Case File
efta-efta01221070DOJ Data Set 9OtherForm 8910
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DOJ Data Set 9
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efta-efta01221070
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0
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Form 8910
Alternative Motor Vehicle Worksheet
2017
Keep for your records
Namo(s) shown on return
Identifying Number
Part I
Qualified Motor Vehicle
1
Is your motor vehicle a Qualified fuel cell vehicle?
Yes
No
Part II
Vehicle Year, Make, and Model
2
Model year. Check one:
a
2018
2017
2016
3
Honda
a Ei Clarity
Toyota
b l
l Mirai
Hyundai
c Ell
Tucson Fuel Cell
Other
d Ell
Other qualifying vehicle (also
complete Part IV)
2015
2014
2013
Part III
Other Information
4
Date purchased (mm/ddfyyyy - must be 2016 or later)
5
Date placed in service (mm/dd/yyyy - must be 2017)
6
Business / investment use percent
Part IV
Tentative Credit
7
Year
8
Make
9
Model
10
Vehicle Identification Number
11
Maximum credit allowable
12
Phaseout percentage
13
Tentative credit. Multiply line 11 by line 12
EFTA01221070
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