÀi` EPNFTUJD
QBSUOFST
XIFUIFS
UIFZ
GJMF
KPJOUMZ
PS
TFQBSBUFMZ
PO
UIF
TBNF
SFUVSO
4FF
*34
1VC
"SNFE
'PSDFT¿
5BY
(VJEF
GPS
EFUBJMFE
JOGPSNBUJPO
'JMM
JO
UIF
hˆv ˆ˜ .JMJUBSZ $PNCBU
;POFh
PWBMʈvʈÌÊ>««ˆiÃÊ̜ÊޜÕ How to avoid penalties and interest. 9œÕÊ܈ÊLiÊV >À}i`ʈ˜ÌiÀiÃÌʜvÊ£ä¯Ê«iÀÊÞi>À]ÊVœ“«œÕ˜`i`Ê`>ˆÞ]ÊvœÀÊ>˜ÞÊÌ>ÝʘœÌÊ «>ˆ`ʜ˜Ê̈“i°Ê˜ÌiÀiÃÌʈÃÊV>VՏ>Ìi`ÊvÀœ“ÊÌ iÊ`ÕiÊ`>ÌiʜvÊÌ iÊÀiÌÕÀ˜Ê̜ÊÌ iÊ`>ÌiÊ Ì iÊÌ>ÝʈÃÊ«>ˆ`° 9œÕÊ܈ÊLiÊV >À}i`Ê>Êx¯Ê«iÀ‡“œ˜Ì Ê«i˜>ÌÞÊvœÀÊv>ˆÕÀiÊ̜ÊfiiÊ>ÊÀiÌÕÀ˜ÊœÀÊ«>ÞÊ >˜ÞÊ Ì>ÝÊ `ÕiÊ œ˜Ê ̈“i°Ê / iÊ «i˜>ÌÞÊ ˆÃÊ V>VՏ>Ìi`Ê œ˜Ê Ì iÊ Õ˜«>ˆ`Ê Ì>ÝÊ vœÀÊ i>V ʓœ˜Ì ʜÀÊ«>ÀÌʜvÊ>ʓœ˜Ì ÊÌ >ÌÊÌ iÊÀiÌÕÀ˜ÊˆÃʘœÌÊfii`ʜÀÊÌ iÊÌ>ÝʈÃʘœÌÊ«>ˆ`°

Tax tables for income of $100,000 or less Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $0 - 2,499 $2,500 - 4,999 $5,000 - 7,499 $7,500 - 9,999 $0 - 49 $0 $2,500 - 2,549

$101 $5,000 - 5,049 $201 $7,500 - 7,549 $301 50 - 99 3 2,550 - 2,599 103 5,050 5,099 203 7,550 - 7,599 303 100 - 149 5 2,600 - 2,649 105 5,100 - 5,149 205 7,600 - 7,649 305 150 - 199 7 2,650 - 2,699 107 5,150 - 5,199 207 7,650 - 7,699 307 200 - 249 9 2,700 - 2,749 109 5,200 - 5,249 209 7,700 - 7,749 309 250 - 299 11 2,750 - 2,799 111 5,250 - 5,299 211 7,750 - 7,799 311 300 - 349 13 2,800 - 2,849 113 5,300 - 5,349 213 7,800 - 7,849 313 350 - 399 15 2,850 - 2,899 115 5,350 - 5,399 215 7,850 - 7,899 315 400 - 449 17 2,900 - 2,949 117 5,400 - 5,449 217 7,900 - 7,949 317 450 - 499 19 2,950 - 2,999 119 5,450 - 5,499 219 7,950 - 7,999 319 500 - 549 21 $3,000 - 3,049 $121 5,500 - 5,549 221 $8,000 - 8,049 $321 550 - 599 23 3,050 - 3,099 123 5,550 - 5,599 223 8,050 - 8,099 323 600 - 649 25 3,100 - 3,149 125 5,600 - 5,649 225 8,100 - 8,149 325 650 - 699 27 3,150 - 3,199 127 5,650 - 5,699 227 8,150 - 8,199 327 700 - 749 29 3,200 - 3,249 129 5,700 - 5,749 229 8,200 - 8,249 329 750 - 799 31 3,250 - 3,299 131 5,750 - 5,799 231 8,250 - 8,299 331 800 - 849 33 3,300 - 3,349 133 5,800 - 5,849 233 8,300 - 8,349 333 850 - 899 35 3,350 - 3,399 135 5,850 - 5,899 235 8,350 - 8,399 335 900 - 949 37 3,400 - 3,449 137 5,900 - 5,949 237 8,400 - 8,449 337 950 - 999 39 3,450 - 3,499 139 5,950 - 5,999 239 8,450 - 8,499 339 $1,000 - 1,049 $41 3,500 - 3,549 141 $6,000 - 6,049 $241 8,500 - 8,549 341 1,050 - 1,099 43 3,550 - 3,599 143 6,050 - 6,099 243 8,550 - 8,599 343 1,100 - 1,149 45 3,600 - 3,649 145 6,100 - 6,149 245 8,600 - 8,649 345 1,150 - 1,199 47 3,650 - 3,699 147 6,150 - 6,199 247 8,650 - 8,699 347 1,200 - 1,249 49 3,700 - 3,749 149 6,200 - 6,249 249 8,700 - 8,749 349 1,250 - 1,299 51 3,750 - 3,799 151 6,250 - 6,299 251 8,750 - 8,799 351 1,300 - 1,349 53 3,800 - 3,849 153 6,300 - 6,349 253 8,800 - 8,849 353 1,350 - 1,399 55 3,850 - 3,899 155 6,350 - 6,399 255 8,850 - 8,899 355 1,400 - 1,449 57 3,900 - 3,949 157 6,400 - 6,449 257 8,900 - 8,949 357 1,450 - 1,499 59 3,950 - 3,999 159 6,450 - 6,499 259 8,950 - 8,999 359 1,500 - 1,549 61 $4,000 - 4,049 $161 6,500 - 6,549 261 $9,000 - 9,049 $361 1,550 - 1,599 63 4,050 - 4,099 163 6,550 - 6,599 263 9,050 - 9,099 363 1,600 - 1,649 65 4,100 - 4,149 165 6,600 - 6,649 265 9,100 - 9,149 365 1,650 - 1,699 67 4,150 - 4,199 167 6,650 - 6,699 267 9,150 - 9,199 367 1,700 - 1,749 69 4,200 - 4,249 169 6,700 - 6,749 269 9,200 - 9,249 369 1,750 - 1,799 71 4,250 - 4,299 171 6,750 - 6,799 271 9,250 - 9,299 371 1,800 - 1,849 73 4,300 - 4,349 173 6,800 - 6,849 273 9,300 - 9,349 373 1,850 - 1,899 75 4,350 - 4,399 175 6,850 - 6,899 275 9,350 - 9,399 375 1,900 - 1,949 77 4,400 - 4,449 177 6,900 - 6,949 277 9,400 - 9,449 377 1,950 - 1,999 79 4,450 - 4,499 179 6,950 - 6,999 279 9,450 - 9,499 379 $2,000 - 2,049 $81 4,500 - 4,549 181 $7,000 - 7,049 $281 9,500 - 9,549 381 2,050 - 2,099 83 4,550 - 4,599 183 7,050 - 7,099 283 9,550 - 9,599 383 2,100 - 2,149 85 4,600 - 4,649 185 7,100 - 7,149 285 9,600 - 9,649 385 2,150 - 2,199 87 4,650 - 4,699 187 7,150 - 7,199 287 9,650 - 9,699 387 2,200 - 2,249 89 4,700 - 4,749 189 7,200 - 7,249 289 9,700 - 9,749 389 2,250 - 2,299 91 4,750 - 4,799 191 7,250 - 7,299 291 9,750 - 9,799 391 2,300 - 2,349 93 4,800 - 4,849 193 7,300 - 7,349 293 9,800 - 9,849 393 2,350 - 2,399 95 4,850 - 4,899 195 7,350 - 7,399 295 9,850 - 9,899 395 2,400 - 2,449 97 4,900 - 4,949 197 7,400 - 7,449 297 9,900 - 9,949 397 2,450 - 2,499 99 4,950 - 4,999 199 7,450 - 7,499 299 9,950 - 9,999 399
93 If more than $100,000, use Calculation I instructions on page 20.

Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $10,000 - 12,499 $12,500 - 14,999 $15,000 - 17,499 $17,500 - 19,999 $10,000 - 10,049 $402 $12,500 - 12,549 $552 $15,000 - 15,049 $702 $17,500 - 17,549 $852 10,050 - 10,099 405 12,550 - 12,599 555 15,050 - 15,099 705 17,550 - 17,599 855 10,100 - 10,149 408 12,600 - 12,649 558 15,100 - 15,149 708 17,600 - 17,649 858 10,150 - 10,199 411 12,650 - 12,699 561 15,150 - 15,199 711 17,650 - 17,699 861 10,200 - 10,249 414 12,700 - 12,749 564 15,200 - 15,249 714 17,700 - 17,749 864 10,250 - 10,299 417 12,750 - 12,799 567 15,250 - 15,299 717 17,750 - 17,799 867 10,300 - 10,349 420 12,800 - 12,849 570 15,300 - 15,349 720 17,800 - 17,849 870 10,350 - 10,399 423 12,850 - 12,899 573 15,350 - 15,399 723 17,850 - 17,899 873 10,400 - 10,449 426 12,900 - 12,949 576 15,400 - 15,449 726 17,900 - 17,949 876 10,450 - 10,499 429 12,950 - 12,999 579 15,450 - 15,499 729 17,950 - 17,999 879 10,500 - 10,549 432 $13,000 - 13,049 $582 15,500 - 15,549 732 $18,000 - 18,049 $882 10,550 - 10,599 435 13,050 - 13,099 585 15,550 - 15,599 735 18,050 - 18,099 885 10,600 - 10,649 438 13,100 - 13,149 588 15,600 - 15,649 738 18,100 - 18,149 888 10,650 - 10,699 441 13,150 - 13,199 591 15,650 - 15,699 741 18,150 - 18,199 891 10,700 - 10,749 444 13,200 - 13,249 594 15,700 - 15,749 744 18,200 - 18,249 894 10,750 - 10,799 447 13,250 - 13,299 597 15,750 - 15,799 747 18,250 - 18,299 897 10,800 - 10,849 450 13,300 - 13,349 600 15,800 - 15,849 750 18,300 - 18,349 900 10,850 - 10,899 453 13,350 - 13,399 603 15,850 - 15,899 753 18,350 - 18,399 903 10,900 - 10,949 456 13,400 - 13,449 606 15,900 - 15,949 756 18,400 - 18,449 906 10,950 - 10,999 459 13,450 - 13,499 609 15,950 - 15,999 759 18,450 - 18,499 909 $11,000 - 11,049 $462 13,500 - 13,549 612 $16,000 - 16,049 $762 18,500 - 18,549 912 11,050 - 11,099 465 13,550 - 13,599 615 16,050 - 16,099 765 18,550 - 18,599 915 11,100 - 11,149 468 13,600 - 13,649 618 16,100 - 16,149 768 18,600 - 18,649 918 11,150 - 11,199 471 13,650 - 13,699 621 16,150 - 16,199 771 18,650 - 18,699 921 11,200 - 11,249 474 13,700 - 13,749 624 16,200 - 16,249 774 18,700 - 18,749 924 11,250 - 11,299 477 13,750 - 13,799 627 16,250 - 16,299 777 18,750 - 18,799 927 11,300 - 11,349 480 13,800 - 13,849 630 16,300 - 16,349 780 18,800 - 18,849 930 11,350 - 11,399 483 13,850 - 13,899 633 16,350 - 16,399 783 18,850 - 18,899 933 11,400 - 11,449 486 13,900 - 13,949 636 16,400 - 16,449 786 18,900 - 18,949 936 11,450 - 11,499 489 13,950 - 13,999 639 16,450 - 16,499 789 18,950 - 18,999 939 11,500 - 11,549 492 $14,000 - 14,049 $642 16,500 - 16,549 792 $19,000 - 19,049 $942 11,550 - 11,599 495 14,050 - 14,099 645 16,550 - 16,599 795 19,050 - 19,099 945 11,600 - 11,649 498 14,100 - 14,149 648 16,600 - 16,649 798 19,100 - 19,149 948 11,650 - 11,699 501 14,150 - 14,199 651 16,650 - 16,699 801 19,150 - 19,199 951 11,700 - 11,749 504 14,200 - 14,249 654 16,700 - 16,749 804 19,200 - 19,249 954 11,750 - 11,799 507 14,250 - 14,299 657 16,750 - 16,799 807 19,250 - 19,299 957 11,800 - 11,849 510 14,300 - 14,349 660 16,800 - 16,849 810 19,300 - 19,349 960 11,850 - 11,899 513 14,350 - 14,399 663 16,850 - 16,899 813 19,350 - 19,399 963 11,900 - 11,949 516 14,400 - 14,449 666 16,900 - 16,949 816 19,400 - 19,449 966 11,950 - 11,999 519 14,450 - 14,499 669 16,950 - 16,999 819 19,450 - 19,499 969 $12,000 - 12,049 $522 14,500 - 14,549 672 $17,000 - 17,049 $822 19,500 - 19,549 972 12,050 - 12,099 525 14,550 - 14,599 675 17,050 - 17,099 825 19,550 - 19,599 975 12,100 - 12,149 528 14,600 - 14,649 678 17,100 - 17,149 828 19,600 - 19,649 978 12,150 - 12,199 531 14,650 - 14,699 681 17,150 - 17,199 831 19,650 - 19,699 981 12,200 - 12,249 534 14,700 - 14,749 684 17,200 - 17,249 834 19,700 - 19,749 984 12,250 - 12,299 537 14,750 - 14,799 687 17,250 - 17,299 837 19,750 - 19,799 987 12,300 - 12,349 540 14,800 - 14,849 690 17,300 - 17,349 840 19,800 - 19,849 990 12,350 - 12,399 543 14,850 - 14,899 693 17,350 - 17,399 843 19,850 - 19,899 993 12,400 - 12,449 546 14,900 - 14,949 696 17,400 - 17,449 846 19,900 - 19,949 996 12,450 - 12,499 549 14,950 - 14,999 699 17,450 - 17,499 849 19,950 - 19,999 999 Tax tables for Income of $100,000 or less continued 94

95 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $20,000 - 22,499 $22,500 - 24,999 $25,000 - 27,499 $27,500 - 29,999 $20,000 - 20,049 $1,002 $22,500 - 22,549 $1,152 $25,000 - 25,049 $1,302 $27,500 - 27,549 $1,452 20,050 - 20,099 1,005 22,550 - 22,599 1,155 25,050 - 25,099 1,305 27,550 - 27,599 1,455 20,100 - 20,149 1,008 22,600 - 22,649 1,158 25,100 - 25,149 1,308 27,600 - 27,649 1,458 20,150 - 20,199 1,011 22,650 - 22,699 1,161 25,150 - 25,199 1,311 27,650 - 27,699 1,461 20,200 - 20,249 1,014 22,700 - 22,749 1,164 25,200 - 25,249 1,314 27,700 - 27,749 1,464 20,250 - 20,299 1,017 22,750 - 22,799 1,167 25,250 - 25,299 1,317 27,750 - 27,799 1,467 20,300 - 20,349 1,020 22,800 - 22,849 1,170 25,300 - 25,349 1,320 27,800 - 27,849 1,470 20,350 - 20,399 1,023 22,850 - 22,899 1,173 25,350 - 25,399 1,323 27,850 - 27,899 1,473 20,400 - 20,449 1,026 22,900 - 22,949 1,176 25,400 - 25,449 1,326 27,900 - 27,949 1,476 20,450 - 20,499 1,029 22,950 - 22,999 1,179 25,450 - 25,499 1,329 27,950 - 27,999 1,479 20,500 - 20,549 1,032 $23,000 - 23,049 $1,182 25,500 - 25,549 1,332 $28,000 - 28,049 $1,482 20,550 - 20,599 1,035 23,050 - 23,099 1,185 25,550 - 25,599 1,335 28,050 - 28,099 1,485 20,600 - 20,649 1,038 23,100 - 23,149 1,188 25,600 - 25,649 1,338 28,100 - 28,149 1,488 20,650 - 20,699 1,041 23,150 - 23,199 1,191 25,650 - 25,699 1,341 28,150 - 28,199 1,491 20,700 - 20,749 1,044 23,200 - 23,249 1,194 25,700 - 25,749 1,344 28,200 - 28,249 1,494 20,750 - 20,799 1,047 23,250 - 23,299 1,197 25,750 - 25,799 1,347 28,250 - 28,299 1,497 20,800 - 20,849 1,050 23,300 - 23,349 1,200 25,800 - 25,849 1,350 28,300 - 28,349 1,500 20,850 - 20,899 1,053 23,350 - 23,399 1,203 25,850 - 25,899 1,353 28,350 - 28,399 1,503 20,900 - 20,949 1,056 23,400 - 23,449 1,206 25,900 - 25,949 1,356 28,400 - 28,449 1,506 20,950 - 20,999 1,059 23,450 - 23,499 1,209 25,950 - 25,999 1,359 28,450 - 28,499 1,509 $21,000 - 21,049 $1,062 23,500 - 23,549 1,212 $26,000 - 26,049 $1,362 28,500 - 28,549 1,512 21,050 - 21,099 1,065 23,550 - 23,599 1,215 26,050 - 26,099 1,365 28,550 - 28,599 1,515 21,100 - 21,149 1,068 23,600 - 23,649 1,218 26,100 - 26,149 1,368 28,600 - 28,649 1,518 21,150 - 21,199 1,071 23,650 - 23,699 1,221 26,150 - 26,199 1,371 28,650 - 28,699 1,521 21,200 - 21,249 1,074 23,700 - 23,749 1,224 26,200 - 26,249 1,374 28,700 - 28,749 1,524 21,250 - 21,299 1,077 23,750 - 23,799 1,227 26,250 - 26,299 1,377 28,750 - 28,799 1,527 21,300 - 21,349 1,080 23,800 - 23,849 1,230 26,300 - 26,349 1,380 28,800 - 28,849 1,530 21,350 - 21,399 1,083 23,850 - 23,899 1,233 26,350 - 26,399 1,383 28,850 - 28,899 1,533 21,400 - 21,449 1,086 23,900 - 23,949 1,236 26,400 - 26,449 1,386 28,900 - 28,949 1,536 21,450 - 21,499 1,089 23,950 - 23,999 1,239 26,450 - 26,499 1,389 28,950 - 28,999 1,539 21,500 - 21,549 1,092 $24,000 - 24,049 $1,242 26,500 - 26,549 1,392 $29,000 - 29,049 $1,542 21,550 - 21,599 1,095 24,050 - 24,099 1,245 26,550 - 26,599 1,395 29,050 - 29,099 1,545 21,600 - 21,649 1,098 24,100 - 24,149 1,248 26,600 - 26,649 1,398 29,100 - 29,149 1,548 21,650 - 21,699 1,101 24,150 - 24,199 1,251 26,650 - 26,699 1,401 29,150 - 29,199 1,551 21,700 - 21,749 1,104 24,200 - 24,249 1,254 26,700 - 26,749 1,404 29,200 - 29,249 1,554 21,750 - 21,799 1,107 24,250 - 24,299 1,257 26,750 - 26,799 1,407 29,250 - 29,299 1,557 21,800 - 21,849 1,110 24,300 - 24,349 1,260 26,800 - 26,849 1,410 29,300 - 29,349 1,560 21,850 - 21,899 1,113 24,350 - 24,399 1,263 26,850 - 26,899 1,413 29,350 - 29,399 1,563 21,900 - 21,949 1,116 24,400 - 24,449 1,266 26,900 - 26,949 1,416 29,400 - 29,449 1,566 21,950 - 21,999 1,119 24,450 - 24,499 1,269 26,950 - 26,999 1,419 29,450 - 29,499 1,569 $22,000 - 22,049 $1,122 24,500 - 24,549 1,272 $27,000 - 27,049 $1,422 29,500 - 29,549 1,572 22,050 - 22,099 1,125 24,550 - 24,599 1,275 27,050 - 27,099 1,425 29,550 - 29,599 1,575 22,100 - 22,149 1,128 24,600 - 24,649 1,278 27,100 - 27,149 1,428 29,600 - 29,649 1,578 22,150 - 22,199 1,131 24,650 - 24,699 1,281 27,150 - 27,199 1,431 29,650 - 29,699 1,581 22,200 - 22,249 1,134 24,700 - 24,749 1,284 27,200 - 27,249 1,434 29,700 - 29,749 1,584 22,250 - 22,299 1,137 24,750 - 24,799 1,287 27,250 - 27,299 1,437 29,750 - 29,799 1,587 22,300 - 22,349 1,140 24,800 - 24,849 1,290 27,300 - 27,349 1,440 29,800 - 29,849 1,590 22,350 - 22,399 1,143 24,850 - 24,899 1,293 27,350 - 27,399 1,443 29,850 - 29,899 1,593 22,400 - 22,449 1,146 24,900 - 24,949 1,296 27,400 - 27,449 1,446 29,900 - 29,949 1,596 22,450 - 22,499 1,149 24,950 - 24,999 1,299 27,450 - 27,499 1,449 29,950 - 29,999 1,599

96 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $30,000 - 32,499 $32,500 - 34,999 $35,000 - 37,499 $37,500 - 39,999 $30,000 - 30,049 $1,602 $32,500 - 32,549 $1,752 $35,000 - 35,049 $1,902 $37,500 - 37,549 $2,052 30,050 - 30,099 1,605 32,550 - 32,599 1,755 35,050 - 35,099 1,905 37,550 - 37,599 2,055 30,100 - 30,149 1,608 32,600 - 32,649 1,758 35,100 - 35,149 1,908 37,600 - 37,649 2,058 30,150 - 30,199 1,611 32,650 - 32,699 1,761 35,150 - 35,199 1,911 37,650 - 37,699 2,061 30,200 - 30,249 1,614 32,700 - 32,749 1,764 35,200 - 35,249 1,914 37,700 - 37,749 2,064 30,250 - 30,299 1,617 32,750 - 32,799 1,767 35,250 - 35,299 1,917 37,750 - 37,799 2,067 30,300 - 30,349 1,620 32,800 - 32,849 1,770 35,300 - 35,349 1,920 37,800 - 37,849 2,070 30,350 - 30,399 1,623 32,850 - 32,899 1,773 35,350 - 35,399 1,923 37,850 - 37,899 2,073 30,400 - 30,449 1,626 32,900 - 32,949 1,776 35,400 - 35,449 1,926 37,900 - 37,949 2,076 30,450 - 30,499 1,629 32,950 - 32,999 1,779 35,450 - 35,499 1,929 37,950 - 37,999 2,079 30,500 - 30,549 1,632 $33,000 - 33,049 $1,782 35,500 - 35,549 1,932 $38,000 - 38,049 $2,082 30,550 - 30,599 1,635 33,050 - 33,099 1,785 35,550 - 35,599 1,935 38,050 - 38,099 2,085 30,600 - 30,649 1,638 33,100 - 33,149 1,788 35,600 - 35,649 1,938 38,100 - 38,149 2,088 30,650 - 30,699 1,641 33,150 - 33,199 1,791 35,650 - 35,699 1,941 38,150 - 38,199 2,091 30,700 - 30,749 1,644 33,200 - 33,249 1,794 35,700 - 35,749 1,944 38,200 - 38,249 2,094 30,750 - 30,799 1,647 33,250 - 33,299 1,797 35,750 - 35,799 1,947 38,250 - 38,299 2,097 30,800 - 30,849 1,650 33,300 - 33,349 1,800 35,800 - 35,849 1,950 38,300 - 38,349 2,100 30,850 - 30,899 1,653 33,350 - 33,399 1,803 35,850 - 35,899 1,953 38,350 - 38,399 2,103 30,900 - 30,949 1,656 33,400 - 33,449 1,806 35,900 - 35,949 1,956 38,400 - 38,449 2,106 30,950 - 30,999 1,659 33,450 - 33,499 1,809 35,950 - 35,999 1,959 38,450 - 38,499 2,109 $31,000 - 31,049 $1,662 33,500 - 33,549 1,812 $36,000 - 36,049 $1,962 38,500 - 38,549 2,112 31,050 - 31,099 1,665 33,550 - 33,599 1,815 36,050 - 36,099 1,965 38,550 - 38,599 2,115 31,100 - 31,149 1,668 33,600 - 33,649 1,818 36,100 - 36,149 1,968 38,600 - 38,649 2,118 31,150 - 31,199 1,671 33,650 - 33,699 1,821 36,150 - 36,199 1,971 38,650 - 38,699 2,121 31,200 - 31,249 1,674 33,700 - 33,749 1,824 36,200 - 36,249 1,974 38,700 - 38,749 2,124 31,250 - 31,299 1,677 33,750 - 33,799 1,827 36,250 - 36,299 1,977 38,750 - 38,799 2,127 31,300 - 31,349 1,680 33,800 - 33,849 1,830 36,300 - 36,349 1,980 38,800 - 38,849 2,130 31,350 - 31,399 1,683 33,850 - 33,899 1,833 36,350 - 36,399 1,983 38,850 - 38,899 2,133 31,400 - 31,449 1,686 33,900 - 33,949 1,836 36,400 - 36,449 1,986 38,900 - 38,949 2,136 31,450 - 31,499 1,689 33,950 - 33,999 1,839 36,450 - 36,499 1,989 38,950 - 38,999 2,139 31,500 - 31,549 1,692 $34,000 - 34,049 $1,842 36,500 - 36,549 1,992 $39,000 - 39,049 $2,142 31,550 - 31,599 1,695 34,050 - 34,099 1,845 36,550 - 36,599 1,995 39,050 - 39,099 2,145 31,600 - 31,649 1,698 34,100 - 34,149 1,848 36,600 - 36,649 1,998 39,100 - 39,149 2,148 31,650 - 31,699 1,701 34,150 - 34,199 1,851 36,650 - 36,699 2,001 39,150 - 39,199 2,151 31,700 - 31,749 1,704 34,200 - 34,249 1,854 36,700 - 36,749 2,004 39,200 - 39,249 2,154 31,750 - 31,799 1,707 34,250 - 34,299 1,857 36,750 - 36,799 2,007 39,250 - 39,299 2,157 31,800 - 31,849 1,710 34,300 - 34,349 1,860 36,800 - 36,849 2,010 39,300 - 39,349 2,160 31,850 - 31,899 1,713 34,350 - 34,399 1,863 36,850 - 36,899 2,013 39,350 - 39,399 2,163 31,900 - 31,949 1,716 34,400 - 34,449 1,866 36,900 - 36,949 2,016 39,400 - 39,449 2,166 31,950 - 31,999 1,719 34,450 - 34,499 1,869 36,950 - 36,999 2,019 39,450 - 39,499 2,169 $32,000 - 32,049 $1,722 34,500 - 34,549 1,872 $37,000 - 37,049 $2,022 39,500 - 39,549 2,172 32,050 - 32,099 1,725 34,550 - 34,599 1,875 37,050 - 37,099 2,025 39,550 - 39,599 2,175 32,100 - 32,149 1,728 34,600 - 34,649 1,878 37,100 - 37,149 2,028 39,600 - 39,649 2,178 32,150 - 32,199 1,731 34,650 - 34,699 1,881 37,150 - 37,199 2,031 39,650 - 39,699 2,181 32,200 - 32,249 1,734 34,700 - 34,749 1,884 37,200 - 37,249 2,034 39,700 - 39,749 2,184 32,250 - 32,299 1,737 34,750 - 34,799 1,887 37,250 - 37,299 2,037 39,750 - 39,799 2,187 32,300 - 32,349 1,740 34,800 - 34,849 1,890 37,300 - 37,349 2,040 39,800 - 39,849 2,190 32,350 - 32,399 1,743 34,850 - 34,899 1,893 37,350 - 37,399 2,043 39,850 - 39,899 2,193 32,400 - 32,449 1,746 34,900 - 34,949 1,896 37,400 - 37,449 2,046 39,900 - 39,949 2,196 32,450 - 32,499 1,749 34,950 - 34,999 1,899 37,450 - 37,499 2,049 39,950 - 39,999 2,199 Tax tables for Income of $100,000 or less continued

97 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $40,000 - 42,499 $42,500 - 44,999 $45,000 - 47,499 $47,500 - 49,999 $40,000 - 40,049 $2,202 $42,500 - 42,549 $2,364 $45,000 - 45,049 $2,527 $47,500 - 47,549 $2,689 40,050 - 40,099 2,205 42,550 - 42,599 2,367 45,050 - 45,099 2,530 47,550 - 47,599 2,692 40,100 - 40,149 2,208 42,600 - 42,649 2,371 45,100 - 45,149 2,533 47,600 - 47,649 2,696 40,150 - 40,199 2,211 42,650 - 42,699 2,374 45,150 - 45,199 2,536 47,650 - 47,699 2,699 40,200 - 40,249 2,215 42,700 - 42,749 2,377 45,200 - 45,249 2,540 47,700 - 47,749 2,702 40,250 - 40,299 2,218 42,750 - 42,799 2,380 45,250 - 45,299 2,543 47,750 - 47,799 2,705 40,300 - 40,349 2,221 42,800 - 42,849 2,384 45,300 - 45,349 2,546 47,800 - 47,849 2,709 40,350 - 40,399 2,224 42,850 - 42,899 2,387 45,350 - 45,399 2,549 47,850 - 47,899 2,712 40,400 - 40,449 2,228 42,900 - 42,949 2,390 45,400 - 45,449 2,553 47,900 - 47,949 2,715 40,450 - 40,499 2,231 42,950 - 42,999 2,393 45,450 - 45,499 2,556 47,950 - 47,999 2,718 40,500 - 40,549 2,234 $43,000 - 43,049 $2,397 45,500 - 45,549 2,559 $48,000 - 48,049 $2,722 40,550 - 40,599 2,237 43,050 - 43,099 2,400 45,550 - 45,599 2,562 48,050 - 48,099 2,725 40,600 - 40,649 2,241 43,100 - 43,149 2,403 45,600 - 45,649 2,566 48,100 - 48,149 2,728 40,650 - 40,699 2,244 43,150 - 43,199 2,406 45,650 - 45,699 2,569 48,150 - 48,199 2,731 40,700 - 40,749 2,247 43,200 - 43,249 2,410 45,700 - 45,749 2,572 48,200 - 48,249 2,735 40,750 - 40,799 2,250 43,250 - 43,299 2,413 45,750 - 45,799 2,575 48,250 - 48,299 2,738 40,800 - 40,849 2,254 43,300 - 43,349 2,416 45,800 - 45,849 2,579 48,300 - 48,349 2,741 40,850 - 40,899 2,257 43,350 - 43,399 2,419 45,850 - 45,899 2,582 48,350 - 48,399 2,744 40,900 - 40,949 2,260 43,400 - 43,449 2,423 45,900 - 45,949 2,585 48,400 - 48,449 2,748 40,950 - 40,999 2,263 43,450 - 43,499 2,426 45,950 - 45,999 $2,588 48,450 - 48,499 2,751 $41,000 - 41,049 $2,267 43,500 - 43,549 2,429 $46,000 - 46,049 $2,592 48,500 - 48,549 2,754 41,050 - 41,099 2,270 43,550 - 43,599 2,432 46,050 - 46,099 2,595 48,550 - 48,599 2,757 41,100 - 41,149 2,273 43,600 - 43,649 2,436 46,100 - 46,149 2,598 48,600 - 48,649 2,761 41,150 - 41,199 2,276 43,650 - 43,699 2,439 46,150 - 46,199 2,601 48,650 - 48,699 2,764 41,200 - 41,249 2,280 43,700 - 43,749 2,442 46,200 - 46,249 2,605 48,700 - 48,749 2,767 41,250 - 41,299 2,283 43,750 - 43,799 2,445 46,250 - 46,299 2,608 48,750 - 48,799 2,770 41,300 - 41,349 2,286 43,800 - 43,849 2,449 46,300 - 46,349 2,611 48,800 - 48,849 2,774 41,350 - 41,399 2,289 43,850 - 43,899 2,452 46,350 - 46,399 2,614 48,850 - 48,899 2,777 41,400 - 41,449 2,293 43,900 - 43,949 2,455 46,400 - 46,449 2,618 48,900 - 48,949 2,780 41,450 - 41,499 2,296 43,950 - 43,999 2,458 46,450 - 46,499 2,621 48,950 - 48,999 $2,783 41,500 - 41,549 2,299 $44,000 - 44,049 $2,462 46,500 - 46,549 2,624 $49,000 - 49,049 $2,787 41,550 - 41,599 2,302 44,050 - 44,099 2,465 46,550 - 46,599 2,627 49,050 - 49,099 2,790 41,600 - 41,649 2,306 44,100 - 44,149 2,468 46,600 - 46,649 2,631 49,100 - 49,149 2,793 41,650 - 41,699 2,309 44,150 - 44,199 2,471 46,650 - 46,699 2,634 49,150 - 49,199 2,796 41,700 - 41,749 2,312 44,200 - 44,249 2,475 46,700 - 46,749 2,637 49,200 - 49,249 2,800 41,750 - 41,799 2,315 44,250 - 44,299 2,478 46,750 - 46,799 2,640 49,250 - 49,299 2,803 41,800 - 41,849 2,319 44,300 - 44,349 2,481 46,800 - 46,849 2,644 49,300 - 49,349 2,806 41,850 - 41,899 2,322 44,350 - 44,399 2,484 46,850 - 46,899 2,647 49,350 - 49,399 2,809 41,900 - 41,949 2,325 44,400 - 44,449 2,488 46,900 - 46,949 2,650 49,400 - 49,449 2,813 41,950 - 41,999 2,328 44,450 - 44,499 2,491 46,950 - 46,999 2,653 49,450 - 49,499 2,816 $42,000 - 42,049 $2,332 44,500 - 44,549 2,494 $47,000 - 47,049 $2,657 49,500 - 49,549 2,819 42,050 - 42,099 2,335 44,550 - 44,599 2,497 47,050 - 47,099 2,660 49,550 - 49,599 2,822 42,100 - 42,149 2,338 44,600 - 44,649 2,501 47,100 - 47,149 2,663 49,600 - 49,649 2,826 42,150 - 42,199 2,341 44,650 - 44,699 2,504 47,150 - 47,199 2,666 49,650 - 49,699 2,829 42,200 - 42,249 2,345 44,700 - 44,749 2,507 47,200 - 47,249 2,670 49,700 - 49,749 2,832 42,250 - 42,299 2,348 44,750 - 44,799 2,510 47,250 - 47,299 2,673 49,750 - 49,799 2,835 42,300 - 42,349 2,351 44,800 - 44,849 2,514 47,300 - 47,349 2,676 49,800 - 49,849 2,839 42,350 - 42,399 2,354 44,850 - 44,899 2,517 47,350 - 47,399 2,679 49,850 - 49,899 2,842 42,400 - 42,449 2,358 44,900 - 44,949 2,520 47,400 - 47,449 2,683 49,900 - 49,949 2,845 42,450 - 42,499 2,361 44,950 - 44,999 2,523 47,450 - 47,499 2,686 49,950 - 49,999 2,848

98 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $50,000 - 52,499 $52,500 - 54,999 $55,000 - 57,499 $57,500 - 59,999 $50,000 - 50,049 $2,852 $52,500 - 52,549 $3,014 $55,000 - 55,049 $3,177 $57,500 - 57,549 $3,339 50,050 - 50,099 2,855 52,550 - 52,599 3,017 55,050 - 55,099 3,180 57,550 - 57,599 3,342 50,100 - 50,149 2,858 52,600 - 52,649 3,021 55,100 - 55,149 3,183 57,600 - 57,649 3,346 50,150 - 50,199 2,861 52,650 - 52,699 3,024 55,150 - 55,199 3,186 57,650 - 57,699 3,349 50,200 - 50,249 2,865 52,700 - 52,749 3,027 55,200 - 55,249 3,190 57,700 - 57,749 3,352 50,250 - 50,299 2,868 52,750 - 52,799 3,030 55,250 - 55,299 3,193 57,750 - 57,799 3,355 50,300 - 50,349 2,871 52,800 - 52,849 3,034 55,300 - 55,349 3,196 57,800 - 57,849 3,359 50,350 - 50,399 2,874 52,850 - 52,899 3,037 55,350 - 55,399 3,199 57,850 - 57,899 3,362 50,400 - 50,449 2,878 52,900 - 52,949 3,040 55,400 - 55,449 3,203 57,900 - 57,949 3,365 50,450 - 50,499 2,881 52,950 - 52,999 3,043 55,450 - 55,499 3,206 57,950 - 57,999 3,368 50,500 - 50,549 2,884 $53,000 - 53,049 $3,047 55,500 - 55,549 3,209 $58,000 - 58,049 $3,372 50,550 - 50,599 2,887 53,050 - 53,099 3,050 55,550 - 55,599 3,212 58,050 - 58,099 3,375 50,600 - 50,649 2,891 53,100 - 53,149 3,053 55,600 - 55,649 3,216 58,100 - 58,149 3,378 50,650 - 50,699 2,894 53,150 - 53,199 3,056 55,650 - 55,699 3,219 58,150 - 58,199 3,381 50,700 - 50,749 2,897 53,200 - 53,249 3,060 55,700 - 55,749 3,222 58,200 - 58,249 3,385 50,750 - 50,799 2,900 53,250 - 53,299 3,063 55,750 - 55,799 3,225 58,250 - 58,299 3,388 50,800 - 50,849 2,904 53,300 - 53,349 3,066 55,800 - 55,849 3,229 58,300 - 58,349 3,391 50,850 - 50,899 2,907 53,350 - 53,399 3,069 55,850 - 55,899 3,232 58,350 - 58,399 3,394 50,900 - 50,949 2,910 53,400 - 53,449 3,073 55,900 - 55,949 3,235 58,400 - 58,449 3,398 50,950 - 50,999 2,913 53,450 - 53,499 3,076 55,950 - 55,999 3,238 58,450 - 58,499 3,401 $51,000 - 51,049 $2,917 53,500 - 53,549 3,079 $56,000 - 56,049 $3,242 58,500 - 58,549 3,404 51,050 - 51,099 2,920 53,550 - 53,599 3,082 56,050 - 56,099 3,245 58,550 - 58,599 3,407 51,100 - 51,149 2,923 53,600 - 53,649 3,086 56,100 - 56,149 3,248 58,600 - 58,649 3,411 51,150 - 51,199 2,926 53,650 - 53,699 3,089 56,150 - 56,199 3,251 58,650 - 58,699 3,414 51,200 - 51,249 2,930 53,700 - 53,749 3,092 56,200 - 56,249 3,255 58,700 - 58,749 3,417 51,250 - 51,299 2,933 53,750 - 53,799 3,095 56,250 - 56,299 3,258 58,750 - 58,799 3,420 51,300 - 51,349 2,936 53,800 - 53,849 3,099 56,300 - 56,349 3,261 58,800 - 58,849 3,424 51,350 - 51,399 2,939 53,850 - 53,899 3,102 56,350 - 56,399 3,264 58,850 - 58,899 3,427 51,400 - 51,449 2,943 53,900 - 53,949 3,105 56,400 - 56,449 3,268 58,900 - 58,949 3,430 51,450 - 51,499 2,946 53,950 - 53,999 3,108 56,450 - 56,499 3,271 58,950 - 58,999 3,433 51,500 - 51,549 2,949 $54,000 - 54,049 $3,112 56,500 - 56,549 3,274 $59,000 - 59,049 $3,437 51,550 - 51,599 2,952 54,050 - 54,099 3,115 56,550 - 56,599 3,277 59,050 - 59,099 3,440 51,600 - 51,649 2,956 54,100 - 54,149 3,118 56,600 - 56,649 3,281 59,100 - 59,149 3,443 51,650 - 51,699 2,959 54,150 - 54,199 3,121 56,650 - 56,699 3,284 59,150 - 59,199 3,446 51,700 - 51,749 2,962 54,200 - 54,249 3,125 56,700 - 56,749 3,287 59,200 - 59,249 3,450 51,750 - 51,799 2,965 54,250 - 54,299 3,128 56,750 - 56,799 3,290 59,250 - 59,299 3,453 51,800 - 51,849 2,969 54,300 - 54,349 3,131 56,800 - 56,849 3,294 59,300 - 59,349 3,456 51,850 - 51,899 2,972 54,350 - 54,399 3,134 56,850 - 56,899 3,297 59,350 - 59,399 3,459 51,900 - 51,949 2,975 54,400 - 54,449 3,138 56,900 - 56,949 3,300 59,400 - 59,449 3,463 51,950 - 51,999 2,978 54,450 - 54,499 3,141 56,950 - 56,999 3,303 59,450 - 59,499 3,466 $52,000 - 52,049 $2,982 54,500 - 54,549 3,144 $57,000 - 57,049 $3,307 59,500 - 59,549 3,469 52,050 - 52,099 2,985 54,550 - 54,599 3,147 57,050 - 57,099 3,310 59,550 - 59,599 3,472 52,100 - 52,149 2,988 54,600 - 54,649 3,151 57,100 - 57,149 3,313 59,600 - 59,649 3,476 52,150 - 52,199 2,991 54,650 - 54,699 3,154 57,150 - 57,199 3,316 59,650 - 59,699 3,479 52,200 - 52,249 2,995 54,700 - 54,749 3,157 57,200 - 57,249 3,320 59,700 - 59,749 3,482 52,250 - 52,299 2,998 54,750 - 54,799 3,160 57,250 - 57,299 3,323 59,750 - 59,799 3,485 52,300 - 52,349 3,001 54,800 - 54,849 3,164 57,300 - 57,349 3,326 59,800 - 59,849 3,489 52,350 - 52,399 3,004 54,850 - 54,899 3,167 57,350 - 57,399 3,329 59,850 - 59,899 3,492 52,400 - 52,449 3,008 54,900 - 54,949 3,170 57,400 - 57,449 3,333 59,900 - 59,949 3,495 52,450 - 52,499 3,011 54,950 - 54,999 3,173 57,450 - 57,499 3,336 59,950 - 59,999 3,498 Tax tables for Income of $100,000 or less continued

99 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $60,000 - 62,499 $62,500 - 64,999 $65,000 - 67,499 $67,500 - 69,999 $60,000 - 60,049 $3,501 $62,500 - 62,549 $3,714 $65,000 - 65,049 $3,926 $67,500 - 67,549 $4,139 60,050 - 60,099 3,505 62,550 - 62,599 3,718 65,050 - 65,099 3,930 67,550 - 67,599 4,143 60,100 - 60,149 3,510 62,600 - 62,649 3,722 65,100 - 65,149 3,935 67,600 - 67,649 4,147 60,150 - 60,199 3,514 62,650 - 62,699 3,726 65,150 - 65,199 3,939 67,650 - 67,699 4,151 60,200 - 60,249 3,518 62,700 - 62,749 3,731 65,200 - 65,249 3,943 67,700 - 67,749 4,156 60,250 - 60,299 3,522 62,750 - 62,799 3,735 65,250 - 65,299 3,947 67,750 - 67,799 4,160 60,300 - 60,349 3,527 62,800 - 62,849 3,739 65,300 - 65,349 3,952 67,800 - 67,849 4,164 60,350 - 60,399 3,531 62,850 - 62,899 3,743 65,350 - 65,399 3,956 67,850 - 67,899 4,168 60,400 - 60,449 3,535 62,900 - 62,949 3,748 65,400 - 65,449 3,960 67,900 - 67,949 4,173 60,450 - 60,499 3,539 62,950 - 62,999 3,752 65,450 - 65,499 3,964 67,950 - 67,999 4,177 60,500 - 60,549 3,544 $63,000 - 63,049 $3,756 65,500 - 65,549 3,969 $68,000 - 68,049 $4,181 60,550 - 60,599 3,548 63,050 - 63,099 3,760 65,550 - 65,599 3,973 68,050 - 68,099 4,185 60,600 - 60,649 3,552 63,100 - 63,149 3,765 65,600 - 65,649 3,977 68,100 - 68,149 4,190 60,650 - 60,699 3,556 63,150 - 63,199 3,769 65,650 - 65,699 3,981 68,150 - 68,199 4,194 60,700 - 60,749 3,561 63,200 - 63,249 3,773 65,700 - 65,749 3,986 68,200 - 68,249 4,198 60,750 - 60,799 3,565 63,250 - 63,299 3,777 65,750 - 65,799 3,990 68,250 - 68,299 4,202 60,800 - 60,849 3,569 63,300 - 63,349 3,782 65,800 - 65,849 3,994 68,300 - 68,349 4,207 60,850 - 60,899 3,573 63,350 - 63,399 3,786 65,850 - 65,899 3,998 68,350 - 68,399 4,211 60,900 - 60,949 3,578 63,400 - 63,449 3,790 65,900 - 65,949 4,003 68,400 - 68,449 4,215 60,950 - 60,999 3,582 63,450 - 63,499 3,794 65,950 - 65,999 4,007 68,450 - 68,499 4,219 $61,000 - 61,049 $3,586 63,500 - 63,549 3,799 $66,000 - 66,049 $4,011 68,500 - 68,549 4,224 61,050 - 61,099 3,590 63,550 - 63,599 3,803 66,050 - 66,099 4,015 68,550 - 68,599 4,228 61,100 - 61,149 3,595 63,600 - 63,649 3,807 66,100 - 66,149 4,020 68,600 - 68,649 4,232 61,150 - 61,199 3,599 63,650 - 63,699 3,811 66,150 - 66,199 4,024 68,650 - 68,699 4,236 61,200 - 61,249 3,603 63,700 - 63,749 3,816 66,200 - 66,249 4,028 68,700 - 68,749 4,241 61,250 - 61,299 3,607 63,750 - 63,799 3,820 66,250 - 66,299 4,032 68,750 - 68,799 4,245 61,300 - 61,349 3,612 63,800 - 63,849 3,824 66,300 - 66,349 4,037 68,800 - 68,849 4,249 61,350 - 61,399 3,616 63,850 - 63,899 3,828 66,350 - 66,399 4,041 68,850 - 68,899 4,253 61,400 - 61,449 3,620 63,900 - 63,949 3,833 66,400 - 66,449 4,045 68,900 - 68,949 4,258 61,450 - 61,499 3,624 63,950 - 63,999 3,837 66,450 - 66,499 4,049 68,950 - 68,999 4,262 61,500 - 61,549 3,629 $64,000 - 64,049 $3,841 66,500 - 66,549 4,054 $69,000 - 69,049 $4,266 61,550 - 61,599 3,633 64,050 - 64,099 3,845 66,550 - 66,599 4,058 69,050 - 69,099 4,270 61,600 - 61,649 3,637 64,100 - 64,149 3,850 66,600 - 66,649 4,062 69,100 - 69,149 4,275 61,650 - 61,699 3,641 64,150 - 64,199 3,854 66,650 - 66,699 4,066 69,150 - 69,199 4,279 61,700 - 61,749 3,646 64,200 - 64,249 3,858 66,700 - 66,749 4,071 69,200 - 69,249 4,283 61,750 - 61,799 3,650 64,250 - 64,299 3,862 66,750 - 66,799 4,075 69,250 - 69,299 4,287 61,800 - 61,849 3,654 64,300 - 64,349 3,867 66,800 - 66,849 4,079 69,300 - 69,349 4,292 61,850 - 61,899 3,658 64,350 - 64,399 3,871 66,850 - 66,899 4,083 69,350 - 69,399 4,296 61,900 - 61,949 3,663 64,400 - 64,449 3,875 66,900 - 66,949 4,088 69,400 - 69,449 4,300 61,950 - 61,999 3,667 64,450 - 64,499 3,879 66,950 - 66,999 4,092 69,450 - 69,499 4,304 $62,000 - 62,049 $3,671 64,500 - 64,549 3,884 $67,000 - 67,049 $4,096 69,500 - 69,549 4,309 62,050 - 62,099 3,675 64,550 - 64,599 3,888 67,050 - 67,099 4,100 69,550 - 69,599 4,313 62,100 - 62,149 3,680 64,600 - 64,649 3,892 67,100 - 67,149 4,105 69,600 - 69,649 4,317 62,150 - 62,199 3,684 64,650 - 64,699 3,896 67,150 - 67,199 4,109 69,650 - 69,699 4,321 62,200 - 62,249 3,688 64,700 - 64,749 3,901 67,200 - 67,249 4,113 69,700 - 69,749 4,326 62,250 - 62,299 3,692 64,750 - 64,799 3,905 67,250 - 67,299 4,117 69,750 - 69,799 4,330 62,300 - 62,349 3,697 64,800 - 64,849 3,909 67,300 - 67,349 4,122 69,800 - 69,849 4,334 62,350 - 62,399 3,701 64,850 - 64,899 3,913 67,350 - 67,399 4,126 69,850 - 69,899 4,338 62,400 - 62,449 3,705 64,900 - 64,949 3,918 67,400 - 67,449 4,130 69,900 - 69,949 4,343 62,450 - 62,499 3,709 64,950 - 64,999 3,922 67,450 - 67,499 4,134 69,950 - 69,999 4,347

100 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $70,000 - 72,499 $72,500 - 74,999 $75,000 - 77,499 $77,500 - 79,999 $70,000 - 70,049 $4,351 $72,500 - 72,549 $4,564 $75,000 - 75,049 $4,776 $77,500 - 77,549 $4,989 70,050 - 70,099 4,355 72,550 - 72,599 4,568 75,050 - 75,099 4,780 77,550 - 77,599 4,993 70,100 - 70,149 4,360 72,600 - 72,649 4,572 75,100 - 75,149 4,785 77,600 - 77,649 4,997 70,150 - 70,199 4,364 72,650 - 72,699 4,576 75,150 - 75,199 4,789 77,650 - 77,699 5,001 70,200 - 70,249 4,368 72,700 - 72,749 4,581 75,200 - 75,249 4,793 77,700 - 77,749 5,006 70,250 - 70,299 4,372 72,750 - 72,799 4,585 75,250 - 75,299 4,797 77,750 - 77,799 5,010 70,300 - 70,349 4,377 72,800 - 72,849 4,589 75,300 - 75,349 4,802 77,800 - 77,849 5,014 70,350 - 70,399 4,381 72,850 - 72,899 4,593 75,350 - 75,399 4,806 77,850 - 77,899 5,018 70,400 - 70,449 4,385 72,900 - 72,949 4,598 75,400 - 75,449 4,810 77,900 - 77,949 5,023 70,450 - 70,499 4,389 72,950 - 72,999 4,602 75,450 - 75,499 4,814 77,950 - 77,999 5,027 70,500 - 70,549 4,394 $73,000 - 73,049 $4,606 75,500 - 75,549 4,819 $78,000 - 78,049 $5,031 70,550 - 70,599 4,398 73,050 - 73,099 4,610 75,550 - 75,599 4,823 78,050 - 78,099 5,035 70,600 - 70,649 4,402 73,100 - 73,149 4,615 75,600 - 75,649 4,827 78,100 - 78,149 5,040 70,650 - 70,699 4,406 73,150 - 73,199 4,619 75,650 - 75,699 4,831 78,150 - 78,199 5,044 70,700 - 70,749 4,411 73,200 - 73,249 4,623 75,700 - 75,749 4,836 78,200 - 78,249 5,048 70,750 - 70,799 4,415 73,250 - 73,299 4,627 75,750 - 75,799 4,840 78,250 - 78,299 5,052 70,800 - 70,849 4,419 73,300 - 73,349 4,632 75,800 - 75,849 4,844 78,300 - 78,349 5,057 70,850 - 70,899 4,423 73,350 - 73,399 4,636 75,850 - 75,899 4,848 78,350 - 78,399 5,061 70,900 - 70,949 4,428 73,400 - 73,449 4,640 75,900 - 75,949 4,853 78,400 - 78,449 5,065 70,950 - 70,999 4,432 73,450 - 73,499 4,644 75,950 - 75,999 4,857 78,450 - 78,499 5,069 $71,000 - 71,049 $4,436 73,500 - 73,549 4,649 $76,000 - 76,049 $4,861 78,500 - 78,549 5,074 71,050 - 71,099 4,440 73,550 - 73,599 4,653 76,050 - 76,099 4,865 78,550 - 78,599 5,078 71,100 - 71,149 4,445 73,600 - 73,649 4,657 76,100 - 76,149 4,870 78,600 - 78,649 5,082 71,150 - 71,199 4,449 73,650 - 73,699 4,661 76,150 - 76,199 4,874 78,650 - 78,699 5,086 71,200 - 71,249 4,453 73,700 - 73,749 4,666 76,200 - 76,249 4,878 78,700 - 78,749 5,091 71,250 - 71,299 4,457 73,750 - 73,799 4,670 76,250 - 76,299 4,882 78,750 - 78,799 5,095 71,300 - 71,349 4,462 73,800 - 73,849 4,674 76,300 - 76,349 4,887 78,800 - 78,849 5,099 71,350 - 71,399 4,466 73,850 - 73,899 4,678 76,350 - 76,399 4,891 78,850 - 78,899 5,103 71,400 - 71,449 4,470 73,900 - 73,949 4,683 76,400 - 76,449 4,895 78,900 - 78,949 5,108 71,450 - 71,499 4,474 73,950 - 73,999 4,687 76,450 - 76,499 4,899 78,950 - 78,999 5,112 71,500 - 71,549 4,479 $74,000 - 74,049 $4,691 76,500 - 76,549 4,904 $79,000 - 79,049 $5,116 71,550 - 71,599 4,483 74,050 - 74,099 4,695 76,550 - 76,599 4,908 79,050 - 79,099 5,120 71,600 - 71,649 4,487 74,100 - 74,149 4,700 76,600 - 76,649 4,912 79,100 - 79,149 5,125 71,650 - 71,699 4,491 74,150 - 74,199 4,704 76,650 - 76,699 4,916 79,150 - 79,199 5,129 71,700 - 71,749 4,496 74,200 - 74,249 4,708 76,700 - 76,749 4,921 79,200 - 79,249 5,133 71,750 - 71,799 4,500 74,250 - 74,299 4,712 76,750 - 76,799 4,925 79,250 - 79,299 5,137 71,800 - 71,849 4,504 74,300 - 74,349 4,717 76,800 - 76,849 4,929 79,300 - 79,349 5,142 71,850 - 71,899 4,508 74,350 - 74,399 4,721 76,850 - 76,899 4,933 79,350 - 79,399 5,146 71,900 - 71,949 4,513 74,400 - 74,449 4,725 76,900 - 76,949 4,938 79,400 - 79,449 5,150 71,950 - 71,999 4,517 74,450 - 74,499 4,729 76,950 - 76,999 4,942 79,450 - 79,499 5,154 $72,000 - 72,049 $4,521 74,500 - 74,549 4,734 $77,000 - 77,049 $4,946 79,500 - 79,549 5,159 72,050 - 72,099 4,525 74,550 - 74,599 4,738 77,050 - 77,099 4,950 79,550 - 79,599 5,163 72,100 - 72,149 4,530 74,600 - 74,649 4,742 77,100 - 77,149 4,955 79,600 - 79,649 5,167 72,150 - 72,199 4,534 74,650 - 74,699 4,746 77,150 - 77,199 4,959 79,650 - 79,699 5,171 72,200 - 72,249 4,538 74,700 - 74,749 4,751 77,200 - 77,249 4,963 79,700 - 79,749 5,176 72,250 - 72,299 4,542 74,750 - 74,799 4,755 77,250 - 77,299 4,967 79,750 - 79,799 5,180 72,300 - 72,349 4,547 74,800 - 74,849 4,759 77,300 - 77,349 4,972 79,800 - 79,849 5,184 72,350 - 72,399 4,551 74,850 - 74,899 4,763 77,350 - 77,399 4,976 79,850 - 79,899 5,188 72,400 - 72,449 4,555 74,900 - 74,949 4,768 77,400 - 77,449 4,980 79,900 - 79,949 5,193 72,450 - 72,499 4,559 74,950 - 74,999 4,772 77,450 - 77,499 4,984 79,950 - 79,999 5,197 Tax tables for Income of $100,000 or less continued

101 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $80,000 - 82,499 $82,500 - 84,999 $85,000 - 87,499 $87,500 - 89,999 $80,000 - 80,049 $5,201 $82,500 - 82,549 $5,414 $85,000 - 85,049 $5,626 $87,500 - 87,549 $5,839 80,050 - 80,099 5,205 82,550 - 82,599 5,418 85,050 - 85,099 5,630 87,550 - 87,599 5,843 80,100 - 80,149 5,210 82,600 - 82,649 5,422 85,100 - 85,149 5,635 87,600 - 87,649 5,847 80,150 - 80,199 5,214 82,650 - 82,699 5,426 85,150 - 85,199 5,639 87,650 - 87,699 5,851 80,200 - 80,249 5,218 82,700 - 82,749 5,431 85,200 - 85,249 5,643 87,700 - 87,749 5,856 80,250 - 80,299 5,222 82,750 - 82,799 5,435 85,250 - 85,299 5,647 87,750 - 87,799 5,860 80,300 - 80,349 5,227 82,800 - 82,849 5,439 85,300 - 85,349 5,652 87,800 - 87,849 5,864 80,350 - 80,399 5,231 82,850 - 82,899 5,443 85,350 - 85,399 5,656 87,850 - 87,899 5,868 80,400 - 80,449 5,235 82,900 - 82,949 5,448 85,400 - 85,449 5,660 87,900 - 87,949 5,873 80,450 - 80,499 5,239 82,950 - 82,999 5,452 85,450 - 85,499 5,664 87,950 - 87,999 5,877 80,500 - 80,549 5,244 $83,000 - 83,049 $5,456 85,500 - 85,549 5,669 $88,000 - 88,049 $5,881 80,550 - 80,599 5,248 83,050 - 83,099 5,460 85,550 - 85,599 5,673 88,050 - 88,099 5,885 80,600 - 80,649 5,252 83,100 - 83,149 5,465 85,600 - 85,649 5,677 88,100 - 88,149 5,890 80,650 - 80,699 5,256 83,150 - 83,199 5,469 85,650 - 85,699 5,681 88,150 - 88,199 5,894 80,700 - 80,749 5,261 83,200 - 83,249 5,473 85,700 - 85,749 5,686 88,200 - 88,249 5,898 80,750 - 80,799 5,265 83,250 - 83,299 5,477 85,750 - 85,799 5,690 88,250 - 88,299 5,902 80,800 - 80,849 5,269 83,300 - 83,349 5,482 85,800 - 85,849 5,694 88,300 - 88,349 5,907 80,850 - 80,899 5,273 83,350 - 83,399 5,486 85,850 - 85,899 5,698 88,350 - 88,399 5,911 80,900 - 80,949 5,278 83,400 - 83,449 5,490 85,900 - 85,949 5,703 88,400 - 88,449 5,915 80,950 - 80,999 5,282 83,450 - 83,499 5,494 85,950 - 85,999 5,707 88,450 - 88,499 5,919 $81,000 - 81,049 $5,286 83,500 - 83,549 5,499 86,000 - 86,049 $5,711 88,500 - 88,549 5,924 81,050 - 81,099 5,290 83,550 - 83,599 5,503 86,050 - 86,099 5,715 88,550 - 88,599 5,928 81,100 - 81,149 5,295 83,600 - 83,649 5,507 86,100 - 86,149 5,720 88,600 - 88,649 5,932 81,150 - 81,199 5,299 83,650 - 83,699 5,511 86,150 - 86,199 5,724 88,650 - 88,699 5,936 81,200 - 81,249 5,303 83,700 - 83,749 5,516 86,200 - 86,249 5,728 88,700 - 88,749 5,941 81,250 - 81,299 5,307 83,750 - 83,799 5,520 86,250 - 86,299 5,732 88,750 - 88,799 5,945 81,300 - 81,349 5,312 83,800 - 83,849 5,524 86,300 - 86,349 5,737 88,800 - 88,849 5,949 81,350 - 81,399 5,316 83,850 - 83,899 5,528 86,350 - 86,399 5,741 88,850 - 88,899 5,953 81,400 - 81,449 5,320 83,900 - 83,949 5,533 86,400 - 86,449 5,745 88,900 - 88,949 5,958 81,450 - 81,499 5,324 83,950 - 83,999 5,537 86,450 - 86,499 5,749 88,950 - 88,999 5,962 81,500 - 81,549 5,329 $84,000 - 84,049 $5,541 86,500 - 86,549 5,754 $89,000 - 89,049 $5,966 81,550 - 81,599 5,333 84,050 - 84,099 5,545 86,550 - 86,599 5,758 89,050 - 89,099 5,970 81,600 - 81,649 5,337 84,100 - 84,149 5,550 86,600 - 86,649 5,762 89,100 - 89,149 5,975 81,650 - 81,699 5,341 84,150 - 84,199 5,554 86,650 - 86,699 5,766 89,150 - 89,199 5,979 81,700 - 81,749 5,346 84,200 - 84,249 5,558 86,700 - 86,749 5,771 89,200 - 89,249 5,983 81,750 - 81,799 5,350 84,250 - 84,299 5,562 86,750 - 86,799 5,775 89,250 - 89,299 5,987 81,800 - 81,849 5,354 84,300 - 84,349 5,567 86,800 - 86,849 5,779 89,300 - 89,349 5,992 81,850 - 81,899 5,358 84,350 - 84,399 5,571 86,850 - 86,899 5,783 89,350 - 89,399 5,996 81,900 - 81,949 5,363 84,400 - 84,449 5,575 86,900 - 86,949 5,788 89,400 - 89,449 6,000 81,950 - 81,999 5,367 84,450 - 84,499 5,579 86,950 - 86,999 5,792 89,450 - 89,499 6,004 $82,000 - 82,049 $5,371 84,500 - 84,549 5,584 $87,000 - 87,049 $5,796 89,500 - 89,549 6,009 82,050 - 82,099 5,375 84,550 - 84,599 5,588 87,050 - 87,099 5,800 89,550 - 89,599 6,013 82,100 - 82,149 5,380 84,600 - 84,649 5,592 87,100 - 87,149 5,805 89,600 - 89,649 6,017 82,150 - 82,199 5,384 84,650 - 84,699 5,596 87,150 - 87,199 5,809 89,650 - 89,699 6,021 82,200 - 82,249 5,388 84,700 - 84,749 5,601 87,200 - 87,249 5,813 89,700 - 89,749 6,026 82,250 - 82,299 5,392 84,750 - 84,799 5,605 87,250 - 87,299 5,817 89,750 - 89,799 6,030 82,300 - 82,349 5,397 84,800 - 84,849 5,609 87,300 - 87,349 5,822 89,800 - 89,849 6,034 82,350 - 82,399 5,401 84,850 - 84,899 5,613 87,350 - 87,399 5,826 89,850 - 89,899 6,038 82,400 - 82,449 5,405 84,900 - 84,949 5,618 87,400 - 87,449 5,830 89,900 - 89,949 6,043 82,450 - 82,499 5,409 84,950 - 84,999 5,622 87,450 - 87,499 5,834 89,950 - 89,999 6,047

102 Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax Taxable income Amount of tax $90,000 - 92,499 $92,500 - 94,999 $95,000 - 97,499 $97,500 - $99,999 $90,000 - 90,049 6,051 $92,500 - 92,549 $6,264 $95,000 - 95,049 $6,476 $97,500 - 97,549 $6,689 90,050 - 90,099 6,055 92,550 - 92,599 6,268 95,050 - 95,099 6,480 97,550 - 97,599 6,693 90,100 - 90,149 6,060 92,600 - 92,649 6,272 95,100 - 95,149 6,485 97,600 - 97,649 6,697 90,150 - 90,199 6,064 92,650 - 92,699 6,276 95,150 - 95,199 6,489 97,650 - 97,699 6,701 90,200 - 90,249 6,068 92,700 - 92,749 6,281 95,200 - 95,249 6,493 97,700 - 97,749 6,706 90,250 - 90,299 6,072 92,750 - 92,799 6,285 95,250 - 95,299 6,497 97,750 - 97,799 6,710 90,300 - 90,349 6,077 92,800 - 92,849 6,289 95,300 - 95,349 6,502 97,800 - 97,849 6,714 90,350 - 90,399 6,081 92,850 - 92,899 6,293 95,350 - 95,399 6,506 97,850 - 97,899 6,718 90,400 - 90,449 6,085 92,900 - 92,949 6,298 95,400 - 95,449 6,510 97,900 - 97,949 6,723 90,450 - 90,499 6,089 92,950 - 92,999 6,302 95,450 - 95,499 6,514 97,950 - 97,999 6,727 90,500 - 90,549 6,094 $93,000 - 93,049 $6,306 95,500 - 95,549 6,519 $98,000 - 98,049 $6,731 90,550 - 90,599 6,098 93,050 - 93,099 6,310 95,550 - 95,599 6,523 98,050 - 98,099 6,735 90,600 - 90,649 6,102 93,100 - 93,149 6,315 95,600 - 95,649 6,527 98,100 - 98,149 6,740 90,650 - 90,699 6,106 93,150 - 93,199 6,319 95,650 - 95,699 6,531 98,150 - 98,199 6,744 90,700 - 90,749 6,111 93,200 - 93,249 6,323 95,700 - 95,749 6,536 98,200 - 98,249 6,748 90,750 - 90,799 6,115 93,250 - 93,299 6,327 95,750 - 95,799 6,540 98,250 - 98,299 6,752 90,800 - 90,849 6,119 93,300 - 93,349 6,332 95,800 - 95,849 6,544 98,300 - 98,349 6,757 90,850 - 90,899 6,123 93,350 - 93,399 6,336 95,850 - 95,899 6,548 98,350 - 98,399 6,761 90,900 - 90,949 6,128 93,400 - 93,449 6,340 95,900 - 95,949 6,553 98,400 - 98,449 6,765 90,950 - 90,999 6,132 93,450 - 93,499 6,344 95,950 - 95,999 $6,557 98,450 - 98,499 6,769 $91,000 - 91,049 $6,136 93,500 - 93,549 6,349 $96,000 - 96,049 $6,561 98,500 - 98,549 6,774 91,050 - 91,099 6,140 93,550 - 93,599 6,353 96,050 - 96,099 6,565 98,550 - 98,599 6,778 91,100 - 91,149 6,145 93,600 - 93,649 6,357 96,100 - 96,149 6,570 98,600 - 98,649 6,782 91,150 - 91,199 6,149 93,650 - 93,699 6,361 96,150 - 96,199 6,574 98,650 - 98,699 6,786 91,200 - 91,249 6,153 93,700 - 93,749 6,366 96,200 - 96,249 6,578 98,700 - 98,749 6,791 91,250 - 91,299 6,157 93,750 - 93,799 6,370 96,250 - 96,299 6,582 98,750 - 98,799 6,795 91,300 - 91,349 6,162 93,800 - 93,849 6,374 96,300 - 96,349 6,587 98,800 - 98,849 6,799 91,350 - 91,399 6,166 93,850 - 93,899 6,378 96,350 - 96,399 6,591 98,850 - 98,899 6,803 91,400 - 91,449 6,170 93,900 - 93,949 6,383 96,400 - 96,449 6,595 98,900 - 98,949 6,808 91,450 - 91,499 6,174 93,950 - 93,999 6,387 96,450 - 96,499 6,599 98,950 - 98,999 6,812 91,500 - 91,549 6,179 $94,000 - 94,049 $6,391 96,500 - 96,549 6,604 $99,000 - 99,049 $6,816 91,550 - 91,599 6,183 94,050 - 94,099 6,395 96,550 - 96,599 6,608 99,050 - 99,099 6,820 91,600 - 91,649 6,187 94,100 - 94,149 6,400 96,600 - 96,649 6,612 99,100 - 99,149 6,825 91,650 - 91,699 6,191 94,150 - 94,199 6,404 96,650 - 96,699 6,616 99,150 - 99,199 6,829 91,700 - 91,749 6,196 94,200 - 94,249 6,408 96,700 - 96,749 6,621 99,200 - 99,249 6,833 91,750 - 91,799 6,200 94,250 - 94,299 6,412 96,750 - 96,799 6,625 99,250 - 99,299 6,837 91,800 - 91,849 6,204 94,300 - 94,349 6,417 96,800 - 96,849 6,629 99,300 - 99,349 6,842 91,850 - 91,899 6,208 94,350 - 94,399 6,421 96,850 - 96,899 6,633 99,350 - 99,399 6,846 91,900 - 91,949 6,213 94,400 - 94,449 6,425 96,900 - 96,949 6,638 99,400 - 99,449 6,850 91,950 - 91,999 6,217 94,450 - 94,499 6,429 96,950 - 96,999 6,642 99,450 - 99,499 6,854 $92,000 - 92,049 $6,221 94,500 - 94,549 6,434 $97,000 - 97,049 $6,646 99,500 - 99,549 6,859 92,050 - 92,099 6,225 94,550 - 94,599 6,438 97,050 - 97,099 6,650 99,550 - 99,599 6,863 92,100 - 92,149 6,230 94,600 - 94,649 6,442 97,100 - 97,149 6,655 99,600 - 99,649 6,867 92,150 - 92,199 6,234 94,650 - 94,699 6,446 97,150 - 97,199 6,659 99,650 - 99,699 6,871 92,200 - 92,249 6,238 94,700 - 94,749 6,451 97,200 - 97,249 6,663 99,700 - 99,749 6,876 92,250 - 92,299 6,242 94,750 - 94,799 6,455 97,250 - 97,299 6,667 99,750 - 99,799 6,880 92,300 - 92,349 6,247 94,800 - 94,849 6,459 97,300 - 97,349 6,672 99,800 - 99,849 6,884 92,350 - 92,399 6,251 94,850 - 94,899 6,463 97,350 - 97,399 6,676 99,850 - 99,899 6,888 92,400 - 92,449 6,255 94,900 - 94,949 6,468 97,400 - 97,449 6,680 99,900 - 99,949 6,893 92,450 - 92,499 6,259 94,950 - 94,999 6,472 97,450 - 97,499 6,684 99,950 - 99,999 6,897 100,000 - 6,901 Tax tables for Income of $100,000 or less continued $

©2021 DC College Savings Plan, Member FINRA. All Rights Reserved. 580500_ES_DC 0821 Learn more at dccollegesavings.com/tax or 1.800.987.4859. 1 Earnings on non-qualified withdrawals may be subject to federal income tax and a 10% federal penalty tax, as well as state and local income taxes and recapture of DC tax deductions. Tax and other benefits are contingent on meeting other requirements and certain withdrawals are subject to federal, state, and local taxes. 2 K-12 tuition expenses at a private, public or parochial school (up to $10,000 per year per student.) 3 If you make an education loan repayment from your Account, you may not also take a federal income tax deduction for any interest included in that education loan repayment. 4 The apprenticeship program must be registered and certified with the Secretary of Labor under the National Apprenticeship Act. 5 Contributions by DC taxpayers in excess of the annual limit may carry forward the excess of five (5) years and may be deducted in future years on their DC tax return. If a participant makes a non-qualified withdrawal or a transfer/rollover to another state’s program within two (2) years of opening the account, the amount of the deduction is “recaptured” and must be included in the participant’s District of Columbia income. Before you invest, consider whether your or the beneficiary’s home state offers any state tax or other state benefits such as financial aid, scholarship funds, and protection from creditors that that are only available for investments in that state’s qualified tuition program. For more information about The DC College Savings Plan (“The Plan”), call 800.987.4859, or visit dccollegesavings. com to obtain a Program Disclosure Booklet, which includes investment objectives, risks, charges, expenses, and other important information; read and consider it carefully before investing. The Plan is administered by the District of Columbia Office of the Chief Financial Officer, Office of Finance and Treasury. Ascensus College Savings Recordkeeping Services, LLC, the Program Manager, and its affiliates, have overall responsibility for the day-to-day operations, including recordkeeping and administrative services. Ascensus Investment Advisors, LLC serves as the Investment Manager. Save for tuition and save on taxes. Qualified distributions can help pay for: • Tuition at eligible higher education institutions nationwide1 • Certain room & board costs • Computers and laptops • Books and other tools, if required by the school • K-12 Tuition2 • Loan Repayment up to $10,000 lifetime3 • Apprenticeship programs4 Special tax deduction for DC residents DC taxpayers can deduct up to $8,000 for married or domestic couples filing jointly, who have separate accounts, ($4,000 for individuals) when they contribute to their DC College Savings Plan account.5

Office of Tax and Revenue Reeves Center 1101 4th St SW 2nd Floor 2000 14th St NW Lobby 8:15 am–5:30 pm 7 am–7 pm One Judiciary Square Wilson Building 441 4th St NW Lobby 1350 Pennsylvania Av NW Lobby 7 am–7 pm 7 am–7 pm Municipal Center 300 Indiana Av NW Lobby 6:30 am–8 pm DC Public Library https://www.dclibrary.org/ plan-visit Are you unable to hear or speak? Call the DC Relay Service, 202-727-3363. [Spanish] Si necesita ayuda en Español, por favor llame al   para proporcionarle un intérprete GHPDQHUDJUDWXLWD. [Vietnamese] NӃu quý vӏ cҫn giúp āӥ vӅ tiӃng ViӋt, xin gӑi   āӇ chúng tôi thu xӃp có thông dӏch viên āӃn giúp quý vӏ PLӉQSKt. [French] Si vous avez besoin d’aide en Français appelez-le   et l’assistance d’un interprète vous sera IRXUQLHJUDWXLWHPHQW. [Amharic] Ĉīèñħ İñőĒ IJŸÝŝ Ĉ    ŌŎľÞȀ ŇĝDž īøďñȗç ŌåŎčâĿĒâȀ >.RUHDQ@뼑霢꽩ꈑ꽭꽩덵낅넩뻹끉뼍겕陲끥   ꈑ꾥ꄲ냹늱겑ꐩꓩꊁꈑ뭪꾢넩 뇑險鷞鱽鲙 >&KLQHVH@ڕ࣠൞Ꮑ૞ش խ֮ ൷࠹ᚥܗΔᓮሽ੓   ല܍၄ٻ൞༼ࠎՑ᤟୉ࣚ೭Ζ Ask tax questions Contact our Customer Service Administration: 202-727-4TAX (4829) Hours: 8:15 am-5:30 pm, Monday-Friday Visit our Walk-in Center / Pick up forms 1101 4th St SW, 2nd Floor Hours: 9:00 am-4:00 pm, Monday-Friday Need assistance? File or pay online: Þ/aÝ°

°}œv° Get tax forms To download DC tax forms visit DC Tax Forms/Instructions. Request forms by mail: 202-727-4829 Pick up forms: