Page 5

to cover your 2013 dependent care expenses. The $5,000 is shown on your Form W-2, in box 10. In 2013, you incurred and were reimbursed for $4,950 of qualified expenses. You would enter $5,000 on line 12 and $50, the amount forfeited, on line 14. You would also enter $50 on line 14 if, instead of forfeiting the amount, your employer permitted you to carry the $50 forward to use during the grace period in 2014. Line 15 Add the amounts on lines 12 and 13 and subtract from that total, the amount on line 14. Enter the result on line 15. Line 16 Enter the total of all qualified expenses incurred in 2013 for the care of your qualifying person(s). It does not matter when the expenses were paid. Example. You received $2,000 in cash under your employer's dependent care plan for 2013. The $2,000 is shown on your Form W-2, in box 10. Only $900 of qualified expenses were incurred in 2013 for the care of your 5-year-old dependent child. You would enter $2,000 on line 12 and $900 on line 16. Line 18 If filing jointly, figure your and your spouse's earned income separately. Enter your earned income on line 18 and your spouse's earned income on line 19. If your filing status is married filing separately or you or your spouse was a student or disabled, see the instructions for line 19. Earned income for figuring the amount of dependent care benefits you are able to exclude or deduct from your income 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, and 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 Form 1040NR, line 27, from the total of the amounts shown on Schedule SE, Section B, lines 3, 4b, and 5a. 3. If you are filing Schedule C (Form 1040) or C-EZ (Form 1040) as a statutory employee, the amount shown on line 1 of the schedule. 4. Nontaxable combat pay, if you elect to include it in earned income. However, including this income will only give you a larger exclusion or deduction if your (or your spouse's) other earned income is less than the amount entered on line 17. To make the election, include all of your nontaxable combat pay in the amount you enter on line 18 (line 19 for your spouse if filing jointly). If you are filing jointly and both you and your spouse received nontaxable combat pay, you can each make your own election. (In other words, if one of you makes the election, the other one can also make it but does not have to.) The amount of your nontaxable combat pay should be shown in box 12 of your Form(s) W-2 with code Q. You can choose to include your nontaxable combat pay in earned income when figuring your exclusion or deduction, even if you choose not to include it in earned income for the earned income credit (EIC) or the credit for child and dependent care expenses. For purposes of line 18, earned income does not include any dependent care benefits shown on line 12. You must reduce your earned income by any loss from self-employment. Special Situations If you are filing jointly, disregard community property laws. If your spouse was a full-time student or disabled in 2013, see the instructions for lines 4 and 5, earlier. Line 19 If your filing status is married filing separately, see Married Persons Filing Separately, earlier. Are you considered unmarried under that rule? Yes. Enter your earned income (from line 18) on line 19. On line 21, enter $5,000. No. Enter your spouse's earned income on line 19. If you or your spouse was a full-time student or disabled in 2013, see the instructions for lines 4 and 5. On line 21, enter $2,500. Line 24 Include your deductible benefits in the total entered on Schedule C, line 14; Schedule E, line 19 or line 28; or Schedule F, line 15; whichever applies. Lines 27 through 31 If you are reporting dependent care benefits in Part III of the form, you will need to complete lines 27 through 31 if you are also claiming the credit for child and dependent care expenses in Part II of the form. TIP CAUTION ! CAUTION ! Instructions for Form 2441 (2013) ­5­