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Filled-in Schedule EIC—Cynthia and Jerry Grey Cynthia and Jerry Grey 333-00-5555 Kirk Grey Susanne Grey 123-00-5678 800-00-4321 2 0 1 1 2 0 1 3 son daughter 12 12 SCHEDULE EIC (Form 1040) Department of the Treasury Internal Revenue Service (99) Earned Income Credit Qualifying Child Information ▶ Complete and attach to Form 1040 or 1040-SR only if you have a qualifying child. ▶ Go to www.irs.gov/ScheduleEIC for the latest information. OMB No. 1545-0074 2021 Attachment Sequence No. 43 1040 1040-SR . . . . . . . . . EIC ◀ Name(s) shown on return Your social security number If you are separated from your spouse, filing a separate return and meet the requirements to claim the EIC (see instructions), check here Before you begin: • See the instructions for Form 1040, lines 27a, 27b, and 27c, to make sure that (a) you can take the EIC, and (b) you have a qualifying child. • Be sure the child’s name on line 1 and social security number (SSN) on line 2 agree with the child’s social security card. Otherwise, at the time we process your return, we may reduce your EIC. If the name or SSN on the child’s social security card is not correct, call the Social Security Administration at 800-772-1213. • If you have a child who meets the conditions to be your qualifying child for purposes of claiming the EIC, but that child doesn’t have an SSN as defined in the instructions for Form 1040, lines 27a, 27b, and 27c, see the instructions. ▲ ! CAUTION • You can’t claim the EIC for a child who didn’t live with you for more than half of the year. • If your child doesn’t have an SSN as defined in the instructions for Form 1040, lines 27a, 27b, and 27c, see the instructions. • If you take the EIC even though you are not eligible, you may not be allowed to take the credit for up to 10 years. See the instructions for details. • It will take us longer to process your return and issue your refund if you do not fill in all lines that apply for each qualifying child. Qualifying Child Information Child 1 Child 2 Child 3 1 Child’s name If you have more than three qualifying children, you have to list only three to get the maximum credit. First name Last name First name Last name First name Last name 2 Child’s SSN The child must have an SSN as defined in the instructions for Form 1040, lines 27a, 27b, and 27c, unless the child was born and died in 2021 or you are claiming the self-only EIC (see instructions). If your child was born and died in 2021 and did not have an SSN, enter “Died” on this line and attach a copy of the child’s birth certificate, death certificate, or hospital medical records showing a live birth. 3 Child’s year of birth Year If born after 2002 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5. Year If born after 2002 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5. Year If born after 2002 and the child is younger than you (or your spouse, if filing jointly), skip lines 4a and 4b; go to line 5. 4 a Was the child under age 24 at the end of 2021, a student, and younger than you (or your spouse, if filing jointly)? Yes. Go to line 5. No. Go to line 4b. Yes. Go to line 5. No. Go to line 4b. Yes. Go to line 5. No. Go to line 4b. b Was the child permanently and totally disabled during any part of 2021? Yes. Go to line 5. No. The child is not a qualifying child. Yes. Go to line 5. No. The child is not a qualifying child. Yes. Go to line 5. No. The child is not a qualifying child. 5 Child’s relationship to you (for example, son, daughter, grandchild, niece, nephew, eligible foster child, etc.) 6 Number of months child lived with you in the United States during 2021 • If the child lived with you for more than half of 2021 but less than 7 months, enter “7.” • If the child was born or died in 2021 and your home was the child’s home for more than half the time he or she was alive during 2021, enter “12.” months Do not enter more than 12 months. months Do not enter more than 12 months. months Do not enter more than 12 months. For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 13339M Schedule EIC (Form 1040) 2021 Chapter 6 Detailed Examples Page 27