To request this document in an alternate format, please complete the form dor.wa.gov/AccessibilityRequest or call 360-705-6705. Teletype (TTY) users please dial 711. REV 14 0001 (10/24/23) Applicant initials: _____________ Year of birth:___________ Page 1 of 6 Form 14 0001 Mail to: Washington State Dept. of Revenue Attn: Working Families Tax Credit Division PO Box 47468 Olympia, WA, 98504-7468 2023 Working Families Tax Credit Application Skip the paper form and file online! Go to WorkingFamiliesCredit.wa.gov Need help? Email DORWFTC@dor.wa.gov, call 360-763-7300, or read instructions at workingfamiliescredit.wa.gov/get-help. What is your preferred language for receiving communication? English Spanish Other The Department currently sends letters in English only. We are collecting other language preferences to determine which languages are needed in the future. Amended application? Check this box and attach a letter of explanation.

A. Your information 1. First name Middle initial Last name

2. Valid SSN or ITIN

I am currently waiting for an ITIN from the IRS (for myself, my spouse, and/or my child). 3. Date of birth (MM/DD/YYYY) 4. Washington state driver’s license or ID number

I do not have or do not want to provide a Washington State license or ID number. Note: Providing your license or ID number will generally expedite the application review process. 5. Mailing address City State Zip code 6. Primary phone Cell phone Email

B. Residency questions 7. Did you live in Washington for at least 183 days in 2023?

Yes No 8. Is your mailing address in Section A the same as your current primary residence?

Yes No If yes, skip to Section C. 9. If you answered “no” to question 8, what is your current primary residence? Address

City State Zip code

I do not have or do not want to provide an address for my primary residence. Note: Providing your address of primary residence will generally expedite the application review process and decrease the likelihood of additional contact from the Department.

Working Families Tax Credit Application REV 14 0001 (10/24/23) Applicant initials: _____________ Year of birth:___________ Page 2 of 6 C. Eligibility questions 10. What was your filing status for your 2023 federal tax return?

Single Head of household Qualifying Surviving Spouse

Married filing jointly Married filing separately 11. Did you claim the federal EITC in 2023? Yes No If yes, skip to question 13. 12. Did you meet all of the following criteria even though you didn’t claim the federal EITC in 2023? Yes No • You must meet the IRS Adjusted Gross Income (AGI) thresholds based on your tax filing status. View the AGI threshold brackets in the instructions. • If you (and your spouse if applicable) have no children, you (or your spouse) must be 25 - 64 years old at the end of 2023. • If you (or your spouse if applicable) have investment income, it must be less than $11,000. • The following situations do NOT apply to you (these are less common): օ You filed a Federal Form 2555, relating to foreign income. օ You (or your spouse if applicable) were claimed as a qualifying child of another person. օ If you do not have qualifying children, you (or your spouse if applicable) were claimed as a dependent of another person. օ You (or your spouse if applicable) were treated as a U.S. nonresident alien. օ You are currently in a disallowance period from claiming the Federal Earned Income Tax Credit (EITC). D. Spouse information If you do not have a spouse, skip to Section E. 13. First name Middle initial Last name 14. Valid SSN or ITIN

15. Date of birth (MM/DD/YYYY)

E. Information on qualifying children If you do not have qualifying children, skip to Section F. Instructions: Fill out the following information for each qualifying child. A qualifying child can only be claimed by one individual or couple. Review the instructions if you have questions about who you can claim the child. If a qualifying child was born and deceased in 2023, write “deceased” in the Valid SSN or ITIN field. A qualifying child must have one of the following relationships to the applicant: • Child – A child, stepchild, adopted child, foster child or descendant of one of these (for example, grandchild). • Sibling – A sibling, half-sibling, stepsibling or descendant of one of these (for example, niece or nephew).

Working Families Tax Credit Application REV 14 0001 (10/24/23) Applicant initials: _____________ Year of birth:___________ Page 3 of 6 16. Questions Child 1 Child 2 Child 3 First name Middle initial Last name Date of birth (MM/DD/YYYY) Valid SSN or ITIN Select the qualifying child’s relationship to you. Child, stepchild, adopted child, or foster child Sibling, half-sibling, or stepsibling Child, stepchild, adopted child, or foster child Sibling, half-sibling, or stepsibling Child, stepchild, adopted child, or foster child Sibling, half- sibling, or stepsibling Did this child live with you more than half the year? Yes No Yes No Yes No Was this child a student? Yes No Yes No Yes No Was this child permanently and totally disabled during any part of 2023? Yes No Yes No Yes No Did you claim this qualifying child for EITC on your federal tax return? Yes No Yes No Yes No F. Earned income Instructions: Provide income for 2023. Income information 17. Income reported on line 1z, Form 1040 or 1040-SR. 18. Adjusted Gross Income (AGI) reported on line 11, Form 1040 or 1040-SR. 19. Did you itemize your 2023 federal tax return?

Yes No Not sure

Refer to the instructions for information about how to determine if you itemized your tax return. 20. Did any of the following situations apply to you in 2023? If so, check all the boxes that apply.

Self-Employed (reported on Schedule C, Schedule F, and/or Schedule SE and Schedule E).

Member of a clergy or employed by a church and filed a Schedule SE.

Employed by the military and received combat pay reported on Form 1040 or 1040SR line 1i.

Statutory employee and filed a Schedule C with your federal tax return reported on Schedule C line 1.

Had a Medicaid waiver payment reported on Schedule 1 line 8s.

Working Families Tax Credit Application REV 14 0001 (10/24/23) Applicant initials: _____________ Year of birth:___________ Page 4 of 6 G. How would you like to receive your credit? Instructions: Select a method for receiving your credit. If you do not fill out this section, or the direct deposit information provided is invalid, we will send a check to your mailing address you provided in Section A. If you choose direct deposit, it is important your bank account information is accurate. Check with your financial institution to get the correct routing and account numbers to make sure your direct deposit will be accepted. Department of Revenue is not responsible for a lost payment if you enter the wrong account information. Direct deposit Bank routing number Account number

Type of account: Personal Checking Personal Savings

Business Checking Business Savings Mailed check (Make sure your address is correct in Section A Your information, page 1) Prepaid debit card • Prepaid debit cards will only be issued in the name of the primary applicant, and only one card will be issued. • The prepaid debit card will be sent to the mailing address you provided on this application. • Once a refund has been issued on a prepaid debit card, DOR will not be able to change your method of payment. Please ensure all information you have provided is accurate. • To learn more about the prepaid debit card terms and fees, please visit workingfamiliescredit.wa.gov/DebitCards. H. Attachments A copy of your 2023 federal tax return is required. This includes your federal form 1040 or 1040-SR and all forms and schedules submitted as part of your federal return. For example, if your tax return has any of the following, you must submit them with your application: • Schedule EIC • Schedule C • Schedule 1 • Schedule SE • Schedule E • Schedule F I. Declaration and signatures By signing this application, I agree to the following statements under penalties of perjury: • The information provided is true, correct, and complete. • I have documentation to support my responses on this application and can provide them to the department if requested. • I filed the federal income tax return included with this application with the Internal Revenue Service as of the date of signing. • This application is not filed on behalf of a deceased individual. • I have paid sales tax on purchases I made during the period for which the refund is being claimed. Applicant signature ________________________________ Date (MM/DD/YYYY) ____________ Spouse signature* ________________________________ Date (MM/DD/YYYY) ____________ *Required if filing as “married filing jointly.”

Working Families Tax Credit Application REV 14 0001 (10/24/23) Applicant initials: _____________ Year of birth:___________ Page 5 of 6 The Preparer information section (J.) and the Demographic information section (K.) are both voluntary. Completing or not completing these sections will not impact your eligibility for the refund. J. Preparer information 21. Did you prepare your own application? If no, please answer below.

Yes No a. Preparer’s name Phone

b. Preparer’s business name Email c. Preparer Tax Identification Number (PTIN): d. Was this application prepared at a Volunteer Income Tax Assistance (VITA) site?

Yes No If yes, VITA site name To authorize the Department of Revenue to speak with the preparer, a Confidential Tax Information Authorization form is required. You can find the form and attach with this application. K. Demographic information Purpose: Information collected from this application will help inform and improve the program. Your input will ensure that tax dollars are returned to working families like yours. Without your input, the Legislature may find it difficult to evaluate the program’s effectiveness. Your responses to the racial and ethnic background questions will not affect eligibility or benefit amounts. Select any combination. 22. Are you of Hispanic, Latino, or Spanish origin? Please check all that apply. Hispanic, Latino, or Spanish Origin You Spouse Child 1 Child 2 Child 3 No, not of Hispanic, Latino, or Spanish origin Yes, Mexican, Mexican- American, Chicano Yes, Central American (countries below Mexico and above South America) Yes, Caribbean Islands Yes, South American Yes, Indigenous Describe Describe Describe Describe Describe Yes, another Hispanic, Latino, or Spanish origin Describe Describe Describe Describe Describe Prefer not to say

Working Families Tax Credit Application REV 14 0001 (10/24/23) Applicant initials: _____________ Year of birth:___________ Page 6 of 6 23. What race do you consider yourself? Please check all that apply. Race You Spouse Child 1 Child 2 Child 3 American Indian or Alaskan Native Tribe name Tribe name Tribe name Tribe name Tribe name Amhara Asian Indian

Black or African American Chamorro Chinese Eritrean Filipino Japanese Korean Native Hawaiian Oromo Samoan Somali Tigre Vietnamese Western African White Other African Describe Describe Describe Describe Describe Other Asian Describe Describe Describe Describe Describe Other Pacific Islander Describe Describe Describe Describe Describe Other race Describe Describe Describe Describe Describe Prefer not to say 24. How did you hear about the Working Families Tax Credit program? Website Social Media Another organization or agency Word of mouth Other

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 Who is eligible? To qualify for the Working Families Tax Credit (WFTC), you must meet all the following criteria for 2023: • You (or your spouse if applicable) have filed a federal tax return (form 1040 or 1040-SR). • You (or your spouse if applicable) meet the requirements for the federal Earned Income Tax Credit (EITC), OR would meet the requirements for EITC, but filed with an Individual Taxpayer IdenƟficaƟon Number (ITIN). • You (or your spouse if applicable) must be at least 25 and under 65 years of age OR have a qualifying child. • You must have lived in Washington for at least 183 days (more than half the year). • You (and your spouse if applicable) must have an Adjusted Gross Income (AGI) below the thresholds below:

Adjusted Gross Income (AGI) must be less than Number of Qualifying Children Filing Status: Single Filing Status: Married

$17,640 $24,210 0 $46,560 $53,120 1 $52,918 $59,478 2 $56,838 $63,398 3+

What do I need? Please make sure you have the following informaƟon before filing the applicaƟon: 1. A copy of your complete 2023 federal tax return, which includes your form 1040 or 1040-SR and all forms and schedules you filed with your 2023 federal income tax return. a. On the applicaƟon, you will need to provide your wages, salaries, and Ɵps from line 1z and the adjusted gross income (AGI) from line 11. 2. Legal name, social security number (SSN) or individual taxpayer idenƟficaƟon number (ITIN), and dates of birth for you, your spouse (if applicable), and any qualifying children. If you have applied for an ITIN and have not yet received it, check the box on QuesƟon 2 that states “I am currently waiƟng for an ITIN from the IRS (for myself, my spouse, and/or my child).” Your WFTC applicaƟon will not be processed unƟl you contact the Department to provide a valid ITIN. 3. Current mailing address and current residenƟal address. If you use a PO box or private mailbox as a mailing address, you must provide the Department with your current residenƟal address. See “Residency” secƟon for details on what to do if you do not have a residenƟal address. 4. Your bank rouƟng number and account number if you are choosing direct deposit. 5. Applicant signature (and or your spouse if applicable). When do I apply? StarƟng Feb. 1, 2024, for 2023.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 How do I apply? • Online at WFTC.wa.gov • Paper ApplicaƟons are available: o On our website: WFTC.wa.gov o At a local DOR field office:  Bellingham - 1904 Humboldt Street  Bothell - 12100 NE 195th St Suite 100  Kent - 20819 72nd Ave South Suite 680  Port Angeles - 734 E First St Suite B  Richland - 1657 Fowler Street  Seatle - 2101 4th Ave Suite 1400  Spokane - 1330 N Washington Suite 5600  Tacoma - 3315 S 23rd St Suite 300  Tumwater - 6500 Linderson Way SW  Vancouver - 8008 NE 4th Plain Blvd Suite 320  Wenatchee - 630 N Chelan Ave Suite B3  Yakima - 3703 River Rd Suite 3 • Paper applicaƟons can be dropped off at a field office or mailed to: Washington State Department of Revenue Atn: Working Families Tax Credit Division PO Box 47468 Olympia, WA 98504-7468 A. Your InformaƟon 1. Provide your full legal name. Your first name and last name or surname should appear as they do on your social security card or on your ITIN documentaƟon. 2. Provide your full valid “SSN” (Social Security Number) or valid “ITIN” (Individual Taxpayer IdenƟficaƟon Number) in the space provided. • If you have applied for an ITIN from the IRS and have not yet received it, you may sƟll complete the applicaƟon. If so, check the box on the applicaƟon that states, “I am currently waiƟng for an ITIN from the IRS (for myself, my spouse, and/or my child).” Your WFTC applicaƟon will not be processed unƟl you contact the Department and provide the valid ITIN(s). 3. Provide your date of birth in the (MM/DD/YYYY) format. For example, if your birthdate is April 15, 1980, you should put 04/15/1980. 4. If you have a Washington state driver’s license or ID, provide your Washington state driver’s license or State ID number in the box provided. • You may sƟll qualify without a Washington state driver’s license or State ID. Providing this informaƟon will help us expedite the applicaƟon review process. If you do not have a Washington state driver’s license or ID, or are otherwise unable to provide one, check the box staƟng, “I do not have or do not want to provide a Washington State license or ID number.” 5. Provide your current mailing address.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 • This mailing address will be used for all correspondence and for the mailing of payments via check or prepaid debit card. If your mailing address changes, it is important you update it right away. You can update it by calling WFTC at 360-763-7300. • If you have been given permission to receive mail at an organizaƟon or friend or relaƟve’s address, please be sure to include who the mail is in care of on the address line of your applicaƟon. “Care of” means “via” or “by way of.” Also writen as “C/O” on mailed items, this addiƟon means that the envelope will be delivered to a caretaker (the organizaƟon, friend or relaƟve), who will then deliver it to the intended recipient (you). If the mailing address is not a place you reside, the postal service may not deliver the item without the caretaker being stated in the address. For example, the address would read like this on a leter: [Your name] C/O [the organization or your friend or relative’s name] 123 APPLE WAY CITY ST 99999-9999 6. Provide your phone number(s) and email address. B. Residency quesƟons 7. If you lived in Washington for at least 183 days (more than half of the year) in 2023, check the “Yes” box. If you did not live in Washington for at least 183 days, check the “No” box. If you checked “No,” stop here. You are not eligible for the credit. Note: If you are married filing jointly, only one spouse is required to meet the 183-day residency requirement. The individual that meets the residency requirement must be the primary applicant. The spouse residing outside of the state cannot be the primary applicant. 8. If your mailing address is the same as your current primary residence address, check the “Yes” box. If your mailing address is different from your current primary residence address, check the “No” box. If you answered “Yes,” you can move on to SecƟon C. 9. If you answered “No” to quesƟon 8, provide your current primary residenƟal address in the space provided. If you provided a PO Box or a private mailbox as your mailing address, you must check “No” for quesƟon 8 and provide your primary residenƟal address in the space provided. • If you are experiencing homelessness or are otherwise unable to provide a primary residenƟal address, check “No” for quesƟon 8 and check the box staƟng, “I do not have or do not want to provide an address for my primary residence.” Please note that the Department may contact you to verify that you meet the residency requirements. If you checked “No” for quesƟon 8, you must provide a primary residenƟal address, or check that you are opƟng out of providing a primary residenƟal address for your applicaƟon to be complete.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 C. Eligibility quesƟons 10. Check the box that matches the filing status you used to file your 2023 federal income tax return. 11. If you claimed the federal EITC credit in 2023, check the ‘Yes’ box and skip to quesƟon 13. If you did not claim the credit, check the ‘No’ box and conƟnue to quesƟon 12. • If you claimed the EITC, there should be a credit amount listed on line 27 of your 1040. If you claimed the EITC with qualifying children, you should also have filed a Schedule EIC. 12. Do you meet ALL the following requirements? If you do, check the ‘Yes’ box and conƟnue to quesƟon 13. If you do not meet the following requirements, check the “No” box. If you check “No” box, stop here. You are not eligible for the credit.

If you do not know if you were eligible, review the requirements below: • Your Adjusted Gross Income (AGI) from line 11 of your 2023 federal return must be less than:  $17,640 ($24,210 for married filing jointly) if you did not have a qualifying child,  $46,560 ($53,120 for married filing jointly) if you had one qualifying child,  $52,918 ($59,478 for married filing jointly) if you had two qualifying children, or  $56,838 ($63,398 for married filing jointly) if you had three or more qualifying children. • If you (or your spouse if applicable) have no qualifying children, you (or your spouse if applicable) must be 25 - 64 years old at the end of 2023. • If you (or your spouse if applicable) have investment income, it must be less than $11,000. • The following situaƟons do NOT apply to you in 2023:  You filed a Federal Form 2555, relaƟng to foreign earned income.  You (or your spouse if applicable) were claimed as a qualifying child of another person.  If you do not have qualifying children, you (or your spouse if applicable) were claimed as a dependent of another person.  You (or your spouse if applicable) were treated as a U.S. nonresident alien.  You are currently in a disallowance period from claiming the Federal Earned Income Credit (EITC).

D. Spouse InformaƟon If you do not have a spouse or domestic partner, skip to section E. 13. Provide your spouse/domesƟc partner’s legal name. The first name and last name or surname should appear as they do on your spouse’s social security card or ITIN documentaƟon. 14. Provide your spouse/domesƟc partner’s valid “SSN” (Social Security Number) or valid “ITIN” (Individual Taxpayer IdenƟficaƟon Number) in the space provided. 15. Provide your spouse/domesƟc partner’s date of birth in the (MM/DD/YYYY) format. For example, if their birthdate is April 15, 1980, you should put 04/15/1980.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 E. InformaƟon on qualifying children This secƟon is only for applicants who are claiming qualifying children for the credit. You must provide all the informaƟon requested below for your qualifying child(ren). Failure to provide informaƟon can result in a delay in processing your applicaƟon. A qualifying child can only be claimed on one applicaƟon by one individual or couple. Who counts as a qualifying child? A qualifying child must meet the eligibility requirements to be claimed on your applicaƟon. The child must be related to you, be under a certain age, not file a joint return of their own, and have lived with you for more than half of 2023. A qualifying child and a dependent claimed on your federal taxes are not the same for the purposes of the WFTC. If you were able to claim an individual as a dependent on your federal taxes, that does not necessarily mean you can claim them as a qualifying child. Please ensure that any child you claim for the WFTC meets the requirements of a qualifying child described below. RelaƟonship A qualifying child must be related to you in some way. They can either be your child or your sibling. For example, a qualifying child can be your own child (including adopted children), stepchild, foster child, or a descendent of one of these, such as a grandchild. A qualifying child may also be your sibling, halfsibling, stepsibling, or descendent of one of these, such as a niece or nephew. You cannot claim your child’s spouse as a qualifying child. Age A qualifying child must be under the age 19 at the end of 2023 and younger than you (or your spouse if applicable). If the qualifying child is enrolled as a full-Ɵme student, they must be under age 24 at the end of 2023 and younger than you. If your qualifying child is permanently and totally disabled at any Ɵme in 2023, there is no age requirement. Age CalculaƟons: A qualifying child is considered to reach their age the day before their birthdate. Example 1: Your daughter’s birthdate is 1/2/2005. She is considered 18 on 1/1/2024. You can claim your daughter as a qualifying child for the Working Families Tax Credit because she was under 19 (18 years old) at the end of 2023. Example 2: Your son’s birthday is 12/31/2004. He is considered 19 on 12/30/2023. You cannot claim your son as qualifying child because he was not under 19 and not a full-Ɵme student at the end of 2023. Example 3: Your 20-year-old brother, who is a full-Ɵme student and unmarried, lives with you and your spouse. You are 18 and your spouse is 21. You and your spouse file a joint return for 2023. You can claim your brother as a qualifying child for the Working Families Tax Credit because your brother is younger than your spouse. Since he is your brother, a full-Ɵme student, did not file a joint return, and lived with you, he meets the requirements to be your qualifying child.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 Example 4: Your 23-year-old brother, who is a full-Ɵme student and unmarried, lives with you and your spouse. You are 18 and your spouse is 21. You and your spouse will file a joint return for 2023. You cannot claim your brother as a qualifying child for the Working Families Tax Credit because your brother is not younger than you or your spouse. Though he is your brother, a fullƟme student, and lived with you, you cannot claim him as he is not younger than you or your spouse. Example 5: Your 24-year-old nephew lives with you full-Ɵme. He is unmarried and is completely and totally disabled. You can claim your nephew for the Working Families Tax Credit because he is completely and totally disabled, so age is not a factor in his qualificaƟon. Joint Return A qualifying child must not have filed a joint return for 2023 unless they are only filing to claim a refund of income tax withheld or esƟmated tax paid. Example 1: Your daughter and her spouse are both 18 and live with you. They make $10,000 per year combined and are not required to file a federal income tax return. They decide to not file. You can claim your daughter as a qualifying child for the Working Families Tax Credit because she is under 19, lives with you, and has not filed a joint return with her spouse. You cannot claim your child’s spouse as a qualifying child. Example 2: Your son and his spouse are both 18 and live with you. They make $11,000 per year combined and are not required to file a federal income tax return. They do file a joint return to receive a refund of tax withheld. You can claim your son as a qualifying child for the Working Families Tax Credit because he is under 19, lives with you, and filed a joint return only to receive a refund of tax withheld. You cannot claim your child’s spouse as a qualifying child. Example 3: Your grandchild and their spouse are both 18 and live with you. They make $10,000 and are not required to file a federal income tax return. They decide to file a joint return to claim the American Opportunity Tax Credit. You cannot claim your grandchild because they are filing a joint return to claim a credit, not just to receive a refund of tax withheld. Residency A qualifying child must have lived with you for more than half of 2023. If your child was born or died in 2023, they must have lived with you for more than half of the Ɵme they were alive in 2023. Example 1: You and your ex-spouse have a 10-year-old child. The child lived primarily with you and lived with your ex-spouse every other weekend. Since the child lived with you for more than half the year, you can claim your child for the Working Families Tax Credit. Your ex-spouse will not be able to claim the child. Example 2: You moved to Washington on Jan. 1, 2023, for work. Your child came to live with you on Sept. 1, 2023. Since your child only lived with you for 4 months in 2023 (Sept. 1-Dec. 31, 2023), you cannot claim them for the Working Families Tax Credit. Example 3: Your child died on Feb. 28, 2023, and was in the hospital from Jan. 15, 2023, unƟl their death. You can sƟll claim the child for the Working Families Tax Credit for 2023, so long as no other individual can claim them. A child who died in 2023 is treated as having lived with you

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 for more than half of 2023 if your home was the child's home for more than half the Ɵme the child was alive in 2023. Time that you or your child is temporarily away from home due to a special circumstance, such as an illness, is sƟll counted as Ɵme the child lived with you. Tiebreaker Rules A child may be eligible for the Working Families Tax Credit for more than one applicant. However, the child can only be claimed by one person (and that person’s spouse if applicable) per year. See below for the Ɵebreaker rules to determine which person can claim the qualifying child. • If only one of the persons is the child’s parent, the child is treated as the qualifying child of the parent. • If the parents file a joint federal tax return together and can claim the child as a qualifying child, the child is treated as the qualifying child of both parents. • If the parents do not file a joint federal tax return together but both parents can claim the child on their federal tax return, the child is treated as the qualifying child of the parent with whom the child lived with for the longer period during the year. The child must have lived with that parent for at least 183 days. If the child lived with each parent for the same amount of Ɵme, the is child is treated as the qualifying child of the parent who has the higher adjusted gross income (AGI) for the year. • If no parent can claim the child as a qualifying child, the child is treated as the qualifying child of the person who meets all qualifying child requirements and had the highest AGI for the year. • If a parent can claim the child as a qualifying child but no parent does so claim the child, the child is treated as the qualifying child of the person who had the highest AGI for the year, but only if that person’s AGI is higher than the highest AGI of any of the child’s parents who can claim the child. Example 1: You and your 2-year-old son, Jimmy lived with your mother all year. You are 25 years old, unmarried, and your AGI is $9,000. Your mother’s AGI is $22,000. Jimmy meets the relaƟonship, age, residency, and joint return tests for both of you and your mother. However, only one of you can treat him as a qualifying child to claim the WFTC. He is not a qualifying child of anyone else, including his father. If you choose not to claim Jimmy as a qualifying child for the WFTC your mother can treat him as a qualifying child to claim the WFTC. Example 2: You and your 7-year-old niece, your sister’s child, lived with your mother all year. You are 25 years old, and your AGI is $9,300. Your only income was from a part-Ɵme job. Your mother’s AGI is $15,000. Her only income was from her job. Your niece’s parents file jointly, have an AGI of less than $9,000 and do not live with you or their child. Your niece meets the relaƟonship, age, residency, and joint return tests for both you and your mother. However, only your mother can treat her as a qualifying child. This is because your mother’s AGI, $15,000, is more than your AGI, $9,300.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 16. CompleƟng SecƟon E of the Working Families Tax Credit ApplicaƟon • You will not be able to claim more than three children for the credit. For example, if you have 5 children, you will only provide informaƟon for three children. The credit amount and income thresholds do not increase beyond 3 children. • List the legal first name for your qualifying child(ren) as it is writen on their social security card or ITIN documentaƟon. If you are claiming more than one child, list each child’s first name in the separate columns. You will only be able to claim 3 children. Do not provide informaƟon for more than 3 children. • List the legal middle iniƟal for your qualifying child(ren) as it is writen on their social security card or ITIN documentaƟon. If they do not have a middle iniƟal, leave this line blank. • List the legal last name for your qualifying child(ren) as it is writen on their social security card or ITIN documentaƟon. Their legal Last Name does not need to match yours. • Provide the date(s) of birth for your qualifying child(ren) in the (MM/DD/YYYY) format. For example, if your child’s birthdate is May 6, 2005, list their birthdate as 05/06/2005. • Input your child’s full valid SSN or full valid ITIN number in the space provided. If you applied for an ITIN for your child and have not yet received it, you may sƟll complete the applicaƟon, but must check the box in QuesƟon 2. • Select the check box that most closely describes how your qualifying child(ren) is related to you. o Child, stepchild, adopted child or foster child includes any descendent of these, such as a grandchild. o Sibling, half-sibling, or stepsibling includes any descendent of these, such as a niece or nephew. • If your child lived with you for more than half the year, check the “Yes” box. If your child did not live with you for more than half the year, check the “No” box. If you select “No,” you will not be able to claim the child for the Working Families Tax Credit. • If your child(ren) was a full-Ɵme student for any 5 calendar months in 2023, check the “Yes” box. If your child(ren) was not a student in 2023, check the “No” box. To qualify as a student, your child must be under 24 years of age at the end of 2023 and be a full-Ɵme student at a school that has a regular teaching staff, course of study, and a regular student body at the school (example: elementary school, middle school, high school, college, or trade school); or be taking a full-Ɵme, on-farm training course given by a school previously described. o Example 1: Your child lives with you and atends a community college full Ɵme. They are not married and did not file a joint return. They turned 23 in October. Your child does qualify as student because they are atending a community college full Ɵme and were under 24 years of age at the end of the year. o Example 2: Your child lives with you and atends a community college full Ɵme. They are not married and did not file a joint return. They turned 24 in November. Your child does not qualify as a student because they were not under age 24 at the end of 2023. • If your child(ren) was permanently and totally disabled during any part of 2023, check the “Yes” box. If they were not permanently and totally disabled, check the “No” box. A person is considered permanently and totally disabled if both bullets below apply:

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 o He or she cannot engage in any substanƟal gainful acƟvity because of a physical or mental condiƟon, AND o A qualified physician determines that the condiƟon has lasted or can be expected to last conƟnuously for at least a year or can be expected to result in death. • If you claimed your child(ren) for the Earned Income Tax Credit (EITC) on your federal tax return, check the “Yes” box. If you did not claim your child(ren) for the EITC, check the “No” box. F. Earned Income

17. Input the dollar amount listed on line 1z of your 1040 or 1040- SR of your 2023 Federal tax return.

18. Input the Adjusted Gross Income (AGI) reported on line 11 of your 1040 or 1040-SR of your 2023 Federal tax return. Example of “line 11” on form 1040:

If your AGI is greater than or equal to the income threshold pertaining to you, idenƟfied on Page 1 of these instrucƟons, stop here. You are not eligible for the credit.

19. If you itemized your 2023 federal tax return, check the “Yes” box. If you did not itemize, check the “No” box, and if you are unsure whether you itemized your federal return, check the “Not Sure” box. • If you itemized your tax return, you would have completed a Schedule A with your 1040 or 1040-SR. If this schedule was not completed, you did not itemize. If you are not sure if you itemized your tax return in 2023, check the “Not Sure” box.

Example of “line 1z” on form 1040:

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 20. Check the box next to any of the below situaƟons that applied to you in 2023. If none of these situaƟons applied to you in 2023, skip to secƟon G.

DefiniƟons of Possible SituaƟons

Self Employed: You carry on a trade or business as a sole proprietor or an independent contractor; you are a member of a partnership that carries on a trade or business; or you are otherwise in business for yourself (including a part-Ɵme business).

Member of a clergy or employed by a church and filed a Schedule SE: For services in the exercise of the ministry, members of the clergy receive a Form W-2 but do not have social security or Medicare taxes withheld. They must pay social security and Medicare by filing Schedule SE (Form 1040), Self-Employment Tax.

Employed by the military and received combat pay: (1) You must be a member of the United States Armed Forces, and (2) EnƟtlement to the compensaƟon must have fully accrued in a month during which the member served in a designated combat zone or was hospitalized because of wounds, disease, or injury incurred while serving in a designated combat zone.

Statutory employee and filed a Schedule C with your federal tax return: A statutory employee is an independent contractor who is considered an employee for tax withholding purposes. An individual must meet certain criteria to be considered a statutory employee. Statutory employees can also deduct work-related expenses on Schedule C when they file their federal tax return. Example of a Schedule C

Had Medicaid Waiver Payments: Medicaid waiver payments are payments made from the federal government to an individual providing in-home, long-term care for someone who would otherwise be insƟtuƟonalized in a hospital, nursing facility, or intermediate care facility.

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023

G. How would you like to receive your credit? Select “Direct Deposit” if you would like your Working Families Tax Credit to be deposited directly into your bank account. Be sure both your rouƟng number and account number are clearly writen and accurate.

Select “Mailed Check” if you would like your Working Families Tax Credit sent to the mailing address you provided. Select “Prepaid Debit Card” if you would like your Working Families Tax Credit placed on a prepaid debit card and sent to the mailing address you provided. • Prepaid debit cards will only be issued in the name of the primary applicant, and only one card will be issued. • The prepaid debit card will be sent to the mailing address you provided on this applicaƟon. • Once a refund has been issued on a prepaid debit card, DOR will not be able to change your method of payment. Please ensure all informaƟon you have provided is accurate. • To learn more about the prepaid debit card terms and fees, please visit wŌc.wa.gov/DebitCards.

Department of Revenue is not responsible for a lost payment if you enter the wrong account informaƟon or mailing address. If this secƟon is not completed, a check will be sent to the mailing address you provided in SecƟon A. If the direct deposit is rejected by the bank, a check will be mailed to the mailing address you provided in SecƟon A. Make sure your mailing address is correct in SecƟon A (Your informaƟon, page 1). H. Atachments Atach a copy of your federal tax return (Federal Form 1040 or 1040 SR) and ALL applicable schedules. The Federal Form 1040 or 1040 SR is the standard federal income tax form used to report income to the IRS, claim tax deducƟons and credits, and calculate a tax refund or tax bill for the year. If you are unable to provide a copy of your federal tax return, you can request an IRS tax return transcript that summarizes return informaƟon and includes adjusted gross income. If you do not include the enƟre tax return, your applicaƟon may be denied. Request a transcript online: htps://www.irs.gov/individuals/get-transcript

2023 Working Families Tax Credit ApplicaƟon InstrucƟons

WFTC REV 11/21/2023 You can also request a transcript by mail by calling the IRS automated phone transcript service at 800-908-9946. I. DeclaraƟon and signature You, and your spouse if applicable, must sign the applicaƟon to be considered for a refund. By signing this applicaƟon, you agree to all the following: • All the informaƟon you provided is true, correct, and complete. • You can provide supporƟng documentaƟon for all informaƟon provided in the applicaƟon. • You did file a 2023 federal income tax return as of the date you signed your applicaƟon. • The applicaƟon is not submited on behalf of an individual who is deceased. • You have paid Washington State retail sales tax or use tax on goods or services purchased during 2023. Provide the date you (and your spouse if applicable) signed the applicaƟon in the MM/DD/YYYY format. For example, if you signed this applicaƟon on February 3, 2024, write “02/03/2024.” J. Preparer InformaƟon This section is voluntary. 21. If you completed the WFTC applicaƟon yourself, check the “Yes” box. If someone else prepared the applicaƟon for you, check the “No” box. If you checked “No,” provide the following informaƟon for the person who completed the applicaƟon for you: a. the preparer’s name and phone number b. If the person who prepared the applicaƟon is an owner or employee of a business that prepares tax returns, provide the business name and the preparer’s email address. c. If the person who prepared the applicaƟon has a Preparer Tax IdenƟficaƟon Number (PTIN), provide this number in the space provided. d. If this applicaƟon was completed at a Voluntary Income Tax Assistance (VITA) site, check the “Yes” box and provide the name of the site below. If this applicaƟon was not completed at a VITA site, check the “No” box. K. Demographic InformaƟon The demographic informaƟon is voluntary, but it will help the state legislature evaluate the effecƟveness of the Working Families Tax Credit program. 22. If you, your spouse, or child(ren) are of Hispanic, LaƟno, or Spanish origin check all boxes that apply. If you, your spouse, or child(ren) are of another Hispanic, LaƟno, or Spanish origin check “Describe” and write your answer in the space provided. If you, your spouse, or child(ren) prefer not to say, check the “Prefer not to say” box for all applicable individuals. 23. Select all races that applies to you, your spouse, or child(ren). If you select American Indian or Alaskan NaƟve check “Tribe” and write in Tribe name in the space provided. If you, your spouse, or child(ren) prefer not to say, check the “Prefer not to say” box for all applicable individuals. 24. Select how you heard about the Working Families Tax Credit program. Check “Website,” “Social Media,” “Another OrganizaƟon or Agency,” “Word of Mouth,” or “Other.”