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efta-efta01220940DOJ Data Set 9OtherDependent and Nondependent Information Worksheet
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DOJ Data Set 9
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efta-efta01220940
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Dependent and Nondependent Information Worksheet
2014
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Part I — Personal Information
First name . .
Social security no.
Middle initial .
Last name .
Suffix
Date of birth
(inm/ddlyyyy)
age as of 12-31-2014
Did this person pass away in 2014 (deceased)? . .
Yes
No Date of death . . . .
Relationship to taxpayer or spouse
CAUTION: If claiming a child other than your own, see Relationship in the Tax Help.
NOTE: The ability to set your answers to being the same as last year for the dependent is only
available in Step-by-Step mode and not in Forms mode.
Are the answers to the questions below for this person, to determine
whether they are your dependent, the same as they were last year?
►
Yes
Dependency code'.
'Dependency code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Dependent is disabled
No
n
Part II — Earned Income Credit and Child Tax Credit
Is this person a U.S. citizen. U.S. national, or a U.S. resident?
Is this person a resident of Canada or Mexico?
This person is adopted and you are a U.S. citizen or U.S. national
The adopted child lived with you all year
'If the child is adopted, you are a U.S. citizen or U.S. national and they lived with you
all year, they are considered to meet the citizen test and the U.S. citizen box will
automatically be checked yes.
Qualifying for the earned income credit
.
H
Yes
Yes
'EIC code is set based on your selections in the Dependency Exemption/EIC Smart Worksheet
Months lived with taxpayer in the United States
Check if this person is not a qualifying child for the child tax credit
If this dependent has an ITIN issued by the IRS instead of a
social security number issued by the social security administration,
did they meet the substantial presence test? (see Schedule 8812 Instructions)
No
No
rlYes riNo
Part III - Dependent Care Expenses
Qualified child or dependent care expenses incurred and paid in 2014
EFTA01220940
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