Page 3

Columns (a) and (b) Enter the care provider's name and address. If you were covered by your employer's dependent care plan and your employer furnished the care (either at your workplace or by hiring a care provider), enter your employer's name in column (a). Next, enter “See W-2” in column (b). Then, leave columns (c) and (d) blank. But if your employer paid a third party (not hired by your employer) on your behalf to provide the care, you must give information on the third party in columns (a) through (d). Column (c) If the care provider is an individual, enter his or her social security number (SSN). Otherwise, enter the provider's employer identification number (EIN). If the provider is a tax-exempt organization, enter “Tax-Exempt” in column (c). U.S. citizens and resident aliens living abroad. If you are living abroad, your care provider may not have, and may not be required to get, a U.S. taxpayer identification number (for example, an SSN or EIN). If so, enter “LAFCP” (Living Abroad Foreign Care Provider) in the space for the care provider's taxpayer identification number. Column (d) Enter the total amount you actually paid in 2013 to the care provider. Also, include amounts your employer paid to a third party on your behalf. It does not matter when the expenses were incurred. Do not reduce this amount by any reimbursement you received. Line 2 Complete columns (a) through (c) for each qualifying person. If you have more than two qualifying persons, attach a statement to your return with the required information. Be sure to put your name and social security number (SSN) on the statement. Also, enter “See Attached” on the dotted line next to line 3. Column (b) You must enter the qualifying person's SSN. Be sure the name and SSN entered agree with the person's social security card. Otherwise, at the time we process your return, we may reduce or disallow your credit. If the child was born and died in 2013 and did not have an SSN, enter “Died” in column (b) and attach a copy of the child's birth certificate, death certificate, or hospital medical records. To find out how to get an SSN, see Social Security Number (SSN) in the Form 1040 or Form 1040A instructions, or Identifying Number in the Form 1040NR instructions. If the name or SSN on the person's social security card is not correct, call the Social Security Administration at 1-800-772-1213. Column (c) Enter the qualified expenses you incurred and paid in 2013 for the person listed in column (a). Prepaid expenses are treated as paid in the year the care is provided. Do not include in column (c) qualified expenses: You incurred in 2013 but did not pay until 2014. You may be able to use these expenses to increase your 2014 credit. You incurred in 2012 but did not pay until 2013. Instead, see the instructions for line 9. You prepaid in 2013 for care to be provided in 2014. These expenses can only be used to figure your 2014 credit. If you paid qualified expenses for the care of two or more qualifying persons, the applicable dollar limit is $6,000. This limit does not need to be divided equally. For example, if you paid and incurred $2,500 of qualified expenses for the care of one qualifying person and $3,500 for the care of another qualifying person, you can use the total, $6,000, to figure the credit. To qualify for the credit, you must have one or more qualifying persons. You should show the expenses for each child in column (c) of line 2. However, it is possible a qualifying child could have no expenses and a second child could have expenses exceeding $3,000. You should list -0- for the one child and the actual amount for the second child. The $6,000 limit would still be used to compute your credit unless you have already excluded or deducted, in Part III, certain dependent care benefits paid to you (or on your behalf) by your employer. Lines 4 and 5 If filing jointly, figure your and your spouse's earned income separately. Enter your earned income on line 4 and your spouse's earned income on line 5. Earned income for figuring the credit includes the following amounts. 1. The amount shown on Form 1040, line 7; Form 1040A, line 7; or Form 1040NR, line 8; minus any amount: a. Included for a scholarship or fellowship grant that was not reported to you on a Form W-2, b. Also reported on Schedule SE (Form 1040) because you were a member of the clergy or you received $108.28 or more of church employee income, c. Received for work performed while an inmate in a penal institution, or d. Received as a pension or annuity from a nonqualified deferred compensation plan or a nongovernmental section 457(b) plan. This amount may be reported in box 11 of Form W-2. If you received such an amount but box 11 is blank, contact your employer for the amount received as a pension or annuity. 2. The amount shown on Schedule SE, line 3, minus any deduction you claim on Form 1040 or Form 1040NR, line 27. If you use either optional method to figure self-employment tax, subtract any deduction you claim on Form 1040 or Form 1040NR, line 27, from the total of the amounts shown on Schedule SE, Section B, lines 3 and 4b. If you received church employee income of $108.28 or more, subtract any deduction you claim on Form 1040 or TIP Instructions for Form 2441 (2013) ­3­